La actual crisis sanitaria nos invita a repensar el actual modelo de salud, así como sus implicaciones antropológicas, sociales y económicas. A partir de una breve historia del concepto de salud, en este artı́culo tratamos de evidenciar los cambios que ese mismo concepto ha implicado a nivel de relación médico-paciente y a nivel de relaciones sociales. Un nuevo paradigma de salud, más ajustado a los nuevos fenómenos globales que están aconteciendo, implica también una critica a los enfoques (...) individualistas, reduccionistas, tecnocráticos y economicistas que se encontraban en la raı́z del “antiguo” modelo de salud. Por último, proponemos el modelo One Health como una posible respuesta a los problemas teóricos del “antiguo paradigma” de salud, fuertemente enfatizados por la crisis sanitaria actual. (shrink)

La pandemia de la COVID-19 ha recordado la importancia de prevenir y planificarse ante eventos altamente desastrosos para la salud comunitaria. Varios fenómenos emergentes suponen amenazas prospectivas para la Salud Pública. Sin embargo, el carácter mayormente futuro de problemas como la resistencia antibiótica, el impacto del cambio climático en la salud o la bioingeniería de patógenos genera dificultades de análisis. ¿Cuáles son los desafíos éticos y epistemológicos que suscitan los problemas futuros para la Salud Pública? ¿Cómo (...) deben abordarse los problemas morales de escenarios futuros, potencialmente catastróficos? En este artículo se defiende la necesidad de adoptar enfoques éticos anticipativos desde la ética de la Salud Pública. En primer lugar, se argumentará que el abordaje de estos problemas futuros requiere reflexionar sobre el futuro como problema ético y epistémico. En segundo lugar, se analizarán las características de la incipiente ética anticipatoria en los ámbitos de la ética de la tecnología y la bioética. En tercer lugar, se defenderá la aplicación de metodologías de previsión y anticipación en debates sobre la ética de la Salud Pública. Finalmente, se ofrecerán algunas reflexiones para fortalecer los análisis normativos anticipativos a fin de prevenir y atajar de antemano los efectos adversos de las futuras crisis sanitarias. (shrink)

Este número de acceso abierto tiene como objetivo resaltar los puntos de vista de los países latinoamericanos sobre la justicia en un contexto de pandemia y contribuir al diálogo entre estos y con la comunidad científica global. Explora los desafíos globales de la pandemia de COVID-19, las diferencias relevantes entre las medidas de salud pública y su impacto en los países de ingresos altos versus los países de ingresos bajos o medios, y cómo la injusticia global se (...) profundizó debido a la pandemia de COVID-19. También llama la atención sobre las experiencias, los resultados y las respuestas del norte global a la pandemia con respecto a poblaciones vulnerables y trayectorias de exposición que se reproducen en América Latina. (shrink)

Se ofrece un grupo de reflexiones acerca del vínculo entre dos conceptos de amplio uso en el lenguaje académico y no académico contemporáneo: valores universales y problemas globales. ¿Qué son los valores universales? ¿Por qué los seres humanos difieren en cuanto a su interpretación? ¿En qué medida el surgimiento y agudización de los problemas globales se asocia a una práctica distanciada de los verdaderos valores universales? ¿Qué hacer para que sean estos últimos los que en realidad sustenten las relaciones internacionales? (...) ¿Qué papel desempeñan estos valores en la búsqueda de soluciones a los problemas globales? El presente trabajo pretende aproximar una respuesta a estas interrogantes. (shrink)

Este essay-paper busca aportar algunos elementos para el debate de la caracterización del acceso a los medicamentos como un derecho global, partiendo de una serie de reflexiones que teóricos realizan sobre un asunto que se constituye en uno de los principales focos de desigualdad en el mundo.

El Foro Global de Bioética en Investigación (GFBR por sus siglas en inglés) se reunió el 3 y 4 de noviembre en Buenos Aires, Argentina, con el objetivo de discutir la ética de la investigación con mujeres embarazadas. El GFBR es una plataforma mundial que congrega a actores clave con el objetivo de promover la investigación realizada de manera ética, fortalecer la ética de la investigación en salud, particularmente en países de ingresos bajos y medios, y promover colaboración (...) entre países del norte y del sur.a Los participantes en el GFBR provenientes de Latinoamérica incluyeron a eticistas, investigadores, miembros de comités de ética y representantes de autoridades sanitarias provenientes de Argentina, Brasil, Chile, Colombia, Ecuador, El Salvador, Guatemala, Honduras, Panamá, Perú, Nicaragua y la República Dominicana. Una legítima preocupación por la protección de las mujeres embarazadas y sus embriones o fetos ha llevado a la mayoría de los países de la Región de las Américas a limitar la realización de estudios con mujeres embarazadas exclusivamente a aquellos estudios específicos sobre el embarazo, y a requerir la exclusión sistemática de las mujeres embarazadas o de las mujeres que quedan embarazadas en el curso del estudio. Ciertamente, a lo largo de la historia de la ética de la investigación, se ha creído erróneamente que proteger a una población es sinónimo de excluirla de los estudios. Se sabe ahora que proceder así implica exponer a riesgos mucho mayores a la población que se busca proteger. El embarazo implica cambios fisiológicos sustantivos e impacta profundamente la manera como el cuerpo metaboliza los medicamentos. Sin embargo, por evitar hacer investigación con mujeres embarazadas, no se ha producido la evidencia científica necesaria para tomar decisiones sobre tratamientos e intervenciones preventivas con dosis eficaces y seguras para ellas y sus embriones o fetos. A manera de ilustración, en el 2001 había en los Estados Unidos apenas más de una docena de medicamentos aprobados para uso en el embarazo (1) y en el 2011 la Food and Drug Administration (FDA) aprobó por primera vez en 15 años un medicamento para su uso en el embarazo (2). Como consecuencia de no haber producido la evidencia necesaria, se pone en riesgo la salud de las mujeres embarazadas cada vez que se les da atención médica. Las mujeres embarazadas se enferman y las mujeres enfermas se embarazan, y no se sabe si los medicamentos que se les da son eficaces o siquiera seguros para ellas y sus embriones o fetos. (shrink)

