Gluten ataxia is a rare immune-mediated neurological disorder caused by the ingestion of gluten. The diagnosis is not straightforward as antibodies are present in only up to 38% of patients, but often at lower titers. The symptoms of ataxia may be mild at the onset but lead to permanent damage if remain untreated. It is characterized by damage to the cerebellum however, the pathophysiology of the disease is not clearly understood. The present study investigated the neurochemical profile of vermis and (...) right cerebellum and structural changes in various brain regions of patients with gluten ataxia and compared it with healthy controls. Volumetric 3-D T1 and T1-weighted magnetic resonance imaging in the three planes of the whole brain and single-voxel 1H- magnetic resonance spectroscopy of the vermis and right cerebellum were acquired on 3 T human MR scanner. The metabolite concentrations were estimated using LC Model while brain volumes were estimated using the online tool volBrain pipeline and CERES and corrected for partial volumes. The levels of neuro-metabolites were found to be significantly lower in vermis, while N-acetyl aspartate + N-acetyl aspartate glutamate and glycerophosphocholine + phosphocholine was lower in cerebellum regions in the patients with gluten ataxia compared to healthy controls. A significant reduction in the white matter of ; reduction in the volumes of cerebellum lobe and thalamus while lateral ventricles were increased in the patients with gluten ataxia compared to healthy controls. The reduced neuronal metabolites along with structural changes in the brain suggested neuronal degeneration in the patients with gluten ataxia. Our preliminary findings may be useful in understanding the gluten-induced cerebral damage and indicated that MRI and MRS may serve as a non-invasive useful tool in the early diagnosis, thereby enabling better management of these patients. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Narrative Symposium:Conflicting Interests in MedicineLaura Jean Bierut, Sal Cruz-Flores, Laura E. Hodges, Anthony A. Mikulec, Govind K. Nagaldinne, Erine L. Bakanas, John F. Peppin, Joel S. Perlmutter, William H. Seitz Jr., Edward Diao, Andre N. Sofair, and David M. Zientek• To Recruit or Not to Recruit for a Clinical Trial• An Unexpected Lesson• Am I on call for the entire Midwest?• Why is Medicare Wasting Away?• The Downside (...) of the Informed Consent Juggernaut• Expert Testimony at the Food and Drug Administration: Who Wants the Truth?• Crossroads: The Intersection of Personal, Professional Society, and Industry Relationships• A Change of Heart• The Evolution of Conflicts of Interest in a New Subspecialty: A Case Study of the Development of Interventional CardiologyCopyright © 2011 The Johns Hopkins University Press... (shrink)

The U.S. FDA has issued emergency use authorizations for monoclonal antibodies for non-hospitalized patients with mild or moderate COVID-19 disease and for individuals exposed to COVID-19 as post-exposure prophylaxis. One EUA for an oral antiviral drug, molnupiravir, has also been recommended by FDA’s Antimicrobial Drugs Advisory Committee, and others appear likely in the near future. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (...) with increased infectivity and/or severity emerge, further rationing may be required. We identify relevant ethical principles and priority groups for access to therapies based on an integrated approach to population health and medical factors. Using priority categories to allocate scarce therapies effectively operationalizes important ethical values. This strategy is preferable to the current approach of categorical rules based on vaccination, immunocompromise status, or older age, or the ad hoc consideration of clinical risk factors. (shrink)

Bioethicists influence practices and policies in medicine, science, and public health. However, little is known about bioethicists’ views. We recently surveyed 824 U.S. bioethicists on a wide range of ethical issues, including topics related to abortion, medical aid in dying, and resource allocation, among others. We also asked bioethicists about their demographic, religious, academic, and professional backgrounds. We find that bioethicists’ normative commitments predict their views on bioethical issues. We also find that, in important ways, bioethicists’ views do not align (...) with those of the U.S. public: for instance, bioethicists are more likely than members of the public to think abortion is ethically permissible but are less likely to believe compensating organ donors is. Our demographic results indicate the field of bioethics is far less diverse than the U.S. population—less diverse even than other academic disciplines—suggesting far more work needs to be done to build an inclusive field. (shrink)

