BackgroundThe coronavirus 2019 pandemic placed unprecedented pressures on healthcare services and magnified ethical dilemmas related to how resources should be allocated. These resources include, among others, personal protective equipment, personnel, life-saving equipment, and vaccines. Decision-makers have therefore sought ethical decision-making tools so that resources are distributed both swiftly and equitably. To support the development of such a decision-making tool, a systematic review of the literature on relevant ethical values and principles was undertaken. The aim of this review was to identify (...) ethical values and principles in the literature which relate to the equitable allocation of resources in response to an acute public health threat, such as a pandemic.MethodsA rapid systematic review was conducted using MEDLINE, EMBASE, Google Scholar, LitCOVID and relevant reference lists. The time period of the search was January 2000 to 6th April 2020, and the search was restricted to human studies. January 2000 was selected as a start date as the aim was to capture ethical values and principles within acute public health threat situations. No restrictions were made with regard to language. Ethical values and principles were extracted and examined thematically.ResultsA total of 1,618 articles were identified. After screening and application of eligibility criteria, 169 papers were included in the thematic synthesis. The most commonly mentioned ethical values and principles were: Equity, reciprocity, transparency, justice, duty to care, liberty, utility, stewardship, trust and proportionality. In some cases, ethical principles were conflicting, for example, Protection of the Public from Harm and Liberty.ConclusionsAllocation of resources in response to acute public health threats is challenging and must be simultaneously guided by many ethical principles and values. Ethical decision-making strategies and the prioritisation of different principles and values needs to be discussed with the public in order to prepare for future public health threats. An evidence-based tool to guide decision-makers in making difficult decisions is required. The equitable allocation of resources in response to an acute public health threat is challenging, and many ethical principles may be applied simultaneously. An evidence-based tool to support difficult decisions would be helpful to guide decision-makers. (shrink)

We argue that, under certain plausible assumptions, de Sitter space settles into a quiescent vacuum in which there are no dynamical quantum fluctuations. Such fluctuations require either an evolving microstate, or time-dependent histories of out-of-equilibrium recording devices, which we argue are absent in stationary states. For a massive scalar field in a fixed de Sitter background, the cosmic no-hair theorem implies that the state of the patch approaches the vacuum, where there are no fluctuations. We argue that an analogous conclusion (...) holds whenever a patch of de Sitter is embedded in a larger theory with an infinite-dimensional Hilbert space, including semiclassical quantum gravity with false vacua or complementarity in theories with at least one Minkowski vacuum. This reasoning provides an escape from the Boltzmann brain problem in such theories. It also implies that vacuum states do not uptunnel to higher-energy vacua and that perturbations do not decohere while slow-roll inflation occurs, suggesting that eternal inflation is much less common than often supposed. On the other hand, if a de Sitter patch is a closed system with a finite-dimensional Hilbert space, there will be Poincaré recurrences and dynamical Boltzmann fluctuations into lower-entropy states. Our analysis does not alter the conventional understanding of the origin of density fluctuations from primordial inflation, since reheating naturally generates a high-entropy environment and leads to decoherence, nor does it affect the existence of non-dynamical vacuum fluctuations such as those that give rise to the Casimir effect. (shrink)

Objective: There are benefits and risks of giving patients more granular control of their personal health information in electronic health record (EHR) systems. When designing EHR systems and policies, informaticists and system developers must balance these benefits and risks. Ethical considerations should be an explicit part of this balancing. Our objective was to develop a structured ethics framework to accomplish this. -/- Methods: We reviewed existing literature on the ethical and policy issues, developed an ethics framework called a “Points to (...) Consider” (P2C) document, and convened a national expert panel to review and critique the P2C. -/- Results: We developed the P2C to aid informaticists designing an advanced query tool for an electronic health record (EHR) system in Indianapolis. The P2C consists of six questions (“Points”) that frame important ethical issues, apply accepted principles of bioethics and Fair Information Practices, comment on how questions might be answered, and address implications for patient care. -/- Discussion: The P2C is intended to clarify whatis at stake when designers try to accommodate potentially competing ethical commitments and logistical realities. The P2C was developed to guide informaticists who were designing a query tool in an existing EHR that would permit patient granular control. While consideration of ethical issues is coming to the forefront of medical informatics design and development practices, more reflection is needed to facilitate optimal collaboration between designers and ethicists. This report contributes to that discussion. (shrink)

