This open access book discusses individual, collective, and institutional responsibilities with regard to vaccination from the perspective of philosophy and public health ethics. It addresses the issue of what it means for a collective to be morally responsible for the realisation of herd immunity and what the implications of collective responsibility are for individual and institutional responsibilities. The first chapter introduces some key concepts in the vaccination debate, such as ‘herd immunity’, ‘public goods’, and ‘vaccine refusal’; and explains why failure (...) to vaccinate raises certain ethical issues. The second chapter analyses, from a philosophical perspective, the relationship between individual, collective, and institutional responsibilities with regard to the realisation of herd immunity. The third chapter is about the principle of least restrictive alternative in public health ethics and its implications for vaccination policies. Finally, the fourth chapter presents an ethical argument for unqualified compulsory vaccination, i.e. for compulsory vaccination that does not allow for any conscientious objection. The book will appeal to philosophers interested in public health ethics and the general public interested in the philosophical underpinning of different arguments about our moral obligations with regard to vaccination. (shrink)

Abortion is largely accepted even for reasons that do not have anything to do with the fetus' health. By showing that (1) both fetuses and newborns do not have the same moral status as actual persons, (2) the fact that both are potential persons is morally irrelevant and (3) adoption is not always in the best interest of actual people, the authors argue that what we call ‘after-birth abortion’ (killing a newborn) should be permissible in all the cases where abortion (...) is, including cases where the newborn is not disabled. (shrink)

Conscientious objection in health care is a form of compromise whereby health care practitioners can refuse to take part in safe, legal, and beneficial medical procedures to which they have a moral opposition (for instance abortion). Arguments in defense of conscientious objection in medicine are usually based on the value of respect for the moral integrity of practitioners. I will show that philosophical arguments in defense of conscientious objection based on respect for such moral integrity are extremely weak and, if (...) taken seriously, lead to consequences that we would not (and should not) accept. I then propose that the best philosophical argument that defenders of conscientious objection in medicine can consistently deploy is one that appeals to (some form of) either moral relativism or subjectivism. I suggest that, unless either moral relativism or subjectivism is a valid theory—which is exactly what many defenders of conscientious objection (as well as many others) do not think—the role of moral integrity and conscientious objection in health care should be significantly downplayed and left out of the range of ethically relevant considerations. (shrink)

Ethical debate surrounding human enhancement, especially by biotechnological means, has burgeoned since the turn of the century. Issues discussed include whether specific types of enhancement are permissible or even obligatory, whether they are likely to produce a net good for individuals and for society, and whether there is something intrinsically wrong in playing God with human nature. We characterize the main camps on the issue, identifying three main positions: permissive, restrictive and conservative positions. We present the major sub-debates and lines (...) of argument from each camp. The review also gives a flavor of the general approach of key writers in the literature such as Julian Savulescu, Nick Bostrom, Michael Sandel, and Leon Kass. (shrink)

I argue that there are significant moral reasons in addition to harm prevention for making vaccination against certain common infectious diseases compulsory. My argument is based on an analogy between vaccine refusal and tax evasion. First, I discuss some of the arguments for compulsory vaccination that are based on considerations of the risk of harm that the non‐vaccinated would pose on others; I will suggest that the strength of such arguments is contingent upon circumstances and that in order to provide (...) the strongest defence possible of compulsory vaccination, such arguments need to be supplemented by additional arguments. I will then offer my additional argument for compulsory vaccination: I will argue that in both cases of vaccine refusal and of tax evasion individuals fail to make their fair contribution to important social and public goods, regardless of whether each individual contribution ‘makes a difference’. While fairness considerations have sometimes been used to support a moral duty to vaccinate, they have not been appealed to in order to argue for a legal duty to vaccinate. I will suggest that this is due, among other things, to a misapplication of the principle of the least restrictive alternative in public health. Finally, I will address nine possible objections to my argument. (shrink)

