The U.S. National Institute of Allergies and Infectious Diseases and the National Institute of Mental Health have a new research priority: inclusion of terminally ill persons living with HIV in HIV cure-related research. For example, the Last Gift is a clinical research study at the University of California San Diego for PLWHIV who have a terminal illness, with a prognosis of less than 6 months. As end-of-life HIV cure research is relatively new, the scientific community has a timely opportunity to (...) examine the related ethical challenges. Following an extensive review of the EOL and HIV cure research ethics literature, combined with deliberation from various stakeholders and our experience with the Last Gift study to date, we outline considerations to ensure that such research with terminally ill PLWHIV remains ethical, focusing on five topics: 1) protecting autonomy through informed consent, 2) avoiding exploitation and fostering altruism, 3) maintaining a favorable benefits/risks balance, 4) safeguarding against vulnerability through patient-participant centeredness, and 5) ensuring the acceptance of next-of-kin/loved ones and community stakeholders. EOL HIV cure-related research can be performed ethically and effectively by anticipating key issues that may arise. While not unique to the fields of EOL or HIV cure-related research, the considerations highlighted can help us support a new research approach. We must honor the lives of PLWHIV whose involvement in research can provide the knowledge needed to achieve the dream of making HIV infection curable. (shrink)

BackgroundOne of the next frontiers in HIV research is focused on finding a cure. A new priority includes people with HIV (PWH) with non-AIDS terminal illnesses who are willing to donate their bodies at the end-of-life (EOL) to advance the search towards an HIV cure. We endeavored to understand perceptions of this research and to identify ethical and practical considerations relevant to implementing it.MethodsWe conducted 20 in-depth interviews and 3 virtual focus groups among four types of key stakeholders in the (...) United States (PWH, biomedical HIV cure researchers, HIV clinicians, and bioethicists) to obtain triangulated viewpoints because little was known about the ethics of this topic. Each group was queried as to ethical considerations, safeguards, and protections for conducting HIV cure-related research at the EOL to ensure this research remains acceptable.ResultsAll four key stakeholder groups generally supported HIV cure-related research conducted at the EOL because of the history of altruism within the PWH community and the potential for substantial scientific knowledge to be gained. Our informants expressed that: (1) Strong stakeholder and community involvement are integral to the ethical and effective implementation, as well as the social acceptability of this research; (2) PWH approaching the EOL should not inherently be considered a vulnerable class and their autonomy must be respected when choosing to participate in HIV cure-related research at the EOL; (3) Greater diversity among study participants, as well as multi-disciplinary research teams, is necessitated by HIV cure-related research at the EOL; (4) The sensitive nature of this research warrants robust oversight to ensure a favorable risk/benefit balance and to minimize the possibility of therapeutic misconception or undue influence; and (5) Research protocols should remain flexible to accommodate participants’ comfort and needs at the EOL.ConclusionBecause of the ethical issues presented by HIV cure-related research at the EOL, robust ethical safeguards are of utmost importance. The proposed ethical and practical considerations presented herein is a first step in determining the best way to maximize this research’s impact and social value. More much inquiry will need to be directed towards understanding context-specific and cultural considerations for implementing EOL HIV cure research in diverse settings. (shrink)

The Last Gift is an observational HIV cure-related research study conducted with people with HIV at the end of life (EOL) at the University of California San Diego. Participants agree to voluntarily donate blood and other biospecimens while living and their bodies for a rapid research autopsy postmortem to better understand HIV reservoir dynamics throughout the entire body. The Last Gift study was initiated in 2017. Since then, 30 volunteers were enrolled who are either (1) terminally ill with a concomitant (...) condition and have a prognosis of 6 months or less or (2) chronically ill with multiple comorbidities and nearing the EOL.Multiple ethical and logistical challenges have been revealed during this time; here, we share our lessons learnt and ethical analysis. Issues relevant to healthcare research include surrogate informed consent, personal and professional boundaries, challenges posed conducting research in a pandemic, and clinician burnout and emotional support. Issues more specific to EOL and postmortem research include dual roles of clinical care and research teams, communication between research personnel and clinical teams, legally required versus rapid research autopsy, identification of next of kin/loved ones and issues of inclusion. Issues specific to the Last Gift include logistics of body donation and rapid research autopsy, and disposition of the body as a study benefit.We recommend EOL research teams to have clear provisions around surrogate informed consent, rotate personnel to maintain boundaries, limit direct contact with staff associated with clinical care and have a clear plan for legally required versus research autopsies, among other recommendations. (shrink)

Colección de ensayos en memoria del profesor Eloy Rada García.

