The highly contagious 2019 novel coronavirus disease (COVID-19) outbreak has not only impacted health systems, economies, and governments, it has also rapidly grown into a global health crisis, which is now threatening the lives of millions of people globally. While, on one hand, medical institutions are critically attempting to find a cure, on the other hand, governments have introduced striking measures and policies to curtail the rapid spread of the disease. Although COVID-19 has achieved pandemic status and is (...) predominantly viewed as a biomedical issue, it is argued that it should also be treated as a psychological crisis. This paper also reviews the literature to examine and comment on the detrimental effects of isolation, which has been enforced as one of the primary preventative measures to manage the spread of COVID-19. This paper further outlines key recommendations that should be addressed across different levels to buffer against the known adverse effects of isolation, which is especially relevant for the current COVID-19 situation, where a large proportion of the global population is isolated, confined, and/or quarantined. (shrink)

لا تأخذ الأمر على محملٍ شخصي؛ فحين يتعلق الأمر بالمرض والموت، يتلاشى الاهتمام بما إذا كنت صديقي أو قريبي أو جاري أو شخصًا غريبًا عني؛ لا تعنيني الآن هويتك أو علمك أو سياستك، ولا يشغلني أين أو ماذا تعمل، أو ما إذا كنت تعمل أصلاً، ولا يختلف الأمر عندي سواء أكنت ترتدي قناعًا أو تحمل مسدسًا أو تُمسك قلمًا! في الوقت الحالي، أنا لا أثق بك؛ فأنت بالنسبة لي حاملٌ محتملٌ لفيروس قاتل!

According to the care crisis in modern medicine, the existential needs of patients are not sufficiently satisfied. One idea is that to address the crisis physicians should be educated to be virtuous. This suggestion is helpful but incomplete. It does not take into account the part of (non-)human factors, including (medical) technologies. In particular, the paper focuses on online caring forums and argues that they are technological factors that can play the role of focal things, in which (...) the members gather together to do a care-related focal practice. Furthermore, we empirically study the online forums of Ninisite, a popular Persian website on pregnancy, childbirth, and parenting, and suggest that these forums shape focal practices that are helpful in alleviating the care crisis. (shrink)

In recent years, the opioid crisis in the United States has sparked significant discussion on doctor–patient interactions concerning chronic pain treatments, but little to no attention has been given to investigating the vocal aspects of patient talk. This exploratory sociolinguistic study intends to fill this knowledge gap by employing prosodic discourse analysis to examine context-specific linguistic features used by the interlocutors of two distinct medical interactions. We found that patients employed both low pitch and creak as linguistic resources (...) when describing chronic pain, narrating symptoms and requesting opioids. The situational use of both features informs us about the linguistic ways in which patients frame fraught issues like chronic pain in light of the current opioid crisis. This study expands the breadth of phonetic analysis within the domain of discourse analysis, serving to illuminate discussions surrounding the illocutionary role of the lower vocal tract in expressing emotions. (shrink)

The COVID-19 (Coronavirus disease of 2019) pandemic has led to intense conversations about ventilator allocation and reallocation during a crisis standard of care. Multiple voices in the media and multiple state guidelines mention reallocation as a possibility. Drawing upon a range of neuroscientific, phenomenological, ethical, and sociopolitical considerations, the authors argue that taking away someone’s personal ventilator is a direct assault on their bodily and social integrity. They conclude that personal ventilators should not be part of reallocation pools and (...) that triage protocols should be immediately clarified to explicitly state that personal ventilators will be protected in all cases. (shrink)

In "Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical?," Wilkinson (2021) argues that the use of frailty scores in ICU triage does not necessarily involve discrimination on the basis of disability. In support of this argument, he claims, “it is not the disability per se that the score is measuring – rather it is the underlying physiological and physical vulnerability." While we appreciate the attention Wilkinson explicitly pays to disability in this piece, we find (...) the distinction between disability and underlying vulnerability untenable both theoretically and practically. In this peer commentary, we begin with a brief overview of research in philosophy of disability concerning the meaning of the concept itself. We argue that this research demonstrates that many forms of disability do not involve underlying vulnerabilities, and, furthermore, that Wilkinson equivocates between "disability" understood as a medical category vs. "disability" understood as a feature of lived experience. We reject Wilkinson’s distinction on these grounds and offer further considerations to avoid disability discrimination in emergency and crisis standards of care contexts. (shrink)

As the Zika virus pandemic continues to bring worry and fear to health officials and medical scientists, Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have recommended that residents of the Zika-infected countries, e.g., Brazil, and those who have traveled to the area should delay having babies which may involve artificial contraceptive, particularly condom. This preventive policy, however, is seemingly at odds with the Roman Catholic Church’s position on the contraceptive. As least since the promulgation (...) of Paul VI’s 1968 encyclical, Humanae Vitae, the Church has explicitly condemned artificial birth control as intrinsic evil. However, the current pontiff, Pope Francis, during his recent visit to Latin America, remarked that the use of artificial contraception may not be in contradiction to the teaching of Humanae Vitae while drawing a parallel between the current Zika Crisis and the 1960’s Belgian Congo Nun Controversy. The pope mentioned that the traditional ethical principle of the lesser of two evils may be the doctrine that justified the exceptions. The authors of this paper attempt to expand the theological rationale of the pope’s suggestion. In so doing, the authors rely on casuistical reasoning as an analytic tool that compares the Belgian Congo Nun case and the given Zika case, and suggest that the former is highly similar to, if not the same as, the latter in terms of normative moral feature. That is, in both cases the use of artificial contraception is theologically justified in reference to the criteria that the doctrine of the lesser of two evils requires. The authors wish that the paper would provide a solid theological-ethical ground based on which condom-use as the most immediate and effective preventive measure can be recommended in numerous Catholic hospitals as well as among Catholic communities in the world, particularly the most Zika-affected and largest Catholic community in the world, Brazil – 123 million present Brazilian citizens are reported to be Roman Catholic. (shrink)

