The COVID-19 pandemic revealed numerous weaknesses in pandemic preparedness and response, including underfunding, inadequate surveillance, and inequitable distribution of countermeasures. To overcome these weaknesses for future pandemics, WHO released a zero draft of a pandemic treaty in February, 2023, and subsequently a revised bureau's text in May, 2023. COVID-19 made clear that pandemic prevention, preparedness, and response reflect choices and value judgements. These decisions are therefore not a purely scientific or technical exercise, but are fundamentally grounded in ethics. The latest (...) treaty draft reflects these ethical considerations by including a section entitled Guiding Principles and Approaches. Most of these principles are ethical—they establish core values that undergird the treaty. Unfortunately, the treaty draft's set of principles are numerous, overlapping, and show inadequate coherence and consistency. We propose two improvements to this section of the draft pandemic treaty. First, key guiding ethical principles should be clearer and more precise than they currently are. Second, the link between ethical principles and policy implementation should be clearly established and define boundaries on acceptable interpretation, ensuring that signatories abide by these principles. (shrink)

The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. Participation in research is a critical way to support an important public good. Consequently, all have a duty to participate. The (...) current social norm is that individuals participate only if they have a good reason to do so. The public goods argument implies that individuals should participate unless they have a good reason not to. Such a shift would be of great aid to the progress of biomedical research, eventually making society significantly healthier and longer lived. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies' obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic. We argue that an ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability. All parties' obligations should be coordinated and mutually consistent. For (...) instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges. Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others. (shrink)

Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death (...) or illness and unjust disparities; prioritising those who prevent harm or mitigate disparities; recognising contributions to combating an outbreak; and treating similar individuals similarly. Ethically and equitably marshalling available countermeasures requires articulating these fundamental objectives, identifying priority tiers, and recognising trade-offs between prioritising the people at the highest risk of infection and the people at the highest risk of harm if infected. These five values can provide guidance on preferable priority categories for a more ethically sound response and suggest methods for optimising allocation of countermeasures for mpox and other diseases for which countermeasures are in short supply. Properly marshalling available countermeasures will be crucial for future effective and equitable national responses to outbreaks. (shrink)

Volume 19, Issue 7, July 2019, Page 28-30.

Some have objected to human enhancement on the grounds that it violates the autonomy of the enhanced. These objections, however, overlook the interesting possibility that autonomy itself could be enhanced. How, exactly, to enhance autonomy is a difficult problem due to the numerous and diverse accounts of autonomy in the literature. Existing accounts of autonomy enhancement rely on narrow and controversial conceptions of autonomy. However, we identify one feature of autonomy common to many mainstream accounts: reasoning ability. Autonomy can then (...) be enhanced by improving people’s reasoning ability, in particular through cognitive enhancement; given how valuable autonomy is usually taken to be, this gives us extra reason to pursue such cognitive enhancements. Moreover, autonomy-based objections will be especially weak against such enhancements. As we will argue, those who are worried that enhancements will inhibit people’s autonomy should actually embrace those enhancements that will improve autonomy. (shrink)

Moral enhancement is an ostensibly laudable project. Who wouldn’t want people to become more moral? Still, the project’s approach is crucial. We can distinguish between two approaches for moral enhancement: direct and indirect. Direct moral enhancements aim at bringing about particular ideas, motives or behaviors. Indirect moral enhancements, by contrast, aim at making people more reliably produce the morally correct ideas, motives or behaviors without committing to the content of those ideas, motives and/or actions. I will argue, on Millian grounds, (...) that the value of disagreement puts serious pressure on proposals for relatively widespread direct moral enhancement. A more acceptable path would be to focus instead on indirect moral enhancements while staying neutral, for the most part, on a wide range of substantive moral claims. I will outline what such indirect moral enhancement might look like, and why we should expect it to lead to general moral improvement. (shrink)

The right to withdraw from participation in research is recognized in virtually all national and international guidelines for research on human subjects. It is therefore surprising that there has been little justification for that right in the literature. We argue that the right to withdraw should protect research participants from information imbalance, inability to hedge, inherent uncertainty, and untoward bodily invasion, and it serves to bolster public trust in the research enterprise. Although this argument is not radical, it provides a (...) useful way to determine how the right should be applied in various cases. (shrink)

