-/- This chapter evaluates the ethical issues that using cost-effectiveness considerations to set animal health priorities might present, and its conclusions are cautiously optimistic. While using cost-effectiveness calculations in animal health is not without ethical pitfalls, these calculations offer a pathway toward more rigorous priority-setting efforts that allow money spent on animal well-being to do more good. Although assessing quality of life for animals may be more challenging than in humans, implementing prioritization based on cost-effectiveness is less ethically fraught.

This study aims to identify the ethical challenges in the process of product marketing. It conducted a bibliometric study to evaluate the major ethical concerns in the area of product marketing. The data for the current study was extracted using the Scopus database. The study uses VOSviewer and Biblioshiny-bibliometrix to analyze the data. The results revealed that in the twenty-first century, ethical concerns and research related to pharmaceutical marketing, consumption behavior, and sustainability have significantly grown and are emerging as important (...) issues. The study is novel in its approach and develops a theoretical model to know ethical issues related to product marketing with multidimensional process (i.e., identification, search strategy, and analysis) for a long-term sustainable business success. By this study, the academicians and researchers will focus greater attention on the rapidly developing human-techno-centric world to fulfill the organizations’ service promises. The study contributes to the marketing ethics literature, particularly to the literature related to ethical issues in product marketing. (shrink)

Bangladesh continues to experience stubbornly high levels of rural malnutrition amid steady economic growth and poverty reduction. The policy response to tackling malnutrition shows an overwhelmingly technocratic bias, which depoliticizes the broader question of how the agro-food regime is structured. Taking an agrarian and human rights-based approach, this paper argues that rural malnutrition must be analyzed as symptomatic of a deepening agrarian crisis in which the obsession with productivity increases and commercialization overrides people’s democratic right to culturally appropriate, good, nutritious (...) food. Using qualitative insights from a case study of three villages, this research illustrates how agricultural modernization and commercialization reproduce rural malnutrition by degrading local biodiversity and the rural poor’s access to nutrient-rich diets. In so doing, it undermines the official discourse’s simplistic and literal reading of malnutrition as a pathological health condition resulting from the mere absence of certain micronutrients in the human body, and thus questions the adequacy of the proposed solutions. Instead, this research suggests that solving malnutrition in large part involves facilitating the rural poor’s access to nutritious diets through democratizing and reorganizing the agriculture sector in a manner that is eco-friendly and unconstrained by market imperatives. It cautiously advances agroecology and food sovereignty as possible alternatives, while recognizing that overcoming the challenges agrarian class conflict, gender disparity and urban–rural divide pose would not be easy. (shrink)

In response to a crisis, policymakers face the decision of whether to enumerate specific actions the public must do or, instead, to aim at an overall outcome while leaving room open for choice. This essay evaluates the merits and demerits of crisis response that leaves room open for choice, with a particular focus on pandemic response. I evaluate two approaches: trades and offsets. Trades allow individuals or groups to exchange protection against harm or entitlement to engage in risky activity. Offsets (...) allow the same actors to pay to mitigate the effects of decisions that increase risk for others. Choice-friendly approaches can free people to better align their actions with their values, harness local knowledge for better social outcomes, and act as natural experiments. However, they also are subject to objections, including negative externalities, agency problems, exploitation, and exacerbating inequality. (shrink)

Although policymakers and investigators still struggle to quantify and compare the effects of various Covid-related interventions, we are steadily amassing data that could help inform choices. The pandemic’s medical, social, and economic harms have been immense, and they warrant a continuous policy response. All decision makers use some type of mental model to weigh the pros and cons of various policy options. Rigorous economic evaluation formalizes this process. Value judgments will still be required, but economic evaluation can make the decision-making (...) process more systematic, comprehensive, and transparent. (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)

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)