كان من الطبيعي أن ينصب اهتمام العالم خلال الشهور الأخيرة على فيروس كورونا وكيفية تجاوز جائحته بأقل خسائر مُمكنة، فقد بلغ عدد قتلاه حتى اليوم (2 يونيو 2020) 380.265 شخص، وبات الاقتصاد في حالة فوضى يُرثى لها، وتقلصت حياة البشر وخُطتهم اليومية والمستقبلية بشكلٍ شبه كامل، وتعثرت الدراسة بالمدارس والجامعات، واضطرب الأداء الحكومي في أغلب بلدان العالم، ... إلخ. لكن تركيز الجميع على مشكلةٍ بعينها في عالمٍ يعج بالمشكلات من شأنه أن يُقوض كافة الجهود التي بُذلت أو تُبذل من أجل (...) مستقبلٍ أفضل، لاسيما إن كانت هذه المشكلات أشد إلحاحًا وأكثر خطورة. (shrink)

The observation that a crisis of confidence regarding Psychiatry exists is a notion shared even among psychiatrists themselves. Psychiatry has a checkered history and its alliance with the pharmaceutical industry, aka Big-Pharma, continues to reinforce a need for healthy skepticism. Why? Mainly, an over-reliance on the questionable expertise and authority afforded psychiatry as the specialists of mental health. I contend that the authority of psychiatry is misplaced and too often harmful. Since the criteria required to justify and satisfy psychiatric (...) expertise is not fully established as can be substantiated by compelling reasons to rethink its authority as a reliable profession in its current form. Psychiatric expertise is not particularly scientific and this is especially dangerous in a sector that prescribes mind-altering drugs. There are a number of identified criteria that would otherwise substantiate psychiatric expertise and whilst partially existent, are nonetheless deficient. These major yet deficient aspects of psychiatric practice concern diagnostic problems – reliability and verification of diagnoses and accurate testable validity of diagnoses - mainly due to an absence of identifiable underlying biomarkers ordinarily related to disease or biological conditions. Psychiatrists often fail to distinguish between reactive-depression (reaction to external event or circumstance) and endogenous-depression (biological) resulting, in part, from incorrectly distinguishing between conditions constitutive of ‘trait’ (endogenous) and of those of ‘state’ (e.g. reactive depression; adverse effects from medication, etc.). (shrink)

In this paper, I identify two major philosophical crises confronting medicine as a global phenomenon. The first crisis is the epistemological crisis of adopting an epistemic attitude, adequate for improving medical knowledge and practice. The second is the ethical crisis, also known as the “quality-of-care crisis,” arising from the traditional patient-physician dyad. I acknowledge the different proposals put forward in the quest for solutions to these crises. However, I observe that most of these proposals remain (...) inadequate given their over-reliance on the Western biomedical tradition and the medical hegemony that underpins the proposals themselves. Contrary to the approach employed in these proposals, I propose medical pluralism as a viable platform for resolving the philosophic crises in medicine, by critically engaging non-Western medical traditions and thought systems. Ultimately, I make a push for the deliberate inauguration of an African philosophy of medicine and bioethics and other context-specific or indigenous philosophies of medicine and bioethics that will ensure continuous investigations into NMTs and their contribution to global medical issues. (shrink)

The article presents the advantages and limitations of adaptive clinical trials for assessing the effectiveness of medical interventions and specifies the conditions that contributed to their development and implementation in clinical practice. I advance two arguments by discussing different cases of adaptive trials. The normative argument is that responsible adaptation should be taken seriously as a new way of doing clinical research insofar as a valid justification, sufficient understanding, and adequate operational conditions are provided. The second argument is historical. (...) The development of adaptive trials can be related to lessons learned from research in cases of urgency and to the decades-long efforts to end the productivity crisis of pharmaceutical research, which led to the emergence of translational, personalized, and, recently, precision medicine movements. (shrink)

This paper uses the figure of the nomad from the work of Rosi Braidoti to critically examine rhetoric about vaccine and masking mandates, and the science of covid more broadly. I draw out the tensions and ambivalence felt as we navigate this on-going crisis in ways epitomized by the phrase “I have a healthy mistrust of authority, and I am still vaccinated.” Though ambivalent, the nomadic subject finds an affirmative ethics, navigating the “right” response to incite positive change and (...) expose our current states of subjectivity. Recognizing the ambivalence of this state may be useful for feminists who critique medicine for its historical sexist and racist “objectivism,” while also supporting medical science and trust in the case of vaccine mandates. (shrink)

This topic focuses on the problems that arise in providing medical care to the population during armed conflict or martial law. Under such conditions, hospitals, clinics, and other healthcare facilities have to work in challenging circumstances with limited resources and reduced security for medical personnel. This topic explores such issues as how martial law affects the work of medical institutions, what problems arise in providing medical care to the population in war, how war affects the health (...) of the people, and what consequences it may have in the long term. Research in this area will help to understand how to organize better and prepare medical facilities to work in war conditions and ensure high-quality medical care to the population in emergencies. The methods used to write this article were analysis, synthesis, generalization, explanation, and data qualification. The primary and fundamental sources for writing an article may vary depending on the topic, but generally, the following sources can be recommended. Academic studies: these can be scholarly articles, monographs, dissertations, conference papers, and other materials related to the topic of your article. These sources can help you find information about the latest research in the field and allow you to see the approaches and methodologies used in the studies. Official sources: These can be legal documents, reports, regulations, guidelines, and other materials issued by government agencies, ministries, and other departments. These sources can help you understand the rules and regulations governing your article's topic. Expert reviews: these can be interviews with experts in the field, articles, and other materials written by well-known specialists. These sources can help you understand the views and opinions of well-known experts on the issues related to your paper. (shrink)

