Many healthcare agencies are producing evidence-based guidance and policy that may determine the availability of particular healthcare products and procedures, effectively rationing aspects of healthcare. They claim legitimacy for their decisions through reference to evidence-based scientific method and the implementation of just decision-making procedures, often citing the criteria of ‘accountability for reasonableness’; publicity, relevance, challenge and revision, and regulation. Central to most decision methods are estimates of gains in quality-adjusted life-years, a measure that combines the length and quality of survival. (...) However, all agree that the QALY alone is not a sufficient measure of all relevant aspects of potential healthcare benefits, and a number of value assessment frameworks have been suggested. I argue that the practical implementation of these procedures has the potential to lead to a distorted assessment of value. Undue weight may be ascribed to certain attributes, particularly those that favour commercial or political interests, while other attributes that are highly valued by society, particularly those related to care processes, may be omitted or undervalued. This may be compounded by a lack of transparency to relevant stakeholders, resulting in an inability for them to participate in, or challenge, the decisions. The makes it likely that costly new technologies, for which inflated prices can be justified by the current value frameworks, are displacing aspects of healthcare that are highly valued by society. (shrink)

Purpose of the article is to present the way of application of methodology of environmental metrics within the total environmental assessment framework. An inevitable part of sustainable development initiatives is sustainable measurement metrics. This kind of metrics is being represented by three sets of indicators: Environmental, Social and Economic. Sustainability measurement metrics tends to measure environmental safety, social responsibility and economic efficiency. Studying behaviour of companies in sustainability measurement metrics application, using another scientific method is well welcomed. Methods (...) used in article are synthesis, analysis, deduction and comparative analysis. We are synthesizing those methods in a presented model which examines quality of environmental improvements across departments of selected organization. In other words, the model is able to quantify an extent how individual managerial decision contributed towards overall improvement in environmental performance of whole organization. Model works with and additive elements. In order to derive results using multiplicative elements, we are using logarithmic method in a model. Scientific aim of the article is to synthesize scientific methods aimed at environmental performance measurement into unified and universal model usable by managements of small and medium-sized enterprises. The background of this mission is to ensure that environmental performance will be correctly reported, data delivered by various companies will be benchmarkable and consequently, Corporate Social Responsibility concepts worked out by individual organizations will be trustable. In the article, we are discovering that use of proposed universal model has marketable outcomes. Thanks to an existence of thriving markets valuating triple bottom line of sustainability, results delivered by the model helped to a company PintInox, S. p. A. to succeed at such kind of market. Conclusions the article delivers are pointing out an importance of interdisciplinary cooperation within field of sustainable development. (shrink)

Purpose The purpose of this paper is to propose an e-business assessment framework for organizations that aim to enhance the effectiveness of their online presence and maximize the benefits that result from it. The framework is based on three main pillars derived from the academic literature research: e-marketing strategies, customer relationship management strategies and business model strategies. Design/methodology/approach This paper reviews the literature from e-Marketing, CRM and business model strategies, leading to the generation of an e-Business (...) class='Hi'>assessment framework. Second, it takes 19 case studies and analyzes them using ATLAS.ti, through qualitative content analysis, to validate that framework. Findings Pragmatic advice for practitioners derives from research results considering that this framework enables managers to characterize the company in terms of its e-business approach, making it possible to determine the level of depth of competitive online strategies. Lessons for an improved e-business approach can be derived from this paper. Originality/value This study proposes a novel e-business framework to assist organizations that want to have an online presence. This framework is comprised of the factors identified in the literature review that contribute to define and scope that online presence. The framework is then validated through the collection of 19 case studies of companies that have this online presence, validating the theoretical findings. (shrink)

Graduate education is a critical period in shaping and fostering graduate students' awareness about the importance of responsible conduct of research and knowledge and skills in doing good science. However, there is a lack of a standard curriculum and assessment framework for graduate students in Taiwan. The aim of this study was to develop a literacy-based research integrity (RI) assessment framework, including five core RI areas: (1) basic concepts in RI, (2) RI considerations in the research (...) procedure, (3) research ethics and research subject protection, (4) publication and authorship, and (5) conflict of interest. The five areas were derived through a comprehensive review of major topics and areas covered in existing research integrity education and training programs and were rated by RI experts with adequate content validity. Test items on the five core areas were developed across three literacy levels: remembering and understanding, applying and analyzing, and evaluating and creating. Seven thousand and eighty-seven graduate-level trainees took an 18-unit RI course covering the five RI areas. Upon finishing the course, trainees completed a computer-based RI assessment randomly selected from 26 RI testing booklets. The design of test items followed the mastery-oriented assessment principles to promote trainees’ learning of RI with adaptive assessment feedback. Results showed that the items in the RI assessment had adequate discrimination and low difficulty level. Thus, the RI assessment can be used to assess a range of trainees’ RI literacy and can provide the most information in identifying trainees in need of more instruction or alternative training. The low guessing parameters also indicated the online RI assessment had an appropriate control of test exposure and cheating prevention. Higher education authorities can use this framework to assess graduate students' RI literacy based on a standard curriculum and prepare them for conversations about the responsible conduct of research for RI culture-building. (shrink)

