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)

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)

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 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)

This provocative study revives a classical idea about rationality by developing analogies between the structure of personality and the structure of society in the context of contemporary work in the philosophy of mind, ehtics, decision theory, and social choice theory.

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)

Lives and work of Veṅkaṭanātha (Vedantadesika), 1268-1369, and Maṇavāḷa Māmun̲i, 1370-1444, Vaishnavite leaders and exponents of the Viśiṣṭādvaita school in Hindu philosophy from Tamil Nadu.

jild-i 1. Āzādī va marzʹhāyash -- jild-i 2. Istiqlāl (farhangī).

This book presents three of the works of Abdu'l-Bahá, son of the founder of the Bahá'i Faith, dealing with social and political issues.00In 'The Secret of Divine Civilization' (1875) Abdu'l-Bahá supports the administrative and broader social reforms of Mirzá Hosayn Khán, but looks mainly for organic reform through the efforts of Iranian intellectuals to waken and educate the masses. In this work, Abdu'l-Bahá gives virtuous and progressive Islamic clerics a leading role among these intellectuals, indeed most of his appeals are (...) directed specifically to them. 'A Traveller's Narrative' (1889/90) is an authoritative statement of the broad lines of Bahá'i social and political thinking. 'The Art of Governance' (1892/93) was written as Iran entered a pre-revolutionary phase, and ideas that we recognise today as the precursors of political Islam were spreading. It sets out the principles underlying the ideal relationship between religion and politics and between the government and the people.00In addition to presenting the first parallel text translations of these works, the Persian texts incorporate notes on variants in the early published sources. An introduction outlines the intellectual and political landscape from which Abdu'l-Bahá wrote, and in which his expected readers lived. (shrink)

In these skeptical and disillusioned times, there are still groups of people scattered throughout the world who are trying to live out utopian dreams. These communities challenge the inevitability and morality of dominant political and economic models. By putting utopian religious ethics into practice, they attest to the real possibility of social alternatives. In Seeds of the Kingdom, Anna L. Peterson reflects on the experiences of two very different communities, one inhabited by impoverished former refugees in the mountains of El (...) Salvador and the other by Amish farmers in the Midwestern U.S. What makes these groups stand out among advocates of environmental protection, political justice, and sustainable development is their religious orientation. They aim, without apology, to embody the reign of God on earth. The Salvadoran community is grounded in Roman Catholic social thought, while the Amish adhere to Anabaptist tradition. Peterson offers a detailed portrait of these communities' history, social organization, religious life, environmental values, and agricultural practices. She discovers both practical and ideological commonalities in these two comparatively successful and sustainable communities, including a strong collective identity, deep attachment to local landscapes, a desire to preserve non-human as well as human lives, and, perhaps unexpectedly, a utopian horizon that provides both goals and the hope of reaching them. By examining the process by which people struggle to live according to a transcendent value system, she sheds light on both the actual and the potential place of religion in public life. Peterson argues that the Amish and Salvadoran communities, geographically and culturally removed from the industrialized West, have relevance for the political and environmental problems of the developed world. These communities have succeeded in the face of significant internal and external challenges, offering important practical and theoretical lessons on how to achieve ecological sustainability and social justice in the wider world. (shrink)

In addition to the transmission of the science of hadith from the Eastern Islamic world to the west, particularly to Andalusia, a rich literature also developed in Andalusia. Therefore, the development of the science of hadith and hadith methodology in the Andalusian region and the impact of scholars from that region on these sciences is an important issue that deserves attention. This article examines how the intellectual atmosphere of Andalusia was enriched by the hadith works that came from the East (...) and the scholarly activity these works generated. It also addresses the hadith methodology literature that emerged in the Andalusian region and the reflections of this literature in the hadith methodology works of the From this perspective, the study first briefly highlights the hadith and hadith methodology literature that reached Andalusia from the Mashriq region, followed by the works written by Andalusian scholars that contributed to the hadith methodology literature. Subsequently, the influence of hadith methodology works by hadith scholars from the Eastern Islamic world on Andalusian literature is examined. Furthermore, the study evaluates how Andalusian scholars were referenced in the Mashriq hadith methodology literature and their influence on these works. Through this analysis, the interaction between the Mashriq and Andalusian regions within the context of hadith methodology is demonstrated. The contribution of Andalusian scholars to the hadith literature by enriching the knowledge and expertise they received from the East with their interpretations and original works increased the importance of the region in the Islamic world. Additionally, the influence of the hadith methodology works written in Andalusia on Eastern literature reveals the reciprocal nature of cultural interaction. (shrink)