Inequitable access to health care, social inequities, and racist and discriminatory care has resulted in the trend toward poorer health outcomes for Indigenous infants and their families when compared to non‐Indigenous families in Canada. How Indigenous mothers experience care during an admission of their infant to the Neonatal Intensive Care Unit has implications for future health‐seeking behaviors which may influence infant health outcomes. Nurses are well positioned to promote positive health care interactions and improve health outcomes by effectively meeting the (...) needs of Indigenous families. This qualitative study was guided by interpretive description and the Two‐Eyed Seeing framework and aimed to understand how Indigenous mothers experience accessing and using the health care system for their infants. Data were collected by way of interviews and a discussion group with self‐identifying Indigenous mothers of infants less than two years of age living in Hamilton, Ontario, Canada. Data underwent thematic analysis, identifying nursing strategies to support positive health care interactions and promote the health and wellness of Indigenous infants and their families. Building relationships, providing holistic care, and taking a trauma‐informed approach to the involvement of child protection services are three key strategies that nurses can use to positively impact health care experiences for Indigenous families. (shrink)

Jonathan Schaffer (2010) has summoned a new sort of demon – which he calls the debasing demon – that apparently threatens all of our purported knowledge. We show that any debasing skeptical argument must attack the justification condition and can do so only if a plausible thesis about justification is false.

Embark on a visual journey of self-discovery. In Beaming, Marilyne Verschueren-the artist behind internet sensation @beamingdesign-presents 100 expansive visuals designed to stimulate your mind and awaken your intuition. Messages of hope, resilience, and joy are incorporated into radiant art, with each image offering the reader an opportunity for deep contemplation and introspection. Powerful imagery is paired with 25 guided exercises for mindfulness, journaling, and breathwork to deepen your interactive experience. Full of warmth and positive energy, Beaming is an exquisite companion (...) and a stirring call to follow your truth. (shrink)

Transforming our worldviews -- Transforming the fear of death -- Glimpses beyond death and the physical world -- Cosmologies of life, death, and beyond -- Science of the afterlife -- The practice of dying -- Grief as a doorway to transformation -- Dreaming and the transformation of death -- Transformative art -- Life, death, and the quantum soul -- Healing self and society.

Several technological developments, such as self-service technologies and artificial intelligence, are disrupting the retailing industry by changing consumption and purchase habits and the overall retail experience. Although AI represents extraordinary opportunities for businesses, companies must avoid the dangers and risks associated with the adoption of such systems. Integrating perspectives from emerging research on AI, morality of machines, and norm activation, we examine how individuals morally behave toward AI agents and self-service machines. Across three studies, we demonstrate that consumers’ moral concerns (...) and behaviors differ when interacting with technologies versus humans. We show that moral intention is less likely to emerge for AI checkout and self-checkout machines compared with human checkout. In addition, moral intention decreases as people consider the machine less humanlike. We further document that the decline in morality is caused by less guilt displayed toward new technologies. The non-human nature of the interaction evokes a decreased feeling of guilt and ultimately reduces moral behavior. These findings offer insights into how technological developments influence consumer behaviors and provide guidance for businesses and retailers in understanding moral intentions related to the different types of interactions in a shopping environment. (shrink)

Epistemic trespassers judge matters outside their field of expertise. Trespassing is ubiquitous in this age of interdisciplinary research and recognizing this will require us to be more intellectually modest.

The success of digital COVID-19 contact tracing requires a strategy that successfully addresses the digital divide—inequitable access to technology such as smartphones. Lack of access both undermines the degree of social benefit achieved by the use of tracing apps, and exacerbates existing social and health inequities because those who lack access are likely to already be disadvantaged. Recently, Singapore has introduced portable tracing wearables (with the same functionality as a contact tracing app) to address the equity gap and promote public (...) health. We argue that governments have an ethical obligation to ensure fair access to the protective benefits of contract tracing during the pandemic and that wearables are an effective way of addressing some important equity issues. The most contentious issues about contact tracing apps have been the potential infringements of privacy and individual liberty, especially where the use of apps or other technology (such as wearables or QR codes) is required for access to certain spaces. Here we argue that wearables, as opposed to apps alone, will make a digital contact tracing mandate more practical and explain some conditions under which such a mandate would be justified. We focus on Singapore as a case study that has recently deployed contact tracing wearables nationally, but also reference debate about wearables in Australia and New Zealand. Our analysis will be relevant to counties trialling similar portable tracing wearables. (shrink)

