Non-pharmaceutical interventions, including social distancing, quarantine, and isolation, are a potentially attractive means to limit the transmission of a pandemic virus. Many of these interventions are directed at children given children’s disproportionate role in amplifying epidemics. The ethics of non-pharmaceutical interventions can be analyzed using Nancy Kass’ ethics framework for public health. Such an analysis highlights the limited data supporting these interventions’ effectiveness. It also suggests the framework itself needs to be expanded to consider harms other than constraints on liberty (...) and to consider affirmative programs to mitigate these broader harms. (shrink)

This essay provides an account of how to distinguish between health and pathology of trait tokens in medical theory. It proposes to distinguish between two health/pathology concepts—health/pathology pertaining to survival and health/pathology pertaining to reproduction. It defines measures for survival-efficiency and reproduction-efficiency of performances of physiological functions. It provides an account of how, using the efficiency measures, to draw the line between health and pathology. The account draws, but seeks to improve, on Christopher Boorse’s biostatistical theory. In relation to that (...) theory, the suggested account has the advantages that it defines efficiency and that it harmonizes with judgments in medical theory in cases of common diseases and “normal aging.” Furthermore, the essay argues against a competing idea of how to improve on the biostatistical theory, advocated by Peter Schwartz and Daniel Hausman. (shrink)

Cell therapy means treating diseases with the body's own cells. One of the cell types most in demand for therapeutic purposes is the pancreatic β‐cell. This is because diabetes is one of the major healthcare problems in the world. Diabetes can be treated by islet transplantation but the major limitation is the shortage of organ donors. To overcome the shortfall in donors, alternative sources of pancreatic β‐cells must be found. Potential sources include embryonic or adult stem cells or, from existing (...) β‐cells. There is now a startling new addition to this list of therapies: the pancreatic α‐cell. Thorel and colleagues recently showed that under circumstances of extreme pancreatic β‐cell loss, α‐cells may serve to replenish the insulin‐producing compartment. This conversion of α‐cells to β‐cells represents an example of transdifferentiation. Understanding the molecular basis for transdifferentiation may help to enhance the generation of β‐cells for the treatment of diabetes. (shrink)

Open theists argue that God's relationship to time, as conceived in classical theism, is erroneous. They explain that it is contradictory for an atemporal being to act in a temporal universe, including experiencing its temporal successions. Contrary to the atemporalists, redemptive history has shown that God interacts with humans in time. This relational nature of God nullifies the classical notion of God as timelessly eternal. Therefore, it lacks a philosophical and theological basis. Because God is in time, He does not (...) know all future contingencies and, therefore, changes. This study examines open theism's appropriation of the A and B theories of time to the divine-human relationship. The study argues that divine temporality does not solve the tension of divine-human relationships, especially in relation to the future. Further, historical divine temporality does not negate the fact of divine atemporality. It mainly stems from God's choice to create temporal creatures and His relationship with them. Furthermore, if it is not logically and metaphysically contradictory for an omnipresent being to act in space, then it follows that an atemporal being can act in time. Whether time is understood from the metric or psychological point of view, it does not transcend God, and therefore, the limitation it places on human creatures with respect to the future does not apply to God. Lastly, although a few philosophers reject the notion of eternity as timelessly eternal, the doctrine has a philosophical and theological basis in the Scripture. (shrink)

Despite drives’ importance for Nietzsche’s explanation of individuals’ values, controversies persist over how to interpret Nietzsche’s attribution of normative capacities to the drives themselves. On one reading, drives evaluate their aims and recognize the normative authority of other drives’ aims. On another, drives’ normative properties reduce to nonnormative, causal properties. Neither approach is satisfying. The former commits Nietzsche to the homuncular fallacy by granting drives complex cognitive capacities. The latter reading either commits Nietzsche to the naturalistic fallacy, having him derive (...) normative conclusions from descriptive premises, or eliminates normativity from his thought altogether. In response to this impasse, this article advances a Leibniz-informed interpretation of Nietzsche’s drive psychology. By construing the normative and efficient causal orders as parallel modes of explanation distinguished by one’s perspective, a Leibniz-informed reading captures the benefits of extant interpretations while avoiding their drawbacks. (shrink)

