The Faculty of Medicine and Health Sciences of the University of Sherbrooke has observed year after year, that certain students have not started and or completed their immunizations for common infectious diseases, which in effect makes them inadmissible for their clinical internships in healthcare establishments. The program administrators have posed a series of questions on the best way to proceed with these students as, a certain number remain reluctant to vaccination. They are often confronted with ethical dilemmas, are not (...) necessarily comfortable with their rights and responsibilities and wish to be guided throughout the process. This article aims to put forth a procedure that would be put in place to support the administrators in a way for them to obtain a more favorable vaccination level for all of their students in the most reasonable amount of time possible. The interest of the procedure is to move forward in a few simple and well defined steps that are supported by a rigorous legal framework, while respecting the rights and freedoms of the students. It is also designed so that it could be replicated in other faculties of medicine. (shrink)

Soon after the coronavirus disease 2019 (COVID‐19) pandemic outbreak, it became clear that vaccination will be the most useful tool to combat the disease. Despite the apparent safety and efficacy of the developed anti‐COVID‐19 vaccines, relatively high percentages of the population worldwide refused to get vaccinated, including many health workers and health students. The present cross‐sectional study examined the motives, attitudes, and personal characteristics of those who did not get vaccinated against COVID‐19 or vaccinated without complete willingness among nursing (...) students and nursing faculty members in Israel (n = 472). Results show that the vast majority of the study participants (97%) received at least one dose of the anti‐COVID‐19 vaccine. Nearly 37% of the participants indicated that they received the vaccine without complete willingness. As compared to faculty members, nursing students reported lower trust in the efficacy of the vaccine, perceived the COVID‐19 pandemic as a health threat to a lesser extent, exhibited lower institutional and personal trust, and had higher levels of posttraumatic stress disorder symptoms. Non‐Jewish participants were at risk of vaccinating without complete willingness. These findings underscore the need for developing evidence‐based strategies to promote the safety and efficacy of the anti‐COVID‐19 vaccines in nursing schools. (shrink)

Recently, several states in the US have made it more difficult to receive nonmedical exemptions to school vaccine mandates in the hope of better orienting parents towards vaccination. However, little is known about how public-facing school staff implement and enforce mandate policies, including why or how often they steer parents towards nonmedical exemptions. This study focused on Michigan, which has recently added an additional burden for families seeking nonmedical exemptions. We used an anonymous online survey to assess Michigan public-school (...) employees (n = 157) about their knowledge, attitudes, and behaviors regarding Michigan's school enrollment vaccine mandate policy. Our main conclusions are that frontline school staff are generally knowledgeable about vaccines and immunization policy, but are at best ambivalent about their role in immunization governance, believing that other agents should be responsible for ensuring that children are vaccinated. Furthermore, some respondents indicated low vaccine confidence, which was associated with increased ambivalence about, or opposition to, their role in immunization governance. As more jurisdictions within and beyond the US consider introducing or tightening childhood vaccine mandates, it is increasingly important to understand how these policies can be improved by attending to the attitudes and roles of relevant frontline actors. (shrink)

Every September, millions of parents around the country herd their children into pediatricians’ offices with school immunization forms in hand. Their kids have already received a dozen or more shots before the age of two, and, depending on the state in which they live, a dozen more may await them over the ensuing decade. To protect public health, states require that parents have their children immunized before they are permitted to attend public or private school, but the rules vary for (...) homeschooled children. With the spectacular growth in the number of homeschooled students, it is becoming more difficult to reach these youth to ensure that they are immunized at all. These children are frequently unvaccinated, leaving them open to infection by diseases that have been all but stamped out in the United States by immunization requirements. States should encourage parents to have their homeschooled students vaccinated by enacting the same laws that are used for public school students, enforcing current laws through neglect petitions, or requiring that children be immunized before participating in school-sponsored programs. (shrink)

Preventive vaccination is one of the greatest successes of modern medicine. The SARS-CoV-2 epidemic, during which vaccination is the main method of prevention against death and severe disease, gave rise to a resurgence of anti-vaccine movements. The aim of this study was to analyse the attitudes of students towards vaccination and the COVID-19 pandemic. The statistical analysis was performed with the use of the following data-mining methods: correspondence analysis and basket analysis. The obtained results show that students (...) of medicine are characterized with the highest level of knowledge. Students of other medical faculties, on the other hand, have a significantly less uniform views, as do students of non-medical faculties. (shrink)

To protect public health, states require that parents have their children immunized before they are permitted to attend public or private school. But for homeschooled children, the rules vary. With the spectacular growth in the number of homeschooled students, it is becoming more difficult to reach these youth to ensure that they are immunized at all. These children are frequently unvaccinated, leaving them open to infection with diseases that are all but stamped out in the United States with immunization requirements. (...) States should encourage parents to get their homeschooled students vaccinated through enacting the same laws as those used for public school students. This could be done by enforcing current laws through neglect petitions or by requiring that children be immunized before participating in school sponsored programs. As most states require some filing to allow parents to homeschool their children, it would be easy to enact laws requiring that homeschooled children be immunized or exempted before completing registration. (shrink)

As a medical ethicist, I want to explain why college vaccination requirements decidedly do not violate the core principles of medical ethics which include avoiding or lessening harms, promoting benefits, respecting people and their informed and free choices, and promoting justice and fairness. In particular, vaccine requirements do not violate the respect-related requirement to not selfishly “use” and abuse others as “means” for someone else’s benefit. Since false claims on important issues often have dire consequences, it’s important to explain (...) why medical ethics supports vaccinating college students. (shrink)

