Background and ObjectiveThe outbreak of Coronavirus Disease 2019 has raised increased challenges for older adults’ personal growth in diverse cultural settings. The aim of this study was to analyze negative emotions and their role on older adults’ self-growth in Mexico, Italy, Portugal, and Spain, during the COVID-19 pandemic. For this purpose, a cross-national qualitative research was carried out.MethodsData were collected from 338 community-dwelling participants aged 65 years and older, using a semi-structured interview protocol. Older adults were asked about negative emotions (...) that significantly contribute to their self-growth during the COVID-19 pandemic. Content analysis was used to identify key themes.ResultsSeven main negative emotions significantly contributed to seven themes of self-growth, across the samples: sharing difficult experiences with others, supportive partner, spiritual practices, engagement with life, generativity, volunteering activities, and intimacy and sexual satisfaction. Sharing difficult experiences with others was most pertinent to Mexican and to Italian participants, and a supportive partner to Portuguese, and to Spanish participants.ConclusionThe findings of this study indicate that negative emotions during the COVID-19 pandemic contributed to their older adults’ self-growth. This study highlighted the cultural diversity of experiences during the pandemics and underlined the upside of negative emotions and its relation to older adults’ self-growth during this period. (shrink)

The field of bioethics has evolved over the past half-century, incorporating new domains of inquiry that signal developments in health research, clinical practice, public health in its broadest sense and more recently sensitivity to the interdependence of global health and the environment. These extensions of the reach of bioethics are a welcome response to the growth of global health as a field of vital interest and activity. This paper provides a critical interpretive review of how the term “global health ethics” (...) has been used and defined in the literature to date to identify ethical issues that arise and need to be addressed when deliberating on and working to improve the discourse on ethical issues in health globally. Selected publications were analyzed by year of publication and geographical distribution, journal and field, level of engagement, and ethical framework. Of the literature selected, 151 articles were written by authors in high-income countries, as defined by the World Bank country classifications, 8 articles were written by authors in low- or middle-income countries, and 13 articles were collaborations between authors in HIC and LMIC. All of the articles selected except one from 1977 were published after 1998. Literature on global health ethics spiked considerably from the early 2000s, with the highest number in 2011. One hundred twenty-seven articles identified were published in academic journals, 1 document was an official training document, and 44 were chapters in published books. The dominant journals were the American Journal of Bioethics, Developing World Bioethics, and Bioethics. We coded the articles by level of engagement within the ethical domain at different levels: interpersonal, institutional, international, and structural. The ethical frameworks at use corresponded to four functional categories: those examining practical or narrowly applied ethical questions; those concerned with normative ethics; those examining an issue through a single philosophical tradition; and those comparing and contrasting insights from multiple ethical frameworks. This critical interpretive review is intended to delineate the current contours and revitalize the conversation around the future charge of global health ethics scholarship. (shrink)

Rapid Ethical Assessment (REA) is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia.

At the end of the 1990s, Brazil was faced with a potentially explosive HIV/AIDS epidemic. Through an innovative and multifaceted campaign, and despite initial resistance from multinational pharmaceutical companies, the government of Brazil was able to negotiate price reductions for HIV medications and develop local production capacity, thereby averting a public health disaster. Using interview data and document analysis, the authors show that the exercise of corporate social responsibility can be viewed in practice as a dynamic negotiation and an interaction (...) between multiple actors. Action undertaken in terms of voluntary CSR alone may be insufficient. This finding highlights the importance of a strong role for national governments and international organizations to pressure companies to perform better. (shrink)

Over the last decade, the international media has devoted increasing attention to operations that separate conjoined twins. Despite the fairly low odds that a child or adult will survive the operation with all of their vital organs intact, most people fail to question the urgency of being physically separated from one’s identical twin. The drive to surgically tear asunder that which was originally joined, I suggest, is motivated in part by a refusal to acknowledge intercorporeality as a basic condition of (...) human existence that doesn’t undermine identity but makes it possible in the first place. (shrink)

Background Rapid Ethical Assessment is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia. Methods Mixed methods research using a sequential explanatory approach was conducted from July to September 2012, including 241 cross-sectional, self-administered and 19 qualitative, in-depth interviews among health (...) researchers and regulators including ethics committee members in Ethiopian health research institutions and universities. Results In their evaluation of the consent process, only 40.2% thought that the consent process and information given were adequately understood by study participants; 84.6% claimed they were not satisfied with the current consent process and 85.5% thought the best interests of study participants were not adequately considered. Commonly mentioned consent-related problems included lack of clarity, inadequate information, language barriers, cultural differences, undue expectations and power imbalances. About 95.4% believed that consent should be contextualized to the study setting and 39.4% thought REA would be an appropriate approach to improve the perceived problems. Qualitative findings helped to further explore the gaps identified in the quantitative findings and to map-out concerns related to the current research consent process in Ethiopia. Suggestions included, conducting REA during the pre-test phase of studies when applicable. The need for clear guidance for researchers on issues such as when and how to apply the REA tools was stressed. Conclusion The study findings clearly indicated that there are perceived to be correctable gaps in the consent process of medical research in Ethiopia. REA is considered relevant by researchers and stakeholders to address these gaps. Exploring further the feasibility and applicability of REA is recommended. (shrink)

