The ACA shifted U.S. health policy from centering on principles of actuarial fairness toward social solidarity. Yet four legal fixtures of the health care system have prevented the achievement of social solidarity: federalism, fiscal pluralism, privatization, and individualism. Future reforms must confront these fixtures to realize social solidarity in health care, American-style.

The evolution of sex in eukaryotes represents a paradox, given the “twofold” fitness cost it incurs. We hypothesize that the mutational dynamics of the mitochondrial genome would have favored the evolution of sexual reproduction. Mitochondrial DNA (mtDNA) exhibits a high‐mutation rate across most eukaryote taxa, and several lines of evidence suggest that this high rate is an ancestral character. This seems inexplicable given that mtDNA‐encoded genes underlie the expression of life's most salient functions, including energy conversion. We propose that negative (...) metabolic effects linked to mitochondrial mutation accumulation would have invoked selection for sexual recombination between divergent host nuclear genomes in early eukaryote lineages. This would provide a mechanism by which recombinant host genotypes could be rapidly shuffled and screened for the presence of compensatory modifiers that offset mtDNA‐induced harm. Under this hypothesis, recombination provides the genetic variation necessary for compensatory nuclear coadaptation to keep pace with mitochondrial mutation accumulation. (shrink)

Patients with psychiatric illness feel the brunt of the intersection of many of our society's and our health care system's disparities, and the vulnerability of this population during the Covid‐19 pandemic cannot be overstated. Patients with psychiatric illness often suffer from the stigma of mental illness and receive poor medical care. Many patients with severe and persistent mental illness face additional barriers, including poverty, marginal housing, and food insecurity. Patients who require psychiatric hospitalization now face the risk of transmission of (...) Covid‐19 due to the inherent difficulties of social distancing within a psychiatric hospital. Patients whose freedom and self‐determination have been temporarily overruled as they receive involuntary psychiatric treatment deserve a setting that maintains their health and safety. While tele‐mental health has been rapidly expanded to provide new ways to access psychiatric treatment, some patients may have limitations in technological literacy or access to devices. The social isolation, economic fallout, and potential traumatization related to the current pandemic will disproportionately affect this vulnerable population, and society's duties to them must be considered. (shrink)

Despite having international and national legislative frameworks and policies that guarantee children’s rights and encourage their participation in matters affecting them, consulting children has received scant scholarly attention in the African context. Notwithstanding this state of affairs, it is important to ask whether, in keeping with growing progressive practices, having children as active researchers is a feasible goal to achieve and, if so, how might this be possible. Drawing on Swartz and Nyamnjoh’s framework of research existing along an emancipatory continuum, (...) we argue for practical, methodological interventions to bridge the researcher–researched divide. We show, using four case studies, how giving children a voice – a key feature of emancipatory research – as participants in educational research has the potential to afford them space to co-enact the research and develop their sense of agency. The four case studies were drawn from investigations of lived experiences of orphaned children and conceptions of education quality in South Africa; consulting children about sex and HIV/AIDS education in South Africa, Tanzania and Kenya; a study of a community-based peer education programme in South Africa and language and mathematics skills assessments in a large-scale study. Within each case, we evaluate the extent to which the research methods used aims for and achieves children’s participation and emancipation and offer ways to overcome challenges for adopting emancipatory approaches in the schooling sector from ethical, policy and political perspectives. The article concludes with recommendations for implementing emancipatory methodologies in educational research involving children. (shrink)

Prior studies have advanced our knowledge of the individual determinants of corporate philanthropy; however, little empirical research has been conducted on how these determinants combine to influence giving. In this study, the authors develop and test an integrated model of the relationship between firm resources and corporate philanthropy as mediated by managerial discretion and managerial values. In addition, the authors offer organizational slack as an alternative measure of organizational resources. As predicted, the results show that firm resources have a positive (...) effect on corporate philanthropy. This effect is fully mediated by managerial discretion and partially mediated by managerial values. (shrink)

