Some healthcare systems are said to be grounded in solidarity because healthcare is funded as a form of mutual support. This article argues that health care systems that are grounded in solidarity have the right to penalise some users who are responsible for their poor health. This derives from the fact that solidary systems involve both rights and obligations and, in some cases, those who avoidably incur health burdens violate obligations of solidarity. Penalties warranted include direct patient contribution to costs, (...) and lower priority treatment, but not typically full exclusion from the healthcare system. We also note two important restrictions on this argument. First, failures of solidary obligations can only be assumed under conditions that are conducive to sufficiently autonomous choice, which occur when patients are given ‘Golden Opportunities’ to improve their health. Second, because poor health does not occur in a social vacuum, an insistence on solidarity as part of healthcare is legitimate only if all members of society are held to similar standards of solidarity. We cannot insist upon, and penalise failures of, solidarity only for those who are unwell, and who cannot afford to evade the terms of public health. (shrink)

Purposeful infection of healthy volunteers with a microbial pathogen seems at odds with acceptable ethical standards, but is an important contemporary research avenue used to study infectious diseases and their treatments. Generally termed ‘controlled human infection studies’, this research is particularly useful for fast tracking the development of candidate vaccines and may provide unique insight into disease pathogenesis otherwise unavailable. However, scarce bioethical literature is currently available to assist researchers and research ethics committees in negotiating the distinct issues raised by (...) research involving purposefully infecting healthy volunteers. In this article, we present two separate challenge studies and highlight the ethical issues of human challenge studies as seen through a well-constructed framework. Beyond the same stringent ethical standards seen in other areas of medical research, we conclude that human challenge studies should also include: independent expert reviews, including systematic reviews; a publicly available rationale for the research; implementation of measures to protect the public from spread of infection beyond the research setting; and a new system for compensation for harm. We hope these additions may encourage safer and more ethical research practice and help to safeguard public confidence in this vital research alternative in years to come. (shrink)

The idea of using responsibility in the allocation of healthcare resources has been criticized for, among other things, too readily abandoning people who are responsible for being very badly off. One response to this problem is that while responsibility can play a role in resource allocation, it cannot do so if it will leave those who are responsible below a “sufficiency” threshold. This paper considers first whether a view can be both distinctively sufficientarian and allow responsibility to play a role (...) even for those who will be left with very poor health. It then draws several further distinctions that may affect the application of responsibility at this level. We conclude that a more plausible version of the sufficientarian view is to allow a role for responsibility where failure to do so will leave someone else who is not responsible below the sufficiency threshold. However, we suggest that individuals must exhibit “sufficient responsibility” in order for this to apply, involving both a sufficient level of control and an avoidable failure to respond adequately to reasons for action. (shrink)

To explain the phenomenon that certain English verbs resist passivization, Pinker proposed a semantic constraint on the passive in the adult grammar: The greater the extent to which a verb denotes an action where a patient is affected or acted upon, the greater the extent to which it is compatible with the passive. However, a number of comprehension and production priming studies have cast doubt upon this claim, finding no difference between highly affecting agent-patient/theme-experiencer passives and non-actional experiencer theme passives. (...) The present study provides evidence that a semantic constraint is psychologically real, and is readily observed when more fine-grained independent and dependent measures are used. We conclude that a semantic constraint on the passive must be incorporated into accounts of the adult grammar. (shrink)

According to, when forming complex yes/no questions, children do not make errors such as Is the boy who smoking is crazy? because they have innate knowledge of structure dependence and so will not move the auxiliary from the relative clause. However, simple recurrent networks are also able to avoid such errors, on the basis of surface distributional properties of the input (; ). Two new elicited production studies revealed that (a) children occasionally produce structure‐dependence errors and (b) the pattern of (...) children's auxiliary‐doubling errors (Is the boy who is smoking is crazy?) suggests a sensitivity to surface co‐occurrence patterns in the input. This article concludes that current data do not provide any support for the claim that structure dependence is an innate constraint, and that it is possible that children form a structure‐dependent grammar on the basis of exposure to input that exhibits this property. (shrink)

This introductory chapter offers an overview of the various ways that responsibility may be relevant to health care, in order to situate the chapters in this volume in their broader context. The chapter begins by outlining relevant concepts, and explaining why it is worth considering the role of responsibility in health care. The chapter then turns to various ways in which patients might be held responsible in a health care system, before considering objections to these practices. Finally, the chapter considers (...) the role of responsibility in health care beyond holding patients responsible, by considering the responsibility of medical professionals, and of institutions. (shrink)

A volume with 14 chapters on various aspects of the relationship between responsibility and healthcare, plus a substantial introduction that offers a comprehensive overview of the relevant debates and how they relate to one another. Questions of responsibility arise at all levels of health care. Most prominent has been the issue of patient responsibility. Some health conditions that risk death or serious harm are partly the result of lifestyle behaviours such as smoking, lack of exercise, or extreme sports. Are patients (...) with such conditions responsible for them? If so, might healthcare providers, be they state-run systems or private entities, be justified in treating such patients differently? And if they are, which forms of differential treatment are justified? Responsibility isn’t just relevant for patients. Even when individuals affect their health through voluntary behaviour, other influences are also at work before, during, and after the patient’s interaction with the health care system. What are the responsibilities of individual clinicians and other medical professionals, when thinking about individual and public health? What about institutions such as governments or national health care services, or society as a whole? This collection brings together work by world-renowned experts in population ethics, distributive justice, philosophy of action, cognitive science, and medical ethics in order to push the debate forward by elucidating our understanding of these questions, their possible answers, and how they are related. (shrink)