Background Currently there is increasing recognition of the need for research in developing countries where disease burden is high. Understanding the role of local factors is important for undertaking ethical research in developing countries. We explored factors relating to information and communication during the process of informed consent, and the approach that should be followed for gaining consent. The study was conducted prior to a family-based genetic study among people with podoconiosis (non-filarial elephantiasis) in southern Ethiopia. Methodology/Principal Findings We adapted (...) a method of rapid assessment validated in The Gambia. The methodology was entirely qualitative, involving focus-group discussions and in-depth interviews. Discussions were conducted with podoconiosis patients and non-patients in the community, fieldworkers, researchers, staff of the local non-governmental organisation (NGO) working on prevention and treatment of podoconiosis, and community leaders. We found that the extent of use of everyday language, the degree to which expectations of potential participants were addressed, and the techniques of presentation of information had considerable impact on comprehension of information provided about research. Approaching podoconiosis patients via locally trusted individuals and preceding individual consent with community sensitization were considered the optimal means of communication. Prevailing poverty among podoconiosis patients, the absence of alternative treatment facilities, and participants' trust in the local NGO were identified as potential barriers for obtaining genuine informed consent. Conclusions Researchers should evaluate the effectiveness of consent processes in providing appropriate information in a comprehensible manner and in supporting voluntary decision-making on a study-by-study basis. (shrink)

This article reviews the recent crisis in Detroit focusing on the placement of an Emergency Manager in charge of financial decisions, and a bankruptcy process. This political disenfranchisement harmed the pensions of city employees and offered valuable real estate to investors at low prices. While the crisis was long in the making, with deindustrialization and residential segregation beginning in the 1950s, the crisis was exacerbated in 2008 with the mortgage crisis and with water shut-offs to residences. The greatest harms were (...) felt by African American families in the city. The article takes toll of the harms suffered and chronicles movements of resistance against Emergency Management and community organizing efforts. (shrink)

_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

Objectives To determine the role played by law in medical specialists9 decision-making about withholding and withdrawing life-sustaining treatment from adults who lack capacity, and the extent to which legal knowledge affects whether law is followed. Design Cross-sectional postal survey of medical specialists. Setting The two largest Australian states by population. Participants 649 medical specialists from seven specialties most likely to be involved in end-of-life decision-making in the acute setting. Main outcome measures Compliance with law and the impact of legal knowledge (...) on compliance. Results 649 medical specialists (of 2104 potential participants) completed the survey (response rate 31%). Responses to a hypothetical scenario found a potential low rate of legal compliance, 32% (95% CI 28% to 36%). Knowledge of the law and legal compliance were associated: within compliers, 86% (95% CI 83% to 91%) had specific knowledge of the relevant aspect of the law, compared with 60% (95% CI 55% to 65%) within non-compliers. However, the reasons medical specialists gave for making decisions did not vary according to legal knowledge. Conclusions Medical specialists prioritise patient-related clinical factors over law when confronted with a scenario where legal compliance is inconsistent with what they believe is clinically indicated. Although legally knowledgeable specialists were more likely to comply with the law, compliance in the scenario was not motivated by an intention to follow law. Ethical considerations (which are different from, but often align with, law) are suggested as a more important influence in clinical decision-making. More education and training of doctors is needed to demonstrate the role, relevance and utility of law in end-of-life care. (shrink)

Jonathan Lowe argues that metaphysics should be restored to a central position in philosophy, as the most fundamental form of rational inquiry, whose findings underpin those of all other disciplines. He portrays metaphysics as charting the possibilities of existence, by idetifying the categories of being and the relations of ontological dependency between entities of different categories. He proceeds to set out a unified and original metaphysical system: he defends a substance ontology, according to which the existence of the world (...) s one world in time depends upon the existence of persisting things which retain their identity over time and through processes of qualitative change. And he contends that even necessary beings, such as the abstract objects of mathematics, depend ultimately for their existence upon there being a concrete world of enduring substances. Within his system of metaphysics Lowe seeks to answer many of the deepest and most challenging questions in philosophy. (shrink)

This paper examines Aquinas's theory of dualist mental causation, that is, his theory of how human beings can efficiently cause changes in their bodies in virtue of two non-physical mental states of theirs, specifically an act of the intellect and an act of the will. It is first shown that Aquinas's hylomorphism does not lie at the heart of this theory. Rather, a relation that he calls “contact of power” (tactus virtutis) does. The remainder of the paper then investigates the (...) nature of this relation. Since Aquinas discusses key marks of it by contrasting it with physical contact, the paper focuses on this contrast. It is argued that, for Aquinas, the human soul stands in a relation of contact of power to the body or, more precisely, a certain part of the body when it causes a change in it and is holenmerically co-located with it. (shrink)

This chapter contains sections titled: The Syntax and Semantics of Complex Sortal Terms On the Identity of Sorts.