Una vez que se desarrollen vacunas efectivas contra la enfermedad del coronavirus 2019 (COVID-19), estas serán escasas. Esto plantea la cuestión de cómo distribuirlas equitativamente entre países. La asignación de vacunas entre países plantea cuestiones complejas y controvertidas que involucran la opinión pública, la diplomacia, la economía, la salud pública y otras consideraciones. Sin embargo, muchos líderes nacionales, organizaciones internacionales y productores de vacunas reconocen que un factor central en esta toma de decisiones es la ética [1, 2]. No (...) obstante, se ha avanzado poco en la definición de lo que constituye una distribución internacional equitativa de vacunas. Muchos han respaldado la “distribución equitativa de la vacuna contra el COVID-19” sin describir un marco o sin ofrecer recomendaciones [3, 4]. Se han presentado dos propuestas sustantivas para la asignación internacional de una vacuna contra la COVID19, pero presentan graves fallas. Ofrecemos una propuesta más éticamente defendible y práctica para la distribución equitativa de la vacuna COVID19: el Modelo de la Prioridad Equitativa. El Modelo de la Prioridad Justa está orientado principalmente a tres grupos. Una es la alianza COVAX, encabezada por GAVI (por sus siglas en inglés), la Organización Mundial de la Salud (OMS) y la Coalición para Innovaciones en Preparación para Epidemias (CEPI por sus siglas en inglés), que tiene la intención de comprar vacunas para distribuirlas equitativamente entre países [5]. Un segundo grupo son los productores de vacunas. Afortunadamente, muchos productores se han comprometido públicamente con una distribución internacional de vacunas “amplia y equitativa” [2]. El último grupo son los gobiernos nacionales, algunos de los cuales también se han comprometido públicamente con una distribución equitativa [1]. Estos grupos necesitan un marco claro para reconciliar valores en competencia, uno que ellos y otros aceptarán legítimamente como ético y no solo como una afirmación de poder. El Modelo de la Prioridad Justa especifica lo que implica una distribución equitativa de vacunas, dando contenido a sus compromisos. Además, la aceptación de este marco ético común reducirá la duplicación y el desperdicio, lo que facilitará los esfuerzos por lograr una distribución equitativa. Eso, a su vez, promoverá la confianza de los productores en que las vacunas se asignarán de manera equitativa para beneficiar a las personas, lo que motivará un aumento en el suministro de vacunas para distribución internacional. (shrink)

MERC Global’s International Journal of Management (MERC Global’s IJM) is an international peer-reviewed, open access quarterly journal of management science, being brought out with a view to facilitating effective dissemination of the latest thinking and research with respect to various management issues and problem solving methodology relevant for practicing executives as well as for academicians and researchers working in the field of management around the globe. -/- MERC Global’s IJM publishes articles, research papers, abstracts of doctoral dissertations, (...) book reviews, case studies, short communications and bibliography that are interdisciplinary in nature as well as those within the major disciplines, including: marketing, OB/HR, entrepreneurship, production, operations, accounting, finance, business economics, international business, information technology management, social sector management, public sector management, healthcare management, management strategy, research methods, and so forth. (shrink)

MERC Global’s International Journal of Management (MERC Global’s IJM) is an international peer-reviewed, open access quarterly journal of management science, being brought out with a view to facilitating effective dissemination of the latest thinking and research with regard to various management issues and problem solving methodology relevant for practicing executives as well as for academicians and researchers working in the field of management around the globe. -/- MERC Global’s IJM publishes articles, research papers, abstracts of doctoral dissertations, (...) book reviews, case studies, short communications and bibliography that are interdisciplinary in nature as well as those within the major disciplines, including: marketing, OB/HR, entrepreneurship, production, operations, accounting, finance, business economics, international business, information technology management, social sector management, public sector management, healthcare management, management strategy, research methods etc. (shrink)

En este trabajo se comparan dos representaciones en competencia sobre el origen de la bioética para llamar la atención sobre un posible cambio de marco teórico dentro de la disciplina. Por un lado, una representación parroquiana del origen de la bioética, centrada en problemas tecnológicos locales, y fundamentada en tradiciones culturales particulares. Por otro lado, una representación universal y pluralista, que enfrenta problemas de justicia y salud globales y que intenta buscar el fundamento normativo del discurso de la bioética (...) en los derechos humanos. Luego de compararlas, desarrollo algunas razones para mostrar por qué las relaciones entre bioética y derechos humanos están sólidamente justificadas. Por último, planteo dos observaciones críticas que deberían tenerse en cuenta al pensar la relación entre bioética y derechos humanos. (shrink)

En este trabajo se comparan dos representaciones en competencia sobre el origen de la bioética para llamar la atención sobre un posible cambio de marco teórico dentro de la disciplina. Por un lado, una representación parroquiana del origen de la bioética, centrada en problemas tecnológicos locales, y fundamentada en tradiciones culturales particulares. Por otro lado, una representación universal y pluralista, que enfrenta problemas de justicia y salud globales y que intenta buscar el fundamento normativo del discurso de la bioética (...) en los derechos humanos. Luego de compararlas, desarrollo algunas razones para mostrar por qué las relaciones entre bioética y derechos humanos están sólidamente justificadas. Por último, planteo dos observaciones críticas que deberían tenerse en cuenta al pensar la relación entre bioética y derechos humanos. (shrink)

El problema de la transición de los participantes desde una investigación hacia la atención de la salud apropiada es un problema global. La publicación de una nueva versión de la Declaración de Helsinki es una excelente oportunidad para repensar este problema. Según mi interpretación, la Declaración de Helsinki 2013 introduce dos tipos diferentes de obligaciones posinvestigación, a saber, (1) obligaciones de acceso a atención de la salud y (2) obligaciones de acceso a información. Los beneficiarios pretendidos de (...) estas obligaciones son los participantes individuales de estudios de investigación. Y la Declaración identifica a los patrocinadores, investigadores y gobiernos de los países anfitriones como los principales agentes responsables de cumplir con las obligaciones posinvestigación. Para justificar esta interpretación de los tipos, agentes y beneficiarios de las obligaciones posinvestigación, presento primero una clasificación tentativa de las obligaciones posinvestigación. Luego hago una breve reconstrucción conceptual de las formulaciones de las obligaciones posinvestigación en las versiones anteriores de la Declaración y reviso las principales críticas. Finalmente presento un análisis crítico de la nueva formulación de las obligaciones posinvestigación basándome en la discusión de las secciones anteriores. [ABSTRACT] The problem of transitioning research participants when the study is concluded to the appropriate health care is a global problem. The publication of a new version of the Declaration of Helsinki and its public discussion is a great opportunity to rethink this problem. According to my interpretation, the Declaration of Helsinki 2013 identifies two different types of post-trial obligations, namely, (1) obligations of access to health care and (2) the obligations of access to information. The intended beneficiaries of these obligations are individual participants of research studies. And the Declaration identifies the sponsors, researchers and host country governments as the main agents responsible for complying with the post-trial obligations mentioned above. To justify this interpretation of the types, agents and beneficiaries of post-trial obligations, I first introduce a tentative classification of post-trial obligations. Then I make a brief conceptual reconstruction of formulations of post-trial obligations in earlier versions of the Declaration and revise the main critiques. Finally I advance a critical analysis of the new formulation of post-trial obligations based on the discussion in the previous sections. (shrink)

