In times of crises, public health leaders may claim that trials of public health interventions are unethical. One reason for this claim can be that equipoise—i.e. a situation of uncertainty and/or disagreement among experts about the evidence regarding an intervention—has been disturbed by a change of collective expert views. Some might claim that equipoise is disturbed if the majority of experts believe that emergency public health interventions are likely to be more beneficial than harmful. However, such beliefs are (...) not always justified: where high quality research has not been conducted, there is often considerable residual uncertainty about whether interventions offer net benefits. In this essay we argue that high-quality research, namely by means of well-designed randomized trials, is ethically obligatory before, during, and after implementing policies in public health emergencies (PHEs). We contend that this standard applies to both pharmaceutical and non-pharmaceutical interventions, and we elaborate an account of equipoise that captures key features of debates in the recent pandemic. We build our case by analyzing research strategies employed during the COVID-19 pandemic regarding drugs, vaccines, and non-pharmaceutical interventions; and by providing responses to possible objections. Finally, we propose a public health policy reform: whenever a policy implemented during a PHE is not grounded in high-quality evidence that expected benefits outweigh harms, there should be a planned approach to generate high-quality evidence, with review of emerging data at preset time points. These preset timepoints guarantee that policymakers pause to review emerging evidence and consider ceasing ineffective or even harmful policies, thereby improving transparency and accountability, as well as permitting the redirection of resources to more effective or beneficial interventions. (shrink)

An abundance of data unequivocally shows that exercise can be an effective tool in the fight against obesity and its associated co-morbidities. Indeed, physical activity can be more effective than widely-used pharmaceutical interventions. Whilst metformin reduces the incidence of diabetes by 31% (as compared with a placebo) in both men and women across different racial and ethnic groups, lifestyle intervention (including exercise) reduces the incidence by 58%. In this context, it is notable that a group of prominent medics (...) and exercise scientists recently sent a well-publicised letter to the General Medical Council and Medical Schools Council calling for the introduction of evidence-based lifestyle education into all medical curricula. The letter warns that there is a lack of understanding of the impact that exercise and nutrition can have on physical health amongst doctors. In the absence of an educational overhaul, the signatories warn that the government is likely to fail to reach its goal of preventing tens of thousands of premature deaths from heart disease and cancer by 2020. Whilst we agree with the need to address this apparent lack of understanding, we argue that the ethical justification of doing so is not limited to this broadly beneficence-based justification. There is also a justification grounded in the duty of non-maleficence, that is, the duty to avoid unreasonably harming patients. This duty requires that doctors refrain from (i) preventing patients from undergoing beneficial treatment without good reason, (ii) exposing patients to unreasonable risks and (iii) reducing the therapeutic effect of an effective medical intervention. This requires an understanding of the physical impact of exercise. (shrink)

Lockdowns, or modern quarantines, involve the use of novel restrictive non-pharmaceutical interventions (NPIs) to suppress the transmission of COVID-19. In this paper, I aim to critically analyze the emerging history and philosophy of lockdowns, with an emphasis on the communication of health evidence and risk for informing policy decisions. I draw a distinction between evidence-based and modeling-based decision-making. I argue that using the normative framework of evidence-based medicine would have recommended against the use of lockdowns. I first review (...) the World Health Organization’s evidence-based pandemic preparedness plans for respiratory viruses. I then provide a very brief history of COVID-19 modeling, which was cited as justification for the use of lockdowns in the U.K., the U.S., and much of the world. I focus on the so-called Imperial College model designed by Neil Ferguson et al. as well as the so-called Oxford model designed by José Lourenço et al. I analyze the evidence-based pandemic response known as ‘mitigation’, and I compare it with Ferguson et al.’s experimental strategy known as ‘suppression’. I summarize the strengths and weaknesses of these strategies based on their diametric aims and each model’s parametric assumptions. Based on my critical analysis of the suppression strategy, I attempt to expose what has been called the ‘logic of lockdowns’, which Sunetra Gupta of the Oxford model group has suggested is flawed. Finally, I consider Trisha Greenhalgh’s objection to evidence-based policy based on the precautionary principle, and I attempt to offer a response. I conclude with a brief narrative review of the emerging randomized evidence on restrictive NPIs, which seems to support my claim that mitigation was the strategy that would have been recommended by evidence-based medicine. If this is true, then COVID-19 modeling may serve as an important reminder of the enduring lesson of evidence-based medicine: that one should always ‘Trust the Evidence!’ for better health policy. (shrink)

In the following paper I develop an account of Gilles Deleuze’s ethics through his work on Spinoza, which he contrasts with morality, to argue that an ethical response to the COVID-19 pandemic should resist the moralizing of the New Normal and instead have an immanent focus on what is happening to us. In the first part of the paper I detail the novel approach to ethics as ethology that Deleuze works out most explicitly in Spinoza: Practical Philosophy. In the second (...) part I show exactly how Deleuze contrasts ethics from morality and moral thinking before showing the relation of ethics to morality in relation to the New Normal and contrast the Deleuzian ethical perspective from other ethical philosophical accounts that I claim are indicative a moral approach to the New Normal. I conclude by arguing that the prevalence of the New Normal amidst COVID-19 represents a triumph of what Spinoza calls the sad passions and suggest Deleuze’s ethics might be a way to reject those sad passions. (shrink)

In 2014, John O’Keefe was awarded the Nobel Prize in Physiology or Medicine for his work on the hippocampus and its role in encoding map-like representations. His contributions were significantly influenced by Morris water maze studies. O’Keefe himself acknowledged the pivotal role of the Morris water maze, stating that it remains the preeminent behavioral assay for assessing hippocampal function. Indeed, thousands of researchers have turned to the Morris water maze for evidence about navigation abilities and the effects that stress, lesions, (...) pharmaceutical interventions, and more can have on them. This body of studies constitutes an important scientific enterprise. -/- This dissertation is about some of the philosophical dimensions of Morris water maze studies. Chapter 1 is about the different types of information states (including representational states) found across hypotheses about Morris water maze performance. Chapter 2 is about systematic task failures reported in Morris water maze studies. I argue these impose a constraint on what can count as an explanation (a good hypothesis) of task success. While this has the air of a chopping block for scientific hypotheses, I see things a little differently. In Chapter 3, I argue that satisfying the constraint is a formidable challenge for any hypothesis. One that should make researchers second-guess the concepts and strategies employed to explain the roles information states play in the maze task. Chapter 4 focuses on two spatial concepts. I argue that researchers working definitions for the spatial concepts of distal (far) and proximal (near) in maze studies are problematic. They are not ecologically valid, and so claims about them do not generalize to real-life navigation behaviors like migration or scavenging behaviors. Following this, I present alternative definitions in terms of neural information about visual cues. The neural information relevant to this account is non-conceptual, and so it provides a sketch of the ways in which information states can fruitfully contribute to explanations of rat success and failure while maintaining ecological validity. -/- To sum, this dissertation navigates important philosophical dimensions of Morris water maze studies, illustrating the challenges and opportunities involved in using information states to explain and understand animal navigation. (shrink)

