PhD, Institute of Public Health, Unit of Medical Philosophy and Clinical Theory, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099 1014 Copenhagen. Tel: +45 30 32 33 63; Email: s.lauridsen{at}pubhealth.ku.dk ' + u + '@ ' + d + ' '/ /- ->Citizens’ consent to political decisions is often regarded as a necessary condition of political legitimacy. Consequently, legitimate allocation of healthcare has seemed almost unattainable in contemporary pluralistic societies. The problem is that citizens do not agree on (...) any single principle governing priorities among groups of patients. The Accountability for Reasonableness framework suggests an ingenious solution to this problem of moral disagreement. Rather than advocating any substantive distributive principle, its advocates propose a feasible set of conditions, which, if met by decision makers at the institutional level, provide, so it is promised, legitimate decisions. While we agree that A4R represents an important contribution to the priority-setting debate, we challenge the framework in two respects. First, we argue that A4R, and more specifically the relevance condition of A4R, does not enable healthcare institutions to generally distinguish between relevant and irrelevant reasons for priority-setting. Second, we criticize Daniels’ and Sabin's argument that A4R and deliberative democracy constitute necessary and sufficient conditions of a feasible procedure for setting legitimate limits within healthcare. CiteULike Connotea Del.icio.us What's this? (shrink)

Triage is a widespread principle for prioritizing patients in emergency departments. The purpose of triage is to ensure that in emergency situations, whenever medical demand exceeds medical supply, limited resources should be directed to the case with the greatest clinical need. Triage fulfills this purpose by ranking patients according to how acute their condition is and then giving priority to the most acute ones. In this paper, I argue that this current practice of triage needs to be supplemented. Contemporary triage (...) is based on a principle of preserving patients’ core capabilities, which is relevant when it comes to prioritizing acute patients above sub‐acute ones, but not for prioritizing among sub‐acute patients, which is the largest group of emergency patients. Henceforth, I propose to supplement triage with what I term the real dialogue model, a framework that, when combined with enhanced professional autonomy for clinical decision‐makers, enables fair prioritizing among sub‐acute patients. (shrink)

Advance directives (ADs) have for some time been championed by ethicists and patient associations alike as a tool that people newly diagnosed with dementia, or prior to onset, may use to ensure that their future care and treatment are organized in accordance with their interests. The idea is that autonomous people, not yet neurologically affected by dementia, can design directives for their future care that caregivers are morally obligated to respect because they have been designed by autonomous individuals. In this (...) paper, we first criticize the idea that ADs can retain moral authority in severe dementia by arguing that it is paradoxical. Second, we consider two arguments that initially seem to refute this critique of ADs, but we eventually dismiss them. The first argument states that ADs retain moral authority in severe dementia because autonomously formed interests, for example, ADs, can only be appropriately discarded by autonomous persons. This we term the historical autonomy argument. We dismiss it by demonstrating how we, in analog cases, are not obligated to continue to respect autonomously formed interests even though they have been discarded under nonappropriate conditions. The second argument is that ADs can be justified by what we term external interests. While we agree that people with severe dementia plausible can be said to have external interests, we show that ADs cannot express such interests and hence cannot be justified by them. We conclude that none of the discussed arguments support the use of ADs and because of this, the idea of ADs should be reassigned. (shrink)

We characterise the intermediate logics which admit a cut-free hypersequent calculus of the form \, where \ is the hypersequent counterpart of the sequent calculus \ for propositional intuitionistic logic, and \ is a set of so-called structural hypersequent rules, i.e., rules not involving any logical connectives. The characterisation of this class of intermediate logics is presented both in terms of the algebraic and the relational semantics for intermediate logics. We discuss various—positive as well as negative—consequences of this characterisation.

