Recent scholarship has considered the requirements of justice and economic regimes in the work of John Rawls. This work has not delved into the requirements of justice and liberal socialism as deeply as the work that has been done on property-owning democracy. A thorough treatment of liberal socialism and the requirements of justice is needed. This paper seeks to begin to fill this gap. In particular, it needs to be shown if liberal socialism fully answers the requirements of justice better (...) than property-owning democracy. It will be argued that liberal socialism does significantly better in realizing the two principles. This paper has the following structure, first, an overview of Rawls' position on economic regimes, capitalism, and the requirements of justice will be presented. In particular, how the two principles work in tandem to meet the demands of distributive justice will be considered. Second, a review of property-owning democracy will be conducted. Finally, liberal socialism will be examined and discussed as an economic regime that answers the requirements of justice more fully. (shrink)

Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation wishes. Second, families (...) can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (shrink)

Understanding science requires appreciating the values it presupposes and its social context. Both the values that scientists hold and their social context can affect scientific communication. Philosophers of science have recently begun studying scientific communication, especially as it relates to public policy. Some have proposed “guiding principles for communicating scientific findings” to promote trust and objectivity. This paper contributes to this line of research in a novel way using behavioural experimentation. We report results from three experiments testing judgments about the (...) trustworthiness, competence and objectivity of scientists. More specifically, we tested whether such judgments are affected by three factors: consulting or not consulting nonscientists, conducting research under a restrictive or non-restrictive governmental communication policy, and the source of a lab’s funding (i.e., government funding, private funding, or a combination of the two). We found that each of these factors affects ordinary judgments of trustworthiness, competence and objectivity. These findings support several recommendations that could help improve scientific communication and communication policies. (shrink)

Our reluctance to demystify grief is a sign of the distinctive obligation and discomfort that people feel towards those who have died. These feelings, however, are instructive about the nature of grief. As a vehicle of a living person’s relation to the dead, grief is mysterious—and we are rightly reluctant to take that mystery away. But grief is not to be avoided by philosophy on that account. I defend a less Romantic view of grief, in which a grieving person’s experience (...) of “normal” grief: 1) is felt to require an objectively recognized loss; 2) is felt to be dedicated to that lost object; 3) seems to most people to be something that she ought to feel; and 4) probably ought not to be medicalized, nor consequently medicated. This view of grief affords an understanding and appreciation of this rather special and important emotion without reducing its mystery. (shrink)

If business requires ethical solutions that are viable in the liminal landscape between concepts and corporate office, then business ethics and corporate social responsibility should offer tools that can survive the trek, that flourish in this well-traveled, but often unarticulated, environment. Indeed, feminist ethics produces, accesses, and engages such tools. However, work in BE and CSR consistently conflates feminist ethics and feminine ethics and care ethics. I offer clarification and invoke the analytic power of three feminist ethicists 'in action' whose (...) investigations into the "grey zones" of harms; identity and representational conventions; and "asymmetrical reciprocity" harmonize with business ethics' requirements. (shrink)

When Mill published The Subjection of Women in 1869 he wanted to replace the domination of one sex by the other laws based on ‘a principle of perfect equality’. It is widely complained, however, that even advanced countries have still failed to achieve equality between the sexes. Power and wealth and influence are still overwhelmingly in the hands of men. But equalities of these kinds are not the ones required by the principle of equality that Mill had in mind; and, (...) furthermore, a principle that demanded them would actually be incompatible with Mill’s. The conclusion is not, however, that social policies dealing with men and women are all they should be. It is just that although the fundamental problems of feminism could be – and to a considerable extent still can be – expressed in terms of requirements for justice and equality, we have now reached a stage where concentrating on these ideas can distort the real problems, and may actually impede the kind of progress that is needed. (shrink)

This paper examines visual representation from a distinctive, interdisciplinary perspective that draws on ethics, visual studies and critical race theory. Suggests ways to clarify complex issues of representational ethics in marketing communications and marketing representations, suggesting an analysis that makes identity creation central to societal marketing concerns. Analyzes representations of the exotic Other in disparate marketing campaigns, drawing upon tourist promotions, advertisements, and mundane objects in material culture. Moreover, music is an important force in marketing communication: visual representations in music (...) promotions are also explored as data for inquiry. Offers an alternative to phenomenologically based approaches in marketing and consumer research scholarship that use consumer responses to generate data. Contributes additional insight into societal marketing and places global marketing processes within the intersection of ethics, aesthetics and representation. (shrink)

