Public health emergencies have occurred throughout history, encompassing such events as plagues and famines arising from natural causes, disease pandemics interrelated with wars, and industrial accidents such as the 1986 Chernobyl disaster, among others. Law and legal tools have played an important role in addressing such emergencies. Three prime U.S. examples are Congressional authorization of quarantine as early as 1796, legally mandated smallpox vaccination upheld in a landmark 1905 U.S. Supreme Court ruling, and the President's 2003 executive order adding SARS (...) to the federal government's list of “quarantinable communicable diseases.”The public health emergencies of the present — both actual and potential — pose equally serious threats but do so in the context of greatly magnified expectations that stem directly from the attacks of September 11, 2001, and the immediately following anthrax attacks. (shrink)

Public health emergencies have occurred throughout history, encompassing such events as plagues and famines arising from natural causes, disease pandemics interrelated with wars, and industrial accidents such as the 1986 Chernobyl disaster, among others. Law and legal tools have played an important role in addressing such emergencies. Three prime U.S. examples are Congressional authorization of quarantine as early as 1796, legally mandated smallpox vaccination upheld in a landmark 1905 U.S. Supreme Court ruling, and the President's 2003 executive order adding SARS (...) to the federal government's list of “quarantinable communicable diseases.”The public health emergencies of the present — both actual and potential — pose equally serious threats but do so in the context of greatly magnified expectations that stem directly from the attacks of September 11, 2001, and the immediately following anthrax attacks. (shrink)

Medical practice should evolve alongside medical ethics. As our understanding of the ethical implications of physician-patient interactions becomes more nuanced, physicians should integrate those lessons into practice. As early as the 1930s, epidemiological studies began to identify that the rates of medical procedures varied significantly along geographic and socioeconomic lines. Dr. J. Alison Glover recognized that tonsillectomy rates in school children in certain school districts in England and Wales were in some cases eight times the rates of children in other (...) districts, with the only significant predictive factors being the current chief medical officer in the area and the socioeconomic well-being of the child's parents. Unfortunately, Dr. Glover's work revealed that the increase in tonsillectomies did not improve the health of adolescent patients and appeared to be performed “as a routine prophylactic ritual for no particular reason and with no particular result.”. (shrink)

Clinical evidence suggests that many patients undergo surgery that they would decline if fully informed. Failure to communicate the relevant risks, benefits, and alternatives of a procedure violates medical ethics and wastes medical resources. Integrating shared decision-making, a method of communication between provider and patient, into medical decisions can satisfy physicians' ethical obligations and reduce unwanted procedures. This article proposes a three-step process for implementing a nationwide practice of shared decision-making: create model integration programs; provide legal incentives to ease the (...) transition; and incorporate shared decision-making into medical necessity determinations. (shrink)

The objective of this study is to evaluate if use of a patient decision aid, when choosing between a repeat cesarean or a trial of labor after a cesarean, reduces medical liability exposure. The authors conclude that use of a PDA conferred liability protection when potential jurors were presented with a hypothetical malpractice claim against an obstetrician following a TOLAC.

We conducted focus groups with 47 potential jurors who were presented with diferent scenarios in a hypothetical malpractice case involving failure to order a PSA test. Better documentation that a patient made an informed decision to decline a PSA test appeared to provide more medical-legal protection for physicians, especially with the use of a decision aid.

Screening for prostate cancer with the prostate-specific antigen blood test is controversial, as evidence to date has not demonstrated such screening does more good than harm. While the potential benefit of PSA screening on reducing prostate cancer mortality has not been documented in randomized trials, many risks of PSA screening have been well documented. These risks include a substantially higher risk of a prostate cancer diagnosis over a screenee’s lifetime, false-positive and false-negative test results, possible complications from biopsies done in (...) response to suspicious test results, and substantial risks of side effects from subsequent prostate cancer treatments. Nevertheless, PSA screening is widespread in the United States, and many physicians in a national survey reported supporting routine PSA screening as well as getting PSA tests themselves, despite the lack of evidence. (shrink)

Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health (...) literacy in their treatment decisions. Specifically, the article will examine the potential of shared decision-making to bridge gaps in knowledge, increase patient adherence to treatment, and improve health outcomes in low health literacy patient populations. Leveling barriers to treatment information for disadvantaged populations should be a public health imperative, especially if it can be shown to improve health outcomes and reduce health disparities. (shrink)

Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health (...) literacy in their treatment decisions. Specifically, the article will examine the potential of shared decision-making to bridge gaps in knowledge, increase patient adherence to treatment, and improve health outcomes in low health literacy patient populations. Leveling barriers to treatment information for disadvantaged populations should be a public health imperative, especially if it can be shown to improve health outcomes and reduce health disparities. (shrink)

