Throughout history Christians have responded to the need for direct care for the sick in imitation of the healing ministry of Jesus and in the creation of hospitals as signs of God’s love. The COVID-19 pandemic has created a global, unprecedented modern experience of vulnerability. It has resulted in moral distress for doctors and health care workers in overwhelmed facilities. It has also revealed profound inequity in access to health care, the tragic consequences of the neglect of public health and (...) its focus on communities, and the effects of poverty and marginalization on the risk of illness and death. This paper proposes insights from Catholic social teaching that can guide a renewal of public health by rebalancing duties to individuals and communities, and renewing medicine as a public trust. These insights can assist in reducing moral distress in scarcity. (shrink)

oise Baylis, 1234 Le Marchant Street, Halifax, Nova Scotia, Canada B3H 3P7. Tel.: (902)-494–2873; Fax: (902)-494-2924; Email: francoise.baylis{at}dal.ca ' + u + '@' + d + ' '//--> . Abstract Recently, there has been a growing interest in public health and public health ethics. Much of this interest has been tied to efforts to draw up national and international plans to deal with a global pandemic. It is common for these plans to state the importance of drawing upon a well-developed (...) ethics framework and we argue that this framework should reflect the values and insights of feminist relational theory. More specifically, we argue that pandemic planning must be squarely situated in the larger realm of public health and that an ethics framework for public health will be one that recognizes the need to pay particular attention to the vulnerability of subpopulations lacking in social and economic power. We propose an ethics framework for public health that builds on the notions of relational personhood (including relational autonomy and social justice) and relational solidarity. In this way, we aim for a public health ethics that, as appropriate, promotes the public interest and the common good. CiteULike Connotea Del.icio.us What's this? (shrink)

Ethics guidance and ethical frameworks are becoming more explicit and prevalent in health policy proposals. However, little attention has been given to evaluating their roles and impacts in the policy arena. Before this can be investigated, fundamental questions must be asked about the nature of ethics in relation to policy, and about the nexus of the fields of applied ethical analysis and health policy analysis. This paper examines the interdisciplinary stretch between bioethics and health policy analysis. In particular, it highlights (...) areas of scholarship where a health policy ethicsspecialization—as distinctive from bioethics—might develop to address health policy concerns. If policy and ethics both ask the same question, that question is: “What is the good, and how do we achieve (create, protect, cultivate) it?” To answer this question, the new field of “health policy ethics” requires development. First, we should develop a full set of ethical principles and complementary ethical theories germane to public policy per se. Second, we must understand better how explicit attention to ethical concerns affects policy dynamics. Third, we require new policy and ethical analytic approaches that contribute to constructive (not obstructive) policy making. Finally, we need indicators of robust, high quality ethical analysis for the purpose public policy making. (shrink)

Physicians and nurses need to sustain their unique strengths and work in true collaboration, recognizing their interdependence and the complementarity of their knowledge, skills and perspectives, as well as their common moral commitments. In this article, challenges often faced by both nurses and physicians in working collaboratively are explored with a focus on the ways in which each profession's preparation for practice has differed over time, including shifts in knowledge development and codes of ethics guiding their practice. A call for (...) envisioning their practice as shared moral work as well as practical strategies to begin that work are offered as a basis for reflection towards enhanced nurse-physician relationships. (shrink)

Health care systems throughout the developed world face ‘crises’ of quality, financing and sustainability. These pressures have led governments to look for more efficient and equitable ways to allocate public resources. Prioritisation of health care services for public funding has been one of the strategies used by decision makers to reconcile growing health care demands with limited resources. Priority setting at the macro level has yet to demonstrate real successes. This paper describes international approaches to explicit prioritisation at the macro-governmental (...) level in the six experiences most published in the English literature; analyzes the ways in which values, principles and other normative concepts were presented in these international priority setting experiences; and identifies key elements of a more robust framework for ethical analysis which could promote meaningful and effective health priority setting. (shrink)

Special moral, regulatory, and scientific questions surround the inclusion of children in health-related research. These questions arise from a fundamental moral tension between the obligation to expose children to research participation to ensure that they share in the benefits that arise from it and the obligation to protect them from the harms associated with their inappropriate involvement in research. This tension is felt in the development of moral and regulatory frameworks for the protection of child research subjects and in the (...) implementation and interpretation of these frameworks by institutional review boards. (shrink)

The central role that the media plays in communicating to the public health research findings has long been recognized (Cassels 2007), and concerns regarding the media's ability to convey health is...

