In preparation for the development of a rapid tissue donation programme, we surveyed healthcare providers in our institution about knowledge and attitudes related to RTD with lung cancer patients. A 31-item web based survey was developed collecting data on demographics, knowledge and attitudes about RTD. The survey contained three items measuring participants’ knowledge about RTD, five items assessing attitudes towards RTD recruitment and six items assessing HCPs’ level of agreement with factors influencing decisions to discuss RTD. Response options were presented (...) on a 5-point Likert scale. Ninety-one HCPs participated in the study. 66% indicated they had never heard of RTD prior to the survey, 78% rated knowledge of RTD as none or limited and 95.6% reported not having ethical or religious concerns about discussing RTD with patients. The majority were either not comfortable or not sure if they felt comfortable discussing RTD with cancer patients . 56.1% indicated their knowledge of RTD would play an integral role in their decision to discuss RTD with patients. 71.4% reported concerns with RTD discussion and the emotional state of the patient. Physicians and nurses play an important role in initiating conversations about recruitment and donation to research that can ultimately influence uptake. Increasing HCP knowledge about RTD is a necessary step towards building an RTD programme. Our study provides important information about characteristics associated with low levels of knowledge and practice related to RTD where additional education and training may be warranted. (shrink)

Rapid tissue donation (RTD) is an advancing oncology research procedure for collecting tumors, metastases, and unaffected tissue 2–6 h after death. Researchers can better determine rates of progression, response to treatment, and polymorphic differences among patients. Cancer patients may inquire about posthumous body donation for research to offer a personal contribution to research; however, there are barriers to recruiting for an RTD program. Physicians must reassure the patient that their treatment options and quality of care will not be compromised due (...) to participating in RTD. In this commentary we discuss how theories of altruism may explain cancer patients’ desire to participate in an RTD program, the ethical concerns of health care professionals and patients and the use of altruism as a recruitment strategy. We offer recommendations for examining the cultural and ethical climate of the institution prior to initiating such a program such as examining the relationship of healthcare professionals and patients, identifying ethical concerns, and examining ways to promote acceptance and buy-in across professionals, patients, and families. (shrink)

Several authors have suggested that a more parsimonious and conceptually elegant treatment of everyday mereological and topological reasoning can be obtained by adopting a spatial ontology in which regions, not points, are the primitive entities. This paper challenges this suggestion for mereotopological reasoning in two-dimensional space. Our strategy is to define a mereotopological language together with a familiar, point-based interpretation. It is proposed that, to be practically useful, any alternative region-based spatial ontology must support the same sentences in our language (...) as this familiar interpretation. This proposal has the merit of transforming a vague, open-ended question about ontologies for practical mereotopological reasoning into a precise question in model theory. We show that (a version of) the familiar interpretation is countable and atomic, and therefore prime. We conclude that useful alternative ontologies of the plane are, if anything, less parsimonious than the one which they are supposed to replace. (shrink)

The numerically definite syllogistic is the fragment of English obtained by extending the language of the classical syllogism with numerical quantifiers. The numerically definite relational syllogistic is the fragment of English obtained by extending the numerically definite syllogistic with predicates involving transitive verbs. This paper investigates the computational complexity of the satisfiability problem for these fragments. We show that the satisfiability problem (= finite satisfiability problem) for the numerically definite syllogistic is strongly NP-complete, and that the satisfiability problem (= finite (...) satisfiability problem) for the numerically definite relational syllogistic is NEXPTIME-complete, but perhaps not strongly so. We discuss the related problem of probabilistic (propositional) satisfiability, and thereby demonstrate the incompleteness of some proof-systems that have been proposed for the numerically definite syllogistic. (shrink)

By a fragment of a natural language, we understand a collection of sentences forming a naturally delineated subset of that language and equipped with a semantics commanding the general assent of its native speakers. By the semantic complexity of such a fragment, we understand the computational complexity of deciding whether any given set of sentences in that fragment represents a logically possible situation. In earlier papers by the first author, the semantic complexity of various fragments of English involving at most (...) transitive verbs was investigated. The present paper considers various fragments of English involving ditransitive verbs and determines their semantic complexity. (shrink)

Published in the year 2004, Philosophy and the Social Sciences is a valuable contribution to the field of Sociology.

