The Millennium Development Goals were criticised for failing to address the issue of governance, and the associated notions of responsibility and accountability. The Sustainable Development Goals, we argue, need to recognise the structural constraints facing poor countries – the power imbalances in the global economic system that limit their ability to promote the prosperity and well-being of their people, as was clearly brought out by the Commission on Global Governance for Health, of which we were both members [Ottersen, O. P., (...) J. Dasgupta, C. Blouin, Paulo Buss, Virasakdi Chongsuvivatwong, Julio Frenk, Sakiko Fukuda-Parr, et al. 2014. “The Political Origins of Health Inequality: Prospects for Change.” Lancet 383: 630–667]. This article is divided into three parts. We begin by making the case for a global justice perspective which emphasises the responsibility – and hence also accountability – of international organisations and rule-making bodies. We next demonstrate the limitations of accountabi.. (shrink)

This article adapts the economic and social rights fulfillment index (SERF Index) developed by Fukuda-Parr, Lawson-Remer, and Randolph to assess the extent to which each of the 50 US states fulfills the economic and social rights obligations set forth in the International Covenant on Economic, Social and Cultural Rights. It then extends the index to incorporate discrimination and examines differences in economic and social rights fulfillment by race and sex within each of the states. The overall SERF Index (...) score varies between states from below 70% to almost 85%, with wider variation on some of the six substantive rights that comprise the overall SERF Index score. The findings reveal limited sex discrimination but pronounced race discrimination. (shrink)

Since Japan adopted the concept of informed consent from the West, its inappropriate acquisition from patients in the Japanese clinical setting has continued, due in part to cultural aspects. Here, we discuss the current status of and contemporary issues surrounding informed consent in Japan, and how these are influenced by Japanese culture.

The exocyst is a conserved octameric complex that physically tethers a vesicle to the plasma membrane, prior to membrane fusion. It is important not only for secretion and membrane delivery but also, in mammalian cells, for cytokinesis, ciliogenesis, autophagy, tumorigenesis, and host defense. The combination of genome editing and advanced light microscopy of exocyst subunits in living cells has recently shown the complex to be much more dynamic than previously appreciated, and exposed how little we still know about its function (...) and regulation. (shrink)

Public shaming plays an important role in upholding valuable social norms. But, under what conditions, if any, is it morally justifiable? Our aim in this paper is systemically to investigate the morality of public shaming, so as to provide an answer to this neglected question. We develop an overarching framework for assessing the justifiability of this practice, which shows that, while shaming can sometimes be morally justifiable, it very often is not. In turn, our framework highlights several reasons to be (...) concerned about the increasingly widespread phenomenon of online public shaming. (shrink)

How should the Japanese death penalty system stand in the future? While banning the death penalty has become a global trend, Japanese public opinion still supports it, and the government continues to strongly insist retention of the system. Despite worldwide criticism towards Japanese opinion, until very recently have been no reductions in death penalty sentences or executions. Both abolitionist and retentionist countries have strong arguments to support their opinions, thus there is no decisive argument that overwhelmingly refutes others. Consideration for (...) the feelings of the murder victim’s family is significant, and there are certain actions perpetrated by the criminal which seem unforgivable and for which nothing can compensate. At the same time, homicide is a violence that should never be acceptable and therefore cannot be justified, and human error will always allow for the possibility of wrongful convictions. The authors argue that the death penalty should be abolished in principle, but we cannot deny the existence of a criminal for whom the death penalty would be appropriate. Ethically, it would be questionable to accept life imprisonment without parole as an alternative. We are of the position that there is no definite conclusion concerning the ethicality of the death penalty. (shrink)

We are witnessing increasing use of the Internet, particular social media, to criticize (perceived or actual) moral failings and misdemeanors. This phenomenon of so-called ‘online public shaming’ could provide a powerful tool for reinforcing valuable social norms. But it also threatens unwarranted and severe punishments meted out by online mobs. This paper analyses the dangers associated with the informal enforcement of norms, drawing on Locke, but also highlights its promise, drawing on recent discussions of social norms. We then consider two (...) crucial conditions that online public shaming must meet in order to be justifiable: proportionality and accountability. We argue that these requirements are in fact frequently violated, rendering most cases of online public shaming unjustified. While the use of online public shaming against others’ vices has some apparent virtues, it is currently rarely justified, given its own vices. (shrink)

