Throughout the COVID-19 pandemic, shortages of scarce healthcare resources consistently presented significant moral and practical challenges. While the importance of vaccines as a key pharmaceutical intervention to stem pandemic scarcity was widely publicized, a sizable proportion of the population chose not to vaccinate. In response, some have defended the use of vaccination status as a criterion for the allocation of scarce medical resources. In this paper, we critically interpret this burgeoning literature, and describe a framework for thinking about vaccine-sensitive resource (...) allocation using the values of responsibility, reciprocity, and justice. Although our aim here is not to defend a single view of vaccine-sensitive resource allocation, we believe that attending critically with the diversity of arguments in favor (and against) vaccine-sensitivity reveals a number of questions that a vaccine-sensitive approach to allocation should answer in future pandemics. (shrink)

Volume 19, Issue 10, October 2019, Page 88-90.

Background: Despite procedural innovations and increasing numbers of uterus transplant attempts worldwide, the perspectives of uterus transplant (UTx) trial participants are lacking. Methods: We conducted a mixed-methods study with women with absolute uterine factor infertility (AUFI). Participants included women who had previously contacted the Cleveland Clinic regarding the Uterine Transplant Trial and met the initial eligibility criteria for participation. In-depth interviews were conducted in conjunction with FertiQoL, a validated and widely used tool to measure the impact of infertility on the (...) quality of life of infertility patients. Results: All (n = 19) rated their overall health as good; some experienced grief and social isolation. AUFI is a life-framing experience that influences acceptance by family, partners, peers, and one’s self. UTx is a means to gain control of reproductive autonomy. UTx allows family-building and the ability to play an active role in prenatal health and well-being. Establishing and maintaining a supportive relationship is a key issue of AUFI and when considering UTx. Risks of UTx are perceived relative to risks to self/child/family posed by adoption/surrogacy. Participants had no overall preference regarding living or deceased donor. Conclusions: The ways in which women with AUFI conceptualize this condition in their lives and choices around UTx and participating in a study of the procedure are multifaceted and textured. These perspectives are critical to understanding its ethical, legal, and social implications. (shrink)

This chapter introduces the edited volume, The Oxford Handbook of Philosophy and Psychiatry. Published in 2013, the centenary of Karl Jaspers' General Psychopathology, the chapter draws lessons from the last hundred years for the coming century. No predictions are made. Instead, five 'conditions for flourishing' are set out: 1) Particular Problems - the importance of focussing on well-defined particular problems rather than general theory building, 2) Product- orientation - remaining always responsibly product oriented in the specific sense that both sides (...) put in the work necessary to 'go deep' with each other's fields, 3) Partnership - working in partnerships of one kind or another, 4) Process - constant reflection on process based on peer review but leaving scope for the occasional rogue voice to cut innovatively against the grain, and 5) Q - a condition of a different kind, Q is an empirically derived measure of the balance between in-group cohesion and out-group openness required to support creativity. Illustrations are given of how these five conditions for flourishing have underpinned the rapid expansion of philosophy and psychiatry in the closing decades of the twentieth century, and, correspondingly, are also reflected in the Handbook as a whole. Overviews and commentaries on individual contributions to the Handbook are given in extended editorial introductions to each of its eight sections. (shrink)

The Dispossessed has been described by political thinker Andre Gorz as 'The most striking description I know of the seductions—and snares—of self-managed communist or, in other words, anarchist society.' To date, however, the radical social, cultural, and political ramifications of Le Guin's multiple award-winning novel remain woefully under explored. Editors Laurence Davis and Peter Stillman right this state of affairs in the first ever collection of original essays devoted to Le Guin's novel. Among the topics covered in this wide-ranging, (...) international and interdisciplinary collection are the anarchist, ecological, post-consumerist, temporal, revolutionary, and open-ended utopian politics of The Dispossessed. The book concludes with an essay by Le Guin written specially for this volume, in which she reassesses the novel in light of the development of her own thinking over the past 30 years. (shrink)

