All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies' obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic. We argue that an ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability. All parties' obligations should be coordinated and mutually consistent. For (...) instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges. Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

COVID-19 vaccines are likely to be scarce for years to come. Many countries, from India to the U.K., have demonstrated vaccine nationalism. What are the ethical limits to this vaccine nationalism? Neither extreme nationalism nor extreme cosmopolitanism is ethically justifiable. Instead, we propose the fair priority for residents framework, in which governments can retain COVID-19 vaccine doses for their residents only to the extent that they are needed to maintain a noncrisis level of mortality while they are implementing reasonable public (...) health interventions. Practically, a noncrisis level of mortality is that experienced during a bad influenza season, which society considers an acceptable background risk. Governments take action to limit mortality from influenza, but there is no emergency that includes severe lockdowns. This “flu-risk standard” is a nonarbitrary and generally accepted heuristic. Mortality above the flu-risk standard justifies greater governmental interventions, including retaining vaccines for a country's own citizens over global need. The precise level of vaccination needed to meet the flu-risk standard will depend upon empirical factors related to the pandemic. This links the ethical principles to the scientific data emerging from the emergency. Thus, the FPR framework recognizes that governments should prioritize procuring vaccines for their country when doing so is necessary to reduce mortality to noncrisis flu-like levels. But after that, a government is obligated to do its part to share vaccines to reduce risks of mortality for people in other countries. We consider and reject objections to the FPR framework based on a country: having developed a vaccine, raising taxes to pay for vaccine research and purchase, wanting to eliminate economic and social burdens, and being ineffective in combating COVID-19 through public health interventions. (shrink)

Current UK legislation is impacting upon the feasibility and cost-effectiveness of medical record-based research aimed at benefiting the NHS and the public heath. Whereas previous commentators have focused on the Data Protection Act 1998, the Health and Social Care Act 2001 is the key legislation for public health researchers wishing to access medical records without written consent. The Act requires researchers to apply to the Patient Information Advisory Group for permission to access medical records without written permission. We present (...) a case study of the work required to obtain the necessary permissions from PIAG in order to conduct a large scale public health research project. In our experience it took eight months to receive permission to access basic identifying information on individuals registered at general practices, and a decision on whether we could access clinical information in medical records without consent took 18 months. Such delays pose near insurmountable difficulties to grant funded research, and in our case £560 000 of public and charitable money was spent on research staff while a large part of their work was prohibited until the third year of a three year grant. We conclude by arguing that many of the current problems could be avoided by returning PIAG’s responsibilities to research ethics committees, and by allowing “opt-out” consent for many public health research projects. (shrink)

Heath Robinson could perhaps draw a diagram that made sense of the legislative and regulatory structure Bonnicksen describes in this book. However Heath Robinson machines, no matter how baroque, actually achieve something: in the four years covered by this contemporary history the American “system” seems to have achieved very little. That we have not yet seen a confirmed cloned child produced in the USA or elsewhere does not seem due in any part to the activity that Bonnicksen describes. (...) This is not a history of America’s progress towards crafting a policy; it is an account of its failure to make one.The bulk of this book details the legal and regulatory responses to emerging reproductive technology in America following the announcement of the birth of Dolly the cloned lamb in 1997. The remainder gives an overview of the position of other countries around the world, and a brief concluding chapter outlines the options open to the US in the future. Lest anything that follows might suggest otherwise, I found this book interesting and informative, and …. (shrink)

FOSTER J, CHIANG F, HILLARD RC, HALL P and HEATH A. Nursing Inquiry 2010; 17: 309–316 Team process in community‐based participatory research on maternity care in the Dominican RepublicA cross‐cultural team consisting of US trained academic midwife researchers, Dominican nurses, and Dominican community leaders have partnered in this international nursing and midwifery community‐based participatory research (CBPR) project in the Dominican Republic to understand the community experience with publicly funded maternity services. The purpose of the study was to understand community (...) perceptions of maternity services. This article highlights the activities that the research team carried out during each phase of the research process, and how they established team identity, team trust, and team efficacy. This research has created a platform for new avenues for health providers and community to partner to improve maternal‐newborn care. Community‐based participatory research is one way forward to address the past and present inequities constitutive of global health disparities. (shrink)