Abstract:By combining normative philosophy and empirical social science, we craft a research framework for assessing differential expectations embodied in normative conceptions of the economic social contract in the United States. We argue that there are distinct views of such a contract grounded in individualist and communitarian philosophical ideologies. We apply this framework to organizational downsizing, postulating that certain human resource practices, in combination with the respective ideological orientations, will affect perceptions of the justice of downsizing policies.

The sequencing of the human genome and decreasing costs of sequencing technology have led to the notion of ‘personalized medicine’. This has been taken by some authors to indicate that personalized medicine will provide individualized treatments solely based on one’s DNA sequence. We argue this is overly optimistic and misconstrues the notion of personalization. Such interpretations fail to account for economic, policy and structural constraints on the delivery of healthcare. Furthermore, notions of individualization based on genomic data potentially take us (...) down the road of genetic reductionism obscuring the role of environmental factors in disease and ill health. We propose that one should see personalized medicine as a way of using personal genomic information to stratify individuals into subpopulations and suggest that personalized medicine be seen within a broader idea of personalized healthcare, reflecting healthcare that integrates personal genomic data into cultural, environmental and personal contexts. (shrink)

Although social contracts theory has been applied to organizations (Donaldson & Dunfee, 1994), rarely has the theory been tested empirically. This article uses the traditions of communitarianism and individualism to instantiate an ideal-type economic social contract. We asked 269 subjects to complete the Ideological Orientation Scale and to make judgments on eight downsizing scenarios. Using social judgment theory, we assess the direct and indirect influences of ideology on judgments of fairness. Our findings suggest that ideology indeed shapes individual’s conceptions of (...) organizational fairness. (shrink)

The use of algorithms and automated systems, especially those leveraging artificial intelligence (AI), has been exploding in the public sector, but their use has been controversial. Ethicists, public advocates, and legal scholars have debated whether biases in AI systems should bar their use or if the potential net benefits, especially toward traditionally disadvantaged groups, justify even greater expansion. While this debate has become voluminous, no scholars of which we are aware have conducted experiments with the groups affected by these policies (...) about how they view the trade-offs. We conduct a set of two conjoint experiments with a high-quality sample of 973 Americans who identify as Black or African American in which we randomize the levels of inter-group disparity in outcomes and the net effect on such adverse outcomes in two highly controversial contexts: pre-trial detention and traffic camera ticketing. The results suggest that respondents are willing to tolerate some level of disparity in outcomes in exchange for certain net improvements for their community. These results turn this debate from an abstract ethical argument into an evaluation of political feasibility and policy design based on empirics. (shrink)

Caring for children with life-shortening illnesses is a humbling task. While some decisions are simple and safe, the emotionally-charged choices regarding how to best care for these children often...

(Citation/Reference) Williams, S. H. Lewis Carroll handbook.