This study aims to disentangle the often-confounded effects of input frequency and morphophonological complexity in the acquisition of inflection, by focusing on simple and complex verb forms in Japanese. Study 1 tested 28 children aged 3;3–4;3 on stative and simple past forms, and Study 2 tested 30 children aged 3;5–5;3 on completive and simple past forms, with both studies using a production priming paradigm. Mixed effects models for children's responses were built to test the prediction that children's verb use is (...) explained by the relative bias in input frequency between the two inflectional forms. Although Study 1 did not show a significant effect of input bias, Study 2, which corrected for this problem, yielded the predicted relationship. These findings suggest that input frequency effects, at the level of different inflectional forms of the same verb stem, hold even after controlling for morphophonological complexity. (shrink)

All accounts of language acquisition agree that, by around age 4, children’s knowledge of grammatical constructions is abstract, rather than tied solely to individual lexical items. The aim of the present research was to investigate, focusing on the passive, whether children’s and adults’ performance is additionally semantically constrained, varying according to the distance between the semantics of the verb and those of the construction. In a forced‐choice pointing study (Experiment 1), both 4‐ to 6‐year olds (N = 60) and adults (...) (N = 60) showed support for the prediction of this semantic construction prototype account of an interaction such that the observed disadvantage for passives as compared to actives (i.e., fewer correct points/longer reaction time) was greater for experiencer‐theme verbs than for agent‐patient and theme‐experiencer verbs (e.g., Bob was seen/hit/frightened by Wendy). Similarly, in a production/priming study (Experiment 2), both 4‐ to 6‐year olds (N = 60) and adults (N = 60) produced fewer passives for experiencer‐theme verbs than for agent‐patient/theme‐experiencer verbs. We conclude that these findings are difficult to explain under accounts based on the notion of A(rgument) movement or of a monostratal, semantics‐free, level of syntax, and instead necessitate some form of semantic construction prototype account. (shrink)

Whilst certain verbs may appear in both the intransitive inchoative and the transitive causative constructions (The ball rolled/The man rolled the ball), others may appear in only the former (The man laughed/*The joke laughed the man). Some accounts argue that children acquire these restrictions using only (or mainly) statistical learning mechanisms such as entrenchment and pre-emption. Others have argued that verb semantics are also important. To test these competing accounts, adults (Experiment 1) and children aged 5–6 and 9–10 (Experiment 2) (...) were taught novel verbs designed to be construed — on the basis of their semantics — as either intransitive-only or alternating. In support of the latter claim, participants' grammaticality judgments revealed that even the youngest group respected these semantic constraints. Frequency (entrenchment) effects were observed for familiar, but not novel, verbs (Experiment 1). We interpret these findings in the light of a new theoretical account designed to yield effects of both verb semantics and entrenchment/pre-emption. (shrink)

On 26 January 2021, while announcing that the country had reached the mark of 100,000 deaths within 28 days of COVID-19, UK Prime Minister Boris Johnson said that he took “full responsibility for everything that the Government has done” as part of British efforts to tackle the pandemic. The force of this statement was undermined, however, by what followed: -/- What I can tell you is that we truly did everything we could, and continue to do everything that we can, (...) to minimise loss of life and to minimise suffering... -/- Taking these sentiments together, it was hard to avoid the conclusion that the government took responsibility only for doing everything right. Such an admission of responsibility, accommodating no admission of error or wrongdoing, is not really about responsibility at all. Indeed, the UK’s pandemic response has been marked from its earliest days by a shifting of focus from institutional responsibility to personal responsibility for individual UK residents. -/- This paper explores the relationship between these two sites of responsibility—the institutional and the personal—in the context of the sort of pandemic that is ongoing as we write. Section 2 offers some initial definitions and discussions of key terms. Section 3 outlines how these two ideas interact in principle during such emergencies. Section 4 turns to the ‘non-ideal’ implications for personal responsibility of failures of institutional responsibility. While our focus is on the specific context with which we are most familiar, the UK governmental approach, where appropriate we also include examples from other states. (shrink)

There is an ongoing debate in medicine about whether patients have a ‘right not to know’ pertinent medical information, such as diagnoses of life-altering diseases. While this debate has employed various ethical concepts, probably the most widely-used by both defenders and detractors of the right is autonomy. Whereas defenders of the right not to know typically employ a ‘liberty’ conception of autonomy, according to which to be autonomous involves doing what one wants to do, opponents of the right not to (...) know often employ a ‘duty’ understanding, viewing autonomy as involving an obligation to be self-governing. The central contribution of this paper is in showing that neither view of autonomy can reasonably be said to support the extreme stances on the right not to know that they are sometimes taken to. That is, neither can a liberty view properly defend a right not to know without limits, nor can a duty view form the basis of an absolute rejection of the right not to know. While there is still theoretical distance between these two approaches, we conclude that the views are considerably closer on this issue than they first appear, opening the way for a possible compromise. (shrink)

Confronted by contemporary neoliberal crisis, apparently rooted in economistic, or even nihilistic worldviews, the task for the [sociologist] is not simply to impose … critique from without, but to...

