Health policy changes in Nepal displayed struggles against a poor political, geographical, and economic setting; Millennium Development Goal #4 demanded improved infant and child mortality, as well as adequate measles vaccine coverage by the year 2015. Research in this report presents progress and direction of child health care policy across more than a decade of time in attempts of attaining MDG #4 and general child health care advancements. Subsequent observations and suggestions were delineated and offered. Progress since (...) the 1990’s up to 2012 was analyzed by review of serial national survey and report data. Trends and variations between regions were mostly analyzed amongst various child health care determinants. Results indicated many improved factors; Nepal will likely achieve MDG regarding child under-5 mortality, but may not achieve measles vaccine coverage or infant mortality goals. Furthermore, severe regional disparities were evident within Nepal, particularly in the Mid and Far-Western regions. A call for integrated community-based primary health care (CB-PHC) for infants and children became an ultimate ideal. A comprehensive, multidisciplinary, and community based primary care delivery service would address many of the deficits identified as well as reach rural and remote areas that still suffered. Risk and data-based resource allocation promise improved utilization, but also demands more frequent and better data reporting. Coordinated, multi-sector health policy initiatives have been underway; this demonstrated a strong direction in improving child health care from urban to every village. (shrink)

Ableist attitudes and structures regarding disability are increasingly recognized across all sectors of healthcare delivery. After Dobbs, novel questions arose in the USA concerning how to protect reproductive autonomy while avoiding discrimination against and devaluation of disabled persons. As a case study, we examine the Louisiana’s Department of Public Health August 1st Emergency Declaration, “List of Conditions that shall deem an Unborn Child ‘Medically Futile.’” We raise a number of medical, ethical, and public health concerns that lead us (...) to argue the declaration should be rescinded. The ethically objectionable declaration provides valuable lessons concerning how to uphold both reproductive and disability justice in a post-Dobbs landscape. (shrink)

Cora Diamond has claimed that Wittgenstein’s Tractatus contains an early ‘private language argument’: an argument that private objects in other people’s minds can play no role in the language I use for talking about their sensations. She further claims that the Tractatus contains an early version of the later idea that an inner process stands in need of outward criteria. The paper argues against these claims, on the grounds that they depend on an unwarranted construal of the Tractatus’s notion of (...) use. It is further argued that Diamond’s interpretation makes a mystery of the relation between the Tractatus and Wittgenstein’s 1929 account of sensation language, set out in Philosophical Remarks and elsewhere. Finally, the paper considers and defends Michael Dummett’s contention that the Tractatus is a paradigm of semantic realism, in the light of Diamond’s claim that the Tractatus in fact suggests a form of anti-realism about sensation language. (shrink)

Abstract: As much as 60% children born in Nigeria are delivered by unskilled traditional birth attendants (TBAs). Therefore, there is no denying their relevance. Be that as it may these traditional birth attendants are by modern/current standards considered incompetent as regards appropriate skills in regard to the contemporary challenges to safe and effective child-bearing. It is, therefore, imperative for TBAs and other similar cadre of healthcare providers in resource-limited settings to be knowledgeable and have the ability to deploy (...) evidence-based practices in the prevention of diseases. There is no gainsaying the socio economic and political impact of diseases. This study examines the prevention of Mother-To-Child Transmission (PMTCT) of Human Immunodeficiency Virus, HIV, in selected communities in Enugu State. It is about the connection between the traditional birth attendants and this quest. Simply put, as a result of resource limitations, the volume of delivery by the traditional birth attendants is huge. However, the modus operandi of the Traditional Birth Attendants (TBAs) considerably expose the community to the transmission of viruses-including the HIV. This study examines the efforts of TBAs as regards the prevention of Mother-To-Child transmission in selected Local Government Areas of Enugu State, Nigeria. Findings, indicate rooms for improvement. In conclusion, We advocate the adoption of modern practices through regular training to reduce mother-to-child transmission of HIV. This in itself is no small achievement even if only for a case. Here, however, we are speaking about millions of people, this is definitely serious. (shrink)

What is the relation between meaning and use? This chapter first defends a non-reductionist understanding of Wittgenstein’s suggestion that ‘the meaning of a word is its use in the language’; facts about meaning cannot be reduced to, or explained in terms of, facts about use, characterized non-semantically. Nonetheless, it is contended, facts about meaning do supervene on non-semantic facts about use. That supervenience thesis is suggested by comments of Wittgenstein’s and is consistent with his view of meaning and rule-following. Semantic (...) supervenience is then defended against two criticisms: first, John McDowell’s suggestion that the supervenience thesis falsifies the epistemology of meaning and fails to accommodate common-sense truths about meaning; second, a series of counter-examples proposed by Stephen Kearns and Ofra Magidor, who argue that worlds may differ semantically without differing non-semantically. It is argued that neither criticism is convincing: we should accept the thesis that semantic facts supervene on non-semantic facts. (shrink)

It is natural to say that when we acquire a new concept or concepts, or grasp a new theory, or master a new practice, we come to see things in a new way: we perceive phenomena that we were not previously aware of; we come to see patterns or connections that we did not previously see. That natural idea has been applied in many areas, including the philosophy of science, the philosophy of religion, and the philosophy of language. And, in (...) reflecting on the character of philosophy itself, Wittgenstein himself associates the introduction of a new concept in philosophy with the discovery of a new way of looking at things (PI §401), and says that the point of presenting us with an imagined example may be to change our way of looking at things (PI §144). The paper considers four interrelated questions about this association between seeing-as and change, novelty, or innovation. 1. Is there an important difference between the case where the change in someone’s way of seeing things involves the invention or discovery of a completely new concept, a completely new theory etc., and the case where it involves the person’s coming to understand an existing concept or theory? 2. Is there a special connection between seeing-as and conceptual or theoretical change or creativity: a connection that does not obtain between seeing-as and using or applying a familiar theory or system of concepts? 3. In cases where seeing-as is associated with novelty or creativity, is there any sense in which the fact that someone sees things in a new way can help to explain their conceptual or theoretical creativity? 4. To the extent that there is some association between seeing-as and novelty or creativity, why if at all does it matter that one experiences things in a certain way? Would someone who was aspect-blind be any worse off with respect to creativity or innovation than the rest of us? And if so, why? (shrink)

