Las distinciones conceptuales propuestas por Thomas Hobbes reflejan el problema político de considerar lo múltiple en la unidad o la convergencia de innumerables cuerpos, deseos y pasiones en la consolidación de una voluntad soberana unitaria. Ejemplo de ello son las nociones de potentiae (potencias) y potestas (poder), junto a otras como multitud y pueblo o súbditos y soberano. Todas ellas reflejan el problema de la estabilidad del Estado y su legitimidad institucional: la necesidad de generar, de manera continua, un poder (...) común. Con la intención de formular una lectura democrática, el propósito de este artículo es relacionar una lectura iconográfica del frontispicio del Leviatán con la presencia/ausencia de un cuerpo indómito. El trabajo concluye que un rasgo esencial de la teoría política hobbesiana es el sentido de lo democrático fundamentado en la presencia ineludible de cuerpos colectivos que deben ser representados. (shrink)

El objetivo del presente trabajo es identificar el uso político de la imagen al servicio del Estado y la función del régimen democrático al interior del sistema filosófico de Thomas Hobbes. Tal propósito se aborda en dos momentos: I. se propone un análisis iconográfico, con lo cual se destaca una lógica de la presencia/ausencia de la multitud como un cuerpo político (i.e. problema de la dispersión); II. se retoman las discusiones en torno a la función de la democracia, y se (...) expone el problema de la dispersión como el paso de la multitud disuelta al pueblo junto a la consolidación del cuerpo soberano (i.e. régimen democrático). Se concluye que el uso político de la imagen, descrita a partir de la distinción entre la adoración civil y la adoración divina, por parte del poder soberano, es una exhortación hobbesiana a la regulación del miedo (ciu bono del sostenimiento del poder soberano). En consecuencia, el gobierno de la imagen implica el problema del régimen democrático. (shrink)

The Religion is a fascinating topic despite it has some hurdles. Although the study of its constitution, objective and relevance has been understood with effort for different research fields, most of its meaningful contributions do not get more than refuse each other. This research, which presents the main proposals of the United States philosopher Daniel Dennett about religion as natural phenomenon in contrast with the proposal of distinguished religion philosopher, has as a propose to point the less inhospitable lands, in (...) the center of the debate in which it can be possible, making an interdisciplinary proposal, a less conflictive comprehension about religion that can allow those limits that sometimes are imposed to it in a conclusive way for the scientific convictions, biologists postulates, or even for the metaphysics speculations of some theologist forms. (shrink)

La religión es un tema apasionante, aunque sembrado por escollos. Si bien el estudio de su constitución, finalidad y pertinencia ha sido emprendido por diferentes campos de investigación, gran parte de sus más significativos aportes no consiguen más que rebatirse entre sí. Esta investigación, que aborda los planteamientos principales del filósofo estadounidense Daniel Dennett sobre el tema de la religión como fenómeno natural en contraste con los planteamientos de distinguidos filósofos de la religión, tiene como propósito señalar terrenos menos inhóspitos (...) en medio del debate en los que sea posible, haciendo una apuesta interdisciplinar, una comprensión menos conflictiva de la religión que pueda franquear esos límites que se le imponen a veces de manera tan concluyente ya sea por parte de las certezas científicas, de los postulados biologicistas, o incluso de las especulaciones metafísicas de algunas formulaciones teológicas. (shrink)

We describe a form of moral artificial intelligence that could be used to improve human moral decision-making. We call it the “artificial moral advisor”. The AMA would implement a quasi-relativistic version of the “ideal observer” famously described by Roderick Firth. We describe similarities and differences between the AMA and Firth’s ideal observer. Like Firth’s ideal observer, the AMA is disinterested, dispassionate, and consistent in its judgments. Unlike Firth’s observer, the AMA is non-absolutist, because it would take into account the human (...) agent’s own principles and values. We argue that the AMA would respect and indeed enhance individuals’ moral autonomy, help individuals achieve wide and a narrow reflective equilibrium, make up for the limitations of human moral psychology in a way that takes conservatives’ objections to human bioenhancement seriously, and implement the positive functions of intuitions and emotions in human morality without their downsides, such as biases and prejudices. (shrink)

