We discuss the role of prior authorization (PA) in supporting patient-centered care (PCC) by directing health system resources and thus the ability to better meet the needs of individual patients. We begin with an account of PCC as a standard that should be aimed for in patient care. In order to achieve widespread PCC, appropriate resource management is essential in a healthcare system. This brings us to PA, and we present an idealized view of PA in order to (...) argue how at its best, it can contribute to the provision of PCC. PA is a means of cost saving and as such it has mixed success. The example of the US demonstrates how implementation of PA has increased health inequalities whereas best practice has the potential to reduce them. In contrast, systems of universal coverage, like those in Europe, may use the cost savings of PA to better address individuals' care and PCC. The conclusion we offer therefore is an optimistic one, pointing towards areas of supportive overlap between PCC and PA where usually the incongruities are most evident. (shrink)

On 9 August 1994 the German legislature revised the German Drug Law (AMG). Included in the revision is a passage requiring, for the first time, that the sponsors and investigators of clinical studies involving human subjects first obtain the approval of an ethics committee before carrying out such studies. According to the legislation, which takes effect on 17 August 1995, approval is to come from 'an independent ethics committee, set up and administered according to state law [emphasis added]' (1). Although (...) it is clear according to the text that the 16 federal states have been empowered to establish ethics committees within their jurisdictions, this does not mean that the state governments are free to transfer exclusive authority in the matter to their respective medical associations, a step that would effectively abolish Germany's private ethics committees. First, the legislation does not rule out the authorization of private ethics committees. Second, as legal scholars attest, the exclusive control of ethics committees by the medical associations would constitute an illegal monopoly. Third, it is arguable that medical-association ethics committees fail to meet the one prior federal requirement, that of independence. There is a great deal of confusion in Germany today about which kinds of ethics committees (public and/or private) the states will sanction before 17 August 1995. In an attempt to sort things out we present a brief explanation of how ther came to be two kinds of ethics committees in Germany, review the legal battle between the two over the issue of authorization, point out how the German legislature, in passing the recent bill, has missed an opportunity to clarify the issue and, finally suggest why the administration of ethics committees by the medical associations may be incompatible with the requirement that ethics committees be independent. (shrink)

Advance directives for psychiatric care are the subject of debate in a number of Western societies. By using psychiatric advance directives , it would be possible for mentally ill persons who are competent and with their disease in remission, and who want timely intervention in case of future mental crisis, to give prior authorisation to treatment at a later time when they are incompetent, have become non-compliant, and are refusing care. Thus the devastating consequences of recurrent psychosis could be (...) minimised.Ulysses contracts raise a number of ethical questions. In this article the central issues of concern and debate are discussed from a narrative perspective. Ulysses contracts are viewed as elements of an ongoing narrative in which patient and doctor try to make sense of and get a hold on the recurrent crises inherent in the patient's psychiatric condition. (shrink)

Pharmacy Benefit Managers (PBM) induce drug manufacturers to offer rebates to insurers and employers by denying coverage through formulary exclusions, impeding physician prescription through prior authorization, and reducing patient drug use through cost sharing. As they tighten these access obstacles, PBMs reduce the net prices received by the manufacturers.

The pelvic exam is used to assess the health of female reproductive organs and so involves digital penetration by a physician. However, it is common practice for medical students to acquire experience in administering pelvic exams by performing them on unconscious patients without prior authorization. In this article, we argue that such unauthorized pelvic exams (UPEs) are sexual assault. Our argument is simple: in any other circumstance, unauthorized digital penetration amounts to sexual assault. Since there are no morally (...) significant differences between UPEs and other instances of digital penetration, UPEs are sexual assault. So, insofar as one is against sexual assault, one should be against UPEs. (shrink)

Endotracheal intubation (ETI) is a valuable procedure which must be learnt and practised, and performing ETI on cadavers is probably the best way to do this, although lesser alternatives do exist. Performing ETI on a cadaver is viewed with a real and reasonable repugnance and if it is done without proper authorisation it might be illegal. Some form of consent is required. Presumed consent would preferably be governed by statute and should only occur if the community is well informed and (...) therefore in a position of being able to decline. Currently neither statute nor adequate informing exists. Endotracheal intubation on the newly dead may be justifiable according to a Guttman scale if the patient has already consented to organ donation and if further research supports the relevance of the Guttman scale to this question. A "mandated choice" with prior individual consent as a matter of public policy is the best of these solutions, however until such a solution is in place we may not practise endotracheal intubation on the newly dead. (shrink)

