BackgroundFear of cancer recurrence is common amongst cancer survivors. There is rapidly growing research interest in FCR but a need to prioritize research to address the most pressing clinical issues and reduce duplication and fragmentation of effort. This study aimed to establish international consensus among clinical and academic FCR experts regarding priorities for FCR research.MethodsMembers of the International Psycho-oncology Society Fear of Cancer Recurrence Special Interest Group were invited to participate in an online Delphi study. Research domains identified in Round (...) 1 were presented and discussed at a focus group to consolidate the domains and items prior to presentation in further survey rounds aimed at gaining consensus on research priorities of international significance.ResultsThirty four research items were identified in Round 1 and 33 of the items were consolidated into six overarching themes through a focus group discussion with FCR experts. The 33 research items were presented in subsequent rounds of the delphi technique. Twenty one participants contributed to delphi round 1, 16 in round 2, and 25 and 29 participants for subsequent delphi rounds. Consensus was reached for 27 items in round 3.1. A further four research items were identified by panelists and included in round 3.2. After round 3.2, 35 individual research items were ratified by the panelists. Given the high levels of consensus and stability between rounds, no further rounds were conducted. Overall intervention research was considered the most important focus for FCR research. Panelists identified models of care that facilitate greater access to FCR treatment and evaluation of the effectiveness of FCR interventions in real world settings as the two research items of highest priority. Defining the mechanisms of action and active components across FCR/P interventions was the third highest priority identified.ConclusionThe findings of this study outline a research agenda for international FCR research. Intervention research to identify models of care that increase access to treatment are based on a flexible approach based on symptom severity and can be delivered within routine clinical care were identified as research areas to prioritize. Greater understanding of the active components and mechanisms of action of existing FCR interventions will facilitate increased tailoring of interventions to meet patient need. (shrink)

While cancer survivors commonly experience fear and anxiety, a substantial minority experience an enduring and debilitating fear that their cancer will return; a condition commonly referred to as fear of cancer recurrence. Despite recent advances in this area, little is known about FCR among people from Indigenous or other ethnic and racial minority populations. Given the high prevalence and poor outcomes of cancer among people from these populations, a robust understanding of FCR among people from these groups is critical. The (...) current review identified and aggregated existing literature on FCR amongst adult cancer survivors from Indigenous and minority populations. The protocol of this review was registered with PROSPERO in July 2020. A systematic search of bibliographic databases was conducted for relevant articles published from 1997 to November 2019. Data from eligible articles were extracted and appraised for quality by two independent reviewers. Nineteen articles from four countries met the inclusion criteria, including 14 quantitative, 4 qualitative and 1 mixed-methods study. Only one article reported on an Indigenous population. Few studies reported on FCR prevalence or severity. While the variation in tools used to measure FCR hindered a robust estimate of severity, results suggested some differences in FCR severity between minority and dominant populations, although these may have been due to study metholodological differences. Few factors were reported as being associated with FCR in minorities across multiple studies. The qualitative synthesis found five themes associated with the lived experience of FCR: variations in the lived experience of FCR; spirituality and worldview impacting on FCR; the importance of staying positive; complexities around support; and increasing cancer knowledge. The findings of this review highlight differences in FCR across cultures and contexts, which reinforces the need for culturally-specific approaches to this condition. The dearth of research in this area is of concern given the significant burden of cancer in these populations. A deeper understanding of this condition among Indigenous and minority populations is critical to developing and delivering appropriate and effective psychosocial care for cancer survivors from these groups. Systematic Review Registration: identifier [CRD42020161655]. (shrink)

This introduction provides brief outlines of the articles collected in this special issue of the International Journal of Philosophical Studies on the topic of Ethics and Emotions. It also announces the winners of the 2021 Robert Papazian and PERITIA prizes.

Philosophy and Phenomenological Research, EarlyView.

The new western way of war from Vietnam in Iraq -- Theories of the new western way of war -- The global surveillance mode of warfare -- Rules of risk-transfer war -- Iraq: risk economy of a war -- A way of war in crisis.

In the Gorgias, Socrates argues that just punishment, though painful, benefits the unjust person by removing injustice from her soul. This paper argues that Socrates thinks the true judge (i) will never use corporal punishment, because such procedures do not remove injustice from the soul; (ii) will use refutations and rebukes as punishments that reveal and focus attention on psychological disorder (= injustice); and (iii) will use confiscation, exile, and death to remove external goods that facilitate unjust action.