We argue that individuals who have access to vaccines and for whom vaccination is not medically contraindicated have a moral obligation to contribute to the realisation of herd immunity by being vaccinated. Contrary to what some have claimed, we argue that this individual moral obligation exists in spite of the fact that each individual vaccination does not significantly affect vaccination coverage rates and therefore does not significantly contribute to herd immunity. Establishing the existence of a moral obligation to be vaccinated (...) despite the negligible contribution each vaccination can make to the realisation of herd immunity is important because such moral obligation would strengthen the justification for coercive vaccination policies. We show that two types of arguments—namely a utilitarian argument based on Parfit’s Principle of Group Beneficence and a contractualist argument—can ground an individual moral obligation to be vaccinated, in spite of the imperceptible contribution that any single vaccination makes to vaccine coverage rates. We add a further argument for a moral obligation to be vaccinated that does not require embracing problematic comprehensive moral theories such as utilitarianism or contractualism. The argument is based on a “duty of easy rescue” applied to collectives, which grounds a collective moral obligation to realise herd immunity, and on a principle of fairness in the distribution of the burdens that must be borne to realise herd immunity. (shrink)

We address the issue of whether, why and under what conditions, quarantine and isolation are morally justified, with a particular focus on measures implemented in the developing world. We argue that the benefits of quarantine and isolation justify some level of coercion or compulsion by the state, but that the state should be able to provide the strongest justification possible for implementing such measures. While a constrained form of consequentialism might provide a justification for such public health interventions, we argue (...) that a stronger justification is provided by a principle of State Enforced Easy Rescue: a state may permissibly compel individuals to engage in activities that entail a small cost to them but a large benefit to others, because individuals have a moral duty of easy rescue to engage in those activities. The principle of State Enforced Easy Rescue gives rise to an Obligation Enforcement Requirement: the state should create the conditions such that submitting to coercive or compulsive measures becomes a fundamental moral duty of individuals, i.e. a duty of easy rescue. When the state can create such conditions, it has the strongest justification possible for implementing coercive or compulsive measures, because individuals have a moral duty to temporarily relinquish the rights that such measures would infringe. Our argument has significant implications for how public health emergencies in the developing world should be tackled. Where isolation and quarantine measures are necessary, states or the international community have a moral obligation to provide certain benefits to those quarantined or isolated. (shrink)

The rapid development of vaccines against COVID‐19 represents a huge achievement, and offers hope of ending the global pandemic. At least three COVID‐19 vaccines have been approved or are about to be approved for distribution in many countries. However, with very limited initial availability, only a minority of the population will be able to receive vaccines this winter. Urgent decisions will have to be made about who should receive priority for access. Current policy in the UK appears to take the (...) view that those who are most vulnerable to COVID‐19 should get the vaccine first. While this is intuitively attractive, we argue that there are other possible values and criteria that need to be considered. These include both intrinsic and instrumental values. The former are numbers of lives saved, years of life saved, quality of the lives saved, quality‐adjusted life‐years (QALYs), and possibly others including age. Instrumental values include protecting healthcare systems and other broader societal interests, which might require prioritizing key worker status and having dependants. The challenge from an ethical point of view is to strike the right balance among these values. It also depends on effectiveness of different vaccines on different population groups and on modelling around cost‐effectiveness of different strategies. It is a mistake to simply assume that prioritizing the most vulnerable is the best strategy. Although that could end up being the best approach, whether it is or not requires careful ethical and empirical analysis. (shrink)

We argue that, from the point of view public health ethics, vaccination is significantly analogous to seat belt use in motor vehicles and that coercive vaccination policies are ethically justified for the same reasons why coercive seat belt laws are ethically justified. We start by taking seriously the small risk of vaccines’ side effects and the fact that such risks might need to be coercively imposed on individuals. If millions of individuals are vaccinated, even a very small risk of serious (...) side effects implies that, statistically, at some point side effects will occur. Imposing such risks raises issues about individual freedom to decide what risks to take on oneself or on one’s children and about attribution of responsibility in case of adverse side effects. Seat belt requirements raise many of the same ethical issues as vaccination requirements, and seat belt laws initially encountered some opposition from the public that is very similar to some of the current opposition to vaccine mandates. The analogy suggests that the risks of vaccines do not constitute strong enough reasons against coercive vaccination policies and that the same reasons that justify compulsory seat belt use—a measure now widely accepted and endorsed—also justify coercive vaccination policies. (shrink)

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

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

Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage (...) payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated. (shrink)

