Aristophanes' last two surviving plays, Assemblywomen and Wealth, have long been regarded as something of an enigma. The changes in structure – the diminution in the role of the chorus, the disappearance of the parabasis, etc. –, as well as the shift of interest away from the immediacies of current politics towards broader social themes, can reasonably be interpreted as an early stage of the process that ultimately transformed Old Comedy into New, even if it is unlikely ever to be (...) finally agreed whether Aristophanes was leading or following this trend. The decline in freshness, in verbal agility, in sparkle of wit, in theatrical inventiveness, which is perceptible in the earlier play and very marked in the later, may be put down to advancing years and diminishing inspiration. Such an explanation squares with the evidence of a marked decline in Aristophanes' productivity towards the end of his life. Whereas in the first seven years of his career he seems to have produced, or had produced for him, not less than ten plays, and in the years 420–405 approximately another eighteen, the twenty years or so that followed Frogs yielded a further eleven at the very most unless some titles have been completely lost; and since it is not likely that after the outstanding success of Frogs, and the public recognition that followed it, Aristophanes would have experienced any difficulty in securing a chorus, the explanation can only be that he was writing less. But the truly puzzling feature of the two late plays we possess is the apparent sea-change in the author's social orientation. In his fifth-century plays, from Acharnians toFrogs, as has been shown by de Ste Croix, Aristophanes reveals himself as one who instinctively speaks the language and thinks the thoughts of the well-to-do, even if at the same time he can laugh with the common man at ostentatious and useless wealth in the shape of Pyrilampes' peacocks, Leogoras' pheasants or the sultan-like garments of an Athenian imperial official – as one who was happy for the Demos to be sovereign so long as it was willing to be guided by the advice of its' betters', the καλоί тε κáγоθоί of Knights 738 or Frogs 727–9, and to leave them in the quiet enjoyment of their property. At first sight in Assemblywomen and Wealth this seems to have changed almost diametrically. (shrink)

The concept of social entrepreneurship and enterprise has enjoyed a meteoric rise. Its appeal extends over a broad ideological spectrum, and it embraces a range of activities, from solidarity economy to changes within the capitalist market economy. However, the growing popularity of social enterprise has not gone unchallenged. Some see it as the privatization of social choices that belong in the public and civic domain. This article asks: How is the social constituted in social entrepreneurship? After reviewing why social entrepreneurship (...) has become an issue and exploring its various definitions, it argues that a dominant current in the social entrepreneurship literature glorifies the individual entrepreneur while underemphasizing the importance of social processes. Social enterprise is dependent on the social entrepreneur’s civic engagement in mobilizing support. This engagement is critical for the economic, social, and political sustainability of the social enterprise. For social entrepreneurship to enjoy success in a sustained manner, it must first and foremost be “social.”. (shrink)

As scholars integrate empirical approaches to ethical questions in healthcare, relational autonomy theory must inform research design and change practice. Qualitative approaches are well suited to issues where patient values play a central role, and they can be combined with relational autonomy theory to investigate the factors influencing autonomy-rich experiences. This paper draws upon my experience conducting bioethics research related to clinical trial decision-making to develop a systematic method for applying relational autonomy as a theoretical lens to qualitative health research. (...) The resultant practical guide utilizes Susan Sherwin’s theory of relational autonomy and presents an empirical method responsive to autonomy-relevant questions. (shrink)

The term Sustainable Development has been used in many different contexts and consequently has come to represent many different ideas. The purpose of this paper was to explore the underlying meaning of the term Sustainable Development, and to assess the dominant ethic behind such meaning. Through this exploration, we uncovered a change in the semantic meaning of the term, and described what that meaning entails. The term Sustainable Development had the potential, we argue, to stimulate discursive engagement with respect to (...) the future development of society within an ethical framework based around the values of inclusivity, diversity, and integration. The importance of philosophical context within which the term is used influences the definitional process of meaning, and has been simulated into the language of the dominant scientific-economic paradigm. We go on to explore how this meaning change has come about. In doing so we looked to the Enlightenment period and the resulting philosophies to explore the foundations of meaning, and then to the work of Jürgen Habermas to explain how the scientific-economic paradigm came to dominate the meaning of Sustainable Development. (shrink)

