Health policymakers employ utility measures to inform resource allocation decisions. They often rely on a conceptual tool called the quality-adjusted life year that discounts the value of years lived in a state of disability relative to years lived in full health. A representative sample of the general public is asked to place values on hypothetical health states as part of a standard gamble or time trade-off task. Policymakers use the resulting values to calculate the number of QALYs gained through particular (...) interventions. Utilitarian reasoning mandates that policymakers maximize QALYs gained per unit cost.Although many scholars have explored the problems of distributive justice that arise from this system... (shrink)

Feminist criticism of health care and ofbioethics has become increasingly rich andsophisticated in the last years of thetwentieth century. Nonetheless, this body ofwork remains quite marginalized. I believe thatthere are (at least) two reasons for this.First, many people are still confused aboutfeminism. Second, many people are unconvincedthat significant sexism still exists and aretherefore unreceptive to arguments that itshould be remedied if there is no largerbenefit. In this essay I argue for a thin,``core'' conception of feminism that is easy tounderstand and (...) difficult to reject. Corefeminism would render debate within feminismmore fruitful, clear the way for appropriaterecognition of differences among women andtheir circumstances, provide intellectuallycompelling reasons for current non-feminists toadopt a feminist outlook, and facilitatemutually beneficial cooperation betweenfeminism and other progressive socialmovements. This conception of feminism alsomakes it clear that feminism is part of alarger egalitarian moral and political agenda,and adopting it would help bioethics focus onthe most urgent moral priorities. In addition,integrating core feminism into bioethics wouldopen a gateway to the more speculative parts offeminist work where a wealth of creativethinking is occurring. Engaging with thisfeminist work would challenge and strengthenmainstream approaches; it should also motivatemainstream bioethicists to explore othercurrently marginalized parts of bioethics. (shrink)

As library collections and services have increasingly moved from print to digital, much of the work that used to be done by libraries themselves with regard to creating, maintaining, and managing the systems that hold collections and facilitate user access to them is now done primarily by vendors. This change to the information services landscape for academic libraries is the occasion not only of technical and procedural challenges, but also some internal conflicts concerning the ethical demands of the library profession. (...) This essay examines the ways in which these conflicts become acute and obvious when attention is paid to the way in which attempts to promote equity, diversity, and inclusion (EDI) are undermined by the handover of library services to vendors, even when—or perhaps especially when—those vendors use their control of content and platforms to commodify diverse content instead of making the necessary systemic changes required by truly effective EDI efforts. (shrink)

Interactions with teachers and peers are critical for children’s social, behavioral, and academic development in the classroom context. However, these two types of interpersonal interactions in the classroom are usually pursued via separate lines of inquiries. The current study bridges these two areas of research to examine the way in which teachers influence child-perceived peer social support and peer victimization for 2,678 children within 183 classrooms in preschool through grade three. Two levels of teacher influence are considered, namely teacher-child closeness (...) and conflict relationships at the child-level, and teacher management of interpersonal interactions at the classroom-level. Results of multilevel regression models showed that teacher-child closeness was associated with the growth of child-perceived peer social support from fall to spring, whereas teacher-child conflict and teachers’ behavior management practices were associated with the change in child-perceived peer victimization across the academic year. These associations were unique and above and beyond the influence of children’s actual peer social interactions, including reciprocal friendships and the collective classroom reputation of peer victimization. Collectively, findings highlight the multi-faceted teacher roles in shaping children’s perceptions of their peer social experiences during the earliest years of schooling. (shrink)

Most children experience some form of grouping in the classroom every day. Understanding how teachers make grouping decisions and their impacts on children’s social development can shed light on effective teacher practices for promoting positive social dynamics in the classroom. This study examined the influence of teachers’ grouping strategies on changes in young children’s social experiences with peers across an academic year. A total of 1,463 children and 79 teachers from kindergarten to third-grade classrooms participated in this study. Teachers rated (...) children’s behavioral problems as the most important consideration when creating seating charts or assigning children to small groups. Promoting existing or new friendships was rated as the least important consideration. Heterogeneous ability grouping, rated as somewhat important by the teachers, was associated with a decrease in children’s friendships and yet also a decrease in girls’ experience with peer conflicts. Our findings begin to fill in the gaps in the literature on the social impacts of ability grouping for young children. (shrink)

