Climate change harms health and damages and diminishes environmental resources. Gradually it will cause health systems to reduce services, standards of care, and opportunities to express patient autonomy. Prominent public health organizations are responding with preparedness, mitigation, and educational programs. The design and effectiveness of these programs, and of similar programs in other sectors, would be enhanced by greater understanding of the values and tradeoffs associated with activities and public policies that drive climate change. Bioethics could generate such understanding by (...) exposing the harms and benefits in different cultural, socioeconomic, and geographic contexts, and through interdisciplinary risk assessments. Climate change is a bioethics problem because it harms everyone and involves health, values, and responsibilities. This article initiates dialog about the responsibility of bioethics to promote transparency and understanding of the social values and conflicts associated with climate change, and the actions and public policies that allow climate change to worsen. (shrink)

One manifestation of climate change is the increasingly severe extreme weather that causes injury, illness and death through heat stress, air pollution, infectious disease and other means. Leading health organisations around the world are responding to the related water and food shortages and volatility of energy and agriculture prices that threaten health and health economics. Environmental and climate ethics highlight the associated challenges to human rights and distributive justice but rarely address health or encompass bioethical methods or analyses. Public health (...) ethics and its broader umbrella, bioethics, remain relatively silent on climate change. Meanwhile global population growth creates more people who aspire to Western lifestyles and unrestrained socioeconomic growth. Fulfilling these aspirations generates more emissions; worsens climate change; and undermines virtues and values that engender appreciation of, and protections for, natural resources. Greater understanding of how virtues and values are evolving in different contexts, and the associated consequences, might nudge the individual and collective priorities that inform public policy toward embracing stewardship and responsibility for environmental resources necessary to health. Instead of neglecting climate change and related policy, public health ethics and bioethics should explore these issues; bring transparency to the tradeoffs that permit emissions to continue at current rates; and offer deeper understanding about what is at stake and what it means to live a good life in today's world. (shrink)

Guidelines for Institutional Review Boards (IRBs) or research ethics committees exist at national and international levels. These guidelines are based on ethical principles and establish an internationally acceptable standard for the review and conduct of medical research. Having attained a multinational consensus about what these fundamental guidelines should be, IRBs are left to interpret the guidelines and devise their own means of implementing them. Individual and community values bear on the interpretation of the guidelines so different IRBs attain different levels (...) of effectiveness. In the Caribbean and Pan American regions there are few IRBs. Obstacles to the establishment and function of IRBs are exacerbated in developing regions like these by differences in language, literacy, and local value systems; education, administrative expertise, facilities, and access to information are also limited. A regional IRB network might facilitate more uniform ethical review in developing countries, and simplify IRB procedures. (shrink)

There is international recognition of the need for sustainable research ethics committees to provide ethical review of human subjects.

CIOMS has been criticised for not adequately consulting stakeholders about its revised ethical guidelines regarding medical research.

This article presents empirical data on the limited availability of hospice and palliative care to the 6 million people of the English-speaking Caribbean. Ten of the 13 nations therein responded to a survey and reported employing a total of 6 hospice or palliative specialists, and having a total of 15 related facilities. The evolving socioeconomic and cultural context in these nations bears on the availability of such care, and on the willingness to report, assess, and prioritize pain, and to prescribe (...) opiates for pain. Socioeconomics and culture also impinge on what medications and modalities of care are routinely available for pain or other conditions and can challenge professionalism, empathy, and responsiveness to patients’ unrelieved pain. Although all respondents report having a protocol for pain management, hospice, or end-of-life care, their annual medical use of opiates is well below the global mean. The International Narcotics Control Board , which monitors such use, encourages Caribbean and other low- and middle-income countries to increase their use of opiates to treat pain, and to overcome both unfounded fears of addiction and overly restrictive interpretation of related laws and regulations. Contextual considerations like those described here are important to the success of policies and capacity-building programs aiming to increase access to hospice and palliation, and perhaps to improving other aspects of health and healthcare. Exploring and responding to the realities of socioeconomic and cultural conditions will enhance public and policy dialogue and improve the design of interventions to increase access to palliative and hospice care. Improving access to palliative and hospice care in the Caribbean demonstrates beneficence and helps to fulfill human rights conventions. (shrink)

