In the field of health technology assessment, there are several approaches that can be used for ethical analysis. However, there is a scarcity of literature that critically evaluates and compares the strength and weaknesses of these approaches when they are applied in practice. In this paper, we analyse the applicability of some selected approaches for addressing ethical issues in HTA in the field of complex health interventions. Complex health interventions have been the focus of methodological attention in HTA. However, the (...) potential methodological challenges for ethical analysis are as yet unknown.Six of the most frequently described and applied ethical approaches in HTA were critically assessed against a set of five characteristics of complex health interventions: multiple and changing perspectives, indeterminate phenomena, uncertain causality, unpredictable outcomes, and ethical complexity. The assessments are based on literature and the authors’ experiences of developing, applying and assessing the approaches.The Interactive, participatory HTA approach is by its nature and flexibility, applicable across most complexity characteristics. Wide Reflective Equilibrium is also flexible and its openness to different perspectives makes it better suited for complex health interventions than more rigid conventional approaches, such as Principlism and Casuistry. Approaches developed for HTA purposes are fairly applicable for complex health interventions, which one could expect because they include various ethical perspectives, such as the HTA Core Model® and the Socratic approach.This study shows how the applicability for addressing ethical issues in HTA of complex health interventions differs between the selected ethical approaches. Knowledge about these differences may be helpful when choosing and applying an approach for ethical analyses in HTA. We believe that the study contributes to increasing awareness and interest of the ethical aspects of complex health interventions in general. (shrink)

All too often it is said that common-sense philosophers faIl to justify their appeal to common sense as a philosophical standard, and that they merely repeat one another in the glorification of philosophical trivialities. This book challenges these and ot.

Récemment, dans The Problem of the Criterion, Roderick M. Chisholm distinguait deux stratégies visant à résoudre le problème du cercle vicieux, à savoir, celle des «particularistes» pour lesquels il faut d'abord établir ce qu'on sait, partant, formuler les criteres de la connaissance et celle des « méthodistes » qui entendent établir d'abord les critères de la connaissance, partant, son étendue. Voici done notre problème formulé, puisque Chisholm considère Descartes comme un exemple de stratégic «méthodiste» et Thomas Reid ainsi que G.E. (...) Moore comme des exemples de stratégie «particulariste», ces derniers illustrant d'ailleurs la stratégie «la plus raisonnable». Dans le cas de Reid cependant, on verra que même s'il se livre à une critique de la démarche cartésienne, la tentative de réponse au problème du cercle vicieux est chez lui aussi de type «méthodiste», dès lors, susceptible d'une circularité comparable à celle qu'il reproche à Descartes. (shrink)

En parlant des rapports entre la Nouvelle Rhétorique et la France, Pierre-André Taguieff décrivait la situation comme celle d'un rendez-vous manqué. En parlant des rapports entre la philosophie pérelmanienne et la philosophie anglo-saxonne, il faut surtout parler de rendez-vous clandestins. Car dans l'ensemble, ces rendez-vous divers sont d'autant plus évidents qu'ils témoignent sans doute de l'influence réelle d'une philosophie. D'une philosophie dont on retrouve, dans le milieu anglo-saxon, un «air de famille» mais sans que Chaïm Perelman ne soit expressément nommé.

In this revealing volume, nineteen leading philosophers open a window on the inner life of atheism, shattering common stereotypes as they reveal how they came to turn away from religious belief. These highly engaging personal essays capture the marvellous diversity to be found among atheists, providing a portrait that will surprise most readers. Many of the authors express great affection for particular religious traditions, even as they explain why they cannot embrace them. Philosophers Without Gods demonstrates convincingly, with arguments that (...) date back to Plato, that morality is independent of the existence of God. Collectively, these essays highlight the richness of atheistic belief – not only as a valid alternative to religion, but as a profoundly fulfilling and moral way of life. (shrink)