Seeking justice, as Christians, means seriously reconsidering our food consumption in light of multiple instances of injustice: maltreatment of workers, animals, and the environment; and misdistribution of food both globally and domestically. A variety of solutions—including boycotts, labeling, local consumption, generous donations, and Food Sovereignty—would lead to a more just food system.

Public streets are central to the built environment, where individuals seek a fair share of the roadway’s benefits and harms. But the American street, an asphalt landscape typically defined and designed for cars, can be inaccessible, unhealthy, and dangerous for the non-motorized, whose transportation choices have the smallest ecological footprint. Concern for social equity and sustainability requires rethinking the street geographically and ethically, and asking: “In what sense is the street a space of justice? How do traditional street regulation (...) and design manifest ethical priorities? And what might a more just street look like, in theory and practice?” Such questions prompt one to engage both the spatial and moral, thus drawing from critical geography and ethics to analyze roadways in terms of fairness and relational wholeness, and argue for what might be called a shalom street. Engaging such ethical concepts with the technical vocabularies of street regulation and design requires analyzing how national model standards and their interpretation enforce and materialize justice on the street.The promise of more just alternatives such as more sustainable and fair “Complete Streets” to live in needs to be explored. (shrink)

Media use is a pervasive aspect of children’s home experiences but is often not considered in studies of the home learning environment. Media use could be detrimental to children’s language and literacy skills because it may displace other literacy-enhancing activities like shared reading and decrease the quantity and quality of caregiver-child interaction. Thus, the current study asked whether media use is associated with gains in children’s language and literacy skills both at a single time point and across a school year (...) and whether age moderates any association. Children (N = 1583) were from preschool through third grade classrooms and language and literacy skills were measured in the fall and spring of the school year. Parents reported how much time their child spends using media on a typical school day. Regression analyses showed that using 4 hours or more of media was related to lower literacy gains, but not to language gains. Multilevel models conducted as a robustness check showed that this effect did not hold when accounting for classroom. In neither set of models was there an interaction between age and media use. Single-time-point models did show some associations that did not manifest in more stringent models, highlighting the limitations of correlational designs that do not have measures of children’s skills over time. Given the concern and popular press coverage around children’s media use, it is important to acknowledge nonsignificant effects in this domain. These nonsignificant associations suggest that societal fears around children’s media use may be exaggerated. Notably, however, characteristics of children’s media use, like educational content or adult co-use, may moderate any effects. The relation between media use and language and literacy growth did not differ across the age range investigated suggesting that, within this range, younger children are not more vulnerable to detrimental effects. (shrink)

In ‘The Tollgate Principles for the Governance of Geoengineering’, Stephen M. Gardiner and Augustin Fragnière develop a holistic framework for geoengineering governance, pointing out the importance...

Medical issues affecting health care have become everyday media events. In response to mounting public concern, growing numbers of bioethicists are being appointed to medical school faculties and public policy panels. However the ideas voiced in these forums are seldom informed by feminist perspectives. In this important book, a distinguished group of feminist scholars and activists discuss crucial bioethics topics in a feminist light. Among the subjects explored are the care/justice debates, transforming bioethics, practice, and reproduction. The book also (...) covers less commonly discussed issues, such as culturally appropriate responses to reproductive health problems in developing countries. (shrink)

