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)

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)

_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.

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)

Professor Thomas Osborne (SPAIS, University of Bristol, author of Aspects of Enlightenment: Social Theory and The Ethics of Truth (1998) and The Structure of Modern Cultural Theory (2008) visited Prague in mid-2018 and presented a paper On Montesquieu, Markets and the Liberalism of Fear. The interview was conducted online by Dr. Filip Vostal (CSTSS, Institute of Philosophy of the Czech Academy of Sciences) in autumn 2020.

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...

Transplantation continues to push the frontiers of medicine into domains that summon forth troublesome ethical questions. Looming on the frontier today is human facial transplantation. We develop criteria that, we maintain, must be satisfied in order to ethically undertake this as-yet-untried transplant procedure. We draw on the criteria advanced by Dr. Francis Moore in the late 1980s for introducing innovative procedures in transplant surgery. In addition to these we also insist that human face transplantation must meet all the ethical requirements (...) usually applied to health care research. We summarize the achievements of transplant surgery to date, focusing in particular on the safety and efficacy of immunosuppressive medications. We also emphasize the importance of risk/benefit assessments that take into account the physical, aesthetic, psychological, and social dimensions of facial disfiguration, reconstruction, and transplantation. Finally, we maintain that the time has come to move facial transplantation research into the clinical phase. (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...

Diverse Nations, Diverse Responses provides a rich overview of the historical, demographic, and political forces that shape social cohesion. It also provides a comparative analysis of the policy goals that have been pursued, the programs that have been implemented, the ways that social cohesion has been defined and measured, and the effects of such issues on immigrants, minorities, and host communities. The volume provides a cross-national conversation on approaches to social cohesion and will appeal to researchers, policy-makers, and practitioners interested (...) in immigration, diversity management, and the factors that affect policy choice, diversity, and outcomes. (shrink)

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)

This book discusses affective practices in performance through the study of four contemporary performers – Keith Hennessy, Ilya Noé, Caro Novella, and duskin drum – to suggest a tentative rhetoric of performativity generating political affect and permeating attempts at social justice that are often alterior to discourse. The first part of the book makes a case for the political work done alongside discourse by performers practising with materials that are not-known, in ways that are directly relevant to people carrying out (...) their daily lives. In the second part of the book, four case study chapters circle around figures of irresolvable paradox – hendiadys, enthymeme, anecdote, allegory – that gesture to what is not-known, to study strategies for processes of becoming, knowing and valuing. These figures also shape some elements of these performances that make up a suggested rhetorical stance for performativity. (shrink)

Allegories, rhetoric, imagery, commonplaces, cliches and archetypes are discussed in connection with the literary work of authors such as Montaigne, Shakespeare, Jules Verne, Emile Zola and James Joyce.

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.

The feminist in academe, says Paula Bennett, is like Procne married to Tereus, "inextricably wedded to the sources of her harm." An ethical justification of academic feminism can be found, not in cooperation and affiliation, but in the strategies currently necessary to ensure curricular and cultural diversity. Historically contextualized and strategically politicized, this ethic is founded on the claim that universities are places where we may all learn to know what is other than ourselves.

Basileia and tyrannis: exploding myths -- Arete and the right to rule -- Ruling families -- Rulers in the polis -- Epilogue: Athens, ruling and arete.

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)

By way of a selective comparison of the work of Georges Canguilhem and Henri Bergson on their respective conceptions of ‘problematology’, this article argues that the centrality of the notion of the ‘problem’ in each can be found in their differing conceptions of the philosophy of life and the living being. Canguilhem’s model, however, ultimately moves beyond or away from (legislative) philosophy and epistemology towards the question of ethics in so far as his vitalism is a means of signalling the (...) refusal of the supposition that all of the dimensions of life are or might be in our possession. Michel Foucault’s project, though directed for the most part to very different subject-matter, worked out a similar logic in the historical problematology of the sciences of ‘man’ and mentalities of government and power; and the results were equally ethical in so far as Foucault’s nominalist historical problematology entailed the refusal of any idea that all of the dimensions of our anthropological ‘essence’ are, or could be, likewise, in our possession. (shrink)

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)

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)

Background and methods: Psychiatric research can occasionally present particular ethical dilemmas, but it is not clear what kind of problems local research ethics committees actually experience in this field. We aimed to assess the type of problems that committees encounter with psychiatric research, using a postal survey of 211 LRECs.Results: One hundred and seven of those written to replied within the time limit. Twenty eight experienced few problems with psychiatric applications. Twenty six emphasised the value of a psychiatric expert on (...) the committee. The most common issues raised were informed consent and confidentiality . The use of placebos , the validity of psychiatric questionnaires and overuse of psychiatric “jargon” in psychiatric applications also raised concern.Conclusions: Our results suggest that LRECs have specific concerns regarding methodology, consent, and confidentiality in psychiatric research, and that they find psychiatric input invaluable. (shrink)

This book offers an interdisciplinary approach to concepts of the self associated with the development of humanism in England, and to strategies for both inclusion and exclusion in structuring the early modern nation state. It addresses writings about rhetoric and behavior from 1495–1660, beginning with Erasmus’ work on sermo or the conversational rhetoric between friends, which considers the reader as an ‘absent audience’, and following the transference of this stance to a politics whose broadening democratic constituency needed a legitimate structure (...) for governance-at-a-distance. Unusually, the book brings together the impact on behavior of these new concepts about rhetoric, with the growth of the publishing industry, and the emergence of capitalism and of modern medicine. It explores the effects on the formation of the ‘subject’ and political legitimation of the early liberal nation state. It also lays new ground for scholarship concerned with what is left out of both selfhood and politics by that state, studying examples of a parallel development of the ‘self’ defined by friendship not only from educated male writers, but also from women writers and writers concerned with socially ‘middling’ and laboring people and the poor. (shrink)