The world's political and military leaders are under increasing pressure to intervene in the affairs of sovereign nations. Although the sovereignty of states and the corollary principle of nonintervention have been part of the foundation of international law, there is some latitude for states, as well as collective security organizations, to intervene in another state's domestic and foreign affairs, thus making sovereignty and the principle less than absolute. In this paper I first sketch a reasonable foundation for sovereignty of states (...) and the principle of nonintervention. Second, I offer a decision-making procedure for justified intervention. Finally, I argue that there is an important difference between the strategic argument and the humanitarian argument, a difference that may have profound implications for the future use of the latter argument by our political leaders. (shrink)

Drug regulation is fraught with inductive risk. Regulators must make a prediction about whether or not an experimental pharmaceutical will be effective and relatively safe when used by typical patients, and such predictions are based on a complex, indeterminate, and incomplete evidential basis. Such inductive risk has important practical consequences. If regulators reject an experimental drug when it in fact has a favourable benefit/harm profile, then a valuable intervention is denied to the public and a company’s material interests are (...) needlessly thwarted. Conversely, if regulators approve an experimental drug when it in fact has an unfavourable benefit/harm profile, then resources are wasted, people are needlessly harmed, and other potentially more effective treatments are underutilized. Given that such regulatory decisions have these practical consequences, non-epistemic values about the relative importance of these consequences impact the way such regulatory decisions are made (similar to the analysis of laboratory studies on the toxic effects of dioxins presented in Douglas [2000]). To balance the competing demands of the pertinent non-epistemic values, regulators must perform what I call an “inductive risk calculus.” At least in the American context this inductive risk calculus is not well-managed. (shrink)

Non-communicable diseases (NCDs) such as cardiovascular diseases and diabetes are reported to have caused significant deaths for more than a decade. Consequently, NCDs have posed as a threat to the socio-economic well-being of individuals and families, contributed to a rise in healthcare costs and largely undermined the attainment of the Sustainable Development Goals (SDGs) especially in developing countries. According to the World Health Organization (WHO), the prevalence of NCDs have compounded the problem of already ill equipped healthcare systems in these (...) countries as they are faced with constraints to deal with the burden of both infectious and non-communicable diseases. Informed largely by the rapid increase in NCDs and their subsequent threat to public health, we aimed to ascertain the various healthcare interventions that Ghana has fashioned out in her bid to prevent and control the incidence of NCDs, how these interventions were rolled out and examined past and present barriers to their implementation since 1990. We culled the data gathered for this paper from both primary and secondary sources to construct a coherent synthesis and to facilitate discussions on Ghana’s NCDs interventions from 1990 to 2018. A systematic analysis of the data gathered, revealed that Ghana’s healthcare system has by far tackled the NCDs burden in two folds; the clinical care aspect and the health promotion aspect. While certain healthcare interventions were purposively directed toward addressing NCDs, others were directed at promoting healthy lifestyles but had a bearing on the prevention and control of NCDs. Present challenges concerning shortfalls in interventions are a reflection of unresolved challenges in the past. We argue that despite the significant strides made for more than two decades, the interventions have addressed the burden of NCDs with limited success given the trends in NCDs mortality and morbidity. (shrink)

A central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to the intervention. However, in some circumstances it is tempting to say that the moral reason to obtain informed consent prior to administering a medical intervention is outweighed. For example, if an individual’s refusal to undergo a medical intervention would lead to the transmission of a dangerous infectious disease to other members of (...) the community, one might claim that it would be morally permissible to administer the intervention even in the absence of consent. Indeed, as we shall discuss below, there are a number of examples of public health authorities implementing compulsory or coercive measures for the purposes of infectious disease control (IDC). The plausibility of the thought that non-consensual medical interventions might be justified when performed for the purpose of IDC raises the question of whether such interventions might permissibly be used to realize other public goods. In this article we focus on one possibility: whether it could be permissible to non-consensually impose certain interventions that alter brain states or processes through chemical or physical means on serious criminal offenders. We shall suggest that some such interventions might be permissible if they safely and effectively serve to facilitate the offender’s rehabilitation and thereby prevent criminal recidivism. (shrink)

The incidence of chronic non-communicable diseases (NCDs) such as diabetes, hypertension, cancers and cardiovascular diseases in Ghana has created a new mix of healthcare challenge for the country.

This chapter sets the scene for the subsequent philosophical discussions by surveying a number of biological interventions that have been used, or might in the future be used, for the purposes of crime prevention. These interventions are pharmaceutical interventions intended to suppress libido, treat substance abuse or attention deficit-hyperactivity disorder (ADHD), or modulate serotonin activity; nutritional interventions; and electrical and magnetic brain stimulation. Where applicable, we briefly comment on the historical use of these interventions, (...) and in each case we discuss the evidence that they are effective, or might become so with further refinement. The chapter concludes with a comment on some potentially significant differences between the varieties of intervention that we canvass. (shrink)

Michael Walzer argues that except in cases involving genocide or mass slaughter, humanitarian intervention is unjustifiable because “citizens get the government they deserve, or, at least, the government for which they are ‘fit.’”Yet, if people are autonomous and deserve the government that rules over them, then it would seem that they are responsible for the government’s actions, including their nation’s wars of aggression.That line of thought undermines the doctrine of noncombatant immunity, which is perhaps the most important of Walzer’s jus (...) in bello principles. In this way, the concept of self-determination frustrates Walzer’s attempts to keep jus ad bellum and jus in bello considerations separate. (shrink)

