Charland's article suggests that we need to think more about whether decision-making capacity is impaired in severe addiction, working from the idea that drug dealers rely on this understanding of addiction to draw in their clients. Charland argues that it is possible to make a choice without being in control (to make decisions without having decision-making capacity). I argue in support of Charland's ideas by examining the reasons supporting a medical model of addiction and its importance. (For Charland's article and (...) the full set of commentaries, please see the Research Gate link). (shrink)

The number of police departments carrying Narcan keeps increasing at a fast pace throughout the U.S., as it is considered an effective measure to fight the opioid epidemic. However, there have been strong oppositions to the idea of the police Narcan use. Still, in 2018, the nation is debating about it. Though not clearly visible to the public, there are important ethical arguments against the police Narcan use which necessarily involve understanding of the ethical roles and responsibilities of (...) police as the law enforcement agency and apprehension of the moral status of a non-therapeutic opioid use. The authors of the paper investigate, primarily, the existing ethical controversies surrounding the police Narcan use while touching upon the issue of the decriminalizing drug policy in the U.S. The authors conclude that the police can carry and administer Narcan without self-contradiction and that the policymakers’ investigation on the drug decriminalization policy should begin with the understanding of the “common morality” of the American public, the ethical view shared and practiced by the greatest number of people. (shrink)

As a response to the opioid epidemic in the United States, the Centers for Disease Control and Prevention (CDC) published the CDC Guideline for Prescribing Opioids for Chronic Pain in 2016. This document served as a means to reduce risks and address harms of opioid use by recommending that clinicians conduct periodic urine drug testing for patients on chronic opioid therapy. As an unintended result of this recommendation, providers began using unexpected urine drug test results as (...) a reason to dismiss patients from practice, both out of concern for their patients’ wellbeing as well as their own legal risks. Using Husserl’s and Heidegger’s phenomenology, we argue that this science-based, black-and-white practice does not heed the patient as a whole person. Instead, we recommend a more contextual, patient-centered approach that can help us to better understand and manage patient needs in such contexts. (shrink)

Mandatory minimum sentencing provisions have been a feature of the U.S. justice system since 1790. But they have expanded considerably under the war on drugs, and their use has expanded considerably under the Trump Administration; some states are also poised to expand drug-related mandatory minimums further in efforts to fight the current opioid epidemic. In this paper I outline and evaluate three prominent arguments for and against the use of mandatory minimums in the war on drugs—they appeal, respectively, (...) to proportionality, consistency, and efficiency. I ultimately defend the view that the use of mandatory minimums in the war on drugs is unjust. -/- . (shrink)

Any ethical inquiry into addiction research is faced with the preliminary challenge that the term “addiction” is itself a matter of scientific and ethical controversy. Accordingly, the chapter begins with a brief history of the term “addiction.” The chapter then turns to ethical issues surrounding consent and decision-making capacity viewed from the perspective of the current opioid epidemic. One concern is the neglect of the cyclical nature of addiction and the implications of this for the validity of current (...) psychometric instruments used to evaluate decision-making capacity in addiction. Another is the apparent discrepancy—possibly an ethical double standard—in the manner in which society and addiction researchers view the mental capacity and vulnerability of individuals who suffer from severe addiction. On the whole, the main ethical concern of the chapter is the puzzling lack of clinical research on decision-making capacity in research on addiction. (shrink)

Abstract: Advances in new technologies create new ways to stimulate the pleasure center of the human brain via new chemicals, direct application of electricity, electromagnetic fields, “reward hacking” in games and social networks, and in the future, possibly via genetic manipulation, nanorobots and AI systems. This may have two consequences: a) human life may become more interesting, b) humans may stop participating in any external activities, including work, maintenance, reproduction, and even caring for their own health, which could slowly contribute (...) to a decline in human populations. As wireheading is not self-limiting, it may push the addict to his/her limits and ultimately result in life-threatening behavior. Mass unemployment and the provision of basic income would likely feed the industry of pleasures. DIY synthetic biology and computers may create the possibility of homemade very addictive drugs through various routes, like insertion of a morphine-producing gene in plants or stimulation of the brain via electromagnetic fields, which may not be possible to control via limiting the supply chain. If “wireheading knowledge” becomes freely available, it could create a reward-hacking epidemic larger than the current U.S. opioid crisis and possibly contribute to a global civilizational decline. (shrink)

Many epidemics consist in individuals spreading infection to others. From the population perspective, they also have population characteristics important in modeling, explaining, and intervening in epidemics. I analyze epidemiology’s contemporary population perspective through the example of epidemics by examining two central principles attributed to Geoffrey Rose: a distinction between the causes of cases and the causes of incidence, and between “high-risk” and “population” strategies of prevention. Both principles require revision or clarification to capture the sense in which they describe distinct (...) perspectives on the same phenomenon, each perspective capturing a different level of contrastive analysis. (shrink)

