Most phobias are focussed on a small number of fear-inducing stimuli (e.g., snakes, spiders). A review of the evidence supporting biological and cognitive explanations of this uneven distribution of phobias suggests that the readiness with which such stimuli become associated with aversive outcomes arises from biases in the processing of information about threatening stimuli rather than from phylogenetically based associative predispositions or “biological preparedness.” This cognitive bias, consisting of a heightened expectation of aversive outcomes following fear-relevant stimuli, generates and (...) maintains robust learned associations between them. Some of the features of such stimuli which determine this expectancy bias are estimates of how dangerous they are, the semiotic similarity between them and their aversive outcomes, and the degree of prior fear they elicit. Ontogenetic and cultural factors influence these features of fear-relevant stimuli and are hence important in determining expectancy bias. The available evidence does not exclude the possibility that both expectancy biases and specific evolved predispositions coexist, but the former can explain a number of important findings that the latter cannot. (shrink)

Ensuring that countries have adequate research capacities is essential for an effective and efficient response to infectious disease outbreaks. The need for ethical principles and values embodied in international research ethics guidelines to be upheld during public health emergencies is widely recognized. Public health officials, researchers and other concerned stakeholders also have to carefully balance time and resources allocated to immediate treatment and control activities, with an approach that integrates research as part of the outbreak response. Under such circumstances, research (...) “ethics preparedness” constitutes an important foundation for an effective response to infectious disease outbreaks and other health emergencies. A two-day workshop was convened in March 2018 by the World Health Organisation Global Health Ethics Team and the African coaLition for Epidemic Research, Response and Training, with representatives of National Ethics Committees, to identify practical processes and procedures related to ethics review preparedness. The workshop considered five areas where work might be undertaken to facilitate rapid and sound ethics review: preparing national ethics committees for outbreak response; pre-review of protocols; multi-country review; coordination between national ethics committees and other key stakeholders; data and benefit sharing; and export of samples to third countries. In this paper, we present the recommendations that resulted from the workshop. In particular, the participants recommended that Ethics Committees would develop a formal national standard operating procedure for emergency response ethical review; that there is a need to clarify the terminology and expectations of pre-review of generic protocols and agree upon specific terminology; that there is a need to explore mechanisms for multi-country emergency ethical consultation, and to establish procedures for communication between national ethics committees and other oversight bodies and public health authorities. In addition, it was suggested that ethics committees should request from researchers, at a minimum, a preliminary data sharing and sample sharing plan that outlines the benefit to the population from which data and samples are to be drawn. This should be followed in due time by a full plan. It is hoped that the national ethics committees, supported by the WHO, relevant collaborative research consortia and external funding agencies, will work towards bringing these recommendations into practice, for supporting the conduct of effective research during outbreaks. (shrink)

Much has been published about the ethical issues encountered by clinicians in genetics/genomics, but those experienced by clinical laboratory scientists are less well described. Clinical laboratory scientists now frequently face navigating ethical problems in their work, but how they should be best supported to do this is underexplored. This lack of attention is also reflected in the ethics tools available to clinical laboratory scientists such as guidance and deliberative ethics forums, developed primarily to manage issues arising within the clinic.We explore (...) what ethical issues are being experienced by clinical scientists, how they think such issues could be best analysed and managed, and whether their practice might be enhanced by more situated approaches to ethics deliberation and practice such as ethical preparedness. From thematic analysis of cases presented by clinical scientists at a specially convened meeting of the UK Genethics Forum, we derived three main ethical themes: (1) the redistribution of labour and responsibilities resulting from the practice of genomic medicine; (2) the interpretation and certainty of results and (3) the proposal that better standardisation and consistency of ethical approaches (for example, more guidelines and policy) could resolve some of the challenges arising.We argue that although standardisation is important for promoting shared understandings of good (including ethical) practice, supplementary approaches to enhance and sustain ethical preparedness will be important to help clinical scientists and others in the recently expanded genetic/genomic medicine environment foster quality ethical thinking. (shrink)