Although a great deal of research addresses the neural basis of deliberate and intentional emotion-regulation strategies, less attention has been paid to the neural mechanisms involved in implicit forms of emotion regulation. Behavioural research suggests that romantically involved participants implicitly derogate the attractiveness of alternative partners, and the present study sought to examine the neural basis of this effect. Romantically committed participants in the present study were scanned with functional magnetic resonance imaging (fMRI) while indicating whether they would consider each (...) of a series of attractive (or unattractive) opposite-sex others as a hypothetical dating partner both while under cognitive load and no cognitive load. Successful derogation of attractive others during the no cognitive load compared to the cognitive load trials corresponded with increased activation in the ventrolateral prefrontal cortex (VLPFC) and posterior dorsomedial prefrontal cortex (pDMPFC), and decreased activation in the ventral striatum, a pattern similar to those reported in deliberate emotion-regulation studies. Activation in the VLPFC and pDMPFC was not significant in the cognitive load condition, indicating that while the derogation effect may be implicit, it nonetheless requires cognitive resources. Additionally, activation in the right VLPFC correlated with participants' level of relationship investment. These findings suggest that the RVLPFC may play a particularly important role in implicitly regulating the emotions that threaten the stability of a romantic relationship. (shrink)

This commentary highlights the observation that social motivation is usually an imprecisely specified construct. We suggest four social motivation conceptualizations across levels of analysis and explore where the target article situates among these. We then offer theoretical and practical guidance for operationalization and measurement of social motivation to support more comprehensive future research on this complex construct in the autism literature.

Previous research in North America has supported the view that male involvement in committed, romantic relationships is associated with lower testosterone (T) levels. Here, we test the prediction that undergraduate men involved in committed, romantic relationships (paired) will have lower T levels than men not involved in such relationships (unpaired). Further, we also test whether these differences are more apparent in samples collected later, rather than earlier, in the day. For this study, 107 undergraduate men filled out a questionnaire and (...) collected one saliva sample (from which a subject’s T level was measured) at various times across the day. As in previous studies, men involved in committed, romantic relationships had lower salivary T levels, though only during later times of the day. Furthermore, additional analysis of the variation among unpaired subjects indicated that men without prior relationship experience had lower T levels than experienced men. Finally, while paired men as a group had lower T levels than unpaired men, those men at the earliest stage (less than six months) of a current relationship had higher T levels than unpaired men as well as men in longer-term relationships. These results suggest that variation in male testosterone levels may reflect differential behavioral allocation to mating effort. (shrink)

Most ethics guidelines for distributing scarce medical resources during the coronavirus pandemic seek to save the most lives and the most life‐years. A patient’s prognosis is determined using a SOFA or MSOFA score to measure likelihood of survival to discharge, as well as a consideration of relevant comorbidities and their effects on likelihood of survival up to one or five years. Although some guidelines use age as a tiebreaker when two patients’ prognoses are identical, others refuse to consider age for (...) fear of discriminating against the elderly. In this paper, I argue that age is directly relevant for maximizing health benefits, so current ethics guidelines are wrongly excluding or deemphasizing life‐stage in their triage algorithms. Research on COVID‐19 has shown that age is a risk factor in adverse outcomes, independent of comorbidities. And limiting a consideration of life‐years to only one or five years past discharge does not maximize health benefits. Therefore, based on their own stated values, triage algorithms for coronavirus patients ought to include life‐stage as a primary consideration, along with the SOFA score and comorbidities, rather than excluding it or using it merely as a tiebreaker. This is not discriminatory because patients ought to have equal opportunity to experience life‐stages. The equitable enforcement of that right justifies unequal treatment based on age in cases when there is a scarcity of life‐saving resources. A consideration of life‐stage would thus allow healthcare workers to responsibly steward public resources in order to maximize lives and life‐years saved. (shrink)

BackgroundThe COVID-19 pandemic has had a significant impact on the health system worldwide. The organ and tissue donation and transplantation (OTDT) system is no exception and has had to face ethical challenges related to the pandemic, such as risks of infection and resource allocation. In this setting, many Canadian transplant programs halted their activities during the first wave of the pandemic.MethodTo inform future ethical guidelines related to the COVID-19 pandemic or other public health emergencies of international concern, we conducted a (...) literature review to summarize the ethical issues.ResultsThis literature review identified three categories of ethical challenges. The first one describes the general ethical issues and challenges reported by OTDT organizations and transplantation programs, such as risks of COVID-19 transmission and infection to transplant recipients and healthcare professionals during the transplant process, risk of patient waitlist mortality or further resource strain where transplant procedures have been delayed or halted, and resource allocation. The second category describes ethical challenges related to informed consent in the context of uncertainty and virtual consent. Finally, the third category describes ethical issues related to organ allocation, such as social considerations in selecting transplant candidates.ConclusionThis literature review highlights the salient ethical issues related to OTDT during the current COVID-19 pandemic. As medical and scientific knowledge about COVID-19 increases, the uncertainties related to this disease will decrease and the associated ethical issues will continue to evolve. (shrink)