In Brazil, the social demand for veterinary expertise is growing. However, there is still a shortage of professionals trained in this area to apply specific knowledge to each case. Studies and research into forensic veterinary medicine are necessary for veterinary experts to assist in investigations and legal proceedings. Veterinary medicine has subjects on its curriculum that cover the knowledge needed to apply in the fields of animal health, public health and the environment. The interaction between human and veterinary medicine, as (...) well as other areas of health, is of great importance in the prevention and control of various diseases, both in animals and humans. Some cases of infectious bovine abortion have a major impact not only on cattle farming and animal health, but also on public and environmental health. The concept of "One Health" integrates human medicine and health professionals. In this context, knowledge of infectious abortive diseases that affect animal, human and environmental health is fundamental. Cattle are affected by specific infectious abortive diseases, caused by pathogens with different forms of presentation and transmission mechanisms. These include brucellosis, leptospirosis and listeriosis, which are potentially zoonotic diseases. Controlling these diseases can contribute to effective public health actions and reduce global health risks. In order to establish the diagnosis of these diseases, it is essential to properly collect specimens from live or dead animals under biosafety and biosecurity conditions, following the chain of custody for each case. These procedures allow for greater success in diagnosing the suspected agent and facilitate the investigation of other causes. Animal health standards for the prophylaxis and control of these diseases are established by specific legislation, including those of the Ministry of Agriculture, Livestock and Supply (MALS). This literature review was based on current knowledge on the Pubmed platform, Google Scholar, articles and textbooks. The aim of this article is to identify, understand and discuss the main infectious abortive diseases of cattle in the legal and forensic context, which have an impact on cattle farming, animal health, food safety, public and environmental health. -/- Referências bibliográficas Abdullah, N. M., Mohammad, W. M. Z. W., Shafei, M. N., Sukeri, S., Idris, Z., Arifin, W. N., Nozmi, N., Saudi, S. N. S., Samsudin, S., & Zainudin, A.-W. (2019). Leptospirosis and its prevention: knowledge, attitude and practice of urban community in Selangor, Malaysia. BMC Public Health, 19(1), 1–8. Agrimani, D. S. R., Rui, B. R., Cruz, I. V, Romano, R. M., & Lopes, H. C. (2011). 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A., & Lima-Ribeiro, A. M. C. (2010). Leptospirose canina-Revisão de literatura. PUBVET, 4, Art-917. Castro, J. R., Salaberry, S. R. S., Ribeiro, V. C., Souza, M. A., & Lima-Ribeiro, A. M. C. (2010). Brucelose canina-Revisão de literatura. PUBVET, 4(41), Art-981. CFMV. (2017). Código de ética do médico veterinário. Diário Oficial da União. Chaiblich, J. V., Lima, M. L. S., Oliveira, R. F., Monken, M., & Penna, M. L. F. (2017). Estudo espacial de riscos à leptospirose no município do Rio de Janeiro (RJ). Saúde em Debate, 41, 225–240. Coiro, C. J., Langoni, H., Silva, R. C., & Ullmann, L. S. (2011). Fatores de risco para leptospirose, leishmaniose, neosporose e toxoplasmose em cães domiciliados e peridomíciliados em Botucatu-SP. Veterinária e Zootecnia, 18(3), 393–407. Correa Júnior, F. F., & Silva, J. R. G. (2021). Responsabilidade técnica de animais de produção na área de produção animal – Confinamento de bovinos. In A. C. S. G. Assis & R. S. Braga (Eds.), Responsabilidade técnico na medicina veterinária. MED VET Livros. Corrêa, S. H. R., Vasconcelos, S. A., Teixeira, A. A., Dias, R. A., Guimarães, M. A. B., & Ferreira Neto, J. S. (2000). Epidemiologia da leptospirose em animais silvestres na Fundação Parque Zoológico de São Paulo. Brazilian Journal of Veterinary and Animal Science, 41(3), 189–193. Costa, M. (2001). Brucelose bovina e equina. In F. Riet-Correa, A. L. Schild, & R. A. A. Lemos (Eds.), Doenças de ruminantes e equinos (pp. 187–197). Varela Editora e Livraria Ltda. Cruz, C. D., Martinez, M. B., & Destro, M. T. (2008). Listeria monocytogenes: Um agente infeccioso ainda pouco conhecido no Brasil. Alimentos e Nutrição, 19, 195–206. Dallari Júnior, J. A. (2021). Direito médico veterinário. Editora Recanto. DA SILVA, Emanuel Isaque Cordeiro. Relação e Efeitos Bioquímico-nutricionais Sobre a Retenção de Placenta em Vacas. 2020. Dias, F. E. F., Aoki, S. M., Mesquita, L. G., Nunes, C. M., & Garcia, J. F. (2006). Detecção de Leptospira pomona em sêmen bovino por eletroforese capilar fluorescente. Brazilian Journal of Veterinary Research and Animal Science, 43(3), 394–399. Donate, B. R. S., Prado, L. B., Espinoza, L. H. C., Fernandes, M. C., Pedrão, M. B. M., & Santos, E. W. C. O. (2022). Conhecimento da população brasileira quanto à leptospirose, sua profilaxia e transmissão. PUBVET, 16(5), 1–8. Esteves, S. B., Santos, C. M., Silva, B. C. S., Salgado, F. F., Guilloux, A. G. A., Cortez, A., Lucco, R. C., & Miotto, B. A. (2023). Time for change? A systematic review with meta-analysis of leptospires infecting dogs to assess vaccine compatibility in Brazil. Preventive Veterinary Medicine, 105869. Ferreira Júnior, J. A., Nascimento, K. A., & Miguel, M. P. (2015). Aborto e morte neonatal por Listeria monocytogenes em ruminantes. Revista de Literatura: Clínica e Cirurgia de Grandes Animais, 14, 85–89. Ferreira, V., Wiedmann, M., Teixeira, P., & Stasiewicz, M. J. (2014). 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Es probable que las vacunas contra COVID-19 sean escasas en los próximos años. Muchos países, desde la India hasta el Reino Unido, han adoptado el nacionalismo de las vacunas. ¿Cuáles son los límites éticos de este nacionalismo de vacunas? Ni el nacionalismo extremo ni el cosmopolitismo extremo son éticamente justificables. En cambio, proponemos el marco de prioridad justa para quienes residen en un país (PJR, por sus siglas en español), en el que los gobiernos pueden retener las dosis de la (...) vacuna COVID-19 para quienes residen en el país solo en la medida en que sean necesarias para mantener un nivel de mortalidad que no sea de crisis mientras están implementando intervenciones razonables de salud pública. En la práctica, un nivel de mortalidad sin crisis es el experimentado durante una mala temporada de gripe, el cual la sociedad considera un riesgo de fondo aceptable. Los gobiernos toman medidas para limitar la mortalidad por influenza, pero no existe una emergencia que incluya confinamientos severos. Este "estándar de riesgo de gripe" es una heurística no arbitraria y generalmente aceptada. La mortalidad por encima del estándar de riesgo de gripe justifica mayores intervenciones gubernamentales, incluida la retención de vacunas para quienes residen en un país por sobre la necesidad global. El nivel preciso de vacunación necesario para cumplir con el estándar de riesgo de influenza dependerá de factores empíricos relacionados con la pandemia. Esto vincula los principios éticos a los datos científicos que surgen de la emergencia. Por lo tanto, el marco PJR reconoce que los gobiernos deben priorizar la adquisición de vacunas para su país cuando sea necesario para reducir la mortalidad a niveles similares a los de la gripe sin crisis. Pero después de eso, un gobierno está obligado a hacer su parte para compartir vacunas para reducir los riesgos de mortalidad de las personas en otros países. Consideramos y rechazamos las objeciones al marco PJR basadas en que un país (1) haya desarrollado una vacuna, (2) haya aumentado los impuestos para pagar la investigación y compra de vacunas, (3) quiera eliminar las cargas económicas y sociales, y (4) sea ineficaz para combatir el COVID-19 a través de intervenciones de salud pública. (shrink)

