Ethical implications of COVID-19 management-is freedom a desired aim, or a desired means to an end?

Most developed societies managed, due to their prosperity and resource abundance, to structure relationships among free individuals in such a way to leave them fundamentally unstructured, according to the free market principle. As the pandemic illustrated well, this lack of structure when facing collective threats makes it impossible to collectively and proportionately assess and manage its implications and consequences. This may be particularly precarious when introducing comprehensive, monitoring and tracking, surveillance systems dependent on the vaccination status of the individual. If our previously shared aims were successfully and collectively enacted with the greatest of costs, is it permissible that the degree of personal freedom is a commodity, and everyone is a compulsory participant? The need to control one's COVID-19 status allows the individual to become legally free from excessive enactment of sovereignty of the state. Should these rights be regulated by the free market?

Deprivation of liberty and the community nurse.

In this month's Policy column, Iwan Dowie discusses the 'deprivation of liberty' - which is used to safeguard patients who may be lacking sufficient mental capacity to manage their own safety. The author, through previous legal cases, shares how the Deprivation of Liberty Safeguards (DoLS)-an amendment to the Mental Capacity Act 2005-came into being, and the importance of community nurses in knowing the DoLS.

Gratitude, freedom and refusal.

This paper is an exploration of gratitude as a fundamental concept in psychoanalysis. Melanie Klein's classic article "Envy and Gratitude" (1957) named gratitude at one pole on an axis of human suffering and flourishing, but with a few notable exceptions, the article stimulated research into envy. This paper explores the historical and philosophical traditions that have, to some extent unconsciously, influenced our contemporary understandings of gratitude. The paper also works to explore the social and ethical meanings of gratitude as well as gratitude's psychoanalytic significance. The aim is to uncover the overall psychic significance of gratitude and its place in human flourishing.

Might the bioethical principle of individual decisional autonomy have a politically liberalizing effect on soft authoritarian communities?

According to the bioethical principle of individual decisional autonomy, the patient has a right of informed consent to any medical or experimental procedure. The principle is politically liberal by advocating significant individual freedom as guaranteed by law and secured by civil liberties. When practiced in illiberal communities, might it have a political liberalizing effect? I respond first by analyzing cross-national norms of individual decisional autonomy to identify tensions with illiberal community; second, by examining examining Singapore in a single case study to show that liberal bioethics does not promote political liberalization; and third, by showing that the possibility of practicing liberal bioethics in research, clinically as well as in education, does not require a democratic order, and that liberal bioethics is unlikely to encourage the liberalization of illiberal political communities. Hence, it may never contribute to the development of globally effective cross-national norms for the legal regulation of bioethical research and clinical practice. Fourth, to bolster this analysis, I anticipate several possible objections to various of its aspects.

'The way to obtain freedom and equality': Experiences and needs of Thai adolescent mothers in terms of the use smartphone applications for breastfeeding support.

BACKGROUND: Breastfeeding brings about a positive impact on both child and maternal health in the short and long terms. However, adolescent mothers have a lower breastfeeding initiation rate and a shorter breastfeeding duration than adult mothers. Although mobile applications have been found to be the most widely used platform for breastfeeding support, there is still a lack of design specific for adolescents. AIM: To explore the experiences, perspectives and needs of adolescent mothers and professional nurses using smartphone applications for breastfeeding support and the influence of this technology on healthcare in Thailand. METHODS: This formative qualitative research of the 'Development of smartphone application for promoting breastfeeding and learning of infant responsiveness for Thai teenage pregnant women' study intends to design a smartphone application and develop an implementation plan. A purposive sample was used to elicit experiences from adolescent mothers and nurses. Data were collected from 48 adolescent mothers through in-depth interviews with six focus group discussions and 12 nurses, following the data saturation principle. Thematic analysis was conducted, and potential factors and needs were mapped to the capability, opportunity, and motivation model of behaviour change (COM-B). RESULTS: Most adolescent mothers perceived the usefulness of smartphone apps as breastfeeding support resources. The qualitative findings of adolescent mothers were grouped into the following three themes: a friendly breastfeeding tool; allows them to manage their breastfeeding activities; and enhances the accessibility and equality of breastfeeding support. The professional nurses perceived the benefits of using smartphone applications in their work, which included the following three themes: reducing workload and making their work easier; preparation is always better; and increasing the standards of breastfeeding support. CONCLUSION: Adolescent mothers and professional nurses showed favourable attitudes toward smartphone apps for breastfeeding support. These smartphone apps should be tailored to these groups to achieve optimal BF outcomes.

"The right we have to our owne bodies, goods, and liberties": The Freedom of the Ancient Constitution and Common Law in Milton's Early Prose.