The increasing application of artificial intelligence (AI) to healthcare raises both hope and ethical concerns. Some advanced machine learning methods provide accurate clinical predictions at the expense of a significant lack of explainability. Alex John London has defended that accuracy is a more important value than explainability in AI medicine. In this article, we locate the trade-off between accurate performance and explainable algorithms in the context of distributive justice. We acknowledge that accuracy is cardinal from outcome-oriented justice because it helps (...) to maximize patients’ benefits and optimizes limited resources. However, we claim that the opaqueness of the algorithmic black box and its absence of explainability threatens core commitments of procedural fairness such as accountability, avoidance of bias, and transparency. To illustrate this, we discuss liver transplantation as a case of critical medical resources in which the lack of explainability in AI-based allocation algorithms is procedurally unfair. Finally, we provide a number of ethical recommendations for when considering the use of unexplainable algorithms in the distribution of health-related resources. (shrink)

The mathematical developments of the 19th century seemed to undermine Kant’s philosophy. Non-Euclidean geometries challenged Kant’s view that there is a spatial intuition rich enough to yield the truth of Euclidean geometry. Similarly, advancements in algebra challenged the view that temporal intuition provides a foundation for both it and arithmetic. Mathematics seemed increasingly detached from experience as well as its form; moreover, with advances in symbolic logic, mathematical inference also seemed independent of intuition. This paper considers various philosophical responses to (...) these changes, focusing on the idea of modifying Kant’s conception of intuition in order to accommodate the increasing abstractness of mathematics. It is argued that far from clinging to an outdated paradigm, programs based on new conceptions of intuition should be seen as motivated by important philosophical desiderata, such as the truth, apriority, distinctiveness and autonomy of mathematics. (shrink)

Liao and Carbonell argue that medical devices are often not merely biased, but rather materialize oppression through the perpetuation of oppression into the present and future (Liao and Carbonell 2...

This article draws in particular on existential-phenomenological notions of “witnessing.” Witnessing, often conceived in the context of testimony, obviously involves epistemological concerns, such as how we come to know through the experiences and reports of others. I shall argue, however, that witnessing as a mode of intersubjectivity offers understandings that involve questions about how people come to be. More specifically, I want to consider the positive potential of “witnessing” to disrupt intersubjective completeness or closure, particularly as this relates to work (...) on organizing subjectivities, as well as, in the field of organization studies. (shrink)

Kevin Elliott’s A Tapestry of Values is a terrific book, chock full of valuable case studies and incisive analyses. It aims to be useful not only to students of philosophy of science and the other areas of science studies but also to practicing scientists, policymakers, and the public at large—a tall order. And it succeeds admirably for many of these folks. In my comments I suggest what it would need for the rest.

The context of international health research involving human subjects, and this should appear obvious, is the human community. As such, basic questions of how human beings should be treated by other human beings, particularly in situations of unequal power – e.g., in the form of control, choice, or opportunity – lay at the foundations of related ethical discourse when ethics are discussed at all. I trace a narrative that follows upon a recent revision process of international guidelines for biomedical research (...) involving human subjects. I focus in particular upon the issue of a standard of care. In the second section, I draw upon philosophers John Rawls, Claudia Card, and Allen Buchanan to discuss concerns regarding the 'least advantaged members of society' in the context of global inequality. The paper includes reflections upon pedagogy in courses focused upon international health research involving human subjects. (shrink)

The main aim of this article is to reflect on the impact of biases related to artificial intelligence (AI) systems developed to tackle issues arising from the COVID-19 pandemic, with special focus on those developed for triage and risk prediction. A secondary aim is to review assessment tools that have been developed to prevent biases in AI systems. In addition, we provide a conceptual clarification for some terms related to biases in this particular context. We focus mainly on nonracial biases (...) that may be less considered when addressing biases in AI systems in the existing literature. In the manuscript, we found that the existence of bias in AI systems used for COVID-19 can result in algorithmic justice and that the legal frameworks and strategies developed to prevent the apparition of bias have failed to adequately consider social determinants of health. Finally, we make some recommendations on how to include more diverse professional profiles in order to develop AI systems that increase the epistemic diversity needed to tackle AI biases during the COVID-19 pandemic and beyond. (shrink)

Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data collection (...) were performed by two or more independent reviewers for each record. -/- Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. -/- Conclusions: Public views on the authority of the family in organ donation decision-making require further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation. (shrink)

Abstract: This paper restates the thesis of 'The Requirements of Justice and Liberal Socialism" where it was argued that liberal socialism best meets Rawlsian requirements of justice. The recent responses to this paper by Jan Narveson, Jeppe von Platz, and Alan Thomas merit examination and comment. This paper shows that if Rawlsian justice is to be met, then non-personal property must be subject to public control. If just outcomes merit the public control of non-personal property and this control is not (...) utilized, then justice has been subordinated to the objectively less important institution of private property. (shrink)

In contrast to the successful previous year, 2020 turned out to be difficult, not only for the earth’s population due to COVID-19 but also for JDDM with an unusually small sixth volume. Looking back at these two very different years back-to-back led us to some reflection: As the COVID-19 pandemic forcefully illustrates, dynamic decision-making with all its complications and uncertainty is a topic of high relevance for modern societies.