A central theme in Wittgenstein’s post-Tractatus remarks on the limits of language is that we ‘cannot use language to get outside language’. One illustration of that idea is his comment that, once we have described the procedure of teaching and learning a rule, we have ‘said everything that can be said about acting correctly according to the rule’; ‘we can go no further’. That, it is argued, is an expression of anti-reductionism about meaning and rules. A framework is presented for (...) assessing the debate between reductionist and anti-reductionist readings of Wittgenstein’s views about meaning and use. It is argued that that debate cannot be settled merely by reference to Wittgenstein’s general opposition to reductionism. An important argument for anti-reductionism about rules and meaning, from Remarks on the Foundations of Mathematics, is discussed. Putative evidence of reductionism about meaning in the Brown Book is considered; an alternative reading is proposed. The nature of Wittgenstein’s anti-reductionism is examined. It is argued, first, that Wittgenstein accepts that semantic and normative facts supervene on non-semantic, non-normative facts and, second, that at many points his treatment of meaning and rules goes beyond the kind of pleonastic claim that is often taken to define non-reductionist, quietist, positions in philosophy. (shrink)

The paper considers three questions. First, what is the connection between economics and agency? It is argued that causation and explanation in economics fundamentally depend on agency. So a philosophical understanding of economic explanation must be sensitive to an understanding of agency. Second, what is the connection between agency and causation? A causal view of agency-involving explanation is defended against a number of arguments from the resurgent noncausalist tradition in the literature on agency and action-explanation. If agency is fundamental to (...) economic explanation, it is argued, then so is causation. Third, what is the connection between causal explanation and the natural sciences? It is argued that, though the explanations given in economics and other social sciences are causal explanations, they are different in kind from the causal explanations of the natural sciences. On the one hand, then, the causal explanations of the social sciences are irreducible to those found in the natural sciences. On the other hand, the causal relations described by the social sciences are not completely autonomous; they do not float free of, or operate independently from, the causal relations charted by the natural sciences. (shrink)

Part 1 of this paper sketches Wittgenstein’s opposition to scientism in general. Part 2 explores his opposition to scientism in philosophy focusing, in particular, on philosophy of mind; how must philosophy of mind proceed if it is to avoid the kind of scientism that Wittgenstein complains about? Part 3 examines a central anti-scientistic strand in Wittgenstein’s Last Writings on the Philosophy of Psychology volume II: his treatment of the ‘uncertainty’ of the relation between ‘outer’ behaviour and ‘inner’ experiences and mental (...) states. (shrink)

Wittgenstein’s philosophy involves a general anti-platonism about properties or standards of similarity. On his view, what it is for one thing to have the same property as another is not dictated by reality itself; it depends on our classificatory practices and the standards of similarity they embody. Wittgenstein’s anti-platonism plays an important role in the private language sections and in his discussion of the conceptual problem of other minds. In sharp contrast to Wittgenstein’s views stands the contemporary doctrine of natural (...) properties, which holds that there is an objective hierarchy of naturalness amongst properties, a hierarchy that is completely independent of our concepts or practices. Some authors have appealed to the natural properties view to offer an explicitly anti-Wittgensteinian account of sensation concepts. The paper discusses these competing views of properties and sensation concepts. It is argued that, if our account of concepts of conscious states starts from a commitment to natural properties, we are bound to recognize that our actual classificatory practices also play a crucial role in determining which properties our concepts pick out. On the other hand, if we start from the anti-platonist position, we are bound to recognize that we also need a notion of sameness of property that extends beyond our limited capacity to recognize similarity or sameness of property. The correct view, it is concluded, must occupy a middle position between an extreme anti-realism about properties and an extreme version of the natural properties view. It is suggested that Wittgenstein’s own view does just that. (shrink)

The paper discusses two aspects of Wittgenstein’s middle-period discussions of the self and the use of ‘I’. First, it considers the distinction Wittgenstein draws in his 1933 Cambridge lectures between two ‘utterly different’ uses of the word ‘I’. It is shown that Wittgenstein’s discussion describes a number of different and non-equivalent distinctions between uses of ‘I’. It is argued that his claims about some of these distinctions are defensible but that his reasoning in other cases is unconvincing. Second, the paper (...) considers the distinction drawn in the Blue Book between the use of ‘I’ as subject and the use of ‘I’ as object. A number of commentators have contended that this Blue Book distinction between uses of ‘I’ is erroneous, that Wittgenstein soon realized that, and that he dropped the idea of such a distinction from his later work. Against those claims, it is argued that Wittgenstein’s distinction between the use of ‘I’ as subject and its use as object is correct and illuminating. And it is shown that, though we do not find the ‘as-subject’/’as-object’ terminology in Wittgenstein’s subsequent work, the essential point of the Blue Book distinction is not abandoned but remains in place in Philosophical Investigations. (shrink)

Techniques from behavioral economics—nudges—may help physicians increase pediatric vaccine compliance, but critics have objected that nudges can undermine autonomy. Since autonomy is a centrally important value in healthcare decision-making contexts, it counts against pediatric vaccination nudges if they undermine parental autonomy. Advocates for healthcare nudges have resisted the charge that nudges undermine autonomy, and the recent bioethics literature illustrates the current intractability of this debate. This article rejects a principle to which parties on both sides of this debate (...) sometimes seem committed: that nudges are morally permissible only if they are consistent with autonomy. Instead, I argue that, at least in the case of pediatric vaccination, some autonomy-undermining nudges may be morally justified. This is because parental autonomy in pediatric decision-making is not as morally valuable as the autonomy of adult patients, and because the interests of both the vaccinated child and other members of the community can sometimes be weighty enough to justify autonomy-infringing pediatric vaccination nudges. This article concludes with a set of worries about the effect of pediatric vaccination nudges on parent-physician relationships, and it calls on the American Academy of Pediatrics to draw on scientific and bioethics research to develop guidelines for the use of nudges in pediatric practice and, in particular, for the use of pediatric vaccination nudges. (shrink)