This is the first collection of all of the major philosophical works of Cadwallader Colden, one of the most accomplished intellectual and political figures in the American colonies before the Revolution. As Lieutenant Governor of New York he was intimately involved in the tumultuous political life of the times, and he represented the colonial government to the five nations of the Iroquois Confederacy. His History of the Five Indian Nations was the first English history of the Iroquois and a popular (...) book both in the colonies and in Europe. A prolific letter writer, Colden corresponded with many of the major intellectuals of his day, including Benjamin Franklin and Samuel Johnson. He also wrote extensively on a wide range of topics, including philosophy, history, the natural sciences, and mathematics. Although several of Colden's works have been available in anthologies, until now there has never been a collection of all of his philosophical writings. This anthology includes The Principles of Action in Matter, the Introduction to Phylosophy, the Introduction to The History of the Five Indian Nations, and the complete correspondence with Samuel Johnson on the subject of materialism and idealism. Also included is the first publication of Principles of Morality, written in 1745, but never published till now. For students of American philosophy, as well as those interested in the intellectual history of the colonial period, this is an essential work. (shrink)

Josiah Royce (1855?1916) was, in addition to being the pre-eminent metaphysician at the turn of the 19th century in the USA, regarded as ?a logician of the first rank?. At the time of his death in 1916, he had begun a substantial and potentially revolutionary project in logic in which he sought to show the connection between logic and ethics, aesthetics, and metaphysics. His system was developed in light of the work of Bertrand Russell and A. B. Kempe and aimed (...) to include Russell's logic as a subsystem. This more comprehensive logic, which Royce called system Σ, brought together an analysis of the character of experience and knowledge with the principles which served to organize interests and direct actions. The result was to be a logical theory framed by ?a profoundly ethical motive as well as a genuinely intellectual one? that would serve as ?a theory of the way in which activities must go on if they go on at all?. This paper examines three stages in the development of Royce's logical system, its relation to the logic of Principia Mathematica, and prospects for its further development. (shrink)

An appeal to the inexplicable has always been a favourite tactic of the Supernaturalist; and even today those Supernaturalists that remain seem to derive some comfort from it. During the eighteenth and nineteenth centuries, for example, the orthodox Protestant apologetic in this country laid great stress on the ‘inexplicable’ events allegedly associated with Christ's life as anthenticating the truths of revelation. A more general thesis has been put forward as often, and even more often assumed: that the occurrence of inexplicable (...) events demonstrates the reality of a ‘spiritual’ realm. And in current literature we can find it claimed that the hegemony of science or the tenability of materialism is threatened by those inexplicabilities which are now known as the phenomena of ESP. (shrink)

1) The aim of the paper is to trace what we call oblivion in the thought of Martin Heidegger: the question about the nature and the natural being of the Dasein. Two questions are raised: Does Heidegger get trapped in the nature-spirit opposition? Is the Dasein sufficiently and satisfactorily though of in its factuality, if the natural dimension of its being has been silenced? 2) Within representative thought: the world in the original dimension in which the Dasein is rooted and (...) in which the opening up of Being and the prior self-offering of the intra-mundane entity as a tool takes place. 3) Nature in Being and Time: nature as being-at-hand and nature of the surrounding world. 4) Nature as organic or animal life in Fundamental Concepts of Metaphysics: the animal deprived of a world and the question about human animality. 5) Nature as earth in "The Origin of the Work of Art". 6) Two alternatives to think upon nature from [the perspective of] an ontology of negativity: Maurice Merleau-Ponty and Georges Bataille. 7) Conclusion: Heidegger's "oblivion" implies the risk of getting trapped in the classical nature-spirit opposition and of not being able to unfold every dimension of factuality.1) El objetivo del escrito es rastrear lo que llamamos un olvido en el pensamiento de Martin Heidegger: la pregunta por la naturaleza y el ser natural del Dasein. Se plantean dos preguntas: ¿queda Heidegger entrampado en la oposición naturaleza-espíritu? ¿está suficiente y satisfactoriamente pensado el Dasein en su facticidad si ha sido silenciada la dimensión natural de su ser?; 2) Más acá del pensamiento representativo: el mundo como la dimensión originaria en la que arraiga el Dasein y en la que tiene lugar la apertura del ser y el darse previo del ente intra-mundano como útil . 3) La naturaleza en Ser y Tiempo: naturaleza como ser-a-la-mano y naturaleza del mundo circundante. 4) La naturaleza como vida orgánica o animal en Los conceptos fundamentales de la metafísica: el animal privado de mundo y la pregunta por la animalidad de lo humano. 5) La naturaleza como tierra en "El origen de la obra de arte". 6) Dos alternativas para pensar la naturaleza desde una ontología de la negatividad: Maurice Merleau-Ponty y Georges Bataille. 7) Conclusión: el "olvido" heideggeriano implica el riesgo de quedar atrapado en la oposición clásica naturaleza-espíritu y de no desplegar todas la dimensiones de la facticidad. (shrink)