Two of the major arguments against performance-enhancing drugs (PEDs), appealing to fairness and the protection of athletes’ health, have serious flaws. First, there is no relevant moral distinction between the use of PEDs and the use of other performance enhancers that introduce unfairness and that we accept nonetheless. Second, prohibiting PEDs for athletes’ own good ignores the fact that adult athletes are constantly making tradeoffs to improve performance and pursue excellence, including sacrificing their health. We should not paternalistically impose our (...) values on them. On the other side, arguments to allow ‘safe’ PEDs provide no normative criterion to determine the acceptable level of risk, thus begging the question. The reasonable athlete argument solves both sets of problems: it justifies a ban on some performance-enhancing drugs based on health and fairness, while avoiding paternalism, and it also establishes a non-arbitrary standard to determine which drugs ought to be allowed. First, if unsafe PEDs were allowed, some athletes would refuse to take them out of concern for their health. This is a reasonable decision even though it would put them at a competitive disadvantage against athletes who choose to use unsafe PEDs. It would be unfair for clean athletes to suffer a competitive disadvantage for acting reasonably. Therefore, PEDs that pose significant health risks should be prohibited for all athletes. Second, it would be unreasonable for athletes to refuse, on principle, relatively safe and effective PEDs, so a blanket prohibition is also unjustified. Which drugs and which doses to allow should be determined not by athletes’ actual choices but by the hypothetical choices of the reasonable athlete. The resulting sport-specific drug policy would carve a justifiable middle path between complete prohibition and complete permission. (shrink)

Physical touch is central to the emotional intimacy that separates romantic relationships from other social contexts. In this study of 256 adults, we examined whether individual differences in social anxiety influenced comfort with and avoidance of physical touch. Because of prior work on sex difference in touch use, touch comfort, and social anxiety symptoms and impairment, we explored sex-specific findings. We found evidence that women with greater social anxiety were less comfortable with touch and more avoidant of touch in same-sex (...) friendships. Additionally, a woman’s social anxiety had a bigger effect on a man’s comfort with touch and avoidance of touch in the romantic relationship than a man’s social anxiety had on the woman’s endorsement of touch-related problems. These effects were uninfluenced by the length of romantic relationships. Touch is a neglected emotional experience that offers new insights into the difficulties of individuals suffering from social anxiety problems, and their romantic partners. (shrink)

Nearly one-quarter of Costa Rica's export earnings derive from an expanding tourist sector, one that is increasingly diversified in a mix of tourist niches. Ecotourism is the fastest growing niche and its promises are featured in a range of sites and practices, including the largest multinational hospitality and hotel corporations. These companies promote a vision of sustainability that relies on expanding consumption of ‘environmental' amenities through profit-driven global corporations – a vision that is, to some, antithetical to the very meaning (...) of ecotourism. Our study explores the historical evolution of tourist development in Costa Rica, specifically large-scale coastal development, as a means for national development. Amid pressures to attract foreign direct investment in a neoliberal era, Costa Rica has struggled to maintain its developmentalism, which includes social welfare, environmental protection, and public goods, including coastal preservation and public access. We argue Costa Rica's simult.. (shrink)

Recently, many philosophers of religion have sought to defend the rationality of religious belief by shifting the burden of proof onto the critic of religious belief. Some have appealed to extraordinary religious experience in making their case. Religious Experience, Justification, and History restores neglected explanatory and historical considerations to the debate. Through a study of William James, it contests the accounts of religious experience offered in recent works. Through reflection on the history of philosophy, it also unravels the philosophical use (...) of the term justification. Matthew Bagger argues that the commitment to supernatural explanations implicit in the religious experiences employed to justify religious belief contradicts the modern ideal of human flourishing. (shrink)

In this chapter, Altman gives two separate arguments that, in conjunction, support a mixed theory of punishment. First, he shows that consequentialism is insufficient on its own because it cannot capture the condemnatory function of the law as an expression of the community’s resentment. Second, he shows that retributivism is insufficient on its own because any plausible legal arrangement must be committed to some non-retributivist values. He then argues that the institution of punishment is justified by its costs and benefits, (...) and the distribution of punishment—who is punished and how much—is justified by what offenders deserve. This two-tiered model of punishment makes more sense than an alternative scheme, according to which retributivist reasoning informs criminal lawmaking and consequentialist reasoning informs criminal judgments and sentencing. (shrink)

