Absence of health, that is, sickness in Africa is viewed in personalistic terms. A disease is explained as effected by 'the active purposeful intervention of an agent, who may be human', non-human (a ghost, an ancestor, an 'evil spirit), or supernatural (a deity or other very powerful being)' (Foster). Illness is thus attributed to breaking of taboos, offending God and/ or ancestral spirits; witchcraft, sorcery, the evil eye, passion by an evil spirit and a curse from parents or from an (...) offended neighbour. In view of these personalistic theories of ill health, treatment is through ritual purification, exorcism or sacrifices. For an appropriate diagnosis and intervention, it is imperative to determine 'who' caused the illness and then 'why' it was caused, to which answers are offered through divination by a healer. This interpretive framework, is applicable to all types of sickness, facilitates co-existence of African traditional healing and biomedical treatment, that is, plurality of health seeking practices. The approach fails to offer a constructive approach and contradicts the biblical healing framework whereby one may not have explanatory causes to a situation of ill health. This article engaged the biblical concept of shalōm as a relevant constructive framework. The Hebrew concept of shalōm, though distinctly salvific, is inclusive of holistic and personalistic healing aspects. The concept encompasses constructive aspects of completeness, wholeness, health, peace, welfare, safety, soundness, tranquillity, prosperity, perfectness, fullness, rest, harmony and the absence of agitation or discord, which provides a useful holistic healing theological framework. It therefore provides a health and well-being framework that is relational, sensitive and applicable to healing patterns in Africa. Using the case study of the Abaluyia people of East Africa, this article discussed bereavement as a state that requires healing and how the biblical framework of shalōm could be applied in fostering bereavement healing. (shrink)

The rapid development of COVID-19 vaccines in 2020 involved an unprecedented clinical research initiative. The case here involves a Phase I clinical trial of “second-generation” COVID-19 vaccines d...

This review essay looks at Andrew Brei’s edited volume, Ecology, ethics and hope, Candis Callison’s How climate change comes to matter: The communal life of facts, Randall Curren and Ellen Metzger’s Living well now and in the future: Why sustainability matters, Willis Jenkins’ The future of ethics: Sustainability, social justice, and religious creativity, and Byron Williston’s The Anthropocene project: Virtue in the age of climate change. These recent works highlight various normative approaches for engaging with what is often referred to (...) as the Anthropocene. Drawing on virtue ethics, pragmatism, and concepts such as intergenerational justice, they seek to address some of the defining moral challenges of our time: how we should respond to this unprecedented era of anthropogenic climate and environmental change, and what ethical resources we can draw on to guide our response. On a larger level, they reveal how the climate crisis is testing the limits of our current moral systems and helping to drive greater ethical innovation and adaptation in the process. (shrink)

Half of the drug offenders incarcerated in the United States are black, even though whites and blacks use and sell drugs at the same rate, and blacks make up only 13 percent of the population. Noncomparativists about retributive justice see nothing wrong with this picture; for them, an offender’s desert is insensitive to facts about other offenders. By contrast, comparativists about retributive justice assert that facts about others can partially determine an offender’s desert. Not surprisingly, comparativists, especially comparative egalitarians, contend (...) that differential punishment is retributively unjust. I agree with this assessment, but take issue with the reasons egalitarians cite in its favor. In this paper, I argue that differential punishment violates retributive justice because it contributes to structural racial oppression. Over the course of developing and defending this claim, I identify the shortcomings of both comparative egalitarianism and respectarianism, which is the most popular and plausible brand of noncomparativism. (shrink)

Many philosophers and legal theorists worry about punishing the socially disadvantaged as severely as their advantaged counterparts. One philosophically popular explanation of this concern is couched in terms of moral standing: seriously unjust states are said to lack standing to condemn disadvantaged offenders. If this is the case, institutional condemnation of disadvantaged offenders (especially via hard treatment) will often be unjust. I describe two problems with canonical versions of this view. First, its proponents groundlessly claim that disadvantaged offenders may be (...) punished as severely as advantaged ones, even though such punishment is unjust in light of the state’s loss of standing. Second, and more importantly, moral standing arguments prohibit states from blaming advantaged as well as disadvantaged offenders. This unwelcome outcome suggests that standing approaches incorrectly analyze the source of moral misgivings about punishing the disadvantaged. I conclude that those who share such concerns should put standing accounts aside. (shrink)

