Second part of the translation into Spanish of David Lewis' "New Work for a Theory of Universals", corresponding to the last sections of the original paper. || Segunda parte de la traducción al español del trabajo de David Lewis "New Work for a Theory of Universals", correspondiente a últimas secciones del artículo original. Artículo original publicado en: Australasian Journal of Philosophy, Vol. 61, No. 4, Dec. 1983, pp. 343-377.

First part of the translation into Spanish of David Lewis' "New Work for a Theory of Universals", corresponding to the introduction and the first two sections of the original paper. || Primera parte de la traducción al español del trabajo de David Lewis "New Work for a Theory of Universals", correspondiente a la introducción y las dos primeras secciones del artículo original. Artículo original publicado en: Australasian Journal of Philosophy, Vol. 61, No. 4, Dec. 1983, pp. 343-377.

There is a widely acknowledged shortage of and an increasing demand for transplantable human organs and tissues (e.g., kidney, heart, lung, liver, cornea) in developed and developing countries around the world. In response to this need, Lott and Savulescu (2007) propose the creation of a human embryonic stem (hESC) bank to facilitate the equitable and efficient dissemination of human leukocyte anti- gen (HLA) matched tissues and organs to patients in need of replacement. Although not an unreasonable proposal, the authors go (...) on to make a much stronger claim. They argue that hESCs are such important tools for addressing the massive unmet global need for organs that it is ethically justified to require mandatory banking of spare embryos, and they argue for the use of financial (or other) inducements to procure embryos for the derivation of hESCs. (shrink)

While there has been significant discussion in the health sciences and ethics literatures about problems associated with publication practices (e.g., ghost- and gift-authorship, conflicts of interest), there has been relatively little practical guidance developed to help researchers determine how they should fairly allocate credit for multi-authored publications. Fair allocation of credit requires that participating authors be acknowledged for their contribution and responsibilities, but it is not obvious what contributions should warrant authorship, nor who should be responsible for the quality and (...) content of the scientific research findings presented in a publication. In this paper, we review arguments presented in the ethics and health science literatures, and the policies or guidelines proposed by learned societies and journals, in order to explore the link between author contribution and responsibility in multi-author multidisciplinary health science publications. We then critically examine the various procedures used in the field to help researchers fairly allocate authorship. (shrink)

Efforts to bridge emotion theory with neurobiology can be facilitated by dynamic systems (DS) modeling. DS principles stipulate higher-order wholes emerging from lower-order constituents through bidirectional causal processes cognition relations. I then present a psychological model based on this reconceptualization, identifying trigger, self-amplification, and self-stabilization phases of emotion-appraisal states, leading to consolidating traits. The article goes on to describe neural structures and functions involved in appraisal and emotion, as well as DS mechanisms of integration by which they interact. These mechanisms (...) include nested feedback interactions, global effects of neuromodulation, vertical integration, action-monitoring, and synaptic plasticity, and they are modeled in terms of both functional integration and temporal synchronization. I end by elaborating the psychological model of emotion–appraisal states with reference to neural processes. (shrink)

Genetic testing in the workplace is a technology both full of promise and fraught with ethical peril. Though not yet common, it is likely to become increasingly so. We survey the key arguments in favour of such testing, along with the most significant ethical worries. We further propose a set of pragmatic criteria, which, if met, would make it permissible for employers to offer (but not to require) workplace genetic testing.

The concept of the analyst's presence gained attention almost 60 years ago through the writings of the French analyst Sacha Nacht and the Hungarian-British Michael Balint. Anna Freud earlier spoke of the related, but rather ambiguous term "real person of the analyst," which has been widely discussed by many authors since. Both terms- presence and real person- appear frequently in the psychoanalytic literature, usually without much definition or conceptual clarity. Authors have used them in different ways, but in general their (...) intention has been to contrast the analyst's reality as a person with his function as a transference and fantasy object, perhaps as a corrective to the perceived austerity of the classical « one-person » model. Lacan's work represents an exception in attempting to escape the dialectic between intra and inter-psychic, but at the cost of eliminating the influence of the analyst as another subject. In contrast to metapsychologic theories of the mind, the author argues that "real presence" can be better understood as part of the phenomenologic experience of intersubjectivity, The co-presence of the analyst is fundamental to the encounter, rather than an accidental or intentional disruption. (shrink)

