As a neonatal neurologist, I serve families facing tragic decisions in which they must balance trade-offs between death and life with profound disability. I often find myself in complex discussions about future outcome, in which families sort through in real-time what information they value most in making such a choice. Will he laugh? Will he be in pain? Will he know how much he’s loved? In this month’s feature article, Brick et al share the results of an online survey aimed (...) at assessing public views on when a life is not worth living, in an effort to inform ongoing legal and clinical debates about withdrawal of life-sustaining treatment for children. These findings raise important questions about how we define and measure outcomes that matter to parents as they make these tragic decisions. It is challenging to interpret these findings in the absence of context of how decision-making for infants occurs in real-time. The nature of this study and its objective required that cases be substantially simplified. As the authors acknowledge, the prognoses and function of the children involved in these cases were often deeply contested. Prognostic uncertainty is common for children with significant …. (shrink)

Volume 19, Issue 5, May 2019, Page 62-63.

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 U.S. FDA has issued emergency use authorizations for monoclonal antibodies for non-hospitalized patients with mild or moderate COVID-19 disease and for individuals exposed to COVID-19 as post-exposure prophylaxis. One EUA for an oral antiviral drug, molnupiravir, has also been recommended by FDA’s Antimicrobial Drugs Advisory Committee, and others appear likely in the near future. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (...) with increased infectivity and/or severity emerge, further rationing may be required. We identify relevant ethical principles and priority groups for access to therapies based on an integrated approach to population health and medical factors. Using priority categories to allocate scarce therapies effectively operationalizes important ethical values. This strategy is preferable to the current approach of categorical rules based on vaccination, immunocompromise status, or older age, or the ad hoc consideration of clinical risk factors. (shrink)

The possible integration of genomic sequencing (including whole‐genome and whole‐exome sequencing) into the three contexts addressed in this special report—state‐mandated screening programs, clinical care, and direct‐to‐consumer services—raises related but distinct legal issues. This essay will outline the legal issues surrounding the integration of genomic sequencing into state newborn screening programs, parental rights to refuse and access sequencing for their newborns in clinical and direct‐to‐consumer care, and privacy‐related legal issues attending the use of sequencing in newborns.

Is the relationship of self-moving (kinaesthesis) to itself a direct pre-reflective self-awareness, or is it mediated through an Other? This article attempts to address this question, taking the phenomenon of dance as a point of departure, since in dance, movement steps out of its everyday background function to become the principal theme. Rudolf zur Lippe extracts from a dance step of the dances of the Quattrocento, the posa, a concept of sensual reflection. Rather than a conceptual reflection, the posa can (...) be understood as an awareness of one’s own movement. In this article, in a dialogue between critical philosophy, dance science, and phenomenology, terms of a possible sensual reflection in dance will be discussed. (shrink)

In recent years, many studies have highlighted the changing nature of scholarly research, reflecting the new digital tools and techniques that have been developed. But researcher uptake of these tools is strongly influenced by existing information behaviour, itself affected by a number of factors, particularly discipline. This article outlines findings from a recent study which used six case studies to look at the information behaviours of researchers working in different disciplinary fields or academic departments, or using specific tools. The study (...) suggested that researchers’ uses of, and attitudes towards, digital technologies are affected by existing disciplinary habits and preconceptions. Furthermore, it found that the computational and collaborative complexity of the tools that researchers used was linked to their disciplinary backgrounds. (shrink)

For much of 2021, allocating the scarce supply of Covid‐19 vaccines was the world's most pressing bioethical challenge, and similar challenges may recur for novel therapies and future vaccines. In the United States, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) identified three fundamental ethical principles to guide the process: maximize benefits, promote justice, and mitigate health inequities. We argue that critical components of the recommended protocol were internally inconsistent with these principles. Specifically, the ACIP (...) violated its principles by recommending overly broad health care worker priority in phase 1a, using being at least seventy‐five years of age as the only criterion to identify individuals at high risk of death from Covid‐19 during phase 1b, failing to recommend place‐based vaccine distribution, and implicitly endorsing first‐come, first‐served allocation. More rigorous empirical work and the development of a complete ethical framework that recognizes trade‐offs between principles may have prevented these mistakes and saved lives. (shrink)

We propose 4 equity-advancing operational improvements to eligibility and sign-up processes at mass vaccination sites: (1) preregistration using existing information, (2) eligibility rules that recognize the greater burden of COVID-19 in underserved neighborhoods, (3) appointment assignment that prioritizes those with disadvantage, and (4) socioculturally informed outreach to lottery selectees.

