El problema del principio de razón suficiente puede hallar sus primerosindicios en Spinoza; no obstante, es hasta que Leibniz trata de definirlocuando toma cierto rango y cierta importancia filosófica. El problema essi todo tiene una razón (o causa) y si todo tiene una causa, ¿por qué? Ysi no todo tiene una causa, ¿qué razones tenemos para pensar en ello?

Este artículo presenta el principio de razón suficiente según Leibniz. Para ello, primero se muestra una sección donde trata de definirse qué es un principio y cuál es el principio de razón suficiente, para posteriormente pasar a los problemas que tiene la postulación de dicho principio desde la perspectiva de Leibniz.

The standard Kratzerian analysis of modal auxiliaries, such as ‘may’ and ‘can’, takes them to be univocal and context-sensitive. Our first aim is to argue for an alternative view, on which such expressions are polysemous. Our second aim is to thereby shed light on the distinction between semantic context-sensitivity and polysemy. To achieve these aims, we examine the mechanisms of polysemy and context-sensitivity and provide criteria with which they can be held apart. We apply the criteria to modal auxiliaries and (...) show that the default hypothesis should be that they are polysemous, and not merely context-sensitive. We then respond to arguments against modal ambiguity. Finally, we show why modal polysemy has significant philosophical implications. (shrink)

According to the subjective view of lying, speakers can lie by asserting a true proposition, as long as they believe this proposition to be false. This view contrasts with the objective view, according to which lying requires the actual falsity of the proposition asserted. The aim of this paper is to draw attention to pairs of assertions that differ only in intuitively redundant content and to show that such pairs of assertions are a reason to favour the subjective view of (...) lying over the objective one. (shrink)

Although for the last 50 years, ethicists dealing with human experimentation have focused primarily on the need to protect individual research subjects and vulnerable groups, biomedical research, especially in genetics, now requires the establishment of standards for the protection of communities. We have developed such a strategy, based on five steps. (i) Identification of community characteristics relevant to the biomedical research setting, (ii) delineation of a typology of different types of communities using these characteristics, (iii) determination of the range of (...) possible community protections, (iv) creation of connections between particular protections and one or more community characteristics necessary for its implementation, and (v) synthesis of community characteristics and possible protections to define protections appropriate for each type of community. Depending on the particular community, consent and consultation, consultation alone, or no added protections may be required for research. (shrink)

The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. Participation in research is a critical way to support an important public good. Consequently, all have a duty to participate. The (...) current social norm is that individuals participate only if they have a good reason to do so. The public goods argument implies that individuals should participate unless they have a good reason not to. Such a shift would be of great aid to the progress of biomedical research, eventually making society significantly healthier and longer lived. (shrink)

El artículo tiene como objetivo presentar y valorar críticamente la propuesta de John Rogers Searle sobre la libertad. Para esto, en un primer momento mostraremos que para él la libertad debe entenderse desde la perspectiva de la primera persona, es decir desde la experiencia subjetiva. Desde allí establece que la libertad se expresa en el llamado fenómeno de la brecha, es decir, en el salto que experimentamos entre la causa y el efecto en el proceso de realización de una acción. (...) Este salto se manifiesta en los actos llevados a cabo por razones independientes del deseo, como puede observarse en el altruismo fuerte. En un segundo momento, dedicado a la valoración crítica de la propuesta de Searle, consideramos la importancia de la perspectiva de primera persona para entender la libertad. Luego mostramos que una noción analógica de causa permite entender mejor el acto libre, como así también evitar el dualismo y el reduccionismo materialista. Esta visión, propia de la tradición aristotélico-tomista y que podríamos denominar de tercera persona, debe complementarse con una reflexión desde la interioridad, como realiza Michele Federico Sciacca. Concluimos luego con una breve reflexión sobre el tema del vínculo interdisciplinar como forma de entender las temáticas antropológicas. (shrink)