What is it to be mentally healthy? In the ongoing movement to promote mental health, to reduce stigma, and to establish parity between mental and physical health, there is a clear enthusiasm about this concept and a recognition of its value in human life. However, it is often unclear what mental health means in all these efforts and whether there is a single concept underlying them. Sometimes, the initiatives for the sake of mental health are aimed just at reducing mental (...) illness, thus implicitly identifying mental health with the absence of diagnosable psychiatric disease. More ambitiously, there are high-profile proposals to adopt a positive definition, identifying mental health with psychic or even overall well-being. We argue against both: a definition of mental health as mere absence of mental illness is too thin, too undemanding, and too closely linked to psychiatric value judgments, while the definition in terms of well-being is too demanding and potentially oppressive. As a compromise, we sketch out a middle position. On this view, mental health is a primary good, that is, the psychological preconditions of pursuing any conception of the good life, including well-being, without being identical to well-being. (shrink)

Theory of "conceptual pragmatism" takes into account both modern philosophical thought and modern mathematics. Stimulating discussions of metaphysics, a priori, philosophic method, much more.

Research on research ethics—regarding both the governance and practice of the ethical review of human subjects research—has a tumultuous history in North America and Europe. Much of the academic literature focuses on issues to do with regulating the conduct and quality of ethics review of research protocols by ethics committees (research ethics boards (REBs) in Canada and institutional review boards (IRBs) in the United States). In addition, some of the literature attends to issues particular to the review of qualitative research, (...) and still other literature addresses the challenges posed by and the need for research on REBs/IRBs. It is this third group of literature within which our article is situated. (shrink)

Recently, the practice of deciding legal cases on purely statistical evidence has been widely criticised. Many feel uncomfortable with finding someone guilty on the basis of bare probabilities, even though the chance of error might be stupendously small. This is an important issue: with the rise of DNA profiling, courts are increasingly faced with purely statistical evidence. A prominent line of argument—endorsed by Blome-Tillmann 2017; Smith 2018; and Littlejohn 2018—rejects the use of such evidence by appealing to epistemic norms that (...) apply to individual inquirers. My aim in this paper is to rehabilitate purely statistical evidence by arguing that, given the broader aims of legal systems, there are scenarios in which relying on such evidence is appropriate. Along the way I explain why popular arguments appealing to individual epistemic norms to reject legal reliance on bare statistics are unconvincing, by showing that courts and individuals face different epistemic predicaments (in short, individuals can hedge when confronted with statistical evidence, whilst legal tribunals cannot). I also correct some misconceptions about legal practice that have found their way into the recent literature. (shrink)

If I were asked to put forward an ethical principle which I considered to be especially certain, it would be that no one can be responsible, in the properly ethical sense, for the conduct of another. Responsibility belongs essentially to the individual. The implications of this principle are much more far-reaching than is evident at first, and reflection upon them may lead many to withdraw the assent which they might otherwise be very ready to accord to this view of responsibility. (...) But if the difficulties do appear to be insurmountable, and that, very certainly, does not seem to me to be the case, then the proper procedure will be, not to revert to the barbarous notion of collective or group responsibility, but to give up altogether the view that we are accountable in any distinctively moral sense. (shrink)

Researchers face perennial difficulties in studying live jury deliberation. As a result, the academic community struggles to reach a consensus on key matters of legal reform concerning jury trials. The hurdles faced by empirical jury researchers are often legal or institutional. This note argues that the legal and institutional barriers preventing live deliberation research should be removed and discusses two forms that live deliberation research could take.

Recent years have seen fresh impetus brought to debates about the proper role of statistical evidence in the law. Recent work largely centres on a set of puzzles known as the ‘proof paradox’. While these puzzles may initially seem academic, they have important ramifications for the law: raising key conceptual questions about legal proof, and practical questions about DNA evidence. This article introduces the proof paradox, why we should care about it, and new work attempting to resolve it.

