Background The first COVID-19 wave started in February 2020 in France. The influx of patients requiring emergency care and high-level technicity led healthcare professionals to fear saturation of available care. In that context, the multidisciplinary Ethics- Support Cell (EST) was created to help medical teams consider the decisions that could potentially be sources of ethical dilemmas. Objectives The primary objective was to prospectively collect information on requests for EST assistance from 23 March to 9 May 2020. The secondary aim was (...) to describe the Cell’s functions during that period. Research design This observational, real-time study of requests for Cell consultations concerned ethical dilemmas arising during a public health crisis. The EST created a grid to collect relevant information (clinical, patient’s/designated representative’s preferences and ethical principles strained by the situation), thereby assuring that each EST asked the same questions, in the same order. Participants and research context Only our university hospital’s clinicians could request EST intervention. Ethical considerations The hospital Research Ethics Committee approved this study (no. CER-2020-107). The patient, his/her family, or designated representative was informed of this ethics consultation and most met with EST members, which enabled them to express their preferences and/or opposition. Findings/results 33 requests (patients’ mean age: 80.8 years; 29 had COVID-19: 24 with dyspnea, 30 with comorbidities). 17 Emergency Department solicitations concerned ICU admission, without reference to resource constraints; others addressed therapeutic proportionality dilemmas. Discussion Intervention-request motives concerned limited resources and treatment intensity. Management revolved around three axes: the treatment option most appropriate for the patient, the feasibility of implementation, and dignified care for the patient. Conclusions COVID-19 crisis forced hospitals to envisage prioritization of ICU access. Established decision-making criteria and protocols do not enable healthcare professionals to escape ethical dilemmas. That acknowledgement highlights ethical risks, enhances the added-value of nursing and encourages all players to be vigilant to pursue collective deliberations to achieve clear and transparent decisions. (shrink)

Ethical review systems need to build on their experiences of COVID-19 research to enhance their preparedness for future pandemics. Recommendations from representatives from over twenty countries include: improving relationships across the research ecosystem; demonstrating willingness to reform and adapt systems and processes; and making the case robustly for better resourcing.

ABSTRACTHedonic deficits are linked to protracted dysphoric affect in depression, a disorder characterised by emotion context insensitivity. Recent findings from daily life studies contradict the ECI view. This study longitudinally investigated DA across laboratory and daily life contexts and the conditions associated with discrepancies in DA reactivity. Thirty-three healthy controls and 41 adults with major depressive disorder provided responses to neutral and positive films viewed in the laboratory and daily events recorded over the course of three days using ecological momentary (...) assessment methodology. The current study reports on participants’ appraisals of films and events and their subsequent DA, both rated individually after each task and daily event. Despite large group similarities in appraisals of the positive film and life events, MDDs appraised the neutral film and neutral life events as less important and less pleasant (film: d =... (shrink)

U.S. immigration policies and enforcement can make immigrants fearful of accessing healthcare. Although current immigration policies restrict enforcement in “sensitive locations” including healthcare facilities, there are reports of enforcement actions in such settings.

This article introduces a new conceptualisation of the relationship between global distributive justice, development, and the study of peace, which we label the Responsibility for Peace (R4P). In doing so, the article examines the notion of positive peace within peace studies, its relation to arguments within global distributive justice, and to what degree this important relationship is recognised in the primary international framework to prevent and protect populations from mass atrocity crimes, the Responsibility to Protect (R2P). The article argues that (...) despite growing recognition about the links between peace and development within both R2P and global justice discussions, it remains insufficient in terms of positive peace, thus requiring a new heuristic. In response, we argue that global justice demands refocused moral commitments to jus ante bellum (establishing global justice before war) and that this necessitates greater focus on the study of positive peace mechanisms, the identification and reform of structural injustices (against structural violence), and a retooled emphasis on human-centred development that can transcend existing legacies. In other words, we need to better focus on causes and not symptoms. It is this triangulation that we label the Responsibility for Peace (R4P), which should operate both prior to, and independently of, the Responsibility to Protect (R2P). (shrink)

