The article explores the concept of infodemics during the COVID-19 pandemic, focusing on the propagation of false or inaccurate information proliferating worldwide throughout the SARS-CoV-2 health crisis. We provide an overview of disinformation, misinformation and malinformation and discuss the notion of “fake news”, and highlight the threats these phenomena bear for health policies and national and international security. We discuss the mis-/disinformation as a significant challenge to the public health, intelligence, and policymaking communities and highlight the necessity to design measures (...) enabling the prevention, interdiction, and mitigation of such threats. We then present an overview of selected opportunities for applying technology to study and combat disinformation, outlining several approaches currently being used to understand, describe, and model the phenomena of misinformation and disinformation. We focus specifically on complex networks, machine learning, data- and text-mining methods in misinformation detection, sentiment analysis, and agent-based models of misinformation spreading and the detection of misinformation sources in the network. We conclude with the set of recommendations supporting the World Health Organization’s initiative on infodemiology. We support the implementation of integrated preventive procedures and internationalization of infodemic management. We also endorse the application of the cross-disciplinary methodology of Crime Science discipline, supplemented by Big Data analysis and related information technologies to prevent, disrupt, and detect mis- and disinformation efficiently. (shrink)

According to what we call the Principle of Procreative Beneficence, couples who decide to have a child have a significant moral reason to select the child who, given his or her genetic endowment, can be expected to enjoy the most well-being. In the first part of this paper, we introduce PB, explain its content, grounds, and implications, and defend it against various objections. In the second part, we argue that PB is superior to competing principles of procreative selection such as (...) that of procreative autonomy. In the third part of the paper, we consider the relation between PB and disability. We develop a revisionary account of disability, in which disability is a species of instrumental badness that is context- and person-relative. Although PB instructs us to aim to reduce disability in future children whenever possible, it does not privilege the normal. What matters is not whether future children meet certain biological or statistical norms, but what level of well-being they can be expected to have. (shrink)

There has been considerable recent debate on the ethics of human enhancement. A number of prominent authors have been concerned about or critical of the use of technology to alter or enhance human beings, citing threats to human nature and dignity as one basis for these concerns. Frances Kamm has given a detailed rebuttal of Sandel's arguments, arguing that human enhancement is permissible. Nicholas Agar, in his book Liberal Eugenics, argues that enhancement should be permissible but not obligatory. He argues (...) that what distinguishes liberal eugenics from the objectionable eugenic practices of the Nazis is that it is not based on a single conception of a desirable genome and that it is voluntary and not obligatory. This article takes a more provocative position. It aims to argue that, far from its being merely permissible, we have a moral obligation or moral reason to enhance ourselves and our children. Indeed, we have the same kind of obligation as we have to treat and prevent disease. It begins by considering the current interests in and possibilities of enhancement. It then offers three arguments that we have very strong reasons to seek to enhance. (shrink)

Neuroimaging studies of brain-damaged patients diagnosed as in the vegetative state suggest that the patients might be conscious. This might seem to raise no new ethical questions given that in related disputes both sides agree that evidence for consciousness gives strong reason to preserve life. We question this assumption. We clarify the widely held but obscure principle that consciousness is morally significant. It is hard to apply this principle to difficult cases given that philosophers of mind distinguish between a range (...) of notions of consciousness and that is unclear which of these is assumed by the principle. We suggest that the morally relevant notion is that of phenomenal consciousness and then use our analysis to interpret cases of brain damage. We argue that enjoyment of consciousness might actually give stronger moral reasons not to preserve a patient's life and, indeed, that these might be stronger when patients retain significant cognitive function. (shrink)

ABSTRACTTaking some controversial claims philosopher Jason Brennan makes in his book Against Democracy as a starting point, this paper argues in favour of two theses: There is No Such Thing as Superior Political Judgement; There Is No Such Thing as Uncontroversial Social Scientific Knowledge. I conclude that social science experts need to be kept in check, not given more power.

Principles of distributive justice are normative principles designed to guide the allocation of the benefits and burdens of economic activity.