The current humanitarian use of drones is focused on two applications: disaster mapping and medical supply delivery. In response to the growing interest in drone deployment in the aid sector, we sought to develop a resource to support value sensitivity in humanitarian drone activities. Following a bottom-up approach encompassing a comprehensive literature review, two empirical studies, a review of guidance documents, and consultations with experts, this work illuminates the nature and scope of ethical challenges encountered by humanitarian organizations embarking upon (...) innovation programmes. The Framework for the Ethics Assessment of Humanitarian Drones (FEAHD) identifies five values and five key questions related to ethical considerations along the decision chain of humanitarian drone activities. It fills a gap between high-level, principle-based guidance related to humanitarian innovation, and detailed operation-oriented checklists for projects involving the use of drones. In this way, the FEAHD contributes to support value sensitivity in the humanitarian use of drones. (shrink)

The current humanitarian use of drones is focused on two applications: disaster mapping and medical supply delivery. In response to the growing interest in drone deployment in the aid sector, we sought to develop a resource to support value sensitivity in humanitarian drone activities. Following a bottom-up approach encompassing a comprehensive literature review, two empirical studies, a review of guidance documents, and consultations with experts, this work illuminates the nature and scope of ethical challenges encountered by humanitarian organizations embarking upon (...) innovation programmes. The Framework for the Ethics Assessment of Humanitarian Drones (FEAHD) identifies five values and five key questions related to ethical considerations along the decision chain of humanitarian drone activities. It fills a gap between high-level, principle-based guidance related to humanitarian innovation, and detailed operation-oriented checklists for projects involving the use of drones. In this way, the FEAHD contributes to support value sensitivity in the humanitarian use of drones. (shrink)

Cognitive diagnostic assessment has been developed rapidly to provide fine-grained diagnostic feedback on students’ subskills and to provide insights on remedial instructions in specific domains. To date, most cognitive diagnostic studies on reading tests have focused on retrofitting a single booklet from a large-scale assessment. Critical issues in CDA involve the scarcity of research to develop diagnostic tests and the lack of reliability and validity evidence. This study explored the development and validation of the Diagnostic Chinese Reading Comprehension (...) Assessment for primary students under the CDA framework. Reading attributes were synthesized based on a literature review, the national curriculum criteria, the results of expert panel judgments, and student think-aloud protocols. Then, the tentative attributes were used to construct three booklets of reading comprehension items for 2–6 graders at three key stages. The assessment was administered to a large population of students in grades 2–6 from 20 schools in a district of Changchun City, China. Q-matrices were compared and refined using the model-data fit and an empirical validation procedure, and five representative cognitive diagnostic models were compared for optimal performance. The fit indices suggested that a six-attribute structure and the G-DINA model were best fitted for the reading comprehension assessment. In addition, diagnostic reliability, construct, internal and external validity results were provided, supporting CDM classifications as reliable, accurate, and useful. Such diagnostic information could be utilized by students, teachers, and administrators of reading programs and instructions. (shrink)

Background: The United States symbolizes democracy in the new world and contributes to global prosperity. Nevertheless, incrementalism is a historically dominant national approach to public policy implementation that delays democracy and undermines human dignity. Human flourishing and national development are endangered by slow-moving democratic changes. This necessitates a social justice framework that traces the exploitation of incrementalism and the consequences of opportunity gaps. Objectives: This study aims to construct a grounded theory to address and answer the following research question: (...) Are anti-democratic concepts part of a process or strategy that hinders democratic change, and what reinforces it, if anything? Methods: Two categories emerged from a grounded theory of democratic social change. This combination of anti-democratic tenets and democratic principles led to abductive reasoning to fill the research gap. Results: The key finding was the existence of a systematic approach that led to democracy while simultaneously disempowering the same group through legal and extralegal means. Two processes hinder democracy: incrementalism and an anti-democratic demoralizing process. A constructivist social justice grounded theory was developed to analyze and evaluate public policy for barriers and facilitators of democracy. A thorough analysis and evaluation of the impact and consequences of public policy is recommended to better understand how such policies impede democracy and influence American perceptions of justice. (shrink)