In 2022, students at North American universities with third-dose COVID-19 vaccine mandates risk disenrolment if unvaccinated. To assess the appropriateness of booster mandates in this age group, we combine empirical risk-benefit assessment and ethical analysis. To prevent one COVID-19 hospitalisation over a 6-month period, we estimate that 31 207–42 836 young adults aged 18–29 years must receive a third mRNA vaccine. Booster mandates in young adults are expected to cause a net harm: per COVID-19 hospitalisation prevented, we anticipate at least (...) 18.5 serious adverse events from mRNA vaccines, including 1.5–4.6 booster-associated myopericarditis cases in males (typically requiring hospitalisation). We also anticipate 1430–4626 cases of grade ≥3 reactogenicity interfering with daily activities (although typically not requiring hospitalisation). University booster mandates are unethical because they: (1) are not based on an updated (Omicron era) stratified risk-benefit assessment for this age group; (2) may result in a net harm to healthy young adults; (3) are not proportionate: expected harms are not outweighed by public health benefits given modest and transient effectiveness of vaccines against transmission; (4) violate the reciprocity principle because serious vaccine-related harms are not reliably compensated due to gaps in vaccine injury schemes; and (5) may result in wider social harms. We consider counterarguments including efforts to increase safety on campus but find these are fraught with limitations and little scientific support. Finally, we discuss the policy relevance of our analysis for primary series COVID-19 vaccine mandates. (shrink)

Background Human Papilloma Virus vaccine was introduced in Bangladesh through the arrangement of a demonstration project in Gazipur district in 2016, targeting grade five female students and non-school going girls. HPV vaccination is expected to be eventually included in the nationwide immunization program if the demonstration project is successful. However, introduction and implementation of such a vaccination program raises various ethical concerns. This review paper illustrates a step by step assessment of the ethical concerns surrounding the HPV (...) class='Hi'>vaccination implementation in Bangladesh considering specific elements in administering and conducting the program as well as the intended results. Policy-makers, vaccine implementers, vaccine recipients, and an ethics specialist in Bangladesh were interviewed. Electronic database and websites have also been reviewed for relevant published literature and government statements. Main body of the abstract This program imparted inadequate knowledge about HPV and cervical cancer to the recipients and participants. There was lack of autonomous and informed choice of the girls and their parents about taking the vaccine. The program did not have any follow-up plan for the adverse effects in the long run. The impact of a female-only strategy in the larger societal context was overlooked. There was lack of awareness among the implementers about safeguarding the ethical issues pertaining to HPV vaccination. Conclusion Adolescent health education imparted in the scope of the vaccination program should contain adequate information about HPV, its mode of transmission, risk factors along with the importance of secondary prevention despite primary prevention. Adolescent boys should be given HPV related health education as well. The right of making informed choice should be appreciated and respected. More ethical discussion and debate should be done among the public health professionals of Bangladesh in order to increase awareness about ethical issues related to human health. (shrink)

At this point, I think it is fair to say that most of us know someone—a family member, a coworker, a friend, a student—who is resisting getting a vaccine against COVID-19. Frankly, this amazes me. I was recently discussing this with a friend—"Rebecca"—when to my utter shock, she confessed to me that she "does not trust the vaccine" and is not planning to get one until there is more certainty of its efficacy and safety. While there are many things (...) that stood out to be in this conversation, what stood out to me was a particular comment she made; she said to me: "The thing is, I'm a skeptic, and you're not."I admit, this comment threw me for a loop. How could I, a feminist bioethicist who has dedicated a good chunk of... (shrink)

BackgroundAs opioid use disorder (OUD) incidence and its associated deaths continue to persist at elevated rates, the development of novel treatment modalities is warranted. Recent strides in this therapeutic area include novel anti-opioid vaccine approaches. This work compares logistical and ethical considerations surrounding currently available interventions for opioid use disorder with an anti-opioid vaccine approach.MethodsThe opinions of student pharmacists and practicing pharmacists assessing knowledge, perceptions, and attitudes toward current and future OUD management strategies were characterized using a staged, multi-modal (...) research approach incorporating a focus group, pilot survey development and refinement, and final survey deployment. Survey responses were assessed using one- and two-way parametric and non-parametric analyses where appropriate, and multi-dimensional matrix profiles were compared using z-tests following an exhaustive combinatorial sum of differences calculation between items within each compared matrix.ResultsFocus group content analysis revealed a high level of agreeableness among participants regarding anti-opioid vaccine technology and a sense of shared ownership regarding solutions to the opioid epidemic at large. Pilot survey results demonstrated subject ability to consider both pragmatic and ethical considerations related to current therapeutics and novel interventions in a single instrument, with high endurance amongst engaged subjects. Access inequality was the most concerning ethical consideration identified for anti-opioid vaccines. Support for anti-opioid vaccine implementation across various clinical scenarios was strongest for voluntary use amongst individuals in recovery, and lowest for mandatory use in at-risk individuals.ConclusionsEthical and logistical concerns surrounding anti-opioid vaccines were largely similar to those for current OUD therapeutics overall. Anti-opioid vaccines were endorsed as helpful potential additions to current OUD therapeutic approaches, particularly for voluntary use in the later stages of clinical progression. (shrink)

The use of language and images in the media may have a strong effect on people’s political cognition. In this regard, conspiracy theories and misinformation about the COVID-19 vaccine can lead to reluctant uptake of the vaccine even among medical staff. In two experiments, this article tests the hypothesis that the public’s willingness to get vaccinated against the novel coronavirus depends on the framings they are presented with. Two hundred thirty-two female Saudi students are exposed to either pro- or anti- (...) class='Hi'>vaccination messages. In Experiment 1, they are asked to read semi-artificial news stories, and in Experiment 2 political cartoons. The results show that readers of the news articles, but not of the cartoons, are susceptible to framing effects. We consider the implications of how issues are framed for journalists and health professionals. (shrink)