There is growing interest in contact tracing apps for pandemic management. It is crucial to consider ethical requirements before, while, and after implementing such apps. In this paper, we illustrate the complexity and multiplicity of the ethical considerations by presenting an ethical framework for a responsible design and implementation of CT apps. Using this framework as a starting point, we briefly highlight the interconnection of social and political contexts, available measures of pandemic management, and a multi-layer assessment of CT apps. (...) We will discuss some trade-offs that arise from this perspective. We then suggest that public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly communicated implementations of CT apps will likely undermine public trust, and as such, risk impeding general effectiveness. (shrink)

If cultures are always in the making, this book catches one kind of culture on the make. Academics will be familiar with audit in the form of research and teaching assessments - they may not be aware how pervasive practices of 'accountability' are or of the diversity of political regimes under which they flourish. Twelve social anthropologists from across Europe and the Commonwealth chart an influential and controversial cultural phenomenon.

Two theses figure centrally in work on the epistemology of disagreement: Equal Weight (‘EW’) and Uniqueness (‘U’). According to EW, you should give precisely as much weight to the attitude of a disagreeing epistemic peer as you give to your own attitude. U has it that, for any given proposition and total body of evidence, some doxastic attitude is the one the evidence makes rational (justifies) toward that proposition. Although EW has received considerable discussion, the case for U has not (...) been critically evaluated. Endorsing U, we argue, commits one to the highly controversial thesis that whatever fixes your rational attitudes can do so only by fixing what evidence you have. This commitment imposes a relatively demanding requirement on justified belief in U, one that we argue is not satisfied by what is currently the strongest available case for U, due to Roger White [2005]. Our challenge to U makes more trouble for its proponents than do the worries about U expressed by Gideon Rosen [2001] and Thomas Kelly [2010]. Moreover, if Kelly [2010] is correct in thinking that EW “carries with it a commitment to” U—a claim which we accept for reasons similar to Kelly’s but is beyond this paper’s scope (but see Ballantyne and Coffman [forthcoming])—then our challenge to U bears importantly on EW: to the extent that our challenge to U succeeds, EW also suffers. (shrink)

Two theses are central to recent work on the epistemology of disagreement: Conciliationism:?In a revealed peer disagreement over P, each thinker should give at least some weight to her peer's attitude. Uniqueness:?For any given proposition and total body of evidence, the evidence fully justifies exactly one level of confidence in the proposition. 1This paper is the product of full and equal collaboration between its authors. Does Conciliationism commit one to Uniqueness? Thomas Kelly 2010 has argued that it does. After some (...) scene-setting (?1), in ?2 we explain and criticize Kelly's argument, thereby defeating his larger argument that Conciliationism deserves no dialectical special treatment. But we argue further that Conciliationists are committed to a disjunction, one of whose disjuncts is Uniqueness, that amounts to an ?extremely strong and unobvious position? (??3?4). If we are correct, theorists should not treat Conciliationism as a default position in debates about the epistemic significance of disagreement. (shrink)

Changing our minds isn't easy. Even when we recognize our views are disputed by intelligent and informed people, we rarely doubt our rightness. Why is this so? How can we become more open-minded, putting ourselves in a better position to tolerate conflict, advance collective inquiry, and learn from differing perspectives in a complex world? -/- Nathan Ballantyne defends the indispensable role of epistemology in tackling these issues. For early modern philosophers, the point of reflecting on inquiry was to understand (...) how our beliefs are often distorted by prejudice and self-interest, and to improve the foundations of human knowledge. Ballantyne seeks to recover and modernize this classical tradition by vigorously defending an interdisciplinary approach to epistemology, blending philosophical theorizing with insights from the social and cognitive sciences. -/- Many of us need tools to help us think more circumspectly about our controversial views. Ballantyne develops a method for distinguishing between our reasonable and unreasonable opinions, in light of evidence about bias, information overload, and rival experts. This method guides us to greater intellectual openness--in the spirit of skeptics from Socrates to Montaigne to Bertrand Russell--making us more inclined to admit that sometimes we don't have the right answers. With vibrant prose and fascinating examples from science and history, Ballantyne shows how epistemology can help us know our limits. (shrink)