Data indicate the ubiquity and rapid increase of depression wherever war, want and social upheaval are found. The goal of this paper is to clarify such claims and draw conceptual distinctions separating the depressive states that are pathological from those that are normal and normative responses to misfortune. I do so by appeal to early modern writing on melancholy by Robert Burton, where the inchoate and boundless nature of melancholy symptoms are emphasized; universal suffering is separated from the disease states (...) known as melancholy or melancholia, and normal temperamental variation is placed in contrast to such disease states. In Burton's time these distinctions and characterizations could be secured by the anchoring tenets of humoral theory. Without such anchoring, and in light of the findings and assumptions of today's biological diagnostic psychiatry, we must re-visit each of them. My goals here are to show the need for analytic foundations when claims are made about depression such as those cited above, and to draw attention to some contemporary attempts that may help provide those foundations, particularly, attempts to define disorder or disease. With adjustments, one of these (Cooper 2002) is shown to take us some way toward that goal. (shrink)

Over 60% of all epidemics have a zoonotic origin, that is, they result from the transmission of infectious diseases from animals to humans. The spill-over of diseases often happens because humans exploit and use animals. In this article, I outline the four most common interfaces that favour the emergence and spread of zoonotic infectious diseases: wildlife hunting, small-scale farming, industrialised farming practices and live animal markets. I analyse which practices serve human food security – and thus have a non-trivial purpose (...) – and which predominantly have an economic purpose or serve as a symbol of wealth. I conclude that many practices that increase the risk for zoonotic infectious disease outbreaks actually do not contribute to the survival and food security of humans. I make two arguments in turn. First, I argue that in cases where the consumption and use of animal products does not contribute to the food security of a population, then this population has a duty to abstain from them, since they impose a grave and avoidable risk to themselves as well as to innocent third-parties. However, some communities must sometimes rely on practices that increase the risk of emergence and transmission of zoonotic infectious diseases, because they have no healthy alternatives. That is, the food security of the local population depends on the consumption and use of risky animal products. The second argument I advance is that, in such scenarios, the international community has a duty to provide the communities concerned with alternative food options, as well as economic and educational opportunities and technologies, in order to reduce the spill-over risk of infectious diseases. Given that abstention from such practices contributes signifcantly to the public good and benefits the international community, the latter has a corresponding duty to provide local communities which abandon such practices with alternatives. (shrink)

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in (...) the current way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

In recent years, the opioid crisis in the United States has sparked significant discussion on doctor–patient interactions concerning chronic pain treatments, but little to no attention has been given to investigating the vocal aspects of patient talk. This exploratory sociolinguistic study intends to fill this knowledge gap by employing prosodic discourse analysis to examine context-specific linguistic features used by the interlocutors of two distinct medical interactions. We found that patients employed both low pitch and creak as linguistic resources when (...) describing chronic pain, narrating symptoms and requesting opioids. The situational use of both features informs us about the linguistic ways in which patients frame fraught issues like chronic pain in light of the current opioid crisis. This study expands the breadth of phonetic analysis within the domain of discourse analysis, serving to illuminate discussions surrounding the illocutionary role of the lower vocal tract in expressing emotions. (shrink)

In a 2014 article in The Guardian, an Indigenous shaman of the Yanomami people of the Amazon rainforest named Davi Kopenawa offers a devastating critique of white society. It is formed of excerpts from multiple interviews, which form the basis of his memoir The Falling Sky, compiled and translated by his French anthropologist collaborator Bruce Albert. Here I bring the dual lenses of philosophy and dance studies to explore how Kopenawa’s lifelong interaction with white people facilitated his reworking of Yanomami (...) shamanic discourse into a parrhesia against the “epidemic fumes” of climate change, on behalf of the Yanomami of the Amazon, white people, and all the beings of the earth. (shrink)

Introduction: Liposomal bupivacaine (LB) is a long-acting analgesic that, due to its liposomal formulation, purportedly extends its analgesic effect up to 72 hours. However, the clinical efficacy of LB appears mixed. This systematic review seeks to evaluate the effectiveness of liposomal bupivacaine in improving postoperative outcomes compared to ropivacaine (ROPI), another commonly used long-acting analgesic. -/- Materials and Methods: Prospective and randomized controlled trials (RCTs) evaluating the efficacy of LB compared to ROPI were selected for review. Primary outcomes included hospital (...) length of stay (LOS) and postoperative opioid consumption measured in oral morphine equivalents (OME). Secondary outcomes included analgesic cost. -/- Results: 14 studies met the review criteria. We found that LB and ROPI are equivalent in managing postoperative pain. 8 of the 14 trials reported equal efficacy between LB and ROPI as determined by OME post-procedure and 10 of the 14 trials reported similar LOS after surgery. These findings remained consistent across multiple surgical procedures and multiple drug administrative modalities. -/- Conclusion: Our systematic review found that LB was not superior to ROPI in reducing postoperative OME use and hospital LOS. The only consistent finding was the significantly increased cost of LB compared to that of ROPI. Therefore, the use of LB over ROPI cannot be justified. (shrink)

