A recent study dealing with Western European countries suggests a connection between vaccine skepticism and support for populist parties (Kennedy 2019). Of all countries in the study, Italy scored highest on both counts, with 44% of the electorate voting for populists in 2014 and 14% of the population not deeming vaccinations important. The study concludes that both phenomena have a common root in the distrust of elite and experts. While that seems plausible, this paper establishes that there is much more (...) to be said about the relation between populism and the anti-vaccination movement. Using the case study of the Italian anti-vaxxers, I spell out how populists have reinforced an echo chamber in an effort to mobilize it. I argue that besides the common root cause, in this instance there is also indication of a causal relation between populism and anti-vaccination. Moreover, I show that populism and echo chambers in general are conceptually linked through their dichotomous division of society and rejection of legitimate opposition. (shrink)

Discussions about the extended mind have ‘extended’ in various directions in the last decades. While applied to other aspects of human cognition and even consciousness, the extended-mind hypothesis has also been criticized, as it questions fundamental ideas such as the image of a dual world, divided between an external and an internal domain by the border of ‘skin and skull’, the idea of a localized and constant decision center, and the role of internal representations. We suggest that the main virtue (...) of the hypothesis is not as a theory per se, but as a vaccine against persistent metaphysical prejudices about the mind’s structure, functions and borders. Being an hypothesis about the most efficient ways to combine resources and problems, and not a theory about the mind’s a-priori constitution, the extended mind view moves the focus from ontology to pragmatics and helps purify philosophy of mind from metaphysical remainders. (shrink)

Comme tous les autres projets humains, les politiques de santé publique sont souvent affectées par des imperfections et des erreurs. Cependant, elles sont mieux ancrées dans les résultats de la recherche scientifique que d’autres actions humaines en général, et politiques gouvernementales en particulier. D’une manière générale, les données sur lesquelles reposent les politiques de santé publique remplissent les conditions suivantes : méthodes de recherche rigoureuses, tests indépendants et précis, reproductibilité des résultats, mesure du taux d’erreur, capacité à écarter des hypothèses (...) rivales et un degré d’acceptation satisfaisant au sein de la communauté scientifique. Les politiques de santé publique comprennent des campagnes de vaccination de la population, en particulier des enfants. Ces actions de vaccination sont considérées comme sûres et efficaces par les institutions publiques, les organisations de santé, les médecins et les chercheurs en santé. Malgré cela, un nombre croissant de parents choisit de ne pas vacciner leurs enfants. Les fausse nouvelles sur les vaccins publiées dans les médias, en particulier dans les nouveaux médias, par les influenceurs, ont contribué certainement à cette tendance. Ces influenceurs sont insuffisamment qualifiés ou totalement non qualifiés pour commenter l’innocuité et l’efficacité des vaccins dans les médias. Par conséquent, ils ne peuvent pas produire des données fiables et des opinions qualifiées, c’est-à-dire des informations indépendantes, précises, pertinentes, fiables et complètes. Cependant, ces influenceurs parviennent à influencer, dans une large mesure, le comportement des parents en matière de vaccination. La stratégie de lutte contre les fausses nouvelles en publiant des preuves contraires est évidemment nécessaire, mais pas suffisante parce que beaucoup de fausses infos sur les vaccins fonctionnent comme des mythes. Etant fixées d’une manière partiellement irrationnelle, les mythes anti-vaccination ne peuvent être démystifiés seulement avec les dernières preuves scientifiques. C’est pourquoi il est nécessaire d’envisager des stratégies de relations publiques capables d’influencer des opinions collectives irrationnelles. (shrink)

The fact that Internet companies may record our personal data and track our online behavior for commercial or political purpose has emphasized aspects related to online privacy. This has also led to the development of search engines that promise no tracking and privacy. Search engines also have a major role in spreading low-quality health information such as that of anti-vaccine websites. This study investigates the relationship between search engines’ approach to privacy and the scientific quality of the information they (...) return. We analyzed the first 30 webpages returned searching “vaccines autism” in English, Spanish, Italian, and French. The results show that not only “alternative” search engines but also other commercial engines often return more anti-vaccine pages (10–53%) than Google (0%). Some localized versions of Google, however, returned more anti-vaccine webpages (up to 10%) than Google. Health information returned by search engines has an impact on public health and, specifically, in the acceptance of vaccines. The issue of information quality when seeking information for making health-related decisions also impact the ethical aspect represented by the right to an informed consent. Our study suggests that designing a search engine that is privacy savvy and avoids issues with filter bubbles that can result from user-tracking is necessary but insufficient; instead, mechanisms should be developed to test search engines from the perspective of information quality (particularly for health-related webpages) before they can be deemed trustworthy providers of public health information. (shrink)

This paper analyzes the case of public anti-vaccine campaigns and examines whether there may be a normative case for placing limitations on public speech of this type on harm principle grounds. It suggests that there is such a case; outlines a framework for when this case applies; and considers seven objections to the case for limitation. While not definitive, the case that some limitation should be placed on empirically false and harmful speech is stronger than it at first appears.

