Rare diseases are a heterogenic group of disorders with a little in common except of their rarity affecting by less than 5 : 10.000 people. In the world is registered about 6000-8000 rare diseases with 6-8% suffering population only in the European Union. In spite of rarity, they represent an important medical and social problem due to their incidence. For many rare diseases have no treatment, but if it exists and if started on time as being (...) available to patients, there is a good prognosis for them to be able for normal life. The problems of patients affected by rare diseases are related to the lack of diagnosis and timely undergoing as well as their treatment or prevention. Orphan drugs are products intended for treatment, diagnosis or prevention of rare diseases, but for their development and marketing the industry has not been interested in yet because of their marketing reasons. Patients suffering from a rare disease although belonging to the vulnerable group for their specific health needs, is becoming invisible in the health care system due to their additional needs un properly recognized. Ethical problems faced by patients, but also health care professionals are related to the allocation of medical diagnostics, unequal approach to health care, inappropriately specialized social services as well as therapy and rare orphan drugs unavailability. Ethical questions related to clinical trails on orphan drugs, population screening and epidemiology testing on rare diseases will also be discussed in this paper. [Projekat Ministarstva nauke Republike Srbije, br. 41004: Rare diseases: Molecular pathophysiology, the diagnostic and therapeutical modalities, social, ethical and legal aspects] Retke bolesti su veoma heterogena grupa poremecaja i imaju malo toga zajednickog osim retkosti, posto pogadjaju manje od pet osoba na 10.000 ljudi. U svetu je evidentirano izmedju 6.000 i 8.000 retkih bolesti koje pogadjaju sest do osam procenata stanovnistva samo u Evropskoj uniji. Dakle, iako retke, one predstavljaju vazan medicinski i socijalni problem s obzirom na broj obolelih. Za mnoge retke bolesti nema terapije, a ukoliko ona postoji i ako se na vreme zapocne i bude dostupna pacijentima, postoje dobri izgledi da ce oboleli moci da zive normalnim zivotom. Problemi s kojima se susrecu pacijenti sa retkim bolestima vezani su za dijagnostikovanje u smislu nemogucnosti ili nepravovremenog postavljanja dijagnoze, kao i same terapije ili prevencije pojave bolesti. Orphan lekovi su proizvodi koji su namenjeni za lecenje, dijagnozu ili prevenciju retkih bolesti, za ciji razvoj i marketing industrija nije zainteresovana iz trzisnih razloga. Pacijenti s retkim bolestima, iako pripadaju osetljivoj grupi, jer imaju specificne zdravstvene potrebe, ostaju nevidljivi u zdravstvenom sistemu, jer se njihove dodatne specificne potrebe ne prepoznaju. Eticki problemi s kojima se susrecu pacijenti, ali i zdravstveni radnici, ticu se alokacije zdravstvene dijagnostike, nejednakog pristupa zdravstvenoj zastiti i nezi, nedostatka specijalizovanih socijalnih usluga, kao i nepostojanja i nedostupnosti terapije orphan lekovima. Eticka pitanja retkih klinickih ispitivanja orphan lekova i populacionih i skrining ispitivanja u vezi sa retkim bolestima takodje su razmatrani u ovom radu. PR Projekat Ministarstva nauke Republike Srbije, br. 41004: Rare diseases: Molecular pathophysiology, the diagnostic and therapeutical modalities, social, ethical and legal aspects. (shrink)

Nanotechnology is an important platform technology which will add new features like improved biocompatibility, smaller size, and more sophisticated electronics to neuro-implants improving their therapeutic potential. Especially in view of possible advantages for patients, research and development of nanotechnologically improved neuro implants is a moral obligation. However, the development of brain implants by itself touches many ethical, social and legal issues, which also apply in a specific way to devices enabled or improved by nanotechnology. For researchers developing nanotechnology such (...) issues are rather distant from their daily work in the lab, but as soon as they use their materials or devices in medical applications such as therapy of brain diseases they have to be aware of and deal with them. This paper is intended to raise sensitivity for the ethical, legal and social aspects (ELSA) involved in applying nanotechnology in brain implants or other devices by highlighting the short term problems of testing and clinical trials within the existing regulatory frameworks (A), the short and medium-term questions of risks in the application of the devices (B) and the long-term perspectives related to problems of enhancement (C). To identify and address such issues properly nanotechnologists should involve ethical, legal and social experts and regulatory bodies in their research as early as possible. This will help to remove pressure from regulatory bodies, to settle public concern and to prevent non-acceptable developments for the benefit of the patients. (shrink)

