A concretização do direito à saúde deve ser viabilizada pelo Estado, com foco na efetivação das políticas públicas para garantia da implantação e funcionamento dos serviços demandados pelos respectivos grupos populacionais. Destarte, essa escrita objetivou analisar como o direito à saúde é contemplado em comunidades quilombolas de uma região geográfica baiana. Metodologicamente enquadra-se como de abordagem qualitativa, com informações obtidas por meio de entrevistas estruturadas (sobre a infraestrutura e/ou serviços públicos de saúde) desenvolvidas com as representações das Associações de Moradores (...) de 14 quilombos da região geográfica de Guanambi/Bahia durante o ano de 2016. Os achados indicam que uma comunidade possuía estrutura física específica para atendimentos básicos em saúde, no entanto, estava desativada. Três comunidades não tinham cobertura do Programa de Agentes Comunitários de Saúde (PACS). Entre as 11 que indicaram cobertura do Programa, em sete as(os) profissionais não residiam no território do quilombo. Diante da ampla ausência de infraestrutura e recorrente inadequação na prestação de serviços do PACS, evidencia-se a permanente negligência ao direito à saúde nesta população quilombola. (shrink)

Vulnerability and politics are among the relevant and key topics of discussion in the Ethiopian healthcare context. Attempts by the formal bioethics structure in Ethiopia to deliberate on ethical issues relating to vulnerability and politics in healthcare have been limited, even though the informal analysis of bioethical issues has been present in traditional Ethiopian communities. This is reflected in religion, social values, and local moral underpinnings. Thus, the aim of this paper is to discuss the bioethical implications of vulnerability and (...) politics for healthcare in Ethiopia and to suggest possible ways forward. First, we will briefly introduce what has been done to develop bioethics as a field in Ethiopia and what gaps remain concerning its implementation in healthcare practice. This will give a context for our second and main task – analyzing the healthcare challenges in relation to vulnerability and politics and discussing their bioethical implications. In doing so, and since these two concepts are intrinsically broad, we demarcate their scope by focusing on specific issues such as poverty, gender, health governance, and armed conflicts. Lastly, we provide suggestions for the ways forward. (shrink)

While the current debate highlights an increasing deficit of civic engagement, new - and often less visible - forms of “participation” are beginning to be detected, such as those implemented by citizens with migratory background living at the physical and symbolic margins of Western towns. Our study, part of the project “Abitare insieme” (Living together) in Milan’s multicultural suburbs, was developed with a dual purpose: to analyze the relationship between citizens with a migratory background, active citizenship, and their place representations/belongings; (...) to experiment the co-construction of innovative spaces of speech for citizens, through their dialogical involvement in the research. In a framework of participatory research to enhance reflexivity and transformative practices, a survey was designed and administered. In this paper we will discuss the survey results, along with some methodological implication. The aim is to contribute to reinvent the “active citizenship” construct from a transformative, pedagogical, and intercultural perspective. (shrink)

Thousands of youth suffering from acquired brain injury or other early-life neurological disease live, mature, and learn with only limited communication and interaction with their world. Such cognitively capable children are ideal candidates for brain-computer interfaces. While BCI systems are rapidly evolving, a fundamental gap exists between technological innovators and the patients and families who stand to benefit. Forays into translating BCI systems to children in recent years have revealed that kids can learn to operate simple BCI with proficiency akin (...) to adults. BCI could bring significant boons to the lives of many children with severe physical impairment, supporting their complex physical and social needs. However, children have been neglected in BCI research and a collaborative BCI research community is required to unite and push pediatric BCI development forward. To this end, the pediatric BCI Canada collaborative network was formed, under a unified goal to cooperatively drive forward pediatric BCI innovation and impact. This article reflects on the topics and discussions raised in the foundational BCI-CAN meeting held in Toronto, ON, Canada in November 2019 and suggests the next steps required to see BCI impact the lives of children with severe neurological disease and their families. (shrink)

