This article outlines and compares current and proposed global institutional mechanisms to increase equitable access to COVID-19 vaccines, focusing on their institutional and operational complementarities and overlaps. It specifically considers the World Health Organization's (WHO’s) COVAX (COVID-19 Vaccines Global Access) model as part of the Access to COVID-19 Tools Accelerator (ACT-A) initiative, the WHO’s COVID-19 Technology Access Pool (C-TAP) initiative, the proposed TRIPS (Trade-Related Aspects of Intellectual Property Agreement) intellectual property waiver and other proposed WHO and World Trade Organization technology (...) transfer proposals. We argue that while various individual mechanisms each have their specific individual merits—and in some cases weaknesses—overall, many of these current and proposed mechanisms could be highly complementary if used together to deliver equitable global access to vaccines. Nonetheless, we also argue that there are risks posed by the proliferation of proposals in this context, including the potential to disperse stakeholder attention or to delay decisive action. Therefore, we argue that there is now a clear need for concerted global multilateral action to recognise the complementarities of specific models and to provide a pathway for collaboration in attaining global equitable access to vaccines. The institutional infrastructure or proposals to achieve this amply exist at this point in time—but much greater cooperation from industry and clear, decisive and coordinated action from states and international organisations are urgently needed. (shrink)

In June 2020, Gilead agreed to provide the USA with 500 000 doses of remdesivir—an antiviral drug which at that time was percieved to show promise in reducing the recovery time for patients with COVID-19. This quantity represented Gilead’s then full production capacity for July and 90% of its capacity for August and September. Similar deals are evident around access to proposed vaccines for COVID-19, and such deals are only likely to increase. These attempts to secure preferential access to medicines (...) and vaccines, so-called vaccine/treatment nationalism, jeopardise supplies of life-saving treatments and vaccines available elsewhere, and jeopardise global equitable distribution of such vaccines/treatments more generally. Much of the focus to date has been on States’ role in negotiating such deals. However, such developments also demonstrate the power patent holders have in controlling access to life-saving healthcare, determining who obtains access first and at what price. This article argues that the extent of control currently given to patent holders for COVID-19 must be questioned. This article demonstrates that patents have significant implications for healthcare acting as private governance tools over patented inventions. It is only by greater probing of patent holders’ role in delivering access to medicines, diagnostics and vaccines for COVID-19 that equitable global equitable access can be achieved. (shrink)

Genome editing enables very accurate alterations to DNA. It promises profound and potentially disruptive changes in healthcare, agriculture, industry, and the environment. This paper presents a multidisciplinary analysis of the contemporary development of genome editing and the tension between continuity and change. It draws on the idea that actors involved in innovation are guided by “sociotechnical regimes” composed of practices, institutions, norms, and cultural beliefs. The analysis focuses on how genome editing is emerging in different domains and whether this marks (...) continuity or disruption of the established biotechnology regime. In conclusion, it will be argued that genome editing is best understood as a technology platform that is being powerfully shaped by this existing regime but is starting to disrupt the governance of biotechnology. In the longer term is it set to converge with other powerful technology platforms, which together will fundamentally transform the capacity to engineer life. (shrink)

Abstract: We examine how trustworthy behaviour can be achieved in the financial sector. The task is to ensure that firms are motivated to pursue long-term interests of customers rather than pursuing short-term profits. Firms’ self-interested pursuit of reputation, combined with regulation, is often not sufficient to ensure that this happens. We argue that trustworthy behaviour requires that at least some actors show a concern for the wellbeing of clients, or a respect for imposed standards, and that the behaviour of these (...) actors is copied in such a way that it becomes a behavioural norm. We briefly suggest what such behavioural norms might need to be if trustworthy behaviour is to be achieved, and consider how they might be supported; we describe the research that is necessary in order to understand these norms in more detail. We argue that the norms of traders are different from the norms of those engaged in other activities, since they are inevitably self-interested, and we consider the risk that traders’ norms might undermine those of other actors. We analyse the task for governance in dealing with this problem, and the role which leadership by a corporate board and management might play in doing this. We describe the need for further research in to describe how this might be done. (shrink)

Critics have long treated the most important intellectual movement of modern history--the Enlightenment--as if it took shape in the absence of opposition. In this groundbreaking new study, Darrin McMahon demonstrates that, on the contrary, contemporary resistance to the Enlightenment was a major cultural force, shaping and defining the Enlightenment itself from the moment of inception, while giving rise to an entirely new ideological phenomenon-what we have come to think of as the "Right." McMahon skillfully examines the Counter-Enlightenment, showing (...) that it was an extensive, international, and thoroughly modern affair. (shrink)

This chapter contains sections titled: Origins and underlying ideologies 1700–1776 Earlier American business ethics 1777–1890 A mature American business ethics 1891–1963 The rise of social issues in business ethics 1962–1970 Business ethics as a specific discipline American business ethics as global Conclusion.