If metaphysics is centrally concerned with charting the domain of the possible, the only coherent account of the ground of metaphysical possibility and of our capacity for modal knowledge is to be found in a version of essentialism: a version that I call serious essentialism, to distinguish it from certain other views which may superficially appear very similar to it but which, in fact, differ from it fundamentally in certain crucial respects. This version of essentialism eschews any appeal whatever to (...) the notion of possible worlds in its account of the nature and ground of metaphysical possibility, for reasons that which I shall endeavour to explain and justify in this paper. (shrink)

Following the lead of Gustav Bergmann ( 1967 ), if not his precise terminology, ontologies are sometimes divided into those that are ‘relational’ and those that are ‘constituent’ (Wolterstorff 1970 ). Substance ontologies in the Aristotelian tradition are commonly thought of as being constituent ontologies, because they typically espouse the hylemorphic dualism of Aristotle ’s Metaphysics – a doctrine according to which an individual substance is always a combination of matter and form. But an alternative approach drawing more on the (...) fourfold ontological scheme of Aristotle’s Categories is not committed to this doctrine and may regard individual (or ‘primary’) substances as having no constituent structure, their only possible complexity residing in their possession, in some cases, of a multiplicity of substantial parts. However, as we shall see, this does not imply that such an ontology falls instead into the relational camp: for although it invokes, in addition to the category of individual substance, also those of substantial kind (‘secondary’ substance), attribute, and mode (or ‘individual accident’), it need not and arguably should not take there to be external relations between entities in the different categories. On this view, truths of exemplification and instantiation, such as ‘Dobbin is white’ and ‘Dobbin is a horse’, do not need relational truthmakers. Hence, it can be maintained that there are no such relations as ‘exemplification’ and ‘instantiation’, at most only certain relational truths of exemplification and instantiation – truths whose logical form is relational. Th is being so, I shall argue, such an ontology cannot fairly be classified as a ‘relational’ one. (shrink)

We generalize the construction of lattice-valued models of set theory due to Takeuti, Titani, Kozawa and Ozawa to a wider class of algebras and show that this yields a model of a paraconsistent logic that validates all axioms of the negation-free fragment of Zermelo-Fraenkel set theory.

Causal closure arguments against interactionist dualism are currently popular amongst physicalists. Such an argument appeals to some principles of the causal closure of the physical, together with certain other premises, to conclude that at least some mental events are identical with physical events. However, it is crucial to the success of any such argument that the physical causal closure principle to which it appeals is neither too strong nor too weak by certain standards. In this paper, it is argued that (...) various forms of naturalistic dualism, of an emergentist character, are consistent with the strongest physical causal closure principles that can plausibly be advocated. (shrink)

It has long been debated whether objects are ‘sortally’ individuated. This paper begins by clarifying some of the key terms in play—in particular, ‘sortal’, ‘individuation’, and ‘object’. The term ‘individuation’ is taken to have both a cognitive and a metaphysical sense, in the former denoting the singling out of an object in thought and in the latter a determination relation between entities. ‘Sortalism’ is defined as the doctrine that only as falling under some specific sortal concept can an object be (...) successfully singled out in thought. It is argued that such a view is too strong, but that a weaker one, ‘categorialism’, can be defended, this implying that a thinker cannot successfully single out an object in thought without having at least an implicit grasp of the criterion of identity that the object satisfies. (shrink)

This is an ambitious book, dealing with an issue which deserves much greater attention from historians than it has received heretofore. Only the work of John Roach comes to mind as a precursor, dea...

The distinction between data and phenomena introduced by Bogen and Woodward (Philosophical Review 97(3):303–352, 1988) was meant to help accounting for scientific practice, especially in relation with scientific theory testing. Their article and the subsequent discussion is primarily viewed as internal to philosophy of science. We shall argue that the data/phenomena distinction can be used much more broadly in modelling processes in philosophy.

