Larry Temkin draws on the work of Angus Deaton to argue that countries with poor governance sometimes rely on charitable giving and foreign aid in ways that enable them to avoid relying on their own citizens; this can cause them to be unresponsive to their citizens’ needs and thus prevent the long-term alleviation of poverty and other social problems. I argue that the implications of this “lack of government responsiveness argument” (or LOGRA) are both broader and narrower than they (...) might first appear. I explore how LOGRA applies more broadly to certain types of charitable giving in developed countries, with a focus on medical crowdfunding. I then highlight how LOGRA does not apply to charitable giving aimed at alleviating the suffering of the absolutely politically marginalized, or those especially vulnerable people to whom governments are never responsive. (shrink)

In this paper, I defend a version of the medical model of disability, which defines disability as an enduring biological dysfunction that causes its bearer a significant degree of impairment. We should accept the medical model, I argue, because it succeeds in capturing our judgments about what conditions do and do not qualify as disabilities, because it offers a compelling explanation for what makes a condition count as a disability, and because it justifies why the federal government should (...) spend hundreds of billions of dollars, annually, on aid and accommodations for disabled people. After responding to a pair of objections Elizabeth Barnes has raised against the medical model, I contrast it with Guy Kahane and Julian Savulescu's welfarist account of disability, and with Barnes's own mere-difference view. Both of these accounts face serious challenges, although elements of Barnes's view can—and, in my opinion, should—be adopted by proponents of the medical model. (shrink)

If medical complicity is understood as compliance with a directive to act against the professional's best medical judgment, the question arises whether it can ever be justified. This paper will trace the contours of what would legitimate a directive to act against a professional's best medical judgment (and in possible contravention of her oath) using Joseph Raz's service conception of authority. The service conception is useful for basing the legitimacy of authoritative directives on the ability of the (...) putative authority to enable subjects to comply better with reasons that already apply to them. Hence, the service conception bases the legitimacy of practical authority on a certain kind of greater knowledge or expertise. This helps to focus the conundrum regarding complicity on the clash of expertise between the medical expert and the governing body tasked with coordinating behaviour and otherwise devising rules for the social good. The ethical dilemma presented by a hypothetically legitimate directive to act against a professional's best medical judgment also serves to highlight the moral dimension of one's duty to obey a legitimate authority. (shrink)

Physicians in Islamic countries might be requested to participate in the Islamic legal code of qiṣāṣ, in which the victim or family has the right to an eye-for-an-eye retaliation. Qiṣāṣ is only used as a punishment in the case of murder or intentional physical injury. In situations such as throwing acid, the national legal system of some Islamic countries asks for assistance from physicians, because the punishment should be identical to the crime. The perpetrator could not be punished without a (...) physician’s participation, because there is no way to guarantee that the sentence would be carried out without inflicting more injury than the initial victim had suffered. By examining two cases of acid throwing, this paper discusses issues related to physicians’ participation in qiṣāṣ from the perspective of medical ethics and Islamic Shari’a law. From the standpoint of medical ethics, physicians’ participation in qiṣāṣ is not appropriate. First, qiṣāṣ is in sharp contrast to the Hippocratic Oath and other codes of medical ethics. Second, by physicians’ participation in qiṣāṣ, medical practices are being used improperly to carry out government mandates. Third, physician participation in activities that cause intentional harm to people destroys the trust between patients and physicians and may adversely affect the patient–physician relationship more generally. From the standpoint of Shari’a, there is no consensus among Muslim scholars whether qiṣāṣ should be performed on every occasion. We argue that disallowing physician involvement in qiṣāṣ is necessary from the perspectives of both medical ethics and Shari’a law. (shrink)

Most people are completely oblivious to the danger that their medical data undergoes as soon as it goes out into the burgeoning world of big data. Medical data is financially valuable, and your sensitive data may be shared or sold by doctors, hospitals, clinical laboratories, and pharmacies—without your knowledge or consent. Medical data can also be found in your browsing history, the smartphone applications you use, data from wearables, your shopping list, and more. At best, data about (...) your health might end up in the hands of researchers on whose good will we depend to avoid abuses of power.2 Most likely, it will end up with data brokers who might sell it to a future employer, or an insurance company, or the government. At worst, your medical data may end up in the hands of criminals eager to commit extortion or identity theft. In addition to data harms related to exposure and discrimination, the collection of sensitive data by powerful corporations risks the creation of data monopolies that can dominate and condition access to health care. -/- This chapter aims to explore the challenge that big data brings to medical privacy. Section I offers a brief overview of the role of privacy in medical settings. I define privacy as having one’s personal information and one’s personal sensorial space (what I call autotopos) unaccessed. Section II discusses how the challenge of big data differs from other risks to medical privacy. Section III is about what can be done to minimise those risks. I argue that the most effective way of protecting people from suffering unfair medical consequences is by having a public universal healthcare system in which coverage is not influenced by personal data (e.g., genetic predisposition, exercise habits, eating habits, etc.). (shrink)

While donation schemes with dedicated regulatory frameworks have made it relatively easy to donate blood, organs or tissue, it is virtually impossible to donate one’s own medical data. The lack of appropriate framework to govern such data donation makes it practically difficult to give away one’s data, even when this would be within the current limits of the law. Arguments for facilitation of such a process have been advanced but so far have not been implemented. Discussions on the ethics (...) of using medical data tend to take a system-centric perspective and focus on what researchers and the health service may or may not do with data that are placed within their trust. Rarely, if ever, is the question of the data subjects preferences addressed beyond practical matters of obtaining valid consent. This constitutes an important omission in the ethical debate, which this volume seeks to address. (shrink)

We present the details of a methodology for quality assurance in large medical terminologies and describe three algorithms that can help terminology developers and users to identify potential mistakes. The methodology is based in part on linguistic criteria and in part on logical and ontological principles governing sound classifications. We conclude by outlining the results of applying the methodology in the form of a taxonomy different types of errors and potential errors detected in SNOMED-CT.

The European Medical Information Framework project, funded through the IMI programme, has designed and implemented a federated platform to connect health data from a variety of sources across Europe, to facilitate large scale clinical and life sciences research. It enables approved users to analyse securely multiple, diverse, data via a single portal, thereby mediating research opportunities across a large quantity of research data. EMIF developed a code of practice to ensure the privacy protection of data subjects, protect the interests (...) of data sharing parties, comply with legislation and various organisational policies on data protection, uphold best practices in the protection of personal privacy and information governance, and eventually promote these best practices more widely. EMIF convened an Ethics Advisory Board, to provide feedback on its approach, platform, and the EcoP. The most important challenges the ECoP team faced were: how to define, control and monitor the purposes for which federated health data are used; the kinds of organisation that should be permitted to conduct permitted research; and how to monitor this. This manuscript explores those issues, offering the combined insights of the EAB and EMIF core ECoP team. For some issues, a consensus on how to approach them is proposed. For other issues, a singular approach may be premature but the challenges are summarised to help the community to debate the topic further. Arguably, the issues and their analyses have application beyond EMIF, to many research infrastructures connected to health data sources. (shrink)

Considerations of autonomy and independence, properly understood, support strictly egalitarian provision of necessary medical treatment. If the financially better-off can purchase access to necessary medical treatments that the financially less well-off cannot purchase without help, then their discretionary power to give or to withhold monetary gifts indirectly gives them the power to make life-and-death or sickness-and-health decisions for others. To prevent private citizens from having this objectionable form of power, government must ensure that citizens’ finances do not affect (...) their access to medical treatments that significantly prolong life, relieve suffering, or cure or mitigate disabilities. Government should ensure this even if doing so involves leveling down and even if it is unclear whether egalitarian provision of necessary treatment would provide better care to the poor than a less egalitarian health care system would. (shrink)

Medical intake is a cognitively bounded task requiring structured information gathering, emotional awareness, uncertainty monitoring, and disciplined reasoning under strict epistemic limits. Unlike diagnosis or treatment, intake represents a domain where artificial systems may safely contribute — but only if those systems maintain posture, scope, and containment. This paper introduces STOIC, a dual-agent cognitive architecture designed for governed, non-diagnostic medical intake. STOIC does not attempt to replace medical judgment. Instead, it offers a structured, emotionally-stable semantic listening layer (...) that operates alongside clinicians. Through semantic micro-agencies, containment boundaries, and a supervisory governance agent, STOIC provides Agentic AI with a novel ability to convert natural clinical speech into a structured patient intake form while remaining strictly within non-inference, non-diagnostic constraints. By focusing on cognition extraction rather than interpretation, STOIC provides a safe, philosophically coherent model for agentic assistance in medical epistemology. This article outlines the architecture, philosophical rationale, and research potential for STOIC in clinical settings. (shrink)