Background The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. Methods The GFBR is an annual meeting organized by the World Health (...) Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. Results We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. Conclusions The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research. (shrink)

There is little empirical evidence showing a direct link between a capacity for statistical learning (SL) and proficiency with natural language. Moreover, discussion of the role of SL in language acquisition has seldom focused on literacy development. Our study addressed these issues by investigating the relationship between SL and reading ability in typically developing children and healthy adults. We tested SL using visually presented stimuli within a triplet learning paradigm and examined reading ability by administering the Wide Range Achievement Test (...) (WRAT-4; Wilkinson & Robertson, 2006). A total of 38 typically developing children (mean age of 9;5 years, range 6;4–12;5) and 37 healthy adults (mean age of 21 years, range 18–34) were assessed. In children, SL was significantly related to reading ability. Importantly, this relationship was independent of grade and also age. The adult data, too, revealed that SL was significantly related to reading ability. A regression analysis of the combined child and adult data revealed that SL accounted for a unique amount of variance in reading ability, after age and attention had been taken into consideration. For the first time, this study provides empirical evidence that a capacity for more effective SL is related to higher reading ability in the general population. (shrink)

The scope of the issues -- The moral relationship between leaders and followers -- The morality of leaders : motives and deeds -- Puzzles and perils of transformational leadership.

The nature and scope of jurisprudence -- Rights and justice -- Law and morality -- Classical and modern natural law -- Classical and modern legal positivism -- Legal realism -- Sociological jurisprudence -- Critical legal studies.

This thesis develops a hermeneutic philosophy of science to provide insights into physics education. -/- Modernity cloaks the authentic character of modern physics whenever discoveries entertain us or we judge theory by its use. Those who justify physics education through an appeal to its utility, or who reject truth as an aspect of physics, relativists and constructivists, misunderstand the nature of physics. Demonstrations, not experiments, reveal the essence of physics as two characteristic engagements with truth. First, truth in its guise (...) as correspondence enables a human being to prepare for the distinctive event of physics. -/- Second, the event of physics occurs in human perception when someone forces a hidden reality to disclose an aspect of itself. Thus, the ground of physics is our human involvement with reality achieved by way of truth. -/- To support this account of physics, the thesis reports phenomenological investigations into Isaac Newton’s involvement with optics and a secondary school physics laboratory. These involve interpretations of Heidegger’s theory of beings, schema and signification. The project draws upon, and contributes to, the hermeneutic phenomenology of modern physics, a tradition in continental philosophy that begins with Immanuel Kant, and advances particularly from Martin Heidegger to Patrick Heelan. -/- The thesis advocates an ontological pedagogy for modern physics which has as its purpose each individual student’s engagement with reality and truth. Students may achieve this through demonstrations of phenomena that will enable them to dwell with physics, an experience that contrasts with their embroilment in modernity, and which perpetuates nature’s own science. (shrink)

In this chapter I consider the narrow and wider benefits of permitting assisted dying in the specific context of organ donation and transplantation. In addition to the commonly used arguments, there are two other neglected reasons for permitting assisted suicide and/or euthanasia: assisted dying enables those who do not wish to remain alive to prolong the lives of those who do, and also allows many more people to fulfill their wish to donate organs after death. In the first part of (...) this chapter I explore the possibility of allowing those who die with assistance to donate their organs and the potential benefits of doing so in countries where some form of assisted dying is legal; in the second part I consider the added force that organ donation considerations bring to the argument in favour of legalizing assisted dying in countries where such practices remain forbidden. (shrink)

What is it about evil that we find so compelling? From our obsession with serial killers to violence in pop culture, we seem inescapably drawn to the stories of monstrous acts and the aberrant people who commit them. But evil, Dr. Julia Shaw argues, is largely subjective. What one may consider normal, like sex before marriage, eating meat, or working on Wall Street, others find abhorrent. And if evil is only in the eye of the beholder, can it be (...) said to exist at all? In [this book], Shaw uses an engrossing mix of science, popular culture, and real-life examples to break down timely and provocative issues. How similar is your brain to a psychopath's? How many people have murder fantasies? Can artificial intelligence be evil? Do your sexual proclivities make you a bad person? Who becomes a terrorist? If you could travel back in time, would you kill baby Hitler? In asking these questions, Shaw urges readers to discover empathy and to rethink and reshape what it means to be bad. [This book] is a wide-ranging exploration into a fascinating, darkly compelling subject from a wickedly smart and talented writer."--Dust jacket. (shrink)