Background We aimed to examine the ethical concerns Singaporeans have about sharing health-data for precision medicine and identify suggestions for governance strategies. Just as Asian genomes are under-represented in PM, the views of Asian populations about the risks and benefits of data sharing are under-represented in prior attitudinal research. Methods We conducted seven focus groups with 62 participants in Singapore from May to July 2019. They were conducted in three languages and analysed with qualitative content and thematic analysis. Results Four (...) key themes emerged: nuanced understandings of data security and data sensitivity; trade-offs between data protection and research benefits; trust in the public and private sectors; and governance and control options. Participants were aware of the inherent risks associated with data sharing for research. Participants expressed conditional support for data sharing, including genomic sequence data and information contained within electronic medical records. This support included sharing data with researchers from universities and healthcare institutions, both in Singapore and overseas. Support was conditional on the perceived social value of the research and appropriate de-identification and data security processes. Participants suggested that a data sharing oversight body would help strengthen public trust and comfort in data research for PM in Singapore. Conclusion Maintenance of public trust in data security systems and governance regimes can enhance participation in PM and data sharing for research. Contrary to themes in much prior research, participants demonstrated a sophisticated understanding of the inherent risks of data sharing, analysed trade-offs between risks and potential benefits of PM, and often adopted an international perspective. (shrink)

The predominant view is that a study using health data is observational research and should require individual consent unless it can be shown that gaining consent is impractical. But recent arguments have been made that citizens have an ethical obligation to share their health information for research purposes. In our view, this obligation is sufficient ground to expand the circumstances where secondary use research with identifiable health information is permitted without explicit subject consent. As such, for some studies the Institutional (...) Review Board/Research Ethics Committee review process should not assess the practicality of gaining consent for data use. Instead the review process should focus on assessing the public good of the research, public engagement and transparency. (shrink)

This article evaluates an emerging element in popular debate and inquiry: DYOR. (Haven’t heard of the acronym? Then Do Your Own Research.) The slogan is flexible and versatile. It is used frequently on social media platforms about topics from medical science to financial investing to conspiracy theories. Using conceptual and empirical resources drawn from philosophy and psychology, we examine key questions about the slogan’s operation in human cognition and epistemic culture.

The revision of the Council of International Organizations of Medical Sciences (CIOMS) International ethical guidelines for health‐related research (2016) heralds a paradigm shift from the ‘protectionist’ policies that emerged following historical research atrocities of the 20th century, towards a more nuanced and inclusive approach to research participation. Adopting this modified approach will enable countries to secure the benefits of research for individuals and for society as a whole, while at the same time minimizing the potential for exploitation and research‐related harms. (...) This article considers the potential impact of Guideline 16 of the CIOMS 2016 from a New Zealand perspective, with respect to research involving adults with impaired capacity and who are incapable of giving informed consent. While the CIOMS 2016 apply a ‘minimal risk’ threshold to guide research involving adults who lack capacity to consent, New Zealand law currently adopts a ‘best interests’ standard which significantly restricts the scope of permissible research that may be performed in this context. This article argues that the CIOMS 2016 should influence change to New Zealand’s legal framework for ethical review of research. CIOMS 2016 provides useful guidance for the necessary standards and processes to enable the responsible and ethical inclusion of adults with impaired capacity in research. (shrink)