Since the Millennium Ecosystem Assessment in 2005, interest has increased in cultural ecosystem services (CESs) research to understand the complexity of the non-material benefits that people obtain from ecosystems. The intangible and interactive characteristics of CESs present many challenges regarding how to approach, quantify and even define CESs. In this paper, we suggest looking at CESs through the lens of embodied and situated cognition theories. We advocate that such an approach should be applied to the development stage of CES (...) research projects, as the embodied and situated experience of the site aids the development of research questions and future interventions. We described a case study—namely, the Environmental Empathy Research Challenge, which took place during the ColLaboratoire 2020 Research Residency in the Philippines. This case shows how interactive, embodied and situated workshops, such as Embodied Empathy and Walking Maps, contributed to developing a research proposal and a novel research framework, ecological embodied cognition (EEC). EEC focuses on the concept of environmental empathy to redefine the human-environment relationship. Further, based on an example of a participatory research activity, Sensing-Playing-Moving, we examined how interventions founded upon EEC principles enhance environmental empathy. (shrink)

As COVID-19 pandemic continued to propagate, millions of lives are currently at risk especially elderly, people with chronic conditions and pregnant women. Iraq is one of the countries affected by the COVID-19 pandemic. Currently, in Iraq, there is a need for a self-assessment tool to be available in hand for people with COVID-19 concerns. Such a tool would guide people, after an automated assessment, to the right decision such as seeking medical advice, self-isolate, or testing for COVID-19. This (...) study proposes an online COVID-19 self-assessment tool supported by the internet of medical things (IoMT) technology as a means to fight this pandemic and mitigate the burden on our nation’s healthcare system. Advances in IoMT technology allow us to connect all medical tools, medical databases, and devices via the internet in one collaborative network, which conveys real-time data integration and analysis. Our IoMT framework-driven COVID-19 self-assessment tool will capture signs and symptoms through multiple probing questions, storing the data to our COVID-19 patient database, then analyze the data to determine whether a person needs to be tested for COVID-19 or other actions may require to be taken. Further to this, collected data can be integrated and analyzed collaboratively for developing a national health policy and help to manage healthcare resources more efficiently. The IoMT framework-driven online COVID-19 self-assessment tool has a big potential to prevent our healthcare system from being overwhelmed using real-time data collection, COVID-19 databases, analysis, and management of people with COVID-19 concerns, plus providing proper guidance and course of action. (shrink)

The salience of social risks and the incidence of various crises in China have induced widespread concerns among urban residents. Encountering frequent risks places higher demands on the cognition of urban residents. The concept of safety cognition capability is defined within the context of urban residents' daily life, and measurement instruments are developed and tested to lay the foundation for grasping the current safety cognition capability of urban residents and conducting further research. In this study, the five-dimensional structure of urban (...) residents' safety cognition capability was proposed by using the grounded theory method to sort out the interview transcript of interviews with 30 urban residents, and a 38-item URSCC scale was designed and used for surveys conducted in China. The results show that the scale can be used as a valid tool to measure the URSCC, and it can help city managers to better understand the safety needs of residents, as well as monitor the effectiveness of policy implementation. (shrink)

Ethics guidelines and commentary suggest that a central function of research ethics committees is to assess the scientific merit of the protocols they review. However, some commentators object to this role, and evidence suggests that the assessment of scientific merit is a significant source of confusion and animosity between ethics committees and clinical investigators. In this essay, we argue that ethics committees should assess the scientific value and validity of research protocols and that new decision-making tools are needed to (...) help them do so in a systematic, transparent, and reliable way. We present a novel ethical framework that can assist in this task. (shrink)

This article presents an impact assessment framework that allows for the evaluation of positive and negative local-level impacts that have resulted from "responsible trade" interventions such as fair trade and ethical trade. The framework investigates impact relating to (1) livelihood impacts on primary stakeholders; (2) socio-economic impacts on communities; (3) organizational impacts; (4) environmental impacts; (5) policies and institutional impacts; and (6) future prospects. It identifies relevant local-level stakeholders and facilitates the analysis of conflicting interests. The (...) class='Hi'>framework was developed in the context of, and is applied in this article to, the fair trade coffee industry in northern Nicaragua. It was designed, however, so that it can be applied across commodity sectors and responsible trade initiatives. It is able to do this by accommodating for differences in the social, environmental, political and institutional contexts of different areas, and by taking into account the distinct nature of an initiative's overall objectives, different levels of intervention, and the full range of stakeholders involved. (shrink)