“Noverim me, noverim te.” – Saint Augustine, Confessions, 10.1.1. (397-400 AD). -/- What would and will an urban commons look like that is slowly and incrementally being re-socialized? How would that affect urban planning “now” and in times of crisis? How do we prepare for the likelihood of rolling similar crises with an eye on returning the urban commons to citizens? -/- There is the old adage that under capitalism, risk is always socialized and profit is always privatized. We are (...) seeing it now, under the COVID-19 crisis. The huge bailouts launched by governments are symptomatic of the crisis in political economy, just as they were post-2008. “Too big to fail” has sponsored monsters that refuse to back off without threatening the collapse of the entire system. Francisco Goya’s “The sleep of Reason produces monsters …” comes to mind. -/- Physical and immaterial culture, in our current Western civilisation, are intimately linked. Yet the focus for urban design is generally on the material or physical side, with the immaterial left to its own devices. Increasingly, urban design measures are merely ameliorative and aesthetic, with the larger share shaped by a political economy dictated by market ideology or “politicalology.” What transpires, nonetheless, is an immaterial commons that constitutes a public or private intellectual commons – often a mix of the two; but, in the case of domination by market ideology, the privatization of “general intellect” proceeds by abject appropriation. In such a technocratically driven model, subjective states become increasingly important. As Indian architect Balkrishna Vithaldas Doshi once said, “Smart cities are smart people.” -/- How might these two otherwise contiguous and synchronous systems be brought back into a properly civic-minded rapport with or without crisis-driven change? Are there alternate models for the urban commons? What measures might be put in place in advance, or as provisional intercessions? (shrink)

As a subject of inquiry, laws of nature exist in the overlap between metaphysics and the philosophy of science. Over the past three decades, this area of study has become increasingly central to the philosophy of science. It also has relevance to a variety of topics in metaphysics, philosophy of mind, philosophy of language, and epistemology. Readings on Laws of Nature is the first anthology to offer a contemporary history of the problem of laws. The book is organized around three (...) key issues: the matter of distinguishing laws from mere correlations, questions concerning inductive reasoning and laws, and the consideration of whether there are any true laws in science. Designed for class use, the anthology covers a remarkably broad range of views and concerns, and consists exclusively of articles that have proved highly influential in the field. Readings on Laws of Nature will also serve as a valuable research and reference tool for philosophers who do not specialize in the subject, but who have occasion to examine concepts relating to the laws of nature in their own work. (shrink)

The pressure for publication is ever present in academe. Rules for submission are elucidated by conferences, proceedings and journals for the benefit of authors; however, the rules for reviewers and editors are not so well established or consistent. This treatise examines examples of abuse of the editorial process and points to a need for formal recognition of rules for review. The manuscript culminates with proposed Codes of Ethics for researchers, referees and editors and suggestions for improvement of the peer review (...) process. (shrink)

With specific reference to the teaching of Irish and English in Ireland, I am concerned in this paper with the experiences of language dispossession and language pedagogy. Drawing on Jacques Derrida’s key concepts of ‘hospitality’ and ‘monolingualism’, I argue that in Ireland the first of these experiences cannot be separated from the second. Taking into consideration its colonial past as well as the changing linguistic profile of its present, Ireland is at once ‘host’ and ‘hostage’ to the English language and (...) this deconstructing identity has important ramifications for the country’s systematic teaching of English as well as Irish. The primary philosophical text guiding my discussion is Derrida’s ‘Monolingualism of the Other’. (shrink)

This book draws from anthropology, ancient history, theology, philosophy and the Holocaust to redefine architectural history for both architects and historians. It also contains ideas and practical propositions that should help sutdents of architecture to build a more human world.

The case focuses on the decision by the Norwegian Ministry of Finance in 2006 to remove Wal-Mart Stores, Inc. from its investment portfolio because of theretailer's "serious and systematic" abuses of human and labor rights. Discussion of the decision-making process that led to the divestiture, and the impact that Wal-Mart has had on various realms – social, economic, industry, and the supply chain, among others – are included in the case.

