The issue of assessing priorities is one that has become the subject of much debate in the National Health Service particularly in the wake of various documents on priorities from central Government. It has become even more so with the prospect of real cuts in expenditure. Economists claim that their science, or perhaps more accurately art can assist in determining not only how best to achieve various ends but also whether and to what extent competing objectives should be pursued. Such (...) choices cannot be made in the absence of some ethical considerations and it is important that health service decision makers (and in particular the medical profession) are aware if the relationship between economics (and especially cost-benefit analysis) and medical ethics. (shrink)

It is our concern that European Union Directive 2010/63/EU with its current project evaluation of animal research in the form of a harm-benefit analysis may lead to an erosion of the credibility of research. The HBA assesses whether the inflicted harm on animals is outweighed by potential prospective benefits. Recent literature on prospective benefit analysis prioritizes "societal benefits" that have a foreseeable, positive impact on humans, animals, or the environment over benefit in the (...) form of knowledge. In this study, we will argue that whether practical benefits are realized is (a) impossible to predict and (b) exceeds the scope and responsibility of researchers. Furthermore, we believe that the emphasis on practical benefits has the drawback of driving researchers into speculation on the societal benefit of their research and, therefore, into promising too much, thereby leading to a loss of trust and credibility. Thus, the concepts of benefit and benefit assessment in the HBA require a re-evaluation in a spirit that embraces the value of knowledge in our society. The generation of scientific knowledge has been utilised to great benefit for humans, animals, and the environment. The HBA, as it currently stands, tends to turn this idea upside down and implies that research is of value only if the resulting findings bring about immediate societal benefit. (shrink)

This paper defends two main claims. First: although it is easy to lose sight of this, what cost-benefit analysis really demands, in order to approve of a prospective policy, is that it be possible for those who would gain through the policy change to compensate those who would lose through it. And second: in cases where a policy change does, or can reasonably be expected to, lead to someone's death, the demand of compensability is much harder to (...) satisfy than economists typically think. More specifically, their standard move—maintaining that compensability should be judged ex ante, and that it is thus really just risk of death, not death itself, that must be (and often is) compensable—is unsuccessful. Then, the implications of these claims are briefly explored. (shrink)

Nanotechnology (NT)‐enabled disease‐free life is a form of reconstruction of the human body that promises a paradigm shift toward a new form of human existence in an imaginable life. However, as human reconstruction may be within the limits of the concept of “human enhancement,” it is not clear to what extent “enhanced humans” will be ethically acceptable or desired. This study discusses the ethical implications of NT‐embedded enhanced humans and this new imaginable life. First, ethical concerns arising from the existence (...) of a grey zone of certain dilemmas regarding benefits and possible/unpredicted risks are addressed in terms of the four main principles of bioethics. Then, we focus on the ethical problems in human nano‐enhancement. Finally, we study the methods of analyzing these ethical problems within the framework of principlism to conceive a comprehensive and coherent bioethical understanding. (shrink)

The book by Max Tegmark draws attention to the dangers and benefits that await humanity as a result of the Artificial Intelligence (AI) technologies development. Cosmologist and astrophysicist Tegmark, realizing the impossibility to predict the AI development, offers exciting scenarios of civilization development options for tens, thousands, millions and billions of years. The analysis of the opposite scenarios is aimed at the idea formation that the consequences of creating a general AI, superior to the human level, will be more (...) significant than from all other achievements of civilization. Tegmark is one of the founders and leaders of the “Beneficial AGI” movement, he presents the results of the discussion of the issues he raises with leading experts in the field of AI. Tegmark concludes his book with a call to optimism: “My book urge you to think about what future you would like, and not what future scares you, this way we can find goals for which it’s worth working”. (shrink)

Pure shape dynamics (PSD) is a novel implementation of the relational framework originally proposed by Julian Barbour and Bruno Bertotti. PSD represents a Leibnizian/Machian approach to physics in that it completely describes the dynamical evolution of a physical system without resorting to any structure external to the system itself. The chapter discusses how PSD effectively describes a de Broglie-Bohm N-body system and the conceptual benefits of such a relational description. The analysis will highlight the new directions in the quest (...) for an understanding of the nature of the wave function that are opened up by a modern relationalist elaboration on de Broglie's and Bohm's original insights. (shrink)

In advanced technological societies there is growing concern about the prospect of protracted deaths marked by incapacitation, intolerable pain and indignity, and invasion by machines and tubing. Life prolongation for critically ill cancer patients in the United States, for example, literally costs a fortune for very little benefit, typically from $82,845 to $189,339 for an additional year of life. Those who return home after major interventions live on average only 3 more months; the others live out their days in (...) a hospital intensive care unit. (shrink)