A spatial logic is a formal language interpreted over any class of structures featuring geometrical entities and relations, broadly construed. In the past decade, spatial logics have attracted much attention in response to developments in such diverse fields as Artificial Intelligence, Database Theory, Physics, and Philosophy. The aim of this handbook is to create, for the first time, a systematic account of the field of spatial logic. The book comprises a general introduction, followed by fourteen chapters by invited authors. Each (...) chapter provides a self-contained overview of its topic, describing the principal results obtained to date, explaining the methods used to obtain them, and listing the most important open problems. Jointly, these contributions constitute a comprehensive survey of this rapidly expanding subject. (shrink)

Most of the literature on teaching within nursing education presents teaching and learning strategies as unproblematic and widely generalized across contexts, content, learners, and educators. We argue that to be truly effective, teaching strategies must be harmonious with instructor’s beliefs, intentions, and actions. In this paper, we introduce the notion of a plurality of effective teaching based on five different ‘perspectives on teaching’– each composed of different beliefs, intentions, actions, and strategies and illustrated by cases from nursing education. We propose (...) that this foundational conceptualization provides a base from which nurse educators can (1) communicate across differences of philosophical perspective and intent; and (2) critically reflect on their educational practices. (shrink)

Six planetary boundaries have already been exceeded, including climate change, loss of biodiversity, chemical pollution, and land-system change. The health research sector contributes to the environmental crisis we are facing, though to a lesser extent than healthcare or agriculture sectors. It could take steps to reduce its environmental impact but generally has not done so, even as the planetary emergency worsens. So far, the normative case for why the health research sector should rectify that failure has not been made. This (...) paper argues strong philosophical grounds, derived from theories of health and social justice, exist to support the claim that the sector has a duty to avoid or minimise causing or contributing to ecological harms that threaten human health or worsen health inequity. The paper next develops ideas about the duty’s content, explaining why it should entail more than reducing carbon emissions, and considers what limits might be placed on the duty. (shrink)

In the human quest for meaning, work occupies a central position. Most adults spend the majority of their waking hours at work, which often serves as a primary source of purpose, belongingness, and identity. In light of these benefits to employees and their organizations, organizational scholars are increasingly interested in understanding the factors that contribute to meaningful work, such as the design of jobs, interpersonal relationships, and organizational missions and cultures. In a separate line of inquiry, scholars of business ethics (...) have examined meaningful work as a moral issue concerning the management of others and ourselves, exploring whether there are definable characteristics of meaningful work to which we have moral rights, and whether there are moral duties to ourselves and others to fulfill those rights. In this article, we examine contemporary developments in both disciplines about the nature, causes, and consequences of meaningful work; we explore linkages between these disciplines; and we offer conclusions and research opportunities regarding the interface of ethical and organizational perspectives on performing and providing meaningful work. (shrink)

The vision and mission statements of 24 environmental organisations were analysed under the premise that the language used in these statements reflects and influences the priorities of their operation. A dominant perspective, hinging on the concept of 'sustainable development', merged the profile of government agencies and non-governmental groups. The language reflected an utilitarian ethics: the environment was more generally portrayed as resources than as nature. Aesthetic remarks were exceptional, even among groups focusing on wildlife. Despite a broadly claimed link between (...) human welfare and habitat viability, environmental issues were not broadly referred to by humanitarian organisations, while conservation groups comply with societal priorities and needs. Organisational statements seem more concerned about political legitimation by audiences with specific expectations than about articulating purposes with internal structural consequences or goals that advocate change or reflect organisational uniqueness. (shrink)

John Henry Newman is widely acknowledged to be an important theologian. However Newman commentators suggest that his work has received little recognition by philosophers. The general consensus has been that until the latter part of the twentieth century Newman has been an isolated philosophical figure. This essay offers an historical re-evaluation of Newman's philosophical reception in order to explore whether or not his significance has been underestimated. The historical method is used in the analysis and assessment of this question. The (...) study therefore probes the general philosophical reaction to Newman's work in the nineteenth and early twentieth century. In doing so the essay offers an historical investigation and re-evaluation of the claims of Newman having a negligible philosophical legacy. (shrink)