Globalisation is widely understood as a set of processes driven by technological, economic and cultural change. Few have successfully defined the changing character and role of politics in global change. Political institutions such as the nation-state have been seen as undermined by globalisation, or needing to respond to it. This book clarifies the tensions which global change has provoked in our understanding of politics. Politics and Globalisation suggests that globalisation is a process which is politically contested and even politically constituted. (...) The volume presents five key intellectual and political contests in globalisation: · the extent and political significance of globalising changes in economy and society · how and how far the relations and forms of nation-state organisation are transformed · whether the given concepts and methods of political science as a discipline can be applied to global and regional politics, and whether they require radical reformulation; · the role and significance of ethical questions in global change · whether global change is constituted by, or denies, radical political agency. (shrink)

The poetry of Walt Whitman, whose Leaves of Grass was called ôthe secular Scripture of the United Statesö by literary critic Harold Bloom, is a sublime source of contemporary inspiration.

Applications of artificial intelligence/machine learning in health care are dynamic and rapidly growing. One strategy for anticipating and addressing ethical challenges related to AI/ml for health care is patient and public involvement in the design of those technologies – often referred to as ‘co-design’. Co-design has a diverse intellectual and practical history, however, and has been conceptualized in many different ways. Moreover, AI/ml introduces challenges to co-design that are often underappreciated. Informed by perspectives from critical data studies and critical digital (...) health studies, we review the research literature on involvement in health care, and involvement in design, and examine the extent to which co-design as commonly conceptualized is capable of addressing the range of normative issues raised by AI/ml for health care. We suggest that AI/ml technologies have amplified and modified existing challenges related to patient and public involvement, and created entirely new challenges. We outline three pitfalls associated with co-design for ethical AI/ml for health care and conclude with suggestions for addressing these practical and conceptual challenges. (shrink)

COVID-19 has truly affected most of the world over the past many months, perhaps more than any other event in recent history. In the wake of this pandemic are patients, family members, and various types of care providers, all of whom share different levels of moral distress. Moral conflict occurs in disputes when individuals or groups have differences over, or are unable to translate to each other, deeply held beliefs, knowledge, and values. Such conflicts can seriously affect healthcare providers and (...) cause distress during disastrous situations such as pandemics when medical and human resources are stretched to the point of exhaustion. In the current pandemic, most hospitals and healthcare institutions in the United States have not allowed visitors to come to the hospitals to see their family or loved ones, even when the patient is dying. The moral conflict and moral distress among care providers when they see their patients dying alone can be unbearable and lead to ongoing grief and sadness. This paper will explore the concepts of moral distress and conflict among hospital staff and how a system-wide provider wellness programme can make a difference in healing and health. (shrink)

