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)

It has become increasingly difficult for individuals to exercise meaningful control over the personal data they disclose to companies or to understand and track the ways in which that data is exchanged and used. These developments have led to an emerging consensus that existing privacy and data protection laws offer individuals insufficient protections against harms stemming from current data practices. However, an effective and ethically justified way forward remains elusive. To inform policy in this area, we propose the Ethical Data (...) Practices framework. The framework outlines six principles relevant to the collection and use of personal data—minimizing harm, fairly distributing benefits and burdens, respecting autonomy, transparency, accountability, and inclusion—and translates these principles into action-guiding practical imperatives for companies that process personal data. In addition to informing policy, the practical imperatives can be voluntarily adopted by companies to promote ethical data practices. (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)

Book reviewed in this article: Just Doctoring: Medical Ethics in the Liberal State. By Troyen A. Brennan. The Ends of Human Life: Medical Ethics in a Liberal Polity. By Ezekiel J. Emanuel.

Las organizaciones sin fines de lucro han sufrido grandes cambios. Dejó de ser un sector empobrecido, donde se recibían como donaciones aquel dinero que les sobraba a los grandes empresarios, y donde sólo tenían cabida las personas voluntarias. Hoy en día es un sector marcado por el trabajo de personas profesionales y por ser organizaciones capaces de llenar los espacios que ha dejado el Estado sin atender. Además de ser organizaciones inteligentes, con estructuras flexibles, que les permiten responder de manera (...) ágil a los requerimientos de su entorno. Sin embargo para que el sector sin fines de lucro pueda evolucionar de manera exitosa, no sólo necesitan de la labor de sus miembros, también necesitan del compromiso del estado, las universidades y las entidades privadas. Un compromiso que se haga visible a través de alianzas de colaboración entre sí, y así de esta manera trabajar conjuntamente en el desarrollo humano y la inclusión social en Chile. (shrink)

Here, Erich H. Loewy expands on his earlier book Textbook of Medical Ethics (1989) offering healthcare workers and students a new perspective on ethical practice. Textbook of Healthcare Ethics focuses on the social conditions in which medical practice occurs and how ethical healthcare decisions involves nurses, social workers, psychologists, technicians, and patients as well as physicians. This thoroughly revised and expanded edition addresses historical and theoretical underpinnings and practical concerns. A series of case studies serve as a guideline for (...) further discussion. The text examines provocative issues such as organ donation, care of the terminally ill, abortion, HIV-positive healthcare professionals, physician-assisted suicide, and experimentation with fetal tissue. This is an ideal book for all members of the healthcare team as well as students and residents in any discipline of medicine. (shrink)

Objective Some researchers claim that the quality of informed consent of clinical research participants in developing countries is worse than in developed countries. To evaluate this assumption, we reviewed the available data on the quality of consent in both settings. Methods We conducted a comprehensive PubMed search, examined bibliographies and literature reviews, and consulted with international experts on informed consent in order to identify studies published from 1966 to 2010 that used quantitative methods, surveyed participants or parents of paediatric participants (...) in actual trials, assessed comprehension and/or voluntariness, and did not involve testing particular consent interventions. Forty-seven studies met these criteria. We compared data about participant comprehension and voluntariness. The paucity of data and variation in study methodology limit comparison and preclude statistical aggregation of the data. Results and Discussion This review shows that the assertion that informed consent is worse in developing countries than in developed countries is a simplification of a complex picture. Despite the limitations of comparison, the data suggest that: (1) comprehension of study information varies among participants in both developed and developing countries, and comprehension of randomisation and placebo controlled designs is poorer than comprehension of other aspects of trials in both settings; and (2) participants in developing countries appear to be less likely than those in developed countries to say they can refuse participation in or withdraw from a trial, and are more likely to worry about the consequences of refusal or withdrawal. (shrink)

Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search.In sum, teaching in all three subjects combined (...) comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics. (shrink)