This paper brings the concept of affective scaffolding to bear on a much-debated controversy: the expanding use of psy- chiatric medications to treat an increasingly broad range of human discontents. ‘Affective scaffolding’ refers to the variety of ways that agents engage with, recruit or modify their environments to actively shape their emotions, moods, or other affective phenomena. Psychiatric drugs are designed, marketed, and prescribed as technologies that have the special power to transform affective life by intervening on the pathological underpinnings (...) of distress and suffering to change how we feel. The paper develops an account of psychiatric drug use as affective scaffolding and examines how psychiatrization – the complex social process through which psychiatry comes to influence more and more domains of human life – impacts this form of scaffolding. I propose that psychiatrization influences affective scaffolding by biasing individuals toward psychiatric drugs to manage an expanding array of affective experiences. In some cases, I argue, this results in bad pharmaceutical scaffolding. Bad pharmaceutical scaffolding emerges when an agent is influenced to select and rely upon psychiatric drugs in attempts to exert individual control over distress and suffering where (1) at least some of the key determinants of these affective experiences are properties of the agent’s environment, in contrast to, in a strict sense, properties internal to the person, and (2) pharmaceutical scaffolding obviates the need for or displaces other non-pharmaceutical options that would better serve the agent's affective needs and interests. (shrink)

The COVID-19 pandemic has made it especially visible that mortality data are a key component of epidemiological models, being a single indicator that provides information about various health aspects, such as disease prevalence and effectiveness of interventions, and thus enabling predictions on many fronts. In this paper we illustrate the interrelation between facts and values in death statistics, by analyzing the rules for death certification issued by the World Health Organization. We show how the notion of the underlying cause (...) of death can change in view of public health goals. This brings us to a general point about how non-epistemic factors, such as values and goals, are reflected in the choice of different measures in epidemiological models. We finally argue that this analysis is not only relevant from a theoretical point of view but also has important practical consequences. (shrink)

This article introduces a non‐cognitivist account of metaphysical explanation according to which the core function of judgements of the form ⌜x because y⌝ is not to state truth‐apt beliefs. Instead, their core function is to express attitudes of commitment to, and recommendation of the acceptance of certain norms governing interventional conduct at contexts.

Patients’ knowledge of hypertension and treatment has been found to affect health outcomes of hypertension. This study aimed to assess the impact of therapeutic patients’ education on knowledge of hypertension and lifestyle/dietary modification among hypertensive patients in Nigeria. The study was conducted among 317 hypertensive patients randomized into controlled and intervention groups (158 vs 159, respectively) between March 2021 and February 2022. Baseline knowledge of the patients was assessed and intervention was provided for the intervention group with a structured educational (...) program at a baseline and six months. Descriptive data were presented with a frequency table in percentage while the chi-square test and univariate logistic regression were used to determine the association between categorical variables. Out of the total 318 patients, 275 completed the study (response rate: 86.8%) with 136 in the control group and 139 in the intervention group. The mean age of the patients was 59.5 (±12.5) and patients >60 years (49.5%) were the most frequent age category. The baseline knowledge score of hypertension was 9.8 (±2.6) and 9.3 (±2.6) on a scale of 16 points in the control group and intervention group, respectively (P=0.060) while at six months 11.9 (±2.3) vs 10.8 (±2.4) (P<0.001) and 12 months 12.6 (±2.5) vs 9.5 (±2.0) (P<0.001), respectively. Knowledge of lifestyle/dietary modification in the control group and intervention group at baseline was 7.0 (±2.1) and 6.6 (±2.0), respectively, while at six months 7.5 (±1.5) vs 9.9 (±1.3) (P<0.001) and at 12 months 7.2 (±1.5) vs 10.4 (±1.2), respectively. Marital status, body mass index, and family history of hypertension were associated with knowledge of hypertension and lifestyle/dietary modification (P<0.001). The educational intervention provided was associated with a significant improvement in knowledge of hypertension and lifestyle/dietary modification. The marital status of the patients, body mass index and family history of hypertension influenced patients’ level of knowledge. (shrink)

Virtues, broadly understood as stable and robust dispositions for certain responses across morally relevant situations, have been a growing topic of interest in psychology. A central topic of discussion has been whether studies showing that situations can strongly influence our responses provide evidence against the existence of virtues (as a kind of stable and robust disposition). In this review, we examine reasons for thinking that the prevailing methods for examining situational influences are limited in their ability to test dispositional stability (...) and robustness; or, then, whether virtues exist. We make the case that these limitations can be addressed by aggregating repeated, cross-situational assessments of environmental, psychological and physiological variables within everyday life—a form of assessment often called ecological momentary assessment (EMA, or experience sampling). We, then, examine how advances in smartphone application (app) technology, and their mass adoption, make these mobile devices an unprecedented vehicle for EMA and, thus, the psychological study of virtue. We, additionally, examine how smartphones might be used for virtue development by promoting changes in thought and behavior within daily life; a technique often called ecological momentary intervention (EMI). While EMA/I have become widely employed since the 1980s for the purposes of understanding and promoting change amongst clinical populations, few EMA/I studies have been devoted to understanding or promoting virtues within non-clinical populations. Further, most EMA/I studies have relied on journaling, PDAs, phone calls and/or text messaging systems. We explore how smartphone app technology provides a means of making EMA a more robust psychological method, EMI a more robust way of promoting positive change, and, as a result, opens up new possibilities for studying and promoting virtues. (shrink)

This study presented the policy of functional integration of the product planning team as a strategy for the development of the pharmaceutical industry in Palestine. The study population consists of all the workers in companies operating in the field of medicine in Palestine, which are (5) companies producing in the West Bank only for pharmaceuticals used by these companies, which are (296) employees, and was used a simple random sample to choose the sample and size (87) employees of the (...) study population, and to achieve the objectives of the study (87) questionnaires were distributed. The descriptive analytical method was used, and SPSS was used to answer and discuss the study's questions. The results showed that there is a significant relationship between the effectiveness of the policy of product development and the competitiveness of pharmaceutical companies in Palestine (West Bank), where the policy of product development efficiency accounts for 56.6% of the total change in the competitiveness of companies. The product quality component was most influential at all levels of product development effectiveness policy, followed by product identification, product cost reduction, packaging and product deletion. The weakest areas of strategic direction in pharmaceutical companies in Palestine (West Bank) are 67%. The weakest aspects of job integration are: non-regular meetings of representatives of different positions to participate in any project related to product development, to achieve spatial convergence of members of the product planning policy team in offices, laboratories and workplaces. (shrink)

