Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

Initial vaccine allocations for the coronavirus disease 2019 (COVID-19) will be limited. It is crucial to assess the ethical values associated with different methods of allocation, as well as important scientific and practical questions. This Viewpoint identifies three ethical values, benefiting people and limiting harm; prioritizing disadvantaged populations; and equal concern for all. It then explains why these values support prioritizing three groups: health care workers; other essential workers and people in high-transmission settings; and people with medical vulnerabilities associated with (...) poorer COVID-19 outcomes. In contrast, two other groups, people over 65 without medical vulnerabilities and participants in clinical research, present more complex ethical questions. This prioritization also encompasses valuing direct benefits to vaccinated individuals, indirect benefits to individuals protected from spread of infection, and indirect health and socioeconomic benefits to those protected from harm as health system and societal functioning improve. Vaccine allocation that recognizes important ethical values and avoids arbitrariness, waste, and corruption can ensure that the distribution of a COVID-19 vaccine is both fair and perceived as fair. (shrink)

The aim of this paper is to argue that lying differs from mere misleading in a way that can be morally relevant: liars commit themselves to something they believe to be false, while misleaders avoid such commitment, and this difference can make a moral difference. Even holding all else fixed, a lie can therefore be morally worse than a corresponding misleading utterance. But, we argue, there are also cases in which the difference in commitment makes lying morally better than misleading, (...) as well as cases in which the difference is not morally relevant. This view conflicts with the two main positions philosophers have defended in the ethics of lying and misleading, which entail either that lying is in virtue of its nature worse than misleading or that there is no morally relevant difference between lying and misleading. (shrink)

The COVID-19 pandemic revealed numerous weaknesses in pandemic preparedness and response, including underfunding, inadequate surveillance, and inequitable distribution of countermeasures. To overcome these weaknesses for future pandemics, WHO released a zero draft of a pandemic treaty in February, 2023, and subsequently a revised bureau's text in May, 2023. COVID-19 made clear that pandemic prevention, preparedness, and response reflect choices and value judgements. These decisions are therefore not a purely scientific or technical exercise, but are fundamentally grounded in ethics. The latest (...) treaty draft reflects these ethical considerations by including a section entitled Guiding Principles and Approaches. Most of these principles are ethical—they establish core values that undergird the treaty. Unfortunately, the treaty draft's set of principles are numerous, overlapping, and show inadequate coherence and consistency. We propose two improvements to this section of the draft pandemic treaty. First, key guiding ethical principles should be clearer and more precise than they currently are. Second, the link between ethical principles and policy implementation should be clearly established and define boundaries on acceptable interpretation, ensuring that signatories abide by these principles. (shrink)

The eighth-century Latin manuscript Milan, Veneranda Biblioteca Ambrosiana, L 99 Sup. contains fifteen palimpsest leaves previously used for three Greek scientific texts: a text of unknown authorship on mathematical mechanics and catoptrics, known as the Fragmentum Mathematicum Bobiense (three leaves), Ptolemy's Analemma (six leaves), and an astronomical text that has hitherto remained unidentified and almost entirely unread (six leaves). We report here on the current state of our research on this last text, based on multispectral images. The text, incompletely preserved, (...) is a treatise on the construction and uses of a nine-ringed armillary instrument, identifiable as the “meteoroscope” invented by Ptolemy and known to us from passages in Ptolemy's Geography and in writings of Pappus and Proclus. We further argue that the author of our text was Ptolemy himself. (shrink)

Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death (...) or illness and unjust disparities; prioritising those who prevent harm or mitigate disparities; recognising contributions to combating an outbreak; and treating similar individuals similarly. Ethically and equitably marshalling available countermeasures requires articulating these fundamental objectives, identifying priority tiers, and recognising trade-offs between prioritising the people at the highest risk of infection and the people at the highest risk of harm if infected. These five values can provide guidance on preferable priority categories for a more ethically sound response and suggest methods for optimising allocation of countermeasures for mpox and other diseases for which countermeasures are in short supply. Properly marshalling available countermeasures will be crucial for future effective and equitable national responses to outbreaks. (shrink)