The Proceedings of the National Summit on Legal Preparedness for Obesity Prevention and Control is based on a two-part conceptual framework composed of public health and legal perspectives. The public health perspective comprises the six target areas and intervention settings that are the focus of the obesity prevention and control efforts of the Centers for Disease Control and Prevention.This paper presents the legal perspective. Legal preparedness in public health is the underpinning of the framework for the four “assessment” papers and (...) the four “action” papers that are integral to the application of public health law to any particular health issue. In addition, this paper gives real-world grounding to the legal framework through examples that illustrate the four core elements of legal preparedness in public health that are at work in obesity prevention and control. (shrink)

The Proceedings of the National Summit on Legal Preparedness for Obesity Prevention and Control is based on a two-part conceptual framework composed of public health and legal perspectives. The public health perspective comprises the six target areas and intervention settings that are the focus of the obesity prevention and control efforts of the Centers for Disease Control and Prevention.This paper presents the legal perspective. Legal preparedness in public health is the underpinning of the framework for the four “assessment” papers and (...) the four “action” papers that are integral to the application of public health law to any particular health issue. In addition, this paper gives real-world grounding to the legal framework through examples that illustrate the four core elements of legal preparedness in public health that are at work in obesity prevention and control. (shrink)

This chapter offers a proceduralist argument against capital punishment. More specifically, it contends that the possibility of irrevocable mistakes precludes the just administration of the death penalty. At stake is a principle of political morality: legal institutions must strive to remedy their mistakes and to compensate those who suffer from wrongful sanctions. The incompatibility of remedy and execution is the crux of the irrevocability argument: because the wrongly executed cannot enjoy the morally required compensation, execution is impermissible. Along with defending (...) his key premises, Yost explains the complicated role that sentencing uncertainty plays in the argument. He concludes by noting some of the flaws in substantive consequentialist and retributivist justifications of capital punishment. (shrink)

We perceive smells as perduring complex entities within a distal array that might be conceived of as smellscapes. However, the philosophical orthodoxy of Odor Theories has been to deny that smells are perceived as having a distal location. Recent challenges have been mounted to Odor Theories’ veracity in handling the timescale of olfactory perception, how it individuates odors as a distal entities, and their claim that olfactory perception is not spatial. The paper does not aim to dispute these criticisms. Rather, (...) what will be shown is that Molecular Structure Theory, a refinement of Odor Theory, can be further developed to handle these challenges. The theory is further refined by focusing on distal perception that requires considering the perceptual object as mereologically complex persisting odor against a background scene conceived of as a smellscape. What will be offered is an expansion of Molecular Structure Theory to account for distal smell perception within natural environments. (shrink)

We are immersed within an odorous sea of chemical currents that we parse into individual odors with complex structures. Odors have been posited as determined by the structural relation between the molecules that compose the chemical compounds and their interactions with the receptor site. But, naturally occurring smells are parsed from gaseous odor plumes. To give a comprehensive account of the nature of odors the chemosciences must account for these large distributed entities as well. We offer a focused review of (...) what is known about the perception of odor plumes for olfactory navigation and tracking, which we then connect to what is known about the role odorants play as properties of the plume in determining odor identity with respect to odor quality. We end by motivating our central claim that more research needs to be conducted on the role that odorants play within the odor plume in determining odor identity. (shrink)

Capital punishment—the legally authorized killing of a criminal offender by an agent of the state for the commission of a crime—stands in special need of moral justification. This is because execution is a particularly severe punishment. Execution is different in kind from monetary and custodial penalties in an obvious way: execution causes the death of an offender. While fines and incarceration set back some of one’s interests, death eliminates the possibility of setting and pursuing ends. While fines and incarceration narrow (...) one’s routes to happiness, death eliminates its possibility. Not surprisingly, there is much debate about the moral permissibility of capital punishment. This entry maps the terrain of this debate. The first section discusses justifications of the death penalty as they appear in major theories of punishment. The second section surveys moral objections to execution that apply to most justifications. The third addresses procedural criticisms, which do not target the morality of execution so much as the justice of its implementation. (shrink)

