In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)
Contemporary biomedical ethics and environmental ethics share a common ancestry in Aldo Leopold's and Van Rensselaer Potter's initial broad visions of a connected biosphere. Over the past five decades, the two fields have become strangers. Public health ethics, a new subfield of bioethics, emerged from the belly of contemporary biomedical ethics and has evolved over the past 25 years. It has moved from its traditional concern with the tension between individual autonomy and community health to a wider focus on social (...) justice and solidarity. Public health has a broad focus that includes individual, community, and environmental health. Public health ethics attends to these broad commitments reflected in the increasing concern with the connectedness of health of individuals to the health of populations, to the health of animals, to the health of the environment; it is well situated to reconnect all three “fields” of ethics to promote a healthier planet. (shrink)
The attempt to critique the profession of clinical ethics consultation by establishing the impossibility of ethics expertise has been a red herring. Decisions made in clinical ethics cases are almost never based purely on moral judgments. Instead, they are all-things-considered judgments that involve determining how to balance other values as well. A standard of justified decision-making in this context would enable us to identify experts who could achieve these standards more often than others, and thus provide a basis for expertise (...) in clinical ethics consultation. This expertise relies in part on what Richard Zaner calls the “expert knowledge of ethical phenomena”. (shrink)
The question of whether clinical ethics consultants may engage in patient advocacy in the course of consultation has not been addressed, but it highlights for the field that consultants? allegiances, and the boundaries of appropriate professional practice, must be better understood. I consider arguments for and against patient advocacy in clinical ethics consultation, which demonstrate that patient advocacy is permissible, but not central to the practice of consultation. I then offer four recommendations for consultants who engage in patient advocacy, and (...) consider the implications of this issue for the field.1. (shrink)
Confronting any science studies or learning sciences researcher in the 21st century is the reality of interdisciplinary science. New hybrid fields1 collaboratively build new concepts, combine models from two or more disciplines and forge inter-reliant relationships among specialists with different skill sets to solve new problems. This paper emerges from our recognition that inescapable psychological factors, including identity dynamics, must be described and analyzed in order to better understand the social and cognitive practices specific to interdisciplinary science. In analysis of (...) the foundations and opportunities for an... (shrink)
Public health ethics is a nascent field, emerging over the past decade as an applied field merging concepts of clinical and research ethics. Because the “patient” in public health is the population rather than the individual, existing principles might be weighted differently, or there might be different ethical principles to consider. This paper reviewed the evolution of public health ethics, the use of bioethics as its model, and the proposed frameworks for public health ethics through 2010. Review of 13 major (...) public health ethics frameworks published over the past 15 years yields a wide variety of theoretical approaches, some similar foundational values, and a few similar operating principles. Coming to a consensus on the reach, purpose, and ends of public health is necessary if we are to agree on what ethical underpinnings drive us, what foundational values bring us to these underpinnings, and what operating principles practitioners must implement to make ethical decisions. If public health is distinct enough from clinical medicine to warrant its own set of ethical and philosophical underpinnings, then a decision must be made as to whether a single approach is warranted or we can tolerate a variety of equal but different perspectives. (shrink)
For over 100 years, the field of contemporary public health has existed to improve the health of communities and populations. As public health practitioners conduct their work – be it focused on preventing transmission of infectious diseases, or prevention of injury, or prevention of and cures for chronic conditions – ethical dimensions arise. Borrowing heavily from the ethical tools developed for research ethics and bioethics, the nascent field of public health ethics soon began to feel the limits of the clinical (...) model and began creating different frameworks to guide its ethical challenges. Several public health ethics frameworks have been introduced since the late 1990s, ranging from extensions of principle-based models to human rights and social justice perspectives to those based on political philosophy. None has coalesced as the framework of choice in the discipline of public health. This paper examines several of the most-known frameworks of public health ethics for their common theoretical underpinnings and values, and suggests next steps toward the formulation of a single framework. (shrink)
The legitimacy of clinical ethics consultation is often implied to rest on the legitimacy of moral expertise. In turn, moral expertise seems subject to many serious critiques, the success of which implies that clinical ethics consultation is illegitimate. I explore a number of these critiques, and forward “ethics expertise,” as distinct from “moral expertise,” as a way of avoiding these critiques. I argue that “ethics expertise” succeeds in avoiding most of the critiques, captures what clinical ethics consultants might justifiably do, (...) and expresses a subject matter which can be taught and assessed. (shrink)