An unlinked seroprevalence study of HIV and other viruses was conducted on pregnant women on the Caribbean island of Grenada in 1994. Investigators were from both the developed world and the Grenadian Ministry of Health . There was then no board on Grenada to protect research subjects or review ethical aspects of studies. Nurses from the MOH were asked to verbally inform their patients about the study, and request that patients become subjects of the study and give blood for screening. (...) If consent was given nurses took blood and administered a survey about each subjects' knowledge of HIV transmission routes. Nurses shared a spoken dialect and cultural heritage with prospective subjects and were probably more effective than foreign researchers at informing subjects. Informed consent was obtained with a simplified consent form supplemented by conversation with each prospective research subject. Facilitating discussion between people with common cultural backgrounds helps apply the Western approach to informed consent to communities in the developing world. Researchers must disclose all information to nurses or other mediators, and ensure that nurses disclose as much information as possible to prospective subjects. So modified, informed consent maintains respect for persons and becomes applicable and relevant to various cultures. (shrink)

To the Editor: Conflicts of interest pervade medicine with sometimes profound repercussions. The unethical recruitment of oocyte donors, for example, reported by Aaron Levine in “Self-Regulation, Compensation, and the Ethical Recruitment of Oocyte Donors” (Mar–Apr 2010) threatens medical professionalism, societal trust in medicine, and possibly the health of young women. Levine shows that in violation of fertility industry standards, donors with high SAT scores are often paid more than those with lower scores. Such payments are deceptive and ethically problematic because (...) neither intelligence nor SAT score is proven to be genetically transmitted. Moreover, some question the value of aptitude and intelligence tests .. (shrink)

There is international recognition of the need for sustainable research ethics committees to provide ethical review of human subjects research in developing countries, but many developing countries do not have such committees . Theoretical and practical uncertainties encountered by an IRB on the Caribbean island of Grenada offer insight into ethical review of research in developing countries. Theoretical uncertainties include questions about whether means of ensuring confidentiality and obtaining informed consent will be effective in local settings, and whether deviations from (...) Western norms are justifiable. International guidelines are helpful in addressing these concerns, but are subject to interpretation. Guidelines are less helpful in practical areas like selecting members or chairs. They do not address what sort of procedures and paperwork will work in a developing country, or IRBs’ relationships to governments that have no mandate for them. Experiences presented here show that IRBs in developing countries can sustainably adhere to international standards. Sustainability requires knowledge, personal commitment, and an official mandate to uphold international standards. Capacity building must therefore focus on educational programs to make developing country leaders knowledgeable about the value of international guidelines to their nations. Such knowledge is needed before people will become motivated to promote, implement, and uphold the guidelines. People in developing countries must help design bridges to help their nations put international standards into practice. The structure of such bridges may, of necessity, vary in different settings. (shrink)

Stakeholder consultation is part of the democratic process, embraces respect for persons, and is necessary for upholding the principle of justice. People are more likely to uphold standards they have participated in setting, so stakeholder consultation encourages adherence to societal and institutional standards as these evolve. Stakeholder consultation is also responsive to the call to “resocialize” ethics by contextualizing dilemmas and involving the destitute in choices about their healthcare. In resource-poor settings, such consultation promotes local “ownership” of, and leadership within, (...) development programs, which enhances effectiveness and sustainability. Stakeholder consultation is, therefore, a form of capacity building. To succeed, it must be responsive to regional, national, and individual constraints, including socioeconomic, cultural, and political ones. Several such constraints impact on the demand for, and availability of, palliative healthcare in the Caribbean. (shrink)

Andocides is generally not considered one of the best orators. To point up his flawed style, scholars have discussed a notoriously vindictive and humorous section in Andocides 1: in 124ff. Andocides describes the profligate lifestyle of his prosecutor, Callias III the Ceryx, the son of Hipponicus II and dadouchos of the Eleusinian Mysteries.