This study examines the effectiveness of the inoculation strategy in countering vaccine-related misinformation among Hong Kong college students. A three-phase between-subject experiment was conducted to compare the persuasive effects of inoculation messages, supportive messages, and no message control. The results show that inoculation messages were superior to supportive messages at generating resistance to misinformation, as evidenced by more positive vaccine attitudes and stronger vaccine intention. Notably, while we expected the inoculation condition would produce more resistance than the control condition, there (...) was little evidence in favor of this prediction. Attitudinal threat and counterarguing moderated the experimental effects; issue involvement and political trust were found to directly predict vaccine attitudes and intention. The findings suggest that future interventions focus on developing preventive mechanisms to counter misinformation and spreading inoculation over the issue is an effective strategy to generate resistance to misinformation. Interventions should be cautious about using health advocacy initiated by governments among populations with low political trust. (shrink)

Courses on bioethics and the law traditionally have focused their coverage on ethical issues arising from individual patients’ encounters with the medical care system, but the course also provides an excellent opportunity to expose students to ethical issues arising at the intersection of medical care and public health. The following materials were assembled for use near the end of a semester-long law school course in Bioethics & Law. I taught the course relying heavily on problems contained in Barry R. Furrow (...) et al., Bioethics: Health Care Law and Ethics, 7th ed., which was the primary text for the course. (shrink)

ObjectiveWe conducted the following cross-sectional study to comprehensively assess the anxiety among Chinese international students who studied online during the COVID-19 pandemic and its influencing factors.MethodsQuestionnaires were distributed through “Sojump,” and a total of 1,090 valid questionnaires were collected. The questionnaire was divided into two parts: general situation and anxiety assessment of students. The former used a self-made questionnaire, and the international general GAD-7 scale was used to measure anxiety. Chi-square test was used to analyze the differences between groups, and (...) logistic regression analysis was performed for the factors with differences.ResultsAnxiety was found in 707 of 1,090 international students. Chi-square test and multivariate Logistic regression analysis showed that the incidence of anxiety was higher in the group under 22 years of age than in the group over 22 years of age ; International students living in big cities had a higher incidence of anxiety than those living in rural areas ; international students who socialized 3 times or less monthly had a higher incidence of anxiety than those who socialized more than 3 times per month ; international students who expected purely online teaching had a higher incidence of anxiety than those who expected purely offline teaching or dual-track teaching ; international students with a subjective score of online learning experience of 6 or less had a higher incidence of anxiety than those with subjective scores of more than 6. However, gender, emotional status, BMI, major of study, vaccination status, and degree type had no significant difference in the incidence of anxiety among international students who studied online during the COVID-19 pandemic.ConclusionDuring COVID-19, international students who were younger, came from big cities, had low social frequency, expected purely online teaching, and had poor experience of online classes were risk factors for anxiety during online classes. (shrink)

This paper recounts the efforts of a Bioethics student to understand the experience of human subjects of medical research in Kenya. Although the endeavor resulted in more questions than answers, it served to highlight areas where the current system of protections has failed to secure the well-being of those involved. It concludes that, in addition to existing considerations, ethical review ought to include another kind of information: that which can be gained only from listening to the feelings and experiences (...) related by subjects themselves. (shrink)

In the United States, the COVID-19 pandemic has become highly politicized and highly moralized. The current study explored whether participants’ endorsements of binding versus individualizing moral foundations explained partisan differences in views and behaviors regarding COVID-19. Participants completed the Moral Foundations Questionnaire before they indicated how morally permissible they thought it was to violate COVID-19 mandates, report others’ violations, or not get vaccinated. Additionally, they indicated their own prevention behaviors. Results show that endorsement of both individualizing and binding foundations explain (...) partisan differences in moral permissibility ratings. Political conservatism predicted greater endorsement of binding foundations which in turn predicted seeing COVID-19 violations and not getting vaccinated as more morally permissible, and predicted fewer self-reported prevention behaviors. Endorsement of individualizing foundations predicted seeing violations as less morally permissible and reporting others’ violations as more morally permissible. (shrink)

A clear and provocative introduction to the ethics of COVID-19, suitable for university-level students, academics, and policymakers, as well as the general reader. It is also an original contribution to the emerging literature on this important topic. The author has made it available Open Access, so that it can be downloaded and read for free by all those who are interested in these issues. Key features include: -/- A neat organisation of the ethical issues raised by the pandemic. An exploration (...) of the many complex interconnections between these issues. A succinct case for a continued lockdown until we develop a vaccine. An original account of the Deep Moral Problem of the Pandemic, and a Revolutionary Argument for how we should change society post-pandemic. References to, and engagement with, many of the best writings on the pandemic so far (both in popular media and academic journals). -/- ISBN: 978-0-6489016-0-0. (shrink)

Next SectionAccess to medicines, vaccination and care in resource-poor settings is threatened by the emigration of physicians and other health workers. In entire regions of the developing world, low physician density exacerbates child and maternal mortality and hinders treatment of HIV/AIDS. This article invites philosophers to help identify ethical and effective responses to medical brain drain. It reviews existing proposals and their limitations. It makes a case that, in resource-poor countries, ’locally relevant medical training’—teaching primarily locally endemic diseases and (...) practice in scarcity conditions, training in rural communities and admitting rural students preferentially—could help improve retention. Locally relevant training would arguably diminish medical brain drain in five ways. It would (i) make graduates less attractive for Western employers, (ii) align graduates’ expectations with actual practice, diminishing ‘burn-out’, (iii) enhance the professional prestige of local practice, (iv) hold rotations in, and recruit applicants from, rural areas, which is known to improve retention there, and (v) create local career development options that attract practitioners to stay. Such educational reform may raise worries about poor-quality care, breach of the freedom of education and occupation, breach of the freedom of movement, unequal distribution of opportunities among students, hypocrisy and resistance from influential actors. We address these worries. (shrink)

