In this paper we focus on how automated vehicles can reduce the number of deaths and injuries in accident situations in order to protect public health. This is actually a problem not only of public health and ethics, but also of big data—not only in terms of all the different data that could be used to inform such decisions, but also in the sense of deciding how wide the scope of data should be. We identify three key (...) different types of data, including basic data, advanced data and preference data, provide an ethical analysis of the use of these different types of data and of different ways of prioritizing between pedestrians and passengers, and propose four rules that can help set ethical priorities for ethical data use and decision making by automated vehicles. (shrink)

Since the 1970’s epidemiological measures focusing on “health-related quality of life” or simply “quality of life” have figured increasingly as endpoints in clinical trials. Before the 1970’s these measures were known, generically, as performance measures or health status measures. Relabeled as “quality of life measures” they were first used in cancer trials. In the early 2000’s they were relabeled again as “patient-reported outcome measures” or PROMs, in their service to the FDA to support drug labeling claims. To the (...) limited degree that the philosophical literature addresses these measures, it tends to associate them with two major theories of well-being: subjective well-being and the capabilities approach. In this paper, I argue that philosophers ought to treat quality of life measures/proms as a distinct from these theories. I argue that quality of life/proms serve healthcare as vehicles for patient-centered care and this has important consequences for how we theorize these measures. To this end, two requirements set them apart from measures of subjective well-being and the capabilities approach: quality of life/proms need to be patient-directed and inclusive. (shrink)

The ethics of autonomous vehicles has received a great amount of attention in recent years, specifically in regard to their decisional policies in accident situations in which human harm is a likely consequence. Starting from the assumption that human harm is unavoidable, many authors have developed differing accounts of what morality requires in these situations. In this article, a strategy for AV decision-making is proposed, the Ethical Valence Theory, which paints AV decision-making as a type of claim mitigation: different (...) road users hold different moral claims on the vehicle’s behavior, and the vehicle must mitigate these claims as it makes decisions about its environment. Using the context of autonomous vehicles, the harm produced by an action and the uncertainties connected to it are quantified and accounted for through deliberation, resulting in an ethical implementation coherent with reality. The goal of this approach is not to define how moral theory requires vehicles to behave, but rather to provide a computational approach that is flexible enough to accommodate a number of ‘moral positions’ concerning what morality demands and what road users may expect, offering an evaluation tool for the social acceptability of an autonomous vehicle’s ethical decision making. (shrink)

The control principle implies that people should not feel guilt for outcomes beyond their control. Yet, the so-called ‘agent and observer puzzles’ in philosophy demonstrate that people waver in their commitment to the control principle when reflecting on accidental outcomes. In the context of car accidents involving conventional or autonomous vehicles, Study 1 established that judgments of responsibility are most strongly associated with expressions of guilt–over and above other negative emotions, such as sadness, remorse or anger. Studies 2 and (...) 3 then confirmed that, while people generally endorse the control principle, and deny that occupants in an AV should feel guilt when involved in an accident, they nevertheless ascribe guilt to those same occupants. Study 3 also uncovered novel implications of the observer puzzle in the legal context: Passengers in an AV were seen as more legally liable than either passengers in a conventional vehicle, or even their drivers–especially when participants were prompted to reflect on the passengers’ affective experience of guilt. Our findings document an important conflict–in the context of AV accidents–between people’s prescriptive reasoning about responsibility and guilt on one hand, and their counter-normative experience of guilt on the other, with apparent implications for liability decisions. (shrink)

Law is indispensable to the public's health. The twentieth century proved this true as law contributed to each of the century's ten great public health achievements: vaccination, healthier mothers and babies, family planning, safer and healthier foods, fluoridation of drinking water, the control of infectious diseases, the decline in death from heart disease and stroke, recognition of tobacco use as a health hazard, motor vehicle safety, and safer workplaces.The readers of this journal can give examples of the (...) relevant types of laws with ease: Jacobson v. Massachusetts, the 1905 U.S. Supreme Court case that upheld the constitutionality of compulsory vaccination; mandatory immunization for school admission; authorization of state prenatal care programs; mandatory fortification of foods; Title X of the Public Health Service Act; the Pure Food and Drugs Act of 1906; the Safe Drinking Water Act of 1974, and hundreds of state and local enactments regulating food; fluoridation ordinanceswater, and sanitation; the Surgeon General's warning notices on cigarette packs and restrictions on marketing tobacco; seat belt laws and mandated vehicle and highway design features; and laws like the federal Occupational Safety and Health Act of 1970 that regulate working conditions. (shrink)

