This paper presents the most relevant criteria considered in the face of a lack of resources and medical infrastructure to prioritize the treatment of patients affected by the COVID-19 pandemic. From a systematic review, points of view have been collected considering the medical and social fields. Multiple divergences were found in these views depending on the countries, resources, religious approaches, and political aspects that have been adapted according to the circumstances of each nation. Keywords: Triage, COVID-19, public health.

Throughout the 1990-ies Nussbaum, in collaboration with others, has elaborated and argued for a list of human capabilities which specifies necessary conditions of human flourishing. The capabilities approach has been enormously influential in putting issues of global development and justice, and especially justice for women, on the philosophical and political agenda. Moreover, many international agencies and institutions, including the United Nations Development Program, have started to make use of this approach. Despite of its obvious good intentions the approach deserves more (...) serious critical attention from philosophers than it has received until now. In my paper I take up some fundamental problems with Nussbaum’s philosophical framework. I will argue that Nussbaum’s conception of human nature is still (implicitly) Cartesian and, more in particular, that her conception of reason is outdated. It raises problems with respect to the question of universal values, the possibility of which Nussbaum defends by reference to the faculty of reason. (shrink)

We explored the home learning environments of 173 Mexican preschool children (aged 3–6 years) in relation to their numeracy performance. Parents indicated the frequency of their formal home numeracy and literacy activities, and their academic expectations for children’s numeracy and literacy performance. Children completed measures of early numeracy skills. Mexican parent–child dyads from families with either high- or low-socioeconomic status (SES) participated. Low-SES parents (n= 99) reported higher numeracy expectations than high-SES parents (n= 74), but similar frequency of home numeracy (...) activities. In contrast, high-SES parents reported higher frequency of literacy activities. Path analyses showed that operational (i.e., advanced) numeracy activities were positively related to children’s numeracy skills in the high- but not in the low-SES group. These findings improve the understanding of the role of the home environment in different contexts and provide some insights into the sources of the variable patterns of relations between home learning activities and children’s numeracy outcomes. They also suggest that SES is a critical factor to consider in research on children’s home numeracy experiences. (shrink)

Higher education makes an importantcontribution to citizenship. In the UnitedStates, the required portion of the ``liberalarts education'' in colleges and universitiescan be reformed so as to equip students for thechallenges of global citizenship. The paperadvocates focusing on three abilities: theSocratic ability to critize one's owntraditions and to carry on an argument on termsof mutual respect for reason; (2) the abilityto think as a citizen of the whole world, notjust some local region or group; and (3) the``narrative imagination,'' the ability to (...) imaginewhat it would be like to be in the position ofsomeone very different from oneself. The paperdiscusses the role of the ``liberal arts''curriculum in U.S. education and asks howEuropean universities, with their differentstructure, might promote these three abilities. (shrink)

