This paper puts forward a wish list of requirements for formal fairness in the specific context of triage in emergency departments (EDs) and maps the empirical and conceptual research questions that need to be addressed in this context in the near future. The pandemic has brought to the fore the necessity for public debate about how to allocate resources fairly in a situation of great shortage. However, issues of fairness arise also outside of pandemics: decisions about how to allocate (...) resources are structurally unavoidable in healthcare systems, as value judgements underlie every allocative decision, although they are not always easily identifiable. In this paper, we set out to bridge this gap in the context of EDs. In the first part, we propose five formal requirements specifically applied for ED triage to be considered fair and legitimate: publicity, accessibility, relevance, standardisability and accountability. In the second part of the paper, we map the conceptual and empirical ethics questions that will need to be investigated to assess whether healthcare systems guarantee a formally just ED triage. In conclusion, we argue that there is a vast research landscape in need of an in-depth conceptual and empirical investigation in the context of ED triage in ordinary times. Addressing both types of questions in this context is vital for promoting a fair and legitimate ED triage and for fostering reflection on formal fairness allocative issues beyond triage. (shrink)

Standard decision theory, or rational choice theory, is often interpreted to be a theory of instrumental rationality. This dissertation argues, however, that the core requirements of orthodox decision theory cannot be defended as general requirements of instrumental rationality. Instead, I argue that these requirements can only be instrumentally justified to agents who have a desire to have choice dispositions that are stable over time and across different choice contexts. Past attempts at making instrumentalist arguments for the core (...) requirements of decision theory fail due to a pervasive assumption in decision theory, namely the assumption that the agent’s preferences over the objects of choice – be it outcomes or uncertain prospects – form the standard of instrumental rationality against which the agent’s actions are evaluated. I argue that we should instead take more basic desires to be the standard of instrumental rationality. But unless agents have a desire to have stable choice dispositions, according to this standard, instrumental rationality turns out to be more permissive than orthodox decision theory. (shrink)

This paper examines two contexts in ethical theory that some have thought support the claim that attempts, rather than actions, are what are morally required of agents. In each context there is an appeal to the principle that 'ought' implies 'can'. I begin by explaining how I think appeals to this principle typically work. I conclude that not only do the contexts in question not demonstrate that moral requirements range over attempts, but also that any argument in support of (...) that conclusion has serious obstacles to overcome. (shrink)

The problem of collecting, analyzing and evaluating evidence on adverse drug reactions (ADRs) is an example of the more general class of epistemological problems related to scientific inference and prediction, as well as a central problem of the health-care practice. Philosophical discussions have critically analysed the methodological pitfalls and epistemological implications of evidence assessment in medicine, however they have mainly focused on evidence of treatment efficacy. Most of this work is devoted to statistical methods of causal inference with a special (...) attention to the privileged role assigned to randomized controlled trials in Evidence Based Medicine. Regardless of whether the RCT’s privilege holds for efficacy assessment, it is nevertheless important to make a distinction between causal inference of intended and unintended effects, in that the unknowns at stake are heterogonous in the two contexts. This point has been emphasized by epidemiologists in the last decade. Their main focus is methodological, and regards the fact that bias and confounding do not affect studies on intended and unintended effects in the same way. However, deeper concerns ground the intuition for such a distinction; these are related to the constraints which we impose on evidence and their epistemological justification. My thesis is that such constraints ought to be understood to be different in the case of evidence for risk vs. benefit assessment. I present the recent debate on the causal association between acetaminophen and asthma in order to illustrate the point at issue. (shrink)

The recent global financial crisis and worst recession since the Great Depression underscore the theoretical and practical importance of defining requirements for assessing alternative theories of capitalism. The expressed goal of Freeman and his co-authors is to replace value-allocating ‘shareholder capitalism’ with value-creating ‘stakeholder capitalism.’ Each theory combines a different value proposition and principal-agent conception. So interpreted, the value creation proposition suggests two requirements for assessing alternative theories. A proposed better theory of capitalism should demonstrate first practicality of (...) prescriptive guidance for managers and second superiority of its embedded value proposition for sustainable long-term performance. Shareholder and stakeholder conceptions are not the only approaches to developing a theory of capitalism embedding a different value proposition and agency model. Two other conceptions suggest organisational wealth and corporate social responsibility (CSR) theories of capitalism. All four alternatives meet the relatively minimal requirement of practicality. Freeman and his co-authors argue the value creation proposition will outperform the value allocation proposition. But organisational wealth and CSR theories may also outperform shareholder capitalism. Demonstrating that stakeholder capitalism will outperform organisational wealth and CSR theories depends on which principal and value proposition one judges most important in particular conditions. (shrink)

ABSTRACTIn this article I pursue the implications of the statement that constitutional rights are – as Alexy’s principles theory argues – optimisation requirements, and show that they are not. I ar...