The COVID-19 pandemic has been overwhelming public health-care systems around the world. With demand exceeding the availability of medical resources in several regions, hospitals have been forced to invoke triage. To ensure that this difficult task proceeds in a fair and organised manner, governments scrambled experts to draft triage guidelines under enormous time pressure. Although there are similarities between the documents, they vary considerably in how much weight their respective authors place on the different criteria that they propose. Since (...) most of the recommendations do not come with ethical justifications, analysing them requires that one traces back these criteria to their underlying theories of distributive justice. In the literature, COVID-19 triage has been portrayed as a value conflict solely between utilitarian and egalitarian elements. While these two accounts are indeed the main antipodes, I shall show that in fact all four classic theories of distributive justice are involved: utilitarianism, egalitarianism, libertarianism, and communitarianism. Detecting these in the documents and classifying the suggested criteria accordingly enables one to understand the balancing between the different approaches to distributive justice—which is crucial for both managing the current pandemic and in preparation for the next global health crisis. (shrink)

This article starts with a brief analysis of the causes of state collapse as states undergo the process of political evolution. Next, I describe and analyze the mechanisms of social-political crises arising in the process of modernization. Such crises are a consequence of the inability of many traditional institutions and ideologies to keep up with changes in technology, communication, system of education, medical sphere, and with the demographic change. This analysis suggests that an accelerated development can cause a system (...) crisis with potentially serious consequences to the society. It is important to take this aspect into consideration because some scholars insist that the economic reconstruction and development are necessary for nation-building. This actually implies a rapid economic advancement (otherwise, the economy could not be reconstructed and developed). However, one should not ignore the possibility that very rapidly developing countries may run the danger of falling into the trap of fast transformation. The present article describes several mechanisms that can contribute to sociopolitical instability, including social tensions arising from rapid urbanization, youth bulges, and ‘resource curses’. (shrink)

Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and the (...) limits of MSM: the neglect of the bio-psycho-social systemic nature of humans and their context as the object of individual therapeutic and population-oriented interventions. COVID-19 illustrates how a medical problem requires a transdisciplinary approach in epidemiology, pathology, internal medicine, public health, environmental medicine, and socio-economic modeling. Regarding the need for conceptual integration of these different kinds of knowledge we suggest the application of general system theory (GST). This approach endorses an organism-centered view on health and disease, which according to Ludwig von Bertalanffy who was the founder of GST, we call Organismal Systems Medicine (OSM). We argue that systems science offers wider applications in the field of pathology and can contribute to an integrative systems medicine by (i) integration of evidence across functional and structural differentially scaled subsystems, (ii) conceptualization of complex multilevel systems, and (iii) suggesting mechanisms and non-linear relationships underlying the observed phenomena. We underline these points with a proposal on multi-level systems pathology including neurophysiology, endocrinology, immune system, genetics, and general metabolism. An integration of these areas is necessary to understand excess mortality rates and polypharmacological treatments. In the pandemic era this multi-level systems pathology is most important to assess potential vaccines, their effectiveness, short-, and long-time adverse effects. We further argue that these conceptual frameworks are not only valid in the COVID-19 era but also important to be integrated in a medicinal curriculum. (shrink)

This paper considers the obligation higher income countries have to lower and middle income countries during a global pandemic. Further considers which reforms are needed to the global supply-chain of medical resources. The short-comings in distribution and medical infrastructure have exacerbated the health crisis in developing countries. Global justice demands radical redistribution of medical resources in order to prevent mass casualties. This is argued first by highlighting that the COVID-19 pandemic should be acknowledged as an issue (...) of global justice, secondly, higher income countries ought to account for distribution inequity as a matter of rectifying past injustices, and thirdly argue for reform in distribution while considering the vaccine rollout as a prime example. We aim to show how the differences from country to country in response capabilities are a result of the economic foundation colonialism established and a direct result of cyclical poverty, which wealthy countries perpetuate to this day. (shrink)

The study investigated ethical considerations and science diplomacy on coronavirus disease (Covid-19) pandemic in Nigeria. The outbreak of the coronavirus disease (Covid-19) in Nigeria has spread quickly to about 34 states out of the 36 states and over 5000 persons have tested positive as at the time of this research after the first index case of an Italian and there is a projection that in coming days and weeks the number of infected persons and states will increase. The study was (...) guided by two objectives and also adopted the normative ethical theory. The study employed the methods of exposition and critical analysis to explain better the ethical issues and science diplomacy of Covid-19 pandemic in Nigeria. Data was sourced from secondary sources such as journal articles, newspaper, books and internet sources. The findings of the study showed that the citizens have some obligations that will aid the containment of the virus and as well as the government. The study also found out that science diplomacy was used, which has led to Nigeria collaborating with China to get medical aids to effectively fight the pandemic. Consequently, the study recommended amongst others that the Ministry of Health and the Nigeria Center for Disease Control (NCDC) should adopt and enforce the World Health Organization (WHO) Guidance for Managing Ethical Issues in Infectious Disease Outbreak as a working document in crisis like the Covid-19 pandemic that has ravaged Nigeria and the government should involve more in science diplomacy with other countries so that it will help in the fight against Covid-19 and other diseases that may occur in the future. (shrink)

