En este artículo exploramos desde la literatura, por medio de Suenan timbres de Luis Vidales, la dinámica de las nacientes urbes colombianas que inician un proceso acelerado de modernización, carente de un desarrollo adecuado del pensamiento moderno, a la par con los nuevos avances materiales, lo que imposibilita debatir la pertinencia y el proceso de este tipo de transformaciones. Circunstancia que lleva a Colombia a experimentar los idiotismos de la modernización sin modernidad, impidiéndoles a los hombres entender las necesidades y (...) conflictos que genera el progreso. Estas aldeas de principios del siglo XX se convierten rápidamente en proyectos de ciudades determinadas por la aparición de nuevos objetos, creando una atmósfera móvil y ruidosa por oposición a la pasividad de las aldeas, realidad que nos recrea Vidales desde una poética comprometida con los cambios sociales y políticos como poeta de la crítica en Colombia. In this paper, from the literature of Luis Vidales’s Suenan timbres, we explore the dynamics of Colombian rising cities that initiate an accelerated modernization process, deprived of an appropriate development of modern thinking, along with the new material advances, which makes it impossible to debate the relevance and the process followed by these types of transformations. This situation leads Colombia to experience the idiotism of modernization without modernity, impeding men to understand the needs and conflicts generated by progress. These villages from twentieth century beginnings quickly turn into city projects determined by the arrival of new objects, creating a mobile and noisy atmosphere, opposed to villages’ passivity. From poetics committed to social and political change, Vidales recreates reality as a poet of criticism in Colombia. (shrink)

Macroergonomic compatibility refers to the extent to which macroergonomic factors and elements interact positively with humans. It is one of the most complex constructs to measure in work systems and in ergonomics. The goal of this paper is to determine the levels of MC in a manufacturing system. As methods, we use the macroergonomic compatibility index and the Macroergonomic Compatibility Questionnaire. The MCQ was administered in its three versions to collect data about the macroergonomic practices implemented in the manufacturing company. (...) Regarding results, all the macroergonomic factors and most of the macroergonomic elements showed a low level of MC; that is, MCI < 0.7. Only macroergonomic elements Education, Knowledge, and Skills reached a medium level; namely, MCI = 0.709. The factor with the highest level of MC was the Person factor. Similarly, the whole manufacturing system showed a low level of MC. In conclusion, the studied manufacturing company requires urgent macroergonomic interventions. Also, we found that the MCI can effectively measure the level of MC of MFEs and can guide the implementation of macroergonomic practices and explain the MC construct. (shrink)

Burnout syndrome and obesity are two growing conditions that affect employees’ health and company productivity. Recently, several studies have pointed to a possible relationship between both phenomena. However, such a relationship has not been clearly defined. This research analyzes the relationship between BS dimensions and body mass index, the latter being treated as a moderator variable among obese senior and middle managers in the Mexican maquiladora industry through a structural equation model. A total of 361 senior and middle managers completed (...) both the Maslach Burnout Inventory-General Survey [with emotional exhaustion, cynicism, and professional efficacy as subscale dimensions] and a sociodemographic questionnaire. The results showed a statistically significant relationship between EE and PE, with BMI acting as a moderator variable. The results showed that when BMI increases as a moderator variable, the strength of the relationship between EE and PE also changes. For example, although PE had a negative value of 0.14 before the moderator effect, the value increased up to 0.32 when the BMI was factored into the relationship. Therefore, maquiladora industries are being advised to increase their investments on the identification and prevention of employees’ EE and obesity. Such interventions would promote a better quality of life and could prevent economic losses resulting from poor employee performance. (shrink)

The situation and human rights of people living with HIV and AIDS were explored through focus groups in five African countries . A descriptive qualitative research design was used. The 251 informants were people living with HIV and AIDS, and nurse managers and nurse clinicians from urban and rural settings. NVivo™ software was used to identify specific incidents related to human rights, which were compared with the Universal Declaration of Human Rights. The findings revealed that the human rights of people (...) living with HIV and AIDS were violated in a variety of ways, including denial of access to adequate or no health care/services, and denial of home care, termination or refusal of employment, and denial of the right to earn an income, produce food or obtain loans. The informants living with HIV and AIDS were also abused verbally and physically. Country governments and health professionals need to address these issues to ensure the human rights of all people. (shrink)