El artículo tiene como objetivo presentar y valorar críticamente la propuesta de John Rogers Searle sobre la libertad. Para esto, en un primer momento mostraremos que para él la libertad debe entenderse desde la perspectiva de la primera persona, es decir desde la experiencia subjetiva. Desde allí establece que la libertad se expresa en el llamado fenómeno de la brecha, es decir, en el salto que experimentamos entre la causa y el efecto en el proceso de realización de una acción. (...) Este salto se manifiesta en los actos llevados a cabo por razones independientes del deseo, como puede observarse en el altruismo fuerte. Y para Searle, solo un Yo, cuyas características emergen del cerebro, puede asumir estas razones para actuar acorde a ellas. En un segundo momento, dedicado a la valoración crítica de la propuesta de Searle, consideramos la importancia de la perspectiva de primera persona para entender la libertad. Luego mostramos que una noción analógica de causa permite entender mejor el acto libre, como así también evitar el dualismo y el reduccionismo materialista. Esta visión, propia de la tradición aristotélico-tomista y que podríamos denominar de tercera persona, debe complementarse con una reflexión desde la interioridad, como realiza Michele Federico Sciacca, es decir, desde una perspectiva de primera persona. Ambas líneas filosóficas confluyen en la consideración metafísica del hombre. Concluimos luego con una breve reflexión sobre el tema del vínculo interdisciplinar como forma de entender las temáticas antropológicas. (shrink)

Information on the risks and benefits related to surgical procedures is essential for patients in order to obtain their informed consent. Some disciplines, such as sociolinguistics, offer insights that are helpful for patient—professional communication in both written and oral consent. Communication difficulties become more acute when patients make decisions through an informed consent document because they may sign this with a lack of understanding and information, and consequently feel deprived of their freedom to make their choice about different treatments or (...) surgery. This article discusses findings from documentary analysis using the sociolinguistic SPEAKING model, which was applied to the general and specific informed consent documents required for laparoscopic surgery of the bile duct at Torrecárdenas Hospital, Almería, Spain. The objective of this procedure was to identify flaws when information was provided, together with its readability, its voluntary basis, and patients’ consent. The results suggest potential linguistic communication difficulties, different languages being used, cultural clashes, asymmetry of communication between professionals and patients, assignment of rights on the part of patients, and overprotection of professionals and institutions. (shrink)

BackgroundThe use of great apes (GA) in invasive biomedical research is one of the most debated topics in animal ethics. GA are, thus far, the only animal group that has frequently been banned from invasive research; yet some believe that these bans could inaugurate a broader trend towards greater restrictions on the use of primates and other animals in research. Despite ongoing academic and policy debate on this issue, there is no comprehensive overview of the reasons advanced for or against (...) restricting invasive research with GA. To address this gap, we conducted a systematic review of the reasons reported in the academic literature on this topic.MethodsSeven databases were searched for articles published in English. Two authors screened the titles, abstracts, and full texts of all articles. Two journals specialized in animal ethics, and the reference lists of included articles were subsequently also reviewed.ResultsWe included 60 articles, most of which were published between 2006 and 2016. Twenty-five articles argued for a total ban of GA research, 21 articles defended partial restrictions, and 14 articles argued against restrictions. Overall, we identified 110 reason types, 74 for, and 36 against, restricting GA research. Reasons were grouped into nine domains: moral standing, science, welfare, public and expert attitudes, retirement and conservation, respect and rights, financial costs, law and legal status, and longer-term consequences.ConclusionOur review generated five main findings. First, there is a trend in the academic debate in favor of restricting GA research that parallels worldwide policy changes in the same direction. Second, in several domains (e.g., moral standing, and respect and rights), the reasons were rather one-sided in favor of restrictions. Third, some prominent domains (e.g., science and welfare) featured considerable engagement between opposing positions. Fourth, there is low diversity and independence among authors, including frequent potential conflicts of interests in articles defending a strong position (i.e., favoring a total ban or arguing against restrictions). Fifth, scholarly discussion was not the norm, as reflected in a high proportion of non-peer-reviewed articles and authors affiliated to non-academic institutions. (shrink)

