This research draws on complexity theory to provide an alternative conceptualization of issue management. We use six dynamics of complexity drawn from complex adaptive systems—equipoise, turbulence, sensitive conditions, bifurcation, attractor emergence, and symmetry breaking—to develop a metaphorical framework that describes what occurs during various periods of issue activity and what propels issues from one period of activity to another. We illustrate the framework with a case study of the pharmaceutical industry response to the HIV/aids pandemic in Sub-Saharan Africa. The article (...) concludes with a discussion of the additional affordances this framework provides to extend and compliment issue life cycle models. (shrink)

A well-documented defense of the thesis that St. Augustine held the city of man, especially Rome, to contain many relative goods, however evil it was from the absolute standpoint of goodness consisting in the worship of the true God. O'Meara discusses in some detail many contemporary critics, e.g., Ernest Barker, who oppose this interpretation, and argues on the basis of historical circumstance and Augustine's own declarations in works other than the City of God.--R. C. N.

Should we let personal responsibility for health-related behavior influence the allocation of healthcare resources? In this paper, we clarify what it means to be responsible for an action. We rely on a crucial conceptual distinction between being responsible and holding someone responsible, and show that even though we might be considered responsible and blameworthy for our health-related actions, there could still be well-justified reasons for not considering it reasonable to hold us responsible by giving us lower priority. We transform these (...) philosophical considerations into analytical use first by assessing the general features of health-related actions and the corresponding healthcare needs. Then, we identify clusters of structural features that even adversely affected people cannot reasonably deny constitute actions for which they should be held responsible. We summarize the results in an analytical framework that can be used by decision-makers when considering personal responsibility for health as a criterion for setting priorities. (shrink)

In the face of environmental crises such as climate change, pollution and biodiversity loss—which all adversely impact on health—Gils-Schmidt and Salloch explore whether physicians can be justified in taking climate issues into account in clinical care.1 While their approach centres on the ‘climate-sensitive’ decisions, physicians can carry out on the micro-level of clinical decision-making, they encourage further discussions on how climate-related issues can be included across different levels of decision-making in healthcare. We propose a list of tasks and a model (...) to assist with navigating the range of factors and structural elements an environmentally sensitive ethics must address. Stephen Gardiner’s notion of a perfect moral storm is central to understanding these issues.2 Gardiner describes how a perfect moral storm occurs in the centre of three overlapping conditions for human action and policymaking in the face of climate change. This storm is driven by: (1) a lack of interest among current generations to meet global needs and accommodate the well-being of future generations, (2) a lack of ecological concerns for other parts of nature than humans and (3) weak ethical and political theories and institutions shaping policy decisions on issues with severe implications across borders and generations. Moreover, these conditions are embedded in the existing, complex world of ethically unjustified power imbalances and social injustice. The growing awareness of healthcare’s climate footprint has amplified and accelerated global, grassroots action to make healthcare more environmentally friendly. This includes incorporating environmental impacts into quality improvement methodologies, building communities of practice to explore how to make …. (shrink)

The traditional view that having a personality disorder, unlike other mental disorders, is not usually reason enough to consider a person incompetent to make healthcare decisions is challenged. The example of a case in which a woman was treated for a physical disorder without her consent illustrates that personality disorder can render a person incompetent to refuse essential treatment, particularly because it can affect the doctor–patient relationship within which consent is given.

Evidence based medicine has been a topic of considerable controversy in medical and health care circles over its short lifetime, because of the claims made by its exponents about the criteria used to assess the evidence for or against the effectiveness of medical interventions. The central epistemological debates underpinning the debates about evidence based medicine are reviewed by this paper, and some areas are suggested where further work remains to be done. In particular, further work is needed on the theory (...) of evidence and inference; causation and correlation; clinical judgment and collective knowledge; the structure of medical theory; and the nature of clinical effectiveness. (shrink)

This line has been thought corrupt by most editors, though there is no agreement on the remedy. The Herald is plainly asking why the people at home are despondent: picks up the Chorus's phrase . But as Wilamowitz says, ‘ de populo aut senatu Argivorum accipi non potest’: it can only mean the army at Troy, as in lines 538 and 545. The usual inference is that arparw is corrupt.

No one is excused from doing what he ought to do merely because he is unwilling to do it. But what if others are unwilling to play their necessary role in some joint venture that you all ought to undertake: might that excuse you from doing what you yourself ought to do as part of that? It would, if you were genuinely willing to play your necessary part if they were. But the unwillingness of everyone involved cannot reciprocally serve to (...) excuse one another from doing what they ought to do. (shrink)

In this study, the drawbacks of using some religious concepts produced in the tradition of Western thought directly in their studies on Islamic belief will be discussed. The claim in question will be put forward within the framework of the concepts of deism, atheism and especially theism. Especially by reviewing the philosophy of religion studies made in Turkey, the fact that the three concepts mentioned are directly transferred to the philosophy of religion studies carried out in the Islamic world will (...) be revealed as a problem and this situation will be defined as the reduction of Islamic belief to some other concepts. The aim to be achieved by emphasizing such a problem is to ensure that the principles of Islamic belief are understood in their own meaning without reducing them to other meanings. Because every concept produced within the tradition of Western thought is directly related to its own intellectual and practical past. For this reason, when a solution or criticism that is formed in a different sense or dependent on a certain practical past is brought to Islamic thought, the philosophical and practical past of those concepts will also be carried. However, every belief should be evaluated by considering its own meaning and history. Evaluating this problem through concepts that Islam directly rejects, such as deism and atheism, is more understandable than the concept of theism. However, when it comes to the concept of theism, the subject becomes quite complex. Because in almost all sources, Islam is defined as a theistic religion and this is considered as a necessary pre-acceptance for the Islamic belief. However, theism is the understanding of God in modern Western thought, in which Descartes rationalism and Newtonian mechanics are accepted as the dominant element. Such an understanding of God, built within the epistemic boundaries of the thinking subject, is incompatible with the Islamic conception of God. (shrink)