Recent advances in neuroscience have paved the way to innovative applications that cognitively augment and enhance humans in a variety of contexts. This paper aims at providing a snapshot of the current state of the art and a motivated forecast of the most likely developments in the next two decades. Firstly, we survey the main neuroscience technologies for both observing and influencing brain activity, which are necessary ingredients for human cognitive augmentation. We also compare and contrast such technologies, as their (...) individual characteristics (e.g., spatio-temporal resolution, invasiveness, portability, energy requirements and cost) influence their current and future role in human cognitive augmentation. Secondly, we chart the state of the art on neurotechnologies for human cognitive augmentation, keeping an eye both on the applications that already exist and those that are emerging or are likely to emerge in the next two decades. Particularly, we consider applications in the areas of communication, cognitive enhancement, memory, attention monitoring/enhancement, situation awareness and complex problem solving, and we look at what fraction of the population might benefit from such technologies and at the demands they impose in terms of user training. Thirdly, we briefly review the ethical issues associated with current neuroscience technologies. These are important because they may differentially influence both present and future research on (and adoption of) neurotechnologies for human cognitive augmentation: an inferior technology with no significant ethical issues may thrive while a superior technology causing widespread ethical concerns may end up being outlawed. Finally, based on the lessons learned in our analysis, using past trends and considering other related forecasts, we attempt to forecast the most likely future developments of neuroscience technology for human cognitive augmentation and provide informed recommendations for promising future research and exploitation avenues. (shrink)

Pharmacogenetics is an emerging biotechnology concerned with understanding the genetic basis of drug response, and promises to transform the development, marketing and prescription of medicines. This paper is concerned with analysing the move towards segmented drug markets, which is implicit in the commercial development of pharmacogenetics. It is claimed that in future who gets a particular drug will be determined by their genetic make up. Drawing on ideas from the sociology of expectations we examine how pharmaceutical and biotechnology companies are (...) constructing, responding to and realising particular ‘visions’ or expectations of pharmacogenetics and market stratification. We argue that the process of market segmentation remains uncertain, but that the outcome will be fashioned according to the convergence and divergence of the interests of key commercial actors. Qualitative data based both on interviews with industry executives and company documentation will be used to explore how different groups of companies are developing pharmacogenetics in distinct ways, and what consequences these different pathways might have for both clinical practice and health policy. In particular, the analysis will show a convergence of interests between biotechnology and pharmaceutical companies for creating segmented markets for new drugs, but a divergence of interest in segmenting established markets. Whilst biotechnology firms have a strong incentive to innovate, the pharmaceutical industry has no commercial interest in segmenting markets for existing products. This has important implications, as many of the claimed public health benefits of pharmacogenetics will derive from changing the prescribing of existing medicines. One significant implication of this is that biotechnology companies who wish to apply pharmacogenetics to existing medicines will have to explore an alternative convergence of interests with healthcare payers and providers . Healthcare providers may have a strong incentive to use pharmacogenetics to make the prescribing of existing medicine more cost-effective. However, we conclude by suggesting that a question mark hangs over their ability to provide the necessary economic and structural resources to bring such a vision to fruition. (shrink)

How cautious should regulators be? A standard answer is consequentialist: regulators should be just cautious enough to maximize expected social value. This paper charts the prospects of a nonconsequentialist - and more precautionary - alternative. More specifically, it argues that a contractualism focused on ex ante consent can motivate the following regulatory criterion: regulators should permit a socially beneficial risky activity only if no one can be expected to be made worse off by it. Broadly speaking, there are two strategies (...) regulators can use to help risky activities satisfy this criterion: regulators can mandate strict safety standards that protect those who would otherwise stand to lose, and they can require that some of the benefits of the activity be redirected to them. In developing these themes, the paper aims to provide a theoretical grounding for those who oppose using risk-cost-benefit analysis as the primary regulatory standard, and in particular, for advocates of the precautionary principle. (shrink)

Publication date: 24 January 2019 Source: Author: Oksana Koshulko The article presents the results of studies on reasons why female immigrants coming to Turkey as well as basic problems for married female immigrants in Turkey. The article has presented several groups of female immigrants and reasons why female immigrants coming to Turkey. The first group were married female immigrants who gave their reason for coming to Turkey as marriage; the second group were female labor immigrants who came to Turkey seeking (...) work; and the third group were females who wanted to work but they were, or may have been, members or victims of criminal organizations. According to the results of the article, female immigrants face many challenges in the country, within their families and in outside society. Female immigrants, who are considering living in Turkey for any length of time or even for forever, should understand and analyze all possible difficulties and challenges that may arise in their lives in Turkey. At the same time, the country holds wonderful prospects for developing female immigrants and the most important thing is for them to find the means of benefitting from all that is offered. (shrink)

BackgroundThe idea that individuals are responsible for their health has been the focus of debate in the theoretical literature and in its concrete application to healthcare policy in many countries. Controversies persist regarding the form, substance and fairness of allocating health responsibility to the individual, particularly in universal, need-based healthcare systems.ObjectiveTo examine how personal health responsibility has been framed and rationalised in Norwegian key policy documents on priority setting.MethodsDocuments issued or published by the Ministry of Health and Care Services between (...) 1987 and 2018 were thematically analysed. We developed a predefined conceptual framework that guided the analysis. The framework included: the subject and object of responsibility, the level of conceptual abstraction, temporality, normative justificatory arguments and objections to the application of personal health responsibility.ResultsAs an additional criterion, personal health responsibility has been interpreted as relevant if: the patient’s harmful behaviour is repeated after receiving treatment, and if the success of the treatment is conditional on the patient’s behavioural change. When discussed as a retrospective criterion, considerations of reciprocal fairness have been dominant. When discussed as a prospective criterion, the expected benefit of treatment justified its relevance.ConclusionPersonal health responsibility appears to challenge core values of equality, inclusion and solidarity in the Norwegian context and has been repeatedly rejected as a necessary criterion for priority setting. However, the responsibility criterion seems to have some relevance in particular priority setting decisions. (shrink)