Modern Monetary Theory and Distributive Justice shows how the macroeconomic framework called modern money theory (MMT) is relevant to the field of political philosophy called distributive justice. Many of the macroeconomic assumptions of distributive justice are unstated and unexamined. The framework of MMT illuminates these assumptions and provides an alternative vision of distributive justice analysis and prescriptions. In particular, MMT holds that modern money is a nominal state issued token (fiat), there is a distinction between nominal assets and real assets, (...) that state money as a nominal token can cause changes in real terms, and that the macroeconomy has historically not operated at capacity. The upshot of these assumptions held by MMT is that state spending can bring about changes in persons’ well-being without traditional redistributive measures via taxation. This is in contradistinction to standard assumptions in the distributive justice literature, which holds that the macroeconomy is at capacity and, thus, redistribution is the necessary mechanism for enacting improvements in well-being. This is a fundamental shift in how distributive justice can be conceived. (shrink)

Abstract: Minstrels are found in all parts of the world. They perform similar functions in their various societies. They are the custodian of the people’s history, entertainers, educationists, advisers and reconstructionists. The secret behind their success in their roles in the society lies in their ability to impress the audience during their performance. Performance plays an indispensable role in full actualization of the story being told as a full aesthetic experience. In this paper, the writer x-rays the roles of both (...) performance and the context of the play in reconstruction of the society especially in Upper Iweka area of Onitsha town. (shrink)

Rawls’s consideration not to include the choice of economic systems as part of a theory of justice is inconsistent with his comments on redistribution and the political effects of economic inequality. When Rawls’s discussion of economic systems and his discussion of economic inequalities is examined, it is apparent that the selection of economic systems is a pertinent topic for a theory of justice. The propensity for the primary social good of self-respect to be satisfied can be affected by the selection (...) of economic systems. Rawls has incorrectly determined the selection of economic systems to be unimportant if different economic systems can be more advantageous to the satisfaction of self-respect than others. When socialism and Rawls’s version of regulated capitalism are compared, socialism is a maximin solution, and accordingly will be selected by people within the original position under the veil of ignorance. (shrink)

The application of Artificial Intelligence (AI) in healthcare and epidemiology undoubtedly has many benefits for the population. However, due to its environmental impact, the use of AI can produce social inequalities and long-term environmental damages that may not be thoroughly contemplated. In this paper, we propose to consider the impacts of AI applications in medical care from the One Health paradigm and long-term global health. From health and environmental justice, rather than settling for a short and fleeting green honeymoon between (...) health and sustainability caused by AI, it should aim for a lasting marriage. To this end, we conclude by proposing that, in the upcoming years, it could be valuable and necessary to promote more interconnected health, call for environmental cost transparency, and increase green responsibility. (shrink)

This paper will show that Mary Wollstonecraft developed a modern feminist version of virtue ethics. Virtue ethics is an all-encompassing moral theory which holds that the best life for individuals is commensurate with a good society. Simply, self-interest and our public duties are argued as identical and not at odds when we realize what is truly good for ourselves and for others. In the Western philosophic cannon, the most common version of virtue ethics is Aristotle’s, with the Nicomachean Ethics as (...) the definitive presentation. Wollstonecraft’s argument for the political, social, economic, and personal equality of women utilizes ideas that are reminiscent of classical virtue ethics. Her novel and effective addition is to show that the explicit inclusion of women requires a reconsideration of the duties needed for happy lives to be led and for a good society, and good families, to exist. (shrink)

This paper will focus on the problem of environmental refugees related to environmental decay and resource loss. Robert Nozick’s distributive justice theory will be used as a theoretical framework to analyze the problem of environmental refugees. The restrictive nature of Nozick’s theory of distribution is rather practical since it meets with many of the current mores regarding wealth accumulation, desert, and aspirations for inheritance. Given our current reluctance to redistribute to prevent the effects of environmental decay, and to pay to (...) prepare for disasters generally, the prospect of a redistributive solution to environmental refugees that permanently alters patterns of ownership is rather unlikely. Nevertheless, given the rather unfortunate possibility of increasing numbers of environmental refugees in the future, a practical means to provide for their well-being needs to be considered. (shrink)