It is clear throughout Cognitive Gadgets Heyes believes the development of cognitive capacities results from the interaction of genes and experience. However, she opposes cognitive instincts theorists to her own view that uniquely human capacities are cognitive gadgets. Instinct theorists believe that cognitive capacities are substantially produced by selection, with the environment playing a triggering role. Heyes’s position is that humans have similar general learning capacities to those present across taxa, and that sophisticated human cognition is substantially created by our (...) socioculturally transmitted environment. It is a core strategy of Heyes to provide evidence of learning altering a cognitive capacity to conclude that a capacity is a cognitive gadget and not an instinct. We draw on recent work on the evolution of learning preparedness to examine the adequacy of this strategy. In particular, we analyse experimental evolution work showing how selection affects cognition within the laboratory. First, this work reveals that change due to learning can still be retained under genetic assimilation. This suggests that domain-specific adaptation can coexist with learning, moderate nativism, an option missed by the instinct versus gadget distinction. Second, we describe the conditions that select for increased preparedness in learning: certainty, reliability, and particular costs. We consider how these conditions can be used when conducting evolutionary reasoning about cognition, applying them to the important capacity for imitation. We find that the conditions lend theoretical support to moderate nativism about the capacity to imitate, which is supported by psychological evidence. (shrink)

Through the guidelines of D.O No. 22, s. 2021, the study finds that the majority of 304 teachers from both public elementary and secondary schools are married females between the ages of 30 and 40 with 1 to 4 years of work experience and 15,000 to 30,000 monthly income. Findings exposed the “high level of comprehension perceived” in financial knowledge, behavior, and attitude. Also, the perception of asset acquisitions as the highest priority, along with other relevant factors from budgeting and (...) decision-making and retirement preparedness, demonstrated “importance” in the level of their comprehension. The significant difference through test variation in teachers' retirement preparedness and asset acquisitions towards the age variable is significant. Thus, teachers' retirement preparedness based on their perceptions of budgeting has a strong impact on their teaching experience. Accordingly, financial literacy and retirement preparedness have an essential or direct relationship. This indicates a strong impact of financial preparedness on financial literacy. (shrink)

This research presents the results of an exploratory empirical study that assessed perceived organizational preparedness for coping with a major crisis or disaster. A scale was developed and tested to measure perceptions of organizational preparedness. Hypotheses were tested to examine variations in perception of crisis preparedness. Potential for occurrence of crises was also examined and demographics collected. Findings indicate that top-level and middle-level managers have a higher level of perceived preparedness than employees, no differences in perceived (...) preparedness based on size of the city where organizations operate, government organizations expressed a higher perception of crisis preparedness than for-profit organizations, and the highest perception of preparedness was exhibited by organizations employing more than 500 employees. (shrink)

The Proceedings of the National Summit on Legal Preparedness for Obesity Prevention and Control is based on a two-part conceptual framework composed of public health and legal perspectives. The public health perspective comprises the six target areas and intervention settings that are the focus of the obesity prevention and control efforts of the Centers for Disease Control and Prevention.This paper presents the legal perspective. Legal preparedness in public health is the underpinning of the framework for the four “assessment” (...) papers and the four “action” papers that are integral to the application of public health law to any particular health issue. In addition, this paper gives real-world grounding to the legal framework through examples that illustrate the four core elements of legal preparedness in public health that are at work in obesity prevention and control. (shrink)

Considerations of the notion of preparedness have come to the fore in the recent pandemic, highlighting a need to be better prepared to deal with sudden, unexpected and unwanted events. However, the concept of preparedness is also important in relation to planned for and desired interventions resulting from healthcare innovations. We describe ethical preparedness as a necessary component for the successful delivery of novel healthcare innovations, and use recent advances in genomic healthcare as an example. We suggest (...) that practitioners and organisations charged with delivering innovative and ambitious healthcare programmes can only succeed if they are able to exhibit the attribute of ethical preparedness. (shrink)