En los círculos ortodoxos kantianos suelen disculparse las incoherencias del maestro diciendo que era un “hijo de su tiempo”. Ciertamente, en su época aún se excluía en toda Europa a las mujeres de la ciudadanía activa, privándolas de ser sujetos políticos y, con ello, sujetos éticos, de derecho, e incluso, históricos. Pero también es verdad que en ese momento está emergiendo un movimiento en defensa de la igualdad de género , en el que lamentablemente Kant no participa. En el presente (...) artículo, tras un preámbulo histórico en el que se confronta al Kant crítico con sus predecesores y coetáneos en lo tocante al tema de la igualdad de las mujeres, se defiende la tesis de que la verdadera moralidad no es pensable sin una idea de universalidad real o, lo que viene a ser lo mismo, de igualdad de género, porque solo a partir de ella es pensable la individualidad y la autonomía. (shrink)

Si el ser humano no es un mero cúmulo de sentimientos ni una amalgama de sensaciones que se van configurando según los diversos momentos que tejen su devenir vital, ¿cuál es su auténtico yo? ¿Cómo se emprende esa búsqueda interior que nos permite hallar la esencia que se esconde en cada recodo de nuestra existencia? Son muchas las personas que no se han conformado con vivir abosortas ante el espectáculo de "lo que acontece", y que han buscado atender esa necesidad (...) intrínseca de "ir más allá", esculpiendo horizontes que rompen los moldes de la facticidad e insinúan la existencia de un ser que traspasa las fronteras de la contingencia en la que, sin embargo, parecemos estar atrapados inevitablemente. Indagar en la esencia misma de la experiencia humana para hallar su sentido más profundo nos dota de libertad y de la posibilidad de trazar un camino real y verdadero de plenitud para, de este modo, dejar de caer en brazos del ciego azar del que no somos más que irónica expresión. En estaobra, se recoge página a página el amor por esa búsqueda interior de la que emanan todos nuestros anhelos más profundos: esa necesidad imperiosa de conectar con lo absoluto. (shrink)

This study focuses on change strategies generated through a dialogical–reflexive–participatory process designed to improve the care of families of critically ill patients in an intensive care unit (ICU) using a participatory action research in a tertiary hospital in the Balearic Islands (Spain). Eleven professionals (representatives) participated in 11 discussion groups and five in‐depth interviews. They represented the opinions of 49 colleagues (participants). Four main change strategies were created: (i) Institutionally supported practices were confronted to make a shift from professional‐centered work (...) to a more inclusive, patient‐centered approach; (ii) traditional power relations were challenged to decrease the hierarchical power differences between physicians and nurses; (iii) consensus was built about the need to move from an individual to a collective position in relation to change; and (iv) consensus was built about the need to develop a critical attitude toward the conservative nature of the unit. The strategies proposed were both transgressive and conservative; however, when compared with the initial situation, they enhanced the care offered to patients' relatives and patient safety. Transforming conservative settings requires capacity to negotiate positions and potential outcomes. However, when individual critical capacities are articulated with a new approach to micropolitics, transformative proposals can be implemented and sustained. (shrink)

En el libro IX del Muntajab al- aḥkām del jurista andalusí Ibn Abī Zamanīn figura un capítulo acerca del perdón del talión en diferentes casos de delitos de sangre intencionados. Este trabajo ofrece el análisis y comentario de la casuística contenida en este capítulo, así como la edición del texto árabe a partir del manuscrito n. 1730/d de la Biblioteca General de Rabat y cotejado con el n. 5952 de la Biblioteca Nacional de Túnez.

