During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by “crisis standards of care,” but they have key differences. We critically appraise one of the most fundamental differences among policies, namely the use of criteria to categorically exclude (...) certain patients from eligibility for otherwise standard medical services. We examine these categorical exclusion criteria from ethical, legal, disability, and implementation perspectives. Focusing our analysis on the most common type of exclusion criteria, which are disease-specific, we conclude that optimal policies for critical care resource allocation and the use of cardiopulmonary resuscitation (CPR) should not use categorical exclusions. We argue that the avoidance of categorical exclusions is often practically feasible, consistent with public health norms, and mitigates discrimination against persons with disabilities. (shrink)

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of current (...) practices and could guide governments, professional societies, and physicians in allocation decisions. (shrink)

Delays in early language development are characteristic of young autistic children, and one of the most recognizable first concerns that motivate parents to seek a diagnostic evaluation for their child. Although early language abilities are one of the strongest predictors of long-term outcomes, there is still much to be understood about the role of language impairment in the heterogeneous phenotypic presentation of autism. Using a person-centered, Latent Profile Analysis, we first aimed to identify distinct patterns of language and social communication (...) ability in a clinic-based sample of 498 autistic children, ranging in age from 18 to 60 months. Next, a multinomial logistic regression analysis was implemented to examine sociodemographic and child-based developmental differences among the identified language and social communication profiles. Three clinically meaningful profiles were identified from parent-rated and clinician-administered measures: Profile 1 “Relatively Low Language and Social Communication Abilities,” Profile 2 “Relatively Elevated Language and Social Communication Abilities,” and Profile 3 “Informant Discrepant Language and Relatively Elevated Social Communication Abilities.” Overall, young autistic children from the lowest-resource households exhibited the lowest language and social communication abilities, and the lowest non-verbal problem-solving and fine-motor skills, along with more features of attention-deficit/hyperactivity disorder and atypical auditory processing. These findings highlight the need for effective community-based implementation strategies for young autistic children from low-resource households and underrepresented communities to improve access to individualized quality care. (shrink)

In this open peer commentary, we categorize the possible “neuroscience in national security” definitions of misuse of science and identify which, if any, are uniquely presented by advances in neuroscience. To define misuse, we first define what we would consider appropriate use: the application of reasonably safe and effective technology, based on valid and reliable scientific research, to serve a legitimate end. This definition presents distinct opportunities for assessing misuse: misuse is the application of invalid or unreliable science, or is (...) the use of reliable scientific methods to serve illegitimate ends. Ultimately, we conclude that while national security is often a politicized issue, assessing the state of scientific progress should not be. (shrink)

In this commentary, I critique three aspects of Emily Walsh's proposal to reduce the moral and legal weight of advance directives: (1) the ambiguity of its initial thesis, (2) its views about the ethics and legality of clinical practice, and (3) its interpretation and application of Ronald Dworkin’s account of advance directives and L.A. Paul's view on transformative experience. I also consider what Walsh’s proposal would mean for people facing the prospect of dementia. I conclude that our reasons to honor (...) many advance directives survive the move to a transformative experience framework. (shrink)

This Note offers a normative critique of cost-benefit analysis, one informed by deontological moral theory, in the context of the debate over whether tort litigation or a non-tort approach is the appropriate response to mass harm. The first Part argues that the difference between lay and expert intuitions about risk and harm often reflects a difference in normative judgments about the existing facts, rather than a difference in belief about what facts exist, which makes the lay intuitions more defensible. The (...) second Part considers how tort has dealt with this divergence between lay and expert perspectives. It also evaluates how tort's approach has differed from that of public law approaches to accident law, such as legislative compensation and risk regulation by administrative agencies. Ultimately, tort's ability to recognize the value of lay intuitions supports retaining the tort perspective as part of our societal arsenal of responses to risk and harm. This ability can also support a pro-tort perspective in two practical debates in the arena of tort law: that over preemption of tort law by administrative agency judgments, and that over access to tort recovery as part of a no-fault system. (shrink)

