In an era marked by global crises, environmental degradation, social injustice, and mental health challenges, the ancient spiritual tradition of Buddhism has emerged with a renewed commitment to social transformation. Socially Engaged Buddhism, a modern evolution of traditional Buddhist practice, bridges the inner path of mindfulness and liberation with the outer world of activism and civil responsibility. This paper examines how Socially Engaged Buddhism, grounded in the teachings of compassion (karuṇā), non-violence (ahiṃsā), and interdependence (pratītyasamutpāda), has evolved from monastic seclusion (...) to active engagement in the spheres of politics, society, and ecology. Drawing on case studies from Asia, North America, and Europe, and referencing key leaders such as Thich Nhat Hanh, B.R. Ambedkar, and Sulak Sivaraksa, the study examines how Buddhist institutions and lay practitioners are shaping global civil society. Through this lens, the paper critically evaluates the relevance, challenges, and potential future of this transformative movement in a rapidly evolving world. (shrink)

"Healing in Layers: 3D Printing in Healthcare" is a pioneering exploration of how 3D printing technology is revolutionizing the field of biomedicine. This comprehensive book delves into the multitudinous ways 3D printing transforms healthcare, from the conceptualization of medical devices and implants to personalized treatment approaches and organ regeneration. In recent years, 3D printing has emerged as a powerful tool in biomedicine, offering unprecedented opportunities to improve patient care, enhance surgical outcomes, and advance medical research. This book provides an in-depth (...) examination of the transformative potential of 3D printing across various biomedical applications, highlighting its role in shaping the future of healthcare. Readers will gain insights into the different types of 3D printing processes, materials, and software used in bio-medical applications, laying the groundwork for a deeper understanding of its potential impact. Throughout the book, readers will encounter real-world case studies, cutting-edge research developments, and insights from leading experts in the field, providing a comprehensive overview of the current state-of-the-art and future directions of 3D printing in biomedical applications. This book is an essential reading for healthcare professionals, researchers, educators, students, and anyone interested in the intersection of technology and medicine. It offers a compelling glimpse into the future of healthcare, where 3D printing is poised to revolutionize patient care and biomedical innovation globally. (shrink)

Additive manufacturing constructs a 3D object based on the digital model provided by the computer. The design is often regarded as a computer-aided design model or CAD model. The construction requires another technique called 3D printing that brings the 2D model to a 3D object. The layers are added in the printing process according to the geometric data, and the designed part is produced without using a mold or wasting material. This manufacturing technology is rapidly developing and has been used (...) in various sectors, including defense, construction, robotics, aviation, etc. Free-form parts are readily made using this manufacturing technique with customization. These abilities are required in the biomedical field as the need for personalized medicine and customized grafts is growing. The material research has provided different materials that can be used in additive manufacturing, including plastic, metal, composite, and organic materials. The technology has been preferred in the biomedical field due to the need for personal attention to the details and customization needs that are offered in additive manufacturing. The design can be printed using several 3D printing methods, such as fused deposition modeling (FDM), stereolithography (SLA), selective laser sintering (SLS), etc. In this chapter, the need for additive manufacturing in the biomedical field is discussed, including the use of customized 3D models, personalized medicine, and drug delivery. The advantages and limitations of additive manufacturing for the biomedical fields are also discussed, shining light on the future scope of the technology and the field. The application of additive manufacturing is also discussed, highlighting the need for customization and the material used in the process. (shrink)

In the current era, 3D bioprinting is a revolutionary technology in the biomedical field, which has the potential to fabricate life-saving human tissues, organs for transplantation, drug testing and other applications in regenerative medicine. The new technology faces challenges at its development stages for its successful application where intended. The same fate applies to 3D bioprinting. Its application in clinical scenarios raises questions regarding ethical, legal and social perspectives among stakeholders. Ethically, a significant concern involves the potential use of human (...) embryonic stem cells in the development of 3D bioprinted products, which may stimulate moral conflicts regarding the status of embryos, confidentiality issues and obstacles in acquiring informed consent from donors. In the case of xenogeneic cells, it creates religious and psychological uncertainty among people. This advanced technology may raise questions of social inequality among people regarding the affordability of human enhancement. Legal issues regarding ownership, intellectual property and licensing of 3D bioprinted products are hindering its prompt commercialisation. There are no established clinical trial protocols to monitor its safety and efficacy in patients. Also, there are no specific frameworks, especially related to 3D bioprinted products, because there is a misperception of classifying these products as whether they belong to medical devices or biological products. As this technology evolves quickly, strong regulations that balance ethical, legal and social aspects must be developed initially to prevent its misuse. In conclusion, 3D bioprinting holds metamorphic potential for the future of healthcare and biomedical innovation; it also introduces significant ethical and legal challenges that must be addressed. By developing sound policies, regulatory oversight and engaging in public discourse, society can embrace the benefits of 3D bioprinting while mitigating potential harms and promoting reasonable access. This chapter provides a comprehensive review of the key ethical and legal concerns associated with 3D bioprinting, which are essential considerations for the accountable development and implementation of this revolutionary technology. (shrink)

The rapid advancement of 3D printing technology has revolutionized the biomedical field, enabling the design and fabrication of both off-the-shelf and patient-specific biomedical devices with enhanced biomechanical performance. This chapter provides a comprehensive overview of the software tools essential for the 3D printing workflow in biomedical applications, covering medical imaging, data acquisition, segmentation, computer-aided design (CAD), lattice integration, finite element analysis (FEA), support generation, printing simulation, and slicing. By integrating these specialized software solutions, researchers and clinicians can optimize implant design, (...) improve surgical outcomes, and accelerate innovation in patient care. The chapter highlights the capabilities and advantages of commercial and open-source software platforms, offering insights into their roles in facilitating accurate anatomical modelling, structural optimization, and manufacturing efficiency. (shrink)