The ‘What Being the Parent of a New Baby is Like-Revised’ (WPL-R) is an instrument designed to measure adaptation to parenthood. In the process of pilot testing and validating the WPL-R in a postpartum Dutch population, we became aware of the potentially sensitive nature of the measure. Despite the ethics committee waiving the invasive nature of the measure, we conducted a survey to explore its possible effect on women’s thoughts and emotions by using the Positive And Negative Affect Schedule (PANAS) (...) to measure changes associated with completion of the WPL-R. Two hundred and fifteen questionnaires were returned. Our findings indicated a change in PANAS scores, implying an intervening effect when using the WPL-R, in research. This raises the question of whether it is acceptable to use a questionnaire with postpartum women without any knowledge of the possible effect it may have, even though the ethics committee has approved the study and considers the measure to be non-invasive. (shrink)

Two treatises on memory which have come down to us from antiquity are Aristotle’s “On memory and recollection” and Plotinus’ “On perception and memory” ; the latter also wrote at length about memory in his “Problems connected with the soul”. In both authors memory is treated as a ‘modest’ faculty: both authors assume the existence of a persistent subject to whom memory belongs; and basic cognitive capacities are assumed on which memory depends. In particular, both theories use phantasia to explain (...) memory. Aristotle takes representations to be changes in concrete living things which arise from actual perception. To be connected to the original perception the representation has to be taken as a copy of the original experience ‑ this is the way Aristotle defines memory at the end of his investigation. Plotinus does not define memory: he is concerned with the question of what remembers. This is of course the soul, which goes through different stages of incarnation and disincarnation. Since the disembodied soul can remember, so he does not have Aristotle’s resources for explaining the continued presence of representations as changes in the concrete thing. Instead, he thinks that when acquiring a memory we acquire a capacity in respect of the object of the memory, namely to make it present at a later time. (shrink)

The use of list-learning paradigms to explore false memory has revealed several critical findings about the contributions of similarity and relatedness in memory phenomena more broadly. Characterizing the nature of “similarity and relatedness” can inform researchers about factors contributing to memory distortions and about the underlying associative and semantic networks that support veridical memory. Similarity can be defined in terms of semantic properties (e.g., shared conceptual and taxonomic features), lexical/associative properties (e.g., shared connections in associative networks), or structural properties (e.g., (...) shared orthographic or phonological features). By manipulating the type of list and its relationship to a non-studied critical item, we review the effects of these types of similarity on veridical and false memory. All forms of similarity reviewed here result in reliable error rates and the effects on veridical memory are variable. The results across a variety of paradigms and tests provide partial support for a number of theoretical explanations of false memory phenomena, but none of the theories readily account for all results. (shrink)

In a recent re-assessment of the medical aspects of the Plague of Athens which is, to date, the most scholarly and comprehensive, Poole and Holladay have emphasized the tendency of many infectious diseases markedly to decline in virulence over decades and centuries and, sometimes, significantly to change their clinical manifestations. In the light of modern medicine they consider four possibilities: The Plague was a disease which still exists today. This they regard as improbable, It still exists in some remote place (...) or places unknown to medical science. This is discussed and dismissed, It became extinct, It was caused by an agent which nowadays causes a significantly different clinical syndrome. They conclude as follows: ‘The truth, we suggest, almost certainly lies in possibility or . But we can see no way of choosing between them. On either view the question: “What was the Athenian Plague?” is in principle unanswerable if the questioner is wanting to attach to the Plagsie the name of some modern disease or diseases’. (shrink)

The ozone layer, which is part of the atmosphere surrounding the globe, which intensively contains ozone gas, is one of the important and highly concentrated air layers in the bottom of the strateosphere and is a blue color, and it has an important impact in regulating a surface temperature.

