New fetal therapies offer important prospects for improving health. However, having to consider both the fetus and the pregnant woman makes the risk–benefit analysis of fetal therapy trials challenging. Regulatory guidance is limited, and proposed ethical frameworks are overly restrictive or permissive. We propose a new ethical framework for fetal therapy research. First, we argue that considering only biomedical benefits fails to capture all relevant interests. Thus, we endorse expanding the considered benefits to include evidence-based psychosocial effects of fetal therapies. (...) Second, we reject the commonly proposed categorical risk and/or benefit thresholds for assessing fetal therapy research. Instead, we propose that the individual risks for the pregnant woman and the fetus should be justified by the benefits for them and the study’s social value. Studies that meet this overall proportionality criterion but have mildly unfavorable risk–benefit ratios for pregnant women and/or fetuses may be acceptable. (shrink)

‘Authority’ is a term widely used in scholarly debate, including the history of philosophy. However, what is meant by this term is not always clear and the concept is not very well defined. One reason for this is certainly that the phenomenon itself is complex and the corresponding terms are used with a degree of latitude. This makes it difficult to adequately compare and connect the insights that various case studies have to offer. For historians of philosophy, it is thus (...) important to get a sufficient grasp of the concept of authority. This is even more urgent when one studies commentary traditions, in which secondary texts are written in virtue of the existence of texts clad with high authority. Our article combines historical textual research with insights from epistemology, thus providing a discussion of the concept of authority and its importance in textual traditions. We propose a descriptive model that can be used for examining epistemic authority in historical texts. An example from ancient Platonism serves to show both the complexity of the phenomenon and the clarifications that our approach may offer. (shrink)

Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and (...) Policy-relevant Ethics in Singapore Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data. (shrink)

The prospect of consumable meat produced in a laboratory setting without the need to raise and slaughter animals is both realistic and exciting. Not only could such in vitro meat become popular due to potential cost savings, but it also avoids many of the ethical and environmental problems with traditional meat productions. However, as with any new technology, in vitro meat is likely to face some detractors. We examine in detail three potential objections: 1) in vitro meat is disrespectful, either (...) to nature or to animals; 2) it will reduce the number of happy animals in the world; and 3) it will open the door to cannibalism. While each objection has some attraction, we ultimately find that all can be overcome. The upshot is that in vitro meat production is generally permissible and, especially for ethical vegetarians, worth promoting. (shrink)

In this paper, we first classify different types of second opinions and evaluate the ethical and epistemological implications of providing those in a clinical context. Second, we discuss the issue of how artificial intelligent could replace the human cognitive labour of providing such second opinion and find that several AI reach the levels of accuracy and efficiency needed to clarify their use an urgent ethical issue. Third, we outline the normative conditions of how AI may be used as second opinion (...) in clinical processes, weighing the benefits of its efficiency against concerns of responsibility attribution. Fourth, we provide a ‘rule of disagreement’ that fulfils these conditions while retaining some of the benefits of expanding the use of AI-based decision support systems in clinical contexts. This is because the rule of disagreement proposes to use AI as much as possible, but retain the ability to use human second opinions to resolve disagreements between AI and physician-in-charge. Fifth, we discuss some counterarguments. (shrink)

The increased presence of medical AI in clinical use raises the ethical question which standard of explainability is required for an acceptable and responsible implementation of AI-based applications in medical contexts. In this paper, we elaborate on the emerging debate surrounding the standards of explainability for medical AI. For this, we first distinguish several goods explainability is usually considered to contribute to the use of AI in general, and medical AI in specific. Second, we propose to understand the value of (...) explainability relative to other available norms of explainable decision-making. Third, in pointing out that we usually accept heuristics and uses of bounded rationality for medical decision-making by physicians, we argue that the explainability of medical decisions should not be measured against an idealized diagnostic process, but according to practical considerations. We conclude, fourth, to resolve the issue of explainability-standards by relocating the issue to the AI’s certifiability and interpretability. (shrink)

