This study investigates the performance of 21 monolingual and 56 bilingual children aged 5;6-9;0 on German-LITMUS-sentence-repetition (SRT; Hamann et al., 2013) and nonword-repetition-tasks (NWRT; Grimm et al., 2014), which were constructed according to the LITMUS-principles (Language Impairment Testing in Multilingual Settings; Armon-Lotem et al., 2015). Both tasks incorporate complex structures shown to be cross-linguistically challenging for children with Specific Language Impairment (SLI) and aim at minimizing bias against bilingual children while still being indicative of the presence of language impairment across (...) language combinations. Given the great variability in bilingual language exposure and the potential effect of language experience on language performance in bilingual children, we examined whether background variables related to bilingualism, particularly, the degree language dominance as measured by relative amount of use and exposure, could compromise the diagnostic accuracy of the German-LITMUS-SRT and NWRT. We further investigated whether a combination of the two tasks provides better diagnostic accurracy. To address this, we used an unsupervised machine learning algorithm, the Partitioning-Around-Medoids (PAM), for deriving a clinical category for the children as ±language-impaired based on performance scores on SRT and/or NWRT while withholding information about their clinical status based on standardized assessment in L1/L2. Subsequently, we calculated diagnostic accuracy and investigated which background variables (age of onset, length of exposure, degree of language-dominance, socio-economic-status, and risk factors for SLI) best explained clinical-group-membership yielded from the PAM-analysis based on NWRT and/or SRT scores. Results show that although language-dominance influences the performance of bilingual typically-developing children, especially in the SRT, the diagnostic accuracy of the tools is not compromised by language dominance: while risk factors for SLI were significant predictors for clinical group membership in all models, language dominance did not contribute at all to explaining clinical cluster membership as typically-developing or SLI based on any of the combinations of the SRT and NWRT variables. Additionally, results confirm that a combination of SRT scored by correct target structure and the structurally more complex language-dependent part of the NWRT yields better diagnostic accuracy than single measures and is only sensitive for risk factors for SLI and not to dominance levels or SES. (shrink)

Somatic cell count is a diagnostic test of milk for mastitis in cows. Its specificity and sensitivity are less than 1.0, making test results uncertain. I discuss epistemological problems of the test such as underdetermination, undercalibration and underdiscrimination, in the solution of which biomedical and economic factors may play a role. Diagnostics of the SCC should be considered as an epistemological network, functioning in a network in which farmers, veterinarians, epidemiologists and milk industry shift their position following biomedical, (...) technological and economic changes, which is described as an actor-network to understand how human and non-human agents in mastitis may be associated. (shrink)

Many recent developments in artificial intelligence research are relevant for traditional issues in the philosophy of science. One of the developments in AI research we want to focus on in this article is diagnostic reasoning, which we consider to be of interest for the theory of explanation in general and for an understanding of explanatory arguments in economic science in particular. Usually, explanation is primarily discussed in terms of deductive inferences in classical logic. However, in recent AI research it (...) is observed that a diagnostic explanation is actually quite different from deductive reasoning. In diagnostic reasoning the emphasis is on restoring consistency rather than on deduction. Intuitively speaking, the problem diagnostic reasoning is concerned with is the following. Consider a description of a system in which the normal behavior of the system is characterized and an observation that conflicts with this normal behavior. The diagnostic problem is to determine which of the components of the system can, when assumed to be functioning abnormally, account for the conflicting observation. A diagnosis is a set of allegedly malfunctioning components that can be used to restore the consistency of the system description and the observation. In this article, this kind of reasoning is formalized and we show its importance for the theory of explanation. We will show how the diagnosis nondeductively explains the discrepancy between the observed and the correct system behavior. The article also shows the relevance of the subject for real scientific arguments by showing that examples of diagnostic reasoning can be found in Friedman's Theory of the Consumption Function. Moreover, it places the philosophical implications of diagnostic reasoning in the context of Mill's aprioristic methodology. (shrink)

Rationale, aims and objectives: Appropriate use of diagnostic and treatment modalities are essential for rational use of resources. The aim of this study is to evaluate the use of diagnostic modalities and different treatment options and their economic impacts following an acute ankle distortion resulting from an occupational accident. We evaluated the type-of-treatment impact on the victims' course of recovery as well as its impact on the associated accident costs. Research was carried out in Belgium. Methods: An ankle distortion (...) victims' database consisting of 200 cases of (Belgian) occupational accidents during the period 2005-2007 was analysed. Results: Patients who were prescribed immobilization or the use of adjuvant support or physical therapy (118 cases) were not employed during a period of 37 days on average, with a mean total cost of 3140.14 Euros caused by the ankle sprain. Patients without any adjuvant therapy (82 cases) were characterized by an unemployment rate of 15 days on average, and a total cost of 1077.86 Euros. Cast immobilization, although its application is not supported by evidence-based literature, was still applied in 36% of the population studied and resulted in the longest average absence of work of 42 days with an obvious significant increase in medical and total costs. Conclusions: Our results show a high rate of inappropriate use of cast immobilizations for ankle distortions. From an economic point of view and for the same clinical endpoint (being full resumption of the occupational activities), simple conventional treatment, consisting of rest, ice, compression and elevation at diagnosis with allowance of early weight bearing in the further clinical course, leads to the quickest full resumption of activities in combination with the lowest medical costs, if compared with any other kind of treatment. (shrink)

Definition of the problems: The physician-patient-relationship is influenced by economically driven decisions. This study explores the ethical consensus in explaining economical backgrounds of therapeutic and diagnostic interventions to patients, and the clinical practices of patient information.Method: A combination of questionnaire send to members of relevant health care organisations (n=132) and interviews with physicians working in different clinical resorts (n=15).Results and conclusion: In general there is a consensus in truth-telling about the economical background, however this ethical principle in many cases is (...) neglected. Whenever possible physicians try to translate economically driven decisions into medical terms. There is a broad disagreement and a wide range of individual ethical preferences regarding patient information, that can not be controlled by patients in any way. (shrink)

Scholars in philosophy, political science, and the policy community have recently advocated for a ‘sticks and carrots’, or conditional-coercion, approach to human rights violations. On this model, rights violators (usually states) are conceived of as rational agents who should be rewarded for good behavior and punished for bad behavior by other states seeking to improve human rights abroad. External states concerned about human rights abroad should impose punishments against foreign rights violators, and these punitive measures should not be lifted until (...) rights violations in target countries cease. Against these scholars, I argue that the conditional-coercion model is mistaken. In this article, I explicate the ‘sticks and carrots’ approach to human rights, criticize it on both theoretical and empirical grounds, and suggest an alternative approach that I term rights diagnostics. The model I propose is sensitive to the internal political struggles in rights violating states and the incentive structures faced by rights violators. This model takes account of relevant empirical evidence on the role of external coercion and inducements in producing institutional change. I conclude by sketching an institutional design that would potentially implement ‘rights diagnostics’ policy.1. (shrink)

The ongoing economic overhaul of medicine creates two basic imperatives – boosting profits and containing costs – that pose special ethical and philosophical challenges for psychiatry. Because insurance coverage still favors inpatient care, pressures to raise renevues translate into a corresponding pressure on psychiatry as a whole to expand its diagnostic categories, and on individual psychiatrists to ascribe these diagnoses liberally and to hospitalize as many patients as possible. Reciprocally, cost containment requires all physicians to justify their care as (...) clearly as possible and to eliminate those interventions that are not of demonstrable value. Scientific outcome studies are markedly more difficult in psychiatry than elsewhere in medicine, particularly for psychotherapeutic as opposed to pharmacologic modes of care. An emphasis on biological over psychological conceptions of mental illness and treatment might result, not because it is more likely to be correct, but because it is easier to document in conventional ways and less expensive to deliver. An economicsdriven reorganization of psychiatry therefore poses serious philosophical challenges, not only for the profession and its future, but for the clinical care of patients. Keywords: cost containment, epistemology, ethics, economics, metaphysics, psychiatry CiteULike Connotea Del.icio.us What's this? (shrink)