The word “plastic” was derived from the Latin “plasticus” or Greek “plastikos,” meaning to mold or form. Since ancient times, man has been attempting to modify and reshape the human body. The term “Plastic surgery” was used by Eduard Zeis in Berlin in 1838. We stand on the brink of a new era in the medical profession, in terms of the treatment of patients, care of patients, assistance to physicians and surgeons in the form of learning to execute, pharmaceutical research, (...) etc. Three-dimensional (3D) printing represents a technological breakthrough with transformative implications for medicine, particularly in plastic and reconstructive surgery. This technology enables the layer-by-layer fabrication of physical objects based on digital models, offering unparalleled precision and customization. Its applications span preoperative planning, surgical execution, and postoperative rehabilitation, marking a significant advancement over conventional techniques. (shrink)

The bone has the potential advantages of regenerating its biological remodelling in case of fractures. In some cases, it needs a support which is called as an implant until the bone restores to its original state or when the bone fails to regenerate. The proper design of orthopaedic biomaterial consists of biocompatibility, mechanical property, chemical stability and longevity, and the new bone formation is mainly based on the design and surface properties of this implant. Traditional manufacturing technology has some limitations (...) of producing implants with defective morphologies, longer time duration of the process and high number of equipment needed to manufacture the implant. These limitations lead to the innovative way of manufacturing the bone implants called 3D printing, which provides a pathway of producing customized bone implants in cost-effective ways within lesser time duration. It is piercing the medical field especially in orthopaedics and providing promising approach in fabricating non-customized patient-specific bone implants. It is an advanced form of manufacturing technology in creating personalized medical products, dental implants and osteotomy instruments. The metal implants such as spinal fusion, fracture fixation, joint replacement and tumour defect repair parts are precisely designed using this advanced digital fabrication technique. With these advances, it is evident that 3D printing completely revolutionized the orthopaedic implants by overcoming the limitations of custom-sized bone implants. Hence, the chapter discuss the basics principles, methodologies, types, limitations and future perspectives of 3D printing technology in orthopaedic field. (shrink)

Neurosurgery has advanced and expanded into diverse fields over the past century. Neurosurgeons continue to innovate and conduct scientific research to push the limits of their specialization. Given the long-standing need for a unique three-dimensional (3D) viewpoint in neurosurgery, this chapter provides a thorough analysis of the transformative impact of 3D printing technology in the field of neurosurgery, in addition to highlighting its various applications in the diagnosis and treatment of different neurological conditions. Specifically, the use of 3D printing to (...) treat brain tumors, spinal cord injuries, neurodegenerative diseases, and other neurological conditions has brought attention to the potential of the technology to improve understanding of disease pathogenesis through 3D bioprinted models and to personalize medicine through tailored drug delivery systems. Additionally, this chapter also covers the use of various 3D printing technologies, including stereolithography, extrusion-based, injection molding, and laser-assisted bioprinting, for the creation of drug-loaded scaffolds and implants. (shrink)

The metamorphosis of medical imaging data from computed tomography (CT) and magnetic resonance imaging (MRI) into 3D models signifies a pronounced advancement in medical diagnostics, therapeutic planning, and personalized medicine. This process consolidates transforming high-resolution tomographic datasets into 3D anatomical structures through advanced segmentation techniques, such as thresholding, region-growing, and machine learning algorithms. Specially designed software approaching Mimics, 3D Slicer, and OsiriX enables the accurate rendering of these 3D models, essential for visualizing complex anatomical relationships. Furthermore, assimilating virtual and augmented (...) reality (VR/AR) with these models enhances tissue engineering by enabling immersive simulations and real-time visualization for scaffold design and biomaterial interaction. These models also find applications in 3D printing for individual-specific scaffolds, implants, and bioprinted tissues, enabling 3D printing for preoperative planning, surgical rehearsals, and regenerative medicine while assimilating with virtual and augmented reality (VR/AR) environments for progressive diagnostic analysis and real-time surgical navigation. Additionally, 3D modeling is crucial in individual-specific implant design, rehabilitation, and custom devising for unique anatomical structures. Deep learning-based generative modeling and medical image synthesis further enhance the efficacy of 3D models by assisting the translation between numerous imaging modalities, i.e., CT, MRI, etc., reducing the need for multiple scans and enhancing clinical workflows. This convergence of imaging, computational modeling, and artificial intelligence (AI) is driving innovation in healthcare, improving diagnostic precision, surgical outcomes, and medical device development, demonstrating a new era in personalized individual care. (shrink)

Almost over the past four decades, 3D printing has been gaining much interest as an assembly procedure because of its nonexclusive and layer-by-layer construction method involving zero wastage of raw material with accurate precision even for smaller architectures. Later on, by incorporating standard biocompatible materials in the printing machinery even with actual cells, different cellular growth factors, and bioactive compounds like proteins, the same method progressed into 3D bioprinting for tissue buildings, making its way into medicine. This can construct orthopedic (...) bioactive implants with appropriate architecture for bone or organ support, medical devices, tissue engineering scaffolds, ideal tissues and organs for organ transplantation, drug screening, disease modeling, and so on. Depending on the type of biomaterial employed and how the layers need to be connected to the component, different techniques like fused deposition modeling, extrusion-based bioprinting, selective laser sintering, etc. come into functioning. Biocompatibility comes as the first criterion for choosing any biomaterial intended for application in medicine. Bioink constituting cells and one or multiple biomaterials along with different growth factors leads to the printing of cell-laden structures like organs. These can also generate illness and organ failures due to biomaterial-related infections. Thus, natural biomaterials, surface-treated biomaterials, etc., have been employed for the biofabrication of 3D-printed structures rendering no biological rejection. This chapter covers a comprehensive evaluation of different materials used in 3D printing and 3D bioprinting for medicinal purposes which include metals, polymers, ceramics, composites, and bioinks, and their recent and ongoing innovations and adaptations in the development of human care products in the field of medicine. Significant advantages of this method like the capability of producing complex geometries with utmost precision, relatively shorter fabrication periods, low manufacturing costs, and ability to produce controllable structures have paved its way through research academics, industry, and so on. (shrink)