In December 1998, the Office of Inspector General and the Health Care Financing Administration solicited comments from health care providers regarding the federal anti-patient dumping statute, the Emergency Medical Treatment and Active Labor Act. EMTALA is a federal health care law of unprecedented breadth—the first universal benefit guaranteed by the federal government. It requires Medicare-participating hospitals with public emergency rooms, emergency physicians, and ancillary surgical and medical specialists to render adequate stabilizing treatment to whoever requests it. The 1998 Special Advisory (...) Bulletin sought input on four principal dimensions of EMTALA: the statutory obligation to furnish adequate medical screening to anyone who visits an emergency room; the responsibilities of health care providers towards enrollees of managed care organizations ; the prior authorization and payment rules for Medicare and Medicaid; and what practices would promote hospital compliance with EMTALA. (shrink)

According to 2021 data, the United States’ opt-in system of posthumous organ donation results in seventeen Americans dying each day waiting for vital organs, while many good undonated organs go to the grave with the corpse. One of the most aggressive, and compelling, proposals to resolve this tragedy is postmortem organ conscription, also called routine salvaging or organ draft. This proposal entails postmortem retrieval of needed organs, regardless of the prior authorization or refusal of the deceased or his (...) family. The argument of most proponents of conscription relies heavily upon a denial of the possibility of posthumous harms. While I also deny the possibility of posthumous harms, I argue this denial fails to acknowledge other serious wrongs that could be done to the deceased person and his corpse. While the person can no longer be harmed, his _life_, in a roughly biographical sense, can be damaged. Humans highly value life in this sense, often more than biological life. Respect for this sense of life also informs appropriate treatment of particular human corpses, which already have special value beyond mere resource. I will argue that conscription proponents fail to appropriately value lives and human corpses. This failure can lead to multiple wrongs, among them a wrongful exploitation of the vulnerability of a person’s life and corpse and a disrespect of persons. While it is possible that some biographical lives could be made better, or at least less bad, by conscription, the judgments such decisions would require make conscription bad policy. (shrink)

The importance of legal epidemiology in public health law research has undoubtedly grown over the last five years. Scholars and practitioners together have developed guidance on best practices for the field, including: placing emphasis on transdisciplinary collaborations; creating valid, reliable, and repeatable research; and publishing timely products for use in decision-making and change. Despite the energy and expertise researchers have brought to this important work, they name significant challenges in marshalling the diverse skill sets, quality controls, and funding to implement (...) legal epidemiology activities. The Centers for Disease Control and Prevention has worked to develop cross-cutting research and translation on issues of national priority in legal epidemiology, and has explored ways to overcome some of these challenges. As such, this article describes a case study of the use of law to characterize states' prior authorization policies regarding medication used to treat attention-deficit/hyperactivity disorder, a central component of a broader effort to improve behavior therapy options for young children with ADHD. This article highlights the types of legal epidemiology work we have undertaken, the application of this work to an emerging public health problem, and the lessons learned in creating impactful research for the field. (shrink)

