For years a debate has raged within the various literatures of philosophy, psychiatry, and psychology over whether, and to what degree, the concepts that characterize psychopathology are social constructions that reflect cultural values. While the majority position among philosophers has been normativist, i.e., that the conception of a mental disorder is value-laden, a vocal and cogent minority have argued that psychopathology results from malfunctions that can be described by terminology that is objective and scientific. Scientists and clinicians have tended to (...) endorse the objectivist position, with some notable exceptions. (shrink)

Over 115 000 people are waiting for life-saving organ transplants, of whom a small fraction will receive transplants and many others will die while waiting. Existing efforts to expand the number of available organs, including increasing the number of registered donors and procuring organs in uncontrolled environments, are crucial but unlikely to address the shortage in the near future and will not improve donor/recipient compatibility or organ quality. If successful, organ bioengineering can solve the shortage and improve functional outcomes. Studying (...) manufactured organs in animal models has produced valuable data, but is not sufficient to understand viability in humans. Before risking manufactured organ experimentation in living humans, study of bioengineered organs in recently deceased humans would facilitate evaluation of the function of engineered tissues and the complex interactions between the host and the transplanted tissue. Although such studies do not pose risk to human subjects, they pose unique ethical challenges concerning the previous wishes of the deceased, rights of surviving family members, effective operation and fair distribution of medical services, and public transparency. This article investigates the ethical, legal and social considerations in performing engineered organ research on the recently deceased. (shrink)

As the usual regulatory framework did not fit well during the last Ebola outbreak, innovative thinking still needed. In the absence of an outbreak, randomised controlled trials of clinical efficacy in humans cannot be done, while during an outbreak such trials will continue to face significant practical, philosophical, and ethical challenges. This article argues that researchers should also test the safety and effectiveness of novel vaccines in wild apes by employing a pluralistic approach to evidence. There are three reasons to (...) test vaccines in wild populations of apes: i) protect apes; ii) reduce Ebola transmission from wild animals to humans; and iii) accelerate vaccine development and licensing for humans. Data obtained from studies of vaccines among wild apes and chimpanzees may even be considered sufficient for licensing new vaccines for humans. This strategy will serve to benefit both wild apes and humans. (shrink)

Research involving recently deceased humans that are physiologically maintained following declaration of death by neurologic criteria—or ‘research involving the recently deceased’—can fill a translational research gap while reducing harm to animals and living human subjects. It also creates new challenges for honouring the donor’s legacy, respecting the rights of donor loved ones, resource allocation and public health. As this research model gains traction, new empirical ethics questions must be answered to preserve public trust in all forms of tissue donation and (...) in the practice of medicine while respecting the legacy of the deceased and the rights of donor loved ones. This article suggests several topics for immediate investigation to understand the attitudes and experiences of researchers, clinical collaborators, donor loved ones and the public to ensure research involving the recently deceased advances ethically. (shrink)

The 11 original regions for organ allocation in the United States were determined by proximity between hospitals that provided deceased donors and transplant programs. As liver transplants became more successful and demand rose, livers became a scarce resource. A national system has been implemented to prioritize liver allocation according to disease severity, but the system still operates within the original procurement regions, some of which have significantly more deceased donor livers. Although each region prioritizes its sickest patients to be liver (...) transplant recipients, the sickest in less liver-scarce regions get transplants much sooner and are at far lower risk of death than the sickest in more liver-scarce regions. This has resulted in drastic and inequitable regional variation in preventable liver disease related death rate.A new region districting proposal – an eight district model – has been carefully designed to reduce geographic inequities, but is being fought by many transplant centers that face less scarcity under the current model. The arguments put forth against the new proposal, couched in terms of fairness and safety, will be examined to show that the new system is technologically feasible, will save more lives, and will not worsen socioeconomic disparity. While the new model is likely not perfect, it is a necessary step toward fair allocation. (shrink)