This paper examines Aristotle’s account of the individuation of causal powers, which dominated much of scholastic thought about powers, and argues that John Buridan rejected it. It contends that Buridan criticizes Aristotle’s account on two counts. First, he attacks Aristotle’s view that we ought to individuate powers by appeal to their respective activities. Second, Buridan objects to Aristotle’s “single-track” account, which correlates one type of power with only one type of activity. Against this, it is argued, Buridan adopts a multi-track (...) approach, according to which a single power type may be correlated with many different types of activities. The paper claims that the basic idea of Buridan’s multi-track view is still defensible today, and can be viewed as a viable alternative to the contemporary single-track account of power individuation defended, for instance, by Jonathan Lowe. (shrink)

Non-Cartesian substance dualism maintains that persons or selves are distinct from their organic physical bodies and any parts of those bodies. It regards persons as ‘substances’ in their own right, but does not maintain that persons are necessarily separable from their bodies, in the sense of being capable of disembodied existence. In this paper, it is urged that NCSD is better equipped than either Cartesian dualism or standard forms of physicalism to explain the possibility of mental causation. A model of (...) mental causation adopting the NCSD perspective is proposed which, it is argued, is consistent with all that is currently known about the operations of the human central nervous system, including the brain. Physicalism, by contrast, seems ill-equipped to explain the distinctively intentional or teleological character of mental causation, because it effectively reduces all such causation to ‘blind’ physical causation at a neurological level. (shrink)

Background: Increasing use of genetic technologies in clinical and research settings increases the potential for misattributed paternity to be identified. Yet existing guidance from the President's Commission for the Study of Ethical Problems in Biomedical and Behavioral Research and the Institute of Medicine (among others) offers contradictory advice. Genetic health professionals are thus likely to vary in their practice when misattributed paternity is identified, and empirical investigation into the disclosure of misattributed paternity is scarce. Given the relevance of this ethical (...) dilemma and its significance to users of genetic services, this study aimed to investigate the attitudes of lay people with regard to the disclosure of misattributed paternity. Methods: An online questionnaire was hosted and advertised through Amazon's Mechanical Turk to 200 United States residents aged 18 years or older. Respondents were asked to rate (via a Likert scale) the ethical permissibility of possible actions a clinician may carry out when misattributed paternity is identified. Data analysis consisted of preliminary descriptive analysis, chi-squared analysis, and Wilcoxon signed-rank tests. Results: There was no clear majority support for many of the options surveyed across different contexts, with only six out of ten scenarios displaying some general consensus. Men were more likely to support scenarios where the father is informed of paternity. Importantly, participants' views varied according to whether the desires of the father were previously expressed, suggesting that perceptions of the permissibility of a clinician's action will depend on the interests of all parties affected. Conclusions: This sample of the general public showed attitudes that were, at least to some degree, at variance with some professional guidelines. We give arguments for why at least some of these attitudes might be justified. We argue that case-specific judgments should be made and outline some of the relevant ethical considerations. While general guidelines ought to be considered, context-specific moral judgments cannot be avoided. (shrink)

Sue felt welling disgust as the first dark drops of menstrual blood struck the tile in dime-sized drops. “For God’s sake Carrie, you got your period!’ Sue cried. ‘Clean yourself up!”Within the walls of her educational institution, classmates bombard Carrie with feminine hygiene products, chanting “plug it up!” as their disgust for her rises.1 This fictional scene in Stephen King’s Carrie is cruel but is perhaps not inconceivable as something that might occur in reality. In this scene, Carrie is dehumanized, (...) animalistic; she has been rejected for her unwilling transgression of accepted social behavior. Menstrual blood is running down her legs. What makes this scene different to what could conceivably occur in... (shrink)

This chapter contains sections titled: What are Actions? What Are the Identity Conditions of Actions? Agents and their Powers References Further reading.

Contemporary versions of natural rights libertarianism trace their locus classicus to Robert Nozick’s Anarchy, State, and Utopia. But although there have been many criticisms of the version of political libertarianism put forward by Nozick, many of these fail objections to meet basic methodological desiderata. Thus, Nozick’s libertarianism deserves to be re-examined. In this paper I develop a new argument which meets these desiderata. Specifically, I argue that the libertarian conception of self-ownership, the view’s foundation, implies what I call the Asymmetrical (...) Value Claim: a dubious claim about the importance of choice relative to other valuable capacities. I argue that this misunderstands what is really valuable in life, and show how it causes libertarianism to generate counterintuitive public policy recommendations. (shrink)

The theory of negation developed in the grammatical-philosophical system of later Vyākaraṇa remains almost entirely unstudied, despite its close links with the (widely studied) approaches to negation found in other philosophical schools such as Nyāya and Mīmāṃsā, and despite its consequent importance for a comprehensive understanding of the theory of negation in ancient India. In this paper we present an edition, translation and commentary of the relevant sections of Nāgeśa’s _Paramalaghumañjūṣā_, a concise presentation by the final authority of the Pāṇinian (...) tradition, together with an explanatory introduction outlining the grammarians’ theory of negation and its relations particularly with the Nyāya theory of negation. (shrink)

We show that the theories ZF and ZFU are synonymous, answering a question of Visser.