BackgroundPublic health scholars have long called for preparedness to help better negotiate ethical issues that emerge during public health emergencies. In this paper we argue that the concept of ethical preparedness has much to offer other areas of health beyond pandemic emergencies, particularly in areas where rapid technological developments have the potential to transform aspects of health research and care, as well as the relationship between them. We do this by viewing the ethical decision-making process as a behaviour, (...) and conceptualising ethical preparedness as providing a health research/care setting that can facilitate the promotion of this behaviour. We draw on an implementation science and behaviour change model, COM-B, to demonstrate that to be ethically prepared requires having the capability, opportunity, and motivation to work in an ethically prepared way.MethodsWe use two case examples from our empirical research—one pandemic and one non-pandemic related—to illustrate how our conceptualisation of ethical preparedness can be applied in practice. The first case study was of the UK NHSX COVID-19 contact tracing application case study involved eight in-depth interviews with people involved with the development/governance of this application. The second case involved a complex case regarding familial communication discussed at the UK Genethics Forum. We used deductive qualitative analysis based on the COM-B model categories to analyse the transcripbed data from each case study.ResultsOur analysis highlighted that being ethically prepared needs to go beyond merely equipping health professionals with skills and knowledge, or providing research governance actors with ethical principles and/or frameworks. To allow or support these different actors to utilise their skills and knowledge, a focus on the physical and social opportunity is important, as is a better understanding the role of motivation.ConclusionsTo understand ethical preparedness, we need to view the process of ethical decision-making as a behaviour. We have provided insight into the specific factors that are needed to promote this behaviour—using examples from both in the pandemic context as well as in areas of health research and medicine where there have been rapid technological developments. This offers a useful starting point for further conceptual work around the notion of being ethically prepared. (shrink)

By examining the global public good nature of pandemic preparedness we can identify key social justice issues that need to be confronted to increase citizens’ voluntary compliance with prevention and mitigation measures. As people tend to cooperate on a voluntary basis only with systems they consider fair, it becomes difficult to ensure compliance with public health measures in a context of extreme inequality. Among the major inequalities that need to be addressed we can find major differences in the extensiveness (...) and intensiveness of quarantine experiences, lack of opportunities to participate in common efforts, hardship in complying with disease control recommendations, and an unfair distribution of the cooperative surplus. (shrink)

Little is known about study co-ordinators of gene therapy clinical trials. The purposes of this study were to: (1) describe characteristics of co-ordinators of gene therapy (transfer) clinical trials; (2) assess differences between nurse and non-nurse study co-ordinators; and (3) identify factors indicative of study co-ordinators' role preparation that could affect their role performance. This exploratory correlational study employed a convenience sample of 118 co-ordinators in the USA (55 participants; 47% response rate). The researcher created the Study Coordinator Role (...) class='Hi'>Preparedness and Performance Survey to assess factors or correlates of study co-ordinator performance. Analysis of variance was used to compare nurses and non-nurses, and men versus women on their perceived preparedness, perceived quality of orientation, and satisfaction with educational opportunities. The findings contribute to knowledge by identifying present inadequacies in the training of study co-ordinators and in recognizing the need for more effective provision of orientation and continuing education with respect to ethical issues, knowledge of genetic science, and potential research integrity challenges. (shrink)

This paper discusses the relationship between obesity, law, and public health preparedness as well as the relevant roles of public health practitioners, policymakers, and lawyers. Each group believes they have a unique role in this relationship although there can be overlap and/or lack of clarity as to what that role may be.The role of the lawyer in the public policy process is to identify relevant legal issues, to analyze them and give advice on the risks of taking a given (...) action, and to communicate legal advice in a clear manner. Simply put, the lawyer’s role is to dive deep into the law surrounding the topic at hand and to offer advice regarding the permissible limits of policymakers’ options and the associated risks. (shrink)

In his critique of preparedness theory, Davey does not address the limitations of adaptationism. The purpose of this commentary is to outline problems that arise when one assumes that mental illness (e.g., phobic disorder)musthave had adaptive significance for it to have survived the vicissitudes of natural selection.

A number of influential reports on influenza pandemic preparedness include recommendations for extra-autonomous decisions to withdraw mechanical ventilation from some patients, who might still benefit from this technology, when demand for ventilators exceeds supply. An unintended implication of recommendations for nonvoluntary and involuntary termination of life support is that it make pandemic preparedness plans vulnerable to patients’ claims for assisted suicide and active euthanasia. Supporters of nonvoluntary passive euthanasia need to articulate why it is both morally different and (...) morally superior to voluntary active euthanasia if they do not wish to invite expansion of end-of-life options during health system catastrophe. (shrink)

