Population health has recently grown from a series of loosely connected critiques of twentieth-century public health and medicine into a theoretical framework with a corresponding field of research—population health science. Its approach is to promote the public’s health through improving everyday human life: affordable nutritious food, clean air, safe places where children can play, living wages, etc. It recognizes that addressing contemporary health challenges such as the prevalence of type 2 diabetes will take much more than good hospitals and public (...) health departments. -/- Blending philosophy of science/medicine, public health ethics and history, this book offers a framework that explains, analyses and largely endorses the features that define this relatively new field. Presenting a philosophical perspective, Valles helps to clarify what these features are and why they matter, including: searching for health’s “upstream” causes in social life, embracing a professional commitment to studying and ameliorating the staggering health inequities in and between populations; and reforming scientific practices to foster humility and respect among the many scientists and non- scientists who must work collaboratively to promote health. -/- Featuring illustrative case studies from around the globe at the end of all main chapters, this radical monograph is written to be accessible to all scholars and advanced students who have an interest in health—from public health students to professional philosophers. (shrink)

Among the many applications of artificial intelligence (AI), virtual assistants are one of the tools most likely to grow in the future. The development of these systems may play an increasingly important role in many facets of our lives. Therefore, given their potential importance and present and future weight, it is worthwhile to analyze what kind of challenges they entail. In this chapter, we will provide an overview of the ethical aspects of artificial virtual assistants. First, we provide a conceptual (...) clarification of the term ‘virtual assistant’, including different types of interfaces and recommender systems. Second, we address three ethical issues related to the deployment of these systems: their effects on human agency and autonomy and the subsequent cognitive dependence they would generate; the human obsolescence that may cause a generalized extension of the dependence problem; and the invasions of privacy that virtual assistants may cause. Finally, we outline the debates about the use of virtual assistants to improve human moral decisions and some areas in which these systems can be applied. (shrink)

A growing body of literature has engaged with mass incarceration as a public health problem. This article reviews some of that literature, illustrating why and how bioethicists can and should engage with the problem of mass incarceration as a remediable cause of health inequities. “Mass incarceration” refers to a phenomenon that emerged in the United States fifty years ago: imprisoning a vastly larger proportion of the population than peer countries do, with a greatly disproportionate number of incarcerated people being members (...) of marginalized racial and ethnic groups. Bioethicists have long engaged with questions of health justice for incarcerated people, including consent issues for those participating in research and access to health care. This article provides an overview of the individual and public health impacts of mass incarceration. The article argues that mass incarceration is a bioethics issue that should be addressed in medical education, identifies opportunities for bioethicists to guide hospitals’ interactions with law enforcement officials, and calls on bioethicists to be in conversation with medical and nursing students and health care professionals about these groups’ advocacy efforts concerning structural racism, police violence, and mass incarceration. (shrink)

Based on a framework that integrates job demands-resources theory, social cognitive theory Handbook of personality, Guilford Press, New York, pp 154–196, 1999) and regulatory focus theory, the purpose of this research is to investigate the relationship between perceptions of organizational politics and subsequent moral disengagement and unethical behavior. We conducted a laboratory study and also collected data in two separate surveys 6 weeks apart from 206 individuals working full time to investigate the relationships presented in our model. In both studies, (...) we examined the direct relationship of politics perceptions on unethical behavior in organizations as well as the indirect relationship through the influence of moral disengagement. We investigated the moderating effect of regulatory focus on the relationship between moral disengagement and unethical behavior using the survey data. Results indicated that perceptions of politics were significantly related to our mediator, moral disengagement, which was significantly related to our dependent variable, unethical behavior. However, only prevention-focus moderated the relationships examined. Implications for future research and managerial practice are discussed. (shrink)