Coronavirus disease is having an unprecedented and unpredictable impact on the world's economy. The pandemic has driven the world toward adapting to the current circumstances regardless of the business, sector, or industry. The coronavirus epidemic has affected the global economy and service sector. The purpose of the current study is to assess the effect of COVID-19 on service sector growth and sustainability. Global sectors and industries are trying to anchor themselves amidst the pandemic. The study focuses on the sectors that (...) are badly hit by the outbreak and discussed the strategies and responses different countries are taking to sustain their economies. This study concludes that the vital role of Information Technology and digitization supports the economies in their fight against the pandemic and helps them sustain themselves amid crises. This study also contributes to the body of literature by suggesting IT-based solutions for various industries to elevate effective responsiveness and avoid significant losses. (shrink)

Edited by Thomas A. Shannon, this series provides anthologies of critical essays and reflections by leading ethicists in four pivotal areas: reproductive technologies, genetic technologies, death and dying, and health care policy. The goal of this series is twofold: first, to provide a set of readers on thematic topics for introductory or survey courses in bioethics or for courses with a particular theme or time limitation. Second, each of the readers in this series is designed to help students focus more (...) thoroughly and effectively on specific topics that flesh out the ethical issues at the core of bioethics. The series is also highly accessible to general readers interested in bioethics. (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)

A RESPONSABILIDADE CIVIL PELO ABUSO DO DIREITO À LIBERDADE DE EXPRESSÃO EM CONFLITO COM OS DIREITOS DA PERSONALIDADE: UMA ANÁLISE DO CASO DAS BIOGRAFIAS NÃO AUTORIZADAS.

The congregation is challenged by modern times that require various life adjustments, including priestly pastoral ministry. Therefore, this study examined the pastoral ministry style for the parishioner’s rural community of St. Petrus Paulus Ampah Diocese in Palangka Raya. A descriptive qualitative approach was used with data collected using participatory observations, in-depth interviews and document studies. Furthermore, the data analysis involved reducing, displaying and process verification. The participants included parish priests, catechists and station council administrators. The results showed that the congregations (...) did not participate in church activities because the pastoral ministry style did not fulfil their needs, economic factors and lack of Catholic faith knowledge. Therefore, the church authorities in pastoral ministry should create a holistic and transformative congregation based on their needs. The current pastoral ministry practice is based on ecclesiastical organisation building and worship (liturgy) focused service. The church should simultaneously conduct catechism practices and charitable diaconia such as social, economic and spiritual activities. This was an interdisciplinary study that focused on practical and pastoral theology, catechesis and social sciences on Catholics’ pastoral ministry style for rural communities.Contribution: Importantly, it contributes to the literature on pastoral style reforms focusing on the congregation’s socio-economic life. Therefore, it can improve the congregation’s interests, ecclesiastical activities and independence. (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)

In our study, we examine the association between hedge fund activism and a target firm’s corporate social responsibility (CSR) activities and whether activists can promote socially responsible investments while upholding shareholders’ interests. Using different matched samples, we find a strong positive association between the target firm’s CSR in the year before it is targeted by activists and its probability of being targeted by a hedge fund. Classifying hedge fund activists into socially and non-socially responsible funds based on their objectives, we (...) find that both give similar level of consideration to a firm’s CSR activities when initiating campaigns. Similar to DesJardine and Durand (DesJardine and Durand, Strategic Management Journal 41:1054–1082, 2020), we demonstrate that hedge funds have, on average, a negative impact on target firms’ CSR in the years following the initial investments. Complementary to DesJardine and Durand (DesJardine and Durand, Strategic Management Journal 41:1054–1082, 2020), we compare the two types of hedge funds and find an asymmetric effect of the hedge funds’ campaigns. Socially responsible hedge fund campaigns are associated with a large _increase_ in their target’s CSR, whereas non-socially responsible hedge funds _decrease_ this measure in their target. Finally, we find that target firms exhibit a long-term improvement in future stock returns and profitability. These findings provide evidence that certain types of activists, such as socially responsible funds, promote both _stakeholder_ and _shareholders’_ long-term interests. (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 life we considered normal was disrupted due to measures taken to limit the spread of the novel coronavirus. Quarantine, isolation, social distancing, and community containment have influenced consumer behavior and contributed to the rapid development of e-commerce. In pandemic times, even those unfamiliar with the online environment have had to adapt and make acquisitions in this new manner. Hence, we focused our research on measuring the perception of consumers on how the restrictive measures imposed to limit the spread of (...) the COVID-19 virus had influenced their decision to buy a product or service from the online environment, given that purchases are highly subjective and influenced by cumulative effects of economic, social, psychological and behavioral factors. Our paper comes with additional insights from the literature. It adds empirical evidence that reveals that the number of transactions and the value per transaction increased during the COVID-19 pandemic and highlights that online purchases will continue as such even after the pandemic. (shrink)