ZusammenfassungEntscheidungen am Lebensende sind Bestandteil der ärztlichen Tätigkeit. In dieser Studie wurden Berliner Medizinstudierende zu ihren Kenntnissen der rechtlichen Grundlagen und ihrer ethischen Bewertung von passiver und aktiver Sterbehilfe befragt. Im Wintersemester 2002/2003 wurde eine schriftliche Befragung zu ethischen und rechtlichen Aspekten der Sterbehilfe unter den Teilnehmenden eines Pflichtkurses für Medizinstudierende im fünften Studienjahr an der Charité, Universitätsmedizin Berlin durchgeführt. Gruppenunterschiede im Antwortverhalten wurden mit dem χ2-Test nach Pearson geprüft. Von 102 Studierenden beantworteten 85 den Fragebogen (Rücklaufquote = 82,5%). Es (...) wussten 46 Medizinstudierende (54,1%), dass die Therapiebegrenzung am Lebensende legal sein kann; 70 (82,3%) hielten dies für ethisch akzeptabel. Die Tötung auf Verlangen in bestimmten Situationen hielten 35 Studierende (41,2%) für ethisch akzeptabel; 28 (33,0%) befürworteten die Legalisierung der Tötung auf Verlangen in bestimmten Situationen. Im Vergleich zu Ärztinnen und Ärzten in Deutschland wurde die Tötung auf Verlangen von weniger Studierenden abgelehnt. Angesichts der bestehenden Unsicherheiten bei den Studierenden hinsichtlich der rechtlichen und ethischen Bewertung von Entscheidungen am Lebensende sollten diese Aspekte in der medizinischen Ausbildung stärker berücksichtigt werden. (shrink)

On the political and economic legacy of the Duvalier regime and its implications for Haiti's future development. Schecter (sociology, Quebec) presents a personal, literary, and philosophical view of the impact of AIDS on modern life.

Visual aids can improve comprehension of risks associated with medical treatments, screenings, and lifestyles. Do visual aids also help decision makers accurately assess their risk comprehension? That is, do visual aids help them become well calibrated? To address these questions, we investigated the benefits of visual aids displaying numerical information and measured accuracy of self-assessment of diagnostic inferences (i.e., metacognitive judgment calibration) controlling for individual differences in numeracy. Participants included 108 patients who made diagnostic inferences about three medical tests on (...) the basis of information about the sensitivity and false-positive rate of the tests and disease prevalence. Half of the patients received the information in numbers without a visual aid, while the other half received numbers along with a grid representing the numerical information. In the numerical condition, many patients --especially those with low numeracy-- misinterpreted the predictive value of the tests and profoundly overestimated the accuracy of their inferences. Metacognitive judgment calibration mediated the relationship between numeracy and accuracy of diagnostic inferences. In contrast, in the visual aid condition, patients at all levels of numeracy showed high-levels of inferential accuracy and metacognitive judgment calibration. Results indicate that accurate metacognitive assessment may explain the beneficial effects of visual aids and numeracy --a result that accords with theory suggesting that metacognition is an essential part of risk literacy. We conclude that well-designed risk communications can inform patients about health-relevant numerical information while helping them assess the quality of their own risk comprehension. (shrink)

For several decades, there has been a debate in the philosophical literature concerning whether those of us who live in developed countries are morally required to give some of our money to aid agencies. Many contributors to this debate have apparently taken it that one may simply assume that the effects of the work such agencies do are overwhelmingly positive. If one turns to the literature on such agencies that has emerged in recent decades, however, one finds a number of (...) concerns about such agencies and the work they do that put that assumption in serious doubt. This situation raises a number of pressing questions, many of which have received little or no attention from philosophers. After articulating a number of those questions, I focus mainly on what I call the ‘Epistemic Question (for potential contributors to aid agencies)’: How can those of us who are not experts in international aid arrive at an estimate concerning the effects of the work aid agencies do that we have at least some good reason to believe accurate? (shrink)