Philosophical counselling is generally understood as the discussion or resolution of everyday problems with the help of philosophy. However, few agree on this definition. This leads to a crisis of definition for philosophical counselling which in turn causes practical problems regarding, inter alia, the teaching of future philosophical counsellors, the question of method, and the potential scope of philosophical counselling. I identify in this study a prevalent therapeutic thesis on the nature of philosophical counselling which ties together some of (...) the more popular conceptions of philosophical counselling. This thesis predominates when philosophical counsellors focus on the counselling part and neglect the philosophical part of philosophical counselling. This stance keeps philosophical counselling firmly contained within a medico-therapeutic framework. In opposition to this predominant view, I propose a reconceptualisation of philosophical counselling which does not subscribe to the therapeutic thesis and by implication works outside of a medical framework. More specifically, in fleshing out my non-therapeutic understanding of philosophical counselling, I propose twelve context-dependent conditions of philosophical counselling by drawing on a Pyrrhonian disposition and also on examples of philosophical counsellors who begin to work outside of the medico-therapeutic framework. I argue that these conditions should be met for philosophical counselling to stay firmly within the realm of philosophy as an aim in itself, thereby remaining true to its origin and basic orientation, and drawing on its innate strengths. With this fundamental reconceptualisation and the accompanying twelve context-dependent conditions, I propose a novel account of philosophical counselling which (i) does not subscribe to the therapeutic thesis, (ii) gives a novel answer to the problem of educating future philosophical counsellors, and (iii) has a clear scope of potential counselees. (shrink)

Gay men have been severely affected by the AIDS crisis, and gay subjectivity, sexual ethics, and politics continue to be deeply influenced by HIV to this day. PrEP (Pre-Exposure Prophylaxis) is a new, drug-based HIV prevention technique, that allows disentangling gay sex from its widespread, 40 yearlong association with illness and death. This article explores PrEP's fundamental impact on gay subjectivity, sexual ethics, and politics. It traces the genealogy of gay politics regarding homophobia and HIV stigma, suggesting a new (...) biopolitical and body political framework that accounts for the agency of activists as well as pharmapower, and proposing that PrEP is an example of democratic biopolitics. Highlighting the entanglement of medical technology, sexual ethics, and politics, the article shows how conservative and homonormative gay politics developed as a reaction to HIV stigma and how, by overcoming this stigma, PrEP enables a new era of intersectional queer politics and solidarities. It thereby develops a Foucauldian account of sexual liberation beyond the repression hypothesis that accounts for the ambivalence of sexual subjectification and the political potential of sexuality. (shrink)

Dr. Strange sees Dr. Stephen Strange abandon his once-promising medical career to become a superhero with the ability to warp time and space, and to travel through various dimensions. In order to make this transition, he is required to abandon many of his previous assumptions about the way the world works and learn to see things in a new way. Importantly, this is not merely a matter of learning a few facts, or of mastering new techniques. Instead, Dr. Strange (...) is required to alter his conception of the basic nature of the world and of how he relates to it. In time, this change extends to his values as well, as Strange comes to embrace his role in safeguarding the human world from interdimensional threats. -/- It is tempting to interpret Dr. Strange’s experience as one that shows the limits of rational, scientific inquiry, or even of human knowledge more generally. However, in this essay, I’d like to explore a different interpretation: that Strange’s experience can most fruitfully be thought of as a scientific revolution, in which Strange moves from one way of carrying out scientific inquiry to a different, incompatible way of doing it. In order to do this, I’ll be exploring the work of philosopher and historian of science Thomas Kuhn, who wrote a book—The Structure of Scientific Revolutions--about just this topic. Among other things, Kuhn’s work introduced the highly useful (though commonly misunderstood) notion of a paradigm shift. -/- We’ll begin by exploring what Kuhn describes as normal science, which consists of applying a set of well-understood concepts and methods to problems of interest. This “puzzle-solving” aspect of science is exemplified by Strange’s early successes in medicine. During this stage, scientists have good reasons to avoid questioning the basic validity of their paradigm, and to instead blame any problems that arise on other factors, such as human error. (As fans will know, Strange is quite good at assigning blame in just this way.) A crisis only occurs when significant, serious anomalies have accrued, such as those that Strange encounters in the aftermath of his accident. Even then, however, the old paradigm will only be abandoned only if a new paradigm can be found. Again, Strange’s experience bears this out, as he is able to move on only when the Sorcerer Supreme introduces him to the Mystic Arts. -/- Along the way, we’ll consider what it means for a practice to count as a scientific paradigm, and why it’s not just “anything goes.” Among other things, a paradigm requires that practitioners agree on which problems are most important, which techniques are appropriate to which problems, and what exemplary models of successful work look like. The Mystic Arts of Strange’s world, unlike the pseudoscientific theories of our own, plausibly do quite well on these sorts of criteria. (shrink)