`This book grew out of the conviction, not in itself strange or startling, that the ordinary person can and should think straight rather than crooked.' Patrick Shaw has written a commonsense introduction to the use of logic in everyday thought and argument. It explains some of the rules of good argument and some of the ways in which arguments can fail, drawing illustrations from a variety of contemporary and international sources, such as the press, radio, and television. Symbols and (...) technicalities are kept to a minimum in this thorough and provocative investigation of the rational approach to thought - and its limitations. Logic and Its Limits emphasizes the use of logic in helping to settle and clarify disputes. It will help the reader to avoid bad arguments, to detect them in others, and so to think and argue more effectively. A wide range of thought-provoking examples and exercises concerned with contemporary social and political issues make this a readable and stimulating guide for the student and general reader alike. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Aristotle on the Sources of the Ethical Life by Sylvia BerrymanElizabeth C. Shaw and Staff*BERRYMAN, Sylvia. Aristotle on the Sources of the Ethical Life. Oxford: Oxford University Press, 2019. vii + 220 pp. Cloth, $70.00—Berryman’s goals in Aristotle on the Sources of the Ethical Life are threefold: to establish that Aristotle practiced what contemporary philosophers call metaethics; to refute the idea that Aristotle justified those ethics by (...) recourse to human nature, understood as an “external point” for “establishing substantial ethical truths from a value-neutral perspective”; and to demonstrate that, for Aristotle, the source and justification for ethical demands is human practical reason.Locating the source of normativity in practical reason does not mean that there are no “standards of truth other than human beings as a species.” Positioning Aristotle against both “Archimedean” naturalisms as well as relativisms and subjectivisms, Berryman sees Aristotle’s appeals to nature as delimiting “the kinds of normative positions that could guide practical reason,” and practical reason as responsive to biological constraints. Still, nature is no fulcrum. It does not mandate the contents of the life we should live. All of this together makes Berryman’s Aristotle a “constitutive constructivist,” which is to say, a nonskeptical, cognitivist nonfoundationalist.Chapter 1’s “Introduction” sets the stage for the book’s metaethical project. Chapters 2 and 3 argue against two versions of the claim that “Aristotle was not reflective on the sources and justifications for his ethical views.” Chapter 2 places “Aristotle in the Ethics Wars” of the twentieth and twenty-first centuries, challenging the historicist view that “the kind of metaethical reflection about the sources of normativity” that preoccupies modern philosophy in response to “‘disenchantment’ of the modern world picture” would not have been available to Aristotle. Chapter 3, “Nature and the Sources of Normativity,” positions itself against scholars who maintain that Aristotle was complacent about the values of his own society and/or “too philosophically naïve to even reflect on the sources and justifications of ethical claims.” Inhabiting Aristotle’s social and intellectual milieu, it shows how the epistemological questions, commitments to materialist-scientific worldviews, as well as challenges to divine authority posed by fifth-century sophists, Plato, and fourth-century [End Page 381] hedonists meant that “a philosopher in Aristotle’s position could hardly avoid being reflective on questions of the status of ethics.”After establishing in chapter 3 that Aristotle could have grounded ethical claims in his natural philosophy, chapters 4 through 6 make the case that he did not. Exploring the philosophical work done by Aristotle’s appeals to nature, chapter 4, “Is Aristotle an Archimedean Naturalist?”, focuses on the apparent directionality of human development as well as references to “natural justice” and “natural virtue” in Aristotle’s ethical writings, while chapter 5, “Naturalism in Aristotle’s Politics,” scrutinizes the “naturalness of the polis” and “natural slavery” in Politics 1. Finding “only very minimal appeal to human nature” in the ethical treatises, Berryman sees Aristotle’s recourse to nature in Politics 1 as “the main anomaly” for which her refutation of Archimedean naturalism must account. Based on internal evidence in the Politics and comparison with Aristotle’s biological writings, Berryman concludes that Aristotle wrote the Politics before he “developed his more detailed biological theories.” Rather than evidence of naturalism, Aristotle’s appeals to nature in Politics 1, Berryman argues, are an early reflection of the “nomos-phusis distinction found in sophistic controversies” and a “kind of rhetorical move” based on thorough “prejudice and not reasoned inference.” Concluding “The Case Against a Naturalist Reading,” chapter 6 sets the stage for Berryman’s resourcing of Aristotle’s metaethics away from nature by exploring the inadequacies of the instrumental and theoretical rule-guiding reasoning implicit in naturalist accounts of Aristotelian practical reason.Chapters 7 and 8 offer the book’s positive account. After elaborating Aristotle’s rejection of “metaphysical abstractions” as action-guiding, chapter 7, “Aristotle’s Metaethics,” recovers from the Eudemian Ethics human agency as the source of normativity in Aristotle. Action “carries with it an implicit commitment to the norms of practical reasoning,” and “Aristotle’s insight,” Berryman writes, “is the metaethical recognition that the practical... (shrink)

This chapter discusses whether patients should face penalties for unhealthy lifestyle choices. The idea that people should be held responsible for their bad health decisions is often associated with “luck egalitarianism”. This chapter explains the connection between responsibility-sensitive health care policies and luck egalitarianism and outlines some criticisms that have been made of luck egalitarianism in this context. It then highlights the implications of moral responsibility scepticism for luck egalitarians and other proponents of similarly responsibility-sensitive approaches to health care. Theorists (...) who have discussed the practical implications of moral responsibility scepticism have focused primarily on criminal punishment and, in that context, have often invoked an epistemic argument, maintaining that there are at least serious doubts about whether people are morally responsible (in the sense required for retributive punishment) and that, in view of this uncertainty, retributive punishment is unjust, given the serious harm it inflicts on offenders. This chapter argues that this type of reasoning also implies that we should not take patients’ responsibility for their poor health into account when deciding whether to give these patients treatments and that the health system should not impose significant penalties on individuals for harming their own health. Culpability-based desert seems to stand a better chance of helping luck egalitarians (and others with related views) to justify responsibility-sensitive health care policies compared with some alternative approaches. However, this chapter casts doubt on the idea that responsibility-sensitive health care policies based on this kind of desert are justifiable, focusing on doubts about whether people are morally responsible for harming their own health, whether harming one’s own health is morally wrong, and whether significant penalties for harming one’s health would be proportionate. (shrink)