Two approaches to evidential reasoning compete in the biomedical and social sciences: the experimental and the pragmatist. Whereas experimentalism has received considerable philosophical analysis and support since the times of Bacon and Mill, pragmatism about evidence has been neither articulated nor defended. The overall aim is to fill this gap and develop a theory that articulates the latter. The main ideas of the theory will be illustrated and supported by a case study on the smoking/lung cancer controversy in the 1950s.

This paper presents arguments that challenge what I call the fact/value separability thesis: the idea, roughly, that factual judgements can be made independently of judgements of value. I will look at arguments to the effect that facts and values are entangled in the following areas of the scientific process in economics: theory development, economic concept formation, economic modelling, hypothesis testing, and hypothesis acceptance.

In this paper we make a proposal for reforming biomedical research that is aimed to align re-search more closely with the so-called fair-share principle according to which the proportions of global resources as-signed to different diseases should agree with the ratios of human suffering associated with those diseases.

In this review article we describe the current scope, methods, and contents of medical ethics education in medical schools in Western English speaking countries (mainly the United Kingdom, the United States, and Australia). We assess the strengths and weaknesses of current medical ethics curricula, and students’ levels of satisfaction with different teaching approaches and their reported difficulties in learning medical ethics concepts and applying them in clinical practice. We identify three main challenges for medical ethics education: counteracting the bad effects (...) of the “hidden curriculum,” teaching students how to apply ethical knowledge and critical thinking to real cases in clinical practice, and shaping future doctors’ right character through ethics education. We suggest ways in which these challenges could be addressed. On the basis of this analysis, we propose practical guidelines for designing, implementing, teaching, and assessing a medical ethics program within a four-year medical course. (shrink)

Anti-realism is plagued by Fitch’s paradox: the remarkable result that if one accepts that all truths are knowable, minimal assumptions about the nature of knowledge entail that every truth is known. Dorothy Edgington suggests to address this problem by understanding p is knowable to be a counterfactual claim, but her proposal must contend with a forceful objection by Timothy Williamson. I revisit Edgington’s basic idea and find that Williamson’s objection is obviated by a refined understanding of counterfactual knowability that is (...) grounded in possible courses of inquiry. I arrive at a precise definition of knowability that is not just a technical avoidance of paradox, but is metaphysically sound and does justice to the anti-realist idea. (shrink)

One way to make philosophy of science more socially relevant is to attend to specific scientific practises that affect society to a great extent. One such practise is biomedical research. This paper looks at contemporary U.S. biomedical research in particular and argues that it suffers from important epistemic, moral and socioeconomic failings. It then discusses and criticises existing approaches to improve on the status quo, most prominently by Thomas Pogge (a political philosopher), Joseph Stiglitz (a Nobel-prize winning economist) and James (...) Robert Brown (a philosopher of science). Finally, it sketches an alternative proposal and argues for its superiority. The proposal has four components: changing the intellectual property regime; instituting independent clinical research; aligning innovators' and patients' interests; and enacting additional regulation. (shrink)

Public health policies often require individuals to make personal sacrifices for the sake of protecting other individuals or the community at large. Such requirements can be more or less demanding for individuals. This paper examines the implications of demandingness for public health ethics and policy. It focuses on three possible public health policies that pose requirements that are differently demanding: vaccination policies, policy to contain antimicrobial resistance, and quarantine and isolation policies. Assuming the validity of the ‘demandingness objection’ in ethics, (...) we argue that states should try to pose requirements that individuals would have an independent moral obligation to fulfil, and therefore that are not too demanding. In such cases, coercive measures are ethically justified, especially if the interventions also entail some benefits to the individuals; this is, for example, the case of vaccination policies. When public health policies need to require individuals to do something that is too demanding to constitute an independent moral obligation, states have an obligation to either provide incentives to give individuals non-moral reasons to fulfil a certain requirement – as in the case of policies that limit antibiotic prescriptions – or to compensate individuals for being forced to do something that is too demanding to constitute an independent moral obligation – as in the case of quarantine and isolation policies. (shrink)