Photo ID 222412412 © US Navy Medicine | Dreamstime.com ABSTRACT In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. INTRODUCTION Medical resources in an austere environment without quick recourse for resupply or casualty evacuation are often (...) limited. The shortage extends not only to supplies like blood products and drugs, but physicians and other medical personnel. In the midst of a mass casualty scenario, such as a battle that includes intense ground fighting, the medical staff will stretch scarce resources and triage casualties according to specific criteria. Typically, they proceed by providing care for the most severely wounded first, referred to here as conventional triage. At times, though, the staff may reverse the triage so that soldiers with minor wounds can return to the fight. In a mass casualty situation, when medical personnel apply conventional triage and treat casualties from opposing forces, a dilemma may arise. We argue that it can be permissible for military physicians to prioritize their own soldiers over enemy combatants in a mass casualty triage, where reverse triage does not apply. The case we will focus on is as follows: Battlefield Triage: During combat operations on a remote island in the Pacific Ocean, a compatriot soldier and an enemy combatant arrive at the compatriot soldier country’s medical treatment facility. Both have similar gunshot wounds to the abdomen, and they arrive with similar conditions. Both have low oxygen saturation and excessive blood loss. The sole physician only has enough time to stabilize one person. The scenario is brief, and we are aware that medical rules of eligibility will most often dictate how the physician proceeds,[1] but this scenario is useful in setting up the question we focus on in this paper: would it be wrong to favor the stabilization of a soldier just because the soldier is the physician’s compatriot? In other words, can nationality serve as an ethically justified tiebreaker in a situation such as Battlefield Triage?[2] In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. The AMA’s Code of Medical Ethics asserts that physicians have “ethical obligations to place patients’ welfare above their self-interest and above obligations to other groups.”[3] The World Medical Association’s Declaration of Tokyo affirms that “no motive, whether personal, collective or political, shall prevail against this higher purpose” of alleviating distress.[4] Physicians are taught early on that triage decisions must be medically indicated and made without consideration of factors such as race, ethnicity, religion, social status, and nationality. They are taught that public trust and obligations of justice grounded in equality demand that only medical indications be considered. But military physicians in a military setting are beholden to obligations, duties, and responsibilities as members of the military, and when these obligations, duties, and responsibilities conflict, as they do in Battlefield Triage, which loyalties win out and why?[5] Critics of partiality on national grounds argue that partiality undermines public trust in medicine and justice because everyone should be treated equally regardless of nationality.[6] Proponents of partiality argue that military obligations supersede equality and that justice requires partiality in such cases.[7] Despite the critics’ disagreement, both agree that there is a morally right, perhaps even blameless, course of action. Drawing on insights from virtue ethics, we argue that Battlefield Triage is a moral tragedy in which justice is unattainable and there is no action without moral cost. The assumption that there is a morally right choice is flawed. We argue that while no decision in this scenario is free from moral blame, there are reasons to favor treating one’s soldiers over enemy combatants. I. The Case Against Partiality There is a common assumption that there is a morally right or just decision in Battlefield Triage. A number of organizations and scholars claim that it is wrong for military physicians to favor their own soldiers on the grounds of nationality or some form of ‘group membership.’ (In a conflict involving service members from multiple nations working as a coalition, a soldier from an allied country may receive the same priority as the US service member due to ‘group membership.’) The World Medical Association’s WMA Declaration of Lisbon on the Rights of the Patient, which was reaffirmed in 2015, posits that, “[i]n circumstances where a choice must be made between potential patients for a particular treatment that is in limited supply, all such patients are entitled to a fair selection procedure for that treatment. That choice must be based on medical criteria and made without discrimination.”[8] This echoes what was set forth in Article 12 of the Geneva Conventions, which states that “[o]nly urgent medical reasons will authorize priority in the order of treatment to be administered.”[9] The argument for impartiality in Battlefield Triage is that every person is morally equal, and equality entails that medical distribution is, “based on a combination of medical need and urgency.”[10] This is in keeping with the bioethical principles that are generally applied.[11] II. The Case for Partiality On the other side, there are arguments that favoritism is the ethically right decision in Battlefield Triage.[12] The argument asserts that members of the military form a morally significant community of friends and participation in these relationships demands partiality. Just as parents have strong ethical duties to their children and not just any children, military personnel have ethical duties to their group, a group that involves an affirmation of mutual aid and support. Some have termed these ‘associative duties. According to Michael Gross, obligations of friendship, care, and solidarity “leave very little room for generally applicable principles of justice that would obligate a medic to treat enemy or non-compatriot wounded ahead of their compatriots.”[13] This is true in Battlefield Triage, but it may also be true even if the enemy’s soldier were more seriously wounded: “the ethics of small group cohesion, largely an ethics of care, mostly replaces the demands of impartial justice.”[14] In a more recent article, Gross explains that preferential treatment is ethically justified based on fighting capability and “the special obligations people owe friends, family, and, no less, comrades-in-arms.”[15] To not show partiality to the US soldier would be morally wrong on the grounds of friendship and mutual care.[16] III. The Moral Tragedy of Battlefield Triage Defenders and critics of Battlefield Triage favoritism based on nationality both frame their position as just or fair. For example, Justin List argues that physicians are “bound to practice medical neutrality,”[17] Marcus Adams denies that physicians “possess special ethical obligations” to enemy combatants because of their profession.[18] These perspectives assume that there is a morally right decision and that justice is attainable. The assumption that there is or can be a morally right Battlefield Triage decision, and we need to put our heads together to figure it out, remains strongly entrenched. However, the facts of the situation should give us pause; there are too many people and too few resources, and this demands a decision-making process that determines who will receive scarce resources. By its very nature, a battlefield triage decision has to be made based on some characteristic or value, a characteristic or value that will inevitably favor some at the expense of others. This is precisely why competing analyses “in the military context struggle to resolve these conflicts satisfactorily.”