This article considers some different views of fairness and whether they conflict with the use of a version of Cost Effectiveness Analysis (CEA) that calls for maximizing health benefits per dollar spent. Among the concerns addressed are whether this version of CEA ignores the concerns of the worst off and inappropriately aggregates small benefits to many people. I critically examine the views of Daniel Hausman and Peter Singer who defend this version of CEA and Eric Nord among (...) others who criticize it. I come to focus in particular on the use of CEA in allocating scarce resources to the disabled. (shrink)

-/- This chapter evaluates the ethical issues that using cost-effectiveness considerations to set animal health priorities might present, and its conclusions are cautiously optimistic. While using cost-effectiveness calculations in animal health is not without ethical pitfalls, these calculations offer a pathway toward more rigorous priority-setting efforts that allow money spent on animal well-being to do more good. Although assessing quality of life for animals may be more challenging than in humans, implementing prioritization based on cost- (...) class='Hi'>effectiveness is less ethically fraught. (shrink)

Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of the (...) overall impact of health policy. This chapter considers what weight health policy should give to its “spill-over effects,” namely non-health and indirect benefits. (shrink)

The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA’s provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I argue that the ACA is neither (...) uniformly hostile nor uniformly friendly to efforts to set priorities in ways that promote cost and quality. Second, I argue that the ACA does not take a single, unified approach to priority setting; rather, its guidance varies depending on the aspect of the health care system at issue (Patient Centered Outcomes Research Institute, Medicare, essential health benefits) and the factors being excluded from priority setting (age, disability, life expectancy). Third, I argue that cost-effectiveness can be achieved within the ACA's constraints, but that doing so will require adopting new approaches to cost-effectiveness and priority setting. By limiting the use of standard cost-effectiveness analysis, the ACA makes the need for workable rivals to cost-effectiveness analysis a pressing practical concern rather than a mere theoretical worry. (shrink)

This project considers whether and how research ethics can contribute to the provision of cost-effective medical interventions. Clinical research ethics represents an underexplored context for the promotion of cost-effectiveness. In particular, although scholars have recently argued that research on less-expensive, less-effective interventions can be ethical, there has been little or no discussion of whether ethical considerations justify curtailing research on more expensive, more effective interventions. Yet considering cost-effectiveness at the research stage can help ensure that (...) scarce resources such as tissue samples or limited subject popula- tions are employed where they do the most good; can support parallel efforts by providers and insurers to promote cost-effectiveness; and can ensure that research has social value and benefits subjects. I discuss and rebut potential objections to the consideration of cost-effectiveness in research, including the difficulty of predicting effectiveness and cost at the research stage, concerns about limitations in cost-effectiveness analysis, and worries about overly limiting researchers’ freedom. I then consider the advantages and disadvantages of having certain participants in the research enterprise, including IRBs, advisory committees, sponsors, investigators, and subjects, consider cost-effectiveness. The project concludes by qualifiedly endorsing the consideration of cost-effectiveness at the research stage. While incorporating cost-effectiveness considerations into the ethical evaluation of human subjects research will not on its own ensure that the health care system realizes cost-effectiveness goals, doing so nonetheless represents an important part of a broader effort to control rising medical costs. (shrink)

In this extended book review, I summarize Adler's views and critically analyze his key arguments on the measurement of well-being and the foundations of prioritarianism.

Background: Food fortification refers to the process of adding nutrients to foods during their production. It is a cost-effective strategy with well-documented health, economic, and social benefits. Food fortification practices in school meal programs need guidance and legal support from various national policies. Aim: This study aims to analyze how various national policies—such as those related to school feeding, nutrition, health, food safety, agriculture, and the private sector—associate with the implementation of in-school food fortification among countries with school meals (...) programs. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge Theory and inference advantages of Bayesian analysis, was employed on a dataset of 126 government representatives who manage large-scale school meal programs in 126 different countries. Results: Findings showed that food safety policy and agriculture policy were positively and significantly associated with the in-school food fortification practices, while school feeding policy and private sector policy had ambiguous relationships with these practices. Nutrition policy and health policy had a significant negative association with food fortification practices among countries implementing school meal programs. Conclusions: Findings underscore the strong position of food safety policy and agriculture policy in guiding food fortification practices in school meal programs. There is a need to re-assess the implemented nutrition policy and health policy due to their significant negative associations with these practices. Enhancing and strengthening the school feeding policy and private sector policy may increase their potencies in giving positive impacts on in-school food fortification practices. (shrink)

Placebos are often used by clinicians, usually deceptively and with little rationale or evidence of benefit, making their use ethically problematic. In contrast with their typical current use, a provocative line of research suggests that placebos can be intentionally exploited to extend analgesic therapeutic effects. Is it possible to extend the effects of drug treatments by interspersing placebos? We reviewed a database of placebo studies, searching for studies that indicate that placebos given after repeated administration of active treatments acquire medication-like (...) effects. We found a total of 22studies in both animals and humans hinting of evidence that placebos may work as a sort of dose extender of active painkillers. Wherever effective in relieving clinical pain, such placebo use would offer several advantages. First, extending the effects of a painkiller through the use of placebos may reduce total drug intake and side effects. Second, dose-extending placebos may decrease patient dependence. Third, using placebos along with active medication, for part of the course of treatment, should limit dose escalation and lower costs. Importantly, provided that nondisclosure is pre-authorized in the informed consent process and that robust evidence indicates therapeutic benefit comparable to that of standard full-dose therapeutic regimens, introducing dose-extending placebos into the clinical arsenal should be considered. This novel prospect of placebo use has the potential to change our general thinking about painkiller treatments, the typical regimens of painkiller applications, and the ways in which treatments are evaluated. (shrink)

