ABSTRACT In this article, we first document the virtually complete absence of infectious disease examples and concerns at the time bioethics emerged as a field. We then argue that this oversight was not benign by considering two central issues in the field, informed consent and distributive justice, and showing how they might have been framed differently had infectiousness been at the forefront of concern. The solution to this omission might be to apply standard approaches in liberal bioethics, such as autonomy (...) and the harm principle, to infectious examples. We argue that this is insufficient, however. Taking infectious disease into account requires understanding the patient as victim and as vector. Infectiousness reminds us that as autonomous agents we are both embodied and vulnerable in our relationships with others. We conclude by applying this reunderstanding of agency to the examples of informed consent and distributive justice in health care. (shrink)

ABSTRACT In this article, we first document the virtually complete absence of infectious disease examples and concerns at the time bioethics emerged as a field. We then argue that this oversight was not benign by considering two central issues in the field, informed consent and distributive justice, and showing how they might have been framed differently had infectiousness been at the forefront of concern. The solution to this omission might be to apply standard approaches in liberal bioethics, such as autonomy (...) and the harm principle, to infectious examples. We argue that this is insufficient, however. Taking infectious disease into account requires understanding the patient as victim and as vector. Infectiousness reminds us that as autonomous agents we are both embodied and vulnerable in our relationships with others. We conclude by applying this reunderstanding of agency to the examples of informed consent and distributive justice in health care. (shrink)

Syndromic surveillance uses new ways of gathering data to identify possible disease outbreaks. Because syndromic surveillance can be implemented to detect patterns before diseases are even identified, it poses novel problems for informed consent, patient privacy and confidentiality, and risks of stigmatization. This paper analyzes these ethical issues from the viewpoint of the patient as victim and vector. It concludes by pointing out that the new International Health Regulations fail to take full account of the ethical challenges raised by syndromic (...) surveillance. (shrink)

Addressing key issues arising from the nature of death, 'Death, Dying and the Ending of Life' examines important topics relating to bioethics, philosophy and literature.

The prelims comprise: Seeing Infectious Disease as Central The Birth of Bioethics Amid the Decline of Infectious Disease The Shifting Concerns of Public Health Bioethics and Public Health: How the Twain Didn't Meet The Case of HIV Bridging the Gap: Seeing Bioethics in Terms of the Patient as Victim and Vector An Ordinary Example Summing Up: Autonomous Agency in the Context of Infectious Disease Notes.

Since testing for HIV infection became possible in 1985, testing of pregnant women has been conducted primarily on a voluntary, ‘opt-in’ basis. Faden, Geller and Powers, Bayer, Wilfert, and McKenna, among others, have suggested that with the development of more reliable testing and more effective therapy to reduce maternal-fetal transmission, testing should become either routine with ‘opt-out’ provisions or mandatory. We ask, in the light of the new rapid tests for HIV, such as OraQuick, and the development of antiretroviral treatment (...) that can reduce maternal-fetal transmission rates to <2%, whether that time is now. Illustrating our argument with cases from the United States (US), Kenya, Peru, and an undocumented Mexican worker in the US, we show that when testing is accompanied by assured multi-drug therapy for the mother, the argument for opt-out or mandatory testing for HIV in pregnancy is strong, but that it is problematic where testing is accompanied by adverse events such as spousal abuse or by inadequate intrapartum or follow-up treatment. The difference is not a ‘double standard’, but reflects the presence of conflicts between the health interests of the mother and the fetus – conflicts that would be abrogated by the assurance of adequate, continuing multi-drug therapy. In light of these conflicts, where they still occur, careful processes of informed consent are appropriate, rather than opt-out or mandatory testing. (shrink)

Do our lives have meaning? Should we create more people? Is death bad? Should we commit suicide? Would it be better if we were immortal? Should we be optimistic or pessimistic? Life, Death, and Meaning brings together key readings, primarily by English-speaking philosophers, on such 'big questions.'.

This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases’ powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on (...) humans by foreign micro‐organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical‐ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. (shrink)

U.S. researchers and scholars often point to two legal factors as significant obstacles to the inclusion of pregnant women in clinical research: the Department of Health and Human Services’ regulatory limitations specific to pregnant women's research participation and the fear of liability for potential harm to children born following a pregnant woman's research participation. This article offers a more nuanced view of the potential legal complexities that can impede research with pregnant women than has previously been reflected in the literature. (...) It reveals new insights into the role of legal professionals throughout the research pathway, from product conception to market, and it highlights a variety of legal factors influencing decision-making that may slow or halt research involving pregnant women. Our conclusion is that closing the evidence gap created by the underrepresentation and exclusion of pregnant women in research will require targeted attention to the role of legal professionals and the legal factors that influence their decisions. (shrink)

ABSTRACTThe role of Concrete Utopias in the works of Roy Bhaskar are contrasted with the ‘Real Utopias’ of Erik Olin Wright. Critical Realism treats them as ‘possibilities’ that are real because re...

