Hepatitis C is a global public health threat, affecting 56 million people worldwide. The World Health Organization has committed to eliminating hepatitis C by 2030. Although new treatments have revolutionised the treatment and care of people with hepatitis C, treatment uptake has slowed in recent years, drawing attention to the need for innovative approaches to reach elimination targets. One approach involves using existing notifiable disease data to contact people previously diagnosed with hepatitis C. Within these disease surveillance systems, however, competing (...) tensions exist, including protecting individual rights to privacy and autonomy, and broader public health goals. We explore these issues using hepatitis C and Australia’s legislative and regulatory frameworks as a case study. We examine emerging uses of notification data to contact people not yet treated, and describe some of the ethical dilemmas associated with the use and non-use of this data and the protections that exist to preserve individual rights and public health. We reveal weaknesses in rights protections and processes under Australian public health and human rights legislation and argue for consultation with and involvement of affected communities in policy and intervention design before notification data is used to increase hepatitis C treatment coverage. (shrink)

In this paper an economics approach to assessing community values in health care priority setting is examined. The approach is based on the concept of ‘willingness to pay’ (WTP). Eighty two parents were interviewed with regard to three aspects of provision of child health services. For each aspect a choice of two courses of action was presented. Parents were asked which course of action they preferred and what was the maximum amount of money they would be prepared to pay for (...) this rather than their less preferred option. WTP responses are acceptable to the majority of respondents and appear to ‘behave’ in accordance witha priori expectations. A method of assessing the influence of ability to pay on preferences and WTP is outlined. Preferences and WTP do not appear to have been unduly distorted by ability to pay. Use of WTP data does have the potential to provide health care purchasers and providers with information on intensity as well as direction of the preferences of members of the community. (shrink)

Women in Rock, Women in Romanticism is the first book-length work to explore the interrelationships between contemporary female musicians and eighteenth- and nineteenth-century art, music, and literature by women and men. The music and videos of contemporary musicians including Erykah Badu, Beyoncé, The Carters, Hélène Cixous, Missy Elliot, the Indigo Girls, Janet Jackson, Janis Joplin (and Big Brother and the Holding Company), Natalie Merchant, Joni Mitchell, Janelle Monáe, Alanis Morrisette, Siouxsie Sioux, Patti Smith, St. Vincent (Annie Clark), and Alice (...) class='Hi'>Walker are explored through the lenses of pastoral and Afropresentism, Gothic, female Gothic, and the literature of William Blake, Beethoven, Arthur Schopenhauer, Samuel Taylor Coleridge, Charlotte Dacre, Ralph Waldo Emerson, E.T.A. Hoffmann, Ann Radcliffe, William Shakespeare, Mary Shelley, her husband Percy Shelley, Henry David Thoreau, Horace Walpole, Jane Williams, Mary Wollstonecraft, and William Wordsworth to explore how each sheds light on the other, and how women have appropriated, responded to, and been inspired by the work of authors from previous centuries. (shrink)

Vaccine refusal occurs for a variety of reasons. In this article we examine vaccine refusals that are made on conscientious grounds; that is, for religious, moral, or philosophical reasons. We focus on two questions: first, whether people should be entitled to conscientiously object to vaccination against contagious diseases ; second, if so, to what constraints or requirements should conscientious objection to vaccination be subject. To address these questions, we consider an analogy between CO to vaccination and CO to military service. (...) We argue that conscientious objectors to vaccination should make an appropriate contribution to society in lieu of being vaccinated. The contribution to be made will depend on the severity of the relevant disease, its morbidity, and also the likelihood that vaccine refusal will lead to harm. In particular, the contribution required will depend on whether the rate of CO in a given population threatens herd immunity to the disease in question: for severe or highly contagious diseases, if the population rate of CO becomes high enough to threaten herd immunity, the requirements for CO could become so onerous that CO, though in principle permissible, would be de facto impermissible. (shrink)

Many health care systems include programs that allow patients in exceptional circumstances to access medical interventions of as yet unproven benefit. In this article we consider the ethical justifications for—and demands on—these special access programs (SAPs). SAPs have a compassionate basis: They give patients with limited options the opportunity to try interventions that are not yet approved by standard regulatory processes. But while they signal that health care systems can and will respond to individual suffering, SAPs have several disadvantages, including (...) the potential to undermine regulatory and knowledge-generation structures that constitute significant public goods. The “balance” between these considerations depends in part on how broadly SAPs are used, but also on whether SAPs can be made to contribute to the generation of knowledge about the effects of health interventions. We argue that patients should usually be required to contribute outcome data while using SAPs. (shrink)