This paper proposes a framework for an ethical impact assessment which can be performed in regard to any policy, service, project or programme involving information technology. The framework is structured on the four principles posited by Beauchamp and Childress together with a separate section on privacy and data protection. The framework identifies key social values and ethical issues, provides some brief explanatory contextual information which is then followed by a set of questions aimed at the technology (...) developer or policy-maker to facilitate consideration of ethical issues, in consultation with stakeholders, which may arise in their undertaking. In addition, the framework includes a set of ethical tools and procedural practices which can be employed as part of the ethical impact assessment. Although the framework has been developed within a European context, it could be applied equally well beyond European borders. (shrink)

This first part of a two-part series exploring implications of the natural differences between the sexes for the cultural evolution of marriage assesses whether Kant should be condemned as a sexist due to his various offensive claims about women. Being antithetical to modern-day assumptions regarding the equality of the sexes, Kant’s views seem to contradict his own egalitarian ethics. A philosophical framework for making cross-cultural ethical assessments requires one to assess those in other cultures by their own ethical standards. (...) Sexism is inappropriate if it exhibits or reinforces a tendency to dominate the opposite sex. Kant’s theory of marriage, by contrast, illustrates how sexism can be egalitarian: given the natural differences between the sexes, different roles and cultural norms help to ensure that females and males are equal. Judged by the standards of his own day and in the context of his philosophical system, Kant’s sexism is not ethically inappropriate. (shrink)

This paper deals with the ethics of using knowledge about a person’s particular psychological make-up, or about the psychology of judgment and decision-making in general, to shape that person’s decisions and behaviors. Various moral concerns emerge about this practice, but one of the more elusive and underdeveloped concerns is the charge of manipulation. It is this concern that is the focus of this paper. I argue that it is not the case that any of the practices traditionally labeled as “manipulation” (...) are ipso facto morally wrong, nor is it even the case that any of these practices always has a single wrong making feature (e.g., infringement on autonomy) that is always present but may be outweighed by other morally relevant factors and be all things considered ethically permissible or morally right. I argue that the moral status depends on the extent to which the instance of influence (1) threatens or promotes autonomy, (2) has good aims and virtuous overtones or bad ones, and (3) fulfills or fails to fulfill duties, obligations, and expectations that arise out of the relationship between the influencer and influenced. I will explain in detail the moral relevance of these factors, showing why each is necessary, criteria for evaluation each, and demonstrating how they work in specific cases. (shrink)

The genetically manipulated organism crisis demonstrated that technological development based solely on the law of the marketplace and State protection against serious risks to health and safety is no longer a warrant of ethical acceptability. In the first part of our paper, we critique the implicitly individualist social-acceptance model for State regulation of technology and recommend an interdisciplinary approach for comprehensive analysis of the impacts and ethical acceptability of technologies. In the second part, we present a framework for the (...) analysis of impacts and acceptability, devised—with the goal of supporting the development of specific nanotechnological applications—by a team of researchers from various disciplines. At the conceptual level, this analytic framework is intended to make explicit those various operations required in preparing a judgement about the acceptability of technologies that have been implicit in the classical analysis of toxicological risk. On a practical level, we present a reflective tool that makes it possible to take into account all the dimensions involved and understand the reasons invoked in determining impacts, assessing them, and arriving at a judgement about acceptability. (shrink)

Impact investment ventures are growing in the modern economy. However, the recent failures of some impact investment ventures are a cause for concern. Unfortunately, our concern about the ethicality of these kinds of social exchanges seem to emerge when it is too late. Namely, we become concerned about lack of ethics when a venture has failed or is collapsing. A better approach would be for us to have a means to proactively assess and improve the degree to which the arrangements (...) and practices of a social exchange meet ethical standards. Whereas much work has been done to equip social ventures to evaluate their impacts, little work has been done to create frameworks that could be used to assess the degree to which social exchanges integrate ethical practices in their designs. This paper proposes such a framework. For illustration purposes, the proposed framework would also be used to evaluate the One Acre Farm, an impact investment venture in Africa. (shrink)