Background: Meditation is gaining recognition as a tool to impact health and well-being. Samyama is an 8-day intensive residential meditation experience conducted by Isha Foundation requiring several months of extensive preparation and vegan diet. The health effects of Samyama have not been previously studied. The objective was to assess physical and emotional well-being before and after Samyama participation by evaluating psychological surveys and objective health biomarkers.Methods: This was an observational study of 632 adults before and after the Isha Samyama retreat. (...) All participants were invited to complete surveys. Controls included household significant others. Surveys were completed at baseline, just before Samyama, immediately after Samyama, and 3 months later to assess anxiety, depression, mindfulness, joy, vitality, and resilience through validated psychometric scales. Voluntary blood sampling for biomarker analysis was done to assess hemoglobin, HbA1c, lipid profile, and C-reactive protein. Primary outcomes were changes in psychometric scores, body weight, and blood biomarkers.Results: Depression and anxiety scores decreased from T1 to T3, with the effect most pronounced in participants with baseline depression or anxiety. Scores at T4 remained below baseline for those with pre-existing depression or anxiety. Vitality, resilience, joy, and mindfulness increased from T1 to T3. Body weight decreased by 3% from T1 to T3. Triglycerides were lower from T2 to T3. Participants had lower HbA1c and HDL at T2, and lower CRP at all timepoints compared with controls.Conclusions: Participation in the Isha Samyama program led to multiple benefits. The 2-month preparation reduced anxiety, and participants maintained lower anxiety levels at 3 months post-retreat. Physical health improved over the course of the program as evidenced by weight loss and improved HbA1C and lipid profile. Practices associated with the Samyama preparation phase and the retreat may serve as an effective way to improve physical and mental health. Future studies may examine their use as an alternative therapy in patients with depression and/or anxiety.Clinical Trial Registration:www.ClinicalTrials.gov, Identifier: 1801728792. Registered retrospectively on 4/17/2020. (shrink)

A major problem of teaching philosophy to children, in both the public and private sectors, is that the large proportion of children who could benefit by such instruction are never exposed to it. This is the result of many factors including teachers who are not prepared in philosophy, the resistance or inability of schools to offer such instruction, and the unwillingness of philosophers to involve themselves in these kinds of enterprises. Many times the only exposure prospective teachers receive (...) is an undergraduate course in the philosophy of education. And in many instances where even this course is not required, teachers are not introduced to philosophical thinking until they begin their graduate studies. Even here there is often only a one course requirement, and, in any case, the applicability of philosophy to educational practice is often lost by this time. (shrink)

Pharmacological cognitive enhancement (PCE) refers to the use of pharmaceuticals to improve cognitive function when that use is not intended to prevent or treat disease. Those who favour a liberal approach to PCE trust users to make informed decisions about whether enhancing is in their best interest. The author argues that making informed decisions about PCE requires a nuanced risk-benefit analysis that is not accessible to many users. Presently, the PCE use of prescription medications such as methylphenidate and (...) modafinil is widespread but most commonly happens without medical supervision. Direct and indirect barriers generate a situation where the risks and benefits of PCE are inequitably distributed; as a result, PCE is sometimes not in the user’s best interest. This is likely to also be the case for future pharmaceuticals. As a result, even if PCE pharmaceuticals were equitably distributed, its associated risks and benefits would not be. The article concludes with a discussion of the prospects of the clinical consultation on one hand, and e-health solutions on the other, in ameliorating the situation, arguing for cautious optimism. (shrink)

Recent developments in neuroscience have inspired proposals to perform deep brain stimulation on psychopathic detainees. We contend that these proposals cannot meet important ethical requirements that hold for both medical research and therapy. After providing a rough overview of key aspects of psychopathy and the prospects of tackling this condition via deep brain stimulation, we proceed to an ethical assessment of such measures, referring closely to the distinctive features of psychopathic personality, particularly the absence of subjective suffering and a lack (...) of moral motivation. Scrutiny of these factors reveals that two essential bioethical criteria, individual medical benefit and voluntary informed consent, cannot be met in performing neurosurgical experiments or treatments on psychopathic inmates. (shrink)

It is widely held that individuals who are unable to provide informed consent should be enrolled in clinical research only when the risks are low, or the research offers them the prospect of direct benefit. There is now a rich literature on when the risks of clinical research are low enough to enroll individuals who cannot consent. Much less attention has focused on which benefits of research participation count as ‘direct’, and the few existing accounts disagree over how this (...) crucial concept should be defined. This disagreement raises concern over whether those who cannot consent, including children and adults with severe dementia, are being adequately protected. The present paper attempts to address this concern by considering first what additional protections are needed for these vulnerable individuals. This analysis suggests that the extant definitions of direct benefits either provide insufficient protection for research subjects or pose excessive obstacles to appropriate research. This analysis also points to a modified definition of direct benefits with the potential to avoid these two extremes, protecting individuals who cannot consent without blocking appropriate research. (shrink)

