Comprehensive in scope and research, this book will be a crucial resource for researchers in the medical sciences, as well as teachers and students alike.

I address a question in moral metaphysics: How are conflicts between moral obligations possible? I begin by explaining why we cannot give a satisfactory answer to this question simply by positing that such conflicts are conflicts between rules, principles, or reasons. I then develop and defend the “Dispositional Account,” which posits that conflicts between moral obligations are conflicts between the manifestations of obligating dispositions (obligating powers, capacities, etc.), just as conflicts between physical forces are conflicts between the manifestations of (certain) (...) causal dispositions (causal powers, capacities, etc.). This account combines the so-called “moral forces” interpretation of prima facie obligations with a dispositional moral metaphysic according to which the metaphysical grounds of moral obligations are not rules or laws, but rather real, irreducibly dispositional properties (or powers) of moral agents and patients. My principal aims are to offer a theoretically attractive and suitably metaphysical account of conflicts of obligation, and to show that the dispositional moral metaphysic that grounds the Dispositional Account can explain and accommodate plausible normative views that rule- and law-based alternatives cannot, as well as to answer objections that have been pressed against other accounts of moral conflict (especially Ross’s) that appeal to moral dispositions or forces. (shrink)

Based on anthropological fieldwork in Australia and Colombia, this collection of essays uses the workings of the human nervous system to illustrate concepts of culture.

Sander Gilman and David Parent present a fascinating sellection of memoirs, anecdotes, and informal recollections by friends and acquaintances of Nietzsche, translated by Parent from the definitive German collection.

Introduction -- The ethics of care and global politics -- Rethinking human security -- 'Women's work' : the global care and sex economies -- Humanitarian intervention and global security governance -- Peacebuilding and paternalism : reading care through postcolonialism -- Health and human security : gender, care and HIV/AIDS -- Gender, care, and the ethics of environmental security -- Conclusion. Security through care.

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

This book gives a descriptive analysis of specific Madhyamika texts. It compares the ideology of Kumarajiva (a translator of the four Madhyamika treatises 400 A.D.) with the ideologies of the three Chinese contemporaries - HuiYuan, Seng-Jui and Seng-Chao. It envisages an intercultural transmission of religious and philosophical ideas from India to China.

Four ethical values — maximizing benefits, treating equally, promoting and rewarding instrumental value, and giving priority to the worst off — yield six specific recommendations for allocating medical resources in the Covid-19 pandemic: maximize benefits; prioritize health workers; do not allocate on a first-come, first-served basis; be responsive to evidence; recognize research participation; and apply the same principles to all Covid-19 and non–Covid-19 patients.

Metaphysics, morals and science -- The classics : value -- The neo-classics : utility -- The Keynesian revolution -- Development and under-development -- What are the rules of the game?

This book was inspired originally by the debates at the turn of the century about placebo controlled trials of antiretrovirals in HIV positive pregnant women in developing countries. Moving forward from this one limited example, the book includes several additional controversial cases of clinical research conducted in developing countries, and asks probing philosophical questions about the ethics of such trials. All clinical research by its very nature uses people to acquire generalizable knowledge to help future people. But what sorts of (...) "use" are morally permissible? What is it to exploit people? Suppose that a trial conducted in a developing country would not be ethically permissible in the developed world. Can we automatically conclude from this that the trial is unethical, that some sort of morally problematic double standard is in operation? Or might the differences in the two settings justify differences in trial design? This collection of philosophical essays examines these important questions about what exploitation is and when clinical research counts as exploitative. -/- "This is an outstanding contribution to the growing literature on the ethics of research with human subjects and a fine example of what bioethics can offer at its best. Anyone with a serious interest in these issues will need to read this book from start to finish." -Daniel Wikler, Harvard School of Public Health "This book contributes significantly to the literature on exploitation in clinical research conducted in the developing world."--Patricia Marshall, Case Western Reserve University . (shrink)

There has of late been a revival of interest in the problem of practical reason. One of the causes of this revival has been, I think, a reaction against the radical subjectivism to which the emotive theory seemed to lead. Philosophers have wished to show that the method of linguistic analysis can account for that kind of objectivity, whatever kind that might be, which is possessed by our moral opinions, criticisms, etc. The question in what this objectivity consists has, however, (...) remained obscure and recent writing has failed to distinguish at least two quite distinct issues. I hope to show what these are and that they are distinct. (shrink)