We investigated the effects of everyday language exposure on the prediction of orthographic and phonological forms of a highly predictable word during listening comprehension. Native Japanese speakers in Tokyo (Experiment 1) and Berlin (Experiment 2) listened to sentences that contained a predictable word and viewed four objects. The critical object represented the target word (e.g., /sakana/;fish), an orthographic competitor (e.g., /tuno/;horn), a phonological competitor (e.g., /sakura/;cherry blossom), or an unrelated word (e.g., /hon/;book). The three other objects were distractors. The Tokyo (...) group fixated the target and the orthographic competitor over the unrelated objects before the target word was mentioned, suggesting that they pre-activated the orthographic form of the target word. The Berlin group showed a weaker bias toward the target than the Tokyo group, and they showed a tendency to fixate the orthographic competitor only when the orthographic similarity was very high. Thus, prediction effects were weaker in the Berlin group than in the Tokyo group. We found no evidence for the prediction of phonological information. The obtained group differences support probabilistic models of prediction, which regard the built-up language experience as a basis of prediction. (shrink)

Theodor Adorno’s “Late Style in Beethoven” is the first philosophically sophisticated attempt to chronicle, if not fully characterize, movements of the mature artwork. With direct reference to Beethoven’s third and final phase, Adorno offers a complex formulation of aging and artistry. He attempts to capture, ambitiously, the content and internal structure of the late artwork, the forms to which that internal structure is responsible, the artistic conventions governing that structure, the sociohistorical conditions in which the work was produced and, finally, (...) the personality of the late artist. Foremost among these formulations is the idea of late style as putatively strange and difficult. Works of the... (shrink)

This six volume Routledge Library Edition set is dedicated to the work of key nineteenth-century German thinker, Friedrich Nietzsche, whose hugely influential work in the field of philosophy continues to be felt to this day. The six volumes, published between 1948 and 1988, represent a truly wide-ranging analysis of Nietzsche’s life and work, offering an excellent overview of the cannon of critical analysis and interpretation on Nietzsche in the twentieth century. The collection covers Nietzsche’s perspectives and influence upon a variety (...) of sociological and philosophical debates, as well as placing his work in the context of contemporaries such as Richard Wagner, Fyodor Dostoyevsky and Max Stirner. (shrink)

American health policy today faces dual problems of too little coverage at too high a cost. The mix of private and public financing leaves about one seventh of the population without any insurance coverage. At the same time, the coverage Americans do have costs an ever-larger share of our country’s productive capacity. The U.S. pays well above what other countries pay and what many people, health plans, businesses, and governments want to pay. This “paradox of excess and deprivation” results from (...) the incremental approach the U.S. has taken to promoting incompatible policy goals of increasing health insurance coverage and medical quality while trying to control costs, without squarely confronting tradeoffs. This essay examines the record of incremental developments and draws lessons for current efforts at reform. (shrink)

This article clarifies my current and seemingly ever-changing position on issues relating to emotions. The position derives from my differential emotions theory and it changes with new empirical findings and with insights from my own and others’ thinking and writing. The theory distinguishes between first-order emotions and emotion schemas. For example, it proposes that first-order negative emotions are attributable mainly to infants and young children in distress and to older individuals in emergency or highly challenging situations. Emotion schemas are defined (...) as emotion feelings interacting with cognition in motivating the decision making and actions of everyday life. (shrink)

The Slow Professor: Challenging the Culture of Speed in the Academy was published in 2016 to critical acclaim. Rejecting outright the marketisation of the modern university, the book proposed a countercultural approach which denounced the seductive imperatives to overwork and competition and called on academics to make a more deliberate moral choice. In this paper, I critically engage with The Slow Professor's ethical vision. I draw on the work of writers Sally Rooney, John Williams and David Foster Wallace in careful (...) exploration of ‘slowness’ and its cognate terms. I am interested not only in the importance of slowness for university academics but for students in the 21st century university. These students, as pointed out recently by Bruce Macfarlane, are made to carry a plethora of conflicting identities and yet it is perhaps more important that we begin to demand less of our students and not more. Thus, in an era of audit and accountability, this paper explores the possibilities for a less frenetic approach to university teaching and learning. (shrink)

This thought-provoking text explores the ethical dimensions of the professional nursing practice. The authors discuss important topics such as inter-professional relationships, collective action, nursing research, and educational requirements within the context of professional commitment. Providing a balance between an empirical and a philsophical framework, the book stimulates the reader to ponder, analyze and evaluate the professional and ethical aspects of these issues.