Background Informed consent is a universally accepted precondition for scientific researches involving human participants. However, various factors influence the process of obtaining authentic informed consent, and researchers particularly working in resource-poor countries often face considerable difficulties in implementing the universally recommended procedures for obtaining informed consent. We have conducted this Rapid Ethical Assessment to accommodate the local cultural norms and to understand the relevant ethical issues in the Silti community before the conduct of a cluster-randomized controlled trial. Methods This REA (...) was conducted in two purposively selected Woredas/Districts and Worabe Town administration of Silti Zone. Data were collected using in-depth interviews and focus group discussions. Purposive and convenient sampling techniques were used to select respondents. Five in-depth interviews and 15 Focus Group Discussions were conducted in the Amharic language. The collected data was transcribed, translated, and analyzed using a thematic approach. Result Most of the community members never heard about research and therapeutic misconception was common. In the area, the permission of people working in the formal and informal community administration is essential before approaching individuals. The male head of the household should also be involved in the decision before individual household members participate in research. Furthermore, sensitizing the community using public and religious gatherings was suggested before individual recruitment. In the consent process, delivering selected information particularly the purpose and benefits of the research was emphasized and the tendency of preferring verbal consent was documented despite the willingness of the individuals to sign on the consent form. Local health workers were identified as appropriate personnel to communicate information and the procedures of the research were found to be acceptable. However, the value of small incentives was suggested to motivate potential participants. Finally, involving all concerned stakeholders and respecting the cultural norm of the community was emphasized. Conclusion Through REA, we understand the research awareness of the community, their expectation, and the cultural norms relevant to the ethical conduct of research. It enabled us to devise culturally sensitive and scientifically sound strategies to secure authentic informed consent. The process of conducting REA was found to be feasible, quick, and efficient. (shrink)

Gene therapies to treat sickle cell disease are in development and are expected to have high costs. The large eligible population size — by far, the largest for a gene therapy — poses daunting budget challenges and threatens to exacerbate health disparities for Black patients, who make up the vast majority of American sickle cell patients.

Vulnerability and politics are among the relevant and key topics of discussion in the Ethiopian healthcare context. Attempts by the formal bioethics structure in Ethiopia to deliberate on ethical issues relating to vulnerability and politics in healthcare have been limited, even though the informal analysis of bioethical issues has been present in traditional Ethiopian communities. This is reflected in religion, social values, and local moral underpinnings. Thus, the aim of this paper is to discuss the bioethical implications of vulnerability and (...) politics for healthcare in Ethiopia and to suggest possible ways forward. First, we will briefly introduce what has been done to develop bioethics as a field in Ethiopia and what gaps remain concerning its implementation in healthcare practice. This will give a context for our second and main task – analyzing the healthcare challenges in relation to vulnerability and politics and discussing their bioethical implications. In doing so, and since these two concepts are intrinsically broad, we demarcate their scope by focusing on specific issues such as poverty, gender, health governance, and armed conflicts. Lastly, we provide suggestions for the ways forward. (shrink)

O período escravocrata brasileiro deixou marcas profundas nas populações negras e quilombolas. Este sistema contribui para um cenário racista que fomenta injustiças sociais e em saúde. Nesse sentido, o presente texto objetiva investigar na literatura científica o acesso e a utilização dos serviços de saúde pela população negra e quilombola. A partir de uma revisão de literatura do tipo descritiva narrativa. A busca das publicações ocorreu na Biblioteca Virtual de Saúde e no Google Acadêmico. Foram selecionadas 39 publicações entre os (...) anos de 2016 e 2018 organizadas nas seguintes categorias: acesso e utilização dos serviços de saúde pela população negra e quilombola e suas principais morbidades; implicações geográficas e fatores influenciadores no acesso e utilização dos serviços de saúde. As análises indicam que o acesso e utilização dos serviços de saúde pelas populações negras e quilombolas brasileiras sofrem mais importantemente os efeitos nocivos dos marcadores sociais, espaciais, de gênero, de classe socioeconômica e principalmente quanto ao pertencimento étnico-racial. A dificuldade de acesso e utilização dos serviços de saúde pelas populações negras e quilombolas brasileiras repercute as iniquidades, resultando no agravamento de processos de adoecimentos de ordem crônica, como Diabetes e hipertensão, e problemas de qualidade assistencial, como no acompanhamento pré-natal. (shrink)