With the publication recently of two valuable studies on Attic demes, we are now more fully aware of what we know, and do not know, of the deme. With Osborne's work, we now have some idea of the tendency of Athenians to own and maintain property in the deme of origin, but the role of marriage in consolidating property in that deme is more difficult to assess. In contrast to Osborne's focus on the ancestral deme, this brief study will concentrate (...) on the deme into which the woman married; such a deme will be termed the deme of marriage or the marital deme. The study will focus particularly on the families who contracted more than one alliance for their kinswomen into the same outside deme and will emphasize the importance of siblings in securing and maintaining these alliances in the marital deme. (shrink)

Andocides is generally not considered one of the best orators. To point up his flawed style, scholars have discussed a notoriously vindictive and humorous section in Andocides 1: in 124ff. Andocides describes the profligate lifestyle of his prosecutor, Callias III the Ceryx, the son of Hipponicus II and dadouchos of the Eleusinian Mysteries.

An unlinked seroprevalence study of HIV and other viruses was conducted on pregnant women on the Caribbean island of Grenada in 1994. Investigators were from both the developed world and the Grenadian Ministry of Health . There was then no board on Grenada to protect research subjects or review ethical aspects of studies. Nurses from the MOH were asked to verbally inform their patients about the study, and request that patients become subjects of the study and give blood for screening. (...) If consent was given nurses took blood and administered a survey about each subjects' knowledge of HIV transmission routes. Nurses shared a spoken dialect and cultural heritage with prospective subjects and were probably more effective than foreign researchers at informing subjects. Informed consent was obtained with a simplified consent form supplemented by conversation with each prospective research subject. Facilitating discussion between people with common cultural backgrounds helps apply the Western approach to informed consent to communities in the developing world. Researchers must disclose all information to nurses or other mediators, and ensure that nurses disclose as much information as possible to prospective subjects. So modified, informed consent maintains respect for persons and becomes applicable and relevant to various cultures. (shrink)

Interruptions are often inevitable and occur many times in daily life (Ratwani & Trafton, 2010). Interruptions at work can disrupt progress on tasks and result in costly mistakes (Brumby, Cox, Back...

C.S. Peirce, the founder of pragmatism, argued that truth is what we would agree upon, were inquiry to be pursued as far as it could fruitfully go. In this book, Misak argues for and elucidates the pragmatic account of truth, paying attention both to Peirce's texts and to the requirements of a suitable account of truth. An important argument of the book is that we must be sensitive to the difference between offering a definition of truth and engaging in a (...) distinctively pragmatic project. The pragmatic project spells out the relationship between truth and inquiry; it articulates the consequences of a statement's being true. The existence of a distinct pragmatic enterprise has implications for the status of the pragmatic account of truth and for the way in which philosophy should be conducted. (shrink)

Parsa-Parsi et al bring attention to the World Medical Association (WMA) and transparency to its International Code of Medical Ethics (ICoME) revisions.1 We value their report and the revised ICoME but explain here that the ICoME cannot reflect consensus among all WMA members, or the wider medical profession, given structural and epistemic injustices that restrain low-income and middle-income country (LMIC) physicians from participating in activities such as WMA revisions. Such injustices overlook experiences and contributions of those from LMICs and marginalised (...) groups, hindering their access to and influence within medicine.2 They also undermine access to information about, and from, the WMA. Recruiting new members from, and better engaging members in, LMICs would strengthen the WMA and its influence across the medical profession, and better elevate environmental sustainability as a biomedical and bioethical concern. This would be beneficial because there is controversy among physicians, bioethicists and other stakeholders about the relevance of environmental sustainability to medicine.3 4 That its addition to the ICoME was ‘uncontentious’ hints at structural and epistemic injustices in the revision process and homogeneity of those most involved in the revisions. Based on our observations as medical educators, it appears that few medical students and physicians at our institution, and few across the Caribbean and …. (shrink)

