En este artículo exploramos desde la literatura, por medio de Suenan timbres de Luis Vidales, la dinámica de las nacientes urbes colombianas que inician un proceso acelerado de modernización, carente de un desarrollo adecuado del pensamiento moderno, a la par con los nuevos avances materiales, lo que imposibilita debatir la pertinencia y el proceso de este tipo de transformaciones. Circunstancia que lleva a Colombia a experimentar los idiotismos de la modernización sin modernidad, impidiéndoles a los hombres entender las necesidades y (...) conflictos que genera el progreso. Estas aldeas de principios del siglo XX se convierten rápidamente en proyectos de ciudades determinadas por la aparición de nuevos objetos, creando una atmósfera móvil y ruidosa por oposición a la pasividad de las aldeas, realidad que nos recrea Vidales desde una poética comprometida con los cambios sociales y políticos como poeta de la crítica en Colombia. In this paper, from the literature of Luis Vidales’s Suenan timbres, we explore the dynamics of Colombian rising cities that initiate an accelerated modernization process, deprived of an appropriate development of modern thinking, along with the new material advances, which makes it impossible to debate the relevance and the process followed by these types of transformations. This situation leads Colombia to experience the idiotism of modernization without modernity, impeding men to understand the needs and conflicts generated by progress. These villages from twentieth century beginnings quickly turn into city projects determined by the arrival of new objects, creating a mobile and noisy atmosphere, opposed to villages’ passivity. From poetics committed to social and political change, Vidales recreates reality as a poet of criticism in Colombia. (shrink)

Macroergonomic compatibility refers to the extent to which macroergonomic factors and elements interact positively with humans. It is one of the most complex constructs to measure in work systems and in ergonomics. The goal of this paper is to determine the levels of MC in a manufacturing system. As methods, we use the macroergonomic compatibility index and the Macroergonomic Compatibility Questionnaire. The MCQ was administered in its three versions to collect data about the macroergonomic practices implemented in the manufacturing company. (...) Regarding results, all the macroergonomic factors and most of the macroergonomic elements showed a low level of MC; that is, MCI < 0.7. Only macroergonomic elements Education, Knowledge, and Skills reached a medium level; namely, MCI = 0.709. The factor with the highest level of MC was the Person factor. Similarly, the whole manufacturing system showed a low level of MC. In conclusion, the studied manufacturing company requires urgent macroergonomic interventions. Also, we found that the MCI can effectively measure the level of MC of MFEs and can guide the implementation of macroergonomic practices and explain the MC construct. (shrink)

Does public condemnation or shaming of human rights abuses by the United Nations influence foreign aid delivery calculus across Western donor states? I argue that countries shamed in the United Nations Human Rights Council encourage donor states to channel more aid via international and local non-governmental organizations. Furthermore, I find this effect to be more pronounced with increased media coverage. The findings of this paper suggest that international organizations do influence advanced democracies’ foreign policy. Moreover, the paper also finds that (...) donor governments do not punish recipient leaders by scaling back on government-to-government aid, which is more fungible, despite public condemnations of their human rights practices owing largely to strategic concerns. These results are robust to a number of alternative data and estimation techniques. (shrink)

Despite several research on HIV/aids, it is still incumbent to investigate more effective control measures to mitigate its infection level. Therefore, we introduce an HIV/aids-resistant model with behavior change and study its basic properties. In order to determine the most sensitive parameters that are responsible for disease transmission with respect to the basic reproduction number and those responsible for disease prevalence with respect to the endemic equilibrium, the sensitivity analysis was established and it was confirmed that the influx rate of (...) people into the infected population and total abstinence from all risk practices and endemic areas are some of the most sensitive parameters for disease spread and disease eradication, respectively. Furthermore, by considering controls u1\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$u_1$$\end{document} denoting the government’s intervention in promoting and encouraging behavior change, u2\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$u_2$$\end{document} representing intake of balanced nutritional supplementation, and u3\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$u_3$$\end{document} connoting antiretroviral therapy (ART), an optimal control problem was developed and analyzed. Before the establishment of the necessary conditions of the optimal control using Pontryagin’s Maximum Principle, we proved the existence of the optimal control triplet (u1(t),u2(t),u3(t)∈Φ,\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$(u_1(t),u_2(t),u_3(t)\in \Phi,$$\end{document} where Φ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\Phi$$\end{document} is the control set at time t,) which has been neglected by many researchers in recent years. Using the Runge–Kutta scheme, the optimal control problem was solved to understand the best combination of control strategies. Using the demographic and epidemiological data for South Africa on HIV/aids, a numerical simulation was carried out and results are presented on 3D surface plots. The obtained results suggested that the combination of all the considered control measures is the best method to ensure disease eradication. (shrink)

Burnout syndrome and obesity are two growing conditions that affect employees’ health and company productivity. Recently, several studies have pointed to a possible relationship between both phenomena. However, such a relationship has not been clearly defined. This research analyzes the relationship between BS dimensions and body mass index, the latter being treated as a moderator variable among obese senior and middle managers in the Mexican maquiladora industry through a structural equation model. A total of 361 senior and middle managers completed (...) both the Maslach Burnout Inventory-General Survey [with emotional exhaustion, cynicism, and professional efficacy as subscale dimensions] and a sociodemographic questionnaire. The results showed a statistically significant relationship between EE and PE, with BMI acting as a moderator variable. The results showed that when BMI increases as a moderator variable, the strength of the relationship between EE and PE also changes. For example, although PE had a negative value of 0.14 before the moderator effect, the value increased up to 0.32 when the BMI was factored into the relationship. Therefore, maquiladora industries are being advised to increase their investments on the identification and prevention of employees’ EE and obesity. Such interventions would promote a better quality of life and could prevent economic losses resulting from poor employee performance. (shrink)