G.A. Cohen attempts to provide a case for socialism that takes into consideration the reasons why socialism is desirable and some of the problems for its feasibility. He finds that the kind of community sentiment that socialism requires is possible, but the devices of social organization that can facilitate the growth of socialist sentiment along with the effective transmission of information are not currently known. In short, Cohen thinks social scientists and philosophers need to find out how to harness the (...) information transmission capacity of market exchange without the motivational encouragement of rapacious self-interest that market exchange fosters. This paper argues that Cohen’s appraisal of the ineffectiveness of informational transmission in socialist planned economies in incorrect. A democratically planned socialist economy can serve as the basis for the fostering of the socialist community sentiment that Cohen advocates along with the required transmission of economic information. (shrink)

In his Republic, Plato argues that self-rulership cannot be widespread enough in a populace due to structural failures of education. This means that rulership by the few with the use of manipulative mythological devices is inevitable. That is, if a populace cannot rule themselves through the use of their reason, then they will be ruled by others through the use of myth, at best, and at worst, violence. Even given this rather grim conclusion, if we closely examine what Plato has (...) to say about politics, we can see that there is no natural impossibility for generalized rule by the many. That is, there is no aristocracy of birth, but there is an aristocracy of the educated. As I will show below, we can develop a more democratic politics out of Plato if we consider the possibility of a democratic education. Before I do that, I will briefly consider Rawls’ comments on the education of citizens for democracy. This will allow for a clearer consideration of the democratic potential of Plato’s political philosophy in his Republic. (shrink)

G.A. Cohen’s critique of the Rawlsian difference principle points out an inconsistency in its presentation. The initial equality decided by the participants in the original position under the veil of ignorance is not preserved by the inequality sanctioned by the difference principle. Cohen shows how the breakdown of the initial equality of the original position prevents the desired results of the Rawlsian system from being realized. Cohen argues that an egalitarian ethos is required within a society for equality preserving economic (...) distributions and Pareto superior outcomes to occur. Nonetheless, Cohen’s analysis of Rawls misses the ultimate cause of inequality, which is the dynamics of capital accumulation. An egalitarian ethos is only possible if there is a socialist mode of production to facilitate its development. Additionally, Cohen’s critique of Rawlsian constructivism through an argument for intuitionism does not address the natural-material existence of human beings. This existence must be considered for any advantageous social formation. (shrink)

Abstract: Folktale is universal. It is found in all parts of the world. One of the outstanding characteristics of folktale is the possession of trickster. Trickster has different name in the tales of different ethnic groups of the world. In Hausa, he is “ereke”, in Yoruba he is “ijapa”, in Ashanti (Ghana) he is “ananse”, in Trinidad, he is fox, in other parts of Europe, he is either rabbit, monkey or hare etc. A trickster is often something of a rogue. (...) He manages to extricate himself from intrigue and sometimes saves himself from dangerous situation by a display of mental ability. The trickster of the folktales of the Igbo people of Nigeria is tortoise ‘Mbe’. Tortoise is not an outstanding animal. In the case of gathering of animals, he would least be noticed. There are large, ferocious, and beautiful animals that would make the presence of tortoise unnoticed. But when it comes to folktales, tortoise is the smallest among the characters. He so much defeats other characters by his deceptions. His greatest weapon is lies. Most of Igbo folktales are moral tales. They teach moral, yet trickster plays prominent role in the tales of Igbo people. In other words trickster is used in the education of the young. The writer investigated to find reasons for such development through reading books and journals relating to the topic. She studied six Igbo folktales and also through oral interviews of some prominent Igbo people of ages ranging from 20-70 yrs of age. The writer found out amongst other things that Igbo world view on life is responsible to the use of tricksters in their education of the young. (shrink)

This paper will examine the three distributive problems of inequality, social scarcity, and environmental decay. All three of these problems are the result of economic growth that is not properly structured by institutions. It will be argued that each one of these distributive problems exacerbates the other two. Any solution to one of these problems must address the other two as well. This paper will show that these three distributive problems can be minimized through a combination of tax measures, institutional (...) changes, public employment creation, public service provision, and the nationalization of certain industries. (shrink)

Modern money theory is a conjecture concerning fiscal spending and the nature of money. I show that modern money theory provides two interesting insights into distributive justice that have not been addressed in the recent Anglo-American distributive justice literature: (i) that the nature of a sovereign fiat currency allows for some distributive conflicts to be avoided; and (ii) that recent Anglo- American distributive justice theories assume that the economy is at capacity. Based on this, I consider if the policy results (...) of modern money theory can help foster a sense of justice. (shrink)