Soon after the coronavirus disease 2019 (COVID‐19) pandemic outbreak, it became clear that vaccination will be the most useful tool to combat the disease. Despite the apparent safety and efficacy of the developed anti‐COVID‐19 vaccines, relatively high percentages of the population worldwide refused to get vaccinated, including many health workers and health students. The present cross‐sectional study examined the motives, attitudes, and personal characteristics of those who did not get vaccinated against COVID‐19 or vaccinated without complete willingness among nursing students (...) and nursing faculty members in Israel (n = 472). Results show that the vast majority of the study participants (97%) received at least one dose of the anti‐COVID‐19 vaccine. Nearly 37% of the participants indicated that they received the vaccine without complete willingness. As compared to faculty members, nursing students reported lower trust in the efficacy of the vaccine, perceived the COVID‐19 pandemic as a health threat to a lesser extent, exhibited lower institutional and personal trust, and had higher levels of posttraumatic stress disorder symptoms. Non‐Jewish participants were at risk of vaccinating without complete willingness. These findings underscore the need for developing evidence‐based strategies to promote the safety and efficacy of the anti‐COVID‐19 vaccines in nursing schools. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 22 (2002) 47-60 [Access article in PDF] Economic Aspects of Social and Environmental Violence from a Buddhist Perspective Sulak Sivaraksa Pacarayasara I have been asked to write on some economic aspects of social and environmental violence, approaching the subject from a Buddhist perspective. Indeed this invitation offers a wide range of choices, but I shall try to keep my subject matter fairly general (...) and straightforward. The present economic reality, widely known as neoliberal capitalism, prizes the accumulation of profits over human well-being and environmental sustainability. As such, it is criminal and hence definitely not the way to regulate or organize the global society. The present trend, however, is increasingly giving the agents and institutions of capital a free hand to do so.The main beneficiaries of this violent and highly unjust system are invariably transnational corporations (though some critics prefer to call them transnational tyrannies), big financial investors, and their supporters. Roughly two-thirds of what is known today as world trade are simply intrafirm or interfirm trade. Small wonder that they are virtually the present-day "masters of the universe," increasingly accumulating special rights, influence, and power vis-à-vis the mass of humanity. An open secret is that the wealthiest 20 percent of the world's population receive 83 percent of the world's total income—a fact that no longer creates consternation or moral outrage in the mainstream; rather, it is taken as a healthy phenomenon that will contribute to human progress. Moreover, the environment is being plundered to quench the greed—which happens to be a bottomless pit—of the few. Inevitably, this creates a two-tiered system both within and between countries; a small opulent minority builds their castles on the suffering and impoverishment of the absolute majority of humanity. A large segment of humanity enjoys freedom with no opportunities and has the freedom to starve but does not enjoy freedom from poverty. Everyday thousands of children are dying from easily preventable disease. Millions more are malnourished or starving. It is against this backdrop that we need to discuss some of the economic aspects of social and environmental violence from a Buddhist perspective.Let us first deal with the production side of the capitalist equation. What is its main driving force and value system? How do they impact social organization and the environment? [End Page 47] Undeniably, the fuel that keeps the capitalist engine running is profit: the more of it, the better, the argument goes. Hence, corporations must be free to pursue it at all costs. The ends justify the means. It is also argued that the profit generated by the system will eventually trickle down to benefit the mass of humanity. The available evidence points otherwise. To be fair, capitalism does generate some benefits to humanity, but they are largely unintended by-products of the system.In the mainstream discourse, profit is said to derive solely from entrepreneurship —a concept that acts as a bicarbonate of soda for intellectual and moral indigestion. In reality, the easiest and cheapest way to reap massive profit is exploitation or ostracism: One is rich by keeping or making others poor, directly or otherwise. The masters then seek solace in the tenuous assumption that the global economy utilizes the best and disposes the rest. Furthermore, the environment is seen as a subsystem of international capitalism, not vice versa. Hence it is to be raped in order to lubricate the wheels of the capitalist machine. Put differently, the insatiable quest for profit upheld by capitalism really reflects greed, hatred, moral callousness, and wanton criminal negligence toward the well-being of the people and environment. The name of the game is getting ahead even at another's expense, to rise to the top of the pecking order. If one frequents any bookstore, one is likely to find business books with interesting titles such as Divide and Rule and Colonizing the Market. This nefarious aggressiveness is benignly known as "free competition" in mainstream parlance. Those who succeed to the top are lauded as "efficient." If allowed to have a firm... (shrink)

What does it take for an individual to be personally responsible for behaviors that lead to increased risk of disease? We examine three approaches to responsibility that cover the most important aspects of the discussion of responsibility and spell out what it takes, according to each of them, to be responsible for behaviors leading to increased risk of disease. We show that only what we call the causal approach can adequately accommodate widely shared intuitions to the effect that certain (...) causal influences—such as genetic make-up or certain social circumstances—diminish, or undermine personal responsibility. However, accepting the causal approach most likely makes personal responsibility impossible. We therefore need either to reject these widely shared intuitions about what counts as responsibility-softening or undermining or to accept that personal responsibility for behaviors leading to increased risk of disease rests on premises so shaky that personal responsibility is probably impossible. (shrink)

This thesis investigates the nature of psychiatric disorders, and to what extent they can form a basis for classification, explanation, and treatment interventions. These questions are important in the light of the “crisis of validity” in psychiatry, according to which current diagnostic categories do not pick out real disorders. I address the questions by defending an account of psychiatric disorders that can better accommodate social aspects and non-epistemic values than the symptom-based model of the Diagnostic and Statistical Manual (...) of Mental Disorders (DSM) and the brain disease model of the biomedical approach, including the Research Domain Criteria (RDoC). I concentrate on three ways that psychiatric disorders can differ from prototypical natural kinds, such as biological species and chemical elements. First, the concept of psychiatric disorder or mental disorder is partly value-laden and cannot be defined based only on scientific facts. Second, the objects of psychiatric classifications are interactive human kinds because people with disorders respond to their classifications through looping effects. Third, sociocultural factors can shape disorders in complex ways, which is indicated by their cross-cultural variation. I argue that these challenges can be overcome with a pluralistic explanatory account that grants an explicit role to value-sensitive considerations and social scientific research. Based on this, I argue that particular disorders can in principle support inductive inferences. ------------------------------------------------------------------------------------------ My key argument is that although whether a condition is considered pathological is partly a value-laden question, this does not rule out a realist account of particular psychiatric disorders as homeostatic property cluster kinds (HPC). I assert that causal mechanisms responsible for psychiatric kinds can be understood non-metaphysically based on the contrastive-counterfactual and interventionist theories of explanation. An advantage of this account is that it can address the concern that psychiatric explanations require one to relate heterogeneous causal factors on different levels, such as genetic, neurological, psychological, and social. My novel argument is that mechanistic explanations of scientific kinds have applicability domains over which they account for specific aspects of kinds and warrant inductive inferences. That is, identifying the applicability domain of an explanation spells out the conditions under which the explanation is expected to be reliable and when it can break down. This helps to understand how different discipline approaches, including social and cultural ones, can be complementary and make an explanation of a psychiatric kind more reliable. On the other hand, the account also shows how the complex nature of psychiatric kinds can license re-classifications for different epistemic and non-epistemic purposes. Finally, in the light of the social implications of psychiatric classifications, I suggest a value-sensitive or ameliorative approach to engineering the concept of psychiatric disorder. In conclusion, my account shows that research on the social and cultural factors that shape psychiatric disorders, and weighing the non-epistemic values that influence classificatory practices, can and should inform classificatory choices as well as policy and treatment interventions. (shrink)