Cass Sunstein and Richard Thaler's proposal that social and legal institutions should steer individuals toward some options and away from others-a stance they dub "libertarian paternalism"-has provoked much high-level discussion in both academic and policy settings. Sunstein and Thaler believe that steering, or "nudging," individuals is easier to justify than the bans or mandates that traditional paternalism involves. -/- This Article considers the connection between libertarian paternalism and the regulation of reproductive choice. I first discuss the use of nudges to (...) discourage women from exercising their right to choose an abortion, or from becoming or remaining pregnant. I then argue that reproductive choice cases illustrate the limitations of libertarian paternalism. Where choices are politicized or intimate, as reproductive choices often are, nudges become not much easier to justify than traditional mandates or prohibitions. Even beyond the context of reproductive choice, it is not obvious how much easier nudges are to justify than bans or mandates. -/- Part I of this Article briefly introduces Sunstein and Thaler's libertarian paternalism. Part II then turns to the context of reproductive choice. Part II.A reviews restrictions on the right to choose an abortion-particularly post-Casey regulations such as waiting periods, requirements that women receive certain types of information, and requirements that women undergo ultrasound-that pitch themselves as steering choice without entirely closing off the right to choose an abortion. This distinction between nudges and prohibitions echoes Sunstein and Thaler's proposals, but works to subordinate women's choices to the judgment of (often male) experts and administrators-hence my term "libertarian patriarchalism." Part II.B reviews efforts to nudge women-particularly teenagers, HIV-positive women, and others thought to be unsuitable mothers-to avoid pregnancy. -/- Part III considers the normative implications of nudging reproductive decisions. In Part III.A, I argue that the political nature of reproductive choices presents a problem for nudges. I do so by considering a parallel with voting rights. Empirical research shows that voters are more likely to choose the candidate listed first on the ballot. Yet we do not empower the administrator in charge of ballot design to choose a default rule that nudges individuals toward the candidate he sincerely believes would promote choosers' welfare. Given the political nature of reproductive choices, a policymaker's attempting to nudge reproductive decisionmaking in the direction he prefers-or indeed in any direction-fails to show adequate respect for the chooser's agency. In Part III.B, I offer an argument that targets the use of nudges in the context of pregnancy. Finally, in Part III.C, I argue that nudges do not merely add choices to an existing menu, but change the substantive choices available to individuals and thereby impose more-than-trivial costs on them. I conclude by exploring the implications of my arguments for nudges more generally. (shrink)

Several types of inferences are employed in the diagnosis and prognosis of patients with brain injuries and disorders of consciousness. These inferences introduce unavoidable uncertainty, and can be evaluated in light of inductive risk: the epistemic and nonepistemic risks of being wrong. This article considers several ethically significant inductive risks generated by and interacting with inferences about patients with disorders of consciousness, and argues for prescriptive measures to manage and mitigate inductive risk in the context of disorders of consciousness.

. This paper examines the association between long-term compensation and corporate social responsibility for 90 publicly traded Canadian firms. Social responsibility is considered to include concerns for social factors and the environment, 564-578; Kane, E. J., 341-359). Long-term compensation attempts to focus executives efforts on optimizing the longer term, which should direct their attention to factors traditionally associated with socially responsible executives. As hypothesized, we found a significant relationship between the long-term compensation and total CSR weakness as well as the (...) product/environmental weakness dimension of CSR. In addition, we found a marginally significant relationship between long-term compensation and total corporate responsibility. Our findings are that executives long-term compensation is associated with a firms environmental actions, and that firms that utilize long-term compensation are more likely to mitigate product/environment weaknesses than those that do not. Implications for practice and research are discussed. (shrink)