Photo by Hannah Busing on Unsplash INTRODUCTION Religion has long provided guidance that has led to standards reflected in some aspects of medical practices and traditions. The recent bioethical literature addresses numerous new problems posed by advancing medical technology and demonstrates an erosion of standards rooted in religion and long widely accepted as almost axiomatic. In the deep soul-searching that pervades the publications on bioethics, several disturbing and dangerous trends neglect some basic lessons of philosophy, logic, and history. The bioethics (...) discourse on medical aid in dying emphasizes similarity over previously recognized important distinguishing features. For example, it overplays a likeness between assistance in dying and the withdrawal of life-saving technology. In many bioethics’ topics, arguments based on a logical continuum are used to question the lines demarcating important moral differences. l. The Line Between Ethical and Not: Logic Based on Continuum Careful case selection, often either end of a continuum, allows the tearing down or ridiculing of many rules and codes across most professions and fields of interest. This situation holds true for traffic laws as well as medical ethics guidelines. It is relatively simple for those who desire to attack a particular viewpoint by selecting a case that makes that position seem untenable. In the ethics realm, good and bad medicine exist at opposite ends of an ethical continuum, with many practices lying in between. For example, much of medical ethics exists between the Nazi criminal physicians and the most sainted nurse or physician. A gradual progression occurred over less than two decades from a utilitarian position that supported limited euthanasia for those with certain mental illnesses to genocide. German society embraced a utilitarian ethic in which the value of human life no longer was intrinsic but instrumental.[1] Many morally significant points on a continuum were then ignored as the misguided utilitarian policy rampantly continued. A point in the continuum to distinguish between ethically justifiable and that which is not can be difficult to identify compared to the two extremes. This continuum is not unique to ethics but can be applied to almost any other aspect of human life and endeavor. Between a severely ill schizophrenic person and a superbly well-adjusted individual, there is a continuum of mental and psychological function. The existence of a continuum should not paralyze thinking and prevent us from drawing lines and identifying moral differences based on objective criteria as well as moral philosophy. Yet, by focusing on a continuum, many bioethicists use logic to disregard dividing lines between an "ethical" and an "unethical" act. Unfortunately, sometimes bioethicists draw revolutionary conclusions that would change the scope of medical practices which is accepted as ethical. There are many examples of similar shifts on the continuum. Many authors argue for the ethical permissibility of abortion by pointing out that the human fetus is no different in various characteristics, one arguing it is as like an ape or chick as it is like a person,[2] and does not achieve unique human and individual characteristics until well into the first year of life.[3] While human fetuses arguably do not have certain distinctive qualities of personhood, most people shy away from the logical next conclusion: permitting infanticide. For example, Joshua Lederberg condemns infanticide, in the face of biological illogic, because of our emotional commitment to infants, to me, a relatively weak explanation. Sir Francis Crick suggests we might consider birth at two days of life in order to decide whether an infant is a "suitable" member of society.[4] Giublini and Minerva suggest that infanticide should be permissible since late pregnancy abortions are permissible, arguing there is no significant difference between a fetus just before birth and an infant just after birth.[5] Clearly the continuum approach would allow for subjective arguments in favor of later infanticide at other points many days post-birth. Years ago, with a cynical tone, I mentioned infanticide as a further step on the continuum beyond abortion, and I was rightly shouted down as being deliberately provocative to assert the logic would ever stretch so far. While it is not an accepted mainstream position, the movement in academic settings from widespread condemnation to limited possible acceptance of infanticide has taken place in an incredibly short time. Public opinion and medical opinion in these areas have shifted dramatically in a short time. In another area, from a biological and chemical point of view, there is a continuum from man down to a single carbon atom. Yet, it would not seem logical to ignore the emotional differences, the meaning of personhood, or the moral distinction between killing an insect and killing a person. ll. A False Continuum: Medical Aid in Dying I assert that there has been an erosion of ethical guidelines in recent years attributable to using continuums to camouflage important distinctions. James Rachels’ work on active and passive euthanasia, which contends that the two are ethically identical, exemplifies that logic.[6] He illustrates this thesis, using a continuum to compare different scenarios with like consequences as morally equivalent, by comparing the deliberate drowning of a child with a deliberate failure to rescue a drowning child when easily able to do so. The author's comparison proposes that since much of the medical profession has already made peace with withholding treatment in order to hasten death, consistency inexorably demands that we permit active euthanasia as well.[7] When permission for active euthanasia was first introduced, it was limited exclusively to patients suffering severely from an intractable, incurable, and irreversible disease. These guidelines have been continuously eroded. There is now a substantial serious consideration for permitting active euthanasia of healthy elderly individuals who feel that they have completed their lives and are "tired of living."[8] There are many moral and factual differences along the ethical continuum. In human life, there is a difference between a live baby and a fetus, between a viable fetus and one that is not, between a fetus and a zygote, and between a zygote and a sperm cell. Similarly, there is a difference between pulling a trigger to kill someone and not interfering in preventing his death, which is reprehensible though both may be. There is a difference between not resuscitating an 80-year-old man with cancer when his heart stops and injecting him with a fatal dose of potassium chloride. I argue that an overt act of taking life repels civilized human beings is to be commended and encouraged as the reverence for human life or even for just a moment of human life is one of the great contributions of our civilization. CONCLUSION As an orthodox Jew, I feel that divinely inspired guidelines that have stood the test of centuries shape my beliefs, and such guidelines contradict medical aid in dying. I cannot speak to the viewpoint of those who do not access religion in defining their moral stance, nor do I implicate them in the current bioethics' trends, as I am not aware of the personal role of religion in the lives of most such authors. While many nonreligious people have a firm philosophical grounding and oppose medical aid in dying, I suggest that in the absence of any religious or other absolute standards, developing logically defensible ethical guidelines may be challenging. At the least, religion may play a role in defining the points on the continuums that are ethically meaningful and refuting the trending beliefs that if the endpoint is the same, allowing different methods of arriving at that end are somehow ethically equal. The continuum of ways death may result does not negate analysis of whether death is brought about in ways that recognize the importance of life. The German philosopher Hans Jonas said, "It is a question whether without restoring the category of the sacred, the category most thoroughly destroyed by the scientific enlightenment, we can have an ethics able to cope with the extreme powers that we possess today and constantly increase and are compelled to use."[9] While countries vary on the role of religion in policy, with many emphasizing freedoms of religion, a recent position paper released by a group of Jewish, Christian, and Moslem leaders suggested the need for agreement on the unique sanctity of human life.[10] I would recommend that such a document serve as an example of consensus on critical foundational bioethical guidelines for democratic secular societies. - [1] Alexander L Medical science under dictatorship. New England Journal of Medicine, 241, p39-47 DOI10.1056/NEJM194907142410201 [2] Lederberg J. A geneticist looks at contraception and abortion, Annals of Internal Medicine 67, sup 2, 25-27. https:/doi.org/10.7326/0003-4819-67-3-25 [3] Ibid. [4] Editorial, Sociology: Logic of biology. Nature 220, 429 https://www.nature.com/articles/220429b0 [5] Giublini A Minerva F After-birth abortion: why should the baby live. J Med Ethics 39, 261- [6] Rachels J Active and passive euthanasia. New England Journal of Medicine 292, 78-80 [7] Ibid. [8] Cohen-Almagor R Euthanizing people who are "tired of life". in Euthanasia and Assisted Suicide-Lessons from Belgium. Ch 11 of Euthanasia and Assisted Suicide, Cambridge University Press pp173-187. 2017 and DOI; https://doi.org/10.1017/9781108182799.012 [9] Hans Jonas, Technology and Responsibility: Reflections on the New Tasks of Ethics, 1972, found as Chapter IX, Philosophical Essays, 1980. https://inters.org/jonas-technology-responsability [10] A position paper of the Abrahamic Monotheistic religions on matters concerning the end-of-life. Vatican Press 28 October 2019 https://press.vatican.va/content/salastampa/en/bollettino/pubblico/2019/10/28/191028f.html. (shrink)