The future of health research will be characterised by three continuing trends: rising demand for health data; increasing impracticability of obtaining specific consent for secondary research; and decreasing capacity to effectively anonymise data. In this context, governments, clinicians and the research community must demonstrate that they can be responsible stewards of health data. IRBs and RECs sit at heart of this process because in many jurisdictions they have the capacity to grant consent waivers when research is judged to be of (...) particular value. However, several different terms are used to refer to this value, indicating a lack of conceptual clarity regarding the appropriate test for access to health data for research without consent. In this paper we do three things. First we describe the current confusion and instability in terminology relating to public interest in the context of consent waivers. Second we argue for harmonisation of terminology on the grounds of clarity, transparency and consistency. Third we argue that the term ‘public interest’ best reflects the normative work required to justify consent waivers because it is the broadest of the competing terms. ‘Public interest’ contains within its scope positive and negative implications of a study, as well as welfare, justice and rights considerations. In making this argument, we explain the normative basis for consent waivers, and provide a starting place for further discussion about the precise conditions in which a given study can be said to advance the public interest. Ipsos MORI study found that: … the public would be broadly happy with administrative data linking for research projects provided Those projects have social value, broadly defined. Data are de-identified. Data are kept secure. Businesses are not able to access the data for profit. (shrink)

A distinguished philosopher and a practicing minister, Marilyn McCord Adams has written a highly original work on a fundamental dilemma of Christian thought -- ...

Politics of Reality includes nine essays that examine sexism, the exploitation of women, the gay rights movement and other topics from a feminist perspective. -/- The essays "The Problem That Has No Name" and "A Note On Anger" have been translated into Spanish by Maria Lugones for circulation in la Asociacion Argentina de Mujeres en Filosofia.

ABSTRACT: Most of what we believe comes to us from the word of others, but we do not always believe what we are told. We often reject thinkers' reports by attributing biases to them. We may call this debunking. In this essay, I consider how debunking might work and then examine whether, and how often, it can help to preserve rational belief in the face of disagreement.

ABSTRACTMany philosophers have suggested that disagreement is good grounds for scepticism. One response says that disagreement-motivated scepticism can be mitigated to some extent by the thesis that philosophical disputes are often verbal, not genuine. I consider the implications of this anti-sceptical strategy, arguing that it trades one kind of scepticism for others. I conclude with suggestions for further investigation of the epistemic significance of the nature of philosophical disagreement.

I argue that reflection on philosophers who could have been working among us but aren’t can lead us to give up our philosophical beliefs.

Pediatric participation in non-therapeutic research that poses greater than minimal risk has been the subject of considerable thought-provoking debate in the research ethics literature. While the need for more pediatric research has been called morally imperative, and concerted efforts have been made to increase pediatric medical research, the importance of protecting children from undue research risks remains paramount.United States research regulations are derived largely from the deliberations and report of the National Commission for the Protection of Human Subjects of Biomedical (...) and Behavioral Research. The authors of this report specifically designated children as a vulnerable population and suggested additional protections, most of which became U.S. law. One of the more contested sets of regulations surrounds non-therapeutic research, e.g., research that does not offer the potential for direct benefit to participants. Federal regulations allow local Institutional Review Boards to approve non-therapeutic research posing a minor increase above minimal risk when it involves children who have the disease or medical condition that the research addresses. (shrink)

Recent work on the nature of luck widely endorses the thesis that an event is good or bad luck for an individual only if it is significant for that individual. In this paper, I explore this thesis, showing that it raises questions about interests, well-being, and the philosophical uses of luck. In Sect. 1, I examine several accounts of significance, due to Pritchard (2005), Coffman (2007), and Rescher (1995). Then in Sect. 2 I consider what some theorists want to ‘do’ (...) with luck, taking important examples from epistemology (explaining Gettier-style examples) and political philosophy (offering a rationale for the just distribution of resources in society), while suggesting implications for significance. Drawing together lessons from Sects. 1 and 2, I develop a new account of significance in Sect. 3 before concluding with reflections on the debate in Sect. 4. (shrink)

International research, sponsored by for-profit companies, is regularly criticised as unethical on the grounds that it exploits research subjects in developing countries. Many commentators agree that exploitation occurs when the benefits of cooperative activity are unfairly distributed between the parties. To determine whether international research is exploitative we therefore need an account of fair distribution. Procedural accounts of fair bargaining have been popular solutions to this problem, but I argue that they are insufficient to protect against exploitation. I argue instead (...) that a maximin principle of fair distribution provides a more compelling normative account of fairness in relationships characterised by extreme vulnerability and inequality of bargaining potential between the parties. A global tax on international research would provide a mechanism for implementing the maximin account of fair benefits. This model has the capacity to ensure fair benefits and thereby prevent exploitation in international research. (shrink)