The question of whether medical and psychiatric judgements involve a normative or evaluative component has been a source of wide and vehement disagreement. But among those who think such a component is involved, there is considerable further disagreement as to its nature. In this article, I consider several versions of Aristotelian normativism, as propounded by Christopher Megone, Michael Thompson and Philippa Foot, and Martha Nussbaum. The first two, I claim, can be persuasively rebutted by different modes of liberal pluralist challenge (...) — respectively, pluralism about structures of social organisation and pluralism about biological forms. Nussbaum's version, by contrast, is alert to the need for pluralism; I argue, however, that the Aristotelian aspects of her theory hamper her pursuit of those pluralistic aims. (shrink)

Originally published in 1943, Civilization and Disease was based on a series of lectures that the medical historian Henry E. Sigerist delivered at Cornell University in 1940. Now back in print, the book is a wide-ranging account of the importance of social factors on health and illness and the impact that disease has had on societies throughout human history. Despite considerable advances in both medicine and historiography, Civilization and Disease remains a landmark work in the history of medicine and (...) a fascinating look at, first, civilization as a factor in the genesis and spread of disease, and second, the effects of disease on such aspects of civilization as economics, social life, law, philosophy, religion, science, and the arts. In a new foreword written for this edition, Elizabeth Fee outlines Sigerist's life, works, and legacy as a historian, a teacher, and an advocate for universal health care, hailing Civilization and Disease as "an excellent introduction to Sigerist's work.". (shrink)

Vision is the main entrance for environmental input to the human brain. Even if vision is our most used sensory modality, its importance is not limited to environmental exploration. Rather it has strong links to motor competences, further extending to cognitive and social aspects of human life. These multifaceted relationships are particularly important in developmental age and become dramatically evident in presence of complex deficits originating from visual aberrancies. The present review summarizes the available neuropsychological evidence on the (...) development of visual competences, with a particular focus on the associated visuo-motor integration skills in health and disease. With the aim of supporting future research and interventional settings, the goal of the present review is to constitute a solid base to help the translation of neuropsychological hypotheses into straightforward empirical investigations and rehabilitation/training protocols. This approach will further increase the impact, ameliorate the acceptance, and ease the use and implementation of lab-derived intervention protocols in real-life situations. (shrink)

In this paper we try to identify the roots of the persistent contemporary problems in our modernized agriculture: overproduction, loss of biodiversity and of soil fertility, the risk of large animal disease, social controversies on the lack of animal welfare and culling of animals, etc. Attention is paid to the historical development of present-day farming in Holland as an example of European agriculture. We see a blinkered quest for efficiency in the industrialization of agriculture since the Second World War. (...) Key factor is the cultural mindset at the foundation of our modern society, originating from the ideas of the enlightenment. It makes people vulnerable to ideologies, causing them to focus on a certain goal without considering the consequences. Due to the overemphasis on efficiency, modern industrial agriculture has never been comfortably embedded in its ecological and social context, and as a result displays the characteristics of an ideology. The cause of the inability to solve today’s problems is therefore deeper than simply a failure to apply the right mix of standard remedies. Unless stakeholders in farming start to counter this very one-sided approach to efficiency, modernization will continue to cause all kinds of friction. The implications of the results for agricultural policy, farming and further research are discussed. (shrink)

Background In the coronavirus disease 2019 era, doctors have tried to decrease hospital visits and admissions. To this end, telemedicine was implemented in a non-systematic manner according. The objective of this study was to assess the current knowledge and attitudes of physicians in Alexandria, Egypt, and Punjab, India, toward telemedicine and its ethical and medico-legal issues. Method A cross-sectional study was implemented using an anonymous self-administered questionnaire carried out over two months (July and August 2020). A four-point Likert scale was (...) used to collect data about background knowledge, training in telemedicine and ethical and medico-legal issues in telemedicine practice. Results The questionnaire was completed by 175 Egyptian and 51 Indian physicians from different specialties. A significantly higher percentage of Indian physicians practiced telemedicine than Egyptian physicians during the coronavirus disease 2019 era. Although most physicians had no specific training or licensing to practice telemedicine, most of them practiced telemedicine through their social media accounts. Ethical violations involving waiving patient consent were detected. Significant ethical violations to doctors, for example, blackmail, defamation, hate speech, accusations in a court and violations of privacy, were observed. Indian physicians (39.2%) and Egyptian physicians (24%) thought the penalties should be lower in telemedicine than in traditional practice. Finally, most participants would like to continue using telemedicine after the coronavirus disease 2019 era but with improvements. Conclusions Coronavirus disease 2019 changed the acceptance of telemedicine by physicians. Many ethical and legal issues need to be addressed and clarified using formal training before implementation and standardization of telemedicine services. (shrink)