We address the issue of whether, why and under what conditions, quarantine and isolation are morally justified, with a particular focus on measures implemented in the developing world. We argue that the benefits of quarantine and isolation justify some level of coercion or compulsion by the state, but that the state should be able to provide the strongest justification possible for implementing such measures. While a constrained form of consequentialism might provide a justification for such public health interventions, we argue (...) that a stronger justification is provided by a principle of State Enforced Easy Rescue: a state may permissibly compel individuals to engage in activities that entail a small cost to them but a large benefit to others, because individuals have a moral duty of easy rescue to engage in those activities. The principle of State Enforced Easy Rescue gives rise to an Obligation Enforcement Requirement: the state should create the conditions such that submitting to coercive or compulsive measures becomes a fundamental moral duty of individuals, i.e. a duty of easy rescue. When the state can create such conditions, it has the strongest justification possible for implementing coercive or compulsive measures, because individuals have a moral duty to temporarily relinquish the rights that such measures would infringe. Our argument has significant implications for how public health emergencies in the developing world should be tackled. Where isolation and quarantine measures are necessary, states or the international community have a moral obligation to provide certain benefits to those quarantined or isolated. (shrink)

We argue that, from the point of view public health ethics, vaccination is significantly analogous to seat belt use in motor vehicles and that coercive vaccination policies are ethically justified for the same reasons why coercive seat belt laws are ethically justified. We start by taking seriously the small risk of vaccines’ side effects and the fact that such risks might need to be coercively imposed on individuals. If millions of individuals are vaccinated, even a very small risk of serious (...) side effects implies that, statistically, at some point side effects will occur. Imposing such risks raises issues about individual freedom to decide what risks to take on oneself or on one’s children and about attribution of responsibility in case of adverse side effects. Seat belt requirements raise many of the same ethical issues as vaccination requirements, and seat belt laws initially encountered some opposition from the public that is very similar to some of the current opposition to vaccine mandates. The analogy suggests that the risks of vaccines do not constitute strong enough reasons against coercive vaccination policies and that the same reasons that justify compulsory seat belt use—a measure now widely accepted and endorsed—also justify coercive vaccination policies. (shrink)

Shortly before and during World War II many European psychoanalysts found refuge in South America, concentrated in Buenos Aires. Here, together with local professionals, they created a strong, creative and productive psychoanalytic movement that in turn gave birth to theoretical and clinical contributions that transformed psychoanalysis, psychology, medicine and culture in South America. _The Pioneers of Psychoanalysis in South America_ is a collection of those pioneers’ papers, and introduces the reader to a body of ideas and advancements, many of which (...) have had limited and piecemeal exposure within the psychoanalytic community in the rest of the world until now. The editors Nydia Lisman-Pieczanski and Alberto Pieczanski present original papers and essays, many of which have never before been published in English; those that have been translated were rarely presented in context. Each one of the chapters is accompanied by a scholarly introduction written by psychoanalysts, many of whom personally knew the pioneers and their oeuvres in depth, tracing the roots of their ideas in the European analytic schools. _The Pioneers of Psychoanalysis in South America _is divided into six main sections: Psychoanalytic process Psychoanalytic technique Metapsychology Psychoanalysis of children Culture and society Psychosomatic medicine. Nydia Lisman-Pieczanski and Alberto Pieczanski provide a coherent guide to the seminal ideas and practices of the South American psychoanalysts who have made major theoretical and clinical contributions to the advancement of the psychoanalytic discipline. The chapters present the material in a way that is accessible to psychoanalysts from across the globe and will enable them to incorporate the ideas and practices outlined here into their everyday psychoanalytic work. It will also be of interest to psychoanalytic psychotherapists, academics interested in the history and development of psychoanalytic ideas and psychoanalysis, and advanced students. The following link leads to an video interview featuring Nydia Lisman-Pieczanski and Alberto Pieczanski by the Washington Center for Psychoanalysis for the History Project, where they open up about their stories, their marriage, and their new book: https://www.routledge.com/posts/8996. (shrink)