Initial vaccine allocations for the coronavirus disease 2019 (COVID-19) will be limited. It is crucial to assess the ethical values associated with different methods of allocation, as well as important scientific and practical questions. This Viewpoint identifies three ethical values, benefiting people and limiting harm; prioritizing disadvantaged populations; and equal concern for all. It then explains why these values support prioritizing three groups: health care workers; other essential workers and people in high-transmission settings; and people with medical vulnerabilities associated with (...) poorer COVID-19 outcomes. In contrast, two other groups, people over 65 without medical vulnerabilities and participants in clinical research, present more complex ethical questions. This prioritization also encompasses valuing direct benefits to vaccinated individuals, indirect benefits to individuals protected from spread of infection, and indirect health and socioeconomic benefits to those protected from harm as health system and societal functioning improve. Vaccine allocation that recognizes important ethical values and avoids arbitrariness, waste, and corruption can ensure that the distribution of a COVID-19 vaccine is both fair and perceived as fair. (shrink)

Ethical workplace climate has been extensively researched in the for-profit context but neglected in nonprofits. Perhaps because nonprofits promote shared values, engage with people, and implement development interventions creating public good, they are considered implicitly ethical. This assumption has been questioned in recent studies. We attempted to develop a psychometrically valid scale measuring ethical workplace climate following a sequential research design to fill this gap. We interviewed 74 employees from 30 nonprofit organizations using the critical incident technique to generate statements (...) on ethical workplace climate. The statements generated were categorized with expert judges' help, followed by a survey of 507 nonprofit employees across India. The exploratory factor analysis (EFA) and subsequent confirmatory factor analysis (CFA) resulted in a 43-item scale, further reduced to 26 items using stepwise regression. Results of subsequent application of EFA and CFA confirmed a four-factor solution: self-interest, collegiality, internal legitimacy, and stewardship. A follow-up study of 243 members of nonprofit organizations confirmed the hypothesized relationships that ethical work climate has a significant effect on affective commitment and job engagement. Finally, we discussed our findings along theoretical contributions, implications, limitations, and future direction. (shrink)

This paper takes a novel approach to the active bioethical debate over whether advance medical directives have moral authority in dementia cases. Many have assumed that advance directives would lack moral authority if dementia truly produced a complete discontinuity in personal identity, such that the predementia individual is a separate individual from the postdementia individual. I argue that even if dementia were to undermine personal identity, the continuity of the body and the predementia individual’s rights over that body can support (...) the moral authority of advance directives. I propose that the predementia individual retains posthumous rights over her body that she acquired through historical embodiment in that body, and further argue that claims grounded in historical embodiment can sometimes override or exclude moral claims grounded in current embodiment. I close by considering how advance directives grounded in historical embodiment might be employed in practice and what they would and would not justify. (shrink)

The COVID-19 pandemic has forced clinicians, policy-makers and the public to wrestle with stark choices about who should receive potentially life-saving interventions such as ventilators, ICU beds and dialysis machines if demand overwhelms capacity. Many allocation schemes face the question of whether to consider age. We offer two underdiscussed arguments for prioritising younger patients in allocation policies, which are grounded in prudence and fairness rather than purely in maximising benefits: prioritising one’s younger self for lifesaving treatments is prudent from an (...) individual perspective, and prioritising younger patients works to narrow health disparities by giving priority to patients at risk of dying earlier in life, who are more likely to be subject to systemic disadvantage. We then identify some confusions in recent arguments against considering age. (shrink)

We propose six guideposts that states and hospitals should follow to respect disability rights when designing policies for the allocation of scarce, lifesaving medical treatments. Four relate to criteria for decisions. First, do not use categorical exclusions, especially ones based on disability or diagnosis. Second, do not use perceived quality of life. Third, use hospital survival and near-term prognosis (e.g., death expected within a few years despite treatment) but not long-term life expectancy. Fourth, when patients who use ventilators in their (...) daily lives (e.g., home ventilation) present to acute care hospitals, their personal ventilators should not be reallocated to other patients. Fifth, designate triage officers to assess patients individually on the basis of objective medical evidence, not stereotypes or assumptions. Sixth, include disability rights advocates in policy development and dissemination. (shrink)

Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search.In sum, teaching in all three subjects combined (...) comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics. (shrink)

We consider an ethical dilemma in global health: is it ethically acceptable to provide some patients cheaper treatments that are less effective or more toxic than the treatments other patients receive? We argue that it is ethical to consider local resource constraints when deciding what interventions to provide. The provision of cheaper, less effective health care is frequently the most effective way of promoting health and realizing the ethical values of utility, equality, and priority to the worst off.