Sobre que investigan los Maestrantes de nuestra Institución formadora de docentes, es el tema de este trabajo. Con un enfoque cualitativo, metodología de diseño emergente y con instrumentos como formulario Google, el análisis de los documentos de tesis de la generación 2020-2022, presentamos la respuesta a esta interrogante. Los Maestrantes enfrentaron la situación atípica de la pandemia y el confinamiento por covid-19 y realizaron sus tesis bajo la metodología de investigación-acción. Desarrollaron competencias del perfil de egreso de la Institución, al (...) generar conocimiento y mejorar la calidad de su enseñanza en beneficio de sus estudiantes. (shrink)

BackgroundIn June 2019, the Australian state of Victoria joined the growing number of jurisdictions around the world to have legalised some form of voluntary assisted dying. A discourse of safety was prominent during the implementation of the Victorian legislation.Main textIn this paper, we analyse the ethical relationship between legislative “safeguards” and equal access. Drawing primarily on Ruger’s model of equal access to health care services, we analyse the Victorian approach to voluntary assisted dying in terms of four dimensions: horizontal equity, (...) patient agency, high quality care, and supportive social norms. We argue that some provisions framed as safeguards in the legislation create significant barriers to equal access for eligible patients.ConclusionsWhile safety is undoubtedly ethically important, we caution against an overemphasis on safeguarding in voluntary assisted dying legislation given the implications for equal access. (shrink)

In recent years, there has been renewed interest in the development of formal languages for describing mereological (part-whole) and topological relationships between objects in space. Typically, the non-logical primitives of these languages are properties and relations such as `x is connected' or `x is a part of y', and the entities over which their variables range are, accordingly, not points, but regions: spatial entities other than regions are admitted, if at all, only as logical constructs of regions. This paper considers (...) two first-order mereotopological languages, and investigates their expressive power. It turns out that these languages, notwithstanding the simplicity of their primitives, are surprisingly expressive. In particular, it is shown that infinitary versions of these languages are adequate to express (in a sense made precise below) all topological relations over the domain of polygons in the closed plane. (shrink)

In recent years, there has been renewed interest in the development of formal languages for describing mereological (part-whole) and topological relationships between objects in space. Typically, the non-logical primitives of these languages are properties and relations such as ‘xis connected’ or ‘xis a part ofy’, and the entities over which their variables range are, accordingly, notpoints, butregions: spatial entities other than regions are admitted, if at all, only as logical constructs of regions. This paper considers two first-order mereotopological languages, and (...) investigates their expressive power. It turns out that these languages, notwithstanding the simplicity of their primitives, are surprisingly expressive. In particular, it is shown that infinitary versions of these languages are adequate to express (in a sense made precise below) all topological relations over the domain of polygons in the closed plane. (shrink)

This article introduces a special section concerned with precariousness and cultural work. Its aim is to bring into dialogue three bodies of ideas — the work of the autonomous Marxist `Italian laboratory'; activist writings about precariousness and precarity; and the emerging empirical scholarship concerned with the distinctive features of cultural work, at a moment when artists, designers and (new) media workers have taken centre stage as a supposed `creative class' of model entrepreneurs. The article is divided into three sections. It (...) starts by introducing the ideas of the autonomous Marxist tradition, highlighting arguments about the autonomy of labour, informational capitalism and the `factory without walls', as well as key concepts such as multitude and immaterial labour. The impact of these ideas and of Operaismo politics more generally on the precarity movement is then considered in the second section, discussing some of the issues that have animated debate both within and outside this movement, which has often treated cultural workers as exemplifying the experiences of a new `precariat'. In the third and final section we turn to the empirical literature about cultural work, pointing to its main features before bringing it into debate with the ideas already discussed. Several points of overlap and critique are elaborated — focusing in particular on issues of affect, temporality, subjectivity and solidarity. (shrink)

In the Australian state of Victoria, legislation allowing voluntary assisted dying (VAD) passed through parliament in November 2017. There was then an eighteen-month period before the start date for patient access to VAD, referred to as the “implementation period.” The implementation period was intended to allow time for the relevant government department and affected organizations to develop processes before the Act came into effect in June 2019. This qualitative interview study investigates the perspectives of a multidisciplinary sample of twelve clinicians (...) from a single metropolitan hospital during this implementation period. Maximum variation sampling was utilized to ensure breadth across discipline (medical, nursing, allied health), speciality, and stated level of support for the VAD legislation. Four key themes were identified from the interview data: preparing for the unknown, ethical diversity within the organization, building a respectful culture, and concerns about the inability of the legislated approach to capture clinical nuances. Overall, these clinicians’ workplace experiences during the implementation period were shaped by the ethical diversity within their organization and a sense of uncertainty about how the VAD legislation would integrate with the practical realities of their clinical setting. The concept of “ethical diversity” could be a useful one for supporting staff in an organization during a VAD implementation period. (shrink)

