Several attempts have been made to apply the choice-sensitive theory of distributive justice, luck egalitarianism, in the context of health and healthcare. This article presents a framework for this discussion by highlighting different normative decisions to be made in such an application, some of the objections to which luck egalitarians must provide answers and some of the practical implications associated with applying such an approach in the real world. It is argued that luck egalitarians should address distributions of health rather (...) than healthcare, endorse an integrationist theory that combines health concerns with general distributive concerns and be pluralist in their approach. It further suggests that choice-sensitive policies need not be the result of applying luck egalitarianism in this context. (shrink)

Age-based rationing remains highly controversial. This question has been paramount during the Covid-19 pandemic. Analyzing the practices, proposals, and guidelines applied or put forward during the current pandemic, three kinds of age-based rationing are identified: an age-based cut-off, age as a tiebreaker, and indirect age rationing, where age matters to the extent that it affects prognosis. Where age is allowed to play a role in terms of who gets treated, it is justified either because this is believed to maximize benefits (...) from scarce resources or because it is believed to be in accordance with the value of fairness understood as (a) fair innings, where less priority is given to those who have lived a full life or (b) an egalitarian concern for the worse off. By critically assessing prominent frameworks and practices for pandemic rationing, this article considers the balance the three kinds of age-based rationing strike between maximizing benefits and fairness. It evaluates whether elements in the proposals are, in fact, contrary to the justifications of these measures. Such shortcomings are highlighted, and it is proposed to adjust prominent proposals to care for the worse off more appropriately and better consider whether the acquired benefits befalls the young or the old. (shrink)

In the luck egalitarian literature, one influential formulation of luck egalitarianism does not specify whether equalities that do not reflect people’s equivalent exercises of responsibility are bad with regard to inequality. This equivocation gives rise to two competing versions of luck egalitarianism: asymmetrical and symmetrical luck egalitarianism. According to the former, while inequalities due to luck are unjust, equalities due to luck are not necessarily so. The latter view, by contrast, affirms the undesirability of equalities as well as inequalities insofar (...) as they are due to luck. The symmetrical view, we argue, is by far the more compelling, both by internal luck egalitarian standards and in light of the external rightist emphasis on choice and responsibility to which luck egalitarianism may partly be seen as a response. Our main case for the symmetrical view is that when some people, against a background of equal opportunities, do not exercise their responsibility to the same degree as others, they cannot justifiably call for equalizing measures to be put in place. Indeed, such measures would be positively unfair. The symmetrical view, accordingly, rejects compensation in such cases, whereas the asymmetrical view, implausibly, enjoins it. We also examine two objections to this argument. First, that this view fails to qualify as genuinely egalitarian, instead collapsing the notion of equality into the notion of desert. Second, that the opposing asymmetrical view, in contrast to the symmetrical view, can draw support from its compatibility with sufficientarian concerns. Both objections are rebutted. We conclude that luck egalitarians are best served by endorsing the symmetrical, luck-neutralizing stance. (shrink)

Purpose. The purpose of this study is to investigate how professionals learn from varying experiences with errors in health-care digitalization and develop and use negative knowledge and digital ignorance in efforts to improve digitalized health care. Design/methodology/approach. A two-year qualitative field study was conducted in the context of a public health-care organization working with digital patient communication. The data consisted of participant observation, semistructured interviews and document data. Inductive coding and a theoretically informed generation of themes were applied. Findings. The (...) findings show that both health-care and digital communication professionals learn through experiences with digital “rule-” and “knowledge-based” errors in patient communication and develop negative knowledge and awareness of digital ignorance. In their joint efforts, they use negative knowledge to “bend the rules” and to explore digital ignorance in efforts to improve patient communication. Originality/value. This study provides insight into the importance of collaboration between professionals with varying experience of errors in digitalizing patient communication. Such collaboration is required to acknowledge own shortcomings and create complementary negative knowledge to improve digital patient communication. This is particularly important when working with innovative digitalization in health care. (shrink)

According to luck egalitarianism, it is unjust if some are worse off than others through no fault or choice of their own. The most common criticism of luck egalitarianism is the ‘harshness objection’, which states that luck egalitarianism allows for too harsh consequences, as it fails to provide justification for why those responsible for their bad fate can be entitled to society's assistance. It has largely gone unnoticed that the harshness objection is open to a number of very different interpretations. (...) We present four different interpretations of the harshness objection in which the problem pertains to counterintuitive implications, badness of outcome, disproportionality, or inconsistency, respectively. We analyse and discuss appropriate luck egalitarian replies. Disentangling these different versions clarifies what is at the heart of this dispute and reveals the point of the harshness objection. We conclude that only the inconsistency version involves a durable problem for luck egalitarianism. (shrink)