Abstract: Some first person statements, such as ‘I am in pain’, are thought to be immune to error through misidentification (IEM): I cannot be wrong that I am in pain because—while I know that someone is in pain—I have mistaken that person for myself. While IEM is typically associated with the self-ascription of psychological properties, some philosophers attempt to draw anti-Cartesian conclusions from the claim that certain physical self-ascriptions are also IEM. In this paper, I will examine whether some physical (...) self-ascriptions are in fact IEM, and—if they are—what role that fact is supposed to play in arguments for the anti-Cartesian claim that self-consciousness is consciousness of oneself as a material object. I will argue that if we accept the assumptions required to show that physical self-ascriptions are IEM, then IEM cannot play the role it needs to play in these anti-Cartesian arguments. (shrink)

Achieving space domain awareness requires the identification, characterization, and tracking of space objects. Storing and leveraging associated space object data for purposes such as hostile threat assessment, object identification, and collision prediction and avoidance present further challenges. Space objects are characterized according to a variety of parameters including their identifiers, design specifications, components, subsystems, capabilities, vulnerabilities, origins, missions, orbital elements, patterns of life, processes, operational statuses, and associated persons, organizations, or nations. The Space Object Ontology provides a consensus-based realist framework (...) for formulating such characterizations in a computable fashion. Space object data are aligned with classes and relations in the Space Object Ontology and stored in a dynamically updated Resource Description Framework triple store, which can be queried to support space domain awareness and the needs of spacecraft operators. This paper presents the core of the Space Object Ontology, discusses its advantages over other approaches to space object classification, and demonstrates its ability to combine diverse sets of data from multiple sources within an expandable framework. Finally, we show how the ontology provides benefits for enhancing and maintaining longterm space domain awareness. (shrink)

Charles Sanders Peirce (1839-1914), the founder of pragmatism, is generally considered the most significant American philosopher. Popularized by William James and John Dewey, pragmatism advocates that our philosophical theories be linked to experience and practice. The essays in this volume reveal how Peirce developed this concept.

Marshall et al. (2024) raise questions regarding patient refusals of care. In this commentary we address refusals of care from the lens of patient autonomy and provide suggestions for patient cente...

Achieving space situational awareness requires, at a minimum, the identification, characterization, and tracking of space objects. Leveraging the resultant space object data for purposes such as hostile threat assessment, object identification, and conjunction assessment presents major challenges. This is in part because in characterizing space objects we reference a variety of identifiers, components, subsystems, capabilities, vulnerabilities, origins, missions, orbital elements, patterns of life, operational processes, operational statuses, and so forth, which tend to be defined in highly heterogeneous and sometimes inconsistent (...) ways. The Space Domain Ontologies are designed to provide a consensus-based realist framework for formulating such characterizations in a way that is both consistent and computable. Space object data are aligned with classes and relations in a suite of ontologies built around the existing Space Object Ontology. They are stored in a dynamically updated Resource Description Framework triple store, which can be queried to support space situational awareness and the needs of spacecraft operators and analysts. This paper provides an overview of the Space Domain Ontologies and their development and use. It presents the motivation for and advantages of the Space Domain Ontologies, including the benefits they provide for enhancing and maintaining long-term space situational awareness. (shrink)

