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)

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)

The counterfactual comparative account of harm faces problems in cases that involve overdetermination and preemption. An influential strategy for dealing with these problems, drawing on a suggestion made by Derek Parfit, is to appeal to _plural harm_—several events _together_ harming someone. We argue that the most well-known version of this strategy, due to Neil Feit, as well as Magnus Jedenheim Edling’s more recent version, is fatally flawed. We also present some general reasons for doubting that the overdetermination and preemption problems (...) for the counterfactual comparative account can be satisfactorily solved by appealing to plural harm. (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)

Every day, thousands of polls, surveys, and rating scales are employed to elicit the attitudes of humankind. Given the ubiquitous use of these instruments, it seems we ought to have firm answers to what is measured by them, but unfortunately we do not. To help remedy this situation, we present a novel approach to investigate the nature of attitudes. We created a self-transforming paper survey of moral opinions, covering both foundational principles, and current dilemmas hotly debated in the media. This (...) survey used a magic trick to expose participants to a reversal of their previously stated attitudes, allowing us to record whether they were prepared to endorse and argue for the opposite view of what they had stated only moments ago. The result showed that the majority of the reversals remained undetected, and a full 69% of the participants failed to detect at least one of two changes. In addition, participants often constructed coherent and unequivocal arguments supporting the opposite of their original position. These results suggest a dramatic potential for flexibility in our moral attitudes, and indicates a clear role for self-attribution and post-hoc rationalization in attitude formation and change. (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)

We have argued that the counterfactual comparative account of harm and benefit (CCA) violates the plausible adequacy condition that an act that would harm an agent cannot leave her much better off than an alternative act that would benefit her. In a recent paper in this journal, however, Neil Feit objects that our argument presupposes questionable counterfactual backtracking. He also argues that CCA proponents can justifiably reject the condition by invoking so-called plural harm and benefit. In this reply, we argue (...) that Feit’s lines of criticism are both unsuccessful. (shrink)

A fundamental assumption of theories of decision-making is that we detect mismatches between intention and outcome, adjust our behavior in the face of error, and adapt to changing circumstances. Is this always the case? We investigated the relation between intention, choice, and introspection. Participants made choices between presented face pairs on the basis of attractiveness, while we covertly manipulated the relationship between choice and outcome that they experienced. Participants failed to notice conspicuous mismatches between their intended choice and the outcome (...) they were presented with, while nevertheless offering introspectively derived reasons for why they chose the way they did. We call this effect choice blindness. (shrink)

In this paper, we present and defend an analysis of harm that we call the Negative Influence on Well-Being Account (NIWA). We argue that NIWA has a number of significant advantages compared to its two main rivals, the Counterfactual Comparative Account (CCA) and the Causal Account (CA), and that it also helps explain why those views go wrong. In addition, we defend NIWA against a class of likely objections, and consider its implications for several questions about harm and its role (...) in normative theorizing. (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)

Scholarly opinions vary on what language is, how it evolved, and from where or what it evolved. Long considered uniquely human, today scholars argue for evolutionary continuity between human language and animal communication systems. But while it is generally recognized that language is an evolving communication system, scholars continue to debate from which species language evolved, and what behavioral and cognitive features are the precursors to human language. To understand the nature of protolanguage, some look for homologs in gene functionality, (...) brain areas, or anatomical structures such as the supralaryngeal vocal tract; others point toward primates, their gestural, vocal, multimodal, and in later evolving hominins also their pantomimic communication systems; and still others draw parallels between the musicality that characterizes language and the pitch found in the numerous sounds produced by animals. Accordingly, protolanguage theories today are multiple and diverse, and protolanguages might have also been diverse. This special issue on Evolving (Proto)Language/s for Lingua bundles several of the protolanguage theories that were put forward at the sixth edition of the Ways to Protolanguage conference series, held at the Calouste Gulbenkian Foundation in Lisbon, in 2019. Not aimed at surveying all the different ways there are to conceptualize, study, and model protolanguage/s, this issue provides interested readers with good overviews on the role played in current theorizing on protolanguage/s by (paleo)anthropology, genetics, physiology, developmental, evolutionary, ecological, and pragmatic research lines. (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)

The paper argues that causal systems and spatial patterns are species of the same genus, namely pattern, and that a clear view of spatial patterns throws light on some aspects of the ontological nature of causal systems. In particular, it is argued that all patterns (and systems) depend on a fiat delimitation of something which in itself is a unity without borders. Pattern realism is true.

