Amidst growing global endorsements of new biomedical HIV prevention strategies, ARV-based pre-exposure prophylaxis (ARV PrEP) has garnered considerable attention as a potentially promising prevention strategy. Though it may offer more effective protection for certain at-risk groups than conventional prevention strategies (such as sexual partner reduction, condom use, and prevention of mother-to-child transmission), PrEP is more costly. PrEP requires more ongoing contact between individuals and providers, and a level of surveillance from the health system that is not necessary with other preventive (...) measures. In this sense, it represents a new bio-technology for HIV prevention that poses particular challenges for worldwide implementation, given developing countries’ struggling health systems and incomplete HIV treatment programs. Since the emergence of PrEP has stimulated ethical discussions premised on incomplete knowledge of efficacy and implementation, this paper explores the ethical parameters of a likely scenario for PrEP usage in a single, resource-poor country. We first develop a plausible model for PrEP deployment and utilization based on current PrEP research, while carefully considering the reigning institutional values of feasibility and effectiveness in global health approaches. Drawing on ethnographic research of HIV treatment and prevention approaches in Lesotho, we address ethical questions arising from this scenario of PrEP delivery. Lesotho presents a compelling and emblematic case study of PrEP's potential successes and pitfalls in a developing country, given the country's high HIV prevalence, struggles to achieve universal access to HIV treatment regimes, continued existence of stigma around the epidemic, and difficulties in addressing persistent social inequalities that fuel infections. (shrink)

This paper questions an exclusively state-centred framing of global health justice and proposes a multilateral alternative. Using the distribution of COVID-19 vaccines to illustrate, we bring to light a broad range of global actors up and down the chain of vaccine development who contribute to global vaccine inequities. Section 1 (Background) presents an overview of moments in which diverse global actors, each with their own priorities and aims, shaped subsequent vaccine distribution. Section 2 (Collective action failures) characterises collective action failures (...) at each phase of vaccine development that contributed to global vaccine disparities. It identifies as critical the task of establishing upstream strategies to coordinate collective action at multiple stages across a range of actors. Section 3 (A Multilateral model of global health governance) takes up this task, identifying a convergence of interests among a range of stakeholders and proposing ways to realise them. Appealing to a responsibility to protect (R2P), a doctrine developed in response to human rights atrocities during the 1990s, we show how to operationalise R2P through a principle of subsidiarity and present ethical arguments in support of this approach. (shrink)

Seeking consent for genetic and genomic research can be challenging, particularly in populations with low literacy levels, and in emergency situations. All of these factors were relevant to the MalariaGEN study of genetic factors influencing immune responses to malaria in northern rural Ghana. This study sought to identify issues arising in practice during the enrolment of paediatric cases with severe malaria and matched healthy controls into the MalariaGEN study.

Consideration of the experimental activities carried out in one discipline, through the lens of another, can lead to novel insights. Here, we comment from a biological perspective upon experiments in quantum mechanics proposed by physicists that are likely to feasible in the near future. In these experiments, an entire living organism would be knowingly placed into a coherent quantum state for the first time, i.e. would be coerced into demonstrating quantum phenomena. The implications of the proposed experiment for a biologist (...) depend to an extent upon the outcomes. If successful, then the organism will have been temporarily in a state where it has an unmeasurable metabolism—not because a metabolic rate is undetectable, but because any attempt to measure it would automatically bring the organism out of the state. We argue that this would in essence represent a new category of cryptobiosis. Further, the organism would not necessarily retain all of the characteristics commonly attributed to living systems, unlike the currently known categories of cryptobiosis. If organisms can survive having previously been in a coherent state, then we must accept that living systems do not necessarily need to remain in a decoherent state at all times. This would be something new to biologists, even if it might seem trivial to physicists. It would have implications concerning the physical extremes organisms can tolerate, the search for extraterrestrial life, and our philosophical view of animation. (shrink)