C. Thi Nguyen's (2020) recent account of echo chambers as social epistemic structures that actively exclude outsiders’ voices has sparked debate on the connection between echo chambers and epistemic injustice (Santos 2021; Catala 2021; Elzinga 2021).In this paper I am mainly concerned with the connection between echo chambers and testimonial injustice, understood as an instance whereby a speaker receives less epistemic credibility than they deserve, due to a prejudice in the hearer (Fricker 2007). In her reconstruction of the types of (...) testimonial injustice, Catala implicitly equates incidental testimonial injustice as resulting from epistemic prejudice and systematic testimonial injustice as resulting from identity prejudice. As I will argue, there as certain cases that fall in between these interpretations, namely instances of incidental testimonial injustice, whereby the impact on the speaker is localized, but where the credibility deficit nevertheless results from identity prejudice. One example of how this can manifest is the structural distrust against health-care experts in anti-vaccination echo-chambers, wherein said experts’ testimony is dismissed due to unwarranted assumptions regarding their motives qua their social type. To understand the importance and severity of the testimonial injustices in echo chambers, we need to look beyond the specific harms that are done to the targeted speakers and the immediate loss of knowledge, but also take into account the consequences for fairness in public deliberation—the latter being a fundamental condition for procedural democratic legitimacy. (shrink)

Should the government censor dangerous anti-vaccination propoganda? Should it restrict the praise of terrorist groups, or speech intended to promote discriminatory attitudes? In other words, should the government curb the advocacy of dangerous ideas and actions (i.e. 'harmful advocacy'), or should the government take a more permissive approach? Strong free speech supporters argue that citizens should be free to engage in and to hear harmful advocacy, arguing that restrictions are deeply objectionable at best, and, at worst, wholly impermissible. (...) To support their position, strong free speech supporters have offered a wide range of arguments and ideas. One of the most interesting arguments revolves around the idea that restrictions on harmful advocacy are deeply insulting to citizens. The worry, broadly understood, is that this kind of censorship is demeaning, treats citizens as though they are stupid, or as though they are children. As such, even when censorship is effective in preventing harms to citizens, it nonetheless comes at the significant political cost of failing to properly respect the citizenry at large. By contrast, so the thought goes, an alternative political scheme that prohibits censorship, or permits it only in exceptional cases, does a better job of respecting citizens as independent, rational, morally responsible agents. This alternative political system may, sometimes, be less effective at preventing speech harms. But it is a political system where citizens can stand tall and hold their heads high. In this paper, I consider and reject three versions of the worry that censorship is insulting. §1 explores the idea that censorship is insulting qua involving a negative appraisal of the citizens being interfered with. The key idea here is that censorship involves a lack of what Stephen Darwall terms ‘appraisal respect’, insofar as the government is suggesting that citizens cannot be trusted to manage their own beliefs and intentions. Drawing on the work of Thomas Nagel, §2 explores the idea that censorship diminishes the political status of citizens. Finally, §3 explores the suggestion that censorship is incompatible with a full appreciation of the thinking nature of citizens, and thus involves a lack of what Darwall would term ‘recognition respect’. The paper argues that censorship is not necessarily premised upon an insulting view of the citizenry. On the contrary, it argues that the best kind of censorship stems from a rich appreciation of the diverse range of capabilities, needs, vulnerabilities, and responsibilities of citizens, as well as the need for co-operation between citizens if societal flourishing is going to be achieved on a large scale. Granted, such a vision places an emphasis on the imperfections and liabilities of citizens – at least when compared to the rather solitary, highly intellectual creature one sometimes finds in the philosophical literature. Still, such a vision of citizens as imperfect falls well short of being genuinely insulting. To err is human. And there’s nothing insulting about being treated like a human. (shrink)

Virtue signaling—using public moral discourse to enhance one’s moral reputation—is a familiar concept. But, what about profile pictures framed by “Vaccines work!”? Or memes posted to anti-vaccine groups echoing the group’s view that “Only sheep believe Big Pharma!”? These actions don’t express moral views—both claims are empirical (if imprecise). Nevertheless, they serve a similar purpose: to influence the judgments of their audience. But, where rainbow profiles guide their audience to view the agent as morally good, these acts guide their (...) audience to view the agent as epistemically good. They are instances of epistemic virtue signaling. The first goal of this paper is to offer an account of epistemic virtue signaling. I argue that epistemic virtue signaling occurs through both behavioral and propositional signals, and serves purposes similar to those of moral virtue signaling across a wide variety of discourses. The second is to show that there is much work for this concept to do. In particular, this concept illuminates a double bind faced by those who suffer from and seek to overcome testimonial injustice. I close by demonstrating how this double bind arises in the dissolution of medical autonomy, focusing on the care gap faced by pregnant women of color in the United States today, as compared with their white counterparts. (shrink)

The declaration of the COVID-19 pandemic by the World Health Organization on March 11, 2020, led to unprecedented events. All regions of the world participated in implementing preventive health measures such as physical distancing, travel restrictions, self-isolation, quarantines, and facility closures. The pandemic started global disruption of socio-economic systems, covering the postponement or cancellation of public events, supply shortages, schools and universities’ closure, evacuation of foreign citizens, a rise in unemployment and inflation, misinformation, the anti-vaccine movement, and incidents of (...) discrimination toward people affected by or suspected of having coronavirus disease. Attempts have been made to protect the oldest age group at risk, but in many cases, this has led to over-restriction and age discrimination. The rationale for working on the Research Topic "Socio-economic systems in the post-pandemic world: Design thinking, strategic planning, management, and public policy" was the need to start reflecting on resilience and lessons learned from this public health event that revealed the global unpreparedness in critical areas. Also, the pandemic triggered both top-down and bottom-up responses that needed more in-depth analyzes. This Research Topic covers interdisciplinary contributions addressing new thinking, challenges, and transformations required for post-pandemic global, national, regional, and local realities. The presented Research Topic combines studies focused on recognizing the actions and interventions leading to the recovery of socio-economic systems during the tail end and after the pandemic. The studies delivered recommendations regarding, among others, the care of vulnerable, planning socio-economic restart, and imagining the "new normal.". (shrink)

The continuing rejection of anthropogenic global warming by non-experts despite overwhelming scientific consensus is rationally untenable and best described as “pseudoskeptical;” it is akin to AIDS denialism, the advocacy of intelligent design, and anti-vaccination movements.