Background and Aim: Global trends and national policies have made internationalization and paying attention to the international markets of higher education inevitable on the one hand and becoming a legal requirement of Iranian medical sciences universities on the other hand. Therefore, the main goal of this article was to show, by examining the experience of international marketing of higher education in Tehran University of Medical Sciences, what are the futures of international marketing of higher education in medical (...) sciences? Materials and methods: in this documented data and the views, knowledge and lived experiences of the beneficiaries of the University of Medical Sciences were the basis of the study, and in the following, the methods of documentary studies, trend analysis, brainstorming, expert panel, theme analysis and scenario planning were used. Results: The most important achievement of this article is that among the challenges facing the international marketing of higher education in the University of Medical Sciences, two driving forces have the highest importance and uncertainty in shaping the future of this issue, including: sustainable security and cultural development. Conclusion: The normalization of political and economic relations with the world along with appropriate cultural development inside and outside the university and acceptance of cultural, racial, religious, intellectual, ethnic and gender differences strengthens the marketing process of higher education. In such a situation, the risk of investing in providing international higher education will be reduced. Therefore, the most expensive and the most important uncertainty facing the country's universities in international marketing is the attitude and approach of science and technology governance to the relations and structure governing the international system. (shrink)

Applying the Holistic Governance System (HGS) to the Philippines -/- The Philippines has struggled with corruption, political instability, economic inequality, and weak governance. Applying the Holistic Governance System (HGS) could transform the country into a stable, prosperous, and globally competitive nation. -/- Key Challenges in the Philippines: -/- 1. Corruption – Widespread in government agencies, law enforcement, and politics. -/- 2. Political Dynasties & Electoral Manipulation – Many leaders come from elite families, limiting true democracy. -/- 3. (...) Economic Inequality – The wealth gap is extreme, with many Filipinos in poverty. -/- 4. Weak Law Enforcement & Justice System – Crime, illegal drugs, and extrajudicial killings undermine public trust. -/- 5. Underdeveloped Infrastructure – Slow development of transportation, digital connectivity, and urban planning. -/- 6. Brain Drain – Many skilled Filipinos leave for better opportunities abroad. -/- HGS can address these issues by combining the best governance models from around the world while adapting them to the Philippine context. -/- Step-by-Step Implementation of HGS in the Philippines: -/- 1. Political Reform: Replacing Traditional Politics with a Meritocratic Leadership System -/- The Strategic Council (7 Leaders): Instead of a single president, the Philippines would be led by a council of seven experts, each specializing in key areas like economy, education, security, and technology. -/- No Political Dynasties: Candidates must prove their qualifications (economic, scientific, or governance expertise) before being allowed to run. -/- Fixed 10-Year Term: Leaders serve long enough to implement national development plans but cannot seek re-election. -/- ???? Impact: This will eliminate corruption, improve decision-making, and end elite family control of politics. -/- 2. Balanced Democracy: Direct Citizen Participation in Decision-Making -/- Annual Referendums: Inspired by Switzerland, Filipinos will vote directly on key national policies (e.g., education reforms, infrastructure projects). -/- Congress Reform: Replace the current system with: -/- People’s Assembly – Elected by citizens to represent public concerns. -/- Expert Senate – Composed of scientists, economists, and policy experts. -/- ???? Impact: This system prevents corrupt politicians from making bad decisions and gives Filipinos a real voice in governance. -/- 3. Economic Reform: A Hybrid System for Growth & Stability -/- Balanced Free Market + State Planning: -/- Private businesses continue operating, but key industries (energy, healthcare, education, transport) are state-controlled for stability. -/- Large government investment in technology, renewable energy, and industrial growth. -/- Anti-Corruption Crackdown: Modeled after Singapore’s strict anti-corruption policies. -/- Digital Government System: Minimize human corruption by making all government transactions online with AI verification. -/- ???? Impact: The economy grows without exploitation, and corruption is eliminated in business and government. -/- 4. Social Welfare: Universal Services for All Filipinos -/- Free Universal Healthcare: Like Norway & Sweden, all Filipinos receive high-quality medical care. -/- Free Higher Education: Universities are fully funded, with scholarships for top students. -/- Basic Income for the Poor: Prevents extreme poverty and improves national productivity. -/- Affordable Housing & Smart Cities: Government builds modern, eco-friendly, low-cost housing. -/- ???? Impact: This ensures every Filipino has access to education, health, and stable living conditions. -/- 5. Justice & Security: Smart Law Enforcement with AI & Independent Courts -/- AI-Powered Legal System: Reduce human bias in court cases and prevent political influence. -/- Strict Anti-Corruption Laws: Inspired by Singapore, harsh penalties for corruption at all levels. -/- High-Tech Crime Prevention: AI surveillance, digital ID verification, and cybercrime prevention. -/- ???? Impact: A fast, fair, and corruption-free justice system. -/- 6. Infrastructure & Urban Development: Smart Cities & Green Energy -/- Nationwide High-Speed Rail & Smart Transportation: Inspired by China’s urban planning. -/- 100% Renewable Energy Goal: Government investment in solar, wind, and hydro energy. -/- Smart City Development: AI-controlled traffic, clean public spaces, and sustainable urban design. -/- ???? Impact: A modern Philippines with world-class infrastructure and zero energy dependence. -/- 7. Foreign Policy & National Defense: Economic Strength + Global Neutrality -/- Neutrality in Global Conflicts: Inspired by Switzerland, the Philippines avoids military conflicts but strengthens economic ties with all nations. -/- Strong Cybersecurity & Modernized Military: Instead of focusing on war, invest in cyber defense and AI-powered security. -/- Self-Sufficient Agriculture & Industry: Reduce dependence on foreign imports by boosting local food and industrial production. -/- ???? Impact: The Philippines becomes a secure, self-reliant, and economically strong nation. -/- The Future Philippines Under HGS: A Model Nation -/- Final Thoughts: Why the Philippines Needs HGS -/- ???? HGS will transform the Philippines into a: ✅ Politically stable nation with honest, expert-led governance. ✅ Economically strong country with innovation and self-sufficiency. ✅ Corruption-free government with strict anti-corruption policies. ✅ Technology-driven society with AI, smart cities, and digital governance. ✅ Socially progressive state with free healthcare, education, and a guaranteed basic income. -/- By eliminating corruption, restructuring governance, and investing in technology, the Philippines can rise as a global model for modern governance. -/- Roadmap for Transitioning the Philippines to the Holistic Governance System (HGS) -/- Goal: Transform the Philippines into a corruption-free, economically strong, socially progressive, and technologically advanced nation using HGS principles. -/- ???? Phase 1: Laying the Foundation (Year 1-5) -/- Objective: Establish public trust, eliminate corruption, and implement key reforms in government, economy, and education. -/- 1. Anti-Corruption Revolution (Year 1-3) -/- ✅ Create a National Anti-Corruption Tribunal (similar to Singapore’s system) with special prosecutors and AI-powered case review to ensure fair trials. ✅ Strict penalties for corruption (lifetime ban from politics, confiscation of illegally obtained wealth, long prison sentences). ✅ Full Digital Government System – All government transactions go online to remove human corruption (permits, taxes, elections, etc.). -/- ???? Impact: Government corruption is drastically reduced, and public trust in leadership increases. -/- 2. Leadership Reform (Year 2-5) -/- ✅ Ban Political Dynasties – Require strict merit-based qualifications for all public officials. ✅ Restructure the Government: Replace the president with the Strategic Council (7 experts) and reform Congress into: -/- People’s Assembly (elected representatives). -/- Expert Senate (top scientists, economists, and technocrats). ✅ Mandatory Leadership Training – All future leaders must undergo a 5-year program on governance, economics, and philosophy. -/- ???? Impact: The Philippines shifts from a corrupt dynasty-driven system to a competence-based government. -/- 3. Education Reform (Year 2-4) -/- ✅ Upgrade the curriculum to teach critical thinking, technological skills, and the Universal Law of Balance. ✅ Free College Education (funded by corruption money recovery). ✅ Global Research Partnerships with universities in Europe, Singapore, and the U.S. to improve STEM education. -/- ???? Impact: The youth become future innovators and critical thinkers, reducing brain drain. -/- ???? Phase 2: Economic & Social Transformation (Year 6-10) -/- Objective: Transition to a self-sufficient economy with world-class infrastructure and social services. -/- 4. Economic Overhaul (Year 6-10) -/- ✅ Hybrid Economic Model (similar to Singapore & China): -/- Free market for small businesses & entrepreneurship. -/- Government-controlled key industries (healthcare, energy, infrastructure). ✅ AI-Governed Tax System – Automate taxation to prevent tax evasion. ✅ Massive Government Investment in Technology (AI, robotics, green energy, and space research). -/- ???? Impact: The Philippines becomes a tech-driven economy, independent of remittances. -/- 5. Universal Social Welfare System (Year 6-8) -/- ✅ Free Universal Healthcare (Norway model) – Build more hospitals, increase doctor salaries, and implement telemedicine in rural areas. ✅ Basic Income for the Poor (funded by recovered corruption money and AI-driven economic growth). ✅ National Housing Program – Construct affordable smart cities with AI-managed traffic, green energy, and disaster-resistant buildings. -/- ???? Impact: All Filipinos have access to quality healthcare, education, and stable housing. -/- 6. Infrastructure Boom & Smart City Development (Year 6-10) -/- ✅ High-Speed Rail System (China model) – Connect Luzon, Visayas, and Mindanao with a modern railway. ✅ Digital Infrastructure – High-speed internet for all citizens, free public WiFi, and AI-managed urban planning. ✅ 100% Renewable Energy – Solar, wind, and hydro power investments to eliminate electricity shortages. -/- ???? Impact: The Philippines becomes a modern, highly developed nation with smart, efficient cities. -/- ???? Phase 3: Global Powerhouse & Permanent Stability (Year 11-20) -/- Objective: Establish the Philippines as a global leader in innovation, sustainability, and governance. -/- 7. AI-Powered Governance (Year 11-15) -/- ✅ Full AI Integration in Government – Automate law enforcement, policymaking analysis, and economic planning. ✅ Digital Direct Democracy – Filipinos can vote online in annual national referendums on key policies (Switzerland model). -/- ???? Impact: A corruption-proof, people-powered government that makes smart, data-driven decisions. -/- 8. Military & Foreign Policy Reform (Year 11-15) -/- ✅ Neutrality & Economic Diplomacy (Swiss Model) – Stay independent of global conflicts while expanding trade with the U.S., China, and ASEAN. ✅ Cybersecurity Defense System – Develop AI-powered cyber-defense technology to prevent hacking & cyber threats. ✅ Self-Sufficiency in Agriculture & Industry – Invest in high-tech farming and local industries to reduce import reliance. -/- ???? Impact: The Philippines becomes an economically powerful, self-sufficient, and diplomatically respected nation. -/- 9. Space & Advanced Scientific Research (Year 16-20) -/- ✅ Launch a Philippine Space Program (like NASA) to develop satellite technology and space exploration. ✅ Invest in AI & Quantum Computing Research to compete in the global tech industry. ✅ Biotechnology & Medicine Research to create Philippine-made vaccines, treatments, and bio-engineered food solutions. -/- ???? Impact: The Philippines becomes a hub for science, space, and technological innovation. -/- ???? Summary: The New Philippines Under HGS -/- ???? Conclusion: The Philippines as a Global Model Nation -/- By transitioning to HGS, the Philippines will: ✅ Eliminate corruption & political dynasties through AI-powered governance. ✅ Become a tech-driven, self-sufficient economy with free healthcare, education, and infrastructure. ✅ Modernize cities, transport, and digital services for efficiency and sustainability. ✅ Be a global leader in science, AI, and space exploration. -/- . (shrink)