Machine learning (ML) has emerged as a promising tool in psychiatry, revolutionising diagnostic processes and patient outcomes. In this paper, I argue that while ML studies show promising initial results, their application in mimicking clinician-based judgements presents inherent limitations (Shatte et al. in Psychol Med 49:1426–1448. https://doi.org/10.1017/S0033291719000151, 2019). Most models still rely on DSM (the Diagnostic and Statistical Manual of Mental Disorders) categories, known for their heterogeneity and low predictive value. DSM's descriptive nature limits the validity of psychiatric diagnoses, which (...) leads to overdiagnosis, comorbidity, and low remission rates. The application in psychiatry highlights the limitations of supervised ML techniques. Supervised ML models inherit the validity issues of their training data set. When the model's outcome is a DSM classification, this can never be more valid or predictive than the clinician’s judgement. Therefore, I argue that these models have little added value to the patient. Moreover, the lack of known underlying causal pathways in psychiatric disorders prevents validating ML models based on such classifications. As such, I argue that high accuracy in these models is misleading when it is understood as validating the classification. In conclusion, these models will not will not offer any real benefit to patient outcomes. I propose a shift in focus, advocating for ML models to prioritise improving the predictability of prognosis, treatment selection, and prevention. Therefore, data selection and outcome variables should be geared towards this transdiagnostic goal. This way, ML can be leveraged to better support clinicians in personalised treatment strategies for mental health patients. (shrink)

BackgroundDefensive medicine (DM) practice refers to the ordering or prescription of unnecessary treatments or tests while avoiding risky procedures for critically ill patients with the aim to alleviate the physician’s legal responsibility and preserve reputation. Although DM practice is recognized, its dimensions are still uncertain. The subject has been highly investigated in developed countries, but unfortunately, many developing countries are unable to investigate it properly. DM has many serious ramifications, exemplified by the increase in treatment costs for patients and health (...) systems, patients’ exposure to risks, and negative effects on the psychological health of both health providers and recipients. Ultimately, the most serious consequence is the ethical consequences.MethodsThis work is based on a review of the literature related to DM worldwide and a comparison with the available knowledge found in Jordan. It is qualitative with a descriptive nature, aiming to diagnose the current DM practice in Jordan.ResultsThis is the first published article that discusses DM in Jordan by diagnosing its ethical and economic consequences for the health system as well as for patients. Despite the knowledge of the reasons that support its practice, little is being done to solve this issue. The absence of agreeable medical malpractice law, the dearth of unified medical protocols, the overwhelming pressure imposed by patients on medical staff, and the deteriorating patient-physician relationship are some of the causes of DM practice. Surely, the solution to these issues is to focus on fortifying the ethical and humanitarian aspects on the side of both the physician and the patient to ensure positive collaboration. The ethical aim of the physician to treat the patient faithfully and do what is possible to help combined with the appreciation of the physician’s efforts and the choice to not take advantage of the physician through litigation could be the most reasonable solution in the near future.ConclusionJordan is suffering from DM due to the limited financial expenditure on the health sector and the impracticality of medical malpractice law. The authors highlight that the cardinal step in solving this dilemma is restoring the ethical dimension of the patient-physician relationship. (shrink)

The object of this study is the legal framework for the sale or purchase of company shares when the goal of the transaction is the sale of a business. The impact of such transactions on Lithuanian economic development underlines the importance of this study. The recent wave of mergers and acquisitions in Lithuania is likely to substantially increase the number of related legal disputes as well. Legislation on the purchase and sale of company shares and the resulting transfer of (...) business has been enacted in Lithuania only recently. The regulation of such cases remains rather unclear, few cases have been brought to court, and the topic has been barely addressed by legal scholarship in Lithuania to date. It is unclear whether the fact that the real purpose of the transaction is not a simple reassignment of company shares, but business transfer, results in any differences in the interpretation and application of the law. An especially delicate question, raised in Lithuania and other European countries, is whether the buyer may submit a warranty claim to the seller regarding the business acquired. (shrink)

Sweetpotato-pig production is an important system that generates income, utilizes unmarketable crops, and provides manure for soil fertility maintenance. This system is widely practiced from Asia to Africa, with many local variations. Within this system, pigs are generally fed a low nutrient-dense diet, yielding low growth rates and low economic efficiency. Our project in Vietnam went through a process of situation analysis, participatory technology development (PTD), and scaling up over a seven-year period to improve sweetpotato-pig production and to disseminate (...) developed technologies. The situation analysis included a series of pig production assessments in several provinces in northern and southern Vietnam, and pig supply-market chain identification was conducted in 13 provinces. The analysis of these studies informed the project of the following: (1) appropriate locations for our activities; (2) seasonal available feedstuff and farmers’ feeding practices; (3) market fluctuation and requirements; and (4) feeding and management improvement needs based on which the subsequent phase of PTD was designed. The PTD involved a limited number of farmers participating in sweetpotato varietal selection, sweetpotato root and vine silage processing, seasonal feeding combination, and pig feeding with balanced crop-feed diet and silage. Six years of multi-location and multi-season sweetpotato selection resulted in a few promising varieties that yielded up to 75% more dry matter and have since been formally released. The most significant results of silage processing and feeding trials include improved growth, higher feeding efficiency, increased year-round local feedstuff, and considerable labor reduction from eliminated cooking and vine cutting. Once these technologies were developed, a farmer-to-farmer training model was designed for scaling up the adoption and impact. Farmer trainers from seven communes in seven provinces received training in these technologies. In turn, they undertook the responsibility of training other farmers on sweetpotato selection, processing, and feeding. An impact study was also administered to monitor and evaluate (M&E) the dissemination process and to document the impact of the new technologies and farmer-to-farmer training model on pig growth and farmer income generation. The results showed that both participating and non-participating farmers have taken up the technologies, although the former demonstrates higher rates of adoption than the latter. The participants also generated more income and saved more labor from the adoption of the technologies. While the scaling up and M&E activities are on-going, the project has since broadened from a sweetpotato-pig system perspective to a pig-cropfeed system perspective based on farmers’ needs. It has included other crop feeds such as cassava and peanut stems in the research portfolio. New technologies based on on-going PTD will continuously be incorporated into the future training curriculum. (shrink)

In contemporary China, physicians tend to require more diagnostic work-ups and prescribe more expensive medications than are clearly medically indicated. These practices have been interpreted as defensive medicine in response to a rising threat of potential medical malpractice lawsuits. After outlining recent changes in Chinese malpractice law, this essay contends that the overuse of expensive diagnostic and therapeutic interventions cannot be attributed to malpractice concerns alone. These practice patterns are due as well, if not primarily, to the corruption of medical (...) decision-making by physicians being motivated to earn supplementary income, given the constraints of an ill-structured governmental policy by the over-use of expensive diagnostic and therapeutic interventions. To respond to these difficulties of Chinese health care policy, China will need not only to reform the particular policies that encourage these behaviors, but also to nurture a moral understanding that can place the pursuit of profit within the pursuit of virtue. This can be done by drawing on Confucian moral resources that integrate the pursuit of profit within an appreciation of benevolence. It is this Confucian moral account that can formulate a medical care policy suitable to China's contemporary market economy. (shrink)

A business ethics practitioner and a moral theologian discuss business ethics. Drawing from value-added accounting principles, and extending them to include the company's stake-holders, especially its employees, Welch explains their significance for the origin, formation, and direction of his company's new ethics program. Primeaux responds to Welch from a perspective rooted in the economic theory of profit maximization and its ethical implications. Among the similarities in their thinking is a serious consideration of the role of profit for business and (...) business ethics. (shrink)

This study brings together socio-theoretical and ethnographic approaches to psychiatry, demonstrating the role of the clinic as a major consolidator of ideologies as well as the site where personal miseries are registered as markers of social failure. It focuses on innovation in psychiatric taxonomies, changes in the figurative language of the emotions, changes in conceptualizations of the self and how all of these relate to changing socio-economic events and circumstances.