While philosophers are often concerned with the conditions for moral knowledge or justification, in practice something arguably less demanding is just as, if not more, important – reliably making correct moral judgments. Judges and juries should hand down fair sentences, government officials should decide on just laws, members of ethics committees should make sound recommendations, and so on. We want such agents, more often than not and as often as possible, to make the right decisions. The purpose of this paper (...) is to propose a method of enhancing the moral reliability of such agents. In particular, we advocate for a procedural approach; certain internal processes generally contribute to people’s moral reliability. Building on the early work of Rawls, we identify several particular factors related to moral reasoning that are specific enough to be the target of practical intervention: logical competence, conceptual understanding, empirical competence, openness, empathy and bias. Improving on these processes can in turn make people more morally reliable in a variety of contexts and has implications for recent debates over moral enhancement. (shrink)

The prospect of consumable meat produced in a laboratory setting without the need to raise and slaughter animals is both realistic and exciting. Not only could such in vitro meat become popular due to potential cost savings, but it also avoids many of the ethical and environmental problems with traditional meat productions. However, as with any new technology, in vitro meat is likely to face some detractors. We examine in detail three potential objections: 1) in vitro meat is disrespectful, either (...) to nature or to animals; 2) it will reduce the number of happy animals in the world; and 3) it will open the door to cannibalism. While each objection has some attraction, we ultimately find that all can be overcome. The upshot is that in vitro meat production is generally permissible and, especially for ethical vegetarians, worth promoting. (shrink)

As opposed to a ‘one size fits all’ approach, precision medicine uses relevant biological, medical, behavioural and environmental information about a person to further personalize their healthcare. This could mean better prediction of someone’s disease risk and more effective diagnosis and treatment if they have a condition. Big data allows for far more precision and tailoring than was ever before possible by linking together diverse datasets to reveal hitherto-unknown correlations and causal pathways. But it also raises ethical issues relating to (...) the balancing of interests, viability of anonymization, familial and group implications, as well as genetic discrimination. This article analyses these issues in light of the values of public benefit, justice, harm minimization, transparency, engagement and reflexivity and applies the deliberative balancing approach found in theEthical Framework for Big Data in Health and Research to a case study on clinical genomic data sharing. Please refer to that article for an explanation of how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. Our discussion is meant to be of use to those involved in the practice as well as governance and oversight of precision medicine to address ethical concerns that arise in a coherent and systematic manner. (shrink)

It has recently been argued that reproductive genetic manipulation technologies like mitochondrial replacement and germline CRISPR modifications cannot be said to save anyone’s life because, counterfactually, no one would suffer more or die sooner absent the intervention. The present article argues that, on the contrary, reproductive genetic manipulations may be life-saving (and, from this, have therapeutic value) under an appropriate population health perspective. As such, popular reports of reproductive genetic manipulations potentially saving lives or preventing disease are not necessarily mistaken, (...) though such terminology still requires further empirical validation. (shrink)

Mitochondrial replacement therapy requires oocytes of women whose mitochondrial DNA will be transmitted to resultant children. These techniques are scientifically, ethically and socially controversial; it is likely that some women who donate their oocytes for general in vitro fertilisation usage would nevertheless oppose their genetic material being used in MRT. The possibility of oocytes being used in MRT is therefore relevant to oocyte donation and should be included in the consent process when applicable. In present circumstances, specific consent should be (...) obtained. However, once MRT becomes more routine, such consent could be incorporated into the general consent process for oocyte donation. The reported lack of proper consent for MRT from the oocyte donor in the first baby born via the technique is an ethical failing and should be corrected in any future practice of MRT. (shrink)

Though the realm of biology has long been under the philosophical rule of the mechanistic magisterium, recent years have seen a surprisingly steady rise in the usurping prowess of process ontology. According to its proponents, theoretical advances in the contemporary science of evo-devo have afforded that ontology a particularly powerful claim to the throne: in that increasingly empirically confirmed discipline, emergently autonomous, higher-order entities are the reigning explanantia. If we are to accept the election of evo-devo as our best conceptualisation (...) of the biological realm with metaphysical rigour, must we depose our mechanistic ontology for failing to properly “carve at the joints” of organisms? In this paper, I challenge the legitimacy of that claim: not only can the theoretical benefits offered by a process ontology be had without it, they cannot be sufficiently grounded without the metaphysical underpinning of the very mechanisms which processes purport to replace. The biological realm, I argue, remains one best understood as under the governance of mechanistic principles. (shrink)