The Holistic Governance Model (HGM): A Blueprint for the Future -/- Introduction -/- Governments today face increasing challenges, from economic instability and climate change to corruption and social inequality. No single government system has fully solved these issues, but by integrating the best aspects of existing models, we can create an optimal governance system. -/- The Holistic Governance Model (HGM) is a hybrid system that combines elements from Social Democracy, Technocracy, Semi-Direct Democracy, China’s Whole-Process People’s Democracy, and (...) the Modified Westminster System. It leverages AI-driven policy-making, technocratic expertise, direct citizen participation, and long-term national planning to create a balanced, efficient, and just government system. -/- 1. Core Foundations of the Holistic Governance Model -/- The HGM is built on six fundamental pillars, ensuring that governance is efficient, democratic, and sustainable. -/- 1.1. Economic System: A Hybrid of Capitalism and State Planning -/- Inspired by: Singapore (Technocracy), China (State-Controlled Development), Nordic Model (Social Welfare), and Switzerland (Financial Stability) ✅ Key Industries Under State Control: The government regulates healthcare, energy, and transportation while allowing free-market innovation. ✅ Smart Capitalism: Entrepreneurs and businesses thrive, but AI-driven economic planning ensures fair wealth distribution. ✅ Universal Basic Assets (UBA): Instead of universal basic income (UBI), citizens receive free housing, education, and healthcare, ensuring financial security. ✅ AI-Assisted Economy: AI predicts recessions, optimizes budgets, and prevents financial crises. -/- 1.2. Political System: A Dynamic Semi-Direct Democracy -/- Inspired by: Switzerland (Direct Democracy), Westminster System (Parliament), and Singapore (Meritocratic Leadership) ✅ Two-Tier Voting System: -/- General Elections: Citizens vote for representatives every 4-5 years. -/- National Referendums: Citizens directly vote on major policies twice a year. ✅ Technocratic Advisory Board (TAB): A non-political panel of scientists, economists, and AI experts advises the government. ✅ Decentralized Local Governance: Cities and regions have autonomy while aligning with national laws. -/- 1.3. Education & Human Development: AI-Powered Lifelong Learning -/- Inspired by: Nordic Model (Free Education), Singapore (STEM Focus), and China (AI Integration) ✅ Free Public Education for Life: Every citizen has access to continuous learning, including college and skill retraining. ✅ AI-Based Personalized Learning: Students use AI tutors that adapt to their learning pace. ✅ Ethics & Critical Thinking Curriculum: Courses in philosophy, logic, and decision-making prevent misinformation and ignorance. -/- 1.4. Healthcare & Social Welfare: AI-Driven Preventive Medicine -/- Inspired by: Nordic Model (Universal Healthcare), Singapore (Tech-Driven Healthcare), and China (Mass Coverage) ✅ Government-Funded Universal Healthcare: Citizens receive free basic healthcare, with private options available. ✅ AI & Robotics in Medicine: AI diagnoses diseases early, reducing medical costs. ✅ Preventive Healthcare Policy: Citizens receive incentives for maintaining good health (fitness programs, nutrition plans). -/- 1.5. Environmental & Energy Policies: The Green Industrial Revolution -/- Inspired by: China (Renewable Energy Expansion), Nordic Model (Sustainability Laws), and Singapore (Urban Planning) ✅ Mandatory Green Technology Adoption: Businesses must comply with strict eco-friendly policies. ✅ Carbon Credit Economy: Citizens and companies earn rewards for reducing carbon footprints. ✅ 100% Renewable Energy by 2050: The government funds solar, wind, and AI-optimized energy grids. -/- 1.6. Law & Order: AI-Governed Justice & Anti-Corruption Measures -/- Inspired by: Switzerland (Independent Judiciary), Singapore (Strict Law Enforcement), and China (AI in Governance) ✅ AI-Assisted Judiciary: AI helps judges analyze case laws for fair, unbiased rulings. ✅ Zero-Corruption Policy: Public officials caught in corruption face lifetime bans from government service. ✅ Balanced Civil Rights & Security: -/- Freedom of Speech: Citizens can express opinions, but disinformation is regulated. -/- AI Surveillance for Security: AI prevents crime while protecting privacy. -/- 2. Government Structure of HGM -/- 2.1. Executive Branch: The President, Prime Minister, and Technocrats -/- President (Elected by Public Vote) → Oversees national policies and international relations. -/- Prime Minister (Elected by Parliament) → Manages daily governance. -/- Technocratic Economic Council → Expert-led economic planning. -/- AI-Assisted Policy Bureau → Uses AI for healthcare, infrastructure, and environmental policies. -/- 2.2. Legislative Branch: Semi-Direct Parliament -/- Lower House (Elected Officials) → Creates laws based on citizen participation. -/- Upper House (Experts & Regional Representatives) → Reviews laws for scientific and ethical validity. -/- Referendum System → Citizens directly vote on key national issues. -/- 2.3. Judicial Branch: AI-Assisted Supreme Court -/- Independent Court System → Ensures justice and constitutional balance. -/- AI Legal Analysis → AI helps judges analyze previous cases and evidence. -/- 3. Implementation Strategy: How to Apply HGM Worldwide -/- To implement HGM, a phased approach is needed: -/- Phase 1 (0-5 Years): Research & AI Integration -/- ✅ Establish an HGM Global Research Center to develop AI governance models. ✅ Pilot AI-assisted economic planning in select countries. -/- Phase 2 (5-10 Years): Education & Public Awareness -/- ✅ Introduce HGM-based education systems (critical thinking, AI governance). ✅ Encourage political reforms to adopt hybrid governance models. -/- Phase 3 (10-20 Years): Nationwide Policy Implementation -/- ✅ Countries gradually adopt the HGM framework, with AI monitoring national progress. ✅ Global partnerships for climate change action and digital economy growth. -/- Phase 4 (Beyond 20 Years): Global Standardization -/- ✅ Establish an HGM Alliance for international cooperation. ✅ Implement AI-driven global policies on poverty, sustainability, and digital rights. -/- 4. Why the HGM is the Future of Governance -/- The Holistic Governance Model (HGM) offers the most advanced, efficient, and democratic government system by combining AI governance, citizen participation, economic stability, and social equality. -/- Conclusion: A Government System for the 21st Century -/- The Holistic Governance Model (HGM) combines the best government systems into a single, optimized model. By implementing AI, technocracy, direct democracy, and long-term planning, HGM ensures: ✅ Efficient economic management ✅ Social equality without excessive taxation ✅ Democratic participation with AI-driven transparency ✅ Sustainable environmental policies ✅ Corruption-free governance -/- If adopted globally, HGM could transform human civilization into a more just, advanced, and sustainable society. -/- . (shrink)

