This study assesses Latin America and Caribbean countries’ capacity to innovate new pharmaceuticals, defined as developing new drugs and vaccines, repurposing existing drugs, and inventing around patents to produce new drug variations. Vaccine innovation includes reengineering existing vaccines, developing new manufacturing methods, and the clinical development of unapproved vaccine candidates initiated elsewhere.

The demographic and epidemiological transitions are driving pharmaceutical expenditures up in Latin American and the Caribbean, with much of the cost falling on households. The domestic development and manufacturing of bio-similars could make medicines more affordable.

While philosophical questions about health and disease have attracted much attention in recent decades, and while opinions are divided on most issues, influential accounts seem to embrace negativism about health, according to which health is the absence of disease. Some subscribe to unrestricted negativism, which claims that negativism applies not only to the concepts of health and disease as used by healthcare professionals but also to the lay concept that underpins everyday thinking. Whether people conceptualize health in this manner has (...) implications for medical care and public health, and so we set out to examine this claim in two studies. Participants were asked to assess and compare the health states of two people presented in two vignettes. We found that both lay people and medical students conceptualize health as something more than the absence of disease. We argue that our findings highlight a need to rethink unrestricted negativism and indicate a need to rethink the way the debate has traditionally focused on disease. (shrink)

While many profound philosophical questions arise about psychopaths, I wish to draw attention to two limitations in current debates. First, philosophers mainly deal with offender and forensic populations neglecting so-called ‘successful’ psychopaths. Second, philosophers mainly focus on the issue of empathy and responsibility, while relatively little attention is paid to volitional aspects. I address these two limitations together and argue that ‘successful’ psychopaths are volitionally constrained. In order to grasp and explore this deficiency, I argue in favour of a more (...) refined and fine-grained understanding of identifications. (shrink)

In this paper I criticize libertarianism and skepticism about free will. The criticism of libertarianism takes some steps towards filling in an argument that is often mentioned but seldom developed in any detail, the argument that libertarianism is a scientifically implausible view. I say "take some steps" because I think the considerations I muster (at most) favor a less ambitious relative of that argument. The less ambitious claim I hope to motivate is that there is little reason to believe that (...) extant libertarian accounts satisfy a standard of naturalistic plausibility, even if they do satisfy a standard of naturalistic compatibility. The argument against skepticism about free will tries to show (1) perhaps the most prominent form of skeptical argument against the existence of free will does not work, and (2) there is a good general argument against skepticism about free will. (shrink)

The doctor-patient relationship -- Consent, choice, and refusal : adults with capacity -- Treating adults who lack capacity -- Children and young people -- Confidentiality -- Health records -- Contraception, abortion, and birth -- Assisted reproduction -- Genetics -- Caring for patients at the end of life -- Euthanasia and physician assisted suicide -- Responsibilities after a patient's death -- Prescribing and administering medication -- Research and innovative treatment -- Emergency situations -- Doctors with dual obligations -- Providing treatment and (...) care in detention settings -- Education and training -- Teamwork, referral, delegation, and shared care -- Public health dimensions of medical practice -- Reducing risk, clinical error, and poor performance. (shrink)

At the outset of an ethnographic inquiry, we navigated national and international resources to search for theoretical and practical guidance on obtaining parents and children’s informed consent/assent. While much theoretical guidance debating ethical issues to children’s participation in research was found, a paucity of published papers offering practical guidance on assent processes and/or visual representations of child assent forms and information sheets was discovered. The purpose of this article is to describe our experiences, both theoretically and practically, of negotiating the (...) process of obtaining informed consent and assent with parents and children for a non-therapeutic qualitative research study. We hope this article instigates a platform for others to explicate their experience and contributes to the construction of a coherent body of knowledge which will clearly delineate important elements that must be considered when negotiating children’s agreement to participate in research. (shrink)

This paper aims to investigate whether and in what respects the conceptions of the body and of agency that Judith Butler develops in Bodies That Matter are useful contributions to feminist theory. The discussion focuses on the clarification and critical assessment of the arguments Butler presents to refute the charges of linguistic monism and determinism.

: This paper aims to investigate whether and in what respects the conceptions of the body and of agency that Judith Butler develops in Bodies That Matter are useful contributions to feminist theory. The discussion focuses on the clarification and critical assessment of the arguments Butler presents to refute the charges of linguistic monism and determinism.