Animal models of human diseases are often used in biomedical research in place of human subjects. However, results obtained by animal models may fail to hold true for humans. One way of addressing this problem is to make animal models more similar to humans by placing human tissue into animal models, rendering them chimeric. Since technical and ethical limitations make neurological disorders difficult to study in humans, chimeric models with human neural tissue could help advance our understanding of neuropathophysiology. In (...) this article, we examine whether the introduction of human neural tissue and any consequent cognitive change is relevant to the way we ought to treat chimeras. We argue that changes in cognitive abilities are morally relevant to the extent that they increase the capacities that affect the moral status of any entity, including awareness, autonomy, and sociability. We posit that no being, regardless of species, should be treated in a way that is incommensurate with its moral status. Finally, we propose a framework that can be used to guide ethical assessment of research involving chimeras with advanced cognitive capacities. We advance this framework as a useful tool for bringing relevant considerations to the forefront for those considering the ethical merit of proposed chimeric research. In doing so, we examine concepts relevant to the question of how any entity may be treated, including moral status, dignity, and capacities. (shrink)

Converging technologies require intelligent policy-making as they have significant capabilities to develop disruptive innovations. In this regard, future-oriented technology assessment is vital given the great uncertainty about the consequences of and barriers to accessing these technologies. However, few frameworks have been developed to evaluate converging technologies, and most of those have neglected the unique dimensions of these technologies. Therefore, this study aims to provide a policymaking framework for converging technology development. Accordingly, the proposed framework is designed through (...) a meta-synthesis of previous technology assessment frameworks by considering the feasibility, challenges, and achievements of converging technologies development pathways (CTDPs) as the key factors. Then, the framework is implemented in a case study of Iran and an appropriate strategy for each converging technologies development pathway is proposed based on a quadruple matrix of achievements and challenges. The results show that in Iran, biotechnology and cognitive technologies have the highest and lowest development horizons, respectively; and surprisingly, the combined field of biotechnology-cognitive is the most promising pair combination of converging technologies. (shrink)

A longstanding debate exists in both academic literature and popular culture about whether non-informative marketing tactics are manipulative. However, given that we tend to believe that some marketing tactics are manipulative and some are not, the question that marketers, their critics, and consumers need to ask themselves is that of how to actually determine whether any particular marketing tactic is manipulative and whether a given manipulative tactic is, in fact, immoral. This article proposes to operationalize criteria that can be used (...) by marketers for making such determinations and attempts to provide some clarification toward our under- standing of the concept of manipulation and the conditions for the moral acceptability of manipulative marketing practices. It argues that a marketing tactic is manipulative if it is intended to motivate by undermining what the marketer believes is his/her audience’s normal decision-making process either by deception or by playing on a vulnerability that the marketer believes exists in his/her audience’s normal decision-making process. Such a tactic is morally objectionable on several grounds, which make it morally impermissible unless outweighed by sufficient “redemptive” moral considerations. (shrink)

Faculty in a large, urban school of engineering designed a longitudinal study to assess the critical thinking skills of undergraduate students as they progressed through the engineering program. The Paul-Elder critical thinking framework was used to design course assignments and develop a holistic assessment rubric. This paper presents the analysis of the freshman course artifacts (baseline and course critical thinking assignments) and associated faculty scoring sessions for all three cohorts. A total of 649 first semester freshman students at (...) least 18 years old agreed to participate in the study. The majority were white males with a mean high school grade point average of 3.73, ACT composite score of 28.33, and final freshman engineering course grade of 3.57. There was a statistically significant positive relationship between the freshman course artifacts and the faculty scores. Data from the study are being used to enhance the critical thinking experiences for undergraduate engineering students. (shrink)

Faculty in a large, urban school of engineering designed a longitudinal study to assess the critical thinking skills of undergraduate students as they progressed through the engineering program. The Paul-Elder critical thinking framework was used to design course assignments and develop a holistic assessment rubric. This paper presents the analysis of the freshman course artifacts (baseline and course critical thinking assignments) and associated faculty scoring sessions for all three cohorts. A total of 649 first semester freshman students at (...) least 18 years old agreed to participate in the study. The majority were white males with a mean high school grade point average of 3.73, ACT composite score of 28.33, and final freshman engineering course grade of 3.57. There was a statistically significant positive relationship between the freshman course artifacts and the faculty scores. Data from the study are being used to enhance the critical thinking experiences for undergraduate engineering students. (shrink)

