In this paper, we propose a new model for development, one that transcends the North–South dichotomy and goes beyond a narrow conception of development as an economic process. This model requires a paradigm shift toward a new metaphor that develops sustainability, rather than sustains development. We conclude by defending a ‘report card on development’ as a means for evaluating how countries perform within this new paradigm.

In this paper, we explore the role of reciprocity in the employment of restrictive measures in contexts of contagion. Reciprocity should be understood as a substantive value that governs the use, level and extent of restrictive measures. We also argue that independent of the role reciprocity plays in the legitimisation the use of restrictive measures, reciprocity can also motivate support and compliance with legitimate restrictive measures. The importance of reciprocity has implications for how restrictive measures should be undertaken when preparing (...) and evaluating public health responses to contagion. (shrink)

Sunnybrook Health Sciences Centre, Toronto and University of Toronto Ross E. G. Upshur * Sunnybrook Health Sciences Centre, Joint Centre for Bioethics University of Toronto, Toronto * Corresponding author: Ross E. G. Upshur, Primary Care Research Unit, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, #E-349, Toronto, Ontario, Canada M4N 3M5. Tel.: 416-480-4753; Fax: 416-480-4536; Email: ross.upshur{at}sunnybrook.ca ' + u + '@' + d + ' '//--> Abstract Are restrictive measures and duties to care ethically reasonably acceptable to faith-based organizations? This (...) study describes the perceptions of individually interviewed spiritual leaders of the disease control measures used during the recent SARS outbreak in Toronto. Four central themes were identified: the relationship between religious obligation and civic responsibilities; the role of faith-based organizations in supporting public health restrictive measures; the reciprocal obligations of public health and religious communities during restrictions; and justifiable limits to duties to care. We conclude that, within certain constraints, spiritual leaders find restrictive measures ethically reasonable and that spiritual leaders can play an important role during pandemic and epidemic control planning. Public health officials should therefore include them in the early and ongoing deliberations of the criteria and logistics for implementation during public health emergencies. CiteULike Connotea Del.icio.us What's this? (shrink)

Are restrictive measures and duties to care ethically reasonably acceptable to faith-based organizations? This study describes the perceptions of individually interviewed spiritual leaders of the disease control measures used during the recent SARS outbreak in Toronto. Four central themes were identified: the relationship between religious obligation and civic responsibilities; the role of faith-based organizations in supporting public health restrictive measures; the reciprocal obligations of public health and religious communities during restrictions; and justifiable limits to duties to care. We conclude that, (...) within certain constraints, spiritual leaders find restrictive measures ethically reasonable and that spiritual leaders can play an important role during pandemic and epidemic control planning. Public health officials should therefore include them in the early and ongoing deliberations of the criteria and logistics for implementation during public health emergencies. (shrink)

Codes of medical ethics (codes) are part of a longstanding tradition in which physicians publicly state their core values and commitments to patients, peers, and the public. However, codes are not static. Using the historical evolution of the Canadian Medical Association's Code of Ethics as an illustrative case, we argue that codes are living, socio-historically situated documents that comprise a mix of prescriptive and aspirational content. Reflecting their socio-historical situation, we can expect the upheaval of the COVID-19 pandemic to prompt (...) calls to revise codes. Indeed, Alex John London has argued in favour of specific modifications to the World Medical Association's International Code of Medical Ethics (which has since been revised) in light of moral and scientific failures that occurred during the COVID-19 pandemic. Responding to London, we address the more general question: should codes be modified to reflect lessons drawn from the COVID-19 pandemic or future such upheavals? We caution that codes face limitations as instruments of policy change because they are inherently interpretive and ‘multivocal’, that is, they usually underdetermine or provide more than one answer to the question, ‘What should I do now?’ Nonetheless, as both prescriptive and aspirational documents, codes also serve as tools for reflection and deliberation—collective practices that are necessary to engaging with and addressing the moral and scientific uncertainties inherent to medicine. (shrink)

BackgroundAs a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many were (...) exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk.DiscussionIn the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics.SummaryAn honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)

