Hastings Center Report, Volume 52, Issue S1, Page S79-S82, March‐April 2022.

Surveillance is essential for communicable disease prevention and control. Traditional notification of demographic and clinical information, about individuals with selected infectious diseases, allows appropriate public health action and is protected by public health and privacy legislation, but is slow and insensitive. Big data–based electronic surveillance, by commercial bodies and government agencies, which draws on a plethora of internet- and mobile device–based sources, has been widely accepted, if not universally welcomed. Similar anonymous digital sources also contain syndromic information, which can be (...) analysed, using customised algorithms, to rapidly predict infectious disease outbreaks, but the data are nonspecific and predictions sometimes misleading. However, public health authorities could use these online sources, in combination with de-identified personal health data, to provide more accurate and earlier warning of infectious disease events—including exotic or emerging infections—even before the cause is confirmed, and allow more timely public health intervention. Achieving optimal benefits would require access to selected data from personal electronic health and laboratory records and the potential to re-identify individuals found to be involved in outbreaks, to ensure appropriate care and infection control. Despite existing widespread digital surveillance and major potential community benefits of extending its use to communicable disease control, there is considerable public disquiet about allowing public health authorities access to personal health data. Informed public discussion, greater transparency and an ethical framework will be essential to build public trust in the use of new technology for communicable disease control. (shrink)

We report on the case of a 2-year-old female, the youngest person ever to undergo ovarian tissue cryopreservation (OTC). This patient was diagnosed with a rare form of sickle cell disease, which required a bone-marrow transplant, and late effects included high risk of future infertility or complete sterility. Ethical concerns are raised, as the patient's mother made the decision for OTC on the patient's behalf with the intention that this would secure the option of biological childbearing in the future. Based (...) on Beauchamp and Childress's principlism approach of respect for autonomy, nonmaleficence, beneficence, and justice, pursing OTC was ethically justified. (shrink)

Drawing on the recognition that questions of discourse and power are vital components in analysing the public participation in environmental governance, this paper examines the ways in which dominant scientific discourses about the Earth's climate inform the types of public talk facilitated in and by mini-publics, particularly when they are 'scaled up' to address environmental issues such as climate change. World Wide Views on Global Warming (WWViews) serves as a case study. Conceived and organised by the Danish Board of Technology, (...) WWViews was a historically unprecedented public forum in which participants, invited from a range of nations, were given the opportunity to deliberate on key themes addressed in the negotiations taking place during the United Nations Convention on Climate Change in Copenhagen (COP 15). The overarching purpose of this analysis is to invite reflection on the practices and assumptions that serve to make up publics in relation to issues that have been framed, predominantly, as scientific, universal and global. (shrink)

Two cross-modal experiments provide partial support for O'Regan & Noë's (O&N's) claim that sensorimotor contingencies mediate perception. Differences in locating a target sound accompanied by a spatially disparate neutral light correlate with whether the two stimuli were perceived as spatially unified. This correlation suggests that internal representations are necessary for conscious perception, which may also mediate sensorimotor contingencies.

-/- CONCLUSION “The experience in California is clear. Affirmative action has helped to dismantle barriers such as "old boys' networks" that have excluded not only women and individuals of racial or ethnic minorities, but also white American men who did not belong to networks of privilege. Affirmative action has also worked to ensure that our schools, workplaces, and other social institutions fully use our diverse talents, thereby helping our government and social institutions to better serve their communities. -/- In short, (...) affirmative action has helped to bring out the best in us as a society. It challenges us to have the courage of our convictions that: (1) we do want a truly equal opportunity society; and (2) we believe that all Americans, including women and minorities, are competent individuals who have talents to contribute. Passing the CCRI would completely eliminate affirmative action, and thus have the same effect as "throwing the baby out with the bathwater." The "baby" —active and affirmative commitment to equal opportunity— is barely out of its infancy. We must not now abandon our commitment, just when we have taken our first steps towards creating a truly equal opportunity society.” -/- (This essay was written against the backdrop of legislative efforts in the mid 1990s, to overturn “affirmative action” policies at educational institutions, which had given more equal access to higher education for students from previously under-represented communities, particularly white women but also racialized communities. By mischaracterizing affirmative action programs as “gender or racial preferences”, opponents were able to pass the 1996 ballot measure, Proposition 209, the so-called “California Civil Rights Initiative” (CCRI). The ban on “preferences” gained the support of 54.6% of all California voters, including 58% of white women and 66% of white men voters. Use of language was key, as a slight majority of Americans approved of some affirmative actions but opposed racial preferences. The CCRI has had a huge toll on Latino and African American enrollment at UC Berkeley and UCLA, which has never recovered. State contracts for firms owned by women and minorities also dropped sharply. Similar initiatives failed in some states but succeeded elsewhere. See online Encyclopedia). (shrink)

This article addresses two components of the new governing architecture that help to reform the delivery of health care and to control costs of the health care system: the Center for Medicare and Medicaid Innovation and the Independent Payment Advisory Board. The republican controlled federal government has partially disassembled these two components, threatening the effectiveness of federal delivery system reform and cost control initiatives.

