It is unclear whether someone’s responsibility for developing a disease or maintaining his or her health should affect what healthcare he or she receives. While this dispute continues, we suggest that, if responsibility is to play a role in healthcare, the concept must be rethought in order to reflect the sense in which many health-related behaviours occur repeatedly over time and are the product of more than one agent. Most philosophical accounts of responsibility are synchronic and individualistic; we indicate here (...) what paying more attention to the diachronic and dyadic aspects of responsibility might involve and what implications this could have for assessments of responsibility for health-related behaviour. (shrink)

The COVID-19 pandemic has led a number of countries to introduce restrictive ‘lockdown’ policies on their citizens in order to control infection spread. Immunity passports have been proposed as a way of easing the harms of such policies, and could be used in conjunction with other strategies for infection control. These passports would permit those who test positive for COVID-19 antibodies to return to some of their normal behaviours, such as travelling more freely and returning to work. The introduction of (...) immunity passports raises a number of practical and ethical challenges. In this paper, we seek to review the challenges relating to various practical considerations, fairness issues, the risk to social cooperation and the impact on people’s civil liberties. We make tentative recommendations for the ethical introduction of immunity passports. (shrink)

COVID-19 vaccine requirements have generated significant debate. Here, we argue that, on the evidence available, such policies should have recognised proof of natural immunity as a sufficient basis for exemption to vaccination requirements. We begin by distinguishing our argument from two implausible claims about natural immunity: natural immunity is superior to ‘artificial’ vaccine-induced immunity simply because it is ‘natural’ and it is better to acquire immunity through natural infection than via vaccination. We then briefly survey the evidence base for the (...) comparison between naturally acquired immunity and vaccine-induced immunity. While we clearly cannot settle the scientific debates on this point, we suggest that we lack clear and convincing scientific evidence that vaccine-induced immunity has a significantly higher protective effect than natural immunity. Since vaccine requirements represent a substantial infringement of individual liberty, as well as imposing other significant costs, they can only be justified if they are necessary for achieving a proportionate public health benefit. Without compelling evidence for the superiority of vaccine-induced immunity, it cannot be deemed necessary to require vaccination for those with natural immunity. Subjecting them to vaccine mandates is therefore not justified. We conclude by defending the standard of proof that this argument from necessity invokes, and address other pragmatic and practical considerations that may speak against natural immunity exemptions. There are no data in this work. (shrink)

Animals obviously cannot have a right of free speech or a right to vote because they lack the relevant capacities. But their right to life and to be free of exploitation is no less fundamental than the corresponding right of humans, writes Julian H. Franklin. This theoretically rigorous book will reassure the committed, help the uncertain to decide, and arm the polemicist. Franklin examines all the major arguments for animal rights proposed to date and extends the philosophy in new (...) directions. _Animal Rights and Moral Philosophy_ begins by considering the utilitarian argument of equal respect for animals advocated by Peter Singer and, even more favorably, the rights approach that has been advanced by Tom Regan. Despite their merits, both are found wanting as theoretical foundations for animal rights. Franklin also examines the ecofeminist argument for an ethics of care and several rationalist arguments before concluding that Kant's categorical imperative can be expanded to form a basis for an ethical system that includes all sentient beings. Franklin also discusses compassion as applied to animals, encompassing Albert Schweitzer's ethics of reverence for life. He concludes his analysis by considering conflicts of rights between animals and humans. (shrink)

In this article, we outline a novel approach to understanding the role of responsibility in health promotion. Efforts to tackle chronic disease have led to an emphasis on personal responsibility and the identification of ways in which people can ‘take responsibility’ for their health by avoiding risk factors such as smoking and over-eating. We argue that the extent to which agents can be considered responsible for their health-related behaviour is limited, and as such, state health promotion which assumes certain forms (...) of moral responsibility should be avoided. This indicates that some approaches to health promotion ought not to be employed. We suggest, however, that another form of responsibility might be more appropriately identified. This is based on the claim that agents have prudential reasons to maintain their health, in order to pursue those things which make their lives go well—i.e. that maintenance of a certain level of health is rational for many agents, given their pleasures and plans. On this basis, we propose that agents have a self-regarding prudential responsibility to maintain their health. We outline the implications of a prudential responsibility approach to health promotion. (shrink)

The concept of general arousal has a long history in emotion research. However, the concept is more complex and nuanced than is generally appreciated. In this comment, we note some of the early conceptualizations of arousal and how they might comport with more modern representations of the construct. Importantly, we show how modern conceptualizations which incorporate the physiological complexity of arousal measurement and peripheral-central nervous system interactions might help to provide a more solid framework for the construct moving forward. The (...) authors of the target article are to be commended for addressing this important issue. (shrink)