明治期に、はじめて宗教的伝統に基づく他力の発想と西洋から学んだ論理とを結びつけて語ることを試みた清沢満之。これまで清沢が残した思想を高く評価する人物は何度か現れたものの、いまだ忘れられた宗教人・哲学者 である。夏目漱石や正岡子規らとの関係、そして西田幾多郎ら京都学派に与えた影響を辿り、彼の思想が日本思想史に残した大きな影響とその可能性に光を当てる。.

The robust design and conduct of pragmatic cluster randomised trials may be in tension with the ethical requirement to obtain written informed consent from prospective research participants. In our experience, researchers tend to focus on whether a waiver of consent is appropriate for their studies. However, pragmatic cluster randomised trials raise other important questions that have direct implications for determining when an alteration or waiver of consent is permissible. To assist those involved in the design, conduct and review of pragmatic (...) cluster randomised trials, we outline four critical questions to consider: (1) What is the nature of the intervention being evaluated? (2) Is the choice to use cluster randomisation justified? (3) Can the risk of recruitment bias be addressed? and (4) Is an alteration or waiver of consent appropriately justified? We recommend that researchers and research ethics committees conduct a stepwise analysis of a planned cluster randomised trial using these questions. To illustrate the application of this stepwise analysis, we use three pragmatic cluster randomised trials in the haemodialysis setting as case studies. (shrink)

Quality and service improvement (QSI) research employs a broad range of methods to enhance the efficiency of healthcare delivery. QSI research differs from traditional healthcare research and poses unique ethical questions. Since QSI research aims to generate knowledge to enhance quality improvement efforts, should it be considered research for regulatory purposes? Is review by a research ethics committee required? Should healthcare providers be considered research participants? If participation in QSI research entails no more than minimal risk, is consent required? The (...) lack of consensus on answers to these questions highlights the need for ethical guidance. Three distinct approaches to classifying QSI research in accordance with existing ethical principles and regulations can be found in the literature. In the first approach, QSI research is viewed as distinct from other types of healthcare research and does not require regulation. In the second approach, QSI research falls within regulatory guidelines but is exempt from research ethics committee review. In the third approach, QSI research is deemed to be part of the learning healthcare system and, as such, is subject to a different set of ethical principles entirely. In this paper, we critically assess each of these views. While none of these approaches is entirely satisfactory, we argue that use of the ethical principles governing research provides the best means of addressing the numerous questions posed by QSI research. (shrink)

SummaryThis paper studies the context and textual structure of the Portuguese translation of Forbonnais's Elémens du commerce. This analysis is instrumental to understanding the place of this translation in the Portuguese discourse on trade, colonies and political economy in the age of Pombal. The translation of Forbonnais was one of the few to be published in Portugal in the eighteenth century. So, why the Elémens? This paper answers this question by profiling the translator, a key figure in the nomenklatura created (...) by Pombal to promote his commercial and colonial policies. This translation aimed at providing a theoretical background for Pombal's actions to defend Portuguese specialised agriculture against the exploitation of British traders, to substitute imported manufactures with local production, and to put colonial trade under national control. The paper also studies the contemporary debate on translation and its method in order to understand the reasons that led the translator to adopt a ‘paraphrastic style’, a choice that equated translation with a nationalistic politico-economic act, consisting in importing alien contents as ‘raw materials’ and ‘reselling’ them rephrased in what was considered the most ancient and perfect neo-Latin language. In this way, this paper also contributes to the history of translation in the Lusophone area. (shrink)

