Increased international migration of health professionals is weakening healthcare systems in low‐income countries, particularly those in sub‐Saharan Africa. The migration of nurses, physicians and other health professionals from countries in sub‐Saharan Africa poses a major threat to the achievement of health equity in this region. As nurses form the backbone of healthcare systems in many of the affected countries, it is the accelerating migration of nurses that will be most critical over the next few years. In this paper we present (...) a comprehensive analysis of the literature and argue that, from a human rights perspective, there are competing rights in the international migration of health professionals: the right to leave one's country to seek a better life; the right to health of populations in the source and destination countries; labour rights; the right to education; and the right to nondiscrimination and equality. Creative policy approaches are required to balance these rights and to ensure that the individual rights of health professionals do not compromise the societal right to health. (shrink)

Berenicen statim ab urbe dimisit invitus invitam.As for Berenice, he immediately dismissed her from the city against his will, against her will. Suetonius' laconic description of Titus' dismissal of his consort, the Herodian Berenice, after his accession to the Principate has attracted the attention of readers across the centuries. The biographer's use of polyptoton, invitus invitam, to describe the mental states of the Roman princeps and Judaean princess has been read as particularly moving. Perhaps most notably, Racine turned the emperor's (...) banishment of his lover into the central dilemma of his tragedy Bérénice. At the start of his preface to the text of the play, the dramatist amalgamates this sentence with another from earlier in the chapter, retaining the striking repetition, ‘Titus reginam Berenicen cui etiam nuptias pollicitus ferebatur, statim ab Urbe dimisit invitus invitam’. Racine claims that this account of the dismissal of Berenice provides appropriate subject matter for tragic poetry and, to support his case, he compares Virgil's treatment of the separation of Aeneas and Dido to the situation of Titus and Berenice. Suetonius is not normally read as a literarily sophisticated writer, but we should take a cue from Racine's response to this sentence. In this article, I argue that Suetonius himself chose to compare Titus and Berenice with Dido and Aeneas by an allusion in this sentence to Virgil's Aeneid and to Catullus' translation of the Coma Berenices. Within a rather matter-of-fact presentation of the relationship between the Flavian emperor and his Herodian consort, Suetonius evoked a more dramatic model. (shrink)

Variant Creutzfeldt–Jakob disease is a fatal, transmissible, neurodegenerative disorder for which there is currently no effective treatment. vCJD arose from the zoonotic spread of bovine spongiform encephalopathy. There is now compelling evidence for human to human transmission through blood transfusions from presymptomatic carriers and experts are warning that the real epidemic may be yet to come. Imperatives exist for the development of reliable, non-invasive presymptomatic diagnostic tests. Research into such tests is well advanced. In this article the ethical implications of (...) the availability of these tests are elaborated and comparisons drawn with predictive genetic testing for Huntington’s disease and screening for HIV. Paramount to considerations is the issue of whom to test, weighing up respect for personal autonomy against obligations to benefit and protect society. A paradigm is proposed similar to that used for HIV screening but with unique features: compulsory testing of all blood/organ donors and individuals undergoing surgery or invasive procedures who have a significant risk of disease transmission. (shrink)

Navigating limits to confidentiality with adolescent clients can be ethically and professionally challenging. This study follows on from a previous quantitative survey of psychologists about confidentiality dilemmas with adolescents. The current study used qualitative methods to explore such dilemmas in greater depth. Twenty Australian psychologists were interviewed and asked to describe an ethically challenging past case. Cases were then used to facilitate discussion about the decision-making process and outcomes. Interviews were transcribed and analyzed using interpretive content and thematic analysis. Three (...) key findings are discussed. First, it is of little use to perceive confidentiality dilemmas as binary choices because psychologists described 5 distinct options. These can be conceptualized on a spectrum of varying degrees of client autonomy, ranging from “no disclosure” to “disclosure without the client’s knowledge or consent”. Second, confidentiality dilemmas often involve balancing multiple and conflicting risks regarding both immediate and future harm. Third, a range of strategies are employed by psychologists to minimize potential harms when disclosing information. These are primarily aimed at maintaining the therapeutic relationship and empowering clients. These findings and the case studies described provide a valuable resource for teaching and professional development. (shrink)

Austin E. Duncan-Jones; Definition of Identity of Structure, Analysis, Volume 2, Issue 1-2, 1 October 1934, Pages 14–18, https://doi.org/10.1093/analys/2.1-2.14.