Whistleblowing can be defined as the internal or external reporting of violations and abuses of law. The protection and promotion of whistleblowing is extremely important both in the level of the European Union and the Member States. It is also well demonstrated by the fact, that the European Union has adopted a Directive in 2019 on the protection of persons who report breaches of Union law which the Member States also has to implement to their national legal system. Although whistleblowing (...) can be analyses from several points of view, this paper only focuses on its legal aspects. The objective of the article is to present the legal requirements of the European Union and the Hungarian regulation. In this context, the paper aims to analyse how successful was the implementation of the Directive into the Hungarian legal system. (shrink)

In a substantial number of cases, dying patients are brought into a state of lowered consciousness and kept in it until they die in order to prevent or stop severe suffering. Many guidelines and position statements have been published in recent years on sedation until death, as I will call this policy. Some have been published by professional organisations and are meant to be binding for their members, others are the work of task forces and merely aim at providing medical, (...) moral, and legal guidance.1 These guidelines all take the following positions: the patient’s consciousness should not be lowered more than is necessary for preventing her from suffering; it must be impossible to alleviate the suffering in any... (shrink)

Placing the future centre stage as a way of understanding cognition is gaining attention in psychology. The general modern label for this is “prospection” which refers to the process of representing and thinking about possible future states of the world. Several theorists have claimed that episodic and prospective memory, as well as hypothetical thinking (mental simulation) and conditional reasoning are necessary cognitive faculties that enable prospection. Given the limitations in current empirical efforts connecting these faculties to prospection, the aim of (...) this mini review is to argue that the findings show that they are sufficient, but not necessary for prospection. As a result, the short concluding section gives an outline of an alternative conceptualisation of prospection. The proposal is that the critical characteristics of prospection are the discovery of, and maintenance of goals via causal learning. (shrink)

Midwest Studies In Philosophy, EarlyView.

For a response to be personal, then, is for it to be a total response in which aesthetic, moral, perceptual, rational, and religious dimensions may be discriminated, though one particular dimension may be in focus or dominant at any one moment. In the remainder of this paper we shall focus on that abstract phase of the total response which we call perceptual, without prejudice to evaluative responses accompanying it. The "situation experienced," to use E. S. Brightman's terminology, is an undeniable (...) complex within which most of these factors-in-response can usually be distinguished. (shrink)

The U.S. Supreme Court held, in American Manufacturers Mutual Insurance Co. v. Sullivan, 119 S. Ct. 988, that state workers’ compensation system insurers cannot be sued for withholding health care benefits for work-related injuries while they decide whether the treatment is “reasonable” and “necessary.” The respondents, ten employees and two organizations representing employees who received medical benefits under the Workers’ Compensation Act, brought a 42 U.S.C. § 1983 action against state officials, the Pennsylvania State Workers’ Insurance Fund, private insurers, and (...) the school district, alleging that their due process rights were violated by provisions of the Pennsylvania Workers’ Compensation Act, 77 Pa. Cons. Stat. Ann. § 1 et seq.. The Act permits suspension of benefits without notice or opportunity to be heard pursuant to a “utilization review” process.To control costs, Pennsylvania amended its workers’ compensation system in 1993. Under the Act, an employer or its insurer must pay for all reasonable and necessary medical treatment. (shrink)

Perez-Rodriguez and de la Fuente (2017) assume that although human races do not exist in a biological sense (“geneticists and evolutionary biologists generally agree that the division of humans into races/subspecies has no defensible scientific basis,” they exist only as “sociocultural constructions” and because of that maintain an illusory reality, for example, through “racialized” practices in medicine. Agreeing with the main postulates formulated in the article, we believe that the authors treat this problem in a superficial manner and have failed (...) to capture the current state of the field of knowledge in science and the humanities. In our commentary, we want to highlight two main omissions, and to notice three important implications for “a postracial medicine.”. (shrink)