This article argues against the concept of integration as the main mechanism allowing various sociocultural groups to live together and instead proposes ‘radical inclusivity’ as a better, less oppressive model of a pluralistic society. Through analytical and reflective research on the non-cohesion-based approach to integration or inclusion, this article is devoted to examining the affordances and limitations of integration through various forms of spatial interventions. As an example, we will discuss the Ellesmere Green Project in Sheffield (UK) as a (...) typical small urban regeneration executed in a highly diverse part of Sheffield. This piece aims to bring forward the significance of moving beyond the community-as-cohesion model in urban politics and planning for integration. (shrink)

Inspired by recent breakthroughs in predictive modeling, practitioners in both industry and government have turned to machine learning with hopes of operationalizing predictions to drive automated decisions. Unfortunately, many social desiderata concerning consequential decisions, such as justice or fairness, have no natural formulation within a purely predictive framework. In efforts to mitigate these problems, researchers have proposed a variety of metrics for quantifying deviations from various statistical parities that we might expect to observe in a fair world and offered a (...) variety of algorithms in attempts to satisfy subsets of these parities or to trade o the degree to which they are satised against utility. In this paper, we connect this approach to fair machine learning to the literature on ideal and non-ideal methodological approaches in political philosophy. The ideal approach requires positing the principles according to which a just world would operate. In the most straightforward application of ideal theory, one supports a proposed policy by arguing that it closes a discrepancy between the real and the perfectly just world. However, by failing to account for the mechanisms by which our non-ideal world arose, the responsibilities of various decision-makers, and the impacts of proposed policies, naive applications of ideal thinking can lead to misguided interventions. In this paper, we demonstrate a connection between the fair machine learning literature and the ideal approach in political philosophy, and argue that the increasingly apparent shortcomings of proposed fair machine learning algorithms reflect broader troubles faced by the ideal approach. We conclude with a critical discussion of the harms of misguided solutions, a reinterpretation of impossibility results, and directions for future research. (shrink)

In this paper, I argue that the principle of respect for autonomy can serve as the basis for laws that significantly limit conduct, including orders mandating isolation and quarantine. This thesis is fundamentally at odds with an overwhelming consensus in contemporary bioethics that the principle of respect for autonomy, while important in everyday clinical encounters, must be 'curtailed', 'constrained', or 'overridden' by other principles in times of crisis. I contend that bioethicists have embraced an indefensibly 'thin' notion of autonomy that (...) uproots the concept from its foundations in Kantian ethics. According to this thin conception, respect for autonomy, if unconditioned by competing principles (beneficence, justice, non-maleficence) would give competent adults the right to do anything they desired to do so long as they satisfied certain baseline psychological conditions. I argue that the dominant 'principlist' model of bioethical reasoning depends on this thin view of autonomy and show how it deprives us of powerful analytical tools that would help us to think seriously about the foundations of human rights, justice, and law. Then, I offer a brief sketch of a 'thick', historically grounded notion of autonomy and show what we could gain by taking it seriously. (shrink)

Bringing together various scholars from different backgrounds and embodying a truly interdisciplinary approach make Sufism: A Theoretical Intervention in Global International Relations a valuable and timely contribution to the increasing interest in non-Western traditions of thought. It will be of interest to IR theorists as well as scholars in other disciplines who are interested in non-Western traditions of thought and is sure to motivate further research in IR that is inspired by Sufism.

Some early phase clinical studies of candidate HIV cure and remission interventions appear to have adverse medical risk–benefit ratios for participants. Why, then, do people participate? And is it ethically permissible to allow them to participate? Recent work in decision theory sheds light on both of these questions, by casting doubt on the idea that rational individuals prefer choices that maximise expected utility, and therefore by casting doubt on the idea that researchers have an ethical obligation not to enrol (...) participants in studies with high risk–benefit ratios. This work supports the view that researchers should instead defer to the considered preferences of the participants themselves. This essay briefly explains this recent work, and then explores its application to these two questions in more detail. (shrink)

As the demand for explainable deep learning grows in the evaluation of language technologies, the value of a principled grounding for those explanations grows as well. Here we study the state-of-the-art in explanation for neural models for natural-language processing (NLP) tasks from the viewpoint of philosophy of science. We focus on recent evaluation work that finds brittleness in explanations obtained through attention mechanisms.We harness philosophical accounts of explanation to suggest broader conclusions from these studies. From this analysis, we assert the (...) impossibility of causal explanations from attention layers over text data. We then introduce NLP researchers to contemporary philosophy of science theories that allow robust yet non-causal reasoning in explanation, giving computer scientists a vocabulary for future research. (shrink)