Modern generative AI systems have shown the capacity to produce remarkably fluent language, prompting debates both about their semantic understanding and, less prominently, about whether they can perform speech acts. This paper addresses the latter question, focusing on assertion. We argue that to be capable of assertion, an entity must meet two requirements: it must produce outputs with descriptive functions, and it must be capable of being sanctioned by agents with which it interacts. The second requirement arises from the nature (...) of assertion as a norm-governed social practice. Pre-trained large language models that have not been subject to fine-tuning fail to meet the first requirement. Language models that have been fine-tuned for ‘groundedness’ or ‘correctness’ may meet the first requirement, but fail the second. We also consider the significance of the point that AI systems can be used to generate proxy assertions on behalf of human agents. (shrink)

The 2010 Patient Protection and Affordable Care Act was designed to increase health insurance coverage in the United States. Its most controversial feature is the requirement that US residents purchase health insurance. Opponents of the mandate argue that requiring people to contribute to the collective good is inconsistent with respect for individual liberty. Rather than appeal to the collective good, this Viewpoint argues for a duty to buy health insurance based on the moral duty individuals have to reduce certain burdens (...) they pose on others. When some people have a duty to rescue, others may have a duty to take rescue precautions, in this case, to purchase health insurance to cover acute and emergency care needs. Requiring that individuals meet this obligation is consistent with respect of individual liberty. (shrink)

Book reviewed in this article: Just Doctoring: Medical Ethics in the Liberal State. By Troyen A. Brennan. The Ends of Human Life: Medical Ethics in a Liberal Polity. By Ezekiel J. Emanuel.

This article aims to explore two different but interrelated problems. The first objective, the more abstract one, is to discuss the plausibility of fusionism as a theoretical project of bridging the philosophical gap between libertarianism and free-market conservatism. Our thesis is that while fusionism could succeed, as a strategic alliance, in promoting specific policies, the differences between libertarianism and conservatism are irreconcilable at the level of fundamental intellectual assumptions. More precisely, starting from Hayek’s objections to conservatism, we argue that the (...) crucial divide is that between two conceptions about the prerequisites for social order. The second objective is to show how the differences between the policy prescriptions endorsed by conservatives and libertarians within the Tea Party (mainly with regard to religion-related issues) are illustrative for the theoretical point defended in the first sections. (shrink)

El tema del hombre ha sido el centro de la reflexión filosófica de los últimos siglos, siendo motivo de debate desde comienzos de la modernidad. El filósofo italiano Michele Federico Sciacca (1908-1975) tuvo conciencia clara de esto, estableciendo que la filosofía debe ser ontología y, sobre todo, ontología del hombre como existente. Esto para él significa, por lo menos, dos cosas: que el autoconocimiento es el punto de partida en el estudio filosófico y que desde el conocimiento del hombre concreto, (...) de la persona humana, podemos entender todo lo real. (shrink)

El orden geométrico consiste en partir de definiciones y axiomas evidentes por sí mismos. El paralelismo entre ambos órdenes en el sistema de Spinoza, el ordo cognoscendi y el ordo essendi, hace posible postular la intensidad total de lo real, implicando necesariamente una semejanza entre el entendimiento finito, en cuanto productor del primer orden, y el entendimiento infinito, en cuanto productor del segundo orden, ausente en el cartesianismo. Martial Gueroult afirma el método como geométrico en Descartes porque obedece estrictamente a (...) la regla que asegura a la Geometría todo su rigor; mientras que en Spinoza lo es porque, como Geometría, construye los conceptos de los objetos. (shrink)