The exposure of doctors, nurses and other medical professionals to risks in the context of epidemics is significant. While traditional medical ethics offers the thought that these dangers may limit the extent to which a duty to care is applicable in such situations, it has less to say about what we might owe to medical professionals who are disadvantaged in these contexts. Luck egalitarianism, a responsibility-sensitive theory of distributive justice, appears to fare particularly badly in that regard. If we want (...) to maintain that medical professionals are responsible for their decisions to help, cure and care for the vulnerable, luck egalitarianism seems to imply that their claim of justice to medical attention in case of infection is weak or non-existent. The article demonstrates how a recent interpretation of luck egalitarianism offers a solution to this problem. Redefining luck egalitarianism as concerned with responsibility for creating disadvantages, rather than for incurring disadvantage as such, makes it possible to maintain that medical professionals are responsible for their choices and that those infected because of their choice to help fight epidemics have a full claim of justice to medical attention. (shrink)

The official birth of hysterical anorexia is attributed to the French alienist Ernest Charles Lasègue (1816-1883). Starting from his 1873 article, anorexia as a ‘new’ psychopathological picture is subjected to extensive clinical and theoreticalstudy. This paper is not an analysis about the process through which anorexia was formalized as specific psychiatric condition. Rather, it focuses on another important issue: the possibility that the ‘same’ disorder may have different meaning depending on the historical period considered. Furthermore, it is asserted that the (...) study of every pathological form is conditioned by social, individual and cultural conditions. For example, in the same year the English Sir William Gull publishes a paper about “anorexia nervosa” which is described in a different way depending on the different perspective. Lasègue’s description is a way of seeing a kind of sufferance, that is he ‘sees’ this pathology through the hysterical paradigm. Starting from these considerations, this article discusses the construct of ‘hysterical anorexia’ trying to understand why, in late nineteenth century France, hysteria and anorexia were viewed as two aspects of the same specific disorder. Finally, it is discussed why anorexia gradually emerged as an independent mental disorder just after the death of Charcot (1893). (shrink)

Purdue Pharma was being investigated by United States Civil and Criminal compliance agencies for many years and a conclusion has now been reached. Although successful , this author feels that such extremely serious corporate frauds must also punish senior individual executives with long jail sentences -in this case-corporate manslaughter.

COVID-19 began in China in December 2019. As of January 2021, over a hundred million instances had been reported worldwide, leaving a deep socio-economic impact globally. Current investigation studies determined that artificial intelligence (AI) can play a key role in reducing the effect of the virus spread. The prediction of COVID-19 incidence in different countries and territories is important because it serves as a guide for governments, healthcare providers, and the general public in developing management strategies to battle the disease. (...) The prediction proved beneficial in the early months of 2020 to alert nations and territories in danger of an outbreak, allowing them to take preventative measures. Despite the fact that the COVID-19 outbreak has expanded to practically every location on the planet, the prediction has value in terms of monitoring the intensity of the spread and recovery, as well as determining the likelihood of a sequel or tertiary epidemic. COVID-19, like influenza, could become a seasonal or recurring epidemic in the future. COVID-19 activity must so be predicted and monitored now and in the future. (shrink)

At least half of American adults are overweight or obese, and the number may be as high as two-thirds. These facts have spurred anti-obesity campaigns, and those campaigns have provoked difficult questions in public health and population ethics. Should the government merely inform people about the risks of unhealthy food? May it try to change behavior by taxing unhealthy food? May it ban some foods outright? This paper proposes that we should answer these questions using familiar liberal principles. The principles (...) show that several common arguments for obesity interventions are flawed. The principles also highlight several that succeed, and those arguments point toward a new proposal for food labeling and some potential market interventions. (shrink)

This research paper aims to study the cultural representations of the causes of corona pandemic (Covid 19) on the representations of the therapeutic itinerary on an among sample of Algerian society. These representations reveal the inter-relationship between the medical and the cultural representations through beliefs, ideas, and behaviors . Within this context, we applied EMIC questionnaire (The Explanatory Model Interview Catalogue). (MITCHELL G. WEISS, 1992) We used an online form in which a sample of 70 individuals (M, F), aged from (...) 20 to 50 years old, answered to. We relied on the quantitative and qualitative method in analyzing and interpreting the results. We came to the following results in the absence of a medical treatment, family solidarity and prevention measures are key treatments. In addition, the causes tend to be purely human, in the absence of all guaranteed treatments, whether therapeutic or traditional. (shrink)

In this review study, I reflect on Richard Horton’s book and his thesis that Western countries failed in their response to the current epidemic in the first half of 2020, with a few exceptions. In the five sections of the paper, after an initial modification of Horton’s thesis (A), I discuss briefly: the suppression approach in China (B), the mitigation approach in the West (C), the SARS epidemic as the key global public health event (D), the causes of (...) Western failure (epistemic, political, ethical, cultural, etc.) (E), and final envoi (F). (shrink)