Introducción: El examen estatal escrito evalúa la competencia del egresado y debe cumplir los requisitos de su confección y de su análisis informar las deficiencias en el proceso docente educativo para su perfeccionamiento. Objetivo: Caracterizar el examen estatal ordinario escrito y los resultados obtenidos en la Facultad de Estomatología. Camagüey durante el período 2011-2012. Métodos: Se realizó un estudio descriptivo del examen estatal ordinario escrito aplicado a 146 estudiantes. Se elaboró una base de datos con las calificaciones obtenidas, índice académico (...) y una guía con las variables tipo de examen, de preguntas, nivel de asimilación, claridad de formulación, correspondencia con los objetivos de la carrera, clave de calificación y cumplimiento de los criterios de Guilbert, analizados por grupo de expertos. Resultados: En los resultados se aproximó la nota de los excelentes (27,4 %) con el índice académico de los altos rendimientos (28,1 %). La mediana general fue de 86,3. Los temas más explorados fueron Endodoncia (18,8 %), Prótesis y Odontopediatría (10,4 %). Las preguntas con más valor fueron de temas curativos. El nivel de asimilación fue reproductivo y el 35,4 % de preguntas tipo selección múltiple complemento agrupado. Existieron dificultades de diseño del examen y autopreparación de los estudiantes. Conclusiones: Los resultados se aproximaron a los rendimientos académicos. No hubo equidad entre el número, valor de las preguntas por temas y nivel de asimilación. Los errores se asociaron en frecuencia al diseño y redacción de algunas preguntas, insuficiente estudio y en menor grado a la falta de sistematicidad en el proceso docente, que permitieron determinar las deficiencias para su intervención. Introduction: The State written exam evaluates the competence of seniors and must meet the requirements of its preparation and analysis in order to report deficiencies in the educational teaching process for its further development. Objective: To characterize the written regular state exam and the results obtained at the Faculty of Stomatology. Camaguey during the period of 2011-2012. Methods: A descriptive study of the written regular state exam was conducted to 146 students. A data base was developed with the grades obtained, academic index and a guide with the exam- type variables, questions, level of assimilation, clarity of formulation, correspondence with the objectives of the career, key qualification and compliance with the criteria of Guilbert, all analyzed by groups of experts. Results: In the results the excellent notes (27.4%) approached to the academic index of high yield (28.1%). The general average was 86,3. The most explored themes were Endodontics (18.8%), Prosthesis and Pediatric Odontology (10.4%). healing topics were the questions with more value. The level of assimilation was reproductive and 35.4% of multiple choice type questions complement clustered. There were difficulties according to the test design and the students' self study. Conclusions: The results were close to academic performance. There was no equality between the number, value of the questions by topic and level of assimilation. Errors were often associated with the design and wording of some questions, insufficient study and in a lesser extent to the lack of systematic fashion in the teaching process, which allowed to determine deficiencies for its intervention. (shrink)