Addressing distributive justice issues in health policy—ranging from the allocation of health system funding to the allocation of scarce COVID-19 interventions like intensive care unit beds and vaccines—involves the application of ethical principles. Should a principle of sustainability be among them? I suggest that while the value of temporal neutrality underlying such a principle is compelling, it is already implicit in the more basic principle of equal treatment. Munthe et al imagine sustainability accompanying four other principles: need, prognosis, equal treatment (...) and cost-effectiveness. Some are spelled out, however, in ways that are ambiguous or incomplete. (shrink)

Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and (...) disability-adjusted life-years. We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles. (shrink)

Proposals for allocating scarce lifesaving resources in the face of the Covid-19 pandemic have aligned in some ways and conflicted in others. This paper attempts a kind of priority setting in addressing these conflicts. In the first part, we identify points on which we do not believe that reasonable people should differ—even if they do. These are (i) the inadequacy of traditional clinical ethics to address priority-setting in a pandemic; (ii) the relevance of saving lives; (iii) the flaws of first-come, (...) first-served allocation; (iv) the relevance of post-episode survival; (v) the difference between age and other factors that affect life-expectancy; and (vi) the need to avoid quality-of-life judgments. In the second part, we lay out some positions on which reasonable people can and do differ. These include (i) conflicts between maximizing benefits and priority to the worst off; (ii) role-based priority; and (iii) whether patients’ existing lifesaving resources should be subject to redistribution. (shrink)

In this short response to Kerstein and Bognar, we clarify three aspects of the complete lives system, which we propose as a system of allocating scarce medical interventions. We argue that the complete lives system provides meaningful guidance even though it does not provide an algorithm. We also defend the investment modification to the complete lives system, which prioritizes adolescents and older children over younger children; argue that sickest-first allocation remains flawed when scarcity is absolute and ongoing; and argue that (...) Kerstein and Bognar are mistaken to base their allocation principles on differences in personhood. (shrink)

Although consumers increasingly claim to demand ethical products and state that they are willing to reward firms that are ethical, studies have highlighted that there is a significant gap between consumers’ explicit attitudes toward ethical products and their actual purchase behavior. This has major implications for firm policies revolving around business ethics. This research contributes to the understanding of the attitude–behavior gap in ethical consumption that literature has identified but not explored much. We utilize the model of dual attitudes as (...) a basis for the arguments presented in the paper and test them. We suggest that the gap in ethical consumerism exists because individuals have implicit as well as explicit attitudes, which are impacted differentially by stimuli and elicit dissimilar behavioral responses and thus have different implications for business ethics policies. Two longitudinal studies are conducted to better understand the impact of an individual’s dual attitudes on preferences and choice. Our findings support the presence of dual attitudes in consumers. Explicit attitudes are found to be easily influenced by the nature of the stimuli. On the other hand, implicit attitudes are relatively unaffected by the nature of the stimuli present and remain relatively constant. Based on the findings, implicit attitudes guide behavior and determine an individual’s preferences. Even though explicit attitudes react to the stimuli presented, our findings suggest they have no impact on the choice of consumers. These findings improve the understanding of ethical consumption, provide a reason as to why the attitude–behavior gap exists, provide a foundation for future researchers and help firms better understand the impact of perceived business on creating a behavioral shift in ethical consumption. (shrink)

Four ethical values — maximizing benefits, treating equally, promoting and rewarding instrumental value, and giving priority to the worst off — yield six specific recommendations for allocating medical resources in the Covid-19 pandemic: maximize benefits; prioritize health workers; do not allocate on a first-come, first-served basis; be responsive to evidence; recognize research participation; and apply the same principles to all Covid-19 and non–Covid-19 patients.

