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)

In response to commentators, we argue that whether waiving patent rights will meaningfully improve access to COVID-19 vaccines for low income and middle-income countries (LMICs), particularly in the short term, is an empirical matter. We also reject preferentially allocating vaccines to countries that hosted trials because doing so unethically favours those with research infrastructure, rather than those facing the worst burdens from COVID-19.

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)

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)

If asked whether stereotypes about people have the potential to help overcome injustice, I suspect that many think there is a clear-cut answer to this question, and that answer is “no.” Many stereotypes do have harmful effects, from the blatantly dehumanizing to the more subtly disruptive. Reasonably then, a common attitude toward stereotypes is that they are at best shallow, superficial assumptions, and at worst degrading and hurtful vehicles of oppression. I argue that on a broad account of stereotypes, this (...) is not is not an inherent feature of them nor a foregone conclusion about them. At least some positive stereotypes have the potential to help resist certain forms of epistemic injustice--though they likely can only play a limited or temporary role in this regard. The takeaway is that we should approach moral and epistemic analyses of stereotypes by thinking about them as (crude) cognitive tools, and as such, focus on what these tools are being used for, and what their actual impact is. (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)

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)

Are people with flawed faces regarded as having flawed moral characters? An “anomalous-is-bad” stereotype is hypothesized to facilitate negative biases against people with facial anomalies (e.g., scars), but whether and how these biases affect behavior and brain functioning remain open questions. We examined responses to anomalous faces in the brain (using a visual oddball paradigm), behavior (in economic games), and attitudes. At the level of the brain, the amygdala demonstrated a specific neural response to anomalous faces—sensitive to disgust and a (...) lack of beauty but independent of responses to salience or arousal. At the level of behavior, people with anomalous faces were subjected to less prosociality from participants highest in socioeconomic status. At the level of attitudes, we replicated previously reported negative character evaluations made about individuals with facial anomalies, and further identified explicit biases directed against them as a group. Across these levels of organization, the specific amygdala response to facial anomalies correlated with stronger just-world beliefs (i.e., people get what they deserve), less dispositional empathic concern, and less prosociality toward people with facial anomalies. Characterizing the “anomalous-is-bad” stereotype at multiple levels of organization can reveal underappreciated psychological burdens shouldered by people who look different. (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)

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)

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 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)

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)

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)

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)

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)

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)

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)

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)

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)

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

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)

Immunology researchers are beginning to explore the possibilities of reproducibility, reuse and secondary analyses of immunology data. Open-access datasets are being applied in the validation of the methods used in the original studies, leveraging studies for meta-analysis, or generating new hypotheses. To promote these goals, the ImmPort data repository was created for the broader research community to explore the wide spectrum of clinical and basic research data and associated findings. The ImmPort ecosystem consists of four components–Private Data, Shared Data, Data (...) Analysis, and Resources—for data archiving, dissemination, analyses, and reuse. To date, more than 300 studies have been made freely available through the ImmPort Shared Data portal , which allows research data to be repurposed to accelerate the translation of new insights into discoveries. (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)

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)

Hubert Dreyfus has argued that cases of absorbed bodily coping show that there is no room for self-awareness in flow experiences of experts. In this paper, I argue against Dreyfus’ maxim of vanishing self-awareness by suggesting that awareness of agency is present in expert bodily action. First, I discuss the phenomenon of absorbed bodily coping by discussing flow experiences involved in expert bodily action: merging into the flow; immersion in the flow; emergence out of flow. I argue against the claim (...) that flow experience does not involve an awareness of agency for each of these features, while conceding that fluent agency does not involve self-awareness in the thetic sense. I challenge the assumption that the awareness of fluent agency must be understood in terms of a thetic awareness of agency. Instead, I develop an Anscombean account of the awareness of fluent agency in terms of the phenomenal character of knowing one’s aims. I respond to the challenge that if an Anscombean account of the awareness of agency is to succeed, then agents must be able to answer Anscombean questions. I consider the objection that awareness of agency is not a form of self-awareness by outlining an account of self-awareness as self-synthesis that is distinct from self-perception and self-ascription, but which makes room for self-awareness in expert bodily action. (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)

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

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)

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)

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)