We improve on and generalize a 1960 result of Maltsev. For a field F, we denote by $H(F)$ the Heisenberg group with entries in F. Maltsev showed that there is a copy of F defined in $H(F)$, using existential formulas with an arbitrary non-commuting pair of elements as parameters. We show that F is interpreted in $H(F)$ using computable $\Sigma _1$ formulas with no parameters. We give two proofs. The first is an existence proof, relying on a result of Harrison-Trainor, (...) Melnikov, R. Miller, and Montalbán. This proof allows the possibility that the elements of F are represented by tuples in $H(F)$ of no fixed arity. The second proof is direct, giving explicit finitary existential formulas that define the interpretation, with elements of F represented by triples in $H(F)$. Looking at what was used to arrive at this parameter-free interpretation of F in $H(F)$, we give general conditions sufficient to eliminate parameters from interpretations. (shrink)

Recent media articles have stirred controversy over anecdotal reports of medical students practising educational pelvic examinations on women under anaesthesia without explicit consent. The understandable public outrage that followed merits a substantive response from the medical community. As medical students, we offer a unique perspective on consent for trainee involvement informed by the transitional stage we occupy between patient and physician. We start by contextualising the role of educational pelvic examinations under anaesthesia (EUAs) within general clinical skill development in medical (...) education. Then we analyse two main barriers to achieving explicit consent for educational pelvic EUAs: ambiguity within professional guidelines on how to operationalize ‘explicit consent’ and divergent patient and physician perspectives on harm which prevent physicians from understanding what a reasonable patient would want to know before a procedure. To overcome these barriers, we advocate for more research on patient perspectives to empower the reasonable patient standard. Next, we call for minimum disclosure standards informed by this research and created in conjunction with students, physicians and patients to improve the informed consent process and relieve medical student moral injury caused by performing ‘unconsented’ educational pelvic exams. (shrink)

Max Bense gilt als Vorreiter der Computerkunst und der Technikphilosophie und war ein engagierter Förderer von Kunst und Literatur, Promotor interdisziplinären Denkens und politischer Provokateur. Häufig ist es bei der Auseinandersetzung mit Bense jedoch bei diesen Etikettierungen geblieben. Der Sammelband nimmt daher eine konzertierte Neuaufnahme der Diskussion von Max Benses Arbeiten aus literaturwissenschaftlicher, philosophie- und wissenschaftshistorischer sowie aus medien- und ästhetiktheoretischer Perspektive vor. Er versammelt Beiträge zu Themenkomplexen wie der Semiotik, Technikphilosophie, experimentellen Poesie und Ästhetiktheorie, zu Benses lokalen und internationalen (...) Kontakten und Netzwerken sowie zu seinem publizistischen Verhalten im Nationalsozialismus und in der Nachkriegszeit. (shrink)

IntroductionWe aimed to study post-traumatic stress disorder symptoms in breast cancer patients during the coronavirus disease pandemic.Materials and methodsWe included BC patients receiving medical treatment during the first COVID-19 lockdown in France. PTSD symptoms were evaluated using the Impact of Event Scale-Revised questionnaire. Quality of life [Functional Assessment of Cancer Therapy-General ], cognitive complaints [Functional Assessment of Cancer Therapy–Cognitive Function ], insomnia [Insomnia Severity Index ], and psychosocial experiences during lockdown were also evaluated. Multivariable logistic regression was used to identify (...) clinical factors and psychosocial factors associated with PTSD symptoms.ResultsAmong the 253 included BC patients, 46% had metastatic cancer and 52% were treated by chemotherapy alone. COVID-19-induced adjustments in medical oncology practices were experienced by 27% of patients. No case of COVID-19 was reported; 23% of BC patients had PTSD symptoms. Compared to other patients, patients with PTSD symptoms had more fears relative to COVID-19 infection, had more feeling of isolation, and had more prescription or increased use of psychotropic drugs. In the multivariable model adjusted for clinical factors, fears relative to COVID-19 and increased use of psychotropic drugs were independently associated with PTSD symptoms. Besides, patients with PTSD symptoms had poor quality of life, and more cognitive complaints and insomnia.ConclusionPost-traumatic stress disorder symptoms were observed in 23% of BC patients during the first COVID-19 lockdown in France. Psychological supports are needed for patients treated during the COVID-19 pandemic. (shrink)

