In the dissertation I provide an account of action descriptions which emphasizes their role as explanations of consequences. By showing that consequences are ascribed to an action under a description, and only when that description can explain the consequence, I undermine the view that consequences are brute events. Roughly, I reason as follows. If consequences were brute events, then their ascription to an action wouldn't hinge on how we understand the action. We could, for instance, say in ordinary circumstances "John (...) tensed his finger" and as a consequence "Mary became a widow" without any untowardness at all. I show both that we do not do this and that we cannot do it. That we do not do it is supported primarily by linguistic intuitions; mainly I show that there is an infelicity in ascribing to an action a consequence which is not explained by that action. To support the claim that we cannot do this I argue that if there were no "fit" between action and consequence that would make communication difficult. ;I then use this characterization of action descriptions and consequences to serve as a criterion for identifying the privileged description of an action. Any one action may have several action descriptions. In light of this, there is a question raised about which, if any, of these descriptions is privileged. I show that within the wider social context there is a description of the action which is dominant. Then I argue that this description is and should be chosen in virtue of the explanatory power of action descriptions with respect to consequences. (shrink)

A collection of essays on the human genome, European patent law, cloning, and genetic malpractice suits.

In GIVING WELL: THE ETHICS OF PHILANTHROPY, an accomplished trio of editors bring together an international group of distinguished philosophers, social scientists, lawyers and practitioners to identify and address the most urgent moral questions arising today in the practice of philanthropy.

In this paper, I claim that the doctor-patient relationship can be viewed as a vessel of trust. Nonetheless, trust within the doctor-patient relationship has been impaired by managed care. When we conceive of trust as social capital, focusing on the role that it plays in individual and social well-being, trust can be viewed as a public good and a scarce medical resource. Given this, there is a moral obligation to protect the doctor-patient relationship from the cost-containment mechanisms that compromise its (...) ability to produce trust. (shrink)

Although the right to health is universal, many nations that honor it fail to do so in the case of non-citizen immigrants. In this essay, we argue that the reasons typically given for not extending the right to health to immigrants are without merit and that there are good reasons for nations to protect, respect and fulfill the health right of all immigrants. Contrary to the standard view, we argue that health can be understood as a global public good. Two (...) important points follow: because health is non-excludable and non-rivalrous, it is in the health interests of nations to respect, protect and fulfill immigrants’ right to health. Furthermore, meeting the health needs of immigrants is an important way for receiving nations to meet the duties that may be generated by the benefits they incur as a result of health’s global public good dimension, thus ensuring that receiving nations are not free riders. We then argue that because citizens and immigrants dwell together, nations have duties of solidarity to immigrants with respect to health. Using the insights of social psychology, we show that solidarity among diverse people is both a reasonable expectation and a morally desirable one. (shrink)

Dr. Wayne proposes that an autonomy-based approach to the treatment and care of older patients with dementia be replaced with an agency-based approach. In this commentary, I suggest that such a shift is unnecessary and would undermine patients’ moral, legal, and human rights.

It is unclear that United States schools are doing sufficient work to identify and protect the interests of their LGB students this analysis, we rely on certain public-health research in social epidemiology to show that discrimination against LGB adolescents imposes morally significant harms to both adolescents and community. We apply "trust” and “social capital” to educational standards and practices as foundations for educational practices that work toward full equality of LGB students in regard to opportunity and other primary social goods.

Illustrating the collective power and relevance of feminist theory today, Mary Caputi and Patricia Moynagh have carefully selected a diverse international range of leading scholars and activists to critically assess key social and political challenges in the twenty-first century. This Research Handbook demonstrates a variety of feminist analyses that offer compelling insights into an array of topics, including police brutality, the carceral state, racial and sexualised violence, trans rights, climate change, and the denial of reproductive rights. With a (...) focus on the crucial role of feminism in envisioning a more equal world, chapters examine critical and care based approaches to feminist political thought; hostility to the feminist movement; and feminist attempts to unseat institutionalised power and violence. The lived experiences of women, variously situated in a host of cultural and geographic contexts, are explored. These experiences include the thematics of longing and bereavement, as well as different forms of feminist protest and political awakening. Ultimately, this Research Handbook illustrates the continuing need for reinterpretation and reconstruction in this vital field of feminist political thought. The Research Handbook on Feminist Political Thought will prove an essential read for students and scholars of feminist, political and postcolonial theory. Its real-world implications will mean it will additionally appeal to policymakers and activists, as well as academics of philosophy, political science, sociology, and gender and cultural studies. (shrink)