Oral healthcare is attracting much attention after decades of neglect from policymakers. Recent studies have shown a strong association between oral and overall health, which can lead to serious health problems. Availability of oral healthcare services is an essential part of ensuring universal healthcare coverage. More importantly, current gaps in its accessibility by minority or marginalized population groups are crucial public health as well as ethical concerns. One notable effort to address this issue comes from Non-Governmental Organizations (NGOs), which offer (...) oral healthcare services for non-insured refugees. However, the challenge remains that these care services are not comprehensive, which has implications for the refugees’ oral and general health. In this article, we discuss this complex issue in the German healthcare context by including ethical reflections. Therefore, the purpose of this article is to discuss the ethical challenges related to oral healthcare services provided by NGOs for refugees in Germany. First, we will introduce the general oral healthcare context worldwide and in Germany. Second, we will provide a general description of the oral healthcare services provided by NGOs for refugees in Germany, as well as an overview of existing gaps. This will provide us with the context for our third and most important task—discussing the ethical implications of the gaps. In doing so, and since the ethical implications can be several, we demarcate the scope of our analysis by focusing on the specific ethical issues of justice, harm, and autonomy. Finally, we offer some recommendations for how to move forward. (shrink)

O período escravocrata brasileiro deixou marcas profundas nas populações negras e quilombolas. Este sistema contribui para um cenário racista que fomenta injustiças sociais e em saúde. Nesse sentido, o presente texto objetiva investigar na literatura científica o acesso e a utilização dos serviços de saúde pela população negra e quilombola. A partir de uma revisão de literatura do tipo descritiva narrativa. A busca das publicações ocorreu na Biblioteca Virtual de Saúde e no Google Acadêmico. Foram selecionadas 39 publicações entre os (...) anos de 2016 e 2018 organizadas nas seguintes categorias: acesso e utilização dos serviços de saúde pela população negra e quilombola e suas principais morbidades; implicações geográficas e fatores influenciadores no acesso e utilização dos serviços de saúde. As análises indicam que o acesso e utilização dos serviços de saúde pelas populações negras e quilombolas brasileiras sofrem mais importantemente os efeitos nocivos dos marcadores sociais, espaciais, de gênero, de classe socioeconômica e principalmente quanto ao pertencimento étnico-racial. A dificuldade de acesso e utilização dos serviços de saúde pelas populações negras e quilombolas brasileiras repercute as iniquidades, resultando no agravamento de processos de adoecimentos de ordem crônica, como Diabetes e hipertensão, e problemas de qualidade assistencial, como no acompanhamento pré-natal. (shrink)

This paper is a sequel to my 'Theological Misinterpretations of Current Physical Cosmology' (Foundations of Physics [1996], 26 (4); revised in Philo [1998], 1 (1)). There I argued that the Big Bang models of (classical) general relativity theory, as well as the original 1948 versions of the steady state cosmology, are each logically incompatible with the time-honored theological doctrine that perpetual divine creation ('creatio continuans') is required in each of these two theorized worlds. Furthermore, I challenged the perennial theological doctrine (...) that there must be a divine creative cause (as distinct from a transformative one) for the very existence of the world, a ratio essendi. This doctrine is the theistic reply to the question: 'Why is there something, rather than just nothing?' I begin my present paper by arguing against the response by the contemporary Oxford theist Richard Swinburne and by Leibniz to what is, in effect, my counter-question: 'But why should there be just nothing, rather than something?' Their response takes the form of claiming that the a priori probability of there being just nothing, vis-à-vis the existence of alternative states, is maximal, because the non-existence of the world is conceptually the simplest. On the basis of an analysis of the role of simplicity in scientific explanations, I show that this response is multiply flawed, and thus provides no basis for their three contentions that (i) if there is a world at all, then its 'normal', natural, spontaneous state is one of utter nothingness or total non-existence, so that (ii) the very existence of matter, energy and living beings constitutes a deviation from the allegedly 'normal', spontaneous state of 'nothingness', and (iii) that deviation must thus have a suitably potent (external) divine cause. Related defects turn out to vitiate the medieval Kalam Argument for the existence of God, as espoused by William Craig. Next I argue against the contention by such theists as Richard Swinburne and Philip L. Quinn that (i) the specific content of the scientifically most fundamental laws of nature, including the constants they contain, requires supra-scientific explanation, and (ii) a satisfactory explanation is provided by the hypothesis that the God of theism willed them to be exactly what they are. Furthermore, I contend that the theistic teleological gloss on the 'Anthropic Principle' is incoherent and explanatorily unavailing. Finally, I offer an array of considerations against Swinburne's attempt to show, via Bayes's theorem, that the existence of God is more probable than not. (shrink)