Substantial evidence has shown that involvement in peer-to-peer farming networks influences whether a farmer decides to try a new practice. Formally organized farmer networks are emerging as a unique entity that blend the benefits of decentralized exchange of farmer knowledge within the structure of an organization providing a variety of sources of information and forms of engagement. We define formal farmer networks as farmer networks with a distinct membership and organizational structure, leadership that includes farmers, and an emphasis on peer-to-peer (...) learning. This study complements existing ethnographic research on the benefits of organized farmer networking by examining farmers in one longstanding formal farmer network, Practical Farmers of Iowa. Using a nested, mixed-method research design, we analyzed survey and interview data to understand how participation and forms of engagement in the network are associated with the adoption of conservation practices. Responses from 677 farmers from a regular member survey disseminated by Practical Farmers of Iowa in 2013, 2017, and 2020 were pooled and analyzed. GLM binomial and ordered logistic regression results indicate that greater participation in the network, particularly through in-person formats, has a strong and significant association with greater adoption of conservation practices. Logistic regression results show that building relationships in the network is the most important variable for predicting whether a farmer reported adopting conservation practices as a result of participation in PFI. In-depth interviews with 26 surveyed member farmers revealed that PFI supports farmers to adopt by providing information, resources, encouragement, confidence building, and reinforcement. In-person learning formats were more important to farmers relative to independent formats because they were able to have side conversations with other farmers, ask questions, and observe results. We conclude that formal networks are a promising way to expand the use of conservation practices, particularly through targeted efforts to increase relationship building in the network through face-to-face learning opportunities. (shrink)

Our paper contributes to the rapidly expanding body of experimental research on transformative decision making, and in the process, marks out a novel empirical interpretation for assessments of subjective value in transformative contexts. We start with a discussion of the role of subjective value in transformative decisions, and then critique extant experimental work that explores this role, with special attention to Reuter and Messerli (2018). We argue that current empirical treatments miss a crucial feature of practical deliberation manifesting across a (...) variety of everyday decisions: often, people attach more weight to decision criteria that they can know—a phenomenon known as the “evaluability bias.” In transformative contexts, if people cannot know the subjective value of an option, they are unlikely to attach it much weight. Despite this, people may care very much about such value. We then use this point to develop and present new empirical results that, in addition to supporting our concerns about evaluability bias, support the hypothesis that people care about subjective value. Our work enriches the current philosophical understanding of transformative decisions and helps to frame the emerging experimental paradigm for the empirical dimensions of the debate. (shrink)

Conceptions of autonomy in western philosophy and ethics have often centred on self-governance and self-determination. However, a growing bulk of literature also questions such conceptions, including the understanding of the autonomous self as a self-governing independent individual that chooses, acts, and lives in accordance with her or his own values, norms, or sense of self. This article contributes to the critical interrogation of selfhood, autonomy, and autonomous decision making by combining a feminist focus on relational dimensions of selfhood and autonomy (...) with phenomenological philosophy of the embodied self as being-in-the-world. It offers a philosophical investigation of different dimensions of bodily relational autonomy by turning to phenomenological accounts of the lived body as self-reflexive. When so doing, we hope to contribute to bridging the gap that sometimes exists between discussions of autonomy in analytic moral philosophy and of freedom and facticity in phenomenological philosophy. We see this gap as unfortunate, and hold that a nuanced understanding of autonomy and autonomous decision making can be reached if these strands of philosophy are brought into dialogue. (shrink)

This article identifies limitations in traditional approaches to engineering ethics pedagogy, reflected in an overreliance on disaster case studies. Researchers in the field have pointed out that these approaches tend to occlude ethically significant aspects of day-to-day engineering practice and thus reductively individualize and decontextualize ethical decision-making. Some have proposed, as a remedy for these defects, the use of research and theory from Science and Technology Studies to enrich our understanding of the ways in which technology and engineering practice are (...) intricated in social and institutional contexts. While endorsing this approach, this article also argues that STS scholarship may not sufficiently address the kinds of questions about normativity and agency that are essential to engineering ethics. It proposes making use of the growing body of research in a field called “postphenomenology,” an approach that combines STS research with the traditional phenomenological concern with the standpoint of lived-experience. Postphenomenology offers a method of inquiry that combines STS’s investigation into social and institutional dimensions of technology with phenomenological reflection on our lived experience of embodied engagement with technical objects and sociotechnical systems, particularly the ways in which these involvements affect our moral perception and agency. The aim in using this approach in engineering ethics is thus to illuminate moral dimensions of everyday professional life of which practitioners may not typically be aware. The article concludes with some concrete curricular interventions for engineering ethics classrooms. (shrink)