There is a remedy available for many of our ailments: Psychopharmacology promises to alleviate unsatisfying memory, bad moods, and low self-esteem. Bioethicists have long discussed the ethical implications of enhancement interventions. However, they have not considered relevant evidence from psychology and economics. The growth in autonomy in many areas of life is publicized as progress for the individual. However, the broadening of areas at one’s disposal together with the increasing individualization of value systems leads to situations in which the range (...) of options asks too much of the individual. I scrutinize whether increased self-determination and unbound possibilities are really in a person’s best interests. Evidence from psychology and economics challenges the assumption that unlimited autonomy is best in all cases. The responsibility for autonomous self-formation that comes with possibilities provided by neuro-enhancement developments can be a burden. To guarantee quality of life I suggest a balance of beneficence, support, and respect for autonomy. (shrink)

This article explores Franz Brentano's opposition to papal infallibility, and sets this in the context of his development as a Catholic scholar. An active participant in the Catholic revival of the nineteenth century, Brentano contributed to the emergence of neoscholasticism through his philosophical rehabilitation of Aristotle. Brentano ultimately left the Church however as the result of intensive scrutiny of his faith occasioned by his analysis of infallibility. This article explores this crisis of faith by analyzing, for the first time, Brentano's (...) position on papal infallibility, and suggesting ways that it informed his philosophical development. (shrink)

With the world grappling with continued spread of monkeypox internationally, vaccines play a crucial role in mitigating the harms from infection and preventing spread. However, countries with the greatest need - particularly historically endemic countries with the highest monkeypox case-fatality rates - are not able to acquire scarce vaccines. This is unjust, and requires rectification through equitable allocation of vaccines globally. We propose applying the Fair Priority Model for such allocation, which emphasizes three key principles: 1) preventing harm; 2) prioritizing (...) the disadvantaged; and 3) treating people with equal moral concern. Post-exposure prophylaxis (PEPV) has the most potential to mitigate harm, and so ensuring countries have sufficient supply for PEPV should be the first priority. And historically endemic countries, which face disadvantages that compound potential harms from monkeypox, should be the first recipients of such vaccines. Once sufficient supply is allocated for countries to apply PEPV, global allocation could move on to pre-exposure prophylaxis (PrEP), again prioritizing historically endemic countries first before distribution to the rest of the global community, based on projected number of cases and vulnerability to harm. (shrink)

Exponential-constructible functions are an extension of the class of constructible functions. This extension was formulated by Cluckers and Loeser in the context of semi-algebraic and sub-analytic structures, when they studied stability under integration. In this paper, we will present a natural refinement of their definition that allows for stability results to hold within the wider class of [Formula: see text]-minimal structures. One of the main technical improvements is that we remove the requirement of definable Skolem functions from the proofs. As (...) a result, we obtain stability in particular for all intermediate structures between the semi-algebraic and the sub-analytic languages. (shrink)

Decision making in health care contexts is often deeply challenging for the patients, their close ones, and those who care for them. All of them have and perceive different forms of responsibilitie...

Novice designers produced a sequence of sketches while inventing a logo for a novel brand of soft drink. The sketches were scored for the presence of specific objects, their local features and global composition. Self‐assessment scores for each sketch and art critics' scores for the end products were collected. It was investigated whether the design evolves in an essentially random fashion or according to an overall heuristic. The results indicated a macrostructure in the evolution of the design, characterized by two (...) stages. For the majority of participants, the first stage is marked by the introduction and modification of novel objects and their local and global aspects; the second stage is characterized by changes in their global composition. The minority that showed the better designs has a different strategy, in which most global changes were made in the beginning. Although participants did not consciously apply these strategies, their self‐assessment scores reflect the stages of the process. (shrink)

