The growing gap between demands and resources is putting immense pressure on all government spending in Sweden. The gap is especially apparent in care and services for elderly people in light of the rapid aging of the population. The article considers the decisions and priorities concerning resource allocation in the welfare sector in general and in elderly care in particular. The aim is to describe the political and administrative setting and to provide a conceptual structure that outlines the nature of (...) the problem. Various levels of decision making are identified and discussed in the context of political accountability. Current transitions in elderly care are described with respect to service provision, marketisation, coverage rates, and eligibility standards. Basic principles of distribution are highlighted in order to clarify some central concepts of efficiency and justice, and a number of strategies for actual prioritising are identified. The article concludes with an endorsement of more conscious decisions in resource allocation. Existing knowledge and information concerning the effects of various strategies must be utilised, and the values and assumptions used for setting priorities must be made explicit. (shrink)

As synthetic biology develops into a promising science and engineering field, we need to have clear ideas and priorities regarding its safety, security, ethical and public dialogue implications. Based on an extensive literature search, interviews with scientists, social scientists, a 4 week long public e-forum, and consultation with several stakeholders from science, industry and civil society organisations, we compiled a list of priority topics regarding societal issues of synthetic biology for the years ahead. The points presented here are intended (...) to encourage all stakeholders to engage in the prioritisation of these issues and to participate in a continuous dialogue, with the ultimate goal of providing a basis for a multi-stakeholder governance in synthetic biology. Here we show possible ways to solve the challenges to synthetic biology in the field of safety, security, ethics and the science-public interface. (shrink)

In this note I test a specific thesis about the dependence of philosophy of science on science that Laudan presents in his Science and Hypothesis; namely, that the sciences were justificationally prior to the philosophy of science. I argue that Laudan's historical case studies show a justificational priority that goes the other way. I also argue that the justificational role that in Progress and Its Problems the history of science is alleged to play vis-à-vis competing conceptions of scientific rationality (...) is not apparent in Laudan's argumentation in favor of his suggested analysis in terms of problem-solving effectiveness. (shrink)

The general idea that we have of artificial intelligence (AI) consists of the belief that machines will be able to develop conscious thoughts such as those possessed by human beings, and, as computing advances, such thinking will also advance until intelligence to surpass the human being, with which the advancement of AI represents ethical risks in the future. In reality, such a belief hides a cognitive assumption, which assumes that computational engineering explains human intelligence through the mind-computer metaphor. According to (...) this assumption, technology explains cognition, and philosophy, through ethics, reflects on the impact of said technology. However, in this article, I contradict such an assumption and defend that the philosophy in AI is not reduced to the ethics that is present after the use and impact of AI in the world. I intend to expose that a good ethics of AI is the one that reflects on the appropriate risks facing AI, and for this, philosophy, beforehand, must make a cognitive analysis about the possibilities that computing has to create intelligent machines, namely, whether or not the mindcomputer metaphor makes sense. My thesis consists in defending that the philosophical analysis about AI must be carried out both on a cognitive level and on an ethical level, but that the philosophical priority in the cognitive analysis over the ethical priority, since the ethical risks of AI depend of the possibilities of technology, and only the cognitive approach can account for this. (shrink)

Background: Priority setting is necessary in current healthcare services. Discussion of fair process has highlighted the value of developing reasons for allocation decisions on the basis of experience gained from real cases.Aim: To identify the reasons that those with experience of real decision-making concerning resource allocation think relevant in deciding on the priority of a new but expensive drug treatment.Methods: Semistructured interviews with members of committees with responsibility for making resource allocation decisions at a local level in the (...) British National Health Service, analysed using modified grounded theory.Results: 22 interviews were carried out. 14 reasons were identified. Four reasons were almost universally considered most important: cost effectiveness; clinical effectiveness; equality and gross cost. No one reason was considered dominant. Some considerations, such as political directives and fear of litigation, were thought by many participants to distort decision-making. There was a substantial lack of agreement over the relevance of some reasons, such as the absence of alternative treatment for the condition.Conclusions: There is a clear consensus on the importance and role of a limited number of reasons in allocation decisions among participants. A focus on the process of decision-making, however, does not obviate the need for those involved in the process to engage with problematical ethical issues, nor for the importance of further ethical analysis. (shrink)