Several European countries are approving legislative reforms moving to a presumed consent system in order to increase organ donation rates. Nevertheless, irrespective of the consent system in force, family's decisional capacity probably causes a greater impact on such rates. In this contribution we have developed a systematic methodology in order to analyse and compare European organ procurement laws, and we clarify the weight given by each European law to relatives' decisional capacity over individual's preferences (expressed or not while alive) regarding (...) the destination of his or her organs after death. In this sense, the results constitute the first comprehensive and comparative legislative mapping on European transplantation laws. (shrink)

Selgelid and Koplin’s article ‘Kidney Sales and the Burden of Proof’ (K&S 2019) presents a series of detailed and persuasive arguments, intended to demolish my own arguments against the prohibition of organ selling. And perhaps they might succeed, if the case described by the authors were anything like the one I actually make. However, notwithstanding the extensive quotations and the detailed explanations of the way I supposedly argue, this account of my position comprehensively mistakes both the conclusions I reach and (...) the arguments I give for them. -/- I know that there are around many misconceptions about my views on this subject, but I have always hoped they could not survive a reading of what I had actually written. I have just—after a gap of many years—looked again at the two most recent of the texts Koplin and Selgelid refer to, and it goes without saying that I can see various things I could now do better; but I do still find these misinterpretations hard to understand. And since anyone with nothing to go on but this article would reasonably conclude that the original texts were not worth reading, I am grateful to the editors for the opportunity to try to set the record straight. -/- I presume not many readers would be interested in a detailed comparative commentary on the texts, showing where this account gets my intentions wrong. I shall try instead to explain how what I do mean—and what I think I say—diverges from what is said here, and then go on to a brief outline of what my arguments and conclusions really are. I hope this may also give some sense of why, for all the opposition I have encountered since I was first drawn into this debate, I persist in thinking that the work I have been doing is important not only for this topic but for analysis in practical ethics more generally. (shrink)

Harm is a concept in philosophy that has been able to elude definition. Many attempts have been made to formulate a definition of harm, however they have all been futile. This has led many to question if it is even possible to define harm, or if we really even need a definition of harm? My answer to both of these questions is yes, harm is something that is worth caring about and has many practical implications in society today. The theories (...) of harm that have been the closest thus far have been comparative accounts of harm, which compare different states of the agent undergoing the harm. The most common of these comparative accounts has been the counterfactual comparative account of harm. This approach has faced many problems like preemption, overdetermination, and omission. I argue the comparative account of harm is correct, but the wrong comparison is being made. Instead of a counterfactual comparison we should make a temporal comparison, and evaluate whether or not the agent has become worse off than he or she was before the harming event occurred. First I will use Bradley’s model to sketch a brief definition checklist of harm. I will then briefly evaluate a general counterfactual theory of harm and illustrate why it falls short. Next I will pose the temporal comparative account of harm , and explain how it gets around the counterexamples that tripped up the counterfactual approach. Finally I will present some objections to TCA, and try to respond to them. (shrink)

Hun Chung’s recent article “Rawls’s Self-Defeat: A Formal Analysis” argues that the selection of results equivalent to justice as fairness can be derived by utilitarianism. Chung argues that these results can be achieved through the use of Rawls’s constructed utility function from his work Justice as Fairness. Although Chung’s article is finely argued and presented in great detail, this paper will show that Chung made three mistakes in the fundamentals of his argument. First, Chung mistakes Rawls’s constructed utility function as (...) actually utilitarian. Second, Chung confuses the motivations and the assumptions of those held by agents in the original position and those held by utilitarian agents. Last, Chung’s previous mistakes result in the incorrect conclusion that an equal distribution of resources will be selected by representative agents instead of the unequal distribution prescribed by the difference principle. (shrink)

Abstract: Nanka is in Orumba North Local Government Area in Anambra State of Nigeria. This work centred on the function of Nwadunu in Nanka administrative set up. This work is meant to make people understand administrative set up in Nanka clearer. Thus removing doubts that often arise as regards to the function of Nwadunu institution in Nanka. The work is also meant to draw the attention of researchers and educationist to the existence of this unique institution in Nanka. The researcher’s (...) paper being a stepping stone from where other researchers can take off. In carrying out this research, the researcher prepared questionnaires for oral interviews which the researcher administered on Nwadunu himself, the clan head of Umudunu quarter, Nanka and some selected elders from the seven villages that make up Nanka. From analysis of the responses, the researcher was able to arrive at conclusion of what Nwadunu’s position in administration set up in Nanka is. (shrink)