Background: Facial attractiveness influences our perceptions of others, with beautiful faces reaping societal rewards and anomalous faces encountering penalties. The purpose of this study was to determine associations of visual attention with bias and social dispositions toward people with facial anomalies. -/- Methods: Sixty subjects completed tests evaluating implicit bias, explicit bias, and social dispositions before viewing publicly available images of preoperative and postoperative patients with hemifacial microsomia. Eye-tracking was used to register visual fixations. -/- Results: Participants with higher implicit (...) bias scores fixated significantly less on the cheek and ear region preoperatively (P = 0.004). Participants with higher scores in empathic concern and perspective taking fixated more on the forehead and orbit preoperatively (P = 0.045) and nose and lips (P = 0.027) preoperativel. -/- Conclusions: Participants with higher levels of implicit bias spent less visual attention on anomalous facial anatomy, whereas participants with higher levels of empathic concern and perspective taking spent more visual attention on normal facial anatomy. Levels of bias and social dispositions such as empathy may predict layperson gaze patterns toward those with facial anomalies and provide insights to neural mechanisms underlying the "anomalous is bad" paradigm. (shrink)

Recent studies show that racism still exists in the American medical profession, the fact of which legitimizes the historically long-legacy of mistrust towards medical profession and health authorities among African Americans. Thus, it was suspected that the participation of black patients in end-of-life care has always been significantly low stemmed primarily from their mistrust of the medical profession. On the other hand, much research finds that there are other reasons than the mistrust which makes African Americans feel reluctant to the (...) end-of-life care, such as cultural-religious difference and genuine misunderstanding of the services. If so, two crucial questions are raised. One is how pervasive or significant the mistrust is, compared to the other factors, when they opt out of the end-of-life care. The other is if there is a remedy or solution to the seemingly broken relationship. While no studies available answer these questions, we have conducted an experiment to explore them. The research was performed at two Philadelphia hospitals of Mercy Health System, and the result shows that Black patients’ mistrust is not too great to overcome and that education can remove the epistemic obstacles as well as overcome the mistrust. (shrink)

Background: This study tested the core tenets of how facial scars are perceived by characterizing layperson response to faces with scars. The authors predicted that scars closer to highly viewed structures of the face (i.e., upper lip and lower lid), scars aligned against resting facial tension lines, and scars in the middle of anatomical subunits of the face would be rated less favorably. Methods: -/- Volunteers aged 18 years and older from the United States were recruited through Amazon’s Mechanical Turk (...) to complete a face rating survey. Scars were digitally added in different locations and orientations for a total of 14 unique scars added to each face. Each participant rated 50 different faces on confidence, friendliness, and attractiveness. Data were analyzed using linear mixed effects models. Results: -/- A total of 88,850 ratings [82,990 scarred (93.4 percent)] for attractiveness, friendliness, and confidence were analyzed. In univariate linear mixed effects models, the presence of a facial scar did not significantly impact attractiveness (β = 0.016, SE = 0.014, z = 1.089, p = 0.276). A second set of linear mixed effects models identified interactions between location, subunit placement, and orientation to facial tension lines. Scars located on the lower lid mid subunit perpendicular to facial tension lines were rated less attractive (β = −0.065, SE = 0.028, z = −2.293, p = 0.022). Conclusions: -/- On average, a single well-healed facial scar does not negatively affect first impressions of attractiveness, confidence, or friendliness. Specific scar location and orientation combinations, however, such as a perpendicular scar at the mid-lower eyelid, may result in lower perceived attractiveness, confidence, and friendliness. (shrink)

This pre-registered study (osf[dot]io/b9g6v) tested the hypothesis that implicit biases towards people with visible facial differences, like scars and palsies, can be reduced through routine exposure to faces bearing such anomalous features. Participants’ implicit biases were measured before and after they completed one of two exposure interventions—to people with facial anomalies, or to people of color (POC). The interventions were delivered remotely using a custom mobile phone application and consisted of two sessions per day over 5 consecutive days. Each session (...) began with exposure to 10 face photographs (anomalous or POC) followed by another person’s face (anomalous or POC) presented alongside a moral exemplar story ostensibly about them. After receiving the anomalous faces intervention, implicit biases against anomalous faces were significantly reduced but implicit biases against POC were not affected. The POC intervention did not have a targeted effect on bias against people of color, instead reducing biases against both people with visible differences and POC. Reductions in implicit biases were positively associated with perspective taking ratings made during the intervention. These findings suggest that exposure to people with facial anomalies, especially exposure that elicits perspective taking, can reduce implicit biases towards them in a targeted fashion. (shrink)