Law is indispensable to the public's health. The twentieth century proved this true as law contributed to each of the century's ten great public health achievements: vaccination, healthier mothers and babies, family planning, safer and healthier foods, fluoridation of drinking water, the control of infectious diseases, the decline in death from heart disease and stroke, recognition of tobacco use as a health hazard, motor vehicle safety, and safer workplaces.The readers of this journal can give examples of the (...) relevant types of laws with ease: Jacobson v. Massachusetts, the 1905 U.S. Supreme Court case that upheld the constitutionality of compulsory vaccination; mandatory immunization for school admission; authorization of state prenatal care programs; mandatory fortification of foods; Title X of the Public Health Service Act; the Pure Food and Drugs Act of 1906; the Safe Drinking Water Act of 1974, and hundreds of state and local enactments regulating food; fluoridation ordinanceswater, and sanitation; the Surgeon General's warning notices on cigarette packs and restrictions on marketing tobacco; seat belt laws and mandated vehicle and highway design features; and laws like the federal Occupational Safety and Health Act of 1970 that regulate working conditions. (shrink)

In D.A.B.E., Inc., v. Toledo-Lucas County Board of Health, the Supreme Court of Ohio held that the Ohio Revised Code does not grant a local board of health the power to proscribe smoking in all public places as defined by the Lucas County Regional Health District Clean Indoor Air Regulation.On May 24, 2001, the Board of Health of the Lucas County Regional Health District adopted the regulation in question, prohibiting smoking in all public areas in (...) Lucas County, which were defined as “every enclosed, indoor area to which members of the general public are invited or in which members of the general public are normally permitted.” In addition, the regulation prohibited smoking within twenty feet of any entrance or open window of these public areas and in all vehicles of public transportation. (shrink)

In D.A.B.E., Inc., v. Toledo-Lucas County Board of Health, the Supreme Court of Ohio held that the Ohio Revised Code does not grant a local board of health the power to proscribe smoking in all public places as defined by the Lucas County Regional Health District Clean Indoor Air Regulation.On May 24, 2001, the Board of Health of the Lucas County Regional Health District adopted the regulation in question, prohibiting smoking in all public areas in (...) Lucas County, which were defined as “every enclosed, indoor area to which members of the general public are invited or in which members of the general public are normally permitted.” In addition, the regulation prohibited smoking within twenty feet of any entrance or open window of these public areas and in all vehicles of public transportation. (shrink)

I hypothesize here that the ability of probiotics to synthesize neuroactive compounds provides a unifying microbial endocrinology‐based mechanism to explain the hitherto incompletely understood action of commensal microbiota that affect the host's gastrointestinal and psychological health. Once ingested, probiotics enter an interactive environment encompassing microbiological, immunological, and neurophysiological components. By utilizing a trans‐disciplinary framework known as microbial endocrinology, mechanisms that would otherwise not be considered become apparent since any candidate would need to be shared among all three components. The (...) range of neurochemicals produced by probiotics includes neurochemicals for which receptor‐based targets on immune and neuronal elements (intestinal and extra‐intestinal) have been well characterized. Production of neurochemicals by probiotics therefore allows for their consideration as delivery vehicles for neuroactive compounds. This unifying microbial endocrinology‐based hypothesis, which may facilitate the selection and design of probiotics for clinical use, also highlights the largely unrecognized role of neuroscience in understanding how microbes may influence health.Editor's suggested further reading in BioEssays Harvesting the biological potential of the human gut microbiome Abstract. (shrink)