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

The 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)

It is argued that medical science requires a classificatory system that (a) puts functions in the taxonomic center and (b) does justice ontologically to the difference between the processes which are the realizations of functions and the objects which are their bearers. We propose formulae for constructing such a system and describe some of its benefits. The arguments are general enough to be of interest to all the life sciences.

It is argued that medical science requires a classificatory system that (a) puts functions in the taxonomic center and (b) does justice ontologically to the difference between the processes which are the realizations of functions and the objects which are their bearers. We propose formulae for constructing such a system and describe some of its benefits. The arguments are general enough to be of interest to all the life sciences.

This essay expands on Barry Smith’s paper “Against Fantology” of 2005, which defends the view that analytic philosophy has throughout its history been marked by a tendency to conceive the syntax of first-order predicate logic as a key to ontology. I present fantology (or "F(a)ntology") in the light of a more general and in itself ontologically neutral operation that I call a default ontologization of a language. I then discuss Quine’s views, since he is the most outspoken fantologist in the (...) second half of the twentieth century. As Smith points out, “fantology sometimes takes the form of a thesis according to which the language of standard predicate logic can serve the formulation of the truths of natural science in a uniquely illuminating way”. Hence Quine’s doctrine according to which the ontological commitments of a theory become evident only when the theory has been regimented in fantological clothing. (shrink)

The counterfactual comparative account of harm has counterintuitive implications in cases involving overdetermination and preemption. A popular strategy for dealing with these problems appeals to plural harm—several events being jointly harmful. Björn Petersson criticizes this strategy on the grounds that it conflicts with a strong intuition that helps to motivate the counterfactual comparative account, namely, that harming someone essentially involves making a difference for the worse for her. In this paper, I argue that Petersson’s argument is unconvincing.

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)

In this article I argue for an empiricist view on laws. Some laws are fundamental in the sense that they are the result of inductive generalisations of observed regularities and at the same time in their formulation contain a new theoretical predicate. The inductive generalisations simul- taneously function as implicit definitions of these new predicates. Other laws are either explicit definitions or consequences of other previously established laws. I discuss the laws of classical mechanics, relativity theory and electromagnetism in detail. (...) Laws are necessary, whereas acciden- tal generalisations are not. But necessity here is not a modal concept, but rather interpreted as short for the semantic predicate “... is necessarily true”. Thus no modal logic is needed. The neces- sity attributed to law sentences is in turn interpreted as “necessary condition for the rest of the the- ory”, which is true since fundamental laws are implicit definitions of theoretical predicates use in the theory. (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)

Electromagnetism is usually understood as a theory describing how charged particles and eletromagnetic fields interact. In this paper I argue that a double ontology comprising both particles and fields is problematic. Either we should think of electromagnetism as a theory about charged particles directly interacting with each other, or as theory of fields whose local interactions are manifested as field quanta, called "particles." From a purely theoretical point of view the choice between a particle and a field interpretation does not (...) matter much when it concerns classical electromagnetism; both interpretations are possible and, as shown by Quine, there is a general method for translating a theory about one kind of objects into a theory assuming another kind of objects, provided these theories are empirically equivalent. From an empiricist point of view, however, the particle interpretation is the choice, since some particles are directly observable. Testable predictions of electromagnetism are predictions of the motion of charged bodies, in theory represented as particles, so this must be the empiricists' choice of ontology. In quantum electrodynamics one is however forced to chose a field ontology, since a particle ontology for this theory is impossible. So called "quantum particles" are field quanta, which cannot be treated as individuals making up a domain of quantification. There is thus a tension regarding ontology between classical and quantum electrodynamics. But this tension is nothing else than the much debated measurement problem of quantum mechanics. (shrink)