This paper introduces the model of Utilitarian Principlism as a framework for crisis healthcare ethics. In modern Western medicine, during non-crisis times, principlism provides the four guiding principles in biomedical ethics—autonomy, nonmaleficence, beneficence, and justice; autonomy typically emerges as the decisive principle. The physician–patient relationship is a deontological construct in which the physician’s primary duty is to the individual patient and the individual patient is paramount. For this reason, we term the non-crisis ethical framework that guides modern medicine Deontological (...) Principlism. During times of crisis, resources become scarce, standards of care become dynamic, and public health ethics move to the forefront. Healthcare providers are forced to work in non-ideal conditions, and interactions with individual patients must be considered in the context of the crisis. The COVID-19 pandemic has forced healthcare to shift to a more utilitarian framework with a greater focus on promoting the health of communities and populations. This paper puts forth the notion of Utilitarian Principlism as a framework for crisis healthcare ethics. We discuss each of the four principles from a utilitarian perspective and use clinical vignettes, based on real cases from the COVID-19 pandemic, for illustrative purposes. We explore how Deontological Principlism and Utilitarian Principlism are two ends of a spectrum, and the implications to healthcare as we emerge from the pandemic. (shrink)

Concerted, timely action for mitigating climate change is of uttermost importance to keep global warming as close to 1.5°C as possible. Air traffic already plays a strong role in driving climate change and is projected to grow—with only limited technical potential for decarbonizing this means of transport. Therefore, it is desirable to minimize the expansion of air traffic or even facilitate a reduction in affluent countries. Effective policies and behavioral change, especially among frequent flyers, can help to lower greenhouse gas (...) emissions. For both, a positive evaluation and public support is indispensable. This study contributes to understanding air travel behavior and the perception of regulative policies. We examined the role of attitudes, perceived behavioral control, efficacy, global identity, and justice concerns for intentions to avoid flights and aviation-related environmental policy support. We conducted an online survey study with a quota sample of N = 2,530 participants in Germany. The strongest positive predictors of intentions to refrain from flying and policy support were perceived behavioral control to travel without flying, efficacy beliefs that avoiding air travel contributes to climate change mitigation, and intergenerational justice concerns; pro-travel attitude was a negative predictor. Moreover, we tested whether the provision of additional information on climate impact, global and intranational inequalities as well as subsidies affected the intention to avoid air travel and policy support. We found no effects of the different types of information. Nor did we find an interaction between the type of information provided and global or national identity. Our results highlight the need for a shift within the mobility sector that facilitates attractive and accessible transport alternatives in order to strengthen people’s behavioral control to choose other means than planes and their efficacy perceptions. Moreover, raising awareness of the impacts of climate change on future generations and developing strategies to promote people’s concern for intergenerational justice might motivate people to reduce air travel and thereby contribute to a livable future for new generations. (shrink)

Post-Dobbs abortion restrictions impact access and choice in the context of reproductive genetic medicine, raising serious reproductive justice concerns. The consequences of these restrictions are particularly acute and far-reaching for individuals with genetic conditions and their families.

In this article, we conceptualize the under investigated and under theorized relationship between intimate partner violence (IPV) and business responsibility. As an urgent social issue, IPV—understood as abuse of power within the context of an intimate partner relationship, mainly perpetrated by men and involving a pattern of behavior—has been studied for decades in many disciplines. A less common yet vital research perspective is to examine IPV as it relates to the business and to ask how organizations should engage with IPV. (...) In response to this question, we contribute a framework drawing from two distinctions in the business responsibility scholarship: the assumed role of the organization (responsibility to the firm/market; responsibility to the broader socio-political-economic environment); and the second focused on the approach to conceptualizing ethics (justice/fairness; ethics of care). Thus, we explicate four approaches to business responsibility and IPV, which serve the purposes of mapping three selected contributions, identifying limitations of these approaches, and opening up future research opportunities. (shrink)