Both law and science went through revolutionary changes in England in the first half of the seventeenth century, a period of pandemic, conflict, and climate change. The circle of Samuel Hartlib (c. 1600–62) sought a way to regenerate society through reform and innovation. One member of the circle was Sir Cheney Culpeper (1601–66), a barrister and landowner, whose correspondence shows an attempt to synthesize law and natural philosophy into a coherent vision of regeneration. He wrestled as much with how change (...) could be achieved as with what changes would be beneficial. He sought a mutually beneficial relationship between humanity and nature. He urged self-restraint to avoid the abuse of power, political and technological. His most practical and influential work was in agriculture. Paradoxically, however, the efforts of Culpeper and his circle to address the crises of their times have arguably created the very crises of ours. We are, moreover, in what Culpeper describes as a ‘crisis of time’. This essay poses the question as to whether, given the urgency of our situation, we might learn from Culpeper’s generation that regeneration requires revolution as well as reform. (shrink)

In recent years, a number of news stories were reported worldwide involving brain-dead pregnant women. Debates over providing life support to braindead pregnant women and delivery of their children have been around for some decades. Maintaining a woman’s life solely for fetal viability has become a major controversial social issue. Opposing opinions exist where one side supports the woman and her child should be left to die in dignity and the other side claims to protect the unborn child’s right to (...) live. Each group has strong beliefs. This paper addresses main aspects when considering the continuation of somatic support to the brain-dead pregnant woman for the purpose of fetus delivery including; human death, dignity of the woman, rights of the fetus, proportionality of acts, and the woman’s donor status, and independence of mother and fetus. Then, the authors present several diverse opinions and positions concerning the legitimacy of life support for brain-dead women based on them and critically evaluate them. We show that each and every claim can be ethically refuted. This paper also approaches to those claims from three different points of views, which are that of the brain-dead woman, her fetus and her family. We believe that the brain-dead woman’s wish and dignity, the child’s predicted wellbeing after birth, and the family’s beliefs and welfare should all be counted equally when making the final decision. In conclusion, we argue that the decision can be ethically justified only when the interests of all parties are appropriately taken into consideration and protected. (shrink)

For most death discharge patients, hospitals in Japan offer seeing-off services, a practice characteristic of Japanese culture. When a patient dies, nurses usually perform after-death procedures before transferring the body to the mortuary, where the nurses and doctors gather to provide the seeing-off service. This study was carried out to determine differences between the nurses’ and bereaved families’ opinions and thoughts regarding the seeing-off service. Semi-structured interviews were conducted with 17 nurses and 6 bereaved families . The interviews assessed: the (...) reasons why nurses provided seeing-off services; thoughts during the seeing-off service; impressions of the mortuary rituals; and the necessity for the seeing-off service. The results indicated that nurses expressed their courtesy and sense of appreciation during the seeing-off service, which was recognised as an important nursing role. In contrast, bereaved families felt thankful but also doubtful, particularly as regards the mortuary rituals. In light of the differences in perspective between nurses and families, it may be that the level of satisfaction with the seeing-off service is largely affected by the relationship between the family and the medical professionals before the patient's death. Our study also notes that Japanese people respect the dead body and treat it with care, reflecting the unique culture and customs of Japan. (shrink)

Children’s intentions should be respected. Parents are the key persons involved in decision-making related to their children. In Japan, the appropriate ages and standards for a child’s consent and assent, approval, and decision-making are not clearly defined, which makes the process of obtaining consent and assent for clinical research complex. The purpose of this paper is as follows: to understand the attitudes and motives of parents concerning children’s participation in medical research and the factors influencing their decision-making. We also sought (...) to clarify who has the right to be involved in decisions regarding children’s participation in research. A semi-structured Internet survey on parents’ opinions and attitudes and preferences concerning medical research involvement was conducted. Children were divided into three age groups (6–10-year-olds, 11–14-year-olds, and 15–18-year-olds), with three illness severity categories. Possible correlations between the number of children, children’s ages, parents’ educational levels, and parents’ attitudes were examined. Among the participants, 42.3% recognized the term “informed consent.” The proportion of participants who understood “informed consent” increased with educational level. Four out of five participants did not know, or had not heard of, the term “informed assent.” Furthermore, the percentage of those who understood the term “informed assent” increased with academic level. Participants generally believed in prioritizing parents’ opinions over children’s, and that parents and children would ideally reach a joint decision. Although many parents favored collaborative decision-making, they also wanted their own will reflected in the decision and felt they should receive important information before their children do. Decision-making was affected by the condition’s severity and prognosis. This indicates that most Japanese parents believe that their children have the right to know their disease name and treatment; nonetheless, they should be protected. Parents’ values and judgments regarding medical intervention involving their children varied. Children’s ability to consent to treatment and research believed to be in their best interests should be assessed appropriately. They should be permitted to provide consent or assent, and their views should be respected. Involving children in decision-making fosters more open communication and transparency between medical professionals, parents, and children. (shrink)

