Dominant views about the nature of health and disease in bioethics and the philosophy of medicine have presumed the existence of a fixed, stable, individual organism as the bearer of health and disease states, and as such, the appropriate target of medical therapy and ethical concern. However, recent developments in microbial biology, neuroscience, the philosophy of cognitive science, and social and personality psychology (Ickes...

The extended mind thesis maintains that the functional contributions of tools and artefacts can become so essential for our cognition that they can be constitutive parts of our minds. In other words, our tools can be on a par with our brains: our minds and cognitive processes can literally ‘extend’ into the tools. Several extended mind theorists have argued that this ‘extended’ view of the mind offers unique insights into how we understand, assess, and treat certain cognitive (...) conditions. In this chapter we suggest that using AI extenders, i.e., tightly coupled cognitive extenders that are imbued with machine learning and other ‘artificially intelligent’ tools, presents both new ethical challenges and opportunities for mental health. We focus on several mental health conditions that can develop differently by the use of AI extenders for people with cognitive disorders and then discuss some of the related opportunities and challenges. (shrink)

There are a number of important links and similarities between public health and safety. In this extended essay, Gregg D. Caruso defends and expands his public health-quarantine model, which is a non-retributive alternative for addressing criminal behavior that draws on the public health framework and prioritizes prevention and social justice. In developing his account, he explores the relationship between public health and safety, focusing on how social inequalities and systemic injustices affect health outcomes and (...) crime rates, how poverty affects brain development, how offenders often have pre-existing medical conditions (especially mental health issues), how involvement in the criminal justice system itself can lead to or worsen health and cognitive problems, how treatment and rehabilitation methods can best be employed to reduce recidivism and reintegrate offenders back into society, and how a public health approach could be successfully applied within the criminal justice system. Caruso's approach draws on research from the health sciences, social sciences, public policy, law, psychiatry, medical ethics, neuroscience, and philosophy, and he delivers a set of ethically defensible and practically workable proposals for implementing the public health-quarantine model. The essay begins by discussing recent empirical findings in psychology, neuroscience, and the social sciences that provide us with an increased understanding of the social and neurological determinants of health and criminal behavior. It then turns to Caruso's public health-quarantine model and argues that the model provides the most justified, humane, and effective approach for addressing criminal behavior. Caruso concludes by proposing a capability approach to social justice grounded in six key features of human well-being. He argues that we cannot successfully address concerns over public health and safety without simultaneously addressing issues of social justice—including the social determinants of health (SDH) and the social determinants of criminal behavior (SDCB)—and he recommends eight general policy proposals consistent with his model. (shrink)

This discussion revises and extends Jonny Anomaly's ‘public goods’ account of public health ethics in light of recent criticism from Richard Dees. Public goods are goods that are both non-rival and non-excludable. What is significant about such goods is that they are not always provided efficiently by the market. Indeed, the state can sometimes realize efficiency gains either by supplying such goods directly or by compelling private purchase. But public goods are not the only goods that the market may (...) fail to provide efficiently. This point to a way of broadening the public goods account of public health to accommodate Dees' counterexamples, without abandoning its distinctive appeal. On the market failures approach to public health ethics, the role of public health is to correct public health-related market failures of all kinds, so far as possible. The underlying moral commitment is to economic efficiency in the sense of Pareto: if we can re-allocate resources in the economy so as to raise the welfare of some without lowering the welfare of any other, we ought to do so. (shrink)

This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely “imperfect” duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from political philosophy has (...) at times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of “specific” beneficence that should be reflected in a society’s health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature. (shrink)

This phenomenological study aimed to determine the challenges, coping strategies, and significant insights of COVID-19 frontliners during the pandemic. The study utilized a qualitative phenomenological approach, and using purposive sampling technique, the eight (8) participants who worked as a COVID-19 frontliner in General Santos City were identified for an in-depth interview. Thematic analysis was used as a data analysis tool to interpret the data gathered. The results found that COVID-19 frontliners experienced different challenges during the pandemic, including the fear of (...) being infected with the disease, dealing with different patients, long and busy working hours, and mental health disturbance. As for their coping strategies in dealing with those challenges, the COVID-19 frontliners used their families’ support, taking care of themselves, as well as having strong faith in God. Also, valuing public health measures, the importance of self-care, and extending patience and understanding toward the patients were the significant insights shared by the COVID-19 frontliners. Moreover, understanding the impact of COVID-19 on the frontliners’ mental health can be the key to implementing plans and effective interventions to help them function more efficiently. (shrink)

Personal Health Monitoring (PHM) uses electronic devices which monitor and record health-related data outside a hospital, usually within the home. This paper examines the ethical issues raised by PHM. Eight themes describing the ethical implications of PHM are identified through a review of 68 academic articles concerning PHM. The identified themes include privacy, autonomy, obtrusiveness and visibility, stigma and identity, medicalisation, social isolation, delivery of care, and safety and technological need. The issues around each of these are discussed. (...) The system / lifeworld perspective of Habermas is applied to develop an understanding of the role of PHMs as mediators of communication between the institutional and the domestic environment. Furthermore, links are established between the ethical issues to demonstrate that the ethics of PHM involves a complex network of ethical interactions. The paper extends the discussion of the critical effect PHMs have on the patient’s identity and concludes that a holistic understanding of the ethical issues surrounding PHMs will help both researchers and practitioners in developing effective PHM implementations. (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)

Imagine you are the CEO of a hospital [. . .]. Decisions are constantly being made in your organization about how to spend the organization's money. The amount of money available to spend is never adequate to pay for everything you wish you could spend it on, therefore you must set spending priorities. There are two questions you need to be able to answer . . . How should we set priorities in this organization? How do we know when we (...) are doing it well? When people seek to achieve good public policy, the result will tend to be good public policy. In a collective choice process, public‐spirited individual participants produce good public policy by deliberating—talking with each other, listening to each other's arguments, and being willing to learn and change their minds based on such dialogue. –Steven Kelman (1992: 181) Public policy scholars agree that those persons (or agencies) vested with the authority to establish health care priorities should elicit public input before making rationing decisions. The two most common approaches are (i) consultation and (ii) deliberation. Though deliberation has obvious advantages over consultation, it falters in the face of the objection that ordinary citizens lack the cognitive resources for the extended, rigorous inquiry required of them in undertaking the priority‐setting task. To overcome this objection, I propose that deliberative forums for health care rationing should be designed so that they imitate the natural pattern of human experience. The experience of deliberation should encompass both prolonged periods of less‐demanding cognitive activity, in which citizens passively receive information, and briefer periods of more‐demanding cognitive activity, in which they engage in active problem‐solving. In arguing for this thesis, I rely on two theoretical sources and one practical case study, in the following order: (i) John Dewey's metaphysics of experience, (ii) cognitive science research on schemas and frames, and (iii) the Health Care Council in São Paulo, Brazil. (shrink)

