Systems thinking has emerged as a means of conceptualizing and addressing complex public health problems, thereby challenging more commonplace understanding of problems and corresponding solutions as straightforward explanations of cause and effect. Systems thinking tries to address the complexity of problems through qualitative and quantitative modeling based on a variety of systems theories, each with their own assumptions and, more importantly, implicit and unexamined values. To date, however, there has been little engagement between systems scientists and those working in bioethics (...) and public health ethics. The goal of this paper is to begin to consider what it might mean to combine systems thinking with public health ethics to solve public health challenges. We argue that there is a role for ethics in systems thinking in public health as a means of elucidating implicit assumptions and facilitating ethics debate and dialogue with key stakeholders. (shrink)

The “therapeutic obligation” is a physician’s duty to provide his patients with what he believes is the best available treatment. We begin by discussing some prominent formulations of the obligation before raising two related considerations against those formulations. First, they do not make sense of cases where doctors are permitted to provide suboptimal care. Second, they give incorrect results in cases where doctors are choosing treatments in challenging epistemic environments. We then propose and defend an account of the therapeutic obligation (...) that solves the problems that undermined previous efforts at formulating the TO. We conclude by considering how apparent problems with our proposal actually rest on difficulties with informed consent. (shrink)

Socrates is one of the most important yet enigmatic philosophers of all time; his fame has endured for centuries despite the fact that he never actually wrote anything. In 399 B.C.E., he was tried on the charge of impiety by the citizens of Athens, convicted by a jury, and sentenced to death. About these facts there is no disagreement. However, as the sources collected in this book and the scholarly essays that follow them show, several of even the most basic (...) facts about these events were controversial in antiquity, and the questions persist today: How and why was Socrates brought to trial? Why did the jurors, members of the world's first democracy, find him guilty? When he was given an opportunity to escape execution, why did he refuse to do so and instead accept the punishment that he and his friends agreed was unjustly assigned to him? How exactly did Socrates die? Differences of opinion on these and other issues continue to arouse our curiosity and to challenge new generations of students and scholars. The Trial and Execution of Socrates: Sources and Controversies is the first work to collect in one place all of the major ancient sources on Socrates' death--those of both his critics and his defenders--as well as recent scholarly views. Part I includes new translations of Plato's Euthyphro, Apology, Crito, and the death scene from Phaedo, as well as other ancient sources that shed light on Socrates' trial and execution. Part II features some of the most influential recent scholarship on this historically momentous event with work by M. F. Burnyeat, Robert Parker, Mark L. McPherran, Thomas C. Brickhouse and Nicholas D. Smith, Richard Kraut, Christopher Gill, and Enid Bloch. Ideal for undergraduate surveys of ancient Greek philosophy and upper-level courses on Socrates and Socratic philosophy, this unique collection provides an unprecedented look into the many perplexing questions surrounding the trial and execution of this remarkable man. (shrink)

When people encounter potential hazards, their expectations and behaviours can be shaped by a variety of factors including other people's expressions of verbal likelihood. What is the impact of such expressions when a person also has numeric likelihood estimates from the same source? Two studies used a new task involving an abstract virtual environment in which people learned about and reacted to novel hazards. Verbal expressions attributed to peers influenced participants’ behaviour toward hazards even when numeric estimates were also available. (...) Namely, verbal expressions suggesting that the likelihood of harm from a hazard is low yielded more risk taking with respect to said hazard. There were also inverse collateral effects, whereby participants’ behaviour and estimates regarding another hazard in the same context were affected in the opposite direction. These effects may be based on directionality and relativity cues inferred from verbal likelihood expressions. (shrink)

This article advances recent scholarship on energy security by arguing that the concept is best understood as a sociotechnical imaginary, a collective vision for a “good society” realized through technoscientific-oriented policies. Focusing on the 1952 Resources for Freedom report, the authors trace the genealogy of energy security, elucidating how it establishes a morality of efficiency that orients policy action under the guise of security toward the liberalizing of markets in resource states and a robust program of energy research and development (...) in the United States. This evidence challenges the pervasive historical anchoring of the concept in the 1970s and illustrates the importance of the genealogical approach for the emerging literature on energy and sociotechnical imaginaries. Exploring the genealogy of energy security also unpacks key social, political, and economic undercurrents that disrupt the seeming universality of the language of energy, leading the authors to question whether energy security discourse is appropriate for guiding policy action during ongoing global energy transitions. (shrink)

Background: The factors influencing parents’ willingness to enroll their children in biobanks are poorly understood. This study sought to assess parents’ willingness to enroll their children, and their perceived benefits, concerns, and information needs under different consent and data-sharing scenarios, and to identify factors associated with willingness. Methods: This large, experimental survey of patients at the 11 eMERGE Network sites used a disproportionate stratified sampling scheme to enrich the sample with historically underrepresented groups. Participants were randomized to receive one of (...) three consent and data-sharing scenarios. Results: In total, 90,000 surveys were mailed and 13,000 individuals responded (15.8% response rate). 5737 respondents were parents of minor children. Overall, 55% (95% confidence interval 50–59%) of parents were willing to enroll their youngest minor child in a hypothetical biobank; willingness did not differ between consent and data-sharing scenarios. Lower educational attainment, higher religiosity, lower trust, worries about privacy, and attitudes about benefits, concerns, and information needs were independently associated with less willingness to allow their child to participate. Of parents who were willing to participate themselves, 25% were not willing to allow their child to participate. Being willing to participate but not willing to allow one’s child to participate was independently associated with multiple factors, including race, lower educational attainment, lower annual household income, public health care insurance, and higher religiosity. Conclusions: Fifty-five percent of parents were willing to allow their youngest minor child to participate in a hypothetical biobank. Building trust, protecting privacy, and addressing attitudes may increase enrollment and diversity in pediatric biobanks. (shrink)