Background Several jurisdictions, including Singapore, Australia, New Zealand and most recently Ireland, have a public interest or public good criterion for granting waivers of consent in biomedical research using secondary health data or tissue. However, the concept of the public interest is not well defined in this context, which creates difficulties for institutions, institutional review boards and regulators trying to implement the criterion. Main text This paper clarifies how the public interest criterion can be defensibly deployed. We first explain the (...) ethical basis for requiring waivers to only be granted to studies meeting the public interest criterion, then explore how further criteria may be set to determine the extent to which a given study can legitimately claim to be in the public interest. We propose an approach that does not attempt to measure magnitude of benefit directly, but rather takes into account metrics that are more straightforward to apply. To ensure consistent and justifiable interpretation, research institutions and IRBs should also incorporate procedural features such as transparency and public engagement in determining which studies satisfy the public interest requirement. Conclusion The requirement of public interest for consent waivers in secondary biomedical research should be guided by well-defined criteria for systematic evaluation. Such a criteria and its application need to be periodically subject to intra-committee and intra-institution review, reflection, deliberation and amendment. (shrink)

With the recent report of a live birth after use of Mitochondrial replacement therapy, sometimes called ‘Three-parent IVF’, the clinical application of the technique is fast becoming a reality. While the United Kingdom allows the procedure under regulatory scrutiny, it remains effectively outlawed in many other countries. We argue that such prohibitions may violate individuals’ procreative rights, grounded in individuals’ interest in genetic affinity. The interest in genetic affinity was recently endorsed by Singapore’s highest court, reflecting an emphasis on the (...) importance of biological ties found across the globe. We apply that reasoning to make the case for a right to ‘Three-parent IVF’. (shrink)

The research aims to identify the learning organizations and their role in achieving organizational excellence in the Palestinian universities in Gaza Strip. The researchers used descriptive analytical approach and used the questionnaire as a tool for information gathering. The questionnaires were distributed to senior management in the Palestinian universities. The study population reached (344) employees in senior management is dispersed over (3) Palestinian universities. A stratified random sample of (182) workers from the Palestinian universities was selected and the recovery rate (...) was (69.2%). Statistical analysis (SPSS) program was used for analysis and processing the data. The research found the following results: there is a fair degree of approval on "cognitive dimension", there is a high approval about the importance of "organizational dimension", there is moderately consent of the importance of "Community dimension", there is a large degree of consent about the importance of axis of the "leadership excellence", there is a large degree of consent about the importance of axis of the "service-excellence", there is a fair degree approval about the importance of the axis of "cognitive excellence", and there is a moderately consent of the importance of "Organizational Excellence". The research found a group of recommendations including: the need to develop appropriate strategies for the University, employ modern technology in information systems, in addition to provide appropriate environment that achieve learning organizations, develop technological infrastructure, adopt universities for knowledge management in the academic and administrative departments because knowledge is the core of the work of these departments, create technological incubators in universities to adopt excellence academic research projects, and protected them, support them, and market them. Establishing of centers of excellence for scientific research in the university.The need for cooperation and coordination between local, Arab and international universities for the exchange of knowledge, information, and participation programs and training courses, as it provides an opportunity to develop the capabilities and skills of personnel and expertise. (shrink)

This study aims to look at the role of the practice of excellence strategies in education in achieving sustainable competitive advantage for the Higher educational institutions of the faculty of Engineering and Information Technology at Al-Azhar University in Gaza, a model, and the study considered the competitive advantage of educational institutions stems from the impact on the level of each student, employee, and the institution. The study was based on the premise that the development of strategies for excellence in education, (...) and its implementation is a vital important prerequisite to achieve sustainable competitive advantage in higher educational institutions. The study followed a systematic exploratory descriptive methodology through review of the theoretical literature, and the adoption of the experience of the Faculty of Engineering and Information Technology at Al-Azhar University in Gaza as a model for its unique experience in the field of excellence in education. The study results showed that the most important are: There is a strong correlation between the level of exercising excellence strategies in education and the achievement of higher educational institutions to the sustainable competitive advantage. The results include a general required number of important sub results on the subject of the model - Faculty of Engineering and Information Technology at Al-Azhar University in Gaza as follows: - The student considered the academic focus of the operation in the development process of the workers’ skills, particularly academics at the university helps to distinguish students and increase the employment rate after graduation. - The existence of consistency in development efforts and quality improvement for all three levels (student, employee, and the university), and this contributes to the Faculty excellence. - The Faculty has been able to achieve competitive advantages by offering excellent services without harming the efficiency, and this alone is a great success because improving service properties requires great investments, which negatively affect the continued institutional development. The study also reached a set of recommendations as follows: - The need to exercise excellence strategies in education, excellence reward at the national level, and those higher educational institutions follow the criteria for measuring the competitive advantages of its institutions always. - There is a need to increase efforts to implement programs of excellence, the allocation of adequate time, reward outstanding efforts as well. There is a necessity for each faculty to achieve competitive advantage and sustainability, using the general philosophies of competitive advantage, but with a different strategically content from what is in the private commercial sector, it reflects the Faculties mission and objectives, depending on making improvements and excellence in processes that ensure the safety of its outputs. As well as the need to find a balance between the work of teaching and research work of the faculty members, this has important implications regarding the criteria used in the process of excellence evaluation. The study recommended the adoption of strategies for excellence in education on a national public policy level mainly in the processes of change in higher education institutions. The need to support the existence of a common understanding of the efforts of excellence to create a general culture that appreciates excellence in faculties and universities. This underlines the need for transparent, fair rewards systems, to encourage innovation in education. The need to conduct a comprehensive surveys on the graduates of faculties and universities including the areas of employment and skills, because that will give accurate indications of the graduates and will help to establish a link to a more precise about the relationship of excellence strategies with the competitive advantages. (shrink)