Summary measures of health, such as the quality-adjusted life year and disability-adjusted life year, have long been known to incorporate a number of value choices. In this paper, though, I show that the value choices in the construction of such measures extend far beyond what is generally recognized. In showing this, I hope both to improve the understanding of those measures by epidemiologists, health economists and policy-makers, and also to contribute to the general debate about the extent to (...) which such measures should be adjusted to reflect ethical values. (shrink)

It is natural to think that there is a tight connection between whether someone is responsible for some outcome and whether it is appropriate to hold her accountable for that outcome. And this natural thought naturally extends to health: if someone is responsible for her health, then, all else being equal, she is accountable for it. Given this, some have thought that responsibility for health has an important role to play in distributing the benefits and burdens of (...) healthcare. But there is a reason for caution. That health is influenced by social, economic, and environmental factors is a matter of consensus. And some have argued that in light of these social determinants of health, individuals are not typically responsible for their health, rendering inappropriate policies that employ a responsibility‐for‐health criterion. This debate implicates a number of overlapping concepts and questions that are often difficult to pull apart. And I worry that those who maintain that social determinants undermine responsibility for health have latched on to the wrong target. The social determinants of health are relevant to such policies, but, I argue, not by globally undermining responsibility. Rather, social determinants are sometimes responsibility‐undermining, sometimes responsibility‐preserving, and often relevant to whether we should hold individuals accountable for their health regardless of their responsibility. This calls for a more nuanced appraisal of the ways in which the social determinants of health are relevant to such policies. And here I attempt to provide one. (shrink)

This study clarifies the need for a renewed account of the body in physiotherapy to fill sizable gaps between physiotherapeutical theory and practice. Physiotherapists are trained to approach bodily functioning from an objectivist perspective; however, their therapeutic interactions with patients are not limited to the provision of natural-scientific explanations. Physiotherapists’ practice corresponds well to theorisation of the body as the bearer of original bodily intentionality, as outlined by Merleau-Ponty and elaborated upon by enactivists. We clarify how physiotherapeutical practice corroborates Merleau-Ponty’s (...) critical arguments against objectivist interpretations of the body; particularly, his analyses demonstrate that norms of optimal corporeal functioning are highly individual and variable in time and thus do not directly depend on generic physiological structures. In practice, objectively measurable physical deviations rarely correspond to specific subjective difficulties and, similarly, patients’ reflective insights into their own motor deficiencies do not necessarily produce meaningful motor improvements. Physiotherapeutical procedures can be understood neither as mechanical manipulations of patients’ machine-like bodies by experts nor as a process of such manipulation by way of instructing patients’ explicit conscious awareness. Rather, physiotherapeutical practice and theory can benefit from the philosophical interpretation of motor disorders as modifications of bodily intentionality. Consequently, motor performances addressed in physiotherapy are interpreted as relational features of a living organism coupled with its environment, and motor disorders are approached as failures to optimally manage the motor requirements of a given situation owing to a relative loss of the capacity to structure one’s relation with their environment through motor action. Building on this, we argue that the process of physiotherapy is most effective when understood as a bodily interaction to guide patients towards discovering better ways of grasping a situation as meaningful through bodily postures and movements. (shrink)

The majority of studies on absorptive capacity (AC) underscore the importance of absorbing technological knowledge from other firms to create economic value. However, to preserve moral legitimacy and create social value, firms must also discern and adapt to (shifts in) societal values. A comparative case study of eight firms in the food industry reveals how organizations prioritize and operationalize the societal value health in product innovation while navigating inter- and intravalue conflicts. The value-sensitive framework induced in this article extends (...) AC by explaining how technically savvy, economic value–creating firms diverge in their receptivity, articulation, and reflexivity of societal values. (shrink)

Externalist theories hold that a comprehensive understanding of mental disorder cannot be achieved unless we attend to factors that lie outside of the head: neural explanations alone will not fully capture the complex dependencies that exist between an individual’s psychiatric condition and her social, cultural, and material environment. Here, we firstly offer a taxonomy of ways in which the externalist viewpoint can be understood, and unpack its commitments concerning the nature and physical realization of mental disorder. Secondly, we apply a (...) strongly externalist approach to the case of Autistic Spectrum Disorder, and argue that this condition can be illuminated by appeal to the hypothesis of extended cognition. We conclude by briefly considering the significance this strongly externalist approach may have for psychiatric practice and pedagogy. (shrink)

Background The purpose of this study was to examine whether extended use of a variety of screen-based devices, in addition to television, was associated with poor dietary habits and other health-related characteristics and behaviors among US adults. The recent phenomenon of binge-watching was also explored. -/- Methods A survey to assess screen time across multiple devices, dietary habits, sleep duration and quality, perceived stress, self-rated health, physical activity, and body mass index, was administered to a sample of (...) US adults using the Qualtrics platform and distributed via Amazon Mechanical Turk (MTurk). Participants were adults 18 years of age and older, English speakers, current US residents, and owners of a television and at least one other device with a screen. Three different screen time categories (heavy, moderate, and light) were created for total screen time, and separately for screen time by type of screen, based on distribution tertiles. Kruskal-Wallis tests were conducted to examine differences in dietary habits and health-related characteristics between screen time categories. -/- Results Aggregate screen time across all devices totaled 17.5 h per day for heavy users. Heavy users reported the least healthful dietary patterns and the poorest health-related characteristics – including self-rated health – compared to moderate and light users. Moreover, unique dietary habits emerged when examining dietary patterns by type of screen separately, such that heavy users of TV and smartphone displayed the least healthful dietary patterns compared to heavy users of TV-connected devices, laptop, and tablet. Binge-watching was also significantly associated with less healthy dietary patterns, including frequency of fast-food consumption as well as eating family meals in front of a television, and perceived stress. -/- Conclusions The present study found that poorer dietary choices, as well as other negative health-related impacts, occurred more often as the viewing time of a variety of different screen-based devices increased in a sample of US adults. Future research is needed to better understand what factors among different screen-based devices might affect health behaviors and in turn health-related outcomes. Research is also required to better understand how binge-watching behavior contributes impacts health-related behaviors and characteristics. (shrink)