Co-creating knowledge takes a new approach to human phenotypic morality as a biologically based, human lineage specific trait. Authors from very different backgrounds first review research on the nature and origins of morality using the social brain network, and studies of individuals who cannot “know good” or think morally because of brain dysfunction. They find these models helpful but insufficient, and turn to paleoanthropology, cognitive science, and neuroscience to understand human moral capacity and its origins long ago, in the genus (...) Homo. An unusual narrative capturing “morality in action” takes the reader back 900,000 years, and then the authors analyze the essential features of moral thinking and behavior as expressed by early and later species on our lineage. In what has primarily been the province of philosophers to date, the authors’ morality model is presented for further scientific testing. (shrink)

Children are considered by many one of the most vulnerable of all media audiences. After a discussion of the uniqueness of child audiences and commercials' effects on them, this article addresses the values of advertisers who purposely and inadvertently reach children with their messages. Three ethical theories are presented for use in recognizing the special consideration necessary for child audiences. Finally, a model proposed by Robin and Reidenbach (1987) is presented as a means of introducing ethical values and theories into (...) corporate decision-making policies regarding children and advertising. (shrink)

This essay explores the nature of an important collective emotion, namely, collective remorse. Three accounts of collective remorse are presented and evaluated. The first involves an aggregate of group members remorseful over acts of their own associated with their group's act; the second an aggregate of persons remorseful over their group's act. The third account posits, in terms that are explained, a joint commitment of a group's members to constitute as far as is possible a single remorseful body. Construed according (...) to this account the remorse of a nation that has wronged another nation is liable to make a particularly important contribution to international peace. (shrink)

This first scholarly edition in English of the philosophical writings of Novalis (Friedrich von Hardenberg), the German Romantic poet, philosopher, and mining engineer, includes two collections of fragments published in 1798, Miscellaneous Observations and Faith and Love, the controversial essay Christendom or Europe, and substantial selections from his unpublished notebooks.

Berkeley has been notoriously charged with inconsistency because he held that spiritual substance exists, Although he argued against the existence of material substance. Berkeley is only inconsistent on the assumption that his argument in favor of spiritual substance parallels the rejected argument for material substance. I show that berkeley is relying on quite a different argument, One perfectly consistent with his theory of ideas, Based on presuppositions the germs of which can be found in the thought of his predecessors in (...) the theory of ideas, Descartes and locke. (shrink)

A three‐tiered legal structure of the substances constitutive of human beings can accommodate property rights in new products created by the investment of labor in human tissue.

Pro-Ana's are young women who proclaim themselves to be proudly anorexic, and they have created a vibrant community online. This article will examine the nature of the Pro-Ana sites, analyzing their discursive community, and discuss the ethical issues surrounding the sites, wherein many have been censured or shut down by commercial website hosting sites, which has raised issues of censorship versus freedom of speech.

The Waltham Chronicle is an interesting example of a twelfth-century historia fundacionis. Written by one of the secular canons of Waltham just after the refoundation of the house as an Augustinian priory in 1177, it records the legends of the original foundation and miracle stories, together with historical information about the pre-Conquest benefactors and the internal organization of the community. Its value is much more than that of a local history, because of its connection with the literary romances of Harold (...) Godwineson, the religious context of the theology of the Cross, and the general movement to replace sector colleges by houses of regular Benedictine monks or Augustinian canons. This is the first published translation, printed with the original text editied from the two manuscripts containing the Chronicle, with full introduction, historical notes and apparatus criticus, by Leslie Watkiss and Marjorie Chibnall. (shrink)

The Christian faith holds out the promise of abundant life and yet many writers have exposed the ambiguities experienced from the words used when that faith is expressed or discussed or described. While there are many aspects to this exploration, this article investigates a set of words that are used to and for the divine because the one spoken of as the author of this abundant life is described in terms that limit the possibilities for too many people. This article (...) will draw on insights gained through the use of the discipline of psycholinguistics and extrapolate from these insights to offer a methodology for developing a language that expresses abundant life. (shrink)