Evolutionary developmental biology represents a paradigm shift in the understanding of the ontogenesis and evolutionary progression of the denizens of the natural world. Given the empirical successes of the evo-devo framework, and its now widespread acceptance, a timely and important task for the philosophy of biology is to critically discern the ontological commitments of that framework and assess whether and to what extent our current metaphysical models are able to accommodate them. In this paper, I argue that one particular model (...) is a natural fit: an ontology of dispositional properties coherently and adequately captures the crucial casual-cum-explanatory role that the fundamental elements of evo-devo play within that framework. (shrink)

Abstract Do the central aims of epistemology, like those of moral philosophy, require that we designate some important place for those concepts located between the thin-normative and the non-normative? Put another way, does epistemology need "thick" evaluative concepts and with what do they contrast? There are inveterate traditions in analytic epistemology which, having legitimized a certain way of viewing the nature and scope of epistemology's subject matter, give this question a negative verdict; further, they have carried with them a tacit (...) commitment to what we argue to be an epistemic analogue of the reductionistic centralist thesis which Bernard Williams, in our view, successfully repudiates in ethics. In this essay, we challenge the epistemic analogue of the traditional but mistaken thesis. In offering an alternative to it which provides a comfortable home for the epistemic normativity which attends thick evaluative concepts, we align ourselves with what has been recently called the Value Turn in epistemology. From this perspective, we defend that, contrary to tradition, as influenced by centralist assumptions, epistemology does need thick evaluative concepts. Further, the sort of theories that will be able to give thick evaluative concepts an irreducible role in both belief and agent evaluation are adequately social epistemologies. What loosely refer to as second-wave of virtue epistemology is the widespread interest to provide a comfortable home for the role of thick normativity, as it is connected both with epistemic evaluation, and guidance. We recognize that, in breaking from centralism, there is a worry that a resulting anti-centralist theory will be reductionistic in the other direction, making the thick primary. We contend however that second-wave virtue epistemologies take different sources of social and epistemic value into account; they seek the 'right thickness' to ride with conception of epistemology and a field which due in part to virtue theory's resurgence, is today normative, diverse and expansive than was the traditional set of problems from which it emerged. (shrink)

Michael Hauskeller (“Reflections from a Troubled Stream: Giubliani and Minerva on ‘After-Birth Abortion’) has recently suggested that we should resist rationalist tendencies in moral discourse: “[I]s not all morality ultimately irrational? Even the most strongly held moral convictions can be shown to lack a rational basis.” (Hauskeller 2012, p. 18) Hauskeller was responding to Alberto Giubliani and Francesca Minverva’s (2012) recent defense of the permissibility of killing infants, but his anti-rationality arguments have wide-reaching implications. Yet pace Hauskeller, rationality is indeed (...) of crucial importance to any ethical argument. We should not abandon rationality for the sake of refuting one discomforting hypothesis; instead, rationality must be rigorously employed, here and elsewhere, in the search for the truth. (shrink)

The study aims to analyze the impact of top management support for strategic planning on crisis management in UNRWA-Gaza Strip field in Palestine. Several descriptive analytical methods were used for this purpose, and a survey as a tool for data collection. Community size was (881), and the study sample was stratified random (268). The overall findings of the current study show that top management provides needed HR for strategic planning but with no financial support. Also there are shortcomings in the (...) way that organization manages the crises before and after they occur. A crisis management is only practicing during the crisis. The study suggest that top management must provide the financial support for strategic planning, periodic meetings to prepare how to deal with potential crisis in the future, establishing a specialized team and provide them with all sources needed. (shrink)

