Our primary focus is on analysis of the concept of voluntariness, with a secondary focus on the implications of our analysis for the concept and the requirements of voluntary informed consent. We propose that two necessary and jointly sufficient conditions must be satisfied for an action to be voluntary: intentionality, and substantial freedom from controlling influences. We reject authenticity as a necessary condition of voluntary action, and we note that constraining situations may or may not undermine voluntariness, depending on the (...) circumstances and the psychological capacities of agents. We compare and evaluate several accounts of voluntariness and argue that our view, unlike other treatments in bioethics, is not a value-laden theory. We also discuss the empirical assessment of individuals? perceptions of the degrees of noncontrol and self-control. We propose use of a particular Decision Making Control Instrument. Empirical research using this instrument can provide data that will help establish appropriate policies and procedures for obtaining voluntary consent to research. (shrink)

The American Journal of Bioethics, Volume 11, Issue 8, Page W1-W3, August 2011.

Miller (1956) summarized evidence that people can remember about seven chunks in short-term memory (STM) tasks. However, that number was meant more as a rough estimate and a rhetorical device than as a real capacity limit. Others have since suggested that there is a more precise capacity limit, but that it is only three to five chunks. The present target article brings together a wide variety of data on capacity limits suggesting that the smaller capacity limit is real. Capacity limits (...) will be useful in analyses of information processing only if the boundary conditions for observing them can be carefully described. Four basic conditions in which chunks can be identified and capacity limits can accordingly be observed are: (1) when information overload limits chunks to individual stimulus items, (2) when other steps are taken specifically to block the recoding of stimulus items into larger chunks, (3) in performance discontinuities caused by the capacity limit, and (4) in various indirect effects of the capacity limit. Under these conditions, rehearsal and long-term memory cannot be used to combine stimulus items into chunks of an unknown size; nor can storage mechanisms that are not capacity-limited, such as sensory memory, allow the capacity-limited storage mechanism to be refilled during recall. A single, central capacity limit averaging about four chunks is implicated along with other, noncapacity-limited sources. The pure STM capacity limit expressed in chunks is distinguished from compound STM limits obtained when the number of separately held chunks is unclear. Reasons why pure capacity estimates fall within a narrow range are discussed and a capacity limit for the focus of attention is proposed. Key Words: attention; enumeration; information chunks; memory capacity; processing capacity; processing channels; serial recall; short-term memory; storage capacity; verbal recall; working memory capacity. (shrink)

Psychiatry has witnessed a new wave of approaches to clinical phenotyping and the study of psychopathology, including the National Institute of Mental Health’s Research Domain Criteria, clinical staging, network approaches, the Hierarchical Taxonomy of Psychopathology, and the general psychopathology factor, as well as a revival of interest in phenomenological psychopathology. The question naturally emerges as to what the relationship between these new approaches is – are they mutually exclusive, competing approaches, or can they be integrated in some way and used (...) to enrich each other? In this opinion piece, we propose a possible integration between clinical staging and phenomenological psychopathology. Domains identified in phenomenological psychopathology, such as selfhood, embodiment, affectivity, etc., can be overlaid on clinical stages in order to enrich and deepen the phenotypes captured in clinical staging (‘high resolution’ clinical phenotypes). This approach may be useful both ideographically and nomothetically, in that it could complement diagnosis, enrich clinical formulation, and inform treatment of individual patients, as well as help guide aetiological, prediction, and treatment research. The overlaying of phenomenological domains on clinical stages may require that these domains are reformulated in dimensional rather than categorial terms. This integrative project requires assessment tools, some of which are already available, that are sensitive and thorough enough to pick up on the range of relevant psychopathology. The proposed approach offers opportunities for mutual enrichment: clinical staging may be enriched by introducing greater depth to phenotypes; phenomenological psychopathology may be enriched by introducing stages of severity and disorder progression to phenomenological analysis. (shrink)

A formula is a contingent logical truth when it is true in every model M but, for some model M , false at some world of M . We argue that there are such truths, given the logic of actuality. Our argument turns on defending Tarski’s definition of truth and logical truth, extended so as to apply to modal languages with an actuality operator. We argue that this extension is the philosophically proper account of validity. We counter recent arguments to (...) the contrary presented in Hanson’s ‘Actuality, Necessity, and Logical Truth’ (Philos Stud 130:437–459, 2006 ). (shrink)

In this highly original and accessible book, one of our leading philosophers of religion seeks to answer this question by analyzing the several states of mystic union as they are described and explained in the classical primary literature ...