I argue that because bluffing, puffing, and spinning are features of corporate life, they are likely to characterize the doctor-patient relationship in managed care medicine. I show that managed-care organizations (MCOs) and the physicians who contract with them make liberal use of puffing and spinning. In this way, they create a context in which it is likely that patients will also use deceptive mechanisms. Unfortunately, patients risk their health when they deceive their doctors. Using the warranty theory of truth I (...) argue that although bluffing may be ethical in business because all participants agree to it and business has not warranted truth-telling, it is not ethical in a medical context because physicians and MCOs have warranted truth-telling and the quality of medical care depends on it. (shrink)

Meaningful participant engagement has been identified as a key contributor to the success of efforts to share data via a “Medical Information Commons”. We present findings from expert stakeholder interviews aimed at understanding barriers to engagement and the appropriate role of MIC participants. Although most interviewees supported engagement, they distinguished between individual versus collective forms. They also noted challenges including representation and perceived inefficiency, prompting reflection on political aspects of engagement and efficiency concerns.

Offering a format that is significantly different than that offered by other books, Ethical Health Care beings by asking what is meant by health and how it is achieved. The book then proceeds to explore with care and context the nature of the relationship between patients and clinicians, health care providers and the societies in which they inhabit, and finally the relationship between the health care enterprise and the international community. By emphasizing the ethical issues that arise in the broad (...) quest to foster human health, and appreciating that health is not primarily a function of medical interventions, Ethical Health Care introduces students to problems such as the international distribution of pharmaceuticals and the dangers of reemerging infections. To a far greater extent than is done traditionally, Ethical Health Care provides an interdisciplinary perspective to bioethics, relying heavily upon the teachings of economics, law, and public health. (shrink)

This comment on Professor ter Meulen's paper, "Solidarity and Justice in Health Care," offers additional perspectives on solidarity's importance for health. Noting the findings of social epidemiology, the paper explains that health has important public good dimensions. It is both non-rivlalrous because one person's health does not diminish another's, and it is largely determined by non-excludable access goods, including social networks, social determinants, and public health efforts. The public good dimension of health underscores the mutual dependence and shared stake that (...) people have with respect to health, and highlights the importance of coming together in solidarity for the sake of health. This is not to say that solidarity cannot also foster exclusionary tendencies; however, the recognition of mutual dependency with respect to health can foster an inclusive solidarity for the health of all people. (shrink)

In his well‐researched new book, Solidarity and Justice in Health and Social Care, Ruud ter Meulen traces the history of the concept of solidarity and describes the important role that it can play in health care. He contrasts solidarity with other normative concepts, such as autonomy and justice. According to ter Meulen, solidarity entails a commitment and willingness to help others who are “in need of it due to circumstances out of their control” (p. 170). Thus, solidarity exists when people (...) act for the sake of other people who are vulnerable in some way. Ter Meulen treats solidarity as a distinct normative concept and believes that it is critical for health care. No doubt insofar as social ties and cohesion are good for health, so is solidarity. (shrink)

Machine generated contents note: -- Acknowledgements -- Introduction -- Overcoming Indifference -- Social Capital -- Ethics for Enduring Social Capital -- Social Capital and Happiness -- Social Capital and Law -- Giving Back -- Global People -- Bibliography -- Index.

Recent figures show that 151.7 million nonelderly Americans who had private insurance received that insurance from their employers (out of 167.5 million with private insurance). Employers who contract with health plans on behalf of their employees influence the health of their employees and, in turn, the nature and quality of the healthcare system in the United States. Despite the magnitude of their influence, they have been relatively free from both government and ethical guidance with respect to the specific substantive benefits (...) they offer their employees. Employers have enormous discretion with respect to what substantive benefits they include in employer health plans because they are governed by the Employment Retirement Security Act (ERISA). But the decisions that employers make when they choose benefits for their employees are just as much rationing decisions in need of bioethical analysis as are the rationing decisions that are made at the bedside by patients, physicians, and their families. Moreover, even strong discretion, of the kind employers have, is subject to ethical standards. (shrink)

A medical information commons is a networked data environment utilized for research and clinical applications. At three deliberations across the U.S., we engaged 75 adults in two-day facilitated discussions on the ethical and social issues inherent to sharing data with an MIC. Deliberants made recommendations regarding opt-in consent, transparent data policies, public representation on MIC governing boards, and strict data security and privacy protection. Community engagement is critical to earning the public's trust.