Biomedical ontologies are emerging as critical tools in genomic and proteomic research where complex data in disparate resources need to be integrated. A number of ontologies exist that describe the properties that can be attributed to proteins; for example, protein functions are described by Gene Ontology, while human diseases are described by Disease Ontology. There is, however, a gap in the current set of ontologies—one that describes the protein entities themselves and their relationships. We have designed a PRotein Ontology (PRO) (...) to facilitate protein annotation and to guide new experiments. The components of PRO extend from the classification of proteins on the basis of evolutionary relationships to the representation of the multiple protein forms of a gene (products generated by genetic variation, alternative splicing, proteolytic cleavage, and other post-translational modification). PRO will allow the specification of relationships between PRO, GO and other OBO Foundry ontologies. Here we describe the initial development of PRO, illustrated using human proteins from the TGF-beta signaling pathway. (shrink)

In the present essay we attempt to reconstruct Newtonian mechanics under the guidance of logical principles and of a constructive approach related to the genetic epistemology of Piaget and García. Instead of addressing Newton’s equations as a set of axioms, ultimately given by the revelation of a prodigious mind, we search for the fundamental knowledge, beliefs and provisional assumptions that can produce classical mechanics. We start by developing our main tool: the no arbitrariness principle, that we present in a form (...) that is apt for a mathematical theory as classical mechanics. Subsequently, we introduce the presence of the observer, analysing then the relation objective–subjective and seeking objectivity going across subjectivity. We take special care of establishing the precedence among all contributions to mechanics, something that can be better appreciated by considering the consequences of removing them: the consequence of renouncing logic and the laws of understanding is not being able to understand the world, renouncing the early elaborations of primary concepts such as time and space leads to a dissociation between everyday life and physics, the latter becoming entirely pragmatic and justified a-posteriori, changing our temporary beliefs has no real cost other than effort. Finally, we exemplify the present approach by reconsidering the constancy of the velocity of light. It is shown that it is a result of Newtonian mechanics, rather than being in contradiction with it. We also indicate the hidden assumption that leads to the contradiction. (shrink)

Background This pilot study evaluated the speaking book ‘What it means to be part of a clinical trial’. The book aims at empowering populations with information on their rights and responsibilities when enrolled in clinical research. Wide publication of the book—at significant cost—is anticipated. It is important that the book is evaluated within the communities for whom it is intended, and the necessary changes (if any) are made, before translation and large-scale publication takes place. Objective The objective of the study (...) was to measure the efficacy and ease of use of the book. Methods Participants were recruited from a catering company. Participants were questioned on their knowledge of clinical trials and were then given the book. Instructions for use of the book were given to one group (‘experimental’ group). The other group (‘control’ group) was not given any instructions. A week later, the investigators returned, repeated the knowledge questions and asked ‘ease of use’ questions. Results A two-way repeated measure of covariants showed a statistically significant positive increase in knowledge of clinical trials among the intervention group (p=0.02). Results for the control group displayed trends that were not statistically significant. Percentage analysis of ‘ease of use’ questions proved that the book is easy to use, although some changes would be beneficial. Conclusion This study revealed that the speaking book is easy to use. It significantly increased knowledge of clinical trials among the study sample if instructions on use of the book were provided. (shrink)

The objective of this study is to evaluate if use of a patient decision aid, when choosing between a repeat cesarean or a trial of labor after a cesarean, reduces medical liability exposure. The authors conclude that use of a PDA conferred liability protection when potential jurors were presented with a hypothetical malpractice claim against an obstetrician following a TOLAC.

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

L S Penrose’s Limit Theorem – which is implicit in Penrose [7, p. 72] and for which he gave no rigorous proof – says that, in simple weighted voting games, if the number of voters increases indefinitely and the relative quota is pegged, then – under certain conditions – the ratio between the voting powers of any two voters converges to the ratio between their weights. Lindner and Machover [4] prove some special cases of Penrose’s Limit Theorem. They give a (...) simple counter-example showing that the theorem does not hold in general even under the conditions assumed by Penrose; but they conjecture, in effect, that under rather general conditions it holds ‘almost always’ – that is with probability 1 – for large classes of weighted voting games, for various values of the quota, and with respect to several measures of voting power. We use simulation to test this conjecture. It is corroborated with respect to the Penrose–Banzhaf index for a quota of 50% but not for other values; with respect to the Shapley–Shubik index the conjecture is corroborated for all values of the quota. (shrink)