Educators who start a philosophy of medicine or medical ethics class with a philosophical discussion on the definition of basic concepts in medicine, such as health and disease, might relate to this anecdotal account. Students initially find the topic engaging because of the ubiquity of the concept of disease regulating not only their direct encounter with health-related contexts, for example, when veterans returning to school receive accommodations after being diagnosed with Post Traumatic Stress Disorder, but also their social world, say, (...) when they get in an argument with their classmates about whether vaccines cause or prevent diseases, or when they join the campus gym to improve their health. Yet their enthusiasm wanes when they read the seminal naturalist and normative accounts of disease. This happens not because such conceptual work does not have any philosophical sophistication and value but because the discussion seldom makes direct contact with the common uses of the disease concept in the medical, social, moral and institutional contexts in which the students are heavily embedded. As the authors of ‘Rethinking ‘Disease’: A Fresh Diagnosis and a New Philosophical Treatment’ argue, the notion of disease central to the naturalist and normativist positions is conceptually insulated from its applications in various institutional settings in healthcare and also from its personal, social and economic contexts. This insularity largely stems from the fact that traditional conceptual analysis in philosophy assumes a lot more than it can show, including the assumption that concepts, such as disease, have necessary and sufficient conditions that exist independently of the world as we encounter it and are accessed through our intuitions. This is a problem, because the concept of disease plays a crucial role in medical epistemology, scientific research, and ethical and policy-related issues; a philosophical account of disease that does not directly engage …. (shrink)

How far should we go in protecting and promoting public health? Can we force people to give up unhealthy habits and make healthier choices, or does everyone have the right to decide their own lifestyle? Should we stop treating smokers who refuse to give up smoking? Should we put a tax on fatty foods and ban vending machines in schools to address the obesity epidemic? Should parents be required to have their children vaccinated? Are some of our screening programmes unethical (...) Downs syndrome screening, for example or should we be screening people for more conditions, such as Huntington disease? Such questions are at the heart of public health ethics. Holland shows that to understand and debate these issues requires philosophy: moral philosophies, such as utilitarianism and deontology, as well as political philosophies such as liberalism and communitarianism. And philosophy informs other aspects of public health, such as epidemiology and health promotion. The aim of this book is to provide a lively, accessible and philosophically informed introduction to such issues. It is an ideal textbook for students taking courses in public health ethics. And since this book develops systematic discussions of issues in public health ethics, there is also much here to engage and challenge the more advanced reader. (shrink)

_Engaging Bioethics: An Introduction with Case Studies_ draws students into this rapidly changing field, helping them to actively untangle the many issues at the intersection of medicine and moral concern. Presuming readers start with no background in philosophy, it offers balanced, philosophically based, and rigorous inquiry for undergraduates throughout the humanities and social sciences as well as for health care professionals-in-training, including students in medical school, pre-medicine, nursing, public health, and those studying to assist physicians in various capacities. Written by (...) an author team with more than three decades of combined experience teaching bioethics, this book offers Flexibility to the instructor, with chapters that can be read independently and in an order that fits the course structure Up-to-date coverage of current controversies on topics such as vaccination, access to health care, new reproductive technologies, genetics, biomedical research on human and animal subjects, medically assisted death, abortion, medical confidentiality, and disclosure Attention to issues of gender, race, cultural diversity, and justice in health care Integration with case studies and primary sources Pedagogical features to help instructors and students, including Chapter learning objectives Text boxes and figures to explain important terms, concepts, and cases End-of-chapter summaries, key words, and annotated further readings Discussion cases and questions Appendices on moral reasoning and the history of ethical issues at the end and beginning of life An index of cases discussed in the book and extensive glossary/index A companion website with a virtual anthology linking to key primary sources, a test bank, topics for papers, and PowerPoints for lectures and class discussion. (shrink)

For decades, cigarette companies helped to promote the impression that there was no scientific consensus concerning the safety of their product. The appearance of controversy, however, was misleading, designed to confuse the public and to protect industry interests. Created scientific controversies emerge when expert communities are in broad agreement but the public perception is one of profound scientific uncertainty and doubt. In the first book-length analysis of the concept of a created scientific controversy, David Harker explores issues including climate change, (...) Creation science, the anti-vaccine movement and genetically modified crops. Drawing on work in cognitive psychology, social epistemology, critical thinking and philosophy of science, he shows readers how to better understand, evaluate, and respond to the appearance of scientific controversy. His book will be a valuable resource for students of philosophy of science, environmental and health sciences, and social and natural sciences. (shrink)

