Aristotle bequeathed to us a powerful metaphysical picture, of substances in which properties inhere. The picture has turned out to be highly problematic in many ways; but it is nevertheless a picture not easy to dislodge. Less obvious are the normative tones implicit in the picture and the way these permeate our system of values, especially when thinking of ourselves and our ambitions, hopes and fears. These have proved, if anything, even harder to dislodge than the metaphysical picture which supports (...) them. This paper first draws out the ethics suggested by a conception of being as individual substances, and finds both inner tensions among these values—expressed in divergent characteristics in the history of philosophy—and a neglect of a significant set of values. Substance metaphysics prefers freedom, independence and autonomy over relational and reciprocal values, which can even be regarded as existentially threatening. A prominent attempt to accommodate both sorts of values without eschewing substantialist metaphysics is briefly considered, before turning to examine an alternative metaphysics and the values it implies. A metaphysics which takes being as becoming, it is argued, supports an ethics centred on relational values, and their associated virtues of care. (shrink)

Some ethicists assert that there is a consensus that maximising medical outcomes takes precedence as a principle of resource allocation in emergency triage of absolutely scarce resources. But the nature of the current severe acute respiratory syndrome-related coronavirus 2 pandemic and the history of debate about balancing equity and efficiency in resource allocation do not support this assertion. I distinguish a number of concerns with justice and balancing considerations that should play a role in critical care triage policy, focusing on (...) discrimination and on fundamental egalitarian and social justice concerns. (shrink)

Are the small and indolent cancers found in abundance in cancer screening normal variations, risk factors, or disease? Naturalists in philosophy of medicine turn to pathophysiological findings to decide such questions objectively. To understand the role of pathophysiological findings in disease definition, we must understand how they mislead in diagnostic reasoning. Participants on all sides of the definition of disease debate attempt to secure objectivity via reductionism. These reductivist routes to objectivity are inconsistent with the Bayesian nature of clinical reasoning; (...) when they appeal to the sciences, they are inconsistent with what philosophy of biology tells us about its natural kinds. Proposals that we narrow the scope of our claims in the disease definition debates are useful, but paradigms can still distort our reasoning in particular cases, even when we are self-conscious about their status. (shrink)

The seriousness of the risk that healthcare workers faced during SARS, and their response of service in the face of this risk, brings to light unrealistic assumptions about duty and risk that informed the debate on duty to care in the early years of HIV/AIDS. Duty to care is not based upon particular virtues of the health professions, but arises from social reflection on what response to an epidemic would be consistent with our values and our needs, recognizing our shared (...) vulnerability to disease and death. Such reflection underwrites a strong duty of care, but one not to be borne solely by the altruism and heroism of individual healthcare workers. (shrink)

_Critiques of Knowing_ explores what happens to science and computing when we think of them as texts. Lynette Hunter elegantly weaves together vast areas of thought: rhetoric, politics, AI, computing, feminism, science studies, aesthetics and epistemology. _Critiques of Knowing_ shows us that what we need is a radical shake-up of approaches to the arts if the critiques of science and computing are to come to any fruition.

Some argue that the concept of medical need is inadequate to inform the design of a universal health care system—particularly an institutional rather than a residual system. They argue that the concept contradicts the idea of comprehensiveness; leads to unsustainable expenditures; is too indeterminate for policy; and supports only a prioritarian distribution. I argue that ‘comprehensive’ understood as ‘including the full continuum of care’ and ‘medically necessary’ understood as ‘prioritized by medical criteria’ are not contradictory, and that UHC is a (...) solution to the problem of sustainability, not its cause. Those who criticize ‘medical need’ for indeterminacy are not transparent about the source of their commitment to their standards of determinacy: they promote standards that are higher than is necessary for legitimate policy, ignoring opportunity costs. Furthermore, the indeterminacy of concepts affects all risk-sharing systems and all systems that rely on medical standard of care. I then argue that the concept of need in itself does not imply a minimal sufficientist standard or a prioritarian distribution; neither does the idea of legitimate public policy dictate that public services be minimalist. The policy choice for a system of health care that is comprehensive and offers as good care as can be achieved when delivered on equal terms and conditions for all is a coherent option. (shrink)

While much of the debate around the practice of normothermic regional perfusion (NRP) is focused on the potential violation of the dead donor rule (DDR), another concern is whether allowing this pr...

