The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

Political theorists have long criticized policies that deny voting rights to convicted felons. However, some have recently turned to democratic theory to defend this practice, arguing that democratic self-determination justifies, or even requires, disenfranchising felons. I review these new arguments, acknowledge their force against existing criticism, and then offer a new critique of disenfranchisement that engages them on their own terms. Using democratic theory’s “all-subjected principle,” I argue that liberal democracies undermine their own legitimacy when they deny the vote to (...) felons and prisoners. I then show how this argument overcomes obstacles that cause problems for other critiques of disenfranchisement. (shrink)

Ambient assisted living technologies are increasingly presented and sold as essential smart additions to daily life and home environments that will radically transform the healthcare and wellness markets of the future. An ethical approach and a thorough understanding of all ethics in surveillance/monitoring architectures are therefore pressing. AAL poses many ethical challenges raising questions that will affect immediate acceptance and long-term usage. Furthermore, ethical issues emerge from social inequalities and their potential exacerbation by AAL, accentuating the existing access gap between (...) high-income countries and low and middle-income countries. Legal aspects mainly refer to the adherence to existing legal frameworks and cover issues related to product safety, data protection, cybersecurity, intellectual property, and access to data by public, private, and government bodies. Successful privacy-friendly AAL applications are needed, as the pressure to bring Internet of Things devices and ones equipped with artificial intelligence quickly to market cannot overlook the fact that the environments in which AAL will operate are mostly private. The social issues focus on the impact of AAL technologies before and after their adoption. Future AAL technologies need to consider all aspects of equality such as gender, race, age and social disadvantages and avoid increasing loneliness and isolation among, e.g. older and frail people. Finally, the current power asymmetries between the target and general populations should not be underestimated nor should the discrepant needs and motivations of the target group and those developing and deploying AAL systems. Whilst AAL technologies provide promising solutions for the health and social care challenges, they are not exempt from ethical, legal and social issues. A set of ELSI guidelines is needed to integrate these factors at the research and development stage. (shrink)

This report highlights and explores five questions which arose from The Unity of Consciousness and Sensory Integration conference at Brown University in November of 2011: 1. What is the relationship between the unity of consciousness and sensory integration? 2. Are some of the basic units of consciousness multimodal? 3. How should we model the unity of consciousness? 4. Is the mechanism of sensory integration spatio-temporal? 5. How Should We Study Experience, Given Unity Relations?

This is an excerpt of a report that highlights and explores five questions which arose from The Unity of Consciousness and Sensory Integration conference at Brown University in November of 2011. This portion of the report explores the question: Is the mechanism of sensory integration spatio-temporal?

This is an excerpt of a report that highlights and explores five questions which arose from The Unity of Consciousness and Sensory Integration conference at Brown University in November of 2011. This portion of the report explores the question: Are some of the basic units of consciousness multimodal?

This is an excerpt of a report that highlights and explores five questions which arose from The Unity of Consciousness and Sensory Integration conference at Brown University in November of 2011. This portion of the report explores the question: How should we model the unity of consciousness?

This is an excerpt of a report that highlights and explores five questions which arose from The Unity of Consciousness and Sensory Integration conference at Brown University in November of 2011. This portion of the report explores the question: How should we study experience, given unity relations?

Ideal rule utilitarianism says that a moral code C is correct if its acceptance maximizes utility; and that right action is compliance with C. But what if we cannot accept C? Rawls and L. Whitt suggest that C is correct if accepting C maximizes among codes we can accept; and that right action is compliance with C. But what if merely reinforcing a code we can't accept would maximize? G. Trianosky suggests that C is correct if reinforcing it maximizes; (...) and that right action is action that has the effect of reinforcing compliance with C. I object to this and argue that C is correct if both accepting and reinforcing C would maximize and if C is reinforcible; and that right action consists in coming as close as possible to perfect acceptance of and compliance with C. (shrink)

This article considers the question ‘What makes hope rational?’ We take Adrienne Martin’s recent incorporation analysis of hope as representative of a tradition that views the rationality of hope as a matter of instrumental reasons. Against this tradition, we argue that an important subset of hope, ‘fundamental hope’, is not governed by instrumental rationality. Rather, people have reason to endorse or reject such hope in virtue of the contribution of the relevant attitudes to the integrity of their practical identity, (...) which makes the relevant hope not instrumentally but intrinsically valuable. This argument also allows for a new analysis of the reasons people have to abandon hope and for a better understanding of non-fundamental, ‘prosaic’ hopes. (shrink)

In the intersection between eugenics past and present, disability has never been far beneath the surface. Perceived and ascribed disabilities of body and mind were one of the core sets of eugenics traits that provided the basis for institutionalized and sterilization on eugenic grounds for the first 75 years of the 20th-century. Since that time, the eugenic preoccupation with the character of future generations has seeped into what have become everyday practices in the realm of reproductive choice. As Marsha Saxton (...) (2000) and Adrienne Asch (2000, 2003) have forcefully argued, the use of prenatal screening technologies to facilitate the selective abortion of fetuses with features that signify disabling traits—the paradigm here being trisomy 21 in a fetus indicating Down Syndrome in the child—express a negative view of such disabilities sufficient to warrant terminating an otherwise wanted pregnancy. The eliminative structure of what Rosemary Garland Thompson (2012) has called eugenic logic persists in contemporary practices governing reproductive choice, social inclusion, and democratic participation and their relationship to disability. The tie between eugenics and contemporary disability studies suggests that eugenics and reflection on its history can also play a more positive role in disability politics. After focusing on eugenics in the first half of the paper, we will shift in the second half of the paper to eugenic resonances in contemporary thought and practice, concluding with some thoughts about ongoing practices of silencing and the very idea of eradicating disability. (shrink)