In few other areas of bioethical inquiry exists as close a connection between bioethical professional advice and policy development as is the case with HIV and AIDS. Historically, the reasons for this have much to do with one of the groups initially affected most severely by HIV and AIDS, namely well-educated middle-class gay men in developed countries. This particular group of people, highly sophisticated and used to political activism in its pursuit of civil rights-related objectives, engaged the medical profession as (...) well as regulatory agencies such as the US Food and Drug Administration, and legislators (more so in the USA than in other countries) in a number of bioethically interesting policy areas. Many of the controversies of the times were framed as civil rights and/or ethical disputes. The initial areas of concern and inquiry focused on: informed consent to HIV testing and trial participation, the confidentiality of HIV test results, access to trials as a means of access to experimental drugs, the length of time it took to get an experimental drug to the market approval stage, and end-of-life decision-making. This line-up of issues explains why AIDS has become such an interesting topic for bioethicists. Bioethicists concerned about the traditional breadand- butter themes of medical ethics themes of the doctor - patient relationship (e.g., Daniels, 1991; Boyd, 1992), as well as bioethicists more concerned about policy and regulatory issues in the drug research and approval process (e.g., Edgar & Rothman, 1990; Salisbury & Schechter, 1990), found research topics worthy of vigorous pursuit. No surprise, then, that HIV/AIDS led to a probably unprecedented number of books and articles in professional journals (Manuel et al., 1990). HIV/AIDS has become a permanent fixture in all major mainstream bioethics textbooks (e.g., Kuhse & Singer, 1998; Arras & Steinbock, 1999). Reference series in medicine, ethics and law provide for dedicated volumes on AIDS.1 Even specialist bioethics textbooks, for instance those directed at dentistry students, carry chapters on HIV/AIDS (Ozar & Sokol, 2002). 128 Udo Schuklenk AIDS, designated by the medical profession a pandemic lives up to its classification. It did not stop at the borders of developed countries. As one would expect of a primarily sexually transmitted illness in the age of globalisation, it spread rapidly across the globe. Indeed, in many countries it has become one of the main causes of death, as in sub- Saharan Africa (Shisana & Simbayi, 2002). Dramatic increases in the number of AIDS cases are predicted for many Eastern European countries as well as for the two most populous nations on earth, India and China. Some of the HIV/AIDS-related bioethical and policy issues of concern to developed countries remain the same for developing countries. However, in ethically important ways they are dwarfed by concerns over drug prices, intellectual property rights, and affordable access to essential AIDS drugs for the impoverished masses of infected people in such countries. Of increasing importance have become ethical issues pertaining to the ever-growing research industry associated with clinical trials undertaken in developing countries. Indeed, major funding initiatives both in the USA and UK have brought clinical research in developing countries into focus. Some have questioned whether this attention is appropriate, considering other bioethical problems of arguably greater importance to developing countries (Chadwick & Schuklenk, 2003). Standards of clinical care in a study, and after a trial has concluded, as well as community benefits and access to the trial regime after the trial’s conclusion remain contentious issues. It is worth noting that more often than not it was an AIDS-related trial or policy decision that led to a great deal of bioethical analysis, yet the issues discussed almost always have ramifications far beyond AIDS. For instance, decisions about the question of what (if any) standards of care failures in preventive trials (of HIV vaccines or microbicides) ought to receive have important implications for non-AIDS prevention trials. (shrink)

The recent Covid-19 pandemic has brought a broad range of ethical problems to the forefront, raising fundamental questions about the role of government in response to such outbreaks, the scarcity and allocation of health care resources, the unequal distribution of health risks and economic impacts, and the extent to which individual freedom can be restricted. In this clear introduction to the topic Iwao Hirose explores these ethical questions and analyzes the central issues in the ethics of pandemic response and preparedness (...) such as: The general nature of pandemics and the ethics of preparedness Ethical questions about general goals of pandemic response and preparedness The distribution of scarce resources, e.g., ventilators, hospital beds, antiviral drugs and vaccines Restrictions on individual freedom Ethical questions in the wake of pandemics, including contact-tracing, vaccine passports and socioeconomic inequalities. With the use of real-life examples and a clear philosophical approach, The Ethics of Pandemics is a much-needed introduction to some of the most important ethical issues surrounding pandemics. It is essential reading for students of ethics, bioethics, and political philosophy and will also be of interest to those working in related areas such as public policy, public health, health law, nursing and life sciences. (shrink)