Global health has long been characterized by injustice, with certain populations marginalized and made vulnerable by social, economic, and health disparities within and among countries. The pandemic only amplified inequalities. In response to it, the World Health Organization and the United Nations have embarked on transformative normative and financial reforms that could reimagine pandemic prevention, preparedness, and response (PPPR). These reforms include a new strategy to sustainably finance the WHO, a UN political declaration on PPPR, a fundamental revision to the (...) International Health Regulations, and negotiation of a new, legally binding pandemic agreement (popularly called the “Pandemic Treaty”). We revisit the cavernous shortcomings of the global Covid‐19 response, explain potentially transformative legal reforms and the ethical values that underpin them, and propose actionable solutions to advance both health and justice. (shrink)

Ungureanu, Camil and Monti, Paolo Contemporary Political Philosophy and Religion: between Public Reason and PluralismNew York: Routledge, 349 p.ISBN 9780415552196.

El objetivo del presente trabajo es indagar la naturaleza integradora de la biología evolutiva del desarrollo. En particular analizamos las características temporales de los procesos estudiados por diferentes programas de investigación de evo-devo y las comparamos con aquellas propias de los procesos macroevolutivos, microevolutivos y del desarrollo de los organismos. Encontramos que en los principales programas de investigación de evo-devo se recuperan principalmente características propias de los fenómenos macroevolutivos, mientras que en la sub-área de eco-evo-devo se recuperan principalmente características propias (...) de la microevolución.The aim of this study is to investigate the integrative nature of evolutionary developmental biology. We particularly analyzed the temporal characteristics of the processes studied by different research programs of evo-devo and we compared them with those of macroevolution, microevolution and developmentalprocesses of organisms. We found that in the major research programs of evo-devo, macroevolutionary phenomena characteristics are mainly recovered, while in the sub-area of eco-evo-devo microevolutionary characteristics are mainly recovered. (shrink)

Culminada la Guerra Fría, la sociedad global consideró superadas la colisión ideológica y la polarización de teorías. Sin embargo, al finalizar el siglo xx y descollando el siglo xxi surgieron indicios que apuntaban en dirección contraria. Los primeros con el resurgimiento del marxismo que a partir de la tesis humanista de la filosofía de la praxis revive desde Latinoamérica el legado de Mariátegui, el Che Guevara y Camilo Torres R. El artículo se pregunta si el paradigma del marxismo humanista arroga (...) los fundamentos del buen vivir o vivir bien para enfrentar al capitalismo neoliberal y su proyecto desarrollista. La aproximación al tema se hace de manera cualitativa y descriptiva. A través del método de análisis del discurso político expuesto en la teoría crítica al desarrollismo se aborda la caracterización del capitalismo neoliberal y el modelo de desarrollo, continuando con las tesis que desde el marxismo humanista y la estrategia de revolución cultural se estructura para la emancipación en Latinoamérica. Finalmente, se exponen los planteamientos del buen vivir a partir de la apropiación que hacen los neomarxistas para dar la batalla contra el capitalismo neoliberal. (shrink)

Deontic logic is a branch of symbolic logic interested in notions such as obligatory, permissible, optional, ought, and others similar. There are some equivalent ways to present the Standard Deontic Logic or KD. In this paper, we will mention some of them and highlight one that is of interest. With this presentation we can propose a simple algebraic model for the Standard Deontic Logic.

Martha Nussbaum’s capabilities approach is today one of the most influential theories of justice. In her earlier works on the capabilities approach, Nussbaum only applies it to humans, but in later works she extends the capabilities approach to include sentient animals. Contrary to Nussbaum’s own view, some scholars, for example, David Schlosberg, Teea Kortetmäki and Daniel L. Crescenzo, want to extend the capabilities approach even further to include collective entities, such as species and ecosystems. Though I think we have strong (...) reasons for preserving ecosystems and species within the capabilities approach, there are several problems with ascribing capabilities to them, especially if we connect it with the view that species and ecosystems are subjects of justice. These problems are partly a consequence of the fact that an ascription of capabilities to species and ecosystems needs to be based on an overlapping consensus between different comprehensive doctrines, in accordance with the framework of political liberalism on which the capabilities approach builds. First, the ascription of capabilities to species and ecosystems presupposes the controversial standpoint that they are objectively existing entities. Second, the ascription of capabilities to ecosystems and species and the view that they are subjects of justice is justified by claiming that they have integrity and agency, but these characteristics have different meanings when applied to collective entities and humans, respectively. Third, the view that species and ecosystems are subjects of justice seems to require the controversial assumption that they have interests of their own, which differ from the interests of the sentient beings that are part of them. However, even if we do not ascribe capabilities to species and ecosystems and regard them as subjects of justice, there are still strong reasons to protect them within the capabilities approach, as the preservation of ecosystems and species is an important precondition for many human and animal capabilities. (shrink)