Height preferences reflecting positive assortative mating for height—wherein an individual’s own height positively predicts the preferred height of their mate—have been observed in several distinct human populations and are thought to increase reproductive fitness. However, the extent to which assortative preferences for height differ strategically for short-term versus long-term relationship partners, as they do for numerous other indices of mate quality, remains unclear. We explore this possibility in a large representative sample of over 500 men and women aged 15–77 from (...) Canada, Cuba, Norway and the United States. Participants’ own heights were measured, and they indicated their height preferences for a long-term and short-term mate using graphic stimuli containing metric indices. Replicating the “male-taller norm,” participants on average preferred taller-than-average male mates, and shorter-than-average female mates. Positive assortative preferences for height were observed across sexes and samples, however the strength of these height preferences varied with relationship context for men, and not for women. Taller men preferred relatively shorter women for short-term relationships than for long-term relationships, indicating stronger assortative preferences for height in a long-term context. These results provide preliminary evidence that, in addition to mate preferences for other physical traits related to mate quality such as masculinity in the body, face, and voice, assortative preferences for height do vary as a function of expected relationship length, but this was surprisingly only observed in preferences for female height. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

In Emanuel Adler's distinctive constructivist approach to international relations theory, international practices evolve in tandem with collective knowledge of the material and social worlds. This book - comprising a selection of his journal publications, a new introduction and three previously unpublished articles - points IR constructivism in a novel direction, characterized as 'communitarian'. Adler's synthesis does not herald the end of the nation-state; nor does it suggest that agency is unimportant in international life. Rather, it argues that what mediates (...) between individual and state agency and social structures are communities of practice, which are the wellspring and repositories of collective meanings and social practices. The concept of communities of practice casts new light on epistemic communities and security communities, helping to explain why certain ideas congeal into human practices and others do not, and which social mechanisms can facilitate the emergence of normatively better communities. (shrink)

Four ethical values — maximizing benefits, treating equally, promoting and rewarding instrumental value, and giving priority to the worst off — yield six specific recommendations for allocating medical resources in the Covid-19 pandemic: maximize benefits; prioritize health workers; do not allocate on a first-come, first-served basis; be responsive to evidence; recognize research participation; and apply the same principles to all Covid-19 and non–Covid-19 patients.

Pictures are notably absent from the current debate about how to define lying. Theorists in this debate tend to focus on linguistic means of communication and do not consider the possibility of lying with photographs, drawings and other kinds of pictures. The aim of this paper is to show that such a narrow focus is misguided: there is a strong case to be made for the possibility of lying with pictures and this possibility allows for insights concerning the question of (...) how lying should be defined. (shrink)

Interview by Marco Emanuele of James Brusseau. October 27, 2021, The Science of Where. Topics include: AI ethics, Accelerationism, Decentralization.

Many recent definitions of lying are based on the notion of what is said. This paper argues that says-based definitions of lying cannot account for lies involving non-literal speech, such as metaphor, hyperbole, loose use or irony. It proposes that lies should instead be defined in terms of assertion, where what is asserted need not coincide with what is said. And it points to possible implications this outcome might have for the ethics of lying.

Emanuele Avallone, Patrice Bergeron, Dominique Laperle, Michael Quisinsky, Philippe Roy-Lysencourt et Karim Schelkens.

We consider fragments of uniform reflection for formulas in the analytic hierarchy over theories of second order arithmetic. The main result is that for any second order arithmetic theory $T_0$ extending $\mathsf {RCA}_0$ and axiomatizable by a $\Pi ^1_{k+2}$ sentence, and for any $n\geq k+1$, $$\begin{align*}T_0+ \mathrm{RFN}_{\varPi^1_{n+2}} \ = \ T_0 + \mathrm{TI}_{\varPi^1_n}, \end{align*}$$ $$\begin{align*}T_0+ \mathrm{RFN}_{\varSigma^1_{n+1}} \ = \ T_0+ \mathrm{TI}_{\varPi^1_n}^{-}, \end{align*}$$ where T is $T_0$ augmented with full induction, and $\mathrm {TI}_{\varPi ^1_n}^{-}$ denotes the schema of transfinite induction up (...) to $\varepsilon _0$ for $\varPi ^1_n$ formulas without set parameters. (shrink)

1. The opinions expressed are the author's own. They do not reflect any position or policy of the National Institutes of Health, Public Health Service, Department of Health and Human Services, or any of the authors affiliated organizations.

