The Harvard Report, published in April 1999 for public consultation in Hong Kong, proposed a fundamental restructuring in its health care delivery and financing systems. The Report claims to be evidence-based in its approach (Hsiao et al., 1999a). While 'evidence' has been widely collected by the consultancy team through surveys, consultations and focus groups, the recommendations put forth are not value-free. They carry clear ideological preferences. The value assumptions and ethical presuppositions underlying the report are discussed in this paper. The (...) Harvard consultancy study is in favor of a positive government role in regulation and control, a single central body to administer compulsory health insurance for all citizens, and a purchaser-provider split to induce competition. Such preference is based on pre-existing ideology and generic health care management concepts, which are still in the experimental phase internationally. While value and ideology are inevitable factors in any policy choice, the challenge is to lay these values open for reflection and public debate. For Hong Kong, the challenge is also to take on local substantive issues in health care and deal with them head-on, rather than putting hope in a universal, generic solution. (shrink)

Since the World Health Organization first declared the novel coronavirus a pandemic, diverse strategies have emerged to address it. This paper focuses on two leading strategies, elimination and mitigation, and examines their ethical basis. Elimination or ‘Zero-COVID’ dominates policies in Pacific Rim societies. It sets as a goal zero deaths and seeks to contain transmission using stringent short-term lockdowns, followed by strict find, test, trace and isolate methods. Mitigation, which dominates in the US and most European nations, sets targets for (...) community transmission and lifts restrictions once targets are met. This approach takes calculated risks and regards a certain amount of disease and death as ethically justified. Section I examines different societal responses to risk that underlie these different policy approaches. Section II focuses on ethical arguments favouring Zero-COVID and raises health equity objections. Section III proposes a long-term strategy that balances the twin goals of promoting population health and health equity. There are no data available for this work. (shrink)

Worldwide populations are aging with economic development as a result of public health initiatives and advances in therapeutic discoveries. Since 1850, life expectancy has advanced by 1 year for every four. Accompanying this change is the rapid development of anti‐aging science. There are three schools of thought in the field of aging science. One perspective is the life course approach, which considers that aging is a good and natural process to be embraced as a necessary and positive aspect of life, (...) where the aim is to improve the quality of existing lifespan and “compress” morbidity. Another view is that aging is undesirable, and that rejuvenation and indeed immortality are possible since the biological basis of aging is understood, and therefore, strategies are possible for engineering negligible senescence. Finally, a hybrid approach is that life span can be extended by anti‐aging medicines but with uncertain effects on health. While these advances offer much promise, the ethical perspectives are seldom discussed in cross‐disciplinary settings. This article discusses some of the key ethical issues arising from recent advances in biogerontology. (shrink)

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient‐centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube (...) feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision‐making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end‐of‐life care. (shrink)

Volume 20, Issue 7, July 2020, Page 114-116.

This paper argues that, at least in the context of employment, we should reconsider the applicability of the dominant framework in the contemporary literature on exploitation, which views exploitation as a micro-level moral wrong. I present a novel argument showing that these micro-level theories share commitments inconsistent with taking exploitation seriously as a moral wrong. Given the difficulties these theories face, I argue that we should pursue a structural theory of exploitation, and I give a brief sketch of what such (...) a theory might look like. (shrink)

Various forms of research are essential in emergency, disaster and disease outbreak situations, but challenges exist including the long length of time it takes to get research proposals approved. Consequently, it would be very advantageous to have an acceptable model for efficient coordination and communication between and among research ethics committees/IRBs and ministries of health, and templates for expediting ethical review of research proposals in emergency and epidemic situations to be used across the Caribbean and in other low and middle (...) income countries. This project involved a literature search and the interviewing of ministry of health officials, public health practitioners, and research ethics committee/IRB members in Jamaica and St. Lucia, to obtain suggestions for the best model for efficient coordination and communication between research ethics committees, and developed a template for expediting review of research protocols in epidemic and emergency conditions. (shrink)