O texto é uma resenha da Doutrina do Conceito hegeliana recém editada e publicada em português. O terceiro livro da Ciência da Lógica é estruturado em subjetividade, objetividade e ideia, com cada uma destas partes também desenvolvida numa estrutura tripartite. Nesta exposição, merece destaque o movimento contraditório de autodeterminação do conceito, no qual a universalidade se autodiferencia imanentemente em particularidade e o conceito retorna a si mesmo na forma da universalidade concreta. O conceito passa pelas diferentes formas de mediação na (...) teoria do silogismo, especialmente com a mediação da universalidade, quando o conceito se transforma em objetividade. Esta começa com a relação externa do mecanismo, avança para a relação interna do quimismo e conclui na teleologia, onde a liberdade é mais elevada que a necessidade. A Ideia, última parte da Doutrina do Conceito, é a unidade sintética entre conceito e objetividade, com destaque no capítulo da Ideia absoluta na qual Hegel formula uma noção de método como estrutura e movimento do conteúdo e da racionalidade. (shrink)

Cameron et al ’s1 ethical considerations about the ‘Dualism of Values’ in pandemic response emphasise the need to strike a fair balance between the interests of the less vulnerable to COVID-19 and the interests of the more vulnerable. Those considerations are at the basis of ethical defences of focused protection strategies.2 One example is the proposal put forward in the Great Barrington Declaration. It presented focused protection strategies as more ethical alternatives to lockdowns which would prevent lockdowns’ ‘irreparable damage, with (...) the underprivileged disproportionately harmed’.3 Here we want to suggest that a version of Cameron et al ’s analysis can be applied to the case of vaccines to support a focused protection vaccination strategy. At this stage, we should limit vaccination to the vulnerable and not target children in COVID-19 vaccination strategies. We argue that, given the current state of knowledge about COVID-19, immunity and vaccines, it would be wrong to pose the costs and risks of vaccines on children for three reasons. First, they are unlikely to benefit from COVID-19 vaccination …. (shrink)

The range of opportunities people enjoy in life largely depends on social, biological, and genetic factors for which individuals are not responsible. Philosophical debates about equality of opportunities have focussed mainly on addressing social determinants of inequalities. However, the introduction of human bioenhancement should make us reconsider what our commitment to equality entails. We propose a way of improving morally relevant equality that is centred on what we consider a fair distribution of bioenhancements. In the first part, we identify three (...) main positions in the debate on bioenhancement and equality, and we show how each of them fails to meet the demands of a serious commitment to equality. In the second part, we formulate a new proposal that we think better promotes equality of opportunities: people from disadvantaged socio-economic backgrounds should be given access to bioenhancements while people from privileged socio-economic background should be prohibited from using them. We argue that those who are concerned about the inequality implications of bioenhancement should embrace this solution, rather than reject bioenhancement. (shrink)

We show that the quasi-order of continuous embeddability between finitely branching dendrites (a natural class of fairly simple compacta) is $\Sigma_1^1$ -complete. We also show that embeddability between countable linear orders with infinitely many colors is $\Sigma_1^1$ -complete.

Michel Foucault and Roberto Esposito have been two of the most influential biopolitical thinkers of the twentieth century, but their respective approaches to the relationship between life and politics do not address the main problem of the Anthropocene: the relationship between life and energy. Thus, this article analyzes the biophysical limits of biopolitics in the works of Foucault and Roberto Esposito and, to overcome these limits, it proposes to analyze the physiological assembly of the devices of power within the energetic (...) flows of social metabolisms. The article concludes that the physio-political approach to human societies allows us to overcome the biophysical limits of both Foucauldian biopolitics and Esposito's immunological paradigm. (shrink)