It is easier to talk frankly to a person whom one trusts. It is also easier to agree with a scientist whom one trusts. Even though in both cases the psychological state that underlies the behavior is called ‘trust’, it is controversial whether it is a token of the same psychological type. Trust can serve an affective, epistemic, or other social function, and comes to interact with other psychological states in a variety of ways. The way that the functional role (...) of trust changes across contexts and objects is further complicated when communities and individuals mediate it through technologies, and even more so when that mediation involves artificial intelligence (AI) and machine learning (ML). In this chapter I look at the ways in which trust in institutions, and specifically the medical profession, is affected by the use of AI and ML. There are two key elements of this analysis. The first is a disanalogy between institutional trust in medicine and institutional trust in science (Irzik and Kurtulmus 2021, 2019; Kitcher 2001). I note that as AI and ML become a more prominent part of medicine, trust in a medical institution becomes more like trust in a scientific institution. This is problematic for institutional trust in medicine and the practice of medicine, since institutional trust in science has been undermined by, among other things, the spread of misinformation online and the replication crisis (Romero 2019). There is also a strong analogy between the psychological state of the person who trusts a scientific report or testimony and the psychological state of a patient who trusts individual recommendations made by a medical professional in a clinical setting. In both cases, institutional trust makes it less likely that a mistake or malfeasance will result in reactive attitudes, such as blame or anger, directed at other individual members of that institution. However, it also renders people vulnerable enough to blame the institution itself. This, with time, can erode trust in the institution and naturally leads to policy recommendations that aim to preserve institutional trust. I survey two ways in which that can be done with institutional trust in medicine in the age of AI and ML. (shrink)

Does browsing the world through a screen change a person, especially in the context of COVID-19? Recent studies indicate that self-care, psychological well-being, and empathy may suffer. The “Californian ideology” privileges expression of the self even as digital technology tends to interrupt the modern trend towards elaborating distinct selves via texts that convey knowledge. Meanwhile, digital browsing may be fracturing attention and empathy. -/- As these changes proceed, legislators react to a medical and social crisis. Relaxation of business, (...) community center, and school closures prevailed, under pressure from advocates of liberty, jobs, and pro-market economics. A rival set of regulatory reforms would prioritize fighting the virus and providing more relief to its victims as being forms of care for others. In the international domain, nationalist ideology and economic warfare intensify disparities in access to medical care, imported goods, and livelihoods. At stake is how best to take beings into care. (shrink)

Definying illness is not an easy process, nor from medical perspective nor from theological one or individual perspective. However, the most important and truely significant seems to be the latter; how the contemporary man defines illnesses and how he uses this process to redefine his true being. Nowadays we face an obvious spiritual crisis meant to urge each of us to start a new process of redefining our spiritual identity. This paper is intented to remind us of the (...) essence of our being on the one hand and of the Christian duty to fight against illness on the other hand, to bear permanently with us the model of Jesus, of the Holly Parents, who were subject to deseases also out of reasons that are related to God’s iconomy. The limits of medicine are visible there where miracles start to reveal themselves and the healing of the body symbolizes and announces the healing of the entire Being. (shrink)

For the past three years, Coronavirus-19 (Covid-19) has become one of the major global health problems. Unlike any previous virus in the past decades, Covid-19 has shown its unprecedented spreading speed, infection rate, fatality rate, etc. Under this urgent disease outbursting event, scientists around the globe, through the myriad of research and experiments, successfully developed effective vaccines. However, like many other medical innovations, Covid-19 vaccines are categorized as intellectual properties and a scarce resource. As a consequence, the citizens of (...) developed and developing countries face an imbalanced distribution of affordable vaccines. The formation of this issue is not only due to manufacturing, transportation, and other infrastructures, but also strongly correlated with aspects in the legal field, such as intellectual property rights (IPRs). With a humane common sense of vaccination many people, through comparative research method, this article aims to discuss the conflicts between the global crisis of Force Majeure and the interests of certain countries or corporations, possible solutions to resolve this conflict, and future coping strategies that ought to be published. (shrink)

While spreading wide-world, the new coronavirus Sars-CoV-2 made changes in many social departments of our society on levels we never thought about and messes with all our cultural habits. Thus, we witnessed that the religious denominations took into consideration changes without precedent in their cultic history and thus dogmatic as well concerning the actual threat of Coronavirus. We saw for example the Roman-Catholic Church who suspended all masses here and there[1] at first or banned the crucial gestures in rituals [to (...) suspend the distribution of Holy Communion from the Chalice[2], to distribute the Eucharist preferably into the hands of the faithful, and to avoid the physical contact from a peaceful handshake, to forego ash crosses on forehead, to suspend placing water in holy water fonts at the entrance of churches, that the churchgoers "refrain" from kissing or touching the cross for veneration, or even cancellation of masses]. We witnessed Buddhist temples and Protestant churches around Korea [at first] and beyond that have also suspended religious gatherings, and so on. In my case, the Romanian Orthodox Church did the same thing[3], but in a controversial way, firstly making some recommendations for its believers [e.g. not to kiss public icons in Churches, but their indoor ones, and receive Holy Communion with teaspoons for single-use]; afterward same Church reconsidered these recommendations and withdrew its decision [perhaps at the pressure of civil fundamentalists]. How can we qualify all these measures and, moreover, the withdrawal on behalf of religious believers, as weakness, populism, diligence, assuming the human limits, or...something else? What would be the correct and coherent answer religion should assume in this particular regard, and especially what are the reasons to qualify it in a way or another? (shrink)

From the perspectives of early warning and identification of risk, risk quantification and analysis, also as risk management, we propose recommendation, which includes analysis of citizen behavior in panic, cooperation of the institutions in Romania. The whole analysis will be performed from a perspective of the field of economic cybernetics. The 2019-nCoV coronavirus epidemic started in China's Wuhan city, which has spread throughout the country and subsequently, in a very short period of time, in several states, being viewed as a (...) global contagion effect that causes great concern. As the virus gets closer to Romania, it becomes worrying and citizens are already panicking. Therefore, in this article we will analyze, according to public data, what is the current situation and how well Romania is prepared to manage the risks arising from the confirmation of COVID-19 in the country and how the behavior of citizens in a state of panic is influenced. In addition, we analysed the medical system from Romania from the point of view of the analysis of the management of the viable system, in the situation of pandemic crisis the medical system being one of the sensitive points of any system. (shrink)