We have surveyed various recent European opinions on Germ-Line engineering. The majority express more or less severe reservations about any interventions on the human Germ-Line, including therapeutic ones. However, they are divided over the pragmatic, or categorical-ethical nature of the relevant arguments. This split reflects two competing views of technology. The ‘pessimistic’ one is deeply concerned by the slippery slope leading from bona fide therapeutic applications of genetic engineering to eugenic practices. It insists that, if anything can defend us against (...) these evils, it must be a set of strong, ethically-based prohibitions. The other, ‘optimist’ view is more confident in the discriminating powers of societal regulation. We argue for the latter view and suggest that the pragmatic arguments brought to this debate are less problematic than the ethical ones. (shrink)

La filosofía de la historia se ha debatido durante siglos en una estéril lucha entre idealistas y materialistas. El libro de Ignacio Ellacuría es un intento de superar esa dicotomía clásica. Tomando como punto de partida algunos conceptos fundamentales de la filosofía de Zubiri, Ellacuría cree posible asumir y a la vez criticar ambos extremos, desde una actitud más realista. De ahí el título del libro. Es importante destacar que la historia, para Ignacio Ellacuría, es el lugar de realización de (...) la ética. La historia no está hecha, se construye, es un proceso de creación de posibilidades humanas, y, en tanto que tal, una labor ética. La tesis de Zubiri de que el hombre tiene que hacerse cargo de la realidad, en Ellacuría se transforma en esta otra: el ser humano está obligado a encargarse de la realidad, y a cargar con ella. Este es el imperativo ético. Imperativo que, por otra parte, no sólo le obliga individualmente al hombre, en el reducto de la propia conciencia, al modo del idealismo, ni tampoco sólo en tanto que miembro de una clase social, como en el marxismo, sino como sujeto a la vez individual y específico, como miembro a la vez solitario y solidario de la especie humana. La obra póstuma de Ignacio Ellacuría constituye sin duda su más ingente trabajo intelectual en el campo de la filosofía, y representa, por su calidad y contenido, una pieza clave para comprender no solamente su producción estrictamente filosófica, sino también su pensamiento teológico y socio-político. (shrink)

Contemporary psychiatry maintains the myth that it is value neutral by appeal to modern medical science for both its diagnostic categories and its therapeutic interventions, leaving the impression that it relies on reason—that is to say, reason divorced from tradition—to master human nature. Such a practice has a certain way of characterizing and defining humanity's lapses from acceptable human behavior—a lapse from human being. The modern practice of psychiatry applies a particular notion (largely influenced by Enlightenment ideals) of scientific instrumentation (...) to the human person in order to diagnose the ailment and manufacture a corresponding treatment in keeping with a hidden conception of human biological flourishing. This covert vision is an impoverished (and possibly dangerous) one. As much as the practice of psychiatry is constrained by the goals of the dominant moral tradition of our day, it becomes a tool (or technique) for achieving the transient and partial ends of modern individualism. Given this truncated view of human nature and human end, modern psychiatry fails to attend comprehensively to the unity of a life, missing altogether the essential relevance of character formation, and thereby forfeiting excellence in human flourishing. (shrink)

