Antimicrobial resistance (AMR) is an urgent threat to global public health and development. Mitigating this threat requires substantial short-term action on key AMR priorities. While international legal agreements are the strongest mechanism for ensuring collaboration among countries, negotiating new international agreements can be a slow process. In the second article in this special issue, we consider whether harnessing existing international legal agreements offers an opportunity to increase collective action on AMR goals in the short-term. We highlight ten AMR priorities and (...) several strategies for achieving these goals using existing “legal hooks” that draw on elements of international environmental, trade and health laws governing related matters that could be used as they exist or revised to include AMR. We also consider the institutional mandates of international authorities to highlight areas where additional steps could be taken on AMR without constitutional changes. Overall, we identify 37 possible mechanisms to strengthen AMR governance using the International Health Regulations, the Agreement on the Application of Sanitary and Phytosanitary Measures, the Agreement on Trade-Related Aspects of Intellectual Property Rights, the Agreement on Technical Barriers to Trade, the International Convention on the Harmonized Commodity Description and Coding System, and the Basel, Rotterdam, and Stockholm conventions. Although we identify many shorter-term opportunities for addressing AMR using existing legal hooks, none of these options are capable of comprehensively addressing all global governance challenges related to AMR, such that they should be pursued simultaneously with longer-term approaches including a dedicated international legal agreement on AMR. (shrink)

An international legal agreement governing the global antimicrobial commons would represent the strongest commitment mechanism for achieving collective action on antimicrobial resistance (AMR). Since AMR has important similarities to climate change—both are common pool resource challenges that require massive, long-term political commitments—the first article in this special issue draws lessons from various climate agreements that could be applicable for developing a grand bargain on AMR. We consider the similarities and differences between the Paris Climate Agreement and current governance structures for (...) AMR, and identify the merits and challenges associated with different international forums for developing a long-term international agreement on AMR. To be effective, fair, and feasible, an enduring legal agreement on AMR will require a combination of universal, differentiated, and individualized requirements, nationally determined contributions that are regularly reviewed and ratcheted up in level of ambition, a regular independent scientific stocktake to support evidence informed policymaking, and a concrete global goal to rally support. (shrink)

Antimicrobial resistance is one of the greatest public health crises of our time. The natural biological process that causes microbes to become resistant to antimicrobial drugs presents a complex social challenge requiring more effective and sustainable management of the global antimicrobial commons—the common pool of effective antimicrobials. This special issue of Health Care Analysis explores the potential of two legal approaches—one long-term and one short-term—for managing the antimicrobial commons. The first article explores the lessons for antimicrobial resistance that can be (...) learned from recent climate change agreements, and the second article explores how existing international laws can be adapted to better support global action in the short-term. (shrink)

Prologue, invitation to thinking about God In the Hebrew Bible? -- Part I, questions about God? -- Why does God in the Bible have a body? -- What do God's body parts in the Bible mean? -- Why is God angry in the Bible? -- Does God in the Bible have gender or sexuality? -- Part II, questions about God in the world? -- What can creation tell us about God? -- Who-or what-is the Satan? -- Why do people suffer (...) according to the Hebrew Bible? -- Epilogue, God in the Bible and beyond. (shrink)

Hume's Reception in Early America: Expanded Edition brings together the original American responses to one of Britain's greatest men of letters, David Hume. Now available as a single volume paperback, this new edition includes updated further readings suggestions and dozens of additional primary sources gathered together in a completely new concluding section. From complete pamphlets and booklets, to poems, reviews, and letters, to extracts from newspapers, religious magazines and literary and political journals, this book's contents come from a wide variety (...) of sources published in colonial America and the early United States between 1758 and 1850. As well as classics by Thomas Jefferson, John Adams and Alexander Hamilton, it contains scores of unknown and hard-to-locate items, many of which have not been reprinted since their original publication. These responses are divided into four parts covering Hume's Essays; his Philosophical Writings; his History of England; and his Character and Death. Each of those parts has a separate introductory essay, and every selection is introduced by a short headnote that sets the piece in its historical context and provides bibliographical references. Packed with new insights into Hume and American thought and culture, Hume's Reception in Early America reveals the relevance and impact of Hume on American political, philosophical, historical, religious, and aesthetic debates. (shrink)