With the world grappling with continued spread of monkeypox internationally, vaccines play a crucial role in mitigating the harms from infection and preventing spread. However, countries with the greatest need - particularly historically endemic countries with the highest monkeypox case-fatality rates - are not able to acquire scarce vaccines. This is unjust, and requires rectification through equitable allocation of vaccines globally. We propose applying the Fair Priority Model for such allocation, which emphasizes three key principles: 1) preventing harm; 2) prioritizing (...) the disadvantaged; and 3) treating people with equal moral concern. Post-exposure prophylaxis (PEPV) has the most potential to mitigate harm, and so ensuring countries have sufficient supply for PEPV should be the first priority. And historically endemic countries, which face disadvantages that compound potential harms from monkeypox, should be the first recipients of such vaccines. Once sufficient supply is allocated for countries to apply PEPV, global allocation could move on to pre-exposure prophylaxis (PrEP), again prioritizing historically endemic countries first before distribution to the rest of the global community, based on projected number of cases and vulnerability to harm. (shrink)

Intellectual property is one of the highly divisive issues in contemporary philosophical and political debates. The main objective of this paper is to explore some sources of tension between the formal rules of intellectual property (particularly copyright and patents) and the emerging informal norms of file sharing and open access in online environments. We look into the file sharing phenomena not only to illustrate the deepening gap between the two sets of norms, but to cast some doubt on the current (...) regime of intellectual property as an adequate frame for the new type of interactions in online environments. Revisiting the classic Arrow–Demsetz debate about intellectual property and the epistemological issues involved in assessing institutions, we suggest that seeking out new institutional arrangements aligned with the norms-in-use seems to be a more promising strategy in the new technological setting than attempting to reinforce the current legal framework. Moreover, such a strategy is less prone to committing the so-called ‘Nirvana fallacies’. As a secondary task, we try to cast some doubt on the two most common moral justifications of intellectual property as being able to ground the full extent of the current intellectual property regime. (shrink)

BackgroundInformed consent is a key element of ethical clinical research. Addicted population may be at risk for impaired consent capacity. However, very little research has focused on their comprehension of consent forms. The aim of this study is to assess the capacity of addicted individuals to provide consent to research.Methods53 subjects with DSM-5 diagnoses of a Substance Use Disorder and 50 non psychiatric comparison subjects participated in the survey from December 2014 to March 2015. This cross-sectional study was carried out (...) at a community-based Outpatient Treatment Center and at an urban-located Health Centre in Spain. A binary judgment of capacity/incapacity was made guided by the MacArthur Competence Assessment Tool for Clinical Research and a clinical interview. Demographics and clinical characteristics were assessed by cases notes and the Mini-Mental State Examination, the Global Assessment Functional Scale and the Clinical Global Impression Scale.ResultsNPCs performed the best on the MacCAT–CR, and patients with SUD had the worst performance, particularly on the Understanding and Appreciation subscales. 32.7 % SUD people lacked research-related decisional capacity. There were no statistically significant differences between the groups in terms of capacity to consent to research.ConclusionsThe findings of our study provide evidence that a large proportion of individuals with SUD had decisional capacity for consent to research. It is therefore inappropriate to draw conclusions about capacity to make research decisions on the basis of a SUD diagnosis. In the absence of advanced cognitive impairment, acute withdrawal or intoxication, we should assume that addicted persons possess decision-making capacity. Thus, the view that people with SUD would ipso facto lose decision-making power for research consent is flawed and stigmatizing. (shrink)

The fifth and sixth volume of the _Adagia_ (Proverbs) of the Amsterdam edition of the Latin texts of Erasmus give an introduction in German and a critical edition of the Latin text of the third thousand _Adages_.

The fourth volume of the Adagia of the Amsterdam edition of the Latin texts of Erasmus gives an introduction in German and a critical edition of the Latin text of the second half of the second thousand Adages.

The fourth volume of the _Adagia_ (Proverbs) of the Amsterdam edition of the Latin texts of Erasmus gives an introduction in German and a critical edition of the Latin text of the second half of the second thousand _Adages_.