Scholars have long recognized the importance of liberty in Milton's early prose, but they tend to center their analysis on republicanism. Although he would go on to express republicanism, Milton's early tracts tie liberty to English political and legal traditions rather than classical ones. Milton, in his early tracts, utilizes the language of the ancient constitution and the common law as he centers liberty on the property and bodies of English citizens, thus framing liberty in distinctly English terms. Additionally, Milton's early prose accepts the power of the monarch, revealing Milton's initial commitment to the existing political structure.

Examining the impact of personal freedom on income inequality: Evidence from Sub-Saharan Africa and Western European regions.

Rising income inequality has recently garnered intensive attention owing to its significance in theory and practice. This has rendered the mechanism through which inequality can be understood, even from a microscopic perspective, to institute proper policies that curtail it important. We contribute to the literature by examining the effect of freedom on income inequality using data from 34 least-free and 18 most-free countries from 2000 to 2020 in Sub-Saharan Africa and Western Europe, respectively. A novel fixed-effects panel quantile regression econometric estimator was employed, and the findings showed a non-linear relationship between personal freedom and income inequality for both regions. Again, both regions reported an inverse relationship between personal freedom and income inequality within the medium-run quantiles. However, a positive relationship was reported in the short-run and long-run quantiles of Sub-Saharan Africa and Western Europe, respectively, whereas the inverse was the same. Finally, the significant adverse relationship was more dominant in Western Europe, implying that high levels of personal freedom in the region explain the low levels of income inequality compared to Sub-Saharan Africa, which has lower levels of personal freedom and higher income inequality. Concerning the findings, it is recommended that policymakers and governments of least- and most-free regions institutionalise personal liberties that support human capital development and establish mechanisms to implement enacted freedoms.

Age, Political Participation, and Political Context in Africa.

OBJECTIVES: Political participation differs across the age range, but little is known about these patterns outside of developed countries. Political context is a particularly important consideration for all political behavior in Africa, where only a few countries are fully democratic. Drawing from political opportunity structures theory, we investigate how political freedom conditions the age-based pattern of electoral and nonelectoral political engagement, as well as protesting. METHODS: This study merges the fifth, sixth, and seventh rounds of the Afrobarometer data sets, spanning 36 African countries, with country-level data on political freedom from Freedom House. Using multilevel regression models, we examine how political freedom shapes the relationship between age and 3 forms of political participation. RESULTS: Africans aged from 18 to 60 years and living in nonfree countries are most engaged in electoral and nonelectoral political activities, though participation begins to drop markedly past age 60. For protest participation, young Africans living in partially and non-free countries are the most engaged in protests; yet limited political freedom again means a sharp age-based decline. DISCUSSION: The impact of political context on the age-participation association is nuanced in ways not anticipated by mainstream research on the developed West. Repressive regimes, while spurring engagement at younger ages, appear to disproportionately deter older Africans from political engagement, especially its riskiest forms. We conclude by calling for more country-comparative gerontological research with careful attention to contextual heterogeneity, particularly in the understudied Global South.

The role of collectivism, liberty, COVID fatigue, and fatalism in public support for the zero-COVID policy and relaxing restrictions in China.

BACKGROUND: China was the last country in the world to relax COVID-19 restrictions. A successful public health policy requires public support. This analysis examined the factors associated with Chinese support for zero-COVID and relaxing COVID-19 restrictions in China. METHOD: Two online surveys were conducted among Chinese participants in mainland China on June 10-13 (N = 460) and December 2, 2022 (N = 450). These two samples were similar based on the participants' demographics. RESULTS: The results revealed that the perceived health consequences of a COVID-19 policy, perceived norms of approving a COVID-19 policy, and hope positively predicted the participants' support for the COVID-19 policy. The results further showed that collectivism and fatalism positively predicted support for zero-COVID and negatively predicted support for relaxing restrictions. COVID fatigue was negatively associated with support for zero-COVID and positively associated with support for relaxing restrictions. Liberty positively predicted support for relaxing restrictions in June and negatively predicted zero-COVID in December 2023. It did not positively or negatively predict support for the policy adopted by the government. CONCLUSION: Collectivism, liberty, COVID fatigue, and fatalistic beliefs are important considerations connected to public support for a COVID-19 policy. The role of liberty was more nuanced and depended on the survey's time and whether the government adopted the policy.

Democracy's limited impact on innovation: Panel data evidence from developing countries.

This study investigates the relationship between democracy and innovation across 61 developing countries from 2013 to 2020, utilizing data from Global Innovation Index. Employing the Freedom House Index and Polity2 indicators as proxies for democracy, research employs Ordinary Least Squares (OLS), Fixed Effects and SystemGMM techniques to analyze their impact on innovation. The findings of the study reveal no statistically significant relationships between democracy and innovation in developing nations within specified timeframe. Through empirical analysis, including various econometric approaches, it is observed that the level of democracy as measured by these indicators, does not appear to exert a discernable impact on the innovation landscape of these countries. These results carry important implications for public policy. While the promotion of democracy remains a crucial goal, especially for societal development and political stability, this study suggests that solely focusing on enhancing democratic institutions might not necessarily yield immediate direct improvements in the innovation capacities of developing nations. Policymakers and stakeholders involved in fostering innovation ecosystems in these regions may need to consider a more nuanced approach, encompassing factors beyond the scope of democratic governance to effectively spur innovation. Understanding the nuanced relationship between democracy and innovation in developing countries has significant implications for designing targeted policies aimed at enhancing innovation capacities, economic growth and overall societal development in these regions.