This article presents a quantitative way of modeling the interim decisions of clinical trials. While statistical approaches tend to focus on the epistemic aspects of statistical monitoring rules, often overlooking ethical considerations, ethical approaches tend to neglect key epistemic dimension. The proposal is a second-order decision theoretic framework. The framework provides means for retrospective assessment of interim decisions based on a clear and consistent set of criteria that combines both ethical and epistemic considerations. The framework is (...) broadly Bayesian and addresses a fundamental question behind many concerns about clinical trials: What does it take for an interim decision (e.g., whether to stop the trial, or continue) to be a good decision? I provide simulation illustrating the modeling of interim decisions counterfactually using the framework. (shrink)

This article presents a framework for practitioners who may be interested in maintaining adaptive stability of sociotechnical networks. The framework is developed from assembling several concepts that are useful for assessing and for drawing on appropriate moral reasoning strategies as sociotechnical networks are designed, constructed, and adapted. One such strategy involves the ability to assess degrees of perspective sharing and trading relationships in networks using moral imagination. The article uses the case of the design of an environmentally sustainable (...) fabric to illustrate these strategic concepts. The framework also draws on other examples of cases in which sociotechnical networks have become destabilized to illustrate instances in which the framework may have been useful for decreasing a tendency for destabilization. (shrink)

A multi-method, multi-informant method was used to collect data from diverse stakeholders about school climate to inform school improvement efforts as part of the Positive Behaviour Intervention Supports framework. Teachers, administrators, school staff and students completed surveys and parents participated in focus groups to gather perspectives about school climate. Respondents identified safety as a strength at the school, staff and student results suggested interpersonal relationships as an area for improvement and staff identified parent involvement as an area for growth. (...) Both positive and negative perceptions of school climate emerged from the parent focus group. While there are limitations to the generalisability of the results, this case study provides a useful approach for schools to assess their school climate and establish goals for improvement. (shrink)

The aim of this article is to introduce the concept of Cognitive Fitness (CF), identify its key ingredients underpinning both real-time task performance and career longevity in high-risk occupations, and to canvas a holistic framework for their assessment, training, and augmentation. CF as a capacity to deploy neurocognitive resources, knowledge and skills to meet the demands of operational task performance, is likely to be multi-faceted and differentially malleable. A taxonomy of CF constructs derived from Cognitive Readiness (CR) and (...) Mental fitness (MF) literature maps into phases of operational cycles from foundational to advanced, mission-ready and recovery. Foundational cognitive attributes, such as attention, executive control and co-action, were hypothesized to be trainable at the initial Cognitive Gym phase. More advanced training targets at the CR phase included stress and arousal regulation, adaptability, teamwork, situation awareness (including detection, sense-making and prediction) and decision making (de-biasing and confidence calibration). The mission-ready training phase is focused on tolerances (to sleep loss, monotony, pain, frustration, uncertainty) and resistance (to distraction, deception or manipulation). Operational Augmentation phase relies on support tools such as decision aids and fatigue countermeasures, while the Recovery phase employs reflexive (e.g., mindfulness), and restorative practices (e.g., nutrition and sleep hygiene). The periodization of cognitive training in this cycle is hypothesized to optimize both real-time cognitive performance and the resilience that enables life-long thriving. One of the most promising avenues of validating this hypothesis is by developing an expert consensus on the key CF ingredients and their relative importance in high-performance settings. (shrink)

The use of drones in public healthcare is suggested as a means to improve efficiency under constrained resources and personnel. This paper begins by framing drones in healthcare as a social experiment where ethical guidelines are needed to protect those impacted while fully realizing the benefits the technology offers. Then we propose an ethical framework to facilitate the design, development, implementation, and assessment of drones used in public healthcare. Given the healthcare context, we structure the framework according (...) to the four bioethics principles: beneficence, non-maleficence, autonomy, and justice, plus a fifth principle from artificial intelligence ethics: explicability. These principles are abstract which makes operationalization a challenge; therefore, we suggest an approach of translation according to a values hierarchy whereby the top-level ethical principles are translated into relevant human values within the domain. The resulting framework is an applied ethics tool that facilitates awareness of relevant ethical issues during the design, development, implementation, and assessment of drones in public healthcare. (shrink)