Este trabajo se centra, dentro del marco de la práctica jurídica, en la actividad judicial en la frontera oriental granadina en los últimos años del reino nazarí. La fuente documental es el pleito que Lorca y Vera sostuvieron por la delimitación de sus términos a lo largo del siglo XVI. La información viva y real aportada por los testigos, en su mayoría cristianos nuevos y de avanzada edad, viene a arrojar luz sobre la delimitación de competencias, actuaciones y jurisdicciones no (...) sólo del cadí, sino también del alcaide, otro importante representante de la justicia, en un espacio concreto de al-Andalus y en un tiempo concreto de su historia. (shrink)

El presente ensayo toma como punto de partida varios artículos de opinión con el propósito de reflexionar sobre varias cuestiones que han surgido a raíz de la crisis sanitaria, económica y social del COVID-19. La pandemia ha puesto de relieve distintos asuntos trascendentales de nuestra sociedad: la desigualdad, el uso de la tecnología, la percepción de la realidad, el lenguaje, la solidaridad o los servicios públicos.

Physical laws are irresistible. Logical rules are not. That is why logic is said to be normative. Given a system of logic we have a Norma, a standard of correctness. The problem is that we need another Norma to establish when the standard of correctness is to be applied. Subsequently we start by clarifying the senses in which the term ‘Iogic’ and the term ‘normativity’ are being used. Then we explore two different epistemologies for logic to see the sort of (...) defence of the normativity of logic they allow for; if any. The analysis concentrates on the case of classical logic. In particular the issue will be appraised from the perspective put forward by the epistemology based on the methodology of wide reflective equilibrium and the scientific one underlying the view of logic as model. (shrink)

Chez Leibniz tout veut être determiné par certains principes. L'ordre logique, l'ontologie, la métaphysique, la morale, même la volonté divine, dependent entièrement d'eux. Le principe de contradiction décide ce qui est ou non logiquement possible. D'autre part, le principe de raison suffisante est consideré par notre auteur comme principe des existences, mais il n'arrive pas à expliquer la realité. C'est pour cela qu'on fait appel au principe de perfection, une sorte de corollaire du principe de raison qui vient le concretiser. (...) Selon ce que nous cherchons à montrer ici, on pourrait bien l'interpréter comme la racine de la contingence, en même temps que comme le fondement de la liberté; en un mot, il représenterait en quelque sorte la cléf-de-voute de l'univers éthique leibnizien. Il ne faut pas oublier qu'on parle de la règle de ce qui doit être. (shrink)

La contingencia es para Leibniz, junto con la espontaneidad y la inteligencia, un componente esencial de la definición de la verdadera libertad, que nuestro pensador califica como uno de los problemas filosóficos por excelencia: “la cuestión de saber cómo se puede salir del laberinto, la gran cuestión de lo libre y lo necesario”. Leibniz, en diálogo con sus referentes polémicos diferenciará –siguiendo la herencia agustiniana- entre el “libre albedrío” y la “verdadera libertad” o determinación racional, a la que sitúa en (...) un camino intermedio entre el determinismo absoluto y la indiferencia de equilibrio. La libertad de los seres racionales será para Leibniz la condición sine qua non para entrar a formar parte del el reino de la gracia, un mundo moral dentro del mundo natural en el que impera el bien común. (shrink)

Philosophy of history has been condemned in recent times; however, it is becoming increasingly evident that a new Europe cannot do without a critical philosophy of history that analyses values and gives hierarchical structure to diverse experiences and historical memories. From this hypothesis, a result of previous projects, the project “Philosophy of History and Values in the Europe of the 21st century” has these fundamental objectives: 1) critically analyze the complex forms of conceiving science, history (society), culture (languages, religion), law, (...) ethics and politics, in order to understand the full scope of the idea of Europe in which we find ourselves; 2) systemize them with the proposal for a new critical philosophy of history, based on a “practical turn” that contemplates the elements (real responsibility, solidarity and justice) that should form the foundation of social and ethical political relations; 3) apply them to the constructionof a new Europe, in which implicit diversity and the demands of internationality, interculturality and dialogue between the genders can reconcile itself with the basic principles of universality, equality and justice and with the establishment of minimum human rights. The conclusions of our research will help to provide solutions to conflicts that are occurring in the heart of Europe, which at the high point of globalization, transcend European borders. (shrink)

