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

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

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

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

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

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

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

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

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

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)

“Bodily autonomy” has received significant attention in bioethics, medical ethics, and medical law in terms of the general inviolability of a patient’s bodily sovereignty and the rights of patients to make choices (e.g., reproductive choices) that concern their own body. However, the role of the body in terms of how it can or does contribute to a patient’s capacity for, or exercises of their autonomy in clinical decision-making situations has not been explicitly addressed. The approach to autonomy in this paper (...) is aligned with traditional theories that conceive autonomy in terms of an individual’s capacities for, and exercises of rational reflection. However, at the same time, this paper extends these accounts by arguing that autonomy is, in part, embodied. Specifically, by drawing on phenomenological conceptions of the experience of autonomy, we argue that, in principle, the body is a necessary component of the capacity for autonomy. Secondly, through the presentation of two different cases, we highlight ways in which a patient’s body can contribute to the autonomy of treatment choices. Ultimately, we hope to encourage others to explore additional conditions under which a concept of embodied autonomy should be employed in medical decision making, how its underlying principles might be operationalised in clinical situations, and its consequences for approaches to patient autonomy in healthcare practice, policy, and law. (shrink)

Phenomenology gives rise to certain ontological considerations that have far-reaching implications for standard conceptions of patient autonomy in medical ethics, and, as a result, the obligations of and to patients in clinical decision-making contexts. One such consideration is the phenomenological reduction in classical phenomenology, a core feature of which is the characterisation of our primary experiences as immediately and inherently meaningful. This paper builds on and extends the analyses of the phenomenological reduction in the works of Husserl, Heidegger, and Merleau-Ponty (...) in order to identify and explain its implications for our current understanding of the principle of respect for patient autonomy and the norms of clinical decision making. (shrink)

Smajdor argues that “recognition” is the solution to the “reifying attitude” that results from “the urge to protect ‘vulnerable’ people through exclusion from research”. Drawing on theories of reification, we argue that it is the concepts of autonomy and vulnerability themselves that have been reified, resulting in the impoverishment of approaches to autonomy at law and in research ethics. Overcoming such reification demands a deeper consideration of the grounds on which vulnerable individuals are owed recognition and thereby the forms such (...) recognition should take. Smajdor argues for a recognition that appeals to autonomy and that manifests in providing vulnerable individuals with the opportunity to assent. The problem is that this kind of recognition is dependent on a more fundamental kind. It is this second form of recognition that would need to do the heavy lifting for assent-based frameworks to avoid the same problems we find with consent. (shrink)

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

What constitutes a scientific discovery? What role do discoveries play in science, its dynamics and social practices? Must every discovery be attributed to an individual discoverer (or a small number of discoverers)? The paper explores these questions by first critically examining extant philosophical explications of scientific discovery—the models of scientific discovery, propounded by Kuhn, McArthur, Hudson, and Schindler. As a simple, natural and powerful alternative, we proffer the “change-driver model”: in a nutshell, it takes discoveries to be cognitive scientific results (...) that have epistemically advanced science. The model overcomes the shortcomings of its precursors, whilst preserving their insights. We demonstrate its intensional and extensional superiority, especially with respect to the link between scientific discoveries and the dynamics of science, as well as the award system of science. Both as an illustration, and as an application to a recent scientific and political controversy, we apply the considered models of discovery to one of the most momentous discoveries of science: the expansion of the universe. We oppose the 2018 proposal of the International Astronomers’ Union as too simplistic vis-`a-vis the historical complexity of the episode. The change- driver model yields a more nuanced and circumspect verdict: (i) The redshift-distance relation shouldn’t be named the “Hubble-Lemaître Law”, but “Slipher-Lundmark-Hubble-Humason Law”; (ii) Its interpretation in terms of an expanding universe, however, Lemaître ought to be given credit for; but (iii) The establishment of the expansion of the universe, as an evidentially sufficiently warranted result, is a communal achievement, emerging in the 1950s or 1960s. (shrink)

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

Research ethics committees and institutional review boards spend considerable time developing, scrutinising, and revising specific consent processes and materials for survey-based studies conducted on crowdsourcing and online recruitment platforms such as MTurk and Prolific. However, there is evidence to suggest that many users of ICT services do not read the information provided as part of the consent process and they habitually provide or refuse their consent without adequate reflection. In principle, these practices call into question the validity of their consent. (...) In this paper we argue that although the ‘no read problem’ and the routinisation of consent may apply to research participants’ consent practices for studies on crowdsourcing platforms, this is not a serious problem. Furthermore, given that the informational requirements for informed consent in these contexts are minimal, we argue that these participants are, nevertheless, sufficiently informed to give valid consent. We conclude that research ethics committees and institutional review boards should only agonise over the precise details of the informed consent process and materials in those rare cases where appreciable risks to research participants need to be managed. (shrink)