At the very beginning of L’Homme-Machine, La Mettrie claims that Leibnizians with their monads have “rather spiritualized matter than materialized the soul”; a few years later Pierre-Louis Moreau de Maupertuis, President of the Berlin Academy of Sciences and natural philosopher with a strong interest in the modes of transmission of ‘genetic’ information, conceived of living minima which he termed molecules, “endowed with desire, memory and intelligence,” in his Système de la nature ou Essai sur les corps organisés. This text first (...) appeared in Latin in 1751 under the title Dissertatio inauguralis metaphysica de universali naturae systemate, with the pseudonym Dr Baumann; it was translated by Maupertuis in 1754 as Essai sur la formation des corps organisés and was later included in his 1756 Œuvres under the title Système de la nature. Now, it is clear that Maupertuis was a kind of Leibnizian; and that his molecule possessed higher-level, ‘mental’ properties. In that sense he falls under the first category described by La Mettrie. But he was also involved in a debate on this issue with Diderot, who put forth a sustained critique of Maupertuis’ theory of the molecule in the additions to his 1753 Pensées sur l’interprétation de la nature. Where Maupertuis attributes higher-level properties to his living minima, Diderot argues that these properties are ‘organizational’, i.e., they can only be properties of the whole. At issue here is the degree of commitment to a form of materialism. (shrink)

A concretização do direito à saúde deve ser viabilizada pelo Estado, com foco na efetivação das políticas públicas para garantia da implantação e funcionamento dos serviços demandados pelos respectivos grupos populacionais. Destarte, essa escrita objetivou analisar como o direito à saúde é contemplado em comunidades quilombolas de uma região geográfica baiana. Metodologicamente enquadra-se como de abordagem qualitativa, com informações obtidas por meio de entrevistas estruturadas (sobre a infraestrutura e/ou serviços públicos de saúde) desenvolvidas com as representações das Associações de Moradores (...) de 14 quilombos da região geográfica de Guanambi/Bahia durante o ano de 2016. Os achados indicam que uma comunidade possuía estrutura física específica para atendimentos básicos em saúde, no entanto, estava desativada. Três comunidades não tinham cobertura do Programa de Agentes Comunitários de Saúde (PACS). Entre as 11 que indicaram cobertura do Programa, em sete as(os) profissionais não residiam no território do quilombo. Diante da ampla ausência de infraestrutura e recorrente inadequação na prestação de serviços do PACS, evidencia-se a permanente negligência ao direito à saúde nesta população quilombola. (shrink)

"This is an excellent textbook on Neoplatonism which gives the reader a very concise and lucid overview of the basic doctrines and leading thinkers of the last great philosophy to emerge before the Christianization of the Roman Empire. I’ve no doubt that my students next semester will benefit from the analyses contained in the book. The contents of the chapters are very informative and adequately place developments in their socio-cultural context." --Michael B. Simmons, Auburn University at Montgomery.

Oral healthcare is attracting much attention after decades of neglect from policymakers. Recent studies have shown a strong association between oral and overall health, which can lead to serious health problems. Availability of oral healthcare services is an essential part of ensuring universal healthcare coverage. More importantly, current gaps in its accessibility by minority or marginalized population groups are crucial public health as well as ethical concerns. One notable effort to address this issue comes from Non-Governmental Organizations (NGOs), which offer (...) oral healthcare services for non-insured refugees. However, the challenge remains that these care services are not comprehensive, which has implications for the refugees’ oral and general health. In this article, we discuss this complex issue in the German healthcare context by including ethical reflections. Therefore, the purpose of this article is to discuss the ethical challenges related to oral healthcare services provided by NGOs for refugees in Germany. First, we will introduce the general oral healthcare context worldwide and in Germany. Second, we will provide a general description of the oral healthcare services provided by NGOs for refugees in Germany, as well as an overview of existing gaps. This will provide us with the context for our third and most important task—discussing the ethical implications of the gaps. In doing so, and since the ethical implications can be several, we demarcate the scope of our analysis by focusing on the specific ethical issues of justice, harm, and autonomy. Finally, we offer some recommendations for how to move forward. (shrink)