This paper is about syllogistic reasoning, i.e., reasoning from such pairs of premises as, All the chefs are musicians; some of the musicians are painters. We present a computer model that implements the latest account of syllogisms, which is based on the theory of mental models. We also report four experiments that were designed to test this account. Experiments 1 and 2 examined the strategies revealed by the participants' use of paper and pencil as aids to reasoning. Experiment 3 used (...) a new technique to externalize thinking. The participants had to refute, if possible, putative conclusions by constructing external models that were examples of the premises but counterexamples of the conclusions. Experiment 4 used the same techniques to examine the participants' strategies as they drew their own conclusions from syllogistic premises. The results of the experiments showed that individuals not trained in logic can construct counterexamples, that they use similar operations to those implemented in the computer model, but that they rely on a much greater variety of interpretations of premises and of search strategies than the computer model does. We re‐evaluates current theories of syllogistic reasoning in the light of these results. (shrink)

It is widely assumed that informing prospective subjects about the risks and possible benefits of research not only protects their rights as autonomous decisionmakers, but also empowers them to protect their own interests. Yet interviews with patient‐subjects conducted under the auspices of the Advisory Committee on Human Radiation Experiments suggest this is not always the case. Patient‐subjects often trust their physician to guide them through decisions on research participation. Clinicians, investigators, and IRBs must assure that such trust is not misplaced.

Given that mitigating climate change is a large-scale global issue, what obligations do individuals have to lower their personal carbon emissions? I survey recent suggestions by Walter Sinnott-Armstrong and Dale Jamieson and offer models for thinking about their respective approaches. I then present a third model based on the notion of structural violence. While the three models are not mutually incompatible, each one suggests a different focus for mitigating climate change. In the end, I agree with Sinnott-Armstrong that people have (...) limited moral obligations to directly lower personal emissions, but I offer different reasons for this conclusion, namely that the structural arrangements of our lives place a limit on how much individuals can restrict their own emissions. Thus, individuals should focus their efforts on changing the systems instead (e.g., the design of cities, laws and regulation, etc.), which will lead to lower emissions on a larger scale. (shrink)

O estudo filosófico da ética sobre as interações entre os seres humanos e as tecnologias que empregam a Inteligência Artificial se tornou um tópico popular e importante como nunca antes. O estudo dos problemas que concernem essas interações justifica-se por conta das transformações tecnológicas pelas quais as sociedades humanas têm passado, e que ainda podem acarretar profundas mudanças legais, políticas e sociais. O artigo tem como objetivo principal identificar o papel da ética, enquanto disciplina filosófica, com relação ao recente e (...) promissor domínio de investigação sobre a ética da Inteligência Artificial. Após apresentar a posição do filósofo Peter Railton na ética aplicada à Inteligência Artificial, o artigo reconstitui as suas explicações na ética normativa e na metaética. Ao ilustrar as conexões entre a ética aplicada à Inteligência Artificial e a teoria moral, o artigo argumenta que o papel da ética na ética da Inteligência Artificial pode ser explicitado com o auxílio da engenharia conceitual. Essa abordagem mostra que conceitos como ‘agente’ e ‘interesse’, que são cruciais para a ética, como pode ser visto nas explicações de Railton, não devem ser pensados exclusivamente pela ética, ou mesmo somente pela filosofia, mas necessitam ser informados pelas ciências naturais e humanas. O artigo enfatiza a necessidade de realizar a tarefa filosófica de pensar a ética para além da ética, em um contexto interdisciplinar capaz de lidar com os complexos problemas práticos que impactam as sociedades humanas. (shrink)

We asked a series of questions to Monica Cioli and David Rifkind, authors of two important books which focus on the process that enabled art and architecture to acquire a specific political meaning under fascism. The outcome is a dialogue that shows how the relationship between fascism and art is not characterized by a mere appropriation or a mutually functional exploitation between the artist or the architect and the fascist regime. Art prepares a specific appropriation of technology and serves (...) to introduce the political anthropology of the fascist man. Similarly, architecture establishes an organization of urban spaces coherent and necessary to the hierarchical order of the corporatist society. (shrink)