COVID-19 vaccination of children has begun in various high-income countries with regulatory approval and general public support, but largely without careful ethical consideration. This trend is expected to extend to other COVID-19 vaccines and lower ages as clinical trials progress. This paper provides an ethical analysis of COVID-19 vaccination of healthy children. Specifically, we argue that it is currently unclear whether routine COVID-19 vaccination of healthy children is ethically justified in most contexts, given the minimal direct benefit that COVID-19 vaccination (...) provides to children, the potential for rare risks to outweigh these benefits and undermine vaccine confidence, and substantial evidence that COVID-19 vaccination confers adequate protection to risk groups, such as older adults, without the need to vaccinate healthy children. We conclude that child COVID-19 vaccination in wealthy communities before adults in poor communities worldwide is ethically unacceptable and consider how policy deliberations might evolve in light of future developments. (shrink)

Universal health coverage (UHC) is at the center of current efforts to strengthen health systems and improve the level and distribution of health and health services. This document is the final report of the WHO Consultative Group on Equity and Universal Health Coverage. The report addresses the key issues of fairness and equity that arise on the path to UHC. As such, the report is relevant for every actor that affects that path and governments in (...) particular, as they are in charge of overseeing and guiding the progress toward UHC. (shrink)

Recent trends in psychiatry involve a transition from categorical to dimensional frameworks, in which the boundary between health and pathology is understood as a difference in degree rather than as a difference in kind. A major tenet of dimensional approaches is that no qualitative distinction can be made between health and pathology. As a consequence, these approaches tend to characterize such a threshold as pragmatic or conventional in nature. However, dimensional approaches to psychopathology raise several epistemological and ontological (...) issues. First, we review major sources of evidence usually recruited in support of the dimensional trend (focusing on clinical observation and biological data), and we show that these are connected to different conceptualizations of how dimensional traits extend across health and pathology. Second, we criticize two unquestioned assumptions that stand at the core of the dimensional trend: a) that there is continuity from health to pathology at the symptomatic level; b) that such continuity reflects an underlying continuity in the genetic liability for pathological conditions. Third, we argue against the idea of a conventional threshold by showing that such a view implies a linear relationship between the genotype and the phenotype. Fourth, drawing on epigenetics and developmental biology, we offer a characterization of mental disorders as stable and dynamic constellations of multi-level variables that differ qualitatively from ‘healthy states’. We conclude by showing that our account has several theoretical advantages over both categorical and dimensional approaches. Notably, it provides crucial insights into psychological development over time and individual differences, with major implications in terms of intervention and clinical decision-making. (shrink)

I argue that a reasonable understanding of Leopold’s ‘Land Ethic’ is one that identifies possession of health as being a sufficient condition for moral consideration. With this, Leopold extends morality not only to biotic wholes, but to individual organisms, as both can have their health undermined. My argument centers on explaining why Leopold thinks it reasonable to analogize ecosystems both to an organism and to a community: both have a health. My conclusions undermine J. Baird Callicott’s rhetorical (...) dismissal of the organism analogy’s importance, a dismissal crucially serving his thesis that Leopoldians should hold community membership necessary for moral standing. (shrink)

The COVID-19 pandemic has coincided with the proliferation of ethical guidance documents to assist public health authorities, health care providers, practitioners and staff with responding to ethical challenges posed by the pandemic. Like ethical guidelines relating to infectious disease that have preceded them, what unites many COVID-19 guidance documents is their dependency on an under-developed approach to bioethical principlism, a normative framework that attempts to guide actions based on a list of prima facie, unranked ethical principles. By situating (...) them in relation to the key philosophical debates concerning bioethical principlism, we aim to explore the limits and limitations of pandemic ethical guidance documents as, specifically, ethics documents – documents that fulfil the functions of ethics as a fundamentally normative discipline. This means not only determining whether such ethical guidance documents can, in principle, provide adequate action guidance and action justification, but also, more importantly where pandemics are concerned, determining whether they support consistent decision making and transparent processes of justification. Having highlighted the problems with merely furnishing ethical guidelines with substantive ethical content in terms of principles and values, we argue that organizations that develop these documents should, instead, focus on the procedural dimensions of action guidance and action justification, which extend to questions regarding the make-up of the committees, panels and groups that develop such guidelines, the public transparency of justifications for specific pandemic-related advice or interventions and the development of explicit procedures for transparent and consistent decision making. (shrink)

The influence of Kurt Goldstein on the thinking of Georges Canguilhem extended throughout his entire work. This paper seeks to examine this relationship in order to conduct a study of the norm as a nexus or connection between the concept and life. Consequently, this work will be a reflection on the approach to life as a normative activity and self-realization. For this, it will be necessary to redefine the concepts of health and disease, and make a crossover between (...) the two. At the end of this trajectory, it will be found that these concepts can explain the identity between the concept and life, which leads to the unexpected conclusion that the cure is ultimately self-healing. (shrink)

Racial disparities in health outcomes have recently become a flashpoint in the debate about the value of race as a biological concept. What role, if any, race has in the etiology of disease is a philosophically and scientifically contested topic. In this article, I expand on the insights of the new mechanistic philosophy of science to defend a mechanism discovery approach to investigating epidemiological racial disparities. The mechanism discovery approach has explanatory virtues lacking in the populational approach typically employed (...) in the study of race and biomedicine. The explanatory constraints that form an integral part of the new mechanistic approach enable mechanism discovery to avoid the epistemic and normative shortcomings of the populational approach. The methodology of mechanism discovery can fruitfully be extended to the treatment and reversal of epidemiological racial disparities. (shrink)