Thought experiments are ubiquitous in science and especially prominent in domains in which experimental and observational evidence is scarce. One such domain is the causal analysis of singular events in history. A long‐standing tradition that goes back to Max Weber addresses the issue by means of ‘what‐if’ counterfactuals. In this paper I give a descriptive account of this widely used method and argue that historians following it examine difference makers rather than causes in the philosopher’s sense. While difference making is (...) neither necessary nor sufficient for causation, to establish difference makers is more consistent with the historians’ more ultimate purposes. †To contact the author, please write to: Department of Philosophy, Erasmus University, 3000 DR Rotterdam, The Netherlands; e‐mail: [email protected]. (shrink)

Should people be assisted to die or be given euthanasia when they are suffering from terminal medical conditions? Should they be assisted to die when they are suffering but do not have a ‘diagnosable medical illness?’ What about assisted dying for psychiatric conditions? And is there a difference morally between assisted suicide, voluntary active euthanasia and voluntary passive euthanasia?These are deep questions directly addressed or in the background of the productive discussion between Varelius and Young.1 ,2 Their focus is whether (...) doctors should assist people to die who are ‘tired of life’ and experiencing ‘existential suffering’. An example was Edward Brongersma, an 86-year-old man, who was tired of life but with no serious medical condition, who was assisted by Dr Philip Sutorius to commit suicide in 1998. In the Netherlands, where euthanasia is legal, the Dutch Supreme Court ruled in 2002 that this was wrong because "edical expertise, by its nature, does not extend to questions and complaints that do not have a sick- ness or ailment—mental or physical—as their source.3"Sutorius was convicted, but not punished.Robert Young, considering this case, concurs, concluding, "a physician may justifiably consider that an individual who is ‘tired of life’ should consult a non-medical, professional counsellor, and if that produces no change in outlook, choose suicide. Outside Switzerland, an individual who makes that choice has to then be determined enough to do so unassisted .2"I will argue that there is, within current medical ethics and human rights, a method of assisted suicide which could fall within the limits of the law. But first I will review some recent cases involving requests for dying. I will then discuss an alternative which some may argue addresses these cases, and those of …. (shrink)

I contrast Robert Veatch's recent liberal vision of medical decision‐making with a more rationalist liberal model. According to Veatch, physicians are biased in their determination of what is in their patient's overall interests in favour of their medical interests. Because of the extent of this bias, we should abandon the practice of physicians offering what they guess to be the best treatment option. Patients should buddy up with physicians who share the same values —‘deep value pairing’. The goal of choice (...) is maximal promotion of patient values. I argue that if subjectivism about value and valuing is true, this move is plausible. However, if objectivism about value is true — that there really are states which are good for people regardless of whether they desire to be in them — then we should accept a more rationalist liberal alternative. According to this alternative, what is required to decide which course is best is rational dialogue between physicians and patients, both about the patient's circumstances and her values, and not the seeking out of people, physicians or others, who share the same values. Rational discussion requires that physicians be reasonable and empathic. I describe one possible account of a reasonable physician. (shrink)

When we applied for the editorship of the JME 7 years ago, we said that we considered the JME to be the most important journal in medicine. The most profound questions that health professionals face are not scientific or technical, but ethical. Our enormous scientific and medical progress already outstrips our capability to provide treatment. Life can be prolonged at enormous cost, sometimes far beyond the point that the individual appears to be gaining a net benefit from that life. Science (...) can tell us how to achieve something, but it cannot tell us whether we should achieve that end—whether it is good. For that, we need ethics. Ethics grows in importance as our technology creates new possibilities. Where there are no options, there are no ethical questions. However, once there are options, there arise pressing questions about whether to pursue them. We require values and principles to decide how to use medicine and science. During the last 7 years, issues like the creation of brain organoids, human non-human chimeras, mitochondrial transfer, gene editing of embryos and in vitro gametogenesis have grown in prominence. These raise deep questions about moral status and how it should be determined, the limits of modification of humans, and what is good in life. As editors of the JME, we are proud of our small contribution to thinking about these challenges. We are grateful to the hard work of our associate editors and administrative staff, but there is still much more to do. During our term as editors, we have published papers from diverse perspectives, on a wide range of topics. We have seen vigorous debate within the pages of the journal and have often sought to deliberately encourage that debate …. (shrink)