Truthmaker monism is the view that the one and only truthmaker is the world. Despite its unpopularity, this view has recently received an admirable defence by Schaffer :307–324, 2010b). Its main defect, I argue, is that it omits partial truthmakers. If we omit partial truthmakers, we lose the intimate connection between a truth and its truthmaker. I further argue that the notion of a minimal truthmaker should be the key notion that plays the role of constraining ontology and that truthmaker (...) monism is not necessary for an appropriate solution to the problem of finding truthmakers for negative truths. I conclude that we should reject truthmaker monism once and for all. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"And Her Substance Would Be Mine":Envy, Hate, and Ontological Evacuation in Josephine Hart's SinA. Samuel Kimball (bio)Envy involuntarily testifies to a lack of being that puts the envious to shame.—René Girard, A Theatre of EnvySin, offspring of snt-ya, "that which is," in Germanic sun(d)jo, "it is true," "the sin is real," and ultimately from es-, "to be," source of am, is, sooth, soothe; of the Sanskrit roots sat- and (...) sant-, "existing, true, virtuous"; of the Latin, esse, "to be," from which is derived such words as essence, presence, absence, and represent; of the Greek roots einei, "to be" as well as ont-, "being," which provides the name for the philosophical study of being itself, ontology.—Adapted from The American Heritage Dictionaryof Indo-European RootsI: Ruth Garton's Envious NarrationThe etymology of sin suggests that the evil it names reveals something fundamental about being, something ruinous and yet unavoidable, something that endangers or even nullifies being and yet is inseparable from it, even essential to it. In Josephine Hart's second novel, Sin, this something is a species of Girardian desire in the form of a monstrous envy, which impels the first-person narrator, Ruth Garton, to a lifelong hatred of her cousin and stepsister, Elizabeth. The focus of Ruth's confessional narrative, envy, drives Ruth to take covert and increasingly virulent revenge against her quasi-sibling in a self-deluding attempt to appropriate not only the objects of Elizabeth's desire but ultimately Elizabeth's desire itself and the apparent ontological fullness that Ruth attributes to it. Over the course of her life, then, Ruth loses the promise [End Page 239] of her name in her ruthless pursuit of her enemy. As she becomes increasingly frustrated in her efforts to destroy her sister's life, Ruth finally turns her hatred of her nemesis against herself as well as the readers to whom she appeals for understanding. If envy heightens Ruth's consciousness to the point where she can perceive that her desire signals her ontological emptiness, nevertheless, it so captures her, so dominates her emotional and cognitive life, that she is unable to find a way to affirm her own—or anyone else's—being in the world. The result is a spectacular narrative record of the cost of recognizing but being unable to resist the mimeticism of desire.1II. The Girardian Dynamic of SinAs Girard has demonstrated, one of the most difficult existential challenges is to understand that desire is mimetically mediated. The result is that we come into our desire only through someone else's and always want something more and other than we think we want. Behind every move to possess a particular object is a largely unrecognized and in principle unsatisfiable desire for absolute satisfaction in the form of ontological completeness, self-sufficiency, intactness. On the one hand, Girard writes, "by the example of his own desire…the model conveys to the subject the supreme desirability of the object" (1977, 146). On the other hand, since to desire mimetically means to come into desire through the other rather than through oneself, by this same example the model conveys to the subject the contingency, the dependency, the secondariness, hence the emptiness of the subject's desire, even the subject's lack of desire, the lack that, paradoxically, constitutes his or her desire. Therefore, to be subjected to the other's want ultimately has the effect of signaling the seeming priority, fullness, and self-origination of this other person's desire. For this reason Girard asserts that "man... desires being, something he himself lacks and which some other person seems to possess" (146).If at first the other person models the desire that the subject lacks, it is in the logic of mimesis that the other will become a rival and, unless the rivalry is somehow interrupted or abrogated, inevitably an enemy to be destroyed. The subject will become locked into a potentially deadly game of trying to obtain the same object that the model desires, so as to experience the satisfactions—ultimately, the sense of being—that the object in question seems to provide... (shrink)

In the article, the problem of formation of innovation potential of the labor motivation of employees of the social production economic sphere, determining their innovative activity is studied. The importance of positive work motivation of employees increases dramatically in terms of the Fourth industrial revolution. It is connected with the formation in the social production sphere of the sixth technological structure and innovative economy of the 21st century. The author justifies the problem decision of innovative potential formation of labor motivation (...) on the basis of complex application of the principles of the study of social philosophy, sociology, social anthropology and social psychology. The principles of system analysis based on the dialectics of the objective and subjective sides of social activity in the system of social production are applied as well. According to the author opinion, work motivation is a system of dialectically interrelated internal and external motives of human activities that forms the personal conscious program of action, which should lead to the satisfaction of vital needs. In accordance with the hierarchy of needs by A. Maslow, the need for self-actualization is crucial in the system of needs of the socialized individual. In the process of realization of this need, the formation of innovative potential of motivational activity takes place and transformation of the comprehending human homo sapiens into producing human - homo faber. Studying the formation process of labor motivation of socialized individuals in the main historical stages of development of social production: Antiquity, the middle ages, and industrial civilization, the author concludes that the origins of the innovative component of motivation are in Ancient Greece. It is the characteristic only of the free labor of free people aimed at maximum realization of their natural potential in their activities in order to achieve success not only for themselves, but also for the good and prosperity of their cities-policies. However, innovation potential of labor motivation of socialized individuals became fully realized only at the stage of post-industrial development of the technogenic civilization. With the beginning of the Fourth industrial revolution, when science becomes a direct productive force, the demand for innovators that together form the human capital of the innovation economy dramatically increases. Social value of this capital is determined by the innovative component of labor motivation of employees of all spheres of social production. The priority in the formation of motivation should belong to the state and implemented through the combined efforts of government, business and civil society on the basis of balance of rights and obligations of all actors of the labor market. (shrink)