The Office of Human Research Protections was not justified in issuing findings against the SUPPORT Institutions. Our community can learn from the evolving healthcare transformation into learning health systems by thinking about the novel ethical issues about standard of care research raised by the SUPPORT with the same spirit of quality improvement. The current regulatory framework and the concept of foreseeable research risks is insufficient to advance the debate about the ethics of randomization of standard clinical interventions. This article uses (...) the example of the Wisconsin cystic fibrosis randomized clinical trial for newborn screening trial to explore the distinctions between risks of research and clinical care and waivers of informed consent for randomization. Collaborative exploration of these complex policy issues is needed and further deliberation, community engagement, and social science research will be critical to advance novel approaches for informed consent. (shrink)

Volume 20, Issue 4, May 2020, Page 102-103.

Volume 20, Issue 10, October 2020, Page 90-91.

Andrew Eshleman has argued that atheists can believe in God by being fully engaged members of religious communities and using religious discourse in a non-realist way. He calls this position 'fictionalism' because the atheist takes up religion as a useful fiction. In this paper I critique fictionalism along two lines: that it is problematic to successfully be a fictionalist and that fictionalism is unjustified. Reflection on fictionalism will point to some wider problems with religious anti-realism.

Volume 20, Issue 5, June 2020, Page 22-23.

In response to the racial disparities that plague the American criminal justice system, the Movement for Black Lives calls for an end to policing and punishment “as we know it.” But refusing to punish violent offenses leaves unprotected those most vulnerable to crime, and outright abolition thus appears to undermine black rights and liberties. I call this the decarceration dilemma. After discussing Tommie Shelby and Christopher Lewis’s attempts to resolve the dilemma, I offer my own, which employs a procedural rather (...) than a substantive solution. I lean on the principle of expanded asymmetry (EA), which holds that it is better to underpunish than overpunish. After defending EA, I note that it obtains only under conditions of uncertainty. I then show that because virtually all trials of black offenders meet the uncertainty condition, sentencing authorities are obliged to treat black offenders leniently. I conclude by noting the advantages of my proceduralist approach. (shrink)

Currently, there is consensus that community engagement and partnerships are essential to inclusive patient-centered clinical research. Yet there is variation about what it means to do this well an...

A commentary on “SUPPORT and the Ethics of Study Implementation: Lessons for Comparative Effectiveness Research from the Trial of Oxygen Therapy for Premature Babies,” by John D. Lantos and Chris Feudtner, in the January‐February 2015 issue.

Everyone has an opportunity to contribute to climate solutions. To help people engage with this opportunity, it is critical to understand how climate organizations and fundraisers can best communicate with people and win their financial support. In particular, fundraisers often rely on practical skills and anecdotal beliefs at the expense of scientific knowledge. Fundraisers could be motivated to achieve a substantial boost in funding for climate solutions, if there is evidence of the financial gains that science-based fundraising makes available. In (...) this Perspective, we provide a preliminary foray into such evidence. We bring together findings from philanthropic research and climate psychology to identify what factors can help captivate donors. Then, through an experimental study of a charitable appeal for a climate charity, we show how putting these factors into practice may contribute toward an increase in donated money. This provides optimism that evidence-based fundraising can inspire donors to contribute much-needed resources toward climate solutions. (shrink)

I first became aware of bioethics in the spring of 1980. I had spent a thirty‐six‐hour shift shadowing a medical resident, and I was struck that many of the resident's decisions had ethical dimensions. The next day, I came across the Hastings Center Report, and I realized I wanted to explore ethical issues I found implicit in clinical care, even though I still wanted to become a pediatrician. In September 2019, when I attended my first meeting of the U.S. Food (...) and Drug Administration's Pediatric Advisory Committee, as a pediatric pulmonologist, I had the same sense of awe and curiosity that I had forty years ago. What had appeared initially as somewhat technical decisions about the regulation of drug labeling was suffused with ethical questions. The committee was asked to discuss possible changes to the labeling of two previously approved drugs. (shrink)

