Luck egalitarianism provides a reason to object to conditionality in health incentive programmes in some cases when conditionality undermines political values such as solidarity or inclusiveness. This is the case with incentive programmes that aim to restrict access to essential healthcare services. Such programmes undermine solidarity. Yet, most people's lives are objectively worse, in one respect, in non-solidary societies, because solidarity contributes both instrumentally and directly to individuals' well-being. Because solidarity is non-excludable, undermining it will deprive both the (...) prudent and the imprudent citizens of its goods. Thereby, undermining solidarity can make prudent citizens worse off than they would have otherwise been, out of no fault or choice of their own, but rather as a result of somebody else's imprudent choice. This goes against the spirit of luck egalitarianism. Therefore (luck egalitarian) justice can require us to save the imprudent and avoid conditionality in access to essential healthcare services. (shrink)

The development of new methods in the field of prenatal testing leads to an expansion of information that needs to be provided to expectant mothers. The aim of this research is to explore opinions and attitudes of gynecologists in Germany, Poland and Russia towards access to prenatal testing and diagnostics in these countries. Semi-structured interviews were conducted with n = 18 gynecologists in Germany, Poland and Russia. The interviews were analyzed using the methods of content analysis and thematic analysis. (...) Visible in all three countries is a connection of prenatal medicine with the politically and socially contentious issue of pregnancy termination. Respondents in Poland and Russia concentrated on the topic of inadequate resources. Quality of information for expectant mothers is an important point in all three countries. Only in Germany was the issue of language barriers in communication raised. With regard to non-invasive prenatal testing (NIPT) respondents in Germany focused on the ethical issues of routinization of testing; in Poland and Russia they concentrated on fair access to NIPT. Challenges in all three countries arise from structural factors such as imprecise and prohibitive regulations, lack of resources or organization of healthcare services. These should be addressed on a political and medico-ethical level. (shrink)

BackgroundViral pandemics present a range of ethical challenges for policy makers, not the least among which are difficult decisions about how to allocate scarce healthcare resources. One important question is whether healthcare workers should receive priority access to a vaccine in the event that an effective vaccine becomes available. This question is especially relevant in the coronavirus pandemic with governments and health authorities currently facing questions of distribution of COVID-19 vaccines.Main textIn this article, we critically evaluate the (...) most common ethical arguments for granting healthcare workers priority access to a vaccine. We review the existing literature on this topic, and analyse both deontological and utilitarian arguments in favour of HCW prioritisation. For illustrative purposes, we focus in particular on the distribution of a COVID-19 vaccine. We also explore some practical complexities attendant on arguments in favour of HCW prioritisation.ConclusionsWe argue that there are deontological and utilitarian cases for prioritising HCWs. Indeed, the widely held view that we should prioritise HCWs represents an example of ethical convergence. Complexities arise, however, when considering who should be included in the category of HCW, and who else should receive priority in addition to HCWs. (shrink)

Introduction: There is currently no binding, internationally accepted and successful approach to ensure global equitable access to healthcare during a pandemic. The aim of this ethical analysis is to bring into the discussion a legally regulated vaccine allocation as a possible strategy for equitable global access to vaccines. We focus our analysis on COVAX (COVID-19 Vaccines Global Access) and an existing EU regulation that, after adjustment, could promote global vaccine allocation. -/- Methods: The main documents discussing (...) the two strategies are examined with a qualitative content analysis. The ethical values reasonableness, openness and transparency, inclusiveness, responsiveness and accountability serve as categories for our ethical analysis. -/- Results: We observed that the decision-making processes in a legal solution to expand access to vaccines would be more transparent than in COVAX initiative, would be more inclusive, especially of nation states, and the values responsiveness and accountability could be easily incorporated in the development of a new regulation. -/- Discussion: A legal strategy that offers incentives to the pharmaceutical industry in return for global distribution of vaccines according to the Fair Priority Model is an innovative way to achieve global and equitable access to vaccines. However, in the long term, achieving the Sustainable Development Goals will require from all nations to work in solidarity to find durable solutions for global vaccine research and development. Interim solutions, such as our proposed legal strategy for equitable access to vaccines, and efforts to find long-term solutions must be advanced in parallel. (shrink)

The debate regarding the role of conscientious objection in healthcare has been protracted, with increasing demands for curbs on conscientious objection. There is a growing body of evidence that indicates that in some cases, high rates of conscientious objection can affect access to legal medical services such as abortion—a major concern of critics of conscientious objection. Moreover, few solutions have been put forward that aim to satisfy both this concern and that of defenders of conscientious objection—being expected to (...) participate in the provision of services that compromise their moral integrity. Here we attempt to bring some resolution to the debate by proposing a pragmatic, long-term solution offering what we believe to be an acceptable compromise—a quota system for medical trainees in specialties where a conscientious objection can be exercised, and is known to cause conflict. We envisage two main objectives of the quota system we propose. First, as a means to introduce conscientious objection into countries where this is not presently permitted. Second, to minimise or eliminate the effects of high rates of conscientious objection in countries such as Italy, where access to legal abortion provision can be negatively affected. (shrink)

The study highlights the advantages telemedicine offers, such as increased flexibility, reduced commuting time, and better time management. It also examines the challenges doctors face, including the demands of always being digitally accessible, the learning curve of new technologies, and the difficulty in maintaining boundaries between personal and professional life. Using both quantitative and qualitative data, this research compares the telemedicine adaptation experiences of doctors in public versus private hospitals, considering factors such as hospital infrastructure, support systems, and patient load.

Objectives The study aims to evaluate the impact of the Revised Health Insurance Law 2014 on the utilisation of outpatient and inpatient care services, healthcare services utilisation at different levels of providers, types of providers and types of visits across different entitlement groups. Design/setting Secondary data from two waves of the Vietnam Household Living Standard Survey (VHLSS) 2016, VHLSS 2014 were used. A cross-sectional study applying propensity score matching was conducted. Participants A total of 4900 individuals who reported using (...) healthcare services are analysed. Outcomes measure Numbers of outpatient and inpatient visits, frequency of healthcare service utilisation at commune health stations, district hospitals, provincial hospitals, public and private health facilities, number of visits at health facility for medical treatment and health checks per year. Results The result indicates that health insurance (HI) policy increased the number of outpatient visits for the enrolled between 0.87 and 1.29. The greatest impact was found on participants of heavily subsidised health insurance (HSHI) programmes with 1.29 visits per person per year. Similarly, an increase between 0.08 and 0.16 in the number of inpatient admissions was because of participation in HI. With regard to type of healthcare providers, the study found that participation in HI has the most effect on the use of healthcare services at district hospitals. However, the study demonstrated that the impacts of HI on the increase in the frequency of visiting commune health stations, number of visits at the provincial hospital for HSHI groups, and number of visits at health facilities for health check and consultation were sensitive to unobserved characteristics. Conclusion Our findings imply that policy-makers in Vietnam could continue expanding health insurance coverage to increase access to healthcare services for citizens, especially vulnerable groups. In addition, the government should draw more attention to primary healthcare level. (shrink)