Conflict of interests in medicine are typically taken to be financial in nature: it is often assumed that a COI occurs when a healthcare practitioner’s financial interest conflicts with patients’ interests, public health interests, or professional obligations more generally. Even when non-financial COIs are acknowledged, ethical concerns are almost exclusively reserved for financial COIs. However, the notion of “interests” cannot be reduced to its financial component. Individuals in general, and medical professionals in particular, have different types of interests, many of (...) which are non-financial in nature but can still conflict with professional obligations. The debate about healthcare delivery has largely overlooked this broader notion of interests. Here, we will focus on health practitioners’ moral or religious values as particular types of personal interests involved in healthcare delivery that can generate COIs and on conscientious objection in healthcare as the expression of a particular type of COI. We argue that, in the healthcare context, the COIs generated by interests of conscience can be as ethically problematic, and therefore should be treated in the same way, as financial COIs. (shrink)

In a paper recently published in this journal, Navin and Largent argue in favour of a type of policy to regulate non-medical exemptions from childhood vaccination which they call ‘Inconvenience’. This policy makes it burdensome for parents to obtain an exemption to child vaccination, for example, by requiring parents to attend immunization education sessions and to complete an application form to receive a waiver. Navin and Largent argue that this policy is preferable to ‘Eliminationism’, i.e. to policies that do not (...) allow non-medical exemptions, because Inconvenience has been shown to maintain exemption rates low while not harming parents by forcing them to do something that goes against their beliefs. We argue that it is at least doubtful that Inconvenience is ethically preferable to Eliminationism: while the latter disregards the value of liberty, Inconvenience disregards the value of fairness in the distribution of the burdens entailed by the preservation of a public good like herd immunity. We propose a variant of Inconvenience, which we call ‘Contribution’, which we think is preferable to the versions of Inconvenience discussed by Navin and Largent in that it successfully strikes a balance between the values of parents’ liberty, fairness and expected utility. (shrink)

Temporal logic is one of the many areas in which a possible world semantics is adopted. Prior's Ockhamist and Peircean semantics for branching-time, though, depart from the genuine Kripke semantics in that they involve a quantification over histories, which is a second-order quantification over sets of possible worlds. In the paper, variants of the original Prior's semantics will be considered and it will be shown that all of them can be viewed as first-order counterparts of the original semantics.

Spartan institutions were pictured as a model of political stability from the Classical period onwards. The so-called Spartan ‘mirage’ did not involve only its constitutional order but also social and economic institutions. Xenophon begins hisConstitution of the Lacedaemoniansby associating Spartan fame with thepoliteiaset up by Lycurgus, which made the Laconian city the most powerful (δυνατωτάτη) and famous (ὀνομαστοτάτη)polisin Greece (Xen.Lac.1.1). In Aristotle'sPolitics, in which the assessment of Sparta is more complex and nuanced, one finds a critique of contemporary Spartan institutions (...) as well as praise for Lycurgus as a great lawgiver who established the laws of Sparta (Arist.Pol.2.1269a69, 2.1273b20). Most other ancient sources often remark upon the unchangeable features of some Spartan institutions as a key aspect of Spartan εὐνομία. Thucydides maintains that, after a long period of war andstasis, the Dorians established excellent laws and Sparta employed the same constitution for more than four hundred years (Thuc. 1.18.1: τετρακόσια καὶ ὀλίγῳ πλείω ἐς τὴν τελευτὴν τοῦδε τοῦ πολέμου ἀφ᾽ οὗ Λακεδαιμόνιοι τῇ αὐτῇ πολιτείᾳ χρῶνται). (shrink)