The research aims to identify the reality of modern methods applied in the process of performance assessments of employees in the municipalities of Gaza-strip, Complete Census method of community study was used, (571) questionnaires were distributed to all members of the community study, (524) questionnaires were recovery with rate of (91.76%). The most important findings of the study: There were statistically significant relationship differences between the applications of modern methods in the performance assessments of employees in the municipalities of Gaza-strip. (...) There was statistically significant relationship between the evaluation criteria that fit the required performance and the application of standards evaluations on performance of employees in the municipalities of Gaza-strip. There was statistically significant relationship between the use of methods, models for the evaluation of appropriate functions and the application of the performance assessments of employees in the municipalities of Gaza-strip. There was statistically significant relationship between the feedback and the application of performance assessments of employees in the municipalities of Gaza-strip. There was statistically significant relationship between the efficient, professional assessors and the application of the performance assessments of employees in the municipalities of Gaza-strip. There was statistically significant relationship between the extent of awareness of subordinates, participation in the evaluation of their performance and the application of the performance assessments of employees in the municipalities of Gaza-strip. The research also concluded a series of recommendations, including: that the design of evaluation models must be done with the participation of the employees and inform them of it, and that a date must be set to provide feedback and discuss the results with them, that they should be allowed grievance in front of an ad hoc committee in accordance with the known system. Direct manager must inform employees of their performance assessment date, discuss the results of the evaluation with them, and others should be involved with the direct manager of employees in their performance evaluation. The application of modern methods of performance evaluation through the good and purposeful planning should be used, analyzing and employing the results in administrative decisions regarding the employees, and the application of modern methods must be used in an effective and efficient performance evaluation. (shrink)

At the heart of semantics in the 20th century is Frege’s distinction between sense and force. This is the idea that the content of a self-standing utterance of a sentence S can be divided into two components. One part, the sense, is the proposition that S’s linguistic meaning and context associates with it as its semantic interpretation. The second component is S’s illocutionary force. Illocutionary forces correspond to the three basic kinds of sentential speech acts: assertions, orders, and questions. Forces (...) are then kinds of acts in which propositions are deployed with certain purposes. I sketch a speech-act theoretic semantics in which that distinction does not hold. Instead of propositions and forces, the theory proposes proto-illocutionary acts and illocutionary acts. The orthodox notion of a proposition plays no role in the framework, which is a good thing, since that notion is deeply problematic. The framework also shows how expressionists, who embrace a sophisticated speech-act framework, face no Frege-Geach embedding problem, since the latter assumes the Sense/Force distinction. (shrink)

This paper aims to show that Selim Berker’s widely discussed prime number case is merely an instance of the well-known generality problem for process reliabilism and thus arguably not as interesting a case as one might have thought. Initially, Berker’s case is introduced and interpreted. Then the most recent response to the case from the literature is presented. Eventually, it is argued that Berker’s case is nothing but a straightforward consequence of the generality problem, i.e., the problematic aspect of the (...) case for process reliabilism (if any) is already captured by the generality problem. (shrink)

Individual health assessments (IHAs) for asymptomatic individuals provide a challenge to traditional distinctions between patient care and non-medical practice. They may involve undue radiation exposure, lead to false positives, and involve high out-of-pocket costs for recipients. A recent paper (Journal of the American College of Radiology 13(12): 1447–1457.e1, 2016) has criticised the use of IHAs and argued that recipients should be classified as ‘presenters’, not ‘patients’, to distinguish it from regular medical care. I critique this classificatory move, on two grounds: (...) one, it is conceptually suspect. Two, it obviates the medical ethics framework for IHAs, potentially exposing recipients of IHAs to lower standards of oversight and protection. Responsible regulation of IHAs will be easier to ethically justify if those seeking IHAs are considered patients and not merely presenters. (shrink)

In their recent article, Koplin, Gyngell and Savulescu (2019) assess the viability of the precautionary principle as a decision-making tool to determine whether and under what circumstances germline gene editing should proceed. While their survey of different forms of the precautionary principle is illuminating, the most novel contribution is a new account of the precautionary principle, what they dub the Sufficientarian Precautionary Principle (SPP). SPP is meant to avoid several problems with existing accounts, while comporting with at least some of (...) the intuitive force behind the general idea of the precautionary principle. However, as it is only one subsection of a larger paper, SPP is not fully worked out. In this brief response, I will flesh out some problems with SPP as a decision-making tool – particularly that there is a lack of adequate normative justification for adopting it. While this does not constitute a decisive refutation of the approach, SPP needs considerable refinement and clarification before it can be considered viable for use in decision-making. (shrink)

Translated into Danish by Henrik Jøker Bjerre.