Drawing on work from Marina Sbisà’s “Ideology and the Persuasive Use of Presupposition” (1999), Rae Langton has developed a powerful account of the subtle mechanisms through which hate speech and propaganda spread. However, this model has a serious limitation: it focuses too strongly on individual speech acts isolated from their wider context, rendering its applicability to a broader range of cases suspect. In this chapter, I consider the limits of presupposition accommodation to clarify the audience’s role in helping hate speakers, (...) and claim the necessary mechanisms are much more active and social than Langton suggests, with effects not capturable in the analysis of isolated speech acts. I revisit Sbisà’s work on presupposition and develop an alternative model that (1) improves upon the Langtonian model for explaining the power of hate propaganda, and (2) is more in line with Sbisà’s original approach to ideology and the normative aspects of presupposition. (shrink)

Civil disobedience, despite its illegal nature, can sometimes be justified vis-à-vis the duty to obey the law, and, arguably, is thereby not liable to legal punishment. However, adhering to the demands of justice and refraining from punishing justified civil disobedience may lead to a highly problematic theoretical consequence: the debilitation of civil disobedience. This is because, according to the novel analysis I propose, civil disobedience primarily functions as a costly social signal. It is effective by being reliable, reliable by (...) being costly, and costly primarily by being punished. My analysis will highlight a distinctive feature of civil disobedience: civil disobedients leverage the punitive injustice they suffer to amplify their communicative force. This will lead to two paradoxical implications. First, the instability of the moral status of both civil disobedience and its punishment to the extent where the state may be left with no permissible course of action with regard to punishing civil disobedience. Second, by refraining from punishing justified civil disobedience, the state may render uncivil disobedience—illegal political activities that fall short of the standards of civil disobedience—potentially permissible. (shrink)

Norman Daniels’s theory of ‘accountability for reasonableness’ is an influential conception of fairness in healthcare resource allocation. Although it is widely thought that this theory provides a consistent extension of John Rawls’s general conception of justice, this paper shows that accountability for reasonableness has important points of contact with both utilitarianism and intuitionism, the main targets of Rawls’s argument. My aim is to demonstrate that its overlap with utilitarianism and intuitionism leaves accountability for reasonableness open to damaging critiques. The important (...) role that utilitarian-like cost-effectiveness calculations are allowed to play in resource allocation processes disregards the separateness of persons and is seriously unfair towards individuals whose interests are sacrificed for the sake of groups. Furthermore, the function played by intuitions in settling frequent value conflicts opens the door for sheer custom and vested interests to steer decision-making. (shrink)

Suppose you want to do as much good as possible. What should you do? According to members of the effective altruism movement—which has produced much of the thinking on this issue and counts several moral philosophers as its key protagonists—we should prioritise among the world’s problems by assessing their scale, solvability, and neglectedness. Once we’ve done this, the three top priorities, not necessarily in this order, are (1) aiding the world’s poorest people by providing life-saving medical treatments or alleviating poverty (...) itself, (2) preventing global catastrophic risks, such as those posed by nuclear war or rogue artificial intelligence, and (3) ending factory farming. These claims are both plausible and striking. If correct, they should prompt a stark revision of how we approach our altruistic activities. However, the project of determining how to do the most good—as opposed to say, whether we should do the most good—has only recently, within the last ten years, become the subject of serious academic attention. Many key claims have not yet been carefully scrutinised. This is a cause for concern: are effective altruists doing good badly? In this thesis, I critique and develop some of the latest claims about how individuals can do the most good. I do this in three areas: the value of saving lives (preventing premature deaths), how best to improve lives (making people happier during their lives), and cause prioritisation methodology (frameworks for determining which problems are the highest priorities). In each case, I raise novel theoretical considerations that, when incorporated, change the analysis. Roughly speaking, my main conclusions are (1) saving lives is not as straightforwardly good we tend to suppose, may not be good at all, and is not clearly a priority; (2) happiness can be measured through self-reports and, based on the self-reported evidence, treating mental health stands out as an overlooked problem that may be an even more cost-effective way to improve lives than alleviating poverty; (3) the cause prioritisation methodology proposed by effective altruists needs to be moderately reconceptualised and, when it is, it turns out it is not as illuminating a tool as we might have thought and hoped. (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)

The central thesis of this essay is that basic income experiments are justified if their expected benefits in terms of justice exceed their expected costs in terms of justice. The benefits are a function of basic income’s effect on the level of justice attained in the context in which it is implemented, and the experiment’s impact on future policy-making. The costs comprise the sacrifices made as a result of the experiment’s interventional character, as well as the study’s opportunity costs. In (...) light of the proposed standard of justification for basic income experiments, the factors that play a role in it, and the way these interact with one another, this essay provides some practical recommendations for researchers hoping to conduct such an experiment. (shrink)

One widely used method for allocating health care resources involves the use of cost-effectiveness analysis (CEA) to rank treatments in terms of quality-adjusted life-years (QALYs) gained. CEA has been criticized for discriminating against people with disabilities by valuing their lives less than those of non-disabled people. Avoiding discrimination seems to lead to the ’QALY trap’: we cannot value saving lives equally and still value raising quality of life. This paper reviews existing responses to the QALY trap and (...) argues that all are problematic. Instead, we argue that adopting a moderate form of prioritarianism avoids the QALY trap and disability discrimination. (shrink)