This monograph consists of five parts: (1) introductory material including a conference overview; (2) papers presented at an international symposium on the topic of ethical issues in disability and rehabilitation as a section of the Annual Conference of the Society for Disability Studies; (3) responses to the symposium, prepared by four of the participants; (4) selected additional papers which offer views from perspectives or cultures not represented at the Denver conference; and (5) an annotated international bibliography. Representatives from 10 countries (...) discussed ethical issues and decision making in disability and rehabilitation. Conference papers include: "Genetic Engineering--The New Eugenics? Evolving Medical Attitudes towards the Quality of Life" (Hugh Gallagher);"Description of the Decision-Making Project" (Daryl Evans); "Treatment and Nontreatment Decisions with Respect to Extremely Premature, Very Low Birthweight Infants (500-750g)" (Ernle Young); "Allocation of Resources and Distributive Justice" (John Mather); "Quality Assurance as an Aid to Ethical Decision Making in Disability Management: Lessons from Recent Ethical Issues Involving Disadvantaged Groups in New Zealand" (Peter Gow); "Disability and Ethical Issues: A Point of View from the Netherlands" (Yolan Koster-Dreese); "Who Shall Live or How Shall They Live? Consumer and Professional Perspectives on Treatment/Non-Treatment Decisions" (Joseph Kaufert and Patricia Kaufert); and "Debates across Social Movements on Reproductive Technologies, Genetic Engineering, and Eugenics" (Theresia Degener). Conference commentaries include: "The Meeting of Disability and Bioethics: A Beginning Rapprochement" (Adrienne Asch); "A Plea for More Dialogue: Commentary on Ethics Conference" (Robert Slater); "Healing Our Wounds" (Martha Lentz Walker); "Theories and Values: Ethics and Contrasting Perspectives on Disability" (Harlan Hahn); and "Current Example of Ethical Dilemma" (Susan Lacetti). Selected additional papers include: "High-tech Medicine Is Basic Care" (Frederick Abrams); "Prevention of Disabilities as a Medical Question" (G. Schioler); "The Ethics of Disability Prevention: A Parent's Point of View" (Mrs. J. Baker); "A Reference Matrix for Issues of Life and Personhood" (Mike Miles); "Nazi Scientists and Ethics of Today" (Isabel Wilkerson); "Ethical and Policy Issues in Rehabilitation Medicine (Hastings Center Report)" (Arthur Caplan et al.); and "Differing Approaches to Prevention of Disability and Treatment of Impaired Infants Creates Controversies Worldwide" (Barbara Duncan). (JDD). (shrink)

The ratio of index- and ring-finger lengths is thought to be related to prenatal androgen exposure, and in many, though not all, populations, men have a lower average digit ratio than do women. In many studies an inverse relationship has been observed, among both men and women, between 2D:4D ratio and measures of athletic ability. It has been further suggested that, in hunter-gatherer populations, 2D:4D ratio might also be negatively correlated with hunting ability, itself assumed to be contingent on athleticism. (...) This hypothesis has been tested using endurance running performance among runners from a Western, educated, and industrialized population as a proximate measure of hunting ability. However, it has not previously been tested among actual hunter-gatherers using more ecologically valid measures of hunting ability and success. The current study addresses this question among Tanzanian Hadza hunter-gatherers. I employ a novel method of assessing hunting reputation that, unlike previous methods, allows granular distinctions to be made between hunters at all levels of perceived ability. I find no statistically significant relationship between digit ratio and either hunting reputation or two important hunting skills. I confirm that Hadza men have higher mean 2D:4D ratios than men in many Western populations. I discuss the notion that 2D:4D ratio may be the consequence of an allometric scaling relationship between relative and absolute finger lengths. Although it is difficult to draw clear conclusions from these results, the current study provides no support for the theorized relationship between 2D:4D ratio and hunting skill. (shrink)

This book presents a collection of contemporary discourses that reconsider the relationship of democracy as a political ideology and American ideal and education as the foundation of preparing democratic citizens in America.