Should priority in the allocation of organs be given to those who have previously donated or declared their willingness to do so? This article examines the Israeli priority rule in light of two prominent critiques of priority rules, pertaining to failure to reciprocate and unfairness. The scope and content of these critiques are interpreted from the perspective of equality of opportunity. Because the Israeli priority rule may be reasonably criticized for unfairness and failing to reward certain behaviors, the article develops (...) an adjusted priority rule, which removes and adjust the elements in the Israeli priority rule deemed problematic. However, such a priority rule is complex to the extent that it may fail to increase donation rates and furthermore introduce new concerns of fairness, as the better off may be better able to navigate the complex adjusted priority rule. (shrink)

Eli Feiring has developed a concept of forward-looking responsibility in healthcare. On this account, what matters morally in the allocation of scarce healthcare resources is not people's past behaviours but rather their commitment to take on lifestyles that will increase the benefit acquired from received treatment. According to Feiring, this is to be preferred over the backward-looking concept of responsibility often associated with luck egalitarianism. The article critically scrutinises Feiring's position. It begins by spelling out the wider implications of Feiring's (...) view. Against this background, it shows that (i) Feiring's distinction between backward-looking and forward-looking responsibility is incompatible with the Scanlonian notion of responsibility she apparently endorses; (ii) her favoured forward-looking notion of responsibility is subject to the objections levelled against the luck egalitarian view (whatever the strength of such objections). (shrink)

The wishes of registered organ donors are regularly set aside when family members object to donation. This genuine overruling of the wishes of the deceased raises difficult ethical questions. A successful argument for providing the family with a veto must (a) provide reason to disregard the wishes of the dead, and (b) establish why the family should be allowed to decide. One branch of justification seeks to reconcile the family veto with important ideas about respecting property rights, preserving autonomy, and (...) preventing harm. These arguments are ultimately unsuccessful. Another branch of arguments is consequentialist, pointing out the negative consequences of removing the veto. Whether construed as concerning family distress or as a potential drop in the organs available, these arguments are unsuccessful; the first fails to recognize the tremendous distress associated with waiting for an organ, while the second has little supporting evidence. A final section considers and rejects whether combining some of the arguments just examined could justify the family veto. We should thus remove the family veto in organ donation. (shrink)

There has been considerable debate over regulated organ markets. Especially current markets, where people sell one of their kidneys while still alive, have received increased attention. Futures markets remain an interesting and under-discussed alternative specification of a market-based solution to the organ shortage. Futures markets pertain to the sale of the right to procure people’s organs after they die. There is a wide range of possible specifications of the futures market. There are, however, some major unaddressed efficiency concerns. This article (...) presents this class of concerns and discusses the implication for organ futures markets. It identifies a number of inefficiency sources pertaining to crowding out, bad organs, costs and missed opportunities, family refusals, moral hazard and strength of the provided incentive. However, a complete assessment of futures market requires better knowledge regarding the potential reaction from donors, families and health professionals. (shrink)

Due to the shortage of organs, it has been proposed that the ban on organ sales is lifted and a market-based procurement system introduced. This paper assesses four prominent proposals for how such a market could be arranged: unregulated current market, regulated current market, payment-for-consent futures market, and the family-reward futures market. These are assessed in terms of how applicable prominent concerns with organ sales are for each model. The concerns evaluated are that organ markets will crowd out altruistic donation, (...) that consent to sell organs is invalid, that sellers will be harmed, and that commodification of organs will affect human relationships in a negative way. The paper concludes that the family-reward futures market fares best in this comparison but also that it provides the weakest incentive to potential buyers. There is an inverse relationship between how applicable prominent critiques are to organ market models and the increase in available organs they can be expected to provide. (shrink)

Christian Munthe, David Fumagalli and Erik Malmqvist argue that well-known healthcare resource allocation principles, such as need, prognosis, equal treatment and cost-effectiveness, should be supplemented with a principle of sustainability.1 Employing such a principle would entail that the allocation of healthcare resources should take into account whether a specific allocation causes negative dynamics, which would limit the amount of resources available in the future. As examples of allocation decisions, which may have such negative dynamics, they mention those who cause a (...) lack of vaccines, anti-bioethics resistance and drug shortages. Thus, the overall thought is that we can spend and allocate healthcare resources in a certain way at t1, which means that we will have fewer resources available at a later point, t2. The authors argue that we should include a principle of sustainability to justify allocations, which avoids or diminishes the negative dynamics. The authors argue that existing principles cannot sufficiently include proper regard for how our current decisions affect future allocation decisions and, therefore, the people who need healthcare resources in the future. I am sympathetic to the developed argument and believe that the authors are correct that negative dynamics provide reasons to take our ability to meet future health needs …. (shrink)