The article has two aims: (a) to show how the notion of self proposed by Zahavi allows to underlie different aspects of personal identity; (b) to provide some elements that strengthen and complement the arguments of the Danish philosopher. First, I begin with a phenomenological analysis of the acts. Second, I study the identity and the various levels of the self that underlie it. Finally, I present some elements to constitute a metaphysics of the human person as a complement to (...) Zahavi’s phenomenology, considering the philosophy of mind as a framework for reflection. (shrink)

Frequent public uproar over forms of data science that rely on information about people demonstrates the challenges of defining and demonstrating trustworthy digital data research practices. This paper reviews problems of trustworthiness in what we term pervasive data research: scholarship that relies on the rich information generated about people through digital interaction. We highlight the entwined problems of participant unawareness of such research and the relationship of pervasive data research to corporate datafication and surveillance. We suggest a way forward by (...) drawing from the history of a different methodological approach in which researchers have struggled with trustworthy practice: ethnography. To grapple with the colonial legacy of their methods, ethnographers have developed analytic lenses and researcher practices that foreground relations of awareness and power. These lenses are inspiring but also challenging for pervasive data research, given the flattening of contexts inherent in digital data collection. We propose ways that pervasive data researchers can incorporate reflection on awareness and power within their research to support the development of trustworthy data science. (shrink)

The bridge between psychiatry and neuroscience is not the only one we have to build; it is also necessary to narrow the gap between neuroscience and philosophy. This does not imply reducing the latter to the former or vice versa, but rather linking each other without eliminating their own characteristics. Taking that into account, Dan Zahavi’s phenomenology of mind can make a great contribution by presenting itself like a different option within philosophy of mind, which up until the last few (...) years was dominated by the analytic tradition. In this chapter I present Zahavi’s proposal in four steps. Firstly, I clarify the term phenomenology. This question is not accidental because nowadays this concept is used by diverse traditions and with different meanings. Secondly, I make the fundamental distinction between first-person-perspective—which corresponds to Phenomenology—and third-person-perspective—compatible with neuroscience. Thirdly, I explain the methodological stages assumed by Zahavi from the Husserlian tradition. These stages enable him to study from the first-person-perspective rigorously: epoché, phenomenological reduction, eidetic variation, and intersubjective verification. Finally, I develop the issue of naturalization of Phenomenology in order to establish a dialogue between science and philosophy. For Zahavi that naturalization does not necessarily imply reductionism, but can be understood as something necessary for a fruitful exchange between those disciplines. (shrink)

The objective of this study—a substudy to a phase I bioequivalence study—was to compare the effect of standard and concise consent forms on research volunteers’ comprehension of and satisfaction with consent forms, as well as to assess the effect of select volunteer characteristics, such as financial motivations to participate in research, on their comprehension. A 36-item questionnaire measured volunteers’ comprehension, satisfaction, and motivations for participation. Volunteers were randomized to the standard Pfizer consent form or a concise, easier-to-read form. We approached (...) 139 volunteers to participate, and 138 completed the questionnaire . The cohorts did not differ in sociodemographic characteristics. We found that the average comprehension scores for the standard consent form cohort and the concise consent cohort were about the same, and that satisfaction with the consent form was high in both cohorts. Surprisingly, volunteers with a financial motivation had significantly greater comprehension of the study. (shrink)