It is common to focus on the duties of the wrongdoer in cases that involve injustice. Presumably, the wrongdoer owes her victim an apology for having wronged her and perhaps compensation for having harmed her. But, these are not the only duties that may arise. Are other beneficiaries of an injustice permitted to retain the fruits of the injustice? If not, who becomes entitled to those funds? In recent years, the Connection Account has emerged as an influential account that purports (...) to explain cases such as Embezzlement. This account holds that benefiting from injustice can give rise to a corrective duty - that is, a duty of compensation - owed specifically to the victim of the injustice from which the recipient benefits. This duty is grounded in the connection between the victim and the beneficiary of a given injustice. This paper has two aims. First, I show that we must reject the Connection Account on the grounds that it risks failing correctly to identify those who become entitled to the fruits of injustice. I achieve this by developing and defending the fairness objection. Second, I offer an alternative account: the Moral Taintedness Account. This account states that, when identifying who is entitled to the fruits of injustice, the cause and the degree of the harm suffered by a victim are both relevant considerations, though it does not matter whether the victim is the victim of the injustice that gave rise to the fruits in question. This account avoids the problem associated with the Connection Account, and yields intuitive conclusions in an important range of test cases. (shrink)

Background Destination therapy is the permanent implantation of a left ventricular assist device in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications. Because of deeply ingrained cultural and religious beliefs regarding death and (...) the sanctity of life, Japanese society may not be ready to make changes needed to enable patients to have LVADs deactivated under certain circumstances to avoid needless suffering. Main text Western ethical views that permit LVAD deactivation based mainly on respect for autonomy and dignity have not been accepted thus far in Japan and are unlikely to be accepted, given the current Japanese culture and traditional values. Some healthcare professionals might regard patients as ineligible for DT unless they have prepared advance directives. If this were to happen, the right to prepare an advance directive would instead become an obligation to do so. Furthermore, patient selection for DT poses another ethical issue. Given the predominant sanctity of life principle and lack of cost-consciousness regarding medical expenses, medically appropriate exclusion criteria would be ignored and DT could be applied to various patients, including very old patients, the demented, or even patients in persistent vegetative states, through on-site judgment. Conclusion There is an urgent need for Japan to establish and enact a basic act for patient rights. The act should include: respect for a patient’s right to self-determination; the right to refuse unwanted treatment; the right to prepare legally binding advance directives; the right to decline to prepare such directives; and access to nationally insured healthcare. It should enable those concerned with patient care involving DT to seek ethical advice from ethics committees. Furthermore, it should state that healthcare professionals involved in the discontinuation of life support in a proper manner are immune to any legal action and that they have the right to conscientiously object to LVAD deactivation. (shrink)

Automation can bring the risk of technological unemployment, as employees are replaced by machines that can carry out the same or similar work at a fraction of the cost. Some believe that the appropriate response is to tax automation. In this paper, I explore the justifiability of view, maintaining that we can embrace automation so long as we compensate those employees whose livelihoods are destroyed by this process by creating new opportunities for employment. My contribution in this paper is important (...) not only because I develop a theoretical framework that we can use to resolve this urgent policy dispute—a dispute that has been discussed extensively by labour economists, tax lawyers, and policymakers, but largely neglected by political philosophers—but also because my analysis sheds lights on a wider range of controversies relating to the moral and political importance of unemployment. (shrink)