Involuntary psychiatric commitment for suicide prevention and physician aid-in-dying (PAD) in terminal illness combine to create a moral dilemma. If PAD in terminal illness is permissible, it should also be permissible for some who suffer from nonterminal psychiatric illness: suffering provides much of the justification for PAD, and the suffering in mental illness can be as severe as in physical illness. But involuntary psychiatric commitment to prevent suicide suggests that the suffering of persons with mental illness does not justify ending (...) their own lives, ruling out PAD. Since both practices have compelling underlying justifications, the most reasonable accommodation might seem to be to allow PAD for persons with mental illness whose suffering is severe enough to justify self-killing, but prohibit PAD for persons whose suffering is less severe. This compromise, however, would require the articulation of standards by which persons’ mental as well as physical suffering could be evaluated. Doing so would present a serious philosophical challenge. (shrink)

ABSTRACT AIDS raises the moral problem of confidentiality because those in sexual contact with the patient may contract a life‐threatening and incurable disease. Medicine has a tradition in which a patient's condition is regarded as confidential information held by the doctor alone. In this case there is a clear moral inclination to inform those at risk from the disease. In most cases no problem will arise but when it does the moral justification for a violation of confidentiality comes into question. (...) Confidentiality is important because of our respect for certain human values and their importance to our patient. Where that patient acts so as to disregard the welfare of others with whom they are in close relationship, those values are lacking. This lack warrants a departure from our normal canons and provokes a suspension of normal moral privileges. The contention that any transgression, however slight, could be held to justify such a response posits a slope down which we, in fact, have no tendency to slide. (shrink)

At the end of the 1990s, Brazil was faced with a potentially explosive HIV/AIDS epidemic. Through an innovative and multifaceted campaign, and despite initial resistance from multinational pharmaceutical companies, the government of Brazil was able to negotiate price reductions for HIV medications and develop local production capacity, thereby averting a public health disaster. Using interview data and document analysis, the authors show that the exercise of corporate social responsibility can be viewed in practice as a dynamic negotiation and an interaction (...) between multiple actors. Action undertaken in terms of voluntary CSR alone may be insufficient. This finding highlights the importance of a strong role for national governments and international organizations to pressure companies to perform better. (shrink)

This article analyses a recent discourse of responsibility that accompanies states’ foreign aid provision. States adopt this discourse of National Social Responsibility to show their complian...

This paper explores some ways in which artificial intelligence (AI) could be used to improve human moral judgments in bioethics by avoiding some of the most common sources of error in moral judgment, including ignorance, confusion, and bias. It surveys three existing proposals for building human morality into AI: Top-down, bottom-up, and hybrid approaches. Then it proposes a multi-step, hybrid method, using the example of kidney allocations for transplants as a test case. The paper concludes with brief remarks about how (...) to handle several complications, respond to some objections, and extend this novel method to other important moral issues in bioethics and beyond. (shrink)

This paper is in two parts. Part I outlines three traditional approaches to the teaching of critical thinking: the normative, cognitive psychology, and educational approaches. Each of these approaches is discussed in relation to the influences of various methods of critical thinking instruction. The paper contrasts these approaches with what I call the “visualisation” approach. This approach is explained with reference to computer-aided argument mapping (CAAM) which uses dedicated computer software to represent inferences between premise and conclusions. The paper presents (...) a detailed account of the CAAM methodology, and theoretical justification for its use, illustrating this with the argument mapping software Rationale™. A number of Rationale™ design conventions and logical principles are outlined including the principle of abstraction, the MECE principle, and the “Holding Hands” and “Rabbit Rule” heuristics. Part II of this paper outlines the growing empirical evidence for the effectiveness of CAAM as a method of teaching critical thinking. (shrink)