While COVID-19 vaccines provide light at the end of the tunnel in a difficult time, they also bring forth the complex ethical issue of global vaccine distribution. The current unequal global distribution of vaccines is unjust towards the vulnerable living in low-income countries. A vaccine tax should be introduced to remedy this. Under such a scheme, a small fraction of the money spent by a country on vaccines for its own population would go into a fund, such as COVAX, dedicated (...) to buying vaccines and distributing them to the world’s poorest. A vaccine tax would provide a much-needed injection of funds to remedy the unequal distribution of vaccines. The tax allows for a distribution that, to a lesser degree, reflects the ability to pay and is superior to a donation-based model because it minimises the opportunity for free-riding. (shrink)

People’s health is hugely affected by where they live, their occupational status and their socio-economic position. It has been widely argued that the presence of such social determinants in health provides good reasons to reject luck egalitarianism as a theory of distributive justice in health. The literature provides different reasons why this responsibility-sensitive theory of distributive justice should not be applied to health. The critiques submit that the social circumstances undermine or remove people’s responsibility for their health; responsibility sensitive health (...) policies would adversely affect those who are worst off and; the luck egalitarian approach to health distracts from the important task of rectifying socio-economic influences on people's health and provides individualistic solutions to collective problems. But for each of these variants of the critique luck egalitarianism provides suitable answers. The literature on social determinants is no detriment to the project of applying luck egalitarianism to health. (shrink)

Hassoun argues that the poor in the world have a right to health and that the Global Health Impact Index provides consumers in well-off countries with the opportunity to ensure that more people have access to essential medicines. Because of this, these consumers would be ethically obliged to purchase Global Health Impact Index-labeled products in the face of existing global inequalities. In presenting her argument, Hassoun rejects the so-called democratic account of ethical consumption in favor of the positive change account. (...) Two versions of the democratic change account are relevant. One underscores the importance of democratic procedures and institutions, while the other stresses our fundamental moral equality. While at least one prominent institutionalist account has problems, revised versions would be less vulnerable to Hassoun’s counterexamples. Furthermore, institutionalist accounts come with the epistemological gains from democratic procedures and deliberations, which may be especially important under uncertainty. Finally, and perhaps more challenging for the Global Health Impact index project, this measure may place the burden unfairly on those who need to buy medicines. This is a pivotal insight from the non-institutionalist version of the democratic account of ethical consumption. (shrink)

Luck egalitarianism is often taken to task for its alleged harsh implications. For example, it may seem to imply a policy of nonassistance toward uninsured reckless drivers who suffer injuries. Luck egalitarians respond to such objections partly by pointing to a number of factors pertaining to the cases being debated, which suggests that their stance is less inattentive to the plight of the victims than it might seem at first. However, the strategy leaves some cases in which the attribution of (...) individual responsibility is appropriate . One such case is oral health or significant aspects of this. It is appropriate, the paper argues, to hold people responsible for a number of factors that affect their oral health. A luck egalitarian approach inspired by John Roemer can assess whether people have acted responsibly by comparing their choices to those of their peers. A luck egalitarian approach to oral health would recommend prioritizing scarce resources in a responsibility-weighted queuing system and include copayment and general taxation among its measures of financing. (shrink)

Rare diseases pose a particular priority setting problem. The UK gives rare diseases special priority in healthcare priority setting. Effectively, the National Health Service is willing to pay much more to gain a quality-adjusted life-year related to a very rare disease than one related to a more common condition. But should rare diseases receive priority in the allocation of scarce healthcare resources? This article develops and evaluates four arguments in favour of such a priority. These pertain to public values, luck (...) egalitarian distributive justice the epistemic difficulties of obtaining knowledge about rare diseases and the incentives created by a higher willingness to pay. The first is at odds with our knowledge regarding popular opinion. The three other arguments may provide a reason to fund rare diseases generously. However, they are either overinclusive because they would also justify funding for many non-rare diseases or underinclusive in the sense of justifying priority for only some rare diseases. The arguments thus fail to provide a justification that tracks rareness as such. There are no data in this work. (shrink)

In December 2015, Wales became the first country in the UK to move away from an opt-in system in organ procurement. The new legislation introduces the concept of deemed consent whereby a person who neither opt in nor opt out is deemed to have consented to donation. The data released by the National Health Service in July 2017 provide an excellent opportunity to assess this legislation in light of concerns that it would decrease procurement rates for living and deceased donation, (...) as well as sparking an increase in family refusals. None of these concerns have come to pass, with Wales experiencing more registered donors, fewer family refusals and more living donations. However, as the number of actual donors has dropped slightly from a high level, the situation must be monitored closely in the years to come. (shrink)