A patient is diagnosed with the persistent vegetative state (PVS) when they show no evidence of the awareness of the self or the environment for an extended period of time. The chance of recovery of any mental function or the ability to interact in a meaningful way is low. Though rare, the condition, considering its nature as a state outwith the realm of the conscious, coupled with the trauma experienced by the patient's kin as well as health care (...) staff confronted with painful decisions regarding the patient's care, has attracted a considerable amount of discussion within the bioethics community. At present, there is a wealth of literature that discusses the relevant neurology, that elucidates the plethora of ethical challenges in understanding and dealing with the condition, and that analyses the real-world cases which have prominently featured in the mainstream media as a result of emotionally charged, divergent views concerning the provision of care to the patient. However, there is scarcely anything in the published scholarly literature that proposes concrete and practically actionable solutions to the now widely recognized moral conundrums. The present article describes a step in that direction. I start from the very foundations, laying out a sentientist approach which serves as the basis for the consequent moral decision-making, and then proceed to systematically identify and deconstruct the different cases of discord, using the aforementioned foundations as the basis for their resolution. A major intellectual contribution concerns the fluidity of the duty of care which I argue is demanded by the sentientist focus. The said duty is shown initially to have for its object the patient, which depending on the circumstances, can change to the patient's kin, or the health care staff themselves. In conclusion, the proposed framework represents the first comprehensive proposal regarding the decision-making processes involved in the deliberation on the provision of life sustaining treatment to a patient in a PVS. (shrink)

My aim is to extend and complement the arguments that others have already made for the claim that women who are citizens of economically disadvantaged states and who have been trafficked into sex work in economically advantaged states should be considered candidates for asylum. Familiar arguments cite the sexual violence and forced labor that trafficked women are subjected to along with their well-founded fear of persecution if they’re repatriated. What hasn’t been considered is that reproductive rights are also at stake. (...) I explain how reproductive rights are implicated in sex trafficking. Moreover, I contend that sex traffickers’ abuse of women’s reproductive rights is persecutory and that that this persecutory abuse obliges destination states to offer asylum to transnational sex trafficking victims. I start by sketching reproductive human rights doctrine. I then examine studies of women who are in post-trafficking recovery programs in order to ascertain the impact of their past experience of forced sex work on their reproductive freedom and health. On the basis of these findings, I maintain that, among other outrages, sex trafficking systematically violates victims’ reproductive human rights. In view of this abuse, women trafficked into sex work might seem to be prime candidates for asylum in destination states. Yet, economically well-off destination states are not particularly receptive to this idea, and international law provides some justification for their chilliness. Preliminary to challenging them, I explicate four ways in which international anti-trafficking law and international refugee law interfere with viewing women trafficked into sex work as refugees and approving their applications for asylum. The second half of my paper aims to overcome those legal obstacles. In the interest of parsimony and because there are many continuities between U.S. refugee law and anti-trafficking law and the policies of similar destination states, I focus mainly on the U.S. in this part of the paper. To anchor my argument, I spotlight two precedents in refugee law for taking reproductive human rights seriously and several precedents for treating trafficked women as members of a distinct social group as required by refugee law. I then urge that a law enforcement gestalt has gained undue influence over U.S. legal practices where anti-trafficking law intersects with refugee protection law. A human rights gestalt is needed as a counterweight, for otherwise victims of sex trafficking and the reproductive abuse they’ve suffered are erased. Taking up a human rights perspective and mobilizing the precedents I’ve identified, I show that respecting the reproductive human rights of women who have been trafficked into sex work entails that affluent destination states must recognize their right to asylum. (shrink)

The Infectious Disease Ontology (IDO) is a suite of interoperable ontology modules that aims to provide coverage of all aspects of the infectious disease domain, including biomedical research, clinical care, and public health. IDO Core is designed to be a disease and pathogen neutral ontology, covering just those types of entities and relations that are relevant to infectious diseases generally. IDO Core is then extended by a collection of ontology modules focusing on specific diseases and pathogens. In this (...) paper we present applications of IDO Core within various areas of infectious disease research, together with an overview of all IDO extension ontologies and the methodology on the basis of which they are built. We also survey recent developments involving IDO, including the creation of IDO Virus; the Coronaviruses Infectious Disease Ontology (CIDO); and an extension of CIDO focused on COVID-19 (IDO-CovID-19).We also discuss how these ontologies might assist in information-driven efforts to deal with the ongoing COVID-19 pandemic, to accelerate data discovery in the early stages of future pandemics, and to promote reproducibility of infectious disease research. (shrink)

There is significant controversy over whether patients have a ‘right not to know’ information relevant to their health. Some arguments for limiting such a right appeal to potential burdens on others that a patient’s avoidable ignorance might generate. This paper develops this argument by extending it to cases where refusal of relevant information may generate greater demands on a publicly funded healthcare system. In such cases, patients may have an ‘obligation to know’. However, we cannot infer from the fact (...) that a patient has an obligation to know that she does not also have a right not to know. The right not to know is held against medical professionals at a formal institutional level. We have reason to protect patients’ control over the information that they receive, even if in individual instances patients exercise this control in ways that violate obligations. (shrink)

A lively topic of debate in decision theory over recent years concerns our understanding of the different risk attitudes exhibited by decision makers. There is ample evidence that risk-averse and risk-seeking behaviours are widespread, and a growing consensus that such behaviour is rationally permissible. In the context of clinical medicine, this matter is complicated by the fact that healthcare professionals must often make choices for the benefit of their patients, but the norms of rational choice are conventionally grounded in a (...) decision maker’s own desires, beliefs and actions. The presence of both doctor and patient raises the question of whose risk attitude matters for the choice at hand and what to do when these diverge. Must doctors make risky choices when treating risk-seeking patients? Ought they to be risk averse in general when choosing on behalf of others? In this paper, I will argue that healthcare professionals ought to adopt a deferential approach, whereby it is the risk attitude of the patient that matters in medical decision making. I will show how familiar arguments for widely held anti-paternalistic views about medicine can be straightforwardly extended to include not only patients’ evaluations of possible health states, but also their attitudes to risk. However, I will also show that this deferential view needs further refinement: patients’ higher-order attitudes towards their risk attitudes must be considered in order to avoid some counterexamples and to accommodate different views about what sort of attitudes risk attitudes actually are. (shrink)

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)