[19] Drawing on the insights of virtue ethics, we suggest that Battlefield Triage is a moral tragedy. Virtue ethics suggests that morality is about acting virtuously, which is to say that we should do what a virtuous person would do in the situation. Ethics is about figuring out how a just, wise, compassionate, loving, and fair person would act, and then doing that, as one grows in virtue. But life is not always clear cut, and it is possible that virtuous people may find themselves in a moral tragedy, a situation in which, through no fault of one’s own, a person must make a morally objectionable decision. After the action the virtuous person “emerges having done a terrible thing, the very sort of thing that the callous, dishonest, unjust, or in general vicious agent would characteristically do.”[20] Stated differently, a moral tragedy presents a virtuous person with two or more courses of action, all of which have a moral cost.[21] In Battlefield Triage, no matter how the physician goes about deciding, there is going to be defensible concern from those not saved. The fact that there are more people than can be helped fosters competing values in battlefield triage: maximize lives saved, treat people equally, treat the worse off, and support the war effort. Treating people equally may create tension between treating the worse off, maximizing lives saved, and supporting the war effort. Reverse triage is a case in point, as supporting the war effort conflicts with treating the worse off first, as is a fair lottery system since deploying a lottery may not maximize lives saved or support the war effort. There can be reasons why one person is selected over another, to be sure. Yet, there are reasons for making a decision, and that the decision is subject to legitimate moral concern is another. To recognize the moral tragedy of Battlefield Triage is to recognize the impossibility of acting blamelessly in the situation. In this situation, the virtuous military physician is going to have to sacrifice important values such as justice, compassion, and respect for others, even with a defensible criterion in hand. The physician will grieve this sacrifice accordingly. The physician may find her decision difficult or stressful, and rightly so, because of what her circumstances require of her. This kind of moral tragedy results “in actions which betray and violate the rights of persons to whom there may be a strong duty of care. When this happens, it properly triggers an appropriate moral emotion since our moral integrity has been violated and this affects how we think of ourselves and what we have become.”[22] Rather than view her triage decision as the morally superior choice, the virtuous military physician will view her decisions in these circumstances in a different light: it is the least bad option in a terrible situation, and she did something ethically problematic, something that is contrary to her moral character. She deeply regrets the circumstances in which she had to act. IV. Virtue Ethics A virtue ethicist has insight into how one should go about deciding what to do in a moral tragedy, although virtue ethics may not be as helpful as one may hope. The goal of the virtuous military physician in Battlefield Triage is to adopt the best course of action or the action that she feels she ought to do, all things considered. This does not make her choice devoid of serious wrongdoing—a decision must be made, but that does not make it just. The virtuous military physician will approach the situation with courage, responsibility, and insight. She will think about the decision carefully, wisely, and conscientiously; she will weigh the goods and harms of the choices before her, in conjunction with a proper conception of the good life, human worth, and understanding of her obligations to others—including chain of command, fellow soldiers, and the medical community. She is attuned to the value of human life and has a reasonable idea of the various ways her decisions will affect others. She recognizes that she is in this non-ideal situation through no fault of her own: she is not the one fighting in battles; she is serving her country as a physician, whose job it is to save lives, treat everyone justly, and promote military objectives. She regrets the decision she is forced to make in battlefield triage, acting “with immense regret and pain,” Hursthouse explains, “instead of indifferently or gladly.”[23] This is because, no matter what decision is made, the virtuous military physician “does something terrible or horrible,” something she otherwise would not do and is contrary to her values.[24] V. A Resolvable Moral Tragedy Instead of asking whether there is a morally right decision, in which a decision is morally blameless and above reproach, the virtue ethicist asks whether there is a decision with a convincing rationale, knowing that a decision can have a clear rationale but still be morally tragic. It is perfectly reasonable to think that different virtuous persons will arrive at different courses of action: “two virtuous agents, in the same situation,” Hursthouse writes, “may act differently” in irresolvable moral tragedies, in cases in which there is no clear course of action.[25] Because a person must act in a moral tragedy, one goal is to identify reasons for choosing the chosen action. Some decisions are clearly indefensible—treating neither the compatriot soldier nor the enemy combatant in Battlefield Triage would be wrong—and some decisions are more problematic than others. If the military physician selects to treat the soldier because she does not like the enemy combatant’s skin color, such a reason would be deeply problematic. But much of the debate over how to act in a moral tragedy is not over clearly indefensible or problematic criteria. Instead, the literature is largely about different standards or implementations of justice. Some scholars defend nation-impartial triage as right, while others defend nation-aware triage as right, and each argues that the other side is promoting an unjust or otherwise wrong solution to Battlefield Triage. We suggest that Battlefield Triage is a resolvable moral tragedy and that virtue ethics offers convincing reasons to prefer the treatment of the compatriot soldier rather than the enemy combatant on the grounds of national identity. Virtues are integral to living a good life, a flourishing life, but as Aristotle observed long ago, human beings are inherently social, interdependent and interconnected in profound ways.[26] This goes beyond the obvious fact that we need each other to survive day to day (one person makes clothes, another farms, and another makes tools); the claim is that a good or flourishing life depends in large part on one’s social network or community. This is why many of Aristotle’s moral virtues are other facing: justice, friendship, generosity, and magnanimity, to name a few. Courage, a typically self-facing virtue, is understood by Aristotle to be the virtue that regards one’s fear of death in battle, a battle fought on behalf of one’s city.