The coronavirus disease 2019 (COVID-19) pandemic has motivated medical ethicists and several task forces to revisit or issue new guidelines on allocating scarce medical resources. Such guidelines are relevant for the allocation of scarce therapeutics and vaccines and for allocation of ICU beds, ventilators, and other life-sustaining treatments or potentially scarce interventions. Principles underlying these guidelines, like saving the most lives, mitigating disparities, reciprocity to those who assume additional risk (eg, essential workers and clinical trial participants), and equal access may (...) compete with one another. We propose the use of a “categorized priority system” (also known as a “reserve system”) as an improvement over existing allocation methods, particularly because it may be able to achieve disparity mitigation better than other methods. (shrink)

In this paper I ask how educational researchers can believe the subjective perceptions of qualitative participant-observers given the concern for objectivity and generalisability of experimental research in the behavioural and social sciences. I critique the most common answer to this question within the educational research community, which posits the existence of two (or more) equally legitimate epistemological paradigms—positivism and constructivism—and offer an alternative that places a priority in educational research on understanding the purposes and meanings humans attribute to educational (...) practices. Only within the context of what I call a transcendent view from somewhere—higher ideals that govern human activities—can we make sense of quantitative as well as qualitative research findings. (shrink)

I explore some of the ways that assumptions about the nature of substance shape metaphysical debates about the structure of Reality. Assumptions about the priority of substance play a role in an argument for monism, are embedded in certain pluralist metaphysical treatments of laws of nature, and are central to discussions of substantivalism and relationalism. I will then argue that we should reject such assumptions and collapse the categorical distinction between substance and property.

Recent research on genetic and biological diversity suggests that they underlie, and are the source of renewable resources--which are themselves more fundamental than non-renewable resources. If this is the case, then our understandings of the "limits to growth" debate will need modification and current approaches to development--in both the industrial countries and in the Third World--will need reconceptualization. A major part of this will involve a reversal of roles and priorities for agricultural and industrial development. Also, more sustainable/regenerative types of (...) agriculture and food systems will need to be developed. Current explorations along these lines are briefly reviewed. Finally, the links between this and the wider need to develop more sustainable societies are examined. (shrink)

The science of man, by A. Schaff.--The humanistic meaning of natural science, by R. Mukerjee.--The role of social sciences in the struggle for progress, by R. Schlesinger.--Scientific research in developing countries, by J. D. Bernal.--Problems of science and technology in underdeveloped countries by, D. D. Kosambi.--Priorities in scientific research for economic development, by J. Bognar.--Science and technology in underdeveloped countries, by S. H. Zaheer.--Science and scientific workers, by E. Olszewski.--Medical research in developing countries, by C. G. Pandit & N. P. (...) Gupta.--Changing society and crisis of enterprise, by Z. Tanic.--The university and society, by E. G. Edwards.--The intellectual and society, by V. B. Singh.--Indo-Soviet relations in retrospect, by K. P. S. Menon.--Fifteen years of cooperation between Indian and Soviet paediatricians, by I. N. Ussov. (shrink)

Routine management of geriatric problems often raises ethical problems, particularly regarding autonomy of the old person. The carers or children may be unaware of the sensitivity of role reversal in dealing with the financial affairs; the need for a residential carer may compromise the old person’s privacy. Attending a day centre confers much benefit, but one must understand the old person’s resistance to change in the proposal of a new daily regimen. Similarly his or her autonomy must be the (...) class='Hi'>priority in planning for admittance to an old age home, and not the assumption that the family knows best. A common dilemma is the assessment of an old person’s competency in decision making, either about management of his affairs, or regarding consent to treatment, or participation in research. Because cognitive capacity is not always identical with competency, meaningful tools have recently been developed in which the emphasis is on the specific situation to be investigated. (shrink)