In this impassioned polemic, radical environmental philosopher Derrick Jensen debunks the near-universal belief in a hierarchy of nature and the superiority of humans. Vast and underappreciated complexities of nonhuman life are explored in detail--from the cultures of pigs and prairie dogs, to the creative use of tools by elephants and fish, to the acumen of caterpillars and fungi. The paralysis of the scientific establishment on moral and ethical issues is confronted and a radical new framework for assessing the intelligence (...) and sentience of nonhuman life is put forth. Jensen attacks mainstream environmental journalism, which too often limits discussions to how ecological changes affect humans or the economy--with little or no regard for nonhuman life. With his signature compassionate logic, he argues that when we separate ourselves from the rest of nature, we in fact orient ourselves against nature, taking an unjust and, in the long run, impossible position. Jensen expresses profound disdain for the human industrial complex and its ecological excesses, contending that it is based on the systematic exploitation of the earth. Page by page, Jensen, who has been called the philosopher-poet of the environmental movement, demonstrates his deep appreciation of the natural world in all its intimacy, and sounds an urgent call for its liberation from human domination. (shrink)

Guideline 20 of the updated International Ethics Guidelines for Health‐related Research Involving Humans (2016) by the Council for International Organizations of Medical Sciences (CIOMS) provides guidance on research in disasters and disease outbreaks against the background of the need to generate knowledge quickly, overcome practical impediments to implementing such research, and the need to maintain public trust. The guideline recommends that research ethics committees could pre‐screen study protocols to expedite ethical reviews in a situation of crisis, that pre‐arrangements be made (...) regarding data sharing and biomedical sample sharing, and that sponsors and research ethics committees seek to minimize risk to researchers conducting research during a disaster. This paper critiques these recommendations against the background of the findings of a survey of public health officials and chairs of research ethics committees in the Caribbean during 2016, which sought to determine the best template for the expeditious ethical review of research proposals in emergency and epidemic situations in the Caribbean, and whose findings can serve as a model for other low‐ and middle‐income countries. (shrink)

In the Caribbean as in many other areas costly biomedical resources and personnel are limited, and more and more people are turning to alternative medicine and folk practitioners for health care. To meet the goal of providing health care for all, research on nonbiomedical therapies is needed, along with legal recognition of folk practitioners to establish standards of practice.

From the New York Times bestselling author Derrick Bell, a profound meditation on achieving success with integrity. As one of the country's most influential law professors, Derrick Bell has spent a lifetime helping students struggling to maintain a sense of integrity in the face of an overwhelming pressure to succeed at any price. Frequently asked how he managed to be so extraordinarily successful while never giving up the fight for justice and equality, Bell decided to spend his seventieth (...) year writing a book of insight and guidance. The result, Ethical Ambition , is a deeply affecting, uplifting, and brilliant series of meditations that not only challenges us to face some of the most difficult questions that life presents, but dares to offer some solutions. Using incidents from his own life, Bell also looks to literature, history, and other contemporary figures who have refused to compromise their beliefs. In chapters that explore passion, faith courage, inspiration, humility, and relationships, Ethical Ambition address the most fundamental issues of life. (shrink)

What is the source of rights? Rights have been grounded in divine agency, human nature, and morally justified claims, and have been used to assess the moral status of legal and customary social practices. The orthodoxy is that some of our rights are a species of unrecognized or natural rights. For example, black slaves in antebellum America were said to have such rights, and this was taken to provide a basis for establishing the immorality of slavery. Derrick Darby exposes (...) the main shortcomings of the orthodox conception of the source of rights and proposes a radical alternative. He draws on the legacy of race and racism in the USA to argue that all rights are products of social recognition. This bold, lucid and meticulously argued book will inspire readers to rethink the central role assigned to rights in moral, political, and legal theory as well as in everyday evaluative discourse. (shrink)

Discover innovative ways to strengthen your photography business with your iPad Many photographers are turning to the flexible, easy-to-use tools of the iPad and relying on them to wear a variety of hats in their photography business. Whether portable portfolio, editing tool, payment-tracking system, or appointment calendar, the iPad melds together the best attributes of the cell phone and a laptop computer and this unique book highlights them all. With this helpful resource, you'll learn how to get the most out (...) of your iPad to not only improve your business but also enhance your photography. Details how to use your iPad to schedule client appointments, accept payments, sign model releases, track business expenses, and more Teaches you how to take advantage of the hi-res display, cellular and WiFi connectivity, and powerful processor to increase efficiency Covers ways to use the iPad on location with on-the-fly editing techniques Offers suggestions for using the iPad as a backup storage device and how to use it in the studio Features a chapter on shooting movies with your iPad iPad for Digital Photographers shows you how to leverage the strengths of the iPad to enhance your photography and your business. (shrink)