Public attitudes towards cognitive enhancement––e.g., using stimulants like Adderall and Ritalin to improve mental functioning––are mixed. Attitudes vary by context and prompt ethical concerns about fairness, obligation, and authenticity/character. While people may have strong views about the morality of cognitive enhancement, how these views are affected by the physical characteristics of enhancers is unknown. Visible facial anomalies (e.g., scars) bear negatively on perceptions of moral character. This pre-registered study (osf[dot]io/uaw6c/) tested the hypothesis that such negative biases against people with facial (...) anomalies extend to moral beliefs surrounding their use of cognitive enhancement. In an online survey, 941 participants made moral judgments in response to a vignette about a person who had to decide whether or not to enhance. The vignette was accompanied by a face photograph that ostensibly depicted the potential enhancer and either did or did not have visible anomalies. Participants then learned whether the person ultimately decided to enhance. Next, participants played a modified Trust Game with, they were told, the person from the photograph/vignette. Participants judged enhancement to be less fair and enhancers less authentic if they had facial anomalies, while effects on judgments of moral obligation and on behavior were not detected. These findings extend previous work showing that people with visible differences are subject to an “anomalous-is-bad” stereotype that has negative consequences for perceptions of their moral character. While anomalous faces were judged more harshly, these judgments did not appear to affect behavior. These results are discussed in relation to discrimination and policy. (shrink)

In much of the current academic and public discussion, conspiracy theories are portrayed as a negative phenomenon, linked to misinformation, mistrust in experts and institutions, and political propaganda. Rather surprisingly, however, philosophers working on this topic have been reluctant to incorporate a negatively evaluative aspect when either analyzing or engineering the concept conspiracy theory. In this paper, we present empirical data on the nature of the concept conspiracy theory from five studies designed to test the existence, prevalence and exact form (...) of an evaluative dimension to the ordinary concept conspiracy theory. These results reveal that, while there is a descriptive concept of conspiracy theory, the predominant use of conspiracy theory is deeply evaluative, encoding information about epistemic deficiency and often also derogatory and disparaging information. On the basis of these results, we present a new strategy for engineering conspiracy theory to promote theoretical investigations and institutional discussions of this phenomenon. We argue for engineering conspiracy theory to encode an epistemic evaluation, and to introduce a descriptive expression—such as ‘conspiratorial explanation’—to refer to the purely descriptive concept conspiracy theory. (shrink)

A remarkable feature of the philosophical work on conspiracy theory theory has been that most philosophers agree there is nothing inherently problematic about conspiracy theories (AKA the thesis of particularism). Recent work, however, has challenged this consensus view, arguing that there really is something epistemically wrong with conspiracy theorising (AKA generalism). Are particularism and generalism incompatible? By looking at just how much particularists and generalists might have to give away to make their theoretical viewpoints compatible, I will argue that particularists (...) can accept many of the concerns that motivate generalism because generalism can never be about ‘all’ conspiracy theories without being either ahistorical or apolitical. In the end generalist critiques are best seen as useful guidelines or considerations for the appraising of particular conspiracy theories. (shrink)

The concept of the receptive field, first articulated by Hartline, is central to visual neuroscience. The receptive field of a neuron encompasses the spatial and temporal properties of stimuli that activate the neuron, and, as Hubel and Wiesel conceived of it, a neuron’s receptive field is static. This makes it possible to build models of neural circuits and to build up more complex receptive fields out of simpler ones. Recent work in visual neurophysiology is providing evidence that the classical receptive (...) field is an inaccurate picture. The receptive field seems to be a dynamic feature of the neuron. In particular, the receptive field of neurons in V1 seems to be dependent on the properties of the stimulus. In this paper, we review the history of the concept of the receptive field and the problematic data. We then consider a number of possible theoretical responses to these data. (shrink)

What are conspiracy theories? And what, if anything, is epistemically wrong with them? I offer an account on which conspiracy theories are a unique way of holding a belief in a conspiracy. Specifically, I take conspiracy theories to be self-insulating beliefs in conspiracies. On this view, conspiracy theorists have their conspiratorial beliefs in a way that is immune to revision by counter-evidence. I argue that conspiracy theories are always irrational. Although conspiracy theories involve an expectation to encounter some seemingly disconfirming (...) evidence (allegedly planted by the conspirators), resistance to all counter- evidence cannot be justified on these grounds. (shrink)

Conspiracy theories and conspiracy theorists have been accused of a great many sins, but are the conspiracy theories conspiracy theorists believe epistemically problematic? Well, according to some recent work, yes, they are. Yet a number of other philosophers like Brian L. Keeley, Charles Pigden, Kurtis Hagen, Lee Basham, and the like have argued ‘No!’ I will argue that there are features of certain conspiracy theories which license suspicion of such theories. I will also argue that these features only license a (...) limited suspicion of these conspiracy theories, and thus we need to be careful about generalising from such suspicions to a view of the warrant of conspiracy theories more generally. To understand why, we need to get to the bottom of what exactly makes us suspicious of certain conspiracy theories, and how being suspicious of a conspiracy theory does not always tell us anything about how likely the theory in question is to be false. (shrink)