“Doğal din” terimi, bazen doğanın kendisinin ilahi olduğu bir panteistik doktrine atıfta bulunur. “Doğal teoloji” terimi ise aksine, başlangıçta gözlemlenen doğal gerçekler temelinde (ve bazen) Tanrı’nın varlığını savunmaya yönelik projeye atıfta bulunur. Bununla birlikte çağdaş felsefede, hem “doğal din” hem de “doğal teoloji” genel olarak, dinî veya teolojik konuları araştırmak için insana, “doğal” olan bilişsel yetilerini – akıl, algı, içgözlem- kullanma projesini ifade eder. Doğal din veya teoloji, mevcut anlayış üzerine, doğayla ilgili ampirik araştırmalarla sınırlı olmamakla birlikte ayrıca panteistik bir (...) sonuçla da bağlantılı değildir. Bununla birlikte o, özel doğal olmayan yetilere (ESP, telepati, mistik deneyim) veya doğaüstü bilgi kaynaklarına (kutsal metinler, vahiy teolojisi, inanç otoriteleri, doğrudan doğaüstü iletişim) hitap etmekten kaçınır. Genel olarak, doğal din veya teoloji (bundan böyle “doğal teoloji” olarak anılacaktır), diğer felsefi ve bilimsel girişimlerle aynı rasyonel inceleme standartlarına uymayı amaçlamaktadır ve aynı değerlendirme ve eleştiri yöntemlerine tabidir. (shrink)

Mitos ve Logos kavramları Antik Yunan uygarlığında söz kavramına karşılık gelen sözcükleri karşılamak için kullanılmıştır. Felsefe tarihinin başlangıcı için yapılan tanımlamalarda ise mitos kavramının yerine logos kavramının tercih edilmesi iki kavram arasında bir farklılığı ortaya koymak için yapılmaktadır. Bu ayrımın nedeni ise mitos’un daha çok dinsel içerikle anılması logos’un ise içerisinde bir tür akılsallık barındırması şeklindeki yorumlarda kendini göstermektedir. Ancak söz konusu ayrımın ilk doğa filozofu/ilk felsefeci olarak nitelendirilen Thales için geçerli olup olmadığı geçmişte olduğu gibi günümüzde de halen tartışılmaktadır. (...) Felsefe tarihi yazımlarında ilk sıraya konan Thales’in anılan kavramları gerçekten farklı şekilde yorumlayıp yorumlamadığı bizce de tartışmaya açık bir husustur. Bu açıdan bakıldığında Thales, söz konusu kavramları iki farklı problemler alanı olarak mı görmüştür? Onun düşüncelerinde kendinden önceki mitolojik mirasın izleri bulunabilir mi? O, katışıksız bir rasyonel midir, yoksa henüz felsefenin yeni filizlendiği bir toplumda bir ara basamağı mı temsil etmektedir? Bu makalenin içerisinde tartışacağımız bu sorular, felsefe tarihinin başlangıcına ilişkin kavramsal arka planın ne olduğu hakkında bize katkı sağlayacaktır. (shrink)

This essay examines the connection between socioeconomic mobility and equality, and argues for two conclusions: (a) Socioeconomic mobility is conceptually distinct from three common species of equality: (1) equality of opportunity, (2) equality of outcome, and (3) relational equality. -/- (b) However, socioeconomic mobility is connected — in different ways — to each species of equality, and, if we value one or more of these species of equality, these connections endow mobility with derivative normative significance.

Several quantitative surveys have been conducted internationally to gather empirical information about physicians’ general attitudes towards health care rationing. Are physicians ready to accept and implement rationing, or are they rather reluctant? Do they prefer implicit bedside rationing that allows the physician–patient relationship broad leeway in individual decisions? Or do physicians prefer strategies that apply explicit criteria and rules?

Modal ontolojik argüman, Tanrı’nın varlığını sadece bilfiil gerçek olan bu dünyada değil, bütün mümkün dünyalarda göstermeye yönelik bir argümandır. Anselm’in (1033-1109) Proslogion adlı eserinin 3. bölümünde “kendisinden daha büyüğü düşünülemeyen” şeklinde tanımlanan; Tanrı’nın var olmamasının da düşünülemeyeceğini, bu yüzden de varolmamasının imkansızlığı üzerinde kurulu yeni bir argüman bulunduğunu öne süren bazı araştırmacılar, bu argümanı mümkün dünyalar semantiği yardımıyla formüle edip, “modal ontolojik argüman” şeklinde adlandırmışlardır. Çok farklı şekillerde formüle edilmiş bu argüman kabaca Tanrı’nın mümkünse zorunlu olması, dolayısıyla bilfiil gerçek olan (...) bu dünyada da var olması gerektiğini savunur. (shrink)