Summary Background The principle of maximization, which roughly means that we should save more lives and more years of life, is usually taken for granted by the health community. This principle is even more forceful in crises like the COVID-19 pandemic, where we have scarce resources which can be allocated only to some patients. However, the standard consequentialist version of this principle can be challenging particularly when we have to reallocate a resource that has already been given to a patient. (...) -/- Methodology Engaging in thought experiments, conceptual analysis, providing counterexamples, and appealing to moral intuitions, we challenge the standard consequentialist version of the maximization principle and make a case for adopting an alternative deontological version. -/- Discussion In certain cases, the standard consequentialist version of the maximization principle is shown to yield intuitively immoral results. The deontological version of this principle is preferable because it can retain the merits of the standard consequentialist version without falling prey to its problems. -/- Conclusion Compared to the standard consequentialist version, the deontological version of the maximization principle can better guide the ethical decisions of the health community, even in cases where we face a scarcity of resources. (shrink)

Temporal analyses of causal directionality fail if causes needn't precede their effects. Certain well-known difficulties with alternative (non-temporal) analyses have, in recent accounts, been avoided by attending more carefully to the formal features of relations typically figuring in philosophical discussions of causation. I discuss here a representative of such accounts, offered by David Sanford, according to which a correct analysis of causal priority must issue from viewing the condition relation as nonsymmetrical. The theory is shown first to be an (...) implicitly counterfactual treatment at its base: this provides for an explicit reformulation of several key notions in the theory. An argument is then presented, independent of these modal considerations, for the conclusion that causal priority is possible only given certain implausible assumptions about the asymmetric character of causal laws which, I claim, are not met. The best objection to this argument is shown to fail on several counts, partly in light of the counterfactual results offered earlier. It is concluded that, if laws are symmetric, analyses of the sort discussed must look elsewhere for the source of causal priority; but if laws are not symmetric, resting causal priority so heavily on nomological asymmetry is no analysis at all. (shrink)

The paper discusses the critical importance of interdependence and team development for the devel opment of human values, humane organizations, and sustainable earth management. The paper accords priority to the cultivation and nurturance of this spirit over TQM, reengineering, strategic management and the like. While not denying the practical need for hierarchy, specialization and discipline, the paper argues that it is the one-sided emphasis on such features which has aggravated fragmentation in organizations, militating against interdependent teamwork.

Recent decades have seen a fertile period of theorizing within mainstream epistemology which has had a dramatic impact on how epistemology is done. Investigations into contextualist and pragmatic dimensions of knowledge suggest radically new ways of meeting skeptical challenges and of understanding the relation between the epistemological and practical environment. New insights from social epistemology and formal epistemology about defeat, testimony, a priority, probability, and the nature of evidence all have a potentially revolutionary effect on how we understand our (...) epistemological place in the world. Religion is the place where such rethinking can potentially have its deepest impact and importance. Yet there has been surprisingly little infiltration of these new ideas into philosophy of religion and the epistemology of religious belief. -/- Knowledge, Belief, and God incorporates these myriad new developments in mainstream epistemology, and extends these developments to questions and arguments in religious epistemology. The investigations proposed in this volume offer substantial new life, breadth, and sophistication to issues in the philosophy of religion and analytic theology. They pose original questions and shed new light on long-standing issues in religious epistemology; and these developments will in turn generate contributions to epistemology itself, since religious belief provides a vital testing ground for recent epistemological ideas. (shrink)

Increasingly sophisticated and expensive medical technologies, chronic illness and aging, and a population that insists upon the best health care and coverage, together demand that priorities be set in the public funding of health care. This article describes Spanish initiatives in dealing with such problems and analyses the ethical implications of health care legislation and rationing.

Part 1. Introduction -- Introduction: Navigating the Perfect Moral Storm in Light of a Thirty-Five Year Debate -- Thirty-Five Year Climate Change Policy Debate -- Part 2. Priority Ethical Issues -- Ethical Problems with Cost Arguments -- Ethics and Scientific Uncertainty Arguments -- Atmospheric Targets -- Allocating National Emissions Targets -- Climate Change Damages and Adaptation Costs -- Obligations of Sub-national Governments, Organizations, Businesses, and Individuals -- Independent Responsibility to Act -- Part 3. The Crucial Role of Ethics in (...) Climate Change Policy Making -- Why Has Ethics Failed to Achieve Traction? -- Conclusion: Navigating the Perfect Moral Storm. (shrink)