In 2017, Americans spent over $3.4 trillion-nearly 18% of gross domestic poduct-on health care. This spending is unevenly distributed: Almost a quarter is spent on the costliest 1% of patients, and almost half on the costliest 5%. Most of these patients soon return to a lower percentile, but many continue to incur health care costs in the top percentiles year after year. This Article focuses on the challenges that persistently expensive patients present for health law and policy, and how fairly (...) dividing their medical costs among payers illuminates fundamental normative choices about the design and reform of health insurance. In doing so, this Article draws on bioethical and health policy analyses of the fair distribution of medical costs, and examines how legal doctrine shapes health systems' options for responding to expensive patients. Part I of this Article discusses two real-world examples of expensive patients and the debate surrounding them, including the case of an Iowa teenager with hemophilia whose treatments cost more than $10 million per year. Part II then examines the normative question of how the costs of treating expensive patients' medical conditions should be shared and identifies three different dimensions of sharing: (1) scope, from narrow (plan members only) to broad (all of society); (2) boundedness, whether there are limits on the costs others can be asked to bear; and (3) progressivity, whether wealthier individuals are asked to bear more costs (similar to progressivity in tax). Part III then considers how health care reform choices could advance or hamper the adoption of broad, bounded, progressive sharing, with a focus on recent state-level reinsurance programs that legal scholarship has not yet analyzed in depth. -/- This Article contributes to the literature on health care reform in three interlocking ways. First, it develops a novel proposal for fairly sharing the cost of expensive patients' care that could usefully inform state- and federal-level policy discussions. Second, it provides a normative, rather than purely political or economic, analysis of existing and proposed options for sharing expensive patients' costs. Third, it bridges the disconnected literature on reinsurance, limit setting, and health care financing, identifying how proposals in these different areas intersect. (shrink)

Post-modernism and its influence in Sri Lanka.

In contemporary philosophy, various attempts have been made in relation to placing our minds or mental states in the natural world or nature. In this context, there is a clear divide between naturalism and anti-naturalism, materialism and immaterialism, etc. Driven by the influence of naturalistic turn in philosophy and scientism, many philosophers have tried to put forth various naturalistic accounts of the relationship between mind and natural world. However, many of these accounts are naturalistic based on the modern scientific conception (...) of nature which has been hailed as the dominating conception of nature. John McDowell in his magnum opus Mind and World, while criticizing modern scientific account of the relationship between mind and world, has not resorted back to anti-naturalism. Instead, he has tried to give us certain clues to develop an account of an alternative form of naturalism which is at the same time radically different from both scientific naturalism and mysterious anti-naturalism. In this paper, I will try to search for an alternative naturalism following McDowell and examine to what extent this account is tenable. In this context, we shall discuss various approaches to understand the relation between reason/normativity (which is one of the significant constituting elements of our mind) and natural world. (shrink)

Here presented are three singular, philosophical perspectives on the Delhi student protests which took place in 2019 and 2020, before the coronavirus pandemic. The writers hail from India, England...

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)

On the life and philosophy of Śaṅkarācārya.

Event segmentation theory posits that people segment continuous experience into discrete events and that event boundaries occur when there are large transient increases in prediction error. Here, we set out to test this theory in the context of story listening, by using a deep learning language model (GPT‐2) to compute the predicted probability distribution of the next word, at each point in the story. For three stories, we used the probability distributions generated by GPT‐2 to compute the time series of (...) prediction error. We also asked participants to listen to these stories while marking event boundaries. We used regression models to relate the GPT‐2 measures to the human segmentation data. We found that event boundaries are associated with transient increases in Bayesian surprise but not with a simpler measure of prediction error (surprisal) that tracks, for each word in the story, how strongly that word was predicted at the previous time point. These results support the hypothesis that prediction error serves as a control mechanism governing event segmentation and point to important differences between operational definitions of prediction error. (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.

Journal of Human Values, Volume 28, Issue 1, Page 7-10, January 2022.

The study is an attempt to understand the prevailing discourse in India on education as a right by closely reading the parliamentary debates on The Right of Children to Free and Compulsory Educatio...

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)

This book by an internationally reputed Indian scientist traces the developments of Science, Religion and Philosophy in human civilization through the ages. The common underlying bond-more specifically, a linkage of philosophy with both science and religion-has been examined incisively. All the three sub-areas of human culture have been presented from a holistic point of view, and at the same time, stressing some of their irreconcilable basic differences in scope and outlook. Meant primarily for general readers, the book achieves a fine (...) balance between basic comcepts, historical evolution and a critical unbiased analysis of rituals, dogmas, unresolved queries and it leads to an enlightened view of 'humanism', 'Nature', 'Unity of man', need for a new paradigm of social and political order transcending globalization and control of resources of weaker nations by supremacy in global power equation. The book reviews the wisdom of the ancient Hindus, Buddhism, Jainism and of the three semitic religions-Judaism, Christianity and Islam. It presents a concise account of the Indian Vedas, Vedangan, Saddarsana, the two epics and the Bhagavadgita, of the philosophy and science of the Greeks, science and technology of ancient Egypt, Babylonia and China. A valuable special feature is a summary of the status of present-day science, starting with the classical phase, and ending with the developments in the last century comprising the Theory of Relativity, quantum physics, genetics, various aspects of human consciousness, modern astronomy, astrophysics and cosmology. Last but not least, the author critically reviews some of the presentday fashionable discourses on 'science as the best way to reach God' and leads the readers to an appraisal of the on-going researches on the unification of the four fundamental interactions of physical sciences. He ends with the inexorable conclusion that this unification, when fully achieved, would still not strictly identify the unique force as 'God as concieved in different religions. (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)

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?