This paper sets up and then solves a puzzle for the sceptical realist interpretation of Hume. The puzzle takes off when the sceptical realist attributes to Hume the following metaphysical theses: Causal powers grounding necessary connections in nature exist. Causal powers grounding necessary connections in nature are what make things happen.It then attributes an epistemological thesis to him: We have no knowledge of causal powers in nature nor of the necessary connections in nature which these powers ground.But putting these three (...) theses together seems to yield a problematic result. The epistemological thesis seems to have two corollaries as its upshot. We cannot know that causal powers grounding necessary connections in nature exist. We cannot know that causal powers grounding necessary connections in nature are what make things happen.That is, we cannot know and. New Hume’s position, the sceptical realist interpretation, seems to make Hume out to be arguing for a view that is self-undermining or dialectically unstable by his own empiricist lights. I argue that there is an overlooked externalist dimension to Hume’s epistemology and draw on this to solve the puzzle. (shrink)

Literary beauty was once understood as intertwining sensations and ideas, and thus as providing subjective and objective reasons for literary appreciation. However, as theory and philosophy developed, the inevitable claims and counterclaims led to the view that subjective experience was not a reliable guide to literary merit. Literary theory then replaced aesthetics as did philosophy’s focus on literary truth. Along with the demise of the relevance of sensations, literary form also took a back seat. This suggested to some that either (...) literature communicated truth like any other literal form of communication or it was a mere diversion: a springboard to harmless reverie or daydreaming. Neither response satisfactorily captured what was distinctive about literature: the love readers can have for literary texts and the edification or insight claimed of works within each culture’s respective catalogue of classics. However, a concept of literary beauty has again become viable due to developments in theories of pleasure and imagination. If the defining aspect of literature is the imaginative engagement it occasions, and if this imagining is constrained by plausibility and endorsed as effective relative to our goals, ideals, and interests, then literature is not reduced to either mere fact or wish fulfillment. An account of literary beauty is available which defines literature accordingly and explains how subjective and objective reasons for appreciation intertwine to evoke pleasure and insight. (shrink)

Beauty is evil, a surreptitious diversion of earthly delights planted by the devil, according to the third century theologian-philosopher Tertullian. Beauty is a manifestation of the divine on earth, according to another third century philosopher, Plotinus. Could these two really be talking about the same thing? That beauty evokes an experience of pleasure is probably the only point on which all participants in the continuing debate on beauty agree. But what kinds of pleasure one considers relevant to an experience of (...) beauty, is the crux of the problem of beauty. In ancient, medieval and eighteenth century philosophy, the problem of beauty was framed by the larger concern of what constituted a good life. The question regarding the nature of beauty was answered with a view to its role in achieving the good life for those who cultivated its apprehension. In the twentieth century, philosophers framed the problem of beauty as a problem for conceptual analysis. The questions asked were: Is beauty subjective or objective? Are there properties in the object that count towards beauty in all cases; that are sufficient or necessary for an object to be judged beautiful? What kind of pleasure is the pleasure we experience of beauty? I will examine how these questions can be seen to have been answered by earlier philosophical traditions and then I will use these questions as a guide to developing an explanatory theory of beauty based on contemporary theories of perception. (shrink)

Rights, justice, and power raise many interesting questions. Why do such basic concepts as rights and justice have such differentpoints of concern—equality, proportionality, medium rei? Why are there such different perspectives in philosophy, theology, and law? Why is the notion of power in business ethics so isolated from the general discussion of applied justice in treatises on business contracts, employee relations, and in other related topics? Discussions of power seemed parallel with discussions of justice. The two did not seem to (...) intersect. In this paper I shall argue that rights, power, and justice are interrelated. While natural rights are the basis for justice, rights cannotbe realized nor justice become operative without power. I shall call this relationship and the theory underlying it “Transforming Justice.”One of the basic concerns of this article is to notice the lack of interaction between rights and power in the traditional theories ofjustice. Granted that for many philosophers it is sufficient to determine what is just. But the notion of justice as an active virtue that persons are to exercise in their dealings with others goes further. It touches the realities of life that every person experiences. Life doesnot separate rights from power. Reflection upon the current separation of rights from power both in theory and in action is analogous to the separation of the “sensory” from the “imaginative” in art and in life. The urge to devise a framework of justice that brings out thewholeness of its existential being is the underlying rationale for developing a theory of transforming justice. Another purpose fordeveloping a theory of transforming justice is to suggest a conceptual framework of business ethics and corporate social responsibility that incorporates values, rights, power, and virtue. Authors and teachers approach these issues either from a value perspective or from the view that institutions respond only to those who exercise power. Thus, it isnecessary for a conceptual framework to incorporate the dynamics of power and the qualifying aspects of rights or claims.A natural law approach to justice and rights argues that humans have certain basic rights that others, whether humans or institutions, are required to respect. Natural rights theory places the burden or duty on each individual to respect the rights ofevery other person. In addition, justice is usually defined by natural law theorists as “giving each person his or her due,” what is requiredby natural rights, what is owed, earned, or deserved. But its applications fall short of reality. It raises other questions. How does one person get another to give him what is “his due”? How are duties and claims entailed by natural rights enforced in practice? The notionof transforming justice attempts to answer these questions. (shrink)