While promoting population health has been the classic goal of public health practice and policy, in recent decades, new objectives in terms of autonomy and equality have been introduced. These different goals are analysed, and it is demonstrated how they may conflict severly in several ways, leaving serious unclarities both regarding the normative issue of what goal should be pursued by public health, what that implies in practical terms, and the descriptive issue of what goal that actually (...) is pursued in different contexts. A basic conflict of perspective is handled by integrating the ideas of public health striving for health-related autonomy and equality, resulting in a prioritarian oriented population approach to health-related autonomy. This integrated goal is demonstrated to constrain itself in several ways attractive from the point of view of the classic goal, but several serious problems remain. For this reason, a model where all of the three goals are integrated into one coherent structure where they can be assigned varying degrees of importance relative to the level of population health is described. It is argued that this model avoids the problems set out earlier, and is actually normatively preferable to the classic goal alone. It is furthermore argued that the model may be employed as a useful tool for descriptive ethics, as well as a vehicle for international harmonisation of public health policies. A number of practical implications regarding, e.g., the importance of respecting autonomy and the allocation of public health resources are noted, as are a battery of questions for further research. (shrink)

This article discusses the challenging context that health care professionals are confronted with, and the impact of this context on their emotional experiences. Care ethics considers emotions as a valuable source of knowledge for good care. Thinking with care ethical theory and looking through a care ethical lens at a practical case example, the authors discern reflective questions that shed light on a care ethical approach toward the role of emotions in care practices, and may be used by practitioners (...) and facilitators for care ethical reflection on similar cases, in the particular and concrete context where issues around emotional experiences arise. The authors emphasize the importance of allowing emotions to exist, to acknowledge them and to not repress them, so that they can serve as a vehicle for ethical behavior in care practices. They stress the difference between acknowledging emotions and expressing them limitlessly. Formational practices and transformational research practices are being proposed to create moral space in care institutions and to support health care professionals to approach the emotionally turbulent practices they encounter in a way that contributes to good care for all those involved. (shrink)

With the increasing attention to climate change, air pollution, and related public health issues, China’s new energy vehicles industry has developed rapidly. However, few studies investigated the evolution of interorganizational collaborative innovation networks in the sector domain of NEVs and the influence of different drivers on the establishment of innovation relationships. In this context, this paper uses the joint invention patent of Shenzhen, a low-carbon pilot city of China, to investigate the dynamics of network influencing factors. The social (...) network analysis shows that the scale of coinvention network of NEVs is constantly increasing, which is featured with diversified cooperative entities, and collaboration depth is also expanding. The empirical results from the Exponential Random Graph Model demonstrate that, with the deepening of collaborative innovation, technological upgrading caused by knowledge exchange makes organizations in the network more inclined to cognitive proximity and less dependent on geographical proximity. In addition, organizational proximity and triadic closure contribute positively to the collaborative network, with their relevance remaining nearly the same, while the impeding effect of cultural/language difference is slightly decreasing with time. (shrink)

Many people in the developing world access essential health services either partially or primarily through programs run by international non-governmental organizations (INGOs). Given that such programs are typically designed and run by Westerners, and funded by Western countries and their citizens, it is not surprising that such programs are regarded by many as vehicles for Western cultural imperialism. In this chapter, I consider this phenomenon as it emerges in the context of development and humanitarian aid programs, particularly those (...) delivering medical treatment, nutrition and access to clean water. I argue that in order to avoid contributing to cultural imperialism, INGOs have a duty to ensure that they do not offer services in a way that requires their beneficiaries to choose between accessing essential health services and violating or otherwise undermining traditional norms and practices which have significance for their beneficiaries. Following Onora O'Neill, I argue that offers requiring such a choice are effectively “unrefuseable” and so coercive. INGOs therefore, must avoid making such offers, and can accomplish this by means of an iterated process of reciprocal negotiation under conditions of equality, in which both the INGOs’ and the beneficiaries’ deep values and concerns play a role. In essence, I claim that employing such a process is a requirement of procedural justice, given the non-ideal conditions in which INGOs must operate. (shrink)