Given the sordid history of injustices linking genetics to race and ethnicity, considerations of justice are central to ensuring the responsible development of precision medicine programmes around the world. While considerations of justice may be in tension with other areas of concern, such as scientific value or privacy, there are also tensions between different aspects of justice. This paper focuses on three particular aspects of justice relevant to this precision medicine: social justice, distributive justice and human rights. We describe the (...) implications of each for the use of race and ethnicity in precision medicine, and also how they intersect and potentially conflict with each another. By attending to these intersections, we aim to enrich and add nuance to debates over how best to proceed with precision medicine initiatives. (shrink)

Volume 20, Issue 2, February 2020, Page 20-22.

It is generally unquestioned that human subjects research review boards should assess the ethical acceptability of protocols. It says so right on the tin, after all: they are explicitly called research ethics committees in the UK. But it is precisely those sorts of unchallenged assumptions that should, from time to time, be assessed and critiqued, in case they are in fact unfounded. John Stuart Mill's objection to suppressers of dissent is instructive here: “If the opinion is right, they are deprived (...) of the opportunity of exchanging error for truth: if wrong, they lose, what is almost as great a benefit, the clearer perception and livelier impression of truth, produced by its collision with error”.1 Andrew Moore and Andrew Donnelly's compelling article, “The job of ‘ethics committees’”, is just this sort of challenge to conventional wisdom, a rejection of the notion that review boards should be considering ethical matters at all.2 If true, we should be substantially reforming our research ethics policies. And if false, rebuttals would help strengthen and ground the otherwise unquestioned assumption of the role of ethics committees. As it happens, I will argue that their critiques fall into the second category. While mistaken, they present a valuable opportunity to clarify the role of ethics committees and their relationship to relevant codes. In particular, I will defend a hybrid account where codes have strict primacy, but leave significant room for review boards …. (shrink)

The predominant view is that a study using health data is observational research and should require individual consent unless it can be shown that gaining consent is impractical. But recent arguments have been made that citizens have an ethical obligation to share their health information for research purposes. In our view, this obligation is sufficient ground to expand the circumstances where secondary use research with identifiable health information is permitted without explicit subject consent. As such, for some studies the Institutional (...) Review Board/Research Ethics Committee review process should not assess the practicality of gaining consent for data use. Instead the review process should focus on assessing the public good of the research, public engagement and transparency. (shrink)

Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and (...) Policy-relevant Ethics in Singapore Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data. (shrink)

In his Encomium of Helen and On Not Being, Gorgias of Leontinoi discusses the nature and function of speech more extensively than any other surviving author before Plato. His discussions are not only surprising in the way they characterize the power of logos and its effects on a listener but also in how the two descriptions of speech seem to contradict one another. In the Helen, Gorgias claims that logos is a very powerful entity, capable of affecting a listener in (...) whatever way it wants. In On Not-Being, he makes the very different (but no less exaggerated) claim that logos is a non-entity, incapable of referring to anything other than itself. In this essay I show how these apparently contradictory accounts might be brought into harmony with one another.2 In the first part I address some of the interpretive difficulties with the text of Gorgias’s On Not Being (henceforth ONB) and the role that irony plays in the work. In particular I argue (as others have before) that Gorgias’s remarks about the impotency of speech are not meant to be taken seriously. Instead, they are aimed more squarely at raising questions about how exactly speech is thought to function and, more specifically, how linguistic reference works—i.e., how words somehow correspond to things, on one level, and to our ideas about things, on another. In the second and third parts of this paper, I illustrate how Gorgias’s concern with linguistic reference in ONB goes on to inform his notion of logos in the Encomium of Helen. I point specifically to evidence found in an important and often overlooked exit clause at the close of ONB regarding the difference between words and things. There, Gorgias insists that if words manifest meaning at all, they must appeal to their own sort of sense organ. In the Helen, he draws on the concepts of soul (psychē) and opinion (doxa) in order to construct this alternative, psychagogic account in which utterances are actually apprehended in ways akin to sense perception. Whether or not one is convinced by Gorgias’s alternative account of how speech works, the description he gives of logos does notionally circumvent the problem of linguistic reference and, in doing so, pushes one to think beyond the potentially constrictive framework of nomen et nominatum. I argue that, when read in this way, these two early discussions of logos represent a unified progression of serious thought about how speech works. (shrink)