It is probable that few critics, if directly challenged, would admit to believing that a work of literature which was, in some sense, morally objectionable was therefore necessarily totally lacking in literary merit. Nevertheless, it is not uncommon for a man—in the language he uses, in the conclusions he draws, in his obiter dicta—to seem yet to hold a view which, in its bald statement, he has denied. Certainly, those critics who most vehemently wish to dissociate themselves from any claims (...) that art exists for art's sake, or that there are peculiarly ‘aesthetic’ criteria, and who believe that such claims lead to irresponsibility, such critics often use moral concepts extensively in their criticism. Furthermore, they often do this in such a way as to suggest that if a work is morally objectionable, then there is no way of redeeming it aesthetically; for, it would seem, moral criticism exhausts the critical possibilities; no aesthetic saving graces are allowed. (shrink)

During the WHO-GloPID COVID-19 Global Research and Innovation Forum meeting held in Geneva on the 11th and 12th of February 2020 a number of different ethical concepts were used. This paper briefly states what a number of these concepts mean and how they might be applied to discussions about research during the COVID-19 pandemic and related outbreaks. This paper does not seek to be exhaustive and other ethical concepts are, of course, relevant and important.

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

We provide an overview of a proposal for a new metaphysical framework within which theology and science might both find a home. Our proposal draws on the triadic semiotics and threefold system of metaphysical categories of C. S. Peirce. We summarize the key features of a semiotic model of the Trinity, based on observed parallels between Peirce's categories of Firstness, Secondness, and Thirdness and Christian thinking about, respectively, the Father, Son, and Holy Spirit. We test and extend the semiotic model (...) by exploring how Peirce's taxonomy of signs offers a new approach to theological reflection on the Incarnation. This leads to a novel way of framing scientific questions about human evolution in semiotic terms and to a new approach to theological anthropology. Finally, we use the semiotic model of the Trinity as the basis of a trinitarian approach to the theology of creation according to which the semiotic processes that are fundamental to life and to human behavior and cognition may be understood as “vestiges of the Trinity in creation.”. (shrink)

This book presents a systematic account of the role of the personal spiritual ideal of wu-wei--literally "no doing," but better rendered as "effortless action"--in early Chinese thought. Edward Slingerland's analysis shows that wu-wei represents the most general of a set of conceptual metaphors having to do with a state of effortless ease and unself-consciousness. This concept of effortlessness, he contends, serves as a common ideal for both Daoist and Confucian thinkers. He also argues that this concept contains within itself a (...) conceptual tension that motivates the development of early Chinese thought: the so-called "paradox of wu-wei," or the question of how one can consciously "try not to try." Methodologically, this book represents a preliminary attempt to apply the contemporary theory of conceptual metaphor to the study of early Chinese thought. Although the focus is upon early China, both the subject matter and methodology have wider implications. The subject of wu-wei is relevant to anyone interested in later East Asian religious thought or in the so-called "virtue-ethics" tradition in the West. Moreover, the technique of conceptual metaphor analysis--along with the principle of "embodied realism" upon which it is based--provides an exciting new theoretical framework and methodological tool for the study of comparative thought, comparative religion, intellectual history, and even the humanities in general. Part of the purpose of this work is thus to help introduce scholars in the humanities and social sciences to this methodology, and provide an example of how it may be applied to a particular sub-field. (shrink)

Virtues are acquirable, so if intellectual humility is a virtue, it’s acquirable. But there is something deeply problematic—perhaps even paradoxical—about aiming to be intellectually humble. Drawing on Edward Slingerland’s analysis of the paradoxical virtue of wu-wei in Trying Not To Try (New York: Crown, 2014), we argue for an anti-individualistic conception of the trait, concluding that one’s intellectual humility depends upon the intellectual humility of others. Slingerland defines wu-wei as the “dynamic, effortless, and unselfconscious state of mind of a person (...) who is optimally active and effective” (Trying Not to Try, 7). Someone who embodies wu-wei inspires implicit trust, so it is beneficial to appear wu-wei. This has led to an arms race between faking wu-wei on the one hand and detecting fakery on the other. Likewise, there are many benefits to being (or seeming to be) intellectually humble. But someone who makes conscious, strategic efforts to appear intellectually humble is ipso facto not intellectually humble. Following Slingerland’s lead, we argue that there are several strategies one might pursue to acquire genuine intellectual humility, and all of these involve commitment to shared social or epistemic values, combined with receptivity to feedback from others, who must in turn have and manifest relevant intellectual virtues. In other words, other people and shared values are partial bearers of a given individual’s intellectual humility. If this is on the right track, then acquiring intellectual humility demands epistemic anti-individualism. (shrink)