Analysant les caractéristiques majeures des notions contemporaines d'égalité à la lumière d'une bibliographie que l'auteur publiera bientôt, cette étude montre les contradictions qui existent dans la documentation actuelle entre les études traitant implicitement ou explicitement d'égalité, ainsi que l'importance de sept caractéristiques marquantes des théories de l'égalité du XXe siècle. L'auteur soutient que les griefs courants concernant l'absence de clarté de la notion contemporaine d'égalité découlent d'une manière significative d'une réduction systématique de l'ensemble des possibilités ouvertes par la documentation actuelle (...) dans son ensemble, plutôt que de l'absence de définition de l'égalité.Analyzing the major features of the contemporary notions of equality on the basis of the author's forthcoming bibliography on the subject, this paper shows the contradictions between the implicit and the explicit literature on the subject, the main catagories by virtue of which one must assess the contemporary approaches on equality, and the importance of seven outstanding features of XXth Century equality theories. It is argued that current grievances concerning the lack of clarity of the contemporary notion of equality results in a significant manner from the systematic reduction of all the possibilities opened by the present literature on equality as a whole, rather than from a lack of definition of equality. (shrink)

More and more frequently, the general question whether there is an identifiable feminist methodology for investigating historical and philosophical writings about ‘the problem of women’ is raised. As of yet, there is no general, let alone systematic answer to this question, and many would claim it to be unanswerable. Ultimately, indeed, nothing short of the creation of an entirely new form of rationality would seem to be required, if the issue is to replace the so-called phallocentric grammar of our culture.My (...) suggestion here is that a significant way to provide elements of answers to this general question is to analyze works already done in this field with the view of delineating some of the conditions under which an adequate treatment of the women issue can be made. One such condition will be discussed here. It will be claimed that unless one is clear about the issue of equality, one cannot address the central issue raised by most writings on women. (shrink)

An initial distinction is made between two ways of referring in thought to a particular object. One can think of an object in virtue of having a descriptive condition in mind which uniquely denotes that object. Alternatively, one can think about a particular in a more direct way. It is with the nature of this more direct sort of reference that the subsequent discussion is primarily concerned. ;It has been argued that the relation of direct reference is purely causal in (...) nature. A number of difficulties are raised for this causal view. A diagnosis of these difficulties suggests that the causal view ignores the cognitive aspects of direct reference. ;The idea that direct reference is a cognitive relation is not new. Bertrand Russell's notion of knowledge by acquaintance can be thought of as involving the idea of a relation of reference which is direct and cognitive. A good place to begin an exploration of the cognitive dimensions of direct reference is with Russell's notion of acquaintance. Thus this notion is analysed in some depth. ;An objection to the effect that acquaintance is a relation incapable in principle of playing a role in an account of reference is shown to be unfounded. This clears the way for an extended discussion of the nature of acquaintance. This discussion suggests that we should posit a special demonstrative way in which objects can be presented to us. This demonstrative way of being presented with an object is in turn explored by way of an extended metaphor, in which it is suggested that becoming acquainted with an object should be thought of as the opening of a mental file of a special sort for that object. ;Some indirect support for this account of demonstrative modes of presentation and the associated account of direct reference comes from the fact that these notions can help solve the problem of cognitive significance that has been thought to pose a serious threat to theories that somehow treat reference as direct. ;Finally, some potential counterexamples are examined and shown not to seriously threaten the acquaintance theory of direct reference. (shrink)

This article explores refusal of medical treatment by adult patients from ethical and legal perspectives. Initially, consequentialist and deontological ethical theory are outlined. The concepts of autonomy, paternalism and competence are described and an overview of Beauchamp and Childress’s principle-based approach to moral reasoning is given. Relevant common law is discussed and the provisions of the Mental Capacity Act 2005 in assessing competence is evaluated. In order to demonstrate the consideration of moral issues in clinical practice, ethical theory is applied (...) to two well-known incidents: the case of Re MB, where doubt over decision-making capacity led to a paternalistic act to override a patient’s choice; and the death of Emma Gough, a situation where respect for autonomy prevailed when healthcare staff acted lawfully in following a patient’s refusal of life-saving treatment. Finally, guidance from regulatory bodies on the roles and responsibilities of health professionals in relation to this topic are considered. (shrink)

This article marks a decisive step towards the recovery of the French woman writer, journalist, and aviation pioneer Louise Faure-Favier, who today is virtually forgotten. The article begins by sit...