[27] All of this remains true today. Namely, there is an important sense in which our community matters to our lives: it is easier to live a good, flourishing life if one is part of a good, flourishing community. Our community is made up of smaller groups, and it is more accurate to say that we are simultaneous members of different groups within a broader community. A person may be part of a family, friend group, research team, large state university, city, state, and nation. Groups can function well or not, as we all have experienced, and this suggests that there are virtues or excellences that groups can instantiate. Good groups are unified in purpose, with each member doing their duty alongside others for the attainment of that purpose. Good groups manifest solidarity among their members. Although Aristotle does not list solidarity as a virtue, a number of modern-day virtue ethicists have begun examining how group solidarity can be a virtue that contributes to a good or flourishing life.[28] Solidarity is not conceptualized as an individual virtue, a virtue possessed by a person in isolation of others; instead, it is a collective virtue, a virtue that is shared among members of a defined group with particular ends.[29] “A group has solidarity to the extent that its members are disposed to: (1) share values, aims, or goals; (2) care about those values, aims, or goals; (3) act in accordance with those values, aims, or goals; (4) trust the testimony of other group members with respect to those values, aims, and goals; and (5) feel a sense of belonging to the group.”[30] The virtue of collective or group solidarity involves individuals having special concern for each other, shared aims and values, trust, loyalty, and a sense of belonging with these specific others. There is a oneness to the group in the pursuit of a definite goal or purpose, involving mutual support and affirmation of each member. As such, the group has ends and goods above and beyond the good of each individual person. Sometimes solidarity requires personal sacrifice for the collective (for example, a father sacrificing food so his child can eat). The virtue of collective or group solidarity is important to the military and medical community at every level, and for clear reasons. In the military, there is a clear hierarchy of command, unity of purpose and end, mutual trust and support in complex settings, and so on. Soldiers need to know they can count on one another, and solidarity grounds a soldier’s ability to trust others and be assured of mutual aid. In medicine, solidarity maintains self-regulation of the profession, shared values and goals, as well as public support, not to mention that day-to-day operations require physician trust, engagement, and effort toward the ends of clinical care. Physicians need to work together, along with others, in pursuit of health, and disunity is sowed when there is mistrust, selfishness, or disengagement among the healthcare team and organization. Importantly, just as we are all members of various groups and hence may manifest group solidarity in different settings, the virtuous military physician instantiates collective solidarity with both the medical profession and the military. Her dual loyalty contributes to the moral difficulty of acting in Battlefield Triage. The military physician has competing obligations to distinct groups and cannot satisfy all obligations in Battlefield Triage. Solidarity with the military supports the consideration of favoring the soldier for reasons of national identity, whereas solidarity with the medical community does not. Something has to give, which is why it is a moral tragedy. The virtuous military physician, therefore, must weigh the costs of each course of action. To fulfill her obligations to the medical community would require that she does not use nationality and other non-medical considerations in Battlefield Triage. Since the soldier and enemy combatant are equally injured, justice would demand a random process, perhaps a flip of the coin. Although this may satisfy obligations the military physician has to the medical community, this would be costly to the physician’s military group. If word gets out that the physician decides who to treat based on a coin toss, soldiers, families, and citizens may become frustrated and angry. Soldier morale may go down if it becomes known that a coin flip led to the preventable death of a soldier and the saving of an enemy combatant who had killed (or attempted to kill) other soldiers. As Gross highlights, military solidarity involves a mutual aid promise that military personnel promise to help one another.[31] A military physician is part of the military and, as such, is part of the mutual aid promise, which would appear to be violated if the physician flips a coin. Treating a member of one’s own team may be psychologically more beneficial than treating an enemy combatant and may lead to less moral distress.[32] Finally, treating soldiers rather than enemy combatants promotes broader military and social aims, including returning soldiers to health, maintaining unity of purpose, and minimizing community suffering from a soldier’s death. Favoring members of one’s group, that is, triage based on nationality in Battlefield Triage, would fulfill obligations of military group loyalty, which is contrary to the values and duties of medicine. It does not seem as though showing favoritism in this particular situation is very costly to the medical community or general public, but this is because there is recognition that the physician is in the military. Medicine is impartial to non-medical indications partly because of fairness and to promote public trust in medicine. However, Battlefield Triage is unique, as medicine is being practiced in a non-public, wartime setting. In ordinary circumstances, a patient’s identity is irrelevant, and physicians ought not play favorites. Since Battlefield Triage is not an ordinary circumstance, decisions based on patient identity may not undermine public trust in medicine. In addition, it is contestable that fairness in Battlefield Triage requires that no consideration be paid to one’s nationality. Fairness is about giving each person their due, what is owed to them, and the case can be made that soldiers who place themselves in danger for the sake of the common good or a just cause are owed special attention when they suffer harm in the line of duty. In other words, soldiers voluntarily undergo risk to themselves for the greater good, and society owes them for this sacrifice. This plausibly includes preferential treatment in a situation such as Battlefield Triage. So, while the medical community affirms justice demands non-preferential treatment, the military community can affirm the opposite. The demands of fairness are unclear at best or in conflict in this situation: demands of physician justice decry favoritism, while demands of military justice support favoritism. Triage not based on nationality is arguably unfair and triage based on nationality may not undermine public trust, after all. All things considered, there is a clear rationale for favoring nationality-based preferential treatment in Battlefield Triage. Adopting a nationality-based preference in this situation is more defensible than not. This does not make such a decision ethically right or just. Preference based on nationality is the least bad decision, but it is not morally blameless. It involves one in a serious moral wrong, a wrong otherwise avoided and contrary to one’s character. The virtuous military physician is in a situation in which obligations conflict, and we disagree with Gross, who posits that care of fellow soldiers “is important to the near exclusion of all else.”