Abstract: When in 1846, Euhemerus, a Greek philosopher propounded a theory that all Greek gods were once men who were deified in their life time and worshipped as a god after their death. The Greeks never take the assertion kindly. Euphemerus was accused of sacrilege. Later findings by anthropologists proved Euphemerus correct. Heroes and deification of heroes are found in different parts of the world. The writer is aware that deification of a hero is a symbiotic venture. This means that (...) the hero might have worked so hard in solving the people’s problems, the people in return deifies him. In this write up, the writer is looking for the significance of this deification. The writer through oral interviews, visit to library and reading relevant books on the topic is able to arrive at the answer as stated in the write up. (shrink)

Background Consent policies for post-mortem organ procurement (OP) vary throughout Europe, and yet no studies have empirically evaluated the ethical implications of contrasting consent models. To fill this gap, we introduce a novel indicator of governance quality based on the ideal of informed support, and examine national differences on this measure through a quantitative survey of OP policy informedness and preferences in seven European countries. -/- Methods Between 2017–2019, we conducted a convenience sample survey of students (n = 2006) in (...) Austria (AT), Belgium (BE), Denmark (DK), Germany (DE), Greece (GR), Slovenia (SI) and Spain (ES), asking participants about their donation preferences, as well as their beliefs and views about the policy in place. From these measures, we computed indices of informedness, policy support, and fulfilment of unexpressed preferences, which we compared across countries and consent systems. -/- Results Our study introduces a tool for analyzing policy governance in the context of OP. Wide variation in policy awareness was observed: Most respondents in DK, DE, AT and BE correctly identified the policy in place, while those in SI, GR and ES did not. Respondents in opt-out countries (AT, BE, ES and GR) tended to support the policy in place (with one exception, i.e., SI), whereas those in opt-in countries (DE and DK) overwhelmingly opposed it. These results reveal stark differences in governance quality across countries and consent policies: We found a preponderance of informed opposition in opt-in countries and a general tendency towards support–either informed or uninformed–in opt-out countries. We also found informed divergence in opt-in countries and a tendency for convergence–either informed or uninformed–among opt-out countries. -/- Conclusion Our study offers a novel tool for analyzing governance quality and illustrates, in the context of OP, how the strengths and weaknesses of different policy implementations can be estimated and compared using quantitative survey data. (shrink)

Background: Several countries have recently changed their model of consent for organ donation from opt-in to opt-out. We undertook a systematic review to determine public knowledge and attitudes towards these models in Europe. Methods: Six databases were explored between 1 January 2008 and 15 December 2017. We selected empirical studies addressing either knowledge or attitudes towards the systems of consent for deceased organ donation by lay people in Europe, including students. Study selection, data extraction, and quality assessment were conducted by (...) two or more reviewers independently. Findings: Awareness of the consent model was lower in opt-out countries than in opt-in countries. A majority of the public agrees with opt-in, regardless of the law in their own country. There are ambivalent attitudes regarding the opt-out system. The public tend to prefer opt-in and mandatory choice over opt-out when several options are offered. Interpretation: The assumption that people in opt-out countries are aware of the legal requirements to be excluded from the pool of potential donors is not supported by the results of this review. This is a concern, since ignorance hinders people's autonomy regarding organ donation decision-making. Higher awareness of consent model in opt-in countries may reflect greater efforts to inform the public through campaigns to motivate donation. Legal moves towards opt-out are at odds with people's expressed preferences. Main limitations of this review are the lack of data from some countries, study population heterogeneity, and methodological shortcomings. (shrink)

The European Medical Information Framework project, funded through the IMI programme, has designed and implemented a federated platform to connect health data from a variety of sources across Europe, to facilitate large scale clinical and life sciences research. It enables approved users to analyse securely multiple, diverse, data via a single portal, thereby mediating research opportunities across a large quantity of research data. EMIF developed a code of practice to ensure the privacy protection of data subjects, protect the interests of (...) data sharing parties, comply with legislation and various organisational policies on data protection, uphold best practices in the protection of personal privacy and information governance, and eventually promote these best practices more widely. EMIF convened an Ethics Advisory Board, to provide feedback on its approach, platform, and the EcoP. The most important challenges the ECoP team faced were: how to define, control and monitor the purposes for which federated health data are used; the kinds of organisation that should be permitted to conduct permitted research; and how to monitor this. This manuscript explores those issues, offering the combined insights of the EAB and EMIF core ECoP team. For some issues, a consensus on how to approach them is proposed. For other issues, a singular approach may be premature but the challenges are summarised to help the community to debate the topic further. Arguably, the issues and their analyses have application beyond EMIF, to many research infrastructures connected to health data sources. (shrink)