Understanding the nature of science has long been a desired outcome of science education, despite ongoing disagreements about the content, structure, and focus of NOS expectations. Addressing the concern that teachers likely focus only on student learning expectations appearing in standards documents, this study examines the current state of NOS in science education standards documents from nine diverse countries to determine the overt NOS learning expectations that appeared, NOS statements provided near those learning expectations, but not identified as learning outcomes, (...) and NOS statements found in ancillary text. Findings indicate that NOS ideas rarely occur as expectations for student learning and are far more commonly found in ancillary material. Moreover, consensus was not apparent in the overt learning outcomes for students. Given the well-documented poor state of NOS instruction and the consistent lack of NOS appearing in published curriculum materials, the NOS standards appearing in nearly all documents analyzed are unlikely to provide sufficient conceptual or pedagogical support for NOS to be accurately interpreted or translated into meaningful experiences for students. (shrink)

The frontispiece of Hobbes's Leviathan is justly renowned as a powerful visual advertisement for his political philosophy. Consequently, its rich imagery has been the subject of extensive scholarly commentary. Surprisingly, then, its gendered dimensions have received relatively limited attention. This essay explores this neglected facet of the frontispiece. I argue that the image initially appears to present a hypermasculine sovereign. However, upon closer inspection, and considered alongside Hobbes's economic theory, it yields to a reading of the sovereign as an ambiguously (...) gendered figure. Reading the frontispiece through the prism of gender and the economy reveals not a static image of unwavering male power but rather one of an equivocally-sexed creature teeming with life, contradictions, and complexities worthy of continued examination. (shrink)

The business and human rights movement shares several goals with the Benefit Corporation movement: corporations respecting human rights; maintaining a “wide aperture” so that all impacts of a company on people and communities are addressed; and creating rigorous standards of conduct and means of accountability. This paper argues that nonetheless the movements are traveling along parallel tracks and thus missing an opportunity for mutual learning that can improve their effectiveness. The BHR movement can look to B Corps for concrete examples (...) of viable companies that value human rights intrinsically and not just where there is a “business case” to do so. The B Impact Assessment, the B Corp certification tool, can better ensure that B Corps are in fact respecting human rights by adopting BHR standards. And both movements must give greater consideration to the potential contradiction between unlimited scaling—a key goal of B Corps—and the ability of large multinational corporations to respect human rights. (shrink)

Many commentators have contrasted the way that sociability is theorized in the writings of Mary Astell and Damaris Masham, emphasizing the extent to which Masham is more interested in embodied, worldly existence. I argue, by contrast, that Astell's own interest in imagining a constitutively relational individual emerges once we pay attention to her use of religious texts and tropes. To explore the relevance of Astell's Christianity, I emphasize both how Astell's Christianity shapes her view of the individual's relation to society (...) and how Masham's contrasting views can be analyzed through the lens of her charge that Astell is an “enthusiast.” In late seventeenth-century England, “enthusiasm” was a term of abuse that, commentators have recently argued, could function polemically to dismiss those deemed either excessively social or antisocial. By accusing Astell of enthusiasm, I claim, Masham seeks to marginalize the relational self that Astell imagines and to promote a more instrumental view of social ties. I suggest some aspects of Astell's thought that may have struck contemporaries as “enthusiastic” and contrast her vision of the self with Masham's more hedonistic subject. I conclude that, although each woman differently configures the relation between self and society, they share a desire to imagine autonomy within a relational framework. (shrink)

For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a re-clarification of the difference between a health status and an outcome measure, the paper presents an evaluative checklist for use by clinical audit and research staff to review outcome measures for (...) use in routine care settings. Central features include the user-centredness of the measure, its psychometric properties, feasibility of use and utility. The applicability of the checklist is illustrated for outcome measurement in diabetes and stroke care. A modified form of the checklist is proposed for use by the busy clinician as an aid to the critical review of research papers within the context of evidence-based practice and to aid health care practitioners' choice of which outcome measure(s) to use within routine clinical care. (shrink)