PPACA epitomizes comprehensive health care reform legislation. Public health, disease prevention, and wellness were integral considerations in its development. This article reveals the author's personal experiences while working on the framework for health care reform in the United States Senate and reviews activity in the United States House of Representatives. This insider's perspective delineates PPACA's positive effect on public health by examining the infrastructure Congress designed to focus on prevention, wellness, and public health, with a particular focus on the National (...) Prevention, Health Promotion and Public Health Council; the National Prevention, Health Promotion, Public Health, and Integrative Health Care Strategy; and the Prevention and Public Health Fund. The Council, strategy, and fund are especially important because they reflect compliance with some of the Institute of Medicine's recommendations to improve public health in the United States, as well as international health and human rights norms that protect the right to health. (shrink)

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act, a major piece of health care reform legislation. This comprehensive legislation includes provisions that focus on prevention, wellness, and public health. Some, including authors in this symposium, question whether Congress considered public health, prevention, and wellness issues as mere afterthoughts in the creation of PPACA. As this article amply demonstrates, they did not.This article documents the extent of congressional consideration on public health issues based on personal (...) experience working on the framework for health care reform — specifically, my experience as a Fellow for a member of the Health Subcommittee of the Senate Finance Committee from 2008-2009. I also include a review of congressional activity in the United States House of Representatives. Analysis of the congressional meetings and hearings reveals that Congress had a deep understanding about the critical need to reform the U.S. public health and prevention system. (shrink)

In Europe ≈15,000 patients receive larval therapy for wound treatment annually. Over the past few years, clinical studies have demonstrated the success of larvae of Lucilia sericata as debridement agents. This is based on a combination of physical and biochemical actions. Laboratory investigations have advanced our understanding of the biochemical mechanisms underlying the beneficial effects of larval secretions, including removal of dead tissue, reduction of the bacterial burden, and promotion of tissue regeneration. The present article summarizes our current understanding of (...) the microbiological, immunological, and wound healing actions of larval therapy, and the molecules involved in these beneficial effects. Future studies will focus on the isolation, identification, and (pre)clinical testing of the effective molecules of L. sericata larvae. These molecules may be candidates for the development of new agents for the treatment of several infectious and inflammatory diseases, including chronic wounds. (shrink)

This chapter uses feminist standpoint theory to investigate Diotima’s epistemic advantage in Plato’s Symposium. Scholars have wondered why Diotima – a woman speaking about the role of erōs in gestation, childbirth, and childrearing – voices the view that Plato privileges most among all the symposiasts (Halperin 1990, Evans 2006, Hobbs 2007). Feminist standpoint theory is useful in developing a novel answer to this question; it supposes that oppressed groups, because they occupy different social locations, often develop epistemic privileges over their (...) dominant counterparts, especially with respect to finding lacunae in dominant narratives (cf. Hartsock 1987, Collins 1990, Harding 1987 and 1993, and Intemann 2016). This chapter proposes that Diotima’s unique social location – she is an older, non-Athenian woman, well versed in gestation, childbirth, and childrearing – disposes her to know something about erōs that the dominant group, the Athenian pederasts, do not. What she knows is that having erōs for something does not merely inspire one to pursue or possess it; by attending to how erōs affects women, she argues that it also manifests as a desire to reproduce what is beloved and care for it. Diotima’s standpoint is epistemically revelatory, then, because it establishes that love is far more than the pursuit of beauty; it is a creative and laborious act. Moreover, her standpoint is ethically revelatory, since she argues that the highest form of love entails fostering and nourishing virtue in others. Understood in this way, Diotima is espousing something like a protofeminist ethics of care. (shrink)

Greatly aided by an information age in which protesting laborers in a remote offshore outpost can capture front page headlines around the globe, theSarbanes-Oxley Act of 2002 (SARBOX) has made corporate transparency the linchpin for good corporate governance. Under a SARBOX-enhancedregulatory framework, publicly traded corporations are required to rapidly disclose material changes in their financial conditions or operations—changes such as impairments to goodwill, a trademark, or some other intangible corporate asset. Especially challenging for multinational corporations (MNCs) with far-flung corporate empires (...) is the need to stay abreast of the ebb and flow of goodwill, at a time when transnational human rights groups are aggressively mobilizing world opinion against the sweatshop labor conditions that abound at the offshore production sites favored by MNCs. The author explains why the convergence of a digital age of free-flowing information and the advent of SARBOX, a legislative enactment of paraenetic design, is causing the boards of MNCs to more critically evaluate the long-term costs of their offshore operations. (shrink)