Background Standard interpretations of the ethical principle of respect for persons have not incorporated the views and values of patients, especially patients from groups underrepresented in research. This limits the ability of research ethics scholarship, guidance, and oversight to support inclusive, patient-centered research. This study aimed to identify the practical approaches that patients in community-based settings value most for conveying respect in genomics research. Methods We conducted a 3-round, web-based survey using the modified Delphi technique to identify areas of agreement (...) among English-speaking patients at primary care clinics in Washington State and Idaho who had a personal or family history of cancer. In Round 1, respondents rated the importance of 17 items, identified in prior qualitative work, for feeling respected. In Round 2, respondents re-rated each item after reviewing overall group ratings. In Round 3, respondents ranked a subset of the 8 most highly rated items. We calculated each item’s mean and median rankings in Round 3 to identify which approaches were most important for feeling respected in research. Results Forty-one patients consented to the survey, 21 (51%) completed Round 1, and 18 (86% of Round 1) completed each of Rounds 2 and 3. Two sets of rankings were excluded from analysis as speed of response suggested they had not completed the Round 3 ranking task. Respondents prioritized provision of study information to support decision-making (mean ranking 2.6 out of 8; median ranking 1.5) and interactions with research staff characterized by kindness, patience, and a lack of judgment (mean ranking 2.8; median ranking 2) as the most important approaches for conveying respect. Conclusions Informed consent and interpersonal interactions are key ways that research participants experience respect. These can be supported by other approaches to respecting participants, especially when consent and/or direct interactions are infeasible. Future work should continue to engage with patients in community-based settings to identify best practices for research without consent and examine unique perspectives across clinical and demographic groups in different types of research. (shrink)

During the Middle Ages, philosophers and theologians argued over the extramental reality of universal forms or essences. In the early modern period, the relation between subjectivity and objectivity, the individual self and knowledge of the outside world, was a rich subject of debate. Today, there is considerable argument about the relation between spontaneity and determinism within the evolutionary process, whether a principle of spontaneous self-organization as well as natural selection is at work in the aggregation of molecules into cells and (...) the development of primitive forms of life into complex organisms. In _Subjectivity, Objectivity and Intersubjectivity_, Joseph A. Bracken proposes that what is ultimately at stake here is the age-old problem of the relationship between the One and the Many, universality and particularity on different levels of existence and activity within nature. Bracken rejects traditional models of this relationship, wherein either the One or the Many is presupposed to have priority over the other. He instead suggests that a new social ontology—one that is grounded in a theory of universal intersubjectivity—protects both the concrete particularity of individual entities in their specific relations to one another and their enduring corporate reality as a stable community or environment within Nature. What emerges is a bold reimagining of the sometimes strained relationship between religion and science. Bracken's clear writing, sophisticated philosophical analysis, and exemplary scholarship will lend this new work an enthusiastic appreciation by readers with deep interests in philosophy and philosophical theology. (shrink)

The public purse is responsible for funding almost all autism spectrum disorders (ASD) research in Canada (as per Canadian Institutes of Health Research [CIHR]) and for providing some of the existing services and supports for this population. In this article, we consider various reasons why Canada should be concerned to ensure a more equitable distribution of relevant public funding for ASD research than is currently the case to meet the express needs and interests of the diversity of autism stakeholders. As (...) such, we report data to show that CIHR-supported ASD research from the period of 2000–2010 demonstrates a bias focussed on the aetiology of the condition revealing a disproportionate emphasis on only two (Biomedical and Clinical) out of the four research pillars avowed by CIHR, with a comparative lack of fiscal resources committed to Health Systems and Services and Population and Public Health research. We advance certain normative and prudential reasons for funding more Health Systems and Services and Population and Public Health ASD research in Canada. In our view, this would seem to follow from CIHR’s official mandate ‘as a flexible mechanism that will continually align health research funding with changes in the manner in which health problems and opportunities are identified, understood and addressed’. (shrink)

The article traces origins of the contradiction that calls into being the polemics on the moral status of duties to close persons. Special obligations are created by the unique life narrative of an actor that makes different recipients of her actions more or less distant. Those who are less distant are “close ones.” Those who are more distant are “strangers.” The basis of this distance can be different: individual sympathy, consanguinity, belonging to cultural, territorial and political communities. Special obligations presuppose (...) that the preferential treatment of “close ones” is not only permissible but obligatory. This feature of moral duties to close persons makes moral philosophers suspicious because they are prone to endow moral requirements with two interrelated properties: universality and the high level of generality. The main reason for this is that the typical moral duty is a duty of every human being to another human being without any further qualifications. Against the background of such duties, any preference to close persons looks like the breach of moral equality and manifestation of impermissible partiality. Though, common moral beliefs persistently include special obligations in the whole system of moral duty. R. Goodin thinks that they have a priority over positive general duties and yield to negative general duties. The empirical researches of moral evaluations which reviewed in this article in general confirm this conclusion. The ethical theory cannot ignore fundamental features of common moral beliefs. That is why it is doomed to look for ways of reconciling the moral equality and impartiality with the preferential treatment of close persons embedded into special obligations. (shrink)