The European Union Medical Device Regulation (EUMDR 2017/745) and US FDA require orthopedic implants manufacturers to meet the performance testing requirements that are essential for safe clinical use of the implants. This book chapter provides an overview of the importance of the preclinical testing considering the European Union and US FDA expectations. With advancement in the additive manufacturing methods, there are several risks that may arise from the 3D printing manufacturing methods and post-processing of the additively manufactured implants; the current (...) regulations are strictly focusing on risks associated with these technologies. Manufacturers must ensure conformity with the general safety and performance requirements outlined in Annex I of the MDR. This encompasses stringent criteria for biocompatibility, mechanical stability, and material safety, necessitating comprehensive testing and validation. Both the EU MDR and FDA have rigorous testing requirements for 3D-printed orthopedic implants to ensure patient safety and device effectiveness. Manufacturers must adhere to these regulations, providing comprehensive evidence that their devices meet all necessary standards and requirements. (shrink)

Tissue engineering has seen a dramatic change as a result of advances in 3D printing technology, which have made it possible to create complex, realistic structures that closely resemble the structure and functionality of biological tissues. This novel method provides fine-grained control over the creation and design of tissue structures, opening up new avenues for regenerative medicine and drug testing. Complex tissue models can be created using contemporary 3D printing methods. For instance, extrusion-based bioprinting techniques create intricate structures by depositing (...) bio-inks layer by layer. Laser-assisted bioprinting makes the high-resolution, cellular-level implantation of cells and biomaterials possible. Using a photopolymerization-based stereolithography technique, highly detailed microscale structures can be created from digital models by carefully irradiating liquid resins with light. Furthermore, fused deposition modeling (FDM) and selective laser sintering (SLS) offer reliable techniques for producing strong and adaptable scaffolds, opening the door for developments in regenerative therapies and personalized medicine. The utilization of both natural and synthetic materials, such as polymers, ceramics, and composites, to create functional tissue frameworks is highlighted in this discussion, along with the potential, advantages, and drawbacks of these 3D printing processes in tissue engineering. Developing hydrogels and three-dimensional porous structures that promote tissue growth and regeneration are fundamental concepts in scaffold design. These scaffolds offer mechanical strength and controlled breakdown, facilitating cell adhesion, proliferation, and differentiation. Successful tissue engineering also depends on elements like biocompatibility, pore size optimization, interconnectivity for nutrition diffusion, and the incorporation of bioactive compounds. Tissue regeneration depends heavily on the interactions between cells and scaffolds. The adhesion, migration, proliferation, and differentiation of cells are all directly impacted by the physical and chemical characteristics of 3D-printed scaffolds. Successful tissue engineering applications depend on an understanding of these interactions. 3D printing has a wide range of uses in this industry, from creating organ-on-a-chip systems for drug testing and discovery to rebuilding bone, cartilage, and skin tissues. There are still many obstacles to overcome, such as ensuring the long-term functionality of the modified tissues and scaling up 3D printing for therapeutic applications. To fully achieve the revolutionary promise of 3D printing in tissue engineering and regenerative medicine, future research is concentrating on developing biomaterials, improving scaffold designs, and resolving ethical and regulatory issues. (shrink)

3D printing has rapidly emerged as a transformative force in medicine, bringing customized, precise, and affordable solutions to a wide array of clinical applications. As technology evolves, future breakthroughs will increasingly transition from conventional applications to highly sophisticated developments such as bioprinting of vascularized tissue and organs, nanoscale resolution printing, and point-of-care manufacturing (PoCM) driven by artificial intelligence and real-time patient information. Bioprinting can revolutionize regenerative medicine by creating functional tissues for transplantation and disease modeling, while nanotechnology integration promises enhanced (...) mechanical properties, drug targeting delivery systems, and smart implants. On the other hand, PoCM platforms bring a paradigm shift toward decentralized, on-demand healthcare delivery with high impact in emergency, remote, and resource-poor settings. However, despite these promising prospects, the technology faces significant technical, regulatory, and economic challenges. Key challenges include the limited availability of biocompatible and functional materials, the scalability of complex constructs, regulatory normalization, and the affordability of advanced manufacturing technologies. Such challenges will be surmounted by interdisciplinary collaboration, rigorous quality control regimes, and the development of new economic and ethical norms. This chapter outlines the trajectory of 3D printing in medicine, with future directions and the multifaceted challenges that must be overcome to reach its full clinical potential. (shrink)

3D printing is a technique that uses a layer-by-layer construction process for manufacturing different objects from various materials, following the design presented by a computer-aided model. The integration of additive manufacturing, more commonly known as 3D printing, into surgical practice has opened transformative possibilities in the design, fabrication, and deployment of surgical instruments. Also known as additive manufacturing, this technique has emerged as an important technology for producing mass-customized objects and has found its way into agriculture, healthcare, and the automotive (...) industry. In medical surgeries, this technology has been used to manufacture various customized surgical instruments depending on the patient’s specific physiology and the surgeon’s individuality. In surgeries like minimally invasive surgeries and robot-assisted surgeries, this technology has paved the way for the manufacturing of futuristic, customizable tools within a few hours. This chapter explores the emergence and clinical application of 3D-printed surgical tools, with a focused examination of their advantages in customization, cost-effectiveness, and sterilization compatibility—three pivotal factors influencing surgical innovation and healthcare delivery. Furthermore, the chapter addresses critical barriers to adoption, including regulatory uncertainty, sterilization challenges, and the ethical implications of point-of-care manufacturing. It also highlights emerging trends such as surgeon-driven design, hospital-based fabrication labs, and the incorporation of artificial intelligence (AI) for automated tool customization based on preoperative imaging. (shrink)