This paper is predicated on the understanding that clinical encounters between clinicians and patients should be seen primarily as inter-relations among persons and, as such, are necessarily moral encounters. It aims to relocate the discussion to be had in challenging medical decision-making situations, including, for example, as the end of life comes into view, onto a more robust moral philosophical footing than is currently commonplace. In our contemporary era, those making moral decisions must be cognizant of the existence of perspectives (...) other than their own, and be attuned to the demands of inter-subjectivity. Applicable to clinical practice, we propose and justify a Habermasian approach as one useful means of achieving what can be described as dialogic consensus. The Habermasian approach builds around, first, his discourse theory of morality as universalizable to all and, second, communicative action as a cooperative search for truth. It is a concrete way to ground the discourse which must be held in complex medical decision-making situations, in its actual reality. Considerations about the theoretical underpinnings of the application of dialogic consensus to clinical practice, and potential difficulties, are explored. (shrink)

The historical emphasis of medical ethics, based on substantive frameworks and principles derived from them, is no longer seen as sufficiently sensitive to the moral pluralism characteristic of our current era. We argue that moral decision-making in clinical situations is more properly derived from a process of dialogic consensus. This process entails an inclusive, noncoercive, and self-reflective dialogue within the community affected. In order to justify this approach, we make two claims—the first epistemic, and the second normative. The epistemic claim (...) follows from Habermas’ “ways” of knowing. We argue that the dialogue emanating from this episteme focuses on the relevant facts about the patient, as well as on the values attached to these facts, thus allowing facts and their meanings to serve as the basis for reflective action appropriate to the circumstances. The normative claim follows from Habermas’ discourse theory of morality and communicative action. It determines that clinical decision-making should be approached from the perspective of the actual reality of people in their situation of illness, set in their socio-cultural background, and hence be grounded in the second-person perspective. Relocating ethical decision-making from a monological space into one characterized by dialogue is especially appropriate to the clinical encounter. (shrink)

Recently, concerns have been raised about the phenomenon of ‘overdiagnosis’, the diagnosis of a condition that is not causing harm, and will not come to cause harm. Along with practical, ethical, and scientific questions, overdiagnosis raises questions about our concept of disease. In this paper, we analyse overdiagnosis as an epistemic problem and show how it challenges many existing accounts of disease. In particular, it raises ques- tions about conceptual links drawn between disease and dysfunction, harm, and risk. We argue (...) that ‘disease’ should be considered a vague concept with a non-classical structure. On this view, overdiagnosed cases are ‘borderline’ cases of disease, falling in the zone between cases that are clearly disease, and cases that are clearly not disease. We then develop a pre ́cising definition of disease designed to provide practical help in preventing and limiting overdiagnosis. We argue that for this purpose, we can define disease as dysfunction that has a significant risk of causing severe harm to the patient. (shrink)

Following Wittgenstein’s lead, Crispin Wright and others have argued that hinge propositions are immune from skeptical doubt. In particular, the entitlement strategy, as we shall refer to it, says that hinge propositions have a special type of justification because of their role in our cognitive lives. Two major criticisms are raised here against the entitlement strategy when used in attempts to justify belief in the external world. First, the hinge strategy is not sufficient to thwart underdetermination skepticism, since underdetermination considerations (...) lead to a much stronger form of skepticism than is commonly realized. Second, the claim that hinge propositions are necessary to trust perception is false. There is an alternative to endorsing a particular hinge proposition about the external world, external world disjunctivism, which permits us to trust perception, while skirting the difficulties raised by skepticism. (shrink)

Personalised medicine has been discussed as a medical paradigm shift that will improve health while reducing inefficiency and waste. At the same time, it raises new practical, regulatory, and ethical challenges. In this paper, we examine PM strategies epistemologically in order to develop capacities to address these challenges, focusing on a recently proposed strategy for developing patient-specific models from induced pluripotent stem cells so as to make individualised treatment predictions. We compare this strategy to two main PM strategies—stratified medicine and (...) computational models. Drawing on epistemological work in the philosophy of medicine, we explain why these two methods, while powerful, are neither truly personalised nor, epistemologically speaking, novel strategies. Both are forms of correlational black box. We then argue that the iPSC models would count as a new kind of black box. They would not rely entirely on mechanistic knowledge, and they would utilise correlational evidence in a different way from other strategies—a way that would enable personalised predictions. In arguing that the iPSC models would present a novel method of gaining evidence for clinical practice, we provide an epistemic analysis that can help to inform the practical, regulatory, and ethical challenges of developing an iPSC system. (shrink)