Backround Education in ethics and professionalism should reflect the realities medical students encounter in the hospital and clinic. Method We performed content analyses on Case Observation and Assessments (COAs) written by third-year medical students about ethical and professional issues encountered during their internal medicine and paediatrics clinical clerkships. Results A cohort of 141 third-year medical students wrote 272 COAs. Content analyses identified 35 subcategories of ethical and professional issues within 7 major domains: decisions regarding treatment (31.4%), communication (21.4%), professional duties (...) (18.4%), justice (9.8%), student-specific issues (5.4%), quality of care (3.8%), and miscellaneous (9.8%). Conclusions Students encountered a wide variety of ethical and professional issues that can be used to guide pre-clinical and clinical education. Comparison of our findings with results from similar studies suggests that the wording of an assignment (specifying “ethical” issues, “professional” issues, or both) may influence the kinds of issues students identify in their experience-based clinical narratives. (shrink)

This article examines the complex relationship between culture, values, and ethics in mental health care. Cultural competence is a practical, concrete demonstration of the ethical principles of respect for persons, beneficence (doing good), nonmaleficence (not doing harm), and justice (treating people fairly)—the cornerstones of modern ethical codes for the health professions. Five clinical cases are presented to illustrate the range of ethical issues faced by mental health clinicians working in a multicultural environment, including issues of therapeutic boundaries, diagnosis, treatment (...) choice, confidentiality and informed consent, and the just distribution of limited health care resources. (shrink)

Aristotle's Topics is a handbook for dialectic, which can be understood as a philosophical debate between a questioner and a respondent. In book 2, Aristotle mainly develops strategies for making deductions about 'accidents', which are properties that might or might not belong to a subject (for instance, Socrates has five fingers, but might have had six), and about properties that simply belong to a subject without further specification. In the present commentary, here translated into English for the first time, Alexander (...) develops a careful study of Aristotle's text. He preserves objections and replies from other philosophers whose work is now lost, such as the Stoics. He also offers an invaluable picture of the tradition of Aristotelian logic down to his time, including innovative attempts to unify Aristotle's guidance for dialectic with his general theory of deductive argument (the syllogism), found in the Analytics. The work will be of interest not only for its perspective on ancient logic, rhetoric, and debate, but also for its continuing influence on argument in the Middle Ages and later. (shrink)

Data documenting poor understanding among research participants and real-time efforts to assess comprehension in large-scale studies are focusing new attention on informed consent comprehension. Within the context of biobanking consent, we previously convened a multidisciplinary panel to reach consensus about what information must be understood for a prospective participant’s consent to be considered valid. Subsequently, we presented them with data from another study showing that many U.S. adults would fail to comprehend the information the panel had deemed essential. When asked (...) to evaluate the importance of the information again, panelists’ opinions shifted dramatically in the direction of requiring that less information be understood. Follow-up interviews indicated significant uncertainty about defining a threshold of understanding and what should happen when prospective participants are unable to grasp key information. These findings have important implications for urgently needed discussion of whether... (shrink)

For the last eighteen months, I have worked with a group of disability and health policy researchers. I began this interview-based project trying to learn how these researchers’ disability identities shaped their work. How did their disability standpoint contribute to the liberatory nature of their research? I found that the disability standpoint of these researchers was in fact hard-won and grew not just out of their own disability experiences but out of their connections with the larger disability community. These connections, (...) for the most part, helped researchers come to “claim crip,” and that later influenced their research. (shrink)

In qualitative interviews with a diverse group of experts, the vast majority believed unregulated researchers should seek out independent oversight. Reasons included the need for objectivity, protecting app users from research risks, and consistency in standards for the ethical conduct of research. Concerns included burdening minimal risk research and limitations in current systems of oversight. Literature and analysis supports the use of IRBs even when not required by regulations, and the need for evidence-based improvements in IRB processes.

I examine the dynamics of measure development using two case studies: temperature, and health-related quality of life. I argue, following Bas van Fraassen and Leah McClimans that in each case these dynamics have a hermeneutic structure. Measure development is plagued by epistemic circularity, as is the task of interpreting a text, and similar strategies can be used in both measure development and hermeneutics to overcome that circularity. I show that Hans Georg Gadamer’s philosophical hermeneutics in particular are an effective lens (...) through which to examine the development of the temperature standard as described by Hasok Chang. Despite similar grounding in hermeneutics, I note an important difference between measure development for temperature and for health-related quality of life. Namely, while the meaning of temperature can be standardized, the meaning of health-related quality of life cannot. This standardization of meaning for the temperature concept represents a limit to the analogy with hermeneutics. Finally, I argue that the indeterminacy we find in health-related quality of life measurement is a result not only of analogy with the hermeneutic task, but of full-fledged participation in it. (shrink)

Book reviewed in this article: Feminist Ethics. Ed. Claudia Card.