Amidst growing global endorsements of new biomedical HIV prevention strategies, ARV‐based pre‐exposure prophylaxis (ARV PrEP) has garnered considerable attention as a potentially promising prevention strategy. Though it may offer more effective protection for certain at‐risk groups than conventional prevention strategies (such as sexual partner reduction, condom use, and prevention of mother‐to‐child transmission), PrEP is more costly. PrEP requires more ongoing contact between individuals and providers, and a level of surveillance from the health system that is not necessary with other preventive (...) measures. In this sense, it represents a new bio‐technology for HIV prevention that poses particular challenges for worldwide implementation, given developing countries’ struggling health systems and incomplete HIV treatment programs. Since the emergence of PrEP has stimulated ethical discussions premised on incomplete knowledge of efficacy and implementation, this paper explores the ethical parameters of a likely scenario for PrEP usage in a single, resource‐poor country. We first develop a plausible model for PrEP deployment and utilization based on current PrEP research, while carefully considering the reigning institutional values of feasibility and effectiveness in global health approaches. Drawing on ethnographic research of HIV treatment and prevention approaches in Lesotho, we address ethical questions arising from this scenario of PrEP delivery. Lesotho presents a compelling and emblematic case study of PrEP's potential successes and pitfalls in a developing country, given the country's high HIV prevalence, struggles to achieve universal access to HIV treatment regimes, continued existence of stigma around the epidemic, and difficulties in addressing persistent social inequalities that fuel infections. (shrink)

Objective: To determine the views of people with multiple sclerosis (MS) and professionals in relation to confidentiality, consent and access to data within a proposed MS register in the UK. Design: Qualitative study using focus groups (10) and interviews (13). Setting: England and Northern Ireland. Participants: 68 people with MS, neurologists, MS nurses, health services management professionals, researchers, representatives from pharmaceutical companies and social care professionals. Results: People with MS expressed open and altruistic views towards the use of their personal (...) information to facilitate service provision and research, placing trust in responsible guardianship and legitimate use of their information. Participant’s proposed that people with MS should be able to select their individual level of involvement in a register using levels of consent. It was agreed that access to the register should be governed by a guardianship committee composed of a range of stakeholders. People with MS did not wish their details to be used by marketing agencies and did not consider this a legitimate use of their data. Whilst participants were positive of the role a register could play in promoting research, participants felt that access to data by pharmaceutical industries should be administered by the guardianship committee. People with MS are concerned should their employers be able to access their personal information. Professionals were more cautious than people with MS in their approach to the use of patient personal data within a register. Conclusions: Whilst all stakeholders were positive of the benefits of an MS register, development of such a resource must incorporate robust data security and guardianship measures in order to ensure that, whilst opportunities are maximised, risks to the privacy of individuals and legal challenges to professionals are avoided. (shrink)

In this paper we study the variety of order Hilbert algebras, which is the equivalent algebraic semantics of the order implicational calculus of Bull.

Leitch speaks of his procedure with my work as employing an "abrupt asyndetic format" and as being "a metonymic montage in which themes and citations are playfully and copiously combined." One form of this playfulness is the panoply of figures he uses to describe me and my criticism. The need to use figures for this is interesting, as is their incoherence, though the figures can be shown to fall into a rough antithetical pattern. At one moment the deconstructive critic is (...) a fairy godmother able to turn the pumpkin of the Western tradition into a phantasmal coach. He is a magician or wizard who shows that things are not what they have seemed with the great texts of our tradition or who turns them into something other than what they have seemed solidly to be, pragmatic pumpkins, unequivocally there. At the next moment the deconstructer is a disco dancer, moving sideways in the "lateral dance of interpretation" . The more or less benign fairy godmother and dancer then turns into a "nihilistic magician - who dances demonically upon the broken and scattered fragments of the Western tradition." He becomes a ferocious shaman, "Ravening, raging, and uprooting that he may come/Into the desolation of reality" . He is "a bull-deconstructer loose in the china shop of Western tradition" . In the next moment the bull metamorphoses into a lamb, as Leitch realizes the conservative aspects of deconstruction, the way it claims to be rescuing and preserving aspects of our culture which have always been there, both in literary and philosophical works and in the techniques of interpreting them. The same point is made more sharply and critically by William E. Cain in another recent essay on my work . In the final paragraph of his essay, Leitch has fun inventing permutations of an image of sand in the salad from one of my essays. Will deconstruction sandblast the whole shebang, or will the alien grain of sand turn into a pearl of price? J. Hillis Miller is Frederick W. Hilles Professor of English at Yale. His previous contributions to Critical Inquiry are "Ariadne's Thread: Repetition and the Narrative Line" and "The Critic as Host". (shrink)

This book aims to contribute significantly to the understanding of issues of value which repeatedly emerge in interdisciplinary discussions on space and society. Although a recurring feature of discussions about space in the humanities, the treatment of value questions has tended to be patchy, of uneven quality and even, on occasion, idiosyncratic rather than drawing upon a close familiarity with state-of-the-art ethical theory. One of the volume's aims is to promote a more robust and theoretically informed approach to the ethical (...) dimension of discussions on space and society. While the contributions are written in a manner which is accessible across disciplines, the book still withstands scrutiny by those whose work is primarily on ethics. At the same time it allows academics across a range of disciplines an insight into current approaches toward how the work of ethics gets done. The issues of value raised could be used to inform debates about regulation, space law and protocols for microbial discovery as well as longer-range policy debates about funding. (shrink)