The scarcity of livers available for transplants forces tough choices upon us. Lives for those not receiving a transplant are likely to be short. One large group of potential recipients needs a new liver because of alcohol consumption, while others suffer for reasons unrelated to their own behaviour. Should the former group receive lower priority when scarce livers are allocated? This discussion connects with one of the most pertinent issues in contemporary political philosophy; the role of personal responsibility in distributive (...) justice. One prominent theory of distributive justice, luck egalitarianism, assesses distributions as just if, and only if, people's relative positions reflect their exercises of responsibility. There is a principled luck egalitarian case for giving lower priority to those who are responsible for their need. Compared to the existing literature favouring such differentiation, luck egalitarianism provides a clearer rationale of fairness, acknowledges the need for individual assessments of responsibility, and requires initiatives both inside and outside of the allocation systems aimed at mitigating the influence from social circumstances. Furthermore, the concrete policies that luck egalitarians can recommend are neither too harsh on those who make imprudent choices nor excessively intrusive towards those whose exercises of responsibility are assessed. (shrink)

Should we grant a fresh start to those who come to regret their past lifestyle choices? A negative response to this question can be located in the luck egalitarian literature. As a responsibility-sensitive theory of justice, luck egalitarianism considers it just that people’s relative positions reflect their past choices, including those they regret. In a recent article, Vansteenkiste, Devooght and Schokkaert argue against the luck egalitarian view, maintaining instead that those who regret their past choices in health are disadvantaged in (...) a relevant way and should receive compensation. Employing the ideal that people should be made equal as measured by equivalent resources, they purport to show the fairness of such an arrangement through a hypothetical scenario. Relaxing the implicit assumptions of this scenario brings forth several unattractive consequences of the fresh-start idea. The main problem is that in striving to ensure that people’s past choices do not affect their own opportunities, the authors must accept that these choices put heavy strains on the opportunities available to other people. Furthermore, the luck egalitarian position is more compelling than they admit. (shrink)

The late G.A. Cohen is routinely considered a founding father of luck egalitarianism, a prominent responsibility-sensitive theory of distributive justice. David Miller argues that Cohen’s considered beliefs on distributive justice are not best understood as luck egalitarian. While the relationship between distributive justice and personal responsibility plays an important part in Cohen’s work, Miller maintains that it should be considered an isolated theme confined to Cohen’s exchange with Dworkin. We should not understand the view Cohen defends in this exchange as (...) Cohen’s considered view. Accepting this thesis would change both our understanding of Cohen’s political philosophy and many recent luck egalitarian contributions. Miller’s argument offers an opportunity to reassess Cohen’s writings as a whole. Ultimately, however, the textual evidence against Miller’s argument is overwhelming. Cohen clearly considers the exchange with Dworkin to be about egalitarianism as such rather than about the best responsibility-sensitive version of egalitarianism. Furthermore, Cohen often offers luck egalitarian formulations of his own view outside of the exchange with Dworkin and uses luck egalitarianism as an independent yardstick for evaluating principles and distributions. (shrink)

The exposure of doctors, nurses and other medical professionals to risks in the context of epidemics is significant. While traditional medical ethics offers the thought that these dangers may limit the extent to which a duty to care is applicable in such situations, it has less to say about what we might owe to medical professionals who are disadvantaged in these contexts. Luck egalitarianism, a responsibility-sensitive theory of distributive justice, appears to fare particularly badly in that regard. If we want (...) to maintain that medical professionals are responsible for their decisions to help, cure and care for the vulnerable, luck egalitarianism seems to imply that their claim of justice to medical attention in case of infection is weak or non-existent. The article demonstrates how a recent interpretation of luck egalitarianism offers a solution to this problem. Redefining luck egalitarianism as concerned with responsibility for creating disadvantages, rather than for incurring disadvantage as such, makes it possible to maintain that medical professionals are responsible for their choices and that those infected because of their choice to help fight epidemics have a full claim of justice to medical attention. (shrink)

Book review: Joseph Fishkin: Bottlenecks—A New Theory of Equality of Opportunity.

Review: Shlomi Segall (2013) Equality and opportunity.

As the debate over an English opt-out policy for organ procurement intensifies, assessing existing experiences becomes even more important. The Welsh introduction of opt-out legislation provides one important point of reference. With the introduction of deemed consent in December 2015, Wales became the first part of the UK to introduce an opt-out system in organ procurement. My article ‘Deemed consent: assessing the new opt-out approach to organ procurement in Wales’ conducted an early assessment of this.1 Taking its starting point in (...) important concerns often raised in discussion over opt-out legislation, it identified four key parameters to assess the effects. These are living donor rates, deceased donor rates, donor registrations and family refusals. My article compares these indicators before and after the enactment of the Welsh legislation employing a different-in-different design. In his reply to my article ‘Deemed consent: assessing the new opt-out approach to organ procurement in Wales’, Jordan Alexander Parsons offers two interesting critiques. The first pertains to the choice of indicators. Parsons prefer a narrower focus on the effect on deceased donor rates. The second pertains to the choice of data, Parsons preferring a time series of Wales to my different-in-different design. Parsons refers mainly to the official Welsh evaluation,2 a report I also cited in supplement to the NHS Activity Report data I employed. …. (shrink)