Reliance on intuitive and emotive responses is widespread across many areas of bioethics, and the current debate on biotechnological human enhancement is particularly interesting in this respect. A strand of “bioconservatives” that has explicitly drawn connections to the modern conservative tradition, dating back to Edmund Burke, appeals explicitly to the alleged wisdom of our intuitions and emotions to ground opposition to some biotechnologies or their uses. So-called bioliberals, those who in principle do not oppose human bioenhancement, tend to rely on (...) rational arguments and to see intuitions and emotions mostly as sources of biases. This approach often translates into shifting the burden of proof onto bioconservatives and challenging them to provide arguments against the proposed enhancement to back what bioliberals perceive as merely intuitive, emotive, and irrational reactions. -/- In this article, I am going to show that the methodological divide between bioliberals and bioconservatives is less significant than at first glance it appears to be and less significant than it is often taken to be. I will do so by defending two theses. The first is that reliance on intuitions and emotions is not a prerogative of bioconservatives: bioliberals have their typical intuitions and emotive responses and are for this reason exposed to potential biases in the same way as bioconservatives are. The second thesis is that reliance on intuitions and emotions is not necessarily antithetic to reason and rationality. This latter thesis has been philosophically defended with particular reference to the debate on biotechnologies, while the former is perhaps more controversial and more difficult to accept—at least for bioliberals. In both cases, I will support the claims by drawing on resources from the field of moral psychology and the sciences of the mind and, particularly, by applying to some positions in the enhancement debate recent findings about the role of intuitions and emotions in human moral assessment. This new empirically informed perspective holds promises for solving the methodological controversy between bioconservatives and bioliberals, thus enabling proper dialogue and debate between the two sides. (shrink)

Today philosophical discussion on indicative conditionals is dominated by the so called Lewis Triviality Results, according to which, tehere is no binary connective '-->' (let alone truth-functional) such that the probability of p --> q equals the probability of q conditionally on p, so that P(p --> q)= P(q|p). This tenet, that suggests that conditonals lack truth-values, has been challenged in 1991 by Goodman et al. who show that using a suitable three-valued logic the above equation may be restored. In (...) this paper it is first analysed a long neglected paper by Bruno de Finetti, written in 1935, where the essentials of Goodman's theory was clearly outlined. It is also stressed that de Finetti anticipated Kleene's as well as Bochvar and Blamey ideas. In the second part of the paper it is argued that the de Finetti-Goodman's original theory is defective and leads to absurd results. However, a new semantics, called semantics of hypervaluations, is here defined, that avoids the defects of the original theory. This appears to be a powerful challenge to Lewis Triviality results and to the thesis by which conditionals lack truth-values as well. (shrink)

The Australian Federal Government has announced a two-year trial scheme to compensate living organ donors. The compensation will be the equivalent of six weeks paid leave at the rate of the national minimum wage. In this article I analyse the ethics of compensating living organ donors taking the Australian scheme as a reference point. Considering the long waiting lists for organ transplantations and the related costs on the healthcare system of treating patients waiting for an organ, the 1.3 million AUD (...) the Australian Government has committed might represent a very worthwhile investment. I argue that a scheme like the Australian one is sufficiently well designed to avoid all the ethical problems traditionally associated with attaching a monetary value to the human body or to parts of it, namely commodification, inducement, exploitation, and equality issues. Therefore, I suggest that the Australian scheme, if cost-effective, should represent a model for other countries to follow. Nonetheless, although I endorse this scheme, I will also argue that this kind of scheme raises issues of justice in regard to the distribution of organs. Thus, I propose that other policies would be needed to supplement the scheme in order to guarantee not only a higher number of organs available, but also a fair distribution. (shrink)

El concepto de ius cogens encarna una tendencia hacía la limitación de la soberanía de los Estados. Buscar un lugar para el ius cogens dentro del edificio positivista exige profundizar el significado de los enunciados que afirman su existencia. Decir que una norma es ius cogens significa que tiene la fuerza necesaria para no ser derrotada. No significa que esta norma sea derecho natural, puesto que puede ser modificada por otras normas del mismo carácter. Una norma es "imperativa" ex post (...) facto, después de que un juez así la calificó. Esto no implica reconocer a los jueces un poder sin límites. Al contrario, la multiplicación de las jurisdicciones internacionales asegura que ningún juez posea la última palabra: el contenido del ius cogens puede desprenderse del denominador común a las jurisprudencias de las jurisdicciones internacionales y regionales, tal como a las jurisdicciones supremas de los Estados. (shrink)