The COVID-19 pandemic prompted a nudge for public–private cooperation in healthcare to rapidly cope with limited resource. However, Vietnam’s historical reliance on a public healthcare system, combined with a traditional emphasis on socialization in the Polanyian sense, hindered the swift integration of the private sector. This research investigates path dependency in Vietnam’s public health sector, using theories including path dependency, Karl Polanyi’s double movement with legal analysis method to analyze the interplay of historical decisions, and socialist policies in healthcare. Recognizing (...) these institutional and market governance flaws, a deeper understanding of the role of law becomes vital in crafting strategies for a more resilient and sustainable healthcare system in Vietnam. In this article, Ho Chi Minh City is chosen as a case study due to its notable mix of public–private healthcare facilities and its status as a leading area in infection cases during the third COVID-19 wave. The article suggests that there should be a change in the way public and private sectors work together, one that is more in line with market-driven solutions which requires solid legal framework for cooperation beyond merely mobilizing resources. (shrink)

New fetal therapies offer important prospects for improving health. However, having to consider both the fetus and the pregnant woman makes the risk–benefit analysis of fetal therapy trials challenging. Regulatory guidance is limited, and proposed ethical frameworks are overly restrictive or permissive. We propose a new ethical framework for fetal therapy research. First, we argue that considering only biomedical benefits fails to capture all relevant interests. Thus, we endorse expanding the considered benefits to include evidence-based psychosocial effects of fetal (...) therapies. Second, we reject the commonly proposed categorical risk and/or benefit thresholds for assessing fetal therapy research. Instead, we propose that the individual risks for the pregnant woman and the fetus should be justified by the benefits for them and the study’s social value. Studies that meet this overall proportionality criterion but have mildly unfavorable risk–benefit ratios for pregnant women and/or fetuses may be acceptable. (shrink)

A wide range of proposals to alleviate the negative effects of intellectual property regimes is currently under discussion. This article offers a critical evaluation of six of these proposals: the Health Impact Fund, the Access to Knowledge movement, prize systems, open innovation models, compulsory licenses and South-South collaborations. An assessment on how these proposals target the human rights affected by intellectual property will be provided. The conflicting human rights that will be individually discussed are the rights: to benefit from (...) one’s own scientific work, to benefit from the advancement of science, to participate in scientific enterprises and to self-determination. (shrink)

When making an assessment of animal welfare, it is important to take environmental (housing) or animal-based parameters into account. An alternative approach is to focus on the behavior and appearance of the animal, without making actual measurements or quantifying this. None of these tell the whole story. In this paper, we suggest that it is possible to find common ground between these (seemingly) diametrically opposed positions and argue that this may be the way to deal with the complexity of (...) animal welfare. The model will have to be acceptable for the different parties that will be affected by it and real benefits for the animal should result from it. This will be the basis of a practical ethical approach. All this can be condensed into a model that essentially is made up out of three basic elements: the classical welfare analysis with an existing welfare assessment tool, an assessment of the stockholder, and an implementation of the Free Choice Profiling technique. This new framework does not pretend to be a different or better animal welfare matrix; it is intended to integrate existing knowledge and to provide a practical tool to improve animal welfare. It identifies whether there are welfare problems on a farm, if present whether these problems are caused by the housing system or the stockholder, and what can be done to improve the situation. (shrink)

Background: Evidence suggesting adverse drug reactions often emerges unsystematically and unpredictably in form of anecdotal reports, case series and survey data. Safety trials and observational studies also provide crucial information regarding the (un-)safety of drugs. Hence, integrating multiple types of pharmacovigilance evidence is key to minimising the risks of harm. Methods: In previous work, we began the development of a Bayesian framework for aggregating multiple types of evidence to assess the probability of a putative causal link between drugs and (...) side effects. This framework arose out of a philosophical analysis of the Bradford Hill Guidelines. In this article, we expand the Bayesian framework and add “evidential modulators,” which bear on the assessment of the reliability of incoming study results. The overall framework for evidence synthesis, “E-Synthesis”, is then applied to a case study. Results: Theoretically and computationally, E-Synthesis exploits coherence of partly or fully independent evidence converging towards the hypothesis of interest (or of conflicting evidence with respect to it), in order to update its posterior probability. With respect to other frameworks for evidence synthesis, our Bayesian model has the unique feature of grounding its inferential machinery on a consolidated theory of hypothesis confirmation (Bayesian epistemology), and in allowing any data from heterogeneous sources (cell-data, clinical trials, epidemiological studies), and methods (e.g., frequentist hypothesis testing, Bayesian adaptive trials, etc.) to be quantitatively integrated into the same inferential framework. Conclusions: E-Synthesis is highly flexible concerning the allowed input, while at the same time relying on a consistent computational system, that is philosophically and statistically grounded. Furthermore, by introducing evidential modulators, and thereby breaking up the different dimensions of evidence (strength, relevance, reliability), E-Synthesis allows them to be explicitly tracked in updating causal hypotheses. (shrink)