Chapitre 1. Manger à l'ère de la transition alimentaire : entre libertés et sujétions.

In light of the increasing number and complexity of food products on offer to meet the challenges of the food transition, this article looks at the consequences for consumers’ freedom of choice. This freedom of choice cannot be based on total autonomy, which generally leads to a loss of dietary reference points and guilt, or on radical heteronomy dictated by science or hygienic-ecological rationalities, which create tensions and divisions in society. Rather, dietary freedom is an effort to free oneself from the burden of a criterion-based vision of food. It calls for the restoration of an ethic of eating together, based on values and rules capable of preserving common goods and the well-being and survival of our fellow human beings.

US state laws on medical freedom and investigational stem cell procedures: a call to focus on state-based legislation.

The premature marketing of investigational stem cell interventions (SCIs) is a growing market in the US. Several US states have passed legislation to permit and promote unproven and experimental SCIs for individuals with terminal or chronic diseases. These SCI medical freedom laws, which are largely based on right-to-try legislation, increase access to experimental SCIs with little to no oversight. They undermine federal regulatory authority and can compromise patient safety and informed decision-making. SCI medical freedom laws have gone largely unnoticed by scientific societies interested in the responsible translation of stem cell medicine. In this article, we analyze state SCI medical freedom laws and describe their detrimental impact on patients and society. We contend that scientific and medical societies are uniquely poised to advocate against state-based policy promoting unproven SCIs but recognize resource and other constraints to advocate for or against legislation in 50 states. We recommend societies establish coalitions and share resources to address state-based SCI medical freedom laws and other legislation surrounding unproven SCIs.

[Genetic studies on forensic-psychiatric inpatients? : Clinical, ethical and legal considerations]. / Genetische Studien an forensisch Untergebrachten? : Klinische, ethische und juristische Überlegungen.

BACKGROUND: Research on people deprived of liberty raises serious questions, especially concerning behavioral genetic studies. QUESTION: Does including criminally detained patients with mental disorders in genetic studies lead to a gain of new knowledge and can this be ethically and legally justified? METHOD: Evaluation of existing literature and interdisciplinary reflection. RESULTS: After a review of research ethics and legal norms, we consider the benefits and risks of behavioral genetic research, taking the unique situation of test persons deprived of their liberty into account. The fundamental right to freedom of research also justifies foundational research in forensic psychiatry and psychotherapy. The possible future benefits of improving treatment plans must be weighed against the risks resulting from potential data leaks and inappropriate public reception of research results. Then we analyze possible threats to voluntary and informed consent to study participation in more detail by the ethical concept of vulnerability. Alongside problems with grasping complex issues, above all dependencies and power dynamics in the correctional system play a pivotal role. Recommendations on the ethical and legal inclusion of this study population are given. CONCLUSION: Including criminally detained study participants can be ethically and legally justified when autonomous consent is supported by specific organizational and legal procedures and measures, for example via a clear professional and organizational separation of correction and research.

Science at risk? Considering the importance of academic freedom for STEM research production across 17 OECD countries.

Since 2011, a declining trend in academic freedom globally has paralleled a rising tide of neo-nationalism. We use fixed effects models to examine data from the Varieties of Democracy (V-DEM) academic freedom index and bibliometric data for 17 OECD countries across nearly three decades (1981-2007) that precede the recent decline in academic freedom. We find substantial, statistically significant, positive relationships between cross-nationally comparable and longitudinal measures of academic freedom and volume of STEM publications. Additionally, academic freedom positively influenced the quality of STEM publications as measured by journal rankings. Our findings were relatively consistent across various measures of academic freedom and model specifications. We discuss implications for safeguarding academic freedom, applying neo-institutional theory, and identifying directions for future research.

Euthanasia, consensual homicide, and refusal of treatment.

Consensual homicide remains a crime in jurisdictions where active voluntary euthanasia has been legalized. At the same time, both jurisdictions, in which euthanasia is legal and those in which it is not, recognize that all patients (whether severely ill or not) have the right to refuse or withdraw medical treatment (including life-saving treatment). In this paper, I focus on the tensions between these three norms (the permission of active euthanasia, the permission to reject life-saving treatment, and the prohibition of consensual homicide), assuming a justification of euthanasia based on the right to (personal) autonomy. I argue that the best way to provide a coherent account of these norms is to claim that patients have two distinct rights: the right to autonomy and the right to bodily integrity. This solution has some relevant implications for the discussion of the legalization of active euthanasia.