The year 2020 is facing one of the worst public health situations in decades. The world is experiencing a pandemic that has triggered significant challenges to healthcare systems in both high and low‐middle income countries (LMICs). Government policymakers and healthcare personnel are experiencing real‐life ethical dilemmas and are pressed to respond to these situations. Many possible treatments are being investigated, one of which is the use of hydroxychloroquine or chloroquine. These drugs are approved for use by patients with systemic lupus (...) erythematosus (SLE), rheumatoid arthritis, and malaria. The demand for these products has increased, and the stocks are depleting for the patient population for whom the drugs are intended initially. Although both innovator and generic pharmaceutical manufacturers are making plans for increased production, there are challenges with global supply chains disruption and the retention of supplies for local markets. This may cause countries that rely on the importation of pharmaceuticals to be out of stock of supplies for an extended period. There are allegations of off‐label prescribing and hoarding. Pharmacists are the custodians and dispensers of medications and are faced with the task of assessing prescriptions and making decisions about the allocation of these products. This paper seeks to 1) highlight some of the ethical challenges of dispensing hydroxychloroquine by pharmacists during the COVID‐19 pandemic, 2) identify some of the responses to these issues from various regulatory authorities in the USA, and 3) recommend approaches to assist pharmacists in their decision‐making process, especially in LMICs. (shrink)

The year 2020 is facing one of the worst public health situations in decades. The world is experiencing a pandemic that has triggered significant challenges to healthcare systems in both high and low‐middle income countries (LMICs). Government policymakers and healthcare personnel are experiencing real‐life ethical dilemmas and are pressed to respond to these situations. Many possible treatments are being investigated, one of which is the use of hydroxychloroquine or chloroquine. These drugs are approved for use by patients with systemic lupus (...) erythematosus (SLE), rheumatoid arthritis, and malaria. The demand for these products has increased, and the stocks are depleting for the patient population for whom the drugs are intended initially. Although both innovator and generic pharmaceutical manufacturers are making plans for increased production, there are challenges with global supply chains disruption and the retention of supplies for local markets. This may cause countries that rely on the importation of pharmaceuticals to be out of stock of supplies for an extended period. There are allegations of off‐label prescribing and hoarding. Pharmacists are the custodians and dispensers of medications and are faced with the task of assessing prescriptions and making decisions about the allocation of these products. This paper seeks to 1) highlight some of the ethical challenges of dispensing hydroxychloroquine by pharmacists during the COVID‐19 pandemic, 2) identify some of the responses to these issues from various regulatory authorities in the USA, and 3) recommend approaches to assist pharmacists in their decision‐making process, especially in LMICs. (shrink)

Developing World Bioethics, Volume 21, Issue 4, Page 193-200, December 2021.

The Covid-19 pandemic creates an unprecedented threatening situation worldwide with an urgent need for critical reflection and new knowledge production, but also a need for imminent action despite prevailing knowledge gaps and multilevel uncertainty. With regard to the role of research ethics in these pandemic times some argue in favor of exceptionalism, others, including the authors of this paper, emphasize the urgent need to remain committed to core ethical principles and fundamental human rights obligations all reflected in research regulations and (...) guidelines carefully crafted over time. In this paper we disentangle some of the arguments put forward in the ongoing debate about Covid-19 human challenge studies and the concomitant role of health-related research ethics in pandemic times. We suggest it might be helpful to think through a lens differentiating between risk, strict uncertainty and ignorance. We provide some examples of lessons learned by harm done in the name of research in the past and discuss the relevance of this legacy in the current situation. (shrink)

This paper explores the grounds upon which moral judgment of a person's beliefs is properly made. The beliefs in question are non-moral beliefs and the objects of moral judgment are individual instances of believing. We argue that instances of believing may be morally wrong on any of three distinct grounds: (i) by constituting a moral hazard, (ii) by being the result of immoral inquiry, or (iii) by arising from vicious inner processes of belief formation. On this way of articulating the (...) basis of moral judgment of belief it becomes clear that rational and epistemic norms do not exhaust the kinds of normative judgment properly made of a person's state of believing. We argue that there are instances of believing that are both rational and true and yet morally wrong. (shrink)

SummaryComparison of some longitudinal data on infant weight in two samples of Australian Aborigines indicates changes in infant growth between 1966 and 1976 which suggest that at the time when the child comes off the breast, weight gain slows. This faltering of weight gain is often followed by a partial catch-up, but the resultant weight for age at 1 year corresponds with a lower British centile than the child was at just before weaning.

A concise and accessible dictionary of the key terms used in Sartre's philosophy, his major works and philosophical influences.

What's wrong with high executive pay? Beyond envy, is some issue of justice or fairness at stake? And what can anyone do about it? (A lot, as it turns out.).