Rationing healthcare is a difficult task, which includes preventing patients from accessing potentially beneficial treatments. Proponents of implicit rationing argue that politicians cannot resist pressure from strong patient groups for treatments and conclude that physicians should ration without informing patients or the public. The authors subdivide this specific programme of implicit rationing, or “hidden rationing”, into local hidden rationing, unsophisticated global hidden rationing and sophisticated global hidden rationing. They evaluate the appropriateness of these methods of rationing from the perspectives of (...) individual and political autonomy and conclude that local hidden rationing and unsophisticated global hidden rationing clearly violate patients’ individual autonomy, that is, their right to participate in medical decision-making. While sophisticated global hidden rationing avoids this charge, the authors point out that it nonetheless violates the political autonomy of patients, that is, their right to engage in public affairs as citizens. A defence of any of the forms of hidden rationing is therefore considered to be incompatible with a defence of autonomy. (shrink)

Berg, J. Buñuels dagdröm.--Bergström, L. Pessimismens konsekvenser.--Furberg, M. Möjliga teser hos Johannes Climacus.--Halldén, S. Teckenrelationen och språkreglernas juridik.--Hedenius, I. Ett argument mot den rättsfilosofiska domstolsrealismen.--Mates, B. Om Platons argument "den tredje människan."--Marc-Wogau, K. Kant om lögnen.--Næss, A. Om filosofiske projekter som forener empirisk semantikk og metafysisk spekulasjon.--Ofstad, H. Får nazister lettere magesår enn humanister?--Prawitz, D. Om moraliska och logiska satsers sanning.--Stenius, E. Om Descartes' psykofysiska modell.--Tranøy, K. E. Filosofenes etiske ansvar.--Wright, G. H. von. En filosof ser på filosofien.

The inevitable need for rationing of healthcare has apparently presented the medical profession with the dilemma of choosing the lesser of two evils. Physicians appear to be obliged to adopt either an implausible version of traditional professional ethics or an equally problematic ethics of bedside rationing. The former requires unrestricted advocacy of patients but prompts distrust, moral hazard and unfairness. The latter commits physicians to rationing at the bedside; but it is bound to introduce unfair inequalities among patients and lack (...) of political accountability towards citizens. In this paper I shall argue that this dilemma is false, since a third intermediate alternative exists. This alternative, which I term 'administrative gatekeeping', makes it possible for physicians to be involved in rationing while at the same time being genuine advocates of their patients. According to this ideal, physicians are required to follow fair rules of rationing adopted at higher organizational levels within healthcare systems. At the same time, however, they are prohibited from including considerations of cost in their clinical decisions. (shrink)

miembro del Future of Humanity Institute de la Universidad de Oxford y experto en mejoramiento humano y transhumanismo, sobre cuestiones centrales de su labor investigadora.PALABRAS CLAVETRANSHUMANISMO, MEJORAMIENTO HUMANO, ANDERS SANDBERG, BIOTECNOLOGÍAABSTRACTInterview with Anders Sandberg, member of the Future of Humanity Institute at Oxford University and expert in human enhancement and transhumanism, about central topics in his works.KEYWORDSTRANSHUMANISM, HUMAN ENHANCEMENT, ANDERS SANDBERG,BIOTECHNOLOGY.

– The purpose of this paper is to discuss how the use of information technology in schools can influence students’ democratic comprehension., – First, two different ideas of democracy are introduced and how these ideas are linked to cognitivistic and social constructivistic learning theories, respectively, is illustrated. Next, a case study is described, where Engeström’s mediational triangle is used for analysing how the use of interactive whiteboards (IWB) influences the teaching of democracy in a fifth-grade school class., – The paper (...) lists a set of preconditions and recommendations for a use of IWB as support for students’ experience of democracy as a way of living., – As the paper focuses on research design and development of didactical designs, future research and articles can further study the effects of the didactical designs and the democratic comprehension supported hereby. The paper is set in a Danish school context., – It is argued that the IWB can be used as support for developing the students’ democratic comprehension by focusing on and, if necessary, changing the elements of the activity system, e.g. the rules and the roles concerning the use of the IWB., – The paper’s linkage of democratic ideas, learning theory and information technology is relevant for researchers. Teachers can use the paper, as it offers didactical principles for using information technology as support for students’ democratic comprehension. (shrink)