-/- Comprehensive Solutions to Strengthen Government Social Safety Net for Senior Citizens -/- 1. Universal and Sustainable Pension System -/- a. Universal Basic Pension -/- Ensure a non-contributory pension for all senior citizens aged 60 and above, regardless of work history, funded by government revenues. -/- Base amount adjusted annually for inflation and cost of living. -/- b. Tiered Pension Support -/- First tier: Universal pension for all. -/- Second tier: Enhanced pension based on contribution history. -/- Third tier: Private/voluntary (...) retirement savings incentives. -/- c. Sustainable Funding Mechanisms -/- Diversify funding through: -/- Value-added taxes (VAT) earmarked for senior programs. -/- Sovereign wealth funds or social security investment funds. -/- Sin taxes (tobacco, alcohol) allocated for elderly welfare. -/- 2. Comprehensive and Accessible Healthcare -/- a. Free Primary and Preventive Healthcare -/- All seniors receive free annual check-ups, vaccinations, and essential medicines. -/- Geriatric centers established in local health units. -/- b. Expanded PhilHealth/Universal Health Coverage -/- Full coverage of: -/- Hospitalization -/- Long-term care -/- Chronic illness treatment -/- Automatic enrollment of all senior citizens. -/- c. Home-Based and Community Healthcare -/- Government supports home health services and community caregivers. -/- Include mental health and dementia care programs. -/- 3. Affordable and Secure Housing -/- a. Senior Housing Programs -/- Build age-friendly housing units with priority to low-income seniors. -/- Retrofitting grants for family homes to accommodate elder needs. -/- b. Rental Assistance -/- Provide housing vouchers or subsidies for rent and utilities. -/- 4. Social Inclusion and Employment Opportunities -/- a. Lifelong Learning and Digital Access -/- Free community courses on digital literacy, financial management, and health. -/- Equip seniors to participate in the digital economy and social networks. -/- b. Flexible Work and Volunteer Programs -/- Encourage part-time and remote employment for willing seniors. -/- Government-subsidized programs where seniors mentor youth or work in light community service. -/- c. Anti-Discrimination Measures -/- Enforce laws against age discrimination in workplaces and social settings. -/- 5. Legal and Financial Protections -/- a. Protection Against Elder Abuse -/- Create a National Elder Protection Task Force. -/- Hotlines and legal support centers in every region. -/- b. Financial Literacy and Pension Security -/- Establish programs to educate seniors on managing pensions and protecting against scams. -/- 6. Community-Based Support Systems -/- a. Barangay Elderly Support Councils -/- Organize senior representatives in every barangay to help in decision-making and implementation of programs. -/- b. Intergenerational Centers -/- Create spaces for seniors to interact with youth—storytelling, tutoring, and cultural exchanges. -/- 7. Emergency and Climate Resilience Support -/- a. Priority in Disaster Planning -/- Seniors prioritized in evacuation, relief, and medical support. -/- Maintain updated registry of senior citizens for fast emergency response. -/- b. Climate-Controlled Shelters -/- Develop senior-specific climate adaptation centers in heatwave-prone or disaster-vulnerable areas. -/- 8. Monitoring, Transparency, and Feedback -/- a. Senior Citizens’ Ombudsman Office -/- A dedicated government branch to monitor all programs and respond to complaints. -/- b. Regular Impact Assessment -/- Third-party audits and community feedback forums to refine programs. -/- Guiding Principle: Balance in Nature and Society -/- These solutions reflect the universal law of balance: maintaining equilibrium between government responsibility, individual dignity, and intergenerational solidarity. No program should create dependency or injustice, but rather reinforce the natural cycle of care, reciprocity, and purpose throughout aging. -/- . (shrink)

Meritocratic Accountability Governance (MAG): A No-Term-Limit System with Strict Performance-Based Accountability -/- Introduction -/- The debate over term limits in governance has long been contentious. While term limits prevent the abuse of power and encourage leadership renewal, they also disrupt continuity and hinder long-term national strategies. Conversely, authoritarian systems allow leaders to rule indefinitely, but without accountability, they risk dictatorship and corruption. -/- A balanced alternative is Meritocratic Accountability Governance (MAG)—a system that eliminates fixed term limits but (...) enforces strict performance-based leadership retention. This ensures that competent leaders remain in power while underperforming or corrupt leaders are swiftly removed. This essay explores the advantages and risks of MAG and proposes a structured framework for its implementation. -/- The Pros and Cons of Term Limits -/- Term limits offer several advantages: ✔ Prevent the concentration of power ✔ Encourage new leadership and fresh ideas ✔ Reduce the risk of corruption and dynastic politics -/- However, term limits also present serious drawbacks: ✘ Disrupt continuity and long-term national plans ✘ Remove effective leaders even if they are performing well ✘ May result in weak successors who undo progress -/- Authoritarian or indefinite rule allows for stability, as seen in Lee Kuan Yew’s leadership, but also risks power abuse, as seen in historical dictatorships. The challenge is finding a system that allows long-term leadership for effective governance while preventing dictatorship and corruption. -/- Meritocratic Accountability Governance (MAG): A New Model -/- MAG eliminates fixed term limits but ensures continuous performance evaluations and strict accountability measures. Leaders must earn the right to remain in power by consistently meeting national objectives and maintaining public trust. -/- Key Features of MAG -/- 1. Clear Performance Metrics -/- Leaders are evaluated on objective, measurable criteria, including: ✅ Economic Growth – GDP, employment rates, poverty reduction ✅ Education & Healthcare – School quality, literacy rates, medical access ✅ Infrastructure Development – Roads, public transport, utilities ✅ Crime & Social Stability – Crime rates, national security, justice system ✅ Corruption & Governance Transparency – Ethical leadership, financial accountability -/- 2. Independent Oversight Bodies -/- A non-partisan, independent commission evaluates leadership based on performance data, not political influence. This commission includes: ✔ Economists & policy experts – Assess economic and social progress ✔ Legal & anti-corruption officers – Monitor integrity and accountability ✔ Citizen representatives – Ensure public interests are prioritized -/- 3. Public Participation and Approval -/- Instead of fixed elections, MAG employs: ✔ Regular approval referendums – Every 4–6 years, citizens vote on leadership retention ✔ Performance-based leadership retention – If approval ratings drop below 50%, a new leadership selection process begins -/- 4. Strict Anti-Corruption & Abuse of Power Laws -/- ✔ Financial Transparency – Mandatory public disclosure of assets ✔ Severe Legal Penalties – Strict punishment for bribery, fraud, and nepotism ✔ Independent Investigative Bodies – Unbiased corruption monitoring agencies -/- 5. Smooth Transition Mechanisms -/- ✔ Vote of No Confidence – If performance declines, a structured removal process follows ✔ Special Leadership Selection – Ensures a capable replacement through merit-based criteria ✔ Legal Frameworks Preventing Power Abuse – Enforces leadership accountability at all levels -/- Potential Challenges & Solutions -/- Why MAG is a Superior Governance Model -/- 1️⃣ Balances Stability & Accountability – Retains competent leaders while ensuring underperformers are removed 2️⃣ Encourages Long-Term National Development – No need to halt progress due to political transitions 3️⃣ Prevents Corruption & Dictatorship – Implements strict governance laws and transparent leadership evaluations -/- Conclusion -/- Meritocratic Accountability Governance (MAG) presents a compelling alternative to both rigid term limits and unchecked authoritarian rule. By focusing on performance-based leadership retention, independent oversight, public participation, anti-corruption laws, and smooth leadership transitions, MAG ensures governance remains stable, effective, and accountable. -/- If properly designed and implemented, MAG could redefine modern governance, ensuring that leadership is based on merit, service, and national progress rather than personal political careers. This model can create a future where only the most capable and ethical leaders remain in power, leading to a more prosperous and just society. -/- . (shrink)

