Geoffrey Rose’s prevention paradox points to a tension between two prima facie plausible moral principles: that we should save the greater number and that weshould save the most at risk. This paper argues that a novel moral theory, ex-ante contractualism, captures our intuitions in many prevention paradox cases, regardless of our interpretation of probability claims. However, it goes on to show that it might be impossible to square ex-ante contractualism with all of our moral intuitions. It concludes that even if (...) ex-ante contractualism cannot furnish an entire ethics of risk, it does identify important considerations for any such theory. (shrink)

An d rew Ku per begins his cri ti que of my vi ews on poverty by accepti n g the crux of my moral argument: The interests of all persons ought to count equally, and geographic location and citizenship m a ke no intrinsic differen ce to the ri gh t s and obl i ga ti ons of i n d ivi du a l s . Ku per also sets out some key facts about global poverty, for (...) example, that 30,000 children die every day from preventable illness and starvation, while most people in devel oped nati on s have plenty of disposable income that they s pend on lu x u ries and items that sati s f y mere wants, not basic needs. Yet after summarizing an essay I wrote for the New York Times Magazine in which I argued that the avera ge Am erican family should don a te a l a r ge porti on of t h eir income to or ga n i z ati ons like UNICEF and Ox f a m , Ku per wri te s : “ But if Si n ger ’s ex h ort a ti ons make you want to act immediately in the ways he recom m en d s , you s h ould not do so.” Why not? Because the approach I advoc a te “would seriously harm the poor.” These are strong words. It is startling to be told that a substantial transfer of resources from comfortably-off American families to UNICEF or Oxfam would harm the poor. What abo ut those 3 0,0 0 0 ch i l d ren dyi n g from preventable illness and starvation? In its 2001 fund-raising material,the U.S. Committee for UNICEF says that a donation of $17 will provide immunization “to protect a child for life against the six leading ch i l d - killing and maiming diseases:measles,polio. (shrink)

This article begins from the assumption that what was once an integral dimension of progress—the development of literature and of art more generally—now lies outside its scope. The essay falls into three parts that juxtapose French with German intellectual history. The first part examines the notion of literary progress developed by Charles Perrault and Fontenelle, as well as the opposition to it by Boileau and other antiquarians, during the querelle des Anciens et des Modernes in the later seventeenth century. The (...) second part treats the reception of those arguments during the eighteenth century by J. C. Gottsched, J. J. Bodmer, and J. J. Breitinger. Special attention is given to the paradox that Gottsched, the leader of the German antiquarians, and Bodmer, the leader of the German progressives, were equally devoted to the Leibnizian-Wolffian philosophical system and thus that German Romanticism, heavily indebted to Bodmer's poetics, had roots in rationalist philosophy. The essay's third part discusses ideas of literary progress in the writings of the early Romantics J. G. Herder and Friedrich Schlegel. As these discussions show, the conception of general progress was formed in a field that has since dissociated itself from progress's march. (shrink)

The current Medicare prospective payment system has many positive incentives for hospitals to control costs. Hospitals are increasing outpatient surgery, decreasing admissions, decreasing length of stay, and decreasing use of ancillary services. These are just the effects that Congress and the Health Care Financing Administration hoped for to save the Medicare trust fund. However, there has been evidence of some adverse outcomes including premature discharge, “dumping” sicker patients and patients without insurance, and adverse impact on hospitals with specialty centers. We (...) examine these issues and present a possible solution based on a new Computerized Severity Index. (shrink)

