Reflections on Discrimination

In the background are two claims that I want to put on the table. First, although it may be wrong for people to engage in a particular form of discrimination, it does not follow that the government should seek to prevent that discrimination. Second, although it may not be wrong for people to engage in a particular form of discrimination, it does not follow that it would be wrong for the government to seek to prevent that discrimination or to mitigate its effects. The wrongness of individual behavior is obviously related to the justifiability of state action, but the correlation is by no means perfect

The Obligation to Participate in Biomedical Research

The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. Participation in research is a critical way to support an important public good. Consequently, all have a duty to participate. The current social norm is that individuals participate only if they have a good reason to do so. The public goods argument implies that individuals should participate unless they have a good reason not to. Such a shift would be of great aid to the progress of biomedical research, eventually making society significantly healthier and longer lived

Principles for allocation of scarce medical interventions

Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principle

Standing by our principles: Meaningful guidance, moral foundations, and multi-principle methodology in medical scarcity

Background Several quantitative surveys have been conducted internationally to gather empirical information about physicians’ general attitudes towards health care rationing. Are physicians ready to accept and implement rationing, or are they rather reluctant? Do they prefer implicit bedside rationing that allows the physician–patient relationship broad leeway in individual decisions? Or do physicians prefer strategies that apply explicit criteria and rules? Objectives To analyse the range of survey findings on rationing. To discuss differences in response patterns. To provide recommendations for the enhancement of transparency and systematic conduct in reviewing survey literature. Methods A systematic search was performed for all English and non-English language references using CINAHL, EMBASE, and MEDLINE. Three blinded experts independently evaluated title and abstract of each reference. Survey items were extracted that match with: (i) willingness to ration health care or (ii) preferences for different rationing strategies. Results 16 studies were eventually included in the systematic review. Percentages of respondents willing to accept rationing ranged from 94% to 9%. Conclusions The conflicting findings among studies illustrate important ambivalence in physicians that has several implications for health policy. Moreover, this review highlights the importance to interpret survey findings in context of the results of all previous relevant studies

Exploitation and Joint Action

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Designing for the Infrastructure of the Supply Chain of Malay Handwoven Songket in Terengganu

The growing HCI interest in developing contexts and cultural craft practices is ripe to focus on their under-explored homegrown sociotechnical infrastructures. This paper explores the creative infrastructural actions embedded within the practices of songket's supply chain in Terengganu, Malaysia. We report on contextual interviews with 92 participants including preparation workers, weavers, designers, merchants, and customers. Findings indicate that increased creative infrastructural actions are reflected in these actors' resourcefulness for mobilizing information, materials, and equipment, and for making creative artifacts through new technologies weaved within traditional practices. We propose two novel approaches to design in this craft-based infrastructure. First, we explore designing for the social layer of infrastructure and its mutually advantageous exploitative relationships rooted in culture and traditions. Second, we suggest designing for roaming value-creation artifacts, which blend physical and digital materializations of songket textile design. Developed through a collaborative and asynchronous process, we argue that these artifacts represent less-explored vehicles for value co-creation, and that sociotechnical infrastructures as emerging sites of innovation could benefit from HCI research