Use of a placebo control in surgical trials is a divisive issue. We argue that, in principle, placebo controls for surgery are necessary in the same way as for medicine. However, there are important differences between these types of trial, which both increase justification and limit application of surgical studies. We propose that surgical randomised placebo-controlled trials are ethical if certain conditions are fulfilled: the presence of equipoise, defined as a lack of unbiased evidence for efficacy of an intervention; clinically (...) important research question; the risk to patients is minimised and reasonable; there is uncertainty about treatment allocation rather than deception; there is preliminary evidence for efficacy, which justifies a placebo-controlled design; and ideally, the placebo procedure should have some direct benefit to the patient, for example, as a diagnostic tool. Placebo-controlled trials in surgery will most often be justified when surgery is performed to improve function or relieve symptoms and when objective outcomes are not available, while the risk of mortality or significant morbidity is low. In line with medical placebo-controlled trials, the surgical trial should be sufficiently powered and standardised so that its results are valid, consent should be valid, the standard treatment or rescue medication should be provided if possible, and after the trial, the patients should be told which treatment they received and there should be provision for post-trial care if the study may result in long-term negative effects. We comment and contrast our guidelines with those of the American Medical Association. (shrink)

In intensive care, disputes sometimes arise when patients or surrogates strongly desire treatment, yet health professionals regard it as potentially inappropriate. While professional guidelines confirm that physicians are not always obliged to provide requested treatment, determining when treatment would be inappropriate is extremely challenging. One potential reason for refusing to provide a desired and potentially beneficial treatment is because (within the setting of limited resources) this would harm other patients. Elsewhere in public health systems, cost effectiveness analysis is sometimes used (...) to decide between different priorities for funding. In this paper, we explore whether cost-effectiveness could be used to determine the appropriateness of providing intensive care. We explore a set of treatment thresholds: the probability threshold (a minimum probability of survival for providing treatment), the cost threshold (a maximum cost of treatment), the duration threshold (the maximum duration of intensive care), and the quality threshold (a minimum quality of life). One common objection to cost-effectiveness analysis is that it might lead to rationing of life-saving treatment. The analysis in this paper might be used to inform debate about the implications of applying cost-effectiveness thresholds to clinical decisions around potentially inappropriate treatment. (shrink)

We consider whether intervening in the criminal tendency of future children is ethically justifiable. We argue that, if avoidance of.

I argue that Brierley et al are wrong to claim that parents who request futile treatment are acting against the interests of their child. A better ethical ground for withholding or withdrawing life-prolonging treatment is not that it is in the interests of the patient to die, but rather on grounds of the limitation of resources and the requirements of distributive justice. Put simply, not all treatment that might be in a person's interests must ethically be provided.

There are 4 main arguments for euthanasia: (1) arguments appealing to consistency (e.g., from passive to active euthanasia); (2) the argument from respect for autonomy; (3) appeals to justice; and (4) the argument from interests (mercy or relief of suffering). I will argue that only the last is directly relevant to active euthanasia as a medical intervention, though arguments together from autonomy and justice can in practice (through the backdoor) provide a ground for voluntary active medical euthanasia (AME).

Delusions have traditionally been considered the hallmark of mental illness, and their conception, diagnosis and treatment raise many of the fundamental conceptual and practical questions of psychopathology. One of these fundamental questions is whether delusions are understandable. In this paper, we propose to consider the question of understandability of delusions from a philosophy of language perspective. For this purpose, we frame the question of how delusions can be understood as a question about the meaning of delusional utterances. Accordingly, we ask: (...) “what meaning(s) can delusional utterances possibly have?”. We argue that in the current literature, there is a standard approach to the meaning of delusional utterances, namely the descriptive account which assumes that a delusional utterance “p” means that p is the case. Drawing on Speech Act Theory, we argue that solely relying on the descriptive account disregards essential ways of how linguistic meaning is constituted. Further, we show that Speech Act Theory can prove a helpful addition to the theoretical and clinical “toolbox” used for attempting to understand delusional utterances. This, we believe, may address some of the theoretical and clinical shortcomings of using only the currently predominant descriptive account. (shrink)