To revitalize nursing science, there is a need for a new approach to guide nurse scientists in addressing complex problems in health care. By applying theoretical concepts from a revolutionary philosopher of science, Paul K. Feyerabend, new nursing knowledge can be produced using creativity and pluralistic approaches. Feyerabend proposed that methods within and outside of science can produce knowledge. Despite the recognition of Feyerabendian philosophy within science, there is currently a lack of literature regarding the relevance of Feyerabendian philosophy for (...) nursing science. We aim to (a) describe and critique Feyerabendian concepts, (b) discuss the potential application of Feyerabendian philosophy for knowledge production within gerontological nursing and (c) describe theoretical possibilities for nurse scientists in using Feyerabendian philosophy to guide nursing knowledge development. We begin by introducing Feyerabend's life and his inspirations for his theoretical concepts, epistemological anarchism, theoretical pluralism and humanitarianism, and conclude by offering suggestions of how to apply Feyerabendian philosophy in nursing research. (shrink)

To test if dreams contain remote or never-experienced motor skills, we collected during 6 weeks dream reports from 15 paraplegics and 15 healthy subjects. In 9/10 subjects with spinal cord injury and in 5/5 with congenital paraplegia, voluntary leg movements were reported during dream, including feelings of walking , running , dancing , standing up , bicycling , and practicing sports . Paraplegia patients experienced walking dreams just as often as controls . There was no correlation between the frequency of (...) walking dreams and the duration of paraplegia. In contrast, patients were rarely paraplegic in dreams. Subjects who had never walked or stopped walking 4–64 years prior to this study still experience walking in their dreams, suggesting that a cerebral walking program, either genetic or more probably developed via mirror neurons is reactivated during sleep. (shrink)

Desire After Affect offers a detailed analysis of the affective turn and its consequences for the humanities.

Images That Move is concerned with how images take place in wider worlds: how they move around, via processes of transmission and uptake, but, equally importantly, how they move their audiences affectively. Images play a significant part in projects of "poetic world-making" and political transformation. They participate in the production of commensuration or of incommensurability, enact moments of prophecy or exposure, and attract or repel spectators' attention. Images move, then, but not just as they wish, and any examination of images (...) in motion must also recognise the blockages and breakdowns that prevent their movement as well as the enframings or "stickinesses" that trap them in particular places, prevent them from reaching others, or hedge their arrival in specific ways. The contributors explore topics ranging from high art to mass media, religious iconography to pornography, and popular photography to political cartoons in a range of contexts and media including photography in early twentieth century China, art and literature in contemporary South Africa, upscale real estate development in India, occult media images and the aesthetic of appearance in urban Indonesia, and film censorship in Nigeria. All of these instances of the visual continuum require different ways of highlighting and addressing the problematics of images in motion. Images That Move traces some of the tangled paths of images' travels and returns, unfolding their effects and aftereffects and scanning the diverse and variable publics-fixed or ephemeral, situated or dispersed-that these moving images call into being. Contributors: Ernst van Alphen, Christiane Brosius, Steven C. Caton, Finbarr Barry Flood, Brian Larkin, Oliver Moore, Rosalind C. Morris, Christopher Pinney, Patricia Spyer, Mary Margaret Steedly. (shrink)

This work defines various stakeholder roles to overcome the barriers to implementing Education 4.0, which were recently identified in the domain literature. The stakeholder roles are evaluated against these barriers, and such evaluation is structured as a multicriteria sorting problem. To this end, an integrated entropy-based CRITIC-CODAS-SORT under a Fermatean fuzzy environment addresses epistemic uncertainties inherent in decision-making. The FF CRITIC assigns the priority weights of the barriers, while the FF CODAS-SORT determines the high-priority stakeholder roles. A case of an (...) HEI evaluating 57 possible roles of 5 stakeholders is demonstrated here. Findings suggest the lack of collaboration, apprehensive stakeholders, cybersecurity threats, health issues, and cost as crucial barriers to the HEI. The sorting process yields 13 high-priority roles, encompassing those within the influence of the government, university management, human resource function, and educators. Various managerial insights are offered as inputs to the design of initiatives in EDUC4 implementation. (shrink)