AbstractWhen considering the manner of death, two categories can be distinguished, namely natural death and unnatural death. Though most physicians think that the distinction between the two is evident, this is not the case.When comparing the Netherlands, Belgium, England and Germany it is noticed that the terms natural and unnatural might be used in law but are not defined by law. In practice, the term unnatural death is used when there is an external cause of death, but even that turns (...) out to not be sufficient in making an obvious difference between the two terms. Different countries may even label the same death differently. A, at times philosophical and semantic, discussion shows that when it comes to causes of death a very large grey area exists between natural and unnatural causes of death. The Netherlands, Belgium and Germany even have the possibility to label a death as natural without actually knowing the cause of death.In conclusion, we recommend a new system in which the circumstances surrounding a death are properly investigated. This should lead to a report to an independent legal expert, who is able to decide if and what conclusion can be drawn, from a judicial and a public point of view, thereby, making the distinction and the use of the terms natural and unnatural/nonnatural obsolete. (shrink)

Questioning gender is about taking an active, critical role in the technological design of our daily behaviour. It is a deconstruction of the oppositions that exist in the discourses of Ambient Intelligence designers, the ICT industry and computer scientists. What underlies the assumption that Ambient Intelligence will, by disappearing into our environment, bring humans both an easy and entertaining life? The gender perspective can uncover power relations within the promotion and realisation of Ambient Intelligence that satisfy an obvious wish for (...) a technological heaven. The deconstruction of the promise of progress and a better life reveals what is overvalued, what is undervalued and what is ignored. This paper is a deconstruction of the view, currently prevalent in the discourses of Ambient Intelligence; a view of humans and the way they live. A view that will influence the way women and men will be allowed to construct their lives. (shrink)

Broad genome-wide testing is increasingly finding its way to the public through the online direct-to-consumer marketing of so-called personal genome tests. Personal genome tests estimate genetic susceptibilities to multiple diseases and other phenotypic traits simultaneously. Providers commonly make use of Terms of Service agreements rather than informed consent procedures. However, to protect consumers from the potential physical, psychological and social harms associated with personal genome testing and to promote autonomous decision-making with regard to the testing offer, we argue that current (...) practices of information provision are insufficient and that there is a place – and a need – for informed consent in personal genome testing, also when it is offered commercially. The increasing quantity, complexity and diversity of most testing offers, however, pose challenges for information provision and informed consent. Both specific and generic models for informed consent fail to meet its moral aims when applied to personal genome testing. Consumers should be enabled to know the limitations, risks and implications of personal genome testing and should be given control over the genetic information they do or do not wish to obtain. We present the outline of a new model for informed consent which can meet both the norm of providing sufficient information and the norm of providing understandable information. The model can be used for personal genome testing, but will also be applicable to other, future forms of broad genetic testing or screening in commercial and clinical settings. (shrink)

Broad genome‐wide testing is increasingly finding its way to the public through the online direct‐to‐consumer marketing of so‐called personal genome tests. Personal genome tests estimate genetic susceptibilities to multiple diseases and other phenotypic traits simultaneously. Providers commonly make use of Terms of Service agreements rather than informed consent procedures. However, to protect consumers from the potential physical, psychological and social harms associated with personal genome testing and to promote autonomous decision‐making with regard to the testing offer, we argue that current (...) practices of information provision are insufficient and that there is a place – and a need – for informed consent in personal genome testing, also when it is offered commercially. The increasing quantity, complexity and diversity of most testing offers, however, pose challenges for information provision and informed consent. Both specific and generic models for informed consent fail to meet its moral aims when applied to personal genome testing. Consumers should be enabled to know the limitations, risks and implications of personal genome testing and should be given control over the genetic information they do or do not wish to obtain. We present the outline of a new model for informed consent which can meet both the norm of providing sufficient information and the norm of providing understandable information. The model can be used for personal genome testing, but will also be applicable to other, future forms of broad genetic testing or screening in commercial and clinical settings. (shrink)

In response to commentators, we argue that whether waiving patent rights will meaningfully improve access to COVID-19 vaccines for low income and middle-income countries (LMICs), particularly in the short term, is an empirical matter. We also reject preferentially allocating vaccines to countries that hosted trials because doing so unethically favours those with research infrastructure, rather than those facing the worst burdens from COVID-19.

