Background The world is threatened by future pandemics. Vaccines can play a key role in preventing harm, but there will inevitably be shortages because there is no possibility of advance stockpiling. We therefore need some method of prioritising access. Main text This paper reports a critical interpretative review of the published literature that discusses ethical arguments used to justify how we could prioritise vaccine during an influenza pandemic. We found that the focus of the literature was often on proposing different (...) groups as priorities. Different reasons were often suggested as a means of justifying such priority groupings. We suggest that much of the literature, wrongly, assumes that we are able to plan priority groups prior to the time of a particular pandemic and development of a particular vaccine. We also point out the surprising absence of various issues from the literature. Conclusions The literature proposes a wide range of ways to prioritise vaccines, focusing on different groups and ‘principles’. Any plan to use pandemic vaccine must provide justifications for its prioritisation. The focus of this review was influenza pandemic vaccines, but lessons can be learnt for future allocations of coronavirus vaccine, if one becomes available. (shrink)

This study evaluated the biological dimension of meditation and self-transcendent states. A convenience sample of 513 participants was drawn from attendees at a 4-day guided meditation workshop. Half were randomly assigned to an active placebo control intervention. All were assessed on a variety of measures, both psychological [anxiety, pain, posttraumatic stress disorder, positive emotions, and transcendent states], and physiological. Additional biological assessments including salivary immunoglobulin-A, cortisol, and Quantitative Electroencephalography were obtained from subset of the Experimental group. No significant difference in (...) psychological symptoms or positive emotions was observed between Experimental and placebo groups at baseline. At post-test, significant improvements were noted in the Experimental group, including a 49.5% median increase in SIgA, though cortisol remained unchanged. qEEG z-score analysis identified sustained stress reduction, including delta frequency band amplitude increases, high beta decreases, and faster acquisition of sustained alpha states. Psychological symptoms also improved on all measures. At 6-month follow-up, PTSD and somatic symptoms significantly improved from baseline, and post-test versus 6-month follow-up results indicated significant increases in happiness and spiritual and physical oneness, along with decreases in depressive symptoms. These findings suggest that autonomic self-regulation and transcendent states may be measured in both biological and psychological dimensions and are associated with pervasive health benefits. (shrink)

A longstanding problem in the teacher workforce, internationally and in the UK, is the continuing and substantial numbers of qualified teachers who leave the profession within five years. This paper uses data collected from a survey to the last five years of teacher education graduates of UCL Institute of Education (IOE) in London, to explore what originally motivated them to teach, and the reasons why they have left or may consider leaving in the future. We discovered that despite claiming to (...) be aware of the challenges of workload before entering teaching, workload was the most frequently cited reason for having left, or for leaving in the future. The data spoke to the reality of teaching being worse than expected, and the nature (rather than the quantity) of the workload, linked to notions of performativity and accountability, being a crucial factor. This paper draws on a substantial new source of data and explores reasons for leaving in the context of reported initial motivation of individuals who have left teaching, individuals who are planning to leave and individuals who are planning to stay in teaching. (shrink)

It is generally assumed that the debate between theory‐theory and simulation theory is an empirical one, but this view of the structure of the debate is misleading. It is an a priori truth that theory‐theory is mistaken and equally a priori that simulation in one sense (here labelled ‘co‐cognition’) is central in thinking about the thoughts of others. Given this, it is a further question how our co‐cognitive powers are realized in sub‐personal machinery. Here simulation in quite another sense (that (...) involving such ideas as ‘pretend states’ and ‘off‐line’ mental processes) may provide one possible answer. (shrink)

A number of ethical frameworks have been proposed to support decision-making in public health and the evaluation of public health policy and practice. This is encouraging, since ethical considerations are of paramount importance in health policy. However, these frameworks have various deficiencies, in part because they incorporate substantial ethical positions. In this article, we discuss and criticise a framework developed by James Childress and Ruth Bernheim, which we consider to be the state of the art in the field. Their framework (...) distinguishes aims, such as the promotion of public health, from constraints on the pursuit of those aims, such as the requirement to avoid limitations to liberty, or the requirement to be impartial. We show how this structure creates both theoretical and practical problems. We then go on to present and defend a more practical framework, one that is neutral in avoiding precommitment to particular values and how they ought to be weighted. We believe ethics is at the very heart of such weightings and our framework is developed to reflect this belief. It is therefore both pluralist and value-based. We compare our new framework to Childress and Bernheim’s and outline its advantages. It is justified by its impetus to consider a wide range of alternatives and its tendency to direct decisions towards the best alternatives, as well as by the information provided by the ranking of alternatives and transparent explication of the judgements that motivate this ranking. The new framework presented should be useful to decision-makers in public health, as well as being a means to stimulate further reflection on the role of ethics in public health. (shrink)

