From a global historical viewpoint, federal systems are the exception rather than the rule, even though examples of federalism can already be found in Greek antiquity. From the 17th century onwards there was a revival of federalism, but in the post-World War II-era of decolonization federal systems did not emerge as the most popular form of government.Still, there is considerable variation among federal systems, i.e. those political systems where governmental authority is constitutionally divided among a central «federal» government and «state» (...) governments in such a way, that each type of government has final decision-making authority in at least a few policy fields ; a federation may be either effective or formal, unitary or decentralized, symmetrical or asymmetrical. In order to explain the extent and the kind of federalism in specific cases, the formallegal structure, the socio-economic environment and the political behaviour of elites as well as citizens should be taken into account. Political behaviour should be taken as the key factor, without disregard, however, for its relationship to social factors and format structures. In order to assess their relative importance, comparative research is required; Western Europe and the Third World offer highly promising prospects for this type of research. On the research agenda of federalism, special attention should be given to topics like the informal federal arrangements in cabinet formation, policy-making and public administration, federal party polities, and the impact of public policies on the federal socio-economic environment. (shrink)

The sequencing of the human genome and decreasing costs of sequencing technology have led to the notion of ‘personalized medicine’. This has been taken by some authors to indicate that personalized medicine will provide individualized treatments solely based on one’s DNA sequence. We argue this is overly optimistic and misconstrues the notion of personalization. Such interpretations fail to account for economic, policy and structural constraints on the delivery of healthcare. Furthermore, notions of individualization based on genomic data potentially take us (...) down the road of genetic reductionism obscuring the role of environmental factors in disease and ill health. We propose that one should see personalized medicine as a way of using personal genomic information to stratify individuals into subpopulations and suggest that personalized medicine be seen within a broader idea of personalized healthcare, reflecting healthcare that integrates personal genomic data into cultural, environmental and personal contexts. (shrink)

The spatial organization of the genome is intimately linked to its biological function, yet our understanding of higher order genomic structure is coarse, fragmented and incomplete. In the nucleus of eukaryotic cells, interphase chromosomes occupy distinct.

Pharmacological substances used to improve cognition and brain function range from dietary supplements and caffeine to drugs targeted at altering particular neurochemical concentrations in the brain. This article considers current scientific research into pharmaceutical cognitive enhancement and likely future directions. Then it discusses the trends in the use of PCEs within patients groups for whom they were intended, as well as in those for whom they were not originally intended, including healthy adults and children. Finally, it provides an overview of (...) current and future ethical considerations and concludes that the use of PCE will likely continue both within patient and healthy individuals in the foreseeable future. Information regarding actual use, benefits, and harms in various populations is severely lacking. Therefore, more emphasis should be placed on obtaining the relevant empirical data, for example, by the long-term monitoring of effectiveness and side effects, and by accurate large-scale surveys to assess actual usage. (shrink)

The sudden emergence of the COVID-19 pandemic brought global disruption to every aspect of society including healthcare, supply chain, the economy, and social interaction. Among the many emergent considerations were the safety and public health of the public, patients, essential workers, and healthcare professionals. In certain locations, clinical research was halted—or terminated—in deference to the immediate needs of patient care, and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies focusing on other diseases. Difficult (...) decisions were made rapidly; flexibility and reconsideration were necessary not only because the intensity and severity of infection varied over time and by locale but also because knowledge of the disease and understanding of its treatment grew. Here we discuss the ethical challenges in decision-making and competing ethical tensions during the pandemic in an effort to advance future preparedness. (shrink)

During a pandemic, where there is widespread human infection, various and varying measures are taken that are targeted at public health objectives. During the early stages of a pandemic, these objectives may focus on containing the disease and minimizing its spread, but they may switch to mitigation as the emergent infectious disease takes hold in a population. There has been considerable debate and elucidation of the ethical principles and framework for the various responses including the need to fast track research (...) and vaccine development. However, the measures imposed during a pandemic would have unintended and untoward effect on ongoing clinical research. For example, precautionary measures, such as social distancing, may hamper ongoing clinical research, because recruitment and participation of patients and healthy volunteers is a potential source of virus spread. In this paper, we argue that a framework is needed to ensure the continuity of such research. Such a framework that considers the pertinent issues would need the ‘buy in’ of the key stakeholders (policy makers, funding agencies, institutional authorities, researchers and subjects) to ensure that the issues that are ethically relevant to pandemic planning would not be neglected or overlooked. (shrink)