There is no satisfactory account for the general phenomenon of confabulation, for the following reasons: (1) confabulation occurs in a number of pathological and non-pathological conditions; (2) impairments giving rise to confabulation are likely to have different neural bases; and (3) there is no unique theory explaining the aetiology of confabulations. An epistemic approach to defining confabulation could solve all of these issues, by focusing on the surface features of the phenomenon. However, existing epistemic accounts are unable to offer sufficient (...) conditions for confabulation and tend to emphasise only its epistemic disadvantages. In this paper, we argue that a satisfactory epistemic account of confabulation should also acknowledge those features which are (potentially) epistemically advantageous. For example, confabulation may allow subjects to exercise some control over their own cognitive life which is instrumental to the construction or preservation of their sense of self. (shrink)

Andocides is generally not considered one of the best orators. To point up his flawed style, scholars have discussed a notoriously vindictive and humorous section in Andocides 1: in 124ff. Andocides describes the profligate lifestyle of his prosecutor, Callias III the Ceryx, the son of Hipponicus II and dadouchos of the Eleusinian Mysteries.

Progress in addiction science is hampered by disagreements and ambiguity around its core construct: addiction. Addiction Ontology (AddictO) offers a path to a solution of the kind that has addressed similar problems in other areas of science: a set of clearly and uniquely defined entities to which terms such as ‘addiction’, addictive disorder’ and ‘substance dependence ’can be applied for ease of reference while recognizing that it is the construct definitions and their unique IDs that are central, not the terms.

Clinical delusions are difficult to investigate in the laboratory because they co-occur with other symptoms and with intellectual impairment. Partly for these reasons, researchers have recently begun to use hypnosis with neurologically intact people in order to model clinical delusions. In this paper we describe striking analogies between the behavior of patients with a clinical delusion of mirrored self misidentification, and the behavior of highly hypnotizable subjects who receive a hypnotic suggestion to see a stranger when they look in the (...) mirror. Based on these analogies, we argue that the use of hypnosis is a reliable method to investigate the surface features of clinical delusions. But to what extent can hypnosis successfully recreate delusions? Can it also contribute to a better understanding of delusion formation? Although clinical delusions and hypnotically induced beliefs are different in etiology, some analogies can be identified in the underlying processes that characterise them, based on the two-factor theory of delusion formation. (shrink)

In attempting to debunk moral realism through an appeal to evolutionary facts, debunkers face a series of problems, which we label the problems of scope, corrosiveness, and post‐hoc justification. To overcome these problems, debunkers must assume certain metaphysical or epistemological positions, or otherwise pre‐establish them. In doing so, they must assume or pre‐establish the very conclusion they seek in advancing the argument. This means that such debunking arguments either beg the question against the moral realist or are undermined as standalone (...) metaethical arguments. (shrink)

Manuel DeLanda discusses his neo-materialist philosophy with Christoph Cox.

Nursing research in palliative care raises specific and challenging ethical issues. Questions have arisen about whether such research is morally justified, given the low likelihood of direct benefit to dying patients as research participants. The Canadian Code of ethics for registered nurses outlines eight primary values intended to guide nursing practice. We use these values to explore the moral dimensions of research with the palliative care population. Our conclusion is that palliative care research is needed to foster excellent care for (...) these patients and their families, but that nurses must remain constantly vigilant to ensure that participants are protected from resultant harms. Through this exploration we highlight particular considerations that nurse researchers must contemplate when accessing a vulnerable population. (shrink)

This article examines the relations between methods used in both animal work and study and concepts of animal mind. By "animal work" the authors mean humans and animals working together, and by "animal study" they mean the discipline of ethology, especially the emerging area of cognitive ethology. Within these areas the wide range of conceptions of animal mind includes varying emphases on intelligence, forms of rationality and language, cognition, consciousness, and intentionality. The authors' central concern is to elucidate the vocabulary (...) and the concepts which seem necessary to establishing successful working relationships with sheepdogs and gundogs. Their argument moves toward an emphasis on the appreciation of particular intentional states and recognizes that they invariably deploy elements of a moral vocabulary in achieving creative teamwork performances with dogs and other animals. The article concludes by consid enng the relevance of accounts of work with animals for associated considerations of intentionality. (shrink)

This article presents a computational model of the learning of diagnostic knowledge, based on observations of human operators engaged in real-world troubleshooting tasks. We present a model of problem solving and learning in which the reasoner introspects about its own performance on the problem-solving task, identifies what it needs to learn to improve its performance, formulates learning goals to acquire the required knowledge, and pursues its learning goals using multiple learning strategies. The model is implemented in a computer system which (...) provides a case study based on observations of troubleshooting operators and protocol analysis of the data gathered in the test area of an operational electronics manufacturing plant. The model not only addresses issues in human learning, but, in addition, is computationally justified as a uniform, extensible framework for multistrategy learning. (shrink)