In this book some options concerning the greenhouse effect are assessed from a welfarist point of view: business as usual, stabilization of greenhouse gas emissions and reduction by 25% and by 60%. Up to today only economic analyses of such options are available, which monetize welfare losses. Because this is found to be wanting from a moral point of view, the present study welfarizes (among others) monetary losses on the basis of a hedonistic utilitarianism and other, justice incorporating, welfare ethics. (...) For these welfarist evaluations information about the social consequences of the four options are collected from the literature and eventually corrected; then the consequences for individual well-being are assessed based on psychological research about well-being dependent on the social situation of the individual; finally the aggregation formulas of the respective welfare ethics are applied to these data. Assessments by other types of ethics, e.g. Kantian ethic, are included. The strongest abatement option is found to be optimum with great unanimity. - In addition a cost-welfare analysis of greenhouse gas abatement is undertaken revealing efficient cost-welfare ratios for these measures and the most efficient ratio for the strongest option. - A final, more theoretical part discusses the moral obligations following from such evaluations. The notion of 'moral obligation' is explained in a way that, apart from moral goodness of the required act, reinforcement by formal or informal sanctions is another necessary condition for moral obligations. This leads to a conception of a historical morality according to which the demands of morality rise in the long run. Applying this conception to the greenhouse effect implies that presently we have the moral duty to raise the standards of greenhouse gas abatement as much as is politically feasible. (shrink)

Building information modeling can help in predicting the energy efficiency in future based on dynamic patterns obtained by visualization of data. The aim of this study was to investigate the effective parameters of energy consumption using BIM technology which can evaluate the buildings energy performance. First, three forms of general states in the building were modeled to evaluate the proposed designs in Autodesk Revit Software. Then, the main building form for energy modeling and analysis was selected. Autodesk Revit 2020 (...) software was also used to obtain the results of climate data analysis and building energy consumption index. Finally, the most optimal mode was selected by examining different energy consumption modes. The results showed that the use of building information modeling technology in adjusting the parameters affecting energy consumption can save energy cost up to 58.23% in block D. Energy cost savings for block C and the western lobby were obtained as 51.03% and 43.05%, respectively. Based on energy use intensity, energy cost savings for blocks C, D, and the western lobby were estimated as 16.67%, 16.30%, and 11%, respectively. The results of parametric studies on alternative schemes of energy use intensity optimization showed that 16.30% savings could be achieved by the base building model in a 30-year time horizon. Therefore, it was concluded that optimization of energy consumption would reduce the environmental pollutants emission and contribute to preservation and sustainability of the environment. (shrink)

This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life suffers because of disability-focused exclusion or (...) injustice differently from cases where lower quality of life results from laws of nature, resource scarcity, or appropriate tradeoffs. Decisionmakers should ignore quality-of-life losses that result from injustice or exclusion when ignoring them would improve the prospects of individuals with disabilities; in contrast, they should consider quality-of-life losses that are unavoidable or stem from resource scarcity or permissible tradeoffs. On this proposal, while health systems should not amplify existing injustice against individuals with disabilities, they are not required to altogether ignore the potential effects of disability on quality of life. (shrink)

Although policymakers and investigators still struggle to quantify and compare the effects of various Covid-related interventions, we are steadily amassing data that could help inform choices. The pandemic’s medical, social, and economic harms have been immense, and they warrant a continuous policy response. All decision makers use some type of mental model to weigh the pros and cons of various policy options. Rigorous economic evaluation formalizes this process. Value judgments will still be required, but economic evaluation can make the decision-making (...) process more systematic, comprehensive, and transparent. (shrink)

In this paper I reject the view that the famous ‘Knobe effect’ reveals an asymmetry within people’s judgments concerning actions with good or bad side effects. I agree with interpretations that see the ascriptions made by survey subjects as moral judgments rather than ascriptions of intentionality. On this basis, I aim at providing an explanation as to why people are right in blaming and ‘expraising’ agents that acted on unacceptable motives, but praise and excuse agents who meet intersubjective expectations by (...) acting on acceptable motives. The asymmetry only arises when blameworthiness and praiseworthiness are seen as instances of one and the same concept: moral responsibility. This analysis is backed by a study of Joshua Shepherd who extended and varied Knobe’s original vignettes. (shrink)

As it has been shaped by improvements in its tools and methods, and by its discourse with critics, I describe how the astrological research program has advanced through three stages of modelling and design limitations. Single-factor tests (for example, the many Sun-sign–only experiments that have been published) are typically underdeterministic. Multi-factor tests, unless they are very well designed, can easily become overdeterministic. Chart-matching tests have been vulnerable to confirmation bias errors until the development of a machine-based, whole-chart matching protocol that (...) has objectively produced evidence of high effect-sizes. A meta-analysis of recent results shows the rapid advancement and how to further improve the results. The value of the program is not only to corroborate the taxonomic counterfactuals of astrological “cookbooks,” but to extend their explanatory reach by the comparison of astrological postulates and inferences with philosophies in other disciplines in terms of quantifiable processes and emergent effects. (shrink)

In carrying out cost-benefit or cost-effective analysis, a discount rate should be applied to some kinds of future benefits and costs. It is controversial, though, whether future health is in this class. I argue that one of the standard arguments for discounting (from diminishing marginal returns) is inapplicable to the case of health, while another (favouring a pure rate of time preference) is unsound in any case. However, there are two other reasons that might support a positive (...) discount rate for future health: one relating to uncertainty, and the other relating to the instrumental benefits of improved health. While the latter considerations could be modelled via a discount rate, they could alternatively be modelled more explicitly, in other ways; I briefly discuss which modelling method is preferable. Finally, I argue against the common claims that failing to discount future health would lead to paradox, and/or to inconsistency with the way future cash flows are treated. (shrink)