The multi-disciplinary unit Social Responsibility in Action was developed for students with an interest in ethics who were completing undergraduate degrees in Arts, Commerce, Design or Science at an Australian research-intensive university. The academic objectives of this unit were to increase student awareness, knowledge, understanding and critical thinking skills related to various ethical issues. Lecturers from five disciplines collaborated in the design and delivery of SRA, which comprised lectures, tutorials and a research-based project. Anonymous surveys were administered at the start (...) and end of the semester to obtain feedback on student expectations and learning experience, respectively. Data across three student cohorts showed that at the start of semester, 80% of student comments indicated a desire to expand their interest of ethical matters, 59% a desire to gain understanding and knowledge and 59% to gain critical thinking or communication skills. SRA was extremely well received by students, with 98% of respondents indicating that this multi-disciplinary ethics unit had met their expectations. Students also found that the variety of teaching styles, unit content and multi-disciplinary approach stimulated learning. (shrink)

In their article, Romanis and Adkins delineate pregnancy loss and procreative loss to show that the former is possible without the latter, as in the case of artificial amnion and placenta technology.1 Here, we are interested in examining the reverse—procreative loss without pregnancy loss—to further tease apart these two types of loss. We discuss two cases: being forced to continue a pregnancy despite fetal demise due to abortion restrictions and choosing to selectively reduce a multifetal pregnancy. Our analysis buttresses the (...) authors’ conclusion: due to our fetal-centric conception of pregnancy, we are only able to value pregnancy instrumentally (ie, for the fetus), not intrinsically. Understanding pregnancy as an embodied state rather than a process that not only acknowledges the intrinsic value of pregnancy for pregnant people but also encourages society to intrinsically value pregnant people is important. In 2022, the Supreme Court of the United States removed the constitutional right to an abortion in Dobbs v Jackson Women’s Health Organization, shifting the responsibility of determining abortion regulations to individual US states.2 Due to the Dobbs decision, there …. (shrink)

I discuss some reservations about the exegetical power of the claim that the Tractatus is “anti-metaphysical.” The “resolute” reading has the virtue of fidelity to important and neglected features of the work, both its anti-metaphysical moves and its account of the nature of the activity of philosophy and its status. However, its proponents underestimate the barriers to maintaining a consistent fidelity to these features of the text. The image of a ladder suggests a mere instrumental means to arrive at a (...) place that can itself be characterized independently of our means of arrival; where we arrive via the process of the TLP is the conclusion of an argument, and so cannot be characterized independently of the argument that got us there. In his commitments about the process of logical analysis “within language,” he strives as much as in his statements about the world to return us to our ordinary ways of talking and making sense of what we say to one another. Given the internal relationship Wittgenstein is at pains to emphasize between language, thought, and reality, he could hardly have philosophical commitments about one of these terms (have a residual metaphysics of language) and isolate this from how he thinks about the others. In a discussion of “Senator, you’re no Jack Kennedy” and “Chairman Mao is rare,” I argue that, pace Conant and Diamond’s claims to the contrary, logical categories are being invoked to explain why one cannot mean what one thinks one means in this phrase, and that Wittgenstein is both more anti-metaphysical in his treatment of these logical categories (in contrast with Frege) than the resolute readers consider him to be, and less successful in his treatment of how logical categories rule our judgments of sense and nonsense than they imply he is. Finally, I question the sharp boundary between logic and psychology and the “claustrophobic” feel that is created by a narrow construal of what one can make sense of in another’s words and person that underwrites their account of nonsense via a conflict between the meaning words can contain and our confused desires. Throughout, I discuss relevant passages of the Investigations that resolute readers treat as a re-expression of the themes of the Tractatus, to contrast the “anti-metaphysical” treatment these themes express in the Tractatus with the less dogmatic treatment they receive in the Investigations. (shrink)

In 1747, Kant believed that the mind/body problem presupposed several false and interrelated assumptions that fell under the general view that the essential force of body is vis motrix, namely that bodies act only by causing changes of motion, that bodies can be acted upon only by being moved, and that souls and bodies do not share a common force. He argued in Thoughts on the True Estimation of Living Forces that the traditional vis motrix view, which was defended by (...) Wolff, appealed to an unexplanatory and metaphysically incoherent conception of force. ;Kant maintained that God acted to unify our world in such a way that all its finite substances possess a vis activa capable of producing motion in bodies and representations in souls. Unlike Leibniz's account of vis activa, Kant's account was compatible with the existence of transeunt or externally-directed forces. Indeed, Kant argued that every change in our world involves the exercise of a transeunt force. ;In Living Forces, Kant used these ideas to solve the mind/body problem. This study evaluates Kant's solution and traces his responses in later pre-critical texts to several acute difficulties. Chief among these difficulties was that his account of the "divine schema" of our world was incompatible with his metaphysical dualism: to exist in our world, Kant argued, all substances must possess attractive and repulsive forces, but attributing these forces to souls implied that they also possessed the same material nature as the physical monads out of which material bodies are composed. ;Kant did not recognize this problem until the early 1760s, and in the Dreams of a Spirit-Seer he maintained that it was insoluble. In the Meta-physik L1 lectures , Kant articulated a new understanding of the mind/body problem that centered on the idea that the body is an object of outer sense and the soul an object of inner sense. ;I conclude that, although his understanding of mind/body connectedness remained inadequate in the mid-1770s, Kant's struggles with this and related issues contributed to the development of systematic critical strictures on meta-physical reasoning and to the critical theory of inner sense. (shrink)