The editor's introduction discusses Clarence I. Lewis's conceptual pragmatism when compared with post-empiricist epistemology and argues that several Cartesian assumptions play a major role in the work, not unlike those of Logical Positivism. The suggestion is made that the Cartesian legacy still hidden in Logical Positivism turns out to be a rather heavy ballast for Lewis’s project of restructuring epistemology in a pragmatist key. More in detail, the sore point is the nature of inter-subjectivity. For Lewis, no (...) less than for the Logical Positivists at the time of the Protocols Controversy and Husserl in the Cartesian Meditations, this is a problem without a solution. The reason is that all these philosophers are apparently unable to realize that the existence of a plurality of knowing subjects cannot be treated at once both as a speculative problem and a methodological one. Lewis, thanks to his pragmatist approach both comes closer to the right answer and offers an even more naïve unsatisfactory solution to the pseudo-problem under discussion. The fact that he has clear in mind that inter-subjectivity means not only a plurality of linguistic utterances but also a co-existence of different kinds of practical behaviour. Eventually, the very idea of mind, the key-idea in the book, suffers from the above mentioned tension. In fact, if inter-subjective communication and action is considered at a methodological level, the very idea of mind would not need an analysis, and no kind of ‘reflexive’ analysis. Methodology might be limited to a ‘naïve’ level where the existence of the world and a plurality of subjects be taken as a bedrock of uncritically accepted evidence. Philosophical reflection on ultimate evidence, instead, would take a different approach, maybe the one Wittgenstein was putting into practice in the same years when Mind and the world order was written, namely it would be bound to question the very meaning of the idea of ‘mind’ as an undue fiction – the same carried out by Descartes – when he assumed the Cogito to be at once a body of self-evident truths and a thing or substance, the familiar Platonic idea of psyche or soul. (shrink)

In seeking to clarify the concept of conflict of interest (COI) in debates about physician–industry relationships, Howard Brody (2011) highlights the extent to which the prob- lem turns on a common pejorative understanding of COI. Whether it is the academic or public policy “pharmapologists” or “pharmascolds” talking about COI, there is often a straightforward and overly simplistic correlation made: that is, a conflict of interest—by definition—leads to fraudulent or corrupt behavior. The same type of reasoning is com- monly found in (...) discussions about COI outside the health sciences, most notably in news stories about the awarding of government contracts or the behaviour of corporate executives. The problem is that in focusing on dramatic failures to manage COI (e.g., around Vioxx), there is a tendency to strongly associate COI with extreme forms of financial and even criminal misconduct, leaving the public, policymakers, academics, and professionals with a skewed and limited understanding of the concept. (shrink)

Recent work takes both philosophical and scientific progress to consist in acquiring factive epistemic states such as knowledge. However, much of this work leaves unclear what entity is the subject of these epistemic states. Furthermore, by focusing only on states like knowledge, we overlook progress in intermediate cases between ignorance and knowledge—for example, many now celebrated theories were initially so controversial that they were not known. -/- This paper develops an improved framework for thinking about intellectual progress. Firstly, I argue (...) that we should think of progress relative to the epistemic position of an intellectual community rather than individual inquirers. Secondly, I show how focusing on the extended process of inquiry (rather than the mere presence or absence of states like knowledge) provides a better evaluation of different types of progress. This includes progress through formulating worthwhile questions, acquiring new evidence, and increasing credence on the right answers to these questions. I close by considering the ramifications for philosophical progress, suggesting that my account supports rejecting the most negative views while allowing us to articulate different varieties of optimism and pessimism. (shrink)