In recent years, 3D bioprinting has received great attention in improving precision and competency in different procedures related to dental treatment. Often, computer-aided design, computer-aided manufacturing, and other impression techniques are considered as primary tools for digitalizing the prosthetic field and creating models such as teeth, jaws, and cavities. Subsequently, the procedures, including inlays, onlays, and crowns, are being performed. This chapter highlights the pivotal role of 3D-printed implants in treating dental problems such as diastema, dental loss, crown damage, and (...) restoration of dental fractures. For instance, 3D-printed models of a patient’s dental structure with suitable polymers can be utilized to plan comprehensive surgeries and ensure patient’s recovery in a short time. On the other hand, invisible aligners are presently being developed at a rapid pace using digital printing of patient’s jaw models to treat malocclusions. With advances in digital printing technology, now we are in a level to print prosthesis and other devices on-site, reducing the time required for creation and delivery. Thus, these advancements in digital printing are transforming the field of dentistry by increasing precision, saving manual labor, and improving patient outcome. In this context, the chapter summarizes the recent developments in the 3D bioprinting technology, challenges in choosing different materials for 3D printing, and improving the resolution, composition, mechanical, and biological compatibility of resulting dental implants. (shrink)

In the medical sector, 3D printing technology is an advanced breakthrough for numerous uses, particularly due to its ability to tailor designs. It has a considerable impact, ranging from bioprinting to producing clinical products, such as implants, prosthetics, or orthotics. Considering the multitude of invigorating initiatives and groups in each of these areas, we will today offer you a ranking of the top 3D-printed orthotics. Unlike prosthetics that replace an absent part of the body, orthotics are medical devices designed to (...) support, alleviate, immobilize, control, or correct a part of the body. Given that each patient has distinct characteristics, 3D printing is particularly suited for these types of devices and tools. Needing an orthotic or prosthetic device often involves a labor-intensive, complicated, and disorganized process. For manufacturers, producing well-fitting orthotic and prosthetic devices is expensive and demands highly skilled personnel. Patients can expect that, to a lesser extent, a delay in receiving their device, fewer fittings, and enhanced durability. Creating a comfortable, well-fitting prosthetic limb is not merely a science; it is equally an art. 3D printing has the ability to convert today’s custom, handcrafted manufacturing method into a highly reproducible and uniform process, which ultimately leads to more efficient clinics and improved patient results. (shrink)

Cardiovascular medicine has greatly benefited from the application of 3D printing technology by offering patients unique personalized treatment plans. In this chapter, the techniques of 3D printing in cardiovascular medicine have been described through the topic “3D Printing in Cardiovascular Intervention.” Cardiovascular models help the physician in a better understanding of the disease pathology and can be used for pre-intervention planning in cases requiring any intervention. They improve knowledge of congenital heart disease, aneurysms, and valvular lesions, allowing practitioners to practice (...) for operations and adjust operations according to the characteristics of the patient. This chapter also focuses on biomedical engineering achievements such as new cardiovascular implants created with the use of 3D printers, like stents, heart valves, and tissue scaffolds. By using bioprinting, it is now possible to guarantee the production of functional tissues, including heart muscles and blood vessels, using the patient’s cells, avoiding the risk of possible rejection by the body and leading to worse long-term results. Besides, 3D printing has been useful in medical education and patient consultation since clients and students can relate to a real physical model as compared to a two-dimensional model.However, in its application for cardiovascular medicine, there are still some factors that have not made the solution more popular, such as governmental restrictions, the choice of material, and cost-effective solutions. These barriers are subject to ongoing technological inventions and interdisciplinary works. Therefore, this chapter highlights the advantage of employing 3D printing in reshaping cardiovascular disease to optimize the pronounced development of tailored care within the progressive context of global healthcare delivery. (shrink)

The integration of 3D printing technology into healthcare, particularly in drug delivery, represents a transformative advancement in pharmaceutical treatment. This chapter explores the innovative applications of 3D printing that enhance precision, personalization, and efficiency in drug formulation. Traditional drug delivery methods often encounter challenges such as dosage accuracy and patient compliance. In contrast, 3D printing facilitates the development of complex, customizable drug delivery systems tailored to individual patient needs. By enabling the design of multilayered formulations and precise release mechanisms, this (...) technology optimizes bioavailability and minimizes side effects. Moreover, the capability to integrate diagnostic tools with drug formulations enhances patient-centered treatment approaches. As the field progresses, 3D printing in drug delivery holds substantial promise for revolutionizing therapeutic strategies, improving patient outcomes, and streamlining production processes. This chapter outlines the key advancements, challenges, and future directions of 3D printing in drug delivery, emphasizing its potential to shape the future of medicine. (shrink)

COVID-19 pandemic underscored the importance of point of care (PoC) to improve the detection and treatment in minimal resources and manpower as numerous challenges arose during crisis. Additionally, pandemic also emphasizes the need for personalized medicine. Personalized medicine represents a shift from the traditional “one-size-fits-all” approach to a more customized, individualized treatment strategy that considers the unique genetic, environmental, and lifestyle factors of each patient. The ultimate goal of personalized medicine is to treat patients at the earliest to prevent adverse (...) events that matter to both the clinician and patients. The emergence of 3D printing in healthcare has triggered a revolution in the development of PoC devices by eliminating the reliance on centralized facilities; these devices allow for effective medical interventions even in low-resource settings. Their portability, ease of use, and ability to provide rapid, accurate results make them essential in both emergency and routine healthcare scenarios.This chapter outlines the principle of 3D printing, steps involved, healthcare applications in the development of PoC devices, and its benefits to patients—from concept to real clinical applications, i.e., microfluidic devices, wearable biosensors, and lab-on-a-chip systems, with case studies in infectious disease diagnostics. We also explored regulatory challenges, material standardization, and current technological limits. Future advances in smart materials and bio printing are poised to elevate PoC capabilities, making 3D printing a key driver of faster, more precise, and accessible personalized healthcare. (shrink)