Eyal Shahar’s essay review [1] of James Penston’s remarkable book [2] seems more inspired playful academic provocation than review or essay, expressing dramatic views of impossible validity. The account given of modern biostatistical causation reveals the slide from science into the intellectual confusion and non-science RCTs have created: “…. the purpose of medical research is to estimate the magnitude of the effect of a causal contrast, for example the probability ratio of a binary outcome …” But Shahar’s world is simultaneously (...) not probabilistic, but of absolute uncertainty: “We should have no confidence in any type of evidence ….. We should have no confidence at all”. Shahar’s "Causal contrast" is attractive. It seems to make sense, but bypasses in two words the means of establishing causation by the scientific method. This phrase assumes a numeric statistically significant “contrast” is causal rather than a potential correlation requiring further investigation. The concept of “causal contrast” is a slippery slope from sense into biostatistical non-science. This can be illustrated with an hypothetical RCT where 100% of interventions exhibit a posited treatment effect and 0% of placebo controls. Internal validity is seemingly quite reasonably assumed satisfied (common-sense dictating the likelihood of an awesome magnificent fraud, bias or plain error of the magnitude required is infinitesimal). Scientific method appears satisfied. The RCT demonstrates: (1) strict regularity of outcome in the presence of posited cause; (2) the absence of outcome in its absence and (3) an intervention (experiment) showing the direction of causation is from posited cause to posited effect. Now travel further down the slope from science. Assume 50% of interventions and 0% of controls are positive. We compromise scientific method, but justify this by assuming a large subgroup which we say surely must on these figures be exhibiting the posited treatment effect. But what of 10% of interventions and 9% of placebo controls exhibiting the posited treatment effect? Our biostatistician says the 1% “causal contrast” is statistically significant. But we have: (1) minimal evidence of regularity; (2) the posited outcome irrespective of presence of posited cause and (3) our intervention is at the highest equivocal in demonstrating any form of causation. This is not science. It is, however, where biostatistics has unthinkingly taken us, as Penston has shown comprehensively [2]. We, the audience of published medical research, are now for the 10% / 9% example well down the slope from science. An unattractive hypothesis results requiring numerous assumptions similar to these:- "There is a 'contrast' which is ‘causal’, albeit the method employed is not scientific. An effect of the intervention has been observed in a very small subgroup. This subgroup is susceptible to treatment. The similar number of placebo controls exhibiting the outcome sought is irrelevant, because the 1% difference between intervention and controls is statistically significant. The statistical analysis is valid and reliable. The RCT’s internal validity is sufficiently satisfied. No funding or bias or fraud has affected the results or their analysis.” As Penston notes: “Confirming and refuting the results of research is crucial to science …. But … there’s no way of testing the results of any particular large-scale RCT or epidemiological study. Each study … is left hanging in the air, unsupported.” It gets worse. To identify a rare serious adverse reaction of a frequency of 1:10,000 can require a trial of 200,000 or larger split between controls and interventions. This is not done. But for every 100 who prospectively benefit from the intervention, 9,900 also receive it. And for every 100 benefiting one person (who likely gains no benefit) will suffer a serious unidentified adverse reaction. This is also without taking account of more common adverse reactions whether serious or otherwise. References [1] Shahar, E. (2011) Research and medicine: human conjectures at every turn. International Journal of Person Centered Medicine 1 (2), 250-253. [2] Penston, J. (2010). stats.con: How we’ve been fooled by statistics-based research in medicine. London: The London Press, UK. (shrink)

The scholarship on Frantz Fanon’s theorization of violence is crowded with interpretations that follow the Arendtian paradigm of violence. These interpretations often discuss whether violence is instrumental or non-instrumental in Fanon’s work. This reading, I believe, is the result of approaching Fanon through Hannah Arendt’s framing of violence, i.e. through a binary paradigm of instrumental versus non-instrumental violence. Even some Fanon scholars who question Arendt’s reading of Fanon, do so by employing a similar binary logic, hence repeating the same either/or (...) paradigm of instrumental versus non-instrumental violence. I aim to challenge such interpretations of Fanon by demonstrating that in the context of anticolonial armed struggle in which Fanon writes, the either/or framework of the instrumental/non-instrumental binary of violence cannot fully capture his perspective. Violence can indeed be conceived as having both constructive and instrumental aspects. My argument is supported by Fanon’s corpus, including his 1960 Accra speech, “Why We Use Violence” in Alienation and Freedom. This piece, I suggest, together with Fanon’s other writings, poses a direct challenge to the Arendtian binary of violence. My analysis resists positioning the difference between Arendt and Fanon through the instrumental/non-instrumental binary. By using Judith Butler’s notion of “frame” I complicate their difference and argue Arendt’s framing of violence prevents her from apprehending Fanon and – more importantly – interpretations of Fanon based on this Arendtian frame of violence inevitably lead to misinterpretations. (shrink)

Debates in the philosophy of science typically take place around issues such as realism and theory change. Recently, the debate has been reformulated to bring in the role of experiments in the context of theory change. As regards realism, Ian Hacking’s contribution has been to introduce ‘intervention’ as the basis of realism. He also proposed, following Imre Lakatos, to replace the issue of truth with progress and rationality. In this context we examine the case of the vitalism — reductionism debate (...) in biology inspired by the works of Indian physicist-turned-biologist Jagadish Chandra Bose (1858–1937), in the early twentieth century. Both camps had their characteristic hardcores. Vitalists led by John S. Burdon-Sanderson and Augustus D. Waller accepted religious metaphysics to support their research programme, which ultimately degenerated. Bose worked more with the ideals of science such as Occam’s razor, large-scale systematization of phenomena and novel prediction. I argue that his religious metaphysics, instead of acting as a protective shield, helped him to consolidate his position and allowed further problem shift resulting in a research programme that involved consciousness too. His research programme remains relevant even today. (shrink)

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

The discussion on the 900 Conclusiones projected and sponsored by Giovanni Pico della Mirandola in Rome was cut short by the condemnation of 13 of them by the papal commission in 1487. Princeps Concordiae’s counter-arguments presented in his Apologia, published in the same year, can not be certainly considered a disputatio as Pico had called for; the papal intervention removed in this way the possibility to have a better acquaintance with a work which is still a very difficult one, just (...) for its “unfinished” form. Pedro Garsia’s Determinationes magistrales against Pico’s Apologia are a very poor reply to Pico. In this paper Pico’s arguments against some of the condemned Conclusiones are considered as well as Pedro Garsia’s counter-arguments. Giovanni Pico della Mirandola displays a deep familiarity with medieval logical and semantical doctrines, while Pedro Garsia’s arguments betray a solid ignorance. (shrink)