The objective of the paper is to implement and validate diagnosis in the medical field via refined neutrosophic fuzzy logic (RNFL). As such, we have proposed a Max-Min composition (MMC) method in RNFL. This method deals with the diagnosis under certain constraints like uncertainty and indeterminacy. Further, we have considered the diagnosis problems to validate the sensitivity analysis of the novel multi attribute decision-making technique. Finally, we gave the graphical representations and compared the obtained results with other existing measures (...) in refined neutrosophic fuzzy sets. (shrink)

What does it mean to study places in ‘crisis’ and how does that affect the research done on the ‘rural’? To be considered to be in crisis is not really new as any literature review of rural studies indicates. And yet, we live now in a new context, with new challenges for ‘rural’ research, in particular that of sustainability. Sustainability is the new policy focus and is increasingly reflected in research on rural Europe. Although scholars are beginning to (...) theorize on what is sustainable in and for rural areas, our intention is to take this further. We theorize on what the focus on crisis and, increasingly on sustainability, means for the research we do and the knowledge we produce on rural Europe. Our aim is to bring attention to the politics of past and present knowledge production on the rural to be able to imagine just and sustainable futures. In an analysis of literature primarily from Sweden and the UK, we argue that two construals, that of a rural crisis and that of rural–urban polarization, have set the tone for rural studies and may have overshadowed a more plural approach. We outline what might be needed from rural research to meet future challenges and what the notion of sustainability, with its emphasis on the entanglements of the social, economic and environmental, might mean for the future of rural research. (shrink)

I introduce a distinction between health need and medical need, and raise several questions about their interaction. Health needs are needs that relate directly to our health condition. Medical needs are needs which bear some relation to medical institutions or processes. I suggest that the question of whether medical insurance or public care should cover medical needs, health needs, or only needs which fit both categories is a political question that cannot be resolved definitionally. I (...) also argue against an overly strict definition of medical need on the grounds that this presupposes, wrongly, that medical intervention should always be a last resort. (shrink)

Miracle Max, it seems, is the only remaining miracle worker in all of Florin. Among other things, this means that he (unlike anyone else) can resurrect the recently dead, at least in certain circumstances. Max’s peculiar talents come with significant perks (for example, he can basically set his own prices!), but they also raise a number of ethical dilemmas that range from the merely amusing to the truly perplexing: -/- How much about Max’s “methods” does he need to reveal to (...) his patients? Is it really OK for Max to lie about Valerie’s being a witch, even though she really isn’t? Just how much of the “truth” does Max have to tell his patients? -/- Let’s suppose that Humperdinck had offered Max his old job back. Would it have been OK for Max to accept this offer? What about if Humperdinck wanted him to do experiments at “the Zoo”? -/- Is Max obligated to offer his services to everyone who needs them, such as the (mostly) dead Westley and friends? Or is he free to pick and choose? -/- In this chapter, I’ll consider how these questions might be addressed using concepts of medical ethics. As it turns out, Max’s dilemmas are not too different from the sorts of dilemmas that many medical professionals encounter in their daily lives, and exploring how Max could (or should) respond to them can help us figure out what we can do here in the “real” world. (shrink)

Physicians in Islamic countries might be requested to participate in the Islamic legal code of qiṣāṣ, in which the victim or family has the right to an eye-for-an-eye retaliation. Qiṣāṣ is only used as a punishment in the case of murder or intentional physical injury. In situations such as throwing acid, the national legal system of some Islamic countries asks for assistance from physicians, because the punishment should be identical to the crime. The perpetrator could not be punished without a (...) physician’s participation, because there is no way to guarantee that the sentence would be carried out without inflicting more injury than the initial victim had suffered. By examining two cases of acid throwing, this paper discusses issues related to physicians’ participation in qiṣāṣ from the perspective of medical ethics and Islamic Shari’a law. From the standpoint of medical ethics, physicians’ participation in qiṣāṣ is not appropriate. First, qiṣāṣ is in sharp contrast to the Hippocratic Oath and other codes of medical ethics. Second, by physicians’ participation in qiṣāṣ, medical practices are being used improperly to carry out government mandates. Third, physician participation in activities that cause intentional harm to people destroys the trust between patients and physicians and may adversely affect the patient–physician relationship more generally. From the standpoint of Shari’a, there is no consensus among Muslim scholars whether qiṣāṣ should be performed on every occasion. We argue that disallowing physician involvement in qiṣāṣ is necessary from the perspectives of both medical ethics and Shari’a law. (shrink)

Consensus statement by UK teachers of medical ethics and law.