An examination of the ethical issues raised by the possibility of human life extension, including its desirability, unequal access, and the threat of overpopulation. -/- Life extension—slowing or halting human aging—is now being taken seriously by many scientists. Although no techniques to slow human aging yet exist, researchers have successfully slowed aging in yeast, mice, and fruit flies, and have determined that humans share aging-related genes with these species. In New Methuselahs, John Davis offers a philosophical discussion of the (...) ethical issues raised by the possibility of human life extension. Why consider these issues now, before human life extension is a reality? Davis points out that, even today, we are making policy and funding decisions about human life extension research that have ethical implications. With New Methuselahs, he provides a comprehensive guide to these issues, offering policy recommendations and a qualified defense of life extension. -/- After an overview of the ethics and science of life extension, Davis considers such issues as the desirability of extended life; whether refusing extended life is a form of suicide; the Malthusian threat of overpopulation; equal access to life extension; and life extension and the right against harm. In the end, Davis sides neither with those who argue that there are no moral objections to life enhancement nor with those who argue that the moral objections are so strong that we should never develop it. Davis argues that life extension is, on balance, a good thing and that we should fund life extension research aggressively, and he proposes a feasible and just policy for preventing an overpopulation crisis. (shrink)

Responsible research and innovation has come to represent a change in the relationship between science, technology and society. With origins in the democratisation of science, and the inclusion of ethical and societal aspects in research and development activities, RRI offers a means of integrating society and the research and innovation communities. In this article, we frame RRI activities through the lens of layers of science and technology governance as a means of characterising the context in which the RRI activity is (...) positioned and the goal of those actors promoting the RRI activities in shaping overall governance patterns. RRI began to emerge during a time of considerable deliberation about the societal and governance challenges around nanotechnology, in which stakeholders were looking for new ways of integrating notions of responsibility in nanotechnology research and development. For this reason, this article focuses on nanotechnology as the site for exploring the evolution and growth of RRI. (shrink)

Many studies examine student self-concept during compulsory schooling but few have explored the self-concept of students in higher educational settings. The current study examined self-concept by faculty and gender among higher education students in New Zealand. Participants were 929 undergraduate students from a large New Zealand university. The results showed some differences in verbal and maths self-concept by faculty. Generally, students in faculties teaching subjects more reliant on maths skills had higher maths self-concept than those in faculties where facility in (...) verbal skills was important. The opposite results were found for verbal self-concept. No overall gender differences were found for general, academic, verbal and maths self-concept although a statistically significant difference was found for problem-solving self-concept. This finding suggests students? choice of faculty may be based on perceptions of their skills and capabilities in the various fields, irrespective of gender. (shrink)

This study examines how taxpayer support for government spending can improve tax compliance. While there is ample evidence on the deterrent effect of audit probability on taxpayer noncompliance, there is no evidence related to the moderating role that taxpayer support may have on compliance behavior. We also examine the moderating role that taxpayer ethics plays in compliance decisions. Results of our study indicate that the level of taxpayer support influences taxpayer compliance decisions, in that those with greater support for how (...) tax dollars are spent report higher amounts of taxable income. In addition, we find that audit probability influences taxpayer compliance decisions when there is support for the government’s use of tax dollars for non-welfare programs, such as defense. However, for welfare programs, such as healthcare, taxpayer support leads to increased compliance regardless of audit rate. When taxpayers do not support government programs, their compliance is lower regardless of the audit probability. This highlights the importance of gaining taxpayer support for government programs and indicates that attempts to align the interests of taxpayers with those of the government may increase voluntary compliance among taxpayers. Finally, we find that taxpayer ethics influences compliance such that, for individuals who have lower ethical standards, a high audit rate as well as support for a program may be necessary to improve compliance behavior. Theoretical and practical implications of these findings are discussed. (shrink)

Most discussions of medical futility try to answer the Futility Question: when is a medical procedure futile? No answer enjoys universal support. Some futility policies say that the health care provider will answer this question when the provider and patient cannot agree. This raises the Decision Question: who has the moral authority to decide what to do in cases where futility is disputed? I look for a procedural answer to this question, an answer that does not turn on whether a (...) given party happens to answer the Futility Question correctly. I argue that these policies get it right; the provider should decide because providers have a right of conscientious refusal that extends to refusing procedures on grounds of futility. This is a procedural answer because providers have this right even if they are sincerely mistaken about whether a procedure is futile. (shrink)