Recent scholarship on the social history of health and medicine in colonial India has moved beyond enclavist or hegemonic aspects of imperial medicine and has rather focused on the role of Indian intermediaries and the fractured nature of colonial hegemony. Drawing inspiration from this scholarship, the article highlights the significance of the Indian subordinates in the lock hospital system in the nineteenth century Madras Presidency. This study focuses on a class of Indian subordinates called the “gomastah”, who were (...) employed to detect clandestine prostitution in Madras to control the spread of venereal disease. It also underlines the role of other native and non-native subordinates such as Dhais, Chowdranies and Matrons, the ways in which they became indispensable for the smoother operation of the Contagious Diseases Act and the lock hospitals on a day-to-day basis. By emphasising how Indian subordinates were able to bring in caste biases within colonial governmentality, adding another layer to the colonial prejudices and xenophobia against the native population, it underlines the fact that there was not a one-way appropriation or facilitation of the coloniser’s knowledge or biases by the colonised intermediaries. Rather, it argues for an interaction between them, and highlights the complexities of caste hierarchies and prejudice within the everyday colonial governmentality. Moreover, the article focuses on the consequent chaos and inherent power struggle between different factions of colonial staff. (shrink)

Rare neuromuscular diseases are a group of pathologies characterized by a progressive loss of muscular strength, atrophy, fatigue, and other muscle-related symptoms, which affect quality of life levels. The low prevalence, high geographical dispersion and disability of these individuals involve difficulties in accessing health and social care services. Teleassistance is presented as a useful tool to perform psychosocial interventions in these situations. The main aim of this research is to assess the effects of a teleassistance psychosocial program on (...) the QoL levels of people with RNMDs who have different levels of disability. A sample of 73 participants was divided into an experimental group, which participated in the intervention, and a control wait list group. QoL was evaluated through the SIP and the SF-36, and disability through the WHO-DAS II. The participants with a moderate to severe level of disability were those who most benefited from the intervention. The results also revealed that the psychosocial teleassistance program was suitable to improve physical and psychosocial aspects of people suffering from a rare neuromuscular disease with a moderate level of disability, but just psychosocial aspects in those with a severe level of disability. (shrink)

Consistent findings about the inverse association of social network level with coronary heart disease mortality and morbidity suggest the importance of investigating biological pathways of association. Differences in plasma fibrinogen level were investigated among middle-aged men with weak and strong structural and functional social network ties. Men with low scores in the adequacy of social participation variable (structural) had higher mean values of plasma fibrinogen than those with high scores. The difference remained after adjustment for age, smoking (...) and cardiovascular health status and after possible modifying factors were taken into account, but did not remain significant after allowing for physical fitness. Men with high scores in overall support (functional) had higher plasma fibrinogen levels compared to the men with low scores. This difference persisted after age and cardiovascular health status were taken into account but was explained by smoking. The data suggest that smoking and cardiorespiratory fitness are important mediating or modifying factors between structural and functional aspects of social network ties and plasma fibrinogen. (shrink)

The coronavirus disease 2019 (COVID-19) pandemic has had profound effects on all aspects of society. Families were among those directly impacted by the first measures imposed by health authorities worldwide to contain the spread of the Sars-CoV-2 virus, where social distancing and mandatory quarantine were the main approaches implemented. Notably, little is yet known about how social distancing during COVID-19 has altered families' daily routines, particularly regarding music-related behaviors. The aim of this study was 2-fold: (i) to (...) explore changes in families' daily routine and caregivers' levels of well-being and stress during the COVID-19 outbreak in Brazil and (ii) to investigate whether musical behaviors of caregivers and the children under their care (aged from 3 to 6 years old) changed during social distancing. One hundred and eighty-eight caregivers residing in Brazil participated in an online cross-sectional study conducted between July and August 2020. Our findings suggest significant changes in families' dynamics during the COVID-19 outbreak, with parents (especially mothers) spending more time on childcare and a substantial decrease in caregiver's well-being. Regarding music-related behaviors, our results revealed considerable changes in caregivers' and children's musical activities at home during social distancing, including an increase in child-only musical behaviors and shared caregiver-child activities. Moreover, sociodemographic factors such as caregiver background and well-being as well as the child's disability status significantly influenced musical engagement at home during social distancing. This study captured some features of the home musical environment of middle-class families in Brazil in the first stages of social distancing restrictions during the pandemic and caregivers' role in providing an environment where musical experiences are nurtured. Further research is needed to better understand aspects such as the long-term impact of the changes of musical behaviors at home on musical parenting and families' well-being. (shrink)

This article examines two interrelated aspects of Mexican regional music response to the coronavirus crisis in the música huasteca community: the growth of interactive huapango livestreams as a preexisting but newly significant space for informal community gathering and cultural participation at the onset of the coronavirus pandemic, and the composition of original verses by son huasteco performers addressing the pandemic. Both the livestreams and the newly created coronavirus disease verses reflect critical improvisatory approaches to the pandemic in música huasteca. (...) The interactive livestreams signaled an ad hoc community infrastructure facilitated by social media and an emerging community space fostered by Do-It-Yourself activists. Improvised COVID-related verses presented resonant local and regional themes as a community response to a global crisis. Digital ethnography conducted since March 2020 revealed a regional burst of musical creativity coupled with DIY intentionality, a leveling of access to virtual community spaces, and enhanced digital intimacies established across a wide cultural diaspora in Mexico and the USA. These responses were musically, poetically, and organizationally improvisational, as was the overall outpouring of the son huasteco music inspired by the coronavirus outbreak. Son huasteco is a folk music tradition from the Huasteca, a geo-cultural region spanning the intersection of six states in central Mexico. This study examines a selection of musical responses by discussing improvisational examples in both Spanish and the indigenous language Nahuatl, and in the virtual musical communities of the Huasteca migrant diaspora in digital events such as “Encuentro Virtual de Tríos Huastecos,” the “Huapangos Sin Fronteras” festival and competition, and in the nightly gatherings on social media platforms developed during the pandemic to sustain the Huastecan cultural expression. These phenomena have served as vibrant points of transnational connection and identity in a time where physical gatherings were untenable. (shrink)