To investigate the current status of hospital clinical ethics committees (CEC) and how they have evolved in Canada over the past 20 years, this paper presents an overview of the findings from a 2008 survey and compares these findings with two previous Canadian surveys conducted in 1989 and 1984. All Canadian hospitals over 100 beds, of which at least some were acute care, were surveyed to determine the structure of CEC, how they function, the perceived achievements of these committees and (...) opinions about areas with which CEC should be involved. The percentage of hospitals with CEC in our sample was found to be 85% compared with 58% and 18% in 1989 and 1984, respectively. The wide variation in the size of committees and the composition of their membership has continued. Meetings of CEC have become more regularised and formalised over time. CEC continue to be predominately advisory in their nature, and by 2008 there was a shift in the priority of the activities of CEC to meeting ethics education needs and providing counselling and support with less emphasis on advising about policy and procedures. More research is needed on how best to define what the scope of activities of CEC should be in order to meet the needs of hospitals in Canada and elsewhere. More research also is needed on the actual outcomes to patients, families, health professionals and organisations from the work of these committees in order to support the considerable time committee members devote to this endeavour. (shrink)

Aim: This study explores priority dilemmas in dialysis treatment and care offered elderly patients within the Norwegian public healthcare system.Background: Inadequate healthcare due to advanced age is frequently reported in Norway. The Norwegian guidelines for healthcare priorities state that age alone is not a relevant criterion. However, chronological age, if it affects the risk or effect of medical treatment, can be a legitimate criterion.Method: A qualitative approach is used. Data were collected through semistructured interviews and analysed through hermeneutical content (...) analysis. The informants were five physicians and four nurses from dialysis wards.Findings: Pressing priority dilemmas centre around decision-making concerning withholding and withdrawal of dialysis treatment. Advanced age is rarely an absolute or sole priority criterion. It seems, however, that advanced age appears to be a more subtle criterion in relation with, for example, comorbidity, functional status and cognitive impairment. Nurses primarily prioritise specialised dialysis care and not comprehensive nursing care. The complex needs of elderly patients are therefore often not always met.Conclusions: Clinical priorities should be made more transparent in order to secure legitimate and fair resource allocation in dialysis treatment and care. Difficult decisions concerning withholding or withdrawal of dialysis ought to be openly discussed within the healthcare team as well as with patients and significant others. The biomedical focus and limitations on comprehensive care during dialysis should be debated. (shrink)

Bioethics, Volume 36, Issue 5, Page 500-510, June 2022.

The Continuum Companion to Philosophy of Language offers the definitive guide to contemporary philosophy of language. The book covers all the fundamental questions asked by the philosophy of language - areas that have continued to attract interest historically as well as topics that have emerged more recently as active areas of research. Ten specially commissioned essays from an international team of experts reveal where important work continues to be done in the area and, most valuably, the exciting new directions the (...) field is taking. The Companion explores issues pertaining to the nature of language, form semantics, theories of meaning, reference, intensional contexts, context-dependence, pragmatics, the normativity of language, analyticity, a priority and modality. Featuring a series of indispensable research tools, including an A to Z of key terms and concepts, a detailed list of resources and a fully annotated bibliography, this is the essential reference tool for anyone working in the philosophy of language. (shrink)

The author argues that, while logical rigor requires Whiteheadians to emphasize the ontological priority of the notion of actual entity as a self-constituting subject of experience for the proper understanding of physical reality. Whitehead's understanding of the key category of society in his metaphysics, especially the way that societies and their constituent actual entities reciprocally "constrain " one another's existence and activity and the way that societies are hierarchically ordered to one another within the evolutionary process will presumably have (...) more empirical resonance with natural scientists in their own efforts to understand the emergence of life from non-life, the progressive growth of self-awareness among higher-order animal species, etc. So, in dialogue with natural scientists, why not start with what is psychologically more interesting to the listener? (shrink)

ABSTRACT This study examined how lifestyle factors and gender affect kidney allocation to transplant patients by 99 British and Singaporean participants. Thirty hypothetical patients were generated from a combination of six factors and randomly paired four times. Participants saw 60 patient pairings and, in each pair, chose which patient would receive treatment priority. A Bradley-Terry model was used to derive coefficients for each factor per participant. A mean factor score was then calculated across all participants for each factor. Participants (...) gave lower priority to patients who drank more, were overweight, smoked more and exercised less. A patient’s diet and gender had no significant effect on allocation. There were no significant cross-cultural differences. There were moderate correlations between participants’ self-reported pre- and post-experiment ordering of decision criteria, and these measures and factor coefficients, suggesting a modest level of decision-making consistency. Between participants, moderate levels of concordance with respect to factor importance were observed for self-reported orderings of factors, and weaker agreement for model-derived coefficients. Very similar results were obtained for both British and Singaporean participants, and the implications of the findings are discussed. (shrink)