The New Evil Demon problem has been hotly debated since the case was introduced in the early 1980’s (e.g. Lehrer and Cohen 1983; Cohen 1984), and there seems to be recent increased interest in the topic. In a forthcoming collection of papers on the New Evil Demon problem (Dutant and Dorsch, forthcoming), at least two of the papers, both by prominent epistemologists, attempt to resist the problem by appealing to the distinction between justification and excuses. My primary aim here is (...) to critically evaluate this new excuse maneuver as a response to the New Evil Demon problem. -/- Their response attempts to give us reason to reject the idea that victims of the New Evil Demon have justification for believing as they do. I shall argue that this approach is ultimately unsuccessful, however much of value can be learned from these attempts. In particular, progress in the debate can be made by following those who advance the excuse maneuver and make explicit the connection between epistemic justification and epistemic norms. By doing so, the questions being debated are clarified, as is the methodology being used to attempt to answer them. (shrink)

What does it take for a positive epistemic status to obtain? I argue throughout my thesis that if a positive epistemic status obtains, this is not a brute fact. Instead, if for example a belief is justified, it is justified in virtue of some further condition(s) obtaining. A fundamental topic in epistemology is the question of what sorts of factors can be relevant to determining the positive epistemic status of belief. Epistemic Internalism holds that these factors must be “internal” (in (...) a sense that needs to be specified). Epistemic Externalism is the denial of internalism. My thesis is an explanation and defense of an internalist theory of epistemic justification. -/- The central claim of my thesis is that something is “internal” in this sense only if it is, or can easily be, the object of the agent’s conscious awareness. By considering key cases, I show that without an awareness requirement on justification, the subject cannot avoid what I call the Subject’s Perspective Objection. In developing this objection I examine and respond to an argument against the awareness requirement which claims that such awareness either leads to a vicious regress of requiring higher order beliefs of increasing complexity (if any beliefs are to be justified), or else requiring such awareness is unmotivated. This regress is generated because it is assumed that the relevant kind of awareness must be doxastic. My solution invokes what I call ‘strong non-doxastic awareness’ that grounds non-inferential justification and thereby avoids this dilemma, while meeting the Subject’s Perspective Objection. -/- I also argue that external factors, such as the reliability (actual or conditional) of the mechanism supporting the belief, are not necessary for justification. I argue for this conclusion by comparing what constitutes justified belief in the actual world with one’s counterpart in a ‘demon world’. I argue that this intuition, correctly interpreted, counts in favour of internalism. As I explain, many philosophers moved by arguments presented by externalists about mental content deny that such a case is possible. In opposition I argue that the awareness requirement remains substantially unaffected, no matter which view of content turns out to be correct. What is key is that the two worlds are completely subjectively indistinguishable from each other for those who inhabit them in all the ways of which they are consciously aware. -/- If neither the obtaining of truth nor reliability is necessary for epistemic justification, what makes justification genuinely epistemic? In the final chapter I argue against recent work that assimilates justification with knowledge, as well as for a positive account of the truth connection. As to the former question, I defend the orthodoxy that they are distinct epistemic statuses; as to the latter, I argue that the connection between justification and truth is conceptual. That is, epistemic justification is epistemic because it turns on evidence; evidence is epistemic because it is conceptually linked with truth. Epistemic justification, therefore, is conceptually linked with the truth (via evidence), which is what makes it distinctively epistemic. -/- In short, this thesis is an explanation and defense of an internalist theory of epistemic justification. The central claim of the thesis is that something is “internal” in this sense only if it is, or can easily be, the object of the agent’s conscious awareness. I argue that conscious awareness is a necessary condition of epistemic justification obtaining, and that factors external to consciousness play no justificatory role. (shrink)