The ongoing conflict in Ukraine constitutes a poignant reminder of the enduring relevance and potential devastation associated with nuclear weapons. For decades, the possibility of such catastrophic conflict has not seemed so imminent as in the current world affairs. -/- This contribution presents a comprehensive analysis of nuclear strategy for the 21st century. By examining the evolving geostrategic landscape the talk illuminates key concepts such as nuclear posture, credible deterrence, first & second strike capabilities, flexible response, EMP , variable yield, (...) counterforce & countervalue, limited war and escalation dominance, thereby providing a nuanced understanding of the delicate balance of power in the nuclear arena in modern conflicts. Furthermore, it concentrates on the era that started with the war in Ukraine, offering insights into how recent geopolitical developments influence nuclear doctrines. -/- Through conceivable real-world scenarios, we gain perspective on the multifaceted challenges posed by newer technologies and potential escalation dynamics involving global nuclear actors. -/- Such scenarios include: -/- 1. A non-weaponised or sub-critical test within Russia to intimidate opponents into understanding Russia’s resolve and capabilities. Prior norms have restricted testing since 2000, apart from North Korea. In case of a full surface test, Russia could detonate in uninhabited areas within its own vast territory with minimal fallout. While clarifying military strength, demonstrations risk hardening resistance without incentivising surrender. -/- 2. Coercive atomic threat to compel Ukraine or its supporters to make concessions. By leveraging the spectre of nuclear warfare, Russia could expect to achieve its objectives through intimidation and fear. However, the effectiveness of such a strategy is questionable, as it may provoke a strong international response and further galvanise support for Ukraine. -/- 3. Demonstration detonation over/under the Black Sea to signal resolve without targeting Ukraine itself; possibly amidst negotiations to gain diplomatic leverage, whilst limiting human casualties to zero or causing a mild, non-destructive tsunami. -/- 4. Ukraine could decide to launch a pre-emptive strike on Russian nuclear facilities or weapons, fearing an imminent attack. Such an action would have a high risk of failure and might even provoke a nuclear retaliation from Russia. It could also lead to a broader conflict, as neighbouring countries might feel compelled to intervene. -/- 5. Limited tactical strike against Ukrainian military or infrastructure to weaken capacity and morale. Russia’s 2000+ non-strategic arsenal could target positions using short-range missiles with 0.3 – 5 kiloton yields. Objectives like crippling Kharkiv defences might create no-go zones hindering advances. However, Ukraine might maintain drone and cyber offensive capabilities regardless. -/- 6. Electromagnetic Pulse attack designed to disable critical infrastructure in Ukraine and NATO countries without radioactive fallout. This aims to hinder the war effort and economy without provoking the same conventional military response as a blast. However, an EMP attack affecting NATO shall still be considered an act of war warranting retaliation. -/- 7. A weapon could be deployed accidentally or without proper authorisation. This could occur due to a technical malfunction, miscommunication, human error, or the actions of rogue elements. The consequences of such an event could be catastrophic, leading to a rapid escalation of the conflict and potentially triggering a global crisis. -/- 8. Sub-strategic offensive targeting NATO in the European theatre, so as to fracture allied resolve, against arms routes in Poland, Baltic stockpiles, British naval bases, American troop concentrations in Germany etc. Putin may perceive defeat or deposition as an existential threat, viewing such an option as self-preservation despite adverse consequences. -/- . (shrink)

In the wake of scandals about the unauthorised retention of organs following postmortem examination, the issue of valid consent has returned to the forefront. Emphasis is put on obtaining explicit authorisation from the patient or family prior to any medical intervention, including those involving the dead. Although the controversies in the UK arose from the retention of human material for education or research rather than therapy, concern has been expressed that public mistrust could also adversely affect organ donation for (...) transplantation. At the same time, however, the British Medical Association continues to call for a shift to a system of presumed consent for organ transplantation. This apparent inconsistency can be justified because valid distinctions exist between the reasons requiring explicit consent for retention and the acceptability of presumed consent for transplantation. This paper argues for introducing a system of presumed consent for organ donation, given the overwhelming expressions of public support for transplantation. Ongoing legislative review in the UK provides an ideal chance to alter the default position to one where potential donors can simply acquiesce or opt out of donation. Combined with consultation with their relatives, this could be a much better method of realising individuals’ wishes. It would also achieve a better balance between the duties owed to the deceased and those owed to people awaiting a transplant. (shrink)

The problem of wasteful clinical trials has been debated relentlessly in the medical community. To a significant extent, it is attributed to redundant trials – studies that are carried out to address questions, which can be answered satisfactorily on the basis of existing knowledge and accessible evidence from prior research. This article presents the first evaluation of the potential of the EU Clinical Trials Regulation 536/2014, which entered into force in 2014 but is expected to become applicable at the (...) end of 2021, to prevent such trials. Having reviewed provisions related to the trial authorisation, we propose how certain regulatory requirements for the assessment of trial applications can and should be interpreted and applied by national research ethics committees and other relevant authorities in order to avoid redundant trials and, most importantly, preclude the unnecessary recruitment of trial participants and their unjustified exposure to health risks. (shrink)

This article explores how the type of consent given for organ donation should affect the judgement of a patient's overall benefit with regards to donation of their organs and the pre-mortem interventions required to facilitate this. The findings of a qualitative study of the views of 10 healthcare professionals, combined with a philosophical analysis inform the conclusion that how consent to organ donation is given is a reliable indicator only of the strength of evidence about views on donation and subsequent (...) willingness to undergo pre-mortem interventions. It is not an indicator of the strength of actual desire to donate. Clinical management of living patients prior to donation after circulatory death must therefore respect the values, wishes and beliefs of the potential donation after circulatory death donor. Our participants, however, suggested that the information currently provided is sufficient to authorise donation and that this consent, however provided, was sufficient to proceed with pre-mortem interventions. Respect for autonomy underpinned this ‘all or nothing’ approach. Although the legal requirements for donation authorisation and the protection of patients without capacity are clear, practice and policy regarding consent in donation after circulatory death may be based on donation following brainstem death where the patient is already dead when the family is approached. Custom and practice in donation after circulatory death may need to be revised to protect the interests of the dying potential donor. (shrink)