Diagnostics is becoming one of the most important kinds of epistemic practice: accurate and timely diagnosis is necessary not only for ill people, but for economic, social and political systems and institutions, culture, science, technology, and ecosystems. The analysis of researches into diversity of diagnostics used in various branches enabled the author to develop the outline of the philosophical theory of diagnostics, to identify its subject matter and problems, to name the categories and principles of the (...) epistemological and methodological analysis of diagnostics activities, and to characterize its essential components. Diagnostics is defined as the process of developing cognitive perception of the object being investigated (sought for) and identifying it with existing knowledge of the object (orobjects of the same type). Diagnostics has the following constituents: a) determining something known and constant in the unknown and inconstant; b) identifying the single and occurent with the “ready-made” classification schemes and explanatory patterns, i.e. identifying it with the common and consistent; associating new facts with the known, common and consistent by applying well-tried methods, algorithms and technologies. The author identifies two levels of diagnostics: factual (empirical) and discursive. Discourse is defined as a finite course of reasoning based on a common concept. Reasoning is defined as the search for an answer to a cognitively significant question through drawing a conclusion (making a deduction). The author also analyses the role of argumentative, interpretative (explanatory), qualifying and predictive reasoning in the diagnostic thinking. The specific character of the diagnostic search is determined by an all-important role played in its process by a priori normative (paradigmatic) knowledge, as well as by its orientation to the cognition of the single and individual. The article alsotouches upon the issue of relationship between diagnostics and research investigation. This enables the author to specify the nature of scientific work and identify the correlation of existing knowledge and innovations. (shrink)

Artificial intelligence (AI) is increasingly relied upon by clinicians for making diagnostic and treatment decisions, playing an important role in imaging, diagnosis, risk analysis, lifestyle monitoring, and health information management. While research has identified biases in healthcare AI systems and proposed technical solutions to address these, we argue that effective solutions require human engagement. Furthermore, there is a lack of research on how to motivate the adoption of these solutions and promote investment in designing AI systems that align with values (...) such as transparency and fairness from the outset. Drawing on insights from psychological theories, we assert the need to understand the values that underlie decisions made by individuals involved in creating and deploying AI systems. We describe how this understanding can be leveraged to increase engagement with de-biasing and fairness-enhancing practices within the AI healthcare industry, ultimately leading to sustained behavioral change via autonomy-supportive communication strategies rooted in motivational and social psychology theories. In developing these pathways to engagement, we consider the norms and needs that govern the AI healthcare domain, and we evaluate incentives for maintaining the status quo against economic, legal, and social incentives for behavior change in line with transparency and fairness values. (shrink)

This paper provides an early evaluation of Artificial Intelligence against COVID-19. The main areas where AI can contribute to the fight against COVID-19 are discussed. It is concluded that AI has not yet been impactful against COVID-19. Its use is hampered by a lack of data, and by too much data. Overcoming these constraints will require a careful balance between data privacy and public health, and rigorous human-AI interaction. It is unlikely that these will be addressed in time to be (...) of much help during the present pandemic. In the meantime, extensive gathering of diagnostic data on who is infectious will be essential to save lives, train AI, and limit economic damages. (shrink)

This primarily diagnostic paper offers, from the perspective of relational egalitarianism, a normative analysis of three major injustices in the context of adaptation finance. Adaptation finance includes payments provided by the affluent countries of the Global North to low-income countries in the Global South, countries particularly exposed to the harms of climate change. Relational egalitarianism is the normative view that interactions between people and between institutions have to respect the equal moral status of every human being. The first injustice, from (...) this perspective, consists in the sheer fact that adaptation measures are required at all to deflect harm from people who did not significantly contribute to the causes of climate change. The second injustice consists in the persisting, even increasing adaptation finance gap, as countries of the Global North do neither provide adequate financial means to reduce climate risks, nor even fulfil their commitments to adaptation finance pledged in the Copenhagen Accord in 2009. The third injustice emerges from current procedures to determine criteria for distributing scarce financial resources that consolidate structural injustice. The paper concludes by providing the contours of a practical response to these injustices that respects the demands of relational egalitarianism. (shrink)

Jürgen Habermas’s recent book Die Zukunft der menschlichen Natur (2001) is discussed. Particular attention is paid to the central argument concerning the adverse effects the general acceptance of cloning and pre-implantation genetic diagnostics (PGD) would have on the moral and political self-understanding of present and future generations. The argument turns to a critique of Habermas’s central arguments against PGD, and develops at least two arguments that are in harmony with his general defense of procedural democracy and deontological morality. Appeal (...) is made to Peter Singer and John Rawls to develop arguments that do not reject either PGD or genetic engineering and that are nonetheless in full compliance with the spirit of political modernity, as it is defended and defined by Habermas. The conclusion calls for less moralizing and more political-economic critique of the biotechnologies unleashed by the information revolution. (shrink)

Driven by technological innovations, newborn screening (NBS) panels have been expanded and the development of genomic NBS pilot programs is rapidly progressing. Decisions on disease selection for NBS are still based on the Wilson and Jungner (WJ) criteria published in 1968. Despite this uniform reference, interpretation of the WJ criteria and actual disease selection for NBS programs are highly variable. A systematic literature search [PubMED search “Wilson” AND “Jungner”; last search 16.07.22] was performed to evaluate the applicability of the WJ (...) criteria for current and future NBS programs and the need for adaptation. By at least two reviewers, 105 publications (systematic literature search, N = 77; manual search, N = 28) were screened for relevant content and, finally, 38 publications were evaluated. Limited by the study design of qualitative text analysis, no statistical evaluation was performed, but a structured collection of reported aspects of criticism and proposed improvements was instead collated. This revealed a set of general limitations of the WJ criteria, such as imprecise terminology, lack of measurability and objectivity, missing pediatric focus, and absent guidance on program management. Furthermore, it unraveled specific aspects of criticism on clinical, diagnostic, therapeutic, and economical aspects. A major obstacle was found to be the incompletely understood natural history and phenotypic diversity of rare diseases prior to NBS implementation, resulting in uncertainty about case definition, risk stratification, and indications for treatment. This gap could be closed through the systematic collection and evaluation of real-world evidence on the quality, safety, and (cost-)effectiveness of NBS, as well as the long-term benefits experienced by screened individuals. An integrated NBS public health program that is designed to continuously learn would fulfil these requirements, and a multi-dimensional framework for future NBS programs integrating medical, ethical, legal, and societal perspectives is overdue. (shrink)

While COVID-19 has generated a massive burden of illness worldwide, healthcare workers (HCWs) have been disproportionately exposed to SARS-CoV-2 coronavirus infection. During the so-called ‘first wave’, infection rates among this population group have ranged between 10% and 20%, raising as high as one in every four COVID-19 patients in Spain at the peak of the crisis. Now that many countries are already dealing with new waves of COVID-19 cases, a potential competition between HCW and non-HCW patients for scarce resources can (...) still be a likely clinical scenario. In this paper, we address the question of whether HCW who become ill with COVID-19 should be prioritised in diagnostic, treatment or resource allocation protocols. We will evaluate some of the proposed arguments both in favour and against the prioritisation of HCW and also consider which clinical circumstances might warrant prioritising HCW and why could it be ethically appropriate to do so. We conclude that prioritising HCW’s access to protective equipment, diagnostic tests or even prophylactic or therapeutic drug regimes and vaccines might be ethically defensible. However, prioritising HCWs to receive intensive care unit (ICU) beds or ventilators is a much more nuanced decision, in which arguments such as instrumental value or reciprocity might not be enough, and economic and systemic values will need to be considered. (shrink)