David Tomasi presents new, groundbreaking research on the science and application of Mind-Body Medicine strategies to improve clinical outcomes in inpatient psychiatry settings. Much more than a list of therapeutic recommendations, this book is a thorough description of how Mind-Body Medicine can be successfully applied, from a therapeutic as well as from an organizational, cost-effective analysis viewpoint, to the full spectrum of psychiatric treatments. Furthermore, this study examines the role of multidisciplinary and interdisciplinary treatment teams, with a special (...) focus on the profession and the role of psychotherapists and group therapists, thereby providing solid scientific evidence of the benefits of patient-provider therapeutic alliances. In this sense, this book serves as a guide for professionals and institutions both in the private and the public sphere, to learn effective treatment and management strategies. About the Author Psychotherapist, Researcher, and Philosopher Dr. David Låg Tomasi is the author of Medical Philosophy (ibidem, 2016) and the co-author of Positive Patient Response to a Structured Exercise Program Delivered in Inpatient Psychiatry (Global Advances in Health and Medicine, 2019), the most-read research item from the University of Vermont (Researchgate, 2019). A member of several national and international Academies of Sciences, Dr. Tomasi works in the Inpatient Psychiatry Unit at the UVM Medical Center, and teaches at the University of Vermont and the Community College of Vermont. ---- Ibidem / Columbia University Press. (shrink)

The starting point in the development of probabilistic analyses of token causation has usually been the naïve intuition that, in some relevant sense, a cause raises the probability of its effect. But there are well-known examples both of non-probability-raising causation and of probability-raising non-causation. Sophisticated extant probabilistic analyses treat many such cases correctly, but only at the cost of excluding the possibilities of direct non-probability-raising causation, failures of causal transitivity, action-at-a-distance, prevention, and causation by absence and omission. I show (...) that an examination of the structure of these problem cases suggests a different treatment, one which avoids the costs of extant probabilistic analyses. (shrink)

Academia is a competitive environment. Early Career Researchers (ECRs) are limited in experience and resources and especially need achievements to secure and expand their careers. To help with these issues, this book offers a new approach for conducting research using the combination of mindsponge innovative thinking and Bayesian analytics. This is not just another analytics book. 1. A new perspective on psychological processes: Mindsponge is a novel approach for examining the human mind’s information processing mechanism. This conceptual framework is used (...) to construct models in studies. The framework is highly flexible and widely applicable for many different types of information processes. The mindsponge approach can help researchers discover interesting ideas or even formulate their very own theories when investigating psychosocial phenomena. This approach brings a fresh wind to the current landscape of social sciences and humanities (SSH). 2. Easy-to-follow analysis protocol: The Bayesian Mindsponge Framework (BMF analytics) is useful in terms of computing and visualizing power but also easy to learn and apply. Contrary to being intimidating, the Bayesian analytics section of this book is presented in a reader-friendly manner with a detailed yet clear step-by-step procedure. Examples are from published BMF articles, allowing readers to immediately practice the method and quickly create their own applications. With educational purposes in mind, the book is very suitable for ECRs who are looking to innovate their research methods. 3. Advocating for low-cost, high-quality research: Doing science can be very costly. Mindsponge innovative thinking and BMF analytics help produce impactful studies using openly available data on online repositories. This is based on the authors’ previous works and experiences. The book presents examples of employing the open R package bayesvl on secondary data from different sources. With less financial constraints, researchers can have more freedom of thought to pursue their curiosity and creativity. ECRs in low- and middle-income countries may find this aspect crucial in their careers. 4. Support and collaboration: The authors share their insights from experiences in the academic publishing system to help readers get through the processes of manuscript writing and peer-reviewing more easily. The authors are also ready to support other researchers with further inquiries and collaboration opportunities at the following website, mindsponge(dot)info. This book is for: a) ECRs whose only abundant resources are their innovation capacity and strength of will; b) Researchers in SSH who want to explore a novel approach to thinking and study conducting; c) Low- and middle-income countries’ researchers looking for a cost-effective research protocol; and, d) Innovative thinkers who want to turn their interesting thoughts into good publications. (shrink)

The neurotransmitters GABA and glutamate have been suggested to play a role in Major Depressive Disorder (MDD) through an imbalance between cortical inhibition and excitation. This effect has been highlighted in higher brain areas, such as the prefrontal cortex, but has also been posited in basic sensory cortices. Based on this, magnetic resonance spectroscopy (MRS) was used to investigate potential changes to GABA+ and glutamate+glutamine (Glx) concentrations within the occipital cortex in MDD patients (n = 25) and healthy controls (n (...) = 25). No difference in occipital GABA+ or Glx concentrations, nor in the GABA+/Glx ratio, was found between groups. An analysis of an extended MDD patient and unmatched control dataset (n = 90) found no correlation between metabolite concentrations and depressive symptoms. These results were integrated with prior studies through metabolite-specific meta-analyses, revealing no difference in occipital GABA and Glx concentrations between patients and controls. An effect of publication year on GABA group differences was found, suggesting that previously reported results may have been artifacts of measurement accuracy. Taken together, our results suggest that, contrary to some prior reports, MRS measurements of occipital GABA and Glx do not differ between MDD patients and controls. (shrink)