A major obstacle to broad support of clinical ethics consultation is suspicion regarding the nature of the moral expertise it claims to offer. The suspicion seems to be confirmed when the field fails to make its moral expertise explicit. In this vacuum, critics suggest the following:Clinical ethics consultation's legitimacy depends on its ability to offer an expertise in moral matters.Expertise in moral matters is knowledge of a singular moral truth which applies to everyone.The claim that a clinical ethics consultant can (...) offer knowledge of a singular moral truth in virtue of her professional training is absurd, false, or gravely immoral.Therefore,The field is illegitimate. (shrink)
We historically and conceptually situate distributed cognition by drawing attention to important similarities in assumptions and methods with those of American ?functional psychology? as it emerged in contrast and complement to controlled laboratory study of the structural components and primitive ?elements? of consciousness. Functional psychology foregrounded the adaptive features of cognitive processes in environments, and adopted as a unit of analysis the overall situation of organism and environment. A methodological implication of this emphasis was, to the extent possible, the study (...) of cognitive and other processes in the natural (real world) contexts in which they occur. We therefore emphasize commonalities and differences between functional psychology and D-Cog. One purpose of the comparison is to consider the extent to which criticisms directed at functional psychology are relevant to D-Cog. We also examine the relation between functional psychology and philosophical pragmatism and conclude that D-Cog's conceptual framework would be strengthened through more explicit adoption of philosophical pragmatism, consistent with the eventual trajectory of functional psychology. (shrink)
For the first time, the revised Common Rule specifies that public health surveillance activities are not research. This article reviews the historical development of the public health surveillance exclusion and implications for other foundational public health practices.
Decolonization, as a philosophical and political perspective on power, can help rhetorical critics and philosophers understand how to read moments where power is being consolidated by liberation movements against the emergence of new global coalitions of capital. Decoloniality emerged as a concept following the Bandung Conference in 1955 in Bandung, Indonesia, where representatives of twenty-nine countries in Asia and Africa gathered to debate and define the positionality of Third World nations in a globalizing world. A major goal of Bandung was (...) to oppose colonization and neocolonization across the globe. As a mode of engaging modernity through the application of critical race... (shrink)
Teaching competency in bioethics has been a concern of the field since its start. In 1976, The Hastings Center published the first report on the teaching of contemporary bioethics. Graduate programs culminating in an MA or PhD were not needed at the time, concluded the report. “In the future, however,” the report speculated, “the development and/or changing social priorities may at some point allow, or even require, the creation of new academic structures for graduate education in bioethics.” Although that future (...) might be upon us, the creation of a terminal degree in bioethics has its detractors. Scholars have debated whether bioethics is a discipline with its own methods and theoretical grounding, a multidisciplinary field bringing various professional perspectives to bear on particular types of problems, a set of problem-solving skills to resolve moral disagreements, or something else entirely. Whether or not efforts to develop the methods and theory of bioethics have matured to the point that it is now a discipline in the strictest sense, new bioethics training programs have appeared at all postsecondary levels. In this essay, we examine the number and types of U.S. programs and degrees in this growing field. (shrink)
This paper presents an analysis of emotional and affectively toned discourse in biomedical engineering researchers’ accounts of their problem solving practices. Drawing from our interviews with scientists in two laboratories, we examine three classes of expression: explicit, figurative and metaphorical, and attributions of emotion to objects and artifacts important to laboratory practice. We consider the overall function of expressions in the particular problem solving contexts described. We argue that affective processes are engaged in problem solving, not as simply tacked onto (...) reasoning but as integral to it. The examples we present illustrate the close relation of emotion to problem solving and experimentation; they also implicate social and cultural dimensions of emotion expression. The analysis underscores a need to consider emotional expression to be intimately and importantly tied to the cognitive achievements and social negotiations of laboratory practices. (shrink)
Despite increased interest in “intuition” within cognitive psychology, the conceptual framework of this notion remains problematic. This paper argues that conceptual shortcomings stem from a tendency to ignore the philosophical heritage of intuition or to dismiss the relevance of this heritage to contemporary theory. The paper outlines major understandings of intuition within psychology and prominent philosophical traditions, highlighting important points of inconsistency in these and examining consequences of the inconsistency. It also considers psychological conceptions of intuition that more readily overlap (...) with philosophical accounts and offers some suggestions toward a more philosophically informed notion of intuition relevant to contemporary psychological theory. (shrink)