At least some of your beliefs are commitments. When you believe that P as a commitment, your stance on P is such that you believe it on the basis of your considered judgement. Sometimes, you also believe that you believe P. Such self‐beliefs can also be commissive in a sense, as when they are reflective endorsements of your lower‐order commissive beliefs. In this paper I argue that one's commissive self‐beliefs ontologically constitute one's lower‐order commissive beliefs because one's commissive self‐beliefs instantiate (...) the same inferential dispositions that are constitutive of one's lower‐order commissive beliefs. Constitutive relations between commissive self‐beliefs and first‐order commissive beliefs are maximally epistemically secure because they do not result from any epistemic procedure by which one must try (and possibly fail) to detect one's first‐order commissive beliefs. This maximal epistemic security suffices to warrant one's commissive self‐beliefs, such that one possesses commissive self‐knowledge of an especially privileged sort. (shrink)

Kant famously insists that free will is a condition of morality. The difficulty of providing a demonstration of freedom has left him vulnerable to devastating criticism: critics charge that Kant's post-Groundwork justification of morality amounts to a dogmatic assertion of morality's authority. My paper rebuts this objection, showing that Kant offers a cogent demonstration of freedom. My central claim is that the demonstration must be understood in practical rather than theoretical terms. A practical demonstration of x works by bringing x (...) into existence, and what the demonstration of freedom brings into existence is a moral will, a will regulated by the moral law and capable of acting in accordance with it. Since to act morally is to act freely, bringing a moral will into existence actualizes our capacity for freedom and demonstrates that we possess it. To confirm the viability of such a demonstration, Kant must establish that agents can regulate their wills by practical principles, and that practical judgments are efficacious of themselves (i.e., that non-Humean motivational internalism is true). Kant, I argue, is successful on both counts. (shrink)

Nietzsche distinguished between two forces in art: Apollonian, which represents order and reason, and Dionysian, which represents chaos and energy. Economists, Ward argues, have operated for too long under the assumption that their work reflects the scientific, Apollonian principals that inform physics when they simply do not apply to economics: 'constants' in economics stand in for variables, and the core scientific principles of prediction and replication are all but ignored by economists. Ward encourages economists to reintegrate the standard rigor of (...) the scientific method into their work while embracing the fact of the shape-shifting changeability of human beings. Economists can still aspire to scientific standards, as is demonstrated by the success of biology, in which there is considerable Dionysian variability. Economists must avoid the temptation to wish away dynamic complexity and diversity and must recognize, among other things, that the desire to take risks is fundamentally human. The second half of the book takes some first steps toward creating this new Dionysian Economics. (shrink)

A number of studies in the extant literature report findings that suggest asymmetry in the way reflexive and pronoun anaphors are interpreted in the early stages of processing: that pronouns are less sensitive to structural constraints, as formulated by Binding Theory, than reflexives, in the initial antecedent retrieval process. However, in previous visual world paradigm eye-tracking studies, these conclusions were based on sentences that placed the critical anaphors within picture noun phrases or prepositional phrases, which have independently been shown not (...) to neatly conform to the Binding Theory principles. We present results from a visual world paradigm eye-tracking experiment that show that when critical anaphors are placed in the indirect object position immediately following a verb as a recipient argument, pronoun and reflexive processing are equally sensitive to structural constraints. (shrink)

In this paper, I will critique Paul Draper’s recent model of God’s motivational structure, according to which God can make hard choices. I will argue that this model illegitimately treats value in a purely teleological way, as something to be promoted. Following T.M. Scanlon’s work on value theory, when we consider the fact that value is to be respected rather than merely promoted, this realization will significantly foreclose on the possible cases in which hard choices can conceivably be made by (...) God. Most importantly, I challenge the idea that God can face hard choices between aesthetic and moral value in the way Draper suggests. (shrink)

The creative process has the potential to increase wellbeing and foster human flourishing (Dolan and Metcalfe, 2012 ; Forgeard and Eichner, 2014 ; O’Brien and Murray, 2015 ; Conner et al., 2018 ; Kaufman, 2018 ), yet has received little attention in the humanistic management literature. In this paper, we present three experiments showing that idea originators experience greater relationship conflict with counterparts who have committed perceived “idea theft”, i.e., proposed identical or related ideas. We test a model that identifies (...) a mechanism—self-threat—that mediates the relationship between idea theft and relationship conflict and identifies an intervention to ameliorate that self-threat via self-affirmation. Study 1 demonstrates the idea originator’s attribution of malign attributions to, and negative moral emotions toward, the counterpart. Study 2 demonstrates that idea originators ostracize both those who propose identical ideas and those who propose merely related ideas. In Study 3, evidence for self-threat as the mechanism underlying the negative relational consequences is provided via both a direct test of mediation as well as via moderation by self-affirmation. Our research contributes to the nascent idea theft literature and suggests a way to reduce its negative consequences. (shrink)