Any case raising the profile of ‘assisted-dying’ and public policy naturally causes consternation, excitement, heated debate and concerns from different parties, worried that the law is unclear, unfair, too conservative, too permissive, neglectful of ‘the vulnerable’ or indifferent to the proper scope of freedom for ‘the competent’. It was unsurprising, then, that much attention focused on the litigation between Debbie Purdy and the Director of Public Prosecutions .1–4 Ms Purdy has muscular sclerosis, and would like to be free, at a (...) time of her choosing, to travel to receive assisted suicide in a jurisdiction that permits this. To do so, she will need the help of her husband. In contrast with the famous Pretty case,5 Ms Purdy did not seek a proleptic immunity from prosecution under the Suicide Act 1961. Rather, she invoked her human right to respect for private and family life, and argued that the DPP should publish guidance detailing the basis on which he exercises his discretion to bring a prosecution for the crime of aiding, abetting, counselling or procuring a suicide in England and Wales. Her case, when heard in the House of Lords, was successful. 3A decision to prosecute cases of assisted suicide pivots on the satisfaction of two key issues: the ‘evidential test’—is there sufficient evidence to justify bringing a prosecution?; and the ‘public interest test’—is it in the public interest to bring a prosecution? Rightly or wrongly, the threshold for meeting the evidential test seems to be set very low.6 Focus tends to fall, therefore, on the public interest aspect of the decision. In September 2009, the DPP published interim guidance, which detailed the offence of ‘assisting a …. (shrink)

Effective Altruism is a popular social movement that encourages individuals to donate to organizations that effectively address humanity’s most severe poverty. However, because Effective Altruists are committed to doing the most good in the most effective ways, they often argue that it is wrong to help those nearest to you. In this paper, I target a major subset of Effective Altruists who consider it a moral obligation to do the most good possible. Call these Obligation-Oriented Effective Altruists (OOEAs), and their (...) movement Obligation-Oriented Effective Altruism (OOEA). I argue that insofar as this variety of OOEA seems to commit us to refrain from helping the people right in front of us, there is something intuitively wrong about it. In response, I introduce an alternative model that embraces partiality: Mutual Aid. Mutual Aid is a network of community members, usually from the same geographical region, who share a commitment to offer, receive, and exchange material goods, wealth, and social support. I recommend Mutual Aid as a liberatory model, which—through empathy, solidarity, and care—mobilizes community building and provides a catalyst for community advocacy. As such, we should resist the claims of OOEAs that partially distributing our funds to people or causes we care about is morally wrong or even less than ideal. We do not have a moral obligation to use our funds “effectively;” rather, we have a broader obligation to address human suffering, and Mutual Aid is one moral alternative for discharging this duty. (shrink)

On November 4,1999, in South Central Regional Medical Center v. Pickering, 1999 WL 1000703, the Mississippi Supreme Court created a new legal standard that allows patients to recover damages for fear of exposure to AIDS even though they cannot prove actual exposure. By adopting this standard, the Mississippi Supreme Court joined the minority of jurisdictions seeking to encourage providers to use reasonable care when handling instruments capable of transmitting disease.Plaintiff Jimmie Pickering is a female diabetic, who was receiving treatment at (...) South Central Regional Medical Center between September 30 and October 5, 1987 to regulate her blood sugar levels. Pickering used the hospital's Autoclix machine, which required that Pickering use lancets to prick her finger to draw blood. (shrink)

On November 4,1999, in South Central Regional Medical Center v. Pickering, 1999 WL 1000703, the Mississippi Supreme Court created a new legal standard that allows patients to recover damages for fear of exposure to AIDS even though they cannot prove actual exposure. By adopting this standard, the Mississippi Supreme Court joined the minority of jurisdictions seeking to encourage providers to use reasonable care when handling instruments capable of transmitting disease.Plaintiff Jimmie Pickering is a female diabetic, who was receiving treatment at (...) South Central Regional Medical Center between September 30 and October 5, 1987 to regulate her blood sugar levels. Pickering used the hospital's Autoclix machine, which required that Pickering use lancets to prick her finger to draw blood. (shrink)

Students, the future Information and Communication Technology (ICT) professionals, are often perceived to have little understanding of the ethical issues associated with the use of ICTs. There is a growing recognition that the moral issues associated with the use of the new technologies should be brought to the attention of students. Furthermore, they should be encouraged to explore and think more deeply about the social and legal consequences of the use of ICTs. This paper describes the development of a tool (...) designed to raise students’ awareness of the social impact of ICTs. The tool offers guidance to students undertaking computing and computer-related courses when considering the social, legal and professional implications of the actions of participants in situations of ethical conflict. However, unlike previous work in this field, this tool is not based on an artificial intelligence paradigm. Aspects of the theoretical basis for the design of the tool and the tool’s practical development are discussed. Preliminary results from the testing of the tool are also discussed. (shrink)

HIV/AIDS strikes with the greatest frequency in sub-Saharan Africa, a region lacking resources to deal with this epidemic. To keep millions more people from dying, wealthy countries must provide more help. Yet deeply ingrained biases may distance the sick from those who could provide far more aid. One such prejudice is viewing disease as punishment for sin. This 'punishment theory of disease" ascribes moral blame to those who get sick or those with special relations to them. Religious versions hold that (...) God punishes them in order to castigate, encourage virtue, warn, rehabilitate, or maintain some cosmic order. Its various religious and secular forms are untenable; they lack cogency, risk blaming people unjustly, and jeopardize compassionate care for people. These views are not only irrational but also dangerous because they influence policies and cost lives. We need to cooperate and respond as befits this global public-health disaster and not engage in the misguided and bad faith activity of dividing the world into the blameworthy and blameless. (shrink)

The recent statistics on the prevalence of HIV and AIDS shows that the number of people living with the virus keep on increasing amidst government’s interventions to deal with the epidemic. Pentecostal churches have a potential to deal with the problem, given their theology of experience, but are hindered by some myths about the factors associated with the epidemic highlighted in this article, such as the demonisation of sex and HIV and AIDS, judgemental views, denominationalism and condemnation of condoms. Many (...) scholars interested in the study of HIV and AIDS have researched these myths. The unique contribution that this article makes is a proposal for a strategy of demythologisation of the factors associated with the epidemic among Pentecostals. The article uses a literary analysis to discuss effective ways of dealing with the epidemic in South Africa, such as to talk openly about sex, encourage safer sex, adopt a tolerant approach, embrace a holistic view and reconstruct a theology of HIV and AIDS. (shrink)

Participants in AIDS research may justify noncompliance with protocols by a “coercion defense.” While this defense may not be philosophically successful, a prudent social policy can enhance compliance by encouraging community participation and providing greater access to non‐validated therapies.

HIV/AIDS is the leading cause of morbidity and mortality in the southern African country of Malawi. At the largest referral health facility in Blantyre, the Queen Elizabeth Central Hospital, the majority of patients hospitalized in medical wards and up to a third of those in the maternity unit are infected with HIV. Many patients in the surgical wards also have HIV/AIDS. Health professionals in Blantyre, however, often choose not to write down the diagnosis of HIV or AIDS; rather, they prefer (...) to use ‘SGOT’, ‘ELISA’ and ‘spot test’ to represent the HIV test, while ‘immunosuppression’, ‘↓ CD4 disease’ and ‘ARC’ are preferred instead of ‘AIDS’. It is possible that health professionals’ belief that mentioning HIV and/or AIDS will harm patients is encouraging them to use these euphemisms. The use of less than exact terms to label HIV and AIDS may not be without cost. For instance, future attempts to conduct retrospective case study research may be hampered by this practice, which is not in accordance with the international classification of diseases. It is suggested that, although stigmatization and discrimination could be important driving factors in the use of cryptic language, it may be more worthy to fight discrimination and stigmatization head-on, rather than create avenues where these reactions may be perpetuated. (shrink)

