Este artículo explora la noción de "inquietud" en la fe cristiana según Blaise Pascal. El autor distingue tres tipos de inquietud en Pascal: la inquietud metafísica ante la muerte, la inquietud espiritual por el extravío del mundo en la diversión, y la inquietud de la salvación y el pecado para el creyente. Pascal describe una auténtica angustia ante la finitud (la muerte) y también ante el pecado (la separación de Dios). Pero más allá, hay en Pascal una inquietud propia del (...) cristiano, que "redobla" su responsabilidad al estar ligado a Dios. En "La conversión del pecador" (1653) aparece la inquietud "de" la fe, el temor ante la posibilidad de creer. Luego, en la experiencia del "Memorial" (1654), surge la inquietud "en" la fe, el miedo a perder a Dios una vez que se ha creído y amado. No basta con creer, sino con perseverar creyendo, en la incertidumbre. El "Memorial" no consagra sólo el recuerdo del pasado, sino la fidelidad a lo sucedido. La paz desaparece en la segunda versión, mostrando que la fe no es un estado permanente. La inquietud es constitutiva de la existencia creyente para Pascal. No se trata de alcanzar la certidumbre, sino de continuar creyendo cuando ya se ha creído. (shrink)

Foundation models such as GPT-4 are fine-tuned to avoid unsafe or otherwise problematic behavior, such as helping to commit crimes or producing racist text. One approach to fine-tuning, called reinforcement learning from human feedback, learns from humans' expressed preferences over multiple outputs. Another approach is constitutional AI, in which the input from humans is a list of high-level principles. But how do we deal with potentially diverging input from humans? How can we aggregate the input into consistent data about "collective" (...) preferences or otherwise use it to make collective choices about model behavior? In this paper, we argue that the field of social choice is well positioned to address these questions, and we discuss ways forward for this agenda, drawing on discussions in a recent workshop on Social Choice for AI Ethics and Safety held in Berkeley, CA, USA in December 2023. (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)

The COVID-19 pandemic revealed numerous weaknesses in pandemic preparedness and response, including underfunding, inadequate surveillance, and inequitable distribution of countermeasures. To overcome these weaknesses for future pandemics, WHO released a zero draft of a pandemic treaty in February, 2023, and subsequently a revised bureau's text in May, 2023. COVID-19 made clear that pandemic prevention, preparedness, and response reflect choices and value judgements. These decisions are therefore not a purely scientific or technical exercise, but are fundamentally grounded in ethics. The latest (...) treaty draft reflects these ethical considerations by including a section entitled Guiding Principles and Approaches. Most of these principles are ethical—they establish core values that undergird the treaty. Unfortunately, the treaty draft's set of principles are numerous, overlapping, and show inadequate coherence and consistency. We propose two improvements to this section of the draft pandemic treaty. First, key guiding ethical principles should be clearer and more precise than they currently are. Second, the link between ethical principles and policy implementation should be clearly established and define boundaries on acceptable interpretation, ensuring that signatories abide by these principles. (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)

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search.In sum, teaching in all three subjects combined (...) comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics. (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)

Controversy persists over the ethics of compensating research participants and providing posttrial benefits to communities in developing countries. Little is known about residents' views on these subjects. In this study, interviews about compensation and posttrial benefits from a hypothetical HIV vaccine trial were conducted in Uganda’s Rakai District. Most respondents said researchers owed the community posttrial benefits and research compensation, but opinions differed as to what these should be. Debates about posttrial benefits and compensation rarely include residents' views like these, (...) but future ones should. (shrink)

This paper examines the effects of a decrease in auditor litigation risk in a setting that isolates a change in auditor litigation risk from changes in auditor reputation. _StoneRidge Investment Partners v. Scientific Atlanta_ is a 2008 U.S. Supreme Court ruling that restricted secondary actor liability in class action suits, resulting in a decrease in class actions that listed auditors as defendants. We document that the _StoneRidge_ decision is associated with a negative CAR for clients of Big 4 auditors and (...) industry specialist auditors, in particular those associated with high-litigation risk, low cash, and past incidences of modified going concern opinions. These findings are consistent with investor perception of lower potential payoffs from secondary defendants in class action suits, in particular auditors, following the _StoneRidge_ decision. We also document that auditors are more (less) likely to accept (reject) risky clients and charge lower audit fees to risky clients after _StoneRidge_, consistent with a decrease in auditor litigation risk that increases auditor risk tolerance. Finally, we provide evidence that audit firms issue fewer going concern opinions following _StoneRidge_, consistent with a decrease in litigation risk leading to lower audit quality_._ Our results are relevant to policy makers as they consider the disciplinary role of litigation on audit markets. (shrink)

Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death (...) or illness and unjust disparities; prioritising those who prevent harm or mitigate disparities; recognising contributions to combating an outbreak; and treating similar individuals similarly. Ethically and equitably marshalling available countermeasures requires articulating these fundamental objectives, identifying priority tiers, and recognising trade-offs between prioritising the people at the highest risk of infection and the people at the highest risk of harm if infected. These five values can provide guidance on preferable priority categories for a more ethically sound response and suggest methods for optimising allocation of countermeasures for mpox and other diseases for which countermeasures are in short supply. Properly marshalling available countermeasures will be crucial for future effective and equitable national responses to outbreaks. (shrink)

In our study, we examine the association between hedge fund activism and a target firm’s corporate social responsibility (CSR) activities and whether activists can promote socially responsible investments while upholding shareholders’ interests. Using different matched samples, we find a strong positive association between the target firm’s CSR in the year before it is targeted by activists and its probability of being targeted by a hedge fund. Classifying hedge fund activists into socially and non-socially responsible funds based on their objectives, we (...) find that both give similar level of consideration to a firm’s CSR activities when initiating campaigns. Similar to DesJardine and Durand (DesJardine and Durand, Strategic Management Journal 41:1054–1082, 2020), we demonstrate that hedge funds have, on average, a negative impact on target firms’ CSR in the years following the initial investments. Complementary to DesJardine and Durand (DesJardine and Durand, Strategic Management Journal 41:1054–1082, 2020), we compare the two types of hedge funds and find an asymmetric effect of the hedge funds’ campaigns. Socially responsible hedge fund campaigns are associated with a large _increase_ in their target’s CSR, whereas non-socially responsible hedge funds _decrease_ this measure in their target. Finally, we find that target firms exhibit a long-term improvement in future stock returns and profitability. These findings provide evidence that certain types of activists, such as socially responsible funds, promote both _stakeholder_ and _shareholders’_ long-term interests. (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!

Edited by Thomas A. Shannon, this series provides anthologies of critical essays and reflections by leading ethicists in four pivotal areas: reproductive technologies, genetic technologies, death and dying, and health care policy. The goal of this series is twofold: first, to provide a set of readers on thematic topics for introductory or survey courses in bioethics or for courses with a particular theme or time limitation. Second, each of the readers in this series is designed to help students focus more (...) thoroughly and effectively on specific topics that flesh out the ethical issues at the core of bioethics. The series is also highly accessible to general readers interested in bioethics. (shrink)

No âmbito da pesquisa em educação aparecem e convivem diversas abordagens de pesquisa que orientam as investigações. Dentre elas há a pesquisa qualitativa segundo uma abordagem fenomenológica. Essa afirmação pode ser estendida à pesquisa em Educação Matemática. Assim, no intuito de contribuir para a reflexão sobre pesquisa nesses âmbitos, buscamos, com este texto, explicitar uma compreensão sobre o modo de se constituir a questão de pesquisa em uma atitude de investigação fenomenológica, contextualizada na região de inquérito da Educação Matemática. O (...) processo exposto esclarece o movimento articulador que exige rigor e clareza por parte do pesquisador. Enfim, deixamos, com este texto, pistas do movimento que o pesquisador efetua ao buscar esclarecer a pergunta/questão estabelecida, tornando-a mais clara e lançando luzes sobre a investigação em sua totalidade. Expõe, ainda, uma compreensão dos aspectos epistemológicos e ontológicos acerca desse assunto. (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.