Objective Some researchers claim that the quality of informed consent of clinical research participants in developing countries is worse than in developed countries. To evaluate this assumption, we reviewed the available data on the quality of consent in both settings. Methods We conducted a comprehensive PubMed search, examined bibliographies and literature reviews, and consulted with international experts on informed consent in order to identify studies published from 1966 to 2010 that used quantitative methods, surveyed participants or parents of paediatric participants (...) in actual trials, assessed comprehension and/or voluntariness, and did not involve testing particular consent interventions. Forty-seven studies met these criteria. We compared data about participant comprehension and voluntariness. The paucity of data and variation in study methodology limit comparison and preclude statistical aggregation of the data. Results and Discussion This review shows that the assertion that informed consent is worse in developing countries than in developed countries is a simplification of a complex picture. Despite the limitations of comparison, the data suggest that: (1) comprehension of study information varies among participants in both developed and developing countries, and comprehension of randomisation and placebo controlled designs is poorer than comprehension of other aspects of trials in both settings; and (2) participants in developing countries appear to be less likely than those in developed countries to say they can refuse participation in or withdraw from a trial, and are more likely to worry about the consequences of refusal or withdrawal. (shrink)

En este trabajo realizamos una revisión historiográfica sobre la fabricación de anatomías artificiales que fueron ampliamente demandadas como herramientas didácticas en la enseñanza de la naturaleza, entre finales del siglo XVIII y principios del XX. Se analizan los contextos educativos y sociales que favorecieron la amplia difusión de este tipo de artefactos en el comercio de la cultura científica, y se describen las técnicas de manufactura. Se concluye que estos artefactos, fruto del ingenio humano, son fuentes materiales de extraordinario valor (...) para comprender la construcción y evolución de la ciencia, los avances en los recursos pedagógicos y las innovaciones tecnológicas. (shrink)

This paper presents a graffito written after firing on a Samian-ware bowl dated to the turn of the first and second centuries c.e., which seems to contain part of a hexameter included in the well-known anthology Carmina XII sapientum, the composition of which has recently been attributed to the Christian author Lactantius.

Como podemos observar na sociedade contemporânea, as relações de poder estão cada vez mais disseminadas por todos os lados, seja nas relações familiares, num grupo de amigos, numa instituição, numa empresa, em cargos públicos, etc, e essas relações podem-se caracterizar de forma simples (entre dois indivíduos) ou numa esfera mais complexa (empresa, cidade ou país). E cada uma dessas relações têm em comum o fato de servirem como meio de influência na consulta alheia. Na esfera social, são números demasiados de (...) exemplos ou formas de exercício do poder, todavia podemos destacar as que estão no pódio social, e que são as formas de poder predominantes, são eles: o poder econômico, o poder ideológico e o poder político. O primeiro baseia-se na posse de bens materiais, como meios de produção, à exemplo citado anteriormente o poder do patrão sobre seus empregados, o patrão exerce uma ordem (poder) que, caso não cumprida ou não realizada, o empregado pode até perder seu emprego, por isso o proletário é submetido ao patrão que submete suas leis e vontades sobre os empregados. O segundo exemplo, o poder ideológico, serve-se das ideias ou simplesmente de informações para influenciar, de forma direta ou indireta, a conduta e os princípios dos indivíduos, ou influenciar seus comportamentos sobre algo determinado, à exemplo dessa influência, citemos o papel hegemônico de determinados meios de comunicação sobre as pessoas, o poder que a mídia exerce sobre o comportamento humano é gigantesco. Como exemplo da inclusão mídia na mente humana, podemos citar uma família que se alimentou e se serve satisfeita após a refeição, porém ao assistir um programa e em seu comercial estiver passando a propaganda de um produto alimentício, é da natureza humana sentir fome novamente, e essas famílias irem atrás do produto na própria casa, ou em supermercados, restaurantes, etc, para conseguir o produto. O terceiro e último exemplo, o poder político, goza de ferramentas e variadas técnicas para alcançar a influência na conduta alheia, isto é, tentar mudar uma opinião já formada dos cidadãos sobre determinados assuntos, à exemplo o poder de convencimento de partidos políticos e seus candidatos sobre o eleitorado durante um pleito político ou eleições municipais, estaduais ou federais. Após essa iniciação sobre as três formas de exercício do poder, vamos destrinchar cada uma delas, facilitando a compreensão e os seus respectivos papéis no âmbito social. (shrink)

It is relevant to interpret the perception that students with disabilities, teachers, and managers have about an inclusive educational program, to identify and describe the facilitators and barriers during the training of those students; analyze the relevance of the inclusive program from the perceptions of the participating actors; and assess the program's supports from the perception of students with disabilities. This is a mixed investigation of sequential design and phenomenological approach carried out through surveys and in-depth interviews with the actors.