In this paper I argue that a greater understanding of the part of ethics in leadership will improve leadership studies. Debates over thedefinition of leadership are really debates over what researchers think constitutes good leadership. The ultimate question is not “What is leadership?” but “What is good leadership?” The word good is refers to both ethics and competence. Research into leadership ethics would explore the ethical issues of current leadership research, serve as a critical study of the field, analyze and (...) expand normative theories of leadership, and develop new theories, research questions and ways of thinking about leadership. (shrink)

I examine “The Land Ethic” by Aldo Leopold from a virtue ethics perspective. Following Leopold, I posit the “good” as the “integrity, stability, and beauty” of biotic communities and then develop “land virtues” that foster this good. I recommend and defend three land virtues: respect, prudence, and practical judgment.

ABSTRACT In recent decades poverty has been defined as a relative rather than absolute notion. Those in poverty have been seen as poor relative to a level of income, or social condition, accepted as average or normal for a society. Poverty has been redefined as ‘relative deprivation’. This paper argues, first, that the redefinition of poverty as relative to social norms is a radical departure from the traditional notion of poverty. Secondly, it considers whether such a redefinition gives support to (...) the view that the claims of those in poverty (relative) may be considered as morally equivalent to the claims of those in poverty (absolute). The paper concludes by arguing that the notion of relative poverty is advanced to give support to social and economic policies whose primary aim is equality rather than the relief of poverty. (shrink)

Doctors and dentists have traditionally used antibiotic prophylaxis in certain patient groups in order to prevent infective endocarditis (IE). New guidelines, however, suggest that the risk to patients from using antibiotics is higher than the risk from IE. This paper analyses the relative risks of prescribing and not prescribing antibiotic prophylaxis against the background of Pascal’s Wager, the infamous assertion that it is better to believe in God regardless of evidence, because of the prospective benefits should He exist. Many doctors (...) seem to believe the parallel proposition that it is better to prescribe antibiotics, regardless of evidence, because of the prospective benefit conferred upon the patient. This has been called the “no lose philosophy” in medicine: better safe than sorry, even if the evidence inconveniently suggests that following this mantra is potentially more likely to result in sorry than safe. It transpires that, just as Pascal’s Wager fails to convince because of a lack of evidence to support it and the costs incurred by trying to believe, so the “belts and braces” approach of prescribing antibiotic prophylaxis is unjustifiable given the actual evidence of potential risk and benefit to the patient. Ultimately, there is no no-lose if your clinical decisions, like Pascal’s Wager, are based on faith rather than evidence. (shrink)

In this paper I argue that a greater understanding of the part of ethics in leadership will improve leadership studies. Debates over the definition of leadership are really debates over what researchers think constitutes good leadership. The ultimate question is not "What is leadership?" but "What is good leadership?" The word good is refers to both ethics and competence. Research into leadership ethics would explore the ethical issues of current leadership research, serve as a critical study of the field, analyze (...) and expand normative theories of leadership, and develop new theories, research questions and ways of thinking about leadership. (shrink)

The series of 'trolley' examples issue a challenge to moral principles based on intentions, since it seems that these give the wrong answers in two important cases: 'Fat Man', where they seem to say that it is permissible to push someone in front of a trolley to save others, and 'Loop', where they seem to say that it is wrong to divert a trolley towards a single person whose body will stop it and save others. I reply, first, that there (...) is a parallel between the wrongful intention to mutilate in 'Transplant', where one person's vital organs are removed to save others' lives, and the intention to assault in Fat Man. Secondly, I defend Frances Kamm's view that in Loop one can divert the trolley towards the one without an intention to kill or assault, since good potential side-effects can be taken into account in deciding what to do, without their becoming intentions. (shrink)

This paper discusses a deterministic model of the spread of an infectious disease in a closed population that was proposed byKermack &McKendrick . The mathematical assumptions on which the model is based are listed and criticized. The ‘threshold theorem’ according to which an epidemic develops if, and only if, the initial population density exceeds a certain value determined by the parameters of the model, is discussed. It is shown that the theorem is not true. A weaker result is stated and (...) proved.A new simplified version of the model is discussed. In this model it is assumed that an infected individual becomes infectious after a constant time and that it will removed after a constant time. Numerical simulations of this model show that the form of the fluctuations in the number of diseased individuals depends on the values of the parameters. The number of infectious individuals may oscillate up and down under certain circumstances. Necessary conditions for the number of infectious individuals to rise above previous levels are stated and proved. (shrink)