The emergence of coronavirus disease (COVID-19) from Wuhan city of China engulfed almost the entire world and created a global pandemic. Several countries declared this pandemic as national emergency, forcing millions of people to go into lockdown. This sudden social isolation has caused enormous disruption of daily routine for the global community, especially children. To minimize the transmission of this virus all the educational institutions were closed and moved to online learning to encourage and adhere to social distancing guidelines issued (...) by the authorities from time to time. This abrupt change in the learning environment, restrictions in social interaction and other activities caused unusual situation in the development of child brain. Therefore, it is important and obligatory for the scientific community and healthcare workers to access and analyse the impact of Covid -19 pandemic on the mental health of children. The present article is a case study and was conducted in Doda of Jammu and Kashmir regarding the impact of quarantine on the children. (shrink)

The article aims to investigate and analyze the social impact of industrialization on Badli. Badli is one of the largest industrial zones in Delhi which also bears large slums neighboring to the industries. The literature available on the area is also limited to news articles and government reports, thus further research on Badli is required. The social implications were examined through naturalistic observational research and unstructured interviews of 10 individuals from Badli. Using thematic analysis and secondary data analysis the data (...) was interpreted into common themes and key ideas. The analysis showed most Industries in Badli are unauthorized and have issues such as unemployment, child labor, hazardous working conditions, nominal wages, producing illegal substances and lack of healthcare management. People living in the neighboring slum areas suffer from issues such as poor health care facilities, below par educational infrastructure, high crime rates, harmful drainage and ventilation services, congested housing structures, economic disparity, and toxic family environment. Thus Industrialization has deeper implications on the society of Badli which can be attributed to the influx of migrants, industries and poor governance by the administrative authorities to control and manage the industrial process in Badli. It can be concluded that there is a huge correlation between social change and industrialization. Further studies are required to create socio-economic policies catering to the situation in Badli for a long-lasting sustainable effect on the area. (shrink)

Ill persons suffer from a variety of epistemically-inflected harms and wrongs. Many of these are interpretable as specific forms of what we dub pathocentric epistemic injustices, these being ones that target and track ill persons. We sketch the general forms of pathocentric testimonial and hermeneutical injustice, each of which are pervasive within the experiences of ill persons during their encounters in healthcare contexts and the social world. What’s epistemically unjust might not be only agents, communities and institutions, but the (...) theoretical conceptions of health that structure our responses to illness. Thus, we suggest that although such pathocentric epistemic injustices have a variety of interpersonal and structural causes, they are also sustained by a deeper naturalistic conception of the nature of illness. (shrink)

In July 2014, the roboticist Ronald Arkin suggested that child sex robots could be used to treat those with paedophilic predilections in the same way that methadone is used to treat heroin addicts. Taking this onboard, it would seem that there is reason to experiment with the regulation of this technology. But most people seem to disagree with this idea, with legal authorities in both the UK and US taking steps to outlaw such devices. In this paper, I subject (...) these different regulatory attitudes to critical scrutiny. In doing so, I make three main contributions to the debate. First, I present a framework for thinking about the regulatory options that we confront when dealing with child sex robots. Second, I argue that there is a prima facie case for restrictive regulation, but that this is contingent on whether Arkin’s hypothesis has a reasonable prospect of being successfully tested. Third, I argue that Arkin’s hypothesis probably does not have a reasonable prospect of being successfully tested. Consequently, we should proceed with utmost caution when it comes to this technology. (shrink)

Parenting involves an extraordinary degree of power over children. Republicans are concerned about domination, which, on one view, is the holding of power that fails to track the interests of those over whom it is exercised. On this account, parenting as we know it is dominating due to the low standards necessary for acquiring and retaining parental rights and the extent of parental power. Domination cannot be fully eliminated from child-rearing without unacceptable loss of value. Most likely, republicanism requires (...) that we minimise children’s domination. I examine alternative models of child-rearing that are immune to republican criticism. (shrink)

Decision-making regarding healthcare expenditure hinges heavily on an individual's health status and the certainty about the future. This study uses data on propensity of general health exam (GHE) spending to show that despite the debate on the necessity of GHE, its objective is clear—to obtain more information and certainty about one’s health so as to minimise future risks. Most studies on this topic, however, focus only on factors associated with GHE uptake and overlook the shifts in behaviours and attitudes (...) regarding different levels of cost. To fill the gap, this study analyses a dataset of 2068 subjects collected from Hanoi (Vietnam) and its vicinities using the baseline-category logit method. We evaluate the sensitivity of Vietnamese healthcare consumers against two groups of factors (demographic and socioeconomic-cognitive) regarding payment for periodic GHE, which is not covered by insurance. Our study shows that uninsured, married and employed individuals are less sensitive to cost than their counterparts because they value the information in reducing future health uncertainty. The empirical results challenge the objections to periodic health screening by highlighting its utility. The relevance of behavioural economics is further highlighted through a look at the bounded rationality of healthcare consumers and private insurance companies in using and providing the service, respectively. (shrink)

Healthcare professionals decide wisely about personalized medicine, treatment plans, and resource allocation by utilizing big data analytics and machine learning. To guarantee that algorithmic recommendations are impartial and fair, however, ethical issues relating to prejudice and data privacy must be taken into account. Big data analytics and machine learning have a great potential to disrupt healthcare, and as these technologies continue to evolve, new opportunities to reform healthcare and enhance patient outcomes may arise. In order to investigate (...) the patient’s outcomes with empirical evidence, this research was conducted using an online survey to incorporate healthcare professionals, patient’s reviews, and clinical staff. The data were analyzed using SmartPLS 4.0 to predict the structural model. The findings revealed a direct impact as positive influence of using machine learning on healthcare performance and patient outcomes through big data analytics. Moreover, it is evident that this can lead to personalized treatment plans, early interventions, and improved patient outcomes. Additionally, big data analytics can help healthcare providers optimize resource allocation, improve operational efficiency, and reduce costs. The impact of big data analytics on patient outcome and healthcare performance is expected to continue to grow, making it an important area for investment and research. (shrink)