Studies of epistemic communities and collaborative research in the social sciences have deepened the understanding of how science works, and more specifically how the social dimensions of scientific practice both enable and impede social scientists in realizing their epistemic goals. Two types of studies of epistemic communities are distinguished: general theories of epistemic communities aim to construct accounts of theoretical change applicable to all social scientific specialties, whereas historical studies emphasize the contingencies that affect specific social scientific disciplines, subfields, or (...) institutions. Although collaborative research plays a less pronounced role in the social sciences than in the natural sciences, collaboration has enabled social scientists to investigate topics that would otherwise be difficult to investigate. (shrink)

Çağdaş epistemoloji içerisinde, dışsalcı, güvenilirci ve erdeme dayalı epistemolojik tartışmaların bir benzerini, dini epistemoloji içerisinde etkili bir şekilde yer edinen ve reformcu epistemoloji olarak bilinen yaklaşım üzerinden görebilmek mümkündür. Alvin Plantinga, Nicholas Wolterstorff ve William Alston gibi filozofların öne çıktığı bu yaklaşımın ana iddiası, kanıta ya da argümana dayanmaksızın, Tanrı’nın varlığına inanmanın bütünüyle doğru, rasyonel, makul ve güvenilir olacağı şeklindeki bir tezdir. Kanıtın, gerekçelendirme için zorunlu bir koşul olmadığı fikri, algısal deneyimlerin gerekçelendirilmesine benzer şekilde, dini deneyimlerin de öyle olduğu ve (...) dolayısıyla, aynı epistemik statüye sahip olması gerektiğini öne süren, eşitlik tezine dayanır. İlk ortaya çıktığı günden bugüne, üzerinde çokça konuşulan ve tartışılan bir yaklaşım olan reformcu epistemoloji, özellikle son beş yıl içerisinde, oldukça farklı bir hale gelmiştir. Zira bu yaklaşımı, kanıtsalcılıkla uyumlu, erdem epistemolojisiyle bağlantılı ve diğer teistik dinler üzerinden değerlendiren yeni çalışmalar ortaya çıkmıştır. Bu nedenle, bu makalede, reformcu epistemoloji ana hatlarıyla ele alınmıştır. Beraberinde, ona yöneltilen itirazlara değinilmiş ve sonrasında, bahsi geçen yenilik iddiaları soruşturulmaya çalışılmıştır. Son olarak, teistik inancın rasyonalitesiyle ilgili, farklı bir bakış açısı sunulmuştur. (shrink)

In this Correspondence, I argue that given that scarcity has existed both for critical care resources and for vaccines, allocating critical care resources to prioritize the prevention of early COVID-19 deaths (i.e. COVID-19 deaths among younger patients) could valuably counterbalance the disproportionate exclusion of minority patients and those with life shortening disabilities that age-based vaccine allocation produces. -/- Covid-19 deaths early in life have overwhelmingly befallen minorities and people with life-shortening disabilities. Policies preventing early deaths prevent an outcome widely recognized (...) as worse—dying earlier in one’s life rather than later—while counteracting intersecting forms of injustice. Ultimately, prohibiting the use of age as a tiebreaker in critical care allocation, as Brown et al. propose, will worsen disparities and is not mandated by law. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

In the literature, CSR’s roles on firm performance are found to be positive, negative, or neutral. This inconclusive pattern suggests there may be a more complicated mechanism at work than the traditional focus on simple linear associations. We propose and test an inverted-U-shaped relationship between CSR and shareholder value, the fundamental measure of firm performance. Further, we incorporate a critical firm attribute, marketing capability, to moderate the nonlinear link between CSR and shareholder value, thereby exploring a previous understudied area involving (...) the interplay between CSR and market-side competency. The results show that an initial increase in CSR engagement positively drives firm shareholder value, but the effect turns negative when a firm pursues excessive CSR engagement. Notably, however, this negative association does not apply to firms that have a high marketing capability. Our research generates meaningful implications for a stakeholder view of CSR, strategic management, firm valuation, resource-based theories, and business practices. (shrink)