ABSTRACT A thriving project in contemporary epistemology concerns identifying and explicating the epistemic virtues. Although there is little sustained argument for this claim, a number of prominent sources suggest that curiosity is an epistemic virtue. In this paper, I provide an account of the virtue of curiosity. After arguing that virtuous curiosity must be appropriately discerning, timely and exacting, I then situate my account in relation to two broader questions for virtue responsibilists: What sort of motivations are required for epistemic (...) virtue? And do epistemic virtues need to be reliable? I will sketch an account on which curiosity is only virtuous when rooted in a non-instrumental appreciation of epistemic goods, before arguing that curiosity can exhibit intellectual virtue irrespective of whether one is reliable in satisfying it. (shrink)

Should we use the same standard of proof to adjudicate guilt for murder and petty theft? Why not tailor the standard of proof to the crime? These relatively neglected questions cut to the heart of central issues in the philosophy of law. This paper scrutinises whether we ought to use the same standard for all criminal cases, in contrast with a flexible approach that uses different standards for different crimes. I reject consequentialist arguments for a radically flexible standard of proof, (...) instead defending a modestly flexible approach on non-consequentialist grounds. The system I defend is one on which we should impose a higher standard of proof for crimes that attract more severe punishments. This proposal, although apparently revisionary, accords with a plausible theory concerning the epistemology of legal judgments and the role they play in society. (shrink)

I argue that traditional views on which beliefs are subject only to purely epistemic assessment can reject demographic profiling, even when based on seemingly robust evidence. This is because the moral failures involved in demographic profiling can be located in the decision not to suspend judgment, rather than supposing that beliefs themselves are a locus of moral evaluation. A key moral reason to suspend judgment when faced with adverse demographic evidence is to promote social equality—this explains why positive profiling is (...) dubious, along with more familiar cases of negative profiling, and why profiling is suspect even when no particular action is at stake. My suspension-based view, while compatible with revisionary normative positions, does not presuppose them. Philosophers of all stripes can reject demographic profiling both in thought and deed. (shrink)

Causal reasoning and game-theoretic reasoning are fundamental topics in artificial intelligence, among many other disciplines: this paper is concerned with their intersection. Despite their importance, a formal framework that supports both these forms of reasoning has, until now, been lacking. We offer a solution in the form of (structural) causal games, which can be seen as extending Pearl's causal hierarchy to the game-theoretic domain, or as extending Koller and Milch's multi-agent influence diagrams to the causal domain. We then consider three (...) key questions: i) How can the (causal) dependencies in games - either between variables, or between strategies - be modelled in a uniform, principled manner? ii) How may causal queries be computed in causal games, and what assumptions does this require? iii) How do causal games compare to existing formalisms? To address question i), we introduce mechanised games, which encode dependencies between agents' decision rules and the distributions governing the game. In response to question ii), we present definitions of predictions, interventions, and counterfactuals, and discuss the assumptions required for each. Regarding question iii), we describe correspondences between causal games and other formalisms, and explain how causal games can be used to answer queries that other causal or game-theoretic models do not support. Finally, we highlight possible applications of causal games, aided by an extensive open-source Python library. (shrink)

A current advance within the agricultural industry is the use of genetic engineering to produce novel crops for food production. This technology raises questions about how societies should position themselves with respect to genetically modified (GM) crop development and implementation; namely, how should the potentials and risks of this technology be evaluated? We argue that current methods to evaluate the risks and benefits of GM crops are inadequate and not conducive to the strategic development of this technology, where a way (...) to ameliorate technology assessments for GM crops is to include farmers in the research process of evaluating these crops prior to their commercialization. However, particularities concerning the ethical status of such research require special consideration and vigilance. For example, in such technology assessment initiatives, farmers would occupy both the roles of research participant and research investigator. Other particularities surface due to factors related to the nature of GM crops. These particularities are examined with reference to concepts drawn from the field of research ethics, namely informed consent, compensatory decisions, and issues of participant inclusion/exclusion. (shrink)

I insist that I was able to raise my hand, and I acknowledge that a law would have been broken had I done so, but I deny that I am therefore able to break a law. To uphold my instance of soft determinism, I need not claim any incredible powers. To uphold the compatibilism that I actually believe, I need not claim that such powers are even possible. My incompatibilist opponent is a creature of fiction, but he has his prototypes (...) in real life. He is modeled partly after Peter van Inwagen and partly on myself when I first worried about van Inwagen's argument against compatibilism. (shrink)