Requiring family authorization for apnea testing subtracts health professionals control over death determination, a procedure that has traditionally been considered a matter of clinical expertise alone. In this commentary, we first provide evidence showing that health professionals’ (HPs) disposition to act on death determination without family’s prior consent could be much lower than that referred to by Berkowitz and Garrett (2020). We hypothesize that HPs may have reservations about their own expertise as regards death, and may thus hesitate (...) to impose their views on patients’ families. We then address the theoretical question of clinical expertise in death determination by distinguishing judgments about facts (e.g., the presence or absence of spontaneous breathing) from interpretations given of these facts (i.e., their meaning for the vital status of an individual). We argue that, while clinicians may claim some expert authority on the former, they hold no particular authority on the latter. (shrink)

Along with the Strait of Malacca and the Singapore Straits, the Strait of Hormuz is arguably the most important bottleneck in international navigation because a large part of the global oil production needs to be shipped through this passage, which is only a few kilometers wide. In the context of the dispute about Iran’s nuclear program and new sanctions, Iran has threatened to close the Strait of Hormuz for international shipping, effectively cutting off many Western countries from important oil imports. (...) In this article, the legality of such action as well as the legality of the mere threat to close the Strait of Hormuz are investigated. In addition to the International Law of the Sea, general rules of international law and the international law of armed conflict are taken into consideration. Particular emphasis is put on the sovereignty of other states, which is infringed upon by such threats on the part of the Iranian leadership. First, the question has to be answered whether a passage through these waters would be transit passage through a Strait or normal passage through the coastal state’s territorial sea. The authors of the article conclude that the regime of transit passage applies qua lex specialis, as far as the part of the Strait of Hormuz, which is included in Iran’s territorial waters, is concerned. The next step is to ask the question whether preventing such a passage as well as threatening to prevent such a passage are permissible for Iran. In this context, the potential abuse of otherwise permitted traffic separation schemes is highlighted. Traffic separation schemes are of particular importance in narrow but highly frequented bodies of water, such as the Strait of Hormuz. In addition, the contemporary Iranian state practice has received some attention. One issue to be considered in more detail is the requirement that foreign warships receive authorization from the coastal state prior to entry into the territorial sea. This approach might be incompatible with the right to innocent passage under both the Law of the Sea Convention and customary international law, as there is no clear legal source, which provides for this requirement. Finally, the authors look at the question of the legality of the mere threat to close the Strait of Hormuz as opposed to actually closing the Strait. The sovereignty of other states may be affected to such an extent that such threats already amount to a violation of international law. In light of the historic precedents during the Iran-Iraq War, these threats should not be dismissed lightly. Iran would be well advised to refrain from such rhetoric. (shrink)

Donation after circulatory determination of death (DCDD) is an accepted practice in the United States, but heart procurement under these circumstances has been debated. Although the practice is experiencing a resurgence due to the recently completed trials using ex vivo perfusion systems, interest in thoracoabdominal normothermic regional perfusion (TA-NRP), wherein the organs are reanimated in situ prior to procurement, has raised many ethical questions. We outline practical, ethical, and equity considerations to ensure transplant programs make well-informed decisions about TA-NRP. (...) We present a multidisciplinary analysis of the relevant ethical issues arising from DCDD-NRP heart procurement, including application of the Dead Donor Rule and the Uniform Definition of Death Act, and provide recommendations to facilitate ethical analysis and input from all interested parties. We also recommend informed consent, as distinct from typical “authorization,” for cadaveric organ donation using TA-NRP. (shrink)

In The Ethics of War and the Force of Law, Uwe Steinhoff argues “[t]he legitimate authority criterion should be abandoned.” (33) His position explicitly rejects the views of those defending legitimate authority as both indispensable and prior to the other criteria of the just war theory. In a subtle rejoined to these views, Steinhoff contends these accounts misrepresent the tradition and can provide no effective justification for retaining the criterion. Indeed, the criterion proves redundant. Much of Steinhoff’s analysis is (...) compelling. I shall argue, however, that despite correctly representing the tradition as more “pluralist” regarding possible authorization of war beyond the state, Steinhoff’s rejection of legitimate authority fails to account for its primary justification, namely, as identifying the proper agent through which to gauge the moral action involved in this particular use of force. My essay will advance this view by vindicating Steinhoff’s insight about the plurality of possible actors for whom “war” is appropriate necessitates the criterion of legitimate authority rather than making it redundant. (shrink)