In this short response to Kerstein and Bognar, we clarify three aspects of the complete lives system, which we propose as a system of allocating scarce medical interventions. We argue that the complete lives system provides meaningful guidance even though it does not provide an algorithm. We also defend the investment modification to the complete lives system, which prioritizes adolescents and older children over younger children; argue that sickest-first allocation remains flawed when scarcity is absolute and ongoing; and argue that (...) Kerstein and Bognar are mistaken to base their allocation principles on differences in personhood. (shrink)

A predominância dos temas literários e fenomenológicos nos textos sartrianos dos anos 1930 já chamou atenção de vários especialistas e comentadores da obra do autor. É notável, entretanto, como os exames dos textos dessa época contentam-se, no mais das vezes, em apontar o paralelismo ou a contemporaneidade entre fenomenologia e literatura ali presente, sem realçar a fundamentação que uma parece conferir à outra e que constitui uma das questões mais interessantes que a filosofia sartriana levanta. Há que se incluir, na (...) verdade, a estética literária de Sartre na compreensão de suas teses fenomenológicas; teses estas que, por outro lado, fornecem o solo filosófico da literatura sartriana, em termos tanto de autoria quanto de crítica. O propósito deste artigo é demonstrar, assim, uma dependência ou, se quisermos, implicação mútua entre literatura e fenomenologia não apenas central em relação àquele período da produção de Sartre como, também, determinante para seus projetos teóricos e ficcionais ulteriores. (shrink)

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)

Two recent articles [Gronchi et al., Citation2018. Automatic and controlled attentional orienting in the elderly: A dual-process view of the positivity effect. Acta Psychologica, 185, 229–234; Wirth & Wentura, Citation2020. It occurs after all: Attentional bias towards happy faces in the dot-probe task. Attention, Perception, & Psychophysics, 82(5), 2463–2481] report attentional biases for happy facial expressions in the dot-probe paradigm, albeit in different directions. While Wirth and Wentura report a bias towards happy expressions, Gronchi et al. found a reversed effect. (...) A striking difference between the studies was the task performed by the participants. While in Wirth and Wentura, participants performed a discrimination task, they performed a location task in Gronchi et al. In Experiment 1, we directly compared the two versions of the dot-probe paradigm. With the discrimination task, the bias towards happy faces was replicated. However, the location task yielded a null effect. In Experiment 2, we found a cueing effect with an abrupt onset cue in both tasks. However, for the location task a congruence-sequence effect (a typical characteristic of response-priming processes) occurred. This result suggests that in the location task, attentional processes are confounded with response-priming processes. We recommend to generally use discrimination tasks. (shrink)

Health care costs have been rising steadily in most industrialized countries. These increases are driven primarily by technological advances and, to a lesser degree, by aging of the population. Many factors make it unlikely that market forces alone will limit increases in the costs of health care. These unremitting increases make health care rationing appear both necessary and inevitable.One of the least controversial mechanisms for rationing could be to allow patients to make their own choices as to which kinds of (...) care they would be willing to forgo. This is appealing because it preserves individual freedom of choice regarding health care in a way that other rationing mechanisms often do not. Rationing by patient choice, however, can only happen if patients recognize that resources are limited and need to be conserved, and are willing to forgo marginal benefits. (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.