Nanotechnology research is beginning to see widespread coverage in the media and popular science literatures, but discussions of hopes and fears about nanotechnology have already become polarised into utopian and dystopian visions. More moderate discussions focus on the near-term applications of nanotechnologies, and on potential benefits and harms. However, in exploring the social and ethical implications of nanotechnology, important lessons should be learned from experiences in other fields. In particular, studies of the ethical, legal, and social issues of genetics research (...) have successfully mapped out many of the issues that arise when new technologies are deployed. It is our contention that, for the most part, the ethical and social issues arising in nanomedicine are not altogether new, and thus do not require novel ethical principles or frameworks, nor a massive investment in ‘NELSI’ research. Instead, what is needed is support for the development of a culture of ethics amongst scientists and clinicians, basic scientific and medical knowledge for bioethicists, and a social competency for citizens to participate actively in debates about the implications of new technologies in general. (shrink)

Lee (2017) calls for greater attention to the shared epistemological and normative grounds of both public health ethics and environmental ethics, and to Potter’s original conception of bioethics, which, as she rightly observes, has been largely disregarded in contemporary North American bioethics scholarship and practice. In a previous publication we also argued in favor of reviving the Potterian approach to bioethics; we built a case grounded in “the relatively new field of molecular epigenetics [that] provides novel information that should serve (...) as additional justification for expanding the scope of bioethics to include environmental and public health concerns.”. (shrink)

Despite playing an important role in epistemology, philosophy of science, and more recently in moral philosophy and aesthetics, the nature of understanding is still much contested. One attractive framework attempts to reduce understanding to other familiar epistemic states. This paper explores and develops a methodology for testing such reductionist theories before offering a counterexample to a recently defended variant on which understanding reduces to what an agent knows.

The what next question for moral error theorists asks: if moral discourse is systematically error-ridden, then how, if at all, should moral error theorists continue to employ moral discourse? Recent years have seen growing numbers of moral error theorists come to endorse a wider normative error theory according to which all normative judgements are untrue. But despite this shift, the what next question for normative error theorists has received far less attention. This paper presents a novel solution to this question: (...) revolutionary normative subjectivism. Along the way, two primary contributions are advanced. First, a non-normative methodology for answering the normative error theoretic what next question is developed. Second, revolutionary normative subjectivism is presented and defended in accordance with the proposed methodology. (shrink)

The case study presented by Winch and Sinnott (2011) shows not only how difficult it is for clinicians and researchers to identify conflicts of interest (COI), but also how damaging it can be when there are unin- formed and uncoordinated policy responses by senior administrators.

This paper defends the heretical view that, at least in some cases, we ought to assign legal liability based on purely statistical evidence. The argument draws on prominent civil law litigation concerning pharmaceutical negligence and asbestos-poisoning. The overall aim is to illustrate moral pitfalls that result from supposing that it is never appropriate to rely on bare statistics when settling a legal dispute.

Criminal juries make decisions of great importance. A key criticism of juries is that they are unreliable in a multitude of ways, from exhibiting racial or gendered biases, to misunderstanding their role, to engaging in impropriety such as internet research. Recently, some have even claimed that the use of juries creates injustice on a large-scale, as a cause of low conviction rates for sexual criminality. Unfortunately, empirical research into jury deliberation is undermined by the fact that researchers are unable to (...) study live juries. The indirect sources of evidence used by researchers suffer from various problems, the most important of which is dubious levels of ecological validity. Real jury research—studying live jury deliberation—is controversial. However, as I argue, the objections to it are unconvincing. There is in fact a moral imperative to facilitate real jury research. (shrink)