PurposeSocial exclusion as a result of gender, race, and class inequality is perhaps one of the most pressing challenges associated with the development of a diverse information technology workforce. Women remain under represented in the IT workforce and college majors that prepare students for IT careers. Research on the under representation of women in IT typically assumes women to be homogeneous in nature, something that blinds the research to variation that exists among women. This paper aims to address these issues.Design/methodology/approachThe (...) paper challenges the assumption of heterogeneity by investigating how the intersection of gender, race, and class identities shape the experiences of Black female IT workers and learners in the USA.FindingsThe results of this meta‐analysis offer new ways of theorizing that provide nuanced understanding of social exclusion and varied emancipatory practices in reaction to shared group exposure to oppression.Originality/valueThis study on the under‐representation of women as IT workers and learners in the USA considers race and class as equally important factors for understanding variation among women. In addition, this paper provides rich insights into the experiences of Black women, a group that is largely absent from the research on gender and IT. (shrink)

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.

Bill Poteat was a member of Duke University’s Department of Religion and served a term as Chairman, during which I served with him as Director of Undergraduate Studies. I knew him as a brilliant scholar who devoted his exceptional gifts primarily to his teaching and his students. He was charming, gracious, yet we his Duke professorial colleagues never really knew him. One of our ranks suggested that the idea of Bill as a colleague was an oxymoron. Bill did not attend (...) professional meetings and only rarely had conversation of any sort with colleagues. He lived in Chapel Hill and not Durham. However, he seemed not to be at home in any of his academies-UNC Philosophy Department, Duke Divinity School, or finally the Duke Department of Religion. It was not clear what his commitments were. I knew that he had a Christian heritage and perhaps a Christian “hangover,” and had a Divinity degree from Yale. Nevertheless, his personal faith was not publically expressed. Perhaps it found expression in his zealous efforts to overcome the Cartesianism of the modern mind which he contended was inimical to the Christian understanding of the human person and his/her relationship to God. Yet, he was restless, rarely present to us and perhaps also to himself. (shrink)

Systems of universal health coverage may aspire to provide care based on need and not ability to pay; the complexities of this aspiration call for normative analysis. This special issue arises in the wake of a judicial inquiry into preferential access in the Canadian province of Alberta, the Vertes Commission. I describe this inquiry and set out a taxonomy of forms of differential and preferential access. Papers in this special issue focus on the conceptual specification of health system boundaries and (...) on the normative questions raised by complex models of funding and delivery of care, where patients, providers, and services cross system boundaries. (shrink)

The principle of moderation can be regarded as an ethical principle of virtue or as a principle of government. On the basis of the former, moderation has a personal, ethical sense—not to go towards extremes. The latter model is more generalized and impersonal: moderation as the limitation of power by power. Both conceptions actually meet, though with the latter model more salient, in the work of Montesquieu. This article outlines Montesquieu’s view of moderation emphasizing the extent to which this view (...) cannot be understood apart from his concept of despotism. It shows that Montesquieu’s understanding of moderation entails the balancing and interaction of different powers in a State. As such, his view is more “dynamic” and relational than “substantive.” By exploring the interaction between the models of moderation as virtue and moderation as government in Montesquieu’s work, I then develop the notion of “ruling fear” in considering the continuing relevance of Montesquieu’s perspective for current understandings of moderation and political power. (shrink)

Scientism in medical education distracts educators from focusing on the content of learning; it focuses attention instead on individual achievement and validity in its measurement. I analyze the specific form that scientism takes in medicine and in medical education. The competencies movement attempts to challenge old “scientistic” views of the role of physicians, but in the end it has invited medical educators to focus on validity in the measurement of individual performance for attitudes and skills that medicine resists conceptualizing as (...) objective. Academic medicine should focus its efforts instead on quality and relevance of care. The social accountability movement proposes to shift the focus of academic medicine to the goal of high quality and relevant care in the context of community service and partnership with the institutions that together with medicine create and cope with health and with health deficits. I make the case for this agenda through a discussion of the linked histories of the opioid prescribing crisis and the professionalism movement. (shrink)

Lisa A. Eckenwiler, Long-term care, globalization, and justice, Baltimore: The Johns Hopkins University Press, 2012, reviewed by Lynette Reid.

What, if anything, do we epistemically owe to each other? Various “traditional” views of epistemology might hold either that we don’t epistemically owe anything to each other, because “what we owe to each other” is the realm of the moral, or that what we epistemically owe to each other is just to be epistemically responsible agents. Basu (2019) has recently argued, against such views, that morality makes extra-epistemic demands upon what we should believe about one another. So, what we owe (...) to each other is not just a matter of word and deed, but also of belief. And in fact, Basu argues, sometimes those moral demands require us to believe in ways that cut against orthodox epistemic norms. This paper has three aims. First, to offer two strategies for accommodating the kinds of cases Basu discusses while nonetheless holding that only epistemic normativity makes demands on belief. Second, to offer an alternative account of what we owe to each other that does not hold that morality demands that we sometimes believe against our evidence or in violation of epistemic norms. And third, to give a brief diagnosis of why it seems intuitive that morality makes extra-epistemic doxastic demands on us. Ultimately, I argue that what we epistemically owe to each other does not require us to violate orthodox, invariantist epistemic norms. Morality demands that we have a proper regard for others, not that we sometimes believe against our evidence. (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)