Arguably, ethical guidelines and medical laws on medical confidentiality have fallen short of extrapolating the methodology for dealing with potential ethical complexities in its practice. This drawback has made it difficult for physicians to prevent harm from occurring if it has not yet happened, remove harm if it has already taken place, or minimise harm if it is unavoidable. Therefore, this article attempts to outline certain principles in the form of a framework to govern the management of confidential (...) information in light of Islamic legal maxims. This effort is meant to help health workers to deal with conflicting situations, with reasonable care given to those at risk, while maintaining therapeutic trust and professionalism. The notable significance of this framework is that it is structured after identifying the potential harms in the protection and disclosure of medical confidentiality in selected cases from patient's, doctor's and third party's perspectives and addressing each of them with due importance. (shrink)

This article is an effort to understand how healing of body was used by the Christian missionaries as an important tool for evangelisation with special reference to the Welsh Christian missionaries in North Cachar Hills from 1905 to 1961. The Welsh missionaries opened their mission in this Hill on 1905 with multiple endeavours such as opening schools, churches and dispensaries. North Cachar Hills was a sub division of Cachar district during the colonial period and was inhabited mainly by different indigenous (...) peoples such as the Dimasas, Zeme Nagas, Angami Nagas, old and new Kukis, Khasis, Karbis, etc. The missionaries regarded the local people as ‘heathen’ which means physically and morally ill and their traditional practices of appeasing the evil spirits for their ailments as a primitive act. Moreover the missionaries were not free from euro centrism and regarded their ideas and practices as superior than the traditional beliefs and practices of the natives. It is the intention of the article to highlight the strategy of the colonial administrator as well as the missionaries in operating humanitarian works such as ‘healing the heathens’. This article will also highlight the traditional treatment of illness and the medical measures taken by the colonial government and the responses of the local people on such measures. (shrink)

This study aims to examine the position of medicine within the context of Plato's dialogue Philebus, focusing, on one hand, on the critique the philosopher makes of medicine as a practice and craft governed by specific norms and procedures, and, on the other, on the skillful way in which he draws upon certain medical theories, adapting them to serve his own purposes. The first part of the analysis seeks to understand the reasons behind Plato’s critique of medicine in the (...) Philebus, especially in passage 56b1, where he includes it among the activities that involve “much imprecision and little certainty.” This critique, as will be demonstrated, is closely related to the method of medicine. In this sense, it is important to highlight that, in criticizing medicine, Plato does not seek to establish a rivalry between philosophy and medical practice, but rather to question medicine’s claim to sometimes present itself as the best and only modus vivendi. The second part of the study focuses on analyzing the influence of medicine on Plato’s theory of pleasure, particularly regarding the concept of pleasure as a process of fulfillment. To this end, Hippocratic texts such as On Diseases IV, On the Nature of Man, and On Ancient Medicine are consulted. Finally, through a comparison of recurring key terms, similarities and differences between the medical conception and Plato’s conception of pleasure are highlighted. -/- Keywords: Hippocratic Corpus. Philebus. Disintegration. Pleasure. Method. (shrink)

The objective of this article is to shed light on some challenging questions regarding public health and medical ethics that the Turkish healthcare system has recently been forced to confront. In recent years, terrorists in eastern Turkey have launched increasingly destructive attacks, including numerous attempts to undermine the social order by targeting not only government agencies but also the healthcare system. In this study, 54 terrorist incidents specifically targeting the Turkish healthcare system and healthcare professionals were analyzed and divided (...) into 6 categories according to the type of attack. Each category was evaluated in terms of the relevant ethical issues, with regard to both public health and medical ethics. This study shows that terrorist activity may lead to numerous breaches of public health and clinical ethics rules. Therefore, healthcare policy must involve special precautions to minimize breaches of public health and medical ethics in the face of terrorist attacks. (shrink)

Reflection is widely acknowledged to play a crucial role in enhancing the competence of medical professionals. Developed countries have given importance to implementing reflective practices for professional development. In developing countries, reflective practices are not given much importance as a tool for professional growth. This article aims to uncover the existing practices of reflection and the challenges faced by medical professionals working at a government hospital in Nepal. It also promotes the practice of reflection to improve daily professional (...) practice. This article aims to uncover the existing practices of reflection and the challenges faced by medical professionals working at a government hospital in Nepal. This qualitative study utilized Narrative Inquiry as the research method and conducted semi-structured, in-depth interviews with two medical professionals selected through purposive sampling followed by content analysis of the collected data. The study was based on the theories of social constructivism and transformative learning. After analyzing the data, three significant themes emerged: empathizing through reflection, change in practice through reflection, and barriers to reflective practices. The study identified several barriers to reflective practices, including a negative attitude, sociocultural contexts, and a lack of support from the medical community. It is crucial to encourage self-reflection for medical professionals to enhance their professional growth and promote lifelong learning. This study provides valuable insights into the significance of reflective practices in the professional development of medical personnel, particularly in developing countries. (shrink)

: This article critically examines the constitution of impairment in prenatal testing and screening practices and various discourses that surround these technologies. While technologies to test and screen prenatally are claimed to enhance women's capacity to be self-determining, make informed reproductive choices, and, in effect, wrest control of their bodies from a patriarchal medical establishment, I contend that this emerging relation between pregnant women and reproductive technologies is a new strategy of a form of power that began to emerge (...) in the late eighteenth century. Indeed, my argument is that the constitution of prenatal impairment, by and through these practices and procedures, is a widening form of modern government that increasingly limits the field of possible conduct in response to pregnancy. Hence, the government of impairment in utero is inextricably intertwined with the government of the maternal body. (shrink)

The first case of COVID-19 in Iran was officially reported by the Iranian Government in February 19, 2020. In order to control and prevent the infection, the Government closed all the universities and requested the people to stay at home. Consequently, Tehran University of Medical Sciences (TUMS), like other universities, cancelled all the face-to-face classes in different Schools, and since the exact date for the resolution of this calamity could not be determined, TUMS decided to proceed the education flow (...) through the available Learning Management System (LMS). As one of the departments of the university, TUMS Department of Foreign Languages devised a plan and prepared itself for the new situation. This paper is a narrative account of the transition. Through reading this narration as a case of educational solution in the preset particular situation, language professors can adopt and implement efficient strategies and approaches in their educational settings. (shrink)

This letter was submitted to the Senate Standing Committee on Legal and Constitutional Affairs, Government of Canada, on 29th January, 2021, as final debate over Bill C-7 was being undertaken in the Senate regarding MAiD and the strong opposition to the legislation expressed across the Canadian disability community. It draws on our individual and joint work on eugenics, well-being, and disability.