We provide ethical criteria to establish when vaccine mandates for healthcare workers are ethically justifiable. The relevant criteria are the utility of the vaccine for healthcare workers, the utility for patients (both in terms of prevention of transmission of infection and reduction in staff shortage), and the existence of less restrictive alternatives that can achieve comparable benefits. Healthcare workers have professional obligations to promote the interests of patients that entail exposure to greater risks or infringement of autonomy than ordinary members (...) of the public. Thus, we argue that when vaccine mandates are justified on the basis of these criteria, they are not unfairly discriminatory and the level of coercion they involve is ethically acceptable—and indeed comparable to that already accepted in healthcare employment contracts. Such mandates might be justified even when general population mandates are not. Our conclusion is that, given current evidence, those ethical criteria justify mandates for influenza vaccination, but not COVID-19 vaccination, for healthcare workers. We extend our arguments to other vaccines. (shrink)

Conflict of interests in medicine are typically taken to be financial in nature: it is often assumed that a COI occurs when a healthcare practitioner’s financial interest conflicts with patients’ interests, public health interests, or professional obligations more generally. Even when non-financial COIs are acknowledged, ethical concerns are almost exclusively reserved for financial COIs. However, the notion of “interests” cannot be reduced to its financial component. Individuals in general, and medical professionals in particular, have different types of interests, many of (...) which are non-financial in nature but can still conflict with professional obligations. The debate about healthcare delivery has largely overlooked this broader notion of interests. Here, we will focus on health practitioners’ moral or religious values as particular types of personal interests involved in healthcare delivery that can generate COIs and on conscientious objection in healthcare as the expression of a particular type of COI. We argue that, in the healthcare context, the COIs generated by interests of conscience can be as ethically problematic, and therefore should be treated in the same way, as financial COIs. (shrink)

In a paper recently published in this journal, Navin and Largent argue in favour of a type of policy to regulate non-medical exemptions from childhood vaccination which they call ‘Inconvenience’. This policy makes it burdensome for parents to obtain an exemption to child vaccination, for example, by requiring parents to attend immunization education sessions and to complete an application form to receive a waiver. Navin and Largent argue that this policy is preferable to ‘Eliminationism’, i.e. to policies that do not (...) allow non-medical exemptions, because Inconvenience has been shown to maintain exemption rates low while not harming parents by forcing them to do something that goes against their beliefs. We argue that it is at least doubtful that Inconvenience is ethically preferable to Eliminationism: while the latter disregards the value of liberty, Inconvenience disregards the value of fairness in the distribution of the burdens entailed by the preservation of a public good like herd immunity. We propose a variant of Inconvenience, which we call ‘Contribution’, which we think is preferable to the versions of Inconvenience discussed by Navin and Largent in that it successfully strikes a balance between the values of parents’ liberty, fairness and expected utility. (shrink)

Although the COVID-19 pandemic is a serious public health and economic emergency, and although effective vaccines are the best weapon we have against it, there are groups and individuals who oppose certain kinds of vaccines because of personal moral or religious reasons. The most widely discussed case has been that of certain religious groups that oppose research on COVID-19 vaccines that use cell lines linked to abortions and that object to receiving those vaccine because of their moral opposition to abortion. (...) However, moral opposition to COVID-19 vaccine research can be based on other considerations, both secular and religious. We argue that religious or personal moral objections to vaccine research are unethical and irresponsible, and in an important sense often irrational. They are unethical because of the risk of causing serious harm to other people for no valid reason; irresponsible because they run counter to individual and collective responsibilities to contribute to important public health goals; and in the case of certain kinds of religious opposition, they might be irrational because they are internally inconsistent. All in all, our argument translates into the rather uncontroversial claim that we should prioritize people’s lives over religious freedom in vaccine research and vaccination roll out. (shrink)

We argue that we should provide extra payment not only for extra time worked but also for the extra risks healthcare workers (and those working in healthcare settings) incur while caring for COVID‐19 patients—and more generally when caring for patients poses them at significantly higher risks than normal. We argue that the extra payment is warranted regardless of whether healthcare workers have a professional obligation to provide such risky healthcare. Payment for risk would meet four essential ethical requirements. First, assuming (...) healthcare workers do not have a professional obligation to take on themselves the risks, payments in the form of incentives would preserve autonomy in deciding what risks to take on oneself. Second, even assuming that healthcare workers do have a professional obligation to take on themselves the risks, payments for risk would create fair working conditions by avoiding exploitation. Third, payments for risk would make it more likely that public healthcare systems can discharge their institutional responsibility to provide healthcare in circumstances where healthcare workers may otherwise (perhaps legitimately) opt out. Fourth, payments for risk would guarantee an efficient healthcare system in pandemic situations. Finally, we address two likely objections that some might raise against our proposal, particularly with regard to incentives, namely that such payments or incentives can themselves be coercive and that they represent a form of undue inducement. (shrink)