In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid progress in many areas. However, use of this technology has brought with it philosophical issues and practical problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds (...) in philosophy, maternity care practice and clinical research, draw upon and extend a recent framework for shared decision-making (SDM) that identified a duty of care to the client's knowledge as a necessary condition for SDM. This duty entails the responsibility to acknowledge and overcome epistemic defeaters. This framework is applied to the use of AI in maternity care, in particular, the use of machine learning and deep learning technology to attempt to enhance electronic fetal monitoring (EFM). In doing so, various sub-kinds of epistemic defeater, namely, transparent, opaque, underdetermined, and inherited defeaters are taxonomized and discussed. The authors argue that, although effective current or future AI-enhanced EFM may impose an epistemic obligation on the part of clinicians to rely on such systems' predictions or diagnoses as input to SDM, such obligations may be overridden by inherited defeaters, caused by a form of algorithmic bias. The existence of inherited defeaters implies that the duty of care to the client's knowledge extends to any situation in which a clinician (or anyone else) is involved in producing training data for a system that will be used in SDM. Any future AI must be capable of assessing women individually, taking into account a wide range of factors including women's preferences, to provide a holistic range of evidence for clinical decision-making. (shrink)

Spinoza rarely refers to art. However, there are extensive resources for a Spinozist aesthetics in his discussion of health in the Ethics and of social affects in his political works. There have been recently been a few essays linking Spinoza and art, but this essay additionally fuses Spinoza’s politics to an affective aesthetics. Spinoza’s statements that art makes us healthier (Ethics 4p54Sch; Emendation section 17) form the foundation of an aesthetics. In Spinoza’s definition, “health” is caused by external (...) objects that maintain our power to act in a variety of ways. Humans need such objects because our complex bodies constantly lose or consume many parts necessary to our overall functioning. Notably, Spinoza defines humans’ bodies through this complexity (2p13Sch), so health as maintenance of complexity is a distinctly human endeavor. Further, while art is not the only healthy activity, I argue that art is a particularly potent cure, which explains Spinoza’s otherwise opaque comment that music can cure melancholy (by which he meant a near-total inability to act, akin to death). Rather than only causing frivolous pleasures, art may be as essential to human flourishing as are other human beings in general; other people are “most useful” because of the variety of actions they make possible (4p35Cor & Sch1). Art’s production of a dizzying variety of affects is likewise most useful for health. -/- Having established how art in general affects the individual, I then explain the role of artists in shaping social groups. Artists use vivid and highly charged affective techniques, as do political sovereigns and religious prophets (TTP chapters 1-2 & 15-16). However, sovereigns and prophets are concerned exclusively with “morality,” defined by Spinoza as the use of affects (primarily based on fear and hope) to produce “obedience” in the generic multitude or people at large. An artist, however, rarely causes affects in the whole nation, affecting instead only a smaller niche or “sub-genre” of people. The affects produced in this group are also not identical to those used by sovereigns, since artists do not primarily deploy sad affects of hope and fear but instead use a wide variety of joyful affects. Further, in Spinoza’s analysis of ceremonies (TTP chapter 5), we see how small groups exposed to repeated ceremonies or social practices eventually develop new strengths which they lacked before. Repeated exposure to shared aesthetic “ceremonies” (e.g., live music performances) of the same sub-genre will over time create the capacity of new powers in the sub-genre of people, which distinguishes them from the masses. Spinoza says sovereigns forge a “second nature” for the generic people through affects; we can then affirm that smaller groups exposed to a distinct sub-genre of art can acquire a new “third nature” which will contain unique powers extending beyond healthy maintenance of their existing bodies. That is, art in general is necessary to flourish and remain whole (maintaining health), but it can also occasionally expand what one is to unforeseen heights (through specific artistic sub-genres). (shrink)

Education is essential to life, and the epidemic affected everything. Parents want to get their kids the most important teaching. However, since COVID-19 has affected schools and other institutions, providing education has become the most significant issue. Online learning pedagogy uses technology to provide high-quality learning environments for student-centered learning. Further, this study explores the experiences and challenges faced by Filipino tertiary students regarding the lack of gadgets amidst online learning. Employing the Interpretative Phenomenological Analysis, the findings of this study (...) were: Some college students still have difficulty with online learning. Attending online classes is difficult, especially for students with limited resources. Smartphones, other gadgets, and internet connections play a significant role in online classrooms because they are the ones that students utilize while learning online, which is essential for successful participation in online higher education as well as for solving a variety of other difficulties in the new normal. Further, College students face similar health challenges. Having an online learning setup is not just about students' struggles with learning resources but also about their health issues. When our respondents used their smartphones for an extended period, they reported eye aches and blurred vision. They also said that some of their body parts, such as their legs and back, are aching, and feel pressured because they tend to overthink things in their surroundings, which causes them incredible difficulty in performing their best in attending online classes. Even though college students continue to suffer from a lack of learning resources during online sessions, they do their best to manage their needs and the scarcity of learning resources. Students have unique coping methods for dealing with difficulties in online classes. (shrink)

This introduction to the edited volume on "Testimonial Injustice and Trust" provides (a) a brief overview of the philosophical debate on the notion of ‘testimonial injustice’ and (b) a summary of the 18 chapters constituting this volume. The contributions are divided into four thematic sections. These are (I) Rethinking Testimonial Injustice, (II) Testimonial Injustice and the Question of Trust, (III) The Public Spheres of Testimonial Injustice, and (IV) Testimonial Injustice and Public Health. The contributions criticize, complement, or expand on (...) Fricker’s central case of testimonial injustice and the proposed virtue of testimonial justice, thereby contributing to its better understanding and extending its scope. Moreover, through the application of theories of epistemic injustice, and testimonial injustice in particular, to new real-world cases and contexts, they seek to render our theories and concepts more robust and valuable. (shrink)

At this stage of the COVID-19 pandemic, two policy aims are imperative: avoiding the need for a general lockdown of the population, with all its economic, social and health costs, and preventing the healthcare system from being overwhelmed by the unchecked spread of infection. Achieving these two aims requires the consideration of unpalatable measures. Julian Savulescu and James Cameron argue that mandatory isolation of the elderly is justified under these circumstances, as they are at increased risk of becoming severely (...) ill from COVID-19, and are thus likely to put disproportionate strain on limited healthcare resources. However, their arguments for this strategy are contingent on the lack of viable alternatives. We suggest that there is a possible alternative: a mandatory, centralised contact-tracing app. We argue that this strategy is ethically preferable to the selective isolation of the elderly, because it does not target members of a certain group, relying instead on the movements of each individual, and because it avoids the extended isolation of certain members of the society. Although this type of contact-tracing app has its drawbacks, we contend that this measure warrants serious consideration. (shrink)

