Background and objectives: Summary measures of overall health inequality are independent of group membership and enable international comparisons of distribution of health. We compare inequality between and within countries over time and identify normative issues underlying such comparisons. Methods: We used a set of modeled historical life tables for 193 World Health Organization member states from the years 1990, 2000 and 2008 and calculated inequality in age at death and inequality-adjusted life expectancy. Results: Our calculations suggest that overall health inequalities (...) in age at death have been decreasing in the period 1990–2008 in most countries of the world. Only 20 countries experienced increasing distribution in age at death. Simultaneously, overall life expectancy has increased in 85 per cent of all countries. Thus, the combined measure IALE has improved globally. The same overall trend of reduced health inequality applies to all groups of countries stratified by income level. Conclusion: Overall health inequalities, in addition to average health outcomes, could be reported regularly to monitor the health status of populations and the performance of health systems. We find, on normative grounds, the combined measure IALE to be preferable to measuring trends in inequality only. Likewise, we find the Absolute GiniH to be preferable to Relative GiniH. (shrink)

L'édification spatio-temporelle dont se sert un observateur isolé pour représenter ses résultats de mesures comporte la construction d'un espace physique qui, quoique non catégorique, est applicable sur l'espace euclidien à trois dimensions. Aucun argument ne permet de décider si l'espace est euclidien ou non euclidien. Les expériences permettent seulement à l'observateur d'affirmer que l'espace est pratiquement euclidien en son voisinage.

Background In the context of limited health care budgets in countries where Neglected Tropical Diseases are endemic, scaling up disease control interventions entails the setting of priorities. However, solutions based solely on cost-effectiveness analyses may lead to biased and insufficiently justified priorities. Objectives The objectives of this paper are to 1) demonstrate how a range of equity concerns can be used to identify feasible priority setting criteria, 2) show how these criteria can be fed into a multi-criteria decision-making matrix, and (...) 3) discuss the conditions under which this decision-making procedure should be carried out in a real-world decision-making context. Methods This paper draws on elements from theories of decision analysis and ethical theories of fair resource allocation. We explore six typical NTD interventions by employing a modified multi-criteria decision analysis model with predefined criteria, drawn from a priority setting guide under development by the WHO. To identify relevant evidence for the six chosen interventions, we searched the PubMed and Cochrane databases. Discussion Our in vitro multi-criteria decision analysis suggested that case management for visceral leishmaniasis should be given a higher priority than mass campaigns to prevent soil-transmitted helminthic infections. This seems to contradict current health care priorities and recommendations in the literature. We also consider procedural conditions that should be met in a contextualised decision-making process and we stress the limitations of this study exercise. Conclusion By exploring how several criteria relevant to the multi-facetted characteristics of NTDs can be taken into account simultaneously, we are able to suggest how improved priority settings among NTDs can be realised. (shrink)

BackgroundIn the context of limited health care budgets in countries where Neglected Tropical Diseases (NTDs) are endemic, scaling up disease control interventions entails the setting of priorities. However, solutions based solely on cost‐effectiveness analyses may lead to biased and insufficiently justified priorities.ObjectivesThe objectives of this paper are to 1) demonstrate how a range of equity concerns can be used to identify feasible priority setting criteria, 2) show how these criteria can be fed into a multi‐criteria decision‐making matrix, and 3) discuss (...) the conditions under which this decision‐making procedure should be carried out in a real‐world decision‐making context.MethodsThis paper draws on elements from theories of decision analysis and ethical theories of fair resource allocation. We explore six typical NTD interventions by employing a modified multi‐criteria decision analysis model with predefined criteria, drawn from a priority setting guide under development by the WHO. To identify relevant evidence for the six chosen interventions, we searched the PubMed and Cochrane databases.DiscussionOur in vitro multi‐criteria decision analysis suggested that case management for visceral leishmaniasis should be given a higher priority than mass campaigns to prevent soil‐transmitted helminthic infections. This seems to contradict current health care priorities and recommendations in the literature. We also consider procedural conditions that should be met in a contextualised decision‐making process and we stress the limitations of this study exercise.ConclusionBy exploring how several criteria relevant to the multi‐facetted characteristics of NTDs can be taken into account simultaneously, we are able to suggest how improved priority settings among NTDs can be realised. (shrink)

In this paper I address the current debate on ontic versus epistemic conceptualizations of mechanistic explanation in the mechanisms literature. Illari recently argued that good explanations are subject to both ontic and epistemic constraints: they must describe mechanisms in the world in such fashion that they provide understanding of their workings. Elaborating upon Illari’s ‘integration’ account, I argue that causal role function discovery of mechanisms and their components is an epistemic prerequisite for achieving these two aims. This analysis extends Illari’s (...) account in important ways, putting more pressure on ontic readings of mechanistic explanation and providing an answer to the question how ontic and epistemic constraints on mechanistic explanation are related. I argue these point in terms of cases on memory research drawn from neuroscience and research on extinct neurogenetic mechanisms from early nervous systems biology. (shrink)