Background Analysis of aphasic narratives can be a challenge for clinicians. Previous studies have mainly employed measures that categorized speech samples at the word level. They included quantification of the use and misuse of different word classes, presence and absence of narrative contents and errors, paraphasias, and perseverations, as well as morphological structures and errors within a narrative. In other words, a great amount of research has been conducted in the aphasiology literature focusing on micro-linguistic structures of oral narratives. Aspects (...) of macro- linguistic structures, such as the analysis of content information by a speaker, consistency of using cohesive devices to present information within a narrative, and order of presenting information necessary to form a coherent discourse, have not been extensively investigated. The current investigation proposes a clinical analytic system to target three aspects of macro-linguistic structures in narratives among speakers with aphasia. Specifically, (1) the presence of search events (i.e., the mentioning of key events that allow the listener to understand; Capilouto, Wright, &Wagovich, 2006) within a narrative, (2) the sequence of the mentioned events, and (3) the informativeness (i.e., the fulfillment of lexical items that allow the user to understand what the event is detailing) of the event contents, were focused in the proposed framework. Method Ten controls transcripts from were selected from the AphasiaBank (MacWhinney, Fromm, Forbes, & Holland, 2011). Three narrative tasks, including sequential picture description of ‘Refused Umbrella’, procedural narrative of making a ‘Peanut Butter and Jelly Sandwich’, and telling of ‘Cinderella’ story, were used to establish normative data for the basis of analysis. Specifically, the Search Events (e) and Informative Words (i) used by at least 70% of the speakers were listed for each genre. The sequential order of mentioning the Search Events, i.e., common order of events in 90% of the speakers, (s.total) was determined. Twelve speakers with aphasia (nine fluent and three non-fluent) were recruited and administered the Western Aphasia Battery and Object and Action Naming Battery. Their performance in the above three discourse tasks were orthographically transcribed and analyzed using the following measures: e.total, e.matched with norm, e.missed, e.irrlevant, e.extra, s.total, i.pb&j, i.umbr, i.cind, and i.total. Three samples were randomly chosen to be re-analyzed for inter- and intra-rater reliability. Results Results of an independent t-test suggested significant differences between the fluent and non-fluent subjects in sequential order of Search Events for all genres (s.total) and i.total, suggesting sensitivity of this framework to differentiate between the two fluency groups. Results of Pearson product-moment correlations revealed significant relation between Informative Words and WAB spontaneous speech scores, AQ, as well as OAB scores, for both aphasic groups. The mean value of coefficients for intra-rater reliability (0.992), with significant correlations on e.match, e.miss, and e.extra, was higher than that of inter-rater reliability (0.897). Discussion Based on our preliminary results, this objective framework allowed clinical evaluation of impairment in macro-linguistic structures present in aphasic discourse. Further extension should involve more subjects encompassing a wider range of severity with different types of aphasia. (shrink)

Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the role of the family in (...) the decision-making process. This study does not take into account any indirect effects of defaults, such as potential psychological and behavioural effects on individuals and their relatives. -/- Design Based on previous work regarding consent policies, we created a conceptual model of the decision-making process for deceased organ recovery that included any scenario that could be directly influenced by opt-in or opt-out policies. We then applied this model to internationally published data of the consent process to determine how frequently policy defaults could apply. -/- Main outcome measures We measure the direct impact that opt-in and opt-out policies have per se on deceased organ recovery. -/- Results Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. They only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The direct impact of consent policy defaults is typically circumscribed to a range of 0%–5% of all opportunities for organ recovery. Our study also shows that the intervention of the family improves organ retrieval under opt-in but hinders it under opt-out. -/- Conclusions This study may warn policy makers that, by emphasising the need to introduce presumed consent to increase organ recovery rates, they might be overestimating the influence of the default and underestimating the power granted to families. (shrink)

Janet Malek (91–102, 2019) argues that a “clinical ethics consultant’s religious worldview has no place in developing ethical recommendations or communicating about them with patients, surrogates, and clinicians.” She offers five types of arguments in support of this thesis: arguments from consensus, clarity, availability, consistency, and autonomy. This essay shows that there are serious problems for each of Malek’s arguments. None of them is sufficient to motivate her thesis. Thus, if it is true that the religious worldview of clinical (...) ethics consultants should play no role whatsoever in their work as consultants, this claim will need to be defended on some other ground. (shrink)

Daniel Susskind examines how machines will generate more prosperity, but he is convinced that their proliferation will have some alarming consequences, like higher income inequality, dangerous greed for power to control others, and a world in which people lose their sense of meaning in life for lack of work.