Objectives: Evidence based patient choice seems based on a strong liberal individualist interpretation of patient autonomy; however, not all patients are in favour of such an interpretation. The authors wished to assess whether ideals of autonomy in clinical practice are more in accordance with alternative concepts of autonomy from the ethics literature. This paper describes the development of a questionnaire to assess such concepts of autonomy.Methods: A questionnaire, based on six moral concepts from the ethics literature, was sent to aneurysm (...) patients and their surgeons. The structure of the questionnaire was assessed by factor analysis, and item reduction was based on reliability.Results: Ninety six patients and 58 surgeons participated. The questionnaire consisted of four scales. Two of the scales reflected the paternalistic and consumerist poles of the liberal individualist model, one scale reflected concepts of Socratic autonomy and of procedural independence, and the fourth scale reflected ideals of risk disclosure.Discussion: The Ideal Patient Autonomy Scale is a 14 item normative instrument. It is clearly distinct from the generally used psychological preference questionnaires that assess preferences for physician-patient roles. (shrink)

In The Idea of a Social Science Winch, argues that, sociology is more properly conceived as a branch of philosophy than of empirical science. Winch falls victim here to the Humean assimilation of the empirical to the generalizable. He notes that much of our talk about social practice is in terms of conventions, so that explanations of social action can be given without recourse to statistical or experimental findings. But such talk depends nonetheless on the accuracy and detail with which (...) the situations in which actions occur are? recorded, and this is surely an empirical enterprise. It is the misleading conception of sociology as a discipline, characterized by common procedures, that leads Winch to espouse the assimilation of sociology to conceptual inquiry. We need to see instead that sociology embraces a group of questions and subjects so loosely connected that it would be mistaken to speak of, and idle to project, a procedure common to all of them. (shrink)

The overgeneration argument attempts to show that accepting second-order validity as a sound formal counterpart of logical truth has the unacceptable consequence that the Continuum Hypothesis is either a logical truth or a logical falsehood. The argument was presented and vigorously defended in John Etchemendy’s The Concept of Logical Consequence and it has many proponents to this day. Yet it is nothing but a seductive fallacy. I demonstrate this by considering five versions of the argument; as I show, each is (...) either unsound or lacks a troubling conclusion. (shrink)

Brendel and Miller (2008) take the most distinctive commitment in their pragmatic approach to be treating ethical principles as having a hypothetical status. I am sympathetic to a pragmatic approac...

Background This pilot study evaluated the speaking book ‘What it means to be part of a clinical trial’. The book aims at empowering populations with information on their rights and responsibilities when enrolled in clinical research. Wide publication of the book—at significant cost—is anticipated. It is important that the book is evaluated within the communities for whom it is intended, and the necessary changes (if any) are made, before translation and large-scale publication takes place. Objective The objective of the study (...) was to measure the efficacy and ease of use of the book. Methods Participants were recruited from a catering company. Participants were questioned on their knowledge of clinical trials and were then given the book. Instructions for use of the book were given to one group (‘experimental’ group). The other group (‘control’ group) was not given any instructions. A week later, the investigators returned, repeated the knowledge questions and asked ‘ease of use’ questions. Results A two-way repeated measure of covariants showed a statistically significant positive increase in knowledge of clinical trials among the intervention group (p=0.02). Results for the control group displayed trends that were not statistically significant. Percentage analysis of ‘ease of use’ questions proved that the book is easy to use, although some changes would be beneficial. Conclusion This study revealed that the speaking book is easy to use. It significantly increased knowledge of clinical trials among the study sample if instructions on use of the book were provided. (shrink)

This is the best general book on philosophy for university students: not just an introduction, but a guide which will serve them throughout their studies. It comprises specially commissioned explanatory surveys of the main areas of philosophy, written by thirteen leading philosophers.

I would like to begin with the role of philosophy in solving ecological problems, emphasizing two aspects of its role: the struggle against hostile ideology and the organizing and guiding of activity in the sphere of the development of science and the shaping of its problems. This role of Marxist-Leninist philosophy clearly appears in the complex interdisciplinary problem of the interaction between nature and society.

v. 1. Edinyĭ i︠a︡zyk chelovechestva. --.