Verteilungsgerechtigkeit, Verantwortung und Zufall: Die Bedeutung von Risikoakzeptanz für den Glücksegalitarismus

Luck egalitarians like Ronald Dworkin and G. A. Cohen claim that the influence of luck on the distribution of goods or welfare has to be equalized, whereas inequality must be accepted if the subjects bear responsibility for it. The paper investigates how this claim should be interpreted and if it is plausible. Analyzing several examples, I try to show that the spectrum of pertinent cases is much more limited than Dworkin and Cohen think. Sometimes it seems as if someone is responsible for being in a worse position than someone else, while in fact they didn't have equal opportunities. Fitting cases of responsibility for inequality can be found when we focus on the outcomes of calculated gambles (Dworkin: option luck). But why, and what exactly are cases in point? What distinguishes the risk-taking of someone who buys a lottery ticket from that of a peasant who cultivates a piece of land, knowing that a storm might ruin the crop? I try to demonstrate that an ethically relevant difference occurs when the attitude towards risk differs. Would the agent prefer to receive the expected utility safely, or would she rather gamble?

Effects of the number of removed lymph nodes on survival outcome in patients with sentinel node-negative breast cancer

Background Sentinel lymph node biopsy is the gold standard surgical technique for axillary staging in patients with clinically node-negative. However, it is still uncertain what is the optimal number of sentinel lymph nodes (SLNs) to be removed to reduce the false-negative rate. The aim of this study was to investigate whether patients with a single negative SLN have a worse prognosis than those with two or more negative SLNs. Methods A retrospective review was conducted on a large series of SLN-negative breast cancer patients. Survival outcomes and regional recurrence rate were evaluated according to the number of removed SLNs. Secondly, the contribution of different adjuvant therapies on disease-free survival was explored. Statistical analysis included the chi-square, Wilcoxon–Mann–Whitney test, and Kaplan–Meier survival analysis. Results A total of 1080 patients were included in the study. A first group consisted of 328 patients in whom a single SLN was retrieved, and a second group consisted of 752 patients in whom two or more SLNs were retrieved. There was no relevant difference in median DFS (64.9 vs 41.4) for SLN = 1 vs SLN > 1 groups (HR 0.76, CI 95% 0.39–1.46; p = 0.38). A statistically significant difference in mDFS was showed only for HT-treated patients who were SLN = 1 if compared to SLN > 1 (100.6 months versus 35.3 months). Conclusions There is likely a relationship between the number of resected SNL and mDFS. Our results, however, showed no relevant difference in median DFS for SLN = 1 vs SLN > 1 group, except for a subset of the patients treated with hormone therapy.

Appendix to Chapter 14

In the Forced March Sorites, there is no deductive path to a formal contradiction. Rather, a hapless subject is required to return a verdict in point of F-ness about each successive element in a soritical series for F. Competence requires the appropriate verdicts concerning the clear cases at the poles. Hence, since the verdicts required at the poles are different, the subject must at some point give some kind of differential responses to an adjacent pair of elements between which—for so the series is constructed—she can discern no relevant difference. Since it is a form of incompetence to purport to discriminate cases between which one discerns no relevant difference, it appears to follow that consistently competent use of F throughout the series is metaphysically impossible. It is argued that the intuitionist conception of vagueness provides the means to explain nicely why a differential response need not implicate discrimination.

Black-Boxing 101

This chapter breaks down the black-boxing process into three constitutive steps. First, in the framing stage, the explanandum is sharpened by placing the object of explanation in the appropriate context. This is typically accomplished by constructing a frame, a placeholder that stands in for patterns of behavior in need of explanation. Second, the difference-making stage provides a causal explanation of the framed explanandum. This involves identifying the relevant difference-makers, placeholders that stand in for the mechanisms producing these patterns. The final representation stage determines which mechanistic components and activities should be explicitly represented, and which can be idealized or abstracted away. The outcome of this process is a model of the explanandum, a depiction of the relevant portion of the world. This analysis provides the general definition the reader has been looking for. A black box is a placeholder—frame or difference-maker—in a causal explanation represented in a model.

Abortion and multifetal pregnancy reduction: An ethical comparison

In recent years, multifetal pregnancy reduction (MFPR) has increasingly been a subject of debate in Norway. The intensity of this debate reached a tentative maximum when the Legislation Department delivered their interpretative statement, Section 2 - Interpretation of the Abortion Act, in 2016 in response to a request from the Ministry of Health (2014) that the Legislation Department consider whether the Abortion Act allows for MFPR of healthy fetuses in multiple pregnancies. The Legislation Department concluded that the current abortion legislation [as of 2016] allows for MFPR subject to the constraints that the law otherwise stipulates. The debate has not subsided, and during autumn 2018 it was further intensified in connection with the Norwegian Christian Democratic "crossroads" policy and signals from the Conservatives to consider removing section 2.3c and to forbid MFPR. Many of the arguments in the MFPR debate are seemingly similar to arguments put forward in the general abortion debate, and an analysis to ascertain what distinguishes MFPR from other abortions has yet to be conducted. The aim of this article is, therefore, to examine whether there is a moral distinction between abortion and MFPR of healthy fetuses. We will cover the typical arguments emerging in the debate in Norway and exemplify them with scholarly articles from the literature. We have dubbed the most important arguments against MFPR that we have identified the harm argument, the slippery-slope argument, the intention argument, the grief argument, the long-term psychological effects for the woman argument, and the sorting argument. We conclude that these arguments do not measure up in terms of demonstrating a morally relevant difference between MFPR of healthy fetuses and other abortions. Our conclusion is, therefore — despite what several discussants seem to think — that there is no morally relevant difference between the two. Therefore, on the same conditions as we allow for abortions, we should also allow MFPR. Keywords: abortion, ethics, medical ethics, MFPR, selective MFPR