Abstract: This study has effectively tackled the critical challenge of accurate calorie prediction in dishes by employing a robust neural network-based model. With an outstanding accuracy rate of 99.32% and a remarkably low average error of 0.009, our model has showcased its proficiency in delivering precise calorie estimations. This achievement equips individuals, healthcare practitioners, and the food industry with a powerful tool to promote healthier dietary choices and elevate awareness of nutrition. Furthermore, our in-depth feature importance analysis has shed light (...) on the indispensable role played by specific nutritional attributes in calorie estimation. This unveiling of crucial factors provides valuable insights for further research endeavors and practical applications. Notably, this research extends its impact beyond the immediate context by making substantial contributions to the domains of nutrition science and dietary planning. It underscores the transformative potential of artificial intelligence, demonstrating how it can revolutionize our approach to food, nutrition, and health. As the world grapples with the challenges of diet-related health issues and environmental concerns, the accuracy and precision achieved in calorie prediction through neural networks represent a significant stride towards more informed and conscientious dietary practices. In this era of data-driven decision-making, our research paves the way for healthier lifestyles, heightened nutritional awareness, and a more health-conscious society. (shrink)

Cancer biology features the ascription of normal functions to parts of cancers. At least some ascriptions of function in cancer biology track local normality of parts within the global abnormality of the aberration to which those parts belong. That is, cancer biologists identify as functions activities that, in some sense, parts of cancers are supposed to perform, despite cancers themselves having no purpose. The present paper provides a theory to accommodate these normal function ascriptions—I call it the Modeling Account of (...) Normal Function (MA). MA comprises two claims. First, normal functions are activities whose performance by the function-bearing part contributes to the self-maintenance of the whole system and, thereby, results in the continued presence of that part. Second, MA holds that models of system-level activities that are (partly) constitutive of self-maintenance are improved by including a representation of the relevant function-bearing part and by making reference to the activity/activities that part performs which contribute(s) to those system-level activities. I contrast MA with two other accounts that seek to explicate the ascription of normal functions in biology, namely, the organizational account and the selected effects account. Both struggle to extend to cancer biology. However, I offer ecumenical readings which allow them to recover some ascriptions of normal function to parts of cancers. So, though I contend that MA excels in this respect, the purpose of this paper is served if it provides materials for bridging the gap between cancer biology, philosophy of cancer, and the literature on function. (shrink)

Human-centered explainable AI (HCXAI) advocates for the integration of social aspects into AI explanations. Central to the HCXAI discourse is the Social Transparency (ST) framework, which aims to make the socio-organizational context of AI systems accessible to their users. In this work, we suggest extending the ST framework to address the risks of social misattributions in Large Language Models (LLMs), particularly in sensitive areas like mental health. In fact LLMs, which are remarkably capable of simulating roles and personas, may (...) lead to mismatches between designers' intentions and users' perceptions of social attributes, risking to promote emotional manipulation and dangerous behaviors, cases of epistemic injustice, and unwarranted trust. To address these issues, we propose enhancing the ST framework with a fifth 'W-question' to clarify the specific social attributions assigned to LLMs by its designers and users. This addition aims to bridge the gap between LLM capabilities and user perceptions, promoting the ethically responsible development and use of LLM-based technology. (shrink)

Private funding of life sciences has been extensively criticized as lacking objectivity (e.g., Bekelman et al. 2003). However, it is also important to point out that public funding of life sciences faces many objections. In order to improve the system of publicly funded life sciences and its ability to respond to global health challenges such as the COVID-19 pandemic, we should focus on several aspects. First of all, providing existential stability for researchers, in turn, could result in the decrease (...) of academic misconduct. Secondly, COVID-19 vaccines come from all parts of the world and have to be distributed throughout the world, which is a strong argument in favor of the positive stimulation of global science conducted at less-known research institutions and throughout all countries. This brings us to the quest of working on epistemic decolonization and inclusion in contrast to the current elitist paradigm in science. Finally, publicly funded research, which is at the moment mainly focused on foundational questions, should also be extended to applied ones. Public funding of applied research would lead to its development independently of private financial interests. (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)

Two problems are considered here. One relates to who has moral status, and the other relates to who has moral responsibility. The criteria for mattering morally have long been disputed, and many humans and nonhuman animals have been considered “marginal cases,” on the contested edges of moral considerability and concern. The marginalization of humans and other species is frequently the pretext for denying their rights, including the rights to health care, to reproductive freedom, and to bodily autonomy. There is (...) broad agreement across cultural and philosophical traditions about the capacities and responsibilities of moral agents. I propose an inclusive and expansive way of thinking about moral status, situating it not in the characteristics or capacities of individuals, but in the responsibilities and obligations of moral agents. Moral agents, under this view, are not privileged or entitled to special treatment but rather have responsibilities. I approach this by considering some African communitarian conceptions of moral status and moral agency. I propose that moral agency can also be more expansive and include not just individual moral agents but collective entities that have some of the traits of moral agents: power, freedom, and the capacity to recognize and act on the demands of morality and acknowledge and respect the rights of others. Expanding who and what is a moral agent correspondingly extends moral responsibility for respecting rights and fostering the conditions for the health and well-being of humans and animals onto the collective entities who uniquely have the capacity to attend to global-scale health threats such as pandemics and human-caused climate change. (shrink)