The right temporo-parietal junction (rTPJ) has been associated with two apparently disparate functional roles: in attention and in social cognition. According to one account, the rTPJ initiates a “circuit-breaking” signal that interrupts ongoing attentional processes, effectively reorienting attention. It is argued this primary function of the rTPJ has been extended beyond attention, through a process of evolutionarily cooption, to play a role in social cognition. We propose an alternative account, according to which the capacity for social cognition depends on (...) a network which is both distinct from and in tension with brain areas involved in focused attention and target detection: the default mode network. Theory characterizing the rTPJ based on the area’s purported role in reorienting may be falsely guided by the co-occurrence of two distinct effects in contiguous regions: activation of the supramarginal gyrus (SMG), associated with its functional role in target detection; and the transient release, during spatial reorienting, of suppression of the angular gyrus (AG) associated with focused attention. Findings based on meta-analysis and resting functional connectivity are presented which support this alternative account. We find distinct regions, possessing anti-correlated patterns of resting connectivity, associated with social reasoning (AG) and target detection (SMG) at the rTPJ. The locus for reorienting was spatially intermediate between the AG and SMG and showed a pattern of connectivity with similarities to social reasoning and target detection seeds. These findings highlight a general methodological concern for brain imaging. Given evidence that certain tasks not only activate some areas but also suppress activity in other areas, it is suggested that researchers need to distinguish two distinct putative mechanisms, either of which may produce an increase in activity in a brain area: functional engagement in the task versus release of suppression. (shrink)

The rule of rescue holds that special weight should be given to protecting the lives of assignable individuals in need, implying that less weight is given to considerations of cost-effectiveness. This is sometimes invoked as an argument for funding or reimbursing life-saving treatment in public healthcare even if the costs of such treatment are extreme. At first sight one might assume that an individualist approach to ethics—such as Scanlon’s contractualism—would offer a promising route to justification of the rule (...) of rescue. In this chapter I argue that contractualism cannot endorse the rule of rescue, whereas a collectivist approach that appeals to group solidarity would offer support for rescue cases. The argument, however, has its limitations, and though solidarity is of central concern in shaping public healthcare, there are good reasons for not endorsing the rule of rescue as a moral basis for allocating scarce resources in clinical care. (shrink)

Recently, a number of philosophers have argued that we can and should “consequentialize” non-consequentialist moral theories, putting them into a consequentialist framework. I argue that these philosophers, usually treated as a group, in fact offer three separate arguments, two of which are incompatible. I show that none represent significant threats to a committed non-consequentialist, and that the literature has suffered due to a failure to distinguish these arguments. I conclude by showing that the failure of the consequentializers’ arguments has implications (...) for disciplines, such as economics, logic, decision theory, and linguistics, which sometimes use a consequentialist structure to represent non-consequentialist ethical theories. (shrink)

Davis called for “extreme caution” in the use of non-invasive brain stimulation to treat neurological disorders in children, due to gaps in scientific knowledge. We are sympathetic to his position. However, we must also address the ethical implications of applying this technology to minors. Compensatory trade-offs associated with NIBS present a challenge to its use in children, insofar as these trade-offs have the effect of limiting the child’s future options. The distinction between treatment and enhancement has some normative force here. (...) As the intervention moves away from being a treatment toward being an enhancement—and thus toward a more uncertain weighing of the benefits, risks, and costs—considerations of the child’s best interests diminish, and the need to protect the child’s autonomy looms larger. NIBS for enhancement involving trade-offs should therefore be delayed, if possible, until the child reaches a state of maturity and can make an informed, personal decision. NIBS for treatment, by contrast, is permissible insofar as it can be shown to be at least as safe and effective as currently approved treatments, which are themselves justified on a best interests standard. (shrink)

According to the United Nations Environment Programme (UNEP), buildings are the largest worldwide consumers of energy. Most of the energy used by any building is consumed during the usage (or operational) stage of the building’s life-cycle. Achieving sustainable development at the national level will require minimizing the effects of buildings on the environment with the low energy consumed by buildings. The energy performance of a given building is predicted and assessed by conducting an energy simulation. Using BIM in EPAs greatly (...) reduces time and costs. The purpose of this study was to optimize energy consumption in buildings, using Building Information Modeling Technology (BIM), which can assess energy performance in the building. In this research, the general form of the building was modeled in the Autodesk Revit Software. After reviewing the proposed designs, the main form of the building was selected for modeling. Then, according to the type of materials consumed, the equipment and location of the project, the calculation of the energy consumption of the building was carried out using relevant tools in this scope. Finally, the best possible mode was chosen by examining different energy consumption modes. The results of energy simulation showed that 61.48% of the difference between the best mode of energy consumption optimization and the current state of the building, as well as 79.35%, is compared to the initial state. Finally, parametric studies of alternative cost optimization schemes showed that saving 58.23% of the building's current status for a 30-year horizon. (shrink)

Cheating is a major problem in society, especially in the educational system. From the viewpoint of subjective cost-benefit analysis, concerns about reputation damage as well as considerations of cultural values against unethical behavior can help increase the perceived costs of cheating. To explore deeper into the psychological processes in such assessments, we employ Bayesian Mindsponge Framework (BMF) analytics – an information-processingbased method. Conducting Bayesian analysis on 493 university students from Germany, Vietnam, China, Taiwan, and Japan, we found (...) that reputation concern is negatively associated with cheating behavior. If a student embraces Confucian values, the above negating effect is stronger. Our findings support the notion that mentally simulated negative consequences of cheating reduce the probability of carrying out such behavior. As the educational system is changing rapidly due to technological advancement, a better understanding of the influences of sociocultural factors can be helpful in cheating prevention efforts. (shrink)

In debates over the regulation of communication related to dual-use research, the risks that such communication creates must be weighed against against the value of scientific autonomy. The censorship of such communication seems justifiable in certain cases, given the potentially catastrophic applications of some dual-use research. This conclusion however, gives rise to another kind of danger: that regulators will use overly simplistic cost-benefit analysis to rationalize excessive regulation of scientific research. In response to this, we show how institutional (...) design principles and normative frameworks from free speech theory can be used to help extend the argument for regulating dangerous dual-use research beyond overly simplistic cost-benefit reasoning, but without reverting to an implausibly absolutist view of scientific autonomy. (shrink)