We clarify the significance of quasiprobability in quantum mechanics that is relevant in describing physical quantities associated with a transition process. Our basic quantity is Aharonov’s weak value, from which the QP can be defined up to a certain ambiguity parameterized by a complex number. Unlike the conventional probability, the QP allows us to treat two noncommuting observables consistently, and this is utilized to embed the QP in Bohmian mechanics such that its equivalence to quantum mechanics becomes more transparent. We (...) also show that, with the help of the QP, Bohmian mechanics can be recognized as an ontological model with a certain type of contextuality. (shrink)

In the debate on the basis of moral equality, one conclusion achieves near consensus: that we must reject all accounts that ground equality in the possession of some psychological capacity (Psychological Capacity Accounts). This widely held view crystallises around three objections. The first is the Arbitrariness Objection, which holds that the threshold at which the possession of the relevant capacities places an individual within the required range is arbitrary. The second is the Variations Objection, which holds that there is rational (...) pressure to acknowledge that variations in psychological capacities between individuals are morally relevant. The third is the No Rational Agency Objection, according to which Psychological Capacity Accounts have unpalatable implications for our treatment of humans who do not possess the relevant capacities. We develop a Psychological Capacity Account based on the capacity for a conception of the good and offer a novel defence of the account against these objections. (shrink)

Contemplating one’s own death is a core aspect in the history of Western philosophy. In the modern era, existential philosophy has inherited this tradition and established unique discussions on the concept of “_my_ death,” resting on the premise that this concept is unapproachable via scientific inquiry. Conversely, biological research is essentially conducted within the scope of life phenomena, with death being referred to in the sense of lifespan; thus, death is not among its inherent themes, which automatically excludes the concept (...) of _my_ death from its scope. To establish a dialogue between the two fields, this study questions the widely held premise that _my_ death is unrelated to science and is best examined by philosophy. I consider the movement between continuity and discontinuity as foundational to scientific development, and integrate it with the relationship between the unknown and known. Furthermore, I extend this to the concepts of consciousness and body, and subsequently clarify and define the unknown divisions. Finally, I examine the kinds of unknowns that science confronts to interpret philosophically how an aspect of reproductive theory has unwittingly revealed a completely new dimension of life: _my_ death. Overall, I argue that _my_ death is an essential point of contact between philosophy and biology that reveals the scholarly significance of the unknown. (shrink)

Deleuze and Memorial Culture is a detailed study of contemporary forms of public remembrance. Adrian Parr considers the different character traumatic memory takes throughout the sphere of cultural production and argues that contemporary memorial culture has the power to put traumatic memory to work in a positive way. Drawing on the conceptual apparatus of Gilles Deleuze, she outlines the relevance of his thought to cultural studies and the wider phenomenon of traumatic theory and public remembrance. This book offers a (...) revision of trauma theory that presents trauma not simply as a definitive experience and implicitly negative, but an experience that can foster a sense of hope and optimism for the future. (shrink)

Many individuals have miserable work lives, in which they must toil away at mind-numbing yet exhausting tasks for hours on end, being ordered about by their superiors, perhaps with few guarantees that this source of income will persist for very long. However, this is only half of the story: what is centrally important is that many of those who endure these conditions are denied a fair wage in return for the burdens that they bear. In this article, I reflect on (...) the significance of this fact in order to argue for the evaporation thesis. This thesis holds that individuals’ claims to particular employment-related protections from their government disappear as their earnings increase. In the course of defending this position, I explore the moral difference an employee's wage offer makes to the work conditions that we can expect her to accept, including why there are limits to the role that cash can play here. (shrink)

This dictionary, the first dedicated to the work of Gilles Deleuze, offers an in-depth and lucid introduction to one of the most influential figures in continental philosophy. It defines and contextualizes more than 150 terms relating to Deleuze's philosophy, including "becoming," "body without organs," "deterritorialization," "difference," "repetition," and "rhizome." The entries also explore Deleuze's intellectual influences and the ways in which his ideas have shaped philosophy, feminism, cinema studies, postcolonial theory, geography, and cultural studies. More than just defining and describing (...) specific terms, the dictionary elaborates on Deleuze's ideas to reveal the varied applications of his philosophy. The contributors, who include some of the most prominent Deleuze scholars, bring their expert knowledge and critical opinion to bear on the entries. Their work provides a range of theoretical, historical, and aesthetic contexts for anyone interested in Deleuzian thought. Contributors include: Ronald Bogue, University of Georgia; Rosi Braidotti, Utrecht University; Claire Colebrook, University of Edinburgh; Tom Conley, Harvard University; Eugene Holland, Ohio State University; Tamsin Lorraine, Swarthmore College; Paul Patton, University of New South Wales; Kenneth Surin, Duke University; Alberto Toscano, Goldsmiths College. (shrink)