Proxy agency is the capacity of individuals and groups to act for other individuals or groups in specific social transactions. For example, a legal team acts as a proxy for a client in a courtroom, or the Prime Minister acts as a proxy for the UK Government when attending international meetings, etc. Although a very common social phenomenon, it has not yet received enough philosophical treatment. Currently, the most developed account of this capacity is Ludwig’s proxy agency in collective action. (...) Yet, his account relies on a deflationary, we-content approach to collective intentionality (á la Bratman). In this chapter, I argue that this approach is far too weak to explain proxy agency in institutional contexts—where the individuals and groups formally authorised to perform rule-guided group activities for the principal hold a strong, non-conditional we-commitment. In order to elucidate this feature, I provide an account of proxy agency based on a more robust, we-mode approach to collective intentionality (á la Tuomela). I suggest with this that, for institutional proxy agency to operate as expected, there must be appropriate conditions of sociality in place—which ultimately coheres with the larger project developed by Tuomela on social ontology. (shrink)

Rich with historical and cultural value, these works are published unaltered from the original University of Minnesota Press editions.

Fitch´s problem and the "knowability paradox" involve a couple of argumentations that are to each other in the same relation as Cantor´s uncollected multitudes theorem and Russell´s paradox. The authors exhibit the logical nature of the theorem and of the paradox and show their philosophical import, both from an anti-realist and from a realist perspective. In particular, the authors discuss an anti-realist solution to Fitch´s problem and provide an anti-realist interpretation of the problematic statement "It is knowable that r is (...) known and yet unknown". Then, it is argued that the knowability paradox has a solution even if one adopts a realist point of view. The authors provide a solution that takes into account the ambiguity of the term 'knowability' by deploying a temporal possible world semantics for epistemic modalities. (shrink)

Vallortigara & Rogers (V&R) propose a fundamental role of the environment in determining population-level lateralisation and suggest that genes play no primary function in this phenomenon. Here I argue that genes involved in the coordination of visceral organ laterality and in coupling of different forms of lateralisation do play a role in the control of lateralisation within the population.

Cosmopolitan critics attack the scope-limitation of justice of egalitarian liberal theorists to states. They treat justice as the production of a given set of outcomes for people regardless of location or relationship. However, in doing so they either ignore the relevant agent towards whom principles of justice are addressed or see the question of agency as a practical, derivative question, of a secondary character. This paper argues that a principle of justice without a clearly justified agent is not a genuine (...) principle at all. This is what writers like Rawls mean by the "subject" of justice (analogous to the grammatical subject of a sentence, i.e.,the agent). We should reflect on agents and why they would or would not justifiably carry certain burdens for others and what kind of benefits or goods they are able to secure. The answers to those questions explain why the idea of cosmopolitan global justice is incomplete, either requiring a global basic structural agency or not applying because no relevant agent is present that can create cooperative arrangements between individual persons across the globe. Other moral principles will still apply globally, but they will be distinct from those that apply to basic-structural agencies. This account is not a practice dependence account, as it bases the distinctness of moral and political principles on purely moral and value-based considerations. (shrink)

Este trabajo trata de elaborar una hipótesis sobre el papel de Leibniz en la formación de las grandes categorías de la filosofía práctica moderna, poniendo de relieve una idea de racionalidad «hermenéutica» o «imperfecta» que, partiendo del concepto leibniziano de perspectivismo, constaría de tres grandes vertientes que aquí se denominan «principios»: de contingencia, autonomía y tolerancia. Lo que a Leibniz le interesa es asegurar una libertad autodeterminista de cuño rigurosamente moderno, subrayando que el universo de la praxis humana está presidido (...) por el [actum de lo contingente o de «aquello que puede ser de otra manera». Desde su concepto de individuación no se enfatiza la autonomía racional de un yo desencarnado ni mucho menos de un «autómata previsible», sino la consciencia de una subjetividad autodiferenciada que se propone a sí misma hipótesis viables para salvar la coherencia de sus acciones. El espíritu de tolerancia constituye la conclusión ética de las dos premisas anteriores: la idea general de justicia sólo es asequible desde el peculiar punto de vista de la place d'autruy, que viene a constituir el fundamento de aquélla. (shrink)

I argue racial injustice undermines the reliability of news source reports in the information domain of racial injustice. I argue that this in turn undermines subjects’ doxastic justification in inferences they base on these news sources in the racial injustice information domain. I explain that racial injustice does this undermining through the effect of racial prejudice on news organizations’ members and the effect of society's racially unjust structure on non-dominant racial group-controlled news sources.