Acommon theme throughout the greatest public health achievements of the 20th century is the importance of law. From the seminal successes in immunizations and motor vehicle safety to the recognition and control of tobacco as a health hazard, laws have been invaluable. More recently in this century, laws have been fundamental in public health preparedness to address environmental disasters and terrorist threats. In fact, the first National Summit on Legal Preparedness in 2007 focused on these “urgent threats.” It (...) only seemed natural that the second summit would focus on the “urgent realities” posed by the continuing epidemic of obesity — an epidemic that directly attacks our children’s health and drains our nation’s wealth.Recognized worldwide as an energy imbalance resulting from excess caloric intake and reduced energy expenditure, obesity contributes to diabetes, heart disease, other multiple chronic diseases, impaired quality of life, and premature mortality. (shrink)

Background: Since 2010, the United States has experienced 228 disasters, affecting over 86 million people. Because of population shifts, the growing number of people living with chronic conditions or disabilities, and the growing number of older citizens living independently, access and service gaps often exist for those without money or other transferable resources. There is a lack of evidence regarding individual community members’ capacity to prepare for emergencies. Research objective: The purpose of this study is to highlight participant experiences in (...) becoming better prepared for emergencies and provide insight from a social justice perspective. Research design: This is a descriptive qualitative study, staying very close to the data as an end product rather than a beginning for interpretation. Participants and research context: A total of 13 low-income, uninsured, or under-insured attendees at a medical outreach clinic were interviewed. Ethical considerations: Institutional Review Board approval was obtained from the University of Texas at Tyler. Findings: Four themes emerged from the interview data: (a) evaluation of the emergency-preparedness education, (b) making emergency plans, (c) challenges in preparing for emergencies, and (d) facilitators of emergency preparedness. Discussion: Identifying the potential challenges to individual emergency preparedness among vulnerable populations is the first step in overcoming them. The capacity to comply with such measures, especially the ability of those with limited incomes and other vulnerable populations, must be considered. Conclusion: Synchronized, well-ordered assistance will close gaps in recovery and enhance efficiency in pre- and post-event aid. Theoretically, doing so will promote engaged and resilient members of society who are better able to withstand adverse events. The importance of the relationship between individual preparedness levels and the resiliency of nations supports the social justice imperative to address the needs of vulnerable populations in the mitigation and planning phase of the emergency management cycle. (shrink)

It is commonly supposed that evolutionary explanations of cognitive phenomena involve the assumption that the capacities to be explained are both innate and modular. This is understandable: independent selection of a trait requires that it be both heritable and largely decoupled from other `nearby' traits. Cognitive capacities realized as innate modules would certainly satisfy these contraints. A viable evolutionary cognitive psychology, however, requires neither extreme nativism nor modularity, though it is consistent with both. In this paper, we seek to show (...) that rather weak assumptions about innateness and modularity are consistent with evolutionary explanations of cognitive capacities. Evolutionary pressures can affect the degree to which the development of a capacity is canalized by biasing acquisition/ learning in ways that favor development of concepts and capacities that proved adaptive to an organism's ancestors. q 1999 Elsevier Science B.V. All rights reserved. (shrink)

It is commonly supposed that evolutionary explanations of cognitive phenomena involve the assumption that the capacities to be explained are both innate and modular. This is understandable: independent selection of a trait requires that it be both heritable and largely decoupled from other ”nearby’ traits. Cognitive capacities realized as innate modules would certainly satisfy these contraints. A viable evolutionary cognitive psychology, however, requires neither extreme nativism nor modularity, though it is consistent with both. In this paper, we seek to show (...) that rather weak assumptions about innateness and modularity are consistent with evolutionary explanations of cognitive capacities. Evolutionary pressures can affect the degree to which the development of a capacity is canalized by biasing acquisition/learning in ways that favor development of concepts and capacities that proved adaptive to an organism’s ancestors. (shrink)

This study aims to explore the factors contributing to the perceived preparedness of graduate students for responsible conduct of research (RCR). A convergent mixed design was used, and both interview and quantitative data were collected, analyzed, and integrated to understand the role of individual and institutional factors in the perceived RCR preparedness of graduate students. Both interview and quantitative data converge on the role of mentor instruction and institutional policies in developing RCR preparedness. The findings also suggested (...) that greater exposure of students to ethical norms and practices is critical in nurturing RCR. (shrink)