Purpose Telemedicine has been advancing for decades and is more indispensable than ever in this unprecedented time of the COVID-19 pandemic. As shown, eHealth appears to be effective for routine management of chronic conditions that require extensive and repeated interactions with healthcare professionals, as well as the monitoring of symptoms and diagnostics. Yet much needs to be done to alleviate digital inequalities that stand in the way of making the benefits of eHealth accessible to all. The purpose of this (...) paper is to explore the recent shift in healthcare delivery in response to the COVID-19 pandemic towards telemedicine in healthcare delivery and show how this rapid shift is leaving behind those without digital resources and exacerbating inequalities along many axes. Design/methodology/approach Because the digitally disadvantaged are less likely to use eHealth services, they bear greater risks during the pandemic to meet ongoing medical care needs. This holds true for both medical conditions necessitating lifelong care and conditions of particular urgency such as pregnancy. For this reason, the authors examine two case studies that exemplify the implications of differential access to eHealth: the case of chronic care diseases such as diabetes requiring ongoing care and the case of time-sensitive health conditions such as pregnancy that may be compromised by gaps in continuous care. Findings Not only are the digitally disadvantaged more likely to belong to populations experiencing greater risk – including age and economic class – but they are less likely to use eHealth services and thereby bear greater risks during the pandemic to meet ongoing medical care needs during the pandemic. Social implications At the time of writing, almost 20% of Americans have been unable to obtain medical prescriptions or needed medical care unrelated to the virus. In light of the potential of telemedicine, this does not need to be the case. These social inequalities take on particular significance in light of the COVID-19 pandemic. Originality/value In light of the COVID-19 virus, ongoing medical care requires exposure to risks that can be successfully managed by digital communications and eHealth advances. However, the benefits of eHealth are far less likely to accrue to the digitally disadvantaged. (shrink)

Subject and purpose: Using annual data for the periods 2009–2019, this paper examines trade flows between China and the Visegrad Group countries. The aim of this article is to assess real changes taking place in international trade in the Visegrad Group countries over the last eleven years. The starting point for the analysis was 2009 – the time after the 2008 economic crisis, and it was compared especially to 2018 – a year marked by a significant improvement in the (...) economy. The purpose is to discuss concerns related to the differences in bilateral trade between China and Poland, Czech Republic, Hungary, and Slovak Republic. The main aim of this research is to distinguish the characteristics of bilateral trade by products between V4 and China in years 2009–2019. The purpose of this article is also to systematize and discuss points of view, rationalizing further empirical research. Two research hypotheses, resulting from the research purpose, were formulated: H1: in the V4 countries import exceeds export, and this trend seems to be growing, H2: Chinese goods imported to the V4 are much more sophisticated than those exported. Design/methodology/approach: To assess the initial and current situation on international trade between the V4 and China, the author uses variables obtained from WTO and OEC resources, diagnosing the situation in Poland, Czech Republic, Hungary, and Slovak Republic. The collected empirical data were processed using theoretical methods such as analysis, synthesis, and comparison to formulate conclusions using deductive and inductive inference methods. Practical Implications: The results can be used in scientific and expert work on diagnostic and forecast trends in bilateral trade by products between the V4 and China. Originality/value: It concerns the indication of the importance of the V4 trade with China compared to the share of the V4 countries in world trade. It was also possible to identify the top export and import products of the V4. The findings also confirm the significant change in China’s trading structure. (shrink)

Joseph Fins's book Rights Come to Mind: Brain Injury, Ethics, and the Struggle for Consciousness is a considerable addition to the literature on disorders of consciousness and the murky area of minimally conscious states. Fins brings to this fraught area of clinical practice and neuroethical analysis a series of stories and reflections resulting in a pressing and sustained ethical challenge both to clinicians and to health care systems. The challenge is multifaceted, with diagnostic and therapeutic demands to be met by (...) clinicians and a mix of moral, scientific-economic, and political resonances for health care analysts. Everything in the book resonates with my own clinical experience and the often messy and emotionally wrenching business of providing ongoing care for patients with severe brain injuries and disorders, people who frequently resist the categorizations that well-organized health care systems prefer and that can dictate terms of patient management. (shrink)

The article investigates the consequences for feminist politics of the neoliberal turn. Feminist scholars have analysed the political changes in the situation of women that have been brought about by neoliberalism, but their assessments of neoliberalism’s consequences for feminist theory and politics vary. Feminist thinkers such as Hester Eisenstein and Sylvia Walby have argued that feminism must now return its focus to socialist politics and foreground economic questions of redistribution in order to combat the hegemony of neoliberalism. Some have (...) further identified post-structuralism and its dominance in feminist scholarship as being responsible for the debilitating move away from socialist or Marxist paradigms. I share their diagnosis to the extent that it is my contention that the rapid neoliberalization characterising the last thirty years has put women and feminist thought in a completely new political situation. However, in contrast to those feminist thinkers who put the blame for the current impasse on the rise of poststructuralist modes of thought, it is my contention that the poststructuralist turn in feminist theory in the 1980s and 1990s continues to represent an important theoretical advance. I will discuss Foucault’s genealogy of neoliberalism in order to assess the ways it can contribute to feminist theory and politics today. I contend that Foucault can provide a critical diagnostic framework for feminist theory as well as for prompting new feminist political responses to the spread and dominance of neoliberalism. I will also return to Nancy Fraser and Judith’s Butler’s seminal debate on feminist politics in the journal Social Text (1997) in order to demonstrate that a critical analysis of the economic/cultural distinction must be central when we consider feminist forms of resistance to neoliberalism. (shrink)

In this article I examine some proposals for modification of ethical documents regulating research, particularly, the problems that introducing certain economic clauses may pose. I evaluate suggestions that reject the notion of providing the ‘best proven diagnostic and therapeutic method’ in favor of ‘the highest attainable therapeutic method’ or ‘the proven effective prophylactic, diagnostic and therapeutic methods’. I analyze the plausibility and problems of introducing a double standard and the consequences it may have in developing countries. Finally I highlight (...) the impact these changes may imply for these countries. (shrink)

Governments must keep agricultural systems free of pests that threaten agricultural production and international trade. Biosecurity surveillance already makes use of a wide range of technologies, such as insect traps and lures, geographic information systems, and diagnostic biochemical tests. The rise of cheap and usable surveillance technologies such as remotely piloted aircraft systems presents value conflicts not addressed in international biosurveillance guidelines. The costs of keeping agriculture pest-free include privacy violations and reduced autonomy for farmers. We argue that physical and (...) digital privacy in the age of ubiquitous aerial and ground surveillance is a natural right to allow people to function freely on their land. Surveillance methods must be co-created and justified through using ethically defensible processes such as discourse theory, value-centred design and responsible innovation to forge a cooperative social contract between diverse stakeholders. We propose an ethical framework for biosurveillance activities that balances the collective benefits for food security with individual privacy: establish the boundaries of a biosurveillance social contract; justify surveillance operations for the farmers, researchers, industry, the public and regulators; give decision makers a reasonable measure of control over their personal and agricultural data; and choose surveillance methodologies that give the appropriate information. The benefits of incorporating an ethical framework for responsible biosurveillance innovation include increased participation and accumulated trust over time. Long term trust and cooperation will support food security, producing higher quality data overall and mitigating against anticipated information gaps that may emerge due to disrespecting landholder rights. (shrink)