In this paper I argue that Poston and Dougherty's attempt to undermine the problem of divine hiddenness by using the notion of belief de re is problematic at best. They hold that individuals who appear to be unbelievers (because they are de dicto unbelievers) may actually be de re believers. I construct a set of conditions on ascribing belief de re to show that it is prima facie implausible to claim that seemingly inculpable and apparent unbelievers are really de re (...) believers. Thus, while it is indeed possible that a de dicto unbeliever is a de re believer, it is unlikely that this has sufficiently general application to actual individuals to alleviate the problem of divine hiddenness. (shrink)

COPII coated vesicles bud from an ER domain termed the transitional ER (tER), but the mechanism that clusters COPII vesicles at tER sites is unknown. tER sites are closely associated with early Golgi or pre‐Golgi structures, suggesting that the clustering of nascent COPII vesicles could be achieved by tethering to adjacent membranes. This model challenges the prevailing view that COPII vesicles are clustered by a scaffolding protein at the ER surface. Although Sec16 was proposed to serve as such a scaffolding (...) protein, recent data suggest that rather than organizing COPII into higher‐order structures, Sec16 acts at the level of individual COPII vesicles to regulate COPII turnover. A plausible synthesis is that tER sites are created by tethering to Golgi membranes and are regulated by Sec16. Meanwhile, the COPII vesicles that bud from tER sites are thought to nucleate new Golgi cisternae. Thus, an integrated self‐organization process may generate tER‐Golgi units. (shrink)

While Hume has often been held to have been an agnostic or atheist, several contemporary scholars have argued that Hume was a theist. These interpretations depend chiefly on several passages in which Hume allegedly confesses to theism. In this paper, I argue against this position by giving a threshold characterization of theism and using it to show that Hume does not confess. His most important confession does not cross this threshold and the ones that do are often expressive rather than (...) assertive. I then argue that Hume is best interpreted as an atheist. Instead of interpreting Hume as a proto-logical positivist and arguing on the basis of Hume’s theories of meaning and method, I show that textually he appears to align himself with atheism, that his arguments in the Dialogues on Natural Religion support atheism, and that this position is most consistent with Hume’s naturalism. But, I hold that his atheism is soft and therefore distinct from that of his peers like Baron d’Holbach—while Hume really does reject theism, he neither embraces a dogmatically materialist position nor takes up a purely polemical stance towards theism. I conclude by suggesting several ways in which Hume’s atheistic philosophy of religion is relevant to contemporary discussions. (shrink)

Incidental research findings, as defined in this symposium’s consensus paper, are unexpected findings discovered in the course of research but “beyond the aims of the study.” These include findings generated by research methodology, such as imaging or genetic analysis, findings related to clinical screening for inclusion or exclusion, or direct observations of physical abnormalities or behavior. Decisions about managing incidental research findings involve important ethical considerations regarding a researcher’s obligations to provide care, minimize harms, and respect research participants’ wishes. When (...) the research participant is a child, the triadic relationship between the researcher, child participant, and parent makes these considerations more complicated. (shrink)

This essay articulates a convergence between Foucault and Agamben: the possibility of an uncomplicated belonging to the profane, or to the perfect time of human experience. Agamben articulates a sense of experience as experience that “tears me from myself,” that points to a transformed conception of the world and a body and that connects his thinking to Foucault’s. This article places Agamben with Foucault outside of the alternative between messianism and pessimism. In the “perfect time of human experience,” in potentiality, (...) possibility, and absolute immanence, Agamben finds a way of experiencing, a path along which philosophy has always wanted to step, one that I argue is taken in Foucault’s bio-politics. (shrink)

Genetic testing for cancer susceptibility is an application of biotechnology that has the potential both to improve the psychosocial and physical wellbeing of the population and to cause significant psychosocia1 and physical harms. In spite of the uncertain value of genetic testing, it has captured the interest of biotechnology companies, researchers, health care providers, and the public. As more tests become feasible, pressure may increase to make the tests available and reimbursable. Both the benefits and harms of these tests lie (...) not as much in the tests themselves, as in their power to predict or alter the future. The value of the tests does not derive from the information per se, but from the ability to communicate effectively the information to patients and providers, and the behavioral responses of patients, providers, and others to this information. (shrink)