Background: As genetics technology proceeds, practices of genetic testing have become more heterogeneous: many different types of tests are finding their way to the public in different settings and for a variety of purposes. This diversification is relevant to the discourse on ethical, legal and societal issues (ELSI) surrounding genetic testing, which must evolve to encompass these differences. One important development is the rise of personal genome testing on the basis of genetic profiling: the testing of multiple genetic variants simultaneously (...) for the prediction of common multifactorial diseases. Currently, an increasing number of companies are offering personal genome tests directly to consumers and are spurring ELSI-discussions, which stand in need of clarification. This paper presents a systematic approach to the ELSI-evaluation of personal genome testing for multifactorial diseases along the lines of its test characteristics.DiscussionThis paper addresses four test characteristics of personal genome testing: its being a non-targeted type of testing, its high analytical validity, low clinical validity and problematic clinical utility. These characteristics raise their own specific ELSI, for example: non-targeted genetic profiling poses serious problems for information provision and informed consent. Questions about the quantity and quality of the necessary information, as well as about moral responsibilities with regard to the provision of information are therefore becoming central themes within ELSI-discussions of personal genome testing. Further, the current low level of clinical validity of genetic profiles raises questions concerning societal risks and regulatory requirements, whereas simultaneously it causes traditional ELSI-issues of clinical genetics, such as psychological and health risks, discrimination, and stigmatization, to lose part of their relevance. Also, classic notions of clinical utility are challenged by the newer notion of 'personal utility.'SummaryConsideration of test characteristics is essential to any valuable discourse on the ELSI of personal genome testing for multifactorial diseases. Four key characteristics of the test - targeted/non-targeted testing, analytical validity, clinical validity and clinical utility - together determine the applicability and the relevance of ELSI to specific tests. The paper identifies and discusses four areas of interest for the ELSI-debate on personal genome testing: informational problems, risks, regulatory issues, and the notion of personal utility. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

BackgroundWork stress is a serious problem in primary education. Decades of research underline the importance of participatory, organizational-level work stress prevention approaches. In this approach, measures are planned to tackle causes of work stress in a participatory manner and implemented by a working group consisting of members of the organization. This approach can only be effective if the measures contain effective ingredients to decrease work stress risks and are successfully implemented. The aim of this paper is to present an outline (...) of a work stress prevention approach that is evaluated in primary education. To ensure the appropriateness of measures, a logic model of change is built as part of the risk assessment to facilitate the selection of appropriate measures. Progression on target behaviors as well as implementation factors are real-time monitored during implementation and fed back to the working groups, to provide the opportunity to adjust action plans when needed to optimize implementation.MethodsThe approach consists of five steps: preparation: installing an advisory board and working groups, risk assessment: inventory of work stress risks. In addition, a behavioral analysis is performed to build a logic model of change to facilitate selection of measures, action planning: conducting an action plan with appropriate measures, implementation: implementing the action plan. During implementation progression on target behaviors and implementation factors are monthly monitored and fed back to the working groups, and evaluation: effects of the approach are studied in a controlled trial with measurements at baseline, 1 year, and 2 years follow-up. A process evaluation is carried out using quantitative and qualitative data to study the implementation process of all steps of the work stress approach.DiscussionWe believe that building a logic model of change and real-time monitoring of implementation could be of added value to improve the success of the work stress prevention approach. With this study, we aim to provide more insights into work stress intervention research, especially in primary education.Clinical Trial RegistrationThe study is registered in Netherlands Trial Register. (shrink)

En juillet 2015, une mission d’étude de deux semaines a été consacrée à l’Aphrodision. L’étude archéozoologique menée par M. Leguilloux a porté sur plusieurs ensembles : deux contextes cultuels – les sols de l’oikos 5 et la fosse contenant les résidus de banquet située à l’Ouest de l’autel –, le four construit dans un creux du rocher contre le mur de soutènement de la terrasse orientale et une fosse‑dépotoir postérieure à l’abandon du site. L’ensemble représente 1 590 restes de faune (...) terrestr... (shrink)

This is certainly one of the most beautiful books in philosophy published in the last couple of years. It comprises eighty-four essays, carefully selected, well-translated, covering almost the full range of Croce's immense literary production. Croce is certainly one of the most important and influential thinkers of this century and in this huge anthology the English-speaking reader is given an incomparable instrument to get acquainted with him. The list of the headings which classify the eighty-four essays are: The Logic of (...) Philosophy; Philosophical Criticism; Aesthetics; The Philosophy of Art and Language; The Theory of History; Economics and Ethics; Essays in Criticism and Literary History; Moral and Political History. But first one should read the late Cecil Sprigge's excellent introduction.—M. J. V. (shrink)