This study explored pre-service teachers’ (N = 37) perceptions about teaching controversial global and local topics. Additionally, it examined participants’ level of preparedness, motivation and perceived hindrances to teaching controversial issues. To do so, the study used a interpretive phenomenological approach (IPA). Data from written reflections and semi-structured interviews showed 80 percent of participants lacked exposure to college work that examined controversial issues prior to taking Social Studies Methods course. However, after taking the course, participants were able to identify (...) controversial topics, but they still displayed limited critical awareness and conceptualization of teaching controversial issues. Other findings pointed to the benefits of teaching controversial topics in a planned and intentional manner. (shrink)

There is a fine balance between civil liberties and protection of the public’s health.Legislators, especially those in the western United States, are concerned about selling the Model State Act because of the loss of civil liberties. State constitutions give governors broad powers, such as declaring martial law and giving public health leaders the authority to act. State laws should consider issues such as property rights; taking of businesses and supplies; quarantine and isolation; due process; coordination among states, counties and cities; (...) communication systems; conscription of doctors and nurses; and compensation. When two mock emergency response drills were held in New Mexico, concerns arose regarding opening records associated with dams, national laboratories, waste repositories, and three air force bases. (shrink)

This paper provides an overview of recent US Department of Health and Human Services initiatives and efforts — under the leadership of the General Counsel, the Secretary, and the President — regarding legal preparedness for public health emergencies. In addressing this topic, the paper focuses on four core elements comprising public health legal preparedness:effective legal authorities to support necessary public health activities;competencies of public health professionals to know and then to apply those laws;coordination of the application of laws (...) across jurisdictions and across multiple sectors; andinformation and best practices in public health law. (shrink)

This presentation explores the significance of just military preparedness, or jus ante bellum as a new category of just war theory, for just war thinking, especially with regard to irregular warfare. It articulates six just military preparedness principles. It further discusses how America’s military preparation fails the JMP principles and how this negatively impacts its capability to justly initiate, execute, and conclude war. This critical analysis takes as its point of departure Defense Secretary Robert Gates’s view that the (...) Pentagon needs to be “reprogrammed” toward a “balanced strategy” of preparing for both conventional and irregular warfare. (shrink)

The Centers for Disease Control and Prevention has focused its obesity prevention and control efforts on improving population-level health. A recent Institute of Medicine report identified systems that affect population health, to include health care delivery systems, schools, businesses and employers, communities, and governmental public health infrastructure. CDC uses the public health model to engage these systems, and this process coordinates multiple settings, sectors, and jurisdictions to develop an integrated approach to identify, prevent, and control obesity. The public health approach (...) goes beyond medical care to prioritize policy and environmental strategies that can be implemented across jurisdictional levels, in collaboration with traditional and nontraditional partners. The process ultimately produces tools, guidelines, and interventions that can be used to prevent and control obesity. In this manuscript, we provide an overview of the public health perspective on obesity, outline the public health framework for addressing obesity, and discuss the rationale for leveraging law-based efforts as a tool to accomplish the public health mission. (shrink)

The National Summit on Legal Preparedness for Obesity Prevention and Control was conceived by the Centers for Disease Control and Prevention as a strategic conference to review the current status of legal preparedness for obesity prevention and control, identify potential gaps, and develop specific action options for improving the contribution law can make to reduce the health threat posed by obesity. Working with the collaborating partners and planning committe, the host committe planned and modeled after the Summit CDC’s (...) 2007 conference on public health emergency legal preparedness that resulted in the National Action Agenda for Public Health Emergency Legal Preparedness. The summit was a working meeting that offered invited participants a structured opportunity to deliberate about the laws and legal issues that impact obesity prevention and control from a public health perspective. (shrink)

The detection and spread of pandemic 2009 H1N1 influenza in the United States led to a complex and multi-faceted response by the public health system that lasted more than a year. When the first domestic case of the virus was detected in California on April 15, 2009, and a second, unrelated case was identified more than 130 miles away in the same state on April 17, 2009, the unique combination of influenza virus genes in addition to its emergence and rapid (...) spread at the end of the typical Northern Hemisphere influenza season suggested the potential for a high morbidity, high mortality event. In response, federal, state, and local public health officials conducted epidemiologic investigations with federal and state laboratory support to help to determine the scope of the H1N1 pandemic. On April 26, the Secretary of the U.S. Department of Health and Human Services declared a public health emergency that was renewed through June 23, 2010. The pandemic that ensued tested virtually every aspect of U.S. public health preparedness and response systems, from laboratory capabilities and capacities to social distancing plans. (shrink)