If musical works are abstract objects, which cannot enter into causal relations, then how can we refer to musical works or know anything about them? Worse, how can any of our musical experiences be experiences of musical works? It would be nice to be able to sidestep these questions altogether. One way to do that would be to take musical works to be concrete objects. In this paper, we defend a theory according to which musical works are concrete objects. In (...) particular, the theory that we defend takes musical works to be fusions of performances. We defend this view from a series of objections, the first two of which are raised by Julian Dodd in a recent paper and the last of which is suggested by some comments of his in an earlier paper. (shrink)

Previous studies have shown that children retreat from argument‐structure overgeneralization errors (e.g., *Don’t giggle me) by inferring that frequently encountered verbs are unlikely to be grammatical in unattested constructions, and by making use of syntax‐semantics correspondences (e.g., verbs denoting internally caused actions such as giggling cannot normally be used causatively). The present study tested a new account based on a unitary learning mechanism that combines both of these processes. Seventy‐two participants (ages 5–6, 9–10, and adults) rated overgeneralization errors with higher (...) (*The funny man’s joke giggled Bart) and lower (*The funny man giggled Bart) degrees of direct external causation. The errors with more‐direct causation were rated as less unacceptable than those with less‐direct causation. This finding is consistent with the new account, under which children acquire—in an incremental and probabilistic fashion—the meaning of particular constructions (e.g., transitive causative = direct external causation) and particular verbs, rejecting generalizations where the incompatibility between the two is too great. (shrink)

New reproductive technologies allow parents some choice over their children. Various moral principles have been suggested to regulate such choices. This article starts from a discussion of Julian Savulescu's Principle of Procreative Beneficence, according to which parents ought to choose the child expected to have the best quality of life, before combining two previously separate lines of attack against this principle. First, it is suggested that the appropriate moral principles of guiding reproductive choices ought to focus on general wellbeing (...) rather than prioritizing that of the child and, second, that they ought to be non-maximizing. Though neither of these suggestions is entirely novel, combining them results in a new, and arguably more plausible, principle to regulate procreative choices, which I call the Principle of Generalized Procreative Non-Maleficence. According to this principle, the primary obligation on parents is not to cause harm to other people through their reproductive choices. (shrink)

