Resumen Ésta es la primera traducción al español de las guías “Atención después de la investigación: un marco para los comités de ética de investigación del National Health Service (NHS) (borrador versión 8.0)”. El documento afirma que existe una fuerte obligación moral de garantizar que los participantes enfermos de un estudio clínico hagan una transición después del estudio hacia una atención de la salud apropiada. Con “atención de la salud apropiada” se hace referencia al acceso para los participantes a la (...) atención de la salud, proporcionada principalmente por el National Health Service (en adelante NHS), el sistema de salud del Reino Unido, y/o a la intervención en estudio, también llamada producto o tratamiento en investigación. Las guías “Atención después de la investigación” están dirigidas principalmente a los miembros de los 79 comités de ética de investigación del NHS y a quienes presentan sus estudios de investigación ante estos comités. Se trata de un documento borrador muy avanzado, trabajado en numerosas reuniones, durante más de 3 años, que ha sido discutido por participantes de estudios y miembros de la comunidad, miembros y presidentes de comités de ética de investigación del Reino Unido, especialistas internacionales en ética de la investigación, representantes de la industria y otras partes interesadas. La redacción de las guías es producto de la colaboración de Neema Sofaer y Penney Lewis, ambas investigadoras del King’s College London, en el Centre of Medical Law and Ethics del Dickson Poon School of Law, y Hugh Davies, Asesor en Ética de la Investigación de la Health Research Authority (HRA) del NHS. El traductor del presente documento, Ignacio Mastroleo, participó del workshop en la Fundación Brocher (Ginebra, Suiza, diciembre de 2011) donde se revisó el borrador versión 7.0 y contribuyó en la revisión del borrador de la versión 8.0 durante el 2012. -/- Abstract This is the first Spanish translation of the guidelines “Care after research: a framework for NHS RECs (8th draft)”. The document states that there is a strong moral obligation to ensure that participants in a clinical study who are ill transition after the study to appropriate healthcare. The terms "appropriate healthcare" refer to participants’ access to health care, mainly provided by the National Health Service (NHS), the health system in the UK, and/or to the intervention study also named investigational treatment or product. The guides "Care after research" are mainly directed to members of the 79 NHS committees of research ethics (RECs) and to those who submit their research to these committees. This is a very advanced draft document, worked in several meetings, for more than three years, that has been discussed with study participants and community members, members and chairs of RECs in the UK, international specialists in research ethics, industry representatives and other stakeholders. The drafting of the guidelines is the result of the collaboration of Neema Sofaer and Penney Lewis, both researchers at King's College London, at the Centre of Medical Law and Ethics of Dickson Poon School of Law, and Hugh Davies, Research Ethics Advisor of the Health Research Authority (HRA) of the NHS. The translator of this document, Ignacio Mastroleo, attended the workshop at the Brocher Foundation (Geneva, Switzerland, December 2011) where draft version 7.0 was revised and contributed in the revision of draft version 8.0 during 2012. (shrink)

We respond to a Letter to the Editor regarding "Principlism and contemporary ethical considerations for providers of transgender health care." We address criticisms by Castle & Klein (2024) of blatant fatphobia related to the ethical elements concerning BMI restrictions for gender-affirming surgery. Our response corrects several mischaracterizations of the article and clarifies our position. My co-authors and I remain focused on advocating for patient-centered, ethically sound, evidence-based, and equitable healthcare policies.

Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

This chapter aims to examine the configuration of the sharing economy in the United Kingdom. The chapter provides an examination of the key opportunities and challenges that this socio-economic model generates in the country. It includes an account of different sharing economy initiatives in the United Kingdom, including crowdfunding projects, tool libraries, timesharing banks, men’s sheds, and shared workspaces, commercial sharing economy services, micro-libraries, community-gardening projects, and paid online peer-to-peer accommodation. Increased consumer choice and economic benefits derived from an extended (...) economy around the sharing economy are identified as key opportunities. Key challenges relate to policymaking and taxation of businesses and participants in the sharing economy, as well as the wider enforcement of health and safety regulations and the impact that the recent pandemic is having on the industry. The chapter also provides an examination of the latest developments and regulations in this area. In addition, the chapter identifies the most pressing issues and possible future directions of research in this context. (shrink)

In seeing a tilted penny, we are experientially aware of both its circularity and another shape, which I dub ‘β‐ellipticality’. Some claim that our experiential awareness of the intrinsic shapes/sizes of everyday objects depends upon our experiential awareness of β‐shapes/β‐sizes. In contrast, I maintain that β‐property experiences are the result of what Richard Wollheim calls ‘seeing‐in’, but run in reverse: instead of seeing a three‐dimensional object in a flat surface, we see a flat surface in a three‐dimensional object. Using (...) this new account, I re‐examine the phenomenological directness of visual experience and undermine an argument for skepticism about β‐property experiences. (shrink)