The book contends that contrary to accepted interpretation, moral intuition, rather than any other form of reasoning, least of all formal logic, is the moral method found in the ethics of Aristotle, Aquinas, Kant and Dewey - the first four chapters of the book. These four thinkers represent a dialectical selection of ethical relativism and absolutism as well as a chronological succession from ancient to contemporary thought. The fifth and concluding chapter is a major presentation of the author's thesis on (...) moral intuition as the exact antidote against the dilemma ethics approach, which is widely used today with rapidly diminishing effect and interest. This chapter is a detailed illustration of how moral intuition works out concretely in the lived world. It stresses the unity of moral experience even as this is clouded over by our relatively fewer, but overdramatized, confrontations on some moral issues. (shrink)

Kant famously insists that free will is a condition of morality. The difficulty of providing a demonstration of freedom has left him vulnerable to devastating criticism: critics charge that Kant's post-Groundwork justification of morality amounts to a dogmatic assertion of morality's authority. My paper rebuts this objection, showing that Kant offers a cogent demonstration of freedom. My central claim is that the demonstration must be understood in practical rather than theoretical terms. A practical demonstration of x works by bringing x (...) into existence, and what the demonstration of freedom brings into existence is a moral will, a will regulated by the moral law and capable of acting in accordance with it. Since to act morally is to act freely, bringing a moral will into existence actualizes our capacity for freedom and demonstrates that we possess it. To confirm the viability of such a demonstration, Kant must establish that agents can regulate their wills by practical principles, and that practical judgments are efficacious of themselves (i.e., that non-Humean motivational internalism is true). Kant, I argue, is successful on both counts. (shrink)

In this paper I argue that traditional theism, in its theory, history, and practice has implications for the philosophy of nature. Namely, nature should be designed around aesthetic or meaningful principles and nature should be engineered in order to fulfil a fairly well defined set of purposes. If theism is true, we should be able to study nature objectively as a teleological system. After all, the teleological structure of nature is more important to us as spiritual beings than its mechanisms. (...) Since a teleological philosophy of nature is no longer viable, traditional theism is untenable. (Published Online July 10 2006). (shrink)

This paper argues that Immanuel Kant’s practical philosophy contains a coherent, albeit implicit, defense of the legitimacy of capital punishment, one that refutes the most important objections leveled against it. I first show that Kant is consistent in his application of the ius talionis. I then explain how Kant can respond to the claim that death penalty violates the inviolable right to life. To address the most significant objection – the claim that execution violates human dignity – I argue that (...) motives of honor, as Kant conceives it, require a rational person to will her own execution, were she to commit murder. (shrink)

Decisions regarding life-sustaining medical treatments for young children with profound disabilities can be extremely challenging for families and clinicians. In this study, Brick and colleagues1 surveyed adult residents of the UK about their attitudes regarding withdrawal of treatment using a series of vignettes of infants with varying levels of intellectual and physical disability, based on real and hypothetical cases.1 This is an interesting study on an important topic. We first highlight the limitations of using these survey data to inform public (...) policy and then offer a different interpretation from the authors’ regarding their findings about the value the public appears to place on relational capacity. The authors asked members of the lay public to interpret a disabled child’s best interest in a series of vignettes. The respondents were 92% white; 59% were atheist or reported no religious affiliation. Though the authors note this lack of diversity as a limitation, we would add that this limitation is particularly problematic in this context. Minority views on this issue may differ significantly from the majority perspective. When the stakes are high (as is the case for questions about withdrawing life-sustaining therapy from infants over parental objections), use of public opinion data to directly inform policy requires, at a minimum, a representative sample reflecting both the true diversity of views within the public and a method to justly account for the alternate views of the minority. Even if the sampled population were more …. (shrink)

For many rare diseases, the availability of effective interventions is limited or non-existent. In this context, clinical research evaluating emerging interventions may be the only potentially “the...