BackgroundPublic health scholars have long called for preparedness to help better negotiate ethical issues that emerge during public health emergencies. In this paper we argue that the concept of ethical preparedness has much to offer other areas of health beyond pandemic emergencies, particularly in areas where rapid technological developments have the potential to transform aspects of health research and care, as well as the relationship between them. We do this by viewing the ethical decision-making process as a behaviour, and conceptualising (...) ethical preparedness as providing a health research/care setting that can facilitate the promotion of this behaviour. We draw on an implementation science and behaviour change model, COM-B, to demonstrate that to be ethically prepared requires having the capability, opportunity, and motivation to work in an ethically prepared way.MethodsWe use two case examples from our empirical research—one pandemic and one non-pandemic related—to illustrate how our conceptualisation of ethical preparedness can be applied in practice. The first case study was of the UK NHSX COVID-19 contact tracing application case study involved eight in-depth interviews with people involved with the development/governance of this application. The second case involved a complex case regarding familial communication discussed at the UK Genethics Forum. We used deductive qualitative analysis based on the COM-B model categories to analyse the transcripbed data from each case study.ResultsOur analysis highlighted that being ethically prepared needs to go beyond merely equipping health professionals with skills and knowledge, or providing research governance actors with ethical principles and/or frameworks. To allow or support these different actors to utilise their skills and knowledge, a focus on the physical and social opportunity is important, as is a better understanding the role of motivation.ConclusionsTo understand ethical preparedness, we need to view the process of ethical decision-making as a behaviour. We have provided insight into the specific factors that are needed to promote this behaviour—using examples from both in the pandemic context as well as in areas of health research and medicine where there have been rapid technological developments. This offers a useful starting point for further conceptual work around the notion of being ethically prepared. (shrink)

The best-interests standard is a widely used ethical, legal, and social basis for policy and decision-making involving children and other incompetent persons. It is under attack, however, as self-defeating, individualistic, unknowable, vague, dangerous, and open to abuse. The author defends this standard by identifying its employment, first, as a threshold for intervention and judgment (as in child abuse and neglect rulings), second, as an ideal to establish policies or prima facie duties, and, third, as a standard of reasonableness. Criticisms of (...) the best-interests standard are reconsidered after clarifying these different meanings. (shrink)

This article critically evaluates the central claims of the various feminist responses to new reproductive arrangements and technologies. Proponents of a “progressivism” object to naive technological optimism and raise questions about the control of such technology. Others, such as the FINRRAGE group, raise concerns about the potentially damaging consequences of the new technologies for women. While a central concern is whether these technologies reinforce harmful biologically determinist stereotypes of women, it may be that these critiques function with a devastating gender (...) blindness that puts women at risk in other, heretofore unnoticed, ways. (shrink)

Recalcitrant disputes among health care providers and patients or their families may signal deep cultural differences about what interventions are needed or about clinicians’s professional duties. These issues arose in relation to a mother’s request for hymenoplasty or revirgination for her minor daughter to enable an overseas, forced marriage and protect her from an honor killing. The American College of Obstetrics and Gynecology committee recommends against members performing a hymenoplasty or other female genital cosmetic surgeries due to a lack of (...) data concerning their safety and efficacy. A key issue in such cases is how to determine what is in the minor’s best interest and the scope of health care moral or professional’s duties. The Best Interests Standard can serve as a powerful moral tool for resolving cross-cultural disputes and identifying needed policy. (shrink)

Bioethics is best viewed as both a second-order discipline and also part of public discourse. Since their goals differ, some bioethical activities are more usefully viewed as advancing public discourse than academic disciplines. For example, the “Universal Declaration on Bioethics and Human Rights” sponsored by the United Nations Educational, Scientific, and Cultural Organization seeks to promote ethical guidance on bioethical issues. From the vantage of philosophical ethics, it fails to rank or specify its stated principles, justify controversial principles, clarify key (...) terms, or say what is meant by calling potentially conflicting norms “foundational.” From the vantage of improving the public discourse about bioethical problems and seeking ethical solutions in the public arena, however, this document may have an important role. The goals and relations between bioethics as a second-order discipline and public discourse are explored. (shrink)

The article aims to show the value of taking ecclesiology – the theology of the church – into account in the study of British imperial ideology by describing how Anglican intra-ecclesiological debates shaped mid-nineteenth-century discourse about the British Empire. It highlights the impact of the Oxford Movement on the mind of the British colonial administrator Sir Frederic Rogers, Lord Blachford (1811-1889), by revealing the connections between his imperial thought and concepts arising from Tractarian ecclesiology. In particular, it argues that Rogers’ (...) understanding of British colonial development builds on Tractarian ideas of balance and consistency. By retaining a sense of the importance of the historic connection with the colonies of settlement while respecting their right to be free, Rogers constituted the imperial relationship as a _ via media. _. (shrink)