Because factory-farmed meat production inflicts gratuitous suffering upon animals and wreaks havoc on the environment, there are morally compelling reasons to become vegetarian. Yet industrial plant agriculture causes the death of many field animals, and this leads some to question whether consumers ought to get some of their protein from certain kinds of non factory-farmed meat. Donald Bruckner, for instance, boldly argues that the harm principle implies an obligation to collect and consume roadkill and that strict vegetarianism is thus immoral. (...) But this argument works only if the following claims are true: all humans have access to roadkill, roadkill would go to waste if those who happen upon it don’t themselves consume it, it’s impossible to harvest vegetables without killing animals, the animals who are killed in plant production are all-things-considered harmed by crop farming, and the best arguments for vegetarianism all endorse the harm principle. As I will argue in this paper, each claim is deeply problematic. Consequently, in most cases, humans ought to strictly eat plants and save the roadkill for cats. (shrink)

We have begun work on two separate but related ontologies for the study of neurological diseases. The first, the Neurological Disease Ontology (ND), is intended to provide a set of controlled, logically connected classes to describe the range of neurological diseases and their associated signs and symptoms, assessments, diagnoses, and interventions that are encountered in the course of clinical practice. ND is built as an extension of the Ontology for General Medical Sciences — a high-level candidate OBO Foundry ontology that (...) provides a set of general classes that can be used to describe general aspects of medical science. ND is being built with classes utilizing both textual and axiomatized definitions that describe and formalize the relations between instances of other classes within the ontology itself as well as to external ontologies such as the Gene Ontology, Cell Ontology, Protein Ontology, and Chemical Entities of Biological Interest. In addition, references to similar or associated terms in external ontologies, vocabularies and terminologies are included when possible. Initial work on ND is focused on the areas of Alzheimer’s and other diseases associated with dementia, multiple sclerosis, and stroke and cerebrovascular disease. Extensions to additional groups of neurological diseases are planned. The second ontology, the Neuro-Psychological Testing Ontology (NPT), is intended to provide a set of classes for the annotation of neuropsychological testing data. The intention of this ontology is to allow for the integration of results from a variety of neuropsychological tests that assay similar measures of cognitive functioning. Neuro-psychological testing is an important component in developing the clinical picture used in the diagnosis of patients with a range of neurological diseases, such as Alzheimer’s disease and multiple sclerosis, and following stroke or traumatic brain injury. NPT is being developed as an extension to the Ontology for Biomedical Investigations. (shrink)

When fat people are depicted in popular media, we often take their behavior to be representative of all fat people. How one fat person acts becomes representative of a broader pattern of behavior that all fat people are presumed to share, shaping the way we understand fatness. This way of generalizing presents fatness as a singular experience, reducing fat people to a monolithic narrative that often reinforces anti-fat bias. How do we avoid this reduction? How can we responsibly depict fat (...) characters without perpetuating negative stereotypes about real fat people? Using the case of “Fat Thor” from Avengers: Endgame, I propose the beginnings of an account of responsible artistic agency which can be used to improve the ways that marginalized communities are depicted in art, with a particular focus on fat communities. Central to this account are two features: inclusion of and deference to members of the communities depicted from a variety of backgrounds throughout the production process, and mindfulness of the preexisting narrative web built around the communities depicted. I will use this discussion to highlight the need for a drastic shift in how we consider marginalized populations in art—in reimagining both who tells their stories, and what stories are told on their behalf. (shrink)

The best of Peirce, James, and Dewey has thus resurfaced in deep, interesting, and fruitful ways, explored in this volume by David Bakhurst, Arthur Fine, Ian ...

Traditional approaches to animal ethics commonly emerge from one of two influential ethical theories: Regan’s deontology (The case for animal rights. University of California, Berkeley, 1983) and Singer’s preference utilitarianism (Animal liberation. Avon Books, New York, 1975). I argue that both of the theories are unsuccessful at providing adequate protection for animals because they are unable to satisfy the three conditions of a minimally decent theory of animal protection. While Singer’s theory is overly permissive, Regan’s theory is too restrictive. I (...) argue that a minimally decent animal ethic requires a framework that allows for context-dependent considerations of our complex human–animal relationship in a non-ideal world. A plausible theory which exemplifies this new ethic is virtue ethics. (shrink)