While many argue investment-based criteria for immigration are wrong or at least problematic, skill-based criteria remain relatively uncontroversial. This is normatively inconsistent. This article assesses three prominent normative objections to investment-based selection criteria for immigrants: that they wrongfully discriminate between prospective immigrants that they are unfair, and that they undermine political equality among citizens. It argues that either skill-based criteria are equally susceptible to these objections, or that investment-based criteria are equally shielded from them. Indeed, in some ways investment-based criteria (...) are less normatively problematic than skill-based criteria. Given this analysis, the resistance to investment-based migration criteria, but not to skill-based criteria, is inconsistent. (shrink)

Peter Harrison explains the disappearance of symbolic meanings of animals from seventeenth-century works in natural history through what he calls the “literalist mentality of the reformers.” By contrast, the present article argues in favor of a different understanding of the connection between hermeneutics and Protestant natural history. Martin Luther, Philipp Melanchthon, Johannes Brenz, Johannes Oecolampadius, and Jean Calvin continued to assign moral meanings to natural particulars, and moral interpretations can still be found in the writings of Protestant naturalists such as (...) Conrad Gesner, Caspar Heldelinus, Jeremias Wilde, Thomas Penny, and Thomas Moffett. If there are differences between Protestant and Catholic interpretations of animals, then these differences derive from the reformer’s greater insistence on providing textual support for assigning symbolic meanings, their resulting greater reluctance in assigning prophetic meanings to animals, and their elimination of spiritual interpretations of animals that are in tension with central tenets of Protestant theology. These differences in hermeneutics and theology may explain some of the divergences between the symbolic interpretations of animals proposed by Protestant natural historians and their Catholic colleague, Ulisse Aldrovandi. (shrink)

The chapter concerns some aspects of Russell’s epistemological turn in the period after 1911. In particular, it focuses on two aspects of his philosophy in this period: his attempt to render material objects as constructions out of sense data, and his attitude toward sense data as “hard data.” It examines closely Russell’s “breakthrough” of early 1914, in which he concluded that, viewed from the standpoint of epistemology and analytic construction, space has six dimensions, not merely three. Russell posits a three-dimensional (...) personal or “perspective” space that is inhabited by sense data. This space then forms the basis for constructing the three dimensional space of physics (and of public things). I am concerned with the specifics of this construction: with the properties of the private spaces, the relations among those spaces, and their relation to physical space and to constructed “things,” such as pennies or tables. There are difficulties of interpretation with respect to these relations, which stem from the difficulty of finding a coherent interpretation of Russell’s claim that objects such as tables and pennies look smaller at a greater distance (or look trapezoidal or elliptical from some points of view). I don’t mean to challenge the phenomenal claim that objects do, in some sense, look small in the distance. Rather, I raise difficulties with Russell’s analysis of this fact, in which he appeals to both phenomenal experience and the findings of sensory psychology. I hold that if he wishes to maintain his phenomenal claim about objects appearing smaller with greater distance, he must alter or redescribe aspects of his construction of ordinary things. However, if his construction of things and physical space is based on a problematic description of the private spaces, then his claim that private or perspective spaces are very well known and provide the hard data for knowledge of the physical world faces a challenge. (shrink)

Philosophical work on the concept of consent in the past few decades has got to grips with it as a rich notion. We are increasingly sensitive to consent not as a momentary, atomic, transactional thing, but as a complex idea admitting of various qualities and dimensions. In this paper we note that the recognition of this complexity demands a theoretical framework quite different to those presently extant, and we suggest that the enactive approach is one which offers significant value in (...) this regard. In consonance with arguments made by Laurie Penny about how consent is a continuous and dynamic process, we outline how an enactive approach identifies consent as temporally extended (rather than momentarily transactional), and as affected by the skilfulness of the agents involved, the fitness of community provided resources to negotiate the consensual relationship over time, and the unfolding of circumstances in the situation in which the joint action is taking place. We argue that the value of an enactive perspective on consent is in highlighting these complexities, and providing resources to articulate and theorise them in ways that are not open to other current approaches. (shrink)

I sometimes hear the statement that good has no chance in the battle against evil. People often say “ You won’t change the world anyway” or “That’s what the system looks like”. In fact, some arguments are irresistible, but only in certain circumstances. However, when these circumstances do not occur, and they do not occur very often, it turns out that good has very strong tactics. When you apply it, then it is simply irresistible. What kind of tactics is it? (...) Is it worth using it? Is it worth being a moral person? Sometimes it seems that our evil actions won’t result in any negative consequences. However, evil provides services and demands profits in return. Thus, it is very selfish. How did we pay since we didn’t spend any penny? On the contrary, we even earned something. Isn’t it puzzling? This “profit” is an extremely mysterious phenomenon, yet very real. Therefore, I examined various situations that happened in life and enclosed my major observations in this book. I hope it won’t be only a fascinating reading but above all an abundant source of inspiration for everyone who seeks to understand a deeper sense of the surrounding world. (shrink)