This remarkably comprehensive Handbook provides a multifaceted yet carefully crafted investigation into the work of Immanuel Kant, one of the greatest philosophers the world has ever seen. With original contributions from leading international scholars in the field, this authoritative volume first sets Kant’s work in its biographical and historical context. It then proceeds to explain and evaluate his revolutionary work in metaphysics and epistemology, logic, ethics, aesthetics, philosophy of science, philosophy of religion, political philosophy, philosophy of history, philosophy of education, (...) and anthropology. Key Features: • Draws attention to the foundations of Kant’s varied philosophical insights — transcendental idealism, logic, and the bridge between theoretical and practical reason • Considers hitherto neglected topics such as sexuality and the philosophy of education • Explores the immense impact of his ground-breaking work on subsequent intellectual movements Serving as a touchstone for meaningful discussion about Kant’s philosophical and historical importance, this definitive Handbook is essential reading for Kant scholars who want to keep abreast of the field and for advanced students wishing to explore the frontiers of the subject. (shrink)

This chapter contains sections titled: Physician‐Assisted Suicide Refusing Life‐Saving Medical Treatment Organ Donation: Opt‐in or Opt‐out? Autonomy and the Body.

Anthropocentric biases manifest themselves in two different ways in research on animal cognition. Some researchers claim that only humans have the capacity for reasoning, beliefs, and interests; and others attribute mental concepts to nonhuman animals on the basis of behavioral evidence, and they conceive of animal cognition in more or less human terms. Both approaches overlook the fact that language-use deeply informs mental states, such that comparing human mental states to the mental states of nonlinguistic animals is misguided. In order (...) to avoid both pitfalls -- assuming that animals have mental lives just like we do, or assuming that they have no mental lives at all -- I argue for a functional methodological approach. Researchers should study animal cognition by identifying environmental inputs, the functional role of internal states, and behavioral outputs. Doing so will allow for cross-species comparisons in a way that the use of folk psychological terms does not. (shrink)

In this book, leading Christian political thinkers and practitioners critique the Rawlsian concepts of “justice as fairness” and “public reason” from the perspective of Christian political theory and practice. It provides a new level of analysis from Christian perspectives, including implications for such hot topics as the culture war.

In the classical Stueckelberg-Horwitz-Piron relativistic Hamiltonian mechanics, a significant aspect of evolution of the classical n-body particle system with mutual interaction is the method by which events along distinct particle world lines are put into correspondence as a dynamical state. Approaches to this procedure are discussed in connection with active and passive symmetry principles.

Among mainstream political philosophers, Charles Mills is probably best known, not as the author of The Racial Contract, but for his long-running critique of ideal theory and Rawls for his association with it. Yet the critique of ideal theory that followed the publication of The Racial Contract is prefigured in that very work, where we find in inchoate form what would be further developed later on. In the book, this early formulation of the critique occupies a small part of a (...) larger, more general argument condemning mainstream political philosophy for the way that it has ignored race. In this paper, I explore the relation of the critique to this more general argument. It might be thought that the general argument leads inevitably to the critique of ideal theory. I will argue that this is not so. I will show how Mills’ more general argument can be made without taking the further step of critiquing ideal theorizing. The blame for why mainstream political philosophy has ignored race, and continues to ignore race, I will argue, should be placed elsewhere. (shrink)

Recently Robert Forman has attempted to muster support for the largely abandoned position that mystical experiences cross-culturally include an unmediated, non-relative core. To reopen the debate he has solicited essays from likeminded scholars for his book, The Problem of Pure Consciousness. Predictably the focus of the volume rests on the refutation of the position most notably expounded by Steven Katz in his influential article of 1978, ‘Language, Epistemology and Mysticism’.

Over the course of the last four decades, William Leon McBride has distinguished himself as one of the most esteemed and accomplished philosophers of his generation. This volume—which celebrates the occasion of his seventy-fifth birthday—includes contributions from colleagues, friends, and formers students and pays tribute to McBride’s considerable achievements as a teacher, mentor, and scholar.

Prior to recent decades, the United States Supreme Court often invoked the political question doctrine to avoid deciding controversial questions of individual rights. 1 By the 1970s and 1980s, standing limits traced to Article IIIs arsenal of threshold decision making, 3 in the last decade the Court has turned with increasing frequency to the distinction between facial and as-applied challenges to perform the gatekeeping function. However, although there is a considerable body of scholarship concerning the conventional justiciability doctrines, scholars have (...) only recently begun to address the range of questions implicated by the Courtand they have generally focused on narrow doctrinal questions about the proper treatment of discrete rights such as abortion, free exercise of religion, and freedom of speech. The papers in this issue of LegalTheory and the next view these issues in a broader jurisprudential context. (shrink)