In medical settings, machines are in close proximity with human beings: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. Machines in these contexts are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. -/- As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a (...) code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for empathy and emotion detection necessary? What about consciousness? -/- The essays in this collection by researchers from both humanities and science describe various theoretical and experimental approaches to adding medical ethics to a machine, what design features are necessary in order to achieve this, philosophical and practical questions concerning justice, rights, decision-making and responsibility, and accurately modeling essential physician-machine-patient relationships. -/- This collection is the first book to address these 21st-century concerns. (shrink)

In contemporary healthcare, medical image categorization is essential for illness prediction, diagnosis, and therapy planning. The emergence of digital imaging technology has led to a significant increase in research into the use of machine learning (ML) techniques for the categorization of images in medical data. We provide a thorough summary of recent developments in this area in this review, using knowledge from the most recent research and cutting-edge methods.We begin by discussing the unique challenges and opportunities associated with (...) medical image classification, including the complexity of anatomical structures, variability in imaging modalities, and the need for interpretability and reliability in clinical settings. Subsequently, we survey a wide range of ML algorithms and techniques employed for medical image classification, including traditional methods such as support vector machines and k-nearest neighbors, as well as deep learning approaches like convolutional neural networks (CNNs) and recurrent neural networks (RNNs). Furthermore, we examine key considerations in dataset preparation, feature extraction, and model evaluation specific to medical image classification tasks. We highlight the importance of large, annotated datasets, transfer learning, and data augmentation techniques in enhancing model performance and generalization. (shrink)

One of the best-known principles of halakha is that Shabbat is violated to save a life. Who does this saving and how do we know that a life is in danger? What categories of illness violate Shabbat and who decides? A historical-sociological analysis of the roles played by Jew, non-Jew, and physician according to the approach of “medical cosmology” can help us understand the differences in the approach of the Shulchan Aruch compared to later decisors (e.g., the Mishnah Berurah). (...) Such differences illuminate how premodern medical triage coexisted with a different halakhic understanding than that of the biomedical age. (shrink)

Medicalisation is a social phenomenon in which conditions that were once under legal, religious, personal or other jurisdictions are brought into the domain of medical authority. Low sexual desire in females has been medicalised, pathologised as a disease, and intervened upon with a range of pharmaceuticals. There are two polarised positions on the medicalisation of low female sexual desire: I call these the mainstream view and the critical view. I assess the central arguments for both positions. Dividing the two (...) positions are opposing models of the aetiology of low female sexual desire. I conclude by suggesting that the balance of arguments supports a modest defence of the critical view regarding the medicalisation of low female sexual desire. (shrink)

Marx claims that economic crisis is endemic to capitalism and will worsen as capitalism develops. The article situates Marx’s crisis theory within the discipline of political economy, explains its relationship to mainstream economics, charts economic crises that have happened since the 1840s, and explains Marx’s crisis theorem of the fall in the rate of profit. In conclusion, the 2008 economic crisis, and the notion of crisis in general, are speculatively considered. Special attention is given to (...) the affective desire to own a home, particularly as this is desire is developed by capitalism, in relation to the sub-prime mortgage credit crisis. (shrink)

Inflationary cosmology has been widely accepted due to its successful predictions: for a “generic” initial state, inflation produces a homogeneous, flat, bubble with an appropriate spectrum of density perturbations. However, the discovery that inflation is “generically eternal,” leading to a vast multiverse of inflationary bubbles with different low-energy physics, threatens to undermine this account. There is a “predictability crisis” in eternal inflation, because extracting predictions apparently requires a well-defined measure over the multiverse. This has led to discussions of anthropic (...) predictions based on a measure over the multiverse, and an assumption that we are typical observers. I will give a pessimistic assessment of attempts to make predictions in this sense, emphasizing in particular problems that arise even if a unique measure can be found. (shrink)

Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. While such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to “medicalization” of human love and heartache—for some, a source of serious concern. In this essay, we argue that the “medicalization of love” need not necessarily be problematic, on balance, but could plausibly be expected to have either good (...) or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help direct the course of love’s “medicalization”—should it happen to occur—more toward the “good” side than the “bad.”. (shrink)

World Crisis and Underdevelopment examines the impact of poverty and other global crises in generating forms of structural coercion that cause agential and societal underdevelopment. It draws from discourse ethics and recognition theory in criticizing injustices and pathologies associated with underdevelopment. Its scope is comprehensive, encompassing discussions about development science, philosophical anthropology, global migration, global capitalism and economic markets, human rights, international legal institutions, democratic politics and legitimation, world religions and secularization, and moral philosophy in its many varieties.

What I call medically enabled suicides have four distinctive features: 1. They are instigated by actions of a suicidal individual, actions she intends to result in a physiological condition that, absent lifesaving medical interventions, would be otherwise fatal to that individual. 2. These suicides are ‘completed’ due to medical personnel acting in accordance with recognized legal or ethical protocols requiring the withholding or withdrawal of care from patients (e.g., following an approved advance directive). 3. The suicidal individual acts (...) purposefully to ensure that medical personnel will act on these protocols. 4. These suicides do not involve medical personnel providing aid in dying in the standard sense, either through (a) active voluntary euthanasia, or (b) assistance by means of prescriptions, etc. -/- Regardless of how common medically enabled suicides are, they raise compelling questions at the interface of medicine and individual choice. After first clarifying the concept of medically enabled suicide and exploring some of the reasons why it might be attractive to suicidal individuals, I then investigate two apparent dilemmas that medically enabled suicides raise for medical care providers. The first alleges that medical care providers may not contribute to harming their patients, and so they may not contribute to their patients’ suicides. The second alleges that if care providers, as a matter of personal conscience, believe that suicide is wrong, then they may not be compelled to contribute to their patient’s acting wrongly by assenting to the wishes of a patient pursuing medically enabled suicide. Both dilemmas arise from the fact that while medical personnel are bound by widely accepted precepts of medical ethics to honor the competent wishes of their patients, medically enabled suicides entangle them in their patients’ suicidal plans in ways that result in their contributing to those suicides. I conclude that neither dilemma should be resolved in the direction of medical personnel having the right to refrain from involvement in medically enabled suicides. Thus, while we may find medically enabled suicide distasteful or exploitative, a strong case cannot be made that medical personnel refusing to involve themselves in such suicides is ethically permissible. (shrink)