In this paper, we first briefly describe neuroimaging technology, our reasons for studying magnetic resonance imaging (MRI) technology, and then provide a discussion of what we have identified as priority issues for paediatric MRI research. We examine the issues of respectful involvement of children in the consent process as well as privacy and confidentiality for this group of MRI research participants. In addition, we explore the implications of unexpected findings for paediatric MRI research participants. Finally, we explore the ethical issues (...) concerning advances in functional MRI. This paper aims to provide a clear description of priority paediatric MRI research ethics issues to make some preliminary recommendations regarding next steps. (shrink)

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. (...) The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary. (shrink)

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. (...) The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary. (shrink)

Frankfurt gave an account of “bullshit” as a statement made without regard to truth or falsity. Austin argued that a large amount of language consists of speech acts aimed at goals other than truth or falsity. We don't want our account of bullshit to include all performatives. I develop a modification of Frankfurt's account that makes interesting and useful categorizations of various speech acts as bullshit or not and show that this account generalizes to many other kinds of act as (...) well. I show that this illuminates some of Graeber's classification of “bullshit jobs,” though it doesn't fully agree with it. (shrink)

In a recent article, Director makes the case that many individuals with bipolar disorder have the capacity to consent to many decisions while acutely manic, even when those decisions are out of character and cause harm. Referring to recent qualitative evidence, I argue that Director overlooks a key mechanism of manic incapacity, an inflexible experience of the future that impairs one’s ability to value. Without attention to the illness-specific experience of decision-making, capacity assessments risk false negatives in people with mania.

Many Jews, Christians, and Muslims adhere to the following three claims: First, God has comprehensive knowledge of all that is, was, and will be. Second, God makes use of this knowledge in order to exercise providential control over the world. Third, human beings have free will. This combination of views raises philosophical puzzles. My aim in this chapter is to explore how historic Jewish reflection on these puzzles relates to treatment of them by contemporary analytic philosophers.

Bill D'Alessandro talks to Kenny Easwaran about fractal music, Zoom conferences, being a good referee, teaching in math and philosophy, the rationalist community and its relationship to academia, decision-theoretic pluralism, and the city of Manhattan, Kansas.

Organ transplantation from living related donors in Bangladesh first began in October 1982, and became commonplace in 1988. Cornea transplantation from posthumous donors began in 1984 and living related liver and bone marrow donor transplantation began in 2010 and 2014 respectively. The Human Organ Transplantation Act officially came into effect in Bangladesh on 13th April 1999, allowing organ donation from both brain-dead and related living donors for transplantation. Before the legislation, religious leaders issued fatwa, or religious rulings, in favor of (...) organ transplantation. The Act was amended by the Parliament on 8th January, 2018 with the changes coming into effect shortly afterwards on 28th January. However, aside from a few posthumous corneal donations, transplantation of vital organs, such as the kidney, liver, heart, pancreas, and other body parts or organs from deceased donors, has remained absent in Bangladesh. The major question addressed in this article is why the transplantation of vital organs from deceased donors is absent in Bangladesh. In addition to the collection of secondary documents, interviews were conducted with senior transplant physicians, patients and their relatives, and the public, to learn about posthumous organ donation for transplantation. Interviews were also conducted with a medical student and two grief counselors to understand the process of counseling the families and obtaining consent to obtain posthumous cornea donations from brain-dead patients. An interview was conducted with a professional anatomist to understand the processes behind body donation for the purposes of medical study and research. Their narrative reveals that transplant physicians may be reticent to declare brain death as the stipulations of the 1999 act were unclear and vague. This study finds that Bangladeshis have strong family ties and experience anxiety around permitting separating body parts of dead relatives for organ donation for transplantation, or donating the dead body for medical study and research purposes. Posthumous organ donation for transplantation is commonly viewed as a wrong deed from a religious point of view. Religious scholars who have been consulted by the government have approved posthumous organ donation for transplantation on the grounds of necessity to save lives even though violating the human body is generally forbidden in Islam. An assessment of the dynamics of biomedicine, religion and culture leads to the conclusion that barriers to posthumous organ donation for transplantation that are perceived to be religious may actually stem from cultural attitudes. The interplay of faith, belief, religion, social norms, rituals and wider cultural attitudes with biomedicine and posthumous organ donation and transplantation is very complex. Although overcoming the barriers to organ donation for transplantation is challenging, initiation of transplantation of vital organs from deceased donors is necessary within Bangladesh. This will ensure improved healthcare outcomes, prevent poor people from being coerced into selling their organs to rich recipients, and protect the solidarity and progeny of Bangladeshi families. (shrink)