While we often talk about time using spatial terms, experimental investigation of space-time associations has focused primarily on the space in front of the participant. This has had two consequences: the disregard of the space behind the participant and the creation of potential task demands produced by spatialized manual button-presses. We introduce and test a new paradigm that uses auditory stimuli and vocal responses to address these issues. Participants made temporal judgments about deictic or sequential relationships presented auditorily along a (...) body-centered sagittal or transversal axis. Results involving the transversal axis replicated previous work while sagittal axis results were surprising. Deictic judgments did not use the sagittal axis but sequential judgments did, in a previously undocumented way. Participants associated earlier judgments with the space in front of them and later judgments with the space behind them. These findings, using a new approach, p.. (shrink)

This empirical study advances the understanding of the theory of investment in human capital by outlining limitations to its applicability in the context of return to education. The study uses the concept of moral hazard to examine circumstances when financial support for education purpose generates less desirable post-graduation incomes. This study explores the relationship between financial support and post-graduation incomes using data from the Survey of Income and Program Participation that is designed to measure the economic situation of individuals. Results (...) suggest that students are less likely to engage in moral hazardous behavior to the degree to which they are older and to the degree to which they receive costlier financial assistance. (shrink)

An increasing number of patients receive diagnoses of disease without having any symptoms. These include diseases detected through screening programs, as incidental findings from unrelated investigations, or via routine checks of various biological variables like blood pressure or cholesterol. In this article, we draw on narrative identity theory to examine how the process of making sense of being diagnosed with asymptomatic disease can trigger certain overlooked forms of harm for patients. We show that the experience of asymptomatic disease can involve (...) ‘mismatches’ between one’s beliefs about one’s health status on the one hand, and bodily sensations or past experience on the other. Patients’ attempts to integrate these diagnoses into their self-narratives often involve either forming inaccurate beliefs about bodily sensations and/or past experience, or coming to believe that feelings and experience do not necessarily track or predict health status, leading to an ongoing sense of vulnerability to ill health. These resulting alterations in self-understanding can sometimes be considered harmful, in view of their implications for ascriptions of responsibility and ongoing anxiety. (shrink)

The ability to represent same-different relations is an important condition for abstract thought. However, there is mixed evidence for when this ability develops, both ontogenetically and phylogenetically. Apparent success in relational reasoning may be evidence for genuine conceptual understanding or may be the result of low-level, perceptual strategies. We introduce a method to discriminate these possibilities by pitting two conditions that are perceptually matched but conceptually different: in a "fused" condition, same and different objects are joined, creating single objects that (...) have the same perceptual features as the two object pairs in the "relational" condition. However, the "fused" objects do not provide evidence for the relation 'same.' Using this method with human toddlers in a causal relational reasoning task provides evidence for genuine conceptual understanding. This novel technique offers a simple manipulation that may be applied to a variety of existing match-to-sample procedures used to assess same-different reasoning to include in future research with non-human animals across species, as well as human infants. (shrink)

In this paper I challenge the orthodox view of the significance of Platonic value problems. According to this view, such problems are among the central questions of epistemology, and answering them is essential for justifying the status of epistemology as a major branch of philosophical enquiry. I challenge this view by identifying an assumption on which Platonic value problems are based – the value assumption – and considering how this assumption might be resisted. After articulating a line of thought that (...) supports the assumption, I highlight one way of undermining it, which is to deny that we desire knowledge and not just true belief because we prefer knowledge to true belief. I then consider an attempt to undermine the value assumption in this way, inspired by Bernard Williams. I contend that Williams's argument fails, but also that seeing why it fails is instructive for future attempts to resist the value assumption. (shrink)

Unlike topics such as criminal responsibility, dangerousness has only recently begun to interest philosophically minded penologists. The most likely explanation is that until the middle of this century the periods for which people who had done serious harm to others were incarcerated in the UK so long that when they were released their age or condition or circumstances made them unlikely to repeat their crimes. It was only when pressure of resources—in plain terms overcrowded prisons and mental hospitals—forced the shortening (...) of these periods that it became politically necessary to worry about the possible dangerousness of really substantial numbers of prisoners and patients who became eligible for release. The problem was not entirely new. A few lifers, for example, had been set free each year, under licences which lasted for the rest of their lives; and the Special Hospitals which housed the violent insane had discharged carefully selected inmates, also under supervision. But by the late 1960s the introduction of parole, the Mental Health Act and the abolition of capital punishment had greatly increased the number of cases in which the problem of dangerousness had to be faced, and difficult decisions had to be taken. (shrink)