There is broad agreement that child labor is wrong and should be eliminated. This chapter examines the three main moral objections to child labor and considers their limitations: harm-based objections, objections from failing to benefit children, and objections from exploitation. Harm-based objections struggle with baselines for comparison and difficulties with Non-Identity problems. Even if child labor is not harmful, it may be wrong because it prevents children from enjoying other benefits, such as schooling. However, is schooling necessarily (...) more beneficial for children than work? Some kinds of child labor may not be harmful, and may benefit children, but they may still be wrong because they are exploitative. I consider some ways to address exploitative child labor, inspired by campaigns led by child workers. The chapter ends with a surprising conclusion that challenges the broad consensus with which we began: we may have duties to promote child labor. (shrink)

Adaptation and stress are two main concepts useful for better understanding the phases of illness and health-related human behavior. The two faces of adaptation, adaptation as a process and adaptation as a product, have raised the question of how long the adaptation process will take in cancer trajectories. The care setting transition from clinical-based into home-based cancer care has stressed the role of family caregivers (FCG) in cancer management. This study examines how types of demanded healthcare information affect the (...) FCG’s role in catalyzing the adaptation of female cancer patients. The mindsponge theory was used in conceptual development and results interpretation. Bayesian Mindsponge Framework (BMF) analytics was used for statistical analysis on a dataset of 48 spouses (husbands) and 12 other family members in five congested communities of Surabaya, Indonesia. Results showed that among the six types of demanded healthcare information, FCGs with a higher tendency to demand cancer-specific information are more likely to need support in catalyzing the adaptation of female cancer patients. Meanwhile, FCGs with a higher demand for information on alternative therapies are less likely to need support in catalyzing cancer adaptation. Other types of healthcare information have ambiguous effects on the need for support in cancer adaptation assistance. This study reveals that the demanded cancer-specific information, e.g., cancer’s prognosis or likely outcome, must be prioritized to assist FCG’s role in catalyzing adaptation among female cancer patients. Cancer prognosis and outcomes reflect the future of cancer care results. (shrink)

Child soldiers, who often appear to be both victims and perpetrators, present a vexing moral and legal challenge: how can we protect the rights of children while seeking justice for the victims of war crimes? There has been little stomach, either in domestic or international courts, for prosecuting child soldiers—but neither has this challenge been systematically addressed in international law. Establishing a uniform minimum age of criminal responsibility would be a major step in the right direction; we argue (...) that such a standard ought to be guided by the best evidence from neuropsychology about the development, during childhood and adolescence, of the executive functions that give rise to morally and legally responsible agents. In light of that evidence, which suggests that the brain’s executive functions are still maturing into early adulthood, we recommend a graded structure of culpability for child soldiers. (shrink)

Some people oppose abortion on the grounds that fetuses have full moral status and thus a right to not be killed. We argue that special obligations that hold between mother and fetus also hold between parents and their children. We argue that if these special obligations necessitate the sacrifice of bodily autonomy in the case of abortion, then they also necessitate the sacrifice of bodily autonomy in the case of organ donation. If we accept the argument that it is obligatory (...) to override a woman’s bodily autonomy for the sake of an unborn child’s survival, we must continue to override the bodily autonomy of parents to ensure the survival of their living children, until the parent no longer has a special obligation to their child to the same degree as their special obligation to the fetus. And if the life of a child is truly more important than the bodily autonomy of its parents, as must be the case to force women to carry unwanted pregnancies to term, this should remain true until such a time that their children are no longer considered their responsibility. Thus, parity of reasoning suggests that policies compelling the gestation of a fetus should be accompanied by policies compelling organ donation. (shrink)

The global response to child labour is based on the standards set by three major international conventions. This review examines the historical development of the conceptualizations of various forms of child labour, relevant views and perspectives, contemporary theoretical underpinnings, and policy suggestions. The emerging evidence shows that child labour incidences in all its forms have increased in many parts of the world, and the global target to eradicate child labour by 2025 seems unattainable. The evaluation indicates (...) that the current global age-based abolitionist policy to fight child labour has lost some ground. The covid-19 pandemic has worsened the situation and the worst forms of child labour have become even more widespread and deeply normalized in many contexts and communities. The current scholarship of child labour remains critically ignorant of the relevant societal and cultural norms. Contemporary theorists and empiricists emphasize on constructing knowledge with the children and families engaged in child labour and focusing on finding innovative community-led alternatives to the worst forms of child labour. Regulations, policies, and support programmes must recognize the economic contribution of working children and work towards the children's best interests. (shrink)

I occasionally write on topics relating to psychology since I am a trained psychoanalyst. One of the evils which plagues us is child abuse which a psychologist had correctly called soul murder in the 1990s. This article was written to sensitize parents. And also is philosophy (of evil) in praxes.