Destination therapy is the permanent implantation of a left ventricular assist device in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications. Because of deeply ingrained cultural and religious beliefs regarding death and the (...) sanctity of life, Japanese society may not be ready to make changes needed to enable patients to have LVADs deactivated under certain circumstances to avoid needless suffering. Western ethical views that permit LVAD deactivation based mainly on respect for autonomy and dignity have not been accepted thus far in Japan and are unlikely to be accepted, given the current Japanese culture and traditional values. Some healthcare professionals might regard patients as ineligible for DT unless they have prepared advance directives. If this were to happen, the right to prepare an advance directive would instead become an obligation to do so. Furthermore, patient selection for DT poses another ethical issue. Given the predominant sanctity of life principle and lack of cost-consciousness regarding medical expenses, medically appropriate exclusion criteria would be ignored and DT could be applied to various patients, including very old patients, the demented, or even patients in persistent vegetative states, through on-site judgment. There is an urgent need for Japan to establish and enact a basic act for patient rights. The act should include: respect for a patient’s right to self-determination; the right to refuse unwanted treatment; the right to prepare legally binding advance directives; the right to decline to prepare such directives; and access to nationally insured healthcare. It should enable those concerned with patient care involving DT to seek ethical advice from ethics committees. Furthermore, it should state that healthcare professionals involved in the discontinuation of life support in a proper manner are immune to any legal action and that they have the right to conscientiously object to LVAD deactivation. (shrink)

There is a steadily growing literature on the role of the immune system in psychiatric disorders. So far, these advances have largely taken the form of correlations between specific aspects of inflammation (e.g. blood plasma levels of inflammatory markers, genetic mutations in immune pathways, viral or bacterial infection) with the development of neuropsychiatric conditions such as autism, bipolar disorder, schizophrenia and depression. A fundamental question remains open: why are psychiatric disorders and immune responses intertwined? To address this would require a (...) step back from a historical mind–body dualism that has created such a dichotomy. We propose three contributions of active inference when addressing this question: translation, unification, and simulation. To illustrate these contributions, we consider the following questions. Is there an immunological analogue of sensory attenuation? Is there a common generative model that the brain and immune system jointly optimise? Can the immune response and psychiatric illness both be explained in terms of self-organising systems responding to threatening stimuli in their external environment, whether those stimuli happen to be pathogens, predators, or people? Does false inference at an immunological level alter the message passing at a psychological level (or vice versa) through a principled exchange between the two systems? (shrink)

While attention is widely recognised as central to perception, the term is often used to mean very different things. Prominent theories of attention — notably the premotor theory — relate it to planned or executed eye movements. This contrasts with the notion of attention as a gain control process that weights the information carried by different sensory channels. We draw upon recent advances in theoretical neurobiology to argue for a distinction between attentional gain mechanisms and salience attribution. The former depends (...) upon estimating the precision of sensory data, while the latter is a consequence of the need to actively engage with the sensorium. Having established this distinction, we consider the intimate relationship between attention and salience. (shrink)

In Born Free and Equal: A Philosophical Inquiry into the Nature of Discrimination, Kasper Lippert-Rasmussen defends the harm-based account of the wrongness of discrimination, which explains the wrongness of discrimination with reference to the harmfulness of discriminatory acts. Against this view, we offer two objections. The conditions objection states that the harm-based account implausibly fails to recognize that harmless discrimination can be wrong. The explanation objection states that the harm-based account fails adequately to identify all of the wrong-making properties of (...) discriminatory acts. We argue that the structure of a satisfactory view cannot be outcome-focused. A more promising family of views focuses on the deliberation of the discriminator and in particular on the reasons that motivate or fail to motivate her action. (shrink)