The international response to the Ebola outbreak has excluded Africans and their interests

LSE’s Katherine Furman explores how ethics could have played a more prominent role in the management of the current outbreak of Ebola in West Africa

Moral responsibility, culpable ignorance and suppressed disagreement

Ignorance can excuse otherwise blameworthy action, but only if the ignorance itself is blameless. One way to avoid culpable ignorance is to pay attention when epistemic peers disagree. Expressed disagreements place an obligation on the agent to pay attention when an interlocutor disagrees, or risk culpable ignorance for which they might later be found blameworthy. Silence, on the other hand, is typically taken as assent. But in cases of suppressed disagreement, the silenced interlocutor has information that could save the agent from ignorance in scenarios where that ignorance might lead to harmful action, and silence does not actually indicate assent. The problem is further complicated because the agent might not be aware of the fact that a silenced interlocutor has information that could prevent ignorance, and consequent harmful action. In this paper, I provide a new account of excuses from ignorance in situations of suppressed disagreement. I do this in the context of two cases; Kelly’s (2005) hypothetical case of the Tyrannical Dictator, and the real-world case of former South African President Thabo Mbeki and his AIDS denialist policies in the late 1990s and early 2000s

Exploring the possibility of an Ubuntu-based political philosophy

It is typically said that there are two questions that political philosophy seeks to address: ‘who gets what?’ and ‘who decides on who gets what?’ South Africa, along with much of the rest of the world, has answered the second question badly and currently ranks as one of the world’s most unequal societies. Counter-intuitively, South Africa maintains a social-political order that (re)produces this inequality along with great enthusiasm for ubuntu, an African ethic that at a minimum requires that we treat each other humanely. However, due to the view that ubuntu has been co-opted in support of South Africa’s unjust system, ubuntu has largely been ignored by radical thinkers. The aim of this thesis is therefore to explore the possibility of an ubuntu-based political philosophy, with the core assumption that political philosophy is rooted in ethical theory. Three tasks are therefore undertaken in this thesis. Firstly, ubuntu is articulated as an ethic. Secondly, it is compared to similar Western ethical theories in order to determine if there are distinguishing characteristics that make ubuntu a more appropriate founding ethic for South African political philosophy. Finally, whether ubuntu can find real-world applicability will be assessed by looking at the way ubuntu has been used in the la

Objectivity in Science and Law: A Shared Rescue Strategy

The ideal of objectivity is in crisis in science and the law, and yet it continues to do important work in both practices. This article describes that crisis and develops a shared rescue strategy for objectivity in both domains. In a recent article, Inkeri Koskinen (2018) attempts to bring unity to the fragmented discourse on objectivity in the philosophy of science with a risk account of objectivity. To put it simply, she argues that we call practitioners, processes, and products of science objective when they identify and manage certain important epistemic risks. We endorse this view and attempt to tailor Koskinen’s strategy to the problem of objectivity in the legal context. To do so, we develop a novel notion of phronetic risk, and argue that we call practitioners, processes, and products of law objective when they identify and manage certain important epistemic and/or phronetic risks. Our attempt to rescue objectivity is especially important for work at the intersection of law and psychiatry. For that intersection represents a place where skeptical worries about objectivity in science and law work in tandem to pose serious critical challenges to contemporary practice; and our rescue strategy represents a promising way to negotiate those challenges

AIDS denialism in South Africa: a case study in the rationality and ethics of science policy

From 28 October 1999 to 26 September 2000 Mbeki publically endorsed the position of ‘denialist’ AIDS scientists – a marginal group who oppose the claim that HIV causes AIDS – and used their views as the basis for a policy of not providing ARVs (antiretrovirals – the treatment that prevents HIV from replicating) via the public health system. This policy persisted until 2004, with severe consequences – best estimates indicate that it resulted in 171,000 avoidable new infections and 343,000 deaths over the 1999 – 2002 period. I use this case to address two questions. First, is it reasonable for policy makers to consult non-mainstream scientists in the process of policy development? Second, can they be held personally morally responsible for the consequences of having done so when things go very badly wrong? I begin by providing a motivation for why philosophers should be interested in real-world cases. Having justified the philosophical “methodology” of this thesis, I move on to describing the specific case of South African AIDS denialism in the early 2000s. I then take a chronological step back in order to assess the rationality of accepting HIV as the sole cause of AIDS in 1984, when the virus was first identified. I argue that it was rational, but that some explanatory power was lost when other competing accounts of the disease’s aetiology were discarded. I argue that this explanatory loss can be accounted for by re-considering the way causation is understood in biomedicine and epidemiology. Having settled the scientific issues of the case, I then move on to the question of moral responsibility. I specifically look at when an agent can be held morally responsible for their ignorance, and the role of suppressed disagreement in the production of that ignorance

On Trusting Neighbors More Than Experts: An Ebola Case Study

In this paper I argue that rumors pose a challenge to effective science communication. I also argue that it is sometimes reasonable for ordinary laypeople to trust rumors over the experts. The argument goes like this. There are strong fact-value entanglements in the sciences. Further, my friends and neighbors may be more likely than the experts to make value judgments that line up with my own. As such, it can make sense for me to pay close attention to their testimony. It may even make sense for me to trust testimony within my peer network—or “rumors”—more than the experts, especially if the experts' values are especially opaque or suspicious to me. I ground this discussion in the recent West Africa Ebola outbreak, where rumors posed a substantial challenge to containing the epidemic

Mild Idiopathic Infantile Hypercalcemia—Part 1: Biochemical and Genetic Findings

Context: Idiopathic infantile hypercalcemia (IIH), an uncommon disorder characterized by elevated serum concentrations of 1,25 dihydroxyvitamin D (1,25(OH)2D) and low parathyroid hormone (PTH) levels, may present with mild to severe hypercalcemia during the first months of life. Biallelic variants in the CYP24A1 or SLC34A1 genes are associated with severe IIH. Little is known about milder forms. Objective: This work aims to characterize the genetic associations and biochemical profile of mild IIH. Methods: This is a cross-sectional study including children between age 6 months and 17 years with IIH who were followed in the Calcium Clinic at the Hospital for Sick Children (SickKids), Toronto, Canada. Twenty children with mild IIH on calcium-restricted diets were evaluated. We performed a dietary assessment and analyzed biochemical measures including vitamin D metabolites and performed a stepwise molecular genetic analysis. Complementary biochemical assessments and renal ultrasounds were offered to first-degree family members of positive probands. Results: The median age was 16 months. Median serum levels of calcium (2.69 mmol/L), urinary calcium:creatinine ratio (0.72 mmol/mmol), and 1,25(OH)2D (209 pmol/L) were elevated, whereas intact PTH was low normal (22.5 ng/L). Mean 1,25(OH)2D/PTH and 1,25(OH)2D/25(OH)D ratios were increased by comparison to healthy controls. Eleven individuals (55%) had renal calcification. Genetic variants were common (65%), with the majority being heterozygous variants in SLC34A1 and SLC34A3, while a minority showed variants of CYP24A1 and other genes related to hypercalciuria. Conclusion: The milder form of IIH has a distinctive vitamin D metabolite profile and is primarily associated with heterozygous SLC34A1 and SLC34A3 variants. Keywords: CYP24A1; genetic; hypercalcemia; nephrocalcinosis; nephrolithiasis; vitamin