Multiculturalism is higher on the daily political agenda than it has ever been. Leading politicians and public commentators speak with an unparalleled bluntness about the perceived limitations of multiculturalism while representatives of cultural, minorities express concern about marginalisation. This debate is taking place against a background of fear about terrorism, the integrity of national identities and a loosely construed ‘clash of civilizations’. Secularism is pitted against religious fundamentalism, respect for difference against the right of freedom of speech, integration against self-determination, (...) and duties of citizenship against minority rights. This book confronts the reality of moral conflict in the debate on multiculturalism while resisting the simplification which too frequently accompanies daily commentary on both sides of an increasingly polarised debate. The volume as a whole marks an important step in the attempt to examine the underlying concepts, of the nature and legitimate extent of disagreement, of secularism, the nature of power, the state and citizenship, which inevitably constitute key assumptions in the debate. Bringing together leading scholars on multiculturalism: Gerald Gaus, Peter Jones, John Horton, Tariq Modood, Chandran Kukathas, Bhikhu Parekh, Matthew Festenstein and Cecile Laborde, this book discusses the latest developments in the field. It will be of strong interest students and scholars of multiculturalism, political science, political theory, international relations, sociology, philosophy and anthropology. (shrink)

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

The starting point of this paper is the need to promote a people-centred corporate social responsibility framework in a context where many human needs and rights remain unsatisfied and where businesses may have both a positive and a negative impact on the quality of life of human beings today and tomorrow and may even lead to irreversible damage. Our normative definition of CSR is consistent with the criteria established by the EU Commission in 2011. We conceive CSR as a responsibility (...) towards human development in two complementary ways: a holistic responsibility shared by companies together with other actors to safeguard humanity and a direct liability of each company for its impact on stakeholders' capabilities. We apply Nussbaum's list of central capabilities and concept of thresholds to specify the nature and extent of corporate responsibilities towards employees, subcontractors, investors, customers, and humanity as a whole. In addition, we leverage fieldwork in developing and developed countries to analyse the effect of business activities on human capabilities. We demonstrate that by quantifying the impact of businesses' activities on various dimensions of stakeholders' lives, and especially on the most vulnerable ones, these businesses can be held accountable for the negative externalities they produce. (shrink)

Liberal societies conventionally treat religion as unique under the law, requiring both special protection and special containment. But recently this idea that religion requires a legal exception has come under fire from those who argue that religion is no different from any other conception of the good, and the state should treat all such conceptions according to principles of neutrality and equal liberty. Cécile Laborde agrees with much of this liberal egalitarian critique, but she argues that a simple analogy between (...) the good and religion misrepresents the complex relationships among religion, law, and the state. Religion serves as more than a statement of belief about what is true, or a code of moral and ethical conduct. It also refers to comprehensive ways of life, political theories of justice, modes of voluntary association, and vulnerable collective identities. Disaggregating religion into its various dimensions, as Laborde does, has two clear advantages. First, it shows greater respect for ethical and social pluralism by ensuring that whatever treatment religion receives from the law, it receives because of features that it shares with nonreligious beliefs, conceptions, and identities. Second, it dispenses with the Western, Christian-inflected conception of religion that liberal political theory relies on, especially in dealing with the issue of separation between religion and state. As a result, Liberalism's Religion offers a novel answer to the question: Can Western theories of secularism and religion be applied more universally in non-Western societies?--. (shrink)

This article explores the possible convergence between the capabilities approach and utilitarianism to specify CSR. It defends the idea that this key issue is related to the anthropological perspective that underpins both theories and demonstrates that a relational conception of individual freedoms and rights present in both traditions gives adequate criteria for CSR toward the company's stakeholders. I therefore defend "relational capability" as a means of providing a common paradigm, a shared vision of a core component of human development. This (...) could further lead to a set of indicators aimed at assessing corporate social performance as the maximization of the relational capability of people impacted by the activities of companies. In particular, I suggest a way of evaluating the contribution of extractive companies to the communities close to their industrial sites in extremely poor areas, not from the viewpoint of material resources and growth, but from the viewpoint of the quality of the social environment and empowerment. (shrink)

L’un des principaux arguments évoqués contre l’art contemporain au début des années 1990 en France (lors du débat autour de ce qui fut appelé la « crise de l’art contemporain ») consista en l’affirmation que puisqu’aujourd’hui n’importe quoi peut être de l’art, alors l’art d’aujourd’hui c’est n’importe quoi. Ce texte entend montrer que ce raisonnement en deux parties relève d’une confusion qui, une fois clarifiée, permettra de cerner la spécificité de l’art contemporain et des jugements qui peuvent être émis à (...) son égard. (shrink)