Biobanks are proliferating rapidly worldwide because they are powerful tools and organisational structures for undertaking medical research. By linking samples to data on the health of individuals, it is anticipated that biobanks will be used to explore the relationship between genes, environment and lifestyle for many diseases, as well as the potential of individually-tailored drug treatments based on genetic predisposition. However, they also raise considerable challenges for existing legal frameworks and research governance structures. This book critically examines the current governance (...) structures in place for biobanks in England and Wales. It shows that the technologies, techniques and practices involved in biobanking do not always conform neatly to existing legal principles and frameworks that apply to other areas of medical research. Using a socio-legal approach, including interview data gathered from the scientific community, this book provides unique insights and makes recommendations about appropriate governance mechanisms for biobanking in the future. It also explores the issues around the secondary use of information, such as consent and how to protect privacy, when biobanks are accessed by a number of different third parties. These issues have relevance both within England and Wales and to a wide international audience, as well as for other areas where large datasets are used.--Back cover. (shrink)

Financial and nonfinancial conflicts of interest in medicine and surgery are troubling because they have the capacity to skew decision making in ways that might be detrimental to patient care and well-being. The recent case of the Articular Surface Replacement (ASR) hip provides a vivid illustration of the harmful effects of conflicts of interest in surgery.

Volume 24, Issue 10, October 2024, Page 113-114.

Indexicality is a feature of predicates and predicate components (verbs, adjectives, adverbs and the like) as well as of referring expressions. With classic referring indexicals such as 'I' or 'that' a distinctive rule takes us from token and context to some item present in the content which is the semantic correlate of the token. Predicates and predicate components may function in an analogous fashion. For example 'thus' is an indexical adverb which latches onto some manner of performance present in its (...) context. 'John sang thus', said while indicating someone singing discordantly, claims that John sang discordantly. The phenomenon of predicatival indexicality is widespread in English and is expressed in a variety of idioms. Indexical predication plays important epistemological and psychological roles and the notion may have other interesting philosophical applications. (shrink)

Can we understand other minds ‘from the inside’? What would this mean? There is an attraction which many have felt in the idea that creatures with minds, people, invite a kind of understanding which inanimate objects such as rocks, plants and machines, do not invite and that it is appropriate to seek to understand them ‘from the inside’. What I hope to do in this paper is to introduce and defend one version of the so-called ‘simulation’ approach to our grasp (...) and use of psychological concepts, a version which gives central importance to the idea of shared rationality, and in so doing to tease out and defend one strand in the complex of ideas which finds expression in this mysterious phrase. (shrink)

The success of the Human Genome Project has prompted interest in advancing the nascent field of exposomics. The exposome, which is dynamic and variable and changes over time, consists of all the internal and external exposures an individual has over a lifetime beginning with the prenatal period and early childhood. Efforts are underway to decipher the human epigenome by identifying the effects of all deleterious environmental exposures according to duration of exposure and time period. In this article, we argue that (...) the deciphering of the human exposome should be accompanied by sustained efforts to address the ethical, social and legal implications (ELSI) of exposomics. This will require financial investments from the National Institutes of Health (NIH), the European Union and other public and private funding agencies, analogous to support provided by NIH to address ELSI issues in genomics. (shrink)

We provide an intuitive motivation for the hyperreal numbers via electoral axioms. We do so in the form of a Socratic dialogue, in which Protagoras suggests replacing big-oh complexity classes by real numbers, and Socrates asks some troubling questions about what would happen if one tried to do that. The dialogue is followed by an appendix containing additional commentary and a more formal proof.

Racially restrictive marriage laws lay at the intersection of state claims of domestic sovereignty and federal obligations to protect the constitutional rights of citizens. In 1948, California overturned its antimiscegenation law, citing, in addition to the Fourteenth Amendment, the United Nations Charter. This decision sparked a contentious discussion about the relationship of human rights norms to racial conventions in the United States, and triggered a debate about the peril of international law that resulted in an effort to amend the Constitution (...) and limit the treaty-making powers of the president. Both the constitutional and the international logics of individual human rights threatened local custom and energized political opposition. American stigmatization of international human rights norms and treaties was rooted directly in the civil rights struggles in the United States and reflected the potential of international organizations to assault domestic racial conventions at their foundations. (shrink)

In The Teaching Self: Contemplative Practices, Pedagogy, and Research in Education, a rich collection of voices from diverse settings illustrates the ways in which first-person experiences with contemplative practices lay a foundation for contemplative pedagogy and research in teacher education.