ABSTRACTPeople often continue to rely on misinformation in their reasoning after they have acknowledged a retraction; this phenomenon is known as the continued-influence effect. Retractions can be particularly ineffective when the retracted misinformation is consistent with a pre-existing worldview. We investigated this effect in the context of depressive rumination. Given the prevalence of depressotypic worldviews in depressive rumination, we hypothesised that depressive rumination may affect the processing of retractions of valenced misinformation; specifically, we predicted that the retraction of negative misinformation (...) might be less effective in depressive ruminators. In two experiments, we found evidence against this hypothesis: in depressive ruminators, retractions of negative misinformation were at least as effective as they were in control participants, and more effective than retractions of positive misinformation. Findings are interpreted in terms of an attentional bias that may enhance the sali... (shrink)

The paper describes an innovative structured workshop methodology in garden-based-learning called “Nature in Your Face” aimed at provoking a change in citizens behavior and engagement as a consequence of the emotional activation in response to disruptive artistic messages. The methodology challenges the assumption that the change needed to meet the carbon targets can be reached with incremental, non-invasive behavior engineering techniques such as nudging or gamification. Instead, it explores the potential of disruptive communication to push citizens out of their comfort (...) zones and into creative modes of re-creating futures. This is done by confronting us with consequences of consumption by means of art and eco-visualizations. The aim being to achieve awareness, mental flexibility, and spurring debate. Thus, we invite them to react – and act upon these reactions by communicating their feelings or thoughts. This is used as an entrance point for broader and/or deeper engagement in a structured three-step methodology; Framing: A disruptive element is introduced into the local environment. This triggers an emotional reaction, which then is taken up in a process of framing the problem and working with solutions. Twisting: in a guided process, the initial energy from the emotional confrontation is twisted into a creative exploration of innovative solutions, from the perspective of the children. Using: The last stage is using the developed solutions in the local social system. The methodology is being applied in cooperation with a primary school, and is iteratively adjusted and evaluated in a formative, action-research based approach scenario. NiYF is to stimulate societal engagement through deliberately confronting stakeholders with unexpected and potentially upsetting appearances of nature, climate effects, or carbon-neutral lifestyle scenarios. We have verified the practical usefulness and potential of the methodology and found that NiYF triggers societal engagement and transition, negotiating responsibilities and unlocking action potentials. We also found that eco-anxiety, denial, self-efficacy and cognitive dissonance form children’s understanding of plastic. The project marks a paradigm shift from creating knowledge to using knowledge to create action, and a focus on learning from evaluating and adapting the approach in the field. (shrink)

Purpose: to characterize ethics course content, structure, resources, pedagogic methods, and opinions among academic administrators and course directors at U.S. medical schools. Method: An online questionnaire addressed to academic deans and ethics course directors identified by medical school websites was emailed to 157 Association of American Medical Colleges member medical schools in two successive waves in early 2022. Descriptive statistics were utilized to summarize responses. Results: Representatives from 61 (39%) schools responded. Thirty-two (52%) respondents were course directors; 26 (43%) were (...) deans of academic affairs, medical education, or curriculum; and 3 with other roles also completed the survey (5%). All 61 schools reported some form of formal ethics education during the first year of medical school, with most (n = 54, 89%) reporting a formal mandatory introductory course during preclinical education. Schools primarily utilized lecture and small-group teaching methods. Knowledge-based examinations, attendance, and participation were most commonly used for assessment. A large majority regarded ethics as equally or more important than other foundational courses, but fewer (n = 37, 60%) provided faculty training for teaching ethics. Conclusions: Despite a response rate of 39 percent, the authors conclude that medical schools include ethics in their curricula in small-group and lecture formats with heterogeneity regarding content taught. Preclinical curricular redesigns must innovate and implement best practices for ensuring sound delivery of ethics content in future curricula. Additional large-scale research is necessary to determine said best practices. (shrink)

The prospect of using cell-based interventions to treat neurological conditions raises several important ethical and policy questions. In this target article, we focus on issues related to the unique constellation of traits that characterize CBIs targeted at the central nervous system. In particular, there is at least a theoretical prospect that these cells will alter the recipients' cognition, mood, and behavior—brain functions that are central to our concept of the self. The potential for such changes, although perhaps remote, is cause (...) for concern and careful ethical analysis. Both to enable better informed consent in the future and as an end in itself, we argue that early human trials of CBIs for neurological conditions must monitor subjects for changes in cognition, mood, and behavior; further, we recommend concrete steps for that monitoring. Such steps will help better characterize the potential risks and benefits of CBIs as they are tested and potentially used for treatment. (shrink)

In this paper, I situate Logical Argument Mapping within.