The overarching topic of this dissertation is the semantics and pragmatics of definite descriptions. It focuses on the question whether sentences such as ‘the king of France is bald’ literally assert the existence of a unique king or simply presuppose the existence of such a king. One immediate obstacle to resolving this question is that immediate truth value judgments about such sentences are particularly unstable; some elicit a clear intuition of falsity whereas others simply seem awkward or strange. Because of (...) these variations, truth value judgments are generally considered unreliable. In the first chapter of the dissertation, an explanation of this phenomenon is developed. It is observed that when these types of sentences are considered in the context of a discourse, a systematic pattern in judgments emerges. This pattern, it is argued, should be explained in terms of certain pragmatic factors, e.g. whether a speaker’s utterance is interpreted as cooperative. A detailed and general explanation of the phenomenon is then presented which draws importantly on recent research in the semantics and pragmatics of questions and focus. It is shown that the behavior of these judgments can be systematically explained, that truth value judgments are not as unreliable as standardly assumed, and that the proposed explanation best supports the conclusion that definite descriptions presuppose rather than assert existence. In the second chapter, the following problem is investigated. If definite descriptions are assumed to literally assert existence, a sentence such as ‘Hans wants the ghost in his attic to be quiet’ is incorrectly predicted to be true only if Hans wants there to be a ghost in his attic. This prediction is often considered evidence against Russell’s quantificational analysis and evidence in favor of the referential analysis of Frege and Strawson. Against this claim, it is demonstrated that this problem is a general problem about the existence commitments of natural language determiners, i.e. not an argument in favor of a referential analysis. It is shown that in order to avoid these undesirable predictions, quite radical changes to the semantic framework are required. For example, it must be assumed that a sentence of the form ‘The F is G’ has the open sentence ‘x is G’ as its asserted content. A uniform quantificational and presuppositional analysis of definites and indefinites is outlined which by exploiting certain features of so-called dynamic semantics unproblematically assumes that the asserted contents indeed are open sentences. In view of the proposed quantificational/presuppositional analysis, the dissertation is concluded by a rejection of the argument put forward by Reimer and Devitt that definite descriptions are ambiguous between attributive and referential uses. Reimer and Devitt’s argument is based primarily on the assumption that definite descriptions are conventionally used to communicate singular thoughts and that the conventional meaning of a definite description therefore must be fundamentally indexical/directly referential. I argue that this argument relies crucially on tacit assumptions about semantic processing for which no empirical evidence is provided. I also argue that the argument is too general; if sound, it would be an argument for an indexical treatment of most, if not all, other determiners. I then conclude by demonstrating that the view does not explain any new data and thus has no clear motivation. In short, this dissertation provides a detailed pragmatic explanation of a long-standing puzzle about truth value judgments and then outlines a novel dynamic semantic analysis of definites and indefinites. This analysis solves a significant problem about existence commitments — a problem that neither Russell’s nor the Frege/Strawson analysis are equipped to handle. This analysis is then defended against the claim that definite descriptions are ambiguous. (shrink)

This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support (...) the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy. (shrink)

In this paper, I argue that sufficientarian principles are indispensable in the set of principles that have bearing on issues in distributive ethics. I provide two arguments in favor of this claim. First, I argue that sufficientarianism is the only framework that allows us to appropriately analyze what sort of obligations we have toward individuals who are badly off due to their own faults and choices. Second, I argue that sufficientarianism is the only theory that provides an adequate framework for (...) thinking about the desperately badly off. (shrink)