It is no accident that white privilege designed to be both be invisible and weightless to white people. Alison Bailey’s “On White Privilege and Anesthesia: Why Does Peggy McIntosh’s Knapsack Feel Weightless?” extends a weighty invitation white readers to complete the unpacking task McIntosh (1988) began when she compared white privilege to an “invisible and weightless knapsack.” McIntosh focuses primarily making white privilege visible to white people. Bailey’s project continues the conversation by extending a ‘weighty invitation’ to white readers to (...) explore why the metaphorical knapsack, despite the weight of its contents, feels weightless. Here’s the short answer. The knapsack only feels weightless because white people have become anesthetized us to our own brokenness. We are more comfortable considering what white privilege does for us than what it does to us. People of color feel the weight of whiteness every day. The weighty invitation invites white readers to become sensitive to our own insensitivity. To do this Bailey (1) explores white resistance to unpacking the weight; (2) people of color’s testimonies to the daily impact of the weight on their bodies; and (3) how the anesthesia of white privilege distorts our humanity. The article concludes with a McIntosh style list of that the anesthesia of privilege distorts white people’s humanity. (shrink)

Review of All Things Wise and Wonderful by E. Janet Warren.

In a work recently published as part of the Cambridge Elements series, Janet Levin brings together the most important contemporary theories that attempt to answer the question of the mental. In her book, The Metaphysics of Mind (2022), she acknowledges that the metaphysical questions surrounding the mind should be distinguished from the epistemological and moral ones. While taking into consideration the implications of the epistemological and moral questions for the metaphysics of mind, Levin focuses primarily on the metaphysical questions. (...) To accomplish the task at hand, she analyzes Dualism, Type-Identity Theory, Role Functionalism, Russellian Monism, and Eliminativism (or Illusionism). As she makes clear at the outset of her book, the aim of her text is not to argue for or against a certain metaphysical theory of mind, but rather to assess the merits and demerits of each theory objectively. A good metaphysics of mind should account for certain elements that are taken to be key to the controversy over the mental. These elements range from the qualitative character of sensations and perceptual experiences, the outer-directedness of intentional states (beliefs, desires, etc.) to — basically— the space the mind occupies in nature as a whole. In this piece, I review each theory of mind separately, as approached by Levin. Then I conclude my review with some critical remarks about the book. (shrink)

Behaviorism was a peculiarly American phenomenon. As a school of psychology it was founded by John B. Watson (1878-1958) and grew into the neobehaviorisms of the 1920s, 30s and 40s. Philosophers were involved from the start, prefiguring the movement and endeavoring to define or redefine its tenets. Behaviorism expressed the naturalistic bent in American thought, which came in response to the prevailing philosophical idealism and was inspired by developments in natural science itself. There were several versions of naturalism in American (...) philosophy, and also several behaviorisms. Most behaviorists paid homage to Darwinian functionalism; all forswore introspection and made learned changes in behavior the primary subject matter and explanatory domain of psychology. They differed in their descriptions of behavior, modes of explanation, and attitudes toward mentalistic concepts. Watson was a strict materialist who wanted to eliminate all mentalistic talk from psychology. Edward Chace Tolman (1886-1959) regarded mind as a biological function of the organism. He permitted mentalistic terms such as 'purpose' in behavioral description, and posited intervening processes that included 'representations' of the environment, while requiring such processes be studied only as expressed in behavior. Clark L. Hull (1884-1952) developed a hypothetical-deductive version of behaviorism, akin to Tolman's functionalism in positing intervening variables but without his cognitivist constructs. B. F. Skinner (1904-90) rejected intervening variables and developed his own account of the behavior of the whole organism, based on the laws of operant conditioning. The naturalism in American philosophy of the early twentieth century showed respect for the natural sciences, especially biology and psychology. John Dewey (1896, 1911), George Santayana (1905, 1920), and F. J. E. Woodbridge (1909, 1913) expressed this attitude. It animated the neorealism of E. B. Holt and Ralph Barton Perry, who gave special attention to psychology, and the evolutionary naturalism and critical realism of Roy Wood Sellars. This naturalism differed from Watson's in regarding mind as part of nature from a Darwinian and functionalist perspective, and treating behavior as the product of the mental functioning. It fed Tolman's version of behaviorism. It was not materialistic or physical-reductionist. Only later, with Quine and logical empiricism, was behaviorism seen as essentially physicalistic. (shrink)