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)

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)

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)

On the ultimate reality of Hindu philosophy.

We propose a novel edge detector in the presence of Gaussian noise with the use of proximal support vector machine (PSVM). The edges of a noisy image are detected using a two-stage architecture: smoothing of image is first performed using regularized anisotropic diffusion, followed by the classification using PSVM, termed as regularized anisotropic diffusion-based PSVM (RAD-PSVM) method. In this process, a feature vector is formed for a pixel using the denoised coefficient’s class and the local orientations to detect edges in (...) all possible directions in images. From the experiments, conducted on both synthetic and benchmark images, it is observed that our RAD-PSVM approach outperforms the other state-of-the-art edge detection approaches, both qualitatively and quantitatively. (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)

Incomplete penetrance and variable expressivity are non‐Mendelian phenomena resulting in the lack of correlation between genotype and phenotype. Not withstanding the diversity in mechanisms, differential expression of homologous alleles within cells manifests as variations in penetrance and expressivity of mutations between individuals of the same genotype. These phenomena are seen most often in dominantly inherited diseases, implying that they are sensitive to concentration of the gene product. In this framework and the advances in understanding the role of microRNA (miRNA) in (...) fine‐tuning gene expression at translational level, we propose miRNA‐mediated regulation as a mechanism for incomplete penetrance and variable expressivity. The presence of miRNA binding sites at 3′ UTR, co‐expression of target gene–miRNA pairs for genes showing incomplete penetrance and variable expressivity derived from available data lend support to our hypothesis. Single nucleotide polymorphisms in the miRNA target site facilitate the implied differential targeting of the transcripts from homologous alleles. (shrink)

. With an overall objective of establishing association between air pollutants and incidence of respiratory diseases, the environmental professionals and medical practitioners have made significant contribution, using statistical mechanics in modelling epidemiological data, population characteristics, and pollution parameters. Broadly speaking, the studies have shown that the increase in vehicular traffic has been one of the causes of respiratory diseases. However, the WHO Centre for Environment and Health, Europe in its 2005 document states: “There is little evidence for a causal relationship (...) between asthma prevalence/incidence and air pollution in general, though the evidence is suggestive of a causal association between the prevalence/incidence of asthma symptoms and living in close proximity to traffic”. Decision making process in a real world is invariably based on perceptions which are expressed in words or may be in numeric terms and not in probability terms. In the paper, we made an attempt to model the perceptions of experienced pulmonologists in arriving at their combined degree of belief/plausibility/ignorance for all the possible combinations of identified respiratory diseases, using evidence theory and fuzzy relational calculus without collecting sizeable parametric data accumulated over a period of years. Tightening pollution norms by the regulatory authorities is an overall objective of the global efforts on greenhouse gases reduction in general, and air pollution mitigation in particular. The concept of solar battery operated electric vehicles for road transport is advocated, initially for two/three wheelers, and extending it to four wheelers, especially in the developing countries. (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.

Recent events have revived questions about the circumstances that ought to trigger therapists' duty to warn or protect. There is extensive interstate variation in duty to warn or protect statutes enacted and rulings made in the wake of the California Tarasoff ruling. These duties may be codified in legislative statutes, established in common law through court rulings, or remain unspecified. Furthermore, the duty to warn or protect is not only variable between states but also has been dynamic across time. In (...) this article, we review the implications of this variability and dynamism, focusing on three sets of questions: first, what legal and ethics-related challenges do therapists in each of the three broad categories of states (states that mandate therapists to warn or protect, states that permit therapists to breach confidentiality for warnings but have no mandate, and states that give no guidance) face in handling threats of violence? Second, what training do therapists and other professionals involved in handling violent threats receive, and is this training adequate for the task that these professionals are charged with? Third, how have recent court cases changed the scope of the duty? We conclude by pointing to gaps in the empirical and conceptual scholarship surrounding the duty to warn or protect. (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)

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)