A question, long discussed by legal scholars, has recently provoked a considerable amount of philosophical attention: ‘Is it ever appropriate to base a legal verdict on statistical evidence alone?’ Many philosophers who have considered this question reject legal reliance on bare statistics, even when the odds of error are extremely low. This paper develops a puzzle for the dominant theories concerning why we should eschew bare statistics. Namely, there seem to be compelling scenarios in which there are multiple sources of (...) incriminating statistical evidence. As we conjoin together different types of statistical evidence, it becomes increasingly incredible to suppose that a positive verdict would be impermissible. I suggest that none of the dominant views in the literature can easily accommodate such cases, and close by offering a diagnosis of my own. (shrink)

Legal epistemology has been an area of great philosophical growth since the turn of the century. But recently, a number of philosophers have argued the entire project is misguided, claiming that it relies on an illicit transposition of the norms of individual epistemology to the legal arena. This paper uses these objections as a foil to consider the foundations of legal epistemology, particularly as it applies to the criminal law. The aim is to clarify the fundamental commitments of legal epistemology (...) and suggest a way to vindicate it. (shrink)

Since the 1970s, there has been rapid and wide ranging development in the field of new reproductive technologies (NRT). With donor insemination (DI) and in vitro fertilization (IVF), previously infertile couples have been given new hope and the chance to have children. A more recent addition to these new methods of reproduction has been the combination of DI and IVF with surrogate mother arrangements.[1] This technique has subtly changed the realm of reproduction, for with the addition of a third party (...) (the surrogate) to the reproductive environment, the nature of motherhood, fatherhood, and the allocation of parental rights and duties has come into question.... In other words, has commercial surrogacy changed the traditional Western understanding of motherhood and does it do an injustice to the surrogate, the contracting mother, and/or women in general? I will argue that the fragmentation of the legal concept of ‘mother’ has created a range of social and ethical problems that need to be addressed; nevertheless, the basic societal definition of ‘motherhood’ remains substantially unchanged. (shrink)

Jury science is fraught with difficulty. Since legal and institutional hurdles render it all but impossible to study live criminal jury deliberation, researchers make use of various indirect methods to evaluate jury performance. But each of these methods are open to methodological criticism and, strikingly, some of the highest-profile jury research programmes in recent years have reached opposing conclusions. Uncertainty about jury performance is an obstacle for legal reform—ongoing debates about the ‘justice gap’ for complainants of sexual offences has rendered (...) these problems stark. This paper proposes a way to advance the debate. (shrink)

In the debates regarding the ethics of human organoid biobanking, the locus of donor autonomy has been identified in processes of consent. The problem is that, by focusing on consent, biobanking processes preclude adequate engagement with donor autonomy because they are unable to adequately recognise or respond to factors that determine authentic choice. This is particularly problematic in biobanking contexts associated with organoid research or the clinical application of organoids because, given the probability of unforeseen and varying purposes for which (...) a donor’s organoids could be employed and given the different ways in which a donor can relate to her biospecimens, a donor can value her organoids differently in different contexts and her reasons for autonomously permitting use of her cells and tissues in one case may not support an autonomous decision in another. In response, this paper has three aims: firstly, to make the case for why organoid biobanks ought to respect donor autonomy conceived as authentic choice; secondly, to explore the autonomy-respecting limits of established and widely prevalent models of biobank consent; and thirdly, to propose certain conditions that organoid biobanks ought to support or facilitate in order to respect donor autonomy. (shrink)

While the early Confucians were largely content to maintain the rituals of ancient kings as the core of moral education in their time, it is not obvious that contemporary humans could, or should, draw from the particulars of such a tradition. Indeed, even if one takes ritual seriously as a tool for cultivation, there remains a question of how to design moral education programs incorporating ritual. This essay examines impediments faced by a ritualized approach to moral education, how they might (...) be overcome, and how a ritual method could be developed in modernity. I contend that a Confucian notion of ritual, particularly as elaborated in the Xunzi, is both compatible with modern moral education and capable of making a distinct contribution to moral education in terms of how rituals can be used to structure and inculcate a shared climate of respect and humaneness both in- and outside the classroom. Specifically, the ritual education method includes emphases on inculcating moral fluency via symbolic practices and distinctions, training and appropriately associating promoral dispositions, enhancing moral imagination, and developing awareness of other minds. The model is thus a multifaceted approach to moral education through (meta)cognitive development. (shrink)