The scarcity of human organs requires the transplant community to make difficult allocation decisions. This process begins at individual medical centers, where transplant teams decide which patients to place on the transplant waiting list. Each transplant center utilizes its own listing criteria to determine if a patient is eligible for transplantation. These criteria have historically considered preexisting affective and psychotic disorders to be relative or absolute contraindications to transplantation. While attitudes within the field appear to be moving away from this (...) practice, there is no data to confirm that eligibility criteria have changed. There are no nationwide guidelines detailing the manner in which affective and psychotic disorders should impact transplant eligibility. Individual transplant centers thus form their own transplant eligibility criteria, resulting in significant inter-institution variability. Data from the 1990s indicates that the majority of transplant programs considered certain psychiatric illnesses, such as active schizophrenia, to be absolute contraindications to transplantation. A review of literature reveals that no comprehensive data has been collected on the topic since that time. Furthermore, the limited data available about current practices suggests that psychiatric illness continues to be viewed as a contraindication to transplantation at some transplant centers. In light of this finding, we review psychiatric literature that examines the impact of affective and psychotic disorders on transplant outcomes and conclude that the presence of these disorders is not an accurate predictor of transplant success. We then discuss the requirements of justice as they relate to the creation of a just organ allocation system. We conclude that transplant eligibility criteria that exclude patients with affective and psychotic disorders on the basis of their psychiatric diagnosis alone are unjust. Just listing criteria must incorporate only those factors that have a causative effect on posttransplant morbidity and mortality. Justice also demands that we eliminate current inter-institution practice variations in favor of national transplant eligibility criteria. Given the limited data available about current practices, we call for an updated study investigating the manner in which affect and psychotic disorders impact transplant eligibility determinations. (shrink)

Sports are more than just "games". They can unite countries, start wars, and revolutionize views on race, class, and gender. Through works from philosophy, sociology, medicine, and law, this collection explores intersections of sports and ethics, and identifies the immense role of sports in shaping and reflecting social values.

This collection of essays emphasizes society s increasingly responsible engagement with ethical challenges in emerging medical technology. Expansion of technological capacity and attention to patient safety have long been integral to improving healthcare delivery but only relatively recently have concepts like respect, distributive justice, privacy, and autonomy gained some power to shape the development, use, and refinement of medical tools and techniques. Medical ethics goes beyond making better medicine to thinking about how to make the field of medicine better. These (...) essays showcase several ways in which modern ethical thinking is improving safety, efficacy and efficiency of medical technology, increasing access to medical care, and empowering patients to choose care that comports with their desires and beliefs. Included are complimentary ethical approaches as well as compelling counter-arguments. Together, the articles demonstrate how improving the quality of medical technology relies on every stakeholder -- not just medical researchers and scientists -- to assess each given technology s strengths and pitfalls. This collection also portends one of the next major issues in the ethics of medical technology: developing the requisite moral framework to accompany shifts toward patient-centred personalized healthcare.". (shrink)

Many of the contributions offer personal reflections on those events and experiences that helped shape their response to the general issue of faith seeking understanding."--BOOK JACKET.

This book contains a thorough and balanced series of dialogues introducing key topics in philosophy of religion, such as: the existence and nature of God, the ...

Years ago, one of us had the opportunity to talk with a starting guard in the National Basketball Association about his health care. The player, then a rookie, did not have his own personal doctor. Instead, he received his health care from the team doctor. This athlete was very well paid and could have received care anywhere he wished in the area. But he came from a very poor neighborhood. Growing up, he said, he had no health care other than (...) hearing and eye tests done at his school and maybe vaccinations given by the school nurse. The player said he now felt fine and trusted his team to look out for his health since they were paying him a lot of money and obviously wanted him on the court. While it might seem obvious that conflicts of role could arise for doctors working simultaneously for a team and for an athlete—wanting to please coaches, owners, and maybe fans while looking out for the athletes on the team—that is not how this young player saw things. He trusted his team and those who worked for them, and he figured that their interest in keeping him healthy overlapped nicely with his interest in staying healthy. As someone who did not get much access to health care as a child and had little need for it, he did not have concerns about conflicts of interest and second opinions foremost in his mind. But as is clear from a recent scandal involving the National Football League and concussion research, there are reasons for concern when athletes deal with health care workers paid by their teams. (shrink)