Background:Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty.Objectives:The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi.Methodology:A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were (...) collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0.Ethical consideration:The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi.Results:The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings.Conclusion:The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or (...) it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example. (shrink)

Body representations are known to be dynamically modulated or extended through tool use. Here, we review findings that demonstrate the importance of a user's tool experience or expertise for successful tool embodiment. Examining expert tool users, such as individuals who use tools in professional sports, people who use chopsticks at every meal, or spinal injury patients who use a wheelchair daily, offers new insights into the role of expertise in tool embodiment: Not only does tool embodiment differ between novices and (...) experts, but experts may experience enhanced changes to their body representation when interacting with their own, personal tool. The findings reviewed herein reveal the importance of assessing tool skill in future studies of tool embodiment. (shrink)

There is a familiar chain of reasoning that goes something like this: if everything is caused, no one is free, and thus, no one can be morally responsible. Reasoning like this has made scientific explanations of human behavior (e.g., biology, psychology, and neuroscience) threatening to familiar ideas of responsibility, blameworthiness, and merit. Rather than directly attacking the chain of reasoning that gives rise to these worries, I explore an alternative approach, one that begins by considering the "use" of moral responsibility. (...) What role does the concept play for us? What structure, if any, would an ideal set of practices and attitudes about moral responsibility have to it? I outline a new account of responsibility and consider what it might mean for traditional worries about causal, scientific explanations of human behavior. (shrink)

In this paper, we examine the scientific, legal, and ethical foundations for inclusion of transgender women athletes in competitive sport, drawing on IOC principles and relevant Court of Arbitration for Sport decisions. We argue that the inclusion of trans athletes in competition commensurate with their legal gender is the most consistent position with these principles of fair and equitable sport. Biological restrictions, such as endogenous testosterone limits, are not consistent with IOC and CAS principles. We explore the implications for recognizing (...) that endogenous testosterone values are a ‘natural physical trait’ and that excluding legally recognized women for high endogenous testosterone values constitutes discrimination on the basis of a natural physical trait. We suggest that the justificatory burden for such prima facie discrimination is unlikely to be met. Thus, in place of a limit on endogenous testosterone for women, we argue that ‘legally recognized gender’ is most fully in line with IOC and CAS principles. (shrink)

We sometimes fail unwittingly to do things that we ought to do. And we are, from time to time, culpable for these unwitting omissions. We provide an outline of a theory of responsibility for unwitting omissions. We emphasize two distinctive ideas: (i) many unwitting omissions can be understood as failures of appropriate vigilance, and; (ii) the sort of self-control implicated in these failures of appropriate vigilance is valuable. We argue that the norms that govern vigilance and the value of self-control (...) explain culpability for unwitting omissions. (shrink)

This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medi- cine. The main hypothesis is that grasping a mechanistic explanation of a condi- tion is necessary for a biomedical (...) understanding of that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothe- sis is that clinical understanding combines biomedical understanding of a disease or pathological condition with understanding illness, which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources in addition to those involved in biomedical understanding. (shrink)

The presence of stigmatizing language in the electronic health record (EHR) has been used to measure implicit biases that underlie health inequities. The purpose of this study was to identify the presence of stigmatizing language in the clinical notes of pregnant people during the birth admission. We conducted a qualitative analysis on N = 1117 birth admission EHR notes from two urban hospitals in 2017. We identified stigmatizing language categories, such as Disapproval (39.3%), Questioning patient credibility (37.7%), Difficult patient (21.3%), (...) Stereotyping (1.6%), and Unilateral decisions (1.6%) in 61 notes (5.4%). We also defined a new stigmatizing language category indicating Power/privilege. This was present in 37 notes (3.3%) and signaled approval of social status, upholding a hierarchy of bias. The stigmatizing language was most frequently identified in birth admission triage notes (16%) and least frequently in social work initial assessments (13.7%). We found that clinicians from various disciplines recorded stigmatizing language in the medical records of birthing people. This language was used to question birthing people's credibility and convey disapproval of decision‐making abilities for themselves or their newborns. We reported a Power/privilege language bias in the inconsistent documentation of traits considered favorable for patient outcomes (e.g., employment status). Future work on stigmatizing language may inform tailored interventions to improve perinatal outcomes for all birthing people and their families. (shrink)

many symbols. We define o, as the probability that an arbitrary machine be circular and we prove that o, is a random number that goes beyond..