Traditionally, biomedical research has been devoted to improvement in the understanding and treatment or prevention of disease. Building on the knowledge generated by the long history of disease-oriented research, the next few decades will witness an explosion of biomedical enhancements to make people faster, stronger, smarter, less forgetful, happier, prettier, and live longer (Turner et al. 2003; Vastag 2004; Rose 2002). As with other biomedical interventions, research to assess the safety and efficacy of these enhancements in humans should be conducted (...) before their introduction into clinical practice.1 However, various concerns regarding the ethics of enhancement research could be raised. Those who .. (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)

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)

This paper examines the effects of a decrease in auditor litigation risk in a setting that isolates a change in auditor litigation risk from changes in auditor reputation. _StoneRidge Investment Partners v. Scientific Atlanta_ is a 2008 U.S. Supreme Court ruling that restricted secondary actor liability in class action suits, resulting in a decrease in class actions that listed auditors as defendants. We document that the _StoneRidge_ decision is associated with a negative CAR for clients of Big 4 auditors and (...) industry specialist auditors, in particular those associated with high-litigation risk, low cash, and past incidences of modified going concern opinions. These findings are consistent with investor perception of lower potential payoffs from secondary defendants in class action suits, in particular auditors, following the _StoneRidge_ decision. We also document that auditors are more (less) likely to accept (reject) risky clients and charge lower audit fees to risky clients after _StoneRidge_, consistent with a decrease in auditor litigation risk that increases auditor risk tolerance. Finally, we provide evidence that audit firms issue fewer going concern opinions following _StoneRidge_, consistent with a decrease in litigation risk leading to lower audit quality_._ Our results are relevant to policy makers as they consider the disciplinary role of litigation on audit markets. (shrink)

We study how changes in unemployment risk affect firms’ productivity and whether firm-initiated policies can mitigate the moral hazard problem created by increases in unemployment insurance benefits that might decrease workers’ incentives to work hard. We focus on state-specific changes in UIB levels as a quasi-natural experiment. While a large body of research has examined UIBs, including their effect on unemployed workers, few studies investigate whether UIBs have any impact on a firm’s overall productivity. Using data on firm-level total factor (...) productivity and state-level UIBs, we find a negative association between productivity and UIBs. We also find that the negative association is weaker for firms with higher employee-welfare indices than for firms with lower indices, suggesting that the adverse effect of higher UIBs on productivity is mitigated by policies that benefit workers’ welfare. More specifically, we find that among policies that are under the umbrella of corporate social responsibility, a subset of employee-welfare policies are more effective in managing moral hazard problems than other policies. (shrink)

Informed consent documents are central to the informed consent process and are required for participation in clinical trials in the U.S. The primary purpose of the document is “to assist a prospect...

Defeasible argumentation has been applied successfully in several real-world domains in which it is necessary to handle incomplete and contradictory information. In recent years, there have been interesting attempts to carry out argumentation processes supported by massive repositories developing argumentative reasoning applications. One of such efforts builds arguments by retrieving information from relational databases using the DBI-DeLP framework; this article presents eDBI-DeLP, which extends the original DBI-DeLP framework by providing two novel aspects which refine the interaction between DeLP programs and (...) relational databases. First, we expand the expressiveness of dbi-delp programs by providing ways of controlling how the information in databases is recovered; this is done by introducing filters that enable an improved fine-grained control on the argumentation processes which become useful in applications, providing the semantics and the implementation of such filters. Second, we introduce an argument comparison criterion which can be adjusted at the level of literals to model particular features such as credibility and topic expertise, among others. These new tools can be particularly useful in environments such as medical diagnosis expert systems, decision support systems, or recommender systems based on argumentation, where datasets are often provided in the form of relational databases. (shrink)