Doctoral programs at U.S. universities play a critical role in the development of human resources both in the United States and abroad. This volume reports the results of an extensive study of U.S. research-doctorate programs in five broad fields: physical sciences and mathematics, engineering, social and behavioral sciences, biological sciences, and the humanities. Research-Doctorate Programs in the United States documents changes that have taken place in the size, structure, and quality of doctoral education since the widely used 1982 editions. This (...) update provides selected information on nearly 4,000 doctoral programs in 41 subdisciplines at 274 doctorate-granting institutions. This volume also reports the results of the National Survey of Graduate Faculty, which polled a sample of faculty for their views on the scholarly quality of program faculty and the effectiveness of doctoral programs in preparing research scholars/scientists. This much-anticipated update of such an essential reference will be useful to education administrators, university faculty, and students seeking authoritative information on doctoral programs. (shrink)

The men and women who serve in the armed forces, in the words of Major General Joseph Caravalho, “sign a blank check, co-signed by their families, payable to the Army, Navy, Air Force, or Marines, up to and including their lives.” It is human nature to consider such a pact in polarized terms; the pact concludes in either a celebratory homecoming or funereal mourning. But in reality, surviving catastrophic injury may incur the greatest debt. The small but real possibility of (...) losing the ability to bear biological children due to genitourinary combat injury has been a topic of discussion in hushed tones, behind closed doors. But as policy changes move the conversation into the open, we must be fully aware of the far-reaching and long-term impacts of decisions on those who have sustained genitourinary injury. In January 2016, Secretary of Defense Ashton Carter outlined a set of reforms that would improve the quality of life for military families by recognizing the importance of maintaining fertility, even in the face of severe injury. This first promising step could build a solid foundation of insuring fertility preservation for wounded service members with genitourinary injury, and it could set a precedent beyond the military for insuring treatment for people who have lost their reproductive capacity. Thus, the ethical challenges raised by the new policy require careful analysis. (shrink)

'This book is an excellent, theoretically sound and politically relevant reader', Professor Wolfschaefer, Universitat des Bundeswehr, Hamburg 'Up to date complete overview of European monetary and fiscal policy issues. Highly readable, good mix of theory and data' 'I think the book contains a wealth of useful, precise information, presented in a straightforward, readable way in a quintessentially comparative perspective', Dr M Mclean, Royal Holloway University 'Excellent treatment - quite comprehensive, full references, accessible for non-economists', Charlotte Bretherton, Liverpool John Moores Univesity (...) 'A useful addition to student literature', MJ Macmillan, Exeter University 'This is a top class book and does not limit itself to assessing the adequacy of the European political economy to the precepts of advanced monetary economics...This book is an excellent tool for teaching EMU economics, and raising the level of EMU economics in the reaserch-field of international political economy. Students and scholars will appreciate the explicit assessment the authors make of complex economic issues, and their unbiased stance in the study of EMU economic and political interplay.' Miriam L.Campamella, Jean Monnet Professor, Faculty of Political Science, University of Turin. ECSA Review, Winter 2001This textbook offers a fresh and comprehensive examination of European monetary and fiscal policy in the third stage of Economic and Monetary Union. Professors Eijffinger and de Haan give a brief history of European economic integration before the transition to EMU, and continue with a comprehensive analysis of institutions, legislation, and policies. Their analysis includes the functions and goals of the European Central Bank, the Treaty on European Union, the Stability and Growth Pact, and the harmonization of taxes. Other topics discussed include the targets and instruments of European monetary policy, the integration of European financial markets, and the competition between financial institutions in Europe. (shrink)

Dans son article, Gaëlle Ferré propose une analyse de la production gestuelle de personnes souffrant d'aphasie, fluente ou non-fluente, qu’elle compare avec les gestes effectués par des locuteurs ne souffrant d'aucun trouble du langage. Elle vise à mieux comprendre ce qu'il advient des gestes lors des nombreuses dysfluences de la parole en tant qu’elles sont provoquées par le trouble du langage. Elle tente d'éclairer les liens qui existent entre parole et gestualité dans l'interaction multimo...