While there is significant consensus that undergraduate medical education should include bioethics training, there is widespread debate about how to teach bioethics to medical students. Educators disagree about course methods and approaches, the topics that should be covered, and the effectiveness and metrics for UME ethics training. One issue that has received scant attention is the timing of bioethics education during medical training. The existing literature suggests that most medical ethics education occurs in the pre-clinical years. Follow-up studies indicate that (...) medical students in their clinical rotations have little recall or ability to apply ethics concepts that were learned in their pre-clinical training. Trainees also report a desire for medical ethics to be taught in the context of practical application, which would suggest that the timing of pre-clinical ethics education is flawed. However, moving bioethics training to the clinical years should not be assumed to be the solution to the problems of recall and theory application. We argue that the effectiveness of timing bioethics education will depend on when medical students witness or experience particular categories of ethical dilemmas during their training. Our overarching hypothesis is that ethics education will be most effective when the bioethics training on a particular topic correlates to experiential exposure to that ethical issue. The purpose of our current study was to describe medical students exposure to particular categories of ethical conflicts, dilemmas, or issues. Our results may help bioethics educators better strategize about the most effective timing of medical ethics training in UME. (shrink)

Joseph C. Pitt, based on his understanding of trust and of technology, makes the provocative argument that trusting technology is actually a matter of trusting people. I agree with Pitt’s conclusion but differ with him on the nature of trust. I contend, nonetheless, that my understanding of trust actually reinforces Pitt’s characterization of technology as “humanity at work.”.

The present study explores the Bianchi type I universe in the frame work of f theory of gravity by considering strange quark matter attached to string cloud and domain walls in the presence and absence of magnetism. Field equations are solved by choosing a constant curvature method. It is found that obtained cosmological models are relevant to the early era of evolution of the universe. The strange quark matter may be a source of string cloud and domain walls.

The practice of prenatal screening for disability is sometimes objected to because of the hurt and offence such practices may cause to people currently living with disabilities. This objection is commonly termed “the expressivist objection”. In response to the objection it is standardly claimed that disabilities are analogous to illnesses. And just as it would be implausible to suppose reduction of the incidence of illnesses such as flu sends a negative message to ill people, so it is not plausible to (...) suppose prevention of disability sends a negative message to disabled people. The expressivist objection hinges, however, upon a view of the relationship between disability and self identity which sees disability as part of the identity of the disabled person, in a way in which illnesses such as flu cannot be. This possibility is generally not considered in critiques of the expressivist objection. In this paper, an “identity claim” to the effect that disabilities can be identity constituting is accepted and the force of the expressivist argument is reconsidered in the light of its acceptance. It is concluded that even when such an identity claim is accepted, the expressivist objection is still not morally compelling. (shrink)

This article addresses the aesthetic status of gargoyles in medieval Gothic architecture. Irreducible to the grotesque yet manifestly discrepant with the core of cathedral and monastic buildings, the gargoyle serves as an entry point for an exploration of the stylistic relations comprising the Gothic and reflecting the cultural duality of the ecclesiastic sites of its historical emergence. The relation between gargoyles and the bulk of Gothic structures and ornamentation is discussed in terms of an “aesthetics of contrast.”.

A recent exchange on Benatar’s book Better never to have been between Doyal and Benatar discusses Benatar’s bold claim that people should not be brought into existence. Here, I expand the discussion of original position that the exchange focused on. I also discuss the asymmetries, between benefit and harm and between existence and non-existence, upon which Benatar’s bold claim rests. In both discussions, I show how Benatar’s bold claim can be rejected.

Persistence theories of causation – such as transference theory, conserved-quantity theory, and Douglas Ehring's theory – attempt to analyzecausation in terms of some persisting entityconnecting cause and effect. While mostpersistence accounts are intended as empiricaltheories, this article develops a persistenceanalysis of the concept of causation. The basic idea is that the central concept ofdirect causation can be analyzed in terms ofproperty acquisition. The analysis cohereswith our ordinary causal judgments andprovides a straightforward explanation of thedirection of causation. It also explains whybackwards (...) causation is conceptually problematic. (shrink)

An investigation into some of the literary features of the book of Malachi reveals that each unit is structured in a twofold way. The macrostructure of the book also shows that the book can be divided into two parts. The results of this investigation strengthens the recent trend in the research of Malachi that it is unlikely that the book underwent an extensive redactional process over a period of time and that it is rather more likely that the book was (...) written in a relatively short period of time. (shrink)