Healthcare practitioners have access to a range of ethical guidance. However, the normative role of this guidance in ethical decision-making is underexplored. This paper considers two ways that healthcare practitioners could approach ethics guidance. We first outline the idea of deference to ethics guidance, showing how an attitude of deference raises three key problems: moral value; moral understanding; and moral error. Drawing on philosophical literature, we then advocate an alternative framing of ethics guidance as a form of (...) moral testimony by colleagues and suggest that a more promising attitude to ethics guidance is to approach it in the spirit of ‘critical engagement’ rather than deference. (shrink)

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

Abstract Aim: The COVID-19 infection is transmitted either by human-to-human contact, social-physical contact, and respiratory droplets or by touching items touched by the infected. This has triggered some conflicted behaviors such as stigma, violence, and opposite behavior applause. The aim of this study is to explore several newspaper articles about stigma, violence, or insensitive behavior against healthcare professionals and to analyze the reason for these behaviors during these COVID-19 pandemics. Method: The website of the Turkish Medical Association "Press Releases (...) News" and online newspaper articles have been scanned using keywords and have been classified and analyzed according to the content of articles between the periods of March 11 to April 28, 2020. This is a qualitative study with content analysis. No official ethical permission was obtained as the study was conducted through open access internet news sites. Result: 16 reports were selected from online reports that matched the keywords of the study. 13 of these reports included desensitization, violence, lack of precaution, stigmatization, and applause, and 3 reports included doctors’ statements. After being categorized, content analyses were conducted. Conclusion: This study revealed the necessity of a multi-faceted evaluation of the problems faced by healthcare professionals who are at the forefront of the COVID-19 outbreak. This study has a primary role in the detection, diagnosis, and treatment of the pandemic and reveals that doctors are trying to fulfill their duties in an ethical framework despite stigmatized behavior. Authorities should provide various supports to protect healthcare professionals before, during, and after the epidemic for the success of the COVID-19 outbreak struggle. (shrink)

Most people are completely oblivious to the danger that their medical data undergoes as soon as it goes out into the burgeoning world of big data. Medical data is financially valuable, and your sensitive data may be shared or sold by doctors, hospitals, clinical laboratories, and pharmacies—without your knowledge or consent. Medical data can also be found in your browsing history, the smartphone applications you use, data from wearables, your shopping list, and more. At best, data about your health might (...) end up in the hands of researchers on whose good will we depend to avoid abuses of power.2 Most likely, it will end up with data brokers who might sell it to a future employer, or an insurance company, or the government. At worst, your medical data may end up in the hands of criminals eager to commit extortion or identity theft. In addition to data harms related to exposure and discrimination, the collection of sensitive data by powerful corporations risks the creation of data monopolies that can dominate and condition access to health care. -/- This chapter aims to explore the challenge that big data brings to medical privacy. Section I offers a brief overview of the role of privacy in medical settings. I define privacy as having one’s personal information and one’s personal sensorial space (what I call autotopos) unaccessed. Section II discusses how the challenge of big data differs from other risks to medical privacy. Section III is about what can be done to minimise those risks. I argue that the most effective way of protecting people from suffering unfair medical consequences is by having a public universal healthcare system in which coverage is not influenced by personal data (e.g., genetic predisposition, exercise habits, eating habits, etc.). (shrink)

The need for innovative development of healthcare institutions is determined by the necessity to increase the efficiency of organizational processes based on the formation of new models of cooperation, which will make it possible to get access to new technologies and knowledge. The goal of the study is to determine the parameters of the impact of innovative open cooperation strategy and the strategy of innovative closed cooperation of healthcare institutions on the effectiveness of their organizational structure in (...) the context of dissemination and the use of knowledge. Simulation modeling was applied to generate the most effective organizational management structure in the context of innovative cooperation and knowledge exchange within the organizational processes “Inside-out” and “Inside-in”. It is substantiated that the strategies of innovative cooperation “Open Innovation/Closed Innovation” have a significant impact on the organizational structure of management of healthcare institutions in terms of the “degree of centralization” (Dci), “degree of mediation” (Dii), and “degree of centralization of powers” (Dpi). The values of the selected criteria range from 25,52% to 61,50% in the case of Dii, and from 34,53% to 52,63% in the case of Dci, which indicates a higher efficiency of organizational knowledge exchange processes in healthcare institutions, which adhere to the Open Innovation strategy of innovative cooperation. Therefore, there are significant differences in the effectiveness of the management’s organizational structure depending on the degree of openness of innovative cooperation of healthcare institutions. The strategy of innovative openness allows increasing the number and quality of connections in the context of knowledge exchange between the subjects (actors, agents) of the organizational structure (in a broad sense, considering internal and external levels of externality) of healthcare institutions, regardless of the distance between them and the level of similarity. (shrink)

Within the last decade, epistemic injustice has been a valuable framework for those working on exposing oppressive practices within the healthcare system. As this work has evolved, new terminology has been added to the epistemic injustice literature to bring to light previously obscured epistemic harms in healthcare practices. This paper aims to explore an important concept that has not received the attention it deserves: epistemic isolation. By developing Ian Kidd and Havi Carel’s concept of epistemic isolation, a new (...) range of epistemic harms are brought to the fore, as some of the most marginalised in our society are forced to operate from positions of ignorance. In the words of Kidd and Carel, epistemic isolation occurs in ‘situations where a person or group lacks the knowledge of, or means of access to, particular information; for instance, if they live within a politically repressive society which forbids access to the necessary sources of information in order to protect the government’s hegemony’ (183–184). This paper will demonstrate that such epistemic isolation is uniquely devastating for those with psychiatric illness, exacerbating their already challenging circumstances. (shrink)

William Smith’s recent article criticises the so-called orthodox approaches to the normative analysis of healthcare resource allocation, associated to the requirement that decision-makers should abide by strictly procedural principles of legitimacy defining a deliberative democratic process. Much of the appeal of Smith’s argument goes down to his awareness of real-world processes and, in particular, to the large gap he identifies between well-led democratic deliberation and the messiness of the process through which the intuitively legitimate Affordable Care Act (ACA) was (...) created. This reply aims to demonstrate that the ACA provides no counterexample to orthodox views, seizing this opportunity to explore the specific space that the procedural principles populating orthodox accounts are meant to regulate. Neither general questions of healthcare justice concerning, for example, universal access nor, relatedly, the activity of elected politicians falls within the natural scope of application of such principles, revealing a much more complex picture of the interactions between justice and legitimacy as well as substantive and procedural considerations than acknowledged by Smith. In the end, orthodox accounts of healthcare resource allocation turn out to provide a precious fund of theoretical resources for the normative study of administrators, which might be useful well beyond bioethics and health policy. (shrink)