Deceased organ donation is widely considered as a case of easy rescue―that is, a case in which A may bestow considerable benefits on B while incurring negligent costs herself. Yet, the policy implications of this observation remain unclear. Drawing on Christopher H. Wellman’s samaritan account of political obligations, the paper develops a case for a so-called opt-out system, i.e., a scheme in which people are defaulted into being donors. The proposal’s key idea is that we may arrange people’s options in (...) specific ways for the sake of others. (shrink)

A comprehensive understanding of the ethics of the COVID-19 pandemic priorities must be sensitive to the influence of social inequality. We distinguish between ex-ante and ex-post relevance of social inequality for COVID-19 disadvantage. Ex-ante relevance refers to the distribution of risks of exposure. Ex-post relevance refers to the effect of inequality on how patients respond to infection. In the case of COVID-19, both ex-ante and ex-post effects suggest a distribution which is sensitive to the prevalence social inequality. On this basis, (...) we provide a generic fairness argument for the claim that welfare states ought to favour a healthcare priority scheme that gives particular weight to protecting the socially disadvantaged. (shrink)

According to luck egalitarianism, it is not unfair when people are disadvantaged by choices they are responsible for. This implies that those who are disadvantaged by choices that prevent disadvantage to others are not eligible for compensation. This is counterintuitive. We argue that the problem such cases pose for luck egalitarianism reveals an important distinction between responsibility for creating disadvantage and responsibility for distributing disadvantage which has hitherto been overlooked. We develop and defend a version of luck egalitarianism which only (...) holds people responsible for creating disadvantage. This revision enables luck egalitarianism to offer compensation to those who are disadvantaged by preventing disadvantage to others, like dependent caretakers, without compromising the responsibility–sensitivity at the heart of luck egalitarianism. (shrink)

Teachers encountered numerous challenges posed by the COVID-19 outbreak. Herewith, this study aimed to determine the challenges encountered by Filipino teachers in the new normal and their coping mechanisms. This study employed a qualitative inquiry to determine the challenges encountered and coping mechanisms employed by teachers amid modular instruction, involving 10 teachers from five secondary schools in the Philippines who participated voluntarily. Data were gathered through a written narrative from each participant and were analyzed thematically. Themed findings showed that these (...) teachers are greatly challenged in terms of learning quality transfer, module distribution and retrieval, students’ difficulties in following instruction, power disruption, internet connection, and health risks posed by the pandemic. Nevertheless, these teachers dealt with these difficulties by employing their own coping techniques. Teaching can be challenging and frustrating, especially in these difficult times, but as these teachers demonstrated, everything is possible. Hence, educators must be ready for any situation that may arise. This situation is unlikely to get better anytime soon; instead, teachers will need to adjust to and accept this reality. (shrink)

In 1970, Stewart advocated disenfranchising everyone reaching retirement age or age 70, whichever was earlier. The question of whether senior citizens should be disenfranchised has recently come to the fore due to votes on issues such as Brexit and climate change. Indeed, there is a growing literature which argues that we should increase the voting power of non-senior citizens relative to senior citizens, for reasons having to do with intergenerational justice. Thus, it seems that there are reasons of justice to (...) disenfranchise senior citizens, or at least to grant them a lower voting weight than non-senior citizens. In this paper, we investigate whether there are democratic reasons to do so. To answer this question, we turn to the boundary problem in democratic theory, i.e., the question of who should be included in democratic decision-making. Two prominent solutions, and a more recent one, are particularly relevant: the all-affected principle, the all-subjected principle, and the relational egalitarian principle. When it comes to the all-affected principle and the all-subjected principle, we argue that there is reason to grant most senior citizens a lower voting weight than most non-senior citizens in most decisions. Whether that is the case on the relational egalitarian principle depends on how people relate to each other in society. Indeed, it is sometimes in accordance with the relational egalitarian view to grant senior citizens a greater voting weight than non-senior citizens. (shrink)

According to proponents of the extended mind, bio-external resources, such as a notebook or a smartphone, are candidate parts of the cognitive and mental machinery that realises cognitive states and processes. The present chapter discusses three areas of ethical concern associated with the extended mind, namely mental privacy, mental manipulation, and agency. We also examine the ethics of the extended mind from the standpoint of three general normative frameworks, namely, consequentialism, deontology, and virtue ethics.