A key focus in many debates surrounding the harm in hate speech centres on the subordinating impact hate speech has on its victims. Under such a view, and provided there exists a requisite level of speaker authority a particular speech situation, hate speech can be conceived as something which directly impact’s the victim’s status, and can be contrasted to the view that such speech merely expresses hateful ideas. Missing from these conceptions, however, are the ways in which intersubjective, recognition-sensitive relations (...) influence the kind of harm likely to result from such an act. Understanding the central role of first-person experience is crucial, as, while a victim may have little influence in how their social status is impacted by such an act, the possibility for ‘speaking back’ requires that individuals are equipped with the conditions necessary to reject the authority claims of the speaker. On such a view, this paper aims to use this feature of intersubjectivity to explore the potential ways in which an act of hate speech can be ‘robbed’ of some of its harm by having its authority claims rejected by the victim. Utilizing this enhanced understanding, I reflect upon one particular real-world example of hate speech, in which the target rejects the status-undermining claims made upon her. In the last section, I propose a general institutional outlook aimed towards aiding would-be victims of hate speech to respond to such attempts at normative authority exertion. (shrink)

Classification of the history of science has a long history, and the essays in this Focus section explore that history and its consequences from several different angles. Two of the papers deal with how classifying schemes in bibliography have evolved. A third looks at the way archival organization has changed over the years. Finally, the last essay explores the intersection of human and machine classifying systems. All four contributions look closely at the ramifications of the digital revolution for the way (...) we organize the knowledge of the discipline. (shrink)

This paper offers a new way to make sense of disagreement expansion from a polylogical perspective by incorporating various places in addition to players and positions into the analysis. The concepts build on prior implicit ideas about disagreement space by suggesting how to more fully account for argumentative context, and its construction, in large-scale complex controversies. As a basis for our polylogical analysis, we use a New York Times news story reporting on an oil train explosion—a significant point in the (...) broader controversy over producing oil and gas via hydraulic fracturing. (shrink)

Abstract‘Counterspeech’ is often presented as a way in which individual citizens can respond to harmful speech while avoiding the potentially coercive and freedom-damaging effects of formal speech restrictions. But counterspeech itself can also undermine freedom by contributing to forms of social punishment that manipulate a speaker’s choice set in uncontrolled ways. Specifically, and by adopting a republican perspective, this paper argues that certain kinds of counterspeech candominatewhen they contribute to unchecked social norms that enable others to interfere arbitrarily with speakers. (...) The presence of such domination can pose just as much a threat to freedom of speech as unchecked formal restrictions by threatening an individual’s discursive status, revealing a problem for those who defend counterspeech as a freedom-protecting alternative. Rather than rejecting both counterspeech and legislation outright, however, this paper argues that the republican principle ofparsimonyought to be exercised when deciding on appropriate harmful speech response. While the principle of parsimony allows for suitably-checked formal punishment for some of the most egregious forms of harmful speech, citizen-led counterspeech must be guided by a reliable set of norms against the use of social punishment where those who do engage in social punishment face certain costs. The presence of robust, widely-known, and reliable norms thus supports both formal and informal responses to harmful speech while maintaining a secure discursive status for all. (shrink)

While attacks against members of the LGBT community are increasingly covered as hate crimes and are widely viewed as a form of repression, attacks on women are almost never covered as violations of human rights. We propose that until violence against women is recognized as a form of repression and a threat to the physical security of women, we cannot expect much to be done to prevent it. We posit that policies aimed at preventing violence against women are unlikely to (...) come about unless this abstract concept is connected, through a connection frame, to concrete crimes against women. We conducted a framing analysis of news coverage of all confirmed femicides in Massachusetts in 2013 and find that while journalists have the potential to draw these connection frames, they seldom put these killings in the context of violations of women’s rights. (shrink)

A specific issue for argumentation theory is whether information and communication technologies play any role in governing argument — that is, as parties engage in practical activities across space and time via ICTs, does technology matter for the interplay of argumentative content and process in managing disagreement? The case made here is that technologies do matter because they are not merely conduits of communication but have a role in the pragmatics of communication and argumentation. In particular, ICTs should be recognized (...) as communication-information services that are delegated degrees of responsibility for managing disagreements arising from practical activities. These services are organized around practical theories for designing disagreement space. However, recognizing this relationship between argument and technology requires accounting for procedures, techniques, or rules and speech acts that are not argumentative propositions in any strict sense but that are consequential for what becomes argumentation in any setting. An account about designing disagreement space, grounded in Jackson and Jacobs’s theory of Disagreement Management, is put forward to address these issues while more generally contributing to understanding argument in context. (shrink)

A growing body of literature in feminist philosophy exposes the way in which occupying a particular group identity inhibits an affected agent’s ability to engage in communicative exchange effectively. These accounts reveal a fault in standard liberal defences of free speech, showing how, if free speech is a goal worth pursuing, then it must involve both a concern about the legitimate limits of state interference and of the effect of social norms on an agent’s communicative capacities. Building on the emergence (...) of a ‘critical’ branch of neo-republicanism, this article argues that such speech-related injustices are best understood as a feature of structural domination that threatens the agency of those affected. Recalibrating our understanding of free speech along critical republican lines thus secures discursive agency in our communicative exchanges in a way that both ensures democratic legitimacy and realises equal status for all. (shrink)