3D printing (3DP) began to find its initial applications in pharmaceutical preparations in the early 2000s. Since the first FDA-approved 3D printed formulation, an antiepileptic medication called Spritam (levetiracetam), additive manufacturing (AM) has come a long way. The ability of 3DP to cater to the individualistic needs of patients has supported advancements in personalized and precision medicine. It is involved in the fabrication of a wide range of products, including orodispersible tablets, controlled release preparations, suppositories, medical devices, and printable implants. (...) The technology has penetrated numerous therapeutic fields, and ophthalmology is no exception. Efficient eye-care demands intricacy, which conventional ophthalmological products fail to entirely accomplish due to the common practice of “one size fits all.” The utilization of 3DP in ophthalmoscopy provides instant and accurate diagnosis for most conditions. Moreover, 3DP helps gauge specific anatomical attributes of an individual’s eye, facilitating the development of customizable orbital models, corneal transplants, and bioprinted photoreceptors, to name a few. Customizable treatment through unique delivery systems has also been made possible. Despite proving to be a valuable asset, it has certain limitations. These include the complex nature of the technology, alongside the availability and selection of biomaterials. However, upon gaining formal regulatory approval, 3DP has the potential to dominate therapeutic fields like ophthalmology due to its virtues of precision and personalization. The authors have provided a comprehensive insight into the current scenario, manufacturing advancements, ophthalmology-focused applications, limitations, and future perspectives. (shrink)

Kumar and Banerjee (Some algebras and logics from quasiorder-generated covering-based approximation spaces. J Appl Non-classical Log 2024;34:248-68) characterized a subclass of quasiorder-generated covering-based approximation spaces for which the algebra of definable sets forms a Stone algebra. In this paper, we characterize those subclasses for which the definable sets form dual Stone, regular double Stone, linear Heyting, and well-connected Heyting algebras. As a consequence, discrete dualities of the aforementioned algebras are also obtained. Furthermore, we provide representation theorems of the aforementioned (...) algebras in terms of rough sets determined by a quasiorder. (shrink)

Background Healthcare organizations are driven by mission-driven values, yet these values can be compromised in employee-organization relationships. Hospitals present psychologically challenging environments for their nurses, potentially causing breaches of psychological contracts. Despite extensive research on ethical climates, their impact on mitigating interpersonal deviance in healthcare remains understudied. This warrants investigation into how ethical workplace climates and breaches of psychological contracts affect interpersonal deviance in nurses. Research Objective/Purpose/Aim This study investigates how psychological contract breaches mediate the relationship between ethical climates and (...) interpersonal deviance. Research Design/Method The study employs a cross-sectional design, collecting data from 230 nurses across five hospitals in India. Standard scales are used to measure the constructs in the study, with established reliability and validity. Structural equation modeling (SEM) was utilized to examine the hypotheses outlined in the study. We also tested the moderating effect of work experience in the moderated mediation model. Ethical considerations This study received ethical approval (#ERB-ASBC-2024-027) from the University Ethical Review Board, constituted at Amrita School of Business, Coimbatore. Participants and procedures Permission to conduct the study was obtained from the hospital administration. Nursing staff participated voluntarily. They were informed about the survey’s purpose and their right to withdraw at any time. Consent was obtained on the survey form before recording their responses, and no personal identifiers were collected. Findings An ethical workplace climate reduces nurses’ interpersonal deviance, mediated by psychological contract breach. This mediation is moderated by work experience, with a stronger effect on less-experienced nurses. Conclusion The study suggests that regular assessments of ethical workplace climate can aid in planning effective reinforcements at individual, leadership, or organizational level to reduce interpersonal deviance and perceptions of psychological contract breach. (shrink)

Gluten ataxia is a rare immune-mediated neurological disorder caused by the ingestion of gluten. The diagnosis is not straightforward as antibodies are present in only up to 38% of patients, but often at lower titers. The symptoms of ataxia may be mild at the onset but lead to permanent damage if remain untreated. It is characterized by damage to the cerebellum however, the pathophysiology of the disease is not clearly understood. The present study investigated the neurochemical profile of vermis and (...) right cerebellum and structural changes in various brain regions of patients with gluten ataxia and compared it with healthy controls. Volumetric 3-D T1 and T1-weighted magnetic resonance imaging in the three planes of the whole brain and single-voxel 1H- magnetic resonance spectroscopy of the vermis and right cerebellum were acquired on 3 T human MR scanner. The metabolite concentrations were estimated using LC Model while brain volumes were estimated using the online tool volBrain pipeline and CERES and corrected for partial volumes. The levels of neuro-metabolites were found to be significantly lower in vermis, while N-acetyl aspartate + N-acetyl aspartate glutamate and glycerophosphocholine + phosphocholine was lower in cerebellum regions in the patients with gluten ataxia compared to healthy controls. A significant reduction in the white matter of ; reduction in the volumes of cerebellum lobe and thalamus while lateral ventricles were increased in the patients with gluten ataxia compared to healthy controls. The reduced neuronal metabolites along with structural changes in the brain suggested neuronal degeneration in the patients with gluten ataxia. Our preliminary findings may be useful in understanding the gluten-induced cerebral damage and indicated that MRI and MRS may serve as a non-invasive useful tool in the early diagnosis, thereby enabling better management of these patients. (shrink)