A work of music is repeatable in the following sense: it can be multiply performed or played in different places at the same time, and each such datable, locatable performance or playing is an occurrence of it: an item in which the work itself is somehow present, and which thereby makes the work manifest to an audience. As I see it, the central challenge in the ontology of musical works is to come up with an ontological proposal (i.e. an account (...) of what sort of thing a work of music is) which enables us to explain what such repeatability consists in, whilst doing maximal justice to the way in which we conceive of musical works in our reflective critical and appreciative practice. To this end, many have found it tempting to defend some version or other of the type-token theory : the thesis that a work is a type and its occurrences are its tokens. Much of the early debate prompted by the publication of Jerrold Levinson's seminal 'What a Musical Work Is' in 1980 has taken the type-token theory for granted, choosing to focus on how musical works, qua types, are individuated. (A key question here has been whether we should hold, with the sonicist , that works are identical just in case they sound exactly alike; or whether we should agree with Levinson's contextualist thesis that exact sound-alikes are distinct, if composed in distinct musico-historical contexts.) More recently, however, the type-token theory itself has been put under pressure, and alternatives have been suggested. So, e.g. Gregory Currie and David Davies have held versions of the thesis that musical works (and artworks generally) are acts of composition, whilst Guy Rohrbaugh has recommended that we think more innovatively about our metaphysical categories, and treat musical works (along with all repeatable artworks) as historical individuals . Historical individuals, like particular substances, come into and go out of existence, could have been somewhat different than they are, and can change through time; but such items, unlike particular substances, are nonetheless capable of having occurrences. In the last few years, ontologists of music have also stepped back to consider the very nature of their enterprise. In particular, a debate has ensued concerning the cogency of ontological proposals (such as those of Nelson Goodman, Nicholas Wolterstorff and Julian Dodd) that are substantially revisionary of our folk concept of a work of music. Amie Thomasson, David Davies and Andrew Kania occupy, to a greater or lesser degree, the descriptivist standpoint, according to which such revisionary ontologies are misconceived. The debate between revisionists and descriptivists in the ontology of music – if prosecuted against the backdrop of an awareness of developments in meta-ontology more generally – is a particularly fertile area in the philosophy of music at present. Author Recommends Wollheim, Richard. Art and its Objects . 2nd ed. Cambridge: Cambridge University Press, 1980. This seminal study nicely introduces and motivates the type-token theory, and in the course of doing so, helpfully, although perhaps contentiously, distinguishes types from both sets and properties. Wollheim's treatment was to a large part responsible for stimulating the subsequent debate as to the ontological nature of musical works. Levinson, Jerrold. 'What a Musical Work Is.' Journal of Philosophy 77 (1980); reprinted in his Music, Art and Metaphysics , 63–88. This paper has, perhaps, been the most influential account of the nature of musical works, post-Wollheim. Presuming the type-token theory to be correct, Levinson elaborates it by claiming musical works to be, not sound structures (i.e. structured patterns of sound-types), but a species of types he calls indicated structures . According to Levinson, a work of music is not to be identified with its sound structure, S ; it is, in fact, a compound of S and a performance-means structure, PM , as indicated (typically, via a score) by its composer on a certain occasion : something that we can represent as S/PM -as-indicated-by- X -at- t . Such indicated structures, Levinson argues, fit the bill for being what works of music are, because they come into being with their indication (i.e. their composition), are individuated in terms of the musico-historical context in which they were composed, and have their specified performance-means (i.e. their instrumentation) essentially. Wolterstorff, Nicholas. Works and Worlds of Art . Oxford: Clarendon Press, 1980. Part I of this book sees Wolterstorff defend a Platonistic version of the type-token theory (although Wolterstorff calls them 'kinds' rather than 'types'). According to Wolterstorff, considerations about the existence conditions of types commit us to the thesis that works of music, qua types, are entities that cannot come into or go out of existence. Kivy, Peter. 'Platonism in Music: A Kind of Defence.' Grazer Philosophische Studien 19 (1983): 109–29. In this article, Kivy ingeniously (and wittily) defends a variety of Platonism about works of music against the animadversions of Levinson. Currie, Gregory. An Ontology of Art . New York: St, Martin's Press, 1989. Here Currie introduces and defends the thesis that works of music (and, indeed, all artworks) are compositional action-types. The book also contains some well-aimed criticisms of Levinson's account. Dodd, Julian. Works of Music: An Essay in Ontology . Oxford: Oxford University Press, 2007. In this book, Dodd defends the type-token theory, but argues that no version of it can escape the Platonisic consequence that musical works exist at all times (and hence, are discovered, rather than created, by their composers). Dodd also defends another controversial thesis, this time concerning musical works' individuation. According to Dodd, and pace Levinson and others, sonicism is correct: works that sound exactly alike are identical. Rohrbaugh, Guy. 'Artworks as Historical Individuals.' European Journal of Philosophy 11 (2003): 177–205. In this essay, Rohrbaugh makes some pointed criticisms of the type-token theory of repeatable artworks in the course of arguing that such works should be viewed, not as types, but as historical individuals (see above). Rohrbaugh suggests that treating musical works as historical individuals best captures our intuitions about such works' temporal and modal characteristics, and, in the course of elaborating his position, he makes some meta-ontological claims that see him endorsing a non-revisionary, descriptivist approach to the ontology of art. As Rohrbaugh sees it, ontologies of art are 'beholden to our artistic practices' (179), and 'aesthetics should not be beholden to the metaphysics on offer, but rather should drive new work in metaphysics' (197). Ridley, Aaron. 'Against Musical Ontology,' Journal of Philosophy 100 (2003): 203–220. This paper sees Ridley outlining a sceptical attitude towards the project of formulating ontological proposals. In his view, a 'serious philosophical engagement with music is orthogonal to, and may well in fact be impeded by, the pursuit of ontological issues' (203). Thomasson, Amie. 'The Ontology of Art and Knowledge in Aesthetics.' JAAC 63 (2005:221–9). Thomasson defends descriptivism in the ontology of art by arguing that such a position is a consequence of the only defensible solution to a problem in the theory of reference: the so-called 'qua' problem concerning how the reference of a term can be fixed. Davies, David. Art as Performance . Oxford: Blackwell, 2004. Davies' position is characterised by two theses: one methodological, the other ontological. The methodological claim is that the ontology of art faces a pragmatic constraint : roughly speaking, the ontology of art is answerable to the epistemology of art. The ontological claim is that the rigorous enforcement of the pragmatic constraint commits us to the thesis that all artworks are compositional action-tokens. Online Materials http://www.blackwell-compass.com/subject/philosophy/article_view?article_id=phco_articles_bpL173 Dodd, Julian. 'Musical Works: Ontology and Meta-Ontology.' Philosophy Compass 3/6 (2008): 1113–34. doi: [DOI link] http://www3.interscience.wiley.com/journal/118557784/abstract Thomasson, Amie. 'Debates about the Ontology of Art: What are We Doing Here?' Philosophy Compass 1/3 (2006): 245–55. doi: [DOI link] http://www3.interscience.wiley.com/journal/122517227/abstract Davies, David. 'Works and Performances in the Performing Arts.' forthcoming in Philosophy Compass . doi: [DOI link] http://plato.stanford.edu/entries/music/ Kania, Andrew. 'The Philosophy of Music.' Stanford Encyclopedia of Philosophy . Sample Mini-Syllabus Week 1: The Type/Token Theory Introduced Wollheim, Richard. Art and its Objects , §§4–8, 21–3, 35–7. Kivy, Peter. Introduction to a Philosophy of Music , chapter 11. Oxford: Clarendon Press, 2002. Dodd, Julian. Works of Music: An Essay in Ontology , chapter 1. Wolterstorff, Nicholas. Works and Worlds of Art , chapter 2. Week 2: The Type/Token Theory and Platonism in Music Wolterstorff, Nicholas. Works and Worlds of Art , chapter 2. Levinson, Jerrold. 'What a Musical Work Is'. Dodd, Julian. Works of Music: An Essay in Ontology , chapters 2–5. Kivy, Peter. 'Platonism in Music: A Kind of Defence.' Grazer Philosophische Studien 19 (1983): 109–29. Kivy, Peter. 'Platonism in Music: Another Kind of Defence.' American Philosophical Quarterly 24 (1987): 245–52. Predelli, Stefano. 'Against Musical Platonism.' British Journal of Aesthetics 35 (1995): 338–50. Caplan, Ben and Carl Matheson. 'Can a Musical Work be Created?' British Journal of Aesthetics 44 (2004): 113–34. Week 3: Musical Works as Indicated Structures Levinson, Jerrold. 'What a Musical Work Is'. Levinson, Jerrold. 'What a Musical Work Is, Again', in his Music, Art and Metaphysics . Ithaca, NY: Cornell UP, 1990. 215–63. Dodd, Julian. 'Musical Works as Eternal Types.' British Journal of Aesthetics 40 (2000). Davies, Stephen. Musical Works and Performances: A Philosophical Account , chapter 2. Oxford: Oxford University Press, 2000. Howell, Robert. 'Types, Indicated and Initiated.' British Journal of Aesthetics 42 (2002): 105–27. Caplan, Ben and Carl Matheson. 'Fine Individuation.' British Journal of Aesthetics 47 (2007): 113–37. Week 4: Musical Work as Historical Individuals Rohrbaugh, Guy. 'Artworks as Historical Individuals'. Dodd, Julian. Works of Music: An Essay in Ontology , chapter 6. Caplan, Ben and Carl Matheson. 'Defending Musical Perdurantism.' British Journal of Aesthetics 46 (2006): 59–69. Caplan, Ben and Carl Matheson. 'Defending "Defending Musical Perdurantism".' British Journal of Aesthetics 48 (2008): 331–37. Week 5: Musical Works as Compositional Actions Currie, Gregory. An Ontology of Art . New York: St, Martin's Press, 1989. Davies, David. Art as Performance . Oxford: Blackwell, 2004. Dodd, Julian. Works of Music: An Essay in Ontology , chapter 7. Week 6: Meta-ontology of Music: What are we Doing When we do the Ontology of Music? Ridley, Aaron. 'Against Musical Ontology'. Thomasson, Amie. 'The Ontology of Art and Knowledge in Aesthetics'. Thomasson, Amie. Ordinary Objects , chapter 11. OUP, 2007. Davies, David. 'The Primacy of Practice in the Ontology of Art.' Journal of Aesthetics and Art Criticism 67 (2009): 159–72. Kania, Andrew. 'Piece for the End of Time: In Defence of Musical Ontology,' British Journal of Aesthetics 48 (2008): 65–79. Kania, Andrew. 'The Methodology of Musical Ontology: Descriptivism and its Implications.' British Journal of Aesthetics 48 (2008): 426–44. Cameron, Ross. 'There are No Things That are Musical Works.' British Journal of Aesthetics 48 (2008): 295–314. Dodd, Julian. 'Musical Works: Ontology and Meta-Ontology.' Philosophy Compass 3/6 (2008): 1113–1134. doi: [DOI link] Focus Questions 1. Are musical works literally created by their composers? 2. Critically examine Levinson's thesis that musical works are 'indicated structures'. 3. What, if anything, is wrong with the thesis that musical works are identical just in case they sound exactly alike? 4. Should we immediately be sceptical of ontological proposals for works of music that are substantially revisionary of the way in which we ordinarily think of them? (shrink)