Objective: This main aim of the study is to explore COVID-19 pandemic problems from the perspective of public health-clinical care ethics through online mediareports in Turkey. Method: This research was designed as a descriptive and qualitative study that assesses COVID-19 through online media reports on critics between the periods of March 11, 2020 and April 2 2020 as a quantitative as number of reports and qualitative study, across Turkey. Reports were from Turkish Medical Association websites which included newspaper reports. (...) Study data were presented as statistically and qualitative data case and headlines. No ethical or ofTicial permission was sought as the study was conducted through open access internet news sites. Results: This online reports analysis retrieved about 6723 articles about the COVID-19. According to study data, information about COVID-19 were themed as follows: general deTiciencies in taking action and isolation, lack of isolation, passengers and transport vehicles not quarantined ; insufTicient diagnostic tests, decision to test after healthcare professionals become infected, lack of equipment, lack of evaluation outbreak countries [Table 2]. Conclusion and Suggestions: COVID-19 is a pandemic and is a global public health problem that concerns every individual and needs to be handled carefully. This requires a multi-faceted preparation and education. In this context, healthcare professionals should be well trained in this aspect and have all the necessary equipment throughout the process. Additionally, it should work systematically with the cooperation of all health organizations, the Ministry of Health, local governments and of course the media, in order to inform society, fairly distribute the resources and to implement the safety measures effectively. BrieTly, lack of transparency, insufTicient information, limited resources, lack of public health protection measures such as partial quarantine decision, partial implementation of the scientiTic board's re c ommenda ti on s fo r e c on omi c rea s on s, and contradiction of the explanations are revealed as serious ethical problems. (shrink)

The paper addresses the use of heterogeneous ensembles of intelligent unmanned vehicles in such a perspective field of innovations as an unmanned fishery. The issues of joint activity of unmanned vehicles of different types in fishing operations based on intelligent technologies are investigated. The “smart fishing” approach based on the joint fishing operation model is proposed. The operational framework that includes missions, roles, and activity scenarios embedded in the discretized spatial model is presented. The scenario activities are considered (...) as the sequences of pentad that determine executing specific functions concerning the specified waypoint, timepoints, and the states of vehicles. The definition of the plan as the scenario prototype that needs adjusting to the conditions of the situational context is proposed. The coordination problem regarding the joint activities of the unmanned vehicles and their scenarios is defined and the coordination framework based on the distributed common board model and coordination primitives is presented. The prototype of the intelligent scenario-based system including the implementation of both operational and coordination frameworks developed for the control of unmanned vehicles is described. This system makes unmanned vehicles capable to absorb all the latest advances in intelligent technologies to perform smart fishing operations jointly in a large heterogeneous group. The proposed approach to smart fishing using intelligent technologies makes it possible to detach fishermen from the fishing activities dangerous to their life and health, to reduce significantly poaching and illegal fishing, to increase the overall efficiency of fishing operations, and even to save the marine ecosystem. (shrink)

This analysis of the emergent automated vehicle technology focuses on the friction at its interface with society, clouding its future. The sequential focus of development → deployment is reconfigured as reciprocal: society ↔ technology. A best path forward is presented that incorporates environmental and social sustainability factors as they relate to climate change and public health. The path’s signpost is automated electric vehicles deployed in public and private fleets. This course has promise to recover automobility from the damaging, (...) unsustainable legacy of personal internal combustion vehicles—highlighted by their toxic and carbon emissions, and road casualties. (shrink)

Health research has been identified as a vehicle for advancing global justice in health. However, in bioethics, issues of global justice are mainly discussed within an ongoing debate on the conditions under which international clinical research is permissible. As a result, current ethical guidance predominantly links one type of international research (biomedical) to advancing one aspect of health equity (access to new treatments). International guidelines largely fail to connect international research to promoting broader aspects of health (...) equity – namely, healthier social environments and stronger health systems. Bioethical frameworks such as the human development approach do consider how international clinical research is connected to the social determinants of health but, again, do so to address the question of when international clinical research is permissible. It is suggested that the narrow focus of this debate is shaped by high-income countries' economic strategies. The article further argues that the debate's focus obscures a stronger imperative to consider how other types of international research might advance justice in global health. Bioethics should consider the need for non-clinical health research and its contribution to advancing global justice. (shrink)

This Legal Solutions in Health Reform paper discusses the role that tax law can play in the implementation of health reform. The tax code has served as the primary vehicle for subsidizing health care in the U.S. for most of the last century and will likely play a role in any future reform efforts. However, the interplay between tax law and health policy presents a series of critical design and implementation challenges with which any health (...) care reform package — be they liberal or conservative — must grapple. This paper considers some of the most pressing of these issues. While it does not prescribe a particular outcome, it will attempt to identify potential tax solutions that might receive broad support and to observe the policy and administrative design questions that any discussion of these solutions should take into account. (shrink)