We discuss potential biorisks from large language models (LLMs). AI assistants based on LLMs such as ChatGPT have been shown to significantly reduce barriers to entry for actors wishing to synthesize dangerous, potentially novel pathogens and chemical weapons. The harms from deploying such bioagents could be further magnified by AI-assisted misinformation. We endorse several policy responses to these dangers, including prerelease evaluations of biomedical AIs by subject-matter experts, enhanced surveillance and lab screening procedures, restrictions on AI training data, and access (...) controls on biomedical AI. We conclude with a suggestion about future research directions in bioethics. (shrink)

Palliative care serves both as an integrated part of treatment and as a last effort to care for those we cannot cure. The extent to which palliative care should be provided and our reasons for doing so have been curiously overlooked in the debate about distributive justice in health and healthcare. We argue that one prominent approach, the Rawlsian approach developed by Norman Daniels, is unable to provide such reasons and such care. This is because of a central feature in (...) Daniels' account, namely that care should be provided to restore people's opportunities. Daniels' view is both unable to provide pain relief to those who need it as a supplement to treatment and, without justice-based reasons to provide palliative care to those whose opportunities cannot be restored. We conclude that this makes Daniels' framework much less attractive. (shrink)

The work of prominent analytical Marxist G. A. Cohen provides a vision of socialism which has distributive justice and community at its core. While Cohen's view of distributive justice has been hugely influential, much less has been said about community. This article argues that community plays three distinct roles in Cohen's socialism. One is as an independent value, the second is as a necessary adjacent counterpart to justice, which serves both to restrict and facilitate distributive equality, and the third is (...) as a critique of the liberal contractualist view of humanity. We argue that each of these are distinct and valuable elements in Cohen's thought, each of which must be recognized to understand the range and implications of Cohen's socialism. (shrink)

Companies committed to corporate social responsibility should ensure that their managers possess the appropriate competencies to effectively manage the CSR adaptation process. The literature provides insights into the individual competencies these managers need but fails to prioritize them and adequately contextualize them in a manner that makes them meaningful in practice. In this study, we contextualized the competencies within the different job roles CSR managers have in the CSR adaptation process. We interviewed 28 CSR managers, followed by a survey to (...) explore the relative importance of the competencies within each job role. Based on our analysis, we identified six distinct managerial roles, including strategic, coordinating, and stimulating roles. Next, we identified per role key individual CSR-related competencies as prioritized by the respondents. Our results show that the context, as indicated in this study by CSR managers’ job roles, indeed influenced the importance of particular CSR-related competencies, because each role seems to require a different combination and prioritization of these competencies. Moreover, the results suggest that the relative importance of these competencies within each role may be driven by business logic rather than an idealistic logic. The results are presented as a competence profile which can serve as a reflection tool and as a frame of reference to further develop the competence profile for CSR managers. (shrink)

Here we present what we believe is a novel account of what languages are, along with an axiomatically rich representation of languages and language-related data that is based on this account. We propose an account of languages as aggregates of dispositions distributed across aggregates of persons, and in doing so we address linguistic competences and the processes that realize them. This paves the way for representing additional types of language-related entities. Like demographic data of other sorts, data about languages may (...) be of use to researchers in a number of areas, including biomedical research. Data on the languages used in clinical encounters are typically included in medical records, and capture an important factor in patient-provider interactions. Like many types of patient and demographic data, data on a person’s preferred and primary languages are organized in different ways by different systems. This can be a barrier to data integration. We believe that a robust framework for representing language in general and preferred and primary language in particular – which has been lacking in ontologies thus far – can promote more successful integration of language-related data from disparate data sources. (shrink)

As engineering applications require management of ever larger volumes of data, ontologies offer the potential to capture, manage, and augment data with the capability for automated reasoning and semantic querying. Unfortunately, considerable barriers hinder wider deployment of ontologies in engineering. Key among these is lack of a shared top-level ontology to unify and organise disparate aspects of the field and coordinate co-development of orthogonal ontologies. As a result, many engineering ontologies are limited to their scope, and functionally difficult to extend (...) or interoperate with other engineering ontologies. This paper demonstrates how the use of a top-level ontology, specifically the Basic Formal Ontology (BFO), greatly facilitates interoperability of multiple engineering-related ontologies. We constructed a system of formal linked ontologies by re-engineering legacy ontologies to be conformant with BFO and developing new BFO-conformant ontologies to capture knowledge in the engineering design, enterprise, human factors, manufacturing, and application domain of additive manufacturing. The resulting Integrated Framework for Additively Manufactured Products (IFAMP), including the body knowledge instantiated on its basis, serve as the basis for a proposed Design with Additive Manufacturing Method (DWAM), which we believe can support the design of innovative products with semantically enhanced ideation tools and enhanced access to application domain knowledge. The method and its facilitation through the ontological framework are demonstrated using a case study in medicine. (shrink)

Aborda a descrição do sistema digestivo dos não-ruminantes e suas particularidades, o aproveitamento e importância da água e demais nutrientes para o desenvolvimento das aves, suínos, equinos, peixes, cães e gatos. Como os nutrientes e a energia é aproveitada pelos Não-Ruminantes. São descritos o conceito de aditivos e sua importância a ser adicionado nas rações destes animais, e como as rações são formuladas para o atendimento mínimo dos nutrientes e energia, além da formulação do suplemento vitamínico e mineral.