This article draws attention to the limited amount of scholarship on what constitutes fairness and equity in resource allocation to health research by individual funders. It identifies three key decisions of ethical significance about resource allocation that research funders make regularly and calls for prioritizing scholarship on those topics – namely, how health resources should be fairly apportioned amongst public health and health care delivery versus health research, how health research resources should be fairly allocated between health problems experienced domestically (...) versus other health problems typically experienced by disadvantaged populations outside the funder's country, and how domestic and non-domestic health research funding should be further apportioned to different areas, e.g. types of research and recipients. These three topics should be priorities for bioethics research because their outcomes have a substantial bearing on the achievement of health justice. The proposed agenda aims to move discussion on the ethics of health research funding beyond its current focus on the mismatch between worldwide basic and clinical research investment and the global burden of disease. Individual funders’ decision-making on whether and to what extent to allocate resources to non-domestic health research, health systems research, research on the social determinants of health, capacity development, and recipients in certain countries should also be the focus of ethical scrutiny. (shrink)

Although populism is an ideologically fluid political vehicle, it is not one that is intrinsically anti-business. Indeed, different varieties of populist parties may encourage business activity for utilitarian ends, but with their own ideas on what businesses should be doing. This reality implies that initiatives not related to national greatness or priorities as defined by the populist leadership may be viewed as redundant. Key among such initiatives would be corporate social responsibility (CSR). In a populist environment, it is possible that (...) firms may divert resources away from broad-based CSR under pressure from populist governments. This article explores the relationship between populist governance and CSR with an econometric examination of over a thousand firms in 13 countries under both pro- and anti-business populist governments at varying times from 2012 to 2020. Using dynamic panel data methods, we find strong evidence that firms substitute away significantly from CSR under populism. This effect grows significantly larger under anti-business populists. (shrink)

The future of any society, its moral climate, is determined by what happens in the souls of the younger generation. The most responsible mission for the formation of a spiritually developed personality, and therefore the level of spirituality of society as a whole, is entrusted to education as a social branch. The main task of the modern school is to form a new person of the biosocial level, who would live and act in accordance with the universal laws of the (...) Cosmos. It is for this purpose that education must be made so that the priority in it belongs to the question of the formation and development of the spiritual ideal. This issue has always been at the forefront of time and has been given considerable attention. There are many views on the ways and methods of accomplishing this task. (shrink)

This article considers the issues of adaptation and organization of the educational process, barrier-free environment and readiness for professional activity of students with disabilities in inclusive education in conditions of inclusive education in a medical university. The relevance of this work is determined by one of the priority areas of state policy in the field of higher education – access to higher education for people with disabilities in inclusive education. Inclusive education at the university is designed to ensure not (...) only the realization of the right of students with disabilities in inclusive education to higher education, but also to solve the problems of socialization and professional demand for such people. In order to improve the process of introducing inclusive education at the Ryazan State Medical University named after Academician I.P. Pavlov, a study was conducted, the main problems and ways of solving them were identified, related to the organization of the educational process, the conditions of the barrier-free environment and the readiness for professional activity of students with disabilities in inclusive education. An increase in the proportion of university teachers who have undergone advanced training in inclusive education also contributes to solving problems. Adaptation of educational programs and educational and methodological support for persons with disabilities includes psychological, pedagogical and tutor support etc. The organization of the educational process using distance education technologies is one of the priority conditions for teaching students with disabilities and/or HIA. The use of this technology makes it possible to significant-ly expand and modify some educational standards for students with disabilities in inclusive education, namely, to create an individual way for each student with disabilities in inclusive education in a medical university. It is proposed to use training techniques such as: online consultation of teachers; VR technologies; availability of training materials 24/7; online webinars that facilitate the inclusion of such students in the educational and research activities of the university. The professionally organized educational space and educational process of the university provide not only a high level of mastery of professional competencies, but also contribute to the formation of personal qualities of students with disabilities in inclusive education, necessary for their successful socialization, life and activity in society. (shrink)