A new field of biomedical ethics is opening up, concerning what should be done to reduce the direct and indirect impacts of greenhouse gas emissions on human health. Some of these impacts could be described as ‘direct’, in the form of fatalities and illnesses due to the increasingly frequent heatwaves in many countries of recent years, ascribable to anthropogenic climate change. Other impacts are mediated through the air pollution that results from emissions from vehicles in the form of (...) a cocktail of carbon oxides including carbon monoxide, nitrogen dioxide and particulates. Most of the world’s cities have streets with unsafe pollution levels, and one child’s death in Britain has been officially ascribed to air pollution (BBC 2020). This presentation aims to validate the above claims about the impacts of emissions on health, and to suggest remedies. The early phasing out of vehicles powered by internal combustion engines is the ultimate remedy for the latter set of impacts, while the urgent replacement of energy generated from fossil-fuel sources with renewable energy is the best way to remediate the former set. More immediate remedies for air pollution include restricting the use of roads and streets in urbanised areas by vehicles to bicycles and light vehicles with small engines. Medical and nursing education should include the diagnosis and treatment of pulmonary conditions resulting from increased levels of carbon oxides, nitrogen oxides and particulates. Medical and nursing practice should focus on the early identification of vulnerable adults and children at risk from air pollution, and warnings against walking, running or cycling along the most polluted thoroughfares. (shrink)

In this article, the nursing health history is revisited with a hermeneutic lens to uncover means by which this tool can better serve nursing practice. It is argued that further distanciation from the developmental and medical model is necessary to accurately uncover health and history in the nurse–client encounter. Based on the works of prominent hermeneutic philosophers, such as Heidegger, Gadamer, Merleau‐Ponty, Ricoeur, and Taylor, four orientations to health history and nursing are explored: orientation to caring, orientation (...) to narrative, orientation to time, and orientation to the body. The nursing health history is used as a vehicle for illuminating the usefulness of a hermeneutic perspective in everyday nursing practice. This article reveals views of health, history, and health history that are already known to nurses and the nursing milieu but are concealed by more dominant outlooks. The hermeneutical perspective presented in this article can help to reveal the important dimensions of everyday nursing practice and foster a richer attunement with the complex health experiences of individuals. (shrink)

The governance structures of state public health systems vary as much as the states themselves, including the existence and role of state boards of health. Understanding these differences is essential to a complete understanding of the governmental public health enterprise. State boards of health are obvious vehicles for public health policy development in some states, where they work closely with or oversee state health agencies. In other states they do not exist or serve (...) only in a non-binding advisory capacity.In this article, we distinguish and identify state boards of health and state public health advisory boards, examine state boards of health in practice, and discuss their role in advocacy and policy development in the context of state politics. We used a set of mixed qualitative methods, including a literature review, online research of state statutes establishing state board of health authorities, and key informant interviews. Informants were five current and former state board of health members, four current and former state health officers, and nine state health agency senior policy staff, spanning 13 states. (shrink)

The governance structures of state public health systems vary as much as the states themselves, including the existence and role of state boards of health. Understanding these differences is essential to a complete understanding of the governmental public health enterprise. State boards of health are obvious vehicles for public health policy development in some states, where they work closely with or oversee state health agencies. In other states they do not exist or serve (...) only in a non-binding advisory capacity.In this article, we distinguish and identify state boards of health and state public health advisory boards, examine state boards of health in practice, and discuss their role in advocacy and policy development in the context of state politics. We used a set of mixed qualitative methods, including a literature review, online research of state statutes establishing state board of health authorities, and key informant interviews. Informants were five current and former state board of health members, four current and former state health officers, and nine state health agency senior policy staff, spanning 13 states. (shrink)