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

Foundation models such as GPT-4 are fine-tuned to avoid unsafe or otherwise problematic behavior, such as helping to commit crimes or producing racist text. One approach to fine-tuning, called reinforcement learning from human feedback, learns from humans' expressed preferences over multiple outputs. Another approach is constitutional AI, in which the input from humans is a list of high-level principles. But how do we deal with potentially diverging input from humans? How can we aggregate the input into consistent data about "collective" (...) preferences or otherwise use it to make collective choices about model behavior? In this paper, we argue that the field of social choice is well positioned to address these questions, and we discuss ways forward for this agenda, drawing on discussions in a recent workshop on Social Choice for AI Ethics and Safety held in Berkeley, CA, USA in December 2023. (shrink)

Sometimes speakers try to lie and inadvertently assert something true. Subjectivists about lying hold that such speakers are lying despite telling the truth. Objectivists hold that such speakers are not lying: they try to lie but fail. The first aim of this paper is to point to novel cases supporting subjectivism that do not involve speakers inadvertently asserting something true. Its second aim is to use these and other cases to explore the distinction between lying and trying to lie. Which (...) factors can thwart an attempt at lying? In which situations do we judge that a speaker has tried to lie but failed? Attending to these questions not only offers insights into the act of lying, but also helps to scrutinise the objectivist strategy of explaining away intuitions about apparent cases of lying while telling the truth. (shrink)

It is widely held that all lies are assertions: the traditional definition of lying entails that, in order to lie, speakers have to assert something they believe to be false. It is also widely held that assertion contrasts with presupposition and, in particular, that one cannot assert something by presupposing it. Together, these views imply that speakers cannot lie with presuppositions—a view that Andreas Stokke has recently explicitly defended. The aim of this paper is to argue that speakers can lie (...) with presuppositions, and to discuss some of the implications this outcome has for current research on lying, assertion and presupposition. (shrink)

INTRODUCTION The Questions of Medical Ethics Call him Andrew. His face is gaunt and unshaven but peaceful. His eyelids are gently closed. ...

What is the content of a sentence in context? A proposition, says the standard propositional view accepted in much of semantics. A set of propositions, says the hitherto little-explored view of Semantic Pluralism. The aim of this book is to motivate, develop and defend Semantic Pluralism. To achieve this aim, the book puts forward two arguments against Contextualism, the most popular propositional theory. It spells out two versions of Semantic Pluralism: Flexible Pluralism, which takes many expressions to be context-sensitive, and (...) Strong Pluralism, which denies that context-sensitivity is widespread. And it shows how Pluralists can reply to several objections that have been lodged against non-propositional semantic theories. (shrink)

Simonet, Emanuel Nicolas Cortes Christine Bryden is a survivor of dementia and has been a passionate advocate for persons with dementia for more than 20 years. She has written 4 books. Her latest 2 books - Before I Forget and Nothing About Us, Without us! - give an insider's perspective into the lived experience of a person with dementia. This article provides a review of these 2 books which detail Christine Bryden's life story, and in doing so, highlight some (...) of the key messages expressed by the author. These key messages include examining the various misconceptions about persons with dementia, the required care for persons with dementia, as well as the need for building a dementia-friendly society. (shrink)

Background: The health professionals are involved in the paths of care for patients with different medical conditions. Their life is frequently characterized by psychopathological outcomes so that it is possible to identify consistent burdens. Besides the possibility to develop pathological outcomes, some protective factors such as resilience play a fundamental role in facilitating the adaptation process and the management of maladaptive patterns. Personal characteristics and specific indexes such as burdens and resilience are essential variables useful to study in-depth ongoing conditions (...) and possible interventions. The study was aimed at highlighting the presence and the relations among factors as personal variables, burdens, and resilience, to understand health professionals' specific structure and functions.Methods: The observation group was composed of 210 participants, 55 males, and 155 females, aged from 18 to 30 years old with a mean age of 25.92 years old. The study considered personal characteristics of the subjects, such as age, gender, years of study, days of work per week, hours of work per week, and years of work. Our study had been conducted with the use of measures related to burdens and resilience.Results: The performed analyses consisted of descriptive statistics, correlations, and regressions among the considered variables. Several significant correlations emerged among personal characteristics, CBI, and RSA variables. Specifically, age and work commitment indexes appeared to be significantly related to the development of burdens, differently from the years of study. Significant correlations emerged among personal and RSA variables, indicating precise directions for both domains. Age and gender were identified as predictors to perform multivariate regression analyses concerning CBI factors. Significant dependence relations emerged with reference to all CBI variables.Conclusion: Pathological outcomes and resilience factors represent two sides of the health professionals' experiences, also known as “invisible patients.” Greater knowledge about present conditions and future possibilities is a well-known need in literature so that the current analyses considered fundamental factors. In line with state of the art, future studies are needed in order to deepen elusive phenomena underlying maladjustment. (shrink)