Abstract Aim: The COVID-19 infection is transmitted either by human-to-human contact, social-physical contact, and respiratory droplets or by touching items touched by the infected. This has triggered some conflicted behaviors such as stigma, violence, and opposite behavior applause. The aim of this study is to explore several newspaper articles about stigma, violence, or insensitive behavior against healthcare professionals and to analyze the reason for these behaviors during these COVID-19 pandemics. Method: The website of the Turkish Medical Association "Press Releases (...) News" and online newspaper articles have been scanned using keywords and have been classified and analyzed according to the content of articles between the periods of March 11 to April 28, 2020. This is a qualitative study with content analysis. No official ethical permission was obtained as the study was conducted through open access internet news sites. Result: 16 reports were selected from online reports that matched the keywords of the study. 13 of these reports included desensitization, violence, lack of precaution, stigmatization, and applause, and 3 reports included doctors’ statements. After being categorized, content analyses were conducted. Conclusion: This study revealed the necessity of a multi-faceted evaluation of the problems faced by healthcare professionals who are at the forefront of the COVID-19 outbreak. This study has a primary role in the detection, diagnosis, and treatment of the pandemic and reveals that doctors are trying to fulfill their duties in an ethical framework despite stigmatized behavior. Authorities should provide various supports to protect healthcare professionals before, during, and after the epidemic for the success of the COVID-19 outbreak struggle. (shrink)

One fundamental healthcare issue brought to the fore by the current COVID-19 pandemic concerns the scope and nature of the right to healthcare. Given our increasing need for the usually limited healthcare resources, to what extent can we demand provision of these resources as a matter of right? One philosophical way of handling this issue is to clarify the nature of this right. Using the challenges of COVID-19 in the Philippines as the context of analysis, we argue (...) for the view that regards the right to healthcare as fundamentally moral in kind, which should thereby guide its legal and contractual appropriations. In particular, we respond to objections against this view stemming from issues concerning the universality and satisfiability of the right’s correlative duty. We deal with such issues by invoking the relative degree of incumbency of moral rights and the capability-relativity of positive duties. We further contend that as these factors define the scope of the moral right to healthcare, they thus constrain what we can demand as a matter of right to meet our healthcare needs in this time of the pandemic. (shrink)

Some philosophers and segments of the public think age is relevant to healthcare priority-setting. One argument for this is based in equity: “Old” patients have had either more of a relevant good than “young” patients or enough of that good and so have weaker claims to treatment. This article first notes that some discussions of age-based priority that focus in this way on old and young patients exhibit an ambiguity between two claims: that patients classified as old should have (...) a low priority, and that patients classified as young should have high priority. The author next argues, drawing on a problem raised by Christine Overall, that equity cannot justify giving “old” patients low priority, since there is wide variety in the total lifetime experiences of older people, partly influenced by gender, race, class, and disability injustice. Finally, the author suggests that there might be a limited role for age-based prioritization in the context of infant and childhood death, since those who die in childhood are always and uncontroversially among the worst-off. (shrink)

The current thesis discusses how tools for analysing power are developed predominately for adults, and thus remain underdeveloped in terms of understanding injustices related to age, ethnicity/race and gender in childhoods. The overall aim of this dissertation is to inscribe a discourse of intersecting social injustices as relevant for childhoods and child welfare, and by interlinking postcolonial, feminist, and critical childhood studies. The dissertation is set empirically within the policy and practice of Swedish child welfare, here exemplified by (...) the assessment framework Barns Behov i Centrum. It aims to explore how Swedish child welfare, as a field of knowledge, modes of knowing and knowing subjects, constitutes an arena for claims and responses to intersecting social justice issues. The material consists of BBIC primers and selected samples from, a total of 283 case reports from a Swedish social service agency. The case reports address assessments of children. This dissertation is based on four qualitative studies using discourse analysis, as well as analysis inspired by thematic and case-study methodology. Two studies focus on child welfare discourses in BBIC documents involving social problems and violence, and two studies are based on child welfare case reports. Studies I­­-II address child welfare policy and practice by analysing the conditions required for children to participate, in terms of children’s moral status and in terms of status of ‘evidencing’ needs for protection. Studies III­­-IV explore this further from the perspective of intersecting and embodied social injustices in childhoods. Together, the studies interconnect child welfare as a field of knowledge, modes of knowing and knowers with child welfare as a moral arena for claims to rights, recognition, and social justice. The synthesised findings point to child biowelfare, in which justice discourses are largely absent. Biowelfare is informed by a mode of knowing and ‘evidencing’ risks to children’s health and development, which are confined to scientific predicting-believing, seeing-believing by professionals and a moral economy of care, all of which constrain the idea that injustices are structural and intersecting. Biowelfare primarily responds to children as ‘speaking’ biological bodies, rather than as voices of justice. In this sense, injustices of an epistemological nature are interconnected with social injustices. When issues of justice are mobilised in case reports and policy, they come across as rather ‘unjust’, primarily confined to the sphere of the family home of racialised children and not connected to ‘general’ children. In addition to intersections of age, ethnicity/race and gender, class and health are fundamental to recognition and protection in biowelfare. Finally, the dissertation indicates the need for a moral economy which responds to intersecting social injustices such as racial, gender-based and ageist violence in childhoods, and violations of children’s bodily integrity. (shrink)

Most theories of parenthood assume, at least implicitly, that a child will grow up to be an independent, autonomous adult. However, some children with cognitive limitations or psychiatric illness are unable to do so. For this reason, these accounts do not accommodate the circumstances and responsibilities of parents of such adult children. Our article attempts to correct this deficiency. In particular, we describe some of the common characteristics and experiences of this population of parents and children, examine the unique (...) aspects of their relationships, review several philosophical accounts of parental obligations, consider how these accounts might be extrapolated to semiautonomous adult children, and provide suggestions about parental obligations to promote autonomy and independence in adult children with cognitive limitations or psychiatric illness. In extending accounts of parental responsibilities to the case of semiautonomous adults, we find that the parental role includes the duty to continue to provide care—indefinitely if necessary—while cultivating autonomy and independence. (shrink)