L’érosion actuelle de la confiance du public envers les campagnes de vaccination et les décisions de politiques publiques qui y sont associées, aggravée par des scandales comme ceux relatifs à la pandémie H1N1 et l’utilisation du Tamiflu™, risque de diminuer de façon significative l’efficacité de ces interventions importantes pour la santé publique. Un manque de confiance de la population envers les acteurs de santé publique peut conduire à une méfiance accrue face aux interventions, pouvant ainsi compromettre l’atteinte des (...) objectifs recherchés par une intervention spécifique et, conséquemment, avoir un impact important sur les bénéfices attendus pour la population visée par cette intervention. Dans la production des avis d’experts, les membres des comités consultatifs d’experts en immunisation (CCEI) peuvent avoir une influence importante sur la prise de décision publique, notamment, sur la sélection par les décideurs de santé publique de vaccins en particulier et la façon dont les campagnes de vaccination seront déployées. En contrepartie de cette influence sur les décisions publiques, une indépendance et une transparence sont attendues de leur part puisque des mécanismes de divulgation et de gestion de conflits d’intérêts (CI) imparfaits peuvent affecter négativement la confiance du public à l’égard de telles décisions. Il apparaît donc important de s’assurer que des mécanismes de gestion des CI, transparents et robustes, existent pour ces comités. Dans cette étude, les avis ou rapports d’évaluation de la pertinence de la vaccination préparés par un CCEI au Québec ont été examinés pour quatre types de maladies évitables par la vaccination (infections invasives à méningocoques et à pneumocoques, coqueluche et virus du papillome humain). Le but était de : 1) identifier les CI divulgués par les membres du CCEI dans leurs rapports comparativement à ceux déclarés dans leurs publications scientifiques pour ces mêmes infections ; 2) analyser la nature des CI (réel, potentiel, apparent, personnel, financier, institutionnel, etc.) et l’impact potentiel (risque) sur la prise de décision impartiale et sur la confiance du public ; et 3) évaluer les mécanismes de gestion de CI actuellement utilisés par ce CCEI. Les résultats de cette étude montrent que très peu de rapports du CCEI contiennent une section sur les CI par rapport à la pléthore divulguée dans les publications scientifiques publiées par les membres du CCEI. De plus, les CI divulgués dans les rapports fréquemment ne correspondent pas à ceux décrits dans les publications scientifiques. Il serait donc important d’introduire des mesures visant à accroître la transparence des experts en immunisation et d’améliorer les mécanismes de divulgation et de gestion des CI afin de veiller à ce que la confiance du public envers les décideurs en santé publique soit maintenue et améliorée. (shrink)

The paper reports results of the very first survey-based study on the prevalence, frequency and nature of ethical or other non-medical difficulties faced by Polish physicians in their everyday clinical practice. The study involved 521 physicians of various medical specialties, practicing mainly in inpatient healthcare. The study showed that the majority of Polish physicians encounter ethical and other non-medical difficulties in making clinical decisions. However, they confront such difficulties less frequently than their foreign peers. Moreover, Polish doctors indicate different circumstances (...) as a source of the experienced problems. The difficulties most often reported relate to (i) patients (or their proxies) requests for medically non-indicated interventions; (ii) problems with communication with patients (or their proxies) due to the patients’ negative attitude, unwillingness to cooperate, or aggression; and (iii) various difficulties with obtaining informed consent. Polish physicians report difficulties associated with disagreements among care givers or scarcity of resources less frequently than doctors from other countries. The study’s findings provide support for the thesis that a significant portion of Polish physicians still follow a traditional, paternalistic, and hierarchical model of healthcare practice. Instead of promoting patient’s empowerment, engagement, and rights, they often consider these ideas as a threat to physicians’ professional authority and autonomy. The study leads to the conclusion that due to insufficient training in medical ethics, communication skills, and medical law, many Polish physicians lack the knowledge and competence necessary to adequately respond to challenges posed by modern healthcare practice. (shrink)

Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. While such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to “medicalization” of human love and heartache—for some, a source of serious concern. In this essay, we argue that the “medicalization of love” need not necessarily be problematic, on balance, but could plausibly be expected to have either (...) good or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help direct the course of love’s “medicalization”—should it happen to occur—more toward the “good” side than the “bad.”. (shrink)

This chapter critically analyses the ethical and political dimensions of supposedly subtle and non-coercive interventions that aim to ‘prevent crime’ through environmental designs making certain public spaces less attractive for specific groups. Examples include benches designed to discourage sleeping (targeted at homeless people), high-pitched noises or classical music played to deter lingering (targeted at youngsters), and specific lighting to prevent aggression (targeted at nightlife). While these interventions may appear less problematic than more traditional exclusionary measures, they raise ethical (...) and political worries that come into view clearly when we analyse them as instances of nudging, on the one hand, and niche construction and affective scaffolding, on the other. Employing this approach reveals how these exclusionary environmental designs not only risk reinforcing problematic stereotypes and social inequalities and discipline rather than prevent crime, they also can alienate specific groups, constitute affective injustices, and inflexibly reduce the diverse purposes public spaces potentially have. The chapter argues that environments are never neutral as they inevitably support and encourage some bodies, behaviours, moods, and emotions while suppressing and discouraging others. (shrink)

Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed by a critical assessment of (...) some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity. (shrink)

The controversy over the old ideal of “value-free science” has cooled significantly over the past decade. Many philosophers of science now agree that even ethical and political values may play a substantial role in all aspects of scientific inquiry. Consequently, in the last few years, work in science and values has become more specific: Which values may influence science, and in which ways? Or, how do we distinguish illegitimate from illegitimate kinds of influence? In this paper, I argue that this (...) problem requires philosophers of science to take a new direction. I present two case studies in the influence of values on scientific inquiry: feminist values in archaeology and commercial values in pharmaceutical research. I offer a preliminary assessment of these cases, that the influence of values was legitimate in the feminist case, but not in the pharmaceutical case. I then turn to three major approaches to distinguish legitimate from illegitimate influences of values, including the distinction between epistemic and non-epistemic values and Heather Douglas’ distinction between direct and indirect roles for values. I argue that none of these three approaches gives an adequate analysis of the two cases. In the concluding section, I briefly sketch my own approach, which draws more heavily on ethics than the others, and is more promising as a solution to the current problem. This is the new direction in which I think science and values should move. (shrink)