Abortion remains a highly controversial issue in many countries and subject to intense public debate. The aim of this chapter is to summarize the most prominent assumptions and arguments concerning the moral and legal dimensions of abortion on which this debate rests. Where the moral justifiability of abortion is concerned, this chapter focuses on arguments relating to the moral status of the fetus or embryo, the notion of personhood, the biological development of the embryo or fetus, and the moral relevance (...) of specific points in the developmental process. In terms of the legal aspects, we consider concepts and principles invoked at law, principally, the rights of pregnant women and the medical concept of viability. For each moral and legal position in the abortion debate, we provide an overview of the principal assumptions and arguments and acknowledge the main criticisms. (shrink)

At the centenary of Frank H. Knight’s Risk, Uncertainty, and Profit (1921), we explore the continuing relevance of Knightian uncertainty to the theory and practice of entrepreneurship. There are three challenges facing such assessment. First, RUP is complex and difficult to interpret. The key but neglected element of RUP is that Knight’s account is not solely about risk and uncertainty as states of nature, but about how an agent’s beliefs about uncertain outcomes and confidence in those beliefs guide their choices. (...) Second, RUP is Knight’s only effort in this area. His subsequent career led elsewhere, so he did not engage with subsequent interpretations of this work. Third, much of the current literature emphasizes that decisions must be different under the two states of nature with a consequent misunderstanding of entrepreneurial agency. This paper addresses each challenge in sequence. First, we explicate Knight’s (1921) approach and explain why that approach is murky. Second, as a complement to Knight’s interpretation, we examine Frank P. Ramsey’s approach to subjective probabilities to help clarify Knight’s murky approach. What links Knight and Ramsey is a shared pragmatism about entrepreneurial agency under uncertainty that depends upon the beliefs about, and confidence in, their judgments of possible outcomes. This Knight-Ramsey approach does not require actor’s behaviors to be determined by the class of uncertain environment (whether risk, uncertainty, or ambiguity) they face. We focus on the response by the entrepreneur to the existence of uncertainty in all its forms. We argue that this reductive account provides a foundation to examine common problems in management, including managerial hubris, the interaction between entrepreneurs and venture capitalists, and the need for experimentation (such as prototyping and market research) in advance of new product and venture launches. Third, we critique current literature that favors epistemic purism about the ontology of risk and uncertainty and ignores Knight-Ramsey pragmatism in meeting uncertainty, such as using formal and informal institutions for uncertainty mitigation. Our account locates Frank Knight’s subtleties in entrepreneurial behavior firmly in the literature on entrepreneurial agency a century later. (shrink)

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

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

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

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

Background There has been debate on whether a global or unified field of bioethics exists. If bioethics is a unified global field, or at the very least a closely shared way of thinking, then we should expect bioethicists to behave the same way in their academic activities anywhere in the world. This paper investigates whether there is a 'global bioethics' in the sense of a unified academic community. Methods To address this question, we study the web-linking patterns of bioethics institutions, (...) the citation patterns of bioethics papers and the buying patterns of bioethics books. Results All three analyses indicate that there are geographical and institutional differences in the academic behavior of bioethicists and bioethics institutions. Conclusion These exploratory studies support the position that there is no unified global field of bioethics. This is a problem if the only reason is parochialism. But these regional differences are probably of less concern if one notices that bioethics comes in many not always mutually understandable dialects. (shrink)

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

This essay examines whether or not absurdity is intrinsic to human life. It takes Camus’ interpretation of ‘The Absurd’ as its conceptual starting point. It traces such thought back to Schopenhauer, whose work is then critically analysed. This analysis focuses primarily on happiness and meaning. This essay accepts some of Schopenhauer’s premises, but rejects his conclusions. Instead, it considers Nietzsche’s alternatives and the role of suffering in life. It posits that suffering may help people acquire meaning and escape absurdity. It (...) then analyses the role of compassion in absurdity, in reference to Nietzsche’s work and Buddhist teachings. Lastly, it examines absurdity in relation to death, rejecting the notion that death exacerbates absurdity. This paper understands absurdity to be a natural part of the human condition, as characterised by suffering, death and an absence of meaning. It concludes that although human life is absurd by nature, it need not remain so. (shrink)

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

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

In response to the COVID-19 pandemic, large-scale research and pharmaceutical regulatory processes have proceeded at a dramatically increased pace with new and effective, evidence-based COVID-19 interventions rapidly making their way into the clinic. However, the swift generation of high-quality evidence and the efficient processing of regulatory authorisation have given rise to more specific and complex versions of well-known research ethics issues. In this paper, we identify three such issues by focusing on the authorisation of Molnupiravir, a novel antiviral medicine aimed (...) at reducing the ability of SARS-CoV-2 to multiply in the body, for clinical use by the National Health Service in England and the concomitant testing of Molnupiravir through the large-scale PANORAMIC randomised control trial. By analysing the ways in which the authorisation and clinical use of Molnupiravir complicate standard approaches to clinical equipoise, standard of care, and participant consent in the PANORAMIC randomised control trial we will explain some of ethical implications for clinical trials that aim to study the efficacy and safety of new COVID-19 and other therapeutics when conditional authorisation has already been granted and when such treatments have already been made available to patients by national health providers. (shrink)