God, Sex, Science, Gender: An Interdisciplinary Approach to Christian Ethics is a timely, wide-ranging attempt to rescue dialogues on human sexuality, sexual diversity, and gender from insular exchanges based primarily on biblical scholarship and denominational ideology. Too often, dialogues on sexuality and gender devolve into the repetition of party lines and defensive postures, without considering the interdisciplinary body of scholarly research on this complex subject. This volume expands beyond the usual parameters, opening the discussion to scholars in the humanities, social (...) sciences, and natural sciences to foster the development of Christian sexual ethics for contemporary times. Essays by prominent and emerging scholars in the fields of anthropology, sociology, psychology, philosophy, literary studies, theology, and ethics reveal how faith and reason can illuminate our understanding of human sexual and gender diversity. Focusing on the intersection of theology and science and incorporating feminist theory, God, Sex, Science, Gender is a much-needed call for Christian ethicists to map the origins and full range of human sexual experience and gender identity. Essays delve into why human sexuality and gender can be so controversial in Christian contexts, investigate the complexity of sexuality in humans and other species, and reveal the implications of diversity for Christian moral theology. Contributors are Joel Brown, James Calcagno, Francis J. Catania, Pamela L. Caughie, Robin Colburn, Robert Di Vito, Terry Grande, Frank Fennell, Anne E. Figert, Patricia Beattie Jung, Fred Kniss, John McCarthy, Jon Nilson, Stephen J. Pope, Susan A. Ross, Joan Roughgarden, and Aana Marie Vigen. (shrink)

The prelims comprise: Introduction The Physician and the Provider Organization The Physician and the Payer Organization Dealing with Systems Conclusion Notes References.

Bioethics, clinical ethics, and professional ethics are mature, well-developed fields of applied ethics that focus on medical research, patient autonomy and patient care, patient–healthcare professional relationships, and issues that arise in clinical and other medical settings. However, despite these developments, little attention has been paid to the organizational aspects of healthcare in these fields. This is surprising, because in the last 30 years healthcare has become more and more institutionalized in provider, management, and insurer organizations. Despite JCAHO's preoccupation with organizational (...) ethics during the last decade, the philosophical underpinnings of their requirements have been less explored in the literature. Clinical ethics remains preoccupied with clinical patient care and professional ethics with individual professional guidelines; even the American College of Healthcare Executives focuses primarily on healthcare managers, not on healthcare organizations. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

Mammalian sex chromosomes exhibit marked sexual dimorphism in behavior during gametogenesis. During oogenesis, the X chromosomes pair and participate in unrestricted recombination; both are transcriptionally active. However, during spermatogenesis the X and Y chromosomes experience spatial restriction of pairing and recombination, are transcriptionally inactive, and form a chromatin domain that is markedly different from that of the autosomes. Thus the male germ cell has to contend with the potential loss of X‐encoded gene products, and it appears that coping strategies have (...) evolved. Genetic control of sex‐chromosome inactivation during spermatogenesis does not involve pairing or the presence of the Y chromosome or an intact X chromosome, and may therefore be under exogenous control by the gonad. Sex‐chromosome reactivation during oogenesis and inactivation during spermatogenesis probably reflect specific meiotic events such as recombination. Understanding these phenomena may help explain other sex‐related differences in genetic recombination. (shrink)

In this paper, we provide an overview of how the outcomes of the Uruguay Round affected the application of pharmaceutical intellectual property rights globally. Second, we explain how specific pharmaceutical policy tools can help developing states mitigate the worst effects of the TRIPS Agreement. Third, we put forward solutions that could be implemented by the World Bank to help overcome the divide between creating private incentives for research and development of innovative medicines and ensuring access of the poor to medicine. (...) Fourth, we evaluate these solutions on the basis of utilitarian considerations and urge that equitable pricing is morally preferable to the other solutions. (shrink)