Preventive use of force may be defined as the initiation of military action in anticipation of harmful actions that are neither presently occurring nor imminent. This essay explores the permissibility of preventive war from a cosmopolitan normative perspective, one that recognizes the basic human rights of all persons, not just citizens of a particular country or countries. It argues that preventive war can only be justified if it is undertaken within an appropriate rule-governed, institutional framework that is designed to help (...) protect vulnerable countries against unjustified interventions while also avoiding unacceptable risks of the costs of inaction. The key to ensuring the fairness of rules governing the preventive use of force is accountability.This essay proposes a scheme that would make those promoting and those rejecting the preventive use of force more accountable. The proposal contains the following crucial features:States proposing preventive war are required to enter into a contract with a diverse body of states as a condition for authorization of their actions;Prior to taking preventive action, states must make an evidence-based case to the UN Security Council, and agree in advance to submit themselves to an evaluation by an impartial body after the preventive action occurred;Both proponents of action and those opposing it will be held accountable ex post for the accuracy of their prior statements and the proportionality of their actions;Sanctions will be imposed against intervening states or states that opposed preventive action, respectively, depending on the findings of the ex post evaluation.If preventive action were blocked in the Security Council, states seeking to engage in preventive action could then present their case in a different body–a coalition of democratic states–with its own ex post and ex ante accountability procedures. (shrink)

How is it possible for human subjects who are socially constructed to engage in effective and authoritative acts of resistance to the social norms and institutions within which they were formed? Judith Butler, in her engagement with the work of Pierre Bourdieu, locates this possibility in the nature of `speech acts', and in resistance to social norms emanating from the abjected margins of social life. She criticizes Bourdieu for undermining the promise of agency contained in habitus by reducing it to (...) the social field in which it was constituted, thus re-closing `the iron cage' of structural/institutional determination. For Butler, social norms and institutions, dependent as they are on reiterative performance, are intrinsically open to disruption. It is possible, she claims, using as her example Rosa Parks's historical act of resistance in Montgomery, Alabama in 1955, to resist with authority, yet without prior institutional authorization. This article argues that Butler's theory of iterability works to endow the capacity to authorize against the grain of institutional authority with individuals and their acts and hence neglects the social contexts that inform and de-limit this capacity. `Resisting with authority' is possible precisely because it is not endowed by individuals or their acts, but is collective and interactional. (shrink)

Organ procurement policy from the recently deceased recasts families into gatekeepers of a scarce medical resource. To the frustration of organ procurement teams, families do not always authorize organ donation. As a result, efforts to increase the number of organs available for transplantation often seek to limit the authority of families to refuse organ retrieval. For example, in some locales if a deceased family member has satisfied the legal conditions for first-person prior assent, a much looser and easier standard (...) to satisfy than informed consent, organ retrieval may proceed despite the family’s objections. Some countries have replaced voluntary consent to organ donation with forms of organ conscription. Often referred to under the misnomer “presumed consent,” such policies legalize the harvesting of organs at death, unless individuals exercise official options to opt out. As this article explores, however, there are good grounds for affirming the authority of the family to consent to or to deny organ donation on behalf of recently deceased family members, as well as to reject first-person assent and “presumed consent” policies of organ procurement. Insofar as individuals have failed clearly and competently to provide informed consent to organ donation, moral authorization for the use of the person and his body ought to be grounded on the foundational authority of the family, rather than the state’s supposed interests in obtaining organs for transplantation. (shrink)

In medical care, the obtaining of informed consent is taken to be required prior to treatment in order to ensure that patients sufficiently understand the potential risks and benefits of a given medical procedure. In this paper, I begin by looking at the history of informed consent and consider how the norms and laws in medicine have evolved away from benevolent paternalism and toward a blanket obligation to obtain informed consent. In so doing, I consider what values might be (...) taken to underpin such a requirement. After dismissing some unsatisfactory answers, I offer a positive view as to the constellation of values I think informed consent ought to be protecting. I call these bodily self-sovereignty, which I take to be a coupling of two groups of values: autonomy and non-domination on the one hand, and self-ownership and personal integrity on the other. Given the connection between autonomy and responsibility, autonomy is both required for the act of consenting, and respected by allowing it. And, because of our special and inescapable relationship to our own bodies, this authorization is particularly important when our bodies are involved. So, I suggest that informed consent protects our self-sovereignty over our own bodies. (shrink)