Güvenilirci (reliabilist) bilgi teorisi, çağdaş epistemik gerekçelendirme kuramları içerisinde, dışsalcı (externalist) kuramın bir türü olarak kendisine yer bulmaktadır. Kısaca, bir inancı gerekçelendiren şeyin o inancın oluşturulduğu sürecin güvenilirliği olduğunu öne süren bu yaklaşım, bu bilişsel süreçleri özne dışı unsurlara bağladığı içinde dışsalcı bir pozisyonda yer almaktadır. Bu bilgi teorisinin tam karşı konumunda yer alan içselci (internalist) bilgi teorisi ise, özne merkezli bir yaklaşımla, doğru inancı gerekçelendirecek yöntemin, kişinin kendi zihinsel yapısından yola çıkarak, belli kognitif süreçler sonucunda ulaşılabileceğini öne sürmektedir. Epistemik (...) gerekçelendirme kuramları içerisinde birçok tartışmada kendisine yer bulan bu iki bilgi teorisi, kendi içerisinde de birçok farklı kurama kapı aralamıştır. Burada içselci bilgi teorisinden ortaya çıkan erişim içselciliği, farkındalık içselciliği gibi kuramları ve dışsalcı bilgi teorisinden ortaya çıkan süreç güvenilirciliği, gösterge güvenilirciliği ve erdem güvenilirciliği gibi farklı türden kuramları örnek olarak verebiliriz. Öte yandan çağdaş epistemolojideki bu tartışmalar, dini epistemoloji içerisinde de kendisine yer bulmuştur. Özellikle Alvin Plantinga, kendi dini epistemolojisi içerisinde dışsalcı bir tutum sergilemiş ve son dönem çalışmaları içerisinde de güvenilirci bir anlayışla Tanrı inancının epistemik mahiyetini ortaya koymaya çalışmıştır. Bu makalede öncelikle dışsalclık ve onun bir türü olan güvenilirci bilgi anlayışını ve bu kuramlara getirilen eleştirileri ele almaya çalışacağız, daha sonra A. Plantinga’nın son dönem dini epistemolojisinin de yönünü belirleyen güvence (warrant) kavramını açıklayıp, bu kavramın bütün teist dinlere uygulanabilirliğini sorgulayacağız. (shrink)

The article examines Thomas Kuhn's work in the history of science with special attention to its relevance to subsequent developments in social epistemology. The article begins with a discussion of Kuhn's historical work, and the so-called historical turn in philosophy of science. It then examines Kuhn's views on textbook science, followed by an analysis of Kuhn's views on the relationship between the history of science and the philosophy of science. Then it discusses Kuhn's contributions to our understanding of the social (...) dimensions of scientific inquiry. Finally, it discusses his influence on the social epistemology of science and the sociology of science. (shrink)

Epistemolojik olarak bilgiye başvuran ve bilme faaliyetinde bulunan insanın, Kur’an’da önemli bir yeri vardır. Buradaki bilme faaliyetini, salt teolojik bir buyruk olarak, yani Allah’ı bilmek olarak değil, doğru bilgi ile yanlış bilgi arasında hem teorik hem de ahlaki bir farklılık olarak anlamak ve Kur’an'da insana epistemik özellikler atfedildiğini ve böylece insanın epistemik başarılarından dolayı övüldüğünü söyleyebilmek mümkündür. Bu açıdan bakıldığında herhangi bir önermeye yönelik olarak rasyonel bir tutum benimseyen, yani bilen özne ile bu faaliyette isteyerek ve istemeyerek giren kişinin durumu (...) arasında bir fark olduğu açıktır. Doğrusu bu farkın epistemik önceliği kadar, ahlaki önceliği de dikkate değerdir. Nitekim buradaki ahlaki üstünlük, doğru bilgiyi hedefleme ve ona ulaşma noktasında ortaya çıkan erdemdir. Doğru bilgiye ulaşmanın entelektüel bir erdem olduğu düşünüldüğünde, Kur’an’ın Erdem epistemolojisi üzerinden değerlendirilmesi bu noktada önemlidir. Doğrusu erdemli bir bilişsel faaliyet, Kur'an’da açık bir şekilde ana fikir olarak ortaya konulur ve buna göre cehaletten kaçınmak ve doğru bilgiye ulaşmak için erdemli bir çaba göstermek önem taşır. Kur’an’daki ifadeleri bilgeliğe ulaşmak olarak anlayacak olursak, asıl hedef; bilgi ve anlayışımızın, entelektüel ve ahlaki vicdanımızı veya takvamızı güçlendirmesi için kullanılabileceği söylenilebilir ve bu inanç, erdem epistemolojisine dayalı bir yaklaşım içerisinde şekillendirilebilir. (shrink)

Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of the (...) overall impact of health policy. This chapter considers what weight health policy should give to its “spill-over effects,” namely non-health and indirect benefits. (shrink)