There is a growing tendency for medicine to be used not to prevent or heal illnesses, but to fulfil individual personal wishes such as wishes for enhanced work performance, better social skills, children with specific characteristics, stress relief, a certain appearance or a better sex life. While recognizing that the subject of wish-fulfilling medicine may vary greatly and that it may employ very different techniques, this article argues that wish-fulfilling medicine can be described as a cohesive phenomenon with distinctive (...) features. Following a few examples of well established wish-fulfilling medical practices and a brief definition of the phenomenon, both theoretical aspects and ethical implications of such practices are discussed and the question is raised how wish-fulfilling medicine should be evaluated from an ethical point of view. It is concluded that modern medicine is currently ill equipped to provide reasons why wish-fulfilling medicine should be banned or discouraged. The phenomenon of wish-fulfilling medicine serves as a prime example of the vagueness of the descriptive and the lack of decisive orientation of the normative categories employed in modern medicine. (shrink)

Recent scholarship on the social history of health and medicine in colonial India has moved beyond enclavist or hegemonic aspects of imperial medicine and has rather focused on the role of Indian intermediaries and the fractured nature of colonial hegemony. Drawing inspiration from this scholarship, the article highlights the significance of the Indian subordinates in the lock hospital system in the nineteenth century Madras Presidency. This study focuses on a class of Indian subordinates called the “gomastah”, who were (...) employed to detect clandestine prostitution in Madras to control the spread of venereal disease. It also underlines the role of other native and non-native subordinates such as Dhais, Chowdranies and Matrons, the ways in which they became indispensable for the smoother operation of the Contagious Diseases Act and the lock hospitals on a day-to-day basis. By emphasising how Indian subordinates were able to bring in caste biases within colonial governmentality, adding another layer to the colonial prejudices and xenophobia against the native population, it underlines the fact that there was not a one-way appropriation or facilitation of the coloniser’s knowledge or biases by the colonised intermediaries. Rather, it argues for an interaction between them, and highlights the complexities of caste hierarchies and prejudice within the everyday colonial governmentality. Moreover, the article focuses on the consequent chaos and inherent power struggle between different factions of colonial staff.ZusammenfassungDie jüngere Forschung zur Sozialgeschichte der Gesundheit und Medizin im kolonialen Indien hat sich jenseits spezifischer hegemonialer Aspekte der imperialen Medizin mittlerweile verstärkt der Bedeutung ihrer indischen Vermittler und der gebrochenen Natur kolonialer Herrschaft zugewandt. Davon inspiriert beleuchtet der Beitrag die Rolle indischer Subalterner im System der Krankenhäuser für Geschlechtskrankheiten der Provinz Madras im 19. Jahrhundert. Er fokussiert auf die so genannten „Gomastah“, eine Klasse von indischen Untergebenen, die zur Aufdeckung der illegalen Prostitution in Madras eingesetzt wurden, um so die Ausbreitung von Geschlechtskrankheiten zu verhindern. Untersucht wird auch die Rolle anderer einheimischer und nicht einheimischer Untergebener wie der Dhais, Chowdranies und Matrons, die für die reibungslose Umsetzung des Contagious Diseases Act und das alltägliche Funktionieren dieser Krankenhäuser unverzichtbar waren. Indem herausgearbeitet wird, wie indisches Kastendenken in die koloniale Gouvernementalität einfließen konnte und so koloniale Vorurteile und Xenophobie stärkte, unterstreicht der Artikel die Tatsache, dass es keine einseitige Aneignung oder Vermittlung kolonialen Wissens und kolonialer Vorannahmen durch die kolonisierten Vermittler gab. Argumentiert wird vielmehr für deren Interaktion, betont wird die komplexe Bedeutung des Kastensystems und seiner Vorurteile für das alltägliche koloniale Regierungshandeln. Zudem befasst sich der Beitrag mit dem daraus resultierenden Chaos und den inhärenten Machtkämpfen zwischen verschiedenen Gruppierungen des kolonialen Personals. (shrink)

There has been a modern epidemic of heart attacks in the western world, and this paper is concerned with this ‘new’ medical condition and how it arose. Two competing theories are commonly proposed, relating either to conventional accounts of medical science, or to social construction. Whilst recognising that aspects of both theories have some validity, it is claimed that neither is wholly adequate. This issue has particular relevance for heart attacks and is explored in some detail, but it (...) also points to some more general conclusions. First that medical knowledge cannot be separated into ‘scientific’ and ‘social’ compartments but is united by its human aspect; and second that although medical knowledge has a special dimension, when understood in this way, it may also resonate with a more general re-examination of the relationship between scientific and human knowledge. (shrink)

While freedom of movement has been one of the most highly respected human right across the EU, there are various aspects which come into play which still need to be resolved for this to be achieved in practice. One of these key issues is cross border health care. Indeed, there is an increasing awareness of standardisation of health service provision and cross border collaboration in the EU. However, certain groups particularly children may be at risk of suboptimal treatment as (...) a result. We present the case of a child patient which highlights the complexity of this matter spanning family law, health law, social security law as well as ethical issues. EU legislation needs to ensure that children patients have access to high quality care across the EU borders. (shrink)

