BackgroundPublic health scholars have long called for preparedness to help better negotiate ethical issues that emerge during public health emergencies. In this paper we argue that the concept of ethical preparedness has much to offer other areas of health beyond pandemic emergencies, particularly in areas where rapid technological developments have the potential to transform aspects of health research and care, as well as the relationship between them. We do this by viewing the ethical decision-making process as a behaviour, and conceptualising (...) ethical preparedness as providing a health research/care setting that can facilitate the promotion of this behaviour. We draw on an implementation science and behaviour change model, COM-B, to demonstrate that to be ethically prepared requires having the capability, opportunity, and motivation to work in an ethically prepared way.MethodsWe use two case examples from our empirical research—one pandemic and one non-pandemic related—to illustrate how our conceptualisation of ethical preparedness can be applied in practice. The first case study was of the UK NHSX COVID-19 contact tracing application case study involved eight in-depth interviews with people involved with the development/governance of this application. The second case involved a complex case regarding familial communication discussed at the UK Genethics Forum. We used deductive qualitative analysis based on the COM-B model categories to analyse the transcripbed data from each case study.ResultsOur analysis highlighted that being ethically prepared needs to go beyond merely equipping health professionals with skills and knowledge, or providing research governance actors with ethical principles and/or frameworks. To allow or support these different actors to utilise their skills and knowledge, a focus on the physical and social opportunity is important, as is a better understanding the role of motivation.ConclusionsTo understand ethical preparedness, we need to view the process of ethical decision-making as a behaviour. We have provided insight into the specific factors that are needed to promote this behaviour—using examples from both in the pandemic context as well as in areas of health research and medicine where there have been rapid technological developments. This offers a useful starting point for further conceptual work around the notion of being ethically prepared. (shrink)

How did bioethics manage to grow, flourish and ultimately do so well from a very unpromising birth in the 1970s? Many explanations have been advanced. Some ascribe the field9s growth to a puzzling, voluntary abnegation of moral authority by medicine to non-physicians. Some think bioethics survived by selling out to the biomedical establishment—public and private. This transaction involved bestowing moral approbation on all manner of biomedicine9s doings for a seat at a well-stocked funding table. Some see a sort of clever (...) intellectual bamboozlement at work wherein bioethicists pitched a moral elixir of objective expertise that the morally needy but unsophisticated in medicine and the biological sciences were eager to swallow. While each of these reasons has its defenders, I think the main reason that bioethics did well was that it did good. By using the media to move into the public arena, the field engaged the public imagination, provoked dialogue and debate, and contributed to policy changes that benefitted patients and healthcare providers. (shrink)

Contrary to the predominant way of doing physics, we claim that the geometrical structure of a general differentiable space-time manifold can be determined from purely dynamical considerations. Anyn-dimensional manifoldV a has associated with it a symplectic structure given by the2n numbersp andx of the2n-dimensional cotangent fiber bundle TVn. Hence, one is led, in a natural way, to the Hamiltonian description of dynamics, constructed in terms of the covariant momentump (a dynamical quantity) and of the contravariant position vectorx (a geometrical quantity). (...) That is, the Hamiltonian description furnishes a natural way of relating dynamics and geometry. Thus, starting from the Hamiltonian state function (for a particle)—taken as the fundamental dynamical entity—we show that general relativistic physics implies a general pseudo-Riemannian geometry, whereas the physics of the special theory of relativity is tied up with Minkowski space-time, and nonrelativistic dynamics is bound up to Newton-Cartan space-time. (shrink)

Contemporary social-scientific research seeks to identify specific causal mechanisms for outcomes of theoretical interest. Experiments that randomize populations to treatment and control conditions are the “gold standard” for causal inference. We identify, describe, and analyze the problem posed by transformative treatments. Such treatments radically change treated individuals in a way that creates a mismatch in populations, but this mismatch is not empirically detectable at the level of counterfactual dependence. In such cases, the identification of causal pathways is underdetermined in a (...) previously unrecognized way. Moreover, if the treatment is indeed transformative it breaks the inferential structure of the experimental design. Transformative treatments are not curiosities or “corner cases,” but are plausible mechanisms in a large class of events of theoretical interest, particularly ones where deliberate randomization is impractical and quasi-experimental designs are sought instead. They cast long-running debates about treatment and selection effects in a new light, and raise new methodological challenges. (shrink)