Faced with the threat of pandemic influenza, several countries have made the decision to put a number of measures in place which have been incorporated into national plans. In view of the magnitude of the powers and responsibilities that States assume in the event of a pandemic, a review of the various national preparedness and response plans for pandemic influenza brought to light a series of extremely important ethical concerns. Nevertheless, in spite of the recent emergence of literature focusing (...) specifically on the ethical aspects of pandemics, too few studies explicitly examine public participation as one means of ethical contribution to public health policies. Thus this article seeks, in the first place, to present an analysis of the various national preparedness and response plans for pandemic influenza, and secondly, to outline the role that the plans envisage for ethics and more importantly for public participation. (shrink)

Live streaming shopping, the streaming of real-time videos promoting products that consumers can purchase online, has recently been a booming area of e-commerce, especially during the COVID-19 pandemic. The success of live streaming e-commerce largely relies on the extent to which the broadcaster can get consumers engaged by the live stream. Thus, it is important to discover the antecedents of consumer engagement in such a context. Drawing on consumer engagement and neuroscience literature, this study used electroencephalography inter-subject correlation to explore (...) how broadcasters' entrepreneurial passion during live streaming videos influenced consumers' neural engagement as they watched the live streaming videos. We used the framework of displayed passion and preparedness from the entrepreneurial passion literature to predict consumer engagement. We found significant ISC for strong displayed passion, while preparedness had partially significant effects on the first, second, and summed components of ISC. The interaction effects of these two factors on the first and summed components of ISC were partially significant. Strong displayed passion and preparedness activated the left and right prefrontal regions of the consumers' brains. These findings indicate that broadcasters' displayed passion and preparedness can influence consumer engagement in live streaming e-commerce settings. Our findings suggest that a scientific approach could be used to improve a broadcaster's performance by testing ISC during rehearsals before live streaming. (shrink)

We investigate two questions, the relevance of memory for evaluative conditioning effects based on smell-taste pairings, and the potential preparedness of smell-taste combinations for...

We read with great interest the commentaries submitted in response to our paper about clinical scientists and the role of ethical preparedness1. The responses raised some important themes that intersect with those discussed in our paper, and we are grateful for the opportunity to expand on them. Pruski2 highlights the importance of ethics education for clinical scientists, noting insufficient provision of such teaching within the clinical science profession. This gap means that scientists completing higher specialist training, who now encounter more (...) complex ethical challenges, are not benefitting from equivalent ethics education standards enjoyed by their counterparts in medical professions. We agree that clinical scientists deserve access to quality education in ethics in order to develop their skills in this area. Alongside a formal element to education, we see ethical preparedness (EP) as advocating for more informal education opportunities. This can be facilitated through the encouragement and creation of space (both physical and metaphorical) to discuss ethical issues as they arise in practice and explore potential scenarios in a supportive and judgement-free environment. Cultivating such an environment plays is crucial to develop professional skills in navigating ethical challenges, promoting a greater sense of collective responsibility and capability to do justice to ethical issues encountered. Van Steijvoort et al 3 draw …. (shrink)

The unprecedented outbreak of Ebola virus disease in West Africa has raised several novel ethical issues for global outbreak preparedness. It has also illustrated that familiar ethical issues in infectious disease management endure despite considerable efforts to understand and mitigate such issues in the wake of past outbreaks. To improve future global outbreak preparedness and response, we must examine these shortcomings and reflect upon the current state of ethical preparedness. To this end, we focus our efforts in (...) this article on the examination of one substantial area: ethical guidance in pandemic plans. We argue that, due in part to their focus on considerations arising specifically in relation to pandemics of influenza origin, pandemic plans and their existing ethical guidance are ill-equipped to anticipate and facilitate the navigation of unique ethical challenges that may arise in other infectious disease pandemics. We proceed by outlining three reasons why this is so, and situate our analysis in the context of the EVD outbreak and the threat posed by drug-resistant tuberculosis: different infectious diseases have distinct characteristics that challenge anticipated or existing modes of pandemic prevention, preparedness, response, and recovery, clear, transparent, context-specific ethical reasoning and justification within current influenza pandemic plans are lacking, and current plans neglect the context of how other significant pandemics may manifest. We conclude the article with several options for reflecting upon and ultimately addressing ethical issues that may emerge with different infectious disease pandemics. (shrink)