Aim: Explore nurses’ values and perceptions regarding the practice of medical aid in dying. Background: Medical aid in dying is becoming increasing legal in the United States. The laws and American Nurses Association documents limit nursing involvement in this practice. Nurses’ values regarding this controversial topic are poorly understood. Methodology: Cross-sectional electronic survey design sent to nurse members of the American Nurses Association. Inductive thematic content analysis was applied to open-ended comments. Ethical Considerations: Approved by the institutional review board (#191046). (...) Participants: 1213 nurses provided 3639 open-ended comments. More than 80% of participants self-identified as white 58% held a graduate degree; and half were of Christian faith. Results: Values ranged on a continuum expressed through four themes: “Honoring Patient Autonomy without Judgment,” “Honoring with Limitations,” “Not until...,” and “Adamantly against.” Some felt it was a duty to honor the patients’ wishes, set aside own beliefs, and respect patients’ choices often with a spiritual connotation. Nurses held concerns about the process, policy, potential psychological harm, legal risk, and the need to learn more about MAID. Nurse who were adamantly against MAID associated the practice with murder/suicide and against religious beliefs. Disparate values were expressed about changing the MAID legislation to allow patient support with taking MAID medications and allowing MAID via advance directive. Conclusions: Nurses desire more education on MAID. There is not one universally held position on the nurse’s role during MAID. Healthcare policy/standards need to accommodate the wide variation in nurses’ values. Implications: Nurses desire education regarding their role in MAID. Nurses are encouraged to participate in policy discussions as the practice becomes increasingly legal. Managers need to expect that nurses, patients, and families will need psychological support to participate in MAID. Careful construction of policy/standards is needed to minimize conflict, moral distress, and psychological harm amongst nurses. Further research is needed. (shrink)

I argue, contrary to standard claims, that accomplice liability need not be a causal relation. One can be an accomplice to another’s crime without causally contributing to the criminal act of the principal. This is because the acts of aid and encouragement that constitute the basis for accomplice liability typically occur in contexts of under- and over-determination, where causal analysis is confounded. While causation is relevant to justifying accomplice liability in general, only potential causation is necessary in particular cases. (...) I develop this argument through the example of the role of U.S. legal officials in abetting the acts of unlawful interrogation that have taken place since 2001. I also suggest that there may be a limited justification for ex post ratificatory accomplice liability. (shrink)

In this article I consider the role of passing and performance in the everyday lives of alkaptonuria and vitiligo patients. Race, LGBTQ, gender and disability scholars have long used the term passing to describe sub-groups of people within marginal populations who intentionally manipulate their bodies or alter their behaviour in order to claim identities that are not socially assigned to them at birth. In this paper I demonstrate the effectiveness of the passing strategies that patients use in order to mitigate (...) their disease symptoms and render them invisible, thus enabling them to pass as “healthy” or unaffected by their condition. I further consider how patients who choose not to pass utilise resistance strategies in order to generate awareness of their disease and encourage funding for it. I conclude by assessing the effectiveness of these strategies in determining whether or not patients can pass, and the ways in which this is aided or hindered by their social and economic status. (shrink)

ABSTRACT Accurate self‐administration of antiretroviral medication therapy for HIV/aids is a significant clinical and ethical concern because of its implications for individual morbidity and mortality, the health of the public, and escalating healthcare costs. However, the traditional construction of patient medication adherence is oversimplified, myopic, and ethically problematic. Adherence relies on existing social power structures and western normative assumptions about the proper roles of patients and providers, and principally focuses on patient variables, obscuring the powerful socioeconomic and institutional influences on (...) behaviour. Some professionals advocate for alternate approaches to adherence, but many of the available alternatives remain conceptually underdeveloped. Using HIV/aids as an exemplar, this paper presents medication practice as a theoretical reconstruction and explicates its conceptual and ethical evolution. We first propose that one of these alternatives, medication practice, broadens the understanding of individuals’ medication‐taking behaviour, speaks to the inherent power inequities in the patient‐provider interaction, and addresses the ethical shortcomings in the traditional construal. We then integrate medication practice with feminist thought, further validating individuals’ situated knowledge, choices, and multiple roles; more fully recognizing the individual as a multidimensional, autonomous human being; and reducing notions of obedience and deference to authority. Blame is thus extricated from the healthcare relationship, reshaping the traditionally adversarial components of the interaction, and eliminating the view of adherence as a patient problem in need of patient‐centred interventions. (shrink)

Far from an elite practice reserved for the highly educated, criticism is all around us. We turn to the Yelp reviewers to decide what restaurants are best, to Rotten Tomatoes to guide our movie choices, and to a host of voices on social media for critiques of political candidates, beach resorts, and everything in between. Yet even amid this ever-expanding sea of opinions, professional critics still hold considerable power in guiding how we make aesthetic judgements. Philosophers and lovers of art (...) continue to grapple with questions that have fascinated them for centuries: How should we engage with works of art? What might enhance such encounters? Should some people’s views be privileged? Who should count as a critic? And do critics actually help us appreciate art? In Two Thumbs Up, philosopher Stephanie Ross tackles these questions, revealing the ways that critics influence our decisions, and why that’s a good thing. Starting from David Hume’s conception of ideal critics, Ross refines his position and makes the case that review-based journalistic or consumer reporting criticism proves the best model for helping us find and appreciate quality. She addresses and critiques several other positions and, in the process, she demonstrates how aesthetic and philosophical concerns permeate our lives, choices, and culture. Ultimately, whether we’re searching for the right wine or the best concert, Ross encourages us all to find and follow critics whose taste we share. (shrink)

Effective altruism is a philosophy and a social movement that aims to revolutionise the way we do philanthropy. It encourages individuals to do as much good as possible, typically by contributing money to the best-performing aid and development organisations. Surprisingly, this approach has met with considerable resistance among activists and aid providers who argue that effective altruism is insensitive to justice insofar as it overlooks the value of equality, urgency and rights. They also hold that the movement suffers from methodological (...) bias, reaching mistaken conclusions about how best to act for that reason. Finally, concerns have been raised about the ability of effective altruism to achieve systemic change. This article weighs the force of each objection in turn, and looks at responses to the challenge they pose. (shrink)

This paper traces the development of policies dealing with HIV/AIDS in Botswana from their beginning in the late 1980s to the current programme to provide population-wide anti-retroviral therapy (ARV). Using a variety of source material, including long-term ethnographic research, it seeks to account for the failure of Western-inspired approaches in dealing with the pandemic. It does this by looking at the cultural and institutional features that have created resistance to the message and inhibited effective implementation. The negative response to the (...) first educational campaign stressing condom use is described and contextualized in terms of Tswana ideas of morality and illness. Nor, as was initially expected, did the introduction of free ARV therapy operate to break the silence and stigma that had developed around the disease. Take-up was very slow, and did not operate to encourage widespread testing. In 2003, key policymakers in Botswana began to argue for a break with the AIDS position, with its emphasis on voluntarism, confidentiality and the human rights of patients. This resulted in routine testing being introduced in 2004. This links to a major argument running through the paper which is that the failure of policy cannot be attributed solely to the nature of local populations. Western cultural assumptions about also require critical examination. (shrink)