A growing number of animal ethicists defend new omnivorism--the view that it's permissible, if not obligatory, to consume certain kinds of animal flesh and products. This book puts defenders of new omnivorism and advocates of strict veganism into conversation with one another to further debates in food ethics in novel and meaningful ways. The book includes six chapters that defend distinct versions of new omnivorism and six critical responses from scholars who are sympathetic to strict veganism. The contributors debate whether (...) it's ethically permissible to eat the following: "freegan" meat, roadkill, cultured meat, genetically disenhanced animals, possibly insentient animals such as insects, and fish. The volume concludes with two chapters that examine strict vegan and new omnivore policy. Presenting readers with clear defenses and criticisms of the various dietary proposals, this book draws attention to the most important ethical challenges facing traditional animal agriculture and alternative systems of food production. New Omnivorism and Strict Veganism will appeal to scholars and students interested in food ethics, animal ethics, and agricultural ethics. (shrink)

We discuss the impact of horizontal gene transfer (HGT) on phylogenetic reconstruction and taxonomy. We review the power of HGT as a creative force in assembling new metabolic pathways, and we discuss the impact that HGT has on phylogenetic reconstruction. On one hand, shared derived characters are created through transferred genes that persist in the recipient lineage, either because they were adaptive in the recipient lineage or because they resulted in a functional replacement. On the other hand, taxonomic patterns in (...) microbial phylogenies might also be created through biased gene transfer. The agreement between different molecular phylogenies has encouraged interpretation of the consensus signal as reflecting organismal history or as the tree of cell divisions; however, to date the extent to which the consensus reflects shared organismal ancestry and to which it reflects highways of gene sharing and biased gene transfer remains an open question. Preferential patterns of gene exchange act as a homogenizing force in creating and maintaining microbial groups, generating taxonomic patterns that are indistinguishable to those created by shared ancestry. To understand the evolution of higher bacterial taxonomic units, concepts usually applied in population genetics need to be applied. (shrink)

The book shows one individual's (the author) experience of the world, through contacts with government officials and scholars in the Middle East and Asia, Europe and Latin America during the post-Second World War years up to the later 1960s; and then that individual's reflections and study during the succeeding decades, up to and including the first decade of the 21st century, concerning the future of the world and the critical choices that confront the world both in inter-state relations and in (...) maintaining the security of the biosphere. (shrink)

Some animal ethicists argue that eating roadkill is permissible because salvaging and consuming already dead animals doesn’t cause harm to anyone. Moreover, some argue that eating roadkill is actually obligatory, insofar as a diet that includes some roadkill is less harmful than a diet that consists of protein (animal or plant) obtained only from grocery stores and restaurants. Against this view, Abbate argues that eating roadkill is wrong for at least two reasons: (1) better consequences would be produced if roadkill (...) were either left in surrounding habitats for scavenger animals or given to other would-be meat eaters (such as meat-eating friends, family, and/or neighbors), and (2) those who salvage and consume roadkill both benefit from and are involved in wrongdoing, insofar as the animals who are killed by motor vehicles are killed as a result of injustice. (shrink)

In recent discussions, it has been argued that a theory of animal rights is at odds with a liberal abortion policy. In response, Francione (1995) argues that the principles used in the animal rights discourse do not have implications for the abortion debate. I challenge Francione’s conclusion by illustrating that his own framework of animal rights, supplemented by a relational account of moral obligation, can address the moral issue of abortion. I first demonstrate that Francione’s animal rights position, which grounds (...) moral consideration in sentience, is committed to the claim that a sentient fetus has a right to life. I then illustrate that a fully developed account of animal rights that recognizes the special obligations humans have to assist animals when we cause them to be dependent and vulnerable through our voluntary actions or omissions is committed to the following: a woman also has a special obligation to assist a sentient fetus when she causes it to be dependent and vulnerable through her voluntary actions or omissions. From these considerations, it will become evident that a fully developed and consistent animal rights ethic does in fact have implications for the abortion discussion. (shrink)