While the current debate highlights an increasing deficit of civic engagement, new - and often less visible - forms of “participation” are beginning to be detected, such as those implemented by citizens with migratory background living at the physical and symbolic margins of Western towns. Our study, part of the project “Abitare insieme” (Living together) in Milan’s multicultural suburbs, was developed with a dual purpose: to analyze the relationship between citizens with a migratory background, active citizenship, and their place representations/belongings; (...) to experiment the co-construction of innovative spaces of speech for citizens, through their dialogical involvement in the research. In a framework of participatory research to enhance reflexivity and transformative practices, a survey was designed and administered. In this paper we will discuss the survey results, along with some methodological implication. The aim is to contribute to reinvent the “active citizenship” construct from a transformative, pedagogical, and intercultural perspective. (shrink)

Summary The role of ?Sidon? in the Pericope of the Canaanite Woman is far from clear. If the name is read as (Beth-) Saida(n), which is quite possible, the geography of the story becomes much more plausible. This instance has not been dealt with in M. Black's Aramaic Approach.

The role of 'Sidon' in the Pericope of the Canaanite Woman is far from clear. If the name is read as Saida, which is quite possible, the geography of the story becomes much more plausible. This instance has not been dealt with in M. Black's Aramaic Approach.

Biomarkers can be powerful tools to guide diagnosis, treatment, and research. However, prudent use of biomarkers requires formal validation efforts. Although the data needed for biomarker validation has traditionally been hard to access, new research initiatives can ease this process.

In his Philosophical Inquiry concerning Human Liberty (1717), the English deist Anthony Collins proposed a complete determinist account of the human mind and action, partly inspired by his mentor Locke, but also by elements from Bayle, Leibniz and other Continental sources. It is a determinism which does not neglect the question of the specific status of the mind but rather seeks to provide a causal account of mental activity and volition in particular; it is a ‘volitional determinism’. Some decades later, (...) Diderot articulates a very similar determinism, which seeks to recognize the existence of “causes proper to man” (as he says in the Réfutation d’Helvétius). The difference with Collins is that now biological factors are being taken into account. Obviously both the ‘volitional’ and the ‘biological’ forms of determinism are noteworthy inasmuch as they change our picture of the nature of determinism itself, but my interest here is to compare these two determinist arguments, both of which are broadly Spinozist in nature – and as such belong to what Jonathan Israel called in his recent book “the radical Enlightenment,” i.e. a kind of underground Enlightenment constituted by Spinozism – and to see how Collins’ specifically psychological vision and Diderot’s specifically biological vision correspond to their two separate national contexts: determinism in France in the mid-1750s was a much more medico-biological affair than English determinism, which appears to be on a ‘path’ leading to Mill and associationist psychology. (shrink)

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

This volume emphasizes the diversity and fruitfulness of early modern mechanism as a program, as a concept, as a model. Mechanistic study of the living body but also of the mind and mental processes are examined in careful historical focus, dealing with figures ranging from the first-rank (Bacon, Descartes, Spinoza, Cudworth, Gassendi, Locke, Leibniz, Kant) to less well-known individuals (Scaliger, Martini) or prominent natural philosophers who have been neglected in recent years (Willis, Steno, etc.). The volume moves from early modern (...) medicine and physiology to late Enlightenment and even early 19th-century psychology, always maintaining a conceptual focus. It is a contribution to a newly active field in the history and philosophy of early modern life science. It is of interest to scholars studying the history of medicine and the development of mechanistic theories. (shrink)