Many views of utterance comprehension agree that understanding an utterance involves knowing, believing, perceiving, or, anyhow, mentally representing the utterance to mean such-and-such. They include cognitivist as well as many perceptualist views; I give them the generic label ‘representationalist’. Representationalist views have been criticized for placing an undue metasemantic demand on utterance comprehension, viz. that speakers be able to represent meaning as meaning. Critics have adverted to young speakers, say about the age of three, who do comprehend many utterances but (...) may be rather limited in their abilities to think about meaning as such, to cast doubt on this demand. This paper motivates representationalism, examines what the balance of developmental evidence and arguments shows, and identifies options for a representationalist response. Though there is some evidence that three-year-olds have limited abilities to think about meaning as such, they may yet turn out to have a concept of meaning, or at least some proto-semantic concept. Moreover, even if they lack any such concept, there is, I propose, a way of developing representationalism, drawing inspiration from Davidson’s paratactic view of indirect speech reports, on which meaning can be non-conceptually represented. Independently of developmental considerations, this paratactic-style proposal is of interest to friends of a perceptualist view of comprehension. (shrink)

How should one understand comparisons in which neither of two alternatives is at least as good as the other? Much recent literature on comparability problems focuses on what the appropriate explanation of the phenomenon is. Is it due to vagueness or the possibility of non-conventional comparative relations such as parity? This paper argues that the discussions on how to best explain comparability problems has reached an impasse at which it is hard to make any progress. To advance the discussion we (...) suggest a new classification of comparability problems that focuses on the problems they cause for practical reasoning. (shrink)

The orthodox view of proper names, Millianism, provides a very simple and elegant explanation of the semantic contribution of referential uses of names–names that occur as bare singulars and as the argument of a predicate. However, one problem for Millianism is that it cannot explain the semantic contribution of predicative uses of names. In recent years, an alternative view, so-called the-predicativism, has become increasingly popular. According to the-predicativists, names are uniformly count nouns. This straightforwardly explains why names can be used (...) predicatively, but is prima facie less congenial to an analysis of referential uses. To address this issue, the-predicativists argue that referential names are in fact complex determiner phrases consisting of a covert definite determiner and a count noun—and so, a referential name is a definite description. In this paper, I will argue that despite the appearance of increased theoretical complexity, the view that names are ambiguous between predicative and referential types is in fact superior to the unitary the-predicativist view. However, I will also argue that to see why this ambiguity view is better, we need to give up the standard Millian analysis. Consequently, I will first propose an alternative analysis of referential names that retains the virtues of Millianism, but provides an important explanatory connection to the predicative uses. Once this analysis of names is adopted, the explanation for why names are systematically ambiguous between referential and predicative types is both simple and elegant. Second, I will argue that the-predicativism has the appearance of being simpler than an ambiguity view, but is in fact unable to account for certain key properties of referential names without making ad hoc stipulations. (shrink)

A wide range of gene knockout experiments shows that functional stability is an important feature of biological systems. On this backdrop, we present an argument for higher‐level causation based on counterfactual dependence. Furthermore, we sketch a metaphysical picture providing resources to explain the metaphysical nature of functional stability, higher‐level causation, and the relevant notion of levels. Our account aims to clarify the role empirical results and philosophical assumptions should play in debates about reductionism and higher‐level causation. It thereby contributes to (...) the development of a philosophical foundation for systems biology. †To contact the authors, please write to: CSMN/IFIKK, University of Oslo, Box 1020 Blindern, N‐0315, Oslo, Norway; e‐mail: anders[email protected] , [email protected]. (shrink)

Anders, Rudi To solve a problem such as wars between nations and civil wars it is necessary to discover what causes the problem.

Values in Bioethics (ViB), co-sponsored by the International Association of Bioethics, makes available original philosophical books in all areas of bioethics, including medical and nursing ethics, health care ethics, research ethics, environmental ethics, and global bioethics. --.