BackgroundPublic health scholars have long called for preparedness to help better negotiate ethical issues that emerge during public health emergencies. In this paper we argue that the concept of ethical preparedness has much to offer other areas of health beyond pandemic emergencies, particularly in areas where rapid technological developments have the potential to transform aspects of health research and care, as well as the relationship between them. We do this by viewing the ethical decision-making process as a behaviour, and conceptualising (...) ethical preparedness as providing a health research/care setting that can facilitate the promotion of this behaviour. We draw on an implementation science and behaviour change model, COM-B, to demonstrate that to be ethically prepared requires having the capability, opportunity, and motivation to work in an ethically prepared way.MethodsWe use two case examples from our empirical research—one pandemic and one non-pandemic related—to illustrate how our conceptualisation of ethical preparedness can be applied in practice. The first case study was of the UK NHSX COVID-19 contact tracing application case study involved eight in-depth interviews with people involved with the development/governance of this application. The second case involved a complex case regarding familial communication discussed at the UK Genethics Forum. We used deductive qualitative analysis based on the COM-B model categories to analyse the transcripbed data from each case study.ResultsOur analysis highlighted that being ethically prepared needs to go beyond merely equipping health professionals with skills and knowledge, or providing research governance actors with ethical principles and/or frameworks. To allow or support these different actors to utilise their skills and knowledge, a focus on the physical and social opportunity is important, as is a better understanding the role of motivation.ConclusionsTo understand ethical preparedness, we need to view the process of ethical decision-making as a behaviour. We have provided insight into the specific factors that are needed to promote this behaviour—using examples from both in the pandemic context as well as in areas of health research and medicine where there have been rapid technological developments. This offers a useful starting point for further conceptual work around the notion of being ethically prepared. (shrink)

If climate change represents a severe threat to humankind, why then is response to it characterized by inaction at all levels? The authors argue there are two complementary explanations for the lack of motivation. First, our moral judgment system appears to be unable to identify climate change as an important moral problem and there are pervasive doubts about the agency of individuals. This explanation, however, is incomplete: Individual emitters can effectively be held morally responsible for their luxury emissions. Second, doubts (...) about individual agency have become overly emphasized and fail to convincingly exonerate individuals from responsibility. This book extends the second explanation for the motivational gap, namely that the arguments for the lack of individual agency do in fact correspond to mechanisms of moral disengagement. The use of these mechanisms enables consumption elites to maintain their consumptive lifestyles without having to accept moral responsibility for their luxury emissions. (shrink)