The most common corporate reaction to public concern over the ethics of their business practices and the sensitivity of their organization to social expectations is to promote policies and rules designed to bring about a set of socially responsive behaviours and actions. The result of this corporate deontological approach is to create a teleopathic culture that relieves decision makers from the personal responsibil ity for the consequences of their actions and widens the gap between how society expects business to behave (...) and their actual behaviour. The corporate use of a deontological approach effectively allows the substitution of corporate conscience for the moral values of individual decision makers and thus weakens the linkage between individual personal values and behaviour. The creation of teleopathological behaviour in an organization is explored through a juxtaposition of the parables of the Sadhu and the Good Samaritan. The consequences of teleopathic behaviour are then illustrated through an examination of Dow Corning's silicon gel product liability case. (shrink)

Making research data readily accessible during a public health emergency can have profound effects on our response capabilities. The moral milieu of this data sharing has not yet been adequately explored. This article explores the foundation and nature of a duty, if any, that researchers have to share data, specifically in the context of public health emergencies. There are three notable reasons that stand in opposition to a duty to share one’s data, relating to: (i) data property and ownership, (ii) (...) just distribution of benefits and burdens and (iii) the contemporary ethos of science. We argue each reason can be successfully met with corresponding rationale in favour of data sharing. Further support for data sharing has been echoed in policies of health agencies, funding bodies and academic institutions; in documents on the ethical conduct of biomedical research; and in discussions on the nature of public health. From this, we ascertain that sharing data is the morally sound default position. This article then highlights the key roles reciprocity and solidarity play in supporting the practice of data sharing. We conclude with recommendations to regard public health research data as a common-pool resource in order to build a framework for stable data sharing management. (shrink)

An attempt is made to pinpoint the way in which perception is related to belief. Although, for familiar reasons, it is not true to say that we necessarily believe in the existence of the objects we perceive, nor that they actually have their ostensible characteristics, it is argued that the relation between perception and belief is more than merely contingent.There are two main issues to address. The first is that ‘collateral’ beliefs may impede perceptual belief. It is argued that this (...) still assigns an essential role to belief in perception, though the belief may be of an attenuated form. The second is Fred Dretske’s claim that even attenuated belief may be entirely absent from perception. It is argued that ‘non-epistemic’ perception can be understood only by employing the concept of ‘epistemic’ perception; that the former can occur only partially---i.e., within perceptions that are otherwise epistemic; and that by switching attention from the perception of objects to the Phenomenological tradition’s concern with the perception of world, we can see that perception must be entirely permeated with ‘doxastic’ force. (shrink)

An attempt is made to pinpoint the way in which perception is related to belief. Although, for familiar reasons, it is not true to say that we necessarily believe in the existence of the objects we perceive, nor that they actually have their ostensible characteristics, it is argued that the relation between perception and belief is more than merely contingentThere are two main issues to address. the first is that ‘collateral’ beliefs may impede perceptual belief. It is argued that this (...) still assigns an essential role to belief in perception, though the belief may be of an attenuated form. the second is Fred Dretske's claim that even attenuated belief may be entirely absent from perception. It is argued that (a) ‘non‐epistemic’perception can be understood only by employing the concept of ‘epistemic’perception; (b) that the former can occur only partially—i.e., within perceptions that are otherwise epistemic; and (c) that by switching attention from the perception of objects to the Phenomenological tradition's concern with the perception of world, we can see that perception must be entirely permeated with ‘doxastic’force. (shrink)

Médecins Sans Frontières is not morally required to continue providing the same therapeutic and preventative interventions for lead poisoning in Nigeria in the face of conditions that negatively impact on the achievement of their objectives. Nevertheless, Médecins Sans Frontières may have reasons to revise their objectives and adopt different interventions or methods.

Stem cell science is advancing at an unprecedented rate, with thousands of research papers being published every year and many clinical trials for a wide range of conditions underway as registered on ClinicalTrials.gov. This rapidly expanding and alluring field has brought with it ever more complex and multifaceted ethical issues, many of which require new guidelines, consent protocols and even change in legislation, since they do not fit comfortably in the existing bioethical regulations and protocols. Keeping up with the ethical (...) implications of stem cell research is daunting to the expert and non-expert. We review the various types of stem cells and then focus on multipotent and pluripotent cell types, since it is these cell types that bring with them the greatest research and therapeutic potential, while concurrently delivering novel ethical conundrums. Certain key considerations are currently lacking and what is needed is how to obtain permission from individuals who donate their biological material for both scientific inquiry and eventually, for their potential therapeutic utility. (shrink)

A controversy rages over the question of how should controversial topics be taught. Recent work has advanced the “epistemic criterion” as the resolution to this controversy. According to the epistemic criterion, a matter should be taught as controversial when contrary views can be entertained on the matter without the views being contrary to reason. When an issue is noncontroversial, according to the epistemic criterion, the correct position can be taught “directively,” with the teacher endorsing that position. When there is a (...) legitimate controversy, the view should be taught “nondirectively,” with the teacher remaining neutral. In response, Bryan Warnick and Spencer Smith argue that the proponents of the epistemic criterion fail to recognize the multidimensional nature of what it means to learn to be rational. Recognizing this complexity undermines the link between the epistemic status of the controversy and directiveness of one's teaching, suggesting more flexibility in how teachers approach controversial issues. It also implies the need for a new category of teaching, which Warnick and Smith call “soft-directive” teaching. (shrink)