The COVID-19 pandemic highlighted the importance of internet access across various aspects of life, from remote work and online education to healthcare services and social connections. As we transition to a post-pandemic era, a pressing need arises to update our understanding of the multifaceted nature of internet access. This study is one of the first attempts to do so. Using survey data from New Zealand adult internet users (n=960), it compares internet connection types, frequency of internet use (...) at home, social media use, and concerns about online risk between people with and without disabilities. Results show people with disabilities have restricted fibre access and higher wireless broadband (a much slower connection type). People with disabilities use social media platforms less and are more concerned about certain online risks. The findings highlight persistent disparities in internet access for people with disabilities in the post-pandemic era. Implications of the study are discussed. (shrink)

Corruption deprives people of access to health care and can lead to the wrong treatments being administered. Drug counterfeiting, facilitated by corruption, kills en masse. Cases are recorded of water being substituted for life-saving adrenaline and of active ingredients being diluted by counterfeiters, triggering drug-resistant strains of malaria, tuberculosis and HIV. The poor are disproportionately affected by corruption in the health sector, and cannot afford to pay for private alternatives where corruption has depleted public health services. Analysis of corruption (...) in the health sector of the UK can redress the information imbalance between UK government and service providers and patients. Health is a major global industry, a key responsibility and budget expense for governments and businesses. Corruption deprives people of access to health care and leads to poor health outcomes. (shrink)

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

Greg Bognar has recently offered a prioritarian justification for ‘fair innings’ distributive principles that would ration access to healthcare on the basis of patients' age. In this article, I agree that Bognar's principle is among the strongest arguments for age-based rationing. However, I argue that this position is incomplete because of the possibility of ‘time-relative' egalitarian principles that could complement the kind of lifetime egalitarianism that Bognar adopts. After outlining Bognar's position, and explaining the attraction of time-relative egalitarianism, (...) I suggest various ways in which these two kinds of principle could interact. Since various options have very different implications for age-based rationing, proponents of such a rationing scheme must take a position on time-relative egalitarianism to complement a lifetime prioritarian view like Bognar's. (shrink)

Conscientious objection in healthcare has come under heavy criticism on two grounds recently, particularly regarding abortion provision. First, critics claim conscientious objection involves a refusal to provide a legal and beneficial procedure requested by a patient, denying them access to healthcare. Second, they argue the exercise of conscientious objection is based on unverifiable personal beliefs. These characteristics, it is claimed, disqualify conscientious objection in healthcare. Here, we defend conscientious objection in the context of abortion provision. We (...) show that abortion has a dubitable claim to be medically beneficial, is rarely clinically indicated, and that conscientious objections should be accepted in these circumstances. We also show that reliance on personal beliefs is difficult to avoid if any form of objection is to be permitted, even if it is based on criteria such as the principles and values of the profession or the scope of professional practice. (shrink)

Ambient assisted living technologies are increasingly presented and sold as essential smart additions to daily life and home environments that will radically transform the healthcare and wellness markets of the future. An ethical approach and a thorough understanding of all ethics in surveillance/monitoring architectures are therefore pressing. AAL poses many ethical challenges raising questions that will affect immediate acceptance and long-term usage. Furthermore, ethical issues emerge from social inequalities and their potential exacerbation by AAL, accentuating the existing access (...) gap between high-income countries and low and middle-income countries. Legal aspects mainly refer to the adherence to existing legal frameworks and cover issues related to product safety, data protection, cybersecurity, intellectual property, and access to data by public, private, and government bodies. Successful privacy-friendly AAL applications are needed, as the pressure to bring Internet of Things devices and ones equipped with artificial intelligence quickly to market cannot overlook the fact that the environments in which AAL will operate are mostly private. The social issues focus on the impact of AAL technologies before and after their adoption. Future AAL technologies need to consider all aspects of equality such as gender, race, age and social disadvantages and avoid increasing loneliness and isolation among, e.g. older and frail people. Finally, the current power asymmetries between the target and general populations should not be underestimated nor should the discrepant needs and motivations of the target group and those developing and deploying AAL systems. Whilst AAL technologies provide promising solutions for the health and social care challenges, they are not exempt from ethical, legal and social issues. A set of ELSI guidelines is needed to integrate these factors at the research and development stage. (shrink)

Background: Smart sensors have been developed as diagnostic tools for rehabilitation to cover an increasing number of geriatric patients. They promise to enable an objective assessment of complex movement patterns. -/- Objective: This research aimed to identify and analyze the conflicting ethical values associated with smart sensors in geriatric rehabilitation and provide ethical guidance on the best use of smart sensors to all stakeholders, including technology developers, health professionals, patients, and health authorities. -/- Methods: On the basis of a systematic (...) literature search of the scientific databases PubMed and ScienceDirect, we conducted a qualitative document analysis to identify evidence-based practical implications of ethical relevance. We included 33 articles in the analysis. The practical implications were extracted inductively. Finally, we carried out an ethical analysis based on the 4 principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice. The results are reported in categories based on these 4 principles. -/- Results: We identified 8 conflicting aims for using smart sensors. Gains in autonomy come at the cost of patient privacy. Smart sensors at home increase the independence of patients but may reduce social interactions. Independent measurements performed by patients may result in lower diagnostic accuracy. Although smart sensors could provide cost-effective and high-quality diagnostics for most patients, minorities could end up with suboptimal treatment owing to their underrepresentation in training data and studies. This could lead to algorithmic biases that would not be recognized by medical professionals when treating patients. -/- Conclusions: The application of smart sensors has the potential to improve the rehabilitation of geriatric patients in several ways. It is important that patients do not have to choose between autonomy and privacy and are well informed about the insights that can be gained from the data. Smart sensors should support and not replace interactions with medical professionals. Patients and medical professionals should be educated about the correct application and the limitations of smart sensors. Smart sensors should include an adequate representation of minorities in their training data and should be covered by health insurance to guarantee fair access. (shrink)

