Delayed presentation to regular Dutch paediatric care in COVID-19 times: a national survey

We explored the collateral harm in Dutch children and adolescents during the COVID-19 pandemic from experience of paediatricians via an open question distributed via the website of the Dutch Paediatric Society. From the end of March till the first week of July, we received 51 reports of collateral harm involving mostly very young children with mainly acute physical problems but also social problems. In older children, several cases of diabetic ketoacidosis were reported. Our results show that delaying care can lead to seriously ill children, life-threatening situations and that in some cases it can even lead to death. If we want to avoid such a delay at a possible second peak of Corona, general care providers and paediatricians have to join forces and find new ways of working. Systematic data collection of collateral harm in children is needed to be able to intervene adequately.

Antimicrobial peptides: Application informed by evolution

Antimicrobial peptides (AMPs) are essential components of immune defenses of multicellular organisms and are currently in development as anti-infective drugs. AMPs have been classically assumed to have broad-spectrum activity and simple kinetics, but recent evidence suggests an unexpected degree of specificity and a high capacity for synergies. Deeper evaluation of the molecular evolution and population genetics of AMP genes reveals more evidence for adaptive maintenance of polymorphism in AMP genes than has previously been appreciated, as well as adaptive loss of AMP activity. AMPs exhibit pharmacodynamic properties that reduce the evolution of resistance in target microbes, and AMPs may synergize with one another and with conventional antibiotics. Both of these properties make AMPs attractive for translational applications. However, if AMPs are to be used clinically, it is crucial to understand their natural biology in order to lessen the risk of collateral harm and avoid the crisis of resistance now facing conventional antibiotics.

Weighing Lives in War: How National Identity Influences American Public Opinion about Foreign Civilian and Compatriot Fatalities

This article explores how the American public weighs tradeoffs between foreign and compatriot fatalities during war. This focus provides an important window into the meaning and significance of citizenship and national identity and, in turn, the most fateful consequences of inclusion and exclusion in the international context. To examine these attitudes, we conducted an original survey experiment asking subjects to consider a fictional US military operation in Afghanistan. We find that: (1) Americans are significantly more willing to accept the collateral deaths of foreign civilians as compared to American civilians in operations aiming to destroy important military targets; (2) Americans are less willing to risk the lives of American soldiers to minimize collateral harm to foreign civilians as compared to American civilians; (3) Americans who express relatively more favorable views of the United States compared to other nations are more willing to accept foreign collateral deaths in US military operations; and (4) Americans are more willing to accept Afghan civilian collateral deaths than those of citizens from a neutral state, such as India. Many Americans recognize that placing a much higher value on compatriot lives over foreign lives is morally problematic, but choose to do so anyway.

Defending Civilians from Defensive Killing

Helen Frowe’s Defensive Killing is in many respects an excellent book, full of arguments that are original, interesting, important, and often persuasive. In other respects, the book is deeply unsettling, as it forcefully challenges the belief that killing ordinary civilians in armed conflict is a paradigmatic moral wrong. In particular, Frowe argues that civilians who make political, material, strategic, or financial contributions to an unjust war may lose their moral protection from intentional and collateral harm. On this point, Frowe’s arguments are original, interesting, and important but, thankfully, not persuasive.

Displacement as Significant Collateral Harm in War

Traditionally, in deciding whether some strategy or action in war is proportionate and necessary and thus permissible both international law and just war theory focus exclusively on civilian deaths and the destruction of civilian infrastructure. I argue in this paper that any argument that can explain why we should care about collateral killing and damage to infrastructure can also explain why collateral displacement matters. I argue that displacement is a foreseeable near-proximate cause of lethal harm to civilians and is relevant for proportionality and necessity calculi. Accepting my argument has significant consequences for what we are permitted to do in war and for what obligations we have towards refugees that result from our actions in war.

Distributing Death in Humanitarian Interventions

Armed military interventions often inflict large amounts of collateral harm on innocent civilians. Ought intervening soldiers, when possible, to direct collateral harm to one innocent population group rather than the other? Recently several authors have proposed that expected beneficiaries of a military intervention ought to carry greater risk of collateral harm than neutral bystanders who are not subject to the threat the military forces are intervening to avert. According to this view, intervening soldiers ought to reduce the risk of collateral harm to neutral bystanders, even if this means foreseeably imposing a somewhat higher overall number of collateral casualties among those for whom the intervention is conducted. This chapter raises a number of challenges to this view. Even if the beneficiary thesis is accepted with respect to discrete risk-imposing acts, it should not be with respect to risk-imposing strategies individuated on a war-by-war basis.

Human Shields

This chapter defends three claims. First, it is morally impermissible for combatants fighting for a just cause to use civilians supporting an unjust war effort as involuntary human shields. Second, civilians who are forced to serve as involuntary shields by combatants fighting for an unjust cause retain their basic rights; they are not morally liable to intentional harm, and the proportionality of collaterally harming them is not affected by the wrongful conduct of the unjust combatants. Finally, civilians who voluntarily serve as human shields for unjust combatants compromise but do not lose their basic rights. Such voluntary shields are not morally liable to collateral harm, though less is required to justify collateral harm to them than to justify collateral harm to involuntary shields or to civilians who are merely in the wrong place at the wrong time.

To Cause Harm and to be Harmed by Others: New Perspectives on Alcohol's Harms to Others

Objective To examine how sociodemographic factors and alcohol consumption are related to a four-way typology of causing harm to others and/or being harmed by othersș and one's own drinking. Data and Methods Data from the 2011 Danish national survey ( n = 2,569) were analyzed with multinomial logistic regression. Results Younger age and heavy drinking were significant correlates of both causing harm and being harmed. Women and better educated respondents were more likely to report negative effects on relationship and family from another's drinking. Better educated respondents had higher risks for work, financial, or injury harms from another's drinking. Mean alcohol consumption and risky single occasion drinking were related to both causing harm and being harmed from one's own drinking. Conclusions Drinking variables were the strongest correlates of causing harm and being harmed. Efforts to reduce risky drinking may also help reduce exposures to collateral harm.