The ongoing covid-19 epidemic has affected the entire world. Somewhat surprisingly, it is not the case that the most successful countries are the richest one, with the best health care. Nor is there a clear link between success and geographical location. Above all, much of the rich Western world has failed so far to protect public health effectively, and so it is appropriate to consider the question why. In this article, I focus mainly on the choice of the basic (...) epidemiological strategy, which I consider to be one of the key factors of success or failure of many countries. I further criticize the view that the protection of human lives would harm the economy or other important values of societies. (shrink)

According to Marshall et al. (2024), some of the patients who refuse to stay in observation after being resuscitated following an opioid overdose are likely not making an autonomous choice. While I do not intend to dispute this claim, it merits discussion what is the concept of autonomy at play in making this assessment. I contend that the concept at work is more substantive than Marshall et al. acknowledge—and more substantive, too, than the form of autonomy usually thought to (...) underpin the moral justification of the requirement of informed consent . (shrink)

Drawing on Françoise Dastur’s suggestion that the event is a permanent possibility that shapes lived experience, but also, when it occurs, a distinctive temporal rupture, I argue that the initial weeks of the COVID-19 epidemic constitute an event, in her sense. Connecting this phenomenological point to literatures on the politics of temporality, I suggest that the distinction between event and normal experience maps to that between epidemic and endemic. Understanding some of the political and ethical erasures of death (...) and debility in COVID times can thus be mutually informed by phenomenological analysis. (shrink)

Fear, anger and hopelessness were the most frequent traumatic emotional responses in the general public during the first stage of outbreak of the COVID-19 epidemic in the Czech Republic (N = 1,000). The four most frequent categories of fear were determined: (a) fear of the negative impact on household finances, (b) fear of the negative impact on the household finances of significant others, (c) fear of the unavailability of health care, and (d) fear of an insufficient food supply. The (...) pessimistic communications used by the Czech mass media contributed to intensifying traumatic feelings, fears and psychological distress in the general public during the outbreak of the COVID-19 epidemic. The anxious emotional tone of the messages and the presentation of selectively chosen “bad ending stories” contributed to the psychological traumatization of the Czech population. This form of communication was motivated by an effort to reach the broadest audience possible. Older adults were the most affected part of the population because of their isolation and their very limited opportunity to share their worries and emotions with others. The communication used by the Czech mass media during the outbreak of the COVID-19 epidemic is a representative example of a traumatizing form of media communication during an epidemic. (shrink)

Concerns about emerging and re-emerging infectious diseases have given a new lease of life to quarantinist measures: a series of time-honoured techniques for controlling the spread of infectious diseases through breaking the chain of human contagion. Since such measures typically infringe individual rights or privacy their use is subject to legal regulations and gives rise to ethical and political worries and suspicions. Yet in some circumstances they can be very effective. After considering some case studies that show how epidemics are (...) unique, fluid and affected by a multitude of contingent factors, it is argued that the legal and ethical guidelines may not always be the best approach to discipline the use of quarantinist measures. An alternative model based on ex-post political accountability for reasonableness is proposed. This model restores the centrality of political decision and expert judgement in situations characterized by high risk, uncertainty and contingency. It is argued that such alternative model affords quicker and more flexible responses to serious outbreaks of infections, while providing adequate protection against abuses. (shrink)

This essay investigates how British women in the Balkan military zone of WWI wrote on the sanitary crisis, which demonstrated itself in epidemics. It researches how these narratives figured in developing and strengthening their agendas which were part of their cultural and personal background. The military crisis was a way for the British women to prove their worth in the theatres of war, as a prerequisite for obtaining suffrage. The health crisis in the war-stricken Balkans was the main danger of (...) life for these women, and dying in an epidemic was viewed as the closest thing to dying in a battle, which in turn endorsed the possibility of obtaining suffrage. (shrink)

Generic generalisations like ‘Opioids are highly addictive’ are very useful in scientific communication, but they can often be interpreted in many different ways. Although this is not a problem when all interpretations provide the same answer to the question under discussion, a problem arises when a generic generalisation is used to answer a question other than that originally intended. In such cases, some interpretations of the generalisation might answer the question in a way that the original speaker would not endorse. (...) Rather than excising generic generalisations from scientific communication, I recommend that scientific communicators carefully consider the kinds of questions their words might be taken to answer and try to avoid phrasing that might be taken to provide unintended answers. (shrink)

Epidemics are situations that ruin the functioning of the social due to their characteristics concerning the disruption of the usual pace of daily life and reshaping of human actions and social encounters. In terms of its impact, the Covid-19 global epidemic has brought about changes in a series of daily life practices, from business and working life to public encounters, from education and health services to human relations, public encounters and the organization of the society on a time-space scale, (...) based on repetition. Everyday life is directly related to the establishment of the society depending on the repeatability of day-to-day activities as a routine of social relations and public encounters on a certain time-space scale. This study discusses how the society, which became possible as a result of the repetitive structuring of human actions with the Covid-19 epidemic, has transformed through new routines, new habits, new time-space practices and new public encounters. (shrink)