This thesis under the title “Public Health Policy in Resource Allocation: the Role of Ubuntu Ethics in Redressing Resource Disparity between Public and Private Healthcare in South Africa” explores health care disparities pertaining to resource allocation between public and private sector. It is of relevance and importance in South Africa where 54% of the population live on less than US$3 per day. Although the government has instituted certain changes aimed at transforming the public health care system, the resource allocation (...) gap between the two persists and remains wide. The research gives special attention to the role that Ubuntu ethics can play in redressing the resource allocation disparities between public and private health care sectors in South Africa, pointing out the existing gap in financing, as well as human resource between public and private health care sectors, which leads to poor health outcomes in public sector. Therefore, the problem is the prevalent inequality of resource allocation between private and public health care sectors. The analysis of policy gaps, as well as evaluating the cause of disparities in the health system is the goal of this research. The study endeavours to redress the disparities within the context of Ubuntu ethical principles and proposes a change in public policy so as to enhance healthcare for the benefit of the people. The study is philosophical and ethical, so the methodology used is discursive in nature, majorly focusing on critically reviewing existing literature, that is, the philosophical resources on Ubuntu ethics and justice theories as well as a range of government resources inclusive of public health policy documents. Social determinants of health and their impact in a South African context are discussed with the implication that health is not merely freedom from disease and or incapacity, but rather being well mentally, physically and socially. The attainment of a healthy status goes beyond ability to access healthcare services, and incorporates social determinants including but not limited to conditions in which people have been born into, stay, establish career and grow old in. It also includes the arrangements put in place to deal with illness and determine health. Issues of revenue, literacy, communal safety networks, vocation and conditions under-which vocation is undertaken, lack of work and vocation insecurity, early stages of human development, gender, cultural group, dietary insecurity, housing communal exclusion and disability all come into the picture as factors that determine health. But there is also discussion of the socio-economic status as contributors to health inequity wherein alcohol abuse, sugar intake, and smoking are identified as behavioural factors that complicate public health. One outstanding feature of this research is that it establishes a link between Ubuntu and public health policy. The researcher establishes that Ubuntu ethics is appropriate for not only discussing public morality, but also for formulating public policy that is morally tenable for South Africa, especially for the public health sector. This thesis calls for an application of Ubuntu in a proper context in order to enhance societal well-being for the benefit of many, if not all. The research proposes the fundamental principle of Ubuntu ethics in which the good of the community is as important as the good of every member of the community. Since Ubuntu ethics does not merely seek to fulfil what benefits the majority, as would be the case in a utilitarian society, the researcher advocates for the building of consensus on the common good, which should be understood to imply not just what is good for everyone in the community, but also what is good for the continued well-being of the community as a single unit. In this regard, the research finds it important that deliberate effort be made to integrate Ubuntu ethics into policies, citing the example of the National Health Insurance (NHI). The good health of all the members of a community is an assurance of the well-being and continuity of the whole national community. The research concludes that public health policy should integrate Ubuntu ethical values such as community, sharing, care, solidarity, identity, harmony, respect, and dignity into policy documents and legislation. (shrink)

Nanomedicine applications are an extension of traditional pharmaceutical drug development that are targeting the most pressing health concerns through improvements to diagnostics, drug delivery systems, therapeutics, equipment, surgery and prosthetics. The benefits and risks to the individual have been extrapolated to include broader societal impacts of nanomedicine with concerns extending to inequitable distribution of benefits accruing to developed, or North countries, rather than developing, or South countries. Analysis reveals a great deal of overlap between the North and South's most serious (...) health priorities which kill millions each year. A significant amount of nanomedicine research activity is also underway for the most pressing South country-specific health concerns. Nanomedicine development promises profound breakthroughs for both North and South countries; however, the existing inequities in pharmaceutical drug development, patenting, access and delivery remain significant barriers for South countries. (shrink)

New biotechnologies have the potential to both dramatically improve human well-being and dramatically widen inequalities in well-being. This paper addresses a question that lies squarely on the fault line of these two claims: When as a matter of justice are societies obligated to include a new biotechnology in a national healthcare system? This question is approached from the standpoint of a twin aim theory of justice, in which social structures, including nation-states, have double-barreled theoretical objectives with regard to human (...) well-being. The first aim is to achieve a sufficient level of well-being in each of six core dimensions. In the special case of healthcare systems, this aim is focally but not exclusively attentive to achieving health sufficiency as one of the core dimensions. The second aim is to combat the emergence and persistence of densely woven patterns of systematic disadvantage that tend to undermine the achievement of a sufficient level of health and the other core elements of well-being of some persons and groups. Judgments about entitlements to health related resources, including new biotechnologies, are made in light of a threshold notion of health sufficiency. What is enough or sufficient health? The answer that is defended here is that sufficient health is enough health for a decent human life, understood as enough health to live a full life course without preventable, significant functional disability or decrement in health, or treatable pain or suffering. When a state must include a new biotechnology in its national healthcare system is also influenced by ancillary concerns about the connection between health and other core dimensions of well-being. What counts as a significant functional impairment or health decrement is thus explicated, in part, in relation to the theory’s sufficiency aim for the other essential dimensions of well-being, and thus for a decent life, overall. Those elements of health that play a critical role in the experience of sufficient reasoning, affiliation, security, respect and self determination are especially important; any loss of health function or capacity that threatens the individual’s prospects for sufficiency in these other dimensions, including the relational egalitiarian concerns they entail, constitutes a significant functional impairment. Within national borders, individuals are thus entitled to those health-related goods and services that are essential for a sufficiency of each of the dimensions of well-being; with regard to self determination and respect, what is sufficient by way of guaranteed access to specific goods and services is going to depend on the implications of such access for where an individual stands in relation to her co-nationals. The content of any entitlement to health-related goods and services is also necessarily dynamic. What can be done for health and the other core dimensions of well-being as a function of technological innovation and diffusion is in constant flux. The paper concludes by considering the implications of this analysis for the conditions under which states are obligated to include access in their healthcare systems to one biotechnology, deep brain stimulation. (shrink)

Objective Our study sought to (1) describe the practices and preferences of Colombian adolescents in accessing sexual and reproductive health services: accompanied versus alone; (2) compare actual practices with stated preferences; and (3) determine age and gender differences regarding the practice and these stated preferences. -/- Methods 812 participants aged 11–24 years old answered a survey in two Profamilia clinics in the cities of Medellin and Cali in Colombia. A cross-sectional analysis was performed to compare participants’ answers based on the (...) variables of gender and age. -/- Results A quarter of participants visited the clinic alone (25.4%). Females were more likely to go alone in comparison to males (26.3% vs 14.1%; p = 0.031), and older participants went alone more often than younger participants (p < 0.001). Most participants – 72.7% (95 %CI: 69.3–75.9) – expressed a preference in being accompanied to the clinic, and more than 90% had their preferences met. The preferences of older participants were, however, less likely to be met than those of younger participants (p < 0.001), notably, because they predominantly wanted to be accompanied. -/- Conclusion Contemporary public health and bioethics literature advocates in favor of developing health services that better meet the preferences of adolescents. The present research highlights an apparent blind spot related to the role that others (e.g., parents, friends, partners) can or should play in accompanying adolescent patients when they access sexual and reproductive health services. Respecting adolescents’ preferences, and hence their autonomy, is not simply a matter of ensuring freedom from constraints (e.g., their right and ability to go alone). Rather, it should also consider the liberty to choose whether to be accompanied when accessing SHRS and by whom. (shrink)