Much of the contemporary debate about the propriety of non-therapeutic circumcision of male infants and boys revolves around the question of risks vs. benefits. With its headline conclusion that the benefits outweigh the risks, the current circumcision policy of the American Academy of Pediatrics [AAP] (released 2012) is a typical instance of this line of thought. Since the AAP states that it cannot assess the true incidence of complications, however, critics have pointed out that this conclusion is unwarranted. In this (...) paper it is argued that the AAP’s conclusion is untenable not only for empirical reasons related to lack of data, but also for logical and conceptual reasons: the concept of risk employed—risk of surgical complications—is too narrow to be useful in the circumcision debate. Complications are not the only harms of circumcision: the AAP and other parties debating the pros and cons of circumcision should conceptualize their analysis more broadly as risk of harm vs. prospect of benefit, thereby factoring in the value of the foreskin to the individual and the physical and ethical harms of removing it from a non-consenting child. (shrink)

Research on human subjects aims to obtain knowledge of vital importance for human health and functioning. Neuroscientific research specifically is understood as oriented towards three goals: the maintenance of neurological health, the treatment of neurological diseases or syndromes, and the enhancement of neurological functioning. Most guidelines or regulations for pediatric research (whether in the U.S. or elsewhere) require that if a research intervention exposes subjects to more than minimal risk, a prospect of direct benefit is required—along with some other (...) important criteria. It is also required for any research project, that the methods and design will yield scientifically valid knowledge. This is typically met via placebo-controlled trials. This chapter presents an argument to the effect that more than minimal risk research on pediatric subjects cannot meet both ethical requirements. The basic idea is that either the subjects in the control or experimental arm will receive a prospect of direct benefit, but not both. This chapter also argues that the ethical weight or importance of this dilemma is very acute for neuroscientific research given the complexity of the brain’s functioning and the correlated difficulty of judging whether there is a “prospect” of direct benefit. The second half responds to this argument via a case study in neuroscientific research. The solution recapitulates a type of component analysis according to which different ethical principles apply to different activities of a research study. (shrink)

BackgroundBiobanking biospecimens and consent are common practice in paediatric research. We need to explore children and young people’s (CYP) knowledge and perspectives around the use of and consent to biobanking. This will ensure meaningful informed consent can be obtained and improve current consent procedures.MethodsWe designed a survey, in co-production with CYP, collecting demographic data, views on biobanking, and consent using three scenarios: 1) prospective consent, 2) deferred consent, and 3) reconsent and assent at age of capacity. The survey was (...) disseminated via the Young Person’s Advisory Group North England (YPAGne) and participating CYP’s secondary schools. Data were analysed using a qualitative thematic approach by three independent reviewers (including CYP) to identify common themes. Data triangulation occurred independently by a fourth reviewer.ResultsOne hundred two CYP completed the survey. Most were between 16–18 years (63.7%, N = 65) and female (66.7%, N = 68). 72.3% had no prior knowledge of biobanking (N = 73).Acceptability of prospective consent for biobanking was high (91.2%, N = 93) with common themes: ‘altruism’, ‘potential benefits outweigh individual risk’, 'frugality', and ‘(in)convenience’.Deferred consent was also deemed acceptable in the large majority (84.3%, N = 86), with common themes: ‘altruism’, ‘body integrity’ and ‘sample frugality’. 76.5% preferred to reconsent when cognitively mature enough to give assent (N = 78), even if parental consent was previously in place. 79.2% wanted to be informed if their biobanked biospecimen is reused (N = 80).ConclusionProspective and deferred consent acceptability for biobanking is high among CYP in the UK. Altruism, frugality, body integrity, and privacy are the most important themes. Clear communication and justification are paramount to obtain consent. Any CYP with capacity should be part of the consenting procedure, if possible. (shrink)

BackgroundHealthcare providers have to make ethically complex clinical decisions which may be a source of stress. Researchers have recently introduced Artificial Intelligence (AI)-based applications to assist in clinical ethical decision-making. However, the use of such tools is controversial. This review aims to provide a comprehensive overview of the reasons given in the academic literature for and against their use.MethodsPubMed, Web of Science, Philpapers.org and Google Scholar were searched for all relevant publications. The resulting set of publications was title and abstract (...) screened according to defined inclusion and exclusion criteria, resulting in 44 papers whose full texts were analysed using the Kuckartz method of qualitative text analysis.ResultsArtificial Intelligence might increase patient autonomy by improving the accuracy of predictions and allowing patients to receive their preferred treatment. It is thought to increase beneficence by providing reliable information, thereby, supporting surrogate decision-making. Some authors fear that reducing ethical decision-making to statistical correlations may limit autonomy. Others argue that AI may not be able to replicate the process of ethical deliberation because it lacks human characteristics. Concerns have been raised about issues of justice, as AI may replicate existing biases in the decision-making process.ConclusionsThe prospective benefits of using AI in clinical ethical decision-making are manifold, but its development and use should be undertaken carefully to avoid ethical pitfalls. Several issues that are central to the discussion of Clinical Decision Support Systems, such as justice, explicability or human–machine interaction, have been neglected in the debate on AI for clinical ethics so far.Trial registrationThis review is registered at Open Science Framework (https://osf.io/wvcs9). (shrink)