At the end of the sixteenth century, Friar Juan de Torquemada watched the game of volador on the central plaza in Mexico. At the top of a pole some twenty meters high there was a small pivoting platform. Four ropes were wound around the top of the pole and held in place by a wooden frame. Five men dressed in feathery costumes making them look like birds climbed up the shaft. One of them reached the narrow platform and began to (...) dance. Then the other four bird-men tied themselves to the ends of the ropes and plunged into space, head down, held by the ropes around their waists. This initiated a spectacular circular flight in ever widening rings as the cords unwound. They straightened up only at the last moment, just in time to put their feet on the ground, dizzy and staggering. But on that particular day, one of the dancers was not to straighten himself up. The rope had been badly attached and broke, dropping the man like a heavy mass to the ground, lifeless. The Franciscan at once used this as an argument to demand that the Viceroy prohibit this game. But the civil authorities refused to do so, to the monk's great consternation. (shrink)

We argue that many of the benefits theorists have attributed to the ability to forget should instead be attributed to what psychologists call the “fading affect bias,” namely the tendency for the negative emotions associated with past events to fade more substantially than the positive emotions associated with those events. Our principal contention is that the disposition to display the fading affect bias is normatively good. Those who possess it tend to lead better lives and more effectively improve their societies. (...) Secondarily, we note that if Julia Driver’s moral theory is correct, then the disposition to display the fading affect bias is a moral virtue. (shrink)

“States have no morality, they have interests,” remarked an overzealous diplomat. And in this same manner we sometimes see that reasons of state take priority over moral rules. A sweet young thing testifying before a committee of the United State Congress said “sometimes you have to put yourself above the law,” no doubt repeating something that had been said to her. At a time when unrestrained application of the reasons of state can only lead to violence that can no longer (...) be sustained, we can judge to what extent such remarks are without foundation. (shrink)

Although many organizations around the world have engaged in corporate social responsibility programing, there is little evidence of social impact. This is a problematic omission since many programs carry the stigma of marketing ploys used to bolster organizational image or reduce consumer skepticism. To address this issue and build on existing scholarship, the purpose of this study was to evaluate a socially responsible youth employability program in the United Kingdom. The program was developed through the foundation of a professional British (...) soccer team to bolster employability and life skills for marginalized London youth. Program funding was provided by a large multinational bank as part of their CSR agenda. This evaluation was undertaken to understand the beneficiary impacts associated with program deployment. Results from the pre-intervention/post-intervention, sequential mixed-method evaluation show statistically significant differences among several “soft” beneficiary outcomes. However, results are mixed regarding whether the “hard” outcome of employment was achieved by program participants. Qualitative findings buttress these results, indicating a high level of motivation for work, attitude enhancement, and satisfaction with program delivery. (shrink)

Sport is viewed as an arena for positive life skill development, including leadership development. In 2015, the NFHS launched an online Captain’s Leadership Training Course. The main purpose of this study was to examine the effectiveness of the course in improving leadership knowledge and ability. An electronic survey was sent to a sample of athletes, ages 13–19 in eight United States states who had completed the NFHS course within the last 3–18 months. Most athletes completed the course based upon their (...) coach’s recommendation. The course was viewed to be moderately to very useful in helping them in preparing to be a team captain. Participants believed the course to be very to extremely effective in building their knowledge on motivation, communication, decision making, peer modeling, team cohesion and problem solving strategies. Canonical correlation analyses showed that athletes who felt they were more reflective tended to rate the effectiveness of the course lower than their peers. Additionally, analyses did not show any clear demographic characteristics that distinguished between perceptions of the effectiveness of the course, showing the value found in the course was high with all types of scholastic athletes. Athletes felt the course could be improved most in the area of learning how to manage conflict with their peers and coaches. Future research in scholastic leadership should seek to understand the impact of the course prospectively across a high school sport season. (shrink)

Berichte zur Wissenschaftsgeschichte, Volume 45, Issue 1-2, Page 219-244, June 2022.