This guide accompanies the following article: ‘Logic and Divine Simplicity’. Philosophy Compass 6/4 : pp. 282–294, doi: Author’s IntroductionFirst‐order formalizations of classical theistic doctrines are increasingly used in contemporary work in philosophy of religion and philosophical theology, as a means for clarifying the conceptual structure of the doctrines and their role in inferential procedures. But there are a variety of different ways in which such doctrines have been formalized, each representing the doctrines as having different conceptual structures. Moreover, the adequacy (...) of such formalizations as such has, at least with respect to some classes of doctrines, been disputed. One reason for disputing their adequacy derives from the conceptual impact of classical theism’s doctrine of divine simplicity.Author RecommendsFrege, Gottlob ‘Begriffsschrift: a formula language of pure thought,’ trans. Michael Beany, in The Frege Reader, ed. Beany. Oxford: Blackwell, pp. 47–78. The preface contains interesting remarks about the purpose of formalization as understood by the chief pioneer of modern formal logic. These remarks are also connected by Frege to his views on the relation between thought and language more generally.Russell, Bertrand, and Whitehead, A.N. Principia Mathematica, Vol. I. Cambridge: Cambridge University Press.The preface and first section of the long introduction contain remarks on the purpose and advantages of formalization. Chapter 1 of the introduction contains what is probably one of the first formalizations ever of a theistic doctrine, and is given in terms of a definite description analysis.Suppes, Patrick ‘The Desirability of Formalization in Science,’The Journal of Philosophy, Vol. 65, No. 20, pp. 651–64.Clear and concise discussion of some of the advantages of formalization in philosophical inquiry, written by a prominent contemporary American philosopher‐logician.Nieznański, Edward ‘The Beginnings of Formalization in Theology,’ in Advances in Scientific Philosophy: Essays in Honour of Paul Weingartner, eds. Gerhard Schurz and Gregory J.W. Dorn. Amsterdam and Atlanta, GA: Ropodi, pp. 551–9.A valuable paper that narrates, among other things, the programme of formalizing theistic doctrines that emerged in Poland in the 1920s under the influence of the Lvov‐Warsaw School. Various examples of formalizations are also given.Quine, W.V.O. Mathematical Logic. Cambridge, MA: Harvard University Press.In Section 27 of this classic study, Quine offers a formalization of theistic doctrines which seeks to avoid the difficulties of earlier formalizations by means of a subtle extensional singleton set analysis. The proposal has not won many adherents, but is worthy of careful study nonetheless.Woleński, Jan ‘Theism, Fideism, Atheism, Agnosticism,’ in Logic, Ethics and All That Jazz: Essays in Honour of Jordan Howard Sobel, eds. Lars‐Göran Johansson, Jan Österberg, and Rysiek Sliwinski. Uppsala: Uppsala Philosophical Studies, pp. 387–400.A concise but lucid survey of some attempts to formalize theistic doctrines and some problems besetting these attempts. Woleński also proposes his own method of formalization, which could be described as a simplified version of Quine’s method in Mathematical Logic.Bocheński, Joseph The Logic of Religion. New York: New York University Press.The first book‐length treatment of the relation between modern logic and theism. It covers much ground, and remains very readable.Alston, William P. ‘Religious Language and Verificationism,’ in The Rationality of Theism, eds. Paul Moser and Paul Copan. London: Routledge, pp. 17–34.Identifies some problems with attempts at articulating theistic doctrines by means of subject‐predicate language. Highly relevant to formalizations of theistic doctrines, even though this topic is not dealt with explicitly.Kraal, Anders ‘Logic and Divine Simplicity,’Philosophy Compass.Offers a survey of three main methods of formalizing theistic doctrines, and of some variants of these methods. Argues that certain formalizations of theistic doctrines are bound to be rejected as conceptually inadequate by all who understand the doctrines at hand within the framework provided by the traditional doctrine of divine simplicity.Sample Syllabus Week I: The Idea of Formalization and the Project of Formalizing Theistic Doctrines Reading:Frege, Gottlob ‘Begriffsschrift: a formula language of pure thought,’ trans. Michael Beany, in The Frege Reader, ed. Beany. Oxford: Blackwell, pp. 47–78. Russell, Bertrand, and Whitehead, A.N. Principia Mathematica, Vol. I. Cambridge: Cambridge University Press. Suppes, Patrick ‘The Desirability of Formalization in Science,’The Journal of Philosophy, Vol. 65, No. 20, pp. 651–64.Nieznański, Edward ‘The Beginnings of Formalization in Theology,’ in Advances in Scientific Philosophy: Essays in Honour of Paul Weingartner, eds. Gerhard Schurz and Gregory J.W. Dorn. Amsterdam and Atlanta, GA: Ropodi, pp. 551–9. Week II: Formalizing Theistic Doctrines: Three Alternative Methods Reading:Woleński, Jan ‘Theism, Fideism, Atheism, Agnosticism,’ in Logic, Ethics and All That Jazz: Essays in Honour of Jordan Howard Sobel, eds. Lars‐Göran Johansson, Jan Österberg, and Rysiek Sliwinski. Uppsala: Uppsala Philosophical Studies, pp. 387–400.Russell, Bertrand, and Whitehead, A.N. Principia Mathematica, Vol. I. Cambridge: Cambridge University Press. Quine, W.V.O. Mathematical Logic. Cambridge, MA: Harvard University Press. Week III: Arguments for and Against Some Formalizations of Theistic Doctrines Reading:Bocheński, Joseph The Logic of Religion. New York: New York University Press. Kraal, Anders ‘Logic and Divine Simplicity,’Philosophy Compass, Vol. 6, No. 4, pp. 282–94.Focus Questions1 What do Frege, Russell and Whitehead, and Suppes understand the purpose or purposes of logical formalization to be, and why do they think formalization can achieve these purposes?2 Woleński sketches some simple ways of formalizing theistic doctrines such as ‘God exists’ or ‘God is almighty’ in terms of 1‐place predicates which he subsequently abandons in favour of other methods. What reasons lead him to abandon these more simple methods of formalization?3 What are the advantages of the definite description formalization of theistic doctrines offered by Russell and Whitehead?4 Quine offers a subtle formalization of the theistic doctrine ‘God exists’ in terms of singleton sets. What problems are Quine’s formalization intended to accommodate, and how does it seek to accommodate them?5 Which relative merits or demerits are there in Bocheński’s and Kraal’s respective arguments for and against the adequacy of certain formalizations of theistic doctrines? (shrink)

BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...) promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

Anders, Rudi When I see a colourful sunset, my mind goes to a spectacular purple sunset I saw near the Mexican border many years ago. That memory stops me from being fully aware of the scene in front of me. No two sunsets are the same and my memory is stopping me from fully appreciating the spectacle before my eyes. Famous and spectacular places don't work for me because expectations and memories get in the way, but when I walk (...) alone in nature I find my mind stops chattering and I begin to effortlessly notice the shades of green in the foliage, the patterns in the bark on the trees and the sounds and fragrances. It sometimes feels as if am absorbed by the surroundings. When this happens I don't bother with the names of birds or flowers because even that distracts from direct experience. (shrink)

This paper argues that cost-effectiveness analysis in the healthcare sector introduces a discrimination risk that has thus far been underappreciated and outlines some approaches one can take toward this. It is argued that appropriate standards used in cost-effectiveness analysis in the healthcare sector fail to always fully determine an optimal option, which entails that cost-effectiveness analysis often leaves decision makers with large sets of permissible options. Larger sets of permissible options increase the role of decision makers’ biases, whims, and prejudices, (...) which means that the discrimination risk increases. Two ways of mitigating this are identified: tinkering with standards used in the cost-effectiveness analysis and outlining anti-discrimination guidelines for decision makers. (shrink)