The central premise of this book is that biblical Hebrew narrative, in terms of its structure, tends to operate under similar mechanical constraints to those of a stage-play; wherein space is central, characters are fluid, and objects within the narrative tend to take on a deep internal significance. The smaller episodic narrative units within the Hebrew aesthetic tend to grant primacy to space, both ideologically and at the mechanical level of the text itself. However space, as a determinate structural category, (...) has been all but overlooked in the field of biblical studies to date; reflecting perhaps our own inability, as modern readers, to see beyond the dominant cinematic aesthetic of our times. The book is divided into two major sections, each beginning with a more theoretical approach to the function of narrative space, and ending with a practical application of the previous discussion; using Genesis 28:10-22 (the Bethel narrative) and the book of Ruth respectively, as test cases.Where does the notion of free will come from? How and when did it develop, and what did that development involve? In Michael Frede's radically new account of the history of this idea, the notion of a free will emerged from powerful assumptions about the relation between divine providence, correctness of individual choice, and self-enslavement due to incorrect choice. Anchoring his discussion in Stoicism, Frede begins with Aristotle--who, he argues, had no notion of a free will--and ends with Augustine. Frede shows that Augustine, far from originating the idea (as is often claimed), derived most of his thinking about it from the Stoicism developed by Epictetus. (shrink)

Originally published in 1944, this book presents the case for keeping examinations as part of the British school system. Brereton suggests potential reforms and argues that examinations have positive values in 'stimulating pupils and teachers generally, and in co-ordinating the work and aims of schools that might otherwise drift far apart'. This book will be of value to anyone with an interest in the debate surrounding the changing role of examinations in British education.

The theories of reasoned action and planned behaviour have fundamentally changed the view that attitudes directly translate into behaviour by introducing intentions as a crucial intervening stage. Much research across numerous ethical contexts has drawn on these theories to offer a better understanding of how consumers form intentions to act in an ethical way. Persistently, researchers have suggested and discussed the existence of an intention–behaviour gap in ethical consumption. Yet, the factors that influence the extent of this gap and its (...) magnitude have not been systematically examined. We, therefore, contribute to the debate on the intention–behaviour gap by reviewing the empirical TRA/tpb studies that have assessed both intention and behaviour in ethical contexts. The findings from our review show that few studies assessed the intention–behaviour relationship and as a result, there is limited empirical evidence to date to quantify more accurately the intention–behaviour gap in ethical consumption. Our second contribution aims to provide an empirical case study which assesses the magnitude of the intention–behaviour gap in the context of avoidance of sweatshop clothing and to assess the roles of planning and actual behavioural control in potentially reducing the intention–behaviour gap. The findings of our case study suggest that there is indeed a large gap between intention and behaviour, and we conclude by calling for more empirical longitudinal studies to assess the complex nature of the relationship between intention and behaviour. (shrink)

Business ethics have become an important topic globally for both policy-makers and businesses. This paper first discusses the conceptual framework for business ethics followed by ethical management (EM) and corporate social responsibility (CSR) as well as relevant theories. Within this conceptual framework, Korea is used as a country context as to the development of EM and CSR. An important example of an ethical scandal is the major steel manufacturer, POSCO as it was held up as an exemplar and role model (...) of ethical management. However, in 2015, it faced allegations that the engineering and construction overseas unit chief of its Vietnamese subsidiary created a slush fund by overstating payments to Vietnamese contractors. This conceptual paper discusses the factors that created this situation referring to the theory of connection. It locates the case in the EM and CSR literature and analyses what went wrong and what the parent company could have done to prevent this from happening. (shrink)

Canadian and international nursing educators are increasingly concerned with the quality of university nursing education. Contemporary nursing education is fraught by a growing anti‐intellectualism coupled with the dominance of neoliberalism and corporate university business culture. Amid these challenges, nursing schools must prepare nurses to provide care in an era compounded by social and health inequities. The purpose of this paper was to explore the philosophical and contextual factors influencing anti‐intellectualism in nursing education. We use John Henry Newman's view of the (...) purpose of a university education as a heuristic perspective to examine anti‐intellectualism in nursing. We contend that the ideological worship of technological advances, a culture of consumerism, quality improvement and risk management, the primacy of doing over thinking, competency‐based curricula and business models rooted in neoliberal financial policies reinforce anti‐intellectualism in nursing. Anti‐intellectualism is a complex issue to address within the corporate university culture. We propose multiple strategies at the disciplinary, university and sociopolitical levels to decrease anti‐intellectualism. Counteracting anti‐intellectualism requires critical thinking, praxis and emancipation. Nurses should critically examine this anti‐intellectual trend as it limits the advancement of the discipline and marginalizes its contributions within the academy. If nurses do not address this challenge, the survival of nursing as an academic discipline may be jeopardized. (shrink)