The existence of child labor in developing countries like Bangladesh is undoubtedly a serious problem in the era of sustainable development. Undoubtedly to abolish child labor from all level is not so easy. The current study was intended to assess the livelihoods pattern and causes of being involved as child labor in Jhenaidah city-Bangladesh and to find out the ways in which child labor can be diminished gradually. This study was exploratory in nature where convenience sampling (...) was adapted, seventy-five children aged less than 18 years were interviewed with an interview schedule. The extent and prevalence of child labour in a country are being considered as a significant indicator of how far-off that country stays away from the overall sustainable development. The results of this study demonstrate that the majority (17/22.67%) children engaged in performing work in shops or hotels. The X2 (p<0.5) results elucidate that there exists gender difference in child abuse and harassment. The rate of physical and mental abuse and torture was higher in male children, in contrast, the prevalence of sexual harassment and abuse by slung was significantly higher in female children. The working hours as an average above 7 hours or more, and per day wage of children in Jhenaidah found just above 1.4$ (120 BDT). The principal component analysis indicates that lack of parental employment facilities which has directly related to poverty found as the foremost reasons for a child to make involvement as labour before completing age 18, this result is not only applicable for Jhenaidah but also possibly applicable for all developing countries. Besides, father’s education and death of mother were the important indicators of being child laborer. The ways of eliminating child labour are not so easy task because the problem has been indissolubly embedded in our society for long. Hence, it requires moral, political will and commitment from all people in the society for ending and eradicating child labour. Alongside all these, international organizations must make sure their robust participation in enhancing this process. (shrink)

Artistic work during communist regime in Albania has been a strictly controlled area, due to censorship and ideological limitations. However, the creative genius of some individuals was able to transmit religious images in a disguised form, particularly when themes were permissive to ambiguous messages. Depicting child abuse was a taboo for the everyday life, but not when focusing on certain historical periods that were purposefully stigmatized from the state propaganda. Some snapshots and images from the movie ‘Red poppies on (...) the wall’, shot in 1976, will reveal how the director and the working team operated on Christian symbols to showcase their working philosophy. Thus, sketching the abusive environment of an orphanage within the frames of a remote Roman punishment model, did nothing more, rather than confirmed the main concern that was tormenting authors while trying to delimit the events in time. The abused child is a reality beyond time, ideology and religion, and as such artworks dealing with it have their deserved professional space. (shrink)

Fear of cancer is mostly related to cancer recurrence, metastasis, additional cancer, and diagnostic tests. Its legacy as a lethal disease has raised fear of approaching death. Currently, cancer’s total suffering and the worsening phenomena have raised fear, especially among female patients. Family caregivers (FCGs) who are responsible for the day-to-day cancer care at home need to help the patients deal with this fear frequently. Due to the limited care competencies, they need supportive care from healthcare professionals in cancer (...) fear management. This study aims to assess how types of demanded healthcare information affect the FCG’s role in reducing the fear of female cancer patients. The mindsponge theory was used in conceptual development and interpretation. Bayesian Mindsponge Framework (BMF) analytics were used for statistical analysis on a dataset of 48 spouses (husbands) and 12 other family members in five congested communities of Surabaya, Indonesia. Results showed that among the six types of healthcare information, FCGs with higher demand on cancer-specific information and information on cancer physical needs were more likely to need support in reducing the fear of female cancer patients. Meanwhile, FCGs with a higher demand for information on support services were less likely to need support to reduce cancer patients’ fear. Other types of healthcare information have ambiguous effects on the need for support in reducing cancer-induced fear. This study reveals that the demanded cancer-specific information, e.g., cancer’s prognosis or likely outcome and information on cancer physical needs, need to be met in priority to assist FCG’s role in cancer fear management. (shrink)

Investigates the roles of temporal concepts and self-consciousness in the development of episodic memory. According to some theorists, types of long-term memory differ primarily in the degree to which they involve or are associated with self-consciousness (although there may be no substantial differences in the kind of event information that they deliver). However, a known difficulty with this view is that it is not obvious what motivates introducing self-consciousness as the decisive factor in distinguishing between types of memory and what (...) role it is supposed to play in remembering. The authors argue that distinctions between different kinds of memory should be made initially on the basis of the ways in which they represent events. In particular, it is proposed that the way in which remembered events are located in time provides an important criterion for distinguishing between different types of memory. According to this view, if there is a link between memory development and self-consciousness, it is because some temporal concepts emerge developmentally only once certain self-conscious abilities are in place. (shrink)

Soon there will be sex robots. The creation of such devices raises a host of social, legal and ethical questions. In this article, I focus in on one of them. What if these sex robots are deliberately designed and used to replicate acts of rape and child sexual abuse? Should the creation and use of such robots be criminalised, even if no person is harmed by the acts performed? I offer an argument for thinking that they should be. The (...) argument consists of two premises. The first claims that it can be a proper object of the criminal law to regulate wrongful conduct with no extrinsically harmful effects on others. The second claims that the use of robots that replicate acts of rape and child sexual abuse would be wrongful, even if such usage had no extrinsically harmful effects on others. I defend both premises of this argument and consider its implications for the criminal law. I do not offer a conclusive argument for criminalisation, nor would I wish to be interpreted as doing so; instead, I offer a tentative argument and a framework for future debate. This framework may also lead one to question the proposed rationales for criminalisation. (shrink)

Belgium has recently extended its euthanasia legislation to minors, making it the first legislation in the world that does not specify any age limit. I consider two strands in the opposition to this legislation. First, I identify five arguments in the public debate to the effect that euthanasia for minors is somehow worse than euthanasia for adults—viz. arguments from weightiness, capability of discernment, pressure, sensitivity and sufficient palliative care—and show that these arguments are wanting. Second, there is another position in (...) the public debate that wishes to keep the current age restriction on the books and have ethics boards exercise discretion in euthanasia decisions for minors. I interpret this position on the background of Velleman’s “Against the Right to Die” and show that, although costs remain substantial, it actually can provide some qualified support against extending euthanasia legislation to minors. (shrink)