Considering public moral attitudes is a hallmark of the anticipatory governance of emerging biotechnologies, such as heritable human genome editing. However, such anticipatory governance often overlooks that future morality is open to change and that future generations may perform different moral assessments on the very biotechnologies we are trying to govern in the present. In this article, we identify an ’anticipatory gap’ that has not been sufficiently addressed in the discussion on the public governance of heritable genome (...) editing, namely, uncertainty about the moral visions of future generations about the emerging applications that we are currently attempting to govern now. This paper motivates the relevance of this anticipatory gap, identifying the challenges it generates and offering various recommendations so that moral uncertainty does not lead to governance paralysis with regard to human germline genome editing. (shrink)

This book explores the intersection of legal frameworks, healthcare innovation, and computational intelligence, shedding light on how emerging technologies like AI and ML are reshaping the medical landscape. It presents real life challenges such as patient privacy, data security, and compliance issues in smart healthcare by engaging into associated ethical and regulatory implications. Comprising the concepts of predictive analytics, regulatory compliance algorithms, and legal decision-making processes, this book offers a roadmap for stakeholders to navigate the evolving landscape of healthcare (...) innovation responsibly and ethically. Investigates how artificial intelligence supports legal decision-making processes in smart healthcare, addressing ethical and accountability concerns Demonstrates the use of smart contracts and automation tools powered by computational intelligence to streamline legal processes and ensure compliance in smart healthcare initiatives Focuses on managing healthcare data within legal frameworks, emphasizing computational intelligence's role in ensuring privacy and security. Examines how computational intelligence enables predictive analytics models to anticipate legal challenges and compliance issues in smart healthcare. Highlights the development and implementation of computational algorithms for navigating evolving legal frameworks in healthcare. This reference book is a useful resource for scholars and researchers working on smart healthcare. (shrink)

Due to the Coronavirus Disease-2019 (COVID-19) lockdown implemented by the government, we had to transform our classes into the online sphere. The most commonly used methods of online teaching in Government Medical College, Thrissur were, live online lectures, PowerPoint presentations with narrations, prerecorded videos and assignments. Aim: To assess the logistical aspects, merit and demerits of different online teaching-learning methods among phase-1 medical student in a tertiary care teaching hospital during COVID-19 lockdown Materials and Methods: This cross-sectional study (...) was conducted from July 2020 to September 2020, among phase-1 MBBS students of Government Medical College, Thrissur, Kerala, India. Data was collected from 161 students through a questionnaire consisting of two parts. The first part dealt with logistical aspects, like net connectivity, gadget, expenditure, financial burden, residence and eye strain with online teaching learning methods. The second part dealt with the merits and demerits of each type of teaching learning methods, according to the students. All statistical data was analysed using the Statistical Package for the Social Sciences (SPSS) software version 16. Qualitative data was expressed as a percentage. Results: A total of 97.5% population of students was able to frequently access the online classes. Online learning strained the eyes of 47.8% of students. Mobile phones were used by 92.5% of students for attending online classes internet connectivity was mainly through 4G (71.4%) followed by Wi-Fi (19.9%) connections. Their most preferred method of online learning was online live lectures (35.4%) followed by PowerPoint presentations with narrations (33.5%). Blended learning (online and traditional together) was best preferred method of learning (46.6%). Conclusion: Live online lectures and blended learning were preferred by the majority of students. Thus, the online classes can be continued along with the traditional teaching in future. (shrink)

The objective of this article is to shed light on some challenging questions regarding public health and medical ethics that the Turkish healthcare system has recently been forced to confront. In recent years, terrorists in eastern Turkey have launched increasingly destructive attacks, including numerous attempts to undermine the social order by targeting not only government agencies but also the healthcare system. In this study, 54 terrorist incidents specifically targeting the Turkish healthcare system and healthcare professionals were analyzed and divided (...) into 6 categories according to the type of attack. Each category was evaluated in terms of the relevant ethical issues, with regard to both public health and medical ethics. This study shows that terrorist activity may lead to numerous breaches of public health and clinical ethics rules. Therefore, healthcare policy must involve special precautions to minimize breaches of public health and medical ethics in the face of terrorist attacks. (shrink)

This chapter explores the impact of “bureaucratic individualism” and profit-centered models on the medical profession, specifically examining Chronic Moral Injury (CH-MI). Drawing on Alasdair MacIntyre’s philosophy and Farr Curlin and Christopher Tollefsen’s critique of the Provider of Services Model (PSM) in healthcare, we argue that the erosion of practical reason—a key element for pursuing excellence in the profession—has dire consequences. Within the PSM, the focus on consumerism and radical patient autonomy hampers medical professionals’ ability to make value-informed judgments, (...) contributing to CH-MI and a crisis of purpose. The chapter calls for redefining healthcare models to prioritize human flourishing over corporate interests. (shrink)

WHO in 2019 established the Advisory Committee on Developing Global Standards for Governance and Oversight of Human Genome Editing, which has recently published a Draft Governance Framework on Human Genome Editing. Although the Draft Framework is a good point of departure, there are four areas of concern: first, it does not sufficiently address issues related to establishing safety and efficacy. Second, issues that are a source of tension between global standard setting and state sovereignty need to be addressed (...) in a more nuanced fashion. Third, it fails to meaningfully engage with the extent to which the conceptualisation of human dignity may justifiably vary between jurisdictions. Fourth, the meaning of harm to the interests of a future person requires clarity. Provided these four areas of concern can be addressed, the future of the global governance of human genome editing may hold promise. (shrink)

Background: Use of patients’ medical data for secondary purposes such as health research, audit, and service planning is well established in the UK. However, the governance environment, as well as public understanding about this work, have lagged behind. We aimed to systematically review the literature on UK and Irish public views of patient data used in research, critically analysing such views though an established biomedical ethics framework, to draw out potential strategies for future good practice guidance and inform (...) ethical and privacy debates. Methods: We searched three databases using terms such as patient, public, opinion, and electronic health records. Empirical studies were eligible for inclusion if they surveyed healthcare users, patients or the public in UK and Ireland and examined attitudes, opinions or beliefs about the use of patient data for medical research. Results were synthesised into broad themes using a framework analysis. Results: Out of 13,492 papers and reports screened, 20 papers or reports were eligible. While there was a widespread willingness to share patient data for research for the common good, this very rarely led to unqualified support. The public expressed two generalised concerns about the potential risks to their privacy. The first of these concerns related to a party’s competence in keeping data secure, while the second was associated with the motivation a party might have to use the data. Conclusions: The public evaluates trustworthiness of research organisations by assessing their competence in data-handling and motivation for accessing the data. Public attitudes around data-sharing exemplified several principles which are also widely accepted in biomedical ethics. This provides a framework for understanding public attitudes, which should be considered in the development in any guidance for regulators and data custodians. We propose four salient questions which decision makers should address when evaluating proposals for the secondary use of data. (shrink)

Since March of 2020, the world has been brought to its knees by unscientific and unethical mandates. These mandates have destroyed the world economy and the lives of countless innocent individuals. The “cure” that has been offered by medical bureaucrats and politicians has been more deadly than the disease (COVID-19). The imposition of ludicrous lockdowns, mask-wearing, coerced vaccination, and vaccine passports have not only proved to be ineffective, but also much more harmful than SARS-CoV-2 and all its variants. COVID-19 (...) has a recovery rate of close to 99% for most of the world’s population, however, despite this, institutions and power-hungry individuals have trampled upon our civil liberties and ignored our inalienable human rights. It is precisely as Thomas Paine famously stated: “The greatest tyrannies are always perpetrated in the name of the noblest causes.” -/- Many lives have been gratuitously lost because of the administration of deadly medical treatments, and the rejection of effective treatments that follow genuine science. In the process, informed consent has been disparaged and desecrated. For over two years, we were instructed to “trust the science,” but the “science” advocated by medical bureaucrats and greedy politicians was the reason why the world was turned upside-down. In the face of these crimes against humanity, justice will only be brought by real courts and real judges, but this will require the awakening of a critical mass. This book serves as an instrument for this awakening. (shrink)

The results of a recent survey of Nigerian women might give pause to opponents of female genital mutilation (FGM). One could well argue that if these Nigerian women themselves favour FGM, then it is ironically paternalistic to oppose it. Should Western feminists actually support FGM if it is what women in the South want? I argue in this commentary that such an argument rests on shaky statistical, psychological, medical, political and philosophical grounds. We should go on opposing female genital (...) mutilation with all our power. (shrink)