The informed consent process for genetic testing does not commonly address preferences regarding disclosure of results in the event of the patient's death. Adults being tested for familial colorectal cancer were asked whether they want their exome sequencing results disclosed to another person in the event of their death prior to receiving the results. Of 78 participants, 92% designated an individual and 8% declined to. Further research will help refine practices for informed consent.

We surveyed IRB chairs' perspectives on offering individual genetic research results to participants and families, including family members of deceased participants, and the IRB's role in addressing these issues. Given a particular hypothetical scenario, respondents favored offering results to participants but not family members, giving choices at the time of initial consent, and honoring elicited choices. They felt IRBs should have authority regarding the process issues, but a more limited role in medical and scientific issues.

This article draws on in-depth case studies of 61 women and men of diverse sexual identities to show how gender, while apparently diminishing in significance, continues to shape interpretations and experiences of virginity loss in complex ways. Although women and men tended to assign different meanings to virginity, those who shared an interpretation reported similar virginity-loss encounters. Each interpretation of virginity—as a gift, stigma, or process—featured unequal roles for virgin and partner, which interacted with gender differences in power to produce (...) interpretation-specific patterns of gender subordination, only one of which consistently gave men power over women. (shrink)

Volume 20, Issue 5, June 2020, Page 26-28.

: In APo II 3-7 Aristotle discusses a series of difficulties concerning definition, deduction, and demonstration. In this paper I focus on two interrelated but distinct questions: firstly, what are exactly the difficulties emerging from or alluded to in the discussion in II 3-7; secondly, whether and in what sense the discussion in II 3-7 can be considered an aporetic discussion with a specific role to play in the development of the argument in APo II.

The woman at the heart of Pearl Jam’s “Better Man” (Vitalogy, 1994) is trapped. She has committed herself to a relationship that makes her miserable, but she sees no viable alternative to staying in it. She mourns a past self who might have been able to leave and dreams of a dierent way things might be, but remains unable to move on. It is tempting to view her with a mixture of pity and frustration (reecting some of the personal circumstances (...) -- Eddie Vedder’s mother’s second marriage -- informing its composition). As a moral being, she appears to be hopelessly compromised by her situation, even as she is also doing her best to survive under conditions designed to undermine her autonomy and keep her trapped (as abusive relationships do). The song is not so much critical of her choice to stay as it is confused by and resigned to it. -/- What keeps a person where she so clearly does not want to be? -/- The song itself was, at least early in its recorded life for Pearl Jam, similarly compromised. Vedder appears to have thought of it as too “accessible”, too much of a pop hit for the kind of musical vision he had in mind either for Vs. (for which it had originally been intended) or for Vitalogy; by this point in the band’s career, he was ever more actively resisting success, accessibility, and everything that went with the version of rock star life imposed collectively on the band and on him as an individual. The form that resistance took was an exercise of artistic and other forms of control, sometimes exercised in ways that were destructive or damaging (to the band and its internal relationships, its fame or success, its image, its artistic identity, etc.). -/- What keeps an artist or a band where they so clearly do not want to be? In this chapter, I oer a loose exploration of some possible philosophical approaches to answering the question of what keeps us where we are, like it or not, worked out in parallel through the lyrics of “Better Man” and the circumstances of the song’s eventual arrival Vitalogy. My main interest is in examining the ethical dimensions of the question itself -- what, if anything, are we morally required or expected to do under compromised or compromising conditions? My main suggestion is that answering the question might require of us a messier, more ambivalent, and perhaps more compassionate notion of moral agency, inspired by Simone Weil’s work on affliction. (shrink)