Spiritual/religious coping has proven to be a fertile ground for investigating health-related spirituality in action. Ken Pargament and his colleagues have successfully demonstrated that spiritual/religious coping differs significantly from previously identified coping strategies. While much has been accomplished to date, there are undeveloped theoretical and methodological avenues that appear to provide important promise for understanding the complexities of this critical domain of coping. Some scholars have failed to conceptualize and research spiritual/religious coping as a contextual, temporally bounded process. This paper (...) explores the theoretical and methodological advantages of adopting a contextually embedded, process-oriented epistemology—contextual action theory. We propose that doing so will not only address some of the inadequacies of the extant literature but also aid researchers in exploring novel dimensions of spiritual/religious coping. From a contextual action-theory perspective, spiritual/religious coping is viewed as intentional, goal-directed behaviour that is embedded in a social and relational context. This teleonomic reconceptualization enables researchers to understand the constitution and development of intentions involved in the process of spiritual/religious coping over time. Further, a contextual action theory perspective transcends the narrow, individualistic lens of coping and explores joint and collective coping processes that emerge as people draw upon spiritual/religious practices to cope with distress. Thus, spiritual/religious coping is embedded in social and relational context and as part of personal, intentional goal-directed processes over time. The novel contributions of a contextual theoretical perspective to spiritual/religious coping research and theory are illustrated through a case example. (shrink)

Art historians have often discussed Andy Warhol's Factory as a unique creative space in 1960s Manhattan. Similarly, scholars of dance and performance have provided valuable insight into the vanguard activities associated with the Judson Dance Theater located near Union Square. Few studies take time to compare these two places and consider their relationships to one another. This article looks at Warhol's Silver Factory and the performances that took place at Judson Memorial Church more or less simultaneously with a goal of (...) identifying overlapping actors and establishing shared concerns and a sense of radical inclusivity that existed at both sites. (shrink)

A recent development in philosophical scholarship on reparations for black chattel slavery and Jim Crow segregation is reliance upon social science in normative arguments for reparations. Although there are certainly positive things to be said in favor of an empirically informed normative argument for black reparations, given the depth of empirical disagreement about the causes of persistent racial inequalities, and the ethos of 'post-racial' America, the strongest normative argument for reparations may be one that goes through irrespective of how we (...) ultimately explain the causes of racial inequalities. By illuminating the interplay between normative political philosophy and social scientific explanations of racial inequality in the prevailing corrective justice argument for black reparations, I shall explain why an alternative normative argument, which is not tethered to a particular empirical explanation of racial inequality, may be more appealing. (shrink)

Journal of Political Philosophy, Volume 30, Issue 3, Page 273-297, September 2022.

We characterize, in terms of determinacy, the existence of 0 ♯♯ as well as the existence of each of the following: 0 ♯♯♯ , 0 ♯♯♯♯ ,0 ♯♯♯♯♯ , .... For k ∈ ω, we define two classes of sets, (k * Σ 0 1 ) * and (k * Σ 0 1 ) * + , which lie strictly between $\bigcup_{\beta and Δ(ω 2 -Π 1 1 ). We also define 0 1♯ as 0 ♯ and in general, 0 (...) (k + 1)♯ as (0 k♯) ♯ . We then show that the existence of 0 (k + 1)♯ is equivalent to the determinacy of ((k + 1) * Σ 0 1 ) * as well as the determinacy of (k * Σ 0 1 ) * +. (shrink)

The current study highlights individual differences in the joint articulation strategies used by novices practicing a hip-hop dance movement, the wave. Twelve young adults, all naive regarding hip-hop dance performance, practized the wave in 120 trials separated into four blocks with the order of internal or external attentional focus counterbalanced across subjects. Various kinematic analyses were analyzed to capture performance success while exploiting the observed individual differences in order to establish the reliability of the proposed performance indicators. An external focus (...) of attention marginally facilitated the smooth transfer of a wave motion across neighboring limb segments as characterized by a constant propagation speed combined with large wave amplitudes. Systematic correlations between the success indicators were found, exemplifying the various degrees of joint articulation that novices prove capable of during an initial practicing session to try and perform a novel complex motor task. (shrink)

Why do we believe what we believe? The answer may seem obvious: we believe what we've assessed to be true. However, there's a surprisingly basic logical flaw in this theory. And even more surprising is the real answer to the above question.