Uncertainty is a necessary condition for the sound moral and scientific conduct of research involving human subjects. If the expert scientific communities, medical or otherwise, lacked uncertainty about the interventions under investigation, it would be unethical to knowingly subject individuals to inferior or harmful treatment. Moreover, if the relative merits of the interventions were previously established, as indicated by the lack of uncertainty within the relevant expert community, the results of the trial would be of little, if any, scientific value. (...) Despite the important role that uncertainty plays in the formulation and conduct of research involving human subjects, the concept has received inadequate treatment in the research ethics literature. To the limited extent that uncertainty is addressed, much of the emphasis remains on the ethical, not epistemic, aspects of uncertainty. What is left insufficiently examined is the nature and scope of the uncertainty. Often, uncertainty is glossed as agnosticism, indifference, and conflict. Yet these terms represent distinct types of uncertainty, and the type that obtains impacts the epistemic and ethical justifications for a proposed trial. A failure to recognize and clearly articulate the parameters of uncertainty in particular situations compromises our ability to respond to important moral and scientific concerns in the development and conduct of research. This problem is particularly pronounced in public health research that investigates problems resulting not only from uncertainties in scientific knowledge but from institutional failures, economic and social constraints, and lack of political will. Indeed, the role of research in public health is tied to its capacities to successfully navigate such complex questions. The way in which a study is designed and carried out, as well as ethically and scientifically justified, must reflect a robust and systematic characterization of the uncertainties present. Using an example from a study examining the efficacy of using treated sewage sludgeto remediate lead-contaminated soil, I explore and analyze the aforementioned deficiencies in understanding uncertainty among researchers and ethicists. The case study serves as a vehicle through which to illustrate (1) important considerations in characterizing and addressing uncertainty; (2) the influence of the uncertainty characterization on the formulation of parameters used to evaluate the ethical permissibility of the research; and (3) ways in which these parameters might be operationalized in the context of a particular study. (shrink)

The tax code has served as the primary vehicle for subsidizing health care in the U.S. for most of the last century, and will likely play a role in any future reform efforts. This paper discusses the role that the tax law can play in the implementation of health reform. The interplay, however, between the law and health policy presents a series of critical design and implementation challenges with which any health care reform package must grapple. (...) This paper considers some of the most pressing of these issues, and while it does not prescribe a particular outcome, it attempts to identify potential tax solutions. Additionally, the paper addresses the policy and administrative design questions that any discussion of these solutions should take into account. (shrink)

This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach (...) due to rugged natural terrain and have very limited telecommunications infrastructure. The lack of these and other basic services makes it difficult for medical personnel to settle in these areas, which leads to an acute shortage of medical personnel. We comment on this problem and how it is addressed by 'The Virtual Doctor Project', emphasizing that while the telemedicine concept is not new in sub-Saharan Africa, the combination of mobility and connectivity to service a number of villages 'on the go' is an important variation in the shift back to the 1978 Alma Ata principles of the United Nations World Health Organization [WHO].This overview of the Virtual Doctor Project in Zambia provides insight into both the potential for ICT, and the problems and limitations that any "real-world" articulation of this technology must confront. (shrink)

Settler colonisation continues to cause much damage across the globe. It has particularly impacted negatively on Indigenous peoples’ health and wellbeing causing great inequity. Health professional education is a critical vehicle to assist in addressing this; however, non‐Indigenous educators often feel unprepared and lack skill in this regard. In this qualitative study, 20 non‐Indigenous nursing, physiotherapy and occupational therapy educators in Australia were interviewed about their experiences and perspectives of teaching Indigenous health. Findings from the inductive thematic (...) analysis suggest educators require skill development to: identify their discomfort in teaching cultural safety; contextualise the sources of this discomfort and; reflect on how this understanding can improve their teaching. Additionally, educators require professional training to become practitioners of cultural humility and to be facilitators and colearners (rather than experts) of the Aboriginal‐led curriculum. Of relevance to this is educator training in how to decentre non‐Indigenous needs and perspectives. Educators can also renew their teaching practices by understanding what a dominant settler paradigm is, identifying if this is problematically present in their teaching and knowing how to remedy this. Crucial to improved cultural safety teaching is institutional support, which includes Indigenous leadership, institutional commitment, relevant policies, and well‐designed professional development. (shrink)