Quiero introducir en la discusión académica sobre las formas de dominio y los tipos de poder el concepto de higienopolítica”(de higeia, salud), con el fin de categorizar la amenaza totalitaria que habita detrás el tipo de control político sobre la población, basado en la experiencia colectiva del miedo y la paranoia, que se ha comenzado a ejercer en los tiempos de la pandemia global del COVID-19. El concepto de higienopolítica apela a la idea de que en el siglo (...) XXI no solo subsisten formas de dominación que operan sobre el cuerpo basadas en prácticas higiénicas y creencias asociadas a alguna idea de salud, sino que también puede desarrollarse una forma de neototalitarismo tecnobiológico global en la que la salud es el fin último de la civitas. (shrink)

Comentaba en el Prólogo a la 1ª edición que nos cuesta distinguir las técnicas de los métodos y aceptar que la buena investigación clínica es la que se realiza con método riguroso. Este método reposa en cuatro pilares: que la pregunta o cuestión formulada sea relevante, que esté enunciada de manera precisa y operativa, que sea abordada o respondida con el mejor medio disponible en cada circunstancia, y que evite redundancias o repeticiones de cuestiones que ya han sido examinadas por (...) otros investigadores. Añadía que es imprescindible una dosis de curiosidad y de entusiasmo por lo que se examina. Como se ha dicho con frecuencia, el ensayo clínico es, entre los métodos de investigación clínica, el "patrón oro", el que, gracias a su característica inherente (la distribución aleatoria), está sujeto a menores posibilidades de sesgos. Esta consideración no ha cambiado. Sin embargo, mayor validez interna del método no implica mayor relevancia de los resultados obtenidos. Actualmente es común examinar protocolos de ensayos clínicos bien diseñados, cuyo "único" problema es que pretenden evaluar aspectos de escaso interés farmacológico, terapéutico, epidemiológico o sanitario. ¿Qué interés tiene la evaluación del quinto fármaco de una serie en una indicación para la que ya hay cuatro análogos que le han precedido en su desarrollo? ¿Qué interés tiene la evaluación de un nuevo hipocolesterolemiante o de un nuevo fármaco para la osteoporosis si no se conocen, respectivamente, el impacto de la hipercolesterolemia como factor de riesgo de cardiopatía isquémica o la epidemiología de las fracturas en mujeres postmenopáusicas en nuestro medio? En relación con estos ejemplos, tendría mucho más interés conocer los determinantes epidemiológicos y la historia natural de la cardiopatía isquémica en nuestro medio y conocer la epidemiología de las fracturas "espontáneas" y su impacto sobre la demanda asistencial; para ello serían de mucha utilidad métodos de investigación cuya validez intrínseca podría ser considerada "subóptima" en comparación con el ensayo clínico. En los últimos años ha irrumpido con fuerza en numerosísimas publicaciones el concepto de la "medicina basada en pruebas". Esta moda refleja en parte la importancia que de manera creciente reguladores e industria farmacéutica han concedido a los ensayos clínicos: se ha alcanzado un consenso global sobre la necesidad de demostrar la "eficacia" de los nuevos medicamentos por medio de ensayos clínicos controlados. De este modo, los organismos reguladores y autoridades sanitarias exigen ensayos clínicos como uno de los elementos necesarios para obtener el registro de un nuevo medicamento. Como consecuencia, se realizan y publican muchos más ensayos clínicos que antaño, y actualmente se pueden encontrar ensayos que sustentan la eficacia de la mayoría de los medicamentos disponibles en indicaciones específicas. Si hace unos años bastaba con examinar si había ensayos clínicos que demostraran la eficacia de un determinado medicamento antes de adoptarlo como uno de los de uso común (o de incluirlo en el formulario de un hospital), en la actualidad estas decisiones son más complejas, y se basan sobre todo en una consideración atenta de los objetivos, los métodos y los resultados de cada ensayo o de otros estudios destinados a evaluar eficacia, seguridad, conveniencia o comodidad y coste. Un buen clínico debe saber a la vez leer críticamente las publicaciones científicas y producir información relevante. Leer críticamente significa evaluar la pertinencia de los problemas investigados, los métodos aplicados y la interpretación de los resultados obtenidos. Producir información relevante implica saber identificar los problemas que deben y pueden ser objeto de investigación, formularlos, y ser protagonista (generalmente como parte de un equipo) de la elaboración del plan de investigación. En los últimos años se han publicado varios textos similares al que tiene en sus manos, todos ellos de gran calidad. El presente no pretende ser el más exhaustivo, sino sobre todo interesar a los profesionales sanitarios en el apasionante campo de la investigación clínica, en su sentido más amplio, estimulando la autonomía del lector para investigar un problema o una situación, y para aprender a leer las publicaciones científicas clínicas. Su lectura debe contribuir a que términos como "doble ciego", "p<0,05", "casos y controles", etc. dejen de ser fetiches-misterios, para convertirse en herramientas conceptualmente sencillas, útiles para la evaluación de la actividad asistencial. Esta nueva edición está muy ampliada respecto a la anterior. Se han reorganizado las generalidades sobre los objetivos y métodos de la investigación clínica, se han ampliado algunos aspectos del ensayo clínico, como el análisis de subgrupos, los aspectos estadísticos y éticos y las publicaciones sobre ensayos clínicos, se han añadido cuatro nuevos capítulos, sobre efectividad y eficacia, metaanálisis, ensayos en un solo paciente y farmacoeconomía, y el Glosario ha sido revisado y ampliado (sobre todo con términos de farmacocinética, desarrollo preclínico de fármacos, estadística y biotecnología genética), e incluye casi 750 términos. Para su elaboración me he basado en numerosos textos y diccionarios,a aunque he reformulado la mayoría de las definiciones y he optado por añadir en ocasiones algún comentario personal a muchas de ellas. Carles Vallvé ha escrito el capítulo sobre Normas de Buena Práctica Clínica. Agradezco asimismo las precisones y comentarios de Eulalia Dalmau, Javier Jiménez, Josep Maria Castel y Xavier Vidal, así como los comentarios a versiones anteriores de Fernando Antezana y Jorleny Rojas. Eduard Diogène me sugirió la idea de la portada, El sueño de la razón produce monstruos, que Goya comentaba así: " La fantasía abandonada de la razón produce monstruos imposibles: unida con ella es madre de las artes y origen de sus marabillas" La 1ª edición de este libro, que fue promovida por Zeneca, tuvo una amplia difusión, en España y en América Latina. AstraZeneca me propuso preparar esta 2ª edición del mismo modo abierto que en ocasión de la primera; su actual Director Médico Ramón Estiarte me ha ayudado en la selección de términos para el Glosario. A él y al anterior Director Médico de Zeneca, Manuel Martín, agradezco su idea inicial, su estímulo y ayuda, y las facilidades que han dado para la difusión de este libro. Joan-Ramon Laporte. (shrink)