Eyal et al have recently argued that researchers should consider conducting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) human challenge studies to hasten vaccine development. We have conducted (J. L.) and overseen (L. D.) human challenge studies and agree that they can be useful in developing anti-infective agents. We also agree that adults can autonomously choose to undergo risks with no prospect of direct benefit to themselves. However, we disagree that SARS-CoV-2 challenge studies are ethically appropriate at this time, (...) for 3 reasons: (1) current scientific knowledge of SARS-CoV-2 infection is insufficient to manage risks; (2) autonomous decision making, while necessary, does not override concerns about risk; and (3) undertaking challenge studies now would imperil confidence in the research enterprise, potentially undermining the global response to the coronavirus disease 2019 (COVID-19) pandemic. (shrink)

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

According to psychological research, people are more eager to help identified individuals than unidentified ones. This phenomenon significantly influences many important decisions, both individual and public, regarding, for example, vaccinations or the distribution of healthcare resources. This paper aims at presenting definitions of various levels of identifiability as well as a critical analysis of the main philosophical arguments regarding the normative significance of the identifiability effect, which refer to: (1) ex ante contractualism; (2) fair distribution of chances and risks; (3) (...) anti-aggregationist principles that recommend the distribution of bad effects and the concentration of good ones. I will show that these arguments, although connected with interesting philosophical problems regarding e.g. counterfactuals, aggregation, or probability, are unconvincing. (shrink)

Current COVID-19 pandemic and previous SARS/MERS outbreaks have caused a series of major crises to global public health. We must integrate the large and exponentially growing amount of heterogeneous coronavirus data to better understand coronaviruses and associated disease mechanisms, in the interest of developing effective and safe vaccines and drugs. Ontologies have emerged to play an important role in standard knowledge and data representation, integration, sharing, and analysis. We have initiated the development of the community-based Coronavirus Infectious Disease Ontology (CIDO). (...) As an Open Biomedical Ontology (OBO) library ontology, CIDO is an open source and interoperable with other existing OBO ontologies. In this article, the general architecture and the design patterns of the CIDO are introduced, CIDO representation of coronaviruses, phenotypes, anti-coronavirus drugs and medical devices (e.g. ventilators) are illustrated, and an application of CIDO implemented to identify repurposable drug candidates for effective and safe COVID-19 treatment is presented. (shrink)