This article’s conclusion is that the theories of Einstein are generally correct and will still be relevant in the next century (there will be modifications necessary for development of quantum gravity). Those Einsteinian theories are Special Relativity, General Relativity, and the title of a paper he published in 1919 which asked if gravitation plays a role in the composition of elementary particles of matter. This paper was the bridge between General Relativity and the Unified Field Theory he sought during the (...) last 25 years of his life. In an article published in the "Annals of Physics" in 1957, Charles Misner and John Wheeler claimed that Einstein's latest equations demonstrated the unified field theory. But Einstein himself felt he had not fully succeeded. The present article begins with Olbers’ paradox (why is the sky dark at night?) Then it briefly proceeds to the subjects of Newtonian gravity, quantum entanglement, gravitational waves, E=mc^2, dark energy, dark matter, cosmic expansion, redshift, blueshift, the cosmic microwave background, the 1st Law of Thermodynamics, and explanation of advanced waves travelling back in time. The section “vector-tensor-scalar geometry” touches on mass, quantum spin, the Higgs boson and Higgs field, stellar jets, the pervasiveness of photons and gravitons, and supersymmetry. Then come half a dozen paragraphs referring to formation of planets, black holes, and bosons of the weak and strong nuclear forces. They end with Descartes’ space-matter relation. Also added are paragraphs about simply-connected mathematics, non-orientability, consciousness, the Law of Falling Bodies, the multiverse, space-time travel developed from maths’ Brouwer Fixed Point Theorem and from an experiment in electrical engineering performed at Yale University, development from future space-time travel of human flight in the manner of fiction’s Superman and Supergirl, as well as downloaded band-gap implants in the brain that could deal with forms of matter. They could add or delete anything and everything we choose by emulating computers’ copy/paste function to add things; as well as their delete function, to remove things. To complete my seemingly unusual ideas, 6 sections are added – 1) “Advanced and Retarded Waves” is extended to include dinosaurs, ageing, and photography, 2) there’s a bit about space-time warping and “imaginary” computers, 3) several paragraphs about restoring health (even gaining immortality) by using gravity, 4) a section about superconductivity and the electric or magnetic fields of planets (this section mentions Mercury, Planet 9 and precession), 5) a section titled EXPLAINING OCEAN TIDES WHEN GENERAL RELATIVITY SAYS GRAVITY IS A PUSH CAUSED BY THE CURVATURE OF SPACE-TIME (this has subsections about M-Sigma, Geysers on Saturn’s Moon Enceladus, and A Brief History of Gravity), plus 5) the potential of COVID-19 to create the Golden Rule, world peace, eternal life, and a non-economic world that doesn’t use any form of money (no cash, credit cards, digital currency, etc.) The final section is called DISTANT-FUTURE SCIENCE INTERPRETED BY RELIGIONS AS SUPERNATURAL and introduces an idea for becoming immortal in these physical bodies. If the Theory of Everything sought by physicists applies to all space-time, then every person’s brain must be entangled with the 22nd century (and far beyond that time too). (shrink)

Statistics play a critical role in biological and clinical research. However, most reports of scientific results in the published literature make it difficult for the reader to reproduce the statistical analyses performed in achieving those results because they provide inadequate documentation of the statistical tests and algorithms applied. The Ontology of Biological and Clinical Statistics (OBCS) is put forward here as a step towards solving this problem. Terms in OBCS, including ‘data collection’, ‘data transformation in statistics’, ‘data visualization’, ‘statistical data (...) analysis’, and ‘drawing a conclusion based on data’, cover the major types of statistical processes used in basic biological research and clinical outcome studies. OBCS is aligned with the Basic Formal Ontology (BFO) and extends the Ontology of Biomedical Investigations (OBI), an OBO (Open Biological and Biomedical Ontologies) Foundry ontology supported by over 20 research communities. We discuss two examples illustrating how the ontology is being applied. In the first (biological) use case, we describe how OBCS was applied to represent the high throughput microarray data analysis of immunological transcriptional profiles in human subjects vaccinated with an influenza vaccine. In the second (clinical outcomes) use case, we applied OBCS to represent the processing of electronic health care data to determine the associations between hospital staffing levels and patient mortality. Our case studies were designed to show how OBCS can be used for the consistent representation of statistical analysis pipelines under two different research paradigms. By representing statistics-related terms and their relations in a rigorous fashion, OBCS facilitates standard data analysis and integration, and supports reproducible biological and clinical research. (shrink)

There is a widespread consensus that a commodification of body parts is to be prevented. Numerous policy papers by international organizations extend this view to the blood supply and recommend a system of uncompensated volunteers in this area—often, however, without making the arguments for this view explicit. This situation seems to indicate that a relevant source of justified worry or unease about the blood supply system has to do with the issue of commodification. As a result, the current health (...) minister of Ontario is proposing a ban on compensation even for blood plasma—despite the fact that Canada can only generate 30 % of the plasma needed for fractionation into important plasma protein products and has to purchase the rest abroad. In the following, I am going to suggest a number of alternative perspectives on the debate in order to facilitate a less dogmatic and more differentiated debate about the matter. Especially in light of the often over-simplified notions of altruism and commodification, I conclude that the debate has not conclusively established that it would be morally objectionable to provide blood plasma donors with monetary compensation or with other forms of explicit social recognition as an incentive. This is especially true of donations for fractionation into medicinal products by profit-oriented pharmaceutical companies. (shrink)

Introduction: The paper investigates the impact of the use of metaphors in reasoning tasks concerning vaccination, especially for defeasible reasoning cases. We assumed that both metaphor and defeasible reasoning can be relevant to let people understand vaccination as an important collective health phenomenon, by anticipating possible defeating conditions. -/- Methods: We hypothesized that extended metaphor could improve both the argumentative and the communicative effects of the message. We designed an empirical study to test our main hypotheses: participants (N (...) = 196, 78% females; Meanage = 27.97 years, SDage = 10.40) were presented with a text about vaccination, described in either literal or metaphorical terms, based on uncertain vs. safe reasoning scenarios. -/- Results: The results of the study confirmed that defeasible reasoning is relevant for the communicative impact of a text and that an extended metaphor enhances the overall communicative effects of the message, in terms of understandability, persuasion, perceived safety, and feeling of control over the health situation, collective trust in expertise and uptake of experts' advice. However, the results show that this effect is significantly nuanced by the type of defeasible reasoning, especially in the case of participants' trust in expertise and commitment to experts' advice. -/- Conclusion: Both communicative and defeasible reasoning competences are needed to enhance trust in immunization, with possible different outcomes at an individual and collective level. (shrink)