Michael Walzer’s use of John Stuart Mill’s A Few Words on Non-Intervention (1859) helped to inaugurate it as a canonical text of international theory. However, Walzer’s use of the text was highly selective because he viewed the first half as a historically parochial discussion of British foreign policy, and his interest in the second was restricted to the passages in which Mill proposes principles of international morality to govern foreign military interventions to protect third parties. As a result, theorists (...) tend to see those canonized passages as if through a glass darkly. Attention to the detail and context of Mill’s first-half critique of Lord Palmerston’s opposition to the Suez Canal project reveals that his discussion of purely protective intervention is embedded in a broader exploration of the limits of self-defence, including the moral permissibility of preventive military force and the use of protective interventions for defensive purposes. Moreover, reading the text holistically facilitates a refutation of some objections directed at it by Michael Doyle to the effect that Mill’s conception of self-defence incorporates elements of aggression which makes it extremely dangerous when adapted for application to the contemporary world. (shrink)

Medical ghostwriting is the practice in which pharmaceutical companies engage an outside writer to draft a manuscript submitted for publication in the names of “honorary authors,” typically academic key opinion leaders. Using newly-posted documents from paroxetine litigation, we show how the use of ghostwriters and key opinion leaders contributed to the publication of a medical journal article containing manipulated outcome data to favor the proprietary medication. The article was ghostwritten and managed by SmithKline Beecham, now GlaxoSmithKline (GSK) and Scientific (...) Therapeutics Information, Inc. without acknowledging their contribution in the published article. The named authors with financial ties to GSK, had little or no direct involvement in the paroxetine 352 bipolar trial results and most had not reviewed any of the manuscript drafts. The manuscript was originally rejected by peer review; however, its ultimate acceptance to the American Journal of Psychiatry was facilitated by the journal editor who also had financial ties to GSK. Thus, GSK was able to take an under-powered and non-informative trial with negative results and present it as a positive marketing vehicle for off-label promotion of paroxetine for bipolar depression. In addition to the commercial spin of paroxetine efficacy, important protocol-designated safety data were unreported that may have shown paroxetine to produce potentially harmful adverse events. (shrink)

The present study aimed to develop effective moral educational interventions based on social psychology by using stories of moral exemplars. We tested whether motivation to engage in voluntary service as a form of moral behavior was better promoted by attainable and relevant exemplars or by unattainable and irrelevant exemplars. First, experiment 1, conducted in a lab, showed that stories of attainable exemplars more effectively promoted voluntary service activity engagement among undergraduate students compared with stories of unattainable exemplars and non-moral (...) stories. Second, experiment 2, a middle school classroom-level experiment with a quasi-experimental design, demonstrated that peer exemplars, who are perceived to be attainable and relevant to students, better promoted service engagement compared with historic figures in moral education classes. (shrink)

Non-communicable diseases now account for the majority of the global burden of disease and an international campaign has emerged to raise their priority on the post-2015 development agenda. We argue, to the contrary, that there remain strong reasons to prioritize maternal and child health. Policy-makers ought to assign highest priority to the health conditions that afflict the worst off. In virtue of how little healthy life they have had, children who die young are among the globally worst off. Moreover, many (...) interventions to deal with the conditions that cause mortality in the young are low-cost and provide great benefits to their recipients. Consistent with the original Millennium Development Goals, the international community should continue to prioritize reductions in communicable diseases, neonatal conditions, and maternal health despite the shifts in the global burden of disease. (shrink)

Is there is a moral obligation to militarily intervene in another state to stop a genocide from happening (if this can be done with proportionate force)? My answer is that under exceptional circumstances a state or even a non-state actor might have a duty to stop a genocide (for example if these actors have promised to do so), but under most circumstances there is no such obligation. To wit, “humanity,” states, collectives, and individuals do not have an obligation to make (...) such promises in the first place or to create institutions that would impose a legal obligation of intervention upon them. Nor do states or persons or humanity “collectively” have – originally, without specifically creating such duties by contracts or promises – any pro tanto or special duties to save strangers at considerable cost to themselves or their own citizens (including their soldiers). That is, these costs do not merely override a duty to intervene, but rather there is no such duty to begin with – as shown by the fact that in such cases of non-intervention agents would not owe those they let die any compensation: if I do not save someone’s life because saving him would have cost me my arm or would have come with a high risk of losing my own life or would have forced me to kill innocent bystanders, I do not owe this person compensation. Thus the point of this chapter is that there is no “natural” or “general” or “original” duty to militarily intervene (or to create a legal obligation) to stop a genocide. I will consider and refute a number of arguments to the contrary, for example by Lango, Tan, and Pattison. (shrink)

Linguistic intervention in rational decision making is standardly captured in terms of information change. But the standard view gives us no way to model interventions involving expressions that only have an attentional effects on conversational contexts. How are expressions with non‐informational content – like epistemic modals – used to intervene in rational decision making? We show how to model rational decision change without information change: replace a standard conception of value (on which the value of a set of worlds (...) reduces to values of individual worlds in the set) with one on which the value of a set of worlds is determined by a selection function that picks out a generic member world. We discuss some upshots of this view for theorizing in philosophy and formal semantics. (shrink)

There are a number of premises underlying much of the vigorous debate on pharmacological cognitive enhancement. Among these are claims in the enhancement literature that such drugs exist and are effective among the cognitively normal. These drugs are deemed to enhance cognition specifically, as opposed to other non-cognitive facets of our psychology, such as mood and motivation. The focus on these drugs as cognitive enhancers also suggests that they raise particular ethical questions, or perhaps more pressing ones, compared to those (...) raised by other kinds of neuroenhancement. Finally, the use of these drugs is often claimed to be significant and increasing. Taken together, these premises are at the heart of the flurry of debate on pharmacological cognitive enhancement. In this article, it is argued that these are presumptions for which the evidence does not hold up. Respectively, the evidence for the efficacy of these drugs is inconsistent; neurologically it makes little sense to distinguish the cognitive from non-cognitive as separate targets of pharmacological intervention; ethically, the questions raised by cognitive enhancement are in fact no different from those raised by other kinds of neuroenhancement; and finally the prevalence rates of these drugs are far from clear, with the bulk of the claims resting on poor or misrepresented data. Greater conceptual clarity along with a more tempered appreciation of the evidence can serve to deflate some of the hype in the associated literature, leading to a more realistic and sober assessment of these prospective technologies. (shrink)