There is converging evidence that high doses of hallucinogenic drugs can produce significant alterations of self-experience, described as the dissolution of the sense of self and the loss of boundaries between self and world. This article discusses the relevance of this phenomenon, known as “drug-induced ego dissolution (DIED)”, for cognitive neuroscience, psychology and philosophy of mind. Data from self-report questionnaires suggest that three neuropharmacological classes of drugs can induce ego dissolution: classical psychedelics, dissociative anesthetics and agonists of the kappa (...) class='Hi'>opioid receptor (KOR). While these substances act on different neurotransmitter receptors, they all produce strong subjective effects that can be compared to the symptoms of acute psychosis, including ego dissolution. It has been suggested that neuroimaging of DIED can indirectly shed light on the neural correlates of the self. While this line of inquiry is promising, its results must be interpreted with caution. First, neural correlates of ego dissolution might reveal the necessary neurophysiological conditions for the maintenance of the sense of self, but it is more doubtful that this method can reveal its minimally sufficient conditions. Second, it is necessary to define the relevant notion of self at play in the phenomenon of DIED. This article suggests that DIED consists in the disruption of subpersonal processes underlying the “minimal” or “embodied” self, i.e., the basic experience of being a self rooted in multimodal integration of self-related stimuli. This hypothesis is consistent with Bayesian models of phenomenal selfhood, according to which the subjective structure of conscious experience ultimately results from the optimization of predictions in perception and action. Finally, it is argued that DIED is also of particular interest for philosophy of mind. On the one hand, it challenges theories according to which consciousness always involves self-awareness. On the other hand, it suggests that ordinary conscious experience might involve a minimal kind of self-awareness rooted in multisensory processing, which is what appears to fade away during DIED. (shrink)

The present article is presenting the ‘Healthcare Hazards and Its Impact on Health Insurance Business – An Overview during COVID-19’. The present paper studied the health insurance, health insurance plans in India, Indian market size, health care industry, government actions for the COVID-19, and healthcare business in India, private health insurance in India, hazardous of the healthcare industry and health insurances, and Indian healthcare issues in 2019. The author has concluded that all insurance policies are levied higher taxes by the (...) government, these lead higher income to the companies, and these are creating how commissions to the agents and other insurance organizations under reinsurance, but no benefits to the insured. It may not be a long term benefit, why because there is no maturity fund/income, because of these are shortterm benefits; how many of the policyholders are getting the benefits from the general health insurance companies. Hence, the research is required to calculate for the need of levy-the tax from the non-claimant portion of the income of the general health insurance on an annual basis to the health department of the nation. (shrink)

During the recent Ebola epidemic, some commentators and stakeholders argued that it would be unethical to carry out a study that withheld a potential treatment from affected individuals with such a serious, untreatable disease. As a result, the initial trials of experimental treatments did not have control arms, despite important scientific reasons for their inclusion. In this paper, we consider whether the duty to rescue entails that it would be unethical to withhold an experimental treatment from patient-participants with serious (...) diseases for which there are no effective treatments, even when doing so is scientifically necessary to test the effectiveness of the treatment. We argue that the duty to rescue will rarely apply. The context of medical research also throws new light on the content of the duty to rescue, since the interests of future patients—who stand to benefit from the fruits of medical research—are relevant to whether the duty applies. (shrink)

This book analyses three of the most prevalent illnesses of late modernity: anxiety, depression and Alzheimer’s disease, in terms of their relation to cultural pathologies of the social body. Usually these conditions are interpreted clinically in terms of individualized symptoms and responded to discretely, as though for the most part unrelated to each other. However, these diseases also have a social and cultural profile that transcends their particular symptomologies and etiologies. Anxiety, depression and Alzheimer’s are diseases related to disorders of (...) the collective esprit de corps of contemporary society. Multidisciplinary in approach, the book addresses questions of how these conditions are manifest at both the individual and collective levels in relation to hegemonic biomedical and psychologistic understandings. Rejecting such reductive diagnoses, the authors argue that anxiety, depression and Alzheimer’s disease, as well as other contemporary epidemics, are to be analysed in the light of individual and collective experiences of profound and radical changes in our civilization. A diagnosis of our times, Late Modern Subjectivity and its Discontents will appeal to a broad range of scholars with interests in health and illness, the sociology of medicine and contemporary life. (shrink)

We are in a state of impending crisis. And the fault lies in part with academia. For two centuries or so, academia has been devoted to the pursuit of knowledge and technological know-how. This has enormously increased our power to act which has, in turn, brought us both all the great benefits of the modern world and the crises we now face. Modern science and technology have made possible modern industry and agriculture, the explosive growth of the world’s population, global (...) warming, modern armaments and the lethal character of modern warfare, destruction of natural habitats and rapid extinction of species, immense inequalities of wealth and power across the globe, pollution of earth, sea and air, even the aids epidemic (aids being spread by modern travel). All these global problems have arisen because some of us have acquired unprecedented powers to act, via science and technology, without also acquiring the capacity to act wisely. We urgently need to bring about a revolution in universities so that the basic intellectual aim becomes, not knowledge merely, but rather wisdom – wisdom being the capacity to realize what is of value in life, for oneself and others, thus including knowledge and technological know-how, but much else besides. (shrink)

As a result of the world-wide COVID-19 epidemic, an internal tension in the goals of medicine has come to the forefront of public debate. Medical professionals are continuously faced with a tug of...