ABSTRACT: A report on the pioneering of a new pedagogy designed to challenge students to use and improve their memory, increase their awareness of logical fallacies and tacitly embedded contradiction(s) and sensitize them to the deeply symbolic nature of thought in all its expressions (math, logos, music, picture and motor skills), as created, by the author, from in situ research at a senior level (ESL) course in Storytelling at one of East Asia’s premiere second languages university, and from teaching children (...) in several university summer programs. -/- As a Visiting Professor of Foreign Languages, I recently had a glorious opportunity to innovate curriculum and teaching techniques in an East Asian university classroom. Under the auspices of teaching senior level thematic courses in English as a Foreign Language, or more specifically, “storytelling,” I was blessed with the opportunity to innovate both on the level of curriculum and pedagogy. -/- But let me backtrack to set up my story from the start. All of this began in a children’s ESL class at a private language institute where I was given some newly formed intermediate level English classes for middle school students on a new campus that had yet to form a library. While waiting for my standard textbooks to arrive I began innovating with one of my own childrens’ stories titled The Tale of the Purple People Eater (a three page mythic story written in the late 90s. Please see appendix). In working with this story, because I envisioned presenting it orally (from memory) at first as a way to introduce students to memory arts exercises, I was compelled to read it over many times, which, to my surprise revealed a troubling feature: it was riddled with contradictions in every paragraph. At any rate, with the middle school aged students I only touched on this feature very briefly and focused more on language acquisition exercises. The tale nevertheless impressed upon me this bizarre aspect of language where a story can appear naturally cogent on the surface, but can also come apart at the seems if taken “literally.” Hence, later while teaching Storytelling in university with a rather dry textbook, I was invited to supplement the class with exercises of my own. Here I was curious to try work shopping the ‘Tale of The Purple People Eater’ with young adults. This involved three stages: 1) Memory work — or engaging with the unpublished story orally; 2) Exploring the contradictory nature of language and thought; 3) Probing the “deeply-symbolic” nature of meaning. -/- Of course, all of these levels have a long history of precedence in our civilization. Memory arts — though defunct now — had been highly developed in the ancient world, not least among bards who performed oral recitations from memory of the entire Illiad and Odyssey. Dialectics — now transmuted into the debate for show and prizes — had a deeper epistemological mission to discover truth and achieve enlightenment (i.e. Socrates, Boethius and St-Augustine). And if it could not be done via contradictory-prone rationality, it would do it by re-attaching or re-membering broken meanings via the sym-bol (“throwing together”), as per our lineage of platonic poets who created a world compelling enough to make us ask where Jesus went during his (underworld journey) three days in the crypt? Or, and, on what terrain did Dante travel? -/- Lets look at all three: Memory work can be very simple: it amounts to an oral recitation of the story in class followed by a homework assignment wherein the students are asked to reproduce the story (in writing) from memory. They can then compare ‘notes’ in class and by working in groups attempt to produce one version per group of the story in question. In this way we invite them to engage with ‘live’ stories as did our oral-history ancestors. Likewise, by writing it down (“for the first time”) they are re-living the act of our first bardic writer(s) who wove together a collection of competing versions of a popular legend to produce a standard. Very primal work! If Plato thought that writing meant the end of memory in his time, imagine what smart phones are doing to memory now. Contradictions too are easy to work with. It suffices to project a written version of the teacher’s story on the classroom screen — no note taking! — and let students have ample time to read it over and over, at first to check with their own memorized version, and later to seek out logical contradictions in the prose. Any way to ‘repair’ the story? Does it lose credibility because of contradictions? Can it be real without being true? Can it be true without being real? Do reality (L. res = matter) and truth (Gk. a-leithea = un-forgetting) etymologically speaking, share the same domain? -/- Further, if below the surface-meaning the story falls apart, its apparent mythical meaning immediately is called into question. This is a good time to ask the students to propose a (deeper) interpretation. On the surface, the obvious meaning of the Tale of the Purple People Eater, a world in which a purple ogre predatorily feasted on the purple race of the United Peoples of Benetton (a multi-racial nation representing every “skin colour of the rainbow”), revolves around racism, and indeed everyone save for one, thought the story was about racism. -/- I, the author, had the challenge of discovering the deeper meaning of my own story. Because it was written inspirationally one morning, the way we might record the memory of a dream from the night before in a journal, I also was ignorant of the story’s meaning. As luck would have it, a few days before I was to give my class feedback on their interpretations, a meditation on the color “purple” led to the book “The Color Purple” which I first heard of from a friend who, in my reply to a question about the book she was reading (in 1985), summarized it succinctly in one sentence about a black woman’s sexual awakening and liberation. I quickly got the book from the university library as well as the film which I viewed several times before my next class. -/- To my utter amazement, after reading the Tale of the Purple People Eater in light of the Color Purple and adjusting the meaning of color in the tale from the color of people’s complexion to the “color of people’s souls” (to commensurate with the film) as depicted in their clothing and other accoutrements (e.g. automobiles) as reflective of the “health of their souls” (white for revolt, purple for majesty, etc…) where the enslaved Celie is surrounded by drab lifeless colors in the beginning of the film in contrast to the liberated woman she has become in the end of the story symbolized by the extraordinary intensity of the purple shawl that bedecks her like an African queen, the tale can be considered, in part, as a kind of back story of the inner evolution of the book’s and film’s protagonist. -/- Many other cross-polenised metaphors come to the fore: Hippocrates in the tale is the mail man in the film; St-Yves anti-ageing gel is a metaphor for remaining in “childhood (sexual) slavery”; the Ex-Thrax vaccine is the spiritual laxative in the form of letters from Africa (from Ex-Lax and Thrace, a “wild place”) that eases Celie out of her yoke; the egg-shaped conference table with the pointy end in the tale is the kitchen table in the last meeting where Celie threatens her husband with the pointy end of the knife in the film… -/- Of course, the students could not be expected to decode the meaning of a story of this nature whose collective unconscious connotations the author himself had to go to great lengths to excavate almost like a detective of the subconscious. What was important here was the shared engagement between mind and narrative and how it acted as a vehicle for 1) re-membering, 2) becoming aware that all language is a metaphorical cover and 3) that the deep symbol and fused metaphor are divided not by external time and space but by external reality (in the Latin sense, res) and internal truth (in the Greek sense, aleithea). Myth then, in its highest meaning is a hybrid form (of these two) of narrative. Hence both parts real and true. (shrink)

Introduction: Universal health coverage (UHC) was introduced in Iran in 2014. The aim of this study was to evaluate the usage rate of health services by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients after UHC implementation. Material and methods: In 2018, in a cross-sectional study, we evaluated the outpatients’ needs (within its previous month) and inpatients’ needs (within its previous 6 months) of HIV/AIDS patients in Isfahan province (the center of Iran). Concurrently, we estimated the essential health care services (...) that HIV/AIDS patients have to receive regularly, including vaccination for hepatitis B, measurement of CD4, tuberculosis (TB) assessments and TB treatment, anti-retroviral therapy, examination of viral load, treatment approach, and drug side effects counseling. Two checklists were used for assessing the utilization of health services and essential health cares for HIV/AIDS patients, validated by the Ministry of Health and Medical Education of Iran. Data were analyzed by χ2 test, Pearson’s correlation coefficient, and Spearman’s correlation test. Results: Two hundred and thirteen HIV/AIDS patients completed the questionnaires. The mean age of participants was 41.14 ± 9.23. The outpatient service utilization rate was 31.94% in the previous month and the rate of hospitalization was 126 per 1,000 HIV/AIDS patients in the previous 6 months. The majority of HIV/AIDS patients received essential health services more often than the national standard goals estimation. Conclusions: After UHC implementation, the utilization rate of outpatients and inpatients services in HIV/AIDS patients was more than similar indices in the general population. In addition, HIV/AIDS patients received essential health services adequately. (shrink)