We discuss whether and under what conditions people should be allowed to choose which COVID-19 vaccine to receive on the basis of personal ethical views. The problem arises primarily with regard to some religious groups’ concerns about the connection between certain COVID-19 vaccines and abortion. Vaccines currently approved in Western countries make use of foetal cell lines obtained from aborted foetuses either at the testing stage or at the development stage. The Catholic Church’s position is that, if there are alternatives, (...) Catholic people have a moral obligation to request the vaccine whose link with abortion is more remote, which at present means that they should refuse the Oxford/AstraZeneca vaccine. We argue that any consideration regarding free choice of the vaccine should apply to religious and non-religious claims alike, in order to avoid religion-based discrimination. However, we also argue that, in a context of limited availability, considering the significant differences in costs and effectiveness profile of the vaccines available, people should only be allowed to choose the preferred vaccine if: 1) this does not risk compromising vaccination strategies; and 2) they internalize any additional cost that their choice might entail. The State should only subsidize the vaccine that is more cost-effective for any demographic group from the point of view of public health strategies. (shrink)

Many parents are hesitant about, or face motivational barriers to, vaccinating their children. In this paper, we propose a type of vaccination policy that could be implemented either in addition to coercive vaccination or as an alternative to it in order to increase paediatric vaccination uptake in a non-coercive way. We propose the use of vaccination nudges that exploit the very same decision biases that often undermine vaccination uptake. In particular, we propose a policy under which children would be vaccinated (...) at school or day-care by default, without requiring parental authorization, but with parents retaining the right to opt their children out of vaccination. We show that such a policy is likely to be effective, at least in cases in which non-vaccination is due to practical obstacles, rather than to strong beliefs about vaccines, ethically acceptable and less controversial than some alternatives because it is not coercive and affects individual autonomy only in a morally unproblematic way, and likely to receive support from the UK public, on the basis of original empirical research we have conducted on the lay public. (shrink)

We argue that, in certain circumstances, doctors might beprofessionallyjustified to provide abortions even in those jurisdictions where abortion is illegal. That it is at least professionally permissible does not mean that they have an all-things-considered ethical justification or obligation to provide illegal abortions or that professional obligations or professional permissibility trump legal obligations. It rather means that professional organisations should respect and indeed protect doctors’ positive claims of conscience to provide abortions if they plausibly track what is in the best (...) medical interests of their patients. It is the responsibility of state authorities to enforce the law, but it is the responsibility of professional organisations to uphold the highest standards of medical ethics, even when they conflict with the law. Whatever the legal sanctions in place, healthcare professionals should not be sanctioned by the professional bodies for providing abortions according to professional standards, even if illegally. Indeed, professional organisation should lobby to offer protection to such professionals. Our arguments have practical implications for what healthcare professionals and healthcare professional organisations may or should do in those jurisdictions that legally prohibit abortion, such as some US States after the reversal ofRoe v Wade. (shrink)

In this response paper, we respond to the criticisms that Michal Pruski raised against our article “Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests.” We defend our original position against conscientious objection in healthcare by suggesting that the analogies Pruski uses to criticize our paper miss the relevant point and that some of the analogies he uses and the implications he draws are misplaced.

We thank the authors of the five commentaries for their careful and highly constructive consideration of our paper,1 which has enabled us to develop our proposal. Participation in research has traditionally been viewed as altruistic. Over time, payments for inconvenience and lost wages have been allowed, as have small incentives, usually in kind. The problem, particularly with controlled human infection model research or ‘challenge studies’, is that they are unpleasant and time-consuming. Researchers want to offer carrots to incentivise participation. We (...) are proposing that research participation be viewed as a job with the full suite of financial entitlements of fairly remunerated work, including payment for risk and labour law protections. This would be a significant shift from current practice and standards. Ambuehl, Ockenfels and Roth have grasped this basic point and have beautifully elaborated how a fair price could be arrived at using economic theory. They build on our proposal helpfully and suggest ‘ salary for time involvement that is adjusted to account for the amount of discomfort experienced during participation, insurance against ex post adverse outcomes and ex ante compensation for risks that cannot be compensated ex post.’3 This effectively addresses Fernandez Lynch and Largent’s2 concern that compensation for risk is inappropriate for harms which do not eventuate. However, because death cannot be compensated for, there must be payment for risk of death, as Ambuehl, Ockenfels and Roth convincingly argue.3 Indeed, the three-part model suggested by Ambuehl, Ockenfels and Roth makes us realise that job model would be a better title for our model than a payment for risk model. The alternative to a properly remunerated job model is the original altruistic model. However, this …. (shrink)