The Oxford Encyclopedia of Literary Theory presents a broad and in-depth overview of every aspect of literary theory, both traditional and contemporary. Around 180 full-length essays written by international experts illustrate the problems, the concepts, and the methodologies that arise when we discuss literary criticism, offering the most comprehensive exposition and analysis currently available of literary theory in all its many dimensions.

Ideals of democratic participation and rational self-government have long informed modern political theory. As a recent elaboration of these ideals, the concept of deliberative democracy is based on the principle that legitimate democracy issues from the public deliberation of citizens. This remarkably fruitful concept has spawned investigations along a number of lines. Areas of inquiry include the nature and value of deliberation, the feasibility and desirability of consensus on contentious issues, the implications of institutional complexity and cultural diversity for democratic (...) decision making, and the significance of voting and majority rule in deliberative arrangements.The anthology opens with four key essays--by Jon Elster, Jürgen Habermas, Joshua Cohen, and John Rawls--that helped establish the current inquiry into deliberative models of democracy. The nine essays that follow represent the latest efforts of leading democratic theorists to tackle various problems of deliberative democracy. All the contributions address tensions that arise between reason and politics in a democracy inspired by the ideal of achieving reasoned agreement among free and equal citizens. Although the authors approach the topic of deliberation from different perspectives, they all aim to provide a theoretical basis for a more robust democratic practice.Contributors : James Bohman, Thomas Christiano, Joshua Cohen, Jon Elster, David Estlund, Gerald F. Gaus, Jürgen Habermas, James Johnson, Jack Knight, Frank I. Michelman, John Rawls, Henry S. Richardson, Iris Marion Young. (shrink)

Anti-selection occurs when information asymmetry exists between insurers and applicants. When an applicant knows they are at high risk of loss, but the insurer does not, the applicant may try to use this knowledge differential to secure insurance at a lower premium that does not match risk.

The application of machine learning and artificial intelligence in healthcare domains has received much attention in recent years, yet significant questions remain about how these new tools integrate into frontline user workflow, and how their design will impact implementation. Lack of acceptance among clinicians is a major barrier to the translation of healthcare innovations into clinical practice. In this systematic review, we examine when and how clinicians are consulted about their needs and desires for clinical AI tools. Forty-five articles met (...) criteria for inclusion, of which 24 were considered design studies. The design studies used a variety of methods to solicit and gather user feedback, with interviews, surveys, and user evaluations. Our findings show that tool designers consult clinicians at various but inconsistent points during the design process, and most typically at later stages in the design cycle. We also observed a smaller amount of studies adopting a human-centered approach and where clinician input was solicited throughout the design process. A third of all studies reported on clinician trust in clinical AI algorithms and tools. The surveyed articles did not universally report validation against the “gold standard” of clinical expertise or provide detailed descriptions of the algorithms or computational methods used in their work. To realize the full potential of AI tools within healthcare settings, our review suggests there are opportunities to more thoroughly integrate frontline users’ needs and feedback in the design process. (shrink)

This study examines values and value types as well as scores in levels of moral reasoning for␣students enrolled in a business program. These two factors are measured using the Schwartz Personal Values␣Questionnaire and the Defining Issues Test 2. No statistically significant differences in levels of moral␣reasoning, rankings of values, and value types could be attributed to gender. However, eight significant correlations between value types and levels of moral reasoning provide evidence that a systematic relationship exists. The relationships are not only (...) internally consistent but also consistent with the model of values based on motivational goals (Schwartz S. H. and K. Boenke: 2004, Journal of Research in Personality, 38 230–255). (shrink)