[33] Gross fails to appreciate the collective virtue of solidarity as applied to those in medicine. The military physician has duties to fellow soldiers but also to fellow physicians, to the medical community, and humanity. To favor a soldier on grounds of nationality violates her duties and responsibilities to this latter group. She is involved in a moral tragedy and can only seek the most just action given the circumstances, yet, at least in virtue ethics, the action remains far from blameless. CONCLUSION We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. As such, the virtuous military physician incurs a moral cost to acting as she does—there is a moral residue. However, despite being a moral tragedy, there are clear reasons to act in favor of treating one’s own, considering group solidarity. As such, these kinds of tragedies are resolvable: virtuous military physicians should favor treatment of their own, although they would do so with sorrow. - [1] Militaries set forth medical rules of eligibility or guidelines used to determine whether a person qualifies for specific medical interventions or treatments in certain circumstances, and these guidelines are binding for a military physician. For example, despite opposition from medical organizations, militaries have adopted reverse triage guidelines for military physicians to follow. For ethical discussion, see Falzone, Elisabeth, P. Pasquier, C. Hoffmann, O. Barbier, M. Boutonnet, A. Salvadori, A. Jarrassier, J. Renner, B. Malgras, and S. Mérat. "Triage in military settings." Anaesthesia Critical Care & Pain Medicine 36, no. 1 (2017): 43-51. https://doi.org/10.1016/j.accpm.2016.05.004 [2] There are issues that are related to this, including the triage of civilians and allied soldiers. We set related issues aside for purposes of this paper [3] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [4] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [5] This is termed the “dual loyalty” dilemma in military medicine and has been described at length elsewhere: Institute of Medicine (US) Board on Health Sciences Policy. Military Medical Ethics: Issues regarding Dual Loyalties: Workshop Summary. Washington (DC): National Academies Press (US); 2008. Toward a Framework for Resolving Dual Loyalties. Available from: https://www.ncbi.nlm.nih.gov/books/NBK214853/ [6] See Kenneth G. Swan and K.G. Swan, Jr., “Triage: The Past Revisited,” Military Medicine 161:8 (1996): 448–452. https://doi.org/10.1093/milmed/161.8.448; Jerome A. Singh, “American Physicians and dual loyalty obligations in the ‘war on terror,’” BMC Medical Ethics 4.4 (2003): 1–10. https://doi.org/10.1186/1472-6939-4-4; Beam, Thomas E. "Medical Ethics on the Battlefield." Military Medical Ethics: Sect. IV. Medical ethics in the military. Medical ethics on the battlefield: the crucible of military medical ethics 2 (2003): 369-402; Hereth, Blake. "Health justice for unjust combatants." Journal of Military Ethics 20, no. 1 (2021): 67-81. https://doi.org/10.1080/15027570.2021.1949782. [7] See Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. Gross, Michael L. "Comradery, community, and care in military medical ethics." Theoretical medicine and bioethics 32 (2011): 337-350. https://doi.org/10.1007/s11017-011-9189-6. Gross, Michael L. "The limits of impartial medical treatment during armed conflict." In Military medical ethics for the 21st century, pp. 71-84. Routledge, 2016. [8] World Medical Association, WMA Declaration of Lisbon on the Rights of the Patient. 5 December 2022, https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient/ [9] Geneva Convention for the Amelioration of the Condition of Wounded, Sick in Armed Forces in the Field. 12 August 1949. https://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.30_GC-I-EN.pdf. [10] List, Justin M. "Medical neutrality and political activism: physicians' roles in conflict situations." In Physicians at war: The dual-loyalties challenge, pp. 237-253. Dordrecht: Springer Netherlands, 2008. 240 [11] Beauchamp, T., and J. Childress. 2013. Principles of Biomedical Ethics, 7th ed. Oxford, United Kingdom: Oxford University Press. [12] Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. [13] Gross, "Comradery, community, and care in military medical ethics," 347. [14] Gross, “Comradery, community, and care in military medical ethics,” 349. [15] Gross, Michael L. "When medical ethics and military ethics collide." Narrative inquiry in bioethics 13, no. 3 (2023): 199-204. 202 https://dx.doi.org/10.1353/nib.2023.a924191 [16] Our argument draws on virtue ethics, from which care ethics derives, and it is worth clarifying how our argument relates to Gross’s. We do not think that the virtue of friendship grounds triage decisions, for we think it is unlikely that the physician and wounded soldier are friends. Instead, as explained below, we think the collective virtue of group solidarity better captures the moral significance of group loyalty and that Gross would agree with us. But since military physicians are part of distinct groups, with competing obligations, the military physician will be forced to sacrifice a value in battlefield triage cases. In other words, we think Gross downplays the dual group membership of a military physician. [17] List,”Medical neutrality and political activism,” 250. [18] Adams,”Triage priorities and military physicians,” 235. [19] London, Leslie, Leonard S. Rubenstein, Laurel Baldwin-Ragaven, and Adriaan Van Es. "Dual loyalty among military health professionals: human rights and ethics in times of armed conflict." Cambridge Quarterly of Healthcare Ethics 15, no. 4 (2006): 381-391. 383. [20] Hursthouse, R. On Virtue Ethics. OUP 1999. 74 [21] Nussbaum, Martha C. "The costs of tragedy: Some moral limits of cost-benefit analysis." The Journal of Legal Studies 29, no. S2 (2000): 1005-1036, 1007. [22] De Wijze, S. (2005). Tragic-remorse–the anguish of dirty hands. Ethical theory and moral practice, 7(5), 453-471, 457. https://doi.org/10.1007/s10677-005-6836-x [23] Hursthouse, 73 [24] Hursthouse, 81 [25] Hursthouse, 72 [26] Aristotle, Politics 1253a8. Reeve, C. D. C., Indianapolis: Hackett Publishing Co., 2017 [27] Aristotle, Nicomachean Ethics. III.6.114a, 34-35. 2002, Nicomachean Ethics, Christopher Rowe (trans.), Oxford: Oxford University Press [28] Byerly, T. Ryan, and Meghan Byerly. "Collective virtue." The Journal of Value Inquiry 50, no. 1 (2016): 33-50. https://doi.org/10.1007/s10790-015-9484-y; Federico, Veronica. "Conclusion: solidarity as a public virtue." Solidarity as a Public Virtue (2018): 495-542. https://doi.org/10.5771/9783845290058. Rehg, William. "Solidarity and the common good: An analytic framework." Journal of Social Philosophy 38, no. 1 (2007): 7-21. https://doi.org/10.1111/j.1467-9833.2007.00363.x [29] Byerly and Byerly. "Collective virtue." 43 [30] Battaly, Heather. "Solidarity: Virtue or vice?." In Social virtue epistemology, pp. 303-324. Routledge, 2022. 304 [31] Ibid., 2011: 341 [32] It might be thought that displaying altruism by helping an enemy combatant at the expense of one’s fellow soldier may be psychologically satisfiying. For evidence that military physicians find it difficult to treat enemy combatants, see Lundberg, Kristina, Sofia Kjellström, Anders Jonsson, and Lars Sandman. "Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties." Military medicine 179, no. 8 (2014): 821-826. https://doi.org/10.7205/MILMED-D-14-00038. Lamblin, Antoine, Clément Derkenne, Marion Trousselard, and Marie-Ange Einaudi. "Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study." BMC Medical Ethics 22 (2021): 1-13. https://doi.org/10.1186/s12910-021-00723-2 [33] Ibid., 2011: 344. (shrink)