According to Wringe 2006 we have good reasons for accepting the existence of Global Collective Obligations - in other words, collective obligations which fall on the world’s population as a whole. One such reason is that the existence of such obligations provides a plausible solution a problem which is sometimes thought to arise if we think that individuals have a right to have their basic needs satisfied. However, obligations of this sort would be of little interest – either theoretical (...) or practical – if they did not give rise, either directly or indirectly, to any kinds of reasons for individuals to behave in certain ways. -/- In this paper, I shall argue that in many situations, forward-looking global obligations give rise to an obligation on individuals to work towards bringing into existence and support an institutional system which will enable their obligations to be met. My argument for this conclusion involves two steps. In the first step, I address a general question about how collective obligations can give rise to individual obligations without being reducible to them, and which obligations they give rise to. Here I give a Kant-inspired argument, based on the principles that ‘ought implies can’ and that the content of the moral law is given by reflecting on how agents should legislate in a kingdom of ends, which is designed to show that collective obligations can give rise to individual obligations. In the second step I apply this principle to the case of global forward-looking obligations. (shrink)

In this paper, I examine global public reason as a method of justifying a global state. Ultimately, I conclude that global public reason fails to justify a global state. This is the case, because global public reason faces an unwinnable dilemma. The global public reason theorist must endorse either a hypothetical theory of consent or an actual theory of consent; if she endorses a theory of hypothetical consent, then she fails to justify her principles; (...) and if she endorses a theory of actual consent, her theory will lead to a highly unstable political system. On either side of the dilemma, global public reason faces untenable implications. Although similar criticisms have been advanced against domestic public reason, my argument is not repeating points made before me. My argument is new, in that it raises these objections specifically against global public reason, and in that it shows how, due to increased diversity of belief in the global arena, these problems are more pressing for global public reason than they are for domestic public reason. (shrink)

El presente trabajo analiza el reciente Auto del Tribunal Constitucional sobre la posibilidad de prohibir y limitar el derecho fundamental de reunión y manifestación para tutelar la salud, la vida y la integridad de las personas.

This paper discusses the relation between Crispin Wright’s alethic pluralism and my global expressivism. I argue that on many topics Wright’s own view counts as expressivism in my sense, but that truth itself is a striking exception. Unlike me, Wright never seems to countenance an expressivist account of truth, though the materials needed are available to him in his approaches to other topics.

These essays are about education, learning, rational inquiry, philosophy, science studies, problem solving, academic inquiry, global problems, wisdom and, above all, the urgent need for an academic revolution. Despite this range and diversity of topics, there is a common underlying theme. Education ought to be devoted, much more than it is, to the exploration real-life, open problems; it ought not to be restricted to learning up solutions to already solved problems - especially if nothing is said about the problems (...) that provoked the solutions in the first place. There should be much more emphasis on learning how to engage in cooperatively rational exploration of problems: even five year olds could begin to learn how to do this. A central task of philosophy ought to be to keep alive awareness of our unsolved fundamental problems - especially our most fundamental problem of all, encompassing all others: How can our human world - and the world of sentient life more generally - imbued with the experiential, consciousness, free will, meaning and value, exist and best flourish embedded as it is in the physical universe? This is both our fundamental intellectual problem and our fundamental problem of living. As far as the latter is concerned, we are at present heading towards disaster - as our immense, unsolved global problems tell us: population growth, destruction of natural habitats and rapid extinction of species, vast inequalities of wealth and power around the world, pollution of earth, sea and air, our proclivity for war, and above all global warming. If we are to resolve our conflicts and global problems more intelligently, effectively and humanely than we have managed to do so far, then we have to learn how to do it. That, in turn, requires that our institutions of learning, our universities and schools, are rationally designed and devoted to the task. At present they are not. That is the crisis behind all the others. From the past we have inherited the idea that the basic intellectual aim of inquiry ought to be to acquire knowledge. First, knowledge is to be acquired; then, secondarily, it can be applied to help solve social problems. But this is dangerously and damagingly irrational, and it is this irrationality that is, in part, responsible for the genesis of our current global problems, and our current incapacity to solve them. As a matter of supreme urgency, we need to transform academia so that it becomes rationally devoted to helping humanity learn how to make progress towards as good and wise a world as possible. This would involve putting problems of living - including global problems - at the heart of academia, problems of knowledge and technological know-how emerging out of, and feeding back into, the central task to help people tackle problems of living in increasingly cooperatively rational ways. Almost every department and aspect of academia needs to change. We need a new kind of academic inquiry devoted, not just to knowledge, but rather to wisdom - wisdom being the capacity to realize what is of value in life for oneself and others, wisdom including knowledge and technological know-how, but much else besides. So, this is what these essays seek to provoke: a concerted effort to transform our institutions of learning so that they become rationally and effectively devoted to helping us learn how to create a wiser world. With these essays before me, I can see that there is one crucial element of learning about which they say nothing - or nothing explicit. The vital role of play in learning. All mammals - or at any rate almost all mammals - learn by means of play. Cats, tigers, foxes and other predators learn to hunt by means of endless mock fights when kittens and cubs. Deer, sheep and antelope learn to escape by means of playful leaps and bounds when young. We are mammals too. Almost certainly, we learnt how to be adult human beings by means of play during the millions of years we evolved into homo sapiens living in hunting and gathering tribes. Children today, out of school, learn by means of play. Learning by means of play is almost certainly fundamental to our makeup. Education needs to exploit it. Schools and universities need to become places of play. Successful problem solving is often likely to be playful in character. The youthful Einstein called doing physics "getting up to mischief". But our most serious problems of living are so grim, so imbued with suffering, wasted lives and unnecessary death that the idea of approaching them in a playful spirit seems sacrilegious. We need to keep alive tackling of intellectual problems so that playful capacities can be exercised - if for no other reason (and other reasons there are, of course, aplenty). There are two really worthy impulses behind all rational inquiry: delight and compassion. (shrink)