Implicit bias results from living in a society structured by race. Tamar Gendler has drawn attention to several epistemic costs of implicit bias and concludes that paying some costs is unavoidable. In this paper, we reconstruct Gendler’s argument and argue that the epistemic costs she highlights can be avoided. Though epistemic agents encode discriminatory information from the environment, not all encoded information is activated. Agents can construct local epistemic environments that do not activate biasing representations, effectively avoiding the consequences of (...) activation. We conclude that changing our local environments provides a way to avoid paying implicit bias’s epistemic costs. (shrink)

David Lewis and Peter van Inwagen have claimed that there are no “knockdown” arguments in philosophy. Their claim appears to be at odds with common philosophical practice: philosophers often write as though their conclusions are established or proven and that the considerations offered for these conclusions are decisive. In this paper, I examine some questions raised by Lewis’s and van Inwagen’s contention. What are knockdown arguments? Are there any in philosophy? If not, why not? These questions concern the nature of (...) the philosophical enterprise and our answers have implications for the limits on the attitudes of informed, rational thinkers. (shrink)

In this paper, we examine how increasing understanding and explicit awareness of social consciousness can develop through transformations in worldview. Based on a model that emerged from a series of qualitative and quantitative studies on worldview transformation, we identify five developmental levels of social consciousness: embedded, self-reflexive, engaged, collaborative, and resonant. As a person's worldview transforms, awareness can expand to include each of these levels, leading to enhanced prosocial experiences and behaviours. Increased social consciousness can in turn stimulate further transformations (...) in worldview. We then consider an educational curriculum to facilitate the understanding of worldview and the cultivation of social consciousness as core capacities for twenty-first century students and global citizens. (shrink)

This paper explores the implications of conceptualising phenomenology as explanatory for the ongoing dialogue between the phenomenological tradition and cognitive science, especially enactive approaches to cognition. The first half of the paper offers three interlinked arguments: Firstly, that differentiating between phenomenology and the natural sciences by designating one as descriptive and the other as explanatory undermines opportunities for the kind of productive friction that is required for genuine ‘mutual enlightenment’. Secondly, that conceiving of phenomenology as descriptive rather than explanatory risks (...) committing us to what Zahavi (2019) identifies as the error of equating the phenomenological with the phenomenal. Finally, that the erroneous reduction to the descriptive occludes the rich resources that the phenomenological tradition can contribute to investigations of non-human cognition. The second half of the paper then turns to focus specifically on the promising relationship between phenomenology and enactive approaches to cognition. It will suggest that phenomenology must be seen as having explanatory capacities if it is to shed light on the structures of “mind in life” (Thompson, 2007), before drawing on the model of explanation put forward by Louis Sass to explore what this might look like. (shrink)

Background: Brain-dead humans retain many of the physiologic functions of living humans, but they are legally dead and cannot be physically harmed by participation in research. Stakeholder opinions...

Public-private partnerships are established to specifically harness the potential of Big Data in healthcare and can include partners working across the data chain—producing health data, analysing data, using research results or creating value from data. This domain paper will illustrate the challenges that arise when partners from the public and private sector collaborate to share, analyse and use biomedical Big Data. We discuss three specific challenges for PPPs: working within the social licence, public antipathy to the commercialisation of public sector (...) health data, and questions of ownership, both of the data and any resulting intellectual property or products. As a specific example we consider the case of the UK National Health Service providing patient data to Google’s DeepMind AI program to develop a diagnostic app for kidney disease. This article is an application of the framework presented in this issue of ABR. Please refer to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. We use four specific values to help analysis these issues: public benefit, stewardship, transparency and engagement. We demonstrate how the Deliberative Framework can support ethical governance of PPPs involving biomedical big data. (shrink)