Ex-vivo tissue engineering is an emerging medical technology. Its aim is to regenerate tissues and organs and to restore them to full physiological activity. Some clinical trials with human tissue engineered products have been conducted and others will follow. These trials not only have to confirm the therapeutic value of the HTEP, they also have to provide insight in its regenerative activity, its safety and long-term effects. The development of these trials is aggravated by the complexity of the tissue engineering (...) process and product. This paper investigates how this complexity influences the ethical conduct of clinical trials with HTEPs. We focus on the value and validity of the trial, the risk-benefit ratio and the protection of the trial participant. We argue that trials with HTEPs need a robust methodology. The risk-benefit ratio of a new HTEP must be determined and compared with available efficacious therapies. This requires the identification and minimisation of risks associated with tissue engineering. Finally a process as complex as tissue engineering presents serious challenges for the informed consent process, and for the protection of the trial participant during and after the trial. (shrink)

Aims and background: The present work assessed the impact of two decrees on ethics committees in Italy, aimed at bringing the national laws on the conduct of clinical trials into line with the rest of the EC, and regulating and facilitating not-for-profit research.Material and methods: Prospectively collected data from an Italian multicentre study were examined with respect to the ethics review process. Administrative and time elements of the review process were audited. Main outcome measures were time between the application submission (...) and the ethics committee definitive opinion, type and number of application submission forms, number of ethics committees that refused fee exemption, and time between the ethics committee approval and the administrative authorisation.Results: A total of 134 local research ethics committees were approached. Application submission procedures and application forms varied greatly; paper submission was mandatory. The median time from submission to approval was 72 days. Only two LRECs refused the fee exemption. The median time from LREC approval to administrative agreement was 50 days and only 9.6% of local authorities came to a verbal agreement with the sponsor.Conclusions: Italian LRECs are still not sufficiently efficient in complying with the Directive 2001/20/EC requirement . Better coordination of LRECs work is needed although the optimal level of coordination between them is still not known. In the meantime, national guidelines are needed concerning the application of Directive 2001/20/EC. The behaviour of Italian LRECs towards not-for-profit research was excellent although only the fee exemption was requested. (shrink)

We show that arbitrary tautologies of Johansson’s minimal propositional logic are provable by “small” polynomial-size dag-like natural deductions in Prawitz’s system for minimal propositional logic. These “small” deductions arise from standard “large” tree-like inputs by horizontal dag-like compression that is obtained by merging distinct nodes labeled with identical formulas occurring in horizontal sections of deductions involved. The underlying geometric idea: if the height, h(∂), and the total number of distinct formulas, ϕ(∂), of a given tree-like deduction ∂ of a minimal (...) tautology ρ are both polynomial in the length of ρ, |ρ|, then the size of the horizontal dag-like compression ∂ᶜ is at most h(∂)×ϕ(∂), and hence polynomial in |ρ|. That minimal tautologies ρ are provable by tree-like natural deductions ∂ with |ρ|-polynomial h(∂) and ϕ(∂) follows via embedding from Hudelmaier’s result that there are analogous sequent calculus deductions of sequent ⇒ρ. The notion of dag-like provability involved is more sophisticated than Prawitz’s tree-like one and its complexity is not clear yet. Our approach nevertheless provides a convergent sequence of NP lower approximations of PSPACE-complete validity of minimal logic. (shrink)

(2013). Spinoza and the Cosmological Argument According to Letter 12. British Journal for the History of Philosophy: Vol. 21, No. 1, pp. 57-77. doi: 10.1080/09608788.2012.696052.

