Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

ABSTRACTThe known works of the medieval astronomer/astrologer Henry Bate include a set of planetary mean motion tables for the meridian of his Flemish hometown Mechelen. These tables survive in three manuscripts representing two significantly different recensions, but have never been examined for their principles of construction or underlying parameters. Such analysis reveals that Bate employed an unusual value for the length of the tropical year, which was probably derived by comparing ancient and contemporary observations of the vernal equinox. In addition, (...) there are clear signs that Bate kept revising his parameters for the mean motions of Venus and the three superior planets, none of which can be traced back to earlier sources. Together with some of Bate’s preserved statements, these findings support the conclusion that the Tabule Machlinenses were unique among the astronomical tables produced in medieval Latin Christendom for using independently derived parameters that were the result of new observations. Bate’s achievement connects him to a wider milieu of astronomers operating in late-thirteenth-century Paris, who put an increased emphasis on observation and the critical examination of received data. (shrink)

The research investigates the role of leadership in the transformation of denominational structures towards a missional ecclesiology, and focusses on the Highveld Synod of the Dutch Reformed Church. It describes the missional journey of the denomination, and interprets the transformation. The theory of ‘complex leadership’ in complex systems is applied to the investigation of the impact of leadership on a denominational structure. The theory identifies three mechanisms used by leaders as enablers in emergent, self-organisation systems: Leaders disrupt existing patterns, they (...) encourage novelty, and they act as sensemakers. These insights are applied as a tool to interpret the missional transformation of a denomination. (shrink)

Монографія "Функціональність релігії: український контекст".

The two words, except ‘and,’ in the title of this paper are meant to bring to mind two different philosophical claims that, I believe, are intimately related. Both have occasioned much controversy. The relation between them, however, has not been widely recognized. The first claim is the contention that is often expressed by saying that ‘consciousness is always consciousness of something.’ The second claim is the assertion that mental things are distinguished from physical things by their being inherently private. I (...) believe that if intentionality is carefully understood, this understanding allows us to explain why, and in what sense, those mental things called ‘feelings’ are private. I am sufficiently aware of the dismal fate that has been visited on most, if not all, philosophical explanations. Consequently, I do not claim, without qualification, to explain mental privacy. My position is that if what I shall call ‘the thesis of intentionality,’ which differs in certain respects from that mentioned above, is true, then mental privacy can be explained. So, in this paper, I shall first discuss intentionality at some length; secondly, I shall present the consequent explanation of mental privacy. (shrink)

In a 1981 letter to H.L. A. Hart, John Rawls sketches a view of moral objectivity that substantially differs from that of contemporary constructivists. The view he describes does not rely on constitutive features of agency as Korsgaard's does, and it does not bottom out in a form of realism as Scanlon's moral theory does. Instead, Rawls's view grounds objectivity on the fundamental conceptions that could be shared in wide reflective equilibrium. Constructivism grounds objectivity in a kind of intersubjectivity, and (...) Rawls finds the relevant kind of intersubjectivity in the alignment between fundamental convictions. This article develops this Rawlsian view of objectivity and highlights its strengths. (shrink)

The British Journal for the Philosophy of Science 2002 53(4):539-563; doi:10.1093/bjps/53.4.539 © 2002 by British Society for the Philosophy of Science..

(No abstract is available for this citation).

Current UK legislation is impacting upon the feasibility and cost-effectiveness of medical record-based research aimed at benefiting the NHS and the public heath. Whereas previous commentators have focused on the Data Protection Act 1998, the Health and Social Care Act 2001 is the key legislation for public health researchers wishing to access medical records without written consent. The Act requires researchers to apply to the Patient Information Advisory Group for permission to access medical records without written permission. We present a (...) case study of the work required to obtain the necessary permissions from PIAG in order to conduct a large scale public health research project. In our experience it took eight months to receive permission to access basic identifying information on individuals registered at general practices, and a decision on whether we could access clinical information in medical records without consent took 18 months. Such delays pose near insurmountable difficulties to grant funded research, and in our case £560 000 of public and charitable money was spent on research staff while a large part of their work was prohibited until the third year of a three year grant. We conclude by arguing that many of the current problems could be avoided by returning PIAG’s responsibilities to research ethics committees, and by allowing “opt-out” consent for many public health research projects. (shrink)

Volume 46, Issue 1, February 2025, Page 194-196.

Стаття С. Присухіна «Іван Павло ІІ про логіку діалогу між Католицькою Церквою та ісламом» присвячена філософськобогословським напрацюванням Папи Римського Івана Павла ІІ щодо аналізу змістовних характеристик поняття «діалог між католицизмом і ісламом», а також логіки його здійснення в непростому й суперечливому сьогоденні.