It is not clear whether breast cancer screening is a public health intervention or an individual clinical service. The question is important because the concepts best suited for ethical reasoning in public health might be different to the concepts commonly employed in biomedical ethics. We consider it likely that breast screening has elements of a public health intervention and used an empirical ethics approach to explore this further. If breast screening has public health characteristics, it is probable that policy and (...) practice experts will employ socially embedded concepts when reasoning about it. We gathered data on whether and how these concepts existed in the discussion and reasoning of Australian breast screening experts. We found that experts employed these concepts when talking about the purpose and practices of breast screening, and the behaviour of breast screening professionals and consumers. Experts gave varied judgements about breast screening based on reasoning with these concepts, considering it to be more or less successful in contributing to the public interest and in incorporating socially embedded concepts into its operational agenda. Our findings are compatible with breast screening having public health characteristics. We advocate for the incorporation of socially embedded concepts in breast screening policy and practice. (shrink)
The Office of Research Integrity found in 2011 that Vipul Bhrigu, a postdoctoral researcher who sabotaged a colleague’s research materials, was guilty of misconduct. However, I argue that this judgment is ill-considered and sets a problematic precedent for future cases. I first discuss the current federal definition of research misconduct and representative cases of research misconduct. Then, because this case recalls a debate from the 1990s over what the definition of “research misconduct” ought to be, I briefly recapitulate that history (...) and reconsider the Bhrigu case in light of that history and in comparison to other cases involving tampering. Finally, I consider what the aim of a definition of research misconduct ought to be, and argue that the precedent set by the reasoning in this case is problematic. (shrink)
We present a case for defining objectivity as responsibility. We do not attempt to offer new arguments on epistemological issues such as relativism or the fact-value distinction. Instead, we construct a conception of objectivity utilizing analyses from Deweyan pragmatism, feminist theory, and science studies, organizing them around the concept of responsibility. This conception of objectivity can serve as a tool to guide the process of inquiry; by suggesting that participants reflect on the question "how can this inquiry be made more (...) responsible?" it provides a guide for those struggling with the question of how to be more objective. (shrink)
Cognitive science currently offers models of cognition that depart substantively from those of information processing models and classical artificial intelligence, while it embraces methods of inquiry that include case-based, ethnographic, and philosophical methods. To illustrate, five overlapping approaches that constitute departures from classical representational cognitive science are briefly discussed in this paper: dynamical cognition, situated cognition, embodied cognition, extended mind theory, and integrative cognition. Critical responses to these efforts from members of the self-proclaimed cognitive science orthodoxy are also summarized. The (...) paper then discusses ethical and epistemological implications arising from the “new” cognitive science and from critical responses to it and considers the broader importance of this literature for theoretical and philosophical psychology. 2012 APA, all rights reserved). (shrink)
This article presents the first author's experiences as an Australian doctoral student undertaking a PhD by publication in the arena of the social sciences. She published nine articles in refereed journals and a peer-reviewed book chapter during the course of her PhD. We situate this experience in the context of current discussion about doctoral publication practices, in order to inform both postgraduate students and academics in general. The article discusses recent thinking about PhD by publication and identifies the factors that (...) students should consider prior to adopting this approach, in terms of university requirements, supervisors' attitudes, the research subject matter, intellectual property, capacity and working style, and issues of co-authorship. It then outlines our perceptions of the advantages and disadvantages of undertaking a PhD by publication. We suggest that, in general, the advantages outweigh the disadvantages. We conclude by reflecting on how the first author's experiences relate to current discussions about fostering publications by doctoral students. (shrink)
Clinical ethics consultation is on the horns of a dilemma. One horn skewers the field for its lack of standards, while the other horn skewers it for proposing arbitrary or deeply contested foundations. I articulate the dilemma by discussing several critiques of the field and the challenge of formulating standards and suggest that the solution lies, at least until a robust consensus emerges, with establishing a list of proscriptive standards to guide the field.
Reviews the role of intuition or an analogous concept within several divergent philosophical systems and argues that the salient feature common to various accounts of intuition is its non-inferential status. As such, it is argued to be highly relevant to contemporary theory. The paper offers several examples of points of compatibility with contemporary theory, including perception of social affordances, the apprehension linguistic rules and the construction of social norms. In claiming specific ways in which the concept of intuition is relevant (...) to contemporary theoretical psychology, the paper moves toward developing a more comprehensive and historically informed framework for intuition than is currently offered. It also underscores the historical underpinnings of contemporary debates. 2012 APA, all rights reserved). (shrink)
: Virtually nonexistent in traditional American Indian communities, today American Indian women and children experience family violence at rates similar to those of the dominant culture. This article explores violence within American Indian communities as an expression of internalized oppression and as an extension of Euro-American violence against American Indian nations.