Looking at the recent spate of claims about “fake news” which appear to be a new feature of political discourse, I argue that fake news presents an interesting problem in epistemology. Te phenomena of fake news trades upon tolerating a certain indiference towards truth, which is sometimes expressed insincerely by political actors. Tis indiference and insincerity, I argue, has been allowed to fourish due to the way in which we have set the terms of the “public” epistemology that maintains what (...) is considered “rational” public discourse. I argue one potential salve to the problem of fake news is to challenge this public epistemology by injecting a certain ethical consideration back into the discourse. (shrink)

To seek fundamental truths, analytic metaphysicians generally start with observed phenomena. From here they typically move outwards, using discursive thought to posit scientifically informed theories about the ultimate reality behind appearances. Mystics, too, seek to uncover the reality behind appearances. However, their meditative methods typically start with experience and go inwards to a fundamental reality sometimes described as a pure conscious unity. Analytic metaphysicians may be tempted to dismiss the mystical approach as unworthy of investigation. In this paper I will (...) outline and address four challenges that sceptics are likely to advance, arguing that none is persuasive. I shall also attempt to clarify the role and scope of meditation in establishing the viability of mystical data in the construction of any potential metaphysic about fundamental reality. (shrink)

Conspiracy theories are often portrayed as unwarranted beliefs, typically supported by suspicious kinds of evidence. Yet contemporary work in Philosophy argues provisional belief in conspiracy theories is—at the very—least understandable (because conspiracies occur) and if we take an evidential approach—judging individual conspiracy theories on their particular merits—belief in such theories turns out to be warranted in a range of cases. Drawing on this work, I examine the kinds of evidence typically associated with conspiracy theories, showing that the evidential problems typically (...) associated with conspiracy theories are not unique to such theories. As such, if there is a problem with the conspiracy theorist’s use of evidence, it is one of principle: is the principle which guides their use of evidence somehow in error? I argue that whatever we might think about conspiracy theories generally, there is no prima facie case for a scepticism of conspiracy theories based purely on their use of evidence. (shrink)

There is no doubt that custard apple diseases are among the important reasons that destroy the Custard Apple plant and its agricultural crops. This leads to obvious damage to these plants and they become inedible. Discovering these diseases is a good step to provide the appropriate and correct treatment. Determining the treatment with high accuracy depends on the method used to correctly diagnose the disease, expert systems can greatly help in avoiding damage to these plants. The expert system correctly diagnoses (...) Custard Apple disease to make it easier for farmers to find the right treatment based on the appropriate diagnosis. Objectives: A specialized syllable language system was established for the diagnosis of Custard Apple plant disease. (shrink)

This paper examines the role of reason in Shepherd's account of acquiring knowledge of the external world via first principles. Reason is important, but does not have a foundational role. Certain principles enable us to draw the required inferences for acquiring knowledge of the external world. These principles are basic, foundational and, more importantly, self‐evident and thus justified in other ways than by demonstration. Justificatory demonstrations of these principles are neither required, nor possible. By drawing on textual and contextual evidence, (...) I will show that Shepherd should have said that we know the first principles of any science, in general, and that “everything which begins to exist must have a cause”, in particular, via intuition, not via reason. Reasoning about such principles can help their self‐evidence shine through in certain cases; their justification, and our being justified in believing them, does not come from this reasoning, however. (shrink)

The paper points out that the modern formulation of Bohm’s quantum theory known as Bohmian mechanics is committed only to particles’ positions and a law of motion. We explain how this view can avoid the open questions that the traditional view faces according to which Bohm’s theory is committed to a wave-function that is a physical entity over and above the particles, although it is defined on configuration space instead of three-dimensional space. We then enquire into the status of the (...) law of motion, elaborating on how the main philosophical options to ground a law of motion, namely Humeanism and dispositionalism, can be applied to Bohmian mechanics. In conclusion, we sketch out how these options apply to primitive ontology approaches to quantum mechanics in general. (shrink)

In this paper I interrogate the notion of `debunking conspiracy theories’, arguing that the term `debunk’ carries with it pejorative implications, given that the verb `to debunk’ is commonly understood as `to show the wrongness of a thing or concept’. As such, the notion of `debunking conspiracy theories’ builds in the notion that such theories are not just wrong but ought to be shown as being wrong. I argue that we should avoid the term `debunk’ and focus on investigating conspiracy (...) theories. Looking at recent research work in epistemology on conspiracy theory, I argue that the best way to avoid talk of `debunking’ conspiracy theories is by working with a non-pejorative definition of `conspiracy theory’, and forming communities of inquiry which allow us to investigate the warrant of such theories without the prejudice associated with working with a pejorative definition. (shrink)