The African intelligentsia played a pivotal role in the anti-colonial and anti-apartheid struggle in Africa. Not only did it provide intellectual resources to the political struggle leaders but also took active part in the political leadership. Since independence, this role has diminished tremendously, as some of the intelligentsia are ‘silenced’ and others become ‘captured’ by the newly independent states. As a result, a wedge is driven between the intelligentsia and the political leadership. However, given that there is a deficit in (...) efforts to reconstruct Africa, the pan-African intelligentsia are called upon to reinvigorate and reposition themselves to assist in developing organisations and institutions to serve African people worldwide. This call challenges them to take a creative, innovative role in the reconstructive task of Africa, thereby bidding farewell to intellectual isolationism. The article draws from Kwame Nkrumah’s ideas, thereby affirming the relevance of his political ideas in contemporary Africa. (shrink)

This article describes the daunting challenge of precarious housing in Salvokop located in the southern part of inner City of Tshwane, Gauteng Province. Insecure tenure, unmaintained dwellings, overcrowding, mushrooming of backyard shacks and the rise of the informal settlement, all that led to deep levels of vulnerability and neighbourhood deterioration. Current conditions show that life in that neighbourhood is fraught as substandard housing degenerated into slum and squalor. This concern emerged among other salient pressing issues of poverty and vulnerability from (...) the World Café and Focus Groups with the inner city churches including those from Salvokop. The article set out to describe precarious housing, unpleasant living conditions owing to the fact that human beings stay in unsuitable dwellings while the environment deteriorates. Taking into account their circumstances, the article’s aim was to recapture the extent to which the residents suffer as a result of living in dwellings unfit for human habitation, rethinking an alternative model to respond. A theological agenda for future ecclesiological engagement was discerned forthwith recommendations. The article makes a contribution towards the theology of the city in that it stimulates church practices and housing of poor people in Tshwane. It does so by engaging in a unique way grassroots knowledge from the different inner city congregations. This process used the platform of surveys, World Café style gatherings and Focus Groups. In conversation with the primary source, this article also contributed with original data generated with the Salvokop residents whose stories helped to expend on horizons of housing, which is acknowledged. All the inner city church contributors of the realisation of the study objectives are also recognised. (shrink)

Commentators often claim that medical research subjects are coerced into participating in clinical studies. In recent years, such claims have appeared especially frequently in ethical discussions of research in developing countries. Medical research ethics is more important than ever as we move into the 21st century because worldwide the pharmaceutical industry has grown so much and shows no sign of slowing its growth. This means that more people are involved in medical research today than ever before, and in the future (...) even more will be involved. However, despite the pressing need for reflection on research ethics, it is important to carefully identify the concerns we have about research. Otherwise we run the risk that the moral language we use, and which we hear other people use, may do our moral thinking for us. We argue that many recent claims about the occurrence of coercion in medical research are misguided and misuse the word "coercion." We try to identify the real problems, and urge people to attend carefully to the implications of their descriptions of moral problems in research. (shrink)

All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies' obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic. We argue that an ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability. All parties' obligations should be coordinated and mutually consistent. For (...) instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges. Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others. (shrink)

1. The opinions expressed are the author's own. They do not reflect any position or policy of the National Institutes of Health, Public Health Service, Department of Health and Human Services, or any of the authors affiliated organizations.

INTRODUCTION The Questions of Medical Ethics Call him Andrew. His face is gaunt and unshaven but peaceful. His eyelids are gently closed. ...

According to the most popular versions of the flicker defense, Frankfurt-style cases fail to undermine the Principle of Alternative Possibilities (PAP) because agents in these cases are (directly) morally responsible not for making the decisions they make but for making these decisions on their own, which is something they could have avoided doing. Frankfurt defenders have primarily focused on trying to show that the alternative possibility of refraining from making the relevant decisions on their own is not a robust alternative, (...) while generally granting that this alternative cannot easily be eliminated from successful cases of this sort. In a recent issue of this journal, Stockdale (2022) attempts to sidestep the debate concerning robustness and develops a novel kind of Frankfurt-style case in which agents are unable to avoid making the relevant decisions on their own. The fundamental problem with Stockdale’s argument is that it hinges on an implausible conception of acting on one’s own. I help clarify the pertinent sense of what it means to do a thing on one’s own in this context and show that these new cases are unable to overcome the targeted versions of the flicker defense of PAP. (shrink)

This edition goes beyond others that largely leave readers to their own devices in understanding this cryptic work, by providing an entrée into the text that parallels the traditional Chinese way of approaching it: alongside Slingerland's exquisite rendering of the work are his translations of a selection of classic Chinese commentaries that shed light on difficult passages, provide historical and cultural context, and invite the reader to ponder a range of interpretations. The ideal student edition, this volume also includes a (...) general introduction, notes, multiple appendices--including a glossary of technical terms, references to modern Western scholarship that point the way for further study, and an annotated bibliography. (shrink)