In his commentary on Aristotle’s De intepretatione, Ammonius criticises the view, which he ascribes to Alexander of Aphrodisias, that epirrhêmata, ‘adverbs’, fall under the rubric of onoma. While it is difficult to establish Alexander’s view on the basis of Ammonius’s criticism, I argue that an intelligible view can be reconstructed, mainly based on evidence in Alexander’s commentary on the Topics, about different types of adverbs. In particular, I suggest that Alexander, apparently unlike Ammonius, may have drawn a distinction between two (...) classes of adverbs Aristotle deals with in his logical writings: tropoi (modal operators); and ptôseis, i.e. the specific type of ‘inflections’ (adverbs in -ôs derived from a noun – usually an abstract noun) playing a prominent role in several of the topoi Aristotle gives in the Topics. (shrink)

Arts and Humanities in Higher Education, Volume 21, Issue 3, Page 240-262, July 2022. Although the art historical canon has been the subject of fierce debate, it remains an essential construct, shaping textbooks and survey courses. Visual representations of the canon often illustrate these narratives. Students encounter diagrams in their studies and it is important to make them aware of the illusion of scientific objectivity. This paper proposes the use of the computer ontology, as a modeling tool with which students (...) can make translations of existing diagrams. This forces them to reconsider the modeling decisions underlying traditional representations. The article takes as its case study the translation of Alfred Barr’s diagram of Modern Art, using the free tool Protégé. An analysis of this process allows us to consider the ambiguous meanings of nodes, relationships and dimensions of the model. Asking students to actively recreate this network of information is shown to be a valuable addition to traditional survey courses on Modern Art. (shrink)

Recruiting research participants based on genetic information generated about them in a prior study is a potentially powerful way to study the functional significance of human genetic variation, but it also presents ethical challenges. To inform policy development on this issue, we conducted a survey of U.S. institutional review board chairs concerning the acceptability of recontacting genetic research participants about additional research and their views on the disclosure of individual genetic results as part of recruitment. Our findings suggest there is (...) unlikely to be a “one-size-fits-all” solution, but rather several ethically acceptable approaches to genotype-driven recruitment, depending on context. Disclosures made during the consent process for the original study and the clinical validity of the results are key considerations. Researchers must be prepared to communicate and answer questions in clear lay language about what is known and not known regarding the role of genetics in their proposed area of research. (shrink)

The paper analyses the argumentative structure of a difficult passage from Aristotle's Metaphysics XII 7 on the basis of a topos of sameness provided in Top. VII 1. In doing this the article gives an example of how Aristotle's treatises on dialectic can prove useful to understand what he says in his more philosophically committed writings. The article also shows how general argumentative techniques and more or less explicit specific philosophical assumptions interact in shaping Aristotle's arguments and how the distinction (...) of these different factors can help us have a better grasp on Aristotle's text. (shrink)

An audiovisual correspondence (AVC) refers to an observer’s seemingly arbitrary yet consistent matching of sensory features across the two modalities; for example, between an auditory pitch and visual size. Research on AVCs has frequently used a speeded classification procedure in which participants are asked to rapidly classify an image when it is either accompanied by a congruent or an incongruent sound (or vice versa). When, as is typically the case, classification is faster in the presence of a congruent stimulus, researchers (...) have inferred that the AVC is automatic and bottom-up. Such an inference is incomplete because the procedure does not show that the AVC is not subject to top-down influences. To remedy this problem, we devised a procedure that allows us to assess the degree of “bottom-up-ness” and “top-down-ness” in the processing of an AVC. We did this in studies of AVCs between pitch and five visual features: size, height, spatial frequency, brightness, and angularity. We find that all the AVCs we studied involve both bottom-up and top-down processing, thus undermining the prevalent generalization that AVCs are automatic. (shrink)

Philosophy of Song and Singing: An Introduction Jeanette Bicknellroutledge. 2015. pp. 140. £29.99.