Este trabajo es un comentario sobre la primera traducción al español de las guías del Reino Unido “Atención después de la investigación: un marco para los comités de ética de investigación del NHS (borrador versión 8.0)”. El comentario se divide en tres partes. En la primera parte, se busca resumir la información básica necesaria para mejorar la lectura comprensiva de la traducción de las guías. En la segunda parte, se analiza una selección de la normativa argentina que trata sobre atención (...) después de la investigación. En la tercera parte, se presentan las principales limitaciones del borrador de las guías y su traducción. El propósito de este comentario es que los futuros lectores y lectoras puedan hacer un uso crítico y deliberado de las guías, en la evaluación de estudios clínicos o como base para la redacción de guías propias sobre atención después de la investigación. ***This work is a commentary on the first Spanish translation of the UK guidelines “Care after research: a framework for NHS research ethics committees (draft version 8.0)”. The commentary is divided into three parts. The first part seeks to summarize the basic information needed to improve reading comprehension of the translation of the guidelines. The second part analyzes a selection of Argentinean regulations dealing with care after research. The third part presents the main limitations of the guidelines draft and its translation. The purpose of this commentary is that future readers can make a critical and deliberate use of guidelines in the assessment of clinical studies or as a basis for drafting their own guidelines on care after research. (shrink)

With by far the lowest population density in the United States, myriad challenges attach to healthcare delivery in Alaska. In the “Size, Population, and Accessibility” section, we characterize this geographic context, including how it is exacerbated by lack of infrastructure. In the “Distributing Healthcare” section, we turn to healthcare economics and staffing, showing how these bear on delivery—and are exacerbated by geography. In the “Health Care in Rural Alaska” section, we turn to rural care, exploring in more (...) depth what healthcare delivery looks like outside of Alaska’s major cities. This discussion continues in the “Alaska’s Native Villages” section, which specifically analyzes healthcare in Alaska’s indigenous villages, some of the smallest and most isolated communities in the United States. Though many of the ways we could improve Alaskan health care for Alaskan residents are limited by its unique features, the “Justice and Healthcare Delivery” and “Technology and Telemedicine” sections consider ways in which certain policies and technology—including telemedicine—could mitigate the challenges developed in previous sections. (shrink)

The article discusses the role and importance of storytelling in the context of creating and maintaining organisational culture in the healthcare sector. Medical institutions are constantly solving complex tasks related to the provision of high-quality medical care and interaction with patients and staff. In this regard, storytelling is an important tool, aimed at strengthening cultural values and adjusting goals. The study examines the nature of organisational culture, its main components and culture, its main components and the peculiarities of its (...) formation and maintenance in medical institutions. Organisational culture affects all aspects of business processes and is an important element of corporate identity, in particular in the healthcare sector. healthcare. The authors determine that storytelling as a communication tool has become an important part of business communication and management in recent decades part of business communication and management practice in recent decades. Storytelling can be used to form common values and create meaningful narratives that promote cultural change and support the organisational organisational identity of healthcare facilities. Stories in healthcare facilities reveal the specifics and uniqueness of the organisation, help to distinguish it from competitors from competitors and create a competitive advantage in the market. They form the organisation’s identity and the loyalty of employees and customers. Storytelling has an impact on on the organisational culture of a medical institution, promotes stability and highlights the unique character of the organisation character of the organisation; it allows to form values, beliefs and needs of of employees based on the institution’s mission. Storytelling is important for understanding medical discourse and the system of narratives in healthcare organisations. It supports or discredits official narratives or discredit them, depending on the perception of stakeholders. It is important that storytelling in healthcare facilities is accessible to all stakeholders and promote internal identification and loyalty to the institution. Thus, storytelling is an essential tool for building and maintaining organisational culture in healthcare facilities, helping to create a unique identity and competitive advantage. The article aims to stimulating discussion of the experience of using storytelling and further research of this important aspect of management in the healthcare sector. of healthcare enterprises. (shrink)

The study investigated factors that influence the uptake of maternal healthcare services by women in Zimbabwe, using a logit model. Data from the Zimbabwe Demographic Health Survey (ZDHS, 2015) was used. Deteriorating maternal health indicators motivated the study. The effect of socio-economic and demographic factors on the probability of utilising maternal healthcare services was examined. Descriptive statistics and a logit model were used for data analysis. Results from the logit model show that region of residence, insurance cover, educational (...) level, employment status, maternal age, birth order, place of residence, number of living children, maternal age and household income all influence the utilisation of maternal healthcare services by women in Zimbabwe. Basing on research findings, the study recommends that relevant authorities make more available vocational training centres and education institutions since education was found to influence the uptake of maternal healthcare services. There is need to encourage family planning so as to reduce the number of children, especially among the apostolic sect, which affects the uptake of maternal healthcare. Compulsory national health insurance schemes could be adopted to mitigate the effect of low income that discourages the use of institutional facilities for delivery. The issue of balanced regional development needs to be pursued through accelerating devolution to ensure equal access to maternal healthcare facilities in all provinces. (shrink)

The idea that healthcare should become more person-centred is extremely influential. By using recent English policy developments as a case study, this article aims to critically analyse an important element of person-centred care, namely, the belief that to treat patients as persons is to think that care should be ‘co-produced’ by formal healthcare providers and patients together with unpaid carers and voluntary organizations. I draw on insights from political philosophy to highlight overlooked tensions between co-production and values like (...) equality and liberty. Regarding equality, I argue that co-production compounds both problems of gender inequality in the distribution of care labour and the challenges associated with securing equal access to care. Turning to liberty, I identify important commonalities between co-production and republicanism in political philosophy, given their shared insistence on common citizens’ civic virtue. Then, I use against co-production some liberal arguments against republicanism, to highlight a problem of over-demandingness. In bringing my argument to a close, however, I wish to caution against hastily rejecting co-production as a policy programme. (shrink)

This review aimed at exploring the psychosocial disorders of Nigeria as a nation, its effect on the citizens and the remedy. Psychosocial disorder is a mental illness induced by life experiences, stress, as well as maladaptive cognitive and behavioural processes. The prevalence of these disorders include depression, schizophrenia, anxiety disorders, substance use disorder, personality disorder and autism spectrum disorders have rapidly increase over the past years in Nigeria with its negative impact on the socioeconomic status, psychological well-being; peaceful coexistence and (...) mental health of the entire society. These have precipitated some social anomalies such as bribery and corruption, antisocial behaviour, religious fanaticism, terrorism and so on. The study therefore recommends the need for government to implement effective mental health interventions program that would facilitate easy access to mental healthcare services in Nigeria. There is also an urgent need to improve the mental health awareness of Nigerians through education and public mental health campaign. (shrink)

This paper endeavors to provide an explanation of health and the make-up of healthcare through distributive justice theories and access to the development of capabilities as the basis of a just healthcare structure. It also looks at matters around first level attention in healthcare as fundamental in the development of capabilities and access to functional diversity. It amounts, therefore, to a redefinition of bioethical contractualism, applied at the structure as basis of justice and the capability (...) development. (shrink)

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

Social inequalities abound worldwide. However, those social inequalities that encompass the lack of access to resources, including primary healthcare, are more prevalent at older ages in low- and middle-income countries, which is the focus of this chapter. This challenge has become critical due to the increasing population of older age. The design and implementation of key policy measures, including primary healthcare in low- and middle-income countries, is essential in reducing such social disparities. Access to primary (...) class='Hi'>healthcare is perhaps the principal determinant of social equality and/or equity for older people, which in turn supports achieving Sustainable Development Goals and comprehensive healthcare access. (shrink)