Introduction: Responsibility and choice -- The idea of moral responsibility -- Complex choice situations -- Differing types of responsibility -- Hans Jonas' idea of "caring for beings" -- The moral experience of women -- Criticizing rational choice -- The rational choice model 5 -- Bounded rationality -- Myopic and deficient choices -- Violations of the axioms -- Rational fools -- The strategic role of emotions -- Social norms -- The communitarian challenge -- Duty, self-interest, and love -- Responsible decision making (...) -- Norms, goals, and stakeholders -- Choice as problem solving -- Ethical norms -- Who are the stakeholders? -- Co-evolving goals and alternatives -- Responsibility and the diversity of choices -- Rationality and respect -- Deontology -- Choices people can make -- The psychology of choice -- Prospect theory -- The "matching law" -- Incommensurability -- Modeling responsible decision making -- What is a responsible decision? -- Deontological payoffs -- Goal-achievement values -- Payoffs for the stakeholders -- Evaluation from multiple perspectives -- The maximin rule -- A geometric representation -- The procedural model -- Real world cases -- Donna's case -- The Ford Pinto case -- The World Bank environmental policy -- Applications in economics and public policy -- Responsibility and social justice -- The paradox of a paretian liberal -- Res ponsible agency in prisoner's dilemma situations -- Multidimensional cost-benefit analysis -- Ethical and social performance of business -- Nature, society, and future generations -- Epilogue: The responsible person. (shrink)

Monetary intelligence theory asserts that individuals apply their money attitude to frame critical concerns in the context and strategically select certain options to achieve financial goals and ultimate happiness. This study explores the dark side of monetary Intelligence and behavioral economics—dishonesty. Dishonesty, a risky prospect, involves cost–benefit analysis of self-interest. We frame good or bad barrels in the environmental context as a proxy of high or low probability of getting caught for dishonesty, respectively. We theorize: The magnitude and (...) intensity of the relationship between love of money and dishonest prospect may reveal how individuals frame dishonesty in the context of two levels of subjective norm—perceived corporate ethical values at the micro-level and Corruption Perceptions Index at the macro-level, collected from multiple sources. Based on 6382 managers in 31 geopolitical entities across six continents, our cross-level three-way interaction effect illustrates: As expected, managers in good barrels, mixed barrels, and bad barrels display low, medium, and high magnitude of dishonesty, respectively. With high CEV, the intensity is the same across cultures. With low CEV, the intensity of dishonesty is the highest in high CPI entities —the Enron Effect, but the lowest in low CPI entities. CPI has a strong impact on the magnitude of dishonesty, whereas CEV has a strong impact on the intensity of dishonesty. We demonstrate dishonesty in light of monetary values and two frames of social norm, revealing critical implications to the field of behavioral economics and business ethics. (shrink)

This paper develops a form of transcendental naïve realism. According to naïve realism, veridical perceptual experiences are essentially relational. According to transcendental naïve realism, the naïve realist theory of perception is not just one theory of perception amongst others, to be established as an inference to the best explanation and assessed on the basis of a cost-benefit analysis that weighs performance along a number of different dimensions: for instance, fidelity to appearances, simplicity, systematicity, fit with scientific theories, and (...) so on. Rather, naïve realism enjoys a special status in debates in the philosophy of perception because it represents part of the transcendental project of explaining how it is possible that perceptual experience has the distinctive characteristics it does. One of the potentially most interesting prospects of adopting a transcendental attitude towards naïve realism is that it promises to make the naïve realist theory of perception, in some sense, immune to falsification. This paper develops a modest form of transcendental naïve realism modelled loosely on the account of the reactive attitudes provided by Strawson in ‘Freedom and Resentment’, and suggests one way of understanding the claim that naïve realism is immune to falsification. (shrink)

Modern antiretroviral therapies are capable of suppressing HIV in the bloodstream to undetectable levels. Nonetheless, people living with HIV must maintain lifelong adherence to ART to avoid the re-emergence of the infection. So despite the existence and efficacy of ART, there is still substantial interest in development of a cure. But HIV cure trials can be risky, their success is as of yet unlikely, and the medical gain of being cured is limited against a baseline of ART access. The medical (...) prospect associated with participation in cure research thus look poor. Are the risks and burdens that HIV cure research places on participants so high that it is unethical, at present, to conduct it? In this paper, I answer ‘no’. I start my argument by describing a foundational way of thinking about the ethical justification for regulatory limits on research risk; I then apply this way of thinking to HIV cure trials. In offering this analysis, I confine my attention to studies enrolling competent adults and I also do not consider risks research may pose to third parties or society. Rather, my concern is to engage with the thought that some trials are so risky that performing them is an ethically unacceptable way to treat the participants themselves. I reject this thought and instead argue that there is no level of risk, no matter how high, that inherently mistreats a participant. (shrink)