The Greek polis has been arousing interest as a subject for study for a long time, but recent approaches have shown that it is a subject on which there are still important questions to be asked and worthwhile issues to be explored. This book contains a selection of essays which embody the results of the latest research. Beyond the historical development of the Greek polis , the contributors ask questions about the civic institutions of ancient Greece as a whole and (...) their relationships to each other. Questions of power or the significance of a written code of law are discussed as well as the nature of Greek overseas settlements. Development of the Greek Polis presents up-to-date research and asks up-to-date questions on various aspects of an important topic. (shrink)

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

Verweij and Dawson claim that population health has a distributive dimension; Coggon argues that this presupposes a normative commitment to equity in the very definition of population health, which should, rather, be neutral. I describe possible sources of the distributive view, several of which do not presuppose egalitarian commitments. Two relate to the nature of health as a property of individuals ; two relate to the epistemology and pragmatics of public and population health. A fifth source of the distributive view (...) is a critical stance on the concept of population health; I contrast this with Coggon’s account of the public as a shared political imaginary. None of these views is ‘neutral’: they exhibit several different kinds of normativity and quasi-normativity, but this is not problematic. I argue that the critical stance appropriately distinguishes and relates social justice and public health. (shrink)

In their article, “Rare Disease, Advocacy and Justice: Intersecting Disparities in Research and Clinical Care,” Halley et al. (2023) use three case examples to describe challenges patients with rar...

The twin Theses of Eliminative and Multiplicative Materialism will be analyzed and then subsumed by Occam's sword.

Ethics is enabling of agency, but also normative and conventional. At the moment a gendered ethics, or the gendering of ethics, is a helpful approach because it is concerned with issues to do with people often peripheral to and excluded from power. At the moment it can work to keep ethics responsive, but how do we halt the drift into the normative, both as prescriptive and as ideological? A feminist ethics maintains the responsive and undermines prescriptive categories, and is committed (...) to involving disempowered voices in the conversation. The article is particularly concerned with the articulation of the situated, and raises questions about attending to, learning how to listen to and learning how to speak, so that many people from different places can get involved in ethics. Otherwise ethics isn’t ethical. (shrink)

What is lying? -- Why do people lie? -- Little lies -- Lying hurts! -- When someone lies to you -- What if you tell a lie? -- What if you get caught? -- Making it right -- Put an end to lying -- Start telling the truth.

Contentivo de las memorias del "III Seminario de Filosofía y Derecho Contemporáneo", en homenaje al profesor Günther Jakobs, en el cual se analizan algunos de los componentes del derecho penal al tenor de la filosofía del derecho. Esta obra retoma los conceptos de Günther Jakobs, Jaime Bernal Cuéllar, Manuel Cancio Meliá y Teresa Manso Porto, entre otros.

In writing about `whiteness' we are trying to enact a `way of talking' that draws in part on Aboriginal ideas about how to conduct a conversation or tell a story. We also use Homi Bhabha's ideas of `third space' (an `interruptive, interrogative, and enunciative' space) and hybridity as a related way to think through the problems of essentializing binaries and rigid identities. In Aboriginal cultures in Australia and Canada, rather than adopting the `neutral' or `objective' stance common in the academy, (...) it is customary to introduce oneself to one's audience, providing a context to assist in interpretation and exchange. Without such an introduction, real stories cannot be told and productive conversations cannot happen. We thus begin our conversation with each other and with you by examining our personal relationship to the idea of whiteness in order to reveal some of its complexity in Canada and Australia. `Whiteness' as an abstraction has proved useful in moving the invisible norm to visibility, but we show how an awareness of `whiteness' in the two locations can be recuperated to re-privilege the already privileged. Aboriginal speakers and writers have theorized `whiteness', in many cases from outside the academy, in the process `hybridizing' traditional genres. For many of them, Aboriginality, like whiteness, is a construct that often stands in the way of thinking clearly about where to go next in the fight against racism. (shrink)

What's on the other side of stepping out in faith? A supernatural lifestyle. The world is shaking. Anyone can see it. Governments are collapsing. Economies are failing. Nations are in turmoil. People are realizing that things that appeared so stable and promising are subject to fall. The solution? Stepping out in faith and experiencing the miraculous as your new normal. God wants you to live a supernatural lifestyle! Venetia Carpenter learned this first hand, as she shares inspired insights and (...) compelling testimony from personal experiences that show you a lifestyle of faith is not only possible, but should be normal. Prepare to learn: - Why a lifestyle of faith is essential for everyone living in these critical times - How to trust God's supernatural provision to meet your needs - Keys to accessing different levels of faith to release the miraculous As a follower of Jesus Christ, get ready to experience the miraculous life you were meant to live! (shrink)

