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)

The vast majority of health research resources are used to study conditions that affect a small, advantaged portion of the global population. This distribution has been widely criticized as inequitable and threatens to exacerbate health disparities. However, there has been little systematic work on what individual health research funders ought to do in response. In this article, we analyze the general and special duties of research funders to the different populations that might benefit from health research. We assess how these (...) duties apply to governmental, multilateral, nonprofit, and for-profit organizations. We thereby derive a framework for how different types of funders should take the beneficiaries of research into account when they allocate scarce research resources. (shrink)

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

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)

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)

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)

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)

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)

The aim of this study is to stylistically analyze the common symbols in Charles Dickens’s Christmas Books, which revived the Christmas spirit in the dark Victorian era. Experiencing the vast impacts of Industrial Revolution, people in Dickens’s time were suffering from the consequences of industrialism, poverty, class distinctions and shifting values within a dark world. Upon combining sentimentality towards human nature, Dickens, in his Christmas stories, revived a festival which faded away from English life during the 19th (...) c. Through this blending of a Christmas spirit in the dark Victorian era, Dickens drew the desired picture of a better future for his readers. His ‘Dickensian’ style enables questioning and judging the discrepancies in the society and the defects of humanity while entertaining the reader with the concerns of family harmony, forgiveness, charity, happiness, compassion and Christmas joy. Yet instead of presenting his messages explicitly, in the deeper structure, Charles Dickens directs his readers through the messages with the use of symbols in his five Christmas stories. To this end, this study aims at clarifying the common symbols in the stories of Christmas Books to suggest that Dickens lights a candle via his stories for his readers who were imprisoned in the dark Victorian age. (shrink)

Autor prostredníctvom skúmania literárnych diel Charlesa Dickensa, Williama Makepeaca Thackeryho, George Eliotovej a Thomasa Hardyho vytvára mozaiku viktoriánskej morálky Anglicka 19. storočia. Dospel k záveru, že uvedená doba vôbec nebola taká puritánska, ako si ju zvykneme predstavovať a morálne problémy, ktoré ľudstvo rieši v priebehu svojho vývoja sú vo svojej podstate univerzálne, hoci nie totožné. Líšia sa vo svojich individuálnych podobách, v akých sa s nimi stretávame v jednotlivých obdobiach dejín ľudstva.

As the opening line of Dickens' classic novel suggests, it is very often the case that people can imagine both better and worse alternatives to their present reality. Although Dickens was writing about events that occurred over two centuries ago, it remains just as true today that we clearly live in neither the best nor the worst of possible worlds. For instance, we can wish for the amelioration of present difficulties in the Middle East yet still take comfort (...) in the fact that the threat of nuclear war has been greatly reduced since the end of the Cold War. On a more mundane level, it is easy for us to imagine how various aspects of our lives, such as our jobs, marriages, or physical fitness, could be both better and worse. Undoubtedly due to the pervasiveness and intrinsically fascinating qualities of this phenomenon of imagining alternatives to reality, there has been a veritable explosion of research in recent years on what have been termed mental simulation and counterfactual thinking processes. This chapter speculates upon and provides evidence for the antecedents and consequences of two types of counterfactuals: upward (it could have been better) and downward (it could have been worse). The importance of studying the antecedents and consequences of counterfactual direction lie in the differential structures, emotions, intentions, inferences, and behavioral consequences of upward versus downward counterfactual thinking. (shrink)

The irrational exuberance associated with contemporary artificial intelligence (AI) reminds me of Charles Dickens: "it was the age of foolishness, it was the epoch of belief" (cf. Nature Editorial, 2016; to get a feel for the vanity fair that is AI, see Mitchell and Krakauer, 2023; Stilgoe, 2023). It is particularly distressing—feels like yet another rerun of Seinfeld, which is all about nothing (pun intended); we have seen it in the 60s and again in the 90s. AI might have (...) had an inauspicious beginning, which may very well be the original sin, and our current predicament is the attendant divine condemnation. Being unable to stand it, however divine it may be, without further ado, I get to the genesis (instead of getting lost in the here-and-now of this or that so-called breakthrough of AI). Here's my unvarnished critique! (shrink)

In § 35 of Sein und Zeit Heidegger’s denunciation of Gerede, idle talk, is confident and scathing. It sounds so sinister and threatening. What could Heidegger be talking about? One could cite numerous fictional characters (e.g., Pecksniff, Mrs. Gamp, Skimpole, Podsnap – all in Dickens), characters whose speech is very nearly an idiolect of bad faith. And yet there is something so fascinating and creative in their speech, an exuberance in their dissimulation, that one wouldn’t want to miss them. (...) Could idle talk in Heidegger’s sense contribute to the theoretization of Bakhtin's idea of the dialogic and heteroglossia and to the notion of discours as it has been developed by Benveniste, Barthes, and Genette? In prose fiction language is valorized (often implicitly) in terms of meaning/nonsense, serious/non-serious, full/empty. When in fiction language that is deemed low, formulaic, or “empty”-- gossip, chatter, prattle, idiotismes – comes to the fore the narrative elements falters, “nothing much” is said. But a kind of speech as act and process is foregrounded. It is this kind of inadvertence in language, its “idling” state, that Gerede points to. (shrink)

The structure is the backbone of a book. Beneath the surface, it holds everything together and imposes order on the flow. Without a coherent and logical structure, the novel’s key elements are unclear. Victorian Age is known for perfection of the novel from all corners. Though Charles Dickens and Emily Bronte have distinct places in the literary World, Yet their representation of their age has many things in common. The two novels in question “Great Expectations” and “Wuthering Heights” range (...) from Gothic tradition to migration and romance to villainy. Both of these stories can be set off and paralleled to the other. The setting, narration, plot, time era, and lover’s relationships are the elements of comparison as they form the overall structure of a novel. (shrink)

In his essay "Opponents, Audiences, Constituencies, and Community," Edward W. Said throws down a gage to literary theorists and challenges them to break out of disciplinary ghettos, "to reopen the blocked social processes ceding objective representations (hence power) of the world to a small coterie of experts and their clients, to consider that the audience for literacy is not a closed circle of three thousand professional critics but the community of human beings living in society . . . ."' To (...) the literary critic he admonishes: "When you discuss Keats or Shakespeare or Dickens, you may touch on political subjects, of course, but it is assumed that the skills traditionally associated with modern literary criticism . . . are there to be applied to literary texts, not, for instance, to a government document . . . . The intellectual toll this has taken in the work of the most explicitly political of recent critics . . . is very high." Should lawyers not match Said's gage by throwing down one of their own? If literary criticism should be socially engaged, should the social practice of law not be literate? If so, to what end? (shrink)