Hardly anyone disputes that discrimination can be a grave moral wrong. Yet this consensus masks fundamental disagreements about what makes something discrimination, as well as precisely why acts of discrimination are wrong. Benjamin Eidelson develops systematic answers to those two questions. He claims that discrimination is a form of differential treatment distinguished by its special connection to the differential ascription of some property to different people, and goes on to argue that what makes some cases of discrimination intrinsically wrongful (...) is that they manifest an attitude of disrespect for the personhood of those who are disfavored. He endeavors to specify what this attitude consists in, and to demonstrate how attending to its character can help us to better understand the moral dimensions of different forms of wrongful discrimination. The book concludes with an extended discussion of racial profiling in law enforcement. (shrink)

This article critically examines Busk's Democracy in Spite of the Demos, which critiques the “categorical imperative of democracy.” Although Busk effectively challenges the commitment to value-neutral democratic procedures as the foundation for legitimate law, his alternative, curtailing powerful interests ability to manipulate voters using “socially necessary delusions,” risks establishing elite rule. This article instead proposes basic liberal rights as the normative foundation for legitimate public order and militant democracy as its most effective institutional safeguard, arguing that this combination better realizes (...) human emancipation. (shrink)

“Public health legal preparedness” is a term born in the ferment, beginning in the late 1990s, that has led to unprecedented recognition of the essential role law plays in public health and, even more recently, in protecting the public from terrorism and other potentially catastrophic health threats.The initial articulation of public health has not kept pace with rapid evolution in the concept and in practical development of public health preparedness itself. This poses the risk that legal preparedness may fall behind (...) construction of general readiness in the public health system—and may, in fact, undercut achievement of comprehensive public health preparedness for massive threats to health in both the United States and world-wide. Inadvertent results might include both negative health impacts and infringement on individual rights. (shrink)

“Public health legal preparedness” is a term born in the ferment, beginning in the late 1990s, that has led to unprecedented recognition of the essential role law plays in public health and, even more recently, in protecting the public from terrorism and other potentially catastrophic health threats.The initial articulation of public health has not kept pace with rapid evolution in the concept and in practical development of public health preparedness itself. This poses the risk that legal preparedness may fall behind (...) construction of general readiness in the public health system—and may, in fact, undercut achievement of comprehensive public health preparedness for massive threats to health in both the United States and world-wide. Inadvertent results might include both negative health impacts and infringement on individual rights. (shrink)

The notion of a defendant submitting a false guilty plea due to the penal incentive offered is not an uncommon phenomenon. While the practice has been legitimised based on the defendant’s voluntary informed consent, it has often been argued that the structure of the plea-bargaining practice is coercive. Such can be the case whenever the plea offer entails a significant sentence differential, discrepancy in the form of punishment (a non-custodial sentence relative to a custodial one), or when the alternative of (...) pleading guilty includes the risk of capital punishment. Having said that, plea-bargains have often been classified as a “non-coercive offer”, whether due to their advantageous mutual character according to a baseline conception of coercion or being an offer that one can overcome according to an irresistible psychological account. While many scholars have struggled with the ambiguous notion of “coercive offers,” the paper offers an alternative approach, arguing that it is the type of reasons to be considered within the offer that renders the bargain less than fully autonomous. It will be argued that the plea-bargain proposition infuses irrelevant (guilt-uncorrelated) penal considerations unrelated to the question of guilt. Such considerations are the wrong kind of reason for the guilty-plea decision, and due to the defendant’s dependency on the plea offer, they distort the defendant’s intentional character of her autonomous decision. It is part of the conception of the guilty plea. Though a defendant may autonomously intend to consider irrelevant penal considerations, such a decision cannot be genuinely considered a decision regarding the admission of guilt. (shrink)

Socialist courts are supposed to apply the law, not make it, and socialist legality denies judicial decisions any precedential status. In 2011, the Chinese Supreme People’s Court designated selected decisions as Guiding Cases to be referred to by all judges when adjudicating similar disputes. One decade on, the paucity of citations to Guiding Cases has been taken as demonstrating the incongruity of case-based adjudication and the socialist legal tradition. Citations are, however, an imperfect measure of influence. Reproduction of language uniquely (...) traceable to Guiding Cases can also be evidence of their impact on judicial decision-making. We employ a local alignment tool to detect unattributed text reuse of Guiding Cases in local court decisions. Our findings suggest that Guiding Cases are more consequential than commonly assumed, thereby complicating prevailing narratives about the antagonism of socialist legality to case law. (shrink)