Photo by Thought Catalog on Unsplash INTRODUCTION The coronavirus pandemic is a challenge to educators, policy makers, and ordinary people. In facing the threat from COVID-19, school systems and global institutions need “to address the essential matter of each human being and how they are interacting with, and affected by, a much wider set of biological and technical conditions.”[1] Educators must grapple with the societal issues that come with the intent of ensuring the safety of the public. To some, “these (...) are actually as important as the biological concerns of people.”[2] The current global crisis shows that “scientifically, socially, and politically the economy and technosphere are not just related, they are integral to a comprehensive response to major challenges.”[3] In developing these responses, scientists, government leaders, and policy makers need to consider the vulnerabilities of people, especially those in “thrown away” groups.[4] Jerome Ravetz explains that “microscopic viral predators cull our populations, as ever, but with a selection that is not natural but social and political.”[5] Educators must address the underlying vulnerabilities and evaluate the virus as a threat to academic experiences and access to a fair education. ANALYSIS • Critical Pedagogy By definition, the critical approach to teaching is about the problem-posing method of education developed by Paolo Freire. In his Pedagogy of the Oppressed, he proposed a paradigm shift away from the banking method of learning wherein teachers deposit knowledge into the minds of students. Critical pedagogy is an educational approach that challenges students to develop the ability to recognize and criticize dominating theories and evaluate them in their social context. Teachers press students to recognize oppression and try to remedy oppression in their culture.[6] Despite the lack of in-person interaction between the teacher and the students, the effort to use innovative teaching techniques like critical pedagogy should continue. Online learning is not just about the use of technology, although the internet is crucial in the delivery of content. Since human beings are creators of value, they determine the meaning and purpose of technology. In this way, the set of values people have will influence online learning. Teachers cannot be more concerned about outcomes than about the process itself. The process is crucial since the ability of the student to think critically is developed in the exchange between the student and the teacher. The teacher cannot simply dump loads of information (deposit knowledge) but must pose problems to test the analytical and critical skills of students.[7] Education is about how people humanize the world. Policy makers miss the point when they focus on the delivery but do not pay attention to the substantive aspect of learning, which is human empowerment. Education is meant to expand the freedom of people. Education should be seen as an integrative activity. Learning is a formative process that aims to develop the human person. Without the face-to-face encounter between teacher and students, the challenge is finding ways to make learning an effective means to mold the values of young people. • Online Critical Pedagogy & the Role of Technology Physical distance appears to be an impediment in realizing the ideals of learning. The lack of contact between the teacher and the students may prevent a more meaningful interaction since online instruction is impersonal. It can be argued that there is no alternative to some classroom activities, especially laboratory experiments in science courses. The total classroom environment naturally influences the behavior of students when it comes to academic work: the look in the eyes of the professor, the caring ways of a teacher, or the pressure while taking exams contribute to an experience that only a classroom setting can provide. If implemented properly, technology can facilitate the personal relationships between teachers and students while providing meaningful experiences. With the current need for online learning during the COVID-19 pandemic, gadgets are indispensable. Some would even consider gadgets an extension of the human body. A mobile phone is not just any instrument; it has evolved into a novel way of being in the world. Our gadgets are a means of seeing how the outside world unfolds. Modern technological tools allow the interface of people in many fields of experience in a globalized environment. Computers and other digital devices extend the meaning and value of human freedom. For example, a laptop provided to a poor child can redefine the meaning of and what the future might hold for that child. The device is crucial to the whole learning process. Modern tools are critical to self-discovery and greater freedom. The values that people embrace will matter in the new normal. The internet has provided a new democratic space that empowers groups and individuals to express themselves and to understand the world.[8] In an online class, students and teachers alike need to analyze big picture questions and layers of information. For example, the student in an ethics or philosophy class can reflect on the realities of life. With the proper guidance, online education should help define the meaning of moral commitment and human responsibility. CONCLUSION Before the pandemic, policy makers had been pursuing the goals of a globalized economy. They had been fashioning and promoting programs that cater to the interests of a consumer-driven world that has deprived the poor of opportunity. When the pandemic struck, globalization suddenly came to a halt and people realized the things that truly matter in life – family, love, and life itself. The new normal must now emphasize the role of education as a source of inner strength that can empower the person to live well reinforcing values based on a social consciousness. Critical pedagogy is possible under the new normal. The distance between the teacher and student does not make the educational process less real and in the absence of a vaccine, online learning is the safest strategy. Governments cannot freeze an entire school year since education is the only way out from poverty for millions. The COVID-19 pandemic provides a reason to re-imagine teaching using technology to encourage all students to question systems of oppression or greed, as the persistent pursuit of the truth is what education is all about. [1] Hartsell, Layne, Krabbe, Alexander, & Pastreich, Emmanuel. “Covid-19, Global Justice, and a New Biopolitics of the Anthropocene.” Social Ethics Society Journal of Applied Philosophy 6, no. 2 (2020), 3. [2] Ravetz, Jerome. “Science for a Proper Recovery: Post-Normal, not New Normal.” Issues in Science and Technology [Internet] July 15, 2020. https://issues.org/post-normal-science-for-pandemic-recovery/ [3] Hartsell, et al. “Covid-19, Global Justice, and a New Biopolitics of the Anthropocene,” 6. [4] Ravetz, “Science for a Proper Recovery: Post-Normal, not New Normal.” [5] Ibid. [6] Freire, Paolo. Pedagogy of the Oppressed. (New York: Continuum Books, 1993). [7] Freire writes that in such a situation “instead of communicating, the teacher issues communiqués and makes deposits which the students patiently receive, memorize, and repeat.” See his Pedagogy of the Oppressed. [8] Bakardjieva, Maria. Internet Society. (London: Sage Publications, 2005). (shrink)

BackgroundHuman infection studies (HIS) are valuable in vaccine development. Deliberate infection, however, creates challenging questions, particularly in low and middle-income countries (LMICs) where HIS are new and ethical challenges may be heightened. Consultation with stakeholders is needed to support contextually appropriate and acceptable study design. We examined stakeholder perceptions about the acceptability and ethics of HIS in Malawi, to inform decisions about planned pneumococcal challenge research and wider understanding of HIS ethics in LMICs.MethodsWe conducted 6 deliberative focus groups and 15 (...) follow-up interviews with research staff, medical students, and community representatives from rural and urban Blantyre. We also conducted 5 key informant interviews with clinicians, ethics committee members, and district health government officials.ResultsStakeholders perceived HIS research to have potential population health benefits, but they also had concerns, particularly related to the safety of volunteers and negative community reactions. Acceptability depended on a range of conditions related to procedures for voluntary and informed consent, inclusion criteria, medical care or support, compensation, regulation, and robust community engagement. These conditions largely mirror those in existing guidelines for HIS and biomedical research in LMICs. Stakeholder perceptions pointed to potential tensions, for example, balancing equity, safety, and relevance in inclusion criteria.ConclusionsOur findings suggest HIS research could be acceptable in Malawi, provided certain conditions are in place. Ongoing assessment of participant experiences and stakeholder perceptions will be required to strengthen HIS research during development and roll-out. (shrink)

The Power of Critical Thinking: Effective Reasoning About Ordinary and Extraordinary Claims explores the essentials of critical reasoning, argumentation, logic, and argumentative essay writing while also incorporating important topics that most other texts leave out, such as "inference to the best explanation," scientific reasoning, evidence and authority, visual reasoning, and obstacles to critical thinking.The text integrates many pedagogical features, including hundreds of diverse exercises, examples, and illustrations; text boxes that apply critical thinking to student experience; step-by-step guidelines for evaluating (...) claims, arguments, and explanations; a glossary of important terms; and many reminders, summaries, and review notes. New to this editionNew sections on topics suggested by reviewers - The coverage now includes more discussion of legal reasoning, rhetorical ploys, informal fallacies, probability and statistics, and necessary and sufficient conditions.New Essays for Analysis - Nine essays, several of them by women authors, have been added to the collection of "Essays for Evaluation" in Appendix A, each article accompanied by writing prompts and linked to writing assignments in every chapter. Four pairs of essays are arranged in a pro/con format, each pair debating a single issue. New topics include homosexuality, feminists and pornography, adultery, airport security screenings, women in Afghanistan, Islamic extremists and free speech, and fear of vaccines.New text boxes on current topics. The division of labor for the text boxes is the same, but some of the content is new. The three types of boxes are "Newsmakers" ; "From the Web" ; and "Further Thought".The chapter objectives now correspond to the point-by-point summary at the end of each chapter.Important Clarifications - The following discussions are now even clearer: scientific conservatism in theory choice, the relationship between enumerative induction and statistical syllogisms, and informal fallacies.Some new discussions: the straw man fallacy, biased opinion polls, dishonest political discourse, and gut reactions and intuitions. (shrink)