Cultural relativism was the subject of a panel presentation at the 2005 meetings of the American Anthropological Association. In 2007, three of the four presentations were published in Anthropological Quarterly. The present article comprises what was presented in the fourth panel presentation, my own, plus a critical realist critique of the other three papers and the discussant’s introduction of them. The critical realist method of immanent critique, applied here, reveals the gaps, contradictions and non-sequiturs of cultural relativism, and suggests that (...) the critical realist meta-philosophy of philosopher Roy Bhaskar, sociologist Margaret Archer, and others offers anthropologists a stronger theoretical paradigm from which to operate. (shrink)

Whatever the answer to Molyneux's question is, it is certainly not obvious that the answer is ‘yes’. In contrast, it seems clear that we should answer affirmatively a temporal variation on Molyneux's question, introduced by Gareth Evans. I offer a phenomenological explanation of this asymmetry in our responses to the two questions. This explanation appeals to the modality-specific spatial structure of perceptual experience and its amodal temporal structure. On this explanation, there are differences in the perception of spatial properties in (...) different modalities, but these differences do not stand in the way of the objectivity of perceptual experience. (shrink)

The first truly multidisciplinary text of its kind, this book offers an original analysis of the current state of linguistic pragmatics. Cummings argues that no study of pragmatics can reasonably neglect the historical and contemporary influences on this.

Geoengineering as a technological intervention to avert the dangerous climate change has been on the table at least since 2006. The global outreach of the technology exercised in a non-encapsulated system, the concerns with unprecedented levels and scales of impact and the overarching interdisciplinarity of the project make the geoengineering debate ethically quite relevant and complex. This paper explores the ethical desirability of geoengineering from an overall review of the existing literature on the ethics of geoengineering. It identifies the relevant (...) literature on the ethics of geoengineering by employing a standard methodology. Based on various framing of the major ethical arguments and their subsets, the results section presents the opportunities and challenges at stake in geoengineering from an ethical point of view. The discussion section takes a keen interest in identifying the evolving dynamics of the debate, the grey areas of the debate, with underdeveloped arguments being brought to the foreground and in highlighting the arguments that are likely to emerge in the future as key contenders. It observes the semantic diversity and ethical ambiguity, the academic lop-sidedness of the debate, missing contextual setting, need for interdisciplinary approaches, public engagement, and region-specific assessment of ethical issues. Recommendations are made to provide a useful platform for the second generation of geoengineering ethicists to help advance the debate to more decisive domains with the required clarity and caution. (shrink)

BackgroundDealing with end of life is challenging for patients and health professionals alike. The situation becomes even more challenging when a patient requests a legally permitted medical service that a health professional is unable to provide due to a conflict of conscience. Such a scenario arises when Victorian health professionals, with a conscientious objection (CO) to voluntary assisted dying (VAD), are presented with patients who request VAD or merely ask about VAD. The Voluntary Assisted Dying Act 2017 (Vic) recognizes the (...) inherent conflict of conscience that may arise for some health professionals when asked to provide VAD and responds by affording broad protection to conscientious objectors who wish to refuse to take part in the VAD process.MethodsSeventeen semi-structured qualitative interviews were conducted with Victorian health professionals with a self-identified CO to VAD in the lead-up to the implementation of VAD in Victoria. Interviews explored how participants anticipated they would manage their CO in practice. Interviews were transcribed verbatim and analyzed thematically.ResultsOur results reveal that the way in which health professionals claimed they would approach CO conversations is variable and was dependant on the strength of their opposition to VAD. We categorized conscientious objectors according to their approach as either dissuasive non-referrers, passive non-referrers, facilitators or negotiators. Our study also explores the perceived difficulties of exercising one’s CO as identified by our participants.ConclusionThe broad protection offered by the Voluntary Assisted Dying Act 2017 (Vic) encourages a range of behaviors from conscientious objectors, due to the minimal obligations imposed. In order to assist conscientious objectors, more policy, institutional guidance, and education needs to be available to conscientious objectors explicitly addressing how to effectively manage one’s CO. Such guidance is imperative to ensuring that their moral integrity is preserved and that they are exercising their CO appropriately. (shrink)