This ground-breaking collection of new interviews, critical essays, and commentary explores South Asian identity and culture. Sensitive to the false homogeneity implied by "South Asian," "diaspora," "postcolonial," and "Asian American," the contributors attempt to unpack these terms. By examining the social, economic, and historical particularities of people who live "between the lines"—on and between borders—they reinstate questions of power and privilege, agency and resistance. As South Asians living in the United States and Canada, each to some degree must reflect on (...) the interaction of the personal "I," the collective "we," and the world beyond. The South Asian scholars gathered together in this volume speak from a variety of theoretical perspectives; in the essays and interviews that cross the boundaries of conventional academic disciplines, they engage in intense, sometimes contentious, debate. Contributors: Meena Alexander, Gauri Viswanathan, Gayatri Chakravorty Spivak, Amritjit Singh, M. G. Vassanji, Sohail Inayatullah, Ranita Chatterjee, Benita Mehta, Sanjoy Majumder, Mahasveta Barua, Sukeshi Kamra, Samir Dayal, Pushpa Naidu Parekh, Indrani Mitra, Huma Ibrahim, Amitava Kumar, Shantanu DuttaAhmed, Uma Parameswaran. In the series _Asian American History and Culture_, edited by Sucheng Chan, David Palumbo-Liu, Michael Omi, K. Scott Wong, and Linda Trinh Võ. (shrink)

Through an analysis of the moral relationship between people and place, this paper offers a new view of the wrongful character of gentrification, which is pluralistic, locating the wrong in the non-fulfillment of three place-related rights: rights to a home, rights of residency, and place-based rights to a community. By focusing on the multiple ways that people are connected to place, we offer a more complete and systematic account of place-related rights that is not only able to make sense of (...) people’s lived experiences of the harms of gentrification but is also able to address standard criticisms, which have been made of other key accounts of the wrong of gentrification. (shrink)

Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and (...) disability-adjusted life-years. We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles. (shrink)

This paper makes an argument for the democratic value of distrust. It begins by analyzing distrust, since distrust is not merely the negation of trust. The account that it develops is based primarily on Martin Luther King Jr.’s work in Why We Can’t Wait. On this view, distrust is the confident belief that another individual or group of individuals or an institution will not act justly or as justice requires. It is a narrow normative account of distrust, since it concerns (...) a specific normative task. Distinctions between vertical and horizontal distrust, as well as trust and agnostic trust are also discussed. This paper argues that distrust’s democratic value lies in its ability to secure democracy by protecting political minorities from having their voices ignored. As such, distrust can be viewed as a kind of Madisonian “check and balance” that works to prevent tyranny. Distrust also works to secure democracy by forging new or alternative forms of democratic participation. The main example discussed in this paper is King’s involvement in the Birmingham Campaign during the Black Civil Rights movement in America. In this case, King and his supporters’ distrust of fellow White citizens and political institutions led to alternative forms of political expression such as non-violent protests, boycotts, and other forms of civil disobedience, all of which led to greater racial justice by working to alleviate White tyranny. (shrink)

Despite the vast literature on Rawls's work, few have discussed his arguments for the value of democracy. When his arguments have been discussed, they have received staunch criticism. Some critics have charged that Rawls's arguments are not deeply democratic. Others have gone further, claiming that Rawls's arguments denigrate democracy. These criticisms are unsurprising, since Rawls's arguments, as arguments that the principle of equal basic liberty needs to include democratic liberties, are incomplete. In contrast to his trenchant remarks about core civil (...) liberties, Rawls does not say much about the inclusion of political liberties of a democratic sort – such as the right to vote – among the basic liberties. -/- In this paper, I complete some of Rawls's arguments and show that he has grounds for including political liberties, particularly those of a democratic nature, in the principle of equal basic liberty. In doing so, I make some beginning steps toward illustrating the genuinely democratic nature of Rawls's arguments. Rawls believes that a few different arguments can be given for democratic institutions and that these arguments work together to support the value of democracy. In this paper, I focus on Rawls's arguments relating to self-respect. I focus on this set of arguments because they are among the strongest of Rawls's arguments for equal political liberty and its fair value. (shrink)

n this paper, I argue that political solidarity is important to justice. At its core, political solidarity is a relational concept. To be in a relation of political solidarity, is to be in a relation of connection or unity with one’s fellow citizens. I argue that fellow citizens can be said to stand in such a relation when they have attitudes of collective identification, mutual respect, mutual trust, and mutual support and loyalty toward one another. I argue that political solidarity, (...) so conceived, is an integral element of a theory of justice. I argue that there are distinctly social bases for political solidarity and that justice requires that we promote these. Furthermore, as an example of the sort of social and political arrangements that might encourage political solidarity, I discuss Canada’s response to the recent H1N1 pandemic and the failings of this response with respect to members of the Aboriginal community within Canada. I argue that ensuring that members of the Aboriginal community had equal access to the goods they needed to protect themselves against H1N1 infection would have promoted relations of political solidarity and, in turn, would have promoted justice more effectively. (shrink)

It has been widely reported that women are underrepresented in academic philosophy as faculty and students. This article investigates whether this representation may also occur in the domain of journal article publishing. Our study looked at whether women authors were underrepresented as authors in elite ethics journals — Ethics, Philosophy & Public Affairs, the Journal of Political Philosophy, and the Journal of Moral Philosophy — between 2004-2014, relative to the proportion of women employed in academic ethics (broadly construed). We found (...) that women are indeed underrepresented overall in prestigious ethics journal publishing. Though this is not our focus, we discuss possible causes for this finding, such as top ethics journals’ tendency not to publish much feminist philosophy; the impact of women’s lesser professional status or rank within philosophy on their prospects for, and success in, journal publishing; and the review process itself, which may disadvantage or discourage women authors — perhaps especially when their gender, rank, and affiliation are known to the editor or reviewer, or if their work is explicitly feminist. We discuss possible avenues for future research on the "woman problem" in philosophy, noting how our study relates to existing research on this issue. (shrink)