The action of social laws cannot be conceived of apart from the active role of the human subject, without the participation of the subjective factor in the historical process. This viewpoint seems to me to be the only correct one. It derives from the premise, postulated by Marxism, that people's social activity must be regarded as a mode of existence of social reality, the embodiment of the social form of movement of matter, and a mode of functioning of social laws (...) themselves. All social reality, considered as a whole, all so-called "humanized nature," preserves and reproduces itself only if it is embodied in living human activity and by means of it. For example, Marx observed that a machine taken out of the productive process ceases to be a productive force of society. He emphatically rejected the notion that the objective embodiments of the historical process could function and develop automatically, independently of people, and pointed out the dependence of their social functions on living human activity. All objective embodiments of the historical process are only intermediate links and aspects of a process in which individuals renew themselves as they renew the world created by them. (shrink)

Analytical reflections on tasks and functions of philosophy in the modern world, as well as, efforts deriving novel vision of practically all areas of the philosophical thought may become sound only after consideration of the innovations with which modern natural science has crossed the 20—21 centuries boundary. Discoveries in astrophysics at the end of the 20th century offer new and unprecedented perceptions of our world. In this world only 4% of the total Universe energy is attributed to the known forms (...) of the matter, 20% constitutes “dark matter” and 76% is in “dark energy”. The first decade of the 21st century will go on record inhistory of the civilization as the one associated with breakthrough experiments shedding light on the nature of the mysterious types of the matter, and construction of the unified theory of field. It is safe to regard modern science to be on the verge of profound transformations. These changes are bound to alter our outside world comprehension, redefining human being’s place in it. That advances a set of new serious requirements to philosophy as a science that must present ability to adapt to provide adequate and meaningful methodological interpretations to anticipated discoveries. This article addresses the characteristic features of modern conceptual knowledge of the world, with an attempt of offering their philosophical and methodological comprehension. (shrink)

This paper examines the attitudes of circumcised women towards female circumcision in a community where the practice is in vogue. Also described are the type of circumcision performed, who usually performs the circumcision and complications. One hundred volunteers across the social strata were interviewed by means of a structured questionnaire. Data were analysed using frequency tables. The study revealed that 62% of respondents favoured the practice as an instrument for the control of female sexuality and maintenance of cultural pride. Circumcision (...) is mainly by excision of the clitoris and the labia minora performed mainly by traditional birth attendants. Complications include severe pain, difficulty with urination and excessive bleeding. Based on the findings, it is suggested that communities where femal genital mutilation is practised as a social norm should be involved in any eradication campaign, with the support of national and international organisations. Research is also essential to understand FGM in order to design effective reforms. (shrink)

Background and aim With the increasing interest in lifestyle, health and consequences of unhealthy lifestyles for the healthcare system, a new kind of solidarity is gaining importance: lifestyle solidarity. While it might not seem fair to let other people pay for the costs arising from an unhealthy lifestyle, it does not seem fair either to punish people for their lifestyle. However, it is not clear how solidarity is assessed by people, when considering disease risks or lifestyle risks. The aim of (...) this study was to investigate the degree of solidarity with lifestyle as well as with other factors that are related to health outcomes—for example, old age—and the relation between this degree of solidarity and various characteristics. Methods This cross-sectional study is part of the Dutch longitudinal SMILE study. Data on the degree of solidarity with different lifestyles and old age, and the relation between the degree of solidarity and various demographic and other variables were obtained in a questionnaire survey. Results Solidarity with smokers and overweight people was moderate, as was solidarity with older people. Respondents were ambivalent about athletes. Respondents who were younger, male and highly educated, and those with a healthy lifestyle, a small social network, high quality of life and an internal locus of control, showed low solidarity. Conclusions Solidarity with an unhealthy lifestyle and old age is moderate and the degree of solidarity varies among the different subgroups. (shrink)