Traditionally, biomedical research has been devoted to improvement in the understanding and treatment or prevention of disease. Building on the knowledge generated by the long history of disease-oriented research, the next few decades will witness an explosion of biomedical enhancements to make people faster, stronger, smarter, less forgetful, happier, prettier, and live longer (Turner et al. 2003; Vastag 2004; Rose 2002). As with other biomedical interventions, research to assess the safety and efficacy of these enhancements in humans should be conducted (...) before their introduction into clinical practice.1 However, various concerns regarding the ethics of enhancement research could be raised. Those who .. (shrink)

Height preferences reflecting positive assortative mating for height—wherein an individual’s own height positively predicts the preferred height of their mate—have been observed in several distinct human populations and are thought to increase reproductive fitness. However, the extent to which assortative preferences for height differ strategically for short-term versus long-term relationship partners, as they do for numerous other indices of mate quality, remains unclear. We explore this possibility in a large representative sample of over 500 men and women aged 15–77 from (...) Canada, Cuba, Norway and the United States. Participants’ own heights were measured, and they indicated their height preferences for a long-term and short-term mate using graphic stimuli containing metric indices. Replicating the “male-taller norm,” participants on average preferred taller-than-average male mates, and shorter-than-average female mates. Positive assortative preferences for height were observed across sexes and samples, however the strength of these height preferences varied with relationship context for men, and not for women. Taller men preferred relatively shorter women for short-term relationships than for long-term relationships, indicating stronger assortative preferences for height in a long-term context. These results provide preliminary evidence that, in addition to mate preferences for other physical traits related to mate quality such as masculinity in the body, face, and voice, assortative preferences for height do vary as a function of expected relationship length, but this was surprisingly only observed in preferences for female height. (shrink)

Las organizaciones sin fines de lucro han sufrido grandes cambios. Dejó de ser un sector empobrecido, donde se recibían como donaciones aquel dinero que les sobraba a los grandes empresarios, y donde sólo tenían cabida las personas voluntarias. Hoy en día es un sector marcado por el trabajo de personas profesionales y por ser organizaciones capaces de llenar los espacios que ha dejado el Estado sin atender. Además de ser organizaciones inteligentes, con estructuras flexibles, que les permiten responder de manera (...) ágil a los requerimientos de su entorno. Sin embargo para que el sector sin fines de lucro pueda evolucionar de manera exitosa, no sólo necesitan de la labor de sus miembros, también necesitan del compromiso del estado, las universidades y las entidades privadas. Un compromiso que se haga visible a través de alianzas de colaboración entre sí, y así de esta manera trabajar conjuntamente en el desarrollo humano y la inclusión social en Chile. (shrink)

In this short response to Kerstein and Bognar, we clarify three aspects of the complete lives system, which we propose as a system of allocating scarce medical interventions. We argue that the complete lives system provides meaningful guidance even though it does not provide an algorithm. We also defend the investment modification to the complete lives system, which prioritizes adolescents and older children over younger children; argue that sickest-first allocation remains flawed when scarcity is absolute and ongoing; and argue that (...) Kerstein and Bognar are mistaken to base their allocation principles on differences in personhood. (shrink)

Informed consent documents are central to the informed consent process and are required for participation in clinical trials in the U.S. The primary purpose of the document is “to assist a prospect...

This paper focuses on the scholastic technique of the Theravāda scholar-monk Chapaṭa Saddhammajotipāla. Chapaṭa is the author of several scholastic treatises in Pāli, the most voluminous of which is the Suttaniddesa, a commentary on the Pāli grammar of Kaccāyana. I offer a general introduction to the Pāli grammatical tradition and especially to the Pāli grammatical tradition of Burma, together with an introduction to the life and works of Chapaṭa. I also offer the first annotated translation of a passage from the (...) Suttaniddesa and in this way I show how the scholastic technique of Chapaṭa is based on a precise use of quotations, mainly from other Pāli or Sanskrit grammatical texts, but also from Buddhist literature. I finally give a preliminary assessment of typology and purpose of every different type of quotation. Although this paper consists mainly of preliminary work, it is the first essay entirely devoted to the Suttaniddesa, which is one of the most important grammatical works in the Theravāda tradition. (shrink)

AUTOCOMPOSIÇÃO DE CONFLITOS: DA CULTURA DE LITIGÂNCIA À SOLUÇÃO CONSENSUAL.