Parkinson's Disease (PD) is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms generally come on slowly over time. Early in the disease, the most obvious are shaking, rigidity, slowness of movement, and difficulty with walking. Doctors do not know what causes it and finds difficulty in early diagnosing the presence of Parkinson’s disease. An artificial neural network system with back propagation algorithm is presented in this paper for helping doctors in identifying (...) PD. Previous research with regards to predict the presence of the PD has shown accuracy rates up to 93% [1]; however, accuracy of prediction for small classes is reduced. The proposed design of the neural network system causes a significant increase of robustness. It is also has shown that networks recognition rates reached 100%. (shrink)

Technological advancement makes translation convenient due to the emergence of various translation tools. This Explanatory-Sequential study aims to determine the preference and the factors affecting the preference of Filipino and Foreign college students toward the Online Translation Tool. Likewise, it also aimed to identify if there is a significant difference between the respondents' choices. To acquire the data, the researchers used a survey conducted on 15 Filipino and foreign collegiate students enrolled in universities in Manila and a focus group discussion (...) among 3 Filipino students. The transcribed data were analyzed using Thematic Analysis. Moreover, the results of the quantitative data revealed that Google Translate was the preferred Online Translation Tool of Filipino and Foreign students for the reason of accessibility, user-friendliness, and the tendency of users to brand bias. The reasons presented in quantitative data are strengthened by the themes identified in the qualitative data. The three prevailing themes of Brand Bias, Accessibility, and Accuracy constituted the central theme of User Friendliness. It was identified through the Chi-Square Test that there is no significant difference among respondents' preferences (0.345 P-Value) toward online Translation software. (shrink)

Background: Community-based education (CBE) involves educating the head (cognitive), heart (affective), and the hand (practical) by utilizing tools that enable us to broaden and interrogate our value systems. This article reports on the use of virtue ethics (VE) theory for understanding the principles that create, maintain and sustain a socially accountable community placement programme for undergraduate medical students. Our research questions driving this secondary analysis were; what are the goods which are internal to the successful practice of CBE in medicine, (...) and what are the virtues that are likely to promote and sustain them? -/- Methods: We conducted a secondary theoretically informed thematic analysis of the primary data based on MacIntyre’s virtue ethics theory as the conceptual framework. -/- Results: Virtue ethics is an ethical approach that emphasizes the role of character and virtue in shaping moral behavior; when individuals engage in practices (such as CBE), goods internal to those practices (such as a collaborative attitude) strengthen the practices themselves, but also augment those individuals’ virtues, and that of their community (such as empathy). We identified several goods that are internal to the practice of CBE and accompanying virtues as important for the development, implementation and sustainability of a socially accountable community placement programme. A service-oriented mind-set, a deep understanding of community needs, a transformed mind, and a collaborative approach emerged as goods internal to the practice of a socially accountable CBE. The virtues needed to sustain the identified internal goods included empathy and compassion, connectedness, accountability, engagement [sustained relationship], cooperation, perseverance, and willingness to be an agent of change. -/- Conclusion: This study found that MacIntyre’s virtue ethics theory provided a useful theoretical lens for understanding the principles that create, maintain and sustain CBE practice. (shrink)

This chapter argues that the general philosophy of science should learn metaphilosophical lessons from the case of metaphysical underdetermination, as it occurs in non-relativistic quantum mechanics. Section presents the traditional discussion of metaphysical underdetermination regarding the individuality and non-individuality of quantum particles. Section discusses three reactions to it found in the literature: eliminativism about individuality; conservatism about individuality; eliminativism about objects. Section wraps it all up with metametaphysical considerations regarding the epistemology of metaphysics of science.