The notion of understanding occupies an increasingly prominent place in contemporary epistemology, philosophy of science, and moral theory. A central and ongoing debate about the nature of understanding is how it relates to the truth. In a series of influential contributions, Catherine Elgin has used a variety of familiar motivations for antirealism in philosophy of science to defend a non- factive theory of understanding. Key to her position are: (i) the fact that false theories can contribute to the upwards trajectory (...) of scientific understanding, and (ii) the essential role of inaccurate idealisations in scientific research. Using Elgin’s arguments as a foil, I show that a strictly factive theory of understanding has resources with which to offer a unified response to both the problem of idealisations and the role of false theories in the upwards trajectory of scientific understanding. Hence, strictly factive theories of understanding are viable notwithstanding these forceful criticisms. (shrink)

Objective Our study sought to (1) describe the practices and preferences of Colombian adolescents in accessing sexual and reproductive health services: accompanied versus alone; (2) compare actual practices with stated preferences; and (3) determine age and gender differences regarding the practice and these stated preferences. -/- Methods 812 participants aged 11–24 years old answered a survey in two Profamilia clinics in the cities of Medellin and Cali in Colombia. A cross-sectional analysis was performed to compare participants’ answers based on the (...) variables of gender and age. -/- Results A quarter of participants visited the clinic alone (25.4%). Females were more likely to go alone in comparison to males (26.3% vs 14.1%; p = 0.031), and older participants went alone more often than younger participants (p < 0.001). Most participants – 72.7% (95 %CI: 69.3–75.9) – expressed a preference in being accompanied to the clinic, and more than 90% had their preferences met. The preferences of older participants were, however, less likely to be met than those of younger participants (p < 0.001), notably, because they predominantly wanted to be accompanied. -/- Conclusion Contemporary public health and bioethics literature advocates in favor of developing health services that better meet the preferences of adolescents. The present research highlights an apparent blind spot related to the role that others (e.g., parents, friends, partners) can or should play in accompanying adolescent patients when they access sexual and reproductive health services. Respecting adolescents’ preferences, and hence their autonomy, is not simply a matter of ensuring freedom from constraints (e.g., their right and ability to go alone). Rather, it should also consider the liberty to choose whether to be accompanied when accessing SHRS and by whom. (shrink)

Edward Elliott and Jessica Isserow argue that it is not usually in the best interests of ordinary human beings to learn the truth of moral nihilism. According to Elliott and Isserow, ordinary human beings would suffer costs from learning the truth of moral nihilism that are unlikely to be fully compensated for by any benefits. Here I provide reasons to doubt that ordinary human beings would suffer costs from learning the truth of moral nihilism and present a dilemma for Elliott (...) and Isserow’s view. (shrink)

Dans notre société de plus en plus digitalisée, avons-nous vraiment le choix d’adopter ou non les technologies? Comment cette digitalisation impacte-t-elle les personnes âgées en particulier et son écosystème? Quels sont les enjeux éthiques soulevés par cette digitalisation? Ce texte vise à amener des éléments de réflexions en lien avec ces enjeux selon le point de vue de divers experts des domaines de la technologie, du vieillissement et de la bioéthique. Ces experts se sont rencontrés lors d’un symposium ayant eu (...) lieu à Angers, France, en octobre 2019. Le texte est un compte-rendu des échanges et points de vue de ces experts, ainsi que des discussions ouvertes qu’ils ont eues avec l’assistance, portant sur les principaux enjeux soulevés par cette digitalisation selon la perspective des personnes âgées, des proches-aidants, des soignants, de la société et de la recherche. (shrink)