Though modern medicine publicly rejects Cartesian dualism, its treatment of pain and addiction betrays a residual metaphysical separation of mind and body. The institutional distinction between the “legitimate pain patient” and the “addict” re-inscribes ontological dualism through diagnostic and policy frameworks. Patients are compelled to perform metaphysical purity: pain must be somatic, desire must be psychological. The forced choice between opioids or benzodiazepines exemplifies this enacted dualism, requiring individuals to prioritize either body or mind in treatment. Yet the pharmacology of (...) substances like benzodiazepines and stimulants destabilizes the very categories medicine seeks to preserve. Rejecting substance dualism reveals both pain and addiction as dysregulated modes of embodiment — the bodymind’s attempt at equilibrium following trauma. This paper argues that the persistence of dualism in medical governance perpetuates epistemic injustice and ontological hygiene, and calls for a monist model of care integrating somatic and affective distress. -/- Excerpt from a developing project on the metaphysics of embodiment, pain, and addiction in medical practice. (shrink)

Algorithmic governmentality is a new form of political governance interconnected with technology and computation. By coining the term “algorithmic governmentality,” Antoinette Rouvroy argues that this mode of governance reduces everything to data, and people are no longer individuals but dividuals (able to be divided) or readable data profiles. Implementing the concept of algorithmic governmentality, the current study analyses Project Itoh’s award-winning novel Harmony in terms of such relevant concepts as “subjectivity,” “infra-individuality” and “control,” as suggested by Rouvroy and (...) colleagues. The analysis further draws on Foucault’s ideas of “governmentality” and “neoliberalism” and Deleuze’s concepts of “dividuality” and “society of control.” In Itoh’s fictional world, the entire society is subject to the new medical government, which replaced the chaotic world with a perfect but harrowing benevolent society, eradicating disease, suicide and crime. As elucidated in this paper, despite the dominant controlling government, there is a hope for humans to regain and reestablish their subjectivity and give meaning to their own personality by defying the nihilistic computational system. (shrink)

KEY POINTS In Canada, commercial data brokers collect deidentified patient data from pharmacies, private drug insurers, the federal government and medical clinics without patient consent. Although pharmaceutical companies are the data brokers’ primary customers, academics and nonprofit and public entities also use commercial data sets, given the absence of a coordinated public approach to collecting these data across Canada. Risks of commercialized patient data include loss of anonymity, surveillance and marketing, discrimination and violation of Indigenous data sovereignty. Coordinated infrastructure (...) for the collection and coordination of health data across Canada and updated privacy legislation would protect individuals and communities and enable appropriate data uses. (shrink)

Consent governs innumerable everyday social interactions, including sex, medical exams, the use of property, and economic transactions. Yet little is known about how ordinary people reason about the validity of consent. Across the domains of sex, medicine, and police entry, Study 1 showed that when agents lack autonomous decision-making capacities, participants are less likely to view their consent as valid; however, failing to exercise this capacity and deciding in a nonautonomous way did not reduce consent judgments. Study 2 found (...) that specific and concrete incapacities reduced judgments of valid consent, but failing to exercise these specific capacities did not, even when the consenter makes an irrational and inauthentic decision. Finally, Study 3 showed that the effect of autonomy on judgments of valid consent carries important downstream consequences for moral reasoning about the rights and obligations of third parties, even when the consented-to action is morally wrong. Overall, these findings suggest that laypeople embrace a normative, domain-general concept of valid consent that depends consistently on the possession of autonomous capacities, but not on the exercise of these capacities. Autonomous decisions and autonomous capacities thus play divergent roles in moral reasoning about consent interactions: while the former appears relevant for assessing the wrongfulness of consented-to acts, the latter plays a role in whether consent is regarded as authoritative and therefore as transforming moral rights. (shrink)

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of current (...) practices and could guide governments, professional societies, and physicians in allocation decisions. (shrink)

The rapid advancement of digital health innovation, including Artificial Intelligence (AI), is transforming healthcare. The growing role the European Union (EU) plays in regulating the use of AI in healthcare renders national laws insufficient to safeguard patients from unique AIrelated risks. This underscores the urgent need for the recognition of a canon of patients' rights in the scope of EU law. This paper proposes the blueprint for an EU Charter for Digital Patients' Rights, consolidating and adapting existing rights for patients (...) to address these specific challenges. Traditional patients' rights such as the right to privacy and the right to informed consent are interpreted in light of the challenges posed by AI. It also proposes novel rights for patients, such as the right not to be subject to automated medical decision-making and the right to meaningful human contact. This paper highlights the EU's central role in protecting patients' rights and outlines strategies for effective implementation. This comprehensive approach aims to address the current shortcomings and enhance the legal framework governing digital health in Europe. (shrink)

Governments standardly deploy a distinction between goods and services in assessing economic health and tracking national income statistics, of which medical goods and services carry significant importance. In what follows we draw on Basic Formal Ontology (BFO) to introduce a third kind of entity called patterns, which help capture the various ways in which goods and services are intertwined and help also to show how many services generate a new kind of non-goods-related products. Patterns are an overlooked yet essential (...) features of many economic sectors including medicine. Studying patterns offers new insights into various components of economic analysis, including outcomes-oriented evaluations of medical services and the value of human capital in the medical sphere. (shrink)

As opposed to a ‘one size fits all’ approach, precision medicine uses relevant biological, medical, behavioural and environmental information about a person to further personalize their healthcare. This could mean better prediction of someone’s disease risk and more effective diagnosis and treatment if they have a condition. Big data allows for far more precision and tailoring than was ever before possible by linking together diverse datasets to reveal hitherto-unknown correlations and causal pathways. But it also raises ethical issues relating (...) to the balancing of interests, viability of anonymization, familial and group implications, as well as genetic discrimination. This article analyses these issues in light of the values of public benefit, justice, harm minimization, transparency, engagement and reflexivity and applies the deliberative balancing approach found in theEthical Framework for Big Data in Health and Research to a case study on clinical genomic data sharing. Please refer to that article for an explanation of how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. Our discussion is meant to be of use to those involved in the practice as well as governance and oversight of precision medicine to address ethical concerns that arise in a coherent and systematic manner. (shrink)

Introduction: The Kenyan government has put a spirited reform to ensure all Kenyans get universal healthcare. This has led to restructuring of several entities among them the health insurance industry. This is geared at alleviating the burden of catastrophic expenditure on health from the poor Kenyans. However, insurance uptake remains at less than a quarter of the population with many Kenyans still paying for healthcare out-of-pocket. These out-of-pocket payers often don’t afford the ever-increasing cost of healthcare in Kenya. This study (...) looked at how doctors deal with patients given their modality of payment. Methodology: This was an online based survey that was distributed to Kenyan doctors via email by Kenya Medical Association. The survey sought information from the respondents on how they dealt with patients given their modality of payment. In addition, respondents were asked to provide an example of a case they had dealt with that touched on each payment modality. Results: Respondents gave their experiences where insurance had influenced their clinical decisions. Codes developed from the prose were; “inability to pay”, “harmful to the patient”, “changed the prescription” among others Health insurance played a crucial role whenever respondents made decisions. Top on the list of things that the majority indicated would be considered is insurance status and/or their ability of patients to pay for the services. Conclusion: Respondents are stuck in a limbo; striving to give the best care to patients but limited by the patients’ inability to pay. In explaining their experiences, respondents explain a situation where they intend to offer the best, but patients cannot afford. This especially so for those without health insurance who end up either not getting services or at the very best, get inferior services. (shrink)

Most medical research and a substantial amount of non-medical research, especially that involving human participants, is governed by some kind of research ethics committee (REC) following the recommendations of the Declaration of Helsinki for the protection of human participants. The role of RECs is usually seen as twofold: firstly, to make some kind of calculation of the risks and benefits of the proposed research, and secondly, to ensure that participants give informed consent. The extent to which the role (...) of the REC includes the former is not uncontroversial. Indeed, the most prevalent debate on the role of RECs sees liberals and strong paternalists arguing over the importance of informed consent given by competent agents versus the significance of making benevolent decisions on behalf of others. On the one hand, liberals argue for the rights of competent adults to decide for themselves the kinds and extents of risks to which they wish to expose themselves. On the other hand, proponents of strong paternalism raise concerns about the likelihood of participants being able to truly understand the complex data involved in research. They support a role for RECs in which they exercise duties of benevolence towards patients and participants by limiting the extent to which they can be exposed to significant, permanent and irreversible harms. In this paper, we will argue that when it comes to decisions about risk it is neither possible nor desirable for RECs to adopt either role. (shrink)