The translational research community, in general, and the Clinical and Translational Science Awards (CTSA) community, in particular, share the vision of repurposing EHRs for research that will improve the quality of clinical practice. Many members of these communities are also aware that electronic health records (EHRs) suffer limitations of data becoming poorly structured, biased, and unusable out of original context. This creates obstacles to the continuity of care, utility, quality improvement, and translational research. Analogous limitations to sharing objective data in (...) other areas of the natural sciences have been successfully overcome by developing and using common ontologies. This White Paper presents the authors’ rationale for the use of ontologies with computable semantics for the improvement of clinical data quality and EHR usability formulated for researchers with a stake in clinical and translational science and who are advocates for the use of information technology in medicine but at the same time are concerned by current major shortfalls. This White Paper outlines pitfalls, opportunities, and solutions and recommends increased investment in research and development of ontologies with computable semantics for a new generation of EHRs. (shrink)

Our investigative question is what part of the human psyche is active when we are sleeping. We use the single-counter-example method, extracted from Classical Logic, to prove that it could not be the case that one of our existing models for the human psyche could explain the human sleep. The models of the human psyche that we consider are the Freudian, the Jungian, and our own. By proving that no known part could be active whilst we sleep, and we prove (...) all by presenting known facts, we reach the conclusion that we need a new model of psyche to account for the entire complexity of our beings. We associate sleep with dreams. Upon discussing the human dreams in more details, we end up applying the principles of the inference to the best explanation to explain the human dreams by means of references to the spiritual world. That makes us think about how the spiritists would describe our psyche, and we then present a new model. The new model is obviously a fruit of speculation. This time, the model involves all Freudian elements, our extensional elements, body, and soul. We use the synthetic method to construct our new model. Since our sleep time is so important, to the point of obliging us to build a new model for the human psyche, we worry about protecting it. We then use studies on the impact of noise on humans to talk about how bad the consequences of having a person speaking to us during sleep are. This trivially extends to people that are in hypnotic state. We try to make a case against hypnosis and interference with the sleep of human beings by referring to health, spiritual, and world consequences. Our main result is then a new model for the human psyche, and this time a model that has to do with what is beyond what has already been formally acknowledged by us. A secondary result is that we should not allow people to hypnotize others or to speak to them as they sleep. Our conclusions are that there is definitely something beyond our rationality that happens during our sleep time and this something has not been identified by Freud, Jung or us this far. Besides, that we should not allow people to hypnotize others or speak to them as they sleep. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

The COVID-19 pandemic and global climate change crisis remind us that widespread trust in the products of the scientific enterprise is vital to the health and safety of the global community. Insofar as appropriate responses to these crises require us to trust that enterprise, cultivating a healthier trust relationship between science and the public may be considered as a collective public good. While it might appear that scientists can contribute to this good by taking more initiative to communicate their work (...) to public audiences, we raise a concern about unintended consequences of an individualistic approach to such communication. (shrink)

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

Technological advancement makes translation convenient due to the emergence of various translation tools. This Explanatory-Sequential study aims to determine the preference and the factors affecting the preference of Filipino and Foreign college students toward the Online Translation Tool. Likewise, it also aimed to identify if there is a significant difference between the respondents' choices. To acquire the data, the researchers used a survey conducted on 15 Filipino and foreign collegiate students enrolled in universities in Manila and a focus group discussion (...) among 3 Filipino students. The transcribed data were analyzed using Thematic Analysis. Moreover, the results of the quantitative data revealed that Google Translate was the preferred Online Translation Tool of Filipino and Foreign students for the reason of accessibility, user-friendliness, and the tendency of users to brand bias. The reasons presented in quantitative data are strengthened by the themes identified in the qualitative data. The three prevailing themes of Brand Bias, Accessibility, and Accuracy constituted the central theme of User Friendliness. It was identified through the Chi-Square Test that there is no significant difference among respondents' preferences (0.345 P-Value) toward online Translation software. (shrink)

GILBERT JEAN FACCARELLO (Paris, 1950) is professor of economics at Université Panthéon-Assas, Paris, and a member of the Triangle research centre (École Normale Supérieure de Lyon and CNRS). He is presently chair of the ESHET Council (European Society for the History of Economic Thought). He completed his doctoral research in economics at Université de Paris X Nanterre. He has previously taught at the Université de Paris-Dauphine, Université du Maine and École Normale Supérieure de Fontenay/Saint-Cloud (now École Normale Supérieure de Lyon). (...) He is a co-founder of The European Journal of the History of Economic Thought, which he co-edited for 20 years with J. L. Cardoso, Heinz D. Kurz, and A. Murphy. With Alain Béraud, he edited the Nouvelle histoire de la pensée économique (La Découverte, 3 volumes, 1992-2000) and, together with Heinz D. Kurz, he is presently editing a Handbook of the History of Economic Analysis (3 volumes, forthcoming with Edward Elgar). -/- EJPE interviewed Gilbert Faccarello about his research career in the history of economic thought, where he has focused especially on old and new classical and Marxian political economy, and French political economy during the 18th and 19th centuries. G. Faccarello discusses his interest not only in the logical structure and context of the economic ideas of past thinkers but also the links between economic thought, philosophy, and religion. (shrink)