As COVID-19 spread, clinicians warned of mental illness epidemics within the coronavirus pandemic. Funding for digital mental health is surging and researchers are calling for widespread adoption to address the mental health sequalae of COVID-19. -/- We consider whether these technologies improve mental health outcomes and whether they exacerbate existing health inequalities laid bare by the pandemic. We argue the evidence for efficacy is weak and the likelihood of increasing inequalities is high. -/- First, we review recent trends in digital (...) mental health. Next, we turn to the clinical literature to show that many technologies proposed as a response to COVID-19 are unlikely to improve outcomes. Then, we argue that even evidence-based technologies run the risk of increasing health disparities. We conclude by suggesting that policymakers should not allocate limited resources to the development of many digital mental health tools and should focus instead on evidence-based solutions to address mental health inequalities. (shrink)

Loneliness is an invisible epidemic that has swept across the world and has manifested as a serious mental and societal adjustment issues, etc. The present study was designed to make a comparison between males and females on attachment styles (dimensions),Perceived Social Support (dimension) and Loneliness. The authors also examined the relationship between loneliness, attachment style, and perceived social support and Attachment Style and Perceived Social Support as Predictors of Loneliness among College Students. 256 Students studying in Jamia Millia Islamia, (...) and Delhi University were selected through purposive sampling. Measure of Attachment Style Questionnaire, Multidimensional Scale of Perceived Social Support and UCLA Loneliness Scale were administered. Results of the study indicated that both Ambivalent and Avoidant attachment style emerged as a predictor of loneliness. Males experienced greater loneliness as compared to female counterparts. Our study is specific and relevant to parents, mental health professionals and educators working with college students. (shrink)

Diabetes is a major public health issue that affects the nations of our time to a large extent and is described as a non-communicable epidemic. Diabetes mellitus is a common disease where there is too much sugar (glucose) floating around in your blood. This occurs because either the pancreas can’t produce enough insulin or the cells in body have become resistant to insulin. The concentration in this paper is on diagnosis diabetes by designing a proposed expert system. The main (...) goal of this expert system is to get the appropriate diagnosing of the illness, dealing with it quickly, and tips for permanent treatment whenever possible is given out. SL5 object expert system language was used for designing and implementing the proposed expert system. (shrink)

The present study examines the physiological alterations in prolactin (PRL) messenger ribonucleic acid (mRNA) and serum PRL levels during the rat estrous cycle and the effed of naloxone, an endogenous opioid peptide receptor antagonist, on PRL gene expression during the rat estrous cycle. Adult female rats exhibiting at least two consecutive 4-day estrous cycles were used in this study. A single injection of naloxone (2mg/kg b.w.) or saline was given sc 30 mm prior to decapitation. Animals were sacrificed at (...) 10:00 h of each stage of the estrous cycle, and at 2-h intervals from 10:00 h to 20:00 h during the proestrus. PRL mRNA and serum PRL levels were determined by an RNA-blot hybridization with the rat PRL cDNA probe and by a PRL radioimmunoassay, respectively. PRL mRNA and serum PRL levels were not dramatically altered in the morning of each stage of diestrus I, II, and proestrus, and naloxone failed to modify the two parameters. During estrus naloxone clearly suppressed serum PRL levels, but it was unable to modify PRL mRNA levels. A more detailed examination of the proestrus stage revealed that PRL mRNA and serum PRL levels fluctuated as a function of time: PRL mRNA levels reached a maximum level at 12:00 h and gradually decreased until 18:00 h. PRL mRNA levels then rose at 20:00 h. No difference in PRL mRNA levels between the control and naloxone-treated groups was observed. Changes in serum PRL level during proestrus were conversely related to changes in PRL mRNA: serum PRL levels were low from 10:00 h to 14:00 h, then increased and reached a maximum level at 16:00-18:00 h. Following then, serum PRL levels were decreased. Naloxone was effective in suppressing the characteristic afternoon surge of PRL from 16:00 h to 20:00 h. These data clearly showed that alterations in PRL mRNA levels were conversely correlated with changes in serum PRL levels on proestrus, indicating differential regulation of PRL gene expression and secretion. (shrink)

Models not only represent but may also influence their targets in important ways. While models’ abilities to influence outcomes has been studied in the context of economic models, often under the label ‘performativity’, we argue that this phenomenon also pertains to epidemiological models, such as those used for forecasting the trajectory of the Covid-19 pandemic. After identifying three ways in which a model by the Covid-19 Response Team at Imperial College London may have influenced scientific advice, policy, and individual responses, (...) we consider the implications of epidemiological models’ performative capacities. We argue, first, that performativity may impair models’ ability to successfully predict the course of an epidemic; but second, that it may provide an additional sense in which these models can be successful, namely by changing the course of an epidemic. (shrink)