Imagine you fly home from vacation with your one-and-a-half-year-old son who is traveling for free as a “lap child.” In the airport parking lot, you put him into his forward-facing car seat, where he sits much more contentedly than he did in the rear-facing one that was mandatory until his first birthday. After he falls asleep on the way home, you transfer him to his crib without waking him, lowering the side rail so you can lift him in more (...) easily. -/- Many parts of this idyllic parenting picture are deemed unacceptably risky according to recent child safety proposals. While these proposals all aim to improve child safety, their possible impact is unclear because there has been little discussion of the absolute risk and risk reduction involved in each. And while precise figures are lacking, rough estimates indicate that the magnitudes are quite small. I will argue that this risk and benefit data raises important questions about the proposals, including whether parents might reasonably believe that the small absolute risk reduction offered by the proposed changes does not justify the attendant burdens. This possibility—termed the “prevention paradox” in other contexts—highlights ethical and theoretical challenges in this area of public health. (shrink)

This paper discusses different frameworks for understanding imagination and metaphor in the context of research on the imaginative skills of children with autism spectrum disorder (ASD). In contrast to a standard linguistic framework, it advances an embodied and enactive account of imagination and metaphor. The paper describes a case study from a systemic therapeutic session with a child with ASD that makes use of metaphors. It concludes by outlining some theoretical insights into the imaginative skills of children with ASD (...) that follow from taking the embodied-enactive perspective and proposes suggestions for interactive interventions to further enhance imaginative skills and metaphor understanding in children with ASD. (shrink)

While there is a prolific debate surrounding the issue of conscientious objection of individuals towards performing certain clinical acts, this debate ignores the fact that there are other reasons why clinicians might wish to object providing specific services. This paper briefly discusses the idea that healthcare workers might object to providing specific services because they are against their professional judgement, they want to maintain a specific reputation, or they have pragmatic reasons. Reputation here is not simply understood as being (...) in good standing with a professional body. Rather, reputation is treated in the sense that a craftsman might wish to be known for providing a specific type, quality, and style of service. Professionalism is understood as acting according to the philosophical and scientific principles that are the basis of healthcare (such as acting for the benefit of the patient’s health and following well- evidenced treatment pathways). (shrink)

Anatomically detailed dolls have been used to elicit testimony from children in sex abuse cases. However, studies have shown they often provide false accounts in young, preschool-age children. Typically this problem is seen as a cognitive one: with age, children can correctly map their bodies onto a doll due to greater intellectual ability to represent themselves. I argue, along with the work of Maurice Merleau-Ponty, that although certainly cognitive developments aid in representing one’s own body, a discussion of embodiment is (...) required in order to understand the use and abuse of anatomical dolls in forensic interviews. This paper will examine these issues and suggest that a better understanding of embodied perception in both adults and children helps show how phenomenology can provide a more nuanced understanding to a troubling ethical and legal problem. (shrink)

Should a 9-year-old, severely mentally disabled child undergo extensive operations to limit her growth, prevent development of sexual characteristics, and alter appearance, all in the interests of protecting her from other alleged harms and allowing her to be cared for by her family? I think we should resist engaging with this question, and I think the ethics committee was wrong to accept the burden of making the decision regardless of the outcome they arrived at.

_ Source: _Page Count 30 Millions of children worldwide could benefit from adoption. One could argue that prospective parents have a pro tanto duty to adopt rather than create children. For the sake of argument, I assume there is such a duty and focus on a pressing objection to it. Prospective parents may prefer that their children are genetically related to them. I examine eight reasons prospective parents have for preferring genetic children: for parent-child physical resemblance, for family resemblance, (...) for psychological similarity, for the sake of love, to achieve a kind of immortality, for the genetic connection itself, to be a procreator, and to experience pregnancy. I argue that, with the possible exception of the pregnancy desire, these reasons fail to defeat a duty to adopt a child rather than create one, even assuming that we do have some leeway to favor our own interests. (shrink)

In this paper, I analyze the ethical implications of genetic enhancement within the specific framework of the “child’s right to an open future” argument (CROF). Whilst there is a broad ethical consensus that genetic modifications for eradicating diseases or disabilities are in line with – or do not violate – CROF, there is huge disagreement about how to ethically understand genetic enhancement. Here, I analyze this disagreement and I provide a revised formulation of the argument in the specific field (...) of genetic enhancement. First, I argue that CROF is not in contrast with every kind of enhancement. I subsequently discuss whether CROF requires some moral obligations to enhance progeny. My argument is that parents do not have the moral obligation to open as many options as possible for their children. Rather, they should provide them with a reasonable range of opportunities. Finally, I contend that the moral obligations required by CROF are directly dependent on what Allen Buchanan calls the ‘dominant cooperative framework’ in a given society. I conclude by claiming that, at present, parents are not morally obliged to genetically enhance their children since a non-enhanced person already might have access to a reasonable range of opportunities. However, the moral obligation to enhance progeny might arise if a structural modification of the dominant cooperative framework occurs. (shrink)

In *Engaging Capital Emotions,* Douglas Berman and Stephanos Bibas argue that emotion is central to understanding and evaluating the death penalty, and that the emotional case for the death penalty for child rape may be even stronger than for adult murder. Both the Berman and Bibas article and the subsequent Supreme Court decision in Kennedy v. Louisiana (striking down the death penalty for child rape) raise difficult questions about how to measure the heinousness of crimes other than murder, (...) and about the role the pain suffered by victims and victims' families should play in this inquiry. In this Reply, I agree with the authors on the importance of confronting emotion's role in capital punishment, for reasons I discuss in Part A. However, I disagree with their claim that the moral outrage evoked by child rape supports making it a capital crime. Part B explores the difficulties of using the existence of moral outrage as a measure of appropriate punishment. Part C argues that the penal system should not merely reflect moral outrage, but channel and educate it. It suggests that the availability of the death penalty may create an anchoring effect, communicating the message that the death penalty is the proper way to express moral outrage and to honor the worth of murder victims. It explores the consequences of this message. Section II focuses on the role of emotion in deciding whether child rape should be a capital crime. Part A considers the problematic role of victim harm in determining whether the death penalty is appropriate. It explores the question, raised in Kennedy v Louisiana, of whether the effect of a capital trial on child rape victims ought to be part of the calculus. Part B argues that there are three particular problems with allowing juries to sentence child rapists to death: the deleterious effect of anger and empathy, the problem of generic prejudice, and the issue of race. (shrink)