There has been much argument over whether procreative selection is obligatory or wrong. Rebecca Bennett has recently challenged the assumption that procreative choices are properly moral choices, arguing that these views express mere preferences. This article challenges Bennett's view on two fronts. First, I argue that the Non-Identity Problem does not show that there cannot be harmless wrongs – though this would require us to abandon the intuitively attractive ‘person-affecting principle’, that may be a lesser cost than abandoning some more (...) firmly-held intuition. But, even if we accept Bennett's claim that these choices are not moral, that does not show them to be mere personal preferences. I argue that there is a class of non-moral ‘categorical preferences’ that have much the same implications as moral preferences. If a moral preference for able-bodied children is problematic, then so is a non-moral categorical preference. Thus, showing that these preferences are not moral does not show that they are not problematic, since they may still be categorical. (shrink)

Liberty-restricting measures have been implemented for centuries to limit the spread of infectious diseases. This article considers if and when it may be ethically acceptable to impose selective liberty-restricting measures in order to reduce the negative impacts of a pandemic by preventing particularly vulnerable groups of the community from contracting the disease. We argue that the commonly accepted explanation—that liberty restrictions may be justified to prevent harm to others when this is the least restrictive option—fails to adequately accommodate the complexity (...) of the issue or the difficult choices that must be made, as illustrated by the COVID-19 pandemic. We introduce a dualist consequentialist approach, weighing utility at both a population and individual level, which may provide a better framework for considering the justification for liberty restrictions. While liberty-restricting measures may be justified on the basis of significant benefits to the population and small costs for overall utility to individuals, the question of whether it is acceptable to discriminate should be considered separately. This is because the consequentialist approach does not adequately account for the value of equality. This value may be protected through the application of an additional proportionality test. An algorithm for making decisions is proposed. Ultimately whether selective liberty-restricting measures are imposed will depend on a range of factors, including how widespread infection is in the community, the level of risk and harm a society is willing to accept, and the efficacy and cost of other mitigation options. (shrink)

Strategies to increase influenza vaccination rates have typically targeted healthcare professionals and individuals in various high-risk groups such as the elderly. We argue that they should focus on increasing vaccination rates in children. Because children suffer higher influenza incidence rates than any other demographic group, and are major drivers of seasonal influenza epidemics, we argue that influenza vaccination strategies that serve to increase uptake rates in children are likely to be more effective in reducing influenza-related morbidity and mortality than those (...) targeting HCPs or the elderly. This is true even though influenza-related morbidity and mortality amongst children are low, except in the very young. Further, we argue that there are no decisive reasons to suppose that children-focused strategies are less ethically acceptable than elderly or HCP-focused strategies. (shrink)

En el albor del siglo XXI, se necesita promover políticas sociales que potencien la Educación para la Salud, en consonancia con la Agenda 2030 de Naciones Unidas. Se ha procedido a comparar las políticas sociales relacionadas con la Educación para la Salud promulgadas en los territorios españoles según algunas metas establecidas en la Agenda 2030. Mediante un análisis comparativo con el software Atlas.ti versión 22, se han obtenido los resultados, evidenciando que las políticas sociales están sufriendo una transformación pero con (...) diferencias. Se observa que cada vez son más necesarios los compromisos políticos respaldados por una normativa que los acompañe. (shrink)

This ar ti cle pro poses to out line a gen eral itin er ary as to the emer gence of a gen der pro - posal based on fem i nism and its pro mo tion in the in ter na tional and Latin Amer i can en vi ron ment. It also de fines this cat e gory which dates from XVII cen tury France, and of fers some..