In the midst of extreme and dualistic religio-political debates regarding women’s sexual wellness and abortion, one begins to wonder what a new theo-ethical approach might look like which rejects overly-simplistic, harmful understandings of such crucial issues. What might it look like to truly centre women’s full human experiences, loving each other in a way that addresses harm and meets tangible needs? This article examines the complex inequitable structural and institutional realities of sexual wellness and abortion through an intersectional theo-ethical lens. (...) The article then proceeds to suggest a new socio-religio-political ‘Pro-Love’ philosophy, undergirded by foundational theological understandings of justice-oriented love, and situated within the broad fields of Feminist, Liberation, Process, and Queer Theologies, within the Christian tradition. The suggested approach requires systematically addressing root issues affecting the lack of equitable access to sexual wellness and the racist/sexist/classist structures forcing women into under-resourced and unsafe environments, leading to high demand for abortion services. (shrink)

Insight into animal biology and development provided by classical genetic analysis of the model organism Drosophila melanogaster was an incentive to develop advanced genetic tools for this insect. But genetic systems for the over one million other known insect species are largely undeveloped. With increasing information about insect genomes resulting from next generation sequencing, RNA interference is now the method of choice for reverse genetics, although it is constrained by the means of delivery of interfering RNA. A recent advance to (...) ensure sustained delivery with minimal experimental intervention or trauma to the insect is to exploit commensal bacteria for symbiont‐mediated RNA interference. This technology not only offers an efficient means for RNA interference in insects in laboratory conditions, but also has potential for use in the control of human disease vectors, agricultural pests and pathogens of beneficial insects. (shrink)

Strike action in healthcare has been a common global phenomenon. As such action is designed to be disruptive, it creates substantial ethical tension, the most cited of which relates to patient harm, that is, a strike may not only disrupt an employer, but it could also have serious implications for the delivery of care. This article systematically reviewed the literature on strike action in healthcare with the aim of providing an overview of the major justifications for strike action, identifying relative (...) strengths and shortcomings of this literature and providing direction for future discussions, and theoretical and empirical research. Three major themes emerged related to (1) the relationship between healthcare workers, patients and society; (2) the consequences of strike action; and (3) the conduct of strike action. Those who argue against strike action generally cite the harms of such action, particularly as it relates to patients. Many also argue that healthcare workers, because of their skills and position in society, have a special obligation to their patients and society more generally. Those who see this action as not only permissible but also, in some cases, necessary have advanced several points in response, arguing that healthcare workers do not necessarily have any special obligation to their patients or society, and even if so, this obligation is not absolute. Overwhelmingly, when talking about the potential risks of strike action, authors have focused on patient welfare and the impact that a strike could have. Several directions for future work are identified, including greater explorations into how structural and systemic issues impact strike action, the need for greater consideration about the contextual factors that influence the risks and characteristics of strike action and finally the need to tie this literature to existing empirical evidence. (shrink)

It is widely believed that John Maynard Keynes wrote The Economic Consequences of the Peace to protest the reparations imposed on Germany after the First World War. The central thesis of this paper is that Britain’s war debt problem, not German reparations, led Keynes to write The Economic Consequences of the Peace. His main goal at the Paris Peace Conference was to restore Britain’s economic hegemony by solving the war debt problem he helped to create. We show that Keynes was (...) responsible for many of the most notorious aspects of the reparations section of the Treaty, and he crafted his proposals in light of mercantilist theories designed to keep Germany relatively poor after the war. His desperate desire to solve Britain’s war debt problem, mixed with his mercantilist ideas, inspired him to write The Economic Consequences of the Peace. (shrink)

I propose to examine what I take to be the point at issue between subjectivist and objectivist theories of ethics and to explain that the controversy between them is unreal. It springs from a misunderstanding of the nature of appraisal sentences. What I hope to show is that if such sentences were really analysable in the way in which the critics and many of the supporters of subjectivist theories suppose, then those theories would indeed, as it is sometimes put “fail (...) to do justice to the facts of moral experience.” But it seems to me that objectivist theories are no better off. They make exactly the same mistake though in a more sophisticated way. I therefore propose to see whether any useful results can be achieved by construing appraisal sentences on rather different lines. By appraisal sentences I mean sentences of the form “I approve of …, I think well of …, I commend …, etc.” I shall call these simple appraisals, sentences of the form “… is good, … is meritorious, … is praiseworthy, etc.” I shall call these moral appraisals. In these terms, subjectivist theories assert that moral appraisals can always be expressed without change of meaning by simple appraisals, though perhaps the addition of an imperative sentence of some kind is required to complete the translation. Objectivist theories deny this possibility and claim that moral appraisals assert truths about the independent world and not psychological facts about the speaker. (shrink)