David Chalmers appears to assume that we can meaningfully discuss what goes on in human heads without paying any attention to the words in which we couch our statements. This paper challenges this assumption and argues that the initial problem is that of metalanguage: if we want to say something clear and valid about us humans, we must think about ourselves outside conceptual English created by one particular history and culture and try to think from a global, panhuman point of (...) view. This means that instead of relying on untranslatable English words such as 'consciousness' and 'experience' we must try to rely on panhuman concepts expressed in cross-translatable words such as THINK, KNOW, and FEEL (Wierzbicka, 2018). The paper argues that after 'a hundred years of consciousness studies' it is time to try to say something about us (humans), about how we think and how we differ from cats and bats, in words that are clear, stable, and human rather than parochially English. (shrink)

Background: Only data of published study results are available to the scientific community for further use such as informing future research and synthesis of available evidence. If study results are reported selectively, reporting bias and distortion of summarised estimates of effect or harm of treatments can occur. The publication and citation of results of clinical research conducted in Germany was studied.Methods: The protocols of clinical research projects submitted to the research ethics committee of the University of Freiburg in 2000 were (...) analysed. Published full articles in several databases were searched and investigators contacted. Data on study and publication characteristics were extracted from protocols and corresponding publications.Results: 299 study protocols were included. The most frequent study design was randomised controlled trial , followed by uncontrolled studies , laboratory studies and non-randomised studies . 182 were multicentre studies including 97 international collaborations. 152 of 299 had commercial funding and 46 non-commercial funding. 109 of the 225 completed protocols corresponded to at least one full publication ; the publication rate was 48%. 168 of 210 identified publications were cited in articles indexed in the ISI Web of Science. The median was 11 citations per publication .Conclusions: Results of German clinical research projects conducted are largely underreported. Barriers to successful publication need to be identified and appropriate measures taken. Close monitoring of projects until publication and adequate support provided to investigators may help remedy the prevailing underreporting of research. (shrink)

The growing gap between demands and resources is putting immense pressure on all government spending in Sweden. The gap is especially apparent in care and services for elderly people in light of the rapid aging of the population. The article considers the decisions and priorities concerning resource allocation in the welfare sector in general and in elderly care in particular. The aim is to describe the political and administrative setting and to provide a conceptual structure that outlines the nature of (...) the problem. Various levels of decision making are identified and discussed in the context of political accountability. Current transitions in elderly care are described with respect to service provision, marketisation, coverage rates, and eligibility standards. Basic principles of distribution are highlighted in order to clarify some central concepts of efficiency and justice, and a number of strategies for actual prioritising are identified. The article concludes with an endorsement of more conscious decisions in resource allocation. Existing knowledge and information concerning the effects of various strategies must be utilised, and the values and assumptions used for setting priorities must be made explicit. (shrink)

Robert Veatch has proposed a model of the doctor-patient relationship that has as its foundation the sharing of values between the doctor and the patient. This paper uses qualitative research conducted with six doctors involved in the long term, specialised care of HIV positive patients in South Australia to explore the practical application of Veatch’s value sharing model in that setting. The research found that the doctors in this study linked “values” with sexual identity such that they defined value sharing, (...) in part, as a shared set of values and beliefs about sexual identity and practices. They voluntarily identified themselves as either homosexual or heterosexual and they regarded the relation between their own sexual identity and that of their patients as important for the provision of quality care. None of the doctors thought that value sharing, in the way they defined it, was essential to the clinical relationship, but the homosexual doctors attributed a greater degree of importance to it than their heterosexual colleagues. (shrink)

In recent years attention to the philosophical and literary production of P. A. Florenskii has become commonplace. The thinker's intellectual legacy is very great. In September 1919, Florenskii wrote a prospectus for a collection of his own writings, which would have amounted to nineteen volumes. The collection was not published, for a number of reasons; nonetheless, many of the philosopher's works did come out during his lifetime. Florenskii's writing, published in small editions and scattered among various journals, are still quite (...) inaccessible to readers. (shrink)