The St Bartholomew's Day Massacre of 1572 polarised French constitutional ideas. Appearing on one side was a radicalised version of the French constitution. On the other side was the theory of royal absolutism systematically developed by Bodin. The central thesis of this book is that Bodin's absolutism was as unprecedented as the doctrine it opposed. Prior to the 1570s the mainstream of the French tradition had been tentatively constitutionalist and Bodin himself had given strong expression to that tendency in his (...) Methodus of 1566. His earlier theory of sovereignty, elaborated in that work, was implicitly adapted to a notion of limited supremacy. Professor Franklin's aim is to explain how this absolutist view was formed. In doing so, he has clarified many of the notorious obscurities in Bodin's thought and since much of the absolutist doctrine of the seventeenth century was either based on Bodin's theory or relied on similar assumptions, this study will be of great importance and interest to scholars of a later period. (shrink)

Professor Franklin shows how the humanist approach of Jean Bodin and other French jurists of the 16th century led to a break, at least in principle, with the intellectual authority of Roman law and to the attempt to reconstruct juristic science through a comparison and synthesis of all the juridical experience of the most famous states.

Let us first thank the four commentators who have taken the time to read and thoughtfully reflect on our paper. In that paper, we discuss how responsibility concepts must be sensitive to the temporal ( diachronic ) and social ( dyadic ) aspects of health-related behaviour, if responsibility is to play a role in health policy. This ‘if’ is a big one, and Hanna Pickard rightly challenges our position of neutrality with regard to whether or not responsibility should be incorporated (...) into health policy.1 Pickard proposes that responsibility should play a forward-looking role in health policy—used as a tool to facilitate and encourage healthy behaviours where it is reasonable to expect people to adopt such behaviours. While the conditions for such responsibility are similar to those involved in the backward-looking, desert-based responsibility we invoke, they do not warrant responses such as praise, blame, reward and punishment that may follow from desert-based responsibility. Pickard argues that even asking the question of ‘what would desert-based responsibility look like in these health contexts’ risks encouraging moralisation, stigma and blame, all of which have no place in healthcare. We agree that forward-looking responsibility could be an important tool in healthcare. We have offered …. (shrink)

Research using the intermodal preferential looking paradigm (IPLP) has consistently shown that English‐learning children aged 2 can associate transitive argument structure with causal events. However, studies using the same methodology investigating 2‐year‐old children’s knowledge of the conjoined agent intransitive and semantic role assignment have reported inconsistent findings. The aim of the present study was to establish at what age English‐learning children have verb‐general knowledge of both transitive and intransitive argument structure using a new method: the forced‐choice pointing paradigm. The results (...) suggest that young 2‐year‐olds can associate transitive structures with causal (or externally caused) events and can use transitive structure to assign agent and patient roles correctly. However, the children were unable to associate the conjoined agent intransitive with noncausal events until aged 3;4. The results confirm the pattern from previous IPLP studies and indicate that children may develop the ability to comprehend different aspects of argument structure at different ages. The implications for theories of language acquisition and the nature of the language acquisition mechanism are discussed. (shrink)

Tom Regan has powerfully argued that all sentient beings having some awareness of self are equal in inherent value, and that their interests where relevant must be given equal treatment. Yet Regan also contends that there are some situations in which the value of different lives should be compared and choice made between them. He supposes an overloaded lifeboat with five occupants in which all will die unless one is thrown overboard. Four of the occupants are human, one is a (...) dog; and Regan holds that it is the dog that ought to go since its life is of less value than that of a human. Regan has thus been sharply attacked for inconsistency. Some say that the comparison of lives, even in this sort of case, contradicts the principle of equal inherent value and introduces a utilitarian calculation of benefit. Othersobject that no ground of choice exists in situations of this sort. But all these criticisms turn out to be unjustified. (shrink)

The Supreme Court of the United States has recently been petitioned to revisit legal issues pertaining to the lawfulness of imposing a vaccine mandate on individuals with proof of natural immunity during the COVID-19 pandemic. While the petition accepts that the protection of public health during COVID-19 was an important governmental interest, the petitioners maintain that the imposition of a vaccine mandate on individuals with natural immunity was not ‘substantially related’ to accomplishing that purpose. In this short report, we outline (...) how some of the petition’s general arguments interact with points we raised in a 2022 article in this journal defending natural immunity exemptions, in light of new evidence. In particular, we reflect on new evidence pertaining to differences between vaccine-induced immunity, natural immunity, and so-called ‘hybrid’ immunity. We suggest that the nuanced nature of this evidence highlights the importance of making fine-grained judgements about proportionality and necessity when considering vaccine mandates. We conclude by claiming that if future pandemics necessitate the imposition of vaccine mandates, then those seeking to justify them should clearly articulate the relevance (and the evidence) for the comparative protection of vaccine-induced, natural, and hybrid immunity. (shrink)

Strangers to Nature brings together many of the leading scholars who are working to redefine and expand the discourse on animal ethics. This volume will engage both scholars and lay-people by revealing the breadth of theorizing about the human/non-human animal relationship that is currently taking place.