In this paper I question the morality of U.S. military supremacy or hegemony in terms of what constitute the legitimate use of military force and the proper preparation for using such force. I first discuss in a somewhat synoptic fashion how American hegemonic military force has been justified in dishonest ways and wrongly executed. Next, I show that Just War Theory needs to be revised in order to come to a convincing assessment of U.S. military hegemony and its use of (...) military force. This leads me to propose “just military preparedness,” consisting of five principles of just military preparedness, as a new category of JWT. The failure of the United States to satisfy the principles puts into question its very capability of justly resorting to military force, of lawfully executing force, and of establishing a just peace after war. The principles also point to a more humane alternative of how the United States could meet security threats and sustain a peaceful international order. (shrink)

Faced with the threat of pandemic influenza, several countries have made the decision to put a number of measures in place which have been incorporated into national plans. In view of the magnitude of the powers and responsibilities that States assume in the event of a pandemic, a review of the various national preparedness and response plans for pandemic influenza brought to light a series of extremely important ethical concerns. Nevertheless, in spite of the recent emergence of literature focusing (...) specifically on the ethical aspects of pandemics, too few studies explicitly examine public participation as one means of ethical contribution to public health policies. Thus this article seeks, in the first place, to present an analysis of the various national preparedness and response plans for pandemic influenza, and secondly, to outline the role that the plans envisage for ethics and more importantly for public participation. (shrink)

This presentation discusses why just war theory is in need of just military preparedness (jus ante bellum) as a new category of just war thinking and it articulates six principles of just military preparedness. The paper concludes that the United States fails to satisfy any of these principles and addresses how this bears on the application of jus ad bellum, jus in bello, and jus post bellum norms to possible future American military interventions.

Public health legal preparedness begins with effective legal authorities, and law provides a key foundation for public health practice in the United States. Laws not only create public health agencies and fund them, but also authorize and impose duties upon government to protect the public's health while preserving individual liberties. As a result, law is an essential tool in public health practice and is one element of public health infrastructure, as it defines the systems and relationships within which public (...) health practitioners operate.For purposes of this paper, law can be defined as a rule of conduct derived from federal or state constitutions, statutes, local laws, judicial opinions, administrative rules and regulations, international codes, or other pronouncements by entities authorized to prescribe conduct in a legally binding manner. Public health legal preparedness, a subset of public health preparedness, is defined as attainment of legal benchmarks within a public health system. (shrink)

Since the anthrax attacks of 2001 and the severe acute respiratory syndrome outbreak of 2003, significant efforts have been made to develop and revise a range of legal tools designed to strengthen public health emergency responses. The 2009 H1N1 pandemic provided an unprecedented opportunity to implement and exercise many of these mechanisms. At the global level, the World Health Organization declared a public health emergency of international concern pursuant to the revised International Health Regulations [IHR ], and many governments declared (...) national or regional emergencies. At the U.S. federal level, the Secretary of Health and Human Services made public health emergency and Public Readiness and Emergency Preparedness Act declarations. In addition, the Food and Drug Administration issued Emergency Use Authorizations, and President Obama declared a National Emergency. Select state and local governments also declared emergencies. (shrink)

Law can greatly facilitate responses to public health emergencies, including naturally-occurring infectious disease outbreaks and intentional or accidental exposures to chemical, biological, radiological, or nuclear agents. At the federal level, the Secretary of the Department of Health and Human Services, as the lead for federal public health and medical responses to public health emergencies and incidents, has a range of authorities to support federal, state, tribal, local, and territorial responses. For example, under the Public Health Service Act, the Secretary may (...) provide temporary assistance to States to meet health emergency needs or deploy medicine and supplies from the Strategic National Stockpile. The Secretary also may determine that a disease or disorder presents a public health emergency, which may be the first step in triggering other critical legal authorities for response.Since the 2001 anthrax attacks, one focus of public health preparedness has been on developing, distributing, and rapidly dispensing medical countermeasures for CBRN emergencies and pandemics. (shrink)