The biological sciences have always proven a fertile ground for philosophical analysis, one from which has grown a rich tradition stemming from Aristotle and flowering with Darwin. And although contemporary philosophy is increasingly becoming conceptually entwined with the study of the empirical sciences with the data of the latter now being regularly utilised in the establishment and defence of the frameworks of the former, a practice especially prominent in the philosophy of physics, the development of that tradition hasn’t received the (...) wider attention it so thoroughly deserves. This review will briefly introduce some recent significant topics of debate within the philosophy of biology, focusing on those whose metaphysical themes (in everything from composition to causation) are likely to be of wide-reaching, cross-disciplinary interest. (shrink)

The future of health research will be characterised by three continuing trends: rising demand for health data; increasing impracticability of obtaining specific consent for secondary research; and decreasing capacity to effectively anonymise data. In this context, governments, clinicians and the research community must demonstrate that they can be responsible stewards of health data. IRBs and RECs sit at heart of this process because in many jurisdictions they have the capacity to grant consent waivers when research is judged to be of (...) particular value. However, several different terms are used to refer to this value, indicating a lack of conceptual clarity regarding the appropriate test for access to health data for research without consent. In this paper we do three things. First we describe the current confusion and instability in terminology relating to public interest in the context of consent waivers. Second we argue for harmonisation of terminology on the grounds of clarity, transparency and consistency. Third we argue that the term ‘public interest’ best reflects the normative work required to justify consent waivers because it is the broadest of the competing terms. ‘Public interest’ contains within its scope positive and negative implications of a study, as well as welfare, justice and rights considerations. In making this argument, we explain the normative basis for consent waivers, and provide a starting place for further discussion about the precise conditions in which a given study can be said to advance the public interest. Ipsos MORI study found that: … the public would be broadly happy with administrative data linking for research projects provided Those projects have social value, broadly defined. Data are de-identified. Data are kept secure. Businesses are not able to access the data for profit. (shrink)

A strength of liberal political institutions is their ability to accommodate pluralism, both allowing divergent comprehensive doctrines as well as constructing the common ground necessary for diverse people to live together. A pressing question is how far such pluralism extends. Which comprehensive doctrines are simply beyond the pale and need not be accommodated by a political consensus? Rawls attempted to keep the boundaries of reasonable disagreement quite broad by infamously denying that political liberalism need make reference to the concept of (...) truth, a claim that has been criticized by Joseph Raz, Joshua Cohen, and David Estlund. In this paper, we argue that these criticisms fail due to the fact that political liberalism can remain non-committal on the nature of truth, leaving the concept of truth in the domain of comprehensive doctrines while still avoiding the issues raised by Raz, Cohen, and Estlund. Further substantiating this point is the fact that Rawls would, and should, include parties in the overlapping consensus whose views on truth may be incoherent. Once it is seen that political liberalism allows such incoherence to reasonable parties, it is clear that the inclusion of truth and the requirement of coherence urged by Raz, Cohen, and Estlund requires more of reasonable people than is necessary for a political consensus. (shrink)

What role should legislation or policy play in avoiding the complications of in-vitro fertilization? In this article, we focus on single versus double embryo transfer, and assess three arguments in favour of mandatory single embryo transfer: risks to the mother, risks to resultant children, and costs to society. We highlight significant ethical concerns about each of these. Reproductive autonomy and non-paternalism are strong enough to outweigh the health concerns for the woman. Complications due to non-identity cast doubt on the extent (...) to which children are harmed. Twinning may offer an overall benefit rather than burden to society. Finally, including the future health costs for children in reproductive policy is inconsistent with other decisions. We conclude that mandatory single embryo transfer is not justified and that a number of countries should reconsider their current embryo transfer policy. (shrink)

Ethics committees like Institutional Review Boards and Research Ethics Committees are typically empowered to approve or reject proposed studies, typically conditional on certain conditions or revisions being met. While some have argued this power should be primarily a function of applying clear, codified requirements, most institutions and legal regimes allow discretion for IRBs to ethically evaluate studies, such as to ensure a favourable risk-benefit ratio, fair subject selection, adequate informed consent, and so forth. As a result, ethics committees typically make (...) moral demands on researchers: require them to act in a way the committee considers ethically right or appropriate. This paper argues that moral demands are legitimate only if publicly justifiable; and as a result, committee decisions are subject to a public justification requirement. Ethics committees can permissibly request for more information, changes to the research protocol or that the research is delayed or even stopped only if these demands are publicly justifiable. This latter claim is in turn justified on the basis that moral demands to φ are permissible only if we are in a position to know that the addressee ought to φ and that we are in a position to know a proposition only if it is publicly justifiable. This argument suggests that ethics committees must consciously and explicitly appeal to public reasons in their decision-making. In cases where public reasons cannot be offered, committees would not be permitted to reject a given study or make approval conditional on an amendment. (shrink)