One of the perplexing features of an infectious disease is the damage it causes, not only to physical health, but to mental health and to social relationships. This tension between the separation that is required for safety and the human need for contact is especially felt by institutions of higher education. Many such institutions not only educate students but seek to foster the kinds of communities which have thrived on personal interaction and shared physical space. Different institutions have responded to (...) COVID-19 and its impacts on their members differently. Given that the spring semester will begin months before COVID-19 vaccines are widely available, we offer seven recommendations and argue that for a university, college, or other similarly situated educational institution to ethically respond to the pandemic, it must follow these recommendations. These recommendations are grounded in both scientific research and ethical analysis. Proper ethical analysis, which is necessary for the implementation of good policies, cannot be accomplished without an evidence-based grounding. After describing features of the virus and the situation that faces higher education institutions, in general, we turn to a detailed discussion of transmission. We discuss interventions available to institutions, including masking, hygiene, barriers, and testing and surveillance. Our recommendations are supported by an ethical analysis reliant on four themes: expertise, planning, stewardship, and dignity. (shrink)

Covid-19 has occasioned ongoing shifts in discourse as language changes to reflect and shape new stages of the global pandemic and different voices weigh in on topics, such as infectious diseases and vaccine efficacy. This study looks at an instance of this that relates to the ‘global education industry’, where cancellation of the International Baccalaureate’s May 2020 high stakes examination instigated a wide-ranging discussion about the organisation. This was triggered by the publication of IB results for 174,355 students in 146 (...) countries, many of which showed large discrepancies between predicted and final grades. Using computer-assisted discourse analysis and a corpus of tweets containing the hashtag #ibscandal, patterns of language use are analysed, providing valuable new insights into the impact on students in different national contexts. (shrink)

Previous research suggests a higher perceived risk associated with a risky behavior predicts a lower likelihood of involvement in that behavior; however, this relationship can vary based on personality characteristics such as impulsivity and behavioral activation. During the COVID-19 pandemic, individuals began to re-evaluate the level of risk associated with everyday behaviors. But what about risks associated with “typical” risk-taking behaviors? In the present study, 248 undergraduate student participants completed measures of impulsivity, behavioral activation and inhibition, propensity to take (...) risks, numeracy, and perceptions of and involvement in both risk-taking behavior and health promoting behavior. Our study revealed that higher behavioral inhibition and greater propensity to take risks predicted greater likelihood of involvement in COVID-19-related risk behaviors, even after accounting for perceived risks and benefits of the behavior. Greater likelihood of involvement in social risk behaviors was predicted by greater numeracy and risk-taking propensity. Identifying as male, a greater propensity to take risks, and greater impulsivity predicted increased health/safety risk behaviors. Younger age, lower risk-taking propensity, and lower impulsivity were associated with a greater likelihood of donating blood. For the likelihood of registering to become an organ donor, increasing risk perception, both before and during the pandemic, was associated with greater likelihood of registering, but greater risk-taking propensity was associated with a decreased likelihood of organ donation registration. For flu vaccination, a greater propensity to take risks was associated with a greater likelihood of flu vaccination during the 2020–2021 flu season. Both cognitive and personality factors can predict involvement in risk-taking and health-promotion behaviors, warranting their continued examination. (shrink)

This annual edited volume presents an overview of cutting-edge research areas within digital ethics as defined by the Digital Governance Research Group of the University of Oxford. It identifies new challenges and opportunities of influence in setting the research agenda in the field. The 2022 edition of the Yearbook presents research on the following topics: autonomous weapons, cyber weapons, digital sovereignty, smart cities, artificial intelligence for the Sustainable Development Goals, vaccine passports, and sociotechnical pragmatism as an approach to technology. This (...) text appeals to students, researchers, and professionals in the field. (shrink)

This book offers a novel theory of childhood well-being as a social good. It re-examines our fundamental assumptions about parenting, parental authority, and a liberal society's role in the raising of children. The author defends the idea that the good of a child is inexorably linked to the good of society. He identifies and critiques the problematic assumption that parenting is an extension of individual liberty and shows how we run into problems in medical decision-making for children because of this (...) assumption. He develops an objective conception of what is good for a child in liberal society, drawing on the assumptions of liberty, and from here constructs a set of things that society and its members owe children. There are ways in which society should support and intervene in parental decisions to guarantee a child's well-being. Ultimately, raising children is a social activity that requires input from society. The author then applies this theory of childhood well-being to develop a framework for medical decision-making for children. He also uses practical examples, such as vaccinations, parental leave, and healthcare access, to demonstrate the implications of his theory for public policy. The Limits of Parental Authority: Childhood Wellbeing as a Social Good will be of interest to research and advanced students working in bioethics, political philosophy, and public health policy. (shrink)

We write in response to the original article by Rennie and Rudland published in the April 2003 edition of this journal.1 Current and former Dundee Medical School students are concerned at the media misinterpretation of the study and the consequences that this branding of “dishonesty” will have on Dundee Medical School’s reputation and also on individuals embarking on their ….