This essay claims that ‘access to justice’ has erroneously been assumed to be synonymous with invisible concepts instead of access to a lawyer’s language. The Paper outlines how a language concerns the relation between signifiers, better known as word-images, on the one hand, with signfieds, better known as concepts, on the other. The signifieds are universal, artificial and empty in content. Taking the Canadian Charter of Rights and Freedoms as an example, officials have assumed that Charter knowledge has (...) involved signifieds (such as rules, principles, doctrines and tests) as if the signifiers were transparent. But any one signifier differs from another signifier without the lawyer ever accessing the invisible signifieds. Ironically, although the lawyer, law professor or law student believes that s/he is studying legal ‘practice’ and although legal knowledge has been considered a matter of signified concepts, the knowledge has really concerned the differentiating relations of signifiers. As a consequence, the moment of accessing the concepts (signifieds) has been forever deferred. ‘Access to justice’ has become access to the special language of signifiers, a language which lawyers alone are privileged to enforce. Turning to the Charter, lawyers claiming to know the special Charter language became indispensable to social life. Even the meaning-constituting human subject became a signifier, better known as ‘the legal person’ defined by Charter rights. Charter language, however, has deferred an access to the invisible concepts such as ‘freedom’ or ‘democracy’, terms in Section of the text. Access to justice’ has become access to the language of the privileged class of lawyers. The lawyer’s language has become a theoretical language in the name of access to justice. And yet, because the theoretical language has been propagated as concerned with ‘practice’, it has been difficult to challenge the social-cultural content of the language of lawyers. (shrink)

The emergence of coronavirus disease (COVID-19) from Wuhan city of China engulfed almost the entire world and created a global pandemic. Several countries declared this pandemic as national emergency, forcing millions of people to go into lockdown. This sudden social isolation has caused enormous disruption of daily routine for the global community, especially children. To minimize the transmission of this virus all the educational institutions were closed and moved to online learning to encourage and adhere to social distancing guidelines issued (...) by the authorities from time to time. This abrupt change in the learning environment, restrictions in social interaction and other activities caused unusual situation in the development of child brain. Therefore, it is important and obligatory for the scientific community and healthcare workers to access and analyse the impact of Covid -19 pandemic on the mental health of children. The present article is a case study and was conducted in Doda of Jammu and Kashmir regarding the impact of quarantine on the children. (shrink)

A pressing issue in Vietnam which is attracting attention from INGOs and the Vietnamese government is out-of-school-children (OOSC). Comparatively with other developing and middle-income countries, Vietnam hosts some of the most impressive educational attainment rates, on par with developed countries, comprising of almost equal gender parity rates, and ‘achieving’ Millennium Development Goal 4 (MDG), universal primary education, ahead of schedule. There are a wide range of historical, social, structural, cultural and economic factors outside the formal education setting which contribute to (...) the OOSC issue in Vietnam. In this assignment I shall conduct an in-depth analysis into the local and social elements, as well as the political, national and international factors which combine to compound the issue. Uneven distribution of state resources mean that children in rural and mountainous areas disproportionately suffer from low quality schooling and rural communities often lack things like healthcare facilities and clean water which affects educational attainment and completion rates. Geographical positioning of industrialised zones has led to 6.7 million people domestically migrating to find work, migrant children are overrepresented in the OOSC statistics, as are the unknown number of stateless children. Child labour is often a realistic alternative to schooling for impoverished families, and another point to be examined is the ethnic minority population, who disproportionately feature in OOSC statistics. This essay will focus on the rising inequality caused in this author’s opinion by structural adjustment reforms carried out in the late 80’s and 90’s to bring Vietnam into the global trading arena, and whilst considering that there are social and cultural issues which factor into the OOSC issue, I will be examining how implementation of a Neoliberal ideology has increased inequality and therefore compounded the OOSC issue by shining a spotlight on the inherent problems of a Neoliberal focus. To contextualise the argument, I will highlight the nationwide benefits that the reforms have granted to the Vietnamese economy and society. I will use the Neoliberal model compared with the Capabilities Approach to explore whether the Neoliberal and human capital perspective of ‘development as increased human capital’ and nationwide economic gains are sufficient when considering development, and when dealing with the most vulnerable in society. I will argue that the current Neoliberal focus of Vietnam and the wider global society is indeed not sufficient to guarantee access to quality education for the poorest in society, and will argue that Vietnam’s perception of ‘achieving’ MDG 4 which focuses on attainment over quality, is simply not enough. (shrink)