Novice designers produced a sequence of sketches while inventing a logo for a novel brand of soft drink. The sketches were scored for the presence of specific objects, their local features and global composition. Self‐assessment scores for each sketch and art critics' scores for the end products were collected. It was investigated whether the design evolves in an essentially random fashion or according to an overall heuristic. The results indicated a macrostructure in the evolution of the design, characterized by two (...) stages. For the majority of participants, the first stage is marked by the introduction and modification of novel objects and their local and global aspects; the second stage is characterized by changes in their global composition. The minority that showed the better designs has a different strategy, in which most global changes were made in the beginning. Although participants did not consciously apply these strategies, their self‐assessment scores reflect the stages of the process. (shrink)

The central argument developed in this essay is that today we are seeing a proliferation of normative orders where once state normativity ruled and the dominant logic was toward producing a unitary normative framing. One synthesizing image we might use to capture these dynamics is that of a movement from centripetal nation-state articulation to a centrifugal multiplication of specialized assemblages. This multiplication in turn can lead to a sort of simplification of normative structures insofar as: these assemblages are partial and (...) often highly specialized formations centered in particular utilities and purposes. The valence of these particular utilities and purposes can range from the search for justice to narrow self-interest . While this is still a minor process in the larger scale of our geopolity, it signals the beginning of a multi-sited, though partial, disruption of its existing formal architecture. This raises questions about the future of crucial frameworks through which modern societies, economies, and polities have operated: the social contract of liberal states, social democracy as we have come to understand it, modern citizenship, and the formal mechanisms that render certain claims legitimate and others illegitimate in liberal democracies. These frameworks have held together complex interdependencies between rights and obligations, power and the law, wealth and poverty, allegiance and exit.Keywords: assemblages; normative; globalization; denationalization; centripetal; centrifugal; utilities; logics; liberal state; claims. (shrink)

As individuals enter their 80s, they are inevitably confronted with the problem of neuronal loss in the brain. The incidence of the common movement disorder ‘mild parkinsonian signs’ (MPS) is approximately 50% over the age of 85 years. It has long been known that the loss of dopaminergic neurons in the substantia nigra pars compacta is a neuropathological hallmark of Parkinson's disease (PD). Recently, two papers1,2 present clear evidence for a high burden of mitochondrial DNA deletions within substantia nigra neurons (...) in aged individuals and individuals with PD, pointing towards a common pathway inevitably leading to neuronal dysfunction and death. BioEssays 28: 963–967, 2006. © 2006 Wiley Periodicals, Inc. (shrink)

This paper discusses different ways of formulating regulation that takes into account a responsibility towards future generations in environmental issues. A rights-based or human-rights based approach, based on notions of intergenerational equity, can be problematic on a conceptual level, and implementation of rights for future generations is challenging. An alternative approach is based on the assignment of duties to present generations rather than rights of future generations. This approach, which is often used in regulation concerning sustainability, uses goal regulation to (...) avoid conceptual problems with rights of future generations while it still provides the opportunity to safeguard their interests and needs. (shrink)

Name der Zeitschrift: Klio Jahrgang: 96 Heft: 1 Seiten: 183-217.

Theologie und Metaphysik stehen in einem Spannungsverhältnis. Versuchen der Rehabilitierung eines starken metaphysischen Systemsdenkens steht das 'nachmetaphysische Denken' entgegen, welches das Projekt einer rationalen Metaphysik verabschiedet. Wendel und Breul unternehmen einen Vermittlungsversuch: Sie formulieren eine 'Metaphysik nach Kant' als Leitparadigma der Theologie, die ernst nimmt, dass Metaphysik für eine rationale Begründung des Glaubens unverzichtbar ist, sie zugleich jedoch methodisch nur in der Verwurzelung in einer Praxis personaler Lebensformen haltbar ist. So gelingt es diesem Neuansatz, eine an die Moderne anschlussfähige praktische (...) Begründung religiöser Hoffnung zu entwickeln."-- Back cover. (shrink)

The American Journal of Bioethics, Volume 12, Issue 9, Page 53-55, September 2012.