Informed consent forms have been useful in clinical practice and they constitute a part of the shared decision making in the informed consent process. They provide information to patients about clinical procedures and techniques. They also act as a remainder of the information discussed after the medical interview. Sometimes these documents are not readable to everybody. Belgian law specifies that all information that patients receive has to be proportionate verbally, but written information is also handled. The present research analyzes the (...) readability of the Flemish informed consent forms located in the webs of all General Hospitals using a simple random sample of 75 informed consent forms. By using the Douma tool, which bases its analysis in the length of words and sentences, the readability mean of the sample was 46, level “Difficult”. The 59% of them had a difficult level. The 11% were normal. It is a fact, then, that the 59% of the informed consent forms evaluated in this study are not suitable for everybody in Flanders, especially those people with low literacy. There were some researches made in other countries that agreed with these results. Written clinical information was poorly written so the informed consent forms were not working helping patients to recall information nor helping patients to become a part in the shared decision making about their health. The use of readability formulas represented a simple way to discriminate those informed consent forms that had normal readability scores from those that should be adapted. (shrink)

Ray and Cooper (2024) make a very compelling argument for vastly increasing bioethicists’ engagement with environmental justice. I strongly support this proposal and agree with their arguments. Yet...

Philosophy of epidemiology has recently emerged as a distinct branch of philosophy. The field will surely benefit from pluralism, reflected in the broad range of topics and perspectives in this special issue. Here, I argue that a healthy pluralistic field of philosophy of epidemiology has social responsibilities that require the field as a whole to engage actively with research on social determinants of health and health disparities. Practicing epidemiologists and the broader community of public health scientists have gradually acknowledged that (...) much of their attention ought to be paid to these, i.e. inequitable between-population health variations that largely reflect the world’s inequitable distribution of resources and social conditions. The paper illustrates how and why health disparities and social determinants of health, through no ill will, become de facto secondary concerns in Alex Broadbent’s field-defining Philosophy of Epidemiology, showing the ease with which these topics can be incidentally sidelined. As means for philosophy of epidemiology to meet its social responsibility obligations, I suggest philosophy of epidemiology expand its attention to two particular lines research. First, the paper discusses Geoffrey Rose’s concept of “causes of incidence”—causes of disparities between populations—and argues for the importance of engaging with these causes. Second, the paper argues for the value of engaging with Bruce Link and Jo Phelan’s “fundamental causes” model of how flexible social resources serve as buffers from harms, generating a plethora of shifting and locally-contingent health effects. (shrink)

Ian Rumfitt (2000) developed a bilateralist account of logic in which the meaning of the connectives is given by conditions on asserted and rejected sentences. An additional set of inference rules, the coordination principles, determines the interaction of assertion and rejection. Fernando Ferreira (2008) found this account defective, as Rumfitt must state the coordination principles for arbitrary complex sentences. Rumfitt (2008) has a reply, but we argue that the problem runs deeper than he acknowledges and is in fact related to (...) the challenge of establishing proof-theoretic harmony. We motivate a distinctively bilateral criterion for harmony and show how the bilateralist can meet it. This also resolves Ferreira's complaint. (shrink)

This paper presents a new model for how to jointly analyze the ethical and evidentiary dimensions of environmental science cases, with an eye toward making science more participatory and publically...