This paper argues that it is morally wrong for the affluent not to contribute money or time to famine relief. It begins by endorsing an important methodological line of objection against the most prominent philosophical advocate of this claim, Peter Singer. This objection attacks his strategy of invoking a principle the acceptability of which is apparently based upon its conformity with "intuitive" moral judgements in order to defend a strongly counterintuitive conclusion. However, what follows is an argument for that counterintuitive (...) conclusion which claims to circumvent the methodological objection, and moreover without having to resort to a justificational ethical theory. How can this be done? Merely by appealing, it is maintained, to the simple practical considerations which are characteristic of the virtues of kindness and justice. Accordingly, an account of those virtues, outlining the structure of the practical reasoning of their possessors, occupies a central place in the argument. The paper displays the resources for normative argument of a "virtue ethics;" but it claims also that its conclusion cannot be escaped by the adherents of any plausible moral outlook. And this yields a further conclusion. All moral outlooks, and not only those which equate the moral point of view with the impartial point of view, face a "problem of demandingness" - for it seems to be a corollary of the argument that if one is to be living a life which is not immoral, one is precluded from pursuing practically any source of personal satisfaction. (shrink)

While it is largely agreed upon that solidarity is a kind of unity among persons, this agreement is short-lived – for if solidarity involves unity, what kind of unity is this? That is, does solidarity coalesce around shared identity or simply fellow-feeling? Shared action or fate? Or is solidarity merely a matter of commitment to a particular cause to achieve certain ends? Below, I look to examples of Mutual Aid to reject a piece-meal model of solidarity (where solidarity is this (...) but not that) in favor of a more pluralistic account. The notion of solidarity need not be constrained, all or nothing, by a specific strain of interpretation. Instead, we should recognize that solidarity is a matter of variety and degree. (shrink)

In the article, ‘Being Good in a World of Need: Some Empirical Worries and an Uncomfortable Philosophical Possibility,’ Larry Temkin presents some concerns about the possible impact of international aid on the poorest people in the world, suggesting that the nature of the duties of beneficence of the global rich to the global poor are much more murky than some people have made out. -/- In this article, I’ll respond to Temkin from the perspective of effective altruism—one of the targets (...) he attacks. I’ll argue that Temkin’s critique has little empirical justification, given the conclusions he wants to reach, and is therefore impotent. (shrink)

HIV/AIDS has changed from a disease of white gay men in the United States to a pandemic that largely involves women and dependent children in developing countries. Many theologies of disease are necessary to cope with the variety of expressions of this pandemic. Christian theoethical reflection on HIV/AIDS has been largely focused on sexual ethics, with uneven and mainly unhelpful results. Among the ethical issues that shape future useful conversations are globalized economics and resource sharing, the morality and economics of (...) the pharmaceutical industry, and the need for sex education and access to reproductive choice. Considering such issues in international, interreligious, multiscientific contexts is a concrete next step for the religion‐and‐science dialogue. It will put the powerful tools of both fields to the service of the common good. (shrink)

Over the last few decades, psychologists have amassed a great deal of evidence that our thinking is strongly influenced by a number of biases. This research appears to have important implications for moral methodology. It seems likely that these biases affect our thinking about moral issues, and a fuller awareness of them might help us to find ways to counteract their influence, and so to improve our moral thinking. And yet there is little or no reference to such biases in (...) the philosophical literature on many pressing, substantive moral questions. In this paper, I make a start on repairing this omission in relation to one such question, the 'Aid Question', which concerns how much, if anything, we are morally required to give to aid agencies. I begin by sketching a number of biases that seem particularly likely to affect our thinking about that question. I then go on to review the psychological research on 'debiasing' - that is, on attempts to counteract the influence of such biases. And finally I discuss and illustrate certain strategies for counteracting the influence of the biases in question on our thinking about the Aid Question. (shrink)

A central problem facing a probabilistic approach to the problem of induction is the difficulty of sufficiently constraining prior probabilities so as to yield the conclusion that induction is cogent. The Principle of Indifference, according to which alternatives are equiprobable when one has no grounds for preferring one over another, represents one way of addressing this problem; however, the Principle faces the well-known problem that multiple interpretations of it are possible, leading to incompatible conclusions. I propose a partial solution to (...) the latter problem, drawing on the notion of explanatory priority. The resulting synthesis of Bayesian and inference-to-best-explanation approaches affords a principled defense of prior probability distributions that support induction. (shrink)