CRISPR‐Cas technology accelerates development of fast, accurate, and portable diagnostic tools, typified by recent applications in COVID‐19 diagnosis. Parasitic helminths cause devastating diseases afflicting 1.5 billion people globally, representing a significant public health and economic burden, especially in developing countries. Currently available diagnostic tests for worm infection are neither sufficiently sensitive nor field‐friendly for use in low‐endemic or resource‐poor settings, leading to underestimation of true prevalence rates. Mass drug administration programs are unsustainable long‐term, and diagnostic tools – required to (...) be rapid, specific, sensitive, cost‐effective, and user‐friendly without specialized equipment and expertise – are urgently needed for rapid mapping of helminthic diseases and monitoring control programs. We describe the key features of the CRISPR‐Cas12/13 system and emphasise its potential for the development of effective tools for the diagnosis of parasitic and other neglected tropical diseases (NTDs), a key recommendation of the NTDs 2021–2030 roadmap released by the World Health Organization. (shrink)

Habermas has argued that many of the endemic socio- economic problems of Western society are either symptoms or prod ucts of a 'lopsided' process of cultural rationalization, one that has emphasized instrumental forms of rationality over communicative. But other than presenting a rather general typology of lifeworld pathologies, Habermas has not done much to specify what these problems might be, nor has he provided any 'middle-range' analysis of the mechanisms through which they might be generated. This paper discusses some (...) of the ways in which, consistent with Haber mas's general framework, rational choice theory can be used for pre cisely this task. In this analysis, rational choice theory is not presented as a comprehensive theory of action, but is employed as a critical- diagnostic tool that allows the theorist to identify undesirable social interaction patterns that arise from a broader instrumentalization of the lifeworld. Key Words: critical theory • Habermas • instrumental rationality • market failure • rational choice theory. (shrink)

Transcultural comparisons taking the differences and commonalities into consideration in the fields of mental health and ill mental health have always been a focus of scientific interest. The ‘East’ and ‘West’ comparisons in this regard, could be the one most widely deliberated. ‘East and West’, as a human-made conceptual construct, has evolved to signify many social, cultural, political, economic and psychological realities and meanings, beyond its geographical references. Such conceptualizations both reflect and re-construct our realities. -/- Beyond the inequalities (...) and discrepancies in resources, the ‘East and West’ dualism has an impact on mental health theory and praxis in a many different ways. The range, content, patterns and expression of psychopathology and psychiatric symptomatology; the explanatory models of mental disorders; the diagnostic and classification systems; the psychopharmacological and psychotherapeutical interventions; the role of family and psychosocial support systems; basic conceptualizations of mental health and disease are some of the main areas of diversity. -/- This chapter, after briefly discussing the historical roots of the conceptualization of ‘East and West’, will be focused on the relations of mental health and ill mental health with this and related conceptualizations. It is concluded that, in this day of globalization, to improve the quality of psychiatric theory and praxis within a framework of high ethical standards, a paradigm focusing on the unity in diversity and embracing a non-dualistic, non-categorical, and non-hierarchical humanistic approach to cultural differences would bring all the colours of humanity and therefore psychiatry onto the canvas. (shrink)

BackgroundThe clinical introduction of non-invasive prenatal testing for fetal aneuploidies is currently transforming the landscape of prenatal screening in many countries. Since it is noninvasive, safe and allows the early detection of abnormalities, NIPT expanded rapidly and the test is currently commercially available in most of the world. As NIPT is being introduced globally, its clinical implementation should consider various challenges, including the role of the surrounding social and cultural contexts. We conducted a qualitative study with healthcare professionals in Lebanon (...) and Quebec as case studies, to highlight the relevance of cultural contexts and to explore the concerns that should be taken into account for an ethical implementation of NIPT.MethodsWe conducted semi-structured interviews with 20 healthcare professionals (HCPs), 10 from each country, practicing in the field of prenatal screening and follow up diagnostic testing, including obstetricians and gynecologists, nurses, medical geneticists and, genetic counselors. We aimed to 1) explore HCPs’ perceptions and views regarding issues raised by NIPT and 2) to shed light on ways in which the introduction of the same technology (NIPT) in two different contexts (Lebanon and Quebec) raises common and different challenges that are influenced by the cultural norms and legal policies in place.ResultsWe identified challenges to the ethical implementation of NIPT. Some are common to both contexts, including financial/economic, social, and organizational/ educational challenges. Others are specific to each context. For example, challenges for Lebanon include abortion policy and financial profit, and in Quebec challenges include lobbying by Disability rights associations and geographical access to NIPT.ConclusionsOur findings highlight the need to consider specific issues related to various cultural contexts when developing frameworks that can guide an ethically sound implementation of NIPT. Further, they show that healthcare professional education and training remain paramount in order to provide NIPT counseling in a way that supports pregnant women and couples’ choice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Scientific Expertise, Service Users and Democratising Psychiatric ResearchThe author reports no conflict of interests.Friesen outlines six different reasons for democratizing scientific research. Three of them are epistemic and three are ethical. In this commentary I consider how service users might relate to values if significant levels of scientific knowledge are required to understand those values. I specifically consider the traditional theoretical virtues discussed by philosophers of science (Psillos, 1999; (...) Solomon, 2001) whereby we might judge scientific concepts based upon their simplicity, consistency or coverage. This raises questions of how democratic approaches should function when expertise is important.There is a general problem of how democratic institutes should function when members lack understanding. For example, most voters in current European democracies have limited understanding of economics. They may understand some broad principles but would not understand how to actually manage an economy on a daily basis. A simple solution to this is that political parties outline a broad framework and then are given consent to run the economy once elected. Our elected representatives or members of an unelected bureaucracy actually then make the "on the ground" decisions about how to run the economy given the broad framework which the political party was voted in on. This hopefully then means that, with varying degrees of success, people who have some understanding of economies are playing a key role. We can certainly ask important questions about this system, such as what level of economic understanding do citizens have and what level they need, who should constitute the unelected bureaucracy and whether the bureaucracy could actually be elected. My simple point is that this is one approach to limiting the decision-making of people who may lack economic expertise. In relation to democratizing psychiatric research, I consider whether Friesen's approach might mean service users require a level of expertise that they typically lack.Friesen outlines how there is a very high level of value decision involved in psychiatry given the gap between data and theories. Friesen thinks service users should be included in decisions over what values to use. I now provide an example of where making good value decisions might require [End Page 135] significant levels of scientific knowledge. I consider a specific type of value applied to a specific area. There has been recent discussion of service users being involved in decision-making over modifying psychiatric diagnoses, whereby they might play a role in deciding what psychiatric diagnoses there are and what their diagnostic criteria should be (Bueter, 2019; Fellowes, 2023; Tekin, 2022). I consider how we can assess psychiatric diagnoses using theoretical virtues. It should be emphasized that this problem may or may not have applicability to other areas of service user involvement, that theoretical virtues are not the only values which are important for assessing psychiatric diagnoses and that scientists might themselves make bad decisions in relation to theoretical virtues. I now outline five theoretical virtues.First, simplicity. There are lots of different ways to understand simplicity but here I consider how simple a system of psychiatric diagnoses (i.e., the Diagnostic and Statistical Manual of Mental Disorders [DSM]) is. We can ask if the system of psychiatric diagnoses is too simple because it contains too few diagnoses or too complicated because it contains too many diagnoses. Simplicity and complexity might also depend on the degree different diagnoses have overlapping symptoms. We can judge a particular psychiatric diagnosis on the degree it adds to simplicity or complexity. Establishing the strength of this theoretical virtue requires knowledge of many different psychiatric diagnoses.Second, coverage. This relates to the degree that all the phenomena that we desire covered are being covered. We can ask whether a system of psychiatric diagnoses is or is not covering all the symptoms that we think need covering by psychiatry. We can judge particular diagnoses on how they contribute to coverage. Assessing this requires knowledge of a vast range of symptoms.Third, embedded within a theoretical network. Scientific concepts can be connected to other scientific concepts. A diagnosis can be judged on the degree it connects to other well-established areas of science, whereby the diagnosis might have been formulated based upon being... (shrink)