En esta entrevista, conversamos con el Dr. Alejandro De Oto sobre las potencialidades de los estudios poscoloniales a la hora de comprender la configuración de espacios e imágenes de culto, consagrados, venerados o denostados y su vínculo con la historia, las memorias legitimadas y las subalternas, las identidades y las luchas de poder.

In this essay, I focus on two biographical works by Hannah Arendt and Simone de Beauvoir that I read as political texts: Rahel Varnhagen: The Life of a Jewess and “Must We Burn Sade?”. Reading Arendt's Varnhagen and Beauvoir's “Sade” side by side illuminates their shared preoccupation with lived experience and their common political premises: the antagonism between freedom and sovereignty, and the centrality of action and constructive relations with others. My argument is that these texts constitute an original style (...) of political thinking, which I call politico-biographical hermeneutics, or reading the life of others as exercises in political theory. Politico-biographical hermeneutics, as I take it, is not a systematic methodology, but an approach to interpreting sociopolitical forces as they come to bear and are embodied and inscribed in the lived experiences, struggles, and works of representative or exemplary individuals. This approach identifies the political lessons of lived experience and supports one of the central claims of feminist philosophy, namely, that the personal and the political are not antithetical, but relational. (shrink)

Using the bench trial of Colorado’s Amendment 2 as an example, this article focuses on the more general question of expert testimony in moral philosophy. It argues that there is indeed expertise in moral philosophy but argues against admitting such expert testimony in cases dealing with what John Rawls terms “constitutional essentials” and ‘matters of basic justice.” Developing the idea of public reason inherent in the Rawlsian concept of political liberalism, the article argues that philosophers can and should speak out (...) on public issues, if they do so with due respect for certain restrictions, but that they should not serve as expert witnesses on core constitutional questions, since doing so suggests that they claim a type of authority that would require fellow citizens to defer to their views. Such claims to authority in basic ethical matters threaten the mutual respect for divergent comprehensive doctrines that lies at the core of political liberalism. Philosophers have a duty to serve the public good, and they perform this service in fruitful ways. But they should refuse a public role that appears incompatible with equal respect for the committed ethical searching of their fellow citizens. (shrink)