Background Over the last decade, the return of results (ROR) in precision medicine research (PMR) has become increasingly routine. Calls for individual rights to research results have extended the “duty to report” from clinically useful genetic information to traits and ancestry results. ROR has thus been reframed as inherently beneficial to research participants, without a needed focus on who benefits and how. This paper addresses this gap, particularly in the context of PMR aimed at increasing participant diversity, by providing investigator (...) and researcher perspectives on and questions about the assumed value of ROR in PMR.Methods Semi-structured interviews with a purposive sample of investigators and researchers across federally funded PMR studies in three national consortia, as well as observations of study activities, focused on how PM researchers conceptualize diversity and implement inclusive practices across research stages, including navigating ROR.Results Interviewees (1) validated the value of ROR as a benefit of PMR, while others (2) questioned the benefit of clinically actionable results to individuals in the absence of sufficient resources for translating findings into health care for diverse and disadvantaged populations; (3) expressed uncertainties in applying the presumed value of ROR as a benefit for non-clinical results; and (4) and debated when the promise of the value of ROR may undermine trust in PMR, and divert efforts to return value beyond ROR.Conclusions Conceptualizations of diversity and inclusion among PM researchers and investigators raise unique ethical questions where unexamined assumptions of the value of ROR inform study recruitment efforts to enroll minoritized and under-represented populations. A lack of consideration for resources and infrastructure necessary to translate ROR into actionable information may hinder trustworthy community-research relationships. Thus, we argue for a more intentional interrogation of ROR practices as an offer of benefit and for whom. (shrink)

This study examines values and value types as well as scores in levels of moral reasoning for␣students enrolled in a business program. These two factors are measured using the Schwartz Personal Values␣Questionnaire and the Defining Issues Test 2. No statistically significant differences in levels of moral␣reasoning, rankings of values, and value types could be attributed to gender. However, eight significant correlations between value types and levels of moral reasoning provide evidence that a systematic relationship exists. The relationships are not only (...) internally consistent but also consistent with the model of values based on motivational goals (Schwartz S. H. and K. Boenke: 2004, Journal of Research in Personality , 38 230–255). (shrink)

The central role that the media plays in communicating to the public health research findings has long been recognized (Cassels 2007), and concerns regarding the media's ability to convey health is...

In this research, the use of narrative accounts is investigated as the catalyst for the evolution of one coach's identity. Unable to sustain a coaching identity that was deemed to be appropriate by my coaching mentors, I disengaged from the swimming culture. This was due in part to the expression of power within the mentor–mentee relationship embedded in the coach development pathway, as well as within the wider sporting culture. By utilizing a narrative approach; writing and deconstructing my own narratives (...) in relation to coach identity development within the mentor–mentee relationship, I developed an alternative approach. I established a sustainable coaching identity that demonstrated evidence-based judgement and reflective consideration of actions rather than the obtuse reproduction of mentor coach practice. This research suggests that the use of narrative as an integral element in coach education can be powerful in terms of deconstructing cultural ideologies and in the construction of a sustainable coaching identity. The combination of these two components is powerful in terms of enabling a coaching identity to evolve. It is therefore suggested that the development of a sustainable mentor–mentee relationship is inextricably linked with the expression of narrative and the critical reflection on the same. (shrink)

Background: Due to the important role of depression in major illnesses, screening measures for depression are commonly used in medical research. The protocol for managing participants with positive screens is unclear and raises ethical concerns. The aim of this article is to identify and critically discuss the ethical issues that arise when a positive screen for depression is detected, and offer some guidance on managing these issues.DiscussionDeciding on whether to report positive screens to healthcare practitioners is both an ethical and (...) a pragmatic dilemma. Evidence suggests that reporting positive depression screens should only be considered in the context of collaborative care. Possible adverse effects, such as the impact of false-positive results, potentially inappropriate labelling, and potentially inappropriate treatment also need to be considered. If possible, the psychometric properties of the selected screening measure should be determined in the target population, and a threshold for depression that minimises the rate of false-positive results should be chosen. It should be clearly communicated to practitioners that screening scores are not diagnostic for depression, and they should be informed about the diagnostic accuracy of the measure. Research participants need to be made aware of the consequences of the detection of high scores on screening measures, and to be fully informed about the implications of the research protocol.SummaryFurther research is needed and the experiences of researchers, participants, and practitioners need to be collated before the value of reporting positive screens for depression can be ascertained. In developing research protocols, the ethical challenges highlighted should be considered. Participants must be agreeable to the agreed protocol and efforts should be made to minimise potentially adverse effects. (shrink)