With aims to both increase organ supply and better reflect individual donation preferences, many nations worldwide have shifted from ‘opt‐in’ to ‘opt‐out’ systems for post‐mortem organ donation (PMOD). In such countries, while a prospective donor's willingness to donate their organs/tissues for PMOD was previously ascertained—at least partially—by their having recorded positive donation preferences on an official register prior to death, this willingness is now presumed or inferred—at least partially—from their not having recorded an objection to PMOD—on an official organ (...) donation register. Using evidence regarding the presence and prevalence of selective donation preferences, and via exploration of how appeals to donation preferences are used to both motivate and legitimate shifts to opt‐out frameworks, this paper draws attention to a set of previously unexplored problems for opt‐out organ donation arising in contexts where: (a) individuals demonstrate selective post‐mortem organ/tissue donation preferences, (b) legislation provides prospective donors with the opportunity to selectively permit/refuse the donation of certain organs/tissues in line with these preferences. While selective preferences pose few problems for opt‐in systems where a selective occasion is built into the process of signing the donor register, this is not the case for opt‐out systems. The loss of this selective occasion can cause significant problems where appeals to preferences motivate/legitimate shifts to opt‐out but evidence regarding variable preferences does not feed into determinations regarding organ/tissue exclusions. The nature of these problems depends on how the authorization aspect of ‘opt‐out’ systems is framed (e.g. as presumed consent, deemed consent or, given the role of familial consent in many jurisdictions as consent in name only). (shrink)

Scholars have revealed how moral evaluation is woven into formal administrative processes. While research examining these dynamics tends to assume that a person’s naturalized identity (such as race and gender) precedes administrative processing, we argue that social categorization by administrators is the tacit precondition upon which further processing takes place. We make this argument by looking at a set of unusual cases: parole hearings where prisoners fall outside of, conflict with, or move between categories of gender, sexuality, race, and ability. (...) We find that categorization acts as a prerequisite to moral evaluation. When administrators cannot easily categorize a prisoner, they resolve this uncertainty by denying parole. Yet, social categorization can also serve as a pathway to moral approval and administrative allocation. In certain situations, administrators encourage prisoners’ identification with a new social category as proof that they are deserving of parole. In both cases, successful administrative categorization occurs through a combination of what we call narrativization, or crafting a narrative around one’s identity that aligns with administrators’ presumptions, and authorization, or marshalling official evidence from prior classification moments to support identity claims. These insights extend our understanding of classification, moral evaluation, and the administrative reproduction of inequality. (shrink)