Husserlian phenomenology of time, as it is developed on theLectures on the Phenomenology of Inner Time Consciousness, shows some difficulties to explain certain temporal experiences. This is the case of the incompatibility between the rigidity of the retentional modification and the effective approach that a subject may have with his memories. On the one hand, according to the Lectures’ explanation, the darkening of the past occurs in an homogeneous way: The more distant an experience is, the lower the clarity of (...) the associated retention. However, our relation with the past is not so direct. Complementing the studies of the Lectureswith those of the Analysis concerning passive synthesiscould allow to explain this kind of temporal phenomena. (shrink)

RESUMEN Aunque las Lecciones de fenomenología de la conciencia interna del tiempo tienen pocas referencias al marco metódico, ciertos pasajes apuntan a la reducción fenomenológica, de modo que su status se diferenciaría del de las Investigaciones lógicas y se acercaría al de Ideas i. Se ha señalado que aun si la reducción es empleada en este texto, no lo sería en su "versión madura". Se busca determinar el estatus metodológico de las Lecciones a partir de una comparación entre los desarrollos (...) metódicos y las descripciones fenomenológicas que se presentan allí y aquellos consignados en Investigaciones e Ideas, teniendo como idea regulativa el esclarecimiento del papel del tiempo en la ampliación del dominio de la fenomenología como conjunto. ABSTRACT Although there are few references to the methodological framework in On the Phenomenology of the Consciousness of Internal Time, certain passages point to the phenomenological reduction. Therefore, its status would differ from that of the Logical Investigations and approach that of Ideas I. Some have argued that the reduction used in this text is not the "mature version" of the same. The article seeks to determine the methodological status of PCIT on the basis of the comparison between the methodological developments and phenomenological descriptions found in this work and those found in Investigations and Ideas. The regulative idea guiding the analysis is the clarification of the role of time in broadening the sphere of phenomenology as a whole. (shrink)

En este trabajo presentamos el proceso del ordenamiento, catalogación y curaduría de los materiales fotográficos de un antropólogo estadounidense que realizó trabajo de campo en Atlixco, Puebla, México, con indígenas de la etnia nahua en las décadas de 1970 y 1980La metodología utilizada para este trabajo se basó en una propuesta propia de catalogación mínima de materiales fotográficos.Concluimos que la catalogación mínima es adecuada para la interoperabilidad con los estándares internacionales y resulta fácil de aplicar en los contextos universitarios y (...) de archivos locales. (shrink)

Neil Levy (2007) argues that empirical data shows that psychopaths lack the moral knowledge required for moral responsibility. His account is intriguing, and it offers a promising way to think about the significance of psychopaths for work on moral responsibility. In what follows we focus on three lines of concern connected to Levy's account: his interpretation of the data, the scope of exculpation, and the significance of biological explanations for anti-social behavior.

Este trabajo examina diferentes perspectivas docentes para externalizar criterios de evaluación. Se presentan hallazgos de una investigación doctoral que abordan, por una parte, una metodología analítica, que cautela la claridad y transparencia en la comunicación de criterios, segmentando la meta de aprendizaje en pequeñas secuencias, transmitiendo de este modo una idea atomizada acerca del conocimiento. Por otra parte, se explora una visión más holística, sustentada en la interdependencia de los criterios de evaluación, favoreciendo la comprensión del propósito de la tarea (...) en su conjunto. Se analiza la significancia de estos enfoques para la retroalimentación y evaluación formativa. (shrink)

We contribute to feminist and gender scholarship on cultural notions of motherhood by analyzing the importance of motherhood among mothers and non-mothers. Using a national probability sample of U.S. women ages 25-45, we find a continuous distribution of scores measuring perceptions of the importance of motherhood among both groups. Employing OLS multiple regression, we examine why some women place more importance on motherhood, focusing on interests that could compete with valuing motherhood, and controlling for characteristics associated with becoming a mother. (...) Contrary to cultural schemas that view mother and worker identities as competing, we find that education level is not associated with the importance of motherhood for either group and that valuing work success is positively associated with valuing motherhood among mothers. Consistent with feminist explanations for delayed fertility, valuing leisure is negatively associated with valuing motherhood for non-mothers. (shrink)

El canon literario implica un proceso de selección sistemático y jerárquico de escritores, obras y géneros con el fin de delimitar un corpus modélico imitableligado fuertemente a la instrucción pedagógica. En el presente trabajo se analizará el particular proceso de formación y conformación del canon –así como surecepción y transformación respecto de los cánones previos– establecido por Quintiliano en el Libro 10 de la Institutio Oratoria, a fin de demostrar que los criterios de selección que guían dicho canon exceden la (...) mera función didáctica. (shrink)

The article discusses a relatively obscure but significant aspect of work of the Russian and Soviet thinker Alexander Bogdanov—his science fiction novels. The author points out that, using the form...