A challenge faced by defenders of the precautionary principle is to clarify when the evidence that a harmful event might occur suffices to regard this prospect as a real possibility. Plausible versions of the principle must articulate some epistemic threshold, or de minimis requirement, which specifies when precautionary measures are justified. Critics have argued that formulating such a threshold is problematic in the context of the precautionary principle. First, this is because the precautionary principle appears to be ambiguous about the (...) distinction between risk and uncertainty: should the principle merely be invoked when evidential probabilities are absent, or also when probabilities have low epistemic credentials? Secondly, defenders of the precautionary principle face an aggregation puzzle: in judging whether or not the de minimis requirement has been met, how should first-order evidential probabilities and their second-order epistemic standing be aggregated? This article argues that the ambiguity can be resolved, and the epistemological puzzle can be solved. Focusing on decisions in the context of climate uncertainty, I advance a version of the precautionary principle that serves as a plausible decision rule, to be adopted in situations where its main alternative—cost–benefit analysis—does not deliver. (shrink)

Cost-benefit analysis is commonly understood to be intimately connected with utilitarianism and incompatible with other moral theories, particularly those that focus on deontological concepts such as rights. We reject this claim and argue that cost-benefit analysis can take moral rights as well as other non-utilitarian moral considerations into account in a systematic manner. We discuss three ways of doing this, and claim that two of them (output filters and input filters) can account for a wide range (...) of rights-based moral theories, including the absolute notions of moral rights proposed by Hayek, Mayo, Nozick, and Shue. We also discuss whether the use of output filters and input filters can be generalized to cover other non-utilitarian theories, such as Kantian duty ethics and virtue ethics. (shrink)

New fetal therapies offer important prospects for improving health. However, having to consider both the fetus and the pregnant woman makes the risk–benefit analysis of fetal therapy trials challenging. Regulatory guidance is limited, and proposed ethical frameworks are overly restrictive or permissive. We propose a new ethical framework for fetal therapy research. First, we argue that considering only biomedical benefits fails to capture all relevant interests. Thus, we endorse expanding the considered benefits to include evidence-based psychosocial effects of (...) fetal therapies. Second, we reject the commonly proposed categorical risk and/or benefit thresholds for assessing fetal therapy research. Instead, we propose that the individual risks for the pregnant woman and the fetus should be justified by the benefits for them and the study’s social value. Studies that meet this overall proportionality criterion but have mildly unfavorable risk–benefit ratios for pregnant women and/or fetuses may be acceptable. (shrink)

Remote driving, i.e., the capacity of controlling road vehicles at a distance, is an innovative transportation technology often associated with potential ethical benefits, especially when deployed to tackle urban traffic issues. However, prospected benefits could only be reaped if remote driving can be executed in a safe and responsible way. This paper builds on notions elaborated in the philosophical literature on technological mediation to offer a systematic examination of the extent to which current and emerging Human–Machine Interfaces contribute to hindering (...) or supporting the exercise of responsibility behind the remote wheel. More specifically, the analysis discusses how video, audio, and haptic interfaces co-shape the remote driving experience and, at the same time,the operators’ capacity to drive responsibly. The multidisciplinary approach explored in this research offers a novel methodological framework to structure future empirical inquiries while identifying finely tuned multi-sensory HMIs and dedicated training as critical presuppositions to the remote drivers’ exercise of responsibility. (shrink)

Psychological stress reactions to the COVID-19 pandemic are complex and multifaceted. Research provides evidence of a COVID Stress Syndrome, consisting of worry about the dangerousness of getting infected with SARSCoV2 and coming into contact with infected surfaces, worry concerning the personal socioeconomic consequences of COVID-19, xenophobic fears that SARSCOV2 is being spread by foreigners, COVID-19-related traumatic stress symptoms, and compulsive checking and reassurance-seeking about COVID-19. Little is known about how these symptoms are related to vulnerability and protective personality factors. Based (...) on data from 1,976 US and Canadian adults, we conducted a prospective network analysis in which personality factors were initially assessed at Time 1 and then symptoms of the CSS were assessed at Time 2, 2.5 months later. Results indicated that trait optimism and trait resilience were negatively associated with negative emotionality, suggesting a modulatory influence. Negative emotionality was positively linked to the narrower traits of intolerance of uncertainty and health anxiety proneness. These narrower traits, in turn, were prospectively linked to symptoms of the CSS. Results suggest that the effects of broad personality traits on symptoms of the CSS were mediated by narrower traits such as the intolerance of uncertainty. Treatment implications are discussed. (shrink)

Cost-benefit analysis is commonly understood to be intimately connected with utilitarianism and incompatible with other moral theories, particularly those that focus on deontological concepts such as rights. We reject this claim and argue that cost-benefit analysis can take moral rights as well as other non-utilitarian moral considerations into account in a systematic manner. We discuss three ways of doing this, and claim that two of them (output filters and input filters) can account for a wide range (...) of rights-based moral theories, including the absolute notions of moral rights proposed by Hayek, Mayo, Nozick, and Shue. We also discuss whether the use of output filters and input filters can be generalized to cover other non-utilitarian theories, such as Kantian duty ethics and virtue ethics. (shrink)