The paper aims to put certain basic mathematical elements and operations into an empirical perspective, evaluate the empirical status of various analytic operations widely used within psychology and suggest alternatives to procedures criticized as inadequate. Experimentation shows the "manyness" of items to be a perceptual quality for both young children and animals and that natural operations are performed by naive children analogous to those performed by persons tutored in arithmetic. Number, counting, arithmetic operations therefore can make distinctions that are not (...) inevitably arbitrary, and conceptual operations can obviously have a status as natural events with psychology. If the elements and conceptual operations involved in mathematical systems were not inherent in physiological process, various primitive discriminations could not be possible. Also, since some calculi have a natural status in a given empirical circumstance, the axioms of others can not be satisfied. Therefore the psychologist when acting as an empirical scientist seeks a calculus having a structure whose elements are isomorphic with natural units of stimulus and response and whose operations are isomorphic with whatever natural processes are involved. Measurement poses a special problem for the empirical scientist. It concerns but a single class of natural qualities and this only in a limited way. The concept of quantity has a natural counterpart but quantity and measurement are not wholly analogous. Measurement is defined, as H. S. Leonard suggests, as a theoretical activity. Measurement theory has a formal structure but empirical end. Measurement hypothesizes about the position of a particular quality within a definite range of qualities. It therefore is beholden to definite empirical restrictions. Some hypotheses-making systems use terms and relations per se as the context and starting point for dealing with discriminable events. Such procedures are 'transcendent." In empirical science, questions are part of problem-solving activity and their reference is naturally restricted. In providing description and explanation, psychological researchers frequently use calculi in a transcendent way. This results in theories that are only quasi-empirical and "half" true. The roles measurement plays in psychology are discussed. Of particular concern are those cases in which the results of measuring or a theory of measurement are used to define the "real" units, or the "real" relations involved in problematic psychological events, and thence to describe and explain behaviors of interest. Metaphysical or ontological usages of measurement sometimes occur. The implication of these arguments with regard to a view of empirical science is discussed. (shrink)

In this article I explore partial ectogenesis through the lens of choice in childbirth, framing it as a mode of delivery. In doing so, I refocus discussion about partial ectogenesis, ensuring that this centers upon the autonomy and rights of the birthing person—as the procedure required to facilitate external gestation will be performed upon their body. By drawing a critical comparison between “delivery by partial ectogenesis” and request cesarean sections, I argue that delivery by partial ectogenesis ought to be available (...) on the basis of the pregnant person’s request alone. (shrink)

On the usual account of moral reasoning, social science is often seen as able to provide “just the facts,” while philosophy attends to moral values and conceptual clarity and builds formally valid arguments. Yet disciplines are informed by epistemic values—and bioethics might do well to see social scientific practices and their attendant normative understandings about what is humanly important as a significant part of ethics generally.

The capability approach to distributive justice, as defended by Amartya Sen and Martha Nussbaum, represents perhaps the most influential recent attempt to reconcile the competing demands of liberty and equality. Specifically, capability theorists have claimed that their insistence on the universal cultivation of a set of capabilities for basic human "functionings" is fully consistent with a liberal neutrality commitment. Their reason is that these capabilities are, like Rawls's primary goods, rational to want "whatever else one wants." This article suggests, in (...) contrast, that the capability approach fails to satisfy the neutrality requirement endorsed by both Sen and Nussbaum. It further suggests that the non-neutral character of the approach reflects its Rawlsian lineage, and raises serious doubts about the coherence of Rawls's account of primary goods. (shrink)

Currently, an emphasis is being placed on the integration of ethical issues into the business curriculum. This paper investigates the viability of using student group interaction to induce an upward movement in the stages of moral development as advanced by Kohlberg. The results of a classroom experiment using graduate business law students suggest that formulating groups that mix stages of moral development can provide a robust environment for upward movement. In addition, the results suggest strategies for formulating effective groups, based (...) upon entry levels as measured by the Defining Issues Test. (shrink)

Behavioral research has revealed how normal human cognitive processes can tend to lead us astray. But do these affect economic researchers, ourselves? This article explores the consequences of stereotyping and confirmation bias using a sample of published articles from the economics literature on gender and risk aversion. The results demonstrate that the supposedly ‘robust’ claim that ‘women are more risk averse than men’ is far less empirically supported than has been claimed. The questions of how these cognitive biases arise and (...) why they have such power are discussed, and methodological practices that may help to attenuate these biases are outlined. (shrink)

The report of the President's Council on Bioethics, Human Cloning and Human Dignity, addresses the central ethical, political, and policy issue in human embryonic stem cell research: the moral status of extracorporeal human embryos. The Council members were in sharp disagreement on this issue and essentially failed to adequately engage and respectfully acknowledge each others' deepest moral concerns, despite their stated commitment to do so. This essay provides a detailed critique of the two extreme views on the Council (i.e., embryos (...) have full moral status or they have none at all) and then gives theoretical grounding for our judgment about the intermediate moral status of embryos. It also supplies an account of how to address profound moral disagreements in the public arena, especially by way of constructing a middle ground that deliberately pays sincere respect to the views of those with whom it has deep disagreements. (shrink)