Risk prediction in emergency medicine (EM) holds unique challenges due to issues surrounding urgency, blurry research-practise distinctions, and the high-pressure environment in emergency departments (ED). Artificial intelligence (AI) risk prediction tools have been developed with the aim of streamlining triaging processes and mitigating perennial issues affecting EDs globally, such as overcrowding and delays. The implementation of these tools is complicated by the potential risks associated with over-triage and under-triage, untraceable false positives, as well as the potential for the biases of (...) healthcare professionals toward technology leading to the incorrect usage of such tools. This paper explores risk surrounding these issues in an analysis of a case study involving a machine learning triage tool called the Score for Emergency Risk Prediction (SERP) in Singapore. This tool is used for estimating mortality risk in presentation at the ED. After two successful retrospective studies demonstrating SERP’s strong predictive accuracy, researchers decided that the pre-implementation randomised controlled trial (RCT) would not be feasible due to how the tool interacts with clinical judgement, complicating the blinded arm of the trial. This led them to consider other methods of testing SERP’s real-world capabilities, such as ongoing-evaluation type studies. We discuss the outcomes of a risk–benefit analysis to argue that the proposed implementation strategy is ethically appropriate and aligns with improvement-focused and systemic approaches to implementation, especially the learning health systems framework (LHS) to ensure safety, efficacy, and ongoing learning. (shrink)

Randomised placebo-controlled trials (RPCTs) are the gold standard for evaluating novel treatments. However, this design is rarely used in the context of orthopaedic interventions where participants are assigned to a real or placebo surgery. The present study examines attitudes towards RPCTs for orthopaedic surgery among 687 orthopaedic surgeons across the USA. When presented with a vignette describing an RPCT for orthopaedic surgery, 52.3% of participants viewed it as ‘completely’ or ‘mostly’ unethical. Participants were also asked to rank-order the value of (...) five different types of evidence supporting the efficacy of a surgery, ranging from RPCT to an anecdotal report. Responses regarding RPCTs were polarised with 26.4% viewing it as theleastvaluable (even less valuable than an anecdote) and 35.7.% viewing it as themostvaluable. Where equipoise exists, if we want to subject orthopaedic surgeries to the highest standard of evidence (RPCTs) before they are implemented in clinical practice, it will be necessary to educate physicians on the value and ethics of placebo surgery control conditions. Otherwise, invasive procedures may be performed without any benefits beyond possible placebo effects. (shrink)

The crystal δ‐endotoxins of Bacillus thuringiensis (Bt) are a family of insecticidal proteins which have been known for some time to kill insects by lysing their gut epithelial cells, but the precise molecular mechanism of toxicity has remained elusive. The recent publication of the crystal structure of a Bt δ‐endotoxin has made it possible for us to model the molecular events that occur as the toxin binds to its receptor and inserts into the membrane to form a pore. Using our (...) knowledge of insect gut physiology, we can also predict the effect on the insect of the formation of a toxic pore. We present a new model to explain the events that occur in the insect gut during toxin action. (shrink)

Many generativist accounts argue for very early knowledge of inflection on the basis of very low rates of person/number marking errors in young children's speech. However, studies of Spanish and Brazilian Portuguese have revealed that these low overall error rates actually hide important differences across the verb paradigm. The present study investigated children's production of person/number marked verbs by eliciting present tense verb forms from 82 native Finnish-speaking children aged 2;2–4;8 years. Four main findings were observed: Rates of person/number marking (...) errors were higher in low-frequency person/number contexts, even excluding children who showed no evidence of having learned the relevant morpheme, most errors involved the use of higher frequency forms in lower frequency person/number contexts, error rates were predicted not only by the frequency of person/number contexts but also by the frequency of individual “ready-inflected” lexical target forms, and for low-frequency verbs, lower error rates were observed for verbs with high phonological neighborhood density. It is concluded that any successful account of the development of verb inflection will need to incorporate both rote-storage and retrieval of individual inflected forms and phonological analogy across them. (shrink)