Abstract:Facial transplantation is emerging as a therapeutic option for self-inflicted gunshot wounds. The self-inflicted nature of this injury raises questions about the appropriate role of self-harm in determining patient eligibility. Potential candidates for facial transplantation undergo extensive psychosocial screening. The presence of a self-inflicted gunshot wound warrants special attention to ensure that a patient is prepared to undergo a demanding procedure that poses significant risk, as well as stringent lifelong management. Herein, we explore the ethics of considering mechanism of injury (...) in the patient selection process, referring to the precedent set forth in solid organ transplantation. We also consider the available evidence regarding outcomes of individuals transplanted for self-inflicted mechanisms of injury in both solid organ and facial transplantation. We conclude that while the presence of a self-inflicted gunshot wound is significant in the overall evaluation of the candidate, it does not on its own warrant exclusion from consideration for a facial transplantation. (shrink)

I argue that there are at least two concepts of law of nature worthy of philosophical interest: strong law and weak law. Strong laws are the laws investigated by fundamental physics, while weak laws feature prominently in the “special sciences” and in a variety of non-scientific contexts. In the first section, I clarify my methodology, which has to do with arguing about concepts. In the next section, I offer a detailed description of strong laws, which I claim satisfy four criteria: (...) (1) If it is a strong law that L then it also true that L; (2) strong laws would continue to be true, were the world to be different in some physically possible way; (3) strong laws do not depend on context or human interest; (4) strong laws feature in scientific explanations but cannot be scientifically explained. I then spell out some philosophical consequences: (1) is incompatible with Cartwright’s contention that “laws lie” (2) with Lewis’s “best-system” account of laws, and (3) with contextualism about laws. In the final section, I argue that weak laws are distinguished by (approximately) meeting some but not all of these criteria. I provide a preliminary account of the scientific value of weak laws, and argue that they cannot plausibly be understood as ceteris paribus laws. (shrink)

Reflecting the Past: Place, Language, and Principle in Japan’s Medieval Mirror Genre. By Erin L. Brightwell. Harvard East Asian Monograph Series, vol. 433. Cambridge, MA: Harvard University Asia Center, 2020. Pp. xiii + 327. $60.

RésuméCet article démontre qu'un exemple cité par Ernest Adams pour montrer que l'implication matérielle n'est pas l'interprétation correcte de la sémantique de la conjonction de subordination si, n'est rien d'autre qu'un corollaire d'une observation d'jà faite par Lewis Carroll, il y a cent ans, dans l'exposition de son paradoxe du salon de coiffure.

L ’article examine des armoiries situées sur la margelle d’un puits dans la forteresse médiévale d’Arta. Ces armoiries ont été publiées en 1936 par A. Orlandos, qui les a attribuées à la famille italienne dite des Orsini, présente à Arta au xive s. L ’article démontre qu’il faut, au contraire, les attribuer à une autre famille italienne, celle des Tocco, ayant régné à Arta de 1416 à 1449. Il décrit leur composition associant aux armoiries de la famille Tocco elle‑même celles (...) des princes de Tarente, empereurs titulaires de Constantinople, ainsi que la célèbre aigle bicéphale byzantine. Il étudie la signification des armoiries en les replaçant dans le contexte de l’héraldique familiale des Tocco, de celle des familles occidentales liées au monde byzantin et de celle de Byzance. Enfin, il étudie leur postérité dans les armoiries ultérieures des descendants de la famille. (shrink)

The limits of ‘criterial rationality’ (that is, rationality as rule‐following) have been extensively explored in the philosophy of science by Kuhn and others. In this paper I attempt to extend this line of enquiry into mathematics by means of a pair of case studies in early algebra. The first case is the Ars Magna (Nuremburg 1545) by Jerome Cardan (1501–1576), in which a then recently‐discovered formula for finding the roots of some cubic equations is extended to cover all cubics and (...) proved. The second is the formulation by Albert Girard (1595–1632) of an early version of the fundamental theorem of algebra in his L'invention nouvelle en l'algèbre (Amsterdam, 1629). I conclude that in these cases at least, the questions raised in the philosophy of science debate can also be asked of the history of mathematics, and that a modest methodological anarchism is the appropriate stance. (shrink)