Against the background of high demand for protein-rich feed in the EU and the environmental degradation associated with intensive livestock farming, insect-based feed is discussed as a potential sustainable alternative to conventional feed. However, the establishment of such an innovation depends not only upon technical and economic feasibility, but also on social factors impacting acceptability. The aim of this paper was to determine the acceptability of different social actor groups towards the use of insects as livestock feed, and to gain (...) insights into value-based arguments leading to positive or negative attitudes and perceived benefits and risks. By means of qualitative content analysis, we analysed responses of an EU public consultation process linked to the authorization of insect protein in pig and poultry feed. We found a broad range of value-based arguments that influence the complex judgement process of acceptability that have been neglected in prior quantitative surveys. In particular, our results bring forward more critical voices, such as animal welfare concerns and scepticism that insect-based feed can contribute to a more sustainable livestock system. Based on these findings, we discuss whether insects as feed are a viable contribution to a sustainability-oriented transformation of the agri-food system. We conclude that under certain conditions (when raised on low-value organic side streams such as manure) insect-based livestock feed may contribute to incremental sustainability improvements. Overall, however, the innovation has limitations, not only in terms of regulatory conditions but especially with regard to ethical concerns. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Daemonic Figures: Shakespeare and the Question of ConscienceEric SpencerDaemonic Figures: Shakespeare and the Question of Conscience, by Ned Lukacher; x & 228 pp. Ithaca: Cornell University Press, 1994, $37.50 cloth, $15.95 paper.Daemonic Figures is a specialist’s book twice over. Profiting from it requires not only considerable familiarity with Heidegger, but also unquestioning acceptance of the rhetorical conventions and critical methods of contemporary theory. Lukacher uses these conventions and (...) methods to argue that conscience, properly understood, poses uncomfortable questions about the origins of self-knowledge, and leads to a mysterious but presumably enriching encounter with the limits of our certainty. Shakespeare enters the argument as the supreme example of a poet who discovers, through sensitivity to the ambiguities of language, how to peer without flinching into the Heideggerian abyss. Although the book relies too heavily on Heidegger’s unforgiving idiom, and pauses too seldom to justify suggestive but tenuous claims, at its heart lie hard, interesting questions about what having a conscience means.Lukacher wishes to restore to the idea of conscience all its paradoxical force. As a silent inner voice carrying a moral imperative from elsewhere, conscience immediately suggests an internally divided self. And although, according to Lukacher, Christian tradition locates the source of the imperative in God, and classical tradition in natural law, conscience remains irreducibly “uncanny,” because “the most intimate site of human habitation [i.e., the self] is also the strangest of places, for it is there that the (unfamiliar) god comes to presence through the language of moral judgment that tells us that we are and that because we are what we are we should act thus” (p. 7). For Lukacher, then, the question of conscience is the question of being, a question without an answer because it involves the unthinkable idea of something prior to and beyond being. The book argues that whatever speaks to us under the name of conscience must be both within and without any categories we have to explain it.Hence “daemonic figures”: drawing on the Greek notion of a realm of daimones dwelling between the human and divine worlds, Lukacher claims that the “daemon is the cipher, the name, and the figure for the incontrovertible [End Page 240] ghostliness, the familiar strangeness, that dwells between the perceptions and reflections of consciousness and the enigmatic ground of Being itself” (p. 2), or “the medium in which we come to ourselves as precisely that which is divided from itself... from the outset” (p. 6). And because, in Lukacher’s scheme, language articulates this daemonic mediation, we must seek in literary works which explore conscience—like Hamlet and Macbeth—traces of uncanniness welling up through ostensibly coherent words. Literary value accordingly involves “giving us the words with which to bring that enigmatic lack to presence” (p. 92). Simultaneously ubiquitous and inscrutable, conscience both calls to and evades us, and literature makes its home in such paradoxical territory.It follows that Lukacher seeks in texts brief flashes of something else in the midst of what’s apparently going on, a procedure which constantly risks arbitrary idiosyncrasy. For instance, in his chapter on Hamlet, Lukacher notes that the Player’s description of Priam’s death includes a line—“and with a hideous crash / Takes prisoner Pyrrhus’ ear”—whose sequence of sounds produces a ghostly authorial signature: sh... akes... Pyr... ear. And because this “countersignature” appears fragmented, in a context of hesitation, destruction and decline, Lukacher claims it creates an allegory of the “nonrelation at the heart of self-revelation” (p. 135). That is, it (and the larger drama of Hamlet’s revenge to which it obliquely gestures) reveals that at the heart of authorship, of authorized speech, of the moral law of conscience, lies “the silent play of the letter” (p. 135), the “daemonic figure” of dissolution in the midst of self-assertion, which unsettles all authorization. Hence Hamlet’s famous difficulties—he hears the whisper of Otherness in what ought to be a straightforward moral imperative to vengeance.Lukacher justifies this procedure by noting that “Derrida’s writing, no less than that of Heidegger [and presumably Shakespeare], relies on the invention of figures and metaphors through which... (shrink)

Arthur Prior (1914-69) is regarded as New Zealand's greatest 20th-century philosopher. Until World War II, Prior seriously considered a career as a religious journalist, especially when traveling and living on the Continent and in England with his first wife. During these years, Prior wrote widely on theology and contemporary Christianity. In his correspondence with Ursula Bethell and Hugh Teague, Prior discusses in detail his religious and theological thoughts, including his shift from formal theological study into a (...) world of journalism and philosophy. These previously unknown letters, which cover the years from 1936 to 1941, chronicle a substantial part of a fascinating period in Prior's development, both theologically and philosophically, and have been transcribed and annotated for this volume. (shrink)

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and (...) made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

I. Causal Thesis: Dispositions have a causal basis. II. Distinctness Thesis: Dispositions are distinct from their causal basis. III. Impotence Thesis: Dispositions are not causally active.

This is a revised and expanded edition of a seminal work in the logic and philosophy of time, originally published in 1968. Arthur N. Prior was the founding father of temporal logic, and his book offers an excellent introduction to the fundamental questions in the field. Several important papers have been added to the original selection, as well as a comprehensive bibliography of Prior's work and an illuminating interview with his widow, Mary Prior. In addition, the Polish (...) logic which made Prior's writings difficult for many readers has been replaced by standard logical notation. This new edition will secure the classic status of the book. (shrink)

Getting Emotional -- Constructing Discourse -- Telling and Remembering -- Inviting Emotional Tellings -- Eliciting Feelings -- (re)formulating Emotionality -- Managing Emotionality and Distress -- Being Negative -- Reflecting Back, Moving Forward.