The professionalism movement has animated medical education and practice; an extensive literature expresses and categorizes many interpretations of the concept (Hafferty 2006a; Hafferty and Levinson 2008). The inception of the current wave of the movement was in the American Board of Internal Medicine's Project Professionalism. In the face of threats from the growth of managed care and public concerns about conflict of interest, the ABIM's "Physician Charter" called for the profession to publically commit to values of patient welfare, social justice, (...) and respect for patient autonomy (Brennan et al. 2002). The concept of professionalism, or the physician as occupying the role of professional, has taken hold in .. (shrink)

Temkin asks how we should distribute resources between the social determinants of health and health care; Sreenivasan argues that if our goal is fair opportunity, funding universal health coverage is the wrong policy. He argues that social equality in health has not improved under UHC and concludes that fair opportunity would be better served by using the resources to address the SDOH instead. His criticism applies more broadly than he claims: it applies to any argument for UHC based on health (...) equity. However, neither his strong causal conclusion nor his stark policy proposal is justified. I review methodological challenges for establishing the relative causal contributions of health care and social policy, concluding that we may never have a robust causal account to support a consequentialist choice. Fortunately, we may not need to answer the allocation question as a dichotomy. Given what Sen calls the multidimensional nature of health equity and the role of UHC in cost containment, UHC may not be a threat to health equity. I also argue against Sreenivasan's claim that the data he discusses should not trouble sufficientists and prioritarians. The worst-off are not simply lagging in improvement; rather, their health status is stagnating or worsening. (shrink)

The book, which stepwise develops successively more powerful logical and grammatical systems, covers an unusually broad range of material.

Once described as hermaphrodites and later as intersex people, individuals born with intersex variations are routinely subject to so-called “normalizing” medical interventions, often in childhood. Opposition to such practices has been met by attempts to discredit critics and reasserted clinical authority over the bodies of women and men with “disorders of sex development.” However, claims of clinical consensus have been selectively constructed and applied and lack evidence. Limited transparency and lack of access to justice have helped to perpetuate forced interventions. (...) At the same time, associated with the diffusion of distinct concepts of sex and gender, intersex has been constructed as a third legal sex classification, accompanied by pious hopes and unwarranted expectations of consequences. The existence of intersex has also been instrumentalized for the benefit of other, intersecting, populations. The creation of gender categories associated with intersex bodies has created profound risks: a paradoxically narrowed and normative gender binary, maintenance of medical authority over the bodies of “disordered” females and males, and claims that transgressions of social roles ascribed to a third gender are deceptive. Claims that medicalization saves intersex people from “othering,” or that legal othering saves intersex people from medicalization, are contradictory and empty rhetoric. In practice, intersex bodies remain “normalized” or eliminated by medicine, while society and the law “others” intersex identities. That is, medicine constructs intersex bodies as either female or male, while law and society construct intersex identities as neither female nor male. Australian attempts at reforms to recognize the rights of intersex people have either failed to adequately comprehend the population affected or lacked implementation. An emerging human rights consensus demands an end to social prejudice, stigma, and forced medical interventions, focusing on the right to bodily integrity and principles of self-determination. (shrink)

In Capital in the Twenty-First Century, Thomas Piketty argues that markets, absent political intervention, tend toward economic divergence and that this has deleterious consequences for democratic ideals of equal voice and meritocracy. His goal is to foster a public conversation about what a society dominated by wealth—which we already beginning to experience as the twenty-first century begins—would look like if we wish to maintain an egalitarian ethos. His work will contribute to and further motivate several discussions in feminist bioethics, namely, (...) on the funding and organization of care labor, reproductive rights, global health, and commodification. (shrink)

This commentary examines twelve stories in which parents recount how they (and often their co-parent) decided whether or not to circumcise their newborn sons. Several debated whether this should be their decision to make. The stories offer an intimate glimpse into people's efforts to do the best for children in a context of incomplete and changing information and intense public controversy. The commentary explores the diverse meanings and contradictory commonsense beliefs that surround foreskin removal in the United States today. Considering (...) these parents' reflections—and their silences—can help us appreciate the real-life consequences of debates about the ethics of male circumcision. (shrink)

Pierre Thévenaz was Swiss. At the time of his death he was Professor of Philosophy at the University of Lausanne. Earlier he had taught philosophyat the Ecole Polytechnique Fédérale in Zurich, and at the University of Neuchâtel. A large part of his writings are contained in L'Homme et Sa Raison , De Husserl à Merleau-Ponty , La Condition de ia Raison Philosophique . A collection of his articles has been translated into English by James Edie and published under the title. (...) What is Phenomenology? (shrink)