In this chapter, I grant Jc Beall’s assertion that the best understanding of the doctrine of the incarnation posits that Christ is a contradictory being, in the sense that it has him satisfying complementary pairs of predicates. I also argue, however, that by attending to a distinction between predicate negation and sentence negation, this view can be upheld without positing any classical logical contradictions. I argue that the resulting Christological view has several advantages over Beall’s: It is more conservative about (...) avoiding contradiction, exhibits greater logical neutrality, and comports better with Christian tradition. (shrink)

Maureen Junker-Kenny offers a systematic overview of the discipline of theological ethics in the variety of its approaches, which draw upon different philosophical traditions and theological visions in treating its sources. Part One examines the four sources of theological ethics: the Bible, tradition, philosophical accounts of the human, and the individual human sciences. Part Two compares five frameworks in English- and German-speaking theological ethics, based on virtue, worship, natural law, autonomy, and feminist analyses. Part Three compares three types of (...) vision - integralist, praxis-oriented, and discourse-focused -, and Junker-Kenny concludes by situating the investigation of the discipline within contemporary philosophical and theological exchanges on religion in the public sphere. The book provides a framework in which students can locate the specific use of core ethical concepts and argumentations, comparing how each approach relates to the Bible, to historical reason, theological thought, practical self-understandings and interdisciplinary perspectives on ethics in a scientific and technological culture. In an age of globalisation where different cultures, religions, lifestyles and values meet in the workplace, in schools, and in public spaces shaped by religious and cultural traditions, it is necessary to foster the ability to create possibilities and venues for dialogue between different self-understandings. Analysing the variety of approaches to theological ethics helps articulate different visions of what constitutes a fulfilled life, of how the moral vocation of each human being can be supported, and of the role of the Christian faith for ethics. (shrink)

Procédant à une analyse comparative du traitement qu’Aristote réserve à la philia dans les livres VIII et IX de l’ Éthique à Nicomaque et dans le livre VII de l’ Éthique à Eudème, je soutiens dans cet article qu’à bien des égards, l’approche « eudémienne » se révèle plus claire et cohérente. Plusieurs sujets sur lesquels les deux Éthiques offrent des traitements différents sont successivement examinés (par exemple, la méthode endoxique, la théorie du « focal meaning », la question de (...) l’amour de soi, celle de l’auto-suffisance). Je suggère pour finir que la façon la plus simple de rendre compte de ces différences est de faire l’hypothèse que le traitement de l’amitié dans l’ Éthique à Nicomaque précède celui de l’ Éthique à Eudème. (shrink)

This book discusses Asian medicine, which puts enormous emphasis on prevention and preservation of health, and examines how, in recent decades, medical schools in Asia have been increasingly shifting toward a curative approach. It offers an ethnographic investigation of the scenarios in China and India and finds that modern students and graduates in these countries perceive Asian medicine to be as important as Western medicine. There is a growing tendency to integrate Asian medicine with Western medical thought in the academic (...) curriculum that has led to a gradual decline of Asian medical thought and practices. At the same time, there has been a massive rise in patent drugs, health products and cosmetics being sold under the brand names of Asian medicine or herbal medicine. Most of these drugs and health products do not follow the classical formulas found in the Asian medical texts. The book analyses these texts and concludes that contemporary Asian medicine rarely follows the classical texts, and in fact uses Asian medicine brands to sell Western health products and practices. With a particular focus on the formal and professional sector of Chinese herbal medicine and Indian ayurvedic medicine in urban areas, this book appeals to a broad readership, including undergraduate students and academics as well as non-experts. Md. Nazrul Islam is an Associate Professor in the General Education Office, United International College, Beijing Normal University-Hong Kong Baptist University. He was a Visiting Associate Professor in the School of Population and Public Health, University of British Columbia (2015-16) during which time he completed this book manuscript. (shrink)