On 19 July 2016, three medical organisations filed a federal lawsuit against representatives from several Vermont agencies over the Patient Choice and Control at End of Life Act. The law is similar to aid-in-dying laws in four other US states, but the lawsuit hinges on a distinctive aspect of Vermont's law pertaining to patients' rights to information. The lawsuit raises questions about whether, and under what circumstances, there is an ethical obligation to inform terminally ill patients about AID as an (...) end-of-life option. Much of the literature on clinical communication about AID addresses how physicians should respond to patient requests for assisted dying, but neglects the question of how physicians should approach patients who may not know enough about AID to request it. In this article, I examine the possibility of an affirmative duty to inform terminally ill patients about AID in light of ethical concerns about professional responsibilities to patients and the maintenance of the patient–provider relationship. I suggest that we should not take for granted that communication about AID ought to be patient-initiated, and that there may be circumstances in which physicians have good reasons to introduce the topic themselves. By identifying ethical considerations that ought to inform such discussions, I aim to set an agenda for future bioethical research that adopts a broader perspective on clinical communication about AID. (shrink)

This book attempts to give a comprehensive examination of the principal philosophical issues associated with the AIDS pandemic and in particular with the radical challenges that global diseases raise for modern society and political systems. The thesis of the book is that AIDS is but a part of a wider environmental and social crisis that not only challenges received opinion about the relationships between humantiy, technology and the environment, but challenges the ecological adaptability of modern social and political system. The (...) challenge posed by AIDS, and other diseases likely to appear in the next century, are explored in detail. (shrink)

As Shavelson et al. (2023) demonstrate with their example of Imani, the lines drawn between permissible and impermissible aid in dying can seem arbitrary, discriminatory, and inconsistent with the...

This essay examines the many problems with public and private development aid and argues that global liberalization of trade and immigration would have a greater direct effect in reducing global poverty. It also examines and rejects the view that people in rich countries have a strong moral obligation to give to the global poor. Such an obligation is in tension with an ethic that prizes personal projects. A political morality of equal respect and concern is congenial not with foreign aid, (...) but with recognizing the agency of the global poor by lifting the many obstacles they currently face to participating in the market as producers and consumers. (shrink)

There are religious and philosophical versions of the thesis that AIDS is a punishment for homosexual behaviour. It is argued here that the religious version is seriously incomplete. Because of this incompleteness and because of the indeterminacies that ordinarily attend religious argumentation, it is concluded that the claim may be set aside as unconvincing. Homosexual behaviour is then judged for its morality against utilitarian, deontological, and natural law theories of ethics. It is argued that such behaviour involves no impediment to (...) important moral goals and is not therefore immoral. Where natural law might be used to condemn homosexual behaviour, it is argued that the theory itself is not well established. Consequently there is a prima facie reason for rejecting the philosophical version of the punishment thesis. This conclusion is further supported by noting the lack of proportion between the purported immorality of homosexuality and a punishment as devastating as AIDS. (shrink)

ABSTRACT Medical AID organisations such as Médecins Sans Frontières receive several requests from individuals and international academic institutions to conduct research at their implementation sites in Africa. Do AID agencies have an ethical duty to comply with research requests? In this paper we respond to the views and constructed theories (albeit unfounded) of one such researcher, whose request to conduct research at one of our sites in the Democratic Republic of Congo was turned down.

This article’s central aim is to debunk the overly simplified, paradigmatic, and essentialist description of certain types of Muslim sexuality, arguing that such essentialist characterization of Muslims ignores the nonunique social determinants (poverty, education, and sociostructural exclusions) of HIV/aids risk in an increasingly globalized world. To support this argument, we rely on a thematic and comparative analysis. A reoccurring theme in this project is that issues of public health, human rights, justice, and social empowerment are inextricably intertwined. Having established a (...) conceptual framework linking health and human rights, we use a comparative analysis of the cases of Iran, Indonesia, and Bangladesh in an attempt to single out similarities and differences among these cases. All these cases hold a majority Muslim population (at 98%, 86%, and 89%, respectively) and are also representative of the two primary strands of Islam: Shi’a and Sunni. Additionally, each of these states has signed the Declaration of Commitment on HIV/aids and reports the progress of their HIV/aids treatment and prevention efforts to United Nations Program on HIV/aids, the United Nations organization tasked with monitoring and combating the spread of HIV/aids. (shrink)