In this article, I compare the ways in which Baudrillard and Heidegger seek to bring attention to the importance of death for our personal existential situation which has now become repressed in conceptions of existence and society. Heidegger critiques public conceptions of death that serve to cover up its importance. Less well known is that, somewhat in parallel fashion, Baudrillard charts a ‘genealogy’ of the ‘extradition’ of the dead from the centre of the social and he claims that we live (...) currently in a death denying society. This reduces the meaning of our own impending deaths. However, unlike Heidegger, Baudrillard’s ‘genealogical’ critique of the exclusion of death in modern society is not a one-way dismissal because he proposes an alternative social role for death in the form of ‘primitive symbolic exchange’. (shrink)

A vision of future daily life is explored in Ambient Intelligence . It contains the assumption that intelligent technology should disappear into our environment to bring humans an easy and entertaining life. The mental, physical, methodical invisibility of AmI will have an effect on the relation between design and use activities of both users and designers. Especially the ethics discussions of AmI, privacy, identity and security are moved into the foreground. However in the process of using AmI, it will go (...) beyond these themes. The infiltration of AmI will cause the construction of new meanings of privacy, identity and security because the "visible" acting of people will be preceded, accompanied and followed by the invisible and visible acting of the AmI technology and their producers.A question in this paper is: How is it possible to create critical transformative rooms in which doubting will be possible under the circumstances that autonomous 'intelligent agents' surround humans? Are humans in danger to become just objects of artificial intelligent conversations? Probably the relation between mental, physical, methodical invisibility and visibility of AmI could give answers. (shrink)

During the second half of the 20th century several American multidisciplinary social science „disaster research groups“ conducted numerous field studies after earthquakes, factory explosions and “racial riots”, both inside and outside of the United States. Their aim was to investigate the reactions and behavior of individuals, organizations and communities to disasters. All of these groups were either promoted or at least partly founded by different branches of the US military. This article will analyze the groups’ studies and findings on the (...) question of disasters’ psychological effects. The main focus will be on the stance the scientists took on the diagnosis of psychological trauma—especially Post Traumatic Stress Disorder (PTSD)—and the post disaster therapeutic interventions that became widespread in the 1970s and early 1980s. The disaster researchers questioned the need for, as well as the effectiveness and efficiency of “disaster mental health”. At the same time they advocated early ideas of resilience, which later became one of the most important concepts in disaster management and beyond. (shrink)

L’article se propose d’explorer ce qui est dit du mariage et de l’amour dans la correspondance d’une famille bourgeoise qui couvre plusieurs générations sur un large xixe siècle. Trois épisodes ont été retenus qui permettent d’observer bien des tensions entre mariage arrangé et mariage d’inclination. D’abord, au début du siècle, la correspondance d’un jeune homme à l’aube d’une brillante carrière scientifique explicite les « raisons » sociales et économiques qui déterminent son choix matrimonial. Puis, dans les années 1840-1843, l’échange entre (...) fiancés montre comment se construit le sentiment amoureux dans le respect de l’autorité parentale et des conventions en vigueur. Enfin, en 1858, autre moment stratégique dans le processus d’ascension sociale, la correspondance résonne des tractations menées par la famille pour conclure une union d’intérêt. À toutes ces étapes, il apparaît que les femmes assument leur destin social, qui est vécu et écrit comme une responsabilité face au cheminement des hommes de la famille. (shrink)

La prééminence que le libéralisme accorde aux libertés individuelles apparaît parfois comme un obstacle à la mise en œuvre de politiques environnementales contraignantes. Chez Rawls, cette prééminence s’incarne dans le principe de priorité de la liberté : on ne peut restreindre une des libertés de base qu’au nom de la liberté – et donc pas, semble-t-il, pour protéger l’environnement. Il est ici montré que ce principe, retouché à la suite d’une critique de Herbert L. A. Hart, autorise et même exige (...) plus de politiques écologiques qu’il n’y paraît. En outre, deux modestes aménagements internes de la théorie permettent d’en autoriser et exiger plus encore : considérer un environnement de qualité comme un bien premier, et un droit à un environnement de qualité comme une liberté de base. (shrink)