The Universal Formula: Solving the Problem of Free Will Through the Law of Balance By Angelito Malicse Introduction The problem of free will has puzzled humanity for centuries, often viewed as a philosophical or metaphysical enigma. This essay presents a universal formula that resolves this dilemma by focusing on the law of karma and the universal law of balance. It explores the interconnectedness of systems, the critical role of accurate knowledge, and the evolution of emotions in maintaining harmony. By examining (...) real-world examples such as overpopulation, environmental degradation, economic instability, and the flaws of capitalism, this essay demonstrates how the universal formula can guide human decision-making to achieve a balanced and sustainable world. The Law of Karma: Systems and Balance The universal formula begins with the law of karma, which extends beyond cause and effect to encompass the integrity of systems, both natural and man-made. Every system—whether ecological, social, or economic—operates according to the universal law of balance. When imbalances arise, the system becomes dysfunctional, leading to adverse consequences. For example, while humans sit at the top of the food chain, the Earth's ecosystem cannot sustain unchecked overpopulation of our species. Overpopulation leads to the destruction of natural resources as humans consume everything, including plants, animals, and even insects. This voracious consumption damages ecosystems, accelerates deforestation, depletes biodiversity, and disrupts the delicate balance of the natural world. To ensure the sustainability of life on Earth, it is crucial to regulate population growth, conserve natural resources, and refrain from exploiting all animals on land and in the sea. By preserving biodiversity and maintaining the integrity of ecosystems, we protect the foundation of life that supports all species, including humans. Free Will and the Dependence on Correct Knowledge Human free will is not an autonomous force but is entirely dependent on correct knowledge and information. Errors in decision-making, often caused by ignorance, false beliefs, and distorted theories, disrupt the balance of systems. For instance, the failure to regulate overpopulation creates cascading problems, including climate change, pollution, and resource depletion. Without accurate knowledge about the consequences of overpopulation, individuals and societies continue to make decisions that exacerbate these imbalances. Education and government policy play vital roles in addressing these issues. Policies that promote population regulation can maintain a sustainable economy, while education fosters awareness of the need to protect ecosystems and biodiversity. Correct information empowers individuals to make decisions that align with the universal law of balance, preventing errors that destabilize systems. The Flaws of Capitalism and the Need for Balance The efficiency of the capitalistic system increases over time, leading to significant flaws if left unchecked. Private companies continually strive to reduce overhead and operating expenses, often by automating processes and replacing human labor with robotics. While this enhances profitability, it also reduces employment opportunities, suppresses wages, and widens income inequality. These principles, central to the management strategies of most private companies, create systemic imbalances in the economy. The solution lies in adopting a mixed economic system that counterbalances the excesses of capitalism with socialist principles. Governments must play a pivotal role in addressing these imbalances by implementing the following measures: Creating High-Salary Government Jobs: These jobs provide stable income and stimulate local economies. Providing Unemployment Benefits or Universal Basic Income (UBI): These measures ensure that individuals who lose jobs due to automation and efficiency gains still have the purchasing power to meet their needs. Offering Free Healthcare and Education: These fundamental services reduce the financial burden on families, enabling them to invest in other areas of life. Promoting Government Spending: By investing in infrastructure, renewable energy, and public services, governments can create new jobs and maintain the flow of money in the economy. Government spending serves as a balancing mechanism by injecting funds into the economy, which in turn supports private companies through increased consumer demand. This feedback loop creates private-sector jobs, stabilizes the economy, and ensures a balanced flow of resources between public and private sectors. The Role of Emotions in Balancing Systems Human emotions, both positive and negative, serve as essential feedback mechanisms for maintaining balance. Positive emotions, such as love and joy, encourage cooperative behavior and strengthen familial and social bonds. Negative emotions, such as fear and anger, signal imbalances that require corrective action. For example, the unconditional love within a family fosters a nurturing environment that supports the emotional and psychological development of children. This foundation contributes to a high-quality next generation of parents, capable of fostering further generational improvement. Conversely, the absence of such love or a dysfunctional family structure often leads to crime, substance abuse, and other societal problems. These negative outcomes are the effects of systemic imbalances, whether caused by poor parenting, economic hardship, or the lack of a government safety net. Addressing Environmental and Social Imbalances The universal formula underscores the importance of a holistic education system in addressing systemic imbalances. Education must instill values such as cleanliness, discipline, ethics, and good manners while fostering a respect for nature. Teaching children the importance of not harming wildlife and preserving ecosystems is critical to protecting biodiversity and ensuring a harmonious coexistence with other species. Government policies also play a crucial role. Regulations that protect natural resources, reduce pollution, and promote renewable energy can prevent environmental degradation. Policies that provide social safety nets can alleviate poverty and reduce crime by addressing the root causes of economic and social imbalance. The Importance of Holistic Systems Thinking The universal formula emphasizes the interconnectedness of systems, demonstrating that imbalances in one area often ripple through others. For instance, a lack of holistic education contributes to ignorance, which leads to poor decision-making. This, in turn, exacerbates issues such as overpopulation, resource depletion, and social unrest. Producing a high-quality young generation requires a combination of good parenting, access to education, and supportive government policies. By fostering an environment that values balance, discipline, and ethics, societies can produce individuals capable of making decisions that align with the universal law of balance. Conclusion The universal formula offers a comprehensive solution to the problem of free will by integrating the law of karma, the universal law of balance, and the evolutionary role of emotions. By understanding and addressing the root causes of imbalance—whether environmental, social, or economic—humanity can achieve harmony within and across systems. Real-world examples, such as overpopulation, economic instability, environmental destruction, and the flaws of capitalism, highlight the urgent need to apply this formula. Through holistic education, informed policies, and an unwavering commitment to balance, individuals and societies can prevent errors, correct existing imbalances, and create a sustainable and harmonious future. The time to act is now. By embracing the universal formula, humanity can unlock the full potential of free will, ensuring a balanced and equitable world for generations to come. ---. (shrink)

The public interest in the administration of justice requires access to justice for all. But access to justice must be “meaningful” access. Meaningful access requires procedures, processes, and institutional structures that facilitate communication among participants and decision-makers and ensure that judges and other decision-makers have the resources they need to render fully informed and sound decisions. Working from that premise, which is based on a reconceptualization of the objectives and methods of the justice process, the author (...) proposes numerous specific changes in decision-making processes and practices. These changes are required to achieve a standard of decision-making that is consistent with the public interest in the administration of justice within a constitutional framework under the social and political conditions of the early 21st century. The essay illustrates the application of the principles and methods of legitecture to analysis of problems of institutional design in law. (shrink)

One fundamental healthcare issue brought to the fore by the current COVID-19 pandemic concerns the scope and nature of the right to healthcare. Given our increasing need for the usually limited healthcare resources, to what extent can we demand provision of these resources as a matter of right? One philosophical way of handling this issue is to clarify the nature of this right. Using the challenges of COVID-19 in the Philippines as the context of analysis, we argue (...) for the view that regards the right to healthcare as fundamentally moral in kind, which should thereby guide its legal and contractual appropriations. In particular, we respond to objections against this view stemming from issues concerning the universality and satisfiability of the right’s correlative duty. We deal with such issues by invoking the relative degree of incumbency of moral rights and the capability-relativity of positive duties. We further contend that as these factors define the scope of the moral right to healthcare, they thus constrain what we can demand as a matter of right to meet our healthcare needs in this time of the pandemic. (shrink)

The access-to-justice movement broadly concerns the extent to which people have the ability to resolve legally actionable problems. To the extent that individuals seek resolution through civil litigation, they can be disadvantaged by their unmet need for legal services, particularly in high-stakes cases and complicated areas of law. In part, this is because legal services and litigation are cost-prohibitive, especially for indigent plaintiffs. As a result, these individuals are priced out of litigation and, by extension, unable to use law (...) to seek justice. I propose an innovative legal intervention to this problem called “compensatory preliminary damages,” which builds from the work of Gideon Parchomovsky and Alex Stein. I argue that preliminary damages should function as compensatory awards for harm to a plaintiff’s ability to access justice, rather than a contingency loan that might make indigent plaintiffs worse off than before if they lose. As compensatory awards, preliminary damages address a defendant’s liability for a plaintiff’s prospective litigation costs that inequitably affect the plaintiff’s ability to access justice. In short, given a suitable connection between the underlying harms of the case and the plaintiff’s resources to meet their legal needs, the litigation costs that plaintiffs must face to litigate should, in some cases, be compensable. To seek such compensation, I propose that plaintiffs would have to plead, among other things, that their alleged injuries have resulted in various barriers to accessing justice, but that the hardship to the plaintiff and the balance of equities favor shifting the cost to access justice onto the defendant. By awarding such damages, courts make plaintiffs whole for harm to their access to justice that is not conditional on a decision after the merits or their final recovery for the injuries alleged. As such, the award would not need to be repaid. -/- . (shrink)