The study aimed to study the reality of the application of human resource information systems in the major hospitals in the southern Palestinian governorates. Department directors, department heads, and computer engineers), totaling (320) male and female employees during the year (2022), where the researchers prepared a questionnaire to achieve the purpose of the study on human resource information systems (Individual Performance Assessment, Organizational Performance Assessment, Performance Management, Training Development, And Knowledge Management). The most important findings of the two researchers were (...) that human resources management is more effective in the event of application of human resources information systems, and that applications of human resources information systems include individual performance evaluation, institutional performance evaluation, performance management, knowledge dissemination, training and development, decision-making, and appointment. Attraction, problem solving, team building, and quality team building. The study recommended making use of human resources information systems in providing periodic reports that include all activities in the hospital, and enhancing reliance on human resources information systems in building work teams and involving employees in setting the hospital's vision for change management and benefiting from various experiences in leading change. (shrink)

Phyllis Illari & Federica Russo: Causality: Philosophical Theory Meets Scientific Practice. Oxford: Oxford University Press, 2014, 310pp, £29.99 HB.

Controversial view agnosticism is the thesis that we are rationally obligated to withhold judgment about a large portion of our beliefs in controversial subject areas, such as philosophy, religion, morality and politics. Given that one’s social identity is in no small part a function of one’s positive commitments in controversial areas, CVA has unsurprisingly been regarded as objectionably ‘spineless.’ That said, CVA seems like an unavoidable consequence of a prominent view in the epistemology of disagreement—conformism—according to which the rational response (...) to discovering that someone you identify as an epistemic peer or expert about p disagrees with you vis-à-vis p is to withhold judgment. This paper proposes a novel way to maintain the core conciliatory insight without devolving into an agnosticism that is objectionably spineless. The approach offered takes as a starting point the observation that–for reasons that will be made clear—the contemporary debate has bypassed the issue of the reasonableness of maintaining, rather than giving up, representational states weaker than belief in controversial areas. The new position developed and defended here explores this overlooked space; what results is a kind of controversial view. (shrink)

This paper explores the relationship between technological and human intelligence through ‘The New Natural’, a term which at once accepts the nature of technological intelligence as real instead of forever ‘artificial’. It supports an evolutionary, reciprocal relationship between humans and technology that culminates in technological singularity and rejects the primacy of human perception known to popular human access theories, before seriously considering the ‘decentered’ implications of posthuman access. In conversation with western-centric sci-fi film of the late twentieth century, then, this (...) philosophical study explores how the concept of a technology-only intelligence entity can: (1) help us dispose of the core problems often associated with human-only access, (2) neutral-ize our fears of human annihilation at the hands of technological intelligence, and (3) establish strong grounds for why we may have to push back against early conceptions of nature’s opposition to technology, if only so we may resist falling into the great, and most human-centered traps known to the Anthropocene. (shrink)

According to the cognitive model of psychopathology, maladaptive beliefs about oneself, others, and the world are the main factors contributing to the development and persistence of various forms of mental suffering. Therefore, the key therapeutic process of Cognitive Behavioral Therapy (CBT)—a therapeutic approach rooted in the cognitive model—is cognitive restructuring, i.e., a process of revision of such maladaptive beliefs. In this paper, I examine the philosophical assumptions underlying CBT and offer theoretical reasons to think that the effectiveness of belief revision (...) in psychotherapy is very limited. This is the case, I argue, because the cognitive model wrongly assumes that our body of beliefs is unified, while it is in fact fragmented. (shrink)

Intentional action is, in some sense, non-accidental, and one common way action theorists have attempted to explain this is with reference to control. The idea, in short, is that intentional action implicates control, and control precludes accidentality. But in virtue of what, exactly, would exercising control over an action suffice to make it non-accidental in whatever sense is required for the action to be intentional? One interesting and prima facie plausible idea that we wish to explore in this paper is (...) that control is non-accidental in virtue of requiring knowledge – either knowledge-that or knowledge-how (e.g., Beddor and Pavese 2021; cf., Setiya 2008; 2012 and Habgood-Coote 2018). We review in detail some key recent work defending such knowledge-centric theories of control, and we show that none of these accounts holds water. We conclude with some discussion about how control opposes the sort of luck intentional action excludes without doing so by requiring knowledge (that- or how). (shrink)