Synaesthesia is a neurodevelopmental condition characterised by anomalous sensory perceptions and associated alterations in cognitive function. This chapter summarises what is known about the familial transmission of synaesthesia and its genetic underpinnings. Early familiality studies showed evidence for a strong genetic predisposition, a highly skewed female: male ratio, and an absence of male-to-male transmission. These patterns supported an early hypothesis of a single-gene X-linked dominant mode of inheritance with male lethality. Subsequent analyses in larger samples indicated that the mode of (...) inheritance was likely to be more complex, with both the strong female skew and absence of male-to-male transmission brought into question. We review in detail the first whole genome linkage scan for auditory-visual synaesthesia and a subsequent family linkage study on coloured sequence synaesthesia. Together these results suggest linkage to five chromosomes but give no support for linkage to the X-chromosome. We discuss candidate genes within these regions and potential implications for the aetiology of synaesthesia. We also discuss the implications of these pioneering genome scans for our understanding of synaesthesia and of how different synaesthetic phenotypes may arise from different genetic predispositions interacting with other genes and with the environment. (shrink)

Many have interpreted symbolic material culture in the deep past as evidencing the origins sophisticated, modern cognition. Scholars from across the behavioural and cognitive sciences, including linguists, psychologists, philosophers, neuroscientists, primatologists, archaeologists and paleoanthropologists have used such artefacts to assess the capacities of extinct human species, and to set benchmarks, milestones or otherwise chart the course of human cognitive evolution. To better calibrate our expectations, the present paper instead explores the material culture of three contemporary African forager groups. Results show (...) that, while these groups are unequivocally behaviourally modern, they would leave scant long-lasting evidence of symbolic behaviour. Artefact-sets are typically small, perhaps as consequence of residential mobility. When excluding traded materials, few artefacts have components with moderate-strong taphonomic signatures. Present analyses show that artefact function influences preservation probability, such that utilitarian tools for the processing of materials and the preparation of food are disproportionately likely to contain archaeologically traceable components. There are substantial differences in material-use between populations, which create important population-level variation preservation probability independent of cognitive differences. I discuss the factors — cultural, ecological and practical — that influence material choice. In so doing, I highlight the difficulties of using past material culture as an evolutionary or cognitive yardstick. (shrink)

_341_ _Objectives: _In patients with multivessel disease both the detection of the culprit lesion and the exact allocation are important preconditions for sufficient treatment and improved outcome. In a vessel based approach the combination of quantitative coronary angiography and fractional flow reserve measured by a pressure wire should be advantageous compared to myocardial SPECT, as morphological and functional information is delivered simultaneously. Therefore our aim was to evaluate MS in the detection and allocation of hemodynamically significant stenoses obtained by the (...) combined gold standard QCA plus FFR in patients with multivessel disease. _Methods: _FFR and QCA of 95 vessels in 80 patients have been evaluated. Hemodynamically significant target lesions were defined as intermediate stenoses between 50 and 75% with an FFR. (shrink)

Variant Creutzfeldt–Jakob disease is a fatal, transmissible, neurodegenerative disorder for which there is currently no effective treatment. vCJD arose from the zoonotic spread of bovine spongiform encephalopathy. There is now compelling evidence for human to human transmission through blood transfusions from presymptomatic carriers and experts are warning that the real epidemic may be yet to come. Imperatives exist for the development of reliable, non-invasive presymptomatic diagnostic tests. Research into such tests is well advanced. In this article the ethical implications of (...) the availability of these tests are elaborated and comparisons drawn with predictive genetic testing for Huntington’s disease and screening for HIV. Paramount to considerations is the issue of whom to test, weighing up respect for personal autonomy against obligations to benefit and protect society. A paradigm is proposed similar to that used for HIV screening but with unique features: compulsory testing of all blood/organ donors and individuals undergoing surgery or invasive procedures who have a significant risk of disease transmission. (shrink)

The ratio of index- and ring-finger lengths is thought to be related to prenatal androgen exposure, and in many, though not all, populations, men have a lower average digit ratio than do women. In many studies an inverse relationship has been observed, among both men and women, between 2D:4D ratio and measures of athletic ability. It has been further suggested that, in hunter-gatherer populations, 2D:4D ratio might also be negatively correlated with hunting ability, itself assumed to be contingent on athleticism. (...) This hypothesis has been tested using endurance running performance among runners from a Western, educated, and industrialized population as a proximate measure of hunting ability. However, it has not previously been tested among actual hunter-gatherers using more ecologically valid measures of hunting ability and success. The current study addresses this question among Tanzanian Hadza hunter-gatherers. I employ a novel method of assessing hunting reputation that, unlike previous methods, allows granular distinctions to be made between hunters at all levels of perceived ability. I find no statistically significant relationship between digit ratio and either hunting reputation or two important hunting skills. I confirm that Hadza men have higher mean 2D:4D ratios than men in many Western populations. I discuss the notion that 2D:4D ratio may be the consequence of an allometric scaling relationship between relative and absolute finger lengths. Although it is difficult to draw clear conclusions from these results, the current study provides no support for the theorized relationship between 2D:4D ratio and hunting skill. (shrink)