Peter Carruthers has recently argued for a surprising conditional: if a global workspace theory of phenomenal consciousness is both correct and fully reductive, then there are no substantive facts to discover about phenomenal consciousness in nonhuman animals. I present two problems for this conditional. First, it rests on an odd double-standard about the ordinary concept of phenomenal consciousness: its intuitive non-gradability is taken to be unchallengeable by future scientific developments, whereas its intuitive determinacy is predicted to fall by the (...) wayside. Second, it relies on dismissing, prematurely, the live empirical possibility that phenomenal consciousness may be linked to a core global broadcast mechanism that is shared by a wide range of animals. Future developments in the science of consciousness may lead us to reconsider the non-gradability of phenomenal consciousness, but they are unlikely to lead us to accept that there are no facts to discover outside the paradigm case of a healthy adult human. (shrink)

This article questions the use of immigration as a tool to counter global poverty. It argues that poor people have a human right to stay in their home state, which entitles them to receive development assistance without the necessity of migrating abroad. The article thus rejects a popular view in the philosophical literature on immigration which holds that rich states are free to choose between assisting poor people in their home states and admitting them as immigrants when fulfilling duties (...) to assist the global poor. Since the human right to stay is entailed by values that feature prominently in the philosophical debate on immigration, the article further contends that participants in that debate have particular reason to reject the popular ‘choice view’ and endorse the alternative position presented in the article. (shrink)

The global/local contrast is ubiquitous in mathematics. This paper explains it with straightforward examples. It is possible to build a circular staircase that is rising at any point (locally) but impossible to build one that rises at all points and comes back to where it started (a global restriction). Differential equations describe the local structure of a process; their solution describes the global structure that results. The interplay between global and local structure is one of the (...) great themes of mathematics, but rarely discussed explicitly. (shrink)

In contemporary democracies, global capitalism exerts a significant influence over how state power is exercised, raising questions about where political power resides in global politics. This question is important, since our specific considerations about justifiability of political power, i.e. political legitimacy, depend on how we characterize political power at the global level. As a partial answer to this question, I argue that our notion of global political legitimacy should be reoriented to include the structural power of (...) the Transnational Capitalist Class as its subject matter. Structural power is a social relation in which the institutional context makes some agents comply with others’ preferences regardless of actors’ intentional efforts to bring about such outcomes. Even when global business elites do not intentionally exercise power to obtain political control of global governance, their structural power has recognizable effects that partly enforce the world order. To advance my claim, I utilize the radical realists’ argument that the notion of legitimacy is applicable to a broader range of social practices that are beyond dyadic power relations, i.e. rulers intentionally exercising power over subjects. (shrink)

It is sometimes argued that non-agent collectives, including what one might call the ‘global collective’ consisting of the world’s population taken as a whole, cannot be the bearers of non-distributive moral obligations on pain of violating the principle that ‘ought implies can’. I argue that one prominent line of argument for this conclusion fails because it illicitly relies on a formulation of the ‘ought implies can’ principle which is inapt for contexts which allow for the possibility of non-distributive plural (...) predications of agency, which are precisely the contexts in which we might expect non-agents to be obligation-bearers. (shrink)

The prospect of human genetic enhancement requires an institutional response, and probably the creation of new institutions. The governance of genetic enhancement technologies, moreover, needs to be global in scope. In this article, I analyze the debate on the global governance of human genetic enhancement. I begin by offering a philosophical justification for the need to adopt a global framework for governance of technologies that would facilitate the improvement of non-pathological genetic traits. I then summarize the main (...) concrete proposals that have recently emerged to govern genome editing at the global level. Finally, I develop some impediments that limit the impetus for global governance of genetic enhancement. (shrink)

The terms “patriotism” and “nationalism” are distinguished historically, conceptually, and geographically. Historically, patriotism is shown to have roots in the classical republican tradition of political thought, according to which citizens should give priority to the common good of their political or civic, as distinct from national, community. Conceptually, it is argued that patriotism is best understood as a political philosophy, an account of the form or forms of dialogue that citizens should engage in when responding to their conflicts, whereas nationalism (...) is a political ideology, an account of the kinds of things that citizens should be saying within those dialogues, in particular, when they take the form of negotiation. Patriotism, then, is that political philosophy which endorses the maxim “conversation first, negotiation second, force third,” since conversation between citizens has the best prospects for realizing and developing the common good. Nationalism, by contrast, is the ideology of those who, when it comes to political negotiations, give the greatest weight to the needs of their national community. Finally, regarding geography, patriotism is shown to be concerned with the jurisdiction of the state, whereas nationalism emphasizes the permanent and sharply demarcated territory where the national community is located. The chapter then concludes with the recommendation that we all need to affirm a global patriotism, alongside the more local forms. (shrink)