Effective Altruism is a popular social movement that encourages individuals to donate to organizations that effectively address humanity’s most severe poverty. However, because Effective Altruists are committed to doing the most good in the most effective ways, they often argue that it is wrong to help those nearest to you. In this paper, I target a major subset of Effective Altruists who consider it a moral obligation to do the most good possible. Call these Obligation-Oriented Effective Altruists (OOEAs), and their (...) movement Obligation-Oriented Effective Altruism (OOEA). I argue that insofar as this variety of OOEA seems to commit us to refrain from helping the people right in front of us, there is something intuitively wrong about it. In response, I introduce an alternative model that embraces partiality: Mutual Aid. Mutual Aid is a network of community members, usually from the same geographical region, who share a commitment to offer, receive, and exchange material goods, wealth, and social support. I recommend Mutual Aid as a liberatory model, which—through empathy, solidarity, and care—mobilizes community building and provides a catalyst for community advocacy. As such, we should resist the claims of OOEAs that partially distributing our funds to people or causes we care about is morally wrong or even less than ideal. We do not have a moral obligation to use our funds “effectively;” rather, we have a broader obligation to address human suffering, and Mutual Aid is one moral alternative for discharging this duty. (shrink)

Common-sense holds that morality requirespeople who know that they are infected with theHuman Immunodeficiency Virus (HIV) to disclosethis fact to their sexual partners. But manygay men who are HIV-positive do not disclose,and AIDS Service Organizations (ASOs) promotepublic-health policies based on safer sex byall, rather than disclosure by those who knowthat they are infected. The paper shows thatthe common-sense view follows from a minimalsexual morality based on consent. ASOs'seeming rejection of the view follows fromtheir need to take seriously widespreadweakness of will (...) in the realm of sexuality. The author argues that gay men take themselvesto follow the common sense view, but hold thatthe possibility of a partner's HIV infection isbackground information that need not bedisclosed for sexual consent. This suggestionis criticized. The paper concludes with aconsideration of HIV disclosure and sexualethics outside of the gay community and oflegal restrictions on the sexuality of theHIV-positive. (shrink)

The library and information profession in Africa is not well recognized. It does not carry an identifiable set of core activities that share a common understanding across societies in Africa. The number of libraries in Africa is limited for a variety of reasons including lack of resources, populations that are not based in print literacy, and having its roots in the British model of librarianship. HIV/AIDS continues to pose severe problems for Sub-Saharan Africa. Some countries in the region have successfully (...) reduced the number of HIV/AIDS cases, citing information as the main source of prevention, presenting library and information professionals a unique opportunity to collectively organize and establish their role in the fight against the disease. This paper will discuss the opportunity for how LIS professionals engaged in HIV/AIDS information activities can develop and strengthen a positive status for the library and information discipline in Sub-Saharan Africa. (shrink)

--Do patients have the right to know their physician's HIV status?-Can a dentist refuse treatment to an HIV-positive patient?-How do educators determine whether to allow an HIV-positive child to attend school, and if they do, should the parents of other children be informed?-Should a counselor break confidentiality by disclosing to a wife that her husband is infected with HIV?This collection of original essays carefully examines the difficult moral choices the AIDS pandemic has presented for many professionals-physicians, nurses, dentists, teachers and (...) school administrators, business managers, psychotherapists, lawyers, clergy, journalists, and politicians. In the workplace, problems posed by HIV and AIDS have led to a reexamination of traditional codes of ethics. Providing systematic and reasoned discussions, the authors explore the moral, legal, and ethical issues involved in the reconsideration of policies, standards of conduct, and the practicality of balancing personal and professional ethics. Author note: Elliot D. Cohen is Professor of Philosophy at Indian River Community College and Editor-in-Chief of the International Journal of Applied Philosophy.Michael Davis is Senior Research Associate at the Center for the Study of Ethics in Professions, Illinois Institute of Technology. (shrink)