Inductive thinking is a universal human habit; we generalise from our experiences the best we can. The induction problem is to identify which observed regularities provide reasonable justification for inductive conclusions. In the natural sciences, we can often use strict laws in making successful inferences about unobserved states of affairs. In the social sciences, by contrast, we have no strict laws, only regularities which most often are conditioned on ceteris paribus clauses. This makes it much more difficult to make reliable (...) inferences in the social sciences. In particular, we want knowledge about general causal relations in order to be able to determine what to do in order to achieve a certain state of affairs. Knowledge about causal relations that are also valid in the future requires experiments or so called ‘natural experiments’. Only knowledge derived from such experiences enable us to draw reasonably reliable inferences about how to act in order to achieve our goals. (shrink)

Political candidates often believe they must focus their campaign efforts on a small number of swing voters open for ideological change. Based on the wisdom of opinion polls, this might seem like a good idea. But do most voters really hold their political attitudes so firmly that they are unreceptive to persuasion? We tested this premise during the most recent general election in Sweden, in which a left- and a right-wing coalition were locked in a close race. We asked our (...) participants to state their voter intention, and presented them with a political survey of wedge issues between the two coalitions. Using a sleight-of-hand we then altered their replies to place them in the opposite political camp, and invited them to reason about their attitudes on the manipulated issues. Finally, we summarized their survey score, and asked for their voter intention again. The results showed that no more than 22% of the manipulated replies were detected, and that a full 92% of the participants accepted and endorsed our altered political survey score. Furthermore, the final voter intention question indicated that as many as 48% (69.2%) were willing to consider a left-right coalition shift. This can be contrasted with the established polls tracking the Swedish election, which registered maximally 10% voters open for a swing. Our results indicate that political attitudes and partisan divisions can be far more flexible than what is assumed by the polls, and that people can reason about the factual issues of the campaign with considerable openness to change. (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)

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)

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)

The project “A Plurality of Lives” was funded and hosted by the Pufendorf Institute for Advanced Studies at Lund University, Sweden. The aim of the project was to better understand how a second origin of life, either in the form of a discovery of extraterrestrial life, life developed in a laboratory, or machines equipped with abilities previously only ascribed to living beings, will change how we understand and relate to life. Because of the inherently interdisciplinary nature of the project aim, (...) the project took an interdisciplinary approach with a research group made up of 12 senior researchers representing 12 different disciplines. The project resulted in a joint volume, an international symposium, several new projects, and a network of researchers in the field, all continuing to communicate about and advance the aim of the project. (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)

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)

Death can be bad for an individual who has died, according to the “deprivation approach,” by depriving that individual of goods. One worry for this account of death’s badness is the Lucretian symmetry argument: since we do not regret having been born later than we could have been born, and since posthumous nonexistence is the mirror image of prenatal nonexistence, we should not regret dying earlier than we could have died. Anthony Brueckner and John Martin Fischer have developed a response (...) to the Lucretian challenge by arguing that it is rational to have asymmetric attitudes toward posthumous and prenatal nonexistence. Recently, Jens Johansson has criticized the Brueckner/Fischer position, claiming that it is irrelevant whether it is actually rational to care about future pleasures but not past pleasures. What matters, according to Johansson, is whether it would be rational for us to care about past pleasures had we come into existence earlier. In this paper, I add to the conversation between Johansson and Brueckner/Fischer by suggesting a way to defend the latter side’s position in a way that has not yet been suggested. I do this by considering a suggestion of Johansson’s for interpreting the Brueckner/Fischer position and by arguing that Johansson’s worry for the position I consider is actually incoherent. (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)

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