El presente trabajo reflexiona críticamente en torno a la inclusión educativa sobre la base de: a) la labor investigativa desarrollada acerca del derecho a la educación a partir de narrativas de jóvenes con discapacidad en la educación superior, como también de b) diferentes encuentros con estudiantes y docentes de distintos niveles educativos y c) las actividades desarrolladas en el marco de distintas redes en las que confluyen el activismo y el campo académic. Presenta los temas de modo espiralado, es decir, (...) con la intención de desarrollar reflexiones que permitan avanzar en un posicionamiento crítico-activo, pero volviendo permanentemente sobre algunos nudos centrales que tensan el devenir de la inclusión educativa y la discapacidad: la ideología de la normalidad, la lógica binaria, el capacitismo, la colonialidad, los procesos de identificación y la necesidad de promover un giro epistémico para el trabajo institucional cotidiano, tanto en el terreno macro como micropolítico. Se destacan tanto las responsabilidades ineludibles del Estado y de sus sistemas educativos como también de todas las partes que los conformamos. (shrink)

Pensadores griegos y orientales, filósofos antiguos, medioevales y modernos, han tocado el tema de lo corporal de manera fragmentaria que reducen lo corpóreo a mero instrumento. Para evitar este tipo de interpretaciones, queda el expediente de acudir a la síntesis holística; a la versión del "cuerpo total" que somos. La economía imperante es la del "cuerpo poseído". Se tasa, vende y desecha en el mercado la fuerza de trabajo. Se ejerce sobre él una violencia que nos rebasa en todos los (...) frentes; es radical, porque atenta contra la integridad y la dignidad de los cuerpos. Restañar las heridas corporales de nuestros pueblos requiere de la formulación y siembra del conocimiento de la Ética del cuerpo que deberá ir acompañada por un proceso de reconstrucción simbólica de la idea de "cuerpo" en el que todos participemos. Si armonizan necesidades y capacidades corporales propias y ajenas y compaginan nuestras acciones con el respeto al entorno natural, casa del cuerpo, podremos vislumbrar que vamos sobre el camino correcto. The Greek and Eastern thinkers, ancient, medieval and modern philosophers, have dealt with the body only in a fragmentary way that sees it as a mere instrument. To avoid this kind of interpretation we resort to a holistic synthesis-the "total body" version that we really are. The dominant economics is the one of the "possessed body" that can be priced, sold and disposed of as working force. An overpowering violence is applied to it; it is a radical violence as it attempts on bodies' integrity and dignity. The healing of the wounded bodies of our people requires formulating and planting the seeds of the body's ethics that will accompany the reconstruction of an idea of body to be shared by all of us. If we harmonize our own and others' body's needs and abilities, and our actions are in accordance with our natural surroundings, we will be able to make out the right path. (shrink)

Este estudio tuvo como objetivo caracterizar investigaciones sobre representaciones sociales de docentes y estudiantes acerca de la escritura en la educación superior. La revisión sistemática se efectuó siguiendo la metodología propuesta por la Declaración PRISMA. La búsqueda, que fue realizada en las bases de datos WOS, Scopus, Scielo y ERIC, permitió identificar 20 artículos entre los que predomina el enfoque cualitativo. Como elementos recurrentes se destacan la necesidad de que en la universidad se enseñe explícitamente a escribir y la persistencia (...) de representaciones, que vinculan la escritura con la evaluación. (shrink)

Presents essays and articles by 17 philosophers and legal scholars on sexuality, the family, and the proper role of the law in these areas. Subjects include the social construction and reconstruction of care, pornography left and right, homosexuality and the constitution, and declining well-being among US children. For students and general readers interested in sexuality, gender, feminism, and the family. Annotation copyright by Book News, Inc., Portland, OR.

This collection of new essays explores in depth how and why we act when we follow practical standards, particularly in connection with the authority of legal texts and lawmakers. The essays focus on the interplay of intentions and practical reasons, engaging incisive arguments to demonstrate both the close connection between them, and the inadequacy of accounts that downplay this important link. Their wide-ranging discussion includes topics such as legal interpretation, the paradox of intention, the relation between moral and legal obligation, (...) and legal realism. The volume will appeal to scholars and students of legal philosophy, moral philosophy, law, social science, cognitive psychology, and philosophy of action. (shrink)

The philosophers of the Hellenistic schools in ancient Greece and Rome (Epicureans, Stoics, Sceptics, Academics, Cyrenaics) made important contributions to the philosophy of mind and the philosophy of psychology. This volume, which contains the proceedings of the Fifth Symposium Hellenisticum, describes and analyses their contributions on issues such as: the nature of perception, imagination and belief; the nature of the passions and their role in action; the relationship between mind and body; freedom and determinism; the role of pleasure as a (...) goal; the effects of poetry on belief and passion. Written with a high level of historical and philosophical scholarship, the essays are intended both for classicists and for specialists interested in the philosophy of mind. (shrink)

Meditation is an umbrella term for a number of mental training practices designed to improve the monitoring and regulation of attention and emotion. Some forms of meditation are now being used for clinical intervention. To accompany the increased clinical interest in meditation, research investigating the neural basis of these practices is needed. A central hypothesis of contemplative neuroscience is that meditative states, which are unique on a phenomenological level, differ on a neurophysiological level. To identify the electrophysiological correlates of meditation (...) practice, the electrical brain activity of highly skilled meditators engaging in one of six meditation styles was recorded. A mind-wandering task served as a control. Lempel–Ziv complexity showed differences in nonlinear brain dynamics during meditation compared with mind wandering, suggesting that meditation, regardless of practice, affects neural complexity. In contrast, there were no differences in power spectra at six different frequency bands, likely due to the fact that participants engaged in different meditation practices. Finally, exploratory analyses suggest neurological differences among meditation practices. These findings highlight the importance of studying the electroencephalography correlates of different meditative practices. (shrink)

The cognitive disorders that follow brain damage are an important source of insights into the neural bases of human thought. This work offers state-of-the-art reviews of the patient-based approach to central issues in cognitive neuroscience by leaders in the field.

Cette contribution s’inscrit dans l’axe de recherche des projets CIRIT, 2009 SGR 808, et MCeI, FFI2009-09630. Merci à Laia de Ahumada, Maria Toldrà et Pep Valsalobre pour leur collaboration. L’intérêt pour l’écriture féminine antérieure à la fin de l’Ancien Régime va grandissant de façon significative dans l’aire linguistique catalane, en Catalogne, mais aussi dans la Communauté Valencienne et aux Îles Baléares, au moment où l’histoire des femmes se développe et se renforce. Avant les années...