Whether pattern-parsing mechanisms are specific to language or apply across multiple cognitive domains remains unresolved. Formal language theory provides a mathematical framework for classifying pattern-generating rule sets (or “grammars”) according to complexity. This framework applies to patterns at any level of complexity, stretching from simple sequences, to highly complex tree-like or net-like structures, to any Turing-computable set of strings. Here, we explored human pattern-processing capabilities in the visual domain by generating abstract visual sequences made up of abstract tiles differing in (...) form and color. We constructed different sets of sequences, using artificial “grammars” (rule sets) at three key complexity levels. Because human linguistic syntax is classed as “mildly context-sensitive,” we specifically included a visual grammar at this complexity level. Acquisition of these three grammars was tested in an artificial grammar-learning paradigm: after exposure to a set of well-formed strings, participants were asked to discriminate novel grammatical patterns from non-grammatical patterns. Participants successfully acquired all three grammars after only minutes of exposure, correctly generalizing to novel stimuli and to novel stimulus lengths. A Bayesian analysis excluded multiple alternative hypotheses and shows that the success in rule acquisition applies both at the group level and for most participants analyzed individually. These experimental results demonstrate rapid pattern learning for abstract visual patterns, extending to the mildly context-sensitive level characterizing language. We suggest that a formal equivalence of processing at the mildly context sensitive level in the visual and linguistic domains implies that cognitive mechanisms with the computational power to process linguistic syntax are not specific to the domain of language, but extend to abstract visual patterns with no meaning. (shrink)

One INTRODUCTION: IN SEARCH OF THE VOICES OF NURSES IN CHINA Two motives launched this study to search for the voices of nurses in China. ...

pAt various junctures in its history, Buddhist thought has adapted in inventive ways to accommodate important ideological features of the new cultural spheres with which it came into contact. The concept of “skill-in-means” (upāya-kauśalya) played an important role in most of these syncretistic developments by facilitating critical reflexivity, doctrinal flexibility, and expositional creativity. It is surprising that a principle that has favored crosscultural dialogue, co-integration, and hybridization throughout Buddhism’s history should elicit little interest amongst contemporary philosophers wishing to syncretize Anglo-American (...) philosophy with precisely those Indian (and Indo-Tibetan) Buddhist philosophical traditions in which skill-in-means qua meta-doctrine features most prominently, that is, the various traditions falling under the broad banner of Madhyamaka. In this paper, I argue that failure to give due consideration to skill-in-means in “fusion philosophy” methodology and hermeneutics is expressive of lingering metaphilosophical parochialism in what ought to be--and may yet become--a more reflective and cosmopolitan field of research. I further argue that paying heed to skill-in-means makes it clear that, if “fusion” with Madhyamaka philosophical traditions really is the goal, then philosophers engaged in this project will have to expand their metaphilosophical horizons such as to respect and accommodate these traditions’ irreducibly therapeutic orientation./p. (shrink)

Brings together a range of practitioners and academics from the world of business who examine corporate social responsibility in policy and practice in a series of case studies from across the globe.

Internet of Things-based environments pose various challenges due to their anytime/anywhere computing, and the efficient cryptographic based key management is one of the major challenges in Internet of Things. The key management life cycle consists of initialization, key generation, key registration, key backup, key update, key recovery, and key revocation. Our contribution in this paper is to summarize the state-of-the-art key management schemes and techniques in different scenarios, such as mobile ad hoc networks, wireless sensor networks, and the Internet of (...) Things environments. Further different issues related specifically to the Internet of Things environment are discussed and the causes and effects pertaining to the security breach for Internet of Things are identified. Furthermore, in this research work, we develop a novel permutation of threshold and identity-based key management schemes for the Internet of Things environment and have proposed future directions to counteract the attacks on confidentiality, integrity, authentication, and availability of security services in the Internet of Things environment and identified the two key management schemes, that is, identity and threshold schemes for Internet of Things, to resolve Internet of Things key management issues and maximum possible security services effective implementation. We evaluate our scheme with the help of mathematical and statistical techniques. (shrink)

Much ink has been spilled in the last years on whether voting is a duty that citizens ought to discharge in a democracy that aspires to be acceptably just. In this essay, I concentrate on whether a moral duty to participate in elections logically entails that people ought to vote simpliciter or well. I propose that voting well – i.e. with information and a sense of justice – is the electoral duty that we should value. Voting as such is not (...) – at least, not if we care about the substantive quality of democratic outcomes, not only about equality of participation. As a matter of fact, voting well seems to be a more adequate form of political participation than simply voting under varied normative conceptions of democracy, as I will show. At the same time, while we can't freely choose not to follow a moral duty to vote well just because we're not inclined to do so, we have to allow for the possibility that some individuals will not be in a good position to act on it. I conclude by discussing admissible reasons for this inability with respect to our citizenship responsibilities. (shrink)