We contribute to the scientific debate by studying the storylines, discourses and related normative judgments in parliamentary motions by private members of the Swedish parliament from the time period 2010–2019. The paper makes use of an ecofeminist theoretical framework to problematize these storylines, discourses and normative judgments. We conclude that the focus in the material is on economic and technical issues, while issues of justice play a marginal role. None of the important dimensions of energy justice are adequately considered and (...) many of the dominant storylines and discourses are based on the implicit assumption that issues of justice are insignificant. (shrink)

The philosophical debate over disgust and its role in moral discourse has focused on disgust’s epistemic status: can disgust justify judgments of moral wrongness? Or is it misplaced in the moral domain—irrelevant at best, positively distorting at worst? Correspondingly, empirical research into disgust has focused on its role as a cause or amplifier of moral judgment, seeking to establish how and when disgust either causes us to morally condemn actions, or strengthens our pre-existing tendencies to condemn certain actions. Both of (...) these approaches to disgust are based on a set of assumptions that I call, in what follows, the evidential model of disgust. This paper proposes an alternative model, which I call the response model. Instead of looking at disgust as a cause and justification of judgments of moral wrongness, I will argue that disgust is better understood as a response to wrongness. More precisely, I argue that disgust is a response to norm violations, and that it is a fitting response insofar as norm violations are potentially contagious and therefore pose a threat to the stability and maintenance of norms. (shrink)

Legitimacy is a concept that has been largely forgotten by the deconstructive discourse on law and politics. This article seeks, on the one hand, to reassess the role of legitimacy in deconstruction and, on the other hand, to bring deconstructive thinking to bear on the concept of legitimacy. By re-reading Derrida’s “Declarations of Independence” through the lenses of his later texts on sovereignty and (counter)signature, it is argued that, rather than being deconstructible, legitimacy is deconstructing any self-founding of law and (...) power. As such, legitimacy functions not as an evaluative concept of law and order but as a constantly insisting demand that facilitates the principles of responsibility and responsiveness. (shrink)

The article argues that there are different ways of justifying suspension of judgement. We suspend judgement not only privatively, that is, because we lack evidence, but also positively, that is, because there is evidence that provides reasons for suspending judgement: suspension is more than the rational fallback position in cases of insufficient evidence. The article applies the distinction to recent discussions about the role of suspension for inquiry, Turri's puzzle about withholding, and formal representations of suspension.

Empowerment, an already central concept in public health, has gained additional relevance through the expansion of mobile health (mHealth). Especially direct-to-consumer self-testing app companies mobilise the term to advertise their products, which allow users to self-test for various medical conditions independent of healthcare professionals. This article first demonstrates the absence of empowerment conceptualisations in the context of self-testing apps by engaging with empowerment literature. It then contrasts the service these apps provide with two widely cited empowerment definitions by the WHO, (...) which describe the term as a process that, broadly, leads to knowledge and control of health decisions. We conclude that self-testing apps can only partly empower their users, as they, we argue, do not provide the type of knowledge and control the WHO definitions describe. More importantly, we observe that this shortcoming stems from the fact that in the literature on mHealth and in self-testing marketing, empowerment is understood as a goal rather than a process. This characterises a shift in the meaning of empowerment in the context of self-testing and mHealth, one that reveals a lack of awareness for relational and contextual factors that contribute to empowerment. We argue that returning to a process-understanding of empowerment helps to identify these apps’ deficits, and we conclude the article by briefly suggesting several strategies to increase self-testing apps’ empowerment function. (shrink)

Everyone involved with the care and welfare of children and young adults is confronted with the issue of bullying. Bullying behaviors create an uncomfortable, threatening, and hostile environment that make it difficult for children to learn. 101 Facts about Bullying breaks down what the research says about bullying and its effects, offering ideas for what can and should be done to minimize or reduce it. Kevorkian systematically discusses topics ranging from relational bullying to cyber bullying to media and video violence (...) to the legal ramifications of bullying, debunking myth and uncloaking the facts about bullying and its prevention. (shrink)