ABSTRACTEmotional distractors can impair perception of subsequently presented targets, a phenomenon called emotion-induced blindness. Do emotional distractors lose their power to disrupt perception when appearing with increased frequency, perhaps due to desensitisation or enhanced recruitment of proactive control? Non-emotional tasks, such as the Stroop, have revealed that high frequency distractors or conflict lead to reduced interference, and distractor frequency appears to modulate attentional capture by emotional distractors in spatial attention tasks. But emotion-induced blindness is thought to reflect perceptual competition between (...) targets and emotional distractors, and it is unclear whether high frequency emotional stimuli cause less disruption at this relatively early stage of processing. In four experiments, participants searched streams of images for a rotated target image. A negative or neutral distractor appeared before the target, and their relative frequency was manipulated. Across all exper... (shrink)

This collection of articles pays homage to the creativity and scientific rigor Jerome Singer has brought to the study of consciousness and play. It will interest personality, social, clinical and developmental psychologists alike.

This article focuses on the most recent debates in the vibrant and emerging subfield of philosophy of emotion research. Given the dominance of 'cognitivist' theories of emotion in the philosophy, neurobiology, and cognitive science of emotion, we have witnessed a move away from attempts to pit reason and emotion against each other. This move, however, has opened the door to a host of thorny challenges for how we think about our affective relationship with the world, with concepts, and with other (...) minds. (shrink)

Entry of new organizations, including multinational enterprises from emerging markets, raises the ethical question of will they benefit society. The concept of legitimacy answers this question because it is the overall assessment of the appropriateness of organizational ends and means. Moreover, gaining legitimacy enables EMNEs to succeed in new host countries. Past work examined collective level indicators of the legitimacy of MNEs, but recent research recognizes the importance of individuals’ perceptions as the micro-foundation of legitimacy. This study first uses new (...) pragmatism, deontology, and utilitarianism to demonstrate that legitimacy is fundamentally an ethical concept—a perspective that has been overlooked in management research. Second, this study uses a seven-step procedure to develop and validate a measure of individuals’ perceptions of the legitimacy of Chinese EMNEs operating in The Netherlands, a developed country. Six dimensions of legitimacy were identified. The study also finds support for this legitimacy judgment process linking the dimensions: validating knowledge → propriety judgments → generalized judgment. This work provides additional micro-foundations to research on legitimacy and contributes to the ongoing process of construct validation. Future research could use the validated measure in other settings and use specific ethical theories in depth to refine the concept of legitimacy. (shrink)

The struggle over legal abortion access in the United States is a religious controversy, not a scientific debate. Religious activists who believe that meaningful individual life (i.e., “personhood”) begins at a specific “moment-of-conception” are attempting to pass laws that force this view upon all pregnant persons, irrespective of their medical circumstances, individual preferences, or personal religious beliefs. This paper argues that such actions promote a constitutionally prohibited “establishment of religion.” Abortion policy in a secular state must be based upon scientifically (...) accurate biology, not unprovable theological presuppositions. The scientific facts regarding human pregnancy do not support the position that personhood begins with fertilization—at which point a pregnancy does not yet even exist. Abortion policy should regard the embryo/fetus as part of the pregnant individual’s body until delivery. We argue that individual “personhood” only begins when the _latent_ potentialities of the fetal nervous system are _actualized_ in the newborn after delivery. The paper argues that instantiating non-scientific beliefs concerning embryonic/fetal “personhood” into the law as the basis for abortion policy establishes a state-sponsored religion. The protection of religious liberty requires that abortion be decriminalized. Abortion should be treated like any other medical procedure and regulated similarly. To protect both religious freedom and sound medical practice, individual legal personhood should be recognized as beginning only at birth. (shrink)