Este artículo introduce a las "coordenadas" principales de la temática de intercultural. Entendida en primer lugar como movimiento de carácter teórico-práctico, irreductible a un sentido exclusivamente lógico, racional o filosófico. Si bien, ha suscitado el nacimiento de un nuevo modelo de la filosofía -y su concepción de racionalidad- que ya se extiende a diversos lugares del mundo, con una producción bibliográfica significativa. Abriéndose a nuevos sujetos/as, textos, contextos y pretextos que nos revelan múltiples facetas y dimensiones de la realidad, de (...) que son portadores. Algunos descriptores de la interculturalidad serían que es: un horizonte "descentrado", una opción y experiencia, una alternativa liberadora. (shrink)

While anti-exceptionalism about logic is now a popular topic within the philosophy of logic, there’s still a lack of clarity over what the proposal amounts to. currently, it is most common to conceive of AEL as the proposal that logic is continuous with the sciences. Yet, as we show here, this conception of AEL is unhelpful due to both its lack of precision, and its distortion of the current debates. Rather, AEL is better understood as the rejection of certain traditional (...) properties of logic. The picture that results is not of one singular position, but rather a cluster of often connected positions with distinct motivations, understood in terms of their rejection of clusters of the various traditional properties. In order to show the fruitfulness of this new conception of AEL, we distinguish between two prominent versions of the position, metaphysical and epistemological AEL, and show how the two positions need not stand or fall together. (shrink)

Adaptive preference formation is the unconscious altering of our preferences in light of the options we have available. Jon Elster has argued that this is bad because it undermines our autonomy. I agree, but think that Elster's explanation of why is lacking. So, I draw on a richer account of autonomy to give the following answer. Preferences formed through adaptation are characterized by covert influence (that is, explanations of which an agent herself is necessarily unaware), and covert influence undermines our (...) autonomy because it undermines the extent to which an agent's preferences are ones that she has decided upon for herself. This answer fills the lacuna in Elster's argument. It also allows us to draw a principled distinction between adaptive preference formation and the closely related phenomenon of character planning. (shrink)

Decision-making Capacity matters to whether a patient’s decision should determine her treatment. But why it matters in this way isn’t clear. The standard story is that dmc matters because autonomy matters. And this is thought to justify dmc as a gatekeeper for autonomy – whereby autonomy concerns arise if but only if a patient has dmc. But appeals to autonomy invoke two distinct concerns: concern for authenticity – concern that a choice is consistent with an individual’s commitments; and concern for (...) sovereignty – concern that an individual exercises control over that which is hers to control. Here, I argue, neither concern can alone explain why dmc matters. Instead, dmc matters because it indicates a harmony between the two concerns – the demands of each concern are more likely to agree if a patient has dmc. This vindicates the standard story, but also makes clear that dmc is an inappropriate gatekeeper for autonomy. (shrink)

Epicurus seems to have thought that death is not bad for the one who dies, since its badness cannot be located in time. I show that Epicurus’ argument presupposes Presentism, and I argue that death is bad for its victim at all and only those times when the person would have been living a life worth living had she not died when she did. I argue that my account is superior to competing accounts given by Thomas Nagel, Fred Feldman and (...) Neil Feit. (shrink)

The literature on conscientious objection in medicine presents two key problems that remain unresolved: Which conscientious objections in medicine are justified, if it is not feasible for individual medical practitioners to conclusively demonstrate the genuineness or reasonableness of their objections? How does one respect both medical practitioners’ claims of conscience and patients’ interests, without leaving practitioners complicit in perceived or actual wrongdoing? My aim in this paper is to offer a new framework for conscientious objections in medicine, which, by bringing (...) medical professionals’ conscientious objection into the public realm, solves the justification and complicity problems. In particular, I will argue that: an “Uber Conscientious Objection in Medicine Committee” —which includes representatives from the medical community and from other professions, as well as from various religions and from the patient population—should assess various well-known conscientious objections in medicine in terms of public reason and decide which conscientious objections should be permitted, without hearing out individual conscientious objectors; medical practitioners should advertise their conscientious objections, ahead of time, in an online database that would be easily accessible to the public, without being required, in most cases, to refer patients to non-objecting practitioners. (shrink)

There is significant controversy over whether patients have a ‘right not to know’ information relevant to their health. Some arguments for limiting such a right appeal to potential burdens on others that a patient’s avoidable ignorance might generate. This paper develops this argument by extending it to cases where refusal of relevant information may generate greater demands on a publicly funded healthcare system. In such cases, patients may have an ‘obligation to know’. However, we cannot infer from the fact that (...) a patient has an obligation to know that she does not also have a right not to know. The right not to know is held against medical professionals at a formal institutional level. We have reason to protect patients’ control over the information that they receive, even if in individual instances patients exercise this control in ways that violate obligations. (shrink)

We develop positive model theory, which is a non first order analogue of classical model theory where compactness is kept at the expense of negation. The analogue of a first order theory in this framework is a compact abstract theory: several equivalent yet conceptually different presentations of this notion are given. We prove in particular that Banach and Hilbert spaces are compact abstract theories, and in fact very well-behaved as such.