COVID-19 vaccine refusal seems like a paradigm case of irrationality. Vaccines are supposed to be the best way to get us out of the COVID-19 pandemic. And yet many people believe that they should not be vaccinated even though they are dissatisfied with the current situation. In this paper, we analyze COVID-19 vaccine refusal with the tools of contemporary philosophical theories of responsibility and rationality. The main outcome of this analysis is that many vaccine-refusers are responsible for the belief that (...) they should not be vaccinated and epistemically rational in holding it. This is an important result because it provides insights into the legitimacy of certain public health policies. In particular, this result shows that a public health policy that would abandon the project of convincing certain vaccine-refusers with reasons – e.g., by simply making vaccination compulsory – is prima facie illegitimate. (shrink)

Preventive vaccination can protect not just vaccinated individuals, but also others, which is often a central point in discussions about vaccination. To date, there has been no systematic study of self- and other-directed motives behind vaccination. This article has two major goals: first, to examine and distinguish between self- and other-directed motives behind vaccination, especially with regard to vaccinating for the sake of third parties, and second, to explore some ways in which this approach can help (...) to clarify and guide vaccination debates and policy. I propose conceiving of vaccination in terms of three basic elements: the vaccination decision-maker, the vaccine recipient and the primary beneficiary. I develop a taxonomy based on the relations between these elements to distinguish four kinds of vaccination: self-protective, paternalistic, altruistic and indirect. I finally discuss the case of human papillomavirus vaccine regulation for men and women to show how each kind of vaccination is associated with and raises specific ethical questions. (shrink)

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

We ask whether it is reasonable to delay or refuse to take COVID-19 vaccines that have been shown in clinical trials to be safe and effective against infectious diseases. We consider two kinds of vaccine hesitancy. The first is geared to scientifically informed open questions about vaccines. We argue that in cases where the data is not representative of relevant groups, such as pregnant women and ethnic minorities, hesitancy can be reasonable on epistemic grounds. However, we argue that hesitancy is (...) not reasonable if a vaccine has passed well-conducted clinical trials. The second kind of hesitancy is to do with beliefs about the institutions offering a successfully trialled vaccine and the justifiability of cooperating with those institutions. For example, in the UK, distrust of the UK Government or the National Health Service is identified as a factor in the vaccine hesitancy of minority ethnic populations. We ask whether this sort of hesitation is reasonable given normative requirements of fair co-operation, both with those institutions and the wider population. We suggest that the answer is not straightforward. Sometimes the hesitation is unreasonable but understandable. -/- . (shrink)

This article argues that non-consensual vaccination is morally impermissible, for the same reasons for which sexual assault is not permissible. Likewise, mandatory vaccination is morally akin to sexual harassment, and therefore is not to be allowed.

Vaccination can protect vaccinated individuals and often also prevent them from spreading disease to other people. This opens up the possibility of getting vaccinated for the sake of others. In fact, altruistic vaccination has recently been conceptualized as a kind of vaccination that is undertaken primary for the benefit of others. In order to better understand the potential role of altruistic motives in people’s vaccination decisions, we conducted two focus group studies with a total of 37 (...) participants. Study 1 included three focus groups on the subject of HPV vaccination for boys. Study 2 included three focus groups on the subject of pertussis and measles vaccination for childcare workers. We found substantial evidence of other-regarding motives across all focus groups, which suggests that altruistic motives could be an important factor when it comes to people’s vaccination decisions. We address the significance of these findings for vaccination policy surrounding HPV vaccination for boys and vaccination for childcare workers. We also extend the findings to normative work on vaccination for the sake of others more generally. (shrink)

Vaccine research, as well as the development, testing, clinical trials, and commercial uses of vaccines involve complex processes with various biological data that include gene and protein expression, analysis of molecular and cellular interactions, study of tissue and whole body responses, and extensive epidemiological modeling. Although many data resources are available to meet different aspects of vaccine needs, it remains a challenge how we are to standardize vaccine annotation, integrate data about varied vaccine types and resources, and support advanced vaccine (...) data analysis and inference. To address these problems, the community-based Vaccine Ontology (VO) has been developed through collaboration with vaccine researchers and many national and international centers and programs, including the National Center for Biomedical Ontology (NCBO), the Infectious Disease Ontology (IDO) Initiative, and the Ontology for Biomedical Investigations (OBI). VO utilizes the Basic Formal Ontology (BFO) as the top ontology and the Relation Ontology (RO) for definition of term relationships. VO is represented in the Web Ontology Language (OWL) and edited using the Protégé-OWL. Currently VO contains more than 2000 terms and relationships. VO emphasizes on classification of vaccines and vaccine components, vaccine quality and phenotypes, and host immune response to vaccines. These reflect different aspects of vaccine composition and biology and can thus be used to model individual vaccines. More than 200 licensed vaccines and many vaccine candidates in research or clinical trials have been modeled in VO. VO is being used for vaccine literature mining through collaboration with the National Center for Integrative Biomedical Informatics (NCIBI). Multiple VO applications will be presented. (shrink)

In this article, we aim to map out the complexities which characterise debates about the ethics of vaccine distribution, particularly those surrounding the distribution of the COVID-19 vaccine. In doing so, we distinguish three general principles which might be used to distribute goods and two ambiguities in how one might wish to spell them out. We then argue that we can understand actual debates around the COVID-19 vaccine – including those over prioritising vaccinating the most vulnerable – as reflecting disagreements (...) over these principles. Finally, we shift our attention away from traditional discussions of distributive justice, highlighting the importance of concerns about risk imposition, special duties, and social roles in explaining debates over the COVID-19 vaccine. We conclude that the normative complexity this article highlights deepens the need for decision-making bodies to be sensitive to public input. (shrink)