Current UK legislation is impacting upon the feasibility and cost-effectiveness of medical record-based research aimed at benefiting the NHS and the public heath. Whereas previous commentators have focused on the Data Protection Act 1998, the Health and Social Care Act 2001 is the key legislation for public health researchers wishing to access medical records without written consent. The Act requires researchers to apply to the Patient Information Advisory Group for permission to access medical records without written permission. We present (...) a case study of the work required to obtain the necessary permissions from PIAG in order to conduct a large scale public health research project. In our experience it took eight months to receive permission to access basic identifying information on individuals registered at general practices, and a decision on whether we could access clinical information in medical records without consent took 18 months. Such delays pose near insurmountable difficulties to grant funded research, and in our case £560 000 of public and charitable money was spent on research staff while a large part of their work was prohibited until the third year of a three year grant. We conclude by arguing that many of the current problems could be avoided by returning PIAG’s responsibilities to research ethics committees, and by allowing “opt-out” consent for many public health research projects. (shrink)

Of those philosophers that Hume credits with having "begun to put the science of man on a new footing", Bernard Mandeville has received relatively little attention from contemporary philosophers and Hume scholars. In contrast, Mandeville was not so neglected in his own age, a point well-chronicled in F. B. Kaye's introduction to The Fable of the Bees, and substantiated, tangibly, by this collection of writings excellently assembled and edited by J. Martin Stafford. In the eighteenth century and, more particularly, in (...) the decade between the publication of the 1723 edition of the Fable and Mandeville's death, numerous sermons, essays, letters, and books were published with the single intent of refuting what one eighteenth-century critic considered "so monstrous an Opinion", namely, that private vice might render a benefit to the public. What one discovers on reading these early critics is that it is not so much Mandeville's opinion that is monstrous as it is the incessant misinterpretations that are so often used against him. (shrink)

Материалы сборника предназначены для специалистов.

La «question de l'Inconditionné» est développée par Paul Tillich dans une Religionsphilosophie pensée comme Logique de la raison religieuse et comme Théorie du sens, dans une perspective théonome. La présente étude analyse le projet du premier Tillich, après l'avoir situé en relation au paradigme de la Modernité. Tillich mène un double combat, face à l'«hybris religieuse» de l'hétéronomie et à l'«hybris culturelle» de la pure autonomie. Partant de la tension fondamentale entre identité mystique et différence éthique, le projet de Tillich (...) souligne l'aspect paradoxal et dialectique de la religion, son vouloir d'atteindre le contenu inconditionné à travers des formes conditionnées, sa résistance à être pur objet et concept d'une science. Dépassant le paradigme de la Modernité, Tillich construit une Philosophie de la Religion située dans le système des sciences, mais non fondée sur le conditionné, mais au contraire sur l'Inconditionné. Les éléments et catégories du religieux sont soumis à l'analyse à travers un processus méthodologique complexe, critique et dialectique, intuitif et vital; est ainsi formulée l'unité de sens entre le fondé, le fondant et le fondement ultime qui soutient tout. La dialectique du sacré et du profane, du divin et du démoniaque, de la foi et de l'incrédulité, de Dieu et du monde, est éclairée dans la perspective théonome; d'où est surpassée la pure autonomie, en lutte avec l'hétéronomie religieus. (shrink)

In order to cure the social sciences of many of their inveterate diseases, it seems to me extremely important and useful to support and develop in some measure A.S. Tsipko's ideas on the doctrinal preconditions of our difficulties and failures in the building of socialism, ideas that have provoked such wide-ranging responses.

First published in 1945. In this work the author seeks to correct the misinterpretation and incorrect labelling of Shelley's thought. While not neglecting Shelley as a poet, this book focuses on his contributions made to the general movement of political and philosophical thought of his era and by so doing his relevance to contemporary issues. This title will be of interest to students of literature.

Альтернативные определения, излагаемые в книге, реализуют возможности продуктивного мышления, являются источником смысла творческих исканий. Для студентов, преподавателей вузов и всех тех, кто интересуется человекознанием.