In the nineteenth century, astronomers thought that a planet between Mercury and the Sun was causing perturbations in the orbit of Mercury, and they introduced ‘Vulcan’ as a name for such a planet. But they were wrong: there was, and is, no intra-Mercurial planet. Still, these astronomers went around saying things like (2) Vulcan is a planet between Mercury and the Sun. Some philosophers think that, when nineteenth-century astronomers were theorizing about an intra-Mercurial planet, they created a hypothetical planet.

Among the areas of knowledge that the method of reflective equilibrium (RE) has been applied to is that of logical validity. According to RE in logic, we come to be justified in believing a (deductive) logical theory in virtue of establishing some state of equilibrium between our initial judgements over the validity of specific (natural language) arguments and the logical principles which constitute our logical theory. Unfortunately, however, while relatively popular, RE with regards to logical theorizing is underspecified. In particular, (...) it’s unclear what constitute: (1) the relevant logical “data”, (2) logical theories, so that they can be suitably tested, and (3) the mechanisms under which such theories are tested. Considering the various options for how to interpret the position, we argue that in order to be workable the advocate of RE about logic must embrace what we call an _operationalised_, _wide_ and _communal_ version of RE with a _rich_ understanding of logical theories. Fortunately for the advocate of RE, there is an available account of logic’s epistemology which possesses just these properties, _logical predictivism_. However, equally unfortunately, logical predictivism commits the advocate of RE to certain further claims that they have historically been weary of holding. Consequently, it is unclear whether RE about logic itself is a viable proposal, or rather a similar but distinct epistemology of logic. (shrink)

Accoding to G.E. Moore, something''s intrinsic valuedepends solely on its intrinsic nature. Recently Thomas Hurka andShelly Kagan have argued, contra Moore, that something''s intrinsic valuemay depend on its extrinsic properties. Call this view the ConditionalView of intrinsic value. In this paper I demonstrate how a Mooreancan account for purported counterexamples given by Hurka and Kagan. I thenargue that certain organic unities pose difficulties for the ConditionalView.

This book concerns the foundations and implications of a particular form of liberal political theory. Colburn argues that one should see liberalism as a political theory committed to the value of autonomy, understood as consisting in an agent deciding for oneself what is valuable and living life in accordance with that decision. Understanding liberalism this way offers solutions to various problems that beset liberal political theory, on various levels. On the theoretical level, Colburn claims that this position is the only (...) defensible theory of liberalism in current circulation, arguing that other more dominant theories are either self-contradictory or unattractive on closer inspection. And on the practical level, Colburn draws out the substantive commitments of this position in educational, economic, and social policy. Hence, the study provides a blueprint for a radical liberal political agenda which will be of interest to philosophers and to politicians alike. (shrink)

There is an ongoing increase in the use of mobile health technologies that patients can use to monitor health-related outcomes and behaviours. While the dominant narrative around mHealth focuses on patient empowerment, there is potential for mHealth to fit into a growing push for patients to take personal responsibility for their health. I call the first of these uses ‘medical monitoring’, and the second ‘personal health surveillance’. After outlining two problems which the use of mHealth might seem to enable us (...) to overcome—fairness of burdens and reliance on self-reporting—I note that these problems would only really be solved by unacceptably comprehensive forms of personal health surveillance which applies to all of us at all times. A more plausible model is to use personal health surveillance as a last resort for patients who would otherwise independently qualify for responsibility-based penalties. However, I note that there are still a number of ethical and practical problems that such a policy would need to overcome. The prospects of mHealth enabling a fair, genuinely cost-saving policy of patient responsibility are slim. (shrink)

Virtue ethics has long provided fruitful resources for the study of issues in medical ethics. In particular, study of the moral virtues of the good doctor—like kindness, fairness and good judgement—have provided insights into the nature of medical professionalism and the ethical demands on the medical practitioner as a moral person. Today, a substantial literature exists exploring the virtues in medical practice and many commentators advocate an emphasis on the inculcation of the virtues of good medical practice in medical education (...) and throughout the medical career. However, until very recently, no empirical studies have attempted to investigate which virtues, in particular, medical doctors and medical students tend to have or not to have, nor how these virtues influence how they think about or practise medicine. The question of what virtuous medical practice is, is vast and, as we have written elsewhere, the question of how to study doctors’ moral character is fraught with difficulty. In this paper, we report the results of a first-of-a-kind study that attempted to explore these issues at three medical schools in the United Kingdom. We identify which character traits are important in the good doctor in the opinion of medical students and doctors and identify which virtues they say of themselves they possess and do not possess. Moreover, we identify how thinking about the virtues contributes to doctors’ and medical students’ thinking about common moral dilemmas in medicine. In ending, we remark on the implications for medical education. (shrink)

Thanks to David Kaplan (1989a, 1989b), we all know how to handle indexicals like ‘I’. ‘I’ doesn’t refer to an object simpliciter; rather, it refers to an object only relative to a context. In particular, relative to a context C, ‘I’ refers to the agent of C. Since different contexts can have different agents, ‘I’ can refer to different objects relative to different contexts. For example, relative to a context cwhose agent is Gottlob Frege, ‘I’ refers to Frege; relative to (...) a context 0* whose agent is Alexius.. (shrink)