The article analyzes the interdisciplinary methodology of city research within the philosophical and cultural approach. The authors argue that at present, besides sociological and economic approaches to the interpretation of the city, the cultural and philosophical examination of city is of special interest. It combines both theoretical issues and the practical aspects. The authors present the philosophical and cultural analysis of the city as well as the general concept of chronotopia. The concept of chronotope, proposed by M. M. Bakhtin (...) and his followers, is most often used as a tool for the analysis of fiction. According to the authors, the spatio-temporal diagnostics of the city also has significant theoretical and practical potential. The authors discuss various literary and philosophical texts analyzing the feautures and evolution of the “soul of the city” (written by Russians N.P. Antsiferov, I.M. Grevs, Y.M. Lotman, M.S. Kagan, I.I. Mitin as well as by foreign scholars Y. Slezkine, K. Schlogel, exploring the chronotope of Soviet cities). The article presents other modern Russian and foreign researchers who directly collaborated with the authors of this research in joint urban projects: M. Golovanivskaya (“syntax” of urban squares), “Ural matrix” (A. Ivanov, I. Lisovets, E. Trubina), chronotope of a small Israeli city (E. Rimon), Stanford chronotopes (J. Bender, D.E. Wellbery). Since the city, like any cultural phenomenon, manifests itself within a set of spatio-temporal coordinates, the chronotope can be considered as the basic tool for its philosophical and cultural interpretation. The article substantiates the practical aspects of applying chronotopia to the analysis of the city: chronotopes of the past and everyday life in cities of certain types, strategic opportunities and boundaries of the chronotopes of a given city. The authors concludes that the chro-notopia of city is a transdisciplinary field in the cultural and philosophical studies of the city. (shrink)

Bien que Hegel ne propose pas de solution satisfaisante au problème de l'injustice sociale, il est important d'analyser ce problème, car il définit les limites de la société civile. Dans ce court article, je veux montrer que l'injustice sociale est caractérisée par l'insatisfaction, qui produit une classe de hors-caste, car elle n'a ni biens, ni droits. De plus, il y a faille et problème, car Hegel conçoit la société civile à partir d'une axiologie de l'harmonisation et de l'intégration que démentent (...) les processus économiques. En revanche, la perspicacité du diagnostic hégélien démontre bien que l'absence d'intégration et de reconnaissance sociale est un mal aussi grand que la privation matérielle.Although Hegel offers no solution to the problem of social injustice, it is important to analyse this problem, for it defines the limits of civil society. In this short paper, I shall try to show that social injustice is characterized by the dissatisfaction that produces a class of outcaste people who have no goods, nor rights. Furthermore, there is a shortcoming and a problem in Hegel's conception of civil society: it is based on an axiology of harmonization and integration, which is contradicted by economic processes. However, the perspicacious hegelian diagnosis shows clearly that the absence of integration and social recognition is as great an evil as material deprivation. (shrink)

Social anxiety is highly prevalent in adolescents and is often associated with great individual suffering and functional impairment. Psychiatric comorbidity is common and further adds to this burden. The purposes of this study were: (1) to describe the occurrence of diagnosed and self-reported social anxiety among 8,199 Norwegian adolescents aged 13–19 years who participated in the population-based Young-HUNT3 study (2006–2008); (2) to examine associations between sociodemographic characteristics and different subgroups of social anxiety; and (3) to describe the psychiatric health comorbidities (...) among adolescents diagnosed with social anxiety disorder (SAD). In total, 388 (5.9%) of the adolescents screened positive for SAD and were invited into a diagnostic interview, performed by professional nurses, using Anxiety Disorders Interview Schedule for DSM IV: child version (ADIS-C) (response rate = 54.6%). A SAD diagnosis was indicated in 106 individuals (50% of the interview subjects), and more than two-thirds of the adolescents diagnosed with SAD had one or more comorbid psychiatric disorders. Higher mean scores of self-reported social anxiety symptoms, poor self-rated health, sleep problems, poor family economic situation, low physical activity, and having sought professional help within the last year were associated with higher odds of being in the screening positive subgroup. Screening positive subjects who did not meet for a diagnostic interview did not differ notably from the rest of the screening positive group in terms of these sociodemographic characteristics. Based on our results and the fact that individuals with social anxiety often fear interview situations, the use of ADIS-C, screening questions and self-reports seem to be sufficient when aiming to identify epidemiologically representative cohorts of adolescents at risk of social anxiety. (shrink)

Background: The Self-Regulation of Eating Behavior Questionnaire is an economical way of assessing an individual's self-regulatory abilities regarding eating behavior. Such scales are needed in the German population; therefore, the purpose of the present study was the translation and validation of a German version of the SREBQ.Method: First, we conducted a pilot study after the translation procedure. Second, we assessed the final scale in a representative sample of the German population and its underlying factor structure. Further, we tested for measurement (...) invariance and evaluated the SREBQ's associations with related scales to explore convergent and discriminant validity. Finally, we considered differences in SREBQ based on sociodemographic variables and provided derived reference scores.Results: Factor analysis revealed deficiencies in the original model. Thus, we shortened the scale based on statistical considerations and the adapted version showed improved fit in Confirmatory Factor Analysis and reliability. We also found evidence for partial strict invariance, which means the measure is equivalent for the tested groups of age and gender. Item and scale psychometric properties of the shortened version were satisfactory. In terms of diagnostic validity, it was shown that individuals with higher body mass index have worse self-regulation of eating behavior than those with lower.Conclusion: In sum, the SREBQ evidenced good validity and reliability and is suitable for application in medical, psychological, and nutritional research. (shrink)

SummaryAmerican industrial society in the nineteenth century required special diagnostic techniques to assist in hiring physically qualified and dependable workers. The physician responded by employing diagnostic instruments to improve his diagnostic skills and meet the specific demands of business and industry, and as a consequence, the physician achieved a position as a salaried examiner and an effective medical practitioner. This was especially important in an age when the ‘regular’ physician competed for patients with a variety of other healers. The instrument (...) manufacturer aided the industrialization of medicine by producing devices which enabled the physician to treat patients with a greater variety of implements. In using more hardware to diagnose and heal, the reputation of American medicine changed to one of a progressive and effective profession. ‘Mainstream’ American medicine became another form of technology in a society which revered technology and subsequently attracted international esteem.However, this scenario is not novel. Investigation of the social and economic forces that had an equal, if not greater, impact on the mechanization of medicine has largely been ignored. This paper introduces some of the social and economic issues that led to the adoption and reliance on medical technology by the American medical community. (shrink)

This series of articles by Charles Dougherty, Robert Berenson, and Kathleen Powderly and Elaine Smith, as well as “Cost Containment: Challenging Fidelity and Justice” by E. Haavi Morreim (Hastings Center Report, December 1988), result from a Hastings Center project, “Ethics and Prospective Payment Systems: DRGs.” The two-year project was jointly funded by The General Electric Foundation and the American Medical Association Education and Research Foundation.The project tried to gauge the systematic effects of the introduction of cost containment strategies, prospective payment (...) by Diagnostic Related Groups in particular, on the provision of health care and the ethical practice of medicine. Cost containment strategies, no matter how necessary in curbing spiraling medical costs, leave no sector or participants in the health care system untouched—hospitals and other health care institutions; doctors, nurses, social workers and other health care professionals; patients, their families, and the thirty-six to forty million medically indigent. The articles discuss the several and interrelated ethical issues raised by the DRG prospective payment system (Dougherty); its particular affect on the doctor-patient relationship and how it is transforming the ethical practice of medicine (Berenson and Morreim); and its specific impact on the professions and professional ethics of nursing and social work (Powderly and Smith). The overall message of the articles is that the health professions, their provision of care, and the ethics of their practices—as driven by economic considerations and realities—are in the midst of a more or less radical sea change. (shrink)