It is argued here that large-scale organization and networked computing enable new divisions of communicative work aimed at shaping the content, direction, and outcomes of societal conversations. The challenge for argumentation theory and practice lies in attending to these new divisions of communicative work in constituting contemporary argumentative realities. Goffman’s conceptualization of participation frameworks and production formats are applied to articulate the communicative work of organizations afforded by networked computing that invents and innovates argument in all of its senses—as product, (...) process, and procedure. Communicative work, however, may be scaffolding argumentative contexts and practices that are quite different than what has constituted past argumentative realities. The computerization of argument happens as organizations invent and innovate argument practice relative to the demands and opportunities of interorganizational communication. The cases and examples examined here suggest that argument practice is evolving around the logic of conversation and the principle of personalization. The analysis challenges argumentation theory to seriously engage with the construction of communicative contexts and the realization of ideas about disagreement management in organizational practice and information infrastructures. Directions for integrating insights from a design perspective on argument with insights from organizational and information systems theory are proposed for coming to terms with an era of large-scale organization and computerization, in particular the evolution of argument practice, the inscription of argument in the built environment, and the absorption of socio-cultural argument practices by organizations and computation. (shrink)

Biobanks that are run on an opt-in basis depend on people having the motivation to give and to trust in those who control their samples. Yet in the UK trust in the healthcare system has been in decline and there have been a number of health-related scandals that have received widespread media and public attention. Given this background, and the previous public consultations on UK Biobank, the paper explores the way people express their trust and mistrust in the area of (...) medical and genetic information through discussions in six focus groups held in different areas of Britain. The themes that emerged in the discussion were the special character of genetic data; the ease with which information spreads; the public/private divide in genetic research; the potential of genetic information to harm people; choice, consent and lack of control; and the difficulty of establishing trustworthy governing arrangements. The expert agenda of policy-makers and medical ethics does not address the broader concerns expressed by participants. It seems that public consultation and the language of openness and transparency may not be sufficient to establish trust in the governance of genetic databases. Donors will be asked to give freely without any return but the participants' perception of those using the samples is that they are motivated by success and profit rather than healthcare priorities. In this context altruism seems naive and even dangerous. In order to place their trust well people need evidence of a relationship with obligations and expectations on both sides. (shrink)

Everyone wants to be virtuous, but recent psychological investigations suggest that this may not be possible. Mark Alfano challenges this theory and asks, not whether character is empirically adequate, but what characters human beings could have and develop. Although psychology suggests that most people do not have robust character traits such as courage, honesty and open-mindedness, Alfano argues that we have reason to attribute these virtues to people because such attributions function as self-fulfilling prophecies - children become more studious (...) if they are told that they are hard-working and adults become more generous if they are told that they are generous. He argues that we should think of virtue and character as social constructs: there is no such thing as virtue without social reinforcement. His original and provocative book will interest a wide range of readers in contemporary ethics, epistemology, moral psychology and empirically informed philosophy. (shrink)

This book initiates a conversation between the two traditions showing how concepts and tools drawn from one philosophical tradition can help solve problems ...

© JNCCN-Journal of the National Comprehensive Cancer Network.Background: Next-generation tumor sequencing panels, which include multiple established and novel targets across cancers, are emerging in oncology practice, but lack formal positive coverage by US payers. Lack of coverage may impact access and adoption. This study identified challenges of NGTS coverage by private payers.Methods: We conducted semi-structured interviews with 14 NGTS experts on potential NGTS benefits, and with 10 major payers, representing more than 125,000,000 enrollees, on NGTS coverage considerations. We used the (...) framework approach of qualitative research for study design and thematic analyses and simple frequencies to further describe findings.Results: All interviewed payers see potential NGTS benefits, but all noted challenges to formal coverage: 80% state that inherent features of NGTS do not fit the medical necessity definition required for coverage, 70% view NGTS as a bundle of targets versus comprehensive tumor characterization and may evaluate each target individually, and 70% express skepticism regarding new evidence methods proposed for NGTS. Fifty percent of payers expressed sufficient concerns about NGTS adoption and implementation that will preclude their ability to issue positive coverage policies.Conclusions: Payers perceive that NGTS holds significant promise but, in its current form, poses disruptive challenges to coverage policy frameworks. Proactive multidisciplinary efforts to define the direction for NGTS development, evidence generation, and incorporation into coverage policy are necessary to realize its promise and provide patient access. This study contributes to current literature, as possibly the first study to directly interview US payers on NGTS coverage and reimbursement. (shrink)