We respond to open peer commentaries on our target article, "Health Research Priority Setting: The Duties of Individual Funders".

Most public and non-profit organisations that fund health research provide the majority of their funding in the form of grants. The calls for grant applications are often untargeted, such that a wide variety of applications may compete for the same funding. The grant review process therefore plays a critical role in determining how limited research resources are allocated. Despite this, little attention has been paid to whether grant review criteria align with widely endorsed ethical criteria for allocating health research resources. (...) Here, we analyse the criteria and processes that ten of the largest public and non-profit research funders use to choose between competing grant applications. Our data suggest that research funders rarely instruct reviewers to consider disease burden or to prioritise research for sicker or more disadvantaged populations, and typically only include scientists in the review processes. This is liable to undermine efforts to link research funding to health needs. (shrink)

Deepfakes are algorithmically modified video and audio recordings that project one person’s appearance on to that of another, creating an apparent recording of an event that never took place. Many scholars and journalists have begun attending to the political risks of deepfake deception. Here we investigate other ways in which deepfakes have the potential to cause deeper harms than have been appreciated. First, we consider a form of objectification that occurs in deepfaked ‘frankenporn’ that digitally fuses the parts of different (...) women to create pliable characters incapable of giving consent to their depiction. Next, we develop the idea of ‘illocutionary wronging’, in which an individual is forced to engage in speech acts they would prefer to avoid in order to deny or correct the misleading evidence of a publicized deepfake. Finally, we consider the risk that deepfakes may facilitate campaigns of ‘panoptic gaslighting’, where many systematically altered recordings of a single person's life undermine their memory, eroding their sense of self and ability to engage with others. Taken together, these harms illustrate the roles that social epistemology and technological vulnerabilities play in human ethical life. (shrink)

We discuss the role of prior authorization (PA) in supporting patient-centered care (PCC) by directing health system resources and thus the ability to better meet the needs of individual patients. We begin with an account of PCC as a standard that should be aimed for in patient care. In order to achieve widespread PCC, appropriate resource management is essential in a healthcare system. This brings us to PA, and we present an idealized view of PA in order to argue how (...) at its best, it can contribute to the provision of PCC. PA is a means of cost saving and as such it has mixed success. The example of the US demonstrates how implementation of PA has increased health inequalities whereas best practice has the potential to reduce them. In contrast, systems of universal coverage, like those in Europe, may use the cost savings of PA to better address individuals' care and PCC. The conclusion we offer therefore is an optimistic one, pointing towards areas of supportive overlap between PCC and PA where usually the incongruities are most evident. (shrink)

Hundreds of millions of rare biospecimens are stored in laboratories and biobanks around the world. Often, the researchers who possess these specimens do not plan to use them, while other researchers limit the scope of their work because they cannot acquire biospecimens that meet their needs. This situation raises an important and underexplored question: how should scientists allocate biospecimens that they do not intend to use? We argue that allocators should aim to maximise the social value of the research enterprise (...) when allocating scarce biospecimens. We provide an ethical framework for assessing the social value of proposed research projects and describe how the framework could be implemented. (shrink)

Psychological studies show that the beliefs of two agents in a hypothesis can diverge even if both agents receive the same evidence. This phenomenon of belief polarisation is often explained by invoking biased assimilation of evidence, where the agents’ prior views about the hypothesis affect the way they process the evidence. We suggest, using a Bayesian model, that even if such influence is excluded, belief polarisation can still arise by another mechanism. This alternative mechanism involves differential weighting of the evidence (...) arising when agents have different initial views about the reliability of their sources of evidence. We provide a systematic exploration of the conditions for belief polarisation in Bayesian models which incorporate opinions about source reliability, and we discuss some implications of our findings for the psychological literature. (shrink)

School administrators are mandated to take the instructional leadership roles. On this premise, a study assessed the extent of instructional leadership practices of public elementary school administrators in El Salvador City Division, Philippines. Also, it explored their actual practices, challenges encountered, and the ways they overcome the challenges in practicing instructional leadership. It employed a mixed-method research design. It administered the adopted assessment tool on instructional leadership to 15 school administrators and 12 of them were involved in the individual interviews. (...) This was conducted between the last quarter of 2019 and the first quarter of 2020. Descriptive statistics were used to describe the extent of instructional leadership practices. Also, it analyzed the actual practices, the challenges encountered, and the ways of overcoming these challenges using thematic narrative analysis. Results revealed that public school administrators have always practiced the four domains or strands of instructional leadership to a very high extent. Providing the technical assistance, conducting clinical supervision, and innovating teaching and learning emerged as themes of their actual practices. These administrators had encountered challenges in dealing with teachers’ attitudes, conflicting schedules and activities, and teachers’ resistance to changes. They overcome the challenges by trying to meet the competency standards, adapting and modifying the existing programs, contextualizing teaching and learning, and inculcating the value and benefits of class observation. Looking at the findings from the lens of deliberate practice theory, it was concluded that school administrators have indicated they have acquired knowledge and a high level of understanding of their instructional leadership roles. But despite of this, they still met challenges and have tried their best to manage them. This study presented some doable and practical recommendations to the Department of Education (DepEd) and concerned offices which may benefit both the internal and external stakeholders of the schools. (shrink)

This correspondence piece responds to commentaries on the authors' survey of U.S. bioethicists. The authors address two key questions: the definition of a bioethicist and how bioethics should evolve. They identify four distinct roles bioethicists occupy: researchers, pedagogues, consultants, and advocates/activists. The article examines various aspects of inclusiveness in bioethics - demographic, viewpoint, methodological, and topical - while acknowledging inherent tensions and trade-offs between them. For example, including religiously or geographically diverse voices may conflict with other inclusivity goals. The authors (...) argue that while demographic inclusiveness is crucial, other forms of inclusiveness require careful consideration of trade-offs and empirical research to assess their impacts. They emphasize the need for systematic research on bioethicists' beliefs and reasoning, particularly regarding complex issues like disability and racial health disparities. The piece concludes by calling for continued dialogue and better funding for empirical research on ethical perspectives across different groups. (shrink)

Although ethics is an essential component of undergraduate medical education, research suggests current medical ethics curricula face considerable challenges in improving students’ ethical reasoning. This paper discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised, the Medical Ethics (...) Bowl. Finally, we suggest pedagogical advantages to MEBs when compared to other ethics curricula. (shrink)

Discerning the decisionmaking of Kim Jong-Un and the North Korean regime on issues of peaceful engagement and warlike actions endures as a mighty challenge for U.S. intelligence analysts and policymakers. In this report, we seek to inform analysis of Democratic People’s Republic of Korea (DPRK) leadership decisionmaking. To do so, we use three discussion papers that were written to facilitate discussion of an interagency working group. The three papers are assembled here in a single report. The first discussion paper describes (...) decisionmaking among different authoritarian regimes, including North Korea, and the opening up of those economies to outside engagement. The second paper outlines two different scenarios that might occur when conventional deterrence on the Korean Peninsula breaks down and the resulting decisions that North Korea’s leadership could face. The third paper assesses DPRK decisionmaking about nuclear weapon use. The report concludes with some observations, drawn from the issues covered in these three discussion papers, about DPRK decisionmaking and stability on the Korean Peninsula. (shrink)