Peter Singer has famously argued that people living in affluent western countries are morally obligated to donate money to famine relief. The central premise in his argument is that, If it is in our power to prevent something bad from happening, without thereby sacrificing anything of comparable moral importance, we ought, morally, to do so. The present paper offers an argument to the effect that affluent people ought to support foreign aid projects based on a much weaker ethical premise. The (...) new premise states that, If it is in our power to prevent something bad from happening, without thereby sacrificing anything of moral importance, we ought, morally, to do so. This premise, supplemented with a notion of final value drawing on Amartya Sen''s concept of freedom as capabilities and functionings, is conceived as a special version of a weak, egalitarian Pareto principle. (shrink)

With the advent of new AIDS treatment initiatives such as the World Health Organization's “3 by 5” program and the United States' “President's Emergency Plan for AIDS Relief,” the ethical questions about AIDS care in the developing world have changed. No longer are they fundamentally about the conduct of research; now, we must turn our attention to developing treatment programs. In particular, we must think about how to spread limited treatment resources among the vast reservoir of people who need them.

Recent publications by Pogge ( Global ethics: seminal essays. St. Paul: Paragon House 2008 ) and by Singer ( The life you can save: acting now to end world poverty. New York: Random House 2009 ) have resuscitated a debate over the justifiability of famine relief between Singer and ecologist Garrett Hardin in the 1970s. Yet that debate concluded with a general recognition that (a) general considerations of development ethics presented more compelling ethical problems than famine relief; and (b) some (...) form of development would be essential to avoiding the problems of growth noted by Hardin. Better than renewing the debate, we should recognize two points. First, food needs do indeed evoke a moral response that is more direct and compelling than the philosophical positions often generated to rationalize a duty to bring aid. As such the argument for feeding hungry people cannot be generalized into a paradigm for development ethics without distortions that undercut the morally valid elements in Singer’s original argument. Second, contrary to prevailing assumptions in present day development ethics, food aid and famine relief continue to be important priorities for international agencies, notably the World Food Program. Emergency food assistance, the nominal topic of Singer’s original article, thus is an important issue for agricultural as well as development ethics, though one that should indeed be seen as distinct from more complex duties to address the conditions of chronic poverty and underdevelopment. (shrink)

The principle of individual medical confidentiality is one of the moral principles that Africa inherited unquestioningly from the West as part of Western medicine. The HIV/AIDS pandemic in Southern Africa has reduced the relevance of the principle of individual medical confidentiality. Individual medical confidentiality has especially presented challenges for practitioners among the Bantu communities that are well known for their social inter-connectedness and the way they value their extended family relations. Individual confidentiality has raised several unforeseen problems for persons living (...) with HIV/AIDS, ranging from stigma and isolation to feelings of dejection as it drives them away from their families as a way of trying to keep information about their conditions confidential. The involvement of family members in treatment decisions is in line with the philosophy of Ubuntu and serves to respect patients’ and families’ autonomy while at the same time benefiting the individual patient. (shrink)

I argue that a crucial point has been overlooked in the debate over the “numbers problem.” The initial arrangement of parties in the problem can be thought of as chancy, and whatever considerations of fairness recommend the reliance on something like a coin toss in approaching this problem equally recommend treating the initial distribution as a kind of lottery. This fact, I suggest, undermines one of the principal arguments against saving the greater number.

Terminally ill patients in 10 states plus Washington, D.C. have the right to take prescribed medications to end their lives (medical aid in dying). But otherwise-eligible patients with neuromuscular disabilities (ALS and other illnesses) are excluded if they are physically unable to “self-administer” the medications without assistance. This exclusion is incompatible with disability rights laws that mandate assistance to provide equal access to health care. This contradiction between aid-in-dying laws and disability rights laws can force patients and clinicians into violating (...) one or the other, potentially creating an underclass of patients denied medical care that is available to those with other (less physically disabling) terminal illnesses. The immediacy of this issue is demonstrated by a lawsuit in Federal court filed in August 2021, requesting assistance in self-administration for terminally ill patients with neuromuscular diseases. This paper discusses the background of this conflict, the ethical issues at the heart of the dilemma, and recommends potential remedies. (shrink)