We are happy to present the Fall 2017 issue of Constellations journal. Included within are four diverse undergraduate papers ranging vastly in topic. We made a conscious effort to encourage submissions from a wide range of disciplines, provided the work could be broadly considered “historical” in scope. Interdisciplinary cooperation is something that we feel should be celebrated and promoted, and we are currently working with other student journals and organizations to bring an Arts-wide undergraduate research conference to life this spring.We (...) hope that you enjoy the variety of topics covered in this edition, and appreciate your interest and support in Constellations. We would especially like to thank our review team, without which Constellations would remain starcrossed... Assistant Editors:Lucas Nowosaid and Juliana McPhail Senior Reviewers:Bronte WellsSamantha KallenShelby CollingLiuba Gonzalez De ArmasYunus SahinAlex HoggAnastasia Pavlic General Reviewers:Emily HainesFarah KhalidMiranda RondeauStacy FairfulCassidy MunhollandDana KanervaLexi BrunnerDevonne BrandysKatie DuHeather Mark. (shrink)

Encouraged by the success of smoking denormalization strategies as a tobacco-control measure, public health institutions are adopting a similar approach to other health behaviors. For example, a recent controversial ad campaign in New York explicitly aimed to denormalize HIV/AIDS amongst gay men. Authors such as Scott Burris have argued that efforts like this are tantamount to stigmatization and that such stigmatization is unethical because it is dehumanizing. Others have offered a limited endorsement of denormalization/stigmatization campaigns as being justified on consequentialist (...) grounds; namely, that the potential public health benefits outweigh any stigmatizing side effects. In this paper, I examine and reject the blanket condemnation of stigmatization efforts in public health. I argue that the moral status of such efforts are best evaluated within a contractualist, as opposed to a consequentialist, framework. Contractualism in public health ethics asks whether a particular stigmatizing policy could be justified to reasonable individuals who do not know whether they will be affected by that policy. Using this approach, I argue that it is sometimes permissible for public health institutions to engage in health-related stigmatization. (shrink)

What we could call ‘relational non-interventionism’ holds that we have no general obligation to alleviate animal suffering, and that we do not typically have special obligations to alleviate wild animals’ suffering. Therefore, we do not usually have a duty to intervene in nature to alleviate wild animal suffering. However, there are a range of relationships that we may have with wild animals that do generate special obligations to aid—and the consequences of these obligations can be surprising. In this paper, it (...) is argued that we have special obligations to those animals we have historically welcomed or encouraged into our spaces. This includes many wild animals. One of the consequences of this is that we may sometimes possess obligations to actively prevent rewilding—or even to dewild—for the sake of welcomed animals who thrive in human-controlled spaces. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Ethnography as Christian Theology and Ethics ed. by Christian Scharen and Anna Marie VigenJohn KiessEthnography as Christian Theology and Ethics Edited by Christian Scharen and Anna Marie Vigen New York: Continuum, 2011. 304 pp. $29.95Over the past decade, an increasing number of Christian theologians and ethicists have turned to ethnographic methodologies in order to attend more closely to the complexities of lived faith and the bodily character of (...) theological knowledge. For those wishing to get a glimpse of what this looks like in practice, what its implications might be for theology and ethics, and how one might set off and do it oneself, this book is an excellent introduction.Editors Christian Scharen and Aana Marie Vigen organize the book into three parts. The first part orients readers to the use of ethnography in cultural anthropology and reviews the recent “ethnographic turn” in Christian theology and ethics. This is followed by a brief survey of theological critiques of social science and a defense of ethnography against these critiques. Scharen and Vigen argue that the use of ethnography, far from compromising the integrity of theology, has the potential to renew and enrich the discipline through the incorporation of long-overlooked forms of local wisdom. As a method attuned to practical, often noncognitive forms of knowledge, ethnography can help scholars move away from an exclusive focus on texts to a deeper consideration of the theological and ethical claims “embedded and embodied” in the lives and practices of everyday communities (xxii). [End Page 190]Naturally, the best argument for such an approach is exemplification. The second part of the book presents an impressive collection of ethnographic work from contexts as diverse as Chicago, Atlanta, Oregon, Chiapas, Nairobi, and Gulu. Contributors employ ethnography to compare pastoral leadership in two African American churches, track grassroots dissent on the issue of contraception among women living with HIV/AIDS, and reimagine the debate on physician-assisted suicide from the perspective of the poor and disabled. Particularly effective are Vicini’s exploration of the liturgical response of local churches to the legacy of violence in Chiapas and Whitmore’s critical examination of his own place as a white researcher in Northern Uganda, which makes hauntingly transparent the ethical complexities of the research process itself.The final part of the book offers a more practical how-to guide for those looking to do ethnography, covering such issues as institutional review board approval, interview methodology, and accountability to research subjects. This part, like the rest of the book, will be a gift for graduate students facing down a dissertation proposal or scholars contemplating the use of ethnography in their work. Admirably reflexive, vigilantly attentive to issues of power and privilege, and articulate about the ways that research can be a form of discipleship, one can only hope this book will succeed in its aim of encouraging other scholars to “go and do likewise.”Those who have already incorporated ethnographic techniques in their scholarship or who are looking for a fuller articulation of the relation between ethnography, ethics, and theology may find themselves less satisfied with the book. Its treatment of existing options (virtue ethics, Catholic social ethics) and thinkers (David Ford, Stanley Hauerwas, and John Milbank) is thin, and a number of key figures in the broader story of the ethnographic turn in theology (Karl Barth, Dietrich Bonhoeffer, and Hans Frei) are conspicuously missing. Their absence is felt particularly strongly in the unanswered questions the volume provokes, including how to account for God’s difference when appeals to experience become primary (Barth), and how to avoid positivism when appeals to the “reality” of the church become the point of departure for ecclesiology (Bonhoeffer).Such provocations, however, are reminders that we are still at the very early stages of the ethnographic turn in Christian theology and ethics. If this volume is any indication, the future of this exciting intersection of thought and practice looks very promising indeed. [End Page 191]John KiessLoyola University MarylandCopyright © 2013 Society of Christian Ethics... (shrink)

What we could call ‘relational non-interventionism’ holds that we have no general obligation to alleviate animal suffering, and that we do not typically have special obligations to alleviate wild animals’ suffering. Therefore, we do not generally have a duty to intervene in nature to alleviate wild animal suffering. However, there are a range of relationships that we may have with wild animals that do generate special obligations to aid – and the consequences of these obligations can be surprising. In this (...) paper, I argue that we have special obligations to those animals we have historically welcomed or encouraged into our spaces. This includes many wild animals. One of the consequences of this is that we may sometimes possess obligations to actively prevent rewilding – or even to dewild – for the sake of welcomed animals who thrive in human-controlled spaces. (shrink)