Promotion of prescription drugs may appear to be severely limited in some jurisdictions due to restrictions on direct-to-consumer advertising. However, in most jurisdictions, strategies exist to raise consumer awareness about prescription drugs, notably through the deployment of direct-to-consumer information campaigns that encourage patients to seek help for particular medical conditions. In Canada, DTCI is presented by industry and regulated by Health Canada as being purely informational activities, but their design and integration in broader promotional campaigns raise very similar ethical concerns (...) as those associated with DTCA. Specifically, DTCI can be an effective means of familiarizing the public with the scope and benefits of a particular prescription drug and so, like DTCA, can promote increased patient-consumer demand and thus a problematic rise in the prescribing and use of medications that may be neither the most appropriate nor the most cost-effective. Yet, with DTCI the industry is playing within the existing rules and regulations set by health regulators. To respond appropriately to this regulatory incoherence, we argue that DTCI should be regulated as a type of direct-to-consumer indirect advertising. Even if the case and specific regulations presented here are Canadian, the implications extend to every country that has a partial or total prohibition on DTCA. (shrink)

Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today’s (...) severity criteria in Norway and Sweden. The Scandinavian perspective on severity might be conducive to the international discussion, given its long-standing use as a priority setting criterion, despite having reached rather different conclusions so far. We then argue that severity can be viewed as a multidimensional concept, drawing on accounts of need, urgency, fairness, duty to save lives, and human dignity. Such concerns will often be relative to local mores, and the weighting placed on the various dimensions cannot be expected to be fixed. Thirdly, we present what we think are the most pertinent questions to answer about severity in order to facilitate decision making in the coming years of increased scarcity, and to further the understanding of underlying assumptions and values that go into these decisions. We conclude that severity is poorly understood, and that the topic needs substantial further inquiry; thus we hope this article may set a challenging and important research agenda. (shrink)

This paper discusses the possibility of the phenomenon of empathy between humans and robots, starting from what happens during their eye contact. First, it is shown, through the most relevant results of HRI studies on this matter, what are the most important effects of the robot gaze on human emotions and behaviour. Secondly, these effects are compared to what happens during the phenomenon of empathy between humans, taking inspiration from the studies of Edmund Husserl and Edith Stein. Finally, similarities and (...) differences between human-human and human-robot empathy are conceptualized through Merleau-Ponty’s idea of flesh, which is the extended bodily element of the world. If there is a common concept of body, including both machine-bodies and living bodies, then a transcorporeal analogy takes place, thus explaining why the phenomenon of empathy occurs both in human-human and human-robot interactions. (shrink)

Future superintelligent AI will be able to reconstruct a model of the personality of a person who lived in the past based on informational traces. This could be regarded as some form of immortality if this AI also solves the problem of personal identity in a copy-friendly way. A person who is currently alive could invest now in passive self-recording and active self-description to facilitate such reconstruction. In this article, we analyze informational-theoretical relationships between the human mind, its traces, and (...) its future model; based on this analysis, we suggest the instruments to most cost-effectively collect quality data about a person for future resurrection. These guidelines form a “digital immortality protocol”. Digital immortality is plan C for achieving immortality, after plan A, life extension, and plan B, cryonics. (shrink)

Driven by technological innovations, newborn screening (NBS) panels have been expanded and the development of genomic NBS pilot programs is rapidly progressing. Decisions on disease selection for NBS are still based on the Wilson and Jungner (WJ) criteria published in 1968. Despite this uniform reference, interpretation of the WJ criteria and actual disease selection for NBS programs are highly variable. A systematic literature search [PubMED search “Wilson” AND “Jungner”; last search 16.07.22] was performed to evaluate the applicability of the WJ (...) criteria for current and future NBS programs and the need for adaptation. By at least two reviewers, 105 publications (systematic literature search, N = 77; manual search, N = 28) were screened for relevant content and, finally, 38 publications were evaluated. Limited by the study design of qualitative text analysis, no statistical evaluation was performed, but a structured collection of reported aspects of criticism and proposed improvements was instead collated. This revealed a set of general limitations of the WJ criteria, such as imprecise terminology, lack of measurability and objectivity, missing pediatric focus, and absent guidance on program management. Furthermore, it unraveled specific aspects of criticism on clinical, diagnostic, therapeutic, and economical aspects. A major obstacle was found to be the incompletely understood natural history and phenotypic diversity of rare diseases prior to NBS implementation, resulting in uncertainty about case definition, risk stratification, and indications for treatment. This gap could be closed through the systematic collection and evaluation of real-world evidence on the quality, safety, and (cost-)effectiveness of NBS, as well as the long-term benefits experienced by screened individuals. An integrated NBS public health program that is designed to continuously learn would fulfil these requirements, and a multi-dimensional framework for future NBS programs integrating medical, ethical, legal, and societal perspectives is overdue. (shrink)

Recently theorists have demonstrated a growing interest in the ethical aspects of resource allocation in international non-governmental humanitarian, development and human rights organizations (INGOs). This article provides an analysis of Thomas Pogge's proposal for how international human rights organizations ought to choose which projects to fund. Pogge's allocation principle states that an INGO should govern its decision making about candidate projects by such rules and procedures as are expected to maximize its long-run cost-effectiveness, defined as the expected (...) aggregate moral value of the projects it undertakes divided by the expected aggregate cost of these projects? I critique Pogge's argument on two fronts: (1) I demonstrate that his view is problematic on his own terms, even if we accept the cost-effectiveness framework he employs. (2) I take issue with his overall approach because it generates results which can undermine the integrity of INGOs. Further, his approach mis-characterizes the nature of INGOs, and this mistake is at the root of his problematic view of INGO priority-setting. Ultimately, I argue for a conception of INGOs in which they are understood as ?organizations of principle?, in the sense that they are independent moral agents and so should be permitted a fairly wide sphere of autonomy within reasonable moral constraints. (shrink)