Frontotemporal dementia is a neurodegenerative disease that affects the prefrontal cortex, and impairs various aspects relevant to social cognition. Such impairments can emerge as a visible phenomenon in social interaction and therefore can have very real consequences for those who interact with the afflicted. In this article, I examine how attitudes toward FTD patients are indexed through speech features employed by their interlocutors. I focus on three different speech features typically employed by adults and directed towards subordinates (...) or children: directives, let’s/we framed sequences, and initiation-response-evaluation sequences. These forms are used as strategies to affect and guide FTD patient behaviors, and index how FTD patients are socially constructed as ‘child-like’ and in need of assistance and guidance though not necessarily warranted. Thus, FTD patients may be subject to a diminished status as a result of their social impairments. (shrink)

From its inception in 1987 social epistemology has been divided into analytic and critical approaches, represented by Alvin I. Goldman and Steve Fuller, respectively. In this paper, the agendas and some basic ideas of ASE and CSE are compared and assessed by bringing into the discussion also other participants of the debates on the social aspects of scientific knowledge—among them Raimo Tuomela, Philip Kitcher and Helen Longino. The six topics to be analyzed include individual and collective epistemic (...) agents; the notion of scientific community; realism and constructivism; truth-seeking communities; epistemic and social values; science, experts, and democracy. (shrink)

Fecal microbiota transplantation is reportedly the most effective therapy for relapsing Clostridium Difficile infection and a potential therapeutic option for many diseases. It also poses important ethical concerns. This study is an attempt to assess clinicians’ perception and attitudes towards ethical and social challenges raised by fecal microbiota transplantation. A questionnaire was developed which consisted of 20 items: four items covered general aspects, nine were about ethical aspects such as informed consent and privacy issues, four concerned (...) social and regulatory issues, and three were about an FMT bank. This was distributed to participants at the Second China gastroenterology and FMT conference in May 2015. Basic descriptive statistical analyses and simple comparative statistical tests were performed. Nearly three quarters of the 100 respondents were gastro-enterologist physicians. 89% of all respondents believed FMT is a promising treatment modality for some diseases and 88% of whom chose clinical efficacy as the primary reason for recommending FMT. High expectation from patients and pressure on clinicians was reported as the most frequent reasons for not recommending FMT. The clinicians who had less familiarity with FMT reported significantly more worry related to the dignity and psychological impact of FMT compared to those who have high familiarity with FMT.More than half of the respondents were concerned about the commercialization of FMT, although almost one in five respondents did not see this as a problem. We found most respondents have positive attitudes towards FMT but low awareness of published evidence. Informed consent for vulnerable patients, privacy and protection of donors were perceived as the most challenging ethical aspects of FMT. This study identified areas of limited knowledge and ways of addressing ethical issues and indicates the need to devise the education and training for clinicians on FMT. (shrink)

Experts discuss the economic, legal, and social issues surrounding the use of genetic testing in determining eligibility for life insurance. Insurance companies routinely use an individual's medical history and family medical history in determining eligibility for life insurance; this is part of the process of medical underwriting. Insurers have also long used genetic information, often derived from family history, in underwriting. But rapid advances in gene identification and genetic testing are changing the way we look at genetic information. Should (...) the results of genetic testing (which might identify a predisposition toward disease not related to medical history) be available to life insurance medical underwriters? Few if any life insurers currently require genetic testing, but there are no laws or regulations prohibiting its use. Genetics and Life Insurance examines the complex economic, legal, and social issues surrounding the use of genetic information in life insurance underwriting. The contributors are legal scholars, representatives of the life insurance industry (including an actuary and an insurance physician), a geneticist, a genetic counselor, a philosopher, and a consumer advocate. They explore all aspects of an issue that has only recently drawn the attention of policymakers and the public. The book opens with a report on the results of a public opinion poll on genetics and life insurance. Succeeding chapters present the insurer perspective, a discussion of the economics of risk selection in life insurance, background information on the process of underwriting, a scientific analysis of genetic risks and mortality rates, a philosophical discussion of fairness and genetic underwriting, the viewpoints of consumers and genetics counselors, a comparison of different international policy approaches to the issue, and a legal analysis of antitrust implications when insurers collaborate in setting standards for medical underwriting. In the final chapter the editor addresses various policy options, examining the pros and cons of each one and assessing their political feasibility. (shrink)

In June 2021, new waves of the current COVID-19 pandemic are still messing up our lives and magnetizing the compass of our life. No other epidemics or pandemics have been politicized at such a level since ancient times. The full political spectrum from right to left has tried to ride this pandemic and upset the public health response efforts. Statistics and politics have changed our daily approach to this brutal infection, but even crueler has been the palpable miscommunication. Massive and (...) uncontrolled lockdowns and not climate change are destroying the economy of our planet. Intolerance against vaccine opponents and hesitant families has been vocalized with martial tones in both social media and news channels. In this book, the author analyzes the pandemic in a historical context, emphasizes the importance of facemasks, but also highlights our human approach to anti-mask psychology. It would be appalling to call mistakes in public health decisions "learned lessons" because it reduces the gravity of the consequences of inadequate communication. Our youth is our future. The mental issues arising from a lack of social interaction and in-person education are dreadful. Vaccines are powerful and represent the most outstanding progress in medicine. There is light at the end of the tunnel, but vaccine acceptance or herd immunity is not the answer, or probably, not the only one. There is true hope that we are going back to our world, but the COVID-19 pandemic may be an occasion to reconsider the traditional family in the center of our lives and daily politics. A tolerance towards any race needs to be contagious, militant, and blazing to vehemently rebuild and revitalize the American Dream. (shrink)

