Smallpox revisited?

This article reviews the history of smallpox and ethical issues that arise with its threat as a biological weapon. Smallpox killed more people than any infectious disease in history--and perhaps three times more people in the 20th Century than were killed by all the wars of that period. Following a WHO-sponsored global vaccination campaign, smallpox was officially declared eradicated in 1980. It has since been revealed that the Soviet Union, until its fall in the early 1990s, manufactured tens of tons of smallpox for military purposes. A worry is that some of this may have fallen into the hands of "rogue" nations or terrorists. Current U.S. debate questions whether smallpox vaccine should therefore be made available to the American public, which--like the rest of the world--now lacks immunity. Because the vaccine is considerably dangerous, public dialogue cannot resolve this matter if evidence material to the likelihood of attack is classified (i.e. secret). I conclude by recommending numerous future areas for ethics research related to the weaponization of smallpox.     

Should smallpox vaccine be made available to the general public?

In June 2002, the Advisory Committee on Immunization Practices (ACIP) approved draft recommendations concerning preparation for potential biological terror attacks that utilize the smallpox virus. ACIP recommends against both mandatory and voluntary vaccination of the general public. The present paper examines the moral and political considerations both for and against each of the general public vaccination options considered by the ACIP in the context of the state's authority over vaccination for the purposes of protecting public health. Although it is clear that compulsory mass vaccination is not justified at this time, the issues surrounding voluntary vaccination are more complex. Should smallpox vaccination prior to an outbreak be made available to the general public? The paper concludes that the vaccine should not be made available at this time. This conclusion, however, is based upon contingent features of current circumstances, which would change once an outbreak occurred. In the even of a terror-related outbreak of smallpox, the general public's access to voluntary vaccination would become justified, even in areas beyond where the outbreak has occurred.     

“I'm Moderna,what are you?” Evidence that people favor those who received their same brand COVID-19 vaccine

In two studies, we investigated the extent to which people are biased toward people with the same COVID-19 vaccine brand using a monetary allocation task. Informed by theoretical approaches to intergroup bias and the minimal-groups paradigm, we expected that, when deciding how to allocate financial resources among three different people—each with an equal need for assistance but a different COVID-19 vaccine brand—people would allocate more money, on average, to those who received the same versus different vaccine brand than participants personally received. We found in Study 1 (N = 94) that people given a hypothetical $10.00 experimental endowment allocated an average of $2.00 more when a person was a member of their vaccine ingroup than to those from their vaccine brand outgroup. We replicated this effect in Study 2 (N = 219), finding that people continued to allocate more money ($1.42) to a person from their vaccine brand ingroup versus those from their vaccine brand outgroup. Taken together, this work suggests that, among vaccinated people, the brand of another person's vaccine meaningfully influences the allocation of monetary resources and that people are biased toward people with the same COVID-19 vaccine brand. Implications for social identity theories are discussed.     

Biopower,Normalization, and HPV: A Foucauldian Analysis of the HPV Vaccine Controversy

This article utilizes the Foucauldian concepts of biopower and normalization to give an analysis of the debate surrounding the controversial administration of the HPV vaccine to adolescents. My intention is not to solve the problem, rather to utilize a Foucauldian framework to bring various facets of the issue to light, specifically the way the vaccine contributes to strategies of power in reference to how young adults develop within relationships of power. To begin, the article provides an overview of the Foucauldian concepts of biopower and normalization, including how these two strategies of power were present in the administration of the smallpox vaccine in the 19th century. Next, information about HPV and the history of the current controversy in the United States is presented. Lastly, the article presents an analysis of the strategies of biopower and normalization present in the debate on HPV, including an emphasis on how the vaccination is similar to, and different from, 19th century smallpox vaccination. It also explores the way that mechanisms of disease control affect and are affected by individual subjects, in this case, adolescents.     