Ce livre étudie, à travers une série d'épisodes allant de la philosophie des Lumières à notre époque, le problème du matérialisme dans l'histoire de la philosophie et l’histoire des sciences. Comment comprendre les spécificités de l’histoire du matérialisme, des Lumières à nos jours, au sein de la grande histoire de la philosophie et de l’histoire des sciences ? Quelle est l’actualité de l’opposition classique entre le corps et l’esprit ? Qu’est-ce que le rire ou le rêve peuvent nous apprendre du (...) matérialisme ? En traversant l’histoire de ce concept jusqu’à l’émergence d’un « nouveau matérialisme » contemporain, l’ouvrage vise à revitaliser le matérialisme et sa lecture. -/- . (shrink)

The living body appears like an endlessly renewable reservoir of authenticity, hope, and taboo. But, for the sake of conceptual clarity, we are often been told that the (mere) body should be distinguished from the flesh. That is, it’s undeniable that I have a body; that I notice yours; that we worry about their birth and death and upkeep. But the flesh is a more transcendentalized, loaded concept – not least given its frequently religious background (incarnation: the Word made Flesh). (...) It is the body ‘kicked upstairs’, ‘bumped up’ one ontological level. Flesh is like a mantra, an obsessive leitmotif. Is the difference just one of abstraction? Indeed, crucial to the narrative of phenomenology (most obviously in Merleau-Ponty but really, throughout, including in enactivism), to the story of ancestor worship and identity it tells itself and its acolytes around the campfire, is a basic distinction between the merely physical body and the flesh as something requiring ‘mineness’, namely, an understanding of it as uniquely ‘my own’, a feeling of ‘what it is like to be embodied’. This goes back to the Husserlian distinction between Körper, ‘body’ in the sense of one body among others in a vast mechanistic universe of bodies, and Leib, ‘flesh’ in the sense of a subjectivity which is the locus of experience. In this essay I reflect on this vision of the body’s authenticity and its costs, and contrast it with insights derived from Georges Canguilhem, whose critique of mechanism/mechanicism is not done in the name of a wholescale organicism and/or an unproblematized éloge of embodiment and privacy. (shrink)

Thousands of youth suffering from acquired brain injury or other early-life neurological disease live, mature, and learn with only limited communication and interaction with their world. Such cognitively capable children are ideal candidates for brain-computer interfaces. While BCI systems are rapidly evolving, a fundamental gap exists between technological innovators and the patients and families who stand to benefit. Forays into translating BCI systems to children in recent years have revealed that kids can learn to operate simple BCI with proficiency akin (...) to adults. BCI could bring significant boons to the lives of many children with severe physical impairment, supporting their complex physical and social needs. However, children have been neglected in BCI research and a collaborative BCI research community is required to unite and push pediatric BCI development forward. To this end, the pediatric BCI Canada collaborative network was formed, under a unified goal to cooperatively drive forward pediatric BCI innovation and impact. This article reflects on the topics and discussions raised in the foundational BCI-CAN meeting held in Toronto, ON, Canada in November 2019 and suggests the next steps required to see BCI impact the lives of children with severe neurological disease and their families. (shrink)

How do we judge whether an action is morally right or wrong? If an action is wrong, what reason does that give us not to do it? Why should we give such reasons priority over our other concerns and values? In this book, T. M. Scanlon offers new answers to these questions, as they apply to the central part of morality that concerns what we owe to each other. According to his contractualist view, thinking about right and wrong is thinking (...) about what we do in terms that could be justified to others and that they could not reasonably reject. He shows how the special authority of conclusions about right and wrong arises from the value of being related to others in this way, and he shows how familiar moral ideas such as fairness and responsibility can be understood through their role in this process of mutual justification and criticism. Scanlon bases his contractualism on a broader account of reasons, value, and individual well-being that challenges standard views about these crucial notions. He argues that desires do not provide us with reasons, that states of affairs are not the primary bearers of value, and that well-being is not as important for rational decision-making as it is commonly held to be. Scanlon is a pluralist about both moral and non-moral values. He argues that, taking this plurality of values into account, contractualism allows for most of the variability in moral requirements that relativists have claimed, while still accounting for the full force of our judgments of right and wrong. (shrink)