This article considers how global ethical matters might be approached differently in the English-speaking literature if values salient in sub-Saharan Africa and East Asia were taken seriously. Specifically, after pointing out how indigenous values in both of these major parts of the world tend to prescribe honouring harmonious relationships, the article brings out what such an approach to morality entails for political power, foreign relations and criminal justice. For each major issue, it suggests that harmony likely has implications that (...) differ from approaches that currently dominate Western thought, namely those of utility, autonomy and capability. Lacking the space to systematically defend harmony as a fundamental value, it nonetheless urges theorists not to neglect it in future work. (shrink)

This chapter proposes the concept of the mindsponge and its underlying themes that explain why and how executives, managers, and corporations could replace waning values in their mindsets with those absorbed during their exposure to multicultural and global settings. It first provides a brief literature review on global mindset and cultural values, which suggests that not only can a mindset be improved, but that it is learning mechanism can also be developed. Then the chapter offers a conceptual framework, (...) called the 'mindsponge', which builds upon earlier works linking mindset to themes of multi-filtering. The process is proposed to help identify emerging values in the transition economy of Vietnam and also to reconfirm existing core values. The concept of mindsponge provides executives, managers, and organizations with not only a practical framework for improving their global mind-set by identifying and strengthening core values, but also capturing emerging opportunities. (shrink)

The global pessimistic meta-induction argues from the falsity of scientific theories accepted in the past to the likely falsity of currently accepted scientific theories. I contend that this argument commits a statistical error previously unmentioned in the literature and is self-undermining. I then compare the global pessimistic meta-induction to a local pessimistic meta-induction based on recent negative assessments of the reliability of medical research. If there is any future in drawing pessimistic conclusions from the history of science, it (...) lies in local meta-inductions, but these meta-inductions will not result in global distrust of the results of science. (shrink)

Harmony as a basic value is neglected in internationally influential philosophical discussions about rights, power, and other facets of public policy; it is not prominent in articles that appear in widely read journals or in books published by presses with a global reach. Of particular interest, political philosophers and policy makers remain ignorant of the similarities and differences between various harmony-oriented approaches to institutional choice from around the world. In this chapter, I begin to rectify these deficiencies by critically (...) discussing the way harmony has figured into political philosophies from three major traditions in the Global South, namely, African ubuntu, East Asian Confucianism, and South American buen vivir. I point out that, although harmony is at the core of all three political philosophies, it is conceived in different ways, entailing incompatible prescriptions about things such as who should make laws and which sorts of beings have rights against the state. Such contrasting views call for rigorous cross-cultural dialogue amongst theorists of harmony, beyond mounting challenges to more individualist approaches that have been salient in modern Western political thought. (shrink)

I focus on a key argument for global external world scepticism resting on the underdetermination thesis: the argument according to which we cannot know any proposition about our physical environment because sense evidence for it equally justifies some sceptical alternative (e.g. the Cartesian demon conjecture). I contend that the underdetermination argument can go through only if the controversial thesis that conceivability is per se a source of evidence for metaphysical possibility is true. I also suggest a reason to doubt (...) that conceivability is per se a source of evidence for metaphysical possibility, and thus to doubt the underdetermination argument. (shrink)

Most bioethicists who address questions to which global justice matters have not considered the significance of the disputes over the correct theory of global justice. Consequently, the significance of the differences between theories of global justice for bioethics has been obscured. In this paper, I consider when and how these differences are important. I argue that certain bioethical problems can be resolved without addressing disagreements about global justice. People with very different views about global justice (...) can converge on the existence of a duty to aid the very badly off — those in absolute poverty — wherever they may be. However, despite agreement on extreme cases, there should be disagreement over the extent of international obligations to those who are only relatively poor. Consequently, different theories of justice will diverge in their implications for a number of important problems in contemporary bioethics. I close by sketching in more detail two contemporary bioethical issues —concerning pharmaceutical patents and the health worker brain drain —and show how responses to them might be developed by cosmopolitan and statist liberals. (shrink)

Many authors hold that collectives, as well as individuals can be the subjects of obligations. Typically these authors have focussed on the obligations of highly structured groups, and of small, informal groups. One might wonder, however, whether there could also be collective obligations which fall on everyone – what I shall call ' global collective obligations '. One reason for thinking that this is not possible has to do with considerations about agency : it seems as though an entity (...) can only be the subject of obligations if it is an agent. In this paper, I try to show that the argument from agency is not a good reason for being sceptical about the existence of global collective obligations : it derives whatever plausibility it has from the idea that claims about obligation need to be addressable to some agent. My suggestion is that we should accept this principle about the addressability of obligations, but deny that the addressee of an obligation need be the subject of that obligation. The collective obligations of unstructured collections of individuals, including global collective obligations, meet the addressability requirement insofar as they require something of the individuals who make up the collective. (shrink)

The Global Religious Recognition Report (GRR Report) returns for its second edition, this year including more detail on each country and territory's registration policies and on their practices of states extending privileges to some religions and beliefs and not others. Recognition and registration issues continue to impact conditions of freedom of religion or belief throughout the world and it is the purpose of the GRR Report to highlight the extent of these issues nation by nation as part of the (...) report's country-specific approach to the subject. Detailed explanations of registration policy have been gathered from the Office of International Religious Freedom's International Religious Freedom Report in addition to other credible sources. The RoRB classification for each country and territory has been updated in accordance with the criteria set out in the Spectrum of Religious Recognition (SRR) which was included towards the front of this year's report. With more detail provided this year on registration policy in each nation, this report has revealed the complexity of registration issues and the drastic impacts they have on religious freedom. (shrink)

This study identifies global factors conditioning the global problematics of the direction of social development. Global threats were evaluated and defined as dangerous processes, phenomena, and situations that cause harm to health, safety, well-being, and the lives of all humanity, and require removal. The essence of global risks was defined. These risks were defined as events or conditions that may cause a significant negative effect for several countries or spheres within a strategic period if they occur. (...) Global problems were conceptualized. These problems were defined as phenomena, matters, and situations that are not completely understandable, interesting, actual, require solving and regulation, and in addition do not have unified solutions. Current global challenges were analyzed, defined as strategic guidelines that cause transformational changes and are receiving attention from humanity. Global trends were defined as courses of social development. The composition and role of global actors were described, and defined as international organizations, leading states, regional organizations, powerful corporations, institutional investors, large cities, and well-known personalities. The directions of positive courses of social development were developed by means of using the authors’ mechanism of solving the global problematics. (shrink)