The Infectious Diseases Act entered into force officially on 14 November 2018 in Bangladesh. The Act is designed to raise awareness of, prevent, control, and eradicate infectious or communicable diseases to address public health emergencies and reduce health risks. A novel coronavirus disease was first identified in Bangladesh on 8 March 2020, and the Ministry of Health and Family Welfare issued a gazette on 23 March, listing COVID-19 as an infectious disease and addressing COVID-19 as a public health emergency. The (...) gazette empowers the government to monitor the spread of infection. Despite there being an infrastructure of research ethics committees in almost all hospitals in Bangladesh, a lack of such committees in the clinical setting often forces healthcare professionals to allocate scarce healthcare resources to the task. These personnel are often either influenced by materialistic matters or guided by the emergency policies, without reaching a consensus on how to allocate scarce resources in times of need, especially in the time of the COVID-19 pandemic. Ethical dilemmas often arise when a number of patients with COVID-19, especially in poor and middle-class areas, are denied care while elites are prioritized to receive such scarce resources. Resource allocation in healthcare during the COVID-19 pandemic in Bangladesh appears to be unethical and in direct conflict with the biomedical principles of non-maleficence and procedural justice. The findings of this study suggest that the Act needs substantive changes in the stipulation of policy directing hospitals in the provision of resource allocation framework. Furthermore, parliament should produce guidance outlining how to successfully implement the law with the aim of protecting public health in times of emergency, especially the COVID-19 pandemic. (shrink)

We introduce a family of rules for adjusting one's credences in response to learning the credences of others. These rules have a number of desirable features. 1. They yield the posterior credences that would result from updating by standard Bayesian conditionalization on one's peers' reported credences if one's likelihood function takes a particular simple form. 2. In the simplest form, they are symmetric among the agents in the group. 3. They map neatly onto the familiar Condorcet voting results. 4. They (...) preserve shared agreement about independence in a wide range of cases. 5. They commute with conditionalization and with multiple peer updates. Importantly, these rules have a surprising property that we call synergy - peer testimony of credences can provide mutually supporting evidence raising an individual's credence higher than any peer's initial prior report. At first, this may seem to be a strike against them. We argue, however, that synergy is actually a desirable feature and the failure of other updating rules to yield synergy is a strike against them. (shrink)

Smith gives an excellent overview on research in language evolution, in which he discusses several recent models of how linguistic systems and the cognitive capacities involved in language learning may have co‐evolved. He illustrates how combined pressures on language learning and communication/use produce compositionally structured languages. Once in place, a (culturally transmitted) communication system creates new selection pressures on the capacity for acquiring these systems.

This article brings together and compares my own artistic practice of drawing/painting and the eighteenth-century novel Tristram Shandy. In both cases, there is a free play of lines, textual or graphic, which sets ‘all things out of rule’. A whole typology of lines is woven throughout Sterne’s text and reappears, alter-inscribed, in the artworks. The article presents an account of these lines: rectilinear, hylomorphic, fractal and nomadic, as well as the line of incision (or the cut). Each is explored as (...) a specific mode of line with differing effects. To follow these lines is to enter a world of material expressivity, to be exposed to an ontology of becoming and change, of flows and transformations, that overturns the traditional ontology of being and stable identity. Sterne’s use of wild digression, doodles and graphisms, establishes certain proximity between writing and drawing. Both may be seen as types of ‘figured metaphysics’ and as ways of bringing something new into the world. The article concludes with some philosophical observations on the strange event of drawing a line, with reference to the work of Heidegger and Deleuze and Guattari. (shrink)

This article divides into two roughly equal parts, both of which aim to address the act rather than the art of drawing. The second part focuses on a theoretical discussion of drawing. The first bears on a number of themes including the role of drawing in colonial history, drawing and data collection, and drawing and memory. It begins by describing an episode that unfolded as an encounter between two worlds, and two ages—an episode whose meaning and effects are still controversial (...) today. (shrink)