Hristiyan inancı içerisinde merkezi konuma sahip olan mevzulardan birisi de, İsa’nın ölümünden üç gün sonra diriltildiğine yönelik olan inançtır. Hristiyan eskatolojisinin de dayanak noktasını oluşturan bu mevzu, dinler tarihi ya da teoloji gibi disiplinlerin içerisinde tartışıldığı gibi, çeşitli Hristiyan düşünürlerce, din felsefesi disiplini içerisinde de tartışılmıştır. Din felsefesi açısından bakıldığında, konunun merkezi konumda olması, bu mevzunun rasyonel bir zeminde tartışılıp tartışılamayacağını da beraberinde getirmektedir. Bu bağlamda, özellikle din felsefesi içerisinde birçok Hristiyan düşünür tarafından konu ele alınmış ve farklı çevrelerce de (...) mevzuya yönelik karşı itirazlar dile getirilmiştir. Bu noktada yapılan tartışmaların içeriğine baktığımızda, mucize kavramı önem taşımakla birlikte, Hristiyan düşünürlerin argüman haline getirdikleri ve bir delil olarak öne sürdükleri “Boş mezar” ve “Tanıklıklar gibi birçok farklı husususun din felsefesi açısından tartışıldığını söyleyebiliriz. Ayrıca bazı ateist düşünürlerin bu delillere yönelik itirazları olmakla birlikte, bazı Hristiyan tarihçilerinde konuya ilişkin ciddi itirazları bulunmaktadır. Biz de bu makalemizde, İsa’nın ölümünden sonra dirilişinin rasyonel bir şekilde izahının nasıl olabileceği sorusunu merkeze alıp, konuyu Hristiyan düşünürlerin bakış açısından değerlendirmeye çalıştık. Bu noktada İslam gibi farklı dinlerde ve farklı anlatılarda karşımıza çıkan Hz. İsa figürünü konumuzun dışında tuttuğumuzu ayrıca belirtelim. Çünkü bizim yazımızın konusunu oluşturan kişi Hristiyan inancındaki İsa ve bu din içerisinde önem taşıyan kutsal metinler ve bu metinlerde geçen anlatılar oldu. Bu açıdan bakıldığında yazımız içerisinde, konuya ilişkin doğrudan bir teoloji ya da dinler tarihi çerçevesinde değerlendirme yapmaktan çok, din felsefesi içerisinde bize sunulan tartışmalardan yola çıkarak eleştirilerimizi ve tahlillerimizi dile getirmeye çalıştığımızı ifade edebiliriz. (shrink)

We argue that the ethical case for instituting vaccine benefit programs is justified by 2 widely recognized values: (1) reducing overall harm from COVID-19 and (2) protecting disadvantaged individuals. We then explain why they do not coerce, exploit, wrongfully distort decision-making, corrupt vaccination's moral significance, wrong those who have already been vaccinated, or destroy willingness to become vaccinated. However, their cost impacts and their effects on public perception of vaccines should be evaluated.

Recognising that offers of payment to research participants can serve various purposes—reimbursement, compensation and incentive—helps uncover differences between participants, which can justify differential payment of participants within the same study. Participants with different study-related expenses will need different amounts of reimbursement to be restored to their preparticipation financial baseline. Differential compensation can be acceptable when some research participants commit more time or assume greater burdens than others, or if inter-site differences affect the value of compensation. Finally, it may be permissible (...) to offer differential incentive payments if necessary to advance the goals of a study. We encourage investigators and Institutional Review Boards to think about whether to offer payment, in what amounts and for what purpose, and also to consider whether differential payment can help promote the scientific and ethical goals of clinical research. (shrink)

This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life suffers because of disability-focused exclusion or (...) injustice differently from cases where lower quality of life results from laws of nature, resource scarcity, or appropriate tradeoffs. Decisionmakers should ignore quality-of-life losses that result from injustice or exclusion when ignoring them would improve the prospects of individuals with disabilities; in contrast, they should consider quality-of-life losses that are unavoidable or stem from resource scarcity or permissible tradeoffs. On this proposal, while health systems should not amplify existing injustice against individuals with disabilities, they are not required to altogether ignore the potential effects of disability on quality of life. (shrink)

This commentary critically evaluates the capacity for the Green Climate Fund to deliver distributive justice in the light of Conference of Parties 17 and the Durban Platform for Enhanced Action (UNFCCC, 2011b).