This book takes Edmund Husserl's phenomenology and applies it to help psychotherapy practitioners formulate complex psychological problems. The reader will learn about Husserl's system of understanding and its concepts that point to first-person lived experience, and about the work of Husserl scholars who have developed a way to be precise about the experiences that clients have. Through exploring the connection between academic philosophy of consciousness and mental health, themes of biopsychosocial treatment planning, psychopathology of personality and psychological disorders, and (...) the treatment of complex psychological problems become clear. The author shows that Husserlian phenomenology can be used in the design of interventions for clients in a process called formulation. Once the intentionality of consciousness is understood, by asking simple questions, it becomes possible to define problematic experiences. This is a means of creating informed consent for treatment and it makes it clear to clients what is happening for them, so helping them understand themselves and how they see the world. We also see how Husserl's phenomenology is a vehicle for psychotherapists to present their knowledge about the research literature of what has been found to be effective care. This volume applies the concepts and practices of phenomenology in a concrete way, relating them to the practice of therapy and showing the value of a qualitative approach to understanding mental processes and the nature of human beings as motivated by values, meanings and other conscious experiences. This is a readable text in simple language that condenses key aspects of Husserl's thinking in relation to the theory and practice of psychotherapy, and it is suitable for philosophers and practitioners of psychology, psychiatry, and the psychotherapies, including psychoanalysis. (shrink)

. With an overall objective of establishing association between air pollutants and incidence of respiratory diseases, the environmental professionals and medical practitioners have made significant contribution, using statistical mechanics in modelling epidemiological data, population characteristics, and pollution parameters. Broadly speaking, the studies have shown that the increase in vehicular traffic has been one of the causes of respiratory diseases. However, the WHO Centre for Environment and Health, Europe in its 2005 document states: “There is little evidence for a causal (...) relationship between asthma prevalence/incidence and air pollution in general, though the evidence is suggestive of a causal association between the prevalence/incidence of asthma symptoms and living in close proximity to traffic”. Decision making process in a real world is invariably based on perceptions which are expressed in words or may be in numeric terms and not in probability terms. In the paper, we made an attempt to model the perceptions of experienced pulmonologists in arriving at their combined degree of belief/plausibility/ignorance for all the possible combinations of identified respiratory diseases, using evidence theory and fuzzy relational calculus without collecting sizeable parametric data accumulated over a period of years. Tightening pollution norms by the regulatory authorities is an overall objective of the global efforts on greenhouse gases reduction in general, and air pollution mitigation in particular. The concept of solar battery operated electric vehicles for road transport is advocated, initially for two/three wheelers, and extending it to four wheelers, especially in the developing countries. (shrink)

Corporations, through their products and behaviors, exert a strong effect on the well-being of populations. Industries including frearms, motor vehicles, tobacco, and alcohol produce and market products negatively impact public health. All of these industries are composed of corporations, which are legal fctions designed to provide limited exposure to liability, through a variety of mechanisms, for their investors and directors. This means that when actions are taken on behalf of a corporate entity, the individuals responsible generally will not (...) face personal liability for the negative results of those actions. To illustrate this point, this article considers corporate products or practices that have caused harm in varied settings, and analyzes the role that limited liability played in these cases. In addition, the article identifes ways to modify or eliminate some of the principles and practices that accompany limited liability. (shrink)

Corporations, through their products and behaviors, exert a strong effect on the wellbeing of populations. Public health practitioners and academics have long recognized the harms associated with some corporations’ products. For example, firearms are associated with approximately 30,000 deaths in the United States each year1 and over 200,000 deaths globally. Motor vehicles are associated with about 40,000 deaths in the United States each year and over 1.2 million deaths globally. Tobacco products kill about 438,000 people each year in (...) the United States5 and about 4.9 million people worldwide. In addition to producing unsafe or harmful products, some corporations behave in ways that negatively impact the public’s health, such as marketing alcohol to youth and other vulnerable populations. Given these observations, one can conclude that it is possible to quantify the public health impact of individual industries, such as firearms, motor vehicles, tobacco, and alcohol. Health professionals can then target these individual industries to prevent or lessen the harms they cause. (shrink)

This work begins with a brief review – from the _physical education_ movement that began in ancient Greece and is deeply rooted in 19th century Europe, to the _somatics_ movement alive today. The review captures primary historical and conceptual references, relevant to the therapeutic-embodied exploratory work. Then, G. Stanghellini’s mental health care model [ 2 ] is reviewed. This model is considered within reflexive self-awareness and spoken dialogue: the main vehicles in relation with alterity and its consequences in (...) the realm of psychotherapeutic encounter and intervention. This will highlight the individual’s bodily movement and inter-corporeal ‘proto-dialogue’ as a prior realm of therapeutic intervention. Next, a brief consideration of E. Strauss work [ 31 ] is presented. This paper’s hypothesis is that bodily qualitative dynamics highlighted by phenomenology are essential for an effective mental health therapeutic intervention. A ‘seed’ of a framework is proposed in this paper; this seed assesses some phenomenological assets of a positive conception of mental health, for which self-awareness education is key to develop skills such as _kinaesthetic intelligence_ and _attunement_ and to educate healthy persons who can promote edifying social relations and environments. (shrink)