BackgroundHIV prevention research in resource-limited countries is associated with a variety of ethical dilemmas. Key amongst these is the question of what constitutes an appropriate standard of health care (SoC) for participants in HIV prevention trials. This paper describes a community-focused approach to develop a locally-appropriate SoC in the context of a phase III vaginal microbicide trial in Mwanza City, northwest Tanzania.MethodsA mobile community-based sexual and reproductive health service for women working as informal food vendors or in traditional and modern (...) bars, restaurants, hotels and guesthouses has been established in 10 city wards. Wards were divided into geographical clusters and community representatives elected at cluster and ward level. A city-level Community Advisory Committee (CAC) with representatives from each ward has been established. Workshops and community meetings at ward and city-level have explored project-related concerns using tools adapted from participatory learning and action techniques e.g. chapati diagrams, pair-wise ranking. Secondary stakeholders representing local public-sector and non-governmental health and social care providers have formed a trial Stakeholders' Advisory Group (SAG), which includes two CAC representatives.ResultsKey recommendations from participatory community workshops, CAC and SAG meetings conducted in the first year of the trial relate to the quality and range of clinic services provided at study clinics as well as broader standard of care issues. Recommendations have included streamlining clinic services to reduce waiting times, expanding services to include the children and spouses of participants and providing care for common local conditions such as malaria. Participants, community representatives and stakeholders felt there was an ethical obligation to ensure effective access to antiretroviral drugs and to provide supportive community-based care for women identified as HIV positive during the trial. This obligation includes ensuring sustainable, post-trial access to these services. Post-trial access to an effective vaginal microbicide was also felt to be a moral imperative.ConclusionParticipatory methodologies enabled effective partnerships between researchers, participant representatives and community stakeholders to be developed and facilitated local dialogue and consensus on what constitutes a locally-appropriate standard of care in the context of a vaginal microbicide trial in this setting.Trial registrationCurrent Controlled Trials ISRCTN64716212. (shrink)

Recommender Systems (RecSys) have been around since the early days of the Internet, helping users navigate the vast ocean of information and the increasingly available options that have been available for us ever since. The range of tasks for which one could use a RecSys is expanding as the technical capabilities grow, with the disruption of Machine Learning representing a tipping point in this domain, as in many others. However, the increase of the technical capabilities of AI-powered RecSys did not (...) come with a thorough consideration of their ethical implications and, despite being a well-established technical domain, the potential impacts of RecSys on their users are still under-assessed. This paper aims at filling this gap in regards to one of the main impacts of RecSys: personal autonomy. We first describe how technology can affect human values and a suitable methodology to identify these effects and mitigate potential harms: Value Sensitive Design (VSD). We use VSD to carry out a conceptual investigation of personal autonomy in the context of a generic RecSys and draw on a nuanced account of procedural autonomy to focus on two components: competence and authenticity. We provide the results of our inquiry as a value hierarchy and apply it to the design of a speculative RecSys as an example. (shrink)

In order to develop a collaborative experience of reflexive writing, this article explores the ethnographic process through two communication devices used by the authors in their respective fieldwork: tarot readings and evolutionary astrology. Reflecting on their distinct (if not opposing) backgrounds, the authors explore and interpret how their different backgrounds and conversational devices shape their ethnographic experience as a process of revealing the unknown, following the not-knowing approach (Anderson, 1997). The dialogic exchange also reveals how the not-knowing approach affects the (...) collaborative aspect of the reflexive writing experience. (shrink)

The relationship between Sacred Scripture and sacred Tradition is one of the areas that Pope John Paul II indicated in the encyclical Ut unum sint as being in need of fuller study in the ecumenical dialogue. The studies carried out during Vatican II with the aid and reflection of theologians and the preparation of alternative proposals, both official and unofficial, helped to change the whole approach, thus paving the way for the doctrinal Constitution on Divine Revelation. An essential component of (...) this approach is the introduction to the first chapter on Revelation. It introduced a qualitative rather than quantitative approach to the relationship between Scripture and Tradition. Moreover, when these are both linked to the one and only source, Revelation, Tradition is mostly presented as a vibrant and dynamic process guided by the Spirit, necessary for the conservation of the Gospel. This vision, in consonance with the reflection that was being made on the theme by the ecumenical movement during the years of the Council, has contributed to an opening up of dialogue that aims for consensus in areas that have divided Christian Churches for so long. (shrink)

The aim of this article is to develop a postmetaphysical conception of reading by following Kierkegaard’s Either/Or Part I (1843) through such Derridian concepts as secret, hospitality, and spectrality. The work focuses on the three essays addressed to the Symparanekromenoi (“the community of the dead”), a fellowship neither young nor old with an aphoristic way of life (2010b, pp. 137–225) that can be understood as a figure of alterity. Special attention is paid to paratextual features of the book: the texts (...) are actually presented as old papers found in a secretary desk by a pseudonymous editor (“Victor Eremita”), which suggests that every text is a posthumous paper, that is to say, it will always be read after the death of its author. Instead of finding a solid author who holds the semantic weight of the text, these papers are based in a blank of sense, a specter, a secret: if they are sustained on its author, then they are sustained in a mystery, not in a sort of revelation of meaning. (shrink)