We argue for the need for a new language for business – one that is capable of changing the current business decision-making frame of wins and losses to a frame of community and social learning. This paper outlines a classroom exercise about Nelson Mandela’s leadership, involving movies, case studies and poetry, and shows how the more holistic approach helps shift student views of the triple bottom line. Since neuroscience literature has shown that poetry can help enhance learning, students carefully study (...) “Invictus,” a poem written by Victorian-era poet Henley and revered by Mandela. As students dig deeper into the case study through classroom discussion, they begin to see Mandela’s leadership through a new frame, and in doing so broaden their own views. This more holistic approach to studying leadership may allow decision makers to adjust both their goals and the focus of their analysis to go beyond monetary outcomes to include socially and environmentally sustainable outcomes. (shrink)

Plato’s partition argument infers that the soul has parts from the fact that the soul experiences mental conflict. We consider an ambiguity in the concept of mental conflict. According to the first sense of conflict, a soul is in conflict when it has desires whose satisfaction is logically incompatible. According to the second sense of conflict, a soul is in conflict when it has desires which are logically incompatible even when they are unsatisfied. This raises a dilemma: if the mental (...) conflict is supposed to be the latter kind of conflict, then the partition argument is valid but is likely unsound; if it’s supposed to be the former kind, then the partition argument has true premises but is invalid. We explain this dilemma in detail and defend a dispositionalist solution to it. (shrink)

Greatly aided by an information age in which protesting laborers in a remote offshore outpost can capture front page headlines around the globe, theSarbanes-Oxley Act of 2002 (SARBOX) has made corporate transparency the linchpin for good corporate governance. Under a SARBOX-enhancedregulatory framework, publicly traded corporations are required to rapidly disclose material changes in their financial conditions or operations—changes such as impairments to goodwill, a trademark, or some other intangible corporate asset. Especially challenging for multinational corporations (MNCs) with far-flung corporate empires (...) is the need to stay abreast of the ebb and flow of goodwill, at a time when transnational human rights groups are aggressively mobilizing world opinion against the sweatshop labor conditions that abound at the offshore production sites favored by MNCs. The author explains why the convergence of a digital age of free-flowing information and the advent of SARBOX, a legislative enactment of paraenetic design, is causing the boards of MNCs to more critically evaluate the long-term costs of their offshore operations. (shrink)

In industrial societies where civil law and state institutions have become well established secular vehicles for governing the populace, it is widely assumed that the state no longer has an interest in fortifying the religious sector as a complementary source of social control. Thus, a distinction is drawn between the Islamic state that is ruled by religious law and the secular state of Western industrial societies in which religion is deemed to have lost its influence in the public sphere. This (...) dissertation argues that civil law is not religiously neutral and thus challenges a central premise of secularization theory. Introducing a new theoretical model that classifies civil law on the basis of its purpose-to protect religious liberty, engage or fortify the religious sector, or to advance universal norms-the author examines the impact of the three different types of legislation upon religious freedom and the individual autonomy of religious minorities in Sweden, an aggressively secularized industrial society. The author concludes that, viewed from the standpoint of a religious nonconformist, there is no discernible difference between living in a society that is overtly ruled by religious law (e.g., an Islamic state) and living in a "secular” society that is ruled by civil law either embedded with religious norms or designed to facilitate state appropriation of the religious sector as a complementary means of social control. In either environment, the author argues, the religious nonconformist will be forced to conform to the religious norms of the predominant religious group. (shrink)

De Bie et al. provide a novel framework for assessing ethical considerations in artificial womb technology (AWT) based on four phases of human prenatal development (DeBie 2023). As the authors note...

Rapid tissue donation (RTD) is an advancing oncology research procedure for collecting tumors, metastases, and unaffected tissue 2–6 h after death. Researchers can better determine rates of progression, response to treatment, and polymorphic differences among patients. Cancer patients may inquire about posthumous body donation for research to offer a personal contribution to research; however, there are barriers to recruiting for an RTD program. Physicians must reassure the patient that their treatment options and quality of care will not be compromised due (...) to participating in RTD. In this commentary we discuss how theories of altruism may explain cancer patients’ desire to participate in an RTD program, the ethical concerns of health care professionals and patients and the use of altruism as a recruitment strategy. We offer recommendations for examining the cultural and ethical climate of the institution prior to initiating such a program such as examining the relationship of healthcare professionals and patients, identifying ethical concerns, and examining ways to promote acceptance and buy-in across professionals, patients, and families. (shrink)