This chapter examines some of the social science data concerning the relationship between happiness and achievement. The chapter explores further the idea that there are causal links between happiness and achievement, focusing on what common sense has to say about these matters. Reflective common sense supports a bidirectional model of causation: good moods often cause achievement and achievement often causes good moods. Before looking at the studies in support of the claim that happiness promotes achievement, the chapter considers the notion (...) of ‘effect size’. The question of whether positive affect causes achievement can be addressed by two sorts of studies. One type is longitudinal studies; the other is laboratory studies. Correlation, longitudinal, and experimental studies converge to show that positive moods and emotions cause achievement. Social science research suggests that those who are happier than average will be doubly blessed: they are happier and, on average, they will achieve more. (shrink)

Colleen Murphy’s impressive book presents a unified theory of transitional justice as a single, novel, distinct kind of justice, intended to guide normative evaluation of the choices transitional societies make in dealing with the past. I raise three central challenges to Murphy’s theory. First, how do we know that transitional justice is fundamentally a single special kind of justice that permits a grand unified theory? Second, is it plausible to hold, as Murphy claims, that societal transformation is the overarching aim (...) or objective of transitional justice? Third, is transitional justice convincingly explained as pursuing societal transformation ‘through’ or ‘by’ dealing with past wrongdoing? I argue that Murphy’s ambitious and finely detailed account does not fully reckon with dissensus about transitional justice in the field and does not adequately defend the central claim that transitional justice aims at societal transformation to be pursued by responding to past wrongs. (shrink)

Typical modes of reasoning in the Chinese tradition have often been described by Western thinkers as ‘correlative’ or ‘analogical’ in contrast with the supposedly rational, Western mode of reasonin...

This book review essay discusses Principles of Animal Research Ethics (2020), by Tom L. Beauchamp and David DeGrazia.

In The Souls of Black Folk, W.E.B. Du Bois introduces double consciousness as a result of racial prejudice and oppression. Explained as a state of confliction felt by black Americans, Du Bois presents double consciousness as integral to understanding the black experience. Later philosophers question the importance of double consciousness to current race discussions, but this paper contends that double consciousness provides valuable insights into black and white relations. To do this, I will utilize the modern slang term, “Oreo,” to (...) highlight how a perceived incompatibility between blacks and whites could prevent America from achieving a greater unity. (shrink)

This examination of the critical writings of Dionysius of Halicarnassus hopes to suggest two main things: First, recent arguments about the irrelevance of classical rhetoric to postmodern rhetorical criticism-conceived as a general hermeneutic of "rhetoricality", not only render the notion of "rhetorical criticism" itself increasingly problematic, but also tend to presuppose a simplified (and basically neo-Aristotelian) image of "classical rhetoric" that is unsustainable. Second an more importantly, even as we recognise that ancient rhetoric was oriented toward a discursive realm rather (...) different from that of postmodernity, and without advocating a simplistic "return to Dyonisius", nevertheless it may be argued that Dyonisius still embodies a general paradigm of "rhetorical criticism" that merits our consideration. (shrink)

In the United States at present, the death penalty is a possible sentence in 31 out of 50 states, as well as within the military and for federal cases. In the U.S., numbers of executions are declin...

This paper is motivated by the increasing popularity of efficient designs for stated choice experiments. The objective in efficient designs is to create a stated choice experiment that minimizes the standard errors of the estimated parameters. In order to do so, such designs require specifying prior values for the parameters to be estimated. While there is significant literature demonstrating the efficiency improvements of employing efficient designs, the bulk of the literature tests conditions where the priors used to generate the efficient (...) design are assumed to be accurate. However, there is substantially less literature that compares how different design types perform under varying degree of error of the prior. The literature that does exist assumes small fractions are used, which is in contrast to computer-aided surveys that readily allow for large fractions. Further, the results in the literature are abstract in that there is no reference point to provide clear insight on the magnitude of any issue. Our objective is to analyze the robustness of different designs within a typical stated choice experiment context of a trade-off between price and quality. We use as an example transportation mode choice, where the key parameter to estimate is the value of time. Within this context, we test many designs to examine how robust efficient designs are against a misspecification of the prior parameters. The simple mode choice setting allows for insightful visualizations of the designs themselves and also an interpretable reference point for the range in which each design is robust. Not surprisingly, the D-efficient design is most efficient in the region where the true population VOT is near the prior used to generate the design: the prior is $20/h and the efficient range is $10–$30/h. However, the D-efficient design quickly becomes the most inefficient outside of this range, and the estimation significantly degrades above $50/h. The orthogonal and random designs are robust for a much larger range of VOT. The robustness of Bayesian efficient designs varies depending on the variance that the prior assumes. Implementing two-stage designs that first use a small sample to estimate priors are also not robust relative to uninformative designs. Arguably, the random design performs as well as any design, and it will perform even better if data cleaning is done to remove choice tasks where one alternative dominates the other. (shrink)