Este trabajo se centra en la gestión de los bienes naturales comunes, y desarrolla brevemente dos enfoques sobre el ambiente y su cuidado; destaca las ventajas de un enfoque interdisciplinario en la gestión comunal de los bienes naturales y en la consiguiente elaboración de políticas ambientales. Se analiza la gestión comunal de estos bienes comunes partiendo de la noción de responsabilidad fuerte, que cuestiona la concepción de las personas como agentes autointeresados, y se identifican requisitos ineludibles: adecuación a las condiciones (...) sociales y ecológicas de cada lugar, información completa y relevante, procesos democráticos de decisión y reconocimiento por parte de los gobiernos de la capacidad y el derecho de los usuarios de elaborar sus propias normas y monitorear su cumplimiento. (shrink)

The microbiota-gut-brain axis field is at an exciting stage, but the most recent developments in microbiota research still have to find their way into MGB studies. Here we outline the standards for microbiome data generation, the appropriate statistical techniques, and the covariates that should be included in MGB studies to optimize discovery and translation to clinical applications.

In this article, we first review the development of clinical ethics in pediatrics in the United States. We report that, over the last 40 years, most children’s hospitals have ethics committees but that those committees are rarely consulted. We speculate that the reasons for the paucity of ethics consults might be because ethical dilemmas are aired in other venues. The role of the ethics consultant, then, might be to shape the institutional climate and create safe spaces for the discussion of (...) difficult and sometimes contentious issues. Finally, we report how pediatric clinical ethics has evolved differently in a number of other countries around the world. (shrink)

RESUMEN La Estrategia socioeducativa para la familia en el uso de la tecnología sanitaria del lente de contacto, proyecto de investigación del cual derivan los resultados que se exponen en el presente texto; se instituye a partir de un nuevo algoritmo de trabajo por el optometrista, atendiendo a que con la terapéutica encaminada a contrarrestar las complicaciones que ocasiona el uso indebido de la tecnología se ha intentado minimizar las anomalías de enfermedades oculares. Su objetivo general se dirige a un (...) estudio social sobre la innovación, desde la perspectiva de las relaciones ciencia, tecnología y sociedad. El proyecto tiene carácter de innovación tecnológica de tipo Investigación aplicada. Sus resultados validan, desde un enfoque interdisciplinario, las influencias que cada contexto sociocultural ejerce sobre el desarrollo de la ciencia y la tecnología y los impactos sociales. ABSTRACT La The socio-educative strategy for the family in the use of the sanitary technology of the contact lens, research project from which derive the results that are exhibited in the present text; it is instituted from a new work algorithm by the optometrist, attending to that with the therapeutics directed to resist the complications that the undue use of the technology causes, it has tried to minimize the anomalies of ocular illnesses. Its general objectiv goes to a social study on the innovation, from the perspective of the relations science, technology and society. The project has character of technological innovation of type Applied Investigation. Its results validate, from an interdisciplinary approach, the influences that every sociocultural context exercises on the development of the science and the technology and the social impacts. (shrink)

Starting on Bourdieu’s approach to precariousness, this article analyzes this phenomenon as a new flexible norm that displaces the Fordist social norm. The authors argue, based on Gramsci’s study of Fordism, that precarization creates a mechanism of discipline for the legitimization of the loss of both labour and social rights, destroying the Keynesian social pact. Such disciplining happens coercively, both by the use of new technologies and by the generalization of the function of Marx’s industrial reserve army to all productive (...) strata; and also, by consensus, through a transformation in the work culture, leading to a “new flexible man” with a flagrant loss of its autonomy. (shrink)