To accomplish a just transition, energy scenarios is a helpful tool. Participatory and deliberative methods are increasingly used when constructing and assessing energy scenarios to improve the democratic legitimacy of the results. This article contributes to the scientific debate by analyzing how such methods can include considerations of justice issues in a more systematic manner. It is based on a study of four workshops conducted in Sweden, in which the participants discussed different energy scenarios from a justice perspective. It discusses (...) what can be achieved by methods for participatory-deliberative ethics assessment of the consequences of energy scenarios and how such methods should be designed. (shrink)

Zahavi’s book has added greatly to our understanding of some of the difficult issues surrounding the notion of empathy. In this note, however, I argue that by overlooking some essential features of empathy, Zahavi’s account unnecessarily limits its scope. In particular, I argue that Zahavi’s account, by characterizing empathy as an immediate, direct perceptual access to the other’s experiences, overlooks its normative dimension.

O objetivo deste artigo é mostrar como o autor de O livro sobre o Puro Bem, conhecido pelos filósofos latinos como Liber de causis (LdC), desenvolve uma metafísica da causalidade ao propor uma abordagem das causas em um domínio diferente da filosofia natural. Seguindo a linha interpretativa mais recente que toma o conteúdo do LdC como um modelo filosófico original, buscarei apresentar e explicar os critérios que fundamentam a distinção causal (Causa Primeira, intelecto e alma) e a primazia absoluta da (...) Causa Primeira: universalidade, autonomia, anterioridade e eternidade. Na sequência, mostrarei como, a partir da distinção entre a Causa Primeira e o intelecto, decorrem dois tipos de causalidade, a criação (causa de ser) e a informação (causa de forma). Por fim, introduzo brevemente um dos problemas centrais da teoria da causalidade do LdC, a dizer, se a atividade criadora da Causa Primeira depende de um intermediário. (shrink)

In Leviathan Thomas Hobbes defines moral philosophy as 'the science of Virtue and Vice', yet few modern readers take this description seriously. Moreover, it is typically assumed that Hobbes' ethical views are unrelated to his views of science. Influential modern interpreters have portrayed Hobbes as either an amoralist, or a moral contractarian, or a rule egoist, or a divine command theorist. David Boonin-Vail challenges all these assumptions and presents a new, and very unorthodox, interpretation of Hobbes's ethics. He shows that (...) Hobbes is best understood as embracing a theory of virtue concerned with the development of good character traits rather than with rules of behaviour. In focusing in a quite new way on Hobbes's moral theory this book is likely to attract considerable attention amongst both philosophers and intellectual historians. (shrink)

Defending first-person introspective access to own mental states, we argue against Carruthers' claim of mindreading being prior to meta-cognition and for a fundamental difference between how we understand our own and others' mental states. We conclude that a model based on one mechanism but involving two different kinds of access for self and other is sufficient and more consistent with the evidence.

Health care professionals assigned to critical care are confronted on a daily basis with particularly trying situations. Their hard work conditions can become anxiety-provoking, affect their physical and/or psychological condition, decrease their performance and increase their absenteeism rate at work. To face this particularly stressful and sometimes depressing context, some professionals fall back on “gallows humour”, a sort of black humour with a morbid overtone, which is likely to shock certain people. Although gallows humour is very widespread, its use in (...) critical care is extremely controversial and most of the time reprimanded by professional orders. Based on the codes of ethics that govern them, professional orders assume that gallows humour violates the duties and responsibilities of their members towards their patients, rejecting its use straightaway. In this article, we contest the categorical rejection of gallows humour in critical care. We adopt a consequentialist perspective based on the study of scientific literature on the benefits of using humour in the workplace, to defend its ethical acceptability. By enabling us to be better prepared to provide care despite the tragic events experienced by professionals, we will see how the use of gallows humour can ultimately have a positive effect on patients. A consequentialist ethics is not only interested in maximizing the benefits of gallows humour but also in reducing the risk of harm to others related to its use. This important criterion will therefore lead us to define the terms and suggest certain conditions that must be respected for an ethical use of this important defense mechanism by health care professionals in critical care. (shrink)