We conducted a study to review the consenting process in a vaginal Microbicide feasibility study conducted in Mazabuka, Zambia. Participants were drawn from those participating in the microbicide study. A questionnaire and focus group discussion were used to collect information on participants understanding of study aims, risks and benefits. Altogether, 200 participants took part in this study. The results of the study showed that while all participants signed or endorsed their thumbprints to the consent forms, full informed consent was not (...) attained from most of the participants since 77% of the participants had numerous questions about the study and 34% did not know who to get in touch with concerning the study. Study objectives were not fully understood by over 61% of the participants. Sixty four percent of the participants were not sure of the risks of taking part in the microbicide study. A significant number thought the study was all about determining their HIV status. Some participants were concerned that their partners were not on the trial as they were convinced that being on the study meant that that they had a lifetime protection from HIV infection. The process of obtaining consent was inadequate as various phases of the study were not fully understood. We recommend the need for researchers to reinforce the consenting process in all studies and more so when studies are conducted in low literacy populations. (shrink)

In this paper I consider a recent argument of Timothy Williamson’s that epistemic internalism and content externalism are indeed incompatible, and since he takes content externalism to be above reproach, so much the worse for epistemic internalism. However, I argue that epistemic internalism, properly understood, remains substantially unaffected no matter which view of content turns out to be correct. What is key to the New Evil Genius thought experiment is that, given everything of which the inhabitants are consciously aware, the (...) two worlds are subjectively indistinguishable for them, which is what matters on internalist accounts of epistemic justification. I argue that even if a standard moral of the New Evil Genius intuition is untenable due to considerations arising from content externalism, the case can be understood as supporting epistemic internalism in a way that is wholly compatible with content externalism. In short, epistemic internalism is committed to sameness of justificatory status between subjectively indistinguishable counterparts, not sameness of content of their justifiers. (shrink)

BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)

Infants who are born extremely prematurely can survive if they receive intensive medical treatment. However, they also have a high chance of dying, and a proportion of survivors have long-term health problems and disabilities. In many parts of the world, if parents request it, an extremely premature infant can receive palliative care rather than active survival-focused care at birth. But there are variations between countries as to whether or when this is permitted. To help inform ethical debates across Asia and (...) more widely, we present two contrasting views about parental discretion and the treatment of extremely preterm infants. In questions of this nature, disagreement and dissensus are inevitable. Differences in the outcomes of treatment, the resources available, and the values of society mean that we should not expect a uniform approach. We identify points of potential consensus and compromise despite disagreement. (shrink)

Philosophical work on truth covers two streams of inquiry, one concerning the nature (if any) of truth, the other concerning truth-related paradox, especially the Liar. For the most part these streams have proceeded fairly independently of each other. In his "Deflationary Truth and the Liar" (JPL 28:455-488, 1999) Keith Simmons argues that the two streams bear on one another in an important way; specifically, the Liar poses a greater problem for deflationary conceptions of truth than it does for inflationist conceptions. (...) We agree with Simmons on this point; however, we disagree with his main conclusion. In a nutshell, Simmons' main conclusion is that deflationists can solve the Liar only by compromising deflationism. If Simmons is right, then deflationists cannot solve the Liar paradox. In this paper we argue that, pace Simmons, there is an approach to the Liar that is available to deflationists, namely dialetheism. (shrink)

The debate about positive and negative claims of conscience is, in large part, about ethical consistency. In this commentary I argue that there can be differences between conscientious provision of treatment and conscientious nonprovision of treatment that are ethically relevant. However, in many cases, including those described in this commentary, there is not sufficient ethical reason to treat them differently. This means that asymmetrical conscientious objection policies are potentially unjustified.

In this commentary I assess the possible harms to a fetus with trisomy 18 of continued life. I argue that, although there is good reason to avoid subjecting infants to major surgery and prolonged intensive care where there is little chance of benefit, doctors should support and engage honestly with parents who decide to continue their pregnancies. We should ensure that infants with trisomy 18 have access to high quality palliative care.

The evolution of wireless communications, from the first to the fifth generation, has driven Internet of Things (IoT) advancements. IoT is transforming sectors like agriculture, healthcare, and transportation, but also presents challenges like spectrum bandwidth demand, speed requirements, and security issues. IoT environments, with embedded sensors and actuators, connect to other devices to transmit and receive data over the internet. These data are processed locally or in the cloud, enabling decision-making and automation. Various wireless technologies, including Bluetooth, Zigbee, LoRa, and (...) WiFi, cater to specific IoT applications. 5G, with its high speeds, low latency, and efficient bandwidth sharing, is ideal for high-speed data transmission, and thus it provides robust infrastructure for low-latency and bandwidth-sensitive applications. This latest mobile network technology is being rapidly implemented worldwide, providing unprecedented throughput and low latency, which are crucial for the IoT. This paper presents a comprehensive systematic review on 5G security features, vulnerabilities, threats to mobile devices, security in IoT devices, common attacks to IoT devices and protection of data in this environment. Despite enhanced security, 5G faces challenges like Distributed Denial of Service (DDoS), Man In The Middle (MITM), cross-slice disruptions, and side-channel attacks. (shrink)

For any given society, its particular technology of communication has far-reaching consequences, not merely as regards social organization, but on the epistemic level as well. Plato's name-theory of meaning represents the transition from the age of primary orality to that of literacy; Wittgenstein's use-theory of meaning stands for the transition from the age of literacy to that of a second orality (audiovisual communication, electronic information processing). On the basis of a use-theory of meaning the problem of machine consciousness, to which (...) the later Wittgenstein again and again returned, is capable of a non-essentialist solution: appropriate changes in our form of life might well entail a radically different psychological language-game. (shrink)

Messianic peacemakers: Intertextual relationships between Zechariah 9-14 and the Gospel of Matthew. This article deals with images of war, violence and peace and with the role of messianic leaders in Deutero-Zechariah and the way in which texts from Zechariah 9–14 have been interpreted in the Gospel of Matthew. The first section describes the lines of meaning in Zechariah 9–14 on the basis of word fields related to violence and universal peace. The second section discusses Deutero-Zechariah’s own position in the development (...) of messianic expectations in Old Testament texts. In the third section, the question is asked how the meaning of texts from Zechariah 9–14 about messianic leaders has been influenced by earlier prophetic texts, and how these texts in their turn have been transformed and updated in the Gospel of Matthew, which contains explicit quotations from Deutero-Zechariah in 21:5; 26:15; 26:31 and 27:9–10. The fourth section summarises some interesting semantic shifts appearing in Matthew’s gospel compared to Deutero-Zechariah. Moreover, some critical comments are presented against the idea defended in some recent studies that there is a sharp tension between Jesus’s role in Matthew as the bringer of a peaceful ethical message, and his violent and vindictive role at the final judgement. At the end of this article, the burning question is raised whether Zechariah’s and Matthew’s messages, both of which are characterised by a certain degree of exclusivity, can play a constructive role in modern multi-religious discussions about common roads leading to global peace. (shrink)

It is sometimes argued that practices such as organ-selling should be prohibited because they are demeaning to the individuals involved. In this article the plausibility of such an argument is questioned. I will examine what it means to demean or be demeaned, and suggest that the mere fact that an individual is demeaning themself does not provide sufficient justification for legal prohibition. On the contrary, such laws might be argued to be demeaning.