Anti-exceptionalism about logic is the thesis that logic is not special. In this paper, I consider, and reject, a challenge to this thesis. According to this challenge, there are basic logical principles, and part of what makes such principles basic is that they are epistemically exceptional. Thus, according to this challenge, the existence of basic logical principles provides reason to reject anti-exceptionalism about logic. I argue that this challenge fails, and that the exceptionalist positions motivated by it are (...) thus unfounded. I make this case by disambiguating two senses of ‘basic’ and showing that, once this disambiguation is taken into account, the best reason we have for thinking that there are basic principles actually implies that those principles do not require a special epistemology. Consequently, the existence of basic logical principles provides reason to accept, rather than reject, anti-exceptionalism concerning the epistemology of logic. I conclude by explaining how an abductivist, anti-exceptionalist approach to the epistemology of logic can accommodate the notion of basic logical principles. (shrink)

Since the outbreak of the Coronavirus disease 2019 (Covid-19), tremendous efforts have been made by scientists, health professionals, business people, politicians, and laypeople around the world. Covid-19 vaccines are one of the most crucial innovations that help fight against the virus. This paper attempts to revisit the Covid-19 vaccines production process by employing the serendipity-mindsponge-3D creativity management theory. Vaccine production can be considered an information process and classified into three main stages. The first stage involved the processes of absorbing information (...) (e.g., digital data and open science) and rejecting unhelpful information (e.g., misinformation and fake news) for effectively acquiring useful insights. Useful insights were later employed by experts, enterprises, governments, and international organizations through interdisciplinary coordinated efforts for developing vaccines within a short period. Finally, the appearance of multiple types of vaccines enabled more strategic options for vaccine distribution and administration. Findings from this vaccine creativity management process could be used as critical lessons for further improvements of vaccination programs. (shrink)

It is widely accepted that a liberal state has a general duty to protect its people from undue health risks. However, the unprecedented emergent measures against the COVID-19 pandemic taken by governments worldwide give rise to questions regarding the extent to which this duty may be used to justify suspending a vaccine rollout on marginal safety grounds. -/- In this chapter, I use the case of vaccination to argue that while a liberal state has a general duty to protect (...) its people’s health, there is a limit to the measures this duty can be used to justify. First, I argue that since every available option involves different risks and benefits, the incommensurability of the involved risks and benefits forbids the prioritisation of a particular vaccine. Second, I argue that given epistemic limitations and uncertainty, policies that favour certain vaccines are not only epistemically ill-founded but also morally unacceptable. I conclude that in a highly uncertain situation such as the unfolding pandemic, the duty a liberal state ought to uphold is to properly communicate the knowns and unknowns to the general public and help people decide which option to choose for themselves. I call this duty the duty to facilitate risk-taking. (shrink)

A short piece exploring some arguments for mandating vaccination for Covid-19.

This paper suggests two ideas. The first boils down to a meta-ethical thesis that in situations of “crisis” (such as the ongoing pandemic), the language is among the first to die as a system of rational agreement. Another idea is that radical attitudes, specifically pro and contra attitudes, still can be represented sensibly. The author illustrates this thesis in examples of Kant and Mill’s classical ethical theories.

Proponents of vaccine mandates typically claim that everyone who can be vaccinated has a moral or ethical obligation to do so for the sake of those who cannot be vaccinated, or in the interest of public health. I evaluate several previously undertheorised premises implicit to the ‘obligation to vaccinate’ type of arguments and show that the general conclusion is false: there is neither a moral obligation to vaccinate nor a sound ethical basis to mandate vaccination under any circumstances, even (...) for hypothetical vaccines that are medically risk-free. Agent autonomy with respect to self-constitution has absolute normative priority over reduction or elimination of the associated risks to life. In practical terms, mandatory vaccination amounts to discrimination against healthy, innate biological characteristics, which goes against the established ethical norms and is also defeasible a priori. (shrink)

As is the case in other situations of deep uncertainty, the unknowns related to the COVID-19 pandemic have aroused a great deal of attention in the media. Drawing insights both from mediatization theory and ignorance studies, we discuss the coverage of the AstraZeneca vaccine controversies to develop a new concept that we call the mediatization of ignorance. In doing so, we conceptualize the procedure through which unknowns become mediatized as a three-step process that results from a combination of logics from (...) the areas of politics, health, and science/industry. Moreover, we argue that the mediatization of ignorance may have promoted vaccine hesitancy at a moment when vaccination was crucial for addressing the COVID-19 pandemic. We conclude by suggesting the need to explore in further detail the role that ignorance plays not only in the management of the COVID-19 crisis but also in different areas of society. (shrink)

Contributions to COVID-19 vaccination programmes promise valuable collective goods. They can support public and individual health by creating herd immunity and taking the pressure off overwhelmed public health services; support freedom of movement by enabling governments to remove restrictive lockdown policies; and improve economic and social well-being by allowing businesses, schools, and other essential public services to re-open. The vaccinated can contribute to the production of these goods. The unvaccinated, who benefit from, but who do not contribute to these (...) goods can be morally criticised as free-riders. In this paper defends the claim that in the case of COVID-19, the unvaccinated are unfair free-riders. I defend the claim against two objections. First, that they are not unfair free-riders because they lack the subjective attitudes and intentions of free-riders; second, that although the unvaccinated may be free-riders, their free-riding is not unfair. (shrink)