Violent conflicts in emerging democracies or societies in transition threaten the stability of state governance institutions, which brings about insecurity of lives, property and deepens the vicious cycle of poverty and criminality in Africa. The first responsibility of any government is to provide security of lives and property. At no time since Nigeria’s civil war has the country witnessed the resurgence of violence and insecurity that claims hundreds of lives weekly. It is a sectarian insurgence of multiple dimensions. This article (...) makes the case that Boko Haram is not just a religious phenomenon but a reflection of a so- cio-political, economic and ethnic problem caused by bad governance. As a result, Boko Haram has witnessed a cross-border influence and impact which has expanded its frontiers beyondNigeriato neighboring countries in the West African region. The theoretical framework employed in this article posits that Boko Haram has its roots fundamentally in poverty caused by bad governance in the Northern Moslem bend, in Nigeria and the West African Region where corruption, human rights violations, marginalization of cultural, political and religious groups have created the situation whereby weak state structures have abysmally failed to deliver on the development promises made during elections. So the emergence of Nigeria’s Boko Haram violence, as a result of the street poverty and the rise of unemployed street beggars, popularly known as Almajiris, and their use for electoral and party violence, was encouraged by the neglect and abandonment of the masses by the governors and other elected leaders. The expansion and consolidation of the Boko Haram insurgence to other parts of the country and neighboring West African nations was made possible by the already existing failed state institutions, bad governance and corruption and the existing band of small criminal sectarian groups that depend upon their survival on aids from Al Quaeda, drug gangs and sea piracy. The religious dimension is a marginal factor fueled by fundamental socio-economic and political variables which have been thrown up in the first place by bad governance and leadership in Nigeria. (shrink)

Ambiguity in the athlete’s perception and description of pain that opens the door to a series of reinterpretations of athletic experience and events that argue the development of an increasingly inauthentic relation to self and others on the part of those who consume performance as third parties (spectators) and ultimately those who produce it first hand (athletes). The insertion of the spectator into the sport situation as a consumer of the athlete’s activity and the preference given to spectator interpretation shift (...) control of meaning away from the athlete and encourage a demand for athlete suffering in aid of the spectator’s own need for meaning. Through discussions of the function of narrative in sport spectacle, the witnessing role of spectators, and the phenomenon of vicarious substitution, I discuss the representation of the athlete as a character ideal and moral exemplar. At a more developed level of external interpretation, the athlete (or team) becomes the champion of the spectator, the role model or focal point of civic pride whose victory asserts the ascendence of my team and town over yours; and finally, the athlete or team is the intentional object of fan identification: my team is me. I conclude that the existential commitment of the spectator as devoted fan is an inauthentic one. (shrink)

Ambiguity in the athlete’s perception and description of pain that opens the door to a series of reinterpretations of athletic experience and events that argue the development of an increasingly inauthentic relation to self and others on the part of those who consume performance as third parties (spectators) and ultimately those who produce it first hand (athletes). The insertion of the spectator into the sport situation as a consumer of the athlete’s activity and the preference given to spectator interpretation shift (...) control of meaning away from the athlete and encourage a demand for athlete suffering in aid of the spectator’s own need for meaning. Through discussions of the function of narrative in sport spectacle, the witnessing role of spectators, and the phenomenon of vicarious substitution, I discuss the representation of the athlete as a character ideal and moral exemplar. At a more developed level of external interpretation, the athlete (or team) becomes the champion of the spectator, the role model or focal point of civic pride whose victory asserts the ascendence of my team and town over yours; and finally, the athlete or team is the intentional object of fan identification: my team is me. I conclude that the existential commitment of the spectator as devoted fan is an inauthentic one. (shrink)