O objetivo deste artigo é apresentar uma argumentação sobre a possibilidade de se pensar a justiça como uma experiência do i m possível. Parte-se da distinção derridiana entre justiça e direito. Essa distinção trará algumas implicações no que tradicionalmente é entendido como ética. Partindo do jogo ou da différance marcada entre a presença/ausência, pretende-se estabelecer um ponto de diálogo entre Derrida e Levinas. O ponto de aproximação é a questão do terceiro na relação do face a face. Nesse sentido, problematiza-se (...) se a desconstrução pode ser adotada como um possível modo filosófico que fundamente a compreensão da justiça. (shrink)

The importance of socio-economic impacts from the introduction and use of genetically modified crops is reflected in increasing efforts to include them in regulatory frameworks. Aiming to identify and understand the present knowledge on SEI of GM crops, we here report the findings from an extensive study of the published international scientific peer-reviewed literature. After applying specified selection criteria, a total of 410 articles are analysed. The main findings include: limited empirical research on SEI of GM crops in the scientific (...) literature; the main focus of the majority of the published research is on a restricted set of monetary economic parameters; proportionally, there are very few empirical studies on social and non-monetary economic aspects; most of the research reports only short-term findings; the variable local contexts and conditions are generally ignored in research methodology and analysis; conventional agriculture is the commonly used comparator, with minimal consideration of other substantially different agricultural systems; and there is the overall tendency to frame the research upon not validated theoretical assumptions, and to over-extrapolate small-scale and short-term specific results to generalized conclusions. These findings point to a lack of empirical and comprehensive research on SEI of GM crops for possible use in decision-making. Broader questions and improved methodologies, assisted by more rigorous peer-review, will be required to overcome current research shortcomings. (shrink)

Our EcoDialogue Center is an educational space for human sustainability within the University of Veracruz. We propose that creating sustainable knowledge requires re-thinking how we conceive ourselves as human beings. This requires paying attention to what we call “the quality of being,” which means caring about and attending to the physical–emotional–mental–spiritual as the foundation of education. This way we can create a space where we can dialogue contemplatively where all dimensions of our lives interact; the physical, the emotional, the communitarian, (...) the social politic, the planetarium, and the spiritual being act with social–environmental responsibility. (shrink)

It is common to distinguish between “holist” and “reductionist” views of brain function, where the former envisions the brain as functioning as an indivisible unit and the latter as a collection of distinct units that serve different functions. Opposing reductionism, a number of researchers have pointed out that cortical network architecture does not respect functional boundaries, and the neuroanatomist V. Braitenberg proposed to understand the cerebral cortex as a “great mixing machine” of neuronal activity from sensory inputs, motor commands, and (...) intrinsically generated processes. In this paper, we offer a contextualization of Braitenberg’s point, and we review evidence for the interactions of neuronal activity from multiple sensory inputs and intrinsic neuronal processes in the cerebral cortex. We focus on new insights from studies on audiovisual interactions and on the influence of respiration on brain functions, which do not seem to align well with “reductionist” views of areal functional boundaries. Instead, they indicate that functional boundaries are fuzzy and context dependent. In addition, we discuss the relevance of the influence of sensory, proprioceptive, and interoceptive signals on cortical activity for understanding brain-body interactions, highlight some of the consequences of these new insights for debates on embodied cognition, and offer some suggestions for future studies. (shrink)

Moral psychology is the study of how human minds make and are made by human morality. This state of the art volume covers contemporary philosophical and psychological work on moral psychology, as well as notable historical theories and figures in the field of moral psychology, such as Aristotle, Kant, Nietzsche, and the Buddha. The volume’s 50 chapters, authored by leading figures in the field, cover foundational topics, such as character, virtue, emotion, moral responsibility, the neuroscience of morality, weakness of will, (...) and the nature of moral judgments and reasons. The volume also canvases emerging work in applied moral psychology, including adaptive preferences, animals, mental illness, poverty, marriage, race, bias, and victim blaming. (shrink)

This article addresses the relationships between dialectic and learning within the constellations of the conceptual universes of Adorno and Vygotsky. In that order, we proceed to analyze the set of links between the main dialectical categories that structure the dialectical approach that characterizes both representatives of the Marxist thought tradition (process, totality, mediation, fields of force, antagonism, praxis) and the communicating vessels that go from epistemology to aesthetics and that demonstrate the relevance of the tasks of thought in the face (...) of social transformation. Finally, the article addresses the question of an (im)possible analytical horizon that arises, from both thinkers, to emphatically think about social emancipation and its challenges today. (shrink)

Offers a historical-cultural context for the ethos of service in libraries and critically examines this professional value as it intersects with gender, sexuality, race and ethnicity, class, and (dis)ability"--Provided by publisher.