This paper introduces the Emergent Moral Ecology (EME) framework as a novel approach to addressing the complexities of moral responsibility in artificial intelligence (AI) systems. As AI technologies become increasingly autonomous and integrated into critical societal functions, traditional models of moral agency—grounded in anthropocentric concepts like consciousness, free will, and intention—prove inadequate for attributing responsibility. The EME framework reconceptualizes responsibility not as an intrinsic property of agents but as an emergent, context-sensitive function within sociotechnical systems comprising humans, AI entities, institutions, (...) and environments. Drawing from systems theory, ethics of care, process philosophy, and ecological metaphors, the framework posits that moral responsibility arises from the dynamic interactions and relational configurations of the components within these moral ecologies. It introduces foundational principles such as ecological emergence, moral gradients, contextual activation, reciprocal shaping, and temporal extension. Through multidimensional analysis—ontological, relational, contextual, and developmental—the framework offers a rigorous, adaptable tool for ethically assessing and guiding the deployment of AI systems. Case studies involving autonomous vehicles, medical diagnostics, and algorithmic decision-making demonstrate its practical relevance. The EME framework ultimately advocates for a shift from agent-centered ethics to ecology-centered responsibility, offering a philosophically robust and practically viable path for AI governance in an era of moral complexity. (shrink)

The U.S. FDA has issued emergency use authorizations for monoclonal antibodies for non-hospitalized patients with mild or moderate COVID-19 disease and for individuals exposed to COVID-19 as post-exposure prophylaxis. One EUA for an oral antiviral drug, molnupiravir, has also been recommended by FDA’s Antimicrobial Drugs Advisory Committee, and others appear likely in the near future. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (...) with increased infectivity and/or severity emerge, further rationing may be required. We identify relevant ethical principles and priority groups for access to therapies based on an integrated approach to population health and medical factors. Using priority categories to allocate scarce therapies effectively operationalizes important ethical values. This strategy is preferable to the current approach of categorical rules based on vaccination, immunocompromise status, or older age, or the ad hoc consideration of clinical risk factors. (shrink)

An abundance of data unequivocally shows that exercise can be an effective tool in the fight against obesity and its associated co-morbidities. Indeed, physical activity can be more effective than widely-used pharmaceutical interventions. Whilst metformin reduces the incidence of diabetes by 31% (as compared with a placebo) in both men and women across different racial and ethnic groups, lifestyle intervention (including exercise) reduces the incidence by 58%. In this context, it is notable that a group of prominent medics and exercise (...) scientists recently sent a well-publicised letter to the General Medical Council and Medical Schools Council calling for the introduction of evidence-based lifestyle education into all medical curricula. The letter warns that there is a lack of understanding of the impact that exercise and nutrition can have on physical health amongst doctors. In the absence of an educational overhaul, the signatories warn that the government is likely to fail to reach its goal of preventing tens of thousands of premature deaths from heart disease and cancer by 2020. Whilst we agree with the need to address this apparent lack of understanding, we argue that the ethical justification of doing so is not limited to this broadly beneficence-based justification. There is also a justification grounded in the duty of non-maleficence, that is, the duty to avoid unreasonably harming patients. This duty requires that doctors refrain from (i) preventing patients from undergoing beneficial treatment without good reason, (ii) exposing patients to unreasonable risks and (iii) reducing the therapeutic effect of an effective medical intervention. This requires an understanding of the physical impact of exercise. (shrink)

This study steps beyond the traditional arguments of feminism and examines homebirth from a libertarian perspective. It addresses the debate over homebirth and midwifery, which includes the use of direct-entry midwives as well as the philosophical implications of individual autonomy expressed through consumer choice. Furthermore, this paper demonstrates that the medical establishment gains economic and political control primarily through medical licensing, and uses the state to undermine personal freedom as it advances a government-enforced monopoly on birth. At the (...) same time, empirical studies have established a substantial record of high safety and low medical complication rates for homebirth as compared to hospital births. Ultimately, the state’s restriction on medical choices is incompatible with the nonaggression principle and voluntarism, and therefore, with libertarianism. (shrink)

This article assesses whether chronic hunger meets agent-neutral criteria for treatment as a non-communicable pandemic in global health. It integrates Twaddle’s disease–illness–sickness triad with Engel’s biopsychosocial model and operationalizes “pandemic” by six criteria (transnational reach, burden, socioeconomic disruption, international coordination, cross-border externalities, stable governance/financing). A bioethical anchor is added: the right to food, distributive justice, structural non-maleficence, solidarity, and intergenerational responsibility. Empirical substantiation draws on recent institutional evidence and literature on population nutrition, social determinants, syndemics, and governance. We (...) derive multi-level packages (community, national, global) with countercyclical financing and integrated surveillance, and address objections (dilution, medicalization, terminology, thresholds). We link the proposal to SDG-2 and the 2030 Agenda. We conclude that the agent-neutral pandemic framing does not dilute the concept; it sharpens it for decision-making where burden and disruption warrant prioritization. (shrink)

The Sal-Meter Application Charter v1.0 establishes a non-coercive, non-surveillance framework for observing consciousness state-transition dynamics following lived experiences. -/- Operating within the Consciousness Civilization Framework (CCF), the Sal-Meter measures what condition remains after experiences, interactions, or exposures—without evaluating individuals, identities, behaviors, or performance. It generates no scores, rankings, predictions, or automated decisions. -/- At relational and collective scales, the Charter references descriptive indices from the Conscious Field Energy Plus (CFE⁺) framework: the Consciousness Resonance Index (CRI) and Conscious Field Index (CFI). (...) These function strictly as non-normative observational descriptors, not measures of capacity, resilience, or value. -/- The Charter explicitly prohibits identity tracking, surveillance, enforcement, punitive use, profiling, and social scoring. Participation is voluntary, post-experience, non-binding, and reversible. -/- The Sal-Meter functions as an informational measurement substrate beneath existing medical, legal, social, and governance systems—enabling transparency and stabilization without centralized control, ideological imposition, or governance replacement. (shrink)

This document presents the applied philosophical and conceptual bridge between the Consciousness Civilization Framework (CCF) and its first operational measurement prototype, the Sal-Meter. -/- It explains how a consciousness-centered civilizational theory can be translated into a measurable architecture through CAIS (Consciousness–Aptamer Interface System)–compatible design, non-coercive state-based measurement logic, and proof-of-concept implementation principles. -/- Rather than proposing a medical, diagnostic, or predictive system, the work articulates why consciousness measurement must be governed before it is optimized, and how philosophical constraints map (...) directly onto engineering boundaries such as openness, non-monopolization, and post-experience state observation. -/- The document serves as an applied philosophy reference, a conceptual technical proof-of-concept, and a canonical connector within the CCF document constellation, linking foundational theory to downstream technical and governance standards without redefining any canonical specifications. (shrink)

This topic focuses on the problems that arise in providing medical care to the population during armed conflict or martial law. Under such conditions, hospitals, clinics, and other healthcare facilities have to work in challenging circumstances with limited resources and reduced security for medical personnel. This topic explores such issues as how martial law affects the work of medical institutions, what problems arise in providing medical care to the population in war, how war affects the health (...) of the people, and what consequences it may have in the long term. Research in this area will help to understand how to organize better and prepare medical facilities to work in war conditions and ensure high-quality medical care to the population in emergencies. The methods used to write this article were analysis, synthesis, generalization, explanation, and data qualification. The primary and fundamental sources for writing an article may vary depending on the topic, but generally, the following sources can be recommended. Academic studies: these can be scholarly articles, monographs, dissertations, conference papers, and other materials related to the topic of your article. These sources can help you find information about the latest research in the field and allow you to see the approaches and methodologies used in the studies. Official sources: These can be legal documents, reports, regulations, guidelines, and other materials issued by government agencies, ministries, and other departments. These sources can help you understand the rules and regulations governing your article's topic. Expert reviews: these can be interviews with experts in the field, articles, and other materials written by well-known specialists. These sources can help you understand the views and opinions of well-known experts on the issues related to your paper. (shrink)