The book, ‘The Crisis of World and Krishna Pure Monism: A Long Essay’, is more a cathartics of the crisis of world as viewed from the plane of Krishna pure monism than critique of hither to development of idea and philosophy. It sees a correlation of the crisis of world in praxis of objectification of subject, undermining of the knowledge and violation of Krishna pure monism-one has become all and inherence of knowledge. If objectification of subject is (...) juxtaposed with resultant objectification of women, nature, ‘other’, knowledge and idea or Reason or Dharma, it would certainly validate the hypothesis of the essay. The main hypothesis of the essay is as to how objectification of subject on the plane of sciencitization of philosophy and violation of Krishna pure monism-one has become all and inherent knowledge and , and its subversion by muses have led to the crisis of world. The objectification of subject or consciousness or spirit in sciences seems to be cause and effect of objectification of the Woman, Nature, Other, Knowledge and Reason or Idea or Dharma. When one has become all or creator has become creation, the plurality and difference is transitory which appear to have been assigned the permanent value. The transitory value has been given permanence, while the permanent has been dislodged from discourse, conveniently tucked to the abstract. This seems to be real narrative of the crisis of the world. -/- . (shrink)

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, remdesivir (...) and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions. (shrink)

Medical tourism can be defined as the process of travelling outside of an individual’s country to another to seek medical care. The current research studies medical tourism in Ghana historically, focusing on Korle Bu Teaching Hospital in Accra and Komfo Anokye Teaching Hospital in Kumase. Using a qualitative research approach, the study provides a historical argument on the continuities and discontinuities of medical tourism in Ghana. Indeed, medical tourism has undergone several transitions over time. To (...) emphasize, the current contribution has thoroughly discussed the evolution of medical tourism in Ghana, the pull and push factors of medical tourism, its impact on the local health systems and the need to further promote it. The study concludes among other things that the improvement of medical facilities, personnel and equipment, will enhance the medical tourism prospects of the country. (shrink)

In this paper, I defend a version of the medical model of disability, which defines disability as an enduring biological dysfunction that causes its bearer a significant degree of impairment. We should accept the medical model, I argue, because it succeeds in capturing our judgments about what conditions do and do not qualify as disabilities, because it offers a compelling explanation for what makes a condition count as a disability, and because it justifies why the federal government should (...) spend hundreds of billions of dollars, annually, on aid and accommodations for disabled people. After responding to a pair of objections Elizabeth Barnes has raised against the medical model, I contrast it with Guy Kahane and Julian Savulescu's welfarist account of disability, and with Barnes's own mere-difference view. Both of these accounts face serious challenges, although elements of Barnes's view can—and, in my opinion, should—be adopted by proponents of the medical model. (shrink)

In times of crisis, when current theories are revealed as inadequate to task, and new physics is thought to be required—physics turns to re-evaluate its principles, and to seek new ones. This paper explores the various types, and roles of principles that feature in the problem of quantum gravity as a current crisis in physics. I illustrate the diversity of the principles being appealed to, and show that principles serve in a variety of roles in all stages of (...) the crisis, including in motivating the need for a new theory, and defining what this theory should be like. In particular, I consider: the generalised correspondence principle, UV-completion, background independence, and the holographic principle. I also explore how the current crisis fits with Friedman’s view on the roles of principles in revolutionary theory-change, finding that while many key aspects of this view are not represented in quantum gravity, the view could potentially offer a useful diagnostic, and prescriptive strategy. This paper is intended to be relatively non-technical, and to bring some of the philosophical issues from the search for quantum gravity to a more general philosophical audience interested in the roles of principles in scientific theory-change. (shrink)

This paper analyzes the current crisis of the global industrial civilization as a coincidence of external and internal reasons, mainly as a coincidence of economic and environmental crises tendencies. The analysis is based on Habermas´ distinction between four types of social formation, and according to their internal organizational principles and an extent of their social and system integration, also types of crises that can occur in the given type of the social formation. The paper shows that the common reason (...) of economic and environmental crises which are a part of system crisis of industrial civilization is an imperative of growth. This imperative, as Habermas points out, is the immanent principle of institutions and systems of capitalism. Economic and demographic growth of industrial civilization based on capitalism principles has reached its limits. However, all types of social formation, institutions and civilizations are also determined by the imperative of sustainability. The current crisis is then characterized as a display of antagonism between the imperative of growth and imperative of sustainability. This antagonism creates a new category of transformation for sustainable societies or revolution conflicts in states that break environmental and economic limits of growth. These conflicts result from food and water shortages and could bring a growing instability into the world or lead into the collapse of the industrial civilization. (shrink)

When are we obligated to believe someone? To what extent are people authorities about their own experiences? What kind of harm might we enact when we doubt? Questions like these lie at the heart of many debates in social and feminist epistemology, and they’re the driving issue behind a key conceptual framework in these debates—gaslighting. But while the concept of gaslighting has provided fruitful insight, it's also proven somewhat difficult to adjudicate, and seems prone to over-application. In what follows, I (...) argue that Katherine Hawley's theory of trust can provide a useful alternative lens for looking at contested testimony. To do this, I focus on a particularly complex—but increasingly popular—application of gaslighting: the physician/patient relationship, and the idea of ‘medical gaslighting’. I argue that, even though patients can experience harm when they are disbelieved, there are nevertheless good reasons for physicians not to trust patients about at least some of their own narratives. (shrink)