The government of Bangladesh approved the human organ transplantation law in 1999 and updated it in 2018. This legislation approved both living‐related donor and posthumous organ transplantation. The law only allows family members to legally donate organs to their relatives. The main focus of this study was to explore how Bangladeshis make donation decisions on familial organs for transplantation. My ethnographic fieldwork with forty participants (physicians and nurses, a healthcare administrator, organ donors, recipients, and their relatives) disclosed that the organ (...) donation decision was family‐based. An assessment of the relationship between religion, culture, and biomedicine leads to the conclusion that deciding on donating organs to relatives is primarily family‐based and is perceived to be steeped in Islamic ethical principles and religious cultural tradition. The family‐based consent and motivation for donor‐recipient pair organ transplantation strengthen an altruistic environment for the family and act as the moral and legal authority that ensures ethical healthcare outcomes for Bangladeshis. (shrink)

Volume 34, Issue 2-3, June - September 2024.

Many philosophers have argued that "degree of belief" or "credence" is a more fundamental state grounding belief. Many other philosophers have been skeptical about the notion of "degree of belief", and take belief to be the only meaningful notion in the vicinity. This paper shows that one can take belief to be fundamental, and ground a notion of "degree of belief" in the patterns of belief, assuming that an agent has a collection of beliefs that isn't dominated by some other (...) collection in terms of the overall balance of truth and falsity that it could contain. (shrink)

Many philosophers have become worried about the use of standard real numbers for the probability function that represents an agent's credences. They point out that real numbers can't capture the distinction between certain extremely unlikely events and genuinely impossible ones—they are both represented by credence 0, which violates a principle known as “regularity.” Following Skyrms 1980 and Lewis 1980, they recommend that we should instead use a much richer set of numbers, called the “hyperreals.” This essay argues that this popular (...) view is the result of two mistakes. The first mistake, which this essay calls the “numerical fallacy,” is to assume that a distinction that isn't represented by different numbers isn't represented at all in a mathematical representation. In this case, the essay claims that although the real numbers do not make all relevant distinctions, the full mathematical structure of a probability function does. The second mistake is that the hyperreals make too many distinctions. They have a much more complex structure than credences in ordinary propositions can have, so they make distinctions that don't exist among credences. While they might be useful for generating certain mathematical models, they will not appear in a faithful mathematical representation of credences of ordinary propositions. (shrink)

In 1999, the Bangladesh government introduced the Human Organ Transplantation Act allowing organ transplants from both brain-dead and living-related donors. This Act approved organ donation within family networks, which included immediate family members such as parents, adult children, siblings, uncles, aunts, and spouses. Subsequently, in January 2018, the government amended the 1999 Act to include certain distant relatives, such as grandparents, grandchildren, and first cousins, in the donor lists, addressing the scarcity of donors. Nobody, without these relatives, is legally permitted (...) to donate organs for transplantation in Bangladesh. The focus of this study was to investigate who should donate organs for transplantation in Bangladesh. The ethnographic fieldwork revealed that potential donors are not always available to immediate family members, and even when they are, they might be medically unsuitable for transplants. These considerations influenced the government in the revision of the Act. Secondly, the findings of the study suggest maintaining the current family-based regulations for living organ donation in Bangladesh. Furthermore, the study highlighted a potential consequence: amending the regulation to permit donations to unrelated recipients could significantly amplify the issue of organ selling and buying. While Islam advises Muslims to be compassionate towards all humankind, it also encourages Muslims to prioritize saving the lives of family members. This religious belief limits Muslims from donating organs to family members. (shrink)

This reissue was first published in 1978. Anthony Kenny, one of the most distinguished philosophers in England, explores the notion of responsibility and the precise place of the mental element in criminal actions. Bringing the insights of recent philosophy of mind to bear on contemporary developments in criminal law, he writes with the general reader in mind, no specialist training in philosophy being necessary to appreciate his argument. Kenny shows that abstract distinctions drawn by analytic philosophers are relevant (...) to decisions in matters of life and death, and illustrates the philosophical argument throughout by reference to actual legal cases. The topics he covers are of wide general interest and include: mens rea and mental health, strict liability, freedom and determinism, duress and necessity, intoxication and irresistible impulse, intention and purpose, murder and rape, punishment and deterrence, witchcraft and supernatural beliefs. (shrink)