The 14 chapters in _Ethics at the End of Life: New Issues and Arguments_, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters—written (...) by a team of experts—survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section. TABLE OF CONTENTS John K. Davis, "Introduction" Geoffrey Scarre, "Is it possible to be better off dead?" Taylor W. Cyr, "How Does Death Harm the Deceased?" Benjamin Mitchell-Yellin, "The Significance of an Afterlife" Jens Johansson, "The Severity of Death" John K. Davis, "Defining Death" James Stacey Taylor, "Autonomy, Competence, and End of Life" Eric Vogelstein, "Deciding for the Incompetent" Paul T. Menzel, "Change of Mind: An Issue for Advance Directives" Nancy S. Jecker, "Medical Futility and Respect for Patient Autonomy" Paul T. Menzel, "Refusing Lifesaving Medical Treatment and Food and Water by Mouth" Thomas S. Huddle, "Suicide, Physician-Assisted Suicide, the Doing-Allowing Distinction and Double Effect" Michael Cholbi, "Grief and End of Life Surrogate Decision-making" Bruce Jennings, "Solidarity near the End of Life: The Promise of Relational Decision-making in the Care of the Dying" Colin Farrelly, "Justice and the Aging of the Human Species". (shrink)

A “post-work world” can mean a couple of things. First, it can mean a world where we attach less importance to work, restructure work so that tasks and authority are distributed more equitably, and otherwise decenter and reform the world of work. Second, it can mean a world where people are no longer working because robots, artificial intelligence, and other forms of automation have replaced humans and there are no longer enough jobs for everyone. This paper is about the second (...) kind of world, and how to support the workers it leaves behind. -/- Automation has always eliminated jobs, but in the past new jobs have appeared to replace them. This may be changing. Thanks to recent advances in automation, machines and software can now do an increasingly large percentage of the tasks that humans do. “Technological unemployment” is what happens when automation can do so many different tasks that new jobs do not appear in sufficient numbers to employ everyone (Keynes 1932). In short, automation may soon leave a very large part of the potential workforce permanently unemployed, leading to a social, political, economic, and humanitarian crisis. For ease of reference, I refer to the technologically unemployed as being displaced from the economy. -/- The displaced need incomes. One obvious source of funds is the money saved through technological unemployment. On the scale of an entire economy, technological unemployment increases the labor savings from automation, for in addition to the usual labor savings from automation, there is less of a need to pay new workers, for there are fewer new jobs. I call this money the displacement gain. This is money that becomes available precisely because technological unemployment has occurred. It is important to understand that the displacement gain is not the same thing as the profit that results from gains in productivity. Automation does not necessarily produce displacement but it does produce gains in productivity, and the profits from gains in productivity occur even when no one is displaced. A productivity gain does not become a displacement gain until technological unemployment occurs. -/- The core of this paper is a set of arguments that the displacement gain is not the private property of businesses or those who have ownership interests in businesses (I refer to both groups as “capitalists”), nor is it the private property of those lucky enough to still have jobs. For these and additional reasons, the displacement gain is collective property in which every person has an equal interest. Moreover, it is a kind of collective property that has been largely overlooked. (Better-known forms of collective property include the natural world and “social capital.” ) As far back as Thomas Paine (1796), many thinkers have argued that, because we all have equal interests in collective property, it should be distributed to everyone, working or not, rich or poor, as equal and unconditional basic incomes. The displacement gain is a new kind of collective property which can fund basic incomes, and those incomes can support the displaced. That’s how to pay for a post-work world. -/- However, I will argue, in order to distribute those funds equally we must pay unequal basic incomes, for those who are technologically unemployed bear a larger share of the burden involved in creating that collective property, and therefore deserve larger basic incomes to offset their larger burdens. My discussion of this leads to a possible solution to a problem that bedevils basic income proposals: how to prevent businesses from, in effect, appropriating basic incomes from their employees by simply paying them less, using basic incomes as a payroll subsidy . (shrink)

Judith Thomson argues that a fetus may have a right to life yet lack the right to use its mother's body to stay alive. According to Kenneth Einar Himma, Thomson's argument applies only to cases where the parties meet two conditions. First, they must and, second, they must be Himma devises a case involving conjoined twins to show why the mother–fetus case does not meet these conditions.

Proteins account for the catalytic and structural versatility displayed by all cells, yet they are assembled from a set of only 20 common amino acids. With few exceptions, only 61 nucleotide triplets also direct incorporation of these amino acids. Endeavors to expand the genetic code recently progressed to nucleus‐containing cells, after Chin et al.1 transferred Escherichia coli genes for a mutant tyrosine‐adaptor molecule and its synthetase into Saccharomyces cerevisiae. Transformed yeast cells were produced that exhibit efficient site‐specific incorporation of non‐biotic (...) amino acids into proteins. This makes it likely that code complexity can be elevated experimentally in mammals. BioEssays 26:111–115, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Although in Drosophila pair‐rule genes play crucial roles in the genetic hierarchy that subdivides the embryo into segments, the extent to which pair‐rule patterning is utilized by different arthropods and other segmented phyla is unknown. Recent data of Dearden et al.1 and Henry et al.,2 however, hint that a pair‐rule mechanism might play a role in the segmentation process of basal arthropods and vertebrates. BioEssays 25:425–429, 2003. © 2003 Wiley Periodicals, Inc.