The distinction between lying and mere misleading is commonly tied to the distinction between saying and conversationally implicating. Many definitions of lying are based on the idea that liars say something they believe to be false, while misleaders put forward a believed-false conversational implicature. The aim of this paper is to motivate, spell out, and defend an alternative approach, on which lying and misleading differ in terms of commitment: liars, but not misleaders, commit themselves to something they believe to be (...) false. This approach entails that lying and misleading involve speech-acts of different force. While lying requires the committal speech-act of asserting, misleading involves the non-committal speech-act of suggesting. The approach leads to a broader definition of lying that can account for lies that are told while speaking non-literally or with the help of presuppositions, and it allows for a parallel definition of misleading, which so far is lacking in the debate. (shrink)

To understand the endogenous components of the event-related brain potential (ERP), we must use data about the components' antecedent conditions to form hypotheses about the information-processing function of the underlying brain activity. These hypotheses, in turn, generate testable predictions about the consequences of the component. We review the application of this approach to the analysis of the P300 component. The amplitude of the P300 is controlled multiplicatively by the subjective probability and the task relevance of the eliciting events, whereas its (...) latency depends on the duration of stimulus evaluation. These and other factors suggest that the P300 is a manifestation of activity occurring whenever one's model of the environment must be revised. Tests of three predictions based on this “context updating” model are reviewed. Verleger's critique is based on a misconstrual of the model as well as a partial and misleading reading of the relevant literature. (shrink)

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of current (...) practices and could guide governments, professional societies, and physicians in allocation decisions. (shrink)

In the science and values literature, scholars have shown how science is influenced and shaped by values, often in opposition to the ‘value free’ ideal of science. In this paper, we aim to contribute to the science and values literature by showing that the relation between science and values flows not only from values into scientific practice, but also from (allegedly neutral) science to values themselves. The extant literature in the ‘science and values’ field focuses by and large on reconstructing, (...) post hoc, how values have influenced science; our reconstruction of the case studies, instead, aims to show that scientific concepts and methods _too, because of specific identifiable characteristics,_ can promote some values rather than (or at the expense of) others. We explain this bidirectional relation in analogy to debates on the normativity of technical artifacts and on feminist approaches in science, and we illustrate our claims with cases from the health sciences and machine learning. While our arguments in this paper also draw on post hoc reconstructions, we intend to show where, in the science in the making, we should engage not only with the question whether a practice is value-laden, but also how specific conceptual and methodological choices can influence values down the road. All in all, these considerations expand the ways in which philosophers can contribute to more value-aware scientific practices. (shrink)

Goodman’s theorem states that HAω+AC+RDC is conservative over HA. The same result applies to the extensional case, that is, E-HAω+AC+RDC is also conservative over HA. This is due to Beeson. In this article, we modified the Goodman realizability and provide a new proof of the extensional case.

Philosophy of Biology Philosophy of biology is the branch of philosophy of science that deals with biological knowledge. It can be practiced not only by philosophers, but also by scientists who reflect on their own work. The distinctive mark of philosophy of biology is the effort to achieve generalizations about biology, up to various degrees. … Continue reading Philosophy of Biology →.

The debate about justice and health care has occurred largely at a remove from the institutions it concerns; it has been about our most general moral principles, and about what things we value. This debate has foundered. But if the debate is turned in another direction, toward some moral principles that are widely accepted within those institutions, and toward principles that have to do with control over allocation decisions rather than with actually how to make those decisions, agreement may be (...) nearer at hand. (shrink)

Plato’s Euthyphro has been interpreted in two ways. The first one, given by Vlastos, is the so-called “developmentalism” according to which in the Euthyphro (and in the early dialogues) we cannot find any ‘theory of Forms’, which belongs only to Plato’s middle dialogues, but nothing more than a search for definitions. The second one, supported by Allen, claims instead that in the Euthyphro we can find the early (or Socratic) theory of Forms, a theory that has some common items as (...) well as some differences with the later (or Platonic) theory of Forms. Through the detailed analysis of the refutation of Euthyphro second definition of holiness I argue that the ontological status of Holiness and its causal role is already the status and the role played by the Forms in Plato’s middle works. So a metaphysical meaning can be assigned to εἶδος, ἰδέα, παράδειγμα already in the Euthyphro. (shrink)