Public discussions of ethical issues related to the biotechnology industry tend to treat "biotechnology" as a single, undifferentiated technology. Similarly, the pros and cons associated with this entire sector tend to get lumped together, such that individuals and groups often situate themselves as either "pro-" or "anti-" biotechnology as a whole. But different biotechnologies and their particular application context pose very different challenges for ethical corporate decision-making. Even within a single product category, different specialty products can pose strikingly different ethical (...) challenges. In this paper, we focus on the single over-arching category of "genetic testing" and compare tests for disease susceptibility and drug response. We highlight the diversity of ethical challenges - grouped under the broad categories of "truth in advertising" and "protecting intellectual property" - raised by the commercialization and marketing of these technologies. By examining social and technical differences between genetic tests, and the associated corporate ethics challenges posed by their commercialization, our intent is to contribute to the nascent business ethics literature examining issues raised by the development and marketing of genetic tests. (shrink)

L’érosion actuelle de la confiance du public envers les campagnes de vaccination et les décisions de politiques publiques qui y sont associées, aggravée par des scandales comme ceux relatifs à la pandémie H1N1 et l’utilisation du Tamiflu™, risque de diminuer de façon significative l’efficacité de ces interventions importantes pour la santé publique. Un manque de confiance de la population envers les acteurs de santé publique peut conduire à une méfiance accrue face aux interventions, pouvant ainsi compromettre l’atteinte des objectifs recherchés (...) par une intervention spécifique et, conséquemment, avoir un impact important sur les bénéfices attendus pour la population visée par cette intervention. Dans la production des avis d’experts, les membres des comités consultatifs d’experts en immunisation (CCEI) peuvent avoir une influence importante sur la prise de décision publique, notamment, sur la sélection par les décideurs de santé publique de vaccins en particulier et la façon dont les campagnes de vaccination seront déployées. En contrepartie de cette influence sur les décisions publiques, une indépendance et une transparence sont attendues de leur part puisque des mécanismes de divulgation et de gestion de conflits d’intérêts (CI) imparfaits peuvent affecter négativement la confiance du public à l’égard de telles décisions. Il apparaît donc important de s’assurer que des mécanismes de gestion des CI, transparents et robustes, existent pour ces comités. Dans cette étude, les avis ou rapports d’évaluation de la pertinence de la vaccination préparés par un CCEI au Québec ont été examinés pour quatre types de maladies évitables par la vaccination (infections invasives à méningocoques et à pneumocoques, coqueluche et virus du papillome humain). Le but était de : 1) identifier les CI divulgués par les membres du CCEI dans leurs rapports comparativement à ceux déclarés dans leurs publications scientifiques pour ces mêmes infections ; 2) analyser la nature des CI (réel, potentiel, apparent, personnel, financier, institutionnel, etc.) et l’impact potentiel (risque) sur la prise de décision impartiale et sur la confiance du public ; et 3) évaluer les mécanismes de gestion de CI actuellement utilisés par ce CCEI. Les résultats de cette étude montrent que très peu de rapports du CCEI contiennent une section sur les CI par rapport à la pléthore divulguée dans les publications scientifiques publiées par les membres du CCEI. De plus, les CI divulgués dans les rapports fréquemment ne correspondent pas à ceux décrits dans les publications scientifiques. Il serait donc important d’introduire des mesures visant à accroître la transparence des experts en immunisation et d’améliorer les mécanismes de divulgation et de gestion des CI afin de veiller à ce que la confiance du public envers les décideurs en santé publique soit maintenue et améliorée. (shrink)

Antimicrobial resistance is a growing public health concern and is associated with the over- or inappropriate use of antimicrobials in both humans and agriculture. While there has been reco- gnition of this problem on the part of agricultural and public health authorities, there has none- theless been significant difficulty in translating policy recommendations into practical guidelines. In this paper, we examine the process of public health policy development in Quebec agriculture, with a focus on the case of pork production and (...) the role of food animal veterinarians in policy making. We argue that a tendency to employ strictly techno-scientific risk analyses of antimicro- bial use ignores the fundamental social, economic and political realities of key stakeholders and so limits the applicability of policy recommendations developed by government advisory groups. In particular, we suggest that veterinarians’ personal and professional interests, and their ethi- cal norms of practice, are key factors to both the problem of and the solution to the current over-reliance on antimicrobials in food production. (shrink)