This essay develops an account of Martin Luther King Jr.’s justification for and use of what I will call “democratic propaganda”—truthful propaganda that is aimed at promoting and fostering democratic political action by stirring readers’ emotions. I interpret King’s famous “Letter from Birmingham Jail” in the broader context of his work and argue that it is a piece of democratic propaganda. I give an account of what led King to support the use of democratic propaganda and why he hoped it (...) would help to overcome a central problem in the civil rights movement: the political inaction of the white moderates. King emphasizes shame in the Letter, and I argue that this concept offers us a new way of thinking about the efficacy of democratic propaganda. I close by considering the relevance of King’s approach for today’s Black Lives Matter movement. Despite the innovativeness of King’s use of shame, I suggest it may be time for a new approach to Black politics and activism. (shrink)

Few have discussed Rawls's arguments for the value of democracy. This is because his arguments, as arguments that the principle of equal basic liberty should include democratic liberties, are incomplete. Rawls says little about the inclusion of political liberties of a democratic sort – such as the right to vote – among the basic liberties. And, at times, what he does say is unconvincing. My aim is to complete and, where they fail, to reconceive Rawls's arguments and to show that (...) a principle requiring equal political liberty and its fair value is an appropriate component of his theory of justice. (shrink)

L.A. Paul has recently argued that, on the standard model of rationality, individuals cannot make rational decisions about whether to have a child or not. In this paper, I show that Paul’s arguments do not plausibly demonstrate that the standard model of rationality precludes rational decisions to have a child. I argue that there are phenomenal and non-phenomenal values that can be used to determine the value that having a child will have for us and, in turn, that can be (...) used to make rational decisions about whether to have a child or not. I also argue that we can have an approximate idea of what it is like for us to have a child, even before we have a child and that, on the standard model, this is sufficient to make rational decisions to have a child. (shrink)

Initial vaccine allocations for the coronavirus disease 2019 (COVID-19) will be limited. It is crucial to assess the ethical values associated with different methods of allocation, as well as important scientific and practical questions. This Viewpoint identifies three ethical values, benefiting people and limiting harm; prioritizing disadvantaged populations; and equal concern for all. It then explains why these values support prioritizing three groups: health care workers; other essential workers and people in high-transmission settings; and people with medical vulnerabilities associated with (...) poorer COVID-19 outcomes. In contrast, two other groups, people over 65 without medical vulnerabilities and participants in clinical research, present more complex ethical questions. This prioritization also encompasses valuing direct benefits to vaccinated individuals, indirect benefits to individuals protected from spread of infection, and indirect health and socioeconomic benefits to those protected from harm as health system and societal functioning improve. Vaccine allocation that recognizes important ethical values and avoids arbitrariness, waste, and corruption can ensure that the distribution of a COVID-19 vaccine is both fair and perceived as fair. (shrink)

Meena Srinivasan began teaching in order to touch lives, but with the demands of covering her curriculum she all but forgot her aspiration. During a retreat with Thich Nhat Hanh, Meena learned for the first time about mindfulness. In Teach, Breathe, Learn, Srinivasan highlights how mindfulness can be an effective tool in the classroom. What makes this book truly unique is Srinivasan's perspective as a classroom teacher, wrestling daily with the conditions about which she writes. Each chapter begins (...) with a personal narrative concerning a challenge Srinivasan faced during the school day and how a specific mindfulness practice helped. Testimonials from students, colleagues, and parents appear in each chapter, along with a mindfulness practice. Part 1 helps teachers develop compassion and shift from "reacting" to "responding" to demands. Part 2 offers techniques for cultivating loving-kindness and seeing students, colleagues, and parents as oneself. The author shares what research says about the effects of mindfulness practice on academic, social, and emotional learning. The last section of the book introduces the complete curriculum teachers can use to incorporate mindfulness into their classroom, replete with lesson plans, PowerPoint diagrams, handouts, and homework assignments. (shrink)

The paper begins from a working definition of caste as a contentious form of social belonging and a consideration of casteism as a form of inferiorization. It takes anti-casteism as an ideological critique aimed at unmasking the unethical operations of caste, drawing upon B. R. Ambedkar’s notion of caste as ‘graded inequality’. The politico-legal context of the unfinished trajectory of instituting protection against caste discrimination in Britain provides the backdrop for thinking through the philosophical foundations of anti-casteism. The peculiar religio-discursive (...) aspect of ‘emergent vulnerability’ is noted, which explains the recent introduction of the trope of ‘institutional casteism’ used as a shield by deniers of caste against accusations of casteism. The language of protest historically introduced by anti-racists is thus usurped and inverted in a simulated language of anti-colonialism. It is suggested that the stymieing of the UK legislation on caste is an effect of collective hypocrisies, the refusal to acknowledge caste privilege, and the continuity of an agonistic intellectual inheritance, exemplified in the deep differences between Ambedkar and Gandhi in the Indian nationalist discourse on caste. The paper argues that for a modern anti-casteism to develop, at stake is the possibility of an ethical social solidarity. Following Ambedkar, this expansive solidarity can only be found through our willingness to subject received opinions and traditions to critical scrutiny. Since opposed groups ‘make sense’ of their worlds in ways that might generate collective hypocrisies of denial of caste effects, anti-casteism must be geared to expose the lie that caste as the system of graded inequality is benign and seamlessly self-perpetuating, when it is everywhere enforced through penalties for transgression of local caste norms with the complicity of the privileged castes. The ideal for modern anti-casteism is Maitri formed through praxis, eschewing birth-ascribed caste status and loyalties. (shrink)

This paper develops an interpretive framework around ethical learning by using qualitative methods to examine the collective impact of Experiential Learning Activity (ELA) and Critical Action Learning (CAL) on student learning of ethics. The aim is to determine not only the effectiveness of two ethical learning theories but also the student “needs” being fulfilled. To understand their perceptions, we collected students’ personal narratives through focus groups and semi-structured interviews post participation on the experiential and action learning activities. Results indicate that (...) teaching through ELAs and CAL in business ethics lead to social benefits and co-creation which portrayed improved engagement with peers, academics and industry. The outcomes suggest that instead of focussing on teaching ethics, the curriculum should provide opportunities for developing interaction with peers, academics and the society and engage students in real time hands on projects to experience and learn about ethics and the consequences of unethical behaviour. (shrink)