This is a collection of papers read at an international logic colloquium held at Oxford in 1963. The first half contains articles on intuitionistic and modal logics, the propositional calculus, and languages with infinitely long expressions by such logicians as Kripke, Bull, Harrop, and Tait. The second part is primarily concerned with recursive functions and features a monograph by Crossley on constructive order types, as well as contributions by Goodstein, Schütte, and Wang, among others. Especially noteworthy is Kripke's paper (...) which applies Cohen's methods to the semantics of intuitionistic logic.—P. J. M. (shrink)

We provide an empirical investigation of leadership characteristics and social justice issues in the context of financial literacy service-learning. Using a unique dataset of student self-ratings, we find that students experience statistically significant increases in 8 of the 10 leadership dimensions and 7 of the 7 social justice issues examined in this study. Leadership dimensions include: persuasion, building community, “commitment to the growth of people,” stewardship, empathy, awareness, foresight, and listening. Interest in social justice issues include: dignity of the human (...) person, community and the common good, rights and responsibilities, option for the poor, dignity of work, solidarity, and care for God’s creation. The statistically significant increases in these dimensions following the completion of the service-learning suggest positive effects on students’ self-perception of leadership qualities and interests in social justice issues: business school students sense improvement in nurturing growth of employees and colleagues, commitment to serving the need of others, understanding and empathizing with others, ethics, ability to foresee the likely outcome of a situation, and listening intently to others. As a consequence of the financial literacy service-learning, we believe that business students become more prepared toward becoming ethical leaders and citizens with compassion to serve the world for the well-being of all people, rich and poor alike. (shrink)

Metaphysicians go on busily doing metaphysical thinking all over the world, and apparently with a modicum of self-assurance that they are not talking nonsense or pursuing an illusory will-of-the-wisp. Yet other philosophers of empirical, analytical, phenomenological, or other turns of mind seem to have more and more difficulty in understanding just how metaphysicians give meaning and positive content to the vast abstract concepts by which they seek to describe and explain the entire spectrum of reality extending far beyond present or (...) perhaps even possible human experience. Since there is no way of gaining direct insight into dimensions of reality beyond human experience, and since in order to be applied to the whole range of reality these concepts must abstract from purely human experience, it is hard for them to see—and it is a serious problem in itself—how these all-embracing terms can be anything more than empty, formal, verbal symbols or conceptual constructions, with no positive existential content describing reality itself across its whole spectrum. Even the metaphysician himself, though when left alone he may have a sure sense of how to do metaphysical thinking fruitfully, when questioned to explain and justify what he is doing, and is convinced is worth doing, can feel embarrassed and struck dumb as to how to articulate and justify the principles behind the procedures he is following. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:EPILOGUE Robert J. Daly, SJ. Boston College April 2002 Iwill arrange my comments under four headings: (1) what we had hoped to accomplish; (2) what we actually did accomplish; (3) what we may have learned from this; (4) what this might now enable us to do in thefuture. This epilogueisbeingwritten in April, 2002,twenty-twomonths after the conference. To draw what good we can from this delay, writing at this distance (...) allows me to summarize and draw conclusions with, perhaps, a bit more balance. On the other hand, my listening again to the audio record in the course ofpreparing this publication has enabled me to relive something of the original experience. (1)As I indicated in the introduction, we had unrealistically hoped that, by the time ofthe conference, the five presenters, and perhaps also the twoprincipals inthe "Girard-Lonergan Conversation," wouldhavealready exchanged with each other not just first drafts, but even second drafts of their papers, and that the conference itself would then be invited to join a conversation that was already well under way. As it turned out, I couldn't muster the organizational skills and resources needed to achieve this. But reflecting after the fact, I can see that so carefully detailed a preparation might have been counterproductive. Carrying out our original plan might have been at the cost ofimposing more ofa Western analytic pattern on our discussion ofother traditions, and of!thus smothering from the outset some of the insight that did occur. We had also hoped that the opening "Girard-Lonergan Conversation" would provide an analytic resource for the rest of the meeting. But that did not happen to any great extent. (2)The proximate preparation for this conference began with a draft version ofmy paper being sent to the other major presenters. I opened with 194Robert J. Daly, SJ. a series of brief sketches of salient points in the often unhappy but also occasionally felicitous history ofChristianity on this theme ofviolence and institution. Then, after emphasizing the importance of distinguishing between the normative and the descriptive, I tried to make some sense, both rational and theological, of all this data, especially by reflecting on the influences and consequences ofthe belief in hell, on the one hand, and the hope of universal salvation, on the other. The next major religious theme was Judaism. Reuven Kimelman provided a detailed—and, for some, overwhelming—glimpse of the way the talmudic traditions deal with the theme of war and its restrictions. This highly text-oriented and interpretation-of-texts driven presentation seemed to many, at first, to be irrelevant to mimetic theory and to the need to be confronting actual violence. But, in the course of Sandor Goodhart's response, and in the course ofthe at times spirited discussion that followed, we began to understand that how one interprets texts and traditions, and how these are played off against each other, is indeed fundamental to the way Jews typically try to deal with the practical challenges of violence. Qamar-ul Huda's presentation on IsIamfocused stronglyonthe way the spiritual teachings of Islam—i.e., islam as a religion rather than Islam as a political or national institution—foster peace. The initial reaction was somewhat similarto the reaction to Kimelman's paper: disappointment that Huda was not talking more directly about contemporary Muslim extremist violence. But here, too, the discussion enabled us to catch a glimpse both of the inner spiritual resources of Islam, and of the limitations ofthe range of concerns that Westerners typically bring to the table. Francis Clooney, in his presentation ofHinduism, strongly emphasized the great variety in Hinduism, stressing that one cannot speak ofHinduism as such. Much of this variety comes from the several millennia of Hindu history, and from the complex relationships to Buddhism and Jainism which, themselves, are important parts of Hindu history, and also from the fact that only recently have Hindus, after centuries of Moslem or Colonial domination, once again returned to positions of political and military power. Finally, Christopher Ives's presentation on Buddhism, in a way similar to my presentation on Christianity, but more extensively or more consequently, pointed out the various ways in which Buddhism has been politically and... (shrink)