For decades, worries about undue inducement have Pervaded clinical research, and are especially common when research is accompanied by payment or conducted in developing countries. Few ethical judgments carry as much moral opprobrium or are thought to undermine the ethical soundness of a clinical trial as thoroughly as undue inducement. Indeed, the admonition to prevent undue inducement is one of the few explicit instructions in the Common Rules requirements for informed consent.Despite their long history and pervasiveness, charges of undue inducement (...) in clinical research are almost always mistaken. Indeed, I will advance an even more radical claim: Aresearch trial that otherwise fulfills the fundamental ethical requirements for human subjects research inherently cannot create the possibility of undue inducement because substantial risk of serious harm isprecluded. Charges of undue inducement tend to express displaced and mislabeled ethical concerns about other aspects of human subjects research. Consequently, claims of undue inducement should rarely be made, and when they are advanced should be treated with skepticism, placing a heavy burden of proofon those advancing such charges. (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)

COVID-19 vaccines are likely to be scarce for years to come. Many countries, from India to the U.K., have demonstrated vaccine nationalism. What are the ethical limits to this vaccine nationalism? Neither extreme nationalism nor extreme cosmopolitanism is ethically justifiable. Instead, we propose the fair priority for residents framework, in which governments can retain COVID-19 vaccine doses for their residents only to the extent that they are needed to maintain a noncrisis level of mortality while they are implementing reasonable public (...) health interventions. Practically, a noncrisis level of mortality is that experienced during a bad influenza season, which society considers an acceptable background risk. Governments take action to limit mortality from influenza, but there is no emergency that includes severe lockdowns. This “flu-risk standard” is a nonarbitrary and generally accepted heuristic. Mortality above the flu-risk standard justifies greater governmental interventions, including retaining vaccines for a country's own citizens over global need. The precise level of vaccination needed to meet the flu-risk standard will depend upon empirical factors related to the pandemic. This links the ethical principles to the scientific data emerging from the emergency. Thus, the FPR framework recognizes that governments should prioritize procuring vaccines for their country when doing so is necessary to reduce mortality to noncrisis flu-like levels. But after that, a government is obligated to do its part to share vaccines to reduce risks of mortality for people in other countries. We consider and reject objections to the FPR framework based on a country: having developed a vaccine, raising taxes to pay for vaccine research and purchase, wanting to eliminate economic and social burdens, and being ineffective in combating COVID-19 through public health interventions. (shrink)

For decades, worries about undue inducement have Pervaded clinical research, and are especially common when research is accompanied by payment or conducted in developing countries. Few ethical judgments carry as much moral opprobrium or are thought to undermine the ethical soundness of a clinical trial as thoroughly as undue inducement. Indeed, the admonition to prevent undue inducement is one of the few explicit instructions in the Common Rules requirements for informed consent.Despite their long history and pervasiveness, charges of undue inducement (...) in clinical research are almost always mistaken. Indeed, I will advance an even more radical claim: Aresearch trial that otherwise fulfills the fundamental ethical requirements for human subjects research inherently cannot create the possibility of undue inducement because substantial risk of serious harm isprecluded. Charges of undue inducement tend to express displaced and mislabeled ethical concerns about other aspects of human subjects research. Consequently, claims of undue inducement should rarely be made, and when they are advanced should be treated with skepticism, placing a heavy burden of proofon those advancing such charges. (shrink)

One approach to validating simulation models is to formally compare model outputs with independent data. We consider such model validation from the point of view of Frequentist statistics. A range of estimates and tests of goodness of fit have been advanced. We review these approaches, and demonstrate that some of the tests suffer from difficulties in interpretation because they rely on the null hypothesisHypothesis that the model is similar to the observationsObservations. This reliance creates two unpleasant possibilities, namely, a model (...) could be spuriously validated when dataData are too few, or inappropriately rejected when data are too many. Finally, these tests do not allow a principled declaration of what a reasonable level of difference would be considering the purposes to which the model will be put. We consider equivalence tests, and demonstrate that they do not suffer from the previously identified shortcomings. We provide two case studies to illustrate the claims of the chapter. (shrink)

Ethics, religion, and spirituality -- Spirituality in care -- Spirituality and ethics -- Love -- The community of care : fit for purpose -- Values, virtues, and the patient -- Challenging faith -- Spirituality and the domain of justice.