Death and organ procurement: public beliefs and attitudes

Although "brain death" and the dead donor rule--i.e., patients must not be killed by organ retrieval--have been clinically and legally accepted in the U.S. as prerequisites to organ removal, there is little data about public attitudes and beliefs concerning these matters. To examine the public attitudes and beliefs about the determination of death and its relationship to organ transplantation, 1351 Ohio residents >18 years were randomly selected and surveyed using random digit dialing (RDD) sample frames. The RDD telephone survey was conducted using computer-assisted telephone interviews. The survey instrument was developed from information provided by 12 focus groups and a pilot study of the questionnaire. Three scenarios based on hypothetical patients were presented: "brain dead," in a coma, or in a persistent vegetative state (PVS). Respondents provided personal assessments of whether the patient in each scenario was dead and their willingness to donate that patient's organs in these circumstances. More than 98 percent of respondents had heard of the term "brain death," but only one-third (33.7%) believed that someone who was "brain dead" was legally dead. The majority of respondents (86.2%) identified the "brain dead" patient in the first scenario as dead, 57.2 percent identified the patient in a coma as dead (Scenario 2), and 34.1 percent identified the patient in a PVS as dead (Scenario 3). Nearly one-third (33.5%) were willing to donate the organs of patients they classified as alive for at least one scenario, in seeming violation of the dead donor rule. Most respondents were not willing to violate the dead donor rule, although a substantial minority was. However, the majority of respondents were unaware, misinformed, or held beliefs there were not congruent with current definitions of "brain death." This study highlights the need for more public dialogue and education about "brain death" and organ donation.     

Life quality and rehabilitation after a road traffic crash: A literature review

Road traffic injuries continue to pose a worldwide threat to health and well-being of people. In European Union, for example, each year more than 25,000 people are killed and 1.4 million people are injured or disabled in road traffic crashes (RTCs). Additionally, families of RTC victims and their lives are affected emotionally, socially, psychologically, and economically. It should be noted that as in the beginning of 1990s, however, the majority of available literature is focused on the pre-RTC factors (e.g., prevention) rather than the post-RTCs (e.g., the rehabilitation of severely injured) period. As a result, disproportionally greater weight is attached on the pre-RTCs internationally whereas little is known about the psycho-social and economic burden of the post-RTCs period. In this paper, a literature review including the years 1990–2013 was conducted on the publications about post-RTCs period to investigate the possible problems that prevents studying the life quality and rehabilitation after RTCs. Trauma, traffic, injury, rehabilitation, and satisfaction (related to the services and process) were used as keywords and Scopus database (www.scopus.com) was used for searching. In the first step, 443 publications were obtained. Among 443 publications, 75 publications were recorded as relevant. In addition, three publications were suggested by co-authors and 37 publications were obtained by a book source suggested by the reviewer. A total number of 114 publications are presented and evaluated under different components or “stages” of the post-RTCs’ period related to rehabilitation as (a) service utilization indicators (e.g., length of care) and service satisfaction indicators (e.g. satisfaction from services), (b) morbidity indicators (e.g., injury patterns), (c) quality of life indicators (e.g., physical and psychological well-being indicators), (d) social network indicators (e.g., type and frequency of informal care provided by family members), and (e) cost indicators (e.g., overall expenditure). The overall evaluation of the publications in literature, possible implications, suggestions, and future directions were discussed.     

Stone,Ken, Practicing Safer Texts: Food,Sex and Bible in Queer Perspective

Abstract

The past twenty years have witnessed much discussion about the place of lesbian, gay, bisexual and transgendered (LGBT) people in the Church, particularly through two sets of debates: on whether and under what circumstances LGBT people should be ordained, and on whether and under what circumstances LGBT people should have their marital unions blessed. The past twenty years have also witnessed the creation of various liturgical materials responsive to the needs of LGBT people, particularly for events that are crucial to an LGBT person's life and faith but for which there were no existing rites in public worship. However, by concentrating only on the occasional and extraordinary events in a person and a community's life as "queer worship" (with its double sense of both "unusual worship" and "worship for LGBT people"), we are neglecting the myriad ways in which day-to-day ordinary worship is, and is not, queer. This article therefore examines the ways in which heteronormativity and the demand for "covering" can create tacit prohibitions around worship for LGBT Christians. Arguing for the inherent queerness of Christian worship, it suggests practical ways in which LGBT people's lives can more fully integrate into a community's liturgical life, and vice versa.     