Despite an enormous amount of literature on St Augustine of Hippo, this work provides the first examination of what he taught about the resurrection of Jesus Christ. Augustine expounded Christ's resurrection in his sermons, letters, Answer to Faustus the Manichean, the City of God, Expositions of the Psalms, and the Trinity. Saint Augustine on the Resurrection of Christ: Teaching, Rhetoric, and Reception explores what Augustine held about the centrality of Christ's resurrection from the dead, the agency of Christ's resurrection, and (...) the nature of his risen existence. Leading scholar, Gerald O'Collins, investigates the impact of his resurrection on others and his mediatory role as the risen High Priest. O'Collins then unpicks Augustine's rhetorical justification for the resurrection of Christ: evidence from creation, human history, and the desires of all human beings. This groundbreaking study illustrates the enduring significance of Augustine's teaching on and apologetic for the resurrection, and updates, augments, and corrects what Augustine held. (shrink)

Josef Pieper’s insight into Aquinas’s metaphysics, that “createdness determines entirely and all-pervasively the inner structure of the creature,” applies equally to philosopher William Desmond.1 For at the heart of Desmond’s metaphysical project lies a refusal to take creation for granted, a challenge to Bertrand Russell’s assertion that “the universe is just there, and that’s all.”2 Desmond work aims at “renewing metaphysical astonishment before the enigma of being that was, and is, and always will be too much for us, in excess (...) of our groping efforts.”3 This “enigma of being” arouses a sense of astonishment at creation’s givenness, “that it is,” and at creation’s contingency, for all that is “might not have been .. (shrink)

Charles S. Peirce has a great deal to contribute both to understanding and to solving many of the philosophical problems which puzzle contemporary thinkers. In fact it is probably true that in some ways philosophers of our time are in a better position to understand Peirce's thought than those of his own day. In this paper I would like to consider two puzzling notions: 1) the substantiality of things, and 2) the foundations of human knowledge.

When Dr. van Fleteren writes of the articles I criticized as dating from some twenty years ago, the unwary reader might infer that my criticism of those articles was, for its part, relatively recent. The fact is, however, that when the two connected articles I eventually criticized appeared in the volumes of Augustinian Studies, I wrote this reply while Fr. Robert Russell, of happy memory, was still at the helm, and was promised publication in the near future. Meanwhile, however, Fr. (...) Russell had the discourtesy to move on to a more intimate acquaintance with Augustine than any of us on this confused planet can boast of, and someone sowed cockle into field he had tended: in unaccountable fashion my article seems to have disappeared. Only a recent letter of inquiry on my part, and Fr. Allan Fitzgerald’s understanding reply, resulted in this renewal of dialogue between Dr. van Fleteren and me. Let me assure both Dr. van Fleteren and Fr. Fitzgerald that I am grateful for giving it exactly that form, a courteous dialogue. (shrink)