In this paper we critically review recent developments in policies, practices and philosophies pertaining to the mediation between science and the public within the EU and the UK, focusing in particular on the current paradigm of Public Understanding of Science and Technology (PEST) which seeks to depart from the science information-transmission associated with previous paradigms, and enact a deliberative democracy model. We first outline the features of the current crisis in democracy and discuss deliberative democracy as a response to this (...) crisis. We then map out and critically review the broad outlines of recent policy developments in public-science mediation in the EU and UK contexts, focusing on the shift towards the deliberative-democratic model. We conclude with some critical thoughts on the complex interrelationships between democracy, equality, science and informal pedagogies in public-science mediations. We argue that science and democracy operate within distinct value-spheres that are not necessarily consonant with each other. We also problematize the now common dismissal of information-transmission of science as inimical to democratic engagement, and argue for a reassessment of the role and importance of informal science learning for the lay public, provided within the framework of a deliberative democracy that is not reducible to consensus building or the mere expression of opinions rooted in social and cultural givens. This, we argue, can be delivered by a model of PEST that is creative and experimental, with both educational and democratic functions. (shrink)

ABSTRACT This paper offers an account of the early career of Martha Kneale, née Hurst, and of the five papers she published between 1934 and 1950. One on metaphysical and logical necessity, from 1938, is particularly interesting. In it she considers the metaphysics of time and offers an explanation of ‘the necessity of the past’, which has some resemblance to Kripke’s ideas about metaphysical necessities, in that it assigns an important role to experience in how we come to know them. (...) But Kneale’s view is very different from Kripke’s, depending not on doctrines about rigid designation but rather on recognition of the failure of the atomist/empiricist account of ‘simple’ and ‘complex’ concepts. That account cannot deal with such things as the relations of the determinates of a determinable like colour. A plausible corollary of this, which Kneale exploits, is that some of our experience reveals to us that there are phenomena which are intrinsically complex in having multiple distinguishable aspects, but where those aspects are inseparable. Other of the papers show Kneale to have been pursuing interesting lines of thought about McTaggart’s argument against the reality of time and on the mind-body problem. (shrink)

Summary This paper notes and explores the attraction of Dugald Stewart's moral philosophy for women readers and a few women writers. Student lecture notes reveal the chronological development of his ideas, as he drew upon the works of Thomas Reid, Adam Smith, and Adam Ferguson, and responded to political events. Particular attention is paid to Stewart's comments relating to women and gender, through discussions of education, the institution of marriage, and population questions. After 1800, he shifted away from a speculative (...) conjectural history towards a philosophy of moral progress rooted in common sense philosophy and a belief in perfectibility. He taught a system of practical morality relevant to the education of children and strongly emphasised the importance of the association of ideas in childhood. For women readers, the message was contradictory in that he united an apparently conservative reinforcement of the relations of the sexes with a belief in the improvement of the condition of women through education in a modern, progressive, and commercial society. (shrink)

This paper argues that public sector organizational failure may be best understood from a perspective of collective denial. The rise of this phenomenon is examined using testimony from a Public Inquiry into the downfall of a UK hospital, where falling organizational standards led to unethical decision making and an unacceptable number of patient deaths. In this paper, we show how collective denial, over time, became a process that resided within the fabric of organizational life. To explore the organizational processes associated (...) with collective denial, and how and why it occurs, we identify the influence of a ‘narrative of silence.’ This narrative allows ever more serious failings to be justified as organizational members lose contact with reality entering a downward spiral with no recovery. The combined impact of assumptions about leadership capability, enculturated professional identities, and organizational loyalty create an environment where a narrative of silence can develop. (shrink)

This paper seeks to highlight the benefits of prioritizing moderate African communitarian principles as partly demonstrated in the HIV prevention strategies implemented in Uganda in the late 1980s. Pertinent lessons could be drawn so as to achieve the HIV prevention targets envisioned in the post-2015 development era. Communitarianism emphasizes the importance of communities as part of healthy human existence. Its core ethical values include the virtues of generosity, compassion, and solidarity. Persuasion through communication, consensus through dialogue, and the awareness and (...) commitment to responsibilities towards other members of the community, are chief practices relied upon to achieve appropriate social behaviour. All these elements signify individual rootedness in communities and contribute to the healthy existence of its members. Communitarianism is usually classified as either authoritarian/radical or responsive/moderate, depending on the primacy given to either community interests or the individual will and rights. Moderate communitarianism recognizes the individual's capacity for moral reasoning, virtue and free choice. The ensuing form of society is deemed more ethical as it relies on education in the virtues, moral persuasion and informal social controls, without stifling individual identity, agency, and capacity for self-determination. If moderate African communitarianism, in particular, can to a certain extent be associated with the significant aspects of Uganda's HIV prevention strategies in the stated period, then its present-day relevance for HIV prevention and other public health interventions may be emphasized accordingly. This applies especially in view of the ongoing efforts to achieve a balance between individual and collective interests in bioethics. (shrink)

Wittgenstein does not talk much explicitly about reason as a general concept, but this paper aims to sketch some thoughts which might fit his later outlook and which are suggested by his approach to language. The need for some notions in the area of ‘reason’ and ‘rationality’ are rooted in our ability to engage in discursive and persuasive linguistic exchanges. But because such exchanges can (as Wittgenstein emphasises) be so various, we should expect the notions to come in many versions, (...) shaped by history and culture. Awareness of this variety, and of the distinctive elements of our own Western European history, may provide some defence against the temptation of conceptions, such as that of ‘perfect rationality’, which operate in unhelpfully simplified and idealised terms. (shrink)