This paper examines the consequences of a culture of “personal ethics” when using new methodologies, such as the use of social media sites as a source of data for research. Using SM research as an example, this paper explores the practices of a number of actors and researchers within the “Ethics Ecosystem” which as a network governs ethically responsible research behaviour. In the case of SM research, the ethical use of this data is currently in dispute, as even though it (...) is seemingly publically available, concerns relating to privacy, vulnerability, potential harm and consent blur the lines of responsible ethical research behaviour. The findings point to the dominance of a personal, bottom-up, researcher-led, ‘ethical barometer’ for making decisions regarding the permissibility of using SM data. We show that the use of different barometers by different researchers can lead to wide disparities in ethical practice - disparities which are compounded by the lack of firm guidelines for responsible practice of SM research. This has widespread consequences on the development of shared norms and understandings at all levels, and by all actors within the Ethics Ecosystem, and risks inconsistencies in their approaches to ethical decision-making. This paper argues that this governance of ethical behaviour by individual researchers perpetuates a negative cycle of academic practice that is dependent on subjective judgements by researchers themselves, rather than governed by more formalised academic institutions such as the research ethics committee and funding council guidelines. (shrink)

Journal of Political Philosophy, Volume 30, Issue 3, Page 273-297, September 2022.

According to 2021 data, the United States’ opt-in system of posthumous organ donation results in seventeen Americans dying each day waiting for vital organs, while many good undonated organs go to the grave with the corpse. One of the most aggressive, and compelling, proposals to resolve this tragedy is postmortem organ conscription, also called routine salvaging or organ draft. This proposal entails postmortem retrieval of needed organs, regardless of the prior authorization or refusal of the deceased or his family. The (...) argument of most proponents of conscription relies heavily upon a denial of the possibility of posthumous harms. While I also deny the possibility of posthumous harms, I argue this denial fails to acknowledge other serious wrongs that could be done to the deceased person and his corpse. While the person can no longer be harmed, his _life_, in a roughly biographical sense, can be damaged. Humans highly value life in this sense, often more than biological life. Respect for this sense of life also informs appropriate treatment of particular human corpses, which already have special value beyond mere resource. I will argue that conscription proponents fail to appropriately value lives and human corpses. This failure can lead to multiple wrongs, among them a wrongful exploitation of the vulnerability of a person’s life and corpse and a disrespect of persons. While it is possible that some biographical lives could be made better, or at least less bad, by conscription, the judgments such decisions would require make conscription bad policy. (shrink)

Rights externalism, a view I defend in Rights, Race, and Recognition, takes social recognition to be a condition for being a rights bearer. I vindicate this view by answering two recent critics. I concede some ground, particularly with respect to their reservations about what we gain, but argue that claims about what we stand to lose are overblown. I conclude that rights externalism is not detrimental to the critique of racial injustice, and that embracing it has noteworthy virtues. The most (...) significant is that it affords us a conception of rights that takes the realities of lived experiences seriously. (shrink)

Drawing on social psychological evidence showing that the perspective from which the economically advantaged and disadvantaged view economic inequalities matters a great deal for how they are appraised, for when they are considered unfair, and for what evidentiary standards individuals rely upon to reach their conclusions, we argue that choice egalitarianism is unsuitable for articulating the demands of justice when people not only disagree about the causes of inequality but also have motivated reasons to adopt different standards for appraising its (...) fairness. Because choice egalitarianism requires us to take a stand on the causes of inequality it is an unsuitable ideal. This is a serious shortcoming when we are interested in getting people to assume collective responsibility for doing something about inequality in the real world. (shrink)