When considering the possibility of intervening in nature to aid suffering nonhuman animals, we can ask about moral philosophy, which concerns the actions of individuals, or about political philosophy, which concerns the apparatus of the state. My focus in this paper is on the latter, and, in particular, the proposal from Sue Donaldson and Will Kymlicka that nonhuman animals should be offered sovereignty rights over their territories. Such rights, among other things, seriously limit the occasions on which we might intervene (...) in the affairs of the sovereign “community” in question, even if such intervention is in the interests of some of its members. In this paper, I first outline Donaldson and Kymlicka’s proposal as well as (what I call) the failed state objection – the suggestion that, if nonhuman animals are to be considered sovereign, then their “communities” are failed states. I then critically examine Donaldson and Kymlicka’s responses to the failed state objection, arguing that they fail. However, I claim that the failed state objection, even if successful, is not fatal for Donaldson and Kymlicka’s account of nonhuman sovereignty, and that the objection could be read as an internal critique of their project. There are at least two ways that this could be so: First, we could retain a sovereignty account but nonetheless argue for day-to-day intervention to alleviate suffering in nature, or, second, we could argue that though nonhuman animals live in failed states, there are other good reasons to oppose day-to-day intervention. In closing, I compare Donaldson and Kymlicka’s claims about sovereignty to another recent proposal, namely, John Hadley’s account of nonhuman animals as property holders. I suggest that the two proposals are not so far apart, but suggest that neither is appropriate for immediate implementation. Instead, the focus of activists keen to deploy political tools to aid those nonhuman animals suffering in nature should be on changing the ways that nonhuman animals are perceived and treated more generally. On the simplest level, this means adopting veganism and encouraging those around us to do the same. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 20 (2000) 84-89 [Access article in PDF] Christian Views on Ritual Practice Concerning Ritual Practice and Ethics in Buddhism Donald W. MitchellPurdue UniversityThe three papers presented by this panel have given me a much greater knowledge about, and appreciation for, the relationship between ritual practice and ethical action in Tibetan, Zen, and Nichiren Buddhism. I would like to respond to each of the papers one at a (...) time from a Christian point of view by making certain comparisons with the connection between Christian ethics and ritual practice. Let me begin by raising a comparative five points concerning Stephanie Kaza's wonderful description [End Page 84] and insightful analysis of the function of ritual in nurturing authentic personhood in Zen.First, it seems that the practice of ritual in Zen demands a degree of self-sacrifice which in turn aids in the cultivation of the virtue of selflessness. For example, Kaza says that through the participation in ritual practice, "the student is freed from his or her own individual designs and preferences... not asking any questions but just trying to do it better and more fully each time." Or elsewhere Kaza concludes, "Zen ritual is a training ground for intensive practice in giving up the small ego-bound self." In a similar way for the Christian, the self-sacrifice demanded in ritual performance can be seen as nurturing selflessness in the context of community--as aiding one in giving up one's ego in order to participate more fully in the communal life of agape. But more than this, the value of selfless participation in the Christian community that is reinforced by the ritual is connected to a call for future action: It calls one to contribute selflessly together with others to building the reign of God. In Christianity, the performing of ritual with others sensitizes one to the fact that he or she is part of the church working for a collective love and unity that manifests in human community the very holiness of the unity and love of the Trinity. One is thus called within the sacred ritual environment to bring this love and unity into one's everyday environment through ethical behavior.Second, besides selflessness, another positive quality that is cultivated through ritual practice is mindful awareness. As Kaza states in regard to the meal ritual, this practice "cultivates mindful awareness... if one merges wholeheartedly with the process, the meal itself becomes a lesson in co-dependent arising." In other words, the ritual performance brings to mind an awareness of fundamental reality according to Buddhism, namely, dependent arising. Being aware of mutual interdependence brings a deeper sense of compassion for all beings, and a more focused inspiration to act morally on their behalf. So, too, in Christianity, ritual is seen to be a "social drama" that brings to awareness the reality of the mystical body of Christ, the church, being the social form of Jesus Christ in the world. Ritual, as a sacred and dramatic social manifestation of the church, brings this communal reality of Christ to the Christian's mindful awareness by breaking into the secular structures of ordinary consciousness. Furthermore, the ritual also guides, forms, inspires, strengthens, and encourages the participants to re-enter that ordinary life committed to living the values and ideals expressed in the ritual. The formative power of the ritual performance lies, in part, in the fact that ritual ties ideas, values, and ideals to sensual and emotional stimuli in a way that, in the words of Victor Turner, "connects the obligatory into the desirable" (The Forest of Symbols, 1967).Third, Kaza shows how ritual in Zen helps to convey the tradition and promote solidarity within the community. She says that ritual in Zen: "promotes healthy sangha through sharing the stability and continuity of traditional practice forms... which generate a culture of the larger body--familiar and supportive." In Christianity, too, the multidimensional expressions of the ritual performance--the physical movements, sounds, music, smells, verbal articulations, etc.--all blend together in ways that pass on certain ideas, ideals, and values... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 20 (2000) 84-89 [Access article in PDF] Christian Views on Ritual Practice Concerning Ritual Practice and Ethics in Buddhism Donald W. MitchellPurdue UniversityThe three papers presented by this panel have given me a much greater knowledge about, and appreciation for, the relationship between ritual practice and ethical action in Tibetan, Zen, and Nichiren Buddhism. I would like to respond to each of the papers one at a (...) time from a Christian point of view by making certain comparisons with the connection between Christian ethics and ritual practice. Let me begin by raising a comparative five points concerning Stephanie Kaza's wonderful description [End Page 84] and insightful analysis of the function of ritual in nurturing authentic personhood in Zen.First, it seems that the practice of ritual in Zen demands a degree of self-sacrifice which in turn aids in the cultivation of the virtue of selflessness. For example, Kaza says that through the participation in ritual practice, "the student is freed from his or her own individual designs and preferences... not asking any questions but just trying to do it better and more fully each time." Or elsewhere Kaza concludes, "Zen ritual is a training ground for intensive practice in giving up the small ego-bound self." In a similar way for the Christian, the self-sacrifice demanded in ritual performance can be seen as nurturing selflessness in the context of community--as aiding one in giving up one's ego in order to participate more fully in the communal life of agape. But more than this, the value of selfless participation in the Christian community that is reinforced by the ritual is connected to a call for future action: It calls one to contribute selflessly together with others to building the reign of God. In Christianity, the performing of ritual with others sensitizes one to the fact that he or she is part of the church working for a collective love and unity that manifests in human community the very holiness of the unity and love of the Trinity. One is thus called within the sacred ritual environment to bring this love and unity into one's everyday environment through ethical behavior.Second, besides selflessness, another positive quality that is cultivated through ritual practice is mindful awareness. As Kaza states in regard to the meal ritual, this practice "cultivates mindful awareness... if one merges wholeheartedly with the process, the meal itself becomes a lesson in co-dependent arising." In other words, the ritual performance brings to mind an awareness of fundamental reality according to Buddhism, namely, dependent arising. Being aware of mutual interdependence brings a deeper sense of compassion for all beings, and a more focused inspiration to act morally on their behalf. So, too, in Christianity, ritual is seen to be a "social drama" that brings to awareness the reality of the mystical body of Christ, the church, being the social form of Jesus Christ in the world. Ritual, as a sacred and dramatic social manifestation of the church, brings this communal reality of Christ to the Christian's mindful awareness by breaking into the secular structures of ordinary consciousness. Furthermore, the ritual also guides, forms, inspires, strengthens, and encourages the participants to re-enter that ordinary life committed to living the values and ideals expressed in the ritual. The formative power of the ritual performance lies, in part, in the fact that ritual ties ideas, values, and ideals to sensual and emotional stimuli in a way that, in the words of Victor Turner, "connects the obligatory into the desirable" (The Forest of Symbols, 1967).Third, Kaza shows how ritual in Zen helps to convey the tradition and promote solidarity within the community. She says that ritual in Zen: "promotes healthy sangha through sharing the stability and continuity of traditional practice forms... which generate a culture of the larger body--familiar and supportive." In Christianity, too, the multidimensional expressions of the ritual performance--the physical movements, sounds, music, smells, verbal articulations, etc.--all blend together in ways that pass on certain ideas, ideals, and values... (shrink)

Retroviruses replicate by inserting their proviral DNA into host cell chromosomes, usually in cells of the immune system. Nevertheless, an efficacious and safe subunit recombinant vaccine has been prepared against the feline leukemia retrovirus of cats. Because of high rates of morbidity and mortality, particularly in the developing world, the development of a vaccine against human immunodeficiency virus type I (HIV-I) has become very important. The very high rate of mutation or variation of lentiviruses, such as HIV-I, makes a vaccine (...) against this virus particularly difficult. Active research must be encouraged to design a modified envelope vaccine molecule of gp120 subtype E or C for trials in appropriate developing country settings. (shrink)

Comparative political theory is at best an embryonic and marginalized endeavor. As practiced in most Western universities, the study of political theory generally involves a rehearsal of the canon of Western political thought from Plato to Marx. Only rarely are practitioners of political thought willing (and professionally encouraged) to transgress the canon and thereby the cultural boundaries of North America and Europe in the direction of genuine comparative investigation. Border Crossings presents an effort to remedy this situation, fully launching a (...) new era in political theory. Thirteen scholars from around the world examine the various political traditions of West, South, and East Asia and engage in a reflective cross-cultural discussion that belies the assumptions of an Asian "essence" and of an unbridgeable gulf between West and non-West. The denial of essential differences does not, however, amount to an endorsement of essential sameness. As viewed and as practiced by contributors to this ground-breaking volume, comparative political theorizing must steer a course between uniformity and radical separation--this is the path of "border crossings.". (shrink)

In God and Mystery in Words David Brown uses the way in which poetry and drama have in the past opened people to the possibility of religious experience as a launch pad for advocating less wooden approaches to Christian worship today. So far from encouraging imagination and exploration, hymns and sermons now more commonly merely consolidate belief. Again, contemporary liturgy in both its music and its ceremonial fails to take seriously either current dramatic theory or the sociology of ritual. Yet (...) this was not always so. Imagery and hymns mattered, liturgial msic encouraged a sense of drama, sermons required rhetoric. In a characteristically stimulatling and inspiringly expansive study, that ranges from ancient Greek drama to modern poetry, from the meaning of the Logos to the history of vestments, David Brown pleads for a much wider focus on the kind of factors that aid experience of God. (shrink)