Adolescence is a vital stage in a person´s development, stressful events within the most significant subsystems at this stage can lead to anxious-depressive symptomatology. The objective of this study was to design a socio-emotional narrative intervention program in order to decrease anxious-depressive symptoms in adolescents. We seek to strengthen emotional intelligence skills, such as: emotional awareness, self-image, self-concept, self-esteem and self-regulation. The research was quasi-experimental, pretest-post-test was carried out with control group and transverse temporality. The research approach was mixed. The (...) sample consisted of 80 women aged 13 to 15. Quantitative results showed a statistically significant difference in experimental group with medium effect for anxiety and small for depression as well as medium and high in the self-image. A qualitive analysis of the verbal and pictographic productions was carried out. It is important to continue proving the effectiveness of this socio-emotional narrative intervention to decrease anxious and depressive symptomatology in adolescents. (shrink)

Our concern on how and on which terms we are able to live in society, has turned peaceful coexistence into a important thematic for people from different disciplines who aspire to a harmonic and organized means of life. The recurrence of destructive conflict and unequal conditions validate a longstanding question: is it possible for us to live together? With the objective of providing opportunities for understanding and reflection that will draw us closer to open yet not absolute answers, this article (...) provides three considerations: the proposal to assume peaceful and civilized coexistence as a problem of rational organization; the criticism of communitarian to the modern organization project; and a perspective that sees in education and emotional transformation the opportunity to recuperate the harmony in peaceful coexistence, which has been altered by culture. (shrink)

Although disproportionate housework and care responsibilities ascribed to mothers and wives have been found to greatly impact women’s self-employment, less is known about how family-level labor structures may shape daughters’ entrepreneurship. Family business scholarship has shed partial light on this question by showing that household hierarchies and gender norms impede daughters’ recognition and inheritance within family firms in the United States. Drawing on interviews with 32 women microenterprise owners in Zacatecas, Mexico, this article builds on previous research by suggesting that (...) gendered mechanisms and labor structures may in fact position daughters to inherit businesses or business-related resources such as skills, financial capital, and property from their parents. Daughters acquire these assets by virtue of contributing to their parents’ enterprises as part of their childhood chores and maintaining a continued attachment to these businesses into adulthood. Daughters’ job prospects aside from inheritance were found to further shape their perceptions of business succession and inform their decision about whether to take over the family enterprise. Such acquisitions can be said to comprise instances of “gendered inheritance,” in which gendered institutions largely understood as disadvantaging women also may position them to attain valuable assets. (shrink)

Amsterdam University Press is a leading publisher of academic books, journals and textbooks in the Humanities and Social Sciences. Our aim is to make current research available to scholars, students, innovators, and the general public. AUP stands for scholarly excellence, global presence, and engagement with the international academic community.

Although not the main point of his target article, Block defends the view that perception and awareness of perception could be functions of different brain systems. I will argue that the available data do not support this view, and that Block's defense of the view rests on problematic eonstruals of the “executive system” and of the components of information-processing models.

At the Boundaries of Law provides a series of non-technical, interdisciplinary explorations into the nature and effects of legal regulation on women's lives. These essays provide a balance to earlier feminist work which stressed formal equality and disallowed discussion of differences. In questioning the concepts of legal thought, these feminists aim to provide an impetus for some long overdue rethinking not only among lawyers, but among social observers, critics, and scholars as well. The book offers a challenge to much of (...) the mainstream literature, thought and methodology in law and the social sciences. (shrink)

We are sad to say that Advisory Board member Renée Fox died on September 23rd. Renée was an extraordinary friend of Perspectives in Biology and Medicine, celebrating and contributing to its uniqueness over many years.Renée was a pioneer in medical sociology who spent most of her career at the University of Pennsylvania. Her research used participant-observation to explore the work of physicians. In Experiment Perilous, she examined troubling practices of doctors who conducted research on their own patients at the Peter (...) Bent Brigham Hospital in Boston. In The Courage to Fail, written with Judith Swazey, she focused on dangers to patients as their physicians used them as experimental subjects to develop... (shrink)

Las nuevas posibilidades abiertas por la investigación científica, especialmente en el campo de la genética, por un lado generan interrogantes morales hasta ahora desconocidos y, por otro, nos obligan a reformular de una manera totalmente nueva cuestiones y conceptos que hasta ahora funcionaban de forma adecuada. Así ocurre, por ejemplo, con las teorías de la justicia: estamos acostumbrados a que exista un acuerdo relativamente amplio en torno al concepto de persona, y la discusión se suele centrar en el tipo de (...) bienes que habrían de distribuirse entre un conjunto dado de individuos. Pero la posibilidad de transformar los talentos personales y, así, modificar algunos rasgos de nuestra población de acuerdo con criterios actuales, abre un importante debate en la medida en que dichos cambios pueden considerarse recursos y, así, objeto de redistribución. Por otro lado, el hecho de que ciertas alteraciones puedan o incluso deban realizarse con vistas al bien de futuros individuos conlleva el riesgo de que se abra paso una homogeneización social empobrecedora o de que se eliminen valiosas formas de vida y de cultura. Dado que esta incipiente posibilidad plantea aporías y amenazas inquietantes, la reflexión rigurosa constituye una herramienta crítica fundamental e imprescindible. (shrink)

Aan de hand van voorbeelden uit de literatuurkritiek van de oudheid tot heden wordt een pleidooi geconstrueerd voor kritische openheid bij het ondergaan van kunstwerken met anti-democratische en racistische lading, zoals bijvoorbeeld de muziek van Wagner.