This article offers two further philosophical engagements with the writings of the Apostle Paul. The recent work of Francois Laruelle on Paul in his turn to Christian non-theology is placed in dialogue with Nishitani Keiji’s account. This effort is accomplished by briefly grounding the discussion in Friedrich Nietzsche’s interpretation, where Paul is cast as the inventor of Christianity and the primary influence in the religion’s turn to a doctrinal and world-denying form of existence. As described here, Laruelle follows the broad (...) outline of Nietzsche’s interpretation, where Paul once more deviates from the example of Christ and is guilty of encouraging a turn away from the world towards concepts of transcendence and life after death. Nishitani, on the other hand, and despite his affection for Nietzsche’s thought, sees in Paul’s life and writings a turn towards immanence, and offers a heavily contrasting read of Paul, one which deserves greater attention. (shrink)

Kant is gaining popularity in business ethics because the categorical imperative rules out actions such as deceptive advertising and exploitative working conditions, both of which treat people merely as means to an end. However, those who apply Kant in this way often hold businesses themselves morally accountable, and this conception of collective responsibility contradicts the kind of moral agency that underlies Kant's ethics. A business has neither inclinations nor the capacity to reason, so it lacks the conditions necessary for constraint (...) by the moral law. Instead, corporate policies ought to be understood as analogous to legal constraints. They may encourage or discourage certain actions, but they cannot determine a person's maxim - which for Kant is the focus of moral judgment. Because there is no collective intention apart from any intentions of the individual agents who act as members of the corporation, an organization itself has no moral obligations. This poses a dilemma: either apply the categorical imperative to the actions of particular businesspeople and surrender the notion of collective responsibility, or apply a different moral theory to the actions of businesses themselves. Given the diffusion of responsibility in a bureaucracy, the explanatory usefulness of collective responsibility may force business ethicists to abandon Kant's moral philosophy. (shrink)

This book examines the origins and subsequent evolution of multicellularity. The transition from unicellular to multicellular life was one of a few major events in the history of life that created new opportunities for more complex biological systems to evolve.

What could ground normative restrictions concerning cultural appropriation which are not grounded by independent considerations such as property rights or harm? We propose that such restrictions can be grounded by considerations of intimacy. Consider the familiar phenomenon of interpersonal intimacy. Certain aspects of personal life and interpersonal relationships are afforded various protections in virtue of being intimate. We argue that an analogous phenomenon exists at the level of large groups. In many cases, members of a group engage in shared practices (...) that contribute to a sense of common identity, such as wearing certain hair or clothing styles or performing a certain style of music. Participation in such practices can generate relations of group intimacy, which can ground certain prerogatives in much the same way that interpersonal intimacy can. One such prerogative is making what we call an appropriation claim. An appropriation claim is a request from a group member that non-members refrain from appropriating a given element of the group’s culture. Ignoring appropriation claims can constitute a breach of intimacy. But, we argue, just as for the prerogatives of interpersonal intimacy, in many cases there is no prior fact of the matter about whether the appropriation of a given cultural practice constitutes a breach of intimacy. It depends on what the group decides together. (shrink)

Rhythm is key to language acquisition. Across languages, rhythmic features highlight fundamental linguistic elements of the sound stream and structural relations among them. A sensitivity to rhythmic features, which begins in utero, is evident at birth. What is less clear is whether rhythm supports infants' earliest links between language and cognition. Prior evidence has documented that for infants as young as 3 and 4 months, listening to their native language supports the core cognitive capacity of object categorization. This precocious link (...) is initially part of a broader template: listening to a non-native language from the same rhythmic class as and to vocalizations of non-human primates provide English-acquiring infants the same cognitive advantage as does listening to their native language. Here, we implement a machine-learning approach to ask whether there are acoustic properties, available on the surface of these vocalizations, that permit infants' to identify which vocalizations are candidate links to cognition. We provided the model with a robust sample of vocalizations that, from the vantage point of English-acquiring 4-month-olds, either support object categorization or fail to do so. We assess whether supervised ML classification models can distinguish those vocalizations that support cognition from those that do not, and which class of acoustic features best support that classification. Our analysis reveals that principal components derived from rhythm-relevant acoustic features were among the most robust in supporting the classification. Classifications performed using temporal envelope components were also robust. These new findings provide in principle evidence that infants' earliest links between vocalizations and cognition may be subserved by their perceptual sensitivity to rhythmic and spectral elements available on the surface of these vocalizations, and that these may guide infants' identification of candidate links to cognition. (shrink)