The development of genomics has dramatically expanded the scope of genetic research, and collections of genetic biosamples have proliferated in countries with active genomics research programs. In this essay, we consider a particular kind of collection, national biobanks. National biobanks are often presented by advocates as an economic ‘‘resource’’ that will be used by both basic researchers and academic biologists, as well as by pharmaceutical diagnostic and clinical genomics companies. Although national biobanks have been the subject of intense interest (...) in recent social science literature, most prior work on this topic focuses either on bioethical issues related to biobanks, such as the question of informed consent, or on the possibilities for scientific citizenship that they make possible. We emphasize, by contrast, the economic aspect of biobanks, focusing specifically on the way in which national biobanks create biovalue. Our emphasis on the economic aspect of biobanks allows us to recognize the importance of what we call clinical labor—that is, the regularized, embodied work that members of the national population are expected to perform in their role as biobank participants—in the creation of biovalue through biobanks. Moreover, it allows us to understand how the technical way in which national biobanks link clinical labor to databases alters both medical and popular understandings of risk for common diseases and conditions. (shrink)

Research has established that exposure to a combination of diagnostic (i.e., relevant) and nondiagnostic (i.e., irrelevant) information results in predictions that are more regressive than predictions based on diagnostic information (Hackenbrack, 1992; Hoffman and Patton, 1997). This phenomenon has been labeled the dilution effect (e.g., Tetlock and Boettger, 1989) and has been documented when individuals make predictions. This study tests for the dilution effect when small groups make predictions, and examines the effect of using a procedure designed to reduce the (...) dilution effect. Results indicate that group predictions are influenced by nondiagnostic information in the same manner as are individual predictions, and allowing participants to rate the diagnosticity of information prior to making predictions does not reduce the dilution effect. (shrink)

Il y a trois défis pour la sécurité de l’Ouest. Le premier est que l’Ouest, comparé à l’Asie de l’Est, est en déclin. Dans vingt-cinq ans, la taille économique de la Chine continentale pourrait être supérieure à la taille du marché américain ; celle de l’Inde et de l’Indonesie être supérieure à la taille économique de l’Allemagne ; celle de la Corée du Sud excéder l’Angleterre ou la France ou l’Italie. Le second est la prolifération d’un savoir à doubleemploi et (...) le désastre économique de l’ex-Union Soviétique qui auront pour conséquence vraisemblable une prolifération du nucléaire. Le troisième concerne les changements de valeurs qui s’opèrent à l’Ouest et qui favorisent la formation de sociétés occidentales de moins en moins aptes à attaquer ou à se défendre. Mais la réduction du poids de l’Occident dans l’économie globale ne garantit plus que les efforts faciles l’emportent face aux défis du futur, qu’ils viennent des pouvoirs renforcés de l’Est asiatique ou des “desperados” islamiques. Ces défis ne seront vraisemblablement pas relevés au moyen de deux fausses prescriptions qui trouvent quelques faveurs en Europe Continentale. Premièrement, une grande partie de l’Europe de l’Ouest est lasse d’être confrontée à la “destruction créatrice” de ses emplois du fait de la concurrence de l’Asie de l’Est et désire ardemment le protectionnisme. Le remède protectionniste se bâtit sur un diagnostic grandement correct des problèmes occidentaux, mais il est tout de même dangereux si l’on met en perspective la morale, l’économie et la politique du pouvoir. Deuxièmement, certains Européens reconnaissent à juste titre que les grandes puissances historiques, comme la Grande- Bretagne ou la France ou l’Allemagne, n’ont plus une envergure suffisante pour être qualifiées de grandes puissances. Cependant, elles sousestiment la gravité et la vitesse du déclin de l’Occident. Une Europe définie par le noyau dur francoallemand deviendra trop étroite, avant même qu’elle ne soit établie dans cette structure. Vraisemblablement, même l’Union Européenne dans sa totalité sera trop petite avant qu’elle ne devienne une véritable communauté sur le plan sécuritaire. Au lieu de ces fausses prescriptions, cet article propose trois réponses aux dilemmes de l’Occident, ou encore trois façons de gérer le déclin de l’Occident. Premièrement, seule la coopération atlantique promet d’être une réponse efficace au dynamisme de l’Asie de l’Est et au déclin de l’Ouest. De plus, la coopération entre l’Amérique du Nord et l’Europe de l’Ouest a besoin d’être complétée par un nouvel engagement à l’égard d’une économie globale ouverte et d’une disposition à s’ajuster aux défis de celle-ci, afin de coopter l’Est asiatique dans une sphère globale de coprospérité. Cela doit vraisemblablement engendrer quelques coupes radicales dans l’Etat-providence. Deuxièmement, la prolifération nucléaire exige aussi une réponse. Il est concevable que la stratégie de défense contre la Chine soit encore plus difficile dans une vingtaine d’années qu’elle le fut contre l’Union Soviétique dans les années 1980. Mais cela ne devrait pas être une excuse pour ne pas construire des missiles de défense en réponse à ceux de l’Iran, de l’Irak, de la Lybie ou de l’Algerie. Troisièmement, les changements des valeurs en Occident semblent plus difficiles à traiter, mais ils renforcent la nécessité d’investir dans la coopération occidentale plutôt qu’uniquement européenne, la nécessité de coopter l’Asie de l’Est plutôt que de plonger dans une autre guerre froide, et la nécessité de contenir l’Etat-providence plutôt que de le développer. There are three challenges to Western security. First, compared to East Asia the West is in decline. In another twenty-five years, the economic size of Mainland China may exceed the size of the American market, India and Indonesia may exceed Germany, South Korea may exceed Britain or France or Italy. Second, the proliferation of dual use knowledge and the economic disaster in the former Soviet Union are likely to result in some nuclear proliferation. Third, value changes within the West will make Western societies ever less capable of deterrence and defense. But the reduced weight of the West in the global economy no longer guarantees that leisurely efforts succeed in meeting future challengers, whether from East Asian great powers or Islamic desperados. These challenges are unlikely to be met by two false prescriptions which enjoy some appeal in Continental Europe. First, much of Western Europe gets tired of observing the “creative destruction” of its jobs by East Asian competitors and longs for protectionism. The protectionist cure is built on a largely correct diagnosis of some Western problems, but nevertheless dangerous from an economic, moral, and power politics perspective. Second, some Europeans rightly recognize that historical great powers, like Britain or France or Germany, are no longer large enough to be great powers. But they underestimate the severity and speed of the decline of the West. A Franco- German core Europe will become too small, even before it is established. Conceivably, even the entire European Union will be too small before it becomes an effective security community. Instead of these false prescriptions this paper advocates three responses to Western dilemmas, or three modes of managing Western decline. First, only Atlantic cooperation promises to be an effective response to East Asian dynamism and Western decline. Moreover, cooperation between North America and Western Europe needs to be complemented with a renewed commitment to an open global economy and a readiness to adjust to its challenges, in order to coopt East Asia into a global co-prosperity sphere. This is likely to necessitate some radical cuts in the welfare state. Second, nuclear proliferation also needs some response. Conceivably, strategic defense is as difficult against China twenty years from now, as it was against the Soviet Union in the 1980s. But this should be no excuse for not building a missile and air defense against the likes of Iran, Iraq, Lybia, or Algeria. Third, the value changes within the West seem least tractable, but they reinforce the necessity of investing in Western rather than merely European cooperation, the necessity of coopting East Asia rather than stumbling into another Cold War, and the necessity for containing the welfare state rather than expanding it. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:CALL FOR PROPOSALS TRAUMA AND HEALING 12TH EAST-WEST PHILOSOPHER’S CONFERENCE MAY 24-31, 2024 The 12th East-West Philosopher’s Conference will explore the many dimensions of trauma and healing. While trauma can be physical, it can also be psychological, social, political, economic, and cultural—encompassing the immediate effects of global pandemics, the ongoing impacts of ethnic and gender bias, the intergenerational legacies of colonization and geopolitical strife, and the planetary ramifications (...) of anthropogenic climate disruption. Ours is an era in which differences of histories, cultures, and identities are engaged as sources of insight, but also one of retrenchment—a period of relational appreciation, but also one of schism. The global scientific community’s response to the COVID-19 pandemic was a stunning example of human potential for empathetic collaboration in the face of global personal and public health trauma. Yet, the economic trauma of the pandemic has resulted in crumbling international alliances, deepening trade wars, and an unfortunate collective reinvestment in zero-sum endgame framings of geopolitics against which there is no vaccination and through which the terms of healing have become delinked from the restoration of global wholeness. These traumas do not stop shaping our lives when the immediate danger comes to an end. Traumatic pain remains stored in the memories of peoples and individuals, it populates their imagination and shapes horizons of possibility. Thus a philosophical exploration of trauma and healing is not only diagnostic of current problems but also a form of genealogy. We invite participants to reflect upon the relational complexity of both trauma and healing, critically and historically engaging concrete occurrences of trauma while also drawing out theoretical insights regarding healing that strengthens and empowers and resists the forms of personal and social amnesia that make the repetition of trauma so tragically common. Of special interest are panels and papers that explore the trauma and healing at all scales from the interpersonal, to the relational traumas experienced by nations at war and cultures in conflict, thus addressing the interplay of the private and public spheres, of ethics and economics, of the human and the natural sciences, and among disciplines, classes, genders, and generations. Panel and paper proposals are encouraged that explore trauma and healing during the ongoing COVID-19 pandemic, the trauma of refugees, displaced and colonized peoples, trauma and healing in personal relationships, climate change as a form of trauma to the planet and its people, trauma and healing related to issues of gender and sexuality, and how philosophers of all traditions, ancient and modern, cross-culturally deal with trauma and healing. KEYNOTE PRESENTERS: Jin Y. Park, Chair of Philosophy and Religion at American University, Washington DC, “Translating Violence.” Ato Quayson, Jean G. and Morris M. Doyle Professor of Interdisciplinary Studies at Stanford University, CA, “The Ethnography of the Private Sphere: Trauma, Domesticity, and Healing in the Work of Toni Morrison.” We invite proposals for individual papers and panels. Please submit a 250-300 word abstract to the Conference organizers via: [email protected]. Submission Timeline: November 1, 2023 Notifications of acceptance for abstracts and panel proposals received by November 1 will be sent out by December 15, 2023. We have established an early submission timeline to facilitate faculty applying to their own institutions for travel funding. Abstracts received after November 1, 2023, will be vetted as received, taking into consideration the late submission. The absolute deadline for abstract submissions is March 15, 2024. After this, we will not be able to accommodate additional proposals. Final Papers Due: April 15, 2024 CONFERENCE REGISTRATION AND LOGISTICS: Hosted in keeping with the Hawaiian Islands’ spirit of aloha, breakfast and lunch will be provided for all registered presenters, as well as an opening reception and final dinner. The Conference does not provide lodging or travel support, but economical lodgings of various kinds are readily available in Honolulu. ABOUT THE EAST-WEST PHILOSOPHER’S CONFERENCE: The East-West Philosophers’ Conference series is the premier forum for convening philosophers from across the academy who are committed to cross-cultural inquiry. The Conference is the oldest continuous international gathering in Hawai‘i and has been a model of productive collaboration between the University of Hawai‘i at... (shrink)