THIS paper seeks to elucidate the phenomenon known in psychology as 'the specious present,' by postulating a two-dimensional theory of the extensional aspects of time. On this theory, the usual logical and psychological difficulties, encountered in current accounts of this phenomenon, can be resolved. For, when there are two dimensions of time, the same event may be without extension in one of these dimensions ('transition-time'), while it is nevertheless finitely extended in the other of these dimensions ('phase-time'); so that in (...) a definable sense the phases of a finitely enduring event, though successive in one time-order, yet are contemporary in the other. The epistemological standpoint implicit in the paper is generally similar to the one Bertrand Russell has put forward, in his Physics and Experience (Cambridge, 1946), and his Human Knowledge: Its Scope and Limits (London, 1948) (allowing for the changes which would be required in Russell's theory to take into account a second time dimension). A 'psycho-neural parallelism,' or one-one correspondence, is postulated between features of certain 'experiential events' (namely, those experiential events normally held to be happening to some person's mind, which are describable in the language of psychology); and features of certain 'physical events' (namely, those events described in the language of physics, chemistry and physiology, which are ordinarily conceived as happenings in that same person's body). These physical events are conceived of as being causally connected with events in the physical world outside the experient's body, by means of the concepts of light waves, sound waves, chemical stimuli, and consequential processes in the nervous system (central and peripheral) and sense-organs, in the usual way. In terms of this psycho-neural parallelism the physical correlate of the finite temporal span of the specious, or experiential present, is to be found in certain consequences of the uncertainty principle in quantum physics; according to which there is a finite interval of time necessarily associated with a nearly precise determination of energy levels, and of transitions between them. Some of the physical implications of this theory, applied to processes in the material structure of the human body, are discussed qualitatively. But, for the reasons given in the last section of the paper, a quantitative treatment is not yet possible. The paper is greatly indebted in regard to the physical application of the two-dimensional theory of time, to the discussion of the pentadic group structure in Eddington's Fundamental Theory (Cambridge, 1946 and 1950); and in particular to the treatment there of the phase-variable as the 'time-analogue' in the quantum statistics of stationary states. (shrink)

To the question ‘What does it mean to act or to do something?’, replies that it is not easy to identify a common character in actions. Begins by examining the position of Cook Wilson, who maintains that ‘to do something’ means to originate, cause, or bring into existence, either directly or indirectly, some not yet existing state either in oneself or some other body. Although Prichard agrees that usually action involves causing something, he observes that causing a change is not (...) itself an activity. In moving one's hand, one performs that indefinable mental activity of willing some change. The movement of the hand is the effect of the action, not the action itself, a fact overlooked by thinkers like Locke. Turning to the nature of the desire behind one's willing, Prichard rejects the view that this desire is actually a desire for the change willed. Despite forceful objections, Prichard maintains that this desire is the desire for the willing of that change. (shrink)

The phenomenology of controlled action depends on comparisons between predicted and actually perceived sensory feedback called action-effects. We investigated if intervening task-irrelevant but semantically related information influences monitoring processes that give rise to a sense of control. Participants judged whether a moving box “obeyed” or “disobeyed” their own arrow keystrokes or visual cues representing the computer’s choices . During 1 s delays between keystrokes/cues and box movements, participants vocalized directions cued by letters inside the box. Congruency of cued vocalizations was (...) manipulated relative to previously selected keystrokes and upcoming box movements. In Experiment 1, reported obey moves and feelings of control reflected the true frequency of obey moves, but were also modulated by vocalizations. Incongruent vocalizations reduced reported obey moves, whereas congruent vocalizations increased them. In Experiment 2, vocalizations had stronger effects when their congruence with primary-task box movement was consistent for several consecutive moves before congruence changed. In Experiment 3, analogous impacts of vocalizations occurred when the computer selected the directions and participants judged whether the computer had control of the box. We conclude that predicted and perceived action-effects associated with semantically related but separate and ostensibly irrelevant actions can be conflated with one another. This interference is not restricted to actions performed with the same effector or within the same modality, or even by the same actor. Thus in estimating degrees of control, the mind integrates across ongoing action systems, whether or not they are logically task-relevant. (shrink)

The controversies in Bristol, Alder Hey and elsewhere in the UK surrounding the removal and retention of human tissue and organs have led to extensive law reform in all three UK legal systems. This paper reports a short study of the reactions of a range of health professionals to these changes. Three main areas of ethical concern were noted: the balancing of individual rights and social benefit; the efficacy of the new procedures for consent; and the helpfulness for professional practice (...) of the new legislation and regulation. Recognition of these concerns may help in forging a new partnership between professionals and patients and their families. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

Prichard's topic here is the nature of ‘ought’. If we were to take ‘I ought to will x’ to be equivalent to ‘my willing x ought to exist’, then it is true that ‘If I were to will a certain change x, my willing x would be something that ought to exist.’ For this to hold, either my willing x would itself be something good or my willing x would cause something good. Prichard, however, rejects this view on the grounds (...) that one cannot know, in willing x to exist, whether one's willing x is something that ought to exist. One can only know that if one were to will x, one would be willing something that one thought ought to exist. (shrink)