Scholars increasingly point toward schools as meaningful contexts in which to provide psychosocial care for refugee children. Collaborative mental health care in school forms a particular practice of school-based mental health care provision. Developed in Canada and inspired by systemic intervention approaches, collaborative mental health care in schools involves the formation of an interdisciplinary care network, in which mental health care providers and school partners collaborate with each other and the refugee family in a joint assessment (...) of child development and mental health, as well as joint intervention planning and provision. It aims to move away from an individual perspective on refugee children’s development, toward an engagement with refugee families’ perspectives on their migration histories, cultural background and social condition in shaping assessment and intervention, as such fostering refugee empowerment, equality, and participation in the host society. Relating to the first stage of van Yperen’s four-stage model for establishing evidence-based youth care, this article aims to engage in an initial exploration of the effectiveness of a developing school-based collaborative mental health care practice in Leuven, Belgium. First, we propose a detailed description, co-developed through reflection on case documents, written process reflections, intervision, an initial identification of intervention themes, and articulating interconnections with scholarly literature on transcultural and systemic refugee trauma care. Second, we engage in an in-depth exploration of processes and working mechanisms, obtained through co-constructed clinical case analysis of case work collected through our practice in schools in Leuven, Belgium. Our descriptive analysis indicates the role of central processes that may operate as working mechanisms in school-based collaborative mental health care and points to how collaborative mental health care may mobilize the school and the family-school interaction as a vehicle of restoring safety and stability in the aftermath of cumulative traumatization. Our analysis furthermore forms an important starting point for reflections on future research opportunities, and central clinical dynamics touching upon power disparities and low-threshold access to mental health care for refugee families. (shrink)

Rationing health care is not new. As governments world wide struggle to contain the costs of health care, health policy analysts debate how rationing should be done. However, they too often neglect how the mechanisms for funding and allocating health care resources are themselves vehicles for rationing treatment. In the UK, where health care rationing debates currently abound, there has been no formal evaluation of the role of the market in allocating scarce health (...) care resources.The market in health care has increased administration, fragmented services, eroded local accountability, and decreased choice.This fragmentation, and the associated competition between purchasers and providers, means that resource allocation can no longer be monitored and evaluated in a national context. The loss of a population focus has left a vacuum in planning. Services cannot be planned rationally, and so are not able consistently to avoid duplication or to respond cogently to estimates of need.The loss of accountability means that decisions about the allocation of health care resources are no longer open to scrutiny by local people. Increasingly, especially in social and long term care the cost of care is being transferred to the individual. The new mechanisms for resource allocation are distributing resources unfairly: away from the poor, the sick and the elderly.The great myth of the market is that it has enabled decision-making to become explicit. This is not the case. To make health care resource allocation appear rational and acceptable to the public, health authorities have resorted to exercises in consumer consultation, and value laden guidelines where clinical cloaks are used to disguise political decisions on funding. In the UK, until the true role of the internal market is acknowledged, myths and subterfuge will conceal the winners and losers in the new system of rationing health care. (shrink)

Critics of mass culture often identify 1950s-style status competition as one of the central forces driving consumerism. Thomas Frank has challenged this view, arguing that countercultural rebellion now provides the primary source of consumerism in our society, and that ‘cool’ has become its central ideological expression. This paper provides a rearticulation and defense of Frank's thesis, first identifying consumerism as a type of collective action problem, then showing how the ‘hip consumer’ is one who adopts a free-rider strategy in this (...) context. (shrink)

Metaphors used to describe new technologies mediate public understanding of the innovations. Analyzing the linguistic, rhetorical, and affective aspects of these metaphors opens the range of issues available for bioethical scrutiny and increases public accountability. This article shows how such a multidisciplinary approach can be useful by looking at a set of texts about one issue, the use of a newly developed technique for genetic modification, CRISPRcas9.