Reciprocity,Vulnerability, and the Moral Significance of Herd Immunity

This article proposes a novel defense of vaccine mandates: such policies are justifiable because they protect the capabilities of individuals who cannot cultivate individual immunity against infection. We begin by considering a nearby argument that has recently enjoyed popularity, which claims individuals have an enforceable obligation to get vaccinated because they have benefited from community protection (often referred to as ‘herd immunity’), and thus they ought to do their fair share in sustaining that public good by getting vaccinated. We object, however, that this kind of argument misstates the ethical basis for vaccine mandates because community protection primarily protects unvaccinated people. We contend that the duty to vaccinate is not fundamentally an obligation to make a fair contribution to a public good from which vaccinated people benefit, but a duty to protect the wellbeing of otherwise vulnerable third parties. We flesh out our view by drawing on Martha Nussbaum's capabilities approach.     

The fractionation of retrograde amnesia

This single case study describes our investigations of the retrograde memory deficit of a patient who became severely and selectively amnesic after an encephalitic illness. On clinical assessment his retrograde deficit for both personal and public events appeared to encompass his entire adult life. However, he retained knowledge of words introduced into the vocabulary during the retrograde period. The experimental investigation documented his inability to recall, recognize, and place in temporal order the names and faces of famous people for all time periods sampled. By contrast, his recall of either a famous face or a famous name was significantly facilitated by the verbal cue of the person's first name and initial of the surname (i.e., Margaret T...). His performance on a test of "familiarity" that required him to select the famous name or the famous face from two distractors (unknown) was within normal limits. It is argued that names and faces of famous people are represented in more than one system: both in a vocabulary-like fact memory system that is preserved and also in a congnitively mediated schemata that in this case is functionally inoperative.     

Ease of Recall vs Recalled Evidence in Judgment: Experts vs Laymen

When major reasons of fault are presented in a pruned format, people fail to transfer the proportions of the omitted categories to the "all-other-problems" category. The present research investigated the underlying judgmental processes and the effect of domain knowledge on this phenomenon, known as pruning bias. In Experiment 1, although people with higher levels of domain knowledge failed to adjust completely for omission from the fault tree, they were more accurate and less biased than people with lower levels of domain knowledge. In Experiment 2, two hypothe ses are contrasted: The first, the availability explanation, sug gests that the underestimation of the "all-other-problems" category stems from its label being a less effective retrieval cue for specific fault reasons than the labels of major categories. The second hypothesis suggests that people judge by perceived ease of recall. The results suggest that people generating less failure reasons provide higher proportions to the "all-other-problems" category than people generating more reasons. The latter generation condition was perceived to be more difficult, signaling to people that the "all-other-problems" category is not so prevalent. The results of Experiments 3 and 4 indicate, as hypothesized, that the judgments of people with relatively low levels of domain knowledge are influenced by perceived ease of recall, whereas the judgments of people with higher levels of domain knowledge are influenced by recalled evidence. Copyright 2000 Academic Press.     

Assessing attitudes toward gay marriage among selected Christian groups using the lost-letter technique

100 each envelopes were distributed to Christian church parking lots and general public parking lots. Letters were addressed to either the "Gay Marriage Foundation" or to a neutral organization. Significantly more neutral letters (n = 75) were returned than "Gay Marriage Foundation" letters (n = 36) from both types of locations, but no differences were found for return rates. Gay marriage may be a controversial topic for people in this area of California. The limitations of the lost-letter technique prohibit fine distinctions; however, one may infer attitudes toward gay marriage may not be more negative among Christian church attendees than in the general public.     

Public health, public trust and lobbying

Each year, infection with Human Papillomavirus (HPV) leads to millions of abnormal Pap smears and thousands of cases of cervical cancer in the US. Throughout the developing world, where Pap smears are less common, HPV is a leading cause of cancer death among women. So when the international pharmaceutical giant Merck developed a vaccine that could prevent infection with several key strains of HPV, the public health community was anxious to celebrate a major advance. But then marketing and lobbying got in the way. Merck chose to pursue an aggressive lobbying campaign, trying to make its new vaccine mandatory for young girls. The campaign stoked public mistrust about how vaccines come to be mandated, and now it's not just Merck's public image that has taken a hit. The public health community has also been affected. What is the lesson to be learned from this story? Public health communication relies on public trust.     

Be aware to care: Public self-awareness leads to a reversal of the bystander effect

The classic bystander effect stipulates that people help others more when they are alone than when other bystanders are present. We reason that, sometimes, the presence of bystanders can increase helping, notably in situations where public self-awareness is increased through the use of accountability cues (e.g., a camera). We conducted two experiments in which we tested this line of reasoning. In both experiments, participants read messages soliciting support in an online forum. We varied the number of people that were present in that forum to create a bystander and an alone condition. In Study 1, we introduced an accountability cue by making participants' screen-names more salient, and in Study 2, we used a webcam. Both studies indicate that, as expected, the bystander effect can be reversed by means of cues that raise public self-awareness in social settings.     