Fundamento: La ampliación de matrícula con la diversidad de vías de ingreso ha constituido un reto en la educación médica y la evaluación de graduación implica la certificación de la competencia de los egresados, por eso se hace necesario analizar los resultados obtenidos en estas etapas. Objetivo: Comparar los resultados de los ejercicios prácticos, teóricos y notas finales obtenidas por los estudiantes presentados a Exámenes Estatales Ordinarios de los cursos del 2006 al 2012 de la Facultad de Estomatología en la (...) Universidad de Ciencias Médicas de Camagüey. Métodos: Se realizó una investigación descriptiva con 410 estudiantes presentados a exámenes estatales ordinarios en el período 2006-2012. Se clasificaron los grupos con menos o más de 40 estudiantes por cursos. Se obtuvieron las calificaciones de cada ejercicio y nota final estatal por cursos. Se utilizó el método porcentual, media aritmética y mediana obtenida en cada curso. Resultados: Los cursos del 2006-2009 sumaron 99 estudiantes y en los cursos del 2009-2012 se incrementaron hasta 311 educandos. En los exámenes estatales prácticos, los grupos pequeños obtuvieron calificación media de 99,2 y una mediana de 99 y 100; en los grupos numerosos las calificaciones disminuyeron hasta llegar a una media de 93 y una mediana de 95. En los exámenes teóricos, en los tres primeros cursos la media de calificación fue 83,5 y en el grupo numeroso de 83,7. Conclusiones: En los resultados se mantiene la calidad de la base científica de la actuación en todos los cursos, pero ha disminuido la del desempeño en los cursos con incremento de estudiantes. Background: The extension of registration with the diversity of entrance ways has been a challenge in medical education. Graduation assessment involves the certification of the competence among seniors, therefore it is necessary to analyze the results obtained in these stages. Objective: To compare the results of theoretical, practical exercises and final notes obtained by the students submitted to Regular State examinations in the courses from 2006 to 2012 of the Dentistry Faculty at the Medical Sciences University of Camaguey. Methods: A descriptive research with 410 students submitted to Regular State examination was conducted in the period of 2006 to 2012. The groups were classified with less or more than 40 students per courses. The ratings of each exercise and state final note by courses were obtained. The methods used in each course were the percentage method, arithmetic mean and median obtained. Results: The courses from 2006 to 2009 totaled 99 students and in the courses from 2009 to 2012 the number of students increased up to 311. In the State practical tests small groups obtained qualification average of 99.2 and a median of 99 and 100; numerous groups' ratings fell to an average of 93 and an average of 95. In the theoretical tests, in the first three courses the average rating was 83.5 and in the large group it was 83.7. Conclusions: The results maintain the quality of the scientific basis of the performance in all courses, but the performance in courses with students increase has declined. (shrink)

The topic of epistemic injustice in global health ethics is complex, important and vast. While presenting as nuanced and complete a picture of the challenge as we possibly could, we were acutely aware of our positionality and how it gave us a certain viewpoint that would need to be expanded by others with different positions and experiences. We were, therefore, delighted to receive the collected commentaries by Atuire,1 Abimbola,2 Frimpong-Mansoh,3 Nyamnjoh and Ewuoso,4 Tangwa,5 Ambrogi et al.6 We would like to (...) thank these authors for furthering our account by raising questions, pointing out gaps or complementing our analysis. The points raised by these authors—and many points that will undoubtedly be raised by others in future—should be critically engaged with as we collectively define and work towards a more epistemically just global health ethics. Specifically, two points stand out. First, Frimpong-Mansoh accurately diagnoses our ambiguity about being drawn into debates about relativism in bioethics. We …. (shrink)

Gilbertson, Savulescu, Oakley and Wilkinson propose extending the availability of terminal sedation (TS) to patients with intractable pain and/or suffering who are expected to live more than 2 weeks (hence the designation of extended TS (ETS)) and to patients whose values are known but who do not have decision-making capacity.1 Their plan is worthy of serious consideration: it is, after all, based on the fundamental and well-recognised medical ethical values of patient autonomy and beneficence. But, even when restricted to jurisdictions (...) that allow assisted dying, the ETS proposal raises three important issues. When the authors speak of ‘assisted dying’ and of ‘Voluntary Assisted Dying (VAS)’, they refer specifically to the laws in Australia and similar ones in New Zealand, the Netherlands, Belgium, Luxembourg, Switzerland, Spain and Canada that permit clinicians either to provide patients with lethal medications for self-administration (formerly called physician-assisted suicide) or to administer lethal medications themselves (voluntary euthanasia). First, the authors distinguish—as do many patients and the public—between sedation to unconsciousness and death. Indeed, as the authors point out, the difference seems obvious: unconsciousness can be reversed, death cannot. Yet in the case of TS, this may be …. (shrink)

The silencing of the epistemologies, theories, principles, values, concepts and experiences of the global South constitutes a particularly egregious epistemic injustice in bioethics. Our shared responsibility to rectify that injustice should be at the top of the ethics agenda. That it is not, or only is in part, is deeply problematic and endangers the credibility of the entire field. As a first step towards reorienting the field, this paper offers a comprehensive account of epistemic justice for global health ethics. We (...) first introduce several different conceptions of justice and decolonisation in relation to knowledge, purposefully drawing on work emanating from the global South as well as the global North. We then apply those conceptions to the global health ethics context to generate a tripartite account of the layers of epistemic justice in the field: who is producing ethics knowledge; what theories and concepts are being applied to produce ethics knowledge; and whose voices are sought, recorded and used to generate ethics knowledge. These layers reflect that the field spans conceptual and empirical research. We conclude by proposing that, going forward, three avenues are key to achieve greater epistemic justice at each layer and to help decolonise global health ethics: namely, understanding the problem, dialogue and structural change. (shrink)