There are substantial inequalities associated with antibiotics and the determinants of their effectiveness, including the risk of exposure to antibiotic‐resistant microbes, access to relevant treatment advice, diagnostic facilities, risk of life‐threatening infectious disease, and access to antibiotics. Current arrangements (social, political, economic) allow inequalities in the distribution of antibiotic benefits and burdens. This article focuses on the justification of relevant inequalities from a contractualist perspective.

Synthetic biology, as an engineering approach to biological systems, has the potential to disruptively innovate the development of vaccines, therapeutics, and diagnostics. Data accessibility and differences in data-usage capabilities are important factors in shaping this innovation landscape. In this paper, the data that underpin synthetic biology responses to the COVID-19 pandemic are analyzed as positional information goods—goods whose value depends on exclusivity. The positionality of biological data impacts the ability to guide innovations toward societally preferred goals. From both an (...) ethical and economic point of view, positionality can lead to suboptimal as well as beneficial situations. When aiming for responsible innovation (i.e. embedding societal deliberation in the innovation process), it is important to consider hurdles and facilitators in data access and use. Central governance and knowledge commons provide routes to mitigate the negative effects of data positionality. (shrink)

New applications in medicine, science and technology are changing our lives. The delicate border between clinical trials and conventional diagnostic / treatment methods is becoming more evident. At this border new questions arise that need both rational and humanistic answers and that affect humankind‘s understanding of self: What are our responsibilities towards human subjects in clinical trials? What are our responsibilities towards patients and decisionally impaired psychiatry patients? What are rules about the routine techniques on decisionally incompetent psychiatry patients? What (...) are the economic parameters‘ affecting decisions?Many current research projects are concerned with the ethical problems of clinical trials of newly used medication, clinical trials of newly used measurement techniques, clinical trials proposed as conventional treatment methods, new measuring methods or conventional measuring methods on irrelevant patient groups; all being concerned with clinical trials of EEG and neuroscience. In 2009, the Ministry of Health of Turkey implemented new legislation on ―clinical trials and newly established independent ethics committees ‖. These independent and multidisiplinary IRBs analyze research projects and make recommendations about them. What should be the rationale about psychiatric patients in Turkey in a global setting? (shrink)

What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It’s also highly likely to impact on the organisational and business practices (...) of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare institutions. We will suggest that two questions, in particular, are deserving of further attention from philosophers and bioethicists. What does care look like when one is dealing with data as much as people? And, what weight should we give to the advice of machines in our own deliberations about medical decisions? (shrink)

his article develops a set of recommendations for the psychiatric and medical community in the treatment of mental disorders in response to the recently published fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, that is, DSM-5. We focus primarily on the limitations of the DSM-5 in its individuation of Complicated Grief, which can be diagnosed as Major Depression under its new criteria, and Post-Traumatic Stress Disorder (PTSD). We argue that the hyponarrativity of the descriptions of these disorders (...) in the DSM-5, defined as the abstraction of the illness categories from the particular life contingencies and personal identity of the patient (e.g., age, race, gender, socio-economic status), constrains the DSM-5's usefulness in the development of psychotherapeutic approaches in the treatment of mental disorders. While the DSM-5 is useful in some scientific and administrative contexts, the DSM's hyponarrativity is problematic, we argue, given that the DSMs are designed to be useful guides for not only scientific research, but also for the education of medical practitioners and for treatment development. our goal therefore is to offer suggestions for mental health practitioners in using the DSM-5, so that they can avoid or eliminate the problems that may stem from the limitations of hyponarrativity. When such problems are eliminated, we believe that effective psychotherapeutic strategies can be developed, which would be successful in repairing the very relationships that are strained in mental disorder: the patient's relationship to herself, her physical environment, and her social environment. (shrink)