Bangladesh is a signatory of the International Labor Organization’s two landmark conventions on child labor – No.138 on Minimum Age and No. 182 on the Worst Forms of Child Labor. The Bangladesh Labor Act, 2006 prohibits the employment of any child in child labor’s worst forms, including hazardous ones. To eliminate hazardous child labor (HCL) from the country, the government published a list of 38 activities/processes as hazardous to children. However, emerging data suggest that HCL (...) still exists widely in the country, and the COVID-19 pandemic has worsened the situation. The review of existing evidence and relevant reports evinces that the country’s current policies inadequately address the status and remedies of HCL. Based on the author’s desk review, observational experience and visual work, this paper evaluates the competence of the hazardous labor list and current legal protections for children. The findings suggest that lack of implementation, reporting and monitoring opens the floodgate for employers to informally employ children in hazardous work and take advantage of the legal lacunae. Destitute families and street children lack citizenship documents and become easy victims of exploitative employment. The analysis informs that the country’s existing legislative framework and protection policies are critically inadequate to cease HCL in urban areas. (shrink)

This article analyses how child victims of abuse may be subjected to hermeneutical injustice. I start by explaining how child victims are hermeneutically marginalised by adults’ social and epistemic authority, and the stigma around child abuse. In understanding their abuse, I highlight two epistemic obstacles child victims may face: (i) lack of access to concepts of child abuse, thereby causing victims not to know what abuse is; and (ii) myths of child abuse causing misunderstandings (...) of abuse. When these epistemic obstacles cause the child victims to fail to see themselves as being abused and/or to get adults to recognise that they are being abused, I argue that this constitutes hermeneutical injustice. While some may justify obstructing epistemic access to concepts of abuse on the grounds of parental rights and protection of children’s innocence, I reply that both grounds are unjust in light of children’s basic rights and the fact that children can easily be taught such concepts in a child-appropriate manner. The case of child abuse prompts important reflections on existing epistemic injustice literature, particularly on the ways in which hermeneutical injustice materialises, the epistemic responsibilities of institutional bodies and individuals, and the interrelationship between testimonial and hermeneutical injustice. (shrink)

Previously proposed strategies for tackling hermeneutical injustices take for granted the interests people have in certain things about them being intelligible to them and/or to others, and seek to enable them to satisfy these interests. Strategies of this sort I call interests-as-given strategies. I propose that some hermeneutical injustices can instead be tackled by doing away with certain of these interests, and so with the possibility of their unfair non-satisfaction. Strategies of this sort I call interests-in-question strategies. As a case (...) study in when such an interests-in-question strategy ought to be pursued, I look at how to tackle hermeneutical injustices arising in the context of gender-affirming healthcare as provided to adults by the National Health Service in the UK. I argue that considerations of trust, privacy, and respect all support pursuing such a strategy. One way to do so, I suggest, would be by replacing the existing gatekeeping model with an informed consent model for the provision of gender-affirming healthcare. Considerations of hermeneutical justice can hence be added to the already-impressive case for undertaking this shift. (shrink)

A dogma accepted in many ethical, religious, and legal frameworks is that the reasons behind conscientious objection (CO) in healthcare cannot be evaluated or judged by any institution because conscience is individual and autonomous. This paper shows that this background view is mistaken: the requirement to reveal and explain the reasons for conscientious objection in healthcare is ethically justified and legally desirable. Referring to real healthcare cases and legal regulations, this paper argues that these reasons should be (...) evaluated either ex ante or ex post and defends novel conceptual claims that have not been analyzed in the debates on CO. First, a moral threshold requirement: CO is only justified if the reasons behind a refusal are of a moral nature and meet a certain threshold of moral importance. Second, this paper considers the rarely discussed conceptual similarities between CO in healthcare and the legal regulations concerning military refusals that place the burden of proof on conscientious objectors. This paper concludes that conscientious objection in healthcare can be accommodated only in some cases of destroying or killing human organisms. (shrink)

Rare diseases pose a particular priority setting problem. The UK gives rare diseases special priority in healthcare priority setting. Effectively, the National Health Service is willing to pay much more to gain a quality-adjusted life-year related to a very rare disease than one related to a more common condition. But should rare diseases receive priority in the allocation of scarce healthcare resources? This article develops and evaluates four arguments in favour of such a priority. These pertain to public (...) values, luck egalitarian distributive justice the epistemic difficulties of obtaining knowledge about rare diseases and the incentives created by a higher willingness to pay. The first is at odds with our knowledge regarding popular opinion. The three other arguments may provide a reason to fund rare diseases generously. However, they are either overinclusive because they would also justify funding for many non-rare diseases or underinclusive in the sense of justifying priority for only some rare diseases. The arguments thus fail to provide a justification that tracks rareness as such. There are no data in this work. (shrink)

It is common to cite the child’s “right to an open future” in discussions of how parents and the state may and should treat children. However, the right to an open future can only be useful in these discussions if we have some method for deriving the content of the right. In the paper in which he introduces the right to an open future Joel Feinberg seems to provide such a method: he derives the right from the content of (...) adult autonomy rights. In this paper I argue that his argument fails. If it is to give us guidance about the content of the child’s right to an open future, then the right should be interpreted as a right to a maximally open future. But this strong interpretation is unjustified: the arguments that can be found in Feinberg in favor of the right are invalid, and, in any case, this interpretation has implausible implications. A moderate interpretation of the right to an open future, according to which children have a right to acquire some reasonable range of skills and options, is more plausible. However, if a moderate interpretation is correct, there is not only no argument in Feinberg to support it, there is also no method for deriving the content of the right. Without such a method we have to bring in other moral considerations in order to work out the limits on parental discretion and what children are owed. The right to an open future then does no normative work. (shrink)