While the global threat of Ebola Virus Disease in 2014 was concentrated in several West African countries, its effects have been felt in many developed countries including the United States. Initial, select patients with EVD, largely among American health care workers volunteering in affected regions, were subsequently transported back to the states for isolation and treatment in high-level medical facilities. This included Emory University Hospital, which sits adjacent to the federal Centers for Disease Control and Prevention in Atlanta, Georgia.The first (...) domestic case of EVD occurred in late September in Dallas, Texas. Additional exposures of two HCWs generated an array of legal issues for state and local public health authorities, hospitals, and providers. Consideration of these issues led to extensive discussion among lawyers, public health practitioners, and other attendees at a late-breaking session on EVD and Legal Preparedness at the 2014 National Public Health Law conference. In this commentary, session presenters from CDC and Emory University share their expert perspectives on legal and policy issues underlying state and local powers to quarantine and isolate persons exposed to or infected with Ebola, as well as facets of hospital preparedness underlying the successful treatment of patients with EVD. (shrink)

This article focuses on some «disaster ethics» considerations on disaster preparedness and its related responsibilities. After recalling that concerns about preparedness and vulnerability have come to the fore in the domains of «disaster risk reduction» over the last decades, the article will endorse the view that the demarcation between natural disasters and human-induced disasters has becoming blurred and even questionable in many cases. Then, it will be argued that the ethical assessment of disasters needs to consider the entire (...) disaster cycle and that ethical duties extend to the phase of disaster preparedness and require a framework of prospective and shared responsibilities. Accordingly, a number of ethical duties concerning disaster preparedness will be commented upon. Finally, the article will discuss a specific socio-epistemic dynamics of blame assignment that unbalances the appraisal of both vulnerability conditions and moral responsibilities of certain worst-off disaster victims. (shrink)

Public health preparedness must use a comprehensive approach that includes both communities and public health systems. There are three basic questions that should be asked when evaluating public health preparedness in communities of color: 1) Is the community basically healthy?; 2) Does the community have access, to necessary information, resources and services?; and 3) Are the information, resources and services available and provided to the community in a nondiscriminatory manner?Racial-based health disparities is a well documented fact for many (...) communities of color. Individuals from these communities tend to have more morbidity and higher mortality. This health disparity is race based and not just a function of social class. Similarly, access to basic goods and health care is racialized and class based. (shrink)

In an emergency, challenges faced by disabled individuals may be exacerbated by ineffective communication, power outages, transportation shortcomings, and inhospitable shelters. During Hurricanes Katrina and Rita, Gulf Coast shelters did not routinely provide closed captioning or sign language interpreters; for individuals with auditory disabilities, understanding instructions issued in these shelters was extremely difficult. Individuals with mobility-related disabilities experienced challenges evacuating from their homes due to public transportation that could not accommodate wheelchairs. After the hurricanes, difficulties arose in identifying wheelchair-accessible trailers (...) and in communicating with disabled trailer residents. Failing to anticipate these challenges intensifies the disadvantaged situation of those with disabilities during an emergency. (shrink)

This paper rejects most aspects of John W. Lango and Eric Patterson’s proposal that the United States should plan for a possible intervention in Sudan on secessionist and humanitarian grounds and announce this planning as a deterrent to the central government of Sudan attacking the people of South Sudan if they would opt in a January 2011 referendum for independence. I argue that secession is not a just cause for armed intervention and that, rightfully, neither the American people nor many (...) of its men and women in uniform would be prepared to engage in an intervention that might easily escalate. I also caution that American intervention against an Islamic regime might have high global security costs. For the sake of avoiding these negative consequences and harm to the people of Sudan, available nonviolent policy alternatives should be pursued. Still, I grant that the global community should intervene in Sudan if mass slaughter of civilians were to occur as a result of renewed hostilities between North and South Sudan. My objections to Lango and Patterson’s intervention proposal appeal to jus ad bellum principles as well as just military preparedness (jus ante bellum) principles. (shrink)

The terrorist attacks of 2001 were a reminder that individual and collective safety cannot be taken for granted. Since then, physicians, alongside public health professionals and other healthcare professionals as well as nonhealthcare personnel, have been developing plans to enhance the protection of public health and the provision of medical care in response to various threats, including acts of terrorism or bioterrorism. Included in those plans are strategies to attend to large numbers of victims and help prevent greater harm to (...) even larger populations. (shrink)

The Global Health Security Agenda (GHSA) is a multilateral, multisectoral partnership comprised of more than 70 countries, international organizations, foundations, and businesses to strengthen global health security.