Application of egalitarian and prioritarian accounts of health resource allocation in low‐income countries have both been criticized for implying distribution outcomes that allow decreasing/undermining health gains and for tolerating unacceptable standards of health care and health status that result from such allocation schemes. Insufficient health care and severe deprivation of health resources are difficult to accept even when justified by aggregative efficiency or legitimized by fair deliberative process in pursuing equality and priority oriented outcomes. I affirm the sufficientarian argument (...) that, given extreme scarcity of public health resources in low‐income countries, neither health status equality between populations nor priority for the worse off is normatively adequate. Nevertheless, the threshold norm alone need not be the sole consideration when a country's total health budget is extremely scarce. Threshold considerations are necessary in developing a theory of fair distribution of health resources that is sensitive to the lexically prior norm of sufficiency. Based on the intuition that shares must not be taken away from those who barely achieve a minimal level of health, I argue that assessments based on standards of minimal physical/mental health must be developed to evaluate the sufficiency of the total resources of health systems in low‐income countries prior to pursuing equality, priority, and efficiency based resource allocation. I also begin to examine how threshold sensitive health resource assessment could be used in the Philippines. (shrink)

Clinical investigators must engage in just subject recruitment and selection and avoid unduly influencing research participation. There may be tension between the practice of keeping payments to participants low to avoid undue influence and the requirements of justice when recruiting normal healthy volunteers for phase 1 drug studies. By intentionally keeping payments low to avoid unduly influenced participation, investigators, on the recommendation or insistence of institutional review boards, may be targeting or systematically recruiting healthy adult members of lower socio-economic groups (...) for participation in phase 1 studies. Investigators are at risk of routinely failing to fulfill the obligation of justice, which prohibits the systematic targeting and recruiting of subjects for reasons unrelated to the nature of the study. Insofar as we take seriously the obligation to engage in just subject recruitment and selection, I argue that we must acknowledge the implications low payments might have for subject recruitment and selection and examine the effect of low payments. If low payments de facto target the less well-off for phase 1 studies, we must defend the priority ranking of the obligation to avoid undue influence over the obligation of justice or adopt an alternative recruitment approach. This paper identifies a number of alternatives to the current system of low-value payments to research participants. (shrink)

Although discussions of John Rawls’ A Theory of Justice generally refer to Rawls’ two principles of justice, and although Rawls himself labels his principles “the two principles of justice”, Rawls actually sets forth three distinct principles in the following lexical order: the liberty principle, the fair equality of opportunity principle, and the difference principle. Rawls argues at some length for the priority of the liberty principle over the other two. On the other hand, Rawls offers hardly any argument at (...) all for the priority of the fair equality of opportunity principle over the difference principle. In this article I will argue that making the fair equality of opportunity principle separate from and lexically prior to the difference principle is both intuitively unattractive and inconsistent with Rawls’ method of deriving principles of justice from the choices of rational contractors in the original position. (shrink)

This study aims to explore a demoethical model for sustainable development in modern society. It proposes an approach that focuses on organizing activities to improve sustainable development. Specifically, it presents a demoethical model relevant to Society 5.0 and Industry 5.0 organizations. The objective is to identify demoethical values that can drive sustainable development in the era of digitalization. Through a literature review and analysis, this study identifies key components of the demoethical model and provides practical recommendations for stakeholders involved in (...) digital transformation. The analysis of demoethical norms and phenomena, such as education, nurturing, mind, knowledge, science, and honest work, has enabled the identification of values that align with sustainable development in society. The results of the study demonstrate that the notion of a demoethical foundation for sustainability is rooted in the concept of spirituality as the basis for a new societal development scenario and its relationship with nature. The study shows that ideas about the demoethical basis of sustainability are based on the priority of spirituality as the basis of a new scenario for the development of society, as well as the integration of demographic, socio-economical, and ecological components in system-wide modeling. (shrink)

ABSTRACTMother‐to‐child transmission of HIV represents a particularly dramatic aspect of the HIV epidemic with an estimated 600,000 newborns infected yearly, 90% of them living in sub‐Saharan Africa. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. MTCT is responsible for 90% of these infections. Two‐thirds of the MTCT are believed to occur during pregnancy and delivery, and about one‐third through breastfeeding. As the number of women of child bearing age infected with (...) HIV rises, so does the number of infected children. It is apparent that voluntary testing in Botswana has made some valuable inroads in decreasing perinatal HIV transmission, but the statistics showing the increased rate of HIV infection among women 15–24 years of age are not very promising. After reviewing all the pertinent scientific data it is clear that mandatory HIV testing of all pregnant women in conjunction with the implementation of a full package of interventions would save thousands of lives – mothers, newborns and others who could be infected as a result of these women not being aware of their HIV status. If the protection and preservation of human life is a priority in Botswana, then it is time to allow for mandatory HIV testing of all pregnant women, before it is too late for those who are the most vulnerable. To do less would be medically inappropriate and ethically irresponsible. (shrink)