Patient and public involvement is widely thought to be important in the improvement of health care delivery and in health equity. Purpose: The article examines the role of experiential knowledge in service co-production in order to develop opiate substitution treatment services (OST) for high-risk opioid users. Method: Drawing on social representations theory and the concept of social identity, we explore how experts’ by experience and registered nurses’ understandings of OST contain discourses about the social representations, identity, and citizenship of (...) the participants and the effects these may have on developing or hindering inclusive and bottom-up forms of patient and public involvement. Results: The meeting sessions that potentially offer room for creativity and problem-solving fail to provide any new propositions for fixing the system. The health care professionals primarily identify themselves as regulators who protect the correctness of their actions and show little interest in considering experiential knowledge on opioid addiction. Conclusion: The participation of patients has been one of the prominent reforms implemented in health care. The goal of client-centered thinking is often emphasised; however, the implementation is not simple due to the strongly institutionalised knowledge and related working patterns and practices in health care. (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)

Background: The epidemic scourge of rickets in the 19th century was caused by vitamin D deficiency due to inadequate sun exposure and resulted in growth retardation, muscle weakness, skeletal deformities, hypocalcemia, tetany, and seizures. The encouragement of sensible sun exposure and the fortification of milk with vitamin D resulted in almost complete eradication of the disease. Objectives: this paper is going to resolve the exiting problems of rickets by correctly diagnosing and offering the proper treatment. Methods: In this paper, (...) we present an expert system for rickets diagnosis which will helps doctors to explore everything related to the problems of rickets. We look forward to offer simplified answers to most of the rickets disease. (shrink)

The growing epidemic of allergy and allergy-induced asthma poses a significant challenge to population health. This article, written for a target audience of policy-makers in public health, aims to contribute to the development of policies to counter allergy morbidities by demonstrating how principles of social justice can guide public health initiatives in reducing allergy and asthma triggers. Following a discussion of why theories of social justice have utility in analyzing allergy, a step-wise policy assessment protocol formulated on Rawlsian principles (...) of social justice is presented. This protocol can serve as a tool to aid in prioritizing public health initiatives and identifying ethically problematic policies that necessitate reform. Criteria for policy assessment include: 1) whether a tentative public health intervention would provide equal health benefit to a range of allergy and asthma sufferers, 2) whether targeting initiatives towards particular societal groups is merited based on the notion of ‘worst-off status’ of certain population segments, and 3) whether targeted policies have the potential for stigmatization. The article concludes by analyzing three examples of policies used in reducing allergy and asthma triggers in order to convey the general thought process underlying the use of the assessment protocol, which public health officials could replicate as a guide in actual, region-specific policy development. (shrink)

The ongoing COVID-19 pandemic has brought science to the fore of public discourse and, considering the complexity of the issues involved, with it also the challenge of effective and informative science communication. This is a particularly contentious topic, in that it is both highly emotional in and of itself; sits at the nexus of the decision-making process regarding the handling of the pandemic, which has effected lockdowns, social behaviour measures, business closures, and others; and concerns the recording and reporting of (...) disease mortality. To clarify a point that has caused much controversy and anger in the public debate, the first part of the present article discusses the very fundamentals underlying the issue of causative attribution with regards to mortality, lays out the foundations of the statistical means of mortality estimation, and concretizes these by analysing the recording and reporting practices adopted in England and their widespread misrepresentations. The second part of the article is empirical in nature. I present data and an analysis of how COVID-19 mortality has been reported in the mainstream media in the UK and the USA, including a comparative analysis both across the two countries as well as across different media outlets. The findings clearly demonstrate a uniform and worrying lack of understanding of the relevant technical subject matter by the media in both countries. Of particular interest is the finding that with a remarkable regularity (????>0.998), the greater the number of articles a media outlet has published on COVID-19 mortality, the greater the proportion of its articles misrepresented the disease mortality figures. (shrink)