With an increased emphasis on upstream activity and Defence Engagement, it has become increasingly more important for the UK Ministry of Defence (MOD) and government to understand the relationship between conflict and regional instability. As part of this process, the Historical and Operational Data Analysis Team (HODA) in Defence Science and Technology Laboratory (Dstl) was tasked to look at factors that influenced the regional spread of internal conflicts to help aid the decision making of government. Conflict contagion is the (...) process by which a conflict in one state (State A) influences the outbreak of conflict in another state (State B). The aim of looking at these factors was to produce a tool to assist in the cost/benefit analysis of intervening in future conflicts. The task was carried out by quantitatively studying a selection of contagion and non-contagion case studies over a set of 14 numerical variables that covered structural, political, socioeconomic and cultural factors of both States A and B. All case studies took place after the end of the Cold War. The dataset used contained both binary and continuous data. A range of statistical techniques were used including correlation, regression and principal component analyses along with graphical analytical methods. Unfortunately creating a tool to predict contagion has proven difficult and so the scope of the study was changed-as no statistically relevant link was found. However, it was shown that some links do exists between the variables and the existence of contagion, and it also appears it is a combination of variables which has an effect on the likelihood of contagion. Conflict contagion is a rare event and was only recorded in less than 1% of cases present in the dataset. Of the variables analysed, the most significant factor was the number of refugees present in State B who originated in State A for the year before the case study. It is recommended that further work be conducted. It is possible that a more detailed investigation, using a broader range of techniques and/or a wider selection of variables might be successful in assessing the likelihood of conflict contagion. (shrink)

In the modern digital era, cloud storage has become an indispensable service due to its scalability, accessibility, and cost-effectiveness. However, with the vast amount of sensitive information stored on cloud platforms, ensuring data security and privacy remains a critical challenge. Traditional encryption techniques, while secure, often hinder efficient data retrieval, especially when using keyword searches. To address this, attribute-based keyword search (ABKS) offers a promising solution by allowing secure, fine-grained access control and efficient keyword searches over encrypted data. (...) This paper delves into the integration of optimization techniques within ABKS to enhance search efficiency and data security in cloud storage environments. We explore various optimization strategies, such as index compression, query processing enhancement, and encryption optimization, which aim to reduce computational overhead while maintaining robust security measures. Through a comprehensive analysis, the paper illustrates how these techniques can significantly improve the performance of cloud storage systems, ensuring both security and usability. Experimental results demonstrate that optimized ABKS not only accelerates search queries but also reduces storage costs, making it a viable solution for modern cloud storage challenges. Future research directions include exploring advanced machine learning algorithms for predictive search optimizations and further improving the resilience of ABKS against emerging security threats. (shrink)

Control measures, such as “lockdowns”, have been widely used to suppress the COVID-19 pandemic. Under some conditions, they prevent illness and save lives. But they also exact an economic toll. How should we balance the impact of such policies on individual lives and livelihoods (and other dimensions of concern) to determine which is best? A widely used method of policy evaluation, benefit–cost analysis (BCA), answers these questions by converting all the effects of a policy into monetary equivalents and (...) then summing them up. A different method, social welfare analysis, proceeds by determining the effects of a policy on individual wellbeing and then applying an aggregation formula to them to evaluate the overall effects of a policy. In this chapter, we survey these methods and argue that social welfare analysis has important advantages. One crucial advantage is that it enables ethical considerations relating to the impact of policies on individual wellbeing and its distribution to be incorporated into policy assessments in a transparent way. We illustrate this with a simple numerical model for evaluating pandemic policies that vary in terms of the stringency of the controls that they impose on individual behaviour, showing how the evaluation depends on the ethical significance accorded to their impact on the wellbeing of different age and income groups. (shrink)

This study addresses the issue of maintaining nutritional quality amidst financial hardship faced by families in Plateau State, Nigeria. Surveys research designed was used for the study. The study covers 3 local government areas in Plateau State, ensuring diverse representation. The sample size of 400 families residing in Plateau State was used. Questionnaire was used to collect data for the study which capture the demographic information, dietary habits, household budget allocation for food, and perceptions of nutritional value. Mean and standard (...) deviation was used to present result for the findings. The findings of the study revealed that that there should be cost-effective meal planning strategies in promoting healthy eating habits. Also, socioeconomic factors impact cost-effective meal planning in promoting healthy eating habits. Based on the findings, stakeholders, policymakers, and community organizations should implement interventions that support cost-effective meal planning, enhance nutritional literacy, and alleviate financial burdens on families in Plateau State. This study may empower families to make informed dietary choices and achieve better health outcomes despite economic constraints. (shrink)

Hermann von Helmholtz (1821-1894) established results both controversial and enduring: analysis of mixed colors and of combination tones, arguments against nativism, and the analysis of sensation and perception using the techniques of natural science. The paper focuses on Helmholtz’s account of sensation, perception, and representation via “physiological psychology”. Helmholtz emphasized that external stimuli of sensations are causes, and sensations are their effects, and he had a practical and naturalist orientation toward the analysis of phenomenal experience. However, he (...) argued as well that sensation must be interpreted to yield representation, and that representation is geared toward objective representation (the central thesis of contemporary intentionalism). The interpretation of sensation is based on “facts” revealed in experiment, but extends to the analysis of the quantitative, causal relationships between stimuli and responses. A key question for Helmholtz’s theory is the extent to which mental operations are to be ascribed a role in interpreting sensation. (shrink)