This paper investigates conceptions of explanation, teleology, and analogy in the works of Immanuel Kant (1724-1804) and Georges Cuvier (1769-1832). Richards (2000, 2002) and Zammito (2006, 2012, 2018) have argued that Kant’s philosophy provided an obstacle for the project of establishing biology as a proper science around 1800. By contrast, Russell (1916), Outram (1986), and Huneman (2006, 2008) have argued, similar to suggestions from Lenoir (1989), that Kant’s philosophy influenced the influential naturalist Georges Cuvier. In this article, I wish to (...) expand on and further the work of Russell, Outram, and Huneman by adopting a novel perspective on Cuvier and considering (a) the similar conceptions of proper science and explanation of Kant and Cuvier, and (b) the similar conceptions of the role of teleology and analogy in the works of Kant and Cuvier. The similarities between Kant and Cuvier show, contrary to the interpretation of Richards and Zammito, that some of Kant’s philosophical ideas, whether they derived from him or not, were fruitfully applied by some life scientists who wished to transform life sciences into proper sciences around 1800. However, I also show that Cuvier, in contrast to Kant, had a workable strategy for transforming the life sciences into proper sciences, and that he departed from Kant’s philosophy of science in crucial respects. (shrink)

The Russian invasion of Ukraine on February 24, 2022, has already caused large amounts of greenhouse gas (GHG) emissions and will continue to do so for manyyears after hostilities have ceased mainly because of the emissions linked to the rebuilding of destroyed or damaged housing, public buildings, infrastructure, factories, and the like. My aim in this paper is to discuss how in a time of climate emergency such emissions of war should impact the political morality of states initiating, continuing, and (...) ending war (through a just and enduring peace) as understood by just war theory (JWT). My point of departure is a study by Lennard de Klerk and six co-authors detailing the emissions of the first year of the Russo-Ukrainian war. (shrink)

Dynamic Epistemic Logic This article tells the story of the rise of dynamic epistemic logic, which began with epistemic logic, the logic of knowledge, in the 1960s. Then, in the late 1980s, came dynamic epistemic logic, the logic of change of knowledge. Much of it was motivated by puzzles and paradoxes. The number … Continue reading Dynamic Epistemic Logic →.

Decentralized clinical trials (DCTs) have the potential to advance the conduct of clinical trials, but raise several ethical issues, including obtaining valid informed consent. The debate on the ethical issues resulting from digitalization is predominantly focused on direct risks relating to for example data protection, safety, and data quality. We submit however, that a broader view on ethical aspects of DCTs is needed to touch upon the new challenges that come with the DCT practice. Digitalization has impacts that go beyond (...) its direct purposes, by shaping behaviors, experiences, social relations, and values. We examine four elements of the informed consent procedure that are affected by DCTs, while taking these soft impacts of technologies into account: (i) informing participants and testing understanding, (ii) freedoms in relation to responsibilities and burdens, (iii) trust in participant-researcher relations, and (iv) impacts on the concept of privacy. Our analysis reveals that a broad view is key for optimal conduct of DCTs. In addition, it provides insight into the ethical impacts of DCTs on informed consent. Technologies such as DCTs potentially have profound impacts which are not immediately addressed by the existing regulatory frameworks, but nonetheless important to recognize. These findings can guide future practices of DCTs to foster the important values of clinical research in this novel approach for conducting clinical trials. (shrink)

This book is about the interrelationship between nature, semiosis, metarepresentation and (self-)consciousness, and the role played by metarepresentation in ...

Dynamic Epistemic Logic This article tells the story of the rise of dynamic epistemic logic, which began with epistemic logic, the logic of knowledge, in the 1960s. Then, in the late 1980s, came dynamic epistemic logic, the logic of change of knowledge. Much of it was motivated by puzzles and paradoxes. The number … Continue reading Dynamic Epistemic Logic →.

Jill de Villiers has argued that children's mastery of sentential complements plays a crucial role in enabling them to succeed at false-belief tasks. Josef Perner has disputed that and has argued that mastery of false-belief tasks requires an understanding of the multiplicity of perspectives. This paper attempts to resolve the debate by explicating attributions of desires and beliefs as extensions of the linguistic practices of making commands and assertions, respectively. In terms of these linguistic practices one can explain why desire-talk (...) will precede belief-talk and why even older children will have difficulty attributing incompatible desires. (shrink)

According to the traditional view in the philosophy of logic facts of logic bear normative authority regarding how one ought to reason. Usually this is to mean that the relation of logical consequence between statements has some special relevance for how one’s beliefs should cohere. However, as I will argue in this article, this is just one way in which logic is normative for reasoning. For one thing, belief is not the only kind of mental state involved in reasoning. Besides (...) adopting and revising beliefs, rational agents pose and resolve questions. For another thing, the consequence relation of classical logic can be conservatively extended such that it includes logical relations between questions as well. Therefore, there is an argument to be made that not only the inference of new beliefs from extant beliefs but also the process of raising additional questions falls under the normative authority of logic. Accordingly, a nuanced account of the normativity of logic presents itself, which convincingly deals with problems such as clutter-avoidance and the paradox of the preface. (shrink)