In June 2021, new waves of the current COVID-19 pandemic are still messing up our lives and magnetizing the compass of our life. No other epidemics or pandemics have been politicized at such a level since ancient times. The full political spectrum from right to left has tried to ride this pandemic and upset the public health response efforts. Statistics and politics have changed our daily approach to this brutal infection, but even crueler has been the palpable miscommunication. Massive and (...) uncontrolled lockdowns and not climate change are destroying the economy of our planet. Intolerance against vaccine opponents and hesitant families has been vocalized with martial tones in both social media and news channels. In this book, the author analyzes the pandemic in a historical context, emphasizes the importance of facemasks, but also highlights our human approach to anti-mask psychology. It would be appalling to call mistakes in public health decisions "learned lessons" because it reduces the gravity of the consequences of inadequate communication. Our youth is our future. The mental issues arising from a lack of social interaction and in-person education are dreadful. Vaccines are powerful and represent the most outstanding progress in medicine. There is light at the end of the tunnel, but vaccine acceptance or herd immunity is not the answer, or probably, not the only one. There is true hope that we are going back to our world, but the COVID-19 pandemic may be an occasion to reconsider the traditional family in the center of our lives and daily politics. A tolerance towards any race needs to be contagious, militant, and blazing to vehemently rebuild and revitalize the American Dream. (shrink)

The relevance of the study of the problem of Christian axiology is due to the growing interest in religion and the associated change in world outlook and values ​​in contemporary Ukrainian society. The study of religious values ​​is caused by the urgent problem of finding universal moral values ​​of social development and clarifying the content, structure and nature of their functioning. The scientific study of religious values ​​is also relevant because this problem is closely linked to the value (...) class='Hi'>aspects of political life. Christian values ​​are one of the most important factors influencing the formation and development of Ukrainian culture. (shrink)

En la actualidad Cuba desarrolla un Programa de Atención Integral al Paciente con Úlcera de Pie Diabético mediante el uso del Heberprot-P, esencial para disminuir la amputación y la discapacidad. El trabajo tiene el objetivo de realizar un diagnóstico sobre la aplicación del Heberprot-P en el Servicio de Angiología del Hospital Provincial Universitario Manuel Ascunce Domenech de Camagüey. Se realizaron encuestas a pacientes para identificar necesidades sentidas relacionadas con el tratamiento y para las actitudes manifiestas, y se hicieron entrevistas al (...) personal médico y de enfermería. El diagnóstico permitió corroborar la necesaria investigación con enfoque social del servicio de salud escogido a nivel territorial. Destaca elevar el trabajo de captación de pacientes desde el nivel primario de salud para garantizar un mayor alcance del programa, así como la trascendencia del apoyo familiar y la relación profesional de la salud- paciente a fin de lograr la calidad requerida. At present Cuba is developing a program concerning the care of patient with ulcer of the diabetes foot by means of Heberprot-P essential to reduce the amputation and disability. The aim of this paper is to carry out a diagnosis about social aspects of the application of the Heberprot-P in the Angiology service at Manuel Ascunce Domenech Hospital in Camaguey. Some surveys were carry out to identify certain needs related with the treatment and the attitude shown and on the other hand some interview were made to the medical and nursing staff. The diagnosis allowed to verify the need of the research with social approach. The paper highlight how to incorporate patients from the primary health level, in order this program has a higher scope and the importance of the family support and the professional relationship to accomplish the quality required. (shrink)

In little more than a decade, the AIDS epidemic has exerted a profound effect on morbidity and mortality among young adults and children in many parts of the world. One of the more dramatic aspects of AIDS is that it seems to have arisen almost spontaneously as a new epidemic, spreading rapidly within at-risk populations in a way that is unprecedented for the serious infectious diseases of recent memory. Tuberculosis, on the other hand, had only recently been considered (...) a disease of historical importance but of diminishing relevance to current public health priorities, especially in industrialized countries. Over the past decade, however, and in parallel with the AIDS epidemic, there has been a resurgence of tuberculosis in many of the same populations most affected by HIV infection. This has had important implications for clinical practice, public health, and the development of appropriate health policy. A number of elements have converged to promote the development of HIV-related tuberculosis, including biologic, social, and environmental factors. These will be discussed both to provide a context for understanding the relationship between the two epidemics, and as a basis for suggesting strategies for tuberculosis control in the AIDS era. (shrink)

In little more than a decade, the AIDS epidemic has exerted a profound effect on morbidity and mortality among young adults and children in many parts of the world. One of the more dramatic aspects of AIDS is that it seems to have arisen almost spontaneously as a new epidemic, spreading rapidly within at-risk populations in a way that is unprecedented for the serious infectious diseases of recent memory. Tuberculosis, on the other hand, had only recently been considered (...) a disease of historical importance but of diminishing relevance to current public health priorities, especially in industrialized countries. Over the past decade, however, and in parallel with the AIDS epidemic, there has been a resurgence of tuberculosis in many of the same populations most affected by HIV infection. This has had important implications for clinical practice, public health, and the development of appropriate health policy. A number of elements have converged to promote the development of HIV-related tuberculosis, including biologic, social, and environmental factors. These will be discussed both to provide a context for understanding the relationship between the two epidemics, and as a basis for suggesting strategies for tuberculosis control in the AIDS era. (shrink)