Discussions of life extension ethics have focused mainly on whether an extended life would be desirable to have, and on the social consequences of widely available life extension. I want to explore a different range of issues: four ways in which the advent of life extension will change our relationship with death, not only for those who live extended lives, but also for those who cannot or choose not to. Although I believe that, on balance, the reasons in favor of (...) developing life extension outweigh the reasons against doing so, most of these changes probably count as reasons against doing so. First, the advent of life extension will alter the human condition for those who live extended lives, and not merely by postponing death. Second, it will make death worse for those who lack access to life extension, even if those people live just as long as they do now. Third, for those who have access to life extension but prefer to live a normal lifespan because they think that has advantages, the advent of life extension will somewhat reduce some of those advantages, even if they never use life extension. Fourth, refusing life extension turns out to be a form of suicide, and this will force those who have access to life extension but turn it down to choose between an extended life they don't want and a form of suicide they may consider immoral. (shrink)

This new edition of Baran and Davis's successful text provides a comprehensive, historically based, introduction to mass communication theory. Clearly written with examples, graphics, and other materials to illustrate key theories, this edition traces the emergence of two main bodies of mass communication theory: social, behavioral and critical, cultural. The authors emphasize that media theories are human creations that typically are intended to address specific problems or issues.

Deception has evolved to become a fundamental aspect of human interaction. Despite the prolonged efforts in many disciplines, there has been no definite finding of a univocally “deceptive” signal. This work proposes an approach to deception detection combining cognitive load manipulation and T-pattern methodology with the objective of: (a) testing the efficacy of dual task-procedure in enhancing differences between truth tellers and liars in a low-stakes situation; (b) exploring the efficacy of T-pattern methodology in discriminating truthful reports from deceitful ones (...) in a low-stakes situation; (c) setting the experimental design and procedure for following research. We manipulated cognitive load to enhance differences between truth tellers and liars, because of the low-stakes lies involved in our experiment. We conducted an experimental study with a convenience sample of 40 students. We carried out a first analysis on the behaviors’ frequencies coded through the observation software, using SPSS (22). The aim was to describe shape and characteristics of behavior’s distributions and explore differences between groups. Datasets were then analyzed with Theme 6.0 software which detects repeated patterns (T-patterns) of coded events (non-verbal behaviors) that regularly or irregularly occur within a period of observation. A descriptive analysis on T-pattern frequencies was carried out to explore differences between groups. An in-depth analysis on more complex patterns was performed to get qualitative information on the behavior structure expressed by the participants. Results show that the dual-task procedure enhances differences observed between liars and truth tellers with T-pattern methodology; moreover, T-pattern detection reveals a higher variety and complexity of behavior in truth tellers than in liars. These findings support the combination of cognitive load manipulation and T-pattern methodology for deception detection in low-stakes situations, suggesting the testing of directional hypothesis on a larger probabilistic sample of population. (shrink)

On the face of things, the concept of 'profession' does not appear philosophically problematic: just survey the dozen or so occupations everyone calls professions and list their common attributes. Typically, it is said that law, medicine, teaching and other..

This section concerns the question of how best to understand the scientific status of mental health care in general and psychiatry in particular. On the assumption that psychiatry is based, in part at least, on natural science, what is the nature or the general shape of that science? Some of the chapters aim at shedding light on component parts of a scientific world view: causation, explanation, natural kinds, models of medicine, etc. Others concern potentially fruitful scientific approaches to mental health (...) care, drawing on brain imaging results, phenomenology, enactivism and what can be learnt from debate of the status of psychoanalysis. One overall lesson is that twenty-first-century psychiatry needs twenty-first-century philosophy of science. (shrink)

Patients sometimes request procedures their doctors find morally objectionable. Do doctors have a right of conscientious refusal? I argue that conscientious refusal is justified only if the doctor's refusal does not make the patient worse off than she would have been had she gone to another doctor in the first place. From this approach I derive conclusions about the duty to refer and facilitate transfer, whether doctors may provide 'moral counseling,' whether doctors are obligated to provide objectionable procedures when no (...) other doctor is available, why the moral consensus among doctors seems relevant even though it does not determine whether something is morally acceptable, and whether doctors should stay out of fields whose standard procedures they find morally unacceptable. (shrink)