I am an M.D/Ph.D. student and work as a research assistant for the director of a division of the school of medicine who is an M.D. He assigned me to research a certain topic and gave me no guidelines or guidance as to how to do it. Nevertheless, I did the research and wrote it up. My supervisor liked the report and said that he thought it was so good that “I would like to offer you the opportunity to (...) publish it and list you as the primary author.” Some bells went off when he so grandly offered to let me author the report for which I had done 100% of research and writing. I consulted some other people in the field and they said that, as long as I was the primary author, it was legitimate for him to list himself as secondary author if he did some editing later. After editing the abstract only, he e-mailed his revisions to me and in a note at the bottom he asked me what I thought of his revised author order. His name was first, mine second, and the name of his girlfriend was third. I was shocked by what seemed to be a case of unethical author attribution and confronted him asking why he changed the order when we had agreed that I was primary author. He said that he had put in several hours of work. (shrink)

Postural instability marks a prevalent symptom of Parkinson’s disease. It often manifests in increased body sway, which is commonly assessed by tracking the Center of Pressure. Yet, in terms of postural control, the body’s Center of Mass, and not CoP is what is regulated in a gravitational field. The aim of this study was to explore the effect of early- to mid-stage PD on these measures of postural control in response to unpredictable visual perturbations. We investigated three cohorts: 18 patients (...) with early to mid-stage PD [Hoehn & Yahr stage ; 1.94 ± 0.70]; a group of 15 age-matched controls ; and a group of 12 young healthy adults. Participants stood on a force plate to track their CoP, while the movement of their entire body was recorded with a video-based motion tracking system to monitor their CoM. A moving room paradigm was applied through a head-mounted virtual reality headset. The stimulus consisted of a virtual tunnel that stretched in the anterior-posterior direction which either remained static or moved back and forth in an unpredictable fashion.We found differences in mean sway amplitude and mean velocities of CoP and CoM between the groups under both conditions, with higher MSA of CoP and CoM for PD and higher mean velocities of both variables for PD and ECT when compared with YCT. Visual perturbation increased mean CoP velocity in all groups but did not have effects on mean CoM velocity or MSA. While being significantly lower for the young adults, the net effect of visual perturbation on mean CoP velocity was similar between patients with PD and age-matched controls. There was no effect of the visual perturbation on mean CoM velocity for any of the groups.Our simultaneous assessment of CoP and CoM revealed that postural control is reflected differently in CoM and CoP. As the motion of CoM remained mostly unaffected, all groups successfully counteracted the perturbation and maintained their balance. Higher CoP velocity for PD and ECT revealed increased corrective motion needed to achieve this, which however was similar in both groups. Thus, our results suggest increased effort, expressed in CoP velocity, to be an effect of age rather than disease in earlier stages of PD. (shrink)

In response to the COVID-19 pandemic, millions of students in China followed an emergency policy called “Suspending Classes without Stopping Learning” to continue their study online as schools across the country were closed. The present study examines how students adapted to learning online in these unprecedented circumstances. We aimed to explore the relationship between adaptability, academic emotion, and student engagement during COVID-19. 1,119 university students from 20 provinces participated in this longitudinal study (2 time points with a 2-week interval). (...) The results showed that adaptability (the ability to respond to changes) and student engagement are significantly positively correlated with positive academic emotion and negatively correlated with negative academic emotion. Furthermore, adaptability not only directly predicts student engagement, but also affects student engagement through the chain mediation of positive academic emotion and negative academic emotion. The results contribute to the gap in knowledge regarding changes in students’ learning in response to the outbreak. This study further explains the internal mechanisms mediating the relationship between adaptability and student engagement. It may provide references for educational researchers and universities in dampening the negative effects of COVID-19 on students’ learning by improving their adaptability and developing positive academic emotions. (shrink)

The focus of this article is university teachers’ and students’ views of plagiarism, plagiarism detection, and the use of plagiarism detection software as learning support. The data were collected from teachers and students who participated in a pilot project to test plagiarism detection software at a major university in Finland. The data were analysed through factor analysis, T-tests and inductive content analysis. Three distinct reasons for plagiarism were identified: intentional, unintentional and contextual. The teachers did not utilise plagiarism detection to (...) support student learning to any great extent. We discuss the pedagogical implications and suggest that the contextual reasons for plagiarism require focus primarily on study strategies, whereas the intentional reasons require profound discussion about attitudes and conceptions of good learning and university-level study habits. (shrink)

Cheaters and noncheaters were assessed on 2 types of motivation, on perceived social norms regarding cheating, on attitudes about cheating, and on knowledge of institutional policy regarding cheating behavior. All 5 factors were significant predictors of cheating rates. In addition, cheaters were found lower in mastery motivation and higher in extrinsic motivation in courses in which they cheated than in courses in which they did not cheat. Cheaters, in courses in which they cheated, were also lower in mastery motivation and (...) higher in extrinsic motivation than were noncheaters. Finally, cheaters differed from noncheaters on perceived social norms regarding cheating, on their knowledge of institutional policy regarding cheating, and on their attitudes toward cheating. Implications of these findings for institutional interventions are discussed. (shrink)

Academic integrity is becoming increasingly important to managing academic institutions. Accordingly there are efforts to uniformly assess campus attitudes to such issues as cheating in assessments along with the policies and procedures in place to address them. This paper seeks to summarize and understand the attitude of the students and academic staff at an Australian university towards academic integrity, as reflected in the results of a campus-wide survey, using both qualitative and quantitative analysis. The main finding of the quantitative results (...) was the disconnect between academic staff and students belief’s about academic honesty and the reactions of students and academics to dishonest behaviour. Four key themes of academic honesty were identified through qualitative analysis, being those of cheating, student, solutions to cheating and general concerns. (shrink)