Following decades of neglect, the work of the German Jewish philosopher, literary author, cultural critic, and poet Günther Anders (1902–1992) is gaining increasing recognition in the English-speaking world. This translation of “Résistance heute” (Resistance Today) makes one of Anders’s most programmatic and polemical short texts available. Published at the height of his anti-nuclear activism, “Resistance Today” is the written version of a speech Anders delivered in November 1962 upon acceptance of the northwest Italian city of Omegna’s Resistance (...) Prize (other notable recipients included Jean-Paul Sartre and Frantz Fanon). It first appeared in print in the West German left-wing journal Das Argument in November 1963. Clearly written for the occasion, the text condenses (and often further radicalizes) key premises about the end of history, the amoral character of work, and the continuity between Nazi totalitarianism, the nuclear age and the world of consumerism that are developed in great nuance across a range of books that Anders had recently published. Key co-ordinates include: Die Antiquiertheit des Menschen 1 (The Obsolescence of Human Beings 1, 1956), his groundbreaking critique of technology; Der Mann auf der Brücke (The Man on the Bridge, 1959), a philosophical travel diary occasioned by Anders’s 1958 visit to Japan and his participation at the World Conference Against Atomic and Hydrogen Bombs in Tokyo; Burning Conscience (1961), a correspondence with the American reconnaissance pilot Claude Eatherly, who scouted the target area before the Enola Gay went on to drop the atom bomb on Hiroshima. It seems likely that Burning Conscience, which turned into an international bestseller, occasioned the award of the prize. (shrink)

Abstract Normative criteria for evaluations of economic and social outcomes are often formulated in terms of social welfare functions which are essentially and importantly non-satiable. However, there are good reasons to consider certain normative criteria and many policy objectives to be capped, i.e. bounded, and thus satiable provided sufficient resources are made available for their satisfaction. Inspired by the Foster–Greer–Thorbecke class of indicators, this paper uses an interdisciplinary approach to develop a model for assessing outcomes in terms of capped objectives (...) based on an understanding of individual shortfalls from the objective, denoted needs. We present an indicator to measure need satisfaction in a population of individuals with heterogeneous needs and highlight an aggregation problem under scarcity. For such situations, we develop three ways in which the indicator can be weighted that reflect respectively concerns over the frequency, depth and severity of the need shortfalls and show that normative evaluations based on these weighting schemes can conflict, yielding mutually inconsistent outcome rankings. The indicator can be adapted to measure a wide variety of phenomena, e.g. health needs, education shortfalls, deprivation, etc., and it is suited for targeting exercises and other policy implementations. In particular, it allows for exogenous weighting schemes, i.e. weights that can incorporate non-shortfall characteristics relevant for the evaluation, e.g. age, gender, ethnicity, etc. The indicator thus enables new ways for researchers to promote and study satiable objectives in a wide variety of contexts relevant to economic and social policy, e.g. human development programs, poverty reduction, healthcare policies, etc. (shrink)

This article presents an approach to how to make reasonable social choices when independent criteria (e.g., prioritarianism, religious freedom) fail to fully determine what to do. The article outlines different explanations of why independent criteria sometimes fail to fully determine what to do and illustrates how they can still be used to eliminate ineligible alternatives, but it is argued that the independent criteria cannot ground a reasonable social choice in these situations. To complement independent criteria when they fail to fully (...) determine what to do, it is suggested that society must engage in public deliberation by way of generating new reasons that can determine how to rank the alternatives. It is suggested that the approach to social choice presented here reveals a way of accepting the relevance of independent criteria for social choice without letting go of the idea that the attitudes of affected parties matter. (shrink)

Lifetime quality-adjusted life-year (QALY) prioritarianism has recently been defended as a reasonable specification of the prioritarian view that benefits to the worse off should be given priority in health-related priority setting. This paper argues against this view with reference to how it relies on implausible assumptions. By referring to lifetime QALY as the basis for judgments about who is worse off lifetime QALY prioritarianism relies on assumptions of strict additivity, atomism and intertemporal separability of sublifetime attributes. These assumptions entail that (...) a health state at some period in time contributes with the same amount to how well off someone is regardless of intrapersonal and interpersonal distributions of health states. The paper argues that this is implausible and that prioritarians should take both intrapersonal and interpersonal distributions of goods into account when they establish who is worse off. They should therefore not accept that lifetime QALY is a reasonable ground for ascribing priority and reject lifetime QALY prioritarianism. (shrink)