A predominância dos temas literários e fenomenológicos nos textos sartrianos dos anos 1930 já chamou atenção de vários especialistas e comentadores da obra do autor. É notável, entretanto, como os exames dos textos dessa época contentam-se, no mais das vezes, em apontar o paralelismo ou a contemporaneidade entre fenomenologia e literatura ali presente, sem realçar a fundamentação que uma parece conferir à outra e que constitui uma das questões mais interessantes que a filosofia sartriana levanta. Há que se incluir, na (...) verdade, a estética literária de Sartre na compreensão de suas teses fenomenológicas; teses estas que, por outro lado, fornecem o solo filosófico da literatura sartriana, em termos tanto de autoria quanto de crítica. O propósito deste artigo é demonstrar, assim, uma dependência ou, se quisermos, implicação mútua entre literatura e fenomenologia não apenas central em relação àquele período da produção de Sartre como, também, determinante para seus projetos teóricos e ficcionais ulteriores. (shrink)

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

It is widely held that all lies are assertions: the traditional definition of lying entails that, in order to lie, speakers have to assert something they believe to be false. It is also widely held that assertion contrasts with presupposition and, in particular, that one cannot assert something by presupposing it. Together, these views imply that speakers cannot lie with presuppositions—a view that Andreas Stokke has recently explicitly defended. The aim of this paper is to argue that speakers can lie (...) with presuppositions, and to discuss some of the implications this outcome has for current research on lying, assertion and presupposition. (shrink)

The distinction between lying and mere misleading is commonly tied to the distinction between saying and conversationally implicating. Many definitions of lying are based on the idea that liars say something they believe to be false, while misleaders put forward a believed-false conversational implicature. The aim of this paper is to motivate, spell out, and defend an alternative approach, on which lying and misleading differ in terms of commitment: liars, but not misleaders, commit themselves to something they believe to be (...) false. This approach entails that lying and misleading involve speech-acts of different force. While lying requires the committal speech-act of asserting, misleading involves the non-committal speech-act of suggesting. The approach leads to a broader definition of lying that can account for lies that are told while speaking non-literally or with the help of presuppositions, and it allows for a parallel definition of misleading, which so far is lacking in the debate. (shrink)

This paper defends stage theory against the argument from diachronic counting. It argues that stage theorists can appeal to quantifier domain restriction in order to accommodate intuitions about diachronic counting sentences. Two approaches involving domain restriction are discussed. According to the first, domains of counting are usually restricted to stages at the time of utterance. This approach explains intuitions in many cases, but is theoretically costly and delivers wrong counts if diachronic counting is combined with fission or fusion. On the (...) second approach, domains of counting are usually restricted in an indeterminate way, so as to include at most one member of any maximal class of counterpart-interrelated stages (with respect to a certain utterance). This view can accommodate all the relevant intuitions about counting sentences, and it fits well with a new stage-theoretic view of reference that allows speakers to refer to both present and past stages. (shrink)

Defeasible argumentation has been applied successfully in several real-world domains in which it is necessary to handle incomplete and contradictory information. In recent years, there have been interesting attempts to carry out argumentation processes supported by massive repositories developing argumentative reasoning applications. One of such efforts builds arguments by retrieving information from relational databases using the DBI-DeLP framework; this article presents eDBI-DeLP, which extends the original DBI-DeLP framework by providing two novel aspects which refine the interaction between DeLP programs and (...) relational databases. First, we expand the expressiveness of dbi-delp programs by providing ways of controlling how the information in databases is recovered; this is done by introducing filters that enable an improved fine-grained control on the argumentation processes which become useful in applications, providing the semantics and the implementation of such filters. Second, we introduce an argument comparison criterion which can be adjusted at the level of literals to model particular features such as credibility and topic expertise, among others. These new tools can be particularly useful in environments such as medical diagnosis expert systems, decision support systems, or recommender systems based on argumentation, where datasets are often provided in the form of relational databases. (shrink)

Many recent definitions of lying are based on the notion of what is said. This paper argues that says-based definitions of lying cannot account for lies involving non-literal speech, such as metaphor, hyperbole, loose use or irony. It proposes that lies should instead be defined in terms of assertion, where what is asserted need not coincide with what is said. And it points to possible implications this outcome might have for the ethics of lying.

In arguing against a supposed ambiguity, philosophers often rely on the zeugma test. In an application of the zeugma test, a supposedly ambiguous expression is placed in a sentence in which several of its supposed meanings are forced together. If the resulting sentence sounds zeugmatic, that is taken as evidence for ambiguity; if it does not sound zeugmatic, that is taken as evidence against ambiguity. The aim of this article is to show that arguments based on the second direction of (...) the test are misguided: ambiguous expressions, and in particular philosophically contested ones, do not reliably lead to zeugmaticity, so an absence of zeugmaticity provides no meaningful evidence for an absence of ambiguity. (shrink)