Introducing Applied Ethics Edited by Brenda Almond, Blackwell, 1995. Pp. 375. ISBN 0-631-19389-8. 45.00 (hbk), 14.99 (pbk). Environmental Ethics Edited by Robert Elliot, Oxford University Press, 1995. Pp. 255. ISBN 9-19-875144-3. 9.95 (pbk) Medicine and Moral Reasoning Edited by K.W.M. Fulford, Grant Gillett and Janet Martin Soskice Cambridge University Press, 1994. Pp. 207. ISBN 0-521-45325-9 37.50 (hbk), 12.95 (pbk). Enlightenment and Religion. Rational Dissent in Eighteenth-century Britain Edited by Knud Haakonssen, Cambridge University Press, 1996. Pp. xii + 348. ISBN 0-521-56060-8. (...) 40.00. Dialettica, Arte e Societ : Saggio su Theodor W. Adorno By Giacomo Rinaldi, Quattroventi, Urbino, 1994. Pp. 205. L. 30,000. Relevance: Communication and Cognition, new revised edition, By Dan Sperber and Deirdre Wilson, Blackwell, 1995. Pp. 326. ISBN 0-631-19878-4. 15.99. Autobiographical Reflections By Eric Voegelin (Edited, with Introduction, by Ellis Sandoz), Louisiana State University Press, 1996. Pp. 131. ISBN 0807120766 $10.95. (shrink)

Mathematical chemistry is often thought to be a 20th-century subdiscipline of chemistry, but in this paper we discuss several early chemical ideas and some landmarks of chemistry as instances of the mathematical way of thinking; many of them before 1900. By the mathematical way of thinking, we follow Weyl's description of it in terms of functional thinking, i.e. setting up variables, symbolizing them, and seeking for functions relating them. The cases we discuss are Plato's triangles, Geoffroy's affinity table, Lavoisier's classification (...) of substances and their relationships, Mendeleev's periodic table, Cayley's enumeration of alkanes, Sylvester's association of algebra and chemistry, and Wiener's relationship between molecular structure and boiling points. These examples show that mathematical chemistry has much more than a century of history. (shrink)

Appeal to faith is not uncommon in disputes about the mind-body problem. It is tempting to assume that dualists are more likely than physicalists to presuppose faith in supporting their conclusions, but in recent years physicalists have made claims of faith a standard practice. Of course, their version of faith is peculiar, a faith commitment that my colleague, Brendan Sweetman, has called "the scientific faith argument." This type of reasoning is typified by the remarks of J. J. C. Smart: (...) "...the suggestion I wish to resist is... to say 'I have a yellowish-orange after-image' is to report something irreducibly psychical.... It seems to me that science is increasingly giving us a viewpoint whereby organisms are able to be seen as physico-chemical mechanisms; it seems that even the behavior of man himself will one day be explicable in mechanistic terms". Some physicalists assert their faith stridently and dogmatically. Take Paul M. Churchland, for instance: "The human species and all of its features are the wholly physical outcome of a purely physical process.... If this is the correct account of our origins, then there seems neither need, nor room to fit any nonphysical substances or properties into our theoretical account of ourselves. We are creatures of matter. And we should learn to live with that fact". Of course, these views are mere assertions rather than arguments and they reflect a question-begging procedure. But since naturalism--the view that life and consciousness are nothing but the products of physics, matter in motion--is granted a priori by so many in philosophy today, the petitio principii has become the argument of choice. (shrink)

BackgroundThe Western-European concept of libertarian rights-based autonomy, which advocates respect for individual rights, may conflict with African cultural values and norms. African communitarian ethics focuses on the interests of the collective whole or community, rather than rugged individualism. Hence collective decision-making processes take precedence over individual autonomy or consent. This apparent conflict may impact informed consent practice during biomedical research in African communities and may hinder ethical principlism in African bioethics. This study explored African biomedical researchers' perspectives regarding informed consent (...) and potential limitations to the principle of respect for autonomy in African communities.MethodsWe conducted a qualitative study based on in-depth interviews with 12 biomedical researchers, five females and seven males aged 34 to 74 years, currently working at an African university. Interviews lasted 35–40 min each and involved semi-structured open-ended interviews, which allowed participants to offer information about their perceptions and feelings regarding respect for autonomy and informed consent as practised in Africa. Empirical data from the interviews were recorded, transcribed, and analysed using thematic content analysis, together with an interrogation of relevant scientific literature about African communitarian ethics, making evaluations and drawing inferences consistent with the empirical bioethics approach.ResultsBased on these interviews and analysis of relevant literature, we found that informed consent is difficult to apply in an African context because it derives from a Western conception of libertarian rights-based autonomy. Most respondents pointed out that it was challenging to implement informed consent in the African setting. Furthermore, communalism, customary beliefs, spirituality, and relational autonomy are predominant in most African communities, as exemplified by the African moral philosophies of Ubuntu/botho and Ukama, which emphasize communitarianism over individual rights. We also found that language, education, poverty, and cultural beliefs are barriers to obtaining proper informed consent in African communities.ConclusionsWe conclude that there are limitations to applying the principle of respect for autonomy and informed consent in African communities, especially in the context of human biomedical research. We recommend using a more relational approach, such as Ross’s prima facie duties, to implement informed consent in African communities. (shrink)