Act consequentialism states that an act is right if and only if the expected value of its outcome is at least as great as the expected value of any other act’s outcome. Two objections to this view are as follows. The first is that act consequentialism cannot account for our normative ambivalence in cases where agents perform the right act out of bad motives. The second is that act consequentialism is silent on questions of character: questions like ‘What are the (...) right motives to have?’ and ‘What kind of person ought I be?’. These objections have been taken to motivate a move to global consequentialism, on which acts are not the only subjects of normative assessment. Motives and decision-procedures are also judged right or wrong by direct reference to their consequences. In this paper, I argue that these objections fail to motivate the move from act to global consequentialism. (shrink)

Within the literature in green political theory on global environmental threats one can often find dissatisfaction with liberal theories of justice. This is true even though liberal cosmopolitans regularly point to global environmental problems as one reason for expanding the scope of justice beyond the territorial limits of the state. One of the causes for scepticism towards liberal approaches is that many of the most notable anti-cosmopolitan theories are also advanced by liberals. In this paper, I first explain (...) why one of the strongest expressions of liberal anti-cosmopolitanism cannot simply be dismissed because it may fail to support desired environmental ends. The political conception of justice represents one of the most important challenges to cosmopolitanism generally and is thus a serious challenge to viewing global environmental problems in terms of cosmopolitan justice. Second, I will show through the case of anthropogenic global warming that the political conception of justice under current conditions does have clear cosmopolitan implications despite its proponents' claims. (shrink)

Moral expressivists think that moral thoughts and sentences don’t represent or describe the world, at least not in any interesting sense. Global expressivists think that _no_ thoughts or sentences represent the world; local expressivists think that some do and others don’t. Huw Price has influentially argued that local expressivism collapses into global expressivism, due both to the effects of minimalist theories of representation and similar concepts, and to an unappreciated consequence of the success of specific expressivist theories like (...) moral expressivism. In this paper I argue that Price’s arguments don’t succeed. While they can be fixed, doing so makes them miss their intended target. Local expressivists should therefore not be worried by Price’s arguments. (shrink)

Our aim in this paper is to suggest that most current theories of global justice fail to adequately recognise the importance of global public goods. Broadly speaking, this failing can be attributed at least in part to the complexity of the global context, the individualistic focus of most theories of justice, and the localised nature of the theoretical foundations of most theories of global justice. We argue ? using examples (particularly that of protecting antibiotic efficacy) ? (...) that any truly effective theory of global justice must recognise the importance of global public goods. Global public goods confer significant benefits to individuals yet can only be effectively promoted and preserved through collective action and the restriction of individual choice; something which most theories of justice are structurally unequipped to sufficiently promote. (shrink)

If global distributive justice or injustice is to exist, there must be something that is just or unjust: something to which the moral assessments at issue attach. I argue in this paper against one popular candidate for that role: the “global basic structure.” I argue that principles of distributive justice that target the global basic structure fail to satisfy a crucial “action guidance” desideratum and that this problem points to an alternative target that philosophers of global (...) justice have yet to widely acknowledge. We ought to exclusively direct our principles at subspheres of global politics: disaggregating global justice for a disaggregated world. (shrink)

La cobertura universal de salud está en el centro de la acción actual para fortalecer los sistemas de salud y mejorar el nivel y la distribución de la salud y los servicios de salud. Este documento es el informe fi nal del Grupo Consultivo de la OMS sobre la Equidad y Cobertura Universal de Salud. Aquí se abordan los temas clave de la justicia (fairness) y la equidad que surgen en el camino hacia la cobertura (...) universal de salud. Por lo tanto, el informe es pertinente para cada agente que infl uye en ese camino y en particular para los gobiernos, ya que se encargan de supervisar y guiar el progreso hacia la cobertura universal de salud. (shrink)

This chapter explores global debunking arguments, debunking arguments that aim to give one a global defeater. I defend Alvin Plantinga’s view that global defeaters are possible and, once gained, are impossible to escape by reasoning. They thereby must be extinguished by other means: epistemically propitious actions, luck, or grace. I then distinguish between three types of global defeater—pure-undercutters, undercutters-because-rebutters, and undercutters-while-rebutters—and systematically consider how one can deflect such defeaters. Lastly, since I draw insights from the literature (...) on perhaps the most widely discussed global debunking argument in the literature, Plantinga’s evolutionary argument against naturalism, I end up responding to many potential problems for it. This includes the so-called conditionalization problem, as well as those raised by Bergmann (2002), Law (2012), Deem (2018), Hendricks and Anderson (2020), and Wielenberg (in Craig and Wielenberg (2021)). (shrink)

How can what is of value associated with our human world exist and best flourish embedded as it is in the physical universe? Or, as we may put it, how can the God-of-Cosmic-Value exist and best flourish embedded as it is in the God-of-Cosmic-Power? This, I argue, is our fundamental problem – fundamental in both intellectual and practical terms. Here, I tackle the practical aspect of the problem. I consider briefly five global problems – climate change, war, population growth, (...) world poverty, habitat destruction and extinction of species – and argue that, in order to solve them it is essential to bring about a revolution in universities round the world so that the basic aim becomes wisdom and not just knowledge. I conclude by indicating recent developments which suggest the revolution may already be underway. (shrink)

This open-access issue aims to highlight views about justice in a pandemic context from Latin American countries and to contribute to the dialogue between them as well as with the global scientific community. It explores the global challenges of the COVID-19 pandemic, relevant differences between public health measures and their impact on high-income countries versus low- or middle-income countries, and how global injustice deepened because of the COVID-19 pandemic. It also draws attention to experiences, outcomes, and responses (...) to the pandemic from the global north regarding vulnerable populations and exposure paths that are also present in Latin America. (shrink)

We introduce Neuroartes as a biological humanism that concentrates on the development of social interventions. We review several connections between art and the human body, mainly the brain. We suggest art, painting in the present case, as a tool to work with the elderly with cognitive and/or motor impairment for the purpose of helping them with their subjectivity and autonomy.

A globalized world, some argue, needs a global democracy. But there is considerable disagreement about whether global democracy is an ideal worth pursuing. One of the main grounds for scepticism is captured by the slogan: “No global demos, no global democracy.” The fact that a key precondition of democracy—a demos—is absent at the global level, some argue, speaks against the pursuit of global democracy. The paper discusses four interpretations of the skeptical slogan—each based on (...) a specific account of the notion of “the demos”—and concludes that none of them establishes that the global democratic ideal must be abandoned. In so doing, the paper (i) systematizes different types of objections against global democracy, thus bringing some clarity to an otherwise intricate debate and (ii) offers a robust but qualified defense of the global democratic ideal. (shrink)