The progress of poverty reduction in Vietnam determined by regions and the education level of the household members. During 2006-2014, the spillover of the poverty reduction polices in Vietnam was transmitted through accessibility to government preferential credit and public healthcare services. Ensuring that rural households were able to approach to immunization can improve their household’s wealth. The aim of the thesis was an assessment of determinants impacted on poverty in Vietnam, captured by the household characteristics, educational attainments, agricultural resources, (...) and regions. The thesis also evaluated the effectiveness of the poverty reduction policy applied by the Vietnamese government. Subsequently, the interaction effects were used to investigate the role of women in the progress of poverty reduction and how the level of regional development influenced on poverty. The results showed that the probability of being poor decreased when households have favorable conditions in term of household characteristics, educational attainment, and regions. Accessibility to government preferential credits reduced the urban household’s poverty, and health care policies were more compatible with rural households. The yielding results of OLS model and probit models were consistent, guaranteed for robust estimation. The interaction effects showed the effectiveness of policy variables to the corresponding beneficiaries, but the proxies of government agriculture support were insignificant. Further research is recommended to use alternative proxies to have a better evaluation on the poverty reduction policies. (shrink)

This book provides answers to the questions that biomedical and biotechnological research has posed to our societies by proposing the introduction of biorights. It shows how bioscience affects our individual and social lives by discussing and answering important questions such as; Are we becoming more vulnerable and unable to protect ourselves? How can we ensure fairness and justice with regards to the access to health care? Are human dignity, autonomy and equality at risk? Do we need new and special (...) rights: neurorights, genetic rights? What is the meaning and scope of the right to life, health, privacy or non-discrimination? Biorights are the suggested solution for dealing with these challenges. Healthcare professionals, bio-researchers, policy makers, scholars, and citizens will, in this book, find a guide to knowing how bioscience affects our lives. Furthermore, this book provides a comprehensive method for biomedical and biotechnological decision-making that comprises human or basic rights dimensions alongside technical and ethical dimensions. (shrink)

In this paper, I argue that content externalism and privileged access are compatible, but that one can, in a sense, have privileged access to the world. The supposedly absurd conclusion should be embraced.

ABSTRACT Many recent articles argue that participants who seroconvert during HIV prevention trials deserve treatment when they develop AIDS, and there is a general consensus that the participants in HIV/aids treatment trials should have continuing post‐trial access. As a result, the primary concern of many ethicists and activists has shifted from justifying an obligation to treat trial participants, to working out mechanisms through which treatment could be provided. In this paper I argue that this shift frequently conceals an important (...) assumption: that if there is an obligation to supply treatment, then any party who could provide it may be prevailed upon to discharge the obligation. This assumption is false. The reasons why trial participants should get ART affect who has the duty to provide it. We should not burden governments with the obligations of sponsors, nor researchers with the obligations of the international community. And we should not deprive a group of treatment because their need is less salient than that of research participants. Insisting otherwise may lead to people being wrongfully deprived of access to antiretrovirals. (shrink)

Broadening access to both computational and educational resources is crit- ical to diffusing machine learning (ML) innovation. However, today, most ML resources and experts are siloed in a few countries and organizations. In this article, we describe our pedagogical approach to increasing access to applied ML through a massive open online course (MOOC) on Tiny Machine Learning (TinyML). We suggest that TinyML, applied ML on resource-constrained embedded devices, is an attractive means to widen access because TinyML leverages (...) low-cost and globally accessible hardware and encourages the development of complete, self-contained applications, from data collection to deployment. To this end, a collaboration between academia and industry produced a four part MOOC that provides application-oriented instruction on how to develop solutions using TinyML. The series is openly available on the edX MOOC platform, has no prerequisites beyond basic programming, and is designed for global learners from a variety of backgrounds. It introduces real-world applications, ML algorithms, data-set engineering, and the ethi- cal considerations of these technologies through hands-on programming and deployment of TinyML applications in both the cloud and on their own microcontrollers. To facili- tate continued learning, community building, and collaboration beyond the courses, we launched a standalone website, a forum, a chat, and an optional course-project com- petition. We also open-sourced the course materials, hoping they will inspire the next generation of ML practitioners and educators and further broaden access to cutting-edge ML technologies. (shrink)

Should involuntarily childless people have the sameopportunities to access parenthood as those who are not involuntarily childless? In the context of assisted reproductive technologies, affirmative answers to this question are often cashed out in terms of positive rights, including rights to third-party reproduction. In this paper, wecritically explore the scope and extent to which any such right would hold up morally. Ultimately, we argue for a departure away from positive parental rights. Instead, we argue that the state has an (...) imperfect duty to benefit involuntarily childless people in relation to their parental aspirations. (shrink)

An issue about the privacy of the clustered groups designed by algorithms arises when attempts are made to access certain pieces of information about those groups that would likely be used to harm them. Therefore, limitations must be imposed regarding accessing such information about clustered groups. In the discourse on group privacy, it is argued that the right to privacy of such groups should be recognised to respect group privacy, protecting clustered groups against discrimination. According to this viewpoint, this (...) right places a duty on others, for example, private companies, institutions, and governments, to refrain from accessing such information. To defend the idea that the right to privacy should be recognised for clustered groups, at least two requirements must be satisfied. First, clustered group privacy must be conceived of as either a collective good or a participatory good. Since these forms of good are of the type from which no member of a group can be excluded from benefiting, the right to them is defined as a group right. Second, there must be group interests on which to base a group right. Group interests can be either the interests of those members that are a result of their being in the group or the interests of the group as a whole that transcend the interests of its members. However, this paper argues that clustered group privacy cannot be conceived of as either a collective or a participatory good because it is possible for some individuals to be excluded from benefiting from it. Furthermore, due to the lack of awareness among individuals that they are members of a clustered group and the nature of a clustered group itself, such groups cannot have the group interests necessary to establish a group right. Hence, the group right to privacy cannot be recognised for these groups, implying that the group right cannot be considered a means to protect clustered groups against discrimination. Instead, this paper suggests that moral principles need to be articulated within an ethics of vulnerability to identify the moral obligations of protecting vulnerable clustered groups. The duty owed to the vulnerable should involve refraining from accessing certain information about clustered groups in specific contexts. This duty is not engendered by the right to privacy of such groups; it is the duty owed to the vulnerable. The findings highlight the need to articulate moral principles regarding privacy and data protection to protect clustered groups in contexts in which accessing information about them could constitute a reason for discriminatory targeting. (shrink)

In Québec, the Act Respecting Access to Documents Held by Public Bodies and the Protection of Personal Information provides an exception to transparency to most public institutions where public health research is conducted by allowing them to not disclose their uses of personal data. This exceptionalism is ethically problematic due to important concerns and we argue that all those who conduct research should be transparent and accountable for the work they do in the public interest.

In this paper we introduce two issues relevantly related to the cognitive phenomenology debate, which, to our minds, have not been yet properly addressed: the relation between access and phenomenal consciousness in cognition and the relation between conscious thought and inner speech. In the first case, we ask for an explanation of how we have access to thought contents, and in the second case, an explanation of why is inner speech so pervasive in our conscious thinking. We discuss (...) the prospects of explanation for both sides of the debate and argue that cognitive phenomenology defenders are in an overall advantageous position. We also propose an account of inner speech that differs from other influential explanations in some interesting respects. (shrink)