It is widely thought that stealing, trading and destroying cultural artifacts in time of war are inherently immoral actions, and that it is right that they be treated as war crimes, which, indeed, they currently are. But oppressive cultures have their heritage and cultural artifacts too, in the form of monuments, sites of worship, and so on; and for the oppressed, these things may be awful reminders of their subordination, and may even perpetuate it. This chapter suggests that, since cultural (...) objects can be both tools and symbols of unjust oppression, their theft and destruction ought to be seen as appropriate when this would be a means of overcoming oppression. Whatever current law may say, in these instances, it would be morally inappropriate to count such acts as war crimes. Furthermore, it is bizarre that theft and destruction of cultural property are counted as war crimes when soldiers killing each other is not (due to combatant immunity). Surely killing is worse than property destruction and theft. It is therefore argued that, where possible, it would be better for conflicts to be fought using the latter methods. Finally, the chapter responds to many objections to using theft and destruction of cultural property as a method of warfare. E.g. to the objection that such property has timeless, trans-cultural, aesthetic, historical and scientific value, it is replied that justice is a more important value; and to the objection that these practices amount to cultural genocide it is replied that unjust cultures have no right to exist unmodified. (This chapter was formerly entitled: "Culture Weaponized: A Contrarian Theory of the Sometime Appropriateness of the Destruction, Theft and Trade of Art and Cultural Artifacts in Armed Conflict." The PhilPapers archived version is a pre-penultimate version of the published version.). (shrink)

Biological ontologies are used to organize, curate, and interpret the vast quantities of data arising from biological experiments. While this works well when using a single ontology, integrating multiple ontologies can be problematic, as they are developed independently, which can lead to incompatibilities. The Open Biological and Biomedical Ontologies Foundry was created to address this by facilitating the development, harmonization, application, and sharing of ontologies, guided by a set of overarching principles. One challenge in reaching these goals was that the (...) OBO principles were not originally encoded in a precise fashion, and interpretation was subjective. Here we show how we have addressed this by formally encoding the OBO principles as operational rules and implementing a suite of automated validation checks and a dashboard for objectively evaluating each ontology’s compliance with each principle. This entailed a substantial effort to curate metadata across all ontologies and to coordinate with individual stakeholders. We have applied these checks across the full OBO suite of ontologies, revealing areas where individual ontologies require changes to conform to our principles. Our work demonstrates how a sizable federated community can be organized and evaluated on objective criteria that help improve overall quality and interoperability, which is vital for the sustenance of the OBO project and towards the overall goals of making data FAIR. Competing Interest StatementThe authors have declared no competing interest. (shrink)

Grey zone attacks tend to paralyze response for two reasons. First, they present us with choice scenarios of inherently dilemmatic structure, e.g., Prisoners’ Dilemmas and games of chicken, complicated by difficult conditions of choice, such as choice under risk or amid vagueness. Second, they exploit our uncertainty about how much we do or should care about the things under attack¬—each attack is small in effect, but their effects accumulate: how should we decide whether to treat a given attack as something (...) meriting a serious response rather than a mere irritation to be ignored? This chapter brings standard decision theoretic tools to bear on the issues, tools such as the maximization of expected utility principle, and the precautionary principle. But it also develops three innovations. It shows that seeing it as possible to make choices not just of actions given our values, but also choices of values themselves, can extricate us from certain kinds of decision paralysis. It shows how we can rationally regard ourselves as having bright decision lines even when nothing in the circumstance of choice has these lines in its structure. And it shows how certain conflict escalation risks from the former two strategies can be managed by both parties seeing that cooperation can yield a sharable surplus of goods, and that cooperation can be rational upon a rationally defensible change in their values so that each comes to derive utility from the success of both parties. This yields cooperative solutions to what amount to Prisoners’ Dilemmas. The Cold War was prosecuted on the logic of strategic rationality and that part of game theory that is deterrence theory. We need a new logic from decision theorists for the games that constitute grey zone conflict. (shrink)