The overall aim of this article is to discuss the organization of limit setting in healthcare in terms of legitimacy. We argue there is a strong ethical demand that such processes should be arranged to provide adversely affected people well-justified reasons to confer legitimacy to the processes despite favouring a different decision-making outcome. Two increasingly popular approaches, Accountability for Reasonableness (A4R) and Multi-Criteria Decision Analysis (MCDA), can both be applied to support legitimate decision-making processes. However, the role played by ‘fair-minded (...) people’ in the A4R framework can be shown to undermine an adequate conceptualization of legitimacy according to the ethical demand. We discuss and specify conditions enabling A4R to meet this ethical demand when being implemented in a real-world setting without having to renounce the aim of striving for ‘reasonableness’ and impartiality. The methodological approach MCDA describes how to arrange for transparent resource allocation. This approach does not encompass any normative guidance on how to shape limit settings in terms of ‘reasonableness’; it basically promotes ‘rational’ decisions. We discuss how this practical methodology can be integrated with the theoretical A4R framework to meet the ethical demand while at the same time promoting politically required impartiality of healthcare limit setting. (shrink)

2. The Meno offers a dramatic demonstration of the validity of the first argument put forward for Anamnesis and the immortality of the soul in the Phaedo.

In a free society, it is common to hear the request that one â ~keep an open mind.â Just what exactly is it, however, to keep an open-mind? How does open-mindedness function? How does it square with important personal commitments? These issues are particularly acute when it comes to matters of religious belief in which open-mindedness can sound to the pious a bit too much like doubt. Certainly, in a discipline whose discourse remains rational dialogue, effort should be spent discerning (...) the contours of this virtue, especially in light of its formal role in establishing responsiveness to new inquiries in matters philosophical and religious. This book provides a collection of essays serving to promote conversation about open-mindedness, its virtue, and its role and application in problems in the philosophy of religion in particular. (shrink)

Volume 20, Issue 4, May 2020, Page 71-73.

Book reviewed in this article: Protecting The Vulnerable: A Reanalysis of Our Social Responsibilities. By Robert E. Goodin. Chicago: University of Chicago Press.

This paper is a contribution to the study of equality-free logic, that is, first-order logic without equality. We mainly devote ourselves to the study of algebraic characterizations of its relation of elementary equivalence by providing some Keisler-Shelah type ultrapower theorems and an Ehrenfeucht-Fraïssé type theorem. We also give characterizations of elementary classes in equality-free logic. As a by-product we characterize the sentences that are logically equivalent to an equality-free one.

This distinction has sometimes been read as purely epistemic, resting not on things, but on our knowledge of them: there is one world, not two, though it may be apprehended in two ways. But this view is patently at odds with the text. Knowledge and opinion are δυνάμεις, "faculties," to be distinguished and defined by their objects, no less than by the state of mind they produce, and Plato clearly states that the fallibility and unclearness of opinion is rooted in (...) the relative unreality of opinables. (shrink)

Corporate social responsibility is a recognised and common part of business activity. Some of the regularly cited motives behind CSR are employee morale, recruitment and retention, with employees acknowledged as a key organisational stakeholder. Despite the significance of employees in relation to CSR, relatively few studies have examined their engagement with CSR and the impediments relevant to this engagement. This exploratory case study-based research addresses this paucity of attention, drawing on one to one interviews and observation in a large UK (...) energy company. A diversity of engagement was found, ranging from employees who exhibited detachment from the CSR activities within the company, to those who were fully engaged with the CSR activities, and to others who were content with their own personal, but not organisational, engagement with CSR. A number of organisational context impediments, including poor communication, a perceived weak and low visibility of CSR culture, and lack of strategic alignment of CSR to business and personal objectives, served to explain this diversity of employee engagement. Social exchange theory is applied to help explore the volition that individual employees have towards their engagement with CSR activities, and to consider the implications of an implicit social, rather than explicit economic, contract between an organisation and its employees in their engagement with CSR. (shrink)

Evaluation of the potential of a cocaine vaccine requires a detailed understanding of the intended and unintended social consequences of its use. Prospective technology assessment is always difficult, but in the case of treatment and prevention of cocaine addiction we need to understand not only the neuroscience and pharmacology of cocaine addiction, but also social attitudes to drug use and addiction, the social context of drug use, and the factors which make drug use a rational strategy for an addict and (...) make treatment seeking or relapse more or less likely. By considering different scenarios related to differing levels of effectiveness of the vaccine, the authors argue that vaccination will be at best a useful adjunct to existing methods of treatment, rather than a substitute for them. (shrink)

Park and Davies (2024) have conducted impressive work on synthesizing the discussion of vaccination-sensitive rationing and relevant theoretical approaches. In this commentary, we build upon their...