To practise ‘fairly and justly’ a clinician must balance the needs of both the many and the few: the individual patient in front of them, and the many unseen patients in the waiting room, and in the county. They must consider the immediate clinical needs of those in the present, and how their actions will impact on future patients. The good medical practice guidance ‘Make the care of your patient your first concern’ provides no guidance on how doctors should act (...) when they care for multiple patients with conflicting needs. Moreover, conflicting needs extend far past simply those between different patients. At an organisational level, financial obligations must be balanced with clinical ones; the system must support those who work within it in a variety of roles; and, finally, in order for a healthcare service to be sustainable, the demands of current and future generations must be balanced.The central problem, we propose, is that there is no shared philosophical framework on which the provision of care or the development of health policy is based, nor is there a practical, fair and transparent process to ensure that the service is equipped to deal justly with new challenges as they emerge. Many philosophers have grappled with constructing a set of principles which would lead to a ‘good’ society which is just to different users; prominent among them is Rawls.Four important principles can be derived using a Rawlsian approach: equity of access, distributive justice, sustainability and openness. However, Rawls’ approach is sometimes considered too abstract to be applied readily to policymaking; it does not provide clear guidance for how individuals working within existing institutions can enact the principles of justice. We therefore combine the principles derived from Rawls with Scanlonian contractualism: by demanding that decisions are made in a way which cannot be ‘reasonably rejected’ by different stakeholders, we ensure that conflicting needs are considered robustly.We demonstrate how embedding this framework would ensure just policies and fair practice. We illustrate this by using examples of how it would help prevent injustice among different socioeconomic groups, prevent intergenerational injustice and prevent injustice in a crisis, for example, as we respond to new challenges such as COVID-19.Attempts to help individual doctors practise fairly and justly throughout their professional lives are best focused at an institutional or systemic level. We propose a practical framework: combining Scanlonian contractualism with a Rawlsian approach. Adopting this framework would equip the workforce and population to contribute to fair policymaking, and would ultimately result in a healthcare system whose practice and policies—at their core—were just. (shrink)

In this paper we explore the connections between ethics and decision theory. In particular, we consider the question of whether decision theory carries with it a bias towards consequentialist ethical theories. We argue that there are plausible versions of the other ethical theories that can be accommodated by “standard” decision theory, but there are also variations of these ethical theories that are less easily accommodated. So while “standard” decision theory is not exclusively consequentialist, it is not necessarily ethically neutral. Moreover, (...) even if our decision-theoretic models get the right answers vis-`a-vis morally correct action, the question remains as to whether the motivation for the non-consequentialist theories and the psychological processes of the agents who subscribe to those ethical theories are lost or poorly represented in the resulting models. (shrink)

This volume looks outward to the twenty-first century and to the dynamics of this first truly global age. It asks the fundamental question: how might human societies live? In contrast to the orthodoxies of academic Philosophy and International Relations in much of the twentieth century, which marginalised or rejected the study of ethics, the contributors here believe that there is nothing more political than ethics, and therefore deserving of scholarly analysis. By exploring some of the oldest questions about duties and (...) obligations within and beyond humanly constructed boundaries, the essays help us ponder the most profound question in world politics today: who will the twenty-first century be for? (shrink)

This article examines a thesis of interest to social epistemology and some articulations of First Amendment legal theory: that a free market in speech is an optimal institution for promoting true belief. Under our interpretation, the market-for-speech thesis claims that more total truth possession will be achieved if speech is regulatedonlyby free market mechanisms; that is, both government regulation and private sector nonmarket regulation are held to have information-fostering properties that are inferior to the free market. After discussing possible counterexamples (...) to the thesis, the article explores the actual implications of economic theory for the emergence of truth in a free market for speech. When confusions are removed about what is maximized by perfectly competitive markets, and when adequate attention is paid to market imperfections, the failure of the market-for-speech thesis becomes clear. The article closes by comparing the properties of a free market in speech with an adversarial system of discourse. (shrink)

During the COVID-19 pandemic, the media have repeatedly praised healthcare workers for their ‘heroic’ work. Although this gratitude is undoubtedly appreciated by many, we must be cautious about overuse of the term ‘hero’ in such discussions. The challenges currently faced by healthcare workers are substantially greater than those encountered in their normal work, and it is understandable that the language of heroism has been evoked to praise them for their actions. Yet such language can have potentially negative consequences. Here, I (...) examine what heroism is and why it is being applied to the healthcare workers currently, before outlining some of the problems associated with the heroism narrative currently being employed by the media. Healthcare workers have a clear and limited duty to treat during the COVID-19 pandemic, which can be grounded in a broad social contract and is strongly associated with certain reciprocal duties that society has towards healthcare workers. I argue that the heroism narrative can be damaging, as it stifles meaningful discussion about what the limits of this duty to treat are. It fails to acknowledge the importance of reciprocity, and through its implication that all healthcare workers have to be heroic, it can have negative psychological effects on workers themselves. I conclude that rather than invoking the language of heroism to praise healthcare workers, we should examine, as a society, what duties healthcare workers have to work in this pandemic, and how we can support them in fulfilling these. (shrink)

We are developing the Neurological Disease Ontology (ND) to provide a framework to enable representation of aspects of neurological diseases that are relevant to their treatment and study. ND is a representational tool that addresses the need for unambiguous annotation, storage, and retrieval of data associated with the treatment and study of neurological diseases. ND is being developed in compliance with the Open Biomedical Ontology Foundry principles and builds upon the paradigm established by the Ontology for General Medical Science (OGMS) (...) for the representation of entities in the domain of disease and medical practice. Initial applications of ND will include the annotation and analysis of large data sets and patient records for Alzheimer’s disease, multiple sclerosis, and stroke. (shrink)