In bioethics vaccine refusal is often discussed as an instance of free riding on the herd immunity of an infectious disease. However, the social science of vaccine refusal suggests that the reasoning behind refusal to vaccinate more often stems from previous negative experiences in healthcare practice as well as deeply felt distrust of healthcare institutions. Moreover, vaccine refusal often acts like an exit mechanism. Whilst free riding is often met with sanctions, exit, according to Albert Hirschman’s theory of exit and (...) voice is most efficiently met by addressing concerns and increasing the quality and number of feedback channels. If the legitimate grievances responsible for vaccine refusal are not heard or addressed by healthcare policy, further polarization of attitudes to vaccines is likely to ensue. Thus, there is a need in the bioethics of vaccine refusal to understand the diverse ethical questions of this inflammable issue in addition to those of individual responsibility to vaccinate. (shrink)

Anti-intellectualists about knowledge-how insist that, when an agent S knows how to φ, it is in virtue of some ability, rather than in virtue of any propositional attitudes, S has. Recently, a popular strategy for attacking the anti-intellectualist position proceeds by appealing to cases where an agent is claimed to possess a reliable ability to φ while nonetheless intuitively lacking knowledge-how to φ. John Bengson & Marc Moffett (2009; 2011a; 2011b) and Carlotta Pavese (2015a; 2015b) have embraced precisely (...) this strategy and have thus claimed, for different reasons, that anti-intellectualism is defective on the grounds that possessing the ability to φ is not sufficient for knowing how to φ. We investigate this strategy of argument-by-counterexample to the anti- intellectualist’s sufficiency thesis and show that, at the end of the day, anti-intellectualism remains unscathed. (shrink)

There is a tension in our theorizing about laws of nature: our practice of using and reasoning with laws of nature suggests that laws are universal generalizations, but if laws are universal generalizations then we face the problem of explanatory circularity. In this paper I elucidate this tension and show how it motivates a view of laws that I call Minimal Anti-Humeanism. This view says that the laws are the universal generalizations that are not grounded in their instances. I (...) argue that this view has a variety of advantages that could make it attractive to people with both Humean and anti-Humean inclinations. (shrink)

This article discusses the triage response to the COVID-19 delta variant surge of 2021. One issue that distinguishes the delta wave from earlier surges is that by the time it became the predominant strain in the USA in July 2021, safe and effective vaccines against COVID-19 had been available for all US adults for several months. We consider whether healthcare professionals and triage committees would have been justified in prioritising patients with COVID-19 who are vaccinated above those who are unvaccinated (...) in first-order or second-order triage. Given that lack of evidence for a correlation between short-term survival and vaccination, we argue that using vaccination status during first-order triage would be inconsistent with accepted triage standards. We then turn to notions of procedural fairness, equity and desert to argue that that there is also a lack of justification for using vaccination status in second-order triage. In planning for future surges, we recommend that medical institutions base their triage decisions on principles meant to save the most lives, minimise inequity and protect the public’s trust, which for the time being would not be served by the inclusion of vaccination status. (shrink)

I argue that a parental prerogative to sometimes prioritize the interests of one’s children over the interests of others is insufficient to make the parental refusal of routine childhood vaccines morally permissible. This is because the moral permissibility of vaccine refusal follows from such a parental prerogative only if the only (weighty) moral reason in favor of vaccination is that vaccination is a means for promoting the interests of others. However, there are two additional weighty moral reasons in (...) favor of routine vaccination: fairness and concern for the vulnerable. These moral reasons in favor of vaccination are not defeated by a parental prerogative to prioritize the interests of one’s children over the interests of others. (shrink)

Anti-exceptionalism about logic is the doctrine that logic does not require its own epistemology, for its methods are continuous with those of science. Although most recently urged by Williamson, the idea goes back at least to Lakatos, who wanted to adapt Popper's falsicationism and extend it not only to mathematics but to logic as well. But one needs to be careful here to distinguish the empirical from the a posteriori. Lakatos coined the term 'quasi-empirical' `for the counterinstances to putative (...) mathematical and logical theses. Mathematics and logic may both be a posteriori, but it does not follow that they are empirical. Indeed, as Williamson has demonstrated, what counts as empirical knowledge, and the role of experience in acquiring knowledge, are both unclear. Moreover, knowledge, even of necessary truths, is fallible. Nonetheless, logical consequence holds in virtue of the meaning of the logical terms, just as consequence in general holds in virtue of the meanings of the concepts involved; and so logic is both analytic and necessary. In this respect, it is exceptional. But its methodologyand its epistemology are the same as those of mathematics and science in being fallibilist, and counterexamples to seemingly analytic truths are as likely as those in any scientic endeavour. What is needed is a new account of the evidential basis of knowledge, one which is, perhaps surprisingly, found in Aristotle. (shrink)

The devastating impact of the COVID‐19 (coronavirus disease 2019) pandemic is prompting renewed scrutiny of practices that heighten the risk of infectious disease. One such practice is refusing available vaccines known to be effective at preventing dangerous communicable diseases. For reasons of preventing individual harm, avoiding complicity in collective harm, and fairness, there is a growing consensus among ethicists that individuals have a duty to get vaccinated. I argue that these same grounds establish an analogous duty to avoid buying and (...) eating most meat sold today, based solely on a concern for human welfare. Meat consumption is a leading driver of infectious disease. Wildlife sales at wet markets, bushmeat hunting, and concentrated animal feeding operations (CAFOs) are all exceptionally risky activities that facilitate disease spread and impose immense harms on human populations. If there is a moral duty to vaccinate, we also should recognize a moral duty to avoid most meat. The paper concludes by considering the implications of this duty for policy. (shrink)