La condición de discapacidad es una realidad antropológica que no sólo afecta la integridad biológica de los individuos que la padecen sino también su interacción social y hasta su experiencia religiosa. Como una vía de aproximación a dicha realidad, el presente artículo propone un marco histórico-literario que permita comprender el trasfondo teológico de dos situaciones de discapacidad concretas, la ceguera y la sordera, a través de un estudio sobre tales condiciones en las tradiciones bíblicas y extra-bíblicas y en la literatura (...) judía y greco-romana contemporánea a la redacción del Nuevo Testamento. The disability condition is an anthropological reality that affects not only the biological integrity of the individuals who suffer it but also their social interaction and even their religious experience. As a way of approach to such reality, this article proposes a historical and literary framework which leads to understand the theological background of two disabilities situations in specific, blindness and deafness, throughout a study about such conditions on the biblical and extra-biblical traditions and on the Jewish and Greco-Roman literature contemporary to the New Testament redaction. (shrink)

«Palabra de Dios» no se dice sólo con referencia a las Sagradas Escrituras; Jesucristo es la Palabra de Dios por antonomasia frente a la cual las demás expresiones de Palabra de Dios, incluyendo la Biblia, lo serán en sentido análogo y dependiente. Esto significa que tras la hermenéutica bíblica cristiana subyace la fe cristológica, de tal modo que lo que se predica de la naturaleza de la Sagrada Escritura, Palabra de Dios puesta por escrito, sea consecuencia directa de lo que (...) se predica de Jesucristo, Palabra de Dios encarnada. Ello, además de incidir en la vida y la fe del creyente, tiene importantes implicaciones epistemológicas, metodológicas y práxicas para la hermenéutica bíblica hoy. «Word of God» doesn’t onlj refer to the Holj Scaptures; Jesús Christ is the Word of God par excellence against which all other expressions of God’s Word, including the Bible, are anahgous and dependent. This means that behind Christian biblical hermeneutics lies faith in Christ, so that what is preached on the nature of the Holj Scripture, the written Word of God, is directlj dependent on what is preached about Jesús Christ, the Word of God incarnate. This, besides influencing the ufe and faith of the beüever, has important epistemological, methodological and practical consequences for current biblical hermeneutics. (shrink)

From the first books published by Jean-Paul Sartre, it is possible to observe the criticism that the French author makes to the Western metaphysical tradition, directed specifically at philosophers of modernity. For example, L'imagination and L'Imaginaire are two texts dedicated to questioning “the great metaphysical systems”. Furthermore, in these early investigations, Sartre discovers a principle that would allow him to elabo- rate his work Being and nothingness. What is this principle? The main objective of this essay is to determine this (...) principle and its importance in the elaboration of Being and nothingness. In order to achieve this purpose, I will analyze Sartre's criticism of modern philosophers (Descartes and Hume) and his proposal to overcome what Sartre himself calls: the “naive metaphysics of the image” (1978, p. 9), which is nothing more than the fact of reifying the image. (shrink)

We humans can enhance some of our mental and physical abilities above the normal upper limits for our species with the use of particular drug therapies and medical procedures. We will be able to enhance many more of our abilities in more ways in the near future. Some commentators have welcomed the prospect of wide use of human enhancement technologies, while others have viewed it with alarm, and have made clear that they find human enhancement morally objectionable. The Ethics of (...) Human Enhancement examines whether the reactions can be supported by articulated philosophical reasoning, or perhaps explained in terms of psychological influences on moral reasoning. An international team of ethicists refresh the debate with new ideas and arguments, making connections with scientific research and with related issues in moral philosophy. (shrink)

An international team of ethicists refresh the debate about human enhancement by examining whether resistance to the use of technology to enhance our mental and physical capabilities can be supported by articulated philosophical reasoning, or explained away, e.g. in terms of psychological influences on moral reasoning.