A central thesis of this paper is that understanding the nature of child maltreatment is so complex that no one disciplinary specialty is likely to be sufficient for the task. Although life history theory is the guiding principle for our analysis, we argue that an evolutionary explanation adds precision by incorporating empirical findings originating from the fields of anthropology; clinical, developmental, and social psychology; and sociology. Although evolutionary accounts of child maltreatment have been largely limited to the role of (...) the coefficient of relatedness, the prospective reproductive value of a child, and the residual reproductive potential of parents, a case is made for expanding this basic application. An explanatory model is presented that describes how ecological conditions as well as parental and child traits interact to influence the degree of parental investment. As shown in the model, these various “marker variables” alter parental perceptions of the benefits and costs associated with child care and promote low-investment parenting, which leads to disrupted family management practices and to a downward-spiraling, self-perpetuating system of coercive family interaction, increased parental rejection of the child, and even lower parental investment. Child maltreatment is the ultimate outcome of this downward trajectory of family relations. (shrink)

A challenge for cost-benefit analysis is that it ignores ethical values such as justice, fairness, and equity. One standard response is to regard CBA results as just one factor in a more complex decision-process where ethical and democratic factors are also considered. This paper considers an alternative response: extending CBA so that it takes into account not only self-interested input but also moral preferences such as a ‘taste’ for fairness. Drawing on existing research and the example of resource (...) allocation, the paper develops and analyzes objections to extended CBA. Evaluation of these objections, the paper shows, depends on how the original challenge is interpreted and how the problem of ‘ignoring’ ethical values is understood. While some interpretations lead to an impasse between defenders and critics of extended CBA, the paper proposes a novel interpretation – focused on political representationality – and showcases the limits of CBA as a coherent response. (shrink)

A recurring question about cost - benefit analysis concerns its scope. CBA is a decision-making method frequently employed in environmental policy-making, in which things which have no market price are treated as if they were commodities. They are given a monetary value, a form of price. But it is widely held that some things cannot be meaningfully priced, thus substantially limiting the scope of CBA. The aim of this paper is to test some aspects of this broad claim, (...) focusing on problems of incomparability and incommensurability. In particular, the role of rough equality as a putative form of comparison is investigated. I argue that while an assessment of the full significance of rough equality for practical decision-making awaits resolution of a number of important technical questions, it does not provide a strong enough form of comparison to support CBA. (shrink)

Cost-benefit analysis is a widely used governmental evaluation tool, though academics remain skeptical. This volume gathers prominent contributors from law, economics, and philosophy for discussion of cost-benefit analysis, specifically its moral foundations, applications and limitations. This new scholarly debate includes not only economists, but also contributors from philosophy, cognitive psychology, legal studies, and public policy who can further illuminate the justification and moral implications of this method and specify alternative measures. These articles originally appeared in the (...) Journal of Legal Studies. Contributors: - Matthew D. Adler - Gary S. Becker - John Broome - Robert H. Frank - Robert W. Hahn - Lewis A. Kornhauser - Martha C. Nussbaum - Eric A. Posner - Richard A. Posner - Henry S. Richardson - Amartya Sen - Cass R. Sunstein - W. Kip Viscusi. (shrink)

The prospect of using cell-based interventions to treat neurological conditions raises several important ethical and policy questions. In this target article, we focus on issues related to the unique constellation of traits that characterize CBIs targeted at the central nervous system. In particular, there is at least a theoretical prospect that these cells will alter the recipients' cognition, mood, and behavior—brain functions that are central to our concept of the self. The potential for such changes, although perhaps remote, is cause (...) for concern and careful ethical analysis. Both to enable better informed consent in the future and as an end in itself, we argue that early human trials of CBIs for neurological conditions must monitor subjects for changes in cognition, mood, and behavior; further, we recommend concrete steps for that monitoring. Such steps will help better characterize the potential risks and benefits of CBIs as they are tested and potentially used for treatment. (shrink)

Cost-benefit analysis (CBA) evaluates actions in terms of negative consequences (costs) and positive consequences (benefits). Though much has been said on CBA, little attention has been paid to the types of values held by costs and benefits. This paper introduces a simple typology of values in CBA and applies it to three forms of CBA: the common, money-based CBA, CBA based in social welfare, and CBA based in intrinsic value. The latter extends CBA beyond its usual anthropocentric domain. (...) Adequate handling of value typology in CBA avoids analytical mistakes and connects CBA to its consequentialist roots. (shrink)

Cost–benefit analysis (CBA) is much more philosophically interesting than has in general been recognized. Since it is the only well-developed form of applied consequentialism, it is a testing-ground for consequentialism and for the counterfactual analysis that it requires. Ten classes of philosophical problems that affect the practical performance of cost–benefit analysis are investigated: topic selection, dependence on the decision perspective, dangers of super synopticism and undue centralization, prediction problems, the indeterminateness of our control over future (...) decisions, the need to exclude certain consequences for moral reasons, bias in the delimitation of consequences, incommensurability of consequences, difficulties in defending the essential requirement of transferability across contexts, and the normatively questionable but equally essential assumption of interpersonal compensability. (Published Online July 31 2007). (shrink)

Should India build a new steel mill, or London an urban motorway? Should higher education expand, or water supplies be improved? These are typical questions about which cost-benefit analysis has something to say. It is the main tool that economics provides for analysing problems of social choice. It also provides a useful vehicle for understanding the practical value of welfare economics. This new book of readings covers all the main problems that arise in a typical cost-benefit exercise. (...) It is entirely up-to-date, reflecting the most recent research in the area. Part I covers the main theoretical issues affecting cost-benefit analysis. Part II considers the problem of ascribing a monetary value to things. The third part covers six separate case studies drawn from real-life examples. The book begins with an extended elementary introduction written by the editors. (shrink)

Throughout the Fourth Amendment’s history, major doctrinal shifts have been driven by technological change.1 Sometimes the result has been more Fourth Amendment protection,2 sometimes less.3 And in...