_La Peste_, originally published in 1947 by the Nobel Prize-winning writer Albert Camus, chronicles the progression of deadly bubonic plague as it spreads through the quarantined Algerian city of Oran. While most discussions of fictional examples within aesthetics are either historical or hypothetical, Camus offers an example of "pestilence fiction." Camus chose fiction to convey facts--about plagues in the past, his own bout with tuberculosis at age seventeen, living under quarantine away from home for several years, and forced separation from (...) his wife who remained in Algiers while he was abroad in Nazi-occupied France. His own lived experiences undergird an imaginative account of shared human realities with which we can identify: vulnerability to the disease, isolation, fear, and finally humanitarianism. _The Plague_ teaches us to neither covet nor expect what we so casually took for granted. This collection of original essays on philosophical themes in _The Plague_ is of special relevance during and in the aftermath of Covid-19 but also provides reflections that will be of lasting value to those interested in this classic work of literature. The novel explores questions of enduring importance. Do we collectively meet the threshold of ethical behavior posed by Camus who wrote, "What's true of all the evils in the world is true of plague as well. It helps men to rise above themselves"? Or does the absurd undermine the compassionate? Do "heroes" dutifully fight a plague with "common decency," or does human nature resign itself to the normalization of uncontrollable suffering and death? There are myriad ways to approach the novel and this volume encourages readers to ponder human dilemmas in fictional Oran informed by our current pandemic. Series editor forward by Richard Eldridge. List of Contributors includes Steven G. Kellman, Jane E. Schultz, Andrew Edgar, Kathleen Higgins, Edward B. Weiser, Cynthia A. Freeland, and Margaret E. Gray; see "Introduction" by Peg Brand Weiser below. (shrink)

Some physicians, in their care of patients at risk of misusing opioids, use machine learning (ML)-based prediction drug monitoring programmes (PDMPs) to guide their decision making in the prescription of opioids. This can cause a conflict: a PDMP Score can indicate a patient is at a high risk of opioid abuse while a patient expressly reports oppositely. The prescriber is then left to balance the credibility and trust of the patient with the PDMP Score. Pozzi1 argues that a prescriber (...) who downgrades the credibility of a patient’s testimony based on a low PDMP Score is epistemically and morally unjustified and contributes to a form of testimonial injustice. This results in patients being silenced, excluded from decision-making processes and subjected to structural injustices. Additionally, the use of ML systems in medical practices raises concerns about perpetuating existing inequalities, overestimating their capabilities and displacing human authority. However, almost the very same critiques apply to human-based systems. Formalisation, ML systems included, should instead be viewed positively,2 and precisely as a powerful means to begin eroding these and other problems in ethically sensitive domains. In this case, the epistemic virtues of formalisation include promoting transparency, consistency and replicability in decision making. Rigorous ML systems can also help ensure that models …. (shrink)

Several studies have lately revealed that social media conceal at least three dangerous pitfalls. Firstly, social media can negatively impact sociopolitical processes in advanced liberal democracies by becoming vehicles for the spread of false information that augments political polarization (Lee et al. 2017; Ostillio 2018). Secondly, as a result of the first point, social mediacan rapidly become a source of incorrect beliefs for those subjects with low digital literacy (Guess et al. 2019). Thirdly, because of the first and second points, (...) intentionally deceitful manipulations of social media content are potent generators of information cascades that increase group polarizations across groups of vulnerable social media users (Jang and Kim2018, Wang et al. 2018, Colliander 2019). These findings support the claim that the circulation of biased content on social media potentially threatens sociopolitical stability in liberal Western democracies (Duffy 2018; Sunstein 2018). Although this claim is far from being speculative, as shown by the FacebookFile investigations (Wall Street Journal 2019) and the center for humane technology’s recen tresearch, it introduces a thorny dilemma regarding the founding principles of liberal Western democracies. Namely, should Western legislators limit free speech by introducing severe penalties for those who spread fake news and the likes on social media? Or should they let the free market autonomously produce efficient technology allowing people to identify biased social media content?In other words, is a libertarian solution to the plight of online fake news and the like preferable to adequate legislation that punishes those who spread such content? Though appealing, it is unrealistic to believe that the free market can resolve this problem. On the other hand, it is realistic to suppose that Western governments should engage in a merciless battle against biased social media content. For instance, following the publication of the Report of the independent High level Group on fake news and online disinformation in 2018, the European Union introduced new directives to limit the spread of fake news online in 2021, when the Covid19 pandemic started fading. Although initiatives as such might look like limitations of free speech, there is solid philosophical ground to defend such initiatives. To prove this contention, we resort to Hobbes’s (1651, Part II, §18 and §29) argument that humans can avoid falling back into the Hobbesian state of war only if they stipulate a covenant. Specifically, we appeal to Hobbes’s (1651) argument in favor of bestowing the sovereign the right to ban those seditious doctrines that might undermine peace and sociopolitical stability in the Hobbesian Commonwealth. In this regard, we show that the Hobbesian covenant resolves conflict among humans in the same way a correlated equilibrium limits noncooperation in game theory. Namely, like game theory players, citizens enjoy greater welfare whenever they observe rules that mitigate conflict (Slomp 2010). Accordingly, we argue that citizens would be better off only if Western governments introduced severe penalties for those who intentionally spread fake news. Notably, we argue that effective regulation would create disincentives for spreading biased content and incentives for spreading truthful content. Furthermore, we argue that effective regulation against online fake news would assuage the polarizing effects of online availability cascades on social networks. Importantly, we provide empirical evidence supporting these claims by showing that the lack of effective regulation led the American government to miserably fail to contain the devasting effects of the online infodemic (i.e., the epidemic of false online information)that took place during the first two waves of the Covid19 pandemic (Evanega et al. 2020, Milosh et al. 2020). (shrink)