La Alquería de Tablate constituye un núcleo inhabitado único por tratarse de un vestigio arquitectónico con enorme valor patrimonial. El objetivo principal de la investigación e intervención sobre este enclave es la definición de una propuesta que suponga una innovación en el modo de habitar rural. El sistema resultante pues, constituye un ejemplo de cómo acercar la industrialización a la tradición a través de la abstracción de las bases de la arquitectura popular andaluza. Una reflexión sobre la forma de incorporar (...) conceptos como lo reversible, la virtualidad o la actividad agrícola a la arquitectura contemporánea. (shrink)

Ampliación de un estudio anterior en la que se dan a conocer nuevas aportaciones acerca del devenir histórico de la iglesia parroquial de Gilena desde sus orígenes, en el siglo XVI, hasta el siglo XIX.

Euclid proposed to trace pyramids as artifacts to facilitate the study of visual perception. The artifact assumes that the object seen delimits the base of a pyramid at the apex of which is the perceived eye. The artifact faces a serious difficulty when we notice that visual perception is carried out with two cooperating eyes. The article discusses two attempts to modify the Euclidean artifact to make it work without giving up the central assumptions. These attempts correspond to the classical (...) studies of Ptolemy’s binocular vision and Ewald Hering’s contributions in the 19th century. (shrink)

Este ensayo recoge la discusión sobre la vigencia o el fracaso de “la gran teoría del desarrollo”, y tras descartar la simplificada última ‘gran teoría’ del neoliberalismo, muestra el paso desde la gran teoría a la multiplicación de teorías, donde muchos de los nuevos aportes planteados superan el economicismo. Tras la reflexión acerca de si será posible y realista intentar un desarrollo diferente a partir de la vigencia de los derechos humanos como base para una sociedad solidaria, dentro del capitalismo (...) propone la construcción de respuestas glocales en la búsqueda de un nuevo régimen social de acumulación y participación. (shrink)

El concepto de poder ha sido uno de los más tradicionales y arraigados de la ciencia política, desde la temprana reflexión de los griegos hasta la actualidad. Es aún hoy un término de extraordinaria vigencia en el lenguaje científico y popular. Sin embargo, cuando indagamos en su real materialidad, advertimos que el mismo es elusivo, confuso y difuso. Desde la emergencia del positivismo, pasando por las revoluciones burguesas, el concepto se mantuvo más o menos inalterado. Con la emergencia del marxismo, (...) de las ideologías modernas y de las escuelas críticas se persiguió su racionalización y redireccionamiento, sin cuestionar la esencia de su significado. Sugerimos que a partir de la Teoría de la Complejidad y de la Teoría de Redes, el concepto podría muy bien dejarse fuera de la ciencia política o quedar limitado sólo a los alcances de la fuerza o coacción. (shrink)

Santo Tomás establece algunos principios de interpretación, sumamente útiles para aplicar a expresiones de la fe tal como han quedado fijadas en cada confesión cristiana, cuando van a ser «leídas» desde otra distinta. Una misma realidad creída, ha podido y debido proclamarse bajo fórmulas diversas. La diferente locución ha venido exigida precisamente por la expresa voluntad de retener y transmitir la coincidencia exacta en “lo” creído. Lo aparentemente divergente o contrario en el modo de decir no lo es finalmente, una (...) vez plasmado en la realidad que se comunica. Y esto es así, porque las diferencias en la expresión provienen, no solamente de la versión o traducción de un idioma a otro sino también del ambiente y de la estructura intelectual o lingüística de cada Iglesia y de cada creyente, lo cual tiene a su vez mucho que ver con la vivencia espiritual o tradición «desde» la que se habla. Un ejemplo relativamente reciente, lo encontramos, dentro del campo ecuménico, en la solución a que se ha llegado, en relación con el controvertidísimo filioque. Algo semejante podemos decir, de manera general, de toda fórmula que resulta extraña o malsonante para el oyente que no se sitúa en el preciso paraje del orador. (shrink)