-- 05.04.2024 -- Intervention held at the Italian Philosophical Society’s national congress’ section entitled "Texts, Words and Images: Philosophical Traditions and Translations", at Catholic University of the Sacred Heart, Milan, Italy -- -/- The aim of this intervention is to briefly advance an interpretation of the post- COVID19 digitalisation processes as to be recognised within the philosophical framework of Vorstellung Metaphysik, “metaphysics of representation”. I would maintain that the formula, firstly indicated by Martin Heidegger, can provide us with a tool (...) to interpret contemporary culture as founded on an “iteration” of individual and collective consciousness into non-existent digital realities. Moreover, I will argue that these concepts are philosophically relatable to those of alienation and reification that come from Marxist traditions. Ultimately, the analysis will try to use the above mentioned tools to delve into an interpretation of remote working and education as potential carriers of alienation. (shrink)

Nations are understood to have a right to go to war, not only in defense of individual rights, but in defense of their own political standing in a given territory. This paper argues that the political defensive privilege cannot be satisfactorily explained, either on liberal cosmopolitan grounds or on pluralistic grounds. In particular, it is argued that pluralistic accounts require giving implausibly strong weight to the value of political communities, overwhelming the standing of individuals. Liberal cosmopolitans, it is argued, underestimate (...) the difficulties in disentangling a state’s role in upholding or threatening individual interests from its role in providing the social context that shapes and determines those very interests. The paper proposes an alternative theory, “prosaic statism”, which shares the individualistic assumptions of liberal cosmopolitanism, but avoids a form of fundamentalism about human rights, and is therefore less likely to recommend humanitarian intervention in non-liberal states. (shrink)

The first wave of philosophical work on global justice focused largely on the distribution of economic resources, and on the development or reformation of institutions relevant thereto. More recently, however, the horizon has broadened significantly, to also include a concern with the global spread of the right to live under reasonable legal institutions and representative forms of government (cf. “a human right to democracy”). Thus, while the first wave was focused primarily on international (non-territorial) institutions, later work has also brought (...) critical focus to bear on domestic institutions traditionally assumed to be protected by rights of state sovereignty. This naturally raises the question of whether, when, and how the international community can coercively intervene in issues falling under assumed to fall under domestic jurisdiction. Many theorists of global justice will accept, however reluctantly, that coercive means such as military force may be used (even unilaterally, if necessary) to halt a government’s mass atrocities against its civilian population (so-called “humanitarian intervention”). They are, however, for the most part firmly opposed to the use of military force as a tool to force regime change or democratic reform. I will discuss the viability of this stance along two dimensions: (i) can we draw a morally relevant distinction between humanitarian intervention and regime change policies? (ii) can we draw a morally relevant distinction between the use of military force as a policy tool and the use of other kinds of coercive measures such as economic sanctions? (shrink)

Ecological economics is an interdisciplinary science that is primarily concerned with developing interventions to achieve sustainable ecological and economic systems. While ecological economists have, over the last few decades, made various empirical, theoretical, and conceptual advancements, there is one concept in particular that remains subject to confusion: critical natural capital. While critical natural capital denotes parts of the environment that are essential for the continued existence of our species, the meaning of terms commonly associated with this concept, such as (...) ‘non-substitutable’ and ‘impossible to substitute,’ require a clearer formulation then they tend to receive. With the help of equations and graphs, this article develops new definite account of critical natural capital that makes explicit what it means for objective environmental conditions to be essential for continued existence. The second main part of this article turns to the question of formally modeling the priority of conserving critical natural capital. While some ecological economists have maintained that, beyond a certain threshold, critical natural capital possesses absolute infinite value, absolute infinite utility models encounter significant problems. This article shows that a relative infinite utility model provides a better way to model the priority of conserving critical natural capital. (shrink)

While ideal interventions are acknowledged by many as valuable tools for the analysis of causation, recent discussions have shown that, since there are no ideal interventions on upper-level phenomena that non-reductively supervene on their underlying mechanisms, interventions cannot—contrary to a popular opinion—ground an informative analysis of constitution. This has led some to abandon the project of analyzing constitution in interventionist terms. By contrast, this paper defines the notion of a horizontally surgical intervention, and argues that, when combined (...) with some innocuous metaphysical principles about the relation between upper and lower levels of mechanisms, that notion delivers a sufficient condition for constitution. This, in turn, strengthens the case for an interventionist analysis of constitution. (shrink)

Typically, fair machine learning research focuses on a single decision maker and assumes that the underlying population is stationary. However, many of the critical domains motivating this work are characterized by competitive marketplaces with many decision makers. Realistically, we might expect only a subset of them to adopt any non-compulsory fairness-conscious policy, a situation that political philosophers call partial compliance. This possibility raises important questions: how does partial compliance and the consequent strategic behavior of decision subjects affect the allocation outcomes? (...) If k% of employers were to voluntarily adopt a fairness-promoting intervention, should we expect k% progress (in aggregate) towards the benefits of universal adoption, or will the dynamics of partial compliance wash out the hoped-for benefits? How might adopting a global (versus local) perspective impact the conclusions of an auditor? In this paper, we propose a simple model of an employment market, leveraging simulation as a tool to explore the impact of both interaction effects and incentive effects on outcomes and auditing metrics. Our key findings are that at equilibrium: (1) partial compliance by k% of employers can result in far less than proportional (k%) progress towards the full compliance outcomes; (2) the gap is more severe when fair employers match global (vs local) statistics; (3) choices of local vs global statistics can paint dramatically different pictures of the performance vis-a-vis fairness desiderata of compliant versus non-compliant employers; (4) partial compliance based on local parity measures can induce extreme segregation. Finally, we discuss implications for auditors and insights concerning the design of regulatory frameworks. (shrink)

A central feature of experimental development economics is the use of randomized controlled trials (RCTs) to evaluate the effectiveness of prospective socioeconomic interventions. The use of RCTs in development economics raises a host of ethical issues which are just beginning to be explored. In this article, I address one ethical issue in particular: the routine use of the status quo as a control when designing and conducting a development RCT. Drawing on the literature on the principle of standard care (...) in medical research ethics, as well as considerations of distributive justice in non-ideal circumstances, I argue that the practice of using the status quo as a control is ethically justifiable. However, I add an important qualification based on the natural duty of rescue to address the concern that my account is overly permissive. (shrink)