Particular social aspects of the nature of science, such as economics of, and entrepreneurship in science, are understudied in science education research. It is not surprising then that the practical applications, such as lesson resources and teaching materials, are scarce. The key aims of this article are to synthesize perspectives from the literature on economics of science, entrepreneurship, NOS, and science education in order to have a better understanding of how science works in society and illustrate how such (...) a synthesis can be incorporated in the practice of science education. The main objectives of this article are to argue for the role and inclusion of EOS and entrepreneurship in NOS and re-define entrepreneurship in the NOS context; explore the issues emerging in the “financial systems” of the Family Resemblance Approach to NOS and propose the inclusion of contemporary aspects of science, such as EOS and entrepreneurship, into NOS; conceptualize NOS, EOS, and entrepreneurship in a conceptual framework to explain how science works in the society; and transform the theoretical knowledge of how science operates in society into practical applications for science teaching and learning. The conceptual framework that we propose illustrates the links between State, Academia, Market and Industry. We suggest practical lesson activities to clarify how the theoretical discussions on the SAMI cycle framework can be useful and relevant for classroom practice. In this article, science refers to physics, chemistry, and biology. However, we also recommend an application of this framework to other sciences to reveal their social-institutional side. (shrink)

Some contemporary philosophers of action have contended that the intentions, decisions, and actions of collective social agency are reducible to those of the individuals involved. This contention is based on two assumptions: (1) that collective agency would require super-minds, and (2) that actions presuppose causes that move our bodies. The problem of how to account for collective action had not been regarded as a problem in the history of philosophy earlier.The explanation of why ancient Greek philosophers did not see (...) joint agency as a problem is not, as sometimes assumed, that they had no, or only a weak, sense of individuality. Nor is it because they simply overlooked the difference between individual and collective agency. It is, rather, as Aristotle’s conception of humans as ‘social’ or ‘political’ animals indicates, that the aims and ends of actions, and the means to bring them about by acting together, is the result of practice from early on. Without the acquisition of language and moral habituation humans would not become humans. There is, then, a shared understanding about common agency from infancy on. Individuals may disagree about some particular aim and action, and act only because it is a decision of the majority. But no super-minds are required to explain the communality of wishes. That Aristotle ignored the fact that all motion starts in individual bodies is explained by the difference between motions and actions: moves that are not determined by their ends are mere motions, not actions. So what moves an individual body can be the wish to bring about a joint action with another person or with a collective of persons. (shrink)

In the epistemological context of theory transferand scientific exchanges, the aim of this paper is to indicate the presence of Weberian categories and ideas on dependency theory formulated by Fernando Cardosoand Enzo Faletto. Here we see how the construction of this paradigm was based on some issues, concepts, approaches and orientations of the Weberian research program formulated by José Medina Echavarría to explain Latin American development. We will also consider the contexts of enunciation and reception theories, allowing us to talk (...) about the "sociological school" that was formed in the Social Planning Division of ILPES in mid-sixties, crucial for understanding the history of sociology in Latin America. En el contexto de la discusión epistemológica sobre el examen de las transferencias y los intercambios científicos de las teorías, el objetivo de este artículo es señalar la presencia de categorías e ideas weberianas en lateoría de la dependencia formulada por Fernando Cardoso y Enzo Faletto. Aquí veremos cómo la construcción de este paradigma se sustentó en algunos temas, conceptos, enfoques y orientaciones del programa de investigación weberiano formulado por José Medina Echavarría para explicar el desarrollo latinoamericano. También tendremos en cuenta los contextos de enunciación y de recepción de las teorías, lo que nos permitirá hablar de la "escuela sociológica" que se formó en la División de Planificación Social del ILPES a mitad de los años 60, decisiva para comprender la historia de la sociología en América Latina. (shrink)

In moments of daring, some physical scientists consider problems of social inquiry, hoping naively that the methods of physical inquiry will provide them with special insight. In my own work on problems of industrial production where I am searching for “practical” means for optimizing production in some socially satisfactory sense, I find that the physical scientist cannot escape the responsibility for social inquiry. So far as I can understand the nature of this work, it requires for its fruitful (...) pursuit a methodology which leans heavily on the concepts of statistical control of Shewhart, of cybernetics of Wiener and of experimentalism of Singer, Churchman and Ackoff. (shrink)

My comments on Jacqueline Taylor's rich and interesting study1 will focus on a theme which I found particularly thought provoking: the discussion of Hume's treatment of pride. I think the topic of pride is central to the book's structure—closely integrated with the recurring consideration of what is distinctive in Hume's approach to the social significance of the passions.I am going to come at this theme indirectly—through consideration of the differences between Hume and Spinoza on the nature and significance of (...) pride. Taylor shows that Hume has made it possible for pride to be considered as a positive trait, perhaps even as a virtue. Spinoza's attitude to pride in the Ethics is, in contrast, quite negative. The... (shrink)

パンデミック対策は何を目的とし、どのような基準と論理で行われるべきなのか? WHOの倫理指針の作成に携わった経験から分析。.

The interdisciplinary field of neurorobotics looks to neuroscience to overcome the limitations of modern robotics technology, to robotics to advance our understanding of the neural system’s inner workings, and to information technology to develop tools that support those complementary endeavours. The development of these technologies is still at an early stage, which makes them an ideal candidate for proactive and anticipatory ethical reflection. This article explains the current state of neurorobotics development within the Human Brain Project, originating from a close (...) collaboration between the scientific and technical experts who drive neurorobotics innovation, and the humanities and social sciences scholars who provide contextualising and reflective capabilities. This article discusses some of the ethical issues which can reasonably be expected. On this basis, the article explores possible gaps identified within this collaborative, ethical reflection that calls for attention to ensure that the development of neurorobotics is ethically sound and socially acceptable and desirable. (shrink)