Reseña del libro Tiempo de Revueltas. Cuatro: nota roja y sentido trágico [La firma de José Revueltas].

Resumen Desde una visión de fe, la comunión supone la posibilidad de que la existencia criatural participe, por la gracia, de la comunión divina trinitaria. El presente artículo, ubicado en el ámbito de la teología bíblica, busca aportar a la reflexión teológica sistemática a través del rastreo sobre el modo como “la realidad comunional” ha sido percibida, comprendida y expresada por parte del hombre bíblico por medio del recurso a imágenes tomadas de su experiencia histórica y cotidiana. Tales imágenes son, (...) principalmente, la unidad orgánica del cuerpo, la unión esponsal y la mesa compartida.From a faith perspective, communion supposes the possibility that the existence of the creature could be part, through the grace, of Trinitarian divine communion. This article, located in the field of the biblical theology, seeks to contribute to the systematic theological reflection by probing about the way as the “reality of communion” has been perceived, understood, and expressed by the biblical man using images taken from historical and everyday experience. Such images are, mainly, the organic unity of the body, the spousal union, and the shared table. (shrink)

Collaborative forms of work such as extended networks, expert groups, and consortia increasingly structure biomedical activities. They are particularly prominent in the cancer field, where procedures such as multicenter clinical trials have been instrumental in establishing the specialty of oncology, and subfields such as cancer genetics, where bioclinical activities—for example, testing for breast and ovarian cancer genes and follow-up interventions—are predicated on the articulation of a number of tasks performed by new clinical collectives. In this article, we examine the founding (...) and development of a French bioclinical collective—the Groupe Génétique et Cancer —that coordinates and structures the activities of most French actors in cancer genetics and operates simultaneously in the clinical, research, and regulatory domains. To examine the group’s structure and dynamics, the article combines information gathered through traditional fieldwork methods with information elicited from a coauthorship and semantic-network analysis of the publications of GGC members from 1969 to 2001. (shrink)

Antimicrobial resistance is one of the greatest public health crises of our time. The natural biological process that causes microbes to become resistant to antimicrobial drugs presents a complex social challenge requiring more effective and sustainable management of the global antimicrobial commons—the common pool of effective antimicrobials. This special issue of Health Care Analysis explores the potential of two legal approaches—one long-term and one short-term—for managing the antimicrobial commons. The first article explores the lessons for antimicrobial resistance that can be (...) learned from recent climate change agreements, and the second article explores how existing international laws can be adapted to better support global action in the short-term. (shrink)

Antibiotic use in animal farming is one of the main drivers of antibiotic resistance both in animals and in humans. In this paper we propose that one feasible and fair way to address this problem is to tax animal products obtained with the use of antibiotics. We argue that such tax is supported both by deontological arguments, which are based on the duty individuals have to compensate society for the antibiotic resistance to which they are contributing through consumption of animal (...) products obtained with the use of antibiotics; and a cost-benefit analysis of taxing such animal products and of using revenue from the tax to fund alternatives to use of antibiotics in animal farming. Finally, we argue that such a tax would be fair because individuals who consume animal products obtained with the use of antibiotics can be held morally responsible, i.e. blameworthy, for their contribution to antibiotic resistance, in spite of the fact that each individual contribution is imperceptible. (shrink)

In this paper, we examine the importance of two different peer effects as determinants in the adolescent’s decision whether or not to smoke. One is measured at the class level and the other reflects the smoking behaviour of the adolescent’s best friends. A nationally representative wave of Spanish data, collected in different state and private centres of secondary education and vocational training, and several linear probability models are used to estimate the role of peer effects. We find that a 10 (...) % increase in the proportion of classmates is associated with a 3.6 points increment in the probability of smoking. Similarly, if the smoker’s friends go from “only some” to “the majority”, the probability of smoking increases by 39 points. Although both peer effects are significant if introduced separately, the class peer variable is not significant once the closer peer effect is introduced. Our work provides evidence to support the hypothesis that peer effects are important determinants of smoking among adolescents. This has implications for policy-makers, since the existence of peer effects would amplify the effects of interventions. (shrink)