Walter Sinnott-Armstrong has developed and progressively refined an argument against moral intuitionism—the view on which some moral beliefs enjoy non-inferential justification. He has stated his argument in a few different forms, but the basic idea is straightforward. To start with, Sinnott-Armstrong highlights facts relevant to the truth of moral beliefs: such beliefs are sometimes biased, influenced by various irrelevant factors, and often subject to disagreement. Given these facts, Sinnott-Armstrong infers that many moral beliefs are false. What then shall we think (...) of our own moral beliefs? Either we have reason to think some of our moral beliefs are reliably formed or we have no such reason. If the latter, our moral beliefs are unjustified. If we have reason to think some moral beliefs are reliably formed, then those beliefs are not non-inferentially justified, because then we’ll have reason to accept something—namely, that they are reliably formed—that entails or supports those beliefs. But then, either way, our moral beliefs are not non-inferentially justified, and so moral intuitionism is false. This paper takes issue with Sinnott-Armstrong’s interesting and widely discussed argument, which we here call the Empirical Defeat Argument (EDA). According to us, the EDA does not defeat moral intuitionism. In section 1, we will set out the argument, briefly reviewing the rationale Sinnott-Armstrong offers for the premises. Then, in section 2, we identify a critical but dubious epistemological assumption concerning the nature of defeat that undergirds the argument. Finally, in section 3, we will defend our challenge to the EDA by answering two objections. (shrink)

Some epistemologists hold that exploration and elaboration of the nature of luck will allow us to better understand knowledge. I argue this is a mistake.

Intellectual humility is commonly thought to be a mindset, disposition, or personality trait that guides our reactions to evidence as we seek to pursue the truth and avoid error. Over the last decade, psychologists, philosophers, and other researchers have begun to explore intellectual humility, using analytical and empirical tools to understand its nature, implications, and value. This review describes central questions explored by researchers and highlights opportunities for multidisciplinary investigation.

This paper contends that a research ethics approach to the regulation of health data research is unhelpful in the era of population‐level research and big data because it results in a primary focus on consent (meta‐, broad, dynamic and/or specific consent). Two recent guidelines – the 2016 WMA Declaration of Taipei on ethical considerations regarding health databases and biobanks and the revised CIOMS International ethical guidelines for health‐related research involving humans – both focus on the growing reliance on health data (...) for research. But as research ethics documents, they remain (to varying degrees) focused on consent and individual control of data use. Many current and future uses of health data make individual consent impractical, if not impossible. Many of the risks of secondary data use apply to communities and stakeholders rather than individual data subjects. Shifting from a research ethics perspective to a public health lens brings a different set of issues into view: how are the benefits and burdens of data use distributed, how can data research empower communities, who has legitimate decision‐making capacity? I propose that a public health ethics framework – based on public benefit, proportionality, equity, trust and accountability – provides more appropriate tools for assessing the ethical uses of health data. The main advantage of a public health approach for data research is that it is more likely to foster debate about power, justice and equity and to highlight the complexity of deciding when data use is in the public interest. (shrink)

The concept of ‘ownership’ is increasingly central to debates, in the media, health policy and bioethics, about the appropriate management of clinical data. I argue that the language of ownership acts as a metaphor and reflects multiple concerns about current data use and the disenfranchisement of citizens and collectives in the existing data ecosystem. But exactly which core interests and concerns ownership claims allude to remains opaque. Too often, we jump straight from ‘ownership’ to ‘private property’ and conclude ‘the data (...) belongs to the patient’. I will argue here that private property is only one type of relevant relationship between people, communities and data. There are several reasons to doubt that conceptualising data as private property presents a compelling response to concerns about clinical data ownership. In particular I argue that clinical data are co-constructed, so a property account would fail to confer exclusive rights to the patient. A non-property account of ownership acknowledges that the data are ‘about the patient’, and therefore the patient has relevant interests, without jumping to the conclusion that the data ‘belongs to the patient’. On this broader account of ownership, the relevant harm is the severing of the connection between the patient and their data, and the solution is to re-engage and re-connect patients to the data research enterprise. (shrink)

Kierkegaard is considered by many to be the father of existentialism because he is believed to have asserted that our interpretations of existence are the expression of absolutely free choices, or choices for which no rational criteria can be given. This paper argues that that view is false. It presents a sketch of Kierkegaard position on the nature of human rationality, and argues that according to Kierkegaard, there are rational criteria for choosing between competing interpretations of existence and that people (...) make such choices only with reference to these criteria. (shrink)