Healthcare strikes have been a remarkably common and varied phenomenon. Strikes have taken a number of forms, lasting from days to months, involving a range of different staff and impacting a range of healthcare systems, structured and resourced vastly differently. While there has been much debate about strike action, this appears to have done little to resolve the often polarising debate that surrounds such action. Building on the existing normative literature and a recent synthesis of the empirical literature, this paper (...) will present a deliberative framework to assess the justifiability of strike action. I will first review the empirical literature that explores the impact of strike action, on patient outcomes and healthcare delivery. I will then discuss the debates that have occurred in this area, including an existing deliberative framework proposed by Selemogo (2014). I will argue that this framework is overly restrictive in that it could lead us to find otherwise justified strike action, unjust. I will then propose a framework that remedies these shortcomings. The framework outlines two broad conditions that should be met if strike action is to be justified. It then goes on to outline two deliberative, interrelated questions that should be used to assess whether strike action meets these conditions. For the purposes of this framework, healthcare strike action is justified when 1) it makes demands or raises grievances about some form of injustice, unfairness or threat to health and when 2) the risks in striking are proportionate to its demands or grievances. These two conditions should be considered in light of two further questions, namely, the 3) social and political context of the strike and 4) the characteristics of the strike. I will offer some further reflections on the application of this framework and its shortcomings. (shrink)

We respond to recent comments on our proposal to improve justice in ventilator triage, in which we used as an example New Jersey’s publicly available and legally binding Directive Number 2020-03. We agree with Bernard Lo and Doug White that equity implications of triage frameworks should be continually reassessed, which is why we offered six concrete options for improvement, and called for monitoring the consequences of adopted triage models. We disagree with their assessment that we mis-characterised their Model Guidance, (...) as included in the NJ Directive, in ways that undermine our conclusions. They suggest we erroneously described their model as a two-criterion allocation framework; that recognising other operant criterion reveals it ‘likely mitigate[s] rather than exacerbate[s] racial disparities during triage’, and allege that concerns about inequitable outcomes are ‘without evidence’. We highlight two major studies robustly demonstrating why concerns about disparate outcomes are justified. We also show that White and Lo seek to retrospectively—and counterfactually—correct the version of the Model Guideline included in the NJ Directive. However, as our facsimile reproductions show, neither the alleged four-criteria form, nor other key changes, such as dropping the Sequential Organ Failure Assessment score, are found in the Directive. These points matter because our conclusions hence stand, because the public version of the Model Guidance had not been updated to reduce the risk of inequitable outcomes until June 2021 and NJ’s Directive still does not reflect these revisions, and, hence, represents a less equitable version, as acknowledged by its authors. We comment on broader policy implications and call for ways of ensuring accurate, transparent and timely updates for users of high-stakes guidelines. (shrink)

Evidence-Centered Design (ECD) is a framework for the design and development of assessments that ensures consideration and collection of validity evidence from the onset of the test design. Blending learning and assessment requires integrating aspects of learning at the same level of rigor as aspects of testing. In this paper we describe an expansion to the ECD framework (termed e-ECD) such that it includes the specifications of the relevant aspects of learning at each of the three core (...) models in the ECD, as well as making room for specifying the relationship between learning and assessment within the system. The framework proposed here does not assume a specific learning theory or particular learning goals, rather it allows for their inclusion within an assessment framework, such that they can be articulated by researchers or assessment developers that wish to focus on learning. (shrink)

We reported a series of experiments carried out to confront the underlying intuitions of value-based argumentation frameworks (VAFs) with the intuitions of ordinary people. Our goal was twofold. On the one hand, we intended to test VAF as a descriptive theory of human argument evaluations. On the other, we aimed to gain new insights from empirical data that could serve to improve VAF as a normative model. The experiments showed that people’s acceptance of arguments deviates from VAF’s semantics and is (...) rather correlated with the importance given to the promoted values, independently of the perceptions of argument interactions through attacks and defeats. Furthermore, arguments were often perceived as promoting more than one value with different relative strengths. Individuals’ analyses of scenarios were also affected by external factors such as biases and arguments not explicit in the framework. Finally, we confirmed that objective acceptance, that is, the acceptance of arguments under any order of the values, was not a frequent behavior. Instead, participants tended to accept only the arguments that promoted the values they subscribe. (shrink)