This paper argues that it is morally wrong for the affluent not to contribute money or time to famine relief. It begins by endorsing an important methodological line of objection against the most prominent philosophical advocate of this claim, Peter Singer. This objection attacks his strategy of invoking a principle the acceptability of which is apparently based upon its conformity with "intuitive" moral judgements in order to defend a strongly counterintuitive conclusion. However, what follows is an argument for that counterintuitive (...) conclusion which claims to circumvent the methodological objection, and moreover without having to resort to a justificational ethical theory. How can this be done? Merely by appealing, it is maintained, to the simple practical considerations which are characteristic of the virtues of kindness and justice. Accordingly, an account of those virtues, outlining the structure of the practical reasoning of their possessors, occupies a central place in the argument. The paper displays the resources for normative argument of a "virtue ethics;" but it claims also that its conclusion cannot be escaped by the adherents of any plausible moral outlook. And this yields a further conclusion. All moral outlooks, and not only those which equate the moral point of view with the impartial point of view, face a "problem of demandingness" - for it seems to be a corollary of the argument that if one is to be living a life which is not immoral, one is precluded from pursuing practically any source of personal satisfaction. (shrink)

ABSTRACT AIDS raises the moral problem of confidentiality because those in sexual contact with the patient may contract a life‐threatening and incurable disease. Medicine has a tradition in which a patient's condition is regarded as confidential information held by the doctor alone. In this case there is a clear moral inclination to inform those at risk from the disease. In most cases no problem will arise but when it does the moral justification for a violation of confidentiality comes into question. (...) Confidentiality is important because of our respect for certain human values and their importance to our patient. Where that patient acts so as to disregard the welfare of others with whom they are in close relationship, those values are lacking. This lack warrants a departure from our normal canons and provokes a suspension of normal moral privileges. The contention that any transgression, however slight, could be held to justify such a response posits a slope down which we, in fact, have no tendency to slide. (shrink)

Although “you are what you eat” is a well-worn cliché, personal identity does not figure prominently in many debates about the ethics of eating interventions. This paper contributes to a growing philosophical literature theorizing the connection between eating and identity and exploring its implications for eating interventions. I explore how “identity-policing,” a key mechanism for the social constitution and maintenance of identity, applies to eating and trace its ethical implications for eating interventions. I argue that identity policing can be harmful (...) and that eating interventions can subject people to these harms by invoking identity policing qua intervention strategy or by encouraging people to eat in ways that subject them to policing from others. While these harms may be outweighed by the benefits of the intervention being promoted, they should nonetheless be acknowledged and accounted for. To aid in these evaluations, I consider factors that modulate the presence and severity of identity-policing and discuss strategies for developing less harmful eating interventions. I conclude by considering the relationship between identity-policing and identity loss caused by long-term diet change. This paper contributes to the centering of identity in food ethics and to a more comprehensive picture of identity’s ethical importance for eating interventions. (shrink)

Uganda is invoked as a metaphor for a host of arguments and insights about HIV/AIDS. However, much of what has been asserted about the country is not based on the available evidence. This paper reviews findings by epidemiologists and anthropologists, and draws on the author’s experiences of researching in the country since the early 1980s. It comments on various myths about HIV/AIDS in Uganda, including myths about the origin and dissemination of the disease, about the links between HIV/AIDS and war, (...) and about declining rates of infection. It shows that much less is known about Uganda than is commonly supposed, and it offers some alternative hypotheses for interpreting HIV prevalence and incidence data. In particular it draws attention to the importance of mechanisms for social compliance. It concludes by raising concerns about the current enthusiasm for provision of anti-retroviral drugs. (shrink)

Recent publications by Pogge ( Global ethics: seminal essays. St. Paul: Paragon House 2008 ) and by Singer ( The life you can save: acting now to end world poverty. New York: Random House 2009 ) have resuscitated a debate over the justifiability of famine relief between Singer and ecologist Garrett Hardin in the 1970s. Yet that debate concluded with a general recognition that (a) general considerations of development ethics presented more compelling ethical problems than famine relief; and (b) some (...) form of development would be essential to avoiding the problems of growth noted by Hardin. Better than renewing the debate, we should recognize two points. First, food needs do indeed evoke a moral response that is more direct and compelling than the philosophical positions often generated to rationalize a duty to bring aid. As such the argument for feeding hungry people cannot be generalized into a paradigm for development ethics without distortions that undercut the morally valid elements in Singer’s original argument. Second, contrary to prevailing assumptions in present day development ethics, food aid and famine relief continue to be important priorities for international agencies, notably the World Food Program. Emergency food assistance, the nominal topic of Singer’s original article, thus is an important issue for agricultural as well as development ethics, though one that should indeed be seen as distinct from more complex duties to address the conditions of chronic poverty and underdevelopment. (shrink)

BackgroundIn 2004, patient advocate groups were major players in helping pass and implement significant public policy and funding initiatives in stem cells and regenerative medicine. In the following years, advocates were also actively engaged in Washington DC, encouraging policy makers to broaden embryonic stem cell research funding, which was ultimately passed after President Barack Obama came into office. Many advocates did this because they were told stem cell research would lead to cures. After waiting more than 10 years, many of (...) these same patients are now approaching clinics around the world offering experimental stem cell-based interventions instead of waiting for scientists in the US to complete clinical trials. How did the same groups who were once the strongest supporters of stem cell research become stem cell tourists? And how can scientists, clinicians, and regulators work to bring stem cell patients back home to the US and into the clinical trial process?DiscussionIn this paper, we argue that the continued marketing and use of experimental stem cell-based interventions is problematic and unsustainable. Central problems include the lack of patient protection, US liability standards, regulation of clinical sites, and clinician licensing. These interventions have insufficient evidence of safety and efficacy; patients may be wasting money and time, and they may be forgoing other opportunities for an intervention that has not been shown to be safe and effective. Current practices do not contribute to scientific progress because the data from the procedures are unsuitable for follow-up research to measure outcomes. In addition, there is no assurance for patients that they are receiving the interventions promised or of what dosage they are receiving. Furthermore, there is inconsistent or non-existent follow-up care. Public policy should be developed to correct the current situation.ConclusionThe current landscape of stem cell tourism should prompt a re-evaluation of current approaches to study cell-based interventions with respect to the design, initiation, and conduct of US clinical trials. Stakeholders, including scientists, clinicians, regulators and patient advocates, need to work together to find a compromise to keep patients in the US and within the clinical trial process. Using HIV/AIDS and breast cancer advocate cases as examples, we identify key priorities and goals for this policy effort. (shrink)

While it is largely agreed upon that solidarity is a kind of unity among persons, this agreement is short-lived – for if solidarity involves unity, what kind of unity is this? That is, does solidarity coalesce around shared identity or simply fellow-feeling? Shared action or fate? Or is solidarity merely a matter of commitment to a particular cause to achieve certain ends? Below, I look to examples of Mutual Aid to reject a piece-meal model of solidarity (where solidarity is this (...) but not that) in favor of a more pluralistic account. The notion of solidarity need not be constrained, all or nothing, by a specific strain of interpretation. Instead, we should recognize that solidarity is a matter of variety and degree. (shrink)

This essay examines the many problems with public and private development aid and argues that global liberalization of trade and immigration would have a greater direct effect in reducing global poverty. It also examines and rejects the view that people in rich countries have a strong moral obligation to give to the global poor. Such an obligation is in tension with an ethic that prizes personal projects. A political morality of equal respect and concern is congenial not with foreign aid, (...) but with recognizing the agency of the global poor by lifting the many obstacles they currently face to participating in the market as producers and consumers. (shrink)

This article analyses a recent discourse of responsibility that accompanies states’ foreign aid provision. States adopt this discourse of National Social Responsibility to show their complian...