The possibility of enhancing human abilities often raises public concern about equality and social impact. This chapter aims at one particular group of technologies, cognitive enhancement, and one particular fear, that enhancement will create social divisions and possibly expanding inequalities. The chapter argues that cognitive enhancements could offer significant social and economic benefits. The basic forms of internal cognitive enhancement technologies foreseen today are pharmacological modifications, genetic interventions, transcranial magnetic stimulation, and neural implants. Cognitive enhancements can influence the economy through (...) reduction of losses, individual economic benefits, and society‐wide benefits. The strongest objection to the introduction of any enhancement technology is that it will create inequality, injustice, and unfairness. While there are clear economic and social benefits to cognitive enhancement, there exist anumber of obstacles to its development and use. One obstacle is the present system for licensing drugs and medical treatments. (shrink)

The need for education for (as opposed to about) sustainability is urged from many sides. Initiatives in this area tend to focus on formal education. Governmental, supra-governmental and non-governmental bodies all expect much of this kind of education, which is to transform children—and through them society—in the direction of sustainability. Due to the combination of great transformative expectations or ambitions and a focus on schooling (the idea of) compulsory environmental education poses potentially severe problems for governments committed to liberal principles, (...) in particular the principle of state 'neutrality' with respect to 'comprehensive conceptions of the good life'. The central question of this article is whether liberal governments can make environmental education of this kind compulsory without coming into conflict with the liberal principle of state neutrality. I discuss three defences of the compatibility of compulsory environmental education with liberal neutrality, namely those put forward by Derek Bell, Andrew Dobson, and Simon Hailwood, as well as some problems inherent in these defences. In the final section I sketch a form of compulsory environmental education that realises at least some of the aims commonly stated for Education for Sustainability and Education for Sustainable Development, and can be justified on the basis of liberal principles. (shrink)

A notorious debate in the ethics of healthcare rationing concerns whether to address rationing decisions with substantial principles or with a procedural approach. One major argument in favour of procedural approaches is that substantial principles are indeterminate so that we can reasonably disagree about how to apply them. To deal with indeterminacy, we need a just decision process. In this paper I argue that it is a mistake to abandon substantial principles just because they are indeterminate. It is true that (...) reasonable substantial principles designed to deal with healthcare rationing can be expected to be indeterminate. Yet, the indeterminacy is only partial. In some situations we can fully determine what to do in light of the principles, in some situations we cannot. The conclusion to draw from this fact is not that we need to develop procedural approaches to healthcare rationing, but rather that we need a more complex theory in which both substantial principles and procedural approaches are needed. (shrink)

Anders, Rudi They dance in view, they dance in secret. And yet they dance together...

In the initial phase of the COVID-19 pandemic, Sweden’s response stood out as an exception. For example, Sweden did not introduce any lockdowns, while many other countries did. In this paper I take the Swedish Corona Commission’s critique of the initial Swedish response as a point of departure for a general analysis of precaution in relation to pandemics. The Commission points out that in contrast to many other countries Sweden did not follow ‘the precautionary principle’. Based on this critique, the (...) Commission proposes that the precautionary principle should be included among Sweden’s guiding principles for crisis management. However, as the debate on this principle during the last 30 years indicates, the principle is loaded with problems. I discuss one of these problems, namely its lack of clarity. I argue, however, that this problem is not unsurmountable. A principle is lacking clarity precisely by being a principle and not a rule with a well-defined meaning. As a principle it indicates a direction but does not prescribe a specific action. However, to be action-guiding its content needs to be specified by rational deliberation. With this in mind, I propose a framework for specification of the precautionary principle as applied to pandemics. The framework focuses on the principle’s four key elements: threat, uncertainty, action and responsibility. I also suggest certain general ethical restrictions on specification. (shrink)