The COVID-19 Vaccines Global Access Facility represents an unprecedented global collaboration facilitating the development and distribution of vaccines for COVID-19. COVAX pools and channels funds from state and non-state actors to promising vaccine candidates, and has started to distribute successful candidates to participating states. The WHO, one of the leaders of COVAX, recognised vaccine doses would initially be scarce, and therefore, prepared a two-staged allocation mechanism they considered fair. In the first stage, vaccine doses are distributed equally among participating countries, (...) while in the second stage vaccine doses will be allocated according to a country’s need. Ethicists have questioned whether this is the fairest distribution—they argue a country’s need should be taken into account from the start and correspondingly, have proposed a framework that treats individuals with equal moral concern, aims to minimise harm and gives priority to the worst-off. In this paper, we seek to explore these concerns by comparing COVAX’s allocation mechanism to a targeted allocation based on need. We consider which distribution would more likely maximise well-being and align with principles of equity. We conclude that although in theory, a targeted distribution in proportion to a country’s need would be more morally justifiable, when political realities are taken into account, an equal distribution seems more likely to avert a greater number of deaths and reduce disparities. (shrink)

We show that for an uncountable κ in a suitable Cohen real model for any family {A ν } ν<κ of sets of reals there is a σ-homomorphism h from the σ-algebra generated by Borel sets and the sets A ν into the algebra of Baire subsets of 2 κ modulo meager sets such that for all Borel B, B is meager iff h(B) = 0. The proof is uniform, works also for random reals and the Lebesgue measure, and in (...) this way generalizes previous results of Carlson and Solovay for the Lebesgue measure and of Kamburelis and Zakrzewski for the Baire property. (shrink)

The Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association, currently in its fourth edition and considered the reference for the characterization and diagnosis of mental disorders, has undergone various developments since its inception in the mid-twentieth century. With the fifth edition of the DSM presently in field trials for release in 2013, there is renewed discussion and debate over the extent of its relative successes - and shortcomings - at iteratively incorporating scientific evidence on the often ambiguous nature (...) and etiology of mental illness. Given the power that the DSM has exerted both within psychiatry and society at large, this essay seeks to analyze variations in content and context of various editions of the DSM, address contributory influences and repercussion of such variations on the evolving landscape of psychiatry as discipline and practice over the past sixty years. Specifically, we document major modifications in the definition, characterization, and classification of mental disorders throughout successive editions of the DSM, in light of shifting trends in the conceptualization of psychopathology within evolving schools of thought in psychiatry, and in the context of progress in behavioral and psychopharmacological therapeutics over time. We touch upon the social, political, and financial environments in which these changes took places, address the significance of these changes with respect to the legitimacy (and legitimization) of what constitutes mental illness and health, and examine the impact and implications of these changes on psychiatric practice, research, and teaching. We argue that problematic issues in psychiatry, arguably reflecting the large-scale adoption of the DSM, may be linked to difficulties in formulating a standardized nosology of psychopathology. In this light, we highlight 1) issues relating to attempts to align the DSM with the medical model, with regard to increasing specificity in the characterization of discrete mental disease entities and the incorporation of neurogenetic, neurochemical and neuroimaging data in its nosological framework; 2) controversies surrounding the medicalization of cognition, emotion, and behavior, and the interpretation of subjective variables as 'normal' or 'abnormal' in the context of society and culture; and 3) what constitutes treatment, enablement, or enhancement - and what metrics, guidelines, and policies may need to be established to clarify such criteria. (shrink)

a relatively more sympathetic attitude among younger judges, many of them women, and among trainees, may reflect a historical evoluti.

The purpose of this study was to compare exploratory behaviours in children with autism and typically developing preschool children and the course of their adaptation to novelty. A series of five repeated trials was conducted, during which children were allowed to freely explore the experimental room. The results revealed differences between study groups in the overall rate of exploratory activity, which was lower in children with autism. Patterns of time characteristics of exploratory activity showed both similarities and differences between the (...) groups. In both groups, the rate of simple exploratory behaviours decreased with time, while the levels of diversive exploration increased. Children with autism engaged in less complex object manipulation than their peers. Similarly, their adaptation and habituation to a novel environment proceeded in a different way in the low stimulation zone than in the high stimulation zone. In the low and medium stimulation zones, the rate of exploration decreased with time, while in the high stimulation zone it remained relatively constant. In typically developing children, habituation occurred in all stimulation zones. These results suggest the presence of some differences between the patterns of adaptation to novelty in the two groups, which emerge in a stimulation-rich environment. Due to the limitations of the study, in particular the small number of subjects, the present paper should be treated as a preliminary report. (shrink)

ABSTRACT In Mexico informed consent is a legal requirement that ensures that patients who are invited to participate in clinical trials are provided with all the information needed to decide whether to participate, or not, in a research protocol. To improve our understanding of the problems physicians in developing countries encounter, when obtaining informed consent (IC), we examined their opinion on the importance of IC in clinical research, the quantity and quality of the information provided to the participant, and the (...) conditions in which the IC is obtained. Investigators considered that IC was useful to the patients, providing information that helped the patient to make a decision about his/her participation. Nevertheless, they felt that for some aspects of the research, like drug development in general, the use of placebos, and the randomization process, many of the patients were not capable of fully understanding the information provided, referring to the complexity of the information and illiteracy as the main reasons. Many investigators were not acquainted with some of the guidelines established in the Mexican General Law of Health,1 36% of them admitting to not having completed their IC letters. Most investigators gave only minutes to the patient to make a decision and 20% of ICs were obtained while the patient was hospitalized. Except for one investigator, all of them considered that specific training in medical ethics would be useful for the daily clinical work. (shrink)

Neste trabalho nos ocupamos centralmente em compreender a proposta ética de Hans Jonas e como ele apresenta o Princípio Responsabilidade como uma categoria ética a ser norteadora das ações humanas. Apresentamos um breve histórico do desenvolvimento da Filosofia da Tecnologia enquanto uma disciplina filosófica específica e, então, discutimos as principais considerações de Jonas sobre a necessidade de uma ética inteiramente nova que tome a técnica como objeto e a proposta que este apresente de uma ética do futuro pautada na responsabi (...) lidade enquanto princípio. (shrink)

New Zealand is a South Pacific nation with a history of British colonization since the 19th century. It has a population of over four million people and, like other indigenous societies such as in Australia and Canada, Māori are now a minority in their land, and their experience of colonization is that of being dominated by settlers to the detriment of their own systems of society.

In this article, the identification in different civilizations and eras of some cir-umpolar stars as the north pole star are reviewed, the main principles behind and crucial considerations in the past for forming the criteria for north pole star identification are scrutinized, and some profound differences in ancient and medieval views of it are discussed. The point of departure is the identification of the north polar star in Euclid’s Phaenomena as the star HR 4646, and its identification in the Pahlavi (...) Bundahišn and al-Ṣūfī’s Ṣuwar al-kawākib as HR 4893. Because of the inevitable transitory nature of the north pole star, the location of al-Ṣūfī’s north pole star in the manuscript tradition of his magnum opus during the centuries after him is also investigated in detail. A supplementary discussion is included on the confusion between two different entities—the pole of the celestial sphere and the pivot of an indigenous Arabic asterism envisioned as a millstone—in philological, lexical, and literary Islamic works, which chiefly stems from the vague terminology employed. (shrink)