According to current hierarchies of evidence for EBM, evidence of correlation is always more important than evidence of mechanisms when evaluating and establishing causal claims. We argue that evidence of mechanisms needs to be treated alongside evidence of correlation. This is for three reasons. First, correlation is always a fallible indicator of causation, subject in particular to the problem of confounding; evidence of mechanisms can in some cases be more important than evidence of correlation when assessing a causal claim. Second, (...) evidence of mechanisms is often required in order to obtain evidence of correlation. Third, evidence of mechanisms is often required in order to generalise and apply causal claims. While the EBM movement has been enormously successful in making explicit and critically examining one aspect of our evidential practice, i.e., evidence of correlation, we wish to extend this line of work to make explicit and critically examine a second aspect of our evidential practices: evidence of mechanisms. (shrink)

Burt's argument relies on a motte-and-bailey fallacy. Burt aims to argue against the value of genetics for social science; instead she argues against certain interpretations of a specific kind of genetics tool, polygenic scores (PGSs). The limitations, previously identified by behavioural geneticists including ourselves, do not negate the value of PGSs, let alone genetics in general, for social science.

BackgroundThe issue of stigma is very important in the battle against HIV/aids in Africa since it may affect patient attendance at healthcare centres for obtaining antiretroviral medications and regular medical check-ups. Stigmatization creates an unnecessary culture of secrecy and silence based on ignorance and fear of victimization. This study was designed to determine if there is external stigmatization of people living with HIV and AIDS by health care workers at a tertiary hospital in KwaZulu-Natal province, South Africa. The study investigated (...) the impact of knowledge of HIV/aids by HCWs on treatment of patients, as well as the comfort level and attitude of HCWs when rendering care to PLWHA.MethodsA descriptive cross sectional study was designed to collect data using an anonymous self-administered structured questionnaire from 334 HCWs. The study was conducted in clinical departments of a large multidisciplinary 922-bed tertiary care teaching hospital in Durban, KZN.ResultsOverall HCWs had an above average knowledge about HIV/aids although some gaps in knowledge were identified. Tests of statistical significance showed that there was association between level of education and knowledge of HIV/aids ; occupation and knowledge of HIV/aids ; and gender and knowledge of HIV/aids. Test for comfort level was only significant for gender, with males showing more comfort and empathy when dealing with PLWHA. The study also revealed that patients were sometimes tested for HIV without informed consent before surgery, due to fear of being infected, and there was some gossiping about patients' HIV status by HCWs, thereby compromising patient confidentiality. The majority of HCWs showed a willingness to report incidents of stigmatization and discrimination to higher authorities, for better monitoring and control.ConclusionsAlthough knowledge, attitude and comfort level of HCWs taking care of PLWHA was above average, enforcement of existing antidiscrimination laws and continuing education in medical ethics and healthcare law, would greatly improve the performance of HCWs taking care of PLWHAs. More psychological support and counselling should be provided to HCWs, to further reduce the impact of stigmatization and discrimination against PLWHA. (shrink)

What accounts for the capacity of ordinary speakers to comprehend utterances of their language? The phenomenology of hearing speech in one’s own language makes it tempting to many epistemologists to look to perception for an answer to this question. That is, just as a visual experience as of a red square is often taken to give the perceiver immediate justification for believing that there is a red square in front of her, perhaps an auditory experience as of the speaker asserting (...) that p gives the competent hearer immediate justification for believing that the speaker has asserted that p. My aim here is to offer reasons for resisting this temptation. I argue that the perceptual model cannot adequately account for the hearer’s justification in many cases. The arguments here also allow us to draw certain further morals about the role of phenomenology in the epistemology of perception. (shrink)