Purpose. Based on the study of philosophical anthropological concepts, to highlight the project of personality in different historical periods, to reveal the meaning of humanistic issues in the postmodern epoch, to identify the essential features of the image of human of the second half of the XX the beginning of the XXI century. Theoretical basis. The methodological basis of the article is the principles of historicism, integrity, objectivity regarding the mastery of the issue of person’s image in postmodernism. The research (...) applied comparative-historical, culturological, analytical, axiological approaches to reveal the problem of individuality in the second half of the XX the beginning of the XXI century. The theoretical basis of the article consists of scientific works in the field of philosophical anthropology, history, cultural studies, and aesthetics. Originality. The author revealed the peculiarities of transformation of the personality model from antiquity to postmodernism, specified the image of man of the second half of the XX the beginning of the XXI century. Conclusions. The analysis of anthropological ideas of Western philosophy of different ages shows the variety of views about understanding the nature of the person, its complexity and ambiguity. In the epoch of postmodernism humanistic issues are of particular relevance, which is connected with social and political uncertainty, domination of mass consciousness, loss of national and cultural identity. The image of a person of this period is deprived of a solid foundation, it is blurred and relative. The destruction of faith in the absolute in the context of the second half of the twentieth century contributed to the formation of confidence in the interdependence of all things, raised the problem of the personality image to a new ontological level. Orientation in the achievements of European civilization, perception of its anthropological experience, intercultural dialogue contribute to the productive use of the achievements of mankind in order to understand the modern person and to form its adequate image. In its essence, postmodernism does not set the goal to realize a retrospection of subject type. However, separating from the cultural memory the excerpts of ideas about a person, by certain styles and directions, it builds on their formations its own eclectic image of the individual. (shrink)

In this aricle, I argue that Descartes can be seen as a occupying a distinct middle ground between ancient music theory, which was being revived in the Renaissance, and eighteenth-century aestheticians. Descartes’ approach to music had its roots in humanist thought but, even from the start, it wasn’t simply another humanist theory of music. The views Descartes begins to develop in his early years, in the Compendium musicae (1618), is continuous with the views he articulates near the end of his (...) life in the Passions of the Soul (1649). And the position on the effects of music is an interesting and important one, bridging humanist thought with the new philosophy. Unlike the humanists, Descartes will be unwilling to identify particular musical proportions as intrinsically connected with pleasure or other affects, but he will nevertheless develop an objective account of aesthetic value. (shrink)

There is a popular hypothesis that performance on implicit and explicit memory tasks reflects 2 distinct memory systems. Explicit memory is said to store those experiences that can be consciously recollected, and implicit memory is said to store experiences and affect subsequent behavior but to be unavailable to conscious awareness. Although this division based on awareness is a useful taxonomy for memory tasks, the authors review the evidence that the unconscious character of implicit memory does not necessitate that it be (...) treated as a separate system of human memory. They also argue that some implicit and explicit memory tasks share the same memory representations and that the important distinction is whether the task (implicit or explicit) requires the formation of a new association. The authors review and critique dissociations from the behavioral, amnesia, and neuroimaging literatures that have been advanced in support of separate explicit and implicit memory systems by highlighting contradictory evidence and by illustrating how the data can be accounted for using a simple computational memory model that assumes the same memory representation for those disparate tasks. (shrink)

Background: The search for genetic variants between racial/ethnic groups to explain differential disease susceptibility and drug response has provoked sharp criticisms, challenging the appropriateness of using race/ethnicity as a variable in genetics research, because such categories are social constructs and not biological classifications.Objectives: To gain insight into how a group of genetic scientists conceptualise and use racial/ethnic variables in their work and their strategies for managing the ethical issues and consequences of this practice.Methods: In-depth semi-structured interviews were conducted with a (...) purposive sample of 30 genetic researchers who use racial/ethnic variables in their research. Standard qualitative methods of content analysis were used.Results: Most of the genetic researchers viewed racial/ethnic variables as arbitrary and very poorly defined, and in turn as scientifically inadequate. However, most defended their use, describing them as useful proxy variables on a road to “imminent medical progress”. None had developed overt strategies for addressing these inadequacies, with many instead asserting that science will inevitably correct itself and saying that meanwhile researchers should “be careful” in the language chosen for reporting findings.Conclusions: While the legitimacy and consequences of using racial/ethnic variables in genetics research has been widely criticised, ethical oversight is left to genetic researchers themselves. Given the general vagueness and imprecision we found amongst these researchers regarding their use of these variables, they do not seem well equipped for such an undertaking. It would seem imperative that research ethicist move forward to develop specific policies and practices to assure the scientific integrity of genetic research on biological differences between population groups. (shrink)

This paper focuses on natural dualities for varieties of bilattice-based algebras. Such varieties have been widely studied as semantic models in situations where information is incomplete or inconsistent. The most popular tool for studying bilattices-based algebras is product representation. The authors recently set up a widely applicable algebraic framework which enabled product representations over a base variety to be derived in a uniform and categorical manner. By combining this methodology with that of natural duality theory, we demonstrate how to build (...) a natural duality for any bilattice-based variety which has a suitable product representation over a dualisable base variety. This procedure allows us systematically to present economical natural dualities for many bilattice-based varieties, for most of which no dual representation has previously been given. Among our results we highlight that for bilattices with a generalised conflation operation. Here both the associated product representation and the duality are new. Finally we outline analogous procedures for pre-bilattice-based algebras. (shrink)

What should be the content of a package of health care services that we would want to guarantee to all Americans? This question cannot be answered adequately apart from also addressing the issue of fair health care rationing. Consequently, as I argue in this essay, appeal to the language of "basic," "essential," "adequate," "minimally decent," or "medically necessary" for purposes of answering our question is unhelpful. All these notions are too vague to be useful. Cost matters. Effectiveness matters. The clinical (...) circumstances of a patient matters. But what we must ultimately determine is what we mutually agree are the just claims to needed health care of each American in a relatively complex range of clinical circumstances. Answering this question will require a public moral conversation, a fair process of rational democratic deliberation aimed at defining both just claims to needed health care and just limits. (shrink)