This article discloses the findings of a qualitative research on the teaching knowledge gained by normalist pre-service teachers during their teaching practice and how this helps them solve their practice problems in public secondary schools. This teaching knowledge is a social construction generated within the inter-experience and tensions shared with other school agents during their teacher education.

Cet ouvrage étudie les potentialités de la technique/du principe de proportionnalité telle qu'appliquées par les juges en lien avec les droits fondamentaux. Il essaie de répondre à certaines interrogations liées à l'application et à la mise en uvre de cette notion. Les juges, s'inscrivent-ils dans la poursuite d'un activisme judiciaire à travers l'application mitigée de la proportionnalité dans le cadre du contrôle juridictionnel et la mise en balance des intérêts? Est-ce que la proportionnalité implique la nécessité d'établir une hiérarchie entre (...) les droits protégés? Le recours à la mise en balance des intérêts par les juges est-il toujours neutre? Quid de la cohérence jurisprudentielle dans le raisonnement des juges en appliquant ce principe en matière des droits fondamentaux? (shrink)

It has become increasingly difficult for individuals to exercise meaningful control over the personal data they disclose to companies or to understand and track the ways in which that data is exchanged and used. These developments have led to an emerging consensus that existing privacy and data protection laws offer individuals insufficient protections against harms stemming from current data practices. However, an effective and ethically justified way forward remains elusive. To inform policy in this area, we propose the Ethical Data (...) Practices framework. The framework outlines six principles relevant to the collection and use of personal data—minimizing harm, fairly distributing benefits and burdens, respecting autonomy, transparency, accountability, and inclusion—and translates these principles into action-guiding practical imperatives for companies that process personal data. In addition to informing policy, the practical imperatives can be voluntarily adopted by companies to promote ethical data practices. (shrink)

Initial vaccine allocations for the coronavirus disease 2019 (COVID-19) will be limited. It is crucial to assess the ethical values associated with different methods of allocation, as well as important scientific and practical questions. This Viewpoint identifies three ethical values, benefiting people and limiting harm; prioritizing disadvantaged populations; and equal concern for all. It then explains why these values support prioritizing three groups: health care workers; other essential workers and people in high-transmission settings; and people with medical vulnerabilities associated with (...) poorer COVID-19 outcomes. In contrast, two other groups, people over 65 without medical vulnerabilities and participants in clinical research, present more complex ethical questions. This prioritization also encompasses valuing direct benefits to vaccinated individuals, indirect benefits to individuals protected from spread of infection, and indirect health and socioeconomic benefits to those protected from harm as health system and societal functioning improve. Vaccine allocation that recognizes important ethical values and avoids arbitrariness, waste, and corruption can ensure that the distribution of a COVID-19 vaccine is both fair and perceived as fair. (shrink)

The aim of this paper is to argue that lying differs from mere misleading in a way that can be morally relevant: liars commit themselves to something they believe to be false, while misleaders avoid such commitment, and this difference can make a moral difference. Even holding all else fixed, a lie can therefore be morally worse than a corresponding misleading utterance. But, we argue, there are also cases in which the difference in commitment makes lying morally better than misleading, (...) as well as cases in which the difference is not morally relevant. This view conflicts with the two main positions philosophers have defended in the ethics of lying and misleading, which entail either that lying is in virtue of its nature worse than misleading or that there is no morally relevant difference between lying and misleading. (shrink)

Death in the Clinic fills a gap in contemporary medical education by explicitly addressing the concrete clinical realities about death with which practitioners, patients, and their families continue to wrestle. Visit our website for sample chapters!