SELF-REINFORCEMENT EFFECTS: AN ARTIFACT OF SOCIAL STANDARD SETTING?

Two studies were conducted to identify mechanisms responsible for observed "self-reinforcement" effects. In Experiment 1, using a studying task, self-reinforcement procedures did not work when they were private (i.e., when others are not aware of the goals or contingencies), but did work when they were public. Self-delivery of consequences added nothing to the effectiveness of the procedure. The data suggested that public goal setting was the critical element in the procedure's effectiveness. In Experiment 2, an applied extension, goal setting alone was effective in modifying over a long time period studying behaviors of people with significant studying difficulties, but only when the goals were known to others. Overall, the two experiments make more plausible the view that self-reinforcement procedures work by setting a socially available standard against which performance can be evaluated. The procedure itself functions as a discriminative stimulus for stringent or lenient social contingencies. The application of this mechanism to other problems of applied significance is briefly discussed.     

Can you forgive? It depends on how happy you are

This paper examined how individual group status and happiness influence forgiveness. In Study 1, happiness was treated as a trait difference: highly happy people, compared with very unhappy people, were found to be more willing to forgive murderers. More important, an interaction effect between happiness and group status on forgiveness was found, that is, highly happy people tended to be more forgiving when either ingroup or outgroup members were killed; unhappy people, however, tended to be less forgiving about murder when ingroup rather than outgroup members were killed. In Study 2, happiness was treated as an emotional state difference: happiness, rather than sadness, was found to bring greater forgiveness. Moreover, consistent with the interaction effect displayed in Study 1, happy participants tended to forgive more when ingroup or outgroup members were hurt; sad participants tended to forgive less when ingroup members rather than outgroup members were hurt. Implications for connections between happiness, group membership, and forgiveness are discussed.     

"A Christian, Holy People" Martin Luther on Salvation and the Church

Starting from recent uneasiness with Protestant individualism, this article asks whether Luther's theological insights might help address the unintended cultural consequences of the Reformation. Luther's mature thought defines the church as a tangible "Christian, holy people" within history, constituted by distinctive public practices. This church is necessarily institutionalized: the "universal priesthood" is corporate rather than individual, and cannot be fully realized without ministers acting in persona ecclesiae. Ordered ministry and common priesthood are interdependent and mutually constitutive. Finally, following his central principle that God gives spiritual gifts only through public, bodily means, Luther allows no separation of justifying faith from bodily adherence to the Christian people.     

Public Policy and Public Opinion Toward Sex Education and Birth Control for Teenagers

That government policy toward provision of sex education and contraception for adolescents may be influenced by public opinion is reflected in the fact that recent program formulation appears to follow the conventional wisdom of a general conservative shift among the American public, i.e., recent policy toward adolescent pregnancy is conservative in the sense of being reactive rather than preventive. A cheek on the validity of this conventional wisdom was accomplished by integrating available data on public opinion toward sex education and brth control services for teenagers. These data reveal an upward trend in public approval of such services for adolescents that runs counter to the conventional wisdom. This is because the conventional wisdom is not firmly supported by the available data on American opinions and values which demonstrate that the overall movement in attitudes decisively contradicts the idea of a simple conservative swing. Provision of more and better contraceptive services and sex education to teenagers is an important policy goal that would lower the incidence of adolescent pregnancy and would be supported by the American people.     

The end justifies the means, but only in the middle

Achieving goals often requires the completion of sequential actions, such as finishing a series of assignments to pass a class. In the course of pursuing such goals, people can decide how closely to follow their personal standards for each action. We propose that actions at the beginning and end of a sequence appear more diagnostic of the pursuer's personal standards than do actions in the middle. Therefore, people are more likely to adhere to their standards at the beginning and end of goal pursuit-and slack in the middle. We demonstrate this pattern of judgment and behavior in adherence to ethical standards (e.g., cheating), religious traditions (e.g., skipping religious rituals), and performance standards (e.g., "cutting corners" on a task). We also show that the motivation to adhere to standards by using proper means is independent and follows a different pattern from the motivation to reach the end state of goal pursuit.