In the age of neoliberalism, feminists strongly disagree on the ideal legal status of prostitution while the pro-prostitution lobby endeavours to keep their male-dominated business running smoothly. Feminist debates should be concerned with the sex buyers' belief system about women, which is likely to have practical consequences in the way they behave with women (prostituted and non-prostituted) in terms of sexuality and, therefore, for feminist purposes of equality, on a broader scale. A Critical Discourse Analysis of buyer-authored online reviews of (...) prostituted women provides the opportunity to verify whether the relationship they establish with them is based on democratic mutual equality or gendered power relations driven by domination and subordination.En la era del neoliberalismo, no hay consenso entre las feministas acerca del estatus legal que debería tener la prostitución; mientras, el lobby pro-prostitución intenta proteger tan lucrativo negocio. Los debates feministas deben abordar críticamente el sistema de creencias de los sujetos prostituyentes, en tanto que afecta a cómo actúan con las mujeres (prostituidas y no prostituidas) dentro del marco de la sexualidad y, por tanto, al potencial logro de la igualdad fáctica a nivel social. El análisis crítico del discurso online de los sujetos prostituyentes sobre las mujeres prostituidas permite comprobar si las relaciones que establecen con ellas están basadas en términos igualitarios o en la dicotomía dominación-subordinación característica de las relaciones de poder de género. (shrink)

It’s a question that has puzzled philosophers and theologians for centuries and is at the heart of numerous political, social, and personal concerns: Do we have free will? In this cogent and compelling book, Julian Baggini explores the concept of free will from every angle, blending philosophy, sociology, and cognitive science to find rich new insights on the intractable questions that have plagued us. Are we products of our culture, or free agents within it? Are our neural pathways fixed (...) early on by a mixture of nature and nurture, or is the possibility of comprehensive, intentional psychological change always open to us? And what, exactly, are we talking about when we talk about “freedom” anyway? Freedom Regained brings the issues raised by the possibilities—and denials—of free will to thought-provoking life, drawing on scientific research and fascinating encounters with everyone from artists to prisoners to dissidents. He looks at what it means for us to be material beings in a universe of natural laws. He asks if there is any difference between ourselves and the brains from which we seem never able to escape. He throws down the wildcards and plays them to the fullest: What about art? What about addiction? What about twins? And he asks, of course, what this all means for politics. Ultimately, Baggini challenges those who think free will is an illusion. Moving from doubt to optimism to a hedged acceptance of free will, he ultimately lands on a satisfying conclusion: it is something we earn. The result is a highly engaging, new, and more positive understanding of our sense of personal freedom, a freedom that is definitely worth having. (shrink)

Pasiones del alma y sentimientos, el sentido íntimo y la condición carnal, la intrahistoria, las relaciones entre dependencia y dominio, la maternidad, la belleza, los deseos y pretensiones, la amistad, la interpretación de la mujer por la palabra, la amistad y el amor entre hombre y mujer, la sombra que afecta a la imagen de la mujer, ese 'continente misterioso', son algunos de los aspectos investigados en La mujer y su sombra.

How did we find ourselves in a "post-truth" world of "alternative facts"? [This book] sets out to answer these questions for looking at the complex history of truth.... Julian Baggini has identified ten types of supposed truth and explains how easily each can become the midwife of falsehood."--Back cover.

In Unreliability and Point of View in Filmic Narration, Emar Maier makes a distinction between reliable and unreliable narrators. The latter, Maier claims, must be a first-person narrator, as an impersonal, third-person narrator lacks an individual perspective that can be unreliable. He concludes that most film adaptations of unreliably narrated novels are not themselves unreliably narrated, for they feature third person perspectives. I take Maier’s major claims to be that there is a strict distinction between reliable and unreliable narration; and (...) that film shots displaying both a character and that character's hallucinations are not unreliable narration. I will challenge both. (shrink)

L’analyse singulariste de la relation causale Dans l’un de ses textes les plus souvent lus, « Possibilité objective et causalité adéquate en histoire », Max Weber introduit ainsi la procédure de base de l’analyse singulariste des relations causales : L’attribution des effets aux causes prend place à travers un processus de pensée qui inclut une série d’abstractions. La première et la plus décisive a lieu quand nous concevons que l’une ou plusieurs des composantes causales sont modifiées dans ..