Resumen: Actualmente el término genealogía se encuentra bastante extendido en las ciencias sociales como una metodología empleada para explicar problemas contemporáneos. Con todo, la genealogía, en tanto forma de conocimiento, se emplea de maneras disímiles. Filósofos contemporáneos como Bernard Williams y Edward Craig han abordado distintas perspectivas genealógicas, caracterizando las cualidades y posibilidades que ofrece cada una e identificando así dos tipos: lo que denominan genealogías reales y genealogías imaginarias o ficcionales. En este artículo argumento que dicha clasificación es problemática (...) pues, el término genealogía sustancialmente hace referencia a algo que no puede ser imaginario o ficcional. La forma de conocer del genealogista se basa en la recolección de trozos de historia real que permitirán mirar el objeto estudiado desde una nueva perspectiva, por lo tanto, hablar de genealogías imaginarias o ficcionales resulta contradictorio.: Currently the term genealogy is widespread in the social sciences as a methodology used to explain contemporary problems. However, genealogy, as a form of knowledge, is used in different ways. Contemporary philosophers such as Bernard Williams and Edward Craig have addressed different genealogical perspectives, characterizing the qualities and possibilities offered by each and identifying two types: what they call real genealogies and imaginary or fictional genealogies. In this article I argue that such a classification is problematic, because the term genealogy substantially refers to something that cannot be imaginary or fictional. The genealogist’s way of knowing is based on recollecting pieces of real history that will allow him or her to look at the subject matter from a new perspective; therefore, to speak of imaginary or fictional genealogies is contradictory. (shrink)

O estatuto do simples e a questão do real: o horizonte nominalista de David Hume.

Neste trabalho buscamos estabelecer uma relação entre a obra literária e etnográfica elaborada em coautoria pelo Xamã Yanomami Davi Kopenawa e pelo antropólogo Bruce Albert, e a obra cinematográfica El Botón de Nácar, do cineasta chileno Patrício Guzmán. Em ambas, encontram-se presentes os elementos que relacionam a estrutura material e simbólica presente no percurso de produção da colonialidade no contexto da acumulação capitalista, com os imensos conflitos sociais, fundiários e políticos que persistem na organização dos atuais Estados latino-americanos.

Este artigo se insere no quadro maior dos estudos sobre as identidades no cristianismo antigo. A questão central é compreender de que formas as práticas populares se relacionam com o desenvolvimento e a manifestação das identidades cristãs. Como práticas populares elegemos as práticas de judaização, entre os não judeus adeptos da fé em Cristo, existentes no contexto das comunidades cristãs. A judaização é assim compreendida porque foge à instrução/controle das autoridades e da elite intelectual cristã. O recorte espaço-temporal do presente (...) estudo são as comunidades cristãs da província da Ásia Proconsular, no território imperial romano, no século II d.C. O conceito de etnicidade é empregado no exame das cartas do bispo Inácio de Antioquia a comunidades cristãs da Ásia Menor de forma a iluminar possíveis motivações para uma manutenção da judaização entre não judeus crentes em Jesus em detrimento da forte recomendação de seu abandono pelas autoridades cristãs. (shrink)

Este trabalho investigou características sócio-demográficas e vocacionais em 59 alunos de baixa renda, de ambos os sexos, com idades entre 16 e 48 anos. A maioria já prestou vestibular e tem escolha profissional definida. Os alunos relatam possuir pouca informação sobre profissões, processo de escol..

Dopo la Grande Guerra e la Rivoluzione d’Ottobre, l’Europa e la Russia vissero una intensa crisi. Il saggio ricostruisce la dimensione internazionale della situazione in Italia tra il 1919 e 1922. Esso si concentra in particolare su due “futuristi di sinistra”, Vinicio Paladini e Ivo Pannaggi, influenzati da Alexandr Bogdanov e Anatolij Lunačarskij, il futuro Commissario del Popolo per l’Istruzione. Esso si concentra anche sulla rivista “Vešč/Gegenstand/Objet", fondata da El Lissitzky e Ilya Ehrenburg a Berlino nel 1922, i suoi legami (...) con il Purismo francese e Pannaggi. (shrink)

Recent events, by making necessary online classes and exams, are raising plagiarism and cheating practices among students. I offer strategies to deal with both issues at the stake. I argue that institutions and educators should not only focus on how to detect bad practices and punishments, but rather on preventing despicable behaviours through the construction of a more sophisticated educational system.