The perception of genetically modified plants by farmers in Szabolcs-Szatmár-Bereg County, Hungary

In this account we report a study that surveyed and quantified the opinion on the acceptability of genetically modified (GM) crops by farmers working in Szabolcs-Szatmár-Bereg County located in North Easter Hungary. Authors answered the question whether there is a difference in perception and reasoning of the county’s agricultural workers regarding GM crops. We evaluated the impact of age, gender, education, and agricultural education of responders on rating GM plants to be more dangerous than traditional crops. Is there a relevant difference when responders are administered multiple choice questions, rather than single choice questions? Can we change farmers’ position on the GM technology by using multiple choice questions?

Effects of the Number of Removed Lymph Nodes on Survival Outcome in Patients With Sentinel Node-negative Breast Cancer.

Background It is still uncertain what is the optimal number of sentinel lymph nodes (SLN) to be removed to reduce the false negative rate. The aim of this study was to investigate whether patients with a single negative SLN have a worse prognosis than those with two or more negative SLNs.Methods A retrospective review was conducted on a large series of SLN-negative breast cancer patients. Survival outcomes were evaluated according to the number of removed SLNs. Statistical analysis included Chi-square, Wilcoxon Mann Whitney test and Kaplan–Meier survival analysis.Results There was no relevant difference in median DFS (64.9 vs 41.4) for SLN=1 vs SLN>1 groups (HR 0.76, CI 95% 0.39 – 1.46; p = 0.38). A statistically significant difference in mDFS was showed only for HT treated patients who were SLN= 1 if compared to SLN>1 (100.6 months versus 35.3 months). Conclusions Our results showed no relevant difference in median DFS for SLN=1 vs SLN>1 group, except for a subset of the patients treated with hormone therapy.

Two-Year Follow-Up of 4-mm-Long Implants Used as Distal Support of Full-Arch FDPs Compared to 10-mm Implants Installed after Sinus Floor Elevation. A Randomized Clinical Trial

Background: In edentulous patients, bone resorption cannot allow the installation of standard implants and it is demanded to use short implants in the residual alveolar bone or longer implants in grafted bone. Aim: To compare the survival and bone level changes of standard plus short 4-mm implants used as distal support of a maxillary full-arch fixed dental prostheses (FDPs) with standard (10-mm) implants placed in association with a bilateral sinus floor augmentation procedure. Material and Methods: Full-arch FDPs supported by six implants were randomly placed in both groups. In the control group, all implants were 10 mm long and 4.1 mm in diameter. The distal implant in both sides of the maxilla was installed after 4 months from bilaterally sinus floor elevation. In the test group (short group), the distal implant in both sides of the maxilla was 4 mm long and 4.1 mm in diameter. No sinus floor elevations were performed in the test group. Clinical assessments and X-rays were taken at prosthesis delivering and after 6, 12, 18, and 24 months. Patient-reported outcome measures (PROMs) were also evaluated before surgery and after 6, 12, and 24 months. Results: The changes over time of the bone level for the short implants were −0.01 ± 0.11 mm, −0.04 ± 0.13 mm, −0.17 ± 0.29 mm, and −0.28 ± 0.37 mm after 6, 12, 18, and 24 months from prosthesis delivering, respectively. For the standard implants, bone changes were −0.21 ± 0.33 mm (p = 0.103), −0.30 ± 0.32 mm (p = 0.023), −0.40 ± 0.37 mm (p = 0.144), and −0.54 ± 0.49 mm (p = 0.128), respectively. A statistically relevant difference was found only at 12 months after loading between the two groups. Conclusions: Similar results on implant survival rate and marginal bone loss were observed for the short and standard implants, placed in association with a bilateral sinus floor augmentation procedure, used as distal support of a maxillary full-arch FDP. A statistically relevant difference was found only at 12 months after loading between the two groups (p = 0.023).

A fogvatartottak munkáltatásának egyes kérdéseiről

"The history of the development of the employment of prisoners has come a very long way, from hard labour to resocialization. Today the rights of prisoners are respected in their work, but these rights are sometimes different from the normal labour rights. In this study, I review the most relevant difference between the prisoners’ labour rights and the ordinary labour rights. Beyond that, I examine if the intentions formulated in 2015 − full employment and self-sustaining prisons in Hungary − have been achieved or not. In my study, I present some criminal statistics of the employment rates in Hungarian prisons."