During the COVID-19 pandemic, focused protection strategies including selective lockdowns of the elderly were proposed as alternatives to general lockdowns. These selective restrictions would consist of isolating only those most at risk of COVID-19 hospitalization and subsequent use of healthcare resources. The proposal seems to have troubling implications, including the permissibility of selective lockdown on the basis of characteristics such as ethnicity, sex, disability, or BMI. Like age, these factors also correlated with an increased risk of hospitalization from COVID-19. In (...) this paper, we argue that age has meaningful differences as a morally relevant characteristic in the justification for selective restrictions of liberty. Thus, it might justify selective freedom restrictions in a way in which other factors might not. We offer four moral domains that separate age from other proxies: empiricism, operationality, discrimination, and disparity. (shrink)

El lector se encontrará en el presente trabajo con dos capítulos en los cuales se aborda de manera clara e histórica el proceso de codificación europea en el periodo del iluminismo o siglo de las luces, sobre todo en lo que tiene que ver con la codificación en materia de Derecho Penal, en el segundo capítulo se aborda esa influencia del proceso de codificación europeo en el proceso de codificación en América Latina, haciendo énfasis en el impacto de dicho proceso (...) en la expedición de Primer Código Penal de 1837 de la República de la Nueva Granada esto a la luz de los aportes de dos estudiosos y juristas europeos: Cesare Bonesana Marqués de Beccaría y Jeremy Bentham. (shrink)

The objective structured clinical examination is a method for assessment clinical competencies and skills. However, there is a need to improve its design in psychology programs. The aim of this study was to analyze the effect of the different scenario's presentation order with different complexity/difficulty on the autonomic stress response of undergraduate students undergoing a Psychology OSCE. A total of 32 students of Psychology Bachelor's Degree were randomly selected and assigned to two OSCE scenarios of different complexity. While undergoing the (...) scenarios, participants heart rate variability was analyzed as an indicator of participant's stress autonomic response. Results indicate that the order of presentation of different complexity/difficulty scenarios affects the autonomic stress response of undergraduate Psychology students undergoing an OSCE. Students who underwent the high-complexity scenario first, reported significantly higher autonomic stress response than students who began the OSCE with the low-complexity scenario. Highly complex or difficult scenarios require good executive functions or cognitive control, very sensitive to autonomic stress responses. Therefore, OSCE design will benefit from placing easy scenarios first. (shrink)

An international legal agreement governing the global antimicrobial commons would represent the strongest commitment mechanism for achieving collective action on antimicrobial resistance (AMR). Since AMR has important similarities to climate change—both are common pool resource challenges that require massive, long-term political commitments—the first article in this special issue draws lessons from various climate agreements that could be applicable for developing a grand bargain on AMR. We consider the similarities and differences between the Paris Climate Agreement and current governance structures for (...) AMR, and identify the merits and challenges associated with different international forums for developing a long-term international agreement on AMR. To be effective, fair, and feasible, an enduring legal agreement on AMR will require a combination of universal, differentiated, and individualized requirements, nationally determined contributions that are regularly reviewed and ratcheted up in level of ambition, a regular independent scientific stocktake to support evidence informed policymaking, and a concrete global goal to rally support. (shrink)

Antimicrobial resistance (AMR) is an urgent threat to global public health and development. Mitigating this threat requires substantial short-term action on key AMR priorities. While international legal agreements are the strongest mechanism for ensuring collaboration among countries, negotiating new international agreements can be a slow process. In the second article in this special issue, we consider whether harnessing existing international legal agreements offers an opportunity to increase collective action on AMR goals in the short-term. We highlight ten AMR priorities and (...) several strategies for achieving these goals using existing “legal hooks” that draw on elements of international environmental, trade and health laws governing related matters that could be used as they exist or revised to include AMR. We also consider the institutional mandates of international authorities to highlight areas where additional steps could be taken on AMR without constitutional changes. Overall, we identify 37 possible mechanisms to strengthen AMR governance using the International Health Regulations, the Agreement on the Application of Sanitary and Phytosanitary Measures, the Agreement on Trade-Related Aspects of Intellectual Property Rights, the Agreement on Technical Barriers to Trade, the International Convention on the Harmonized Commodity Description and Coding System, and the Basel, Rotterdam, and Stockholm conventions. Although we identify many shorter-term opportunities for addressing AMR using existing legal hooks, none of these options are capable of comprehensively addressing all global governance challenges related to AMR, such that they should be pursued simultaneously with longer-term approaches including a dedicated international legal agreement on AMR. (shrink)