Social epistemologists often operationalize the task of indirectly assessing experts’ trustworthiness to identifying whose beliefs are more reliably true on matters in an area of expertise. Not only does this neglect the philosophically rich space between belief formation and testimonial utterances, it also reduces trustworthiness to reliability. In ethics of trust, by contrast, explicitly relational views of trust include things like good will and responsiveness. One might think that relational aspects can be safely set aside for social epistemology of trust (...) in experts, that such considerations may be relevant for personal relationships but not for expert trustworthiness. Against these claims I argue for the social-epistemic relevance of relational aspects of trust in experts, and to that end I discuss three sorts of considerations – responsively positive, neutral, and negative factors – that can make a difference for expert trustworthiness. (shrink)

It is natural to think that there is a tight connection between whether someone is responsible for some outcome and whether it is appropriate to hold her accountable for that outcome. And this natural thought naturally extends to health: if someone is responsible for her health, then, all else being equal, she is accountable for it. Given this, some have thought that responsibility for health has an important role to play in distributing the benefits and burdens of healthcare. But there (...) is a reason for caution. That health is influenced by social, economic, and environmental factors is a matter of consensus. And some have argued that in light of these social determinants of health, individuals are not typically responsible for their health, rendering inappropriate policies that employ a responsibility‐for‐health criterion. This debate implicates a number of overlapping concepts and questions that are often difficult to pull apart. And I worry that those who maintain that social determinants undermine responsibility for health have latched on to the wrong target. The social determinants of health are relevant to such policies, but, I argue, not by globally undermining responsibility. Rather, social determinants are sometimes responsibility‐undermining, sometimes responsibility‐preserving, and often relevant to whether we should hold individuals accountable for their health regardless of their responsibility. This calls for a more nuanced appraisal of the ways in which the social determinants of health are relevant to such policies. And here I attempt to provide one. (shrink)

Acceding to the demand that public policy should be based on “the best available evidence” can come at significant moral cost. Important policy questions cannot be addressed using “the best available evidence” as defined by the evidence-based policy paradigm; the paradigm can change the meaning of questions so that they can be addressed using the preferred kind of evidence; and important evidence that does not meet the standard defined by the paradigm can get ignored. We illustrate these problems in three (...) contexts of evidence-based policy. (shrink)

Greg Bognar has recently offered a prioritarian justification for ‘fair innings’ distributive principles that would ration access to healthcare on the basis of patients' age. In this article, I agree that Bognar's principle is among the strongest arguments for age-based rationing. However, I argue that this position is incomplete because of the possibility of ‘time-relative' egalitarian principles that could complement the kind of lifetime egalitarianism that Bognar adopts. After outlining Bognar's position, and explaining the attraction of time-relative egalitarianism, I suggest (...) various ways in which these two kinds of principle could interact. Since various options have very different implications for age-based rationing, proponents of such a rationing scheme must take a position on time-relative egalitarianism to complement a lifetime prioritarian view like Bognar's. (shrink)

In this paper I present and defend a highly demanding principle of justice in education that has not been seriously discussed thus far. According to the suggested approach, “all the way equality”, justice in education requires nothing short of equal educational outcome between all individual students. This means not merely between equally able children, or between children from different groups and classes, but rather between all children, regardless of social background, race, sex and ability. This approach may seem implausible at (...) first, due to the far-reaching implications it entails, primarily its requirement to deny better-off children their advantage for the sake of equality. However the paper argues that all-the-way-equality, in fact, does a better job realizing the goals of justice in education than alternative conceptions of justice. It is further argued that at least some of the principle’s most radical consequences, those that make it seem counterintuitive, can be mitigated by balancing all-the-way-equality with competing interests. (shrink)

The reason for characterizing mental states as propositional attitudes is sentence form: ‘S Vs that p’. However, many mental states are not ascribed by means of such sentences, and the sentences that ascribe them cannot be appropriately paraphrased. Moreover, even if a paraphrase were always available, that in itself would not establish the characterization. And the mental states that are ascribable by appropriate senses do not form any natural subset of mental states. A reason for the characterization relying on beliefs, (...) etc., about non‐existing things is also rejected. Last, some sentences ascribing abilities and dispositions have the same grammatical form as some senses that ascribe mental states, so that the attempt to paraphrase the latter would obscure the conceptual relations between the two sorts. It follows that mental states are not relations to propositions. (shrink)

Descriptivists say that every name is synonymous with some definite description, and Descriptivists who are Widescopers say that the definite description that a name is synonymous with must take wide scope with respect to modal adverbs such as “necessarily”. In this paper, I argue against Widescopism. Widescopers should be Super Widescopers: that is, they should say that the definite description that a name is synonymous with must take wide scope with respect to complementizers such as “that”. Super Widescopers should be (...) Super Duper Widescopers: that is, they should say that the definite description that a name is synonymous with must take wide scope with respect to quotation marks. And Super Duper Widescopers should be Ultra Super Duper Widescopers: that is, they should say that, when the definite description that a name is synonymous with itself contains a name, the definite description that that name is synonymous with must take wide scope with respect to modal adverbs, complementizers, and quotation marks. But Descriptivists should not be Ultra Super Duper Widescopers. So Descriptivists should not be Widescopers either. (shrink)