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

The protection of rare species abounds with scientific and ethical considerations. An ethical dilemma can emerge when the life of one species is valued higher than that of another, and so we discuss the basis of ranking, protection, and valuation of plants and animals. A duty to protect rare species exists in this age of great losses to plant and animal life, but the scientific and public communities are not always in agreement regarding what species deserve protection. Using a case (...) study, we illustrate how the decision to kill beavers to protect a rare plant and rare animals found in a tidewater creek demanded an ecological ethic approach. We present the concept of a" conservation mediator" and how its use may help find a common ground between stakeholders and decision-makers in similar situations. (shrink)

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

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

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

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

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

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

SummaryHolm Tetens develops in his book „Gott denken. Ein Versuch über rationale Theologie“ theoretical and practical arguments against a naturalistic and in favour of a theistic understanding of reality. In my paper I focus on Teten’s claim that we are rationally justified to hope for the truth of classical theism. I distinguish between rationally justified and unjustified forms of hope and argue that we are rationally justified to hope for the redemption of reality as promised by classical theism. However, this (...) hope has a weaker basis of justification than Tetens seems to assume because serious objections to classical theism ought to be taken into consideration as well. (shrink)

Recently, a number of authors have suggested that we understand scientific models in the same way as fictional characters, like Sherlock Holmes. The biggest challenge for this approach concerns the ontology of fictional characters. I consider two responses to this challenge, given by Roman Frigg, Ronald Giere and Peter Godfrey-Smith, and argue that neither is successful. I then suggest an alternative approach. While parallels with fiction are useful, I argue that models of real systems are more aptly compared to (...) works that portray real people, like the Emperor Claudius. This approach will allow us to avoid problems with fictional characters. (shrink)

Holm (2022) argues that a class of algorithmic fairness measures, that he refers to as the ‘performance parity criteria’, can be understood as applications of John Broome’s Fairness Principle. We argue that the performance parity criteria cannot be read this way. This is because in the relevant context, the Fairness Principle requires the equalization of actual individuals’ individual-level chances of obtaining some good (such as an accurate prediction from a predictive system), but the performance parity criteria do not guarantee any (...) such thing: the measures merely ensure that certain population-level ratios hold. (shrink)

Commentators of the judicial decisions of Justice Holmes have often situated the decisions inside the doctrines of freedom of expression and the rules and tests approach to legal analysis. This Paper situates his judgments in the context of a political theory. Drawing from his articles, lectures and correspondence, the Paper highlights Holmes’ reaction to the idealism and rationalism of the intellectual current before him. His view of human nature, conditioned by his war experience, is elaborated. The Paper especially (...) examines his theory of political struggle with the process-oriented view that the dominant social groups invariably become the political elite. The Paper then connects his theory of human nature to his legal doctrines, the role of the judiciary, the nature of the state, and a legal right. (shrink)

In “Semantics of Fictional Terms,” Garcia-Carpintero critically surveys the most recent literature on the topic of fictional names. One of his targets is realism about fictional discourse. Realists about fictional discourse believe that: (a) it contains true sentences that have fictional names as their subjects; (b) sentences containing names can be true only if those names have referents; (c) fictional names have fictional characters – abstract objects – as their referents. The fundamental problem that arises for realists is that not (...) all true sentences containing fictional names are plausibly about abstract objects. This leads to the need to introduce disjunctive conceptions of property attribution that Garcia-Carpintero claims are implausible, and that realism should therefore be rejected. He also maintains, however, that (a) is correct. I agree. Furthermore, I am also committed to anti-realism about fictional discourse – that fictional names have no referents. Garcia-Carpintero claims that my view is simply a notational variant of realism. I argue that this is false – that my view could not possibly be a notational variant of any extant realist theory. (shrink)

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

According to possibilism, or non-actualism, fictional characters are possible individuals. Possibilist accounts of fiction do not only assign the intuitively correct truth-conditions to sentences in a fiction, but has the potential to provide powerful explanatory models for a wide range of phenomena associated with fiction (though these two aspects of possibilism are, I argue, crucially distinct). Apart from the classic defense by David Lewis the idea of modeling fiction in terms of possible worlds have been widely criticized. In this article, (...) I provide a defense of a possibilist account against some lines of criticism. To do so, I assume that names for fictional characters are directly referential and a possible-worlds model that accommodates transworld identity. On this background, I argue, it is possible to construct an elegant model of fictional discourse using familiar models of information exchange in ordinary discourse, and I sketch how this model can be used to i) make a natural distinction between fictional and counterfactual discourse, ii) account for creativity, and iii) sustain a natural definition of truth-in-fiction that avoids certain familiar objections to possibilism. Though I set aside questions about the metaphysical commitments of a possible-world interpretation here, there is accordingly reason to think that the battle over possibilist treatments of fiction will have to be fought over metaphysical foundations rather than technical shortcomings. (shrink)