This book was designed primarily as a textbook; though the author hopes that it will prove to be of interests to others beside logic students. Part I of this book covers the fundamentals of the subject the propositional calculus and the theory of quantification. Part II deals with the traditional formal logic and with the developments which have taken that as their starting-point. Part III deals with modal, three-valued, and extensional systems.

“Arthur Prior’s Formal logic has been familiar to students for twenty years, but the historical section that was originally meant to accompany it was never published. In this book P. T. Geach and A. J. P. Kenny have selected from those parts of the material that were not superseded by Prior’s later publications a self-contained study of the philosophical prehistory of contemporary logic. Like Prior’s early work Logic and the Basis of Ethics the material here presented is (...) both historical and critical: Prior was not concerned to decide for us the controverted questions of logical doctrine which he discusses. He may be compared to an experienced judge summing up in a complicated civil action: the case for each side is clearly and fairly presented, and although on some issues the summing-up amounts to a pretty clear direction of the jury, the jurymen themselves are left to decide the issues. The value of such an historical survey is to be measured by the ill effects of ignoring our predecessors’ labours. The course of the philosophy of logic in the decades since Prior wrote these pages has continued to illustrate the saying that those who will not learn the history of philosophy are compelled to relive it.” - Publisher. (shrink)

The general question to which Edwards here addresses himself is "whether any event whatsoever, and volition in particular, can come to pass without a cause of its existence," and among other arguments for a negative answer he has a reductio ad absurdum, arguing that if an act of will can occur without a cause, then anything at all, no matter how fantastic, can occur without a cause. There is, he says in effect, an inner contradiction in the notion that uncaused (...) events are bound always to be acts of will. We must note, however, in following his argument through, that his language is not quite that which I have just used, and in particular he does not speak primarily of what "occurs" but rather of what "begins to be." He says. (shrink)

This paper explores the practice of rewilding and its implications for environmental aesthetic values, qualities and experiences. First, we consider the temporal dimensions of rewilding in regard to the emergence of particular aesthetic qualities over time, and our aesthetic appreciation of these. Second, we discuss how rewilding potentially brings about difficult aesthetic experiences, such as the unscenic and the ugly. Finally, we make progress in critically understanding how rewilding may be understood as a distinctive form of ecological restoration, while resisting (...) the assimilation of rewilding into wilderness discourses. (shrink)

This volume brings together for the first time a collection of studies that investigates how multilingual speakers construct emotions in their talk as a joint discursive practice. The contributions draw on the well established, converging traditions of conversation analysis, discursive psychology, and membership categorization analysis together with recent work on interactional storytelling, stylization, and multimodal analysis. By adopting a discursive approach to emotion in multilingual talk, the volume breaks with the dominant view of emotions as cognitive and intra-psychological phenomena and (...) their study through self-report. Through detailed analyses of original recorded data, the chapters examine how participants produce emotion-implicative actions, identities, stances, and morality through their interactional work in ordinary face-to-face conversation, computer-mediated interaction, institutional talk in medical, educational, and broadcast media settings, and in research interviews. The volume addresses itself to students and researchers interested in language and emotion, multilingual speakers and settings, pragmatics, and discourse analysis. (shrink)

We can best begin from Wilson's "simple little puzzle" about Caesar and Antony: "What would the world be like if Julius Caesar had all the properties of Mark Antony and Mark Antony had all the properties of Julius Caesar?" Wilson's own approach to an answer is indirect--he begins by telling us not what such a world would be like but what it would look like. "Clearly the world would look exactly the same under our supposition." But this assumes that the (...) question "What would such a world look like?" is a proper one; which it surely is not. For his answer to it is meaningless until he specifies to whom this supposed world would look as he says it would. It would look exactly the same to him or to me; but would it have looked the same to Caesar or to Antony? In fact Julius Caesar had the experiences of being called "Julius Caesar," being murdered on the Ides of March, and so on, and these are very different experiences from being called "Mark Antony," dallying on the Nile with Cleopatra, and so on; so I don't see how this alternative course of events could possibly have looked the same to Julius Caesar; or--using a similar line of argument--to Mark Antony. So I cannot agree that, as Wilson goes on to say, "our attempt to describe a distinct possible world has produced just the same old world all over again." I am not, indeed, convinced that even a world which looked to everyone just as the actual one does would necessarily be the same world ; but even putting this doubt aside, since the world mentioned wouldn't look to everyone as the actual world does, it wouldn't be the same even by Wilson's own standards. (shrink)