I claim that differences in the importance attached to economic liberty are more important in debates over the use of genetically modified organisms (GMOs) in agriculture than disagreements about the precautionary principle. I will argue this point by considering a case study: the decision by the U.S. Animal and Plant Health Inspection Service (APHIS) to grant nonregulated status to Roundup Ready soy. I will show that the unregulated release of this herbicide-resistant crop would not be acceptable morally unless one (...) places a very high premium on economic liberty. This is true even if one takes a sound science attitude to unknown risks, rather than a precautionary attitude. I concede that it may not have been within APHIS’s legislative mandate to regulate Roundup Ready soy further, but for those of us who do not put a high premium on economic liberty, this only calls for extending regulatory oversight of GMOs. (shrink)

This article describes a case of a teenager with early complex trauma due to chronic domestic violence. Cannabis use triggered auditory hallucinations, after which the teenager was diagnosed with an acute schizophrenia-like psychotic disorder. Antipsychotic medication did not fully resolve symptoms. Eventually the teenager chose to self-medicate with LSD in order to resolve a suicidal condition. The teenager carried out six unsupervised LSD sessions, followed by an extended period of almost daily use of inhaled low-dose DMT. Psychotic symptoms were (...) mostly resolved after approximately one year. Subsequent cannabis use caused a transient relapse. -/- While his psychosis may have been due to cannabis use in the presence of a genetic predisposition, LSD and DMT did not promote psychotic symptoms in this case, and resolved the suicidal condition in one session. Additional high-dose LSD sessions and low-dose DMT sessions appeared to resolve the symptoms related to the early complex trauma. Alternatively, if psychosis is understood as a massive defense system resulting from early complex trauma, and if his psychotic symptoms were partially due to such trauma, psychedelics appeared to transcend this defense system, providing access to traumatic memories in order to allow for an integrative treatment effect. -/- Information was acquired from medical record excerpts provided by the patient, a semi-structured retrospective video interview, and follow-up interviews a year later. The present case suggests a need for further studies on the relationship between psychedelics and psychotic disorders, the feasibility of supervised vs unsupervised settings for various situations, and alternative therapeutic models for utilizing the hyperaware-hypersensitive state induced by psychedelics. With regard to self-treatment, a harm reduction approach should be adopted. Low-risk psycholytic self-treatment protocols could be developed for future use in public health care systems. (shrink)

Employers seeking to control employee behavior outside of working hours is nothing new. However, recent developments have extended efforts to control employee behavior into new areas, with new significance. Employers seek to control legal behavior by employees outside of working hours, to have significant influence over employee’s health-related behavior, and to monitor and control employee’s social media, even when this behavior has nothing to do with the workplace. In this article, I draw on the work of political theorists (...) Jon Elster, Gerald Gaus and Michael Walzer, and privacy scholars Daniel Solove and Anita Allen, to show what is wrong with this extension of employer control of employee’s outside of work behavior. I argue that there are ethical limits on the controls that employers may put on their employees’ out of work behavior, and that many of these limits should be enshrined into legal protections which would prevent employers from conditioning employment on the regulations criticized. -/- (Please note that the version of this paper on SSRN is a pre-publication version. Please cite and refer to the published version when possible.). (shrink)

Both Heraclitus and Democritus, as the philosophers of historia peri phuseôs, consider nature and human character, habit, law and soul as interrelated emphasizing the links between phusis, kinesis, ethos, logos, kresis, nomos and daimon. On the one hand, Heraclitus’s principle of change (panta rhei) and his emphasis on the element of fire and cosmic motion ultimately dominate his ethics reinforcing his ideas of change, moderation, balance and justice, on the other, Democritus’s atomist description of phusis and motion underlies his principle (...) of moderation and his ideas of health and measured life. In this series, particularly referring to the main principles of motion, moderation and justice, I attempt to describe a coherent pre-Socratic ethical perspective based on the Heraclitean and Democritean fragments. I explore the connections between their physics and ethics also borrowing from Nietzsche’s lectures and writings on the Pre-Socratics. I redefine such Heraclitean and Democritean concepts as harmony, order, perfection, health, self-control, contentment, cheerfulness, concord, sound judgment, wisdom, measure and balance and discuss them under the principles of motion (phusis), moderation (sophrosyne) and justice. In doing so, I also expose the relevance of the Heraclitean notion of logos (interpreting it as the underlying categorical principle of transition between phusis and ethos) in bringing together these ideas and principles. Finally, based on this pre-Socratic Weltanschauung, I assess the possibility of a coherent picture of humanity, its nature and conduct as extending from or fitting into or extending-from-when-fitting-into the cosmos of moving forces and atoms. (shrink)

This chapter aims to examine the configuration of the sharing economy in the United Kingdom. The chapter provides an examination of the key opportunities and challenges that this socio-economic model generates in the country. It includes an account of different sharing economy initiatives in the United Kingdom, including crowdfunding projects, tool libraries, timesharing banks, men’s sheds, and shared workspaces, commercial sharing economy services, micro-libraries, community-gardening projects, and paid online peer-to-peer accommodation. Increased consumer choice and economic benefits derived from an (...) class='Hi'>extended economy around the sharing economy are identified as key opportunities. Key challenges relate to policymaking and taxation of businesses and participants in the sharing economy, as well as the wider enforcement of health and safety regulations and the impact that the recent pandemic is having on the industry. The chapter also provides an examination of the latest developments and regulations in this area. In addition, the chapter identifies the most pressing issues and possible future directions of research in this context. (shrink)

The Hippocratic Oath is a code of ethics defining correct behaviour by physicians they are required to commit themselves to before being accepted into the profession. It was the first code of ethics for any profession. While originating in Ancient Greece, it subsequently evolved, but the current code still embodies many of the core injunctions of the original code. The most widely accepted current form is the 2006 The Declaration of Geneva by the World Medical Association to be taken before (...) being admitted as a member of the medical profession. The most important of its injunctions are: ‘The health of my patient will be my first consideration’ and ‘I will maintain the utmost respect for human life’. The first is a rewording of the injunction from Epidemics, Book I, of the Hippocratic school: ‘Practice two things in your dealings with disease: either help or do not harm the patient.’ This was later simplified to the most basic precept of the Hippocratic Oath: ‘First, do no harm.’ It is one of the principal precepts of bioethics that all students in healthcare that, given an existing problem, it may be better not to do something, or even to do nothing, than to risk causing more harm than good. The development of neurotechnology could be subsumed with little modification under the Geneva formulation of the Hippocratic Oath, extending this precept to a commitment not to damage people’s psychological health. (shrink)