When probability discounting (or probability weighting), one multiplies the value of an outcome by one's subjective probability that the outcome will obtain in decision-making. The broader import of defending probability discounting is to help justify cost-benefit analyses in contexts such as climate change. This chapter defends probability discounting under risk both negatively, from arguments by Simon Caney (2008, 2009), and with a new positive argument. First, in responding to Caney, I argue that small costs and benefits need to be (...) evaluated, and that viewing practices at the social level is too coarse-grained. Second, I argue for probability discounting using a distinction between causal responsibility and moral responsibility. Moral responsibility can be cashed out in terms of blameworthiness and praiseworthiness, while causal responsibility obtains in full for any effect which is part of a causal chain linked to one's act. With this distinction in hand, unlike causal responsibility, moral responsibility can be seen as coming in degrees. My argument is, given that we can limit our deliberation and consideration to that which we are morally responsible for and that our moral responsibility for outcomes is limited by our subjective probabilities, our subjective probabilities can ground probability discounting. (shrink)

The policy makers or lawyers may face the need of legal research for reasons. The congressmen may plan to make new laws to address the challenges of their constituent or to the interest of nation. The lawyers may need to serve their clients who like to know the legal issues involved, the strategies to deal with their loss and recovery, and prospect for winning the case if the dispute has gotten worse. The lawyers may practice in a solo business or (...) might work as an associate lawyer in the law firms. A senior lawyer or partner in some cases may like to exploit the junior work force about the problems or grievances from the potential clients. Since he needs to focus their attention on other matters, such as the business expansion of his law firm or more lucrative cases in need of career hands, he may tap the junior lawyer for the legal research, who could assist with the basis of his final legal opinion. The memorandum, opinion letter and brief would be such forms of professional communication for the lawyers and legal researchers. The congressman also can be supplemented with the aid of staffs in terms of his legal expertise and grasp of the issues standing for carrying their responsibility more effectively. For the lawyers and legal researchers, the structure of state and federal legal system is the kind of important variants to orient their work direction and basic frame for the most efficient and adequate scope of search and analysis. The paradigm change also is revolutionary to impact the general base of people. Decades ago, the research or researcher only related with the class of professionals, such as professors, lawyers, career officers and cadres of enterprises. They would enjoy insulation and exploit their research work as an entrance barrier from lay people. Their large shelves at home study or in the room or corner of office thrust an impression that he or she is learned and knowledgeable. This impliedly communicates his or her prestige of social or professional success. The books and articles seem to symbolize a kind of monopoly which bears to exclude unclassified or non-professional workers. The change is remarkable that every citizen could benefit from the on-line sources of information, which, of course, is generally true of professional knowledge. Now professors fear of plagiarism that students often are the kind of suspect. The legal research would turn on the help of digitization which revolutionizes to incur a new mode of research operation. About the query, the citizens and people can readily verify its truth or falsity with one clique within the personal computer. An enormous amount of information is currently flowing on the internet and on-line sources of reference, which shapes an informative and knowledgeable society. As the medical doctors warned decades ago, the precept is any most effective, “forbear from your intelligence or knowledge work for your health.” Many of them now spend long hours a day to satisfy their curiosity and intelligent search. He or she may be well awarded an academic degree if to recognize their hard work on his PC. Nevertheless, this information age does not always bring a positive progress, which arouses the kind of issues, say, right of privacy, on-line fraud. In some cases, this transformation may lead to an inferior attitude of researcher. My today’s experience is one of exotic case. I have received an e-mail from Google CEO stating that I have been selected as one of twelve winners from the pool of Google users. The award money is enormous which stalls me for some time. The authenticity and reliability have hit my head, and I utilized a verification service website managed by the team of lawyers. It costs five dollars and remaining 24 dollars would be processed upon the progress of interaction. I am waiting for an answer from the team. Then the research nowadays is not limited to the basic context of our subsistence, but influences in any depth into the professional lives. (shrink)

Businesses and people outsource database to realize helpful and low-cost applications and administrations. In arrange to supply adequate usefulness for SQL inquiries, numerous secure database plans have been proposed. In any case, such plans are helpless to protection leakage to cloud server. The most reason is that database is facilitated and handled in cloud server, which is past the control of information proprietors. For the numerical extend inquiry (“>”, “<”, etc.), those plans cannot give adequate protection security against viable (...) challenges, e.g., security spillage of measurable properties, get to design. Besides, expanded number of questions will definitely spill more data to the cloud server. In this paper, we propose a two-cloud engineering for secure database, with a arrangement of crossing point conventions that give security conservation to different numeric-related extend questions. Security analysis shows that privacy of numerical information is strongly protected against cloud providers in our proposed scheme. (shrink)

According to evidentialist views, credence in a proposition p should be proportional to the degree of evidential support that one has in favor of p. However, empirical evidence suggests that our credences are systematically sensitive to practical factors. In this article, I provide a cost–benefit analysis of credences' practical sensitivity. The upshot of this analysis is that credences sensitive to practical factors fare better than practically insensitive ones along several dimensions. All things considered, our credences should be (...) sensitive to practical factors. (shrink)

Time-tested commons characterize by having instituted sanctioning mechanisms that are sensitive to the circumstances and motivations of non-compliers. As a proposed Global Antimicrobial Commons cannot cost-effectively develop sanctioning mechanisms that are consistently sensitive to the circumstances of the global poor, I suggest concentrating on establishing a wider set of incentives that encourages both compliance and participation.