This chapter discusses how justice applies to public health. It begins by outlining three different metrics employed in discussions of justice: resources, capabilities, and welfare. It then discusses different accounts of justice in distribution, reviewing utilitarianism, egalitarianism, prioritarianism, and sufficientarianism, as well as desert-based theories, and applies these distributive approaches to public health examples. Next, it examines the interplay between distributive justice and individual rights, such as religious rights, property rights, and rights against discrimination, by discussing examples such as mandatory (...) treatment and screening. The chapter also examines the nexus between public health and debates concerning whose interests matter to justice (the “scope of justice”), including global justice, intergenerational justice, and environmental justice, as well as debates concerning whether justice applies to individual choices or only to institutional structures (the “site of justice”). The chapter closes with a discussion of strategies, including deliberative and aggregative democracy, for adjudicating disagreements about justice. (shrink)

This paper takes a novel approach to the active bioethical debate over whether advance medical directives have moral authority in dementia cases. Many have assumed that advance directives would lack moral authority if dementia truly produced a complete discontinuity in personal identity, such that the predementia individual is a separate individual from the postdementia individual. I argue that even if dementia were to undermine personal identity, the continuity of the body and the predementia individual’s rights over that body can support (...) the moral authority of advance directives. I propose that the predementia individual retains posthumous rights over her body that she acquired through historical embodiment in that body, and further argue that claims grounded in historical embodiment can sometimes override or exclude moral claims grounded in current embodiment. I close by considering how advance directives grounded in historical embodiment might be employed in practice and what they would and would not justify. (shrink)

When hospitals face surges of patients with COVID-19, fair allocation of scarce medical resources remains a challenge. Scarcity has at times encompassed not only hospital and intensive care unit beds—often reflecting staffing shortages—but also therapies and intensive treatments. Safe, highly effective COVID-19 vaccines have been free and widely available since mid-2021, yet many Americans remain unvaccinated by choice. Should their decision to forgo vaccination be considered when allocating scarce resources? Some have suggested it should, while others disagree. We offer a (...) framework for evaluating when it is ethical and briefly discuss its legality in American law. (shrink)

Certifications of immunity are sometimes called “immunity passports” but are better conceptualized as immunity-based licenses. Such policies raise important questions about fairness, stigma, and counterproductive incentives but could also further individual freedom and improve public health. Immunity licenses should not be evaluated against a baseline of normalcy, ie, uninfected free movement. Rather, they should be compared to the alternatives of enforcing strict public health restrictions for many months or permitting activities that could spread infection, both of which exacerbate inequalities and (...) impose serious burdens. This Viewpoint presents a framework for analyzing the ethics of immunity licenses. (shrink)

Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of the (...) overall impact of health policy. This chapter considers what weight health policy should give to its “spill-over effects,” namely non-health and indirect benefits. (shrink)

We argue that the ethical case for instituting vaccine benefit programs is justified by 2 widely recognized values: (1) reducing overall harm from COVID-19 and (2) protecting disadvantaged individuals. We then explain why they do not coerce, exploit, wrongfully distort decision-making, corrupt vaccination's moral significance, wrong those who have already been vaccinated, or destroy willingness to become vaccinated. However, their cost impacts and their effects on public perception of vaccines should be evaluated.

In December 2006, Indonesia decided to stop sending influenza virus specimens to the World Health Organization’s Global Influenza Surveillance Network (GISN). Indonesia justified its actions by claiming that they were in protest of the injustice of GISN. Its actions stimulated negotiations to improve the workings of GISN by developing and implementing a more just framework for ‘sharing influenza viruses and other benefits’. These negotiations eventually led to the adoption of a new framework for virus and benefit sharing in May 2011, (...) at the World Health Assembly meeting. In this article, we critically evaluate Indonesia’s claims about the unjustness of GISN. We show that arguments based on the values of ownership, contribution and reciprocity work together to support Indonesia’s claim that it was owed an equal share in the benefits of GISN and, in turn, that GISN was unjust because of its failure to ensure this. We also use these values to evaluate the newly agreed upon framework for virus and benefit sharing. We suggest the new framework fails to give proper consideration to the values of ownership, contribution and reciprocity and, as a result, that it is fundamentally unjust. (shrink)

Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search.In sum, teaching in all three subjects combined (...) comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics. (shrink)

The COVID-19 pandemic has forced clinicians, policy-makers and the public to wrestle with stark choices about who should receive potentially life-saving interventions such as ventilators, ICU beds and dialysis machines if demand overwhelms capacity. Many allocation schemes face the question of whether to consider age. We offer two underdiscussed arguments for prioritising younger patients in allocation policies, which are grounded in prudence and fairness rather than purely in maximising benefits: prioritising one’s younger self for lifesaving treatments is prudent from an (...) individual perspective, and prioritising younger patients works to narrow health disparities by giving priority to patients at risk of dying earlier in life, who are more likely to be subject to systemic disadvantage. We then identify some confusions in recent arguments against considering age. (shrink)

Recognising that offers of payment to research participants can serve various purposes—reimbursement, compensation and incentive—helps uncover differences between participants, which can justify differential payment of participants within the same study. Participants with different study-related expenses will need different amounts of reimbursement to be restored to their preparticipation financial baseline. Differential compensation can be acceptable when some research participants commit more time or assume greater burdens than others, or if inter-site differences affect the value of compensation. Finally, it may be permissible (...) to offer differential incentive payments if necessary to advance the goals of a study. We encourage investigators and Institutional Review Boards to think about whether to offer payment, in what amounts and for what purpose, and also to consider whether differential payment can help promote the scientific and ethical goals of clinical research. (shrink)