This paper begins by applying a version of Timothy Williamson’s anti-luminosity argument to normative properties. This argument suggests that there must be at least some unknowable normative facts in normative Sorites sequences, or otherwise we get a contradiction given certain plausible assumptions concerning safety requirements on knowledge and our doxastic dispositions. This paper then focuses on the question of how the defenders of different forms of metaethical anti-realism (namely, error theorists, subjectivists, relativists, contextualists, expressivists, response dependence theorists, and (...) constructivists) could respond to the explanatory challenge created by the previous argument. It argues that, with two exceptions, the metaethical anti-realists need not challenge the argument itself, but rather they can find ways to explain how the unknowable normative facts can obtain. These explanations are based on the idea that our own attitudes on which the normative facts are grounded need not be transparent to us either. Reaching this conclusion also illuminates how metaethical anti-realists can make sense of instances of normative vagueness more generally. (shrink)

Throughout the COVID-19 pandemic, shortages of scarce healthcare resources consistently presented significant moral and practical challenges. While the importance of vaccines as a key pharmaceutical intervention to stem pandemic scarcity was widely publicized, a sizable proportion of the population chose not to vaccinate. In response, some have defended the use of vaccination status as a criterion for the allocation of scarce medical resources. In this paper, we critically interpret this burgeoning literature, and describe a framework for thinking about vaccine-sensitive (...) resource allocation using the values of responsibility, reciprocity, and justice. Although our aim here is not to defend a single view of vaccine-sensitive resource allocation, we believe that attending critically with the diversity of arguments in favor (and against) vaccine-sensitivity reveals a number of questions that a vaccine-sensitive approach to allocation should answer in future pandemics. (shrink)

Bioethics, Volume 36, Issue 6, Page 687-698, July 2022.

In contemporary philosophy of science, the no-miracles argument and the pessimistic induction are regarded as the strongest arguments for and against scientific realism, respectively. In this paper, I construct a new argument for scientific realism which I call the anti-induction for scientific realism. It holds that, since past theories were false, present theories are true. I provide an example from the history of science to show that anti-inductions sometimes work in science. The anti-induction for scientific realism has (...) several advantages over the no-miracles argument as a positive argument for scientific realism. (shrink)

During the recent pandemic, fear of COVID-19 has been widespread and is considered to deteriorate mental health. We assessed whether vaccination can effectively reduce the fear of COVID-19 and, thus, contribute to improving people's mental health status. We used two-wave panel data from a German online study collected in April 2021 (t1) and August/September 2021 (t2) and estimated differences-in-differences to determine whether those who were vaccinated against COVID-19 experienced a reduction of fear of COVID-19, and whether the reduction was (...) more evident as compared to people who were not vaccinated for various reasons. (shrink)

India, despite being the world's largest vaccine manufacturer is now struggling with various unprecedented social, legal, moral issues with the ongoing Covid-19 vaccination program for 1.3 billion people, the largest democracy in the world. With three major vaccines including Covishield, homemade vaccine Covaxin, and Russia's Sputnik V, India is still facing acute scarcity of vaccines and raw material supply. This is not only unfortunate but also reveals the ethically-triggered facts about the imbalanced healthcare system between public and private sectors, (...) ineffective inequitable healthcare policies, unaccountable data reports that raise mistrust and confusion, and a deeper concern about global unfair distribution. In this paper, I have briefly discussed some unparalleled ethical issues raised from the vaccination program of India. (shrink)

That believing truly as a matter of luck does not generally constitute knowing has become epistemic commonplace. Accounts of knowledge incorporating this anti-luck idea frequently rely on one or another of a safety or sensitivity condition. Sensitivity-based accounts of knowledge have a well-known problem with necessary truths, to wit, that any believed necessary truth trivially counts as knowledge on such accounts. In this paper, we argue that safety-based accounts similarly trivialize knowledge of necessary truths and that two ways of (...) responding to this problem for safety, issuing from work by Williamson and Pritchard, are of dubious success. (shrink)

Catch up on the status of the more than 135 vaccines in development against the SARS-CoV-2 virus, ponder the biology and physics of free will and learn how scientists helped win the battle over evolution in US classrooms.

Although a safe, effective, and licensed coronavirus vaccine does not yet exist, there is already controversy over how it ought to be allocated. Justice is clearly at stake, but it is unclear what justice requires in the international distribution of a scarce vaccine during a pandemic. Many are condemning ‘vaccine nationalism’ as an obstacle to equitable global distribution. We argue that limited national partiality in allocating vaccines will be a component of justice rather than an obstacle to it. For there (...) are role-based and community-embedded responsibilities to take care of one’s own, which constitute legitimate moral reasons for some identity-related prioritisation. Furthermore, a good form of vaccine nationalism prioritises one’s own without denying or ignoring duties derived from a principle of equal worth, according to which all persons, regardless of citizenship or identity, equally deserve vaccine-induced protection from COVID-19. Rather than dismissing nationalism as a tragic obstacle, it is necessary to acknowledge that a limited form of it is valuable and expresses moral commitments. Only then can one understand our world of competing obligations, a world where cosmopolitan duties of benevolence sometimes conflict with special obligations of community membership. Once these competing obligations are recognised as such, we can begin the work of designing sound ethical frameworks for achieving justice in the global distribution of a coronavirus vaccine and developing practical strategies for avoiding, mitigating or resolving conflicts of duty. (shrink)