Even where willingness-to-pay as a measure of welfare impact is adjusted for diminishing marginal utility, welfare economics is shown to favour policies that add to the life expectancy or that enhance the quality of life of persons who are already better-off. I propose an alternative, Equal Respect methodology, under an axiomatic claim that at the point of decision the prospective life years of all individuals are of equal intrinsic social value. This justifies equal valuation of risk mitigation across all (...) persons; similarly, all appraised impacts should be scaled to accord equal respect to difficult but no-less-valuable lives. (shrink)

One argument against using cost-benefit analysis to justify policies aimed at promoting human life and health or protecting the environment is that it requires putting a price on priceless goods. This distorts the value of these goods, and it can affect their value by cheapening them. This argument might be rejected by a moral consequentialist who believes that a rational agent should always be able to reflect on his values, even priceless goods, and assess their costs and their (...) importance. This article defends the argument against cost-benefit analysis and suggests that a proper understanding of priceless goods shows that they also raise difficulties for consequentialist moral theories. (shrink)

In evaluating difficult decisions which have a wide social impact, consequentialist ethics offers the most reliable footing. Consequentialism is necessary, for that matter, in order to make room for scientific input which will in turn endeavour to provide accurate and objective predictions of the effects of the decisions in question. In the final analysis, we are dealing with value-laden choices and consequentialism should not be, and in fact cannot be, reduced to one specific ethical option. For this reason a (...) political process is necessary for negotiating between the diversity of perspectives. Such a process will proceed in a more structured manner if techniques to make our ethical evaluation more explicit are used, and the furthest that can be gone in this regard is to try to reduce the various effects, as far as is possible, to one common denominator.Socio-economic cost-benefit analysis is often presented as an objective instrument for evaluating governmental decisions. As a matter of fact, however, it departs from a quite specific utilitarian option , and one which is not easy to accept. From this perspective, decisions are evaluated exclusively on the basis of the subjective advantage they bring to individuals in society. The idea of evaluating the various effects involvedin monetary terms can, nevertheless, remain of value, even when we are inclined to resist the technocratic illusion fostered by some supporters of SCBA. Monetary evaluation should certainly not be considered the last word in the discussion. On the contrary, it should be seen as a necessary reference point for the structuring of a wider ethical and political debate.In this paper I have focused exclusively on difficult governmental decisions which have significant economic aspects, i.e. where many of the effects involved can easily be evaluated in market terms. Of course, when this is not the case, the practical advantages of monetary evaluation techniques disappear. When decisions take place at a more personal level, even consequentialism will lose much of its ethical appeal. (shrink)

This chapter discusses the utility of cost-benefit analysis in decision making, specifically environmental decision making. For the purposes of the discussion here, it uses a type of CBA that incorporates two controversial characteristics, namely, the assumption of comparability and the willingness-to-pay measure. The chapter aims to show that the recognition of a well motivated holistic decision-making strategy can shed light on debates regarding CBA. This strategy is concerned with patterns of choices rather than individual ones, and corresponds with (...) two familiar phenomena—the “pricing” of alternatives and the “embedding effect” in willingness-to-pay studies. This chapter also differentiates CBA from cost-preparedness analysis, and concludes that there need not be any inconsistency in pricing alternatives deemed incomparable and that willingness-to-pay studies can be more accurately interpreted as tracking the “preparedness to pay.”. (shrink)

In this paper I am concerned with risk–benefit analysis; that is, the comparison of the risks of a situation to its related benefits. We all face such situations in our daily lives and they are very common in medicine too, where risk–benefit analysis has become an important tool for rational decision-making. This paper explores risk–benefit analysis from a logical point of view. In particular, it seeks a better understanding of the common view that decisions (...) should be made by weighing risks against benefits and that an option should be chosen if its benefits outweigh its risks. I devote a good deal of this paper scrutinizing this popular view. Specifically, I demonstrate that this mode of reasoning is logically faulty if “risk” and “benefit” are taken in their absolute sense. But I also show that arguing in favour of an action because its benefits outweigh its risks can be valid if we refer to incremental risks and benefits. (shrink)

This article investigates the prospects of deliberative democracy through the analysis of small-scale deliberative events, or mini-publics, using empirical methods to understand the process of preference transformation. Evidence from two case studies suggests that deliberation corrects preexisting distortions of public will caused by either active manipulation or passive overemphasis on symbolically potent issues. Deliberation corrected these distortions by reconnecting participants’ expressed preferences to their underlying “will” as well as shaping a shared understanding of the issue.The article concludes by using (...) these insights to suggest ways that mini-public deliberation might be articulated to the broader public sphere so that the benefits might be scaled up. That mini-public deliberation does not so much change individual subjectivity as reconnect it to the expression of will suggests that scaling up the transformative effects should be possible so long as this involves communicating in the form of reasons rather than preferred outcome alone. (shrink)