PDF includes the introduction. Abstract: In this wide-ranging and authoritative volume, leading scholars engage with the philosophy and writings of Wilhelm Dilthey, a key figure in nineteenth-century thought. Their chapters cover his innovative philosophical strategies and explore how they can be understood in relation to their historical situation, as well as presenting incisive interpretations of Dilthey's arguments, including their development, their content, and their influence on later thought. A key focus is on how Dilthey's work remains relevant to current debates (...) around art and literature, the biographical and autobiographical self, knowledge, language, science, culture, history, society, and psychology and the embodied mind. The volume will be important for researchers in hermeneutics, aesthetics, practical philosophy, and the history of German philosophy, providing a valuable introduction to Dilthey's work as well as detailed critical analysis of its ongoing significance. (shrink)

Alexander Miller has recently considered an ingenious extension of Frank Jackson and Philip Pettit's account of 'program explanation' as a way of defending non-reductive naturalist versions of moral realism against Harman's explanatory criticism. Despite the ingenuity of this extension, Miller concludes that program explanation cannot help such moral realists in their attempt to defend moral properties. Specifically, he argues that such moral program explanations are dispensable from an epistemically unlimited point of view. I show that Miller's argument for this negative (...) claim is inadequate, and that he has, in spite of himself, identified a promising defence of moral realism. (shrink)

Hegel remarked in his discussion of the nothing in the Science of Logic that: “It is well known that in oriental systems, and essentially in Buddhism, nothing, or the void, is the absolute principle.” Schopenhauer commented in a discussion of the joy of death in The World as Will and Representation: “The existence which we know he willingly gives up: what he gets instead of it is in our eyes nothing, because our existence is, with reference to that, nothing. The (...) Buddhist faith calls it Nirvana, i.e., extinction.” It is striking how nineteenth-century German philosophical discourses (from Hegel and Schopenhauer to Mainländer, von Hartmann, and Nietzsche) concerning negativity, nihility, and nothingness explicitly refer to Buddhism, which was initially conceived by Christian missionaries as a “cult of nothingness” and became entangled with European debates concerning pessimism (the Pessimismusstreit) and nihilism. In this article, I reconsider how the interpretation of negativity and nothingness in Schopenhauer and nineteenth-century German thought informed the reception of Buddhism as a philosophical and religious discourse, and trace the ways in which Buddhist emptiness was reinterpreted in the context of the Western problematic of being and nothingness. (shrink)

Work done within the realm of what is sometimes called ‘descriptive ethics’ brings two questions readily to mind: How can empirical findings, in general, inform normative debates? and How can these empirical findings, in particular, inform the normative debate at hand? Brick et al 1 confront these questions in their novel investigation of public views about lives worth living and the permissibility of withdrawing life-sustaining treatment from critically ill infants. Mindful of the is-ought gap, the authors suggest modestly that their (...) data ‘may be useful when constructing guidelines for clinical practice’. In this commentary, I consider some potential limitations on the generalisability of these data in the context of policy and clinical practice, limitations which may in turn serve as directions for future empirical research. The authors’ study presented participants six case scenarios, five of which involved the possibility of withdrawing life-sustaining treatment from critically ill infants. The results revealed that “[a]lmost all respondents agreed that at some level of quality of life, life may be of no benefit or worse than death for an infant” and that “participants significantly favoured withdrawal of treatment for the most severe cases.” One salient detail in these scenarios …. (shrink)

Those giving birth within modern maternity systems are recognised as facing a number of barriers to person-centred care. In this paper, I argue that in order to best facilitate the conditions for positive change, work needs to be done to provide a more granular articulation of the specific barriers. I then offer a nuanced and contextually aware articulation of one key component of the overall failure to ensure person-centred care: medical authority and the expectation of conformity. Articulating these barriers with (...) increased specificity is valuable, as it creates a stronger foundation from which to challenge existing problems which serve to constrain the autonomy of birthing individuals. The analysis offered in this paper also underscores the need for change at an institutional, rather than individual, level. (shrink)

: The feminist ethic of care has often been criticized for its inability to address four problems--the problem of exploitation as it threatens care givers, the problem of sustaining care-giver integrity, the dangers of conceiving the mother-child dyad normatively as a paradigm for human relationships, and the problem of securing social justice on a broad scale among relative strangers. We argue that there are resources within the ethic of care for addressing each of these problems, and we sketch strategies for (...) developing the ethic more fully. (shrink)

Commentators expressed a wide variety of views on whether there is a basic capacity limit of 3 to 5 chunks and, among those who believe in it, about why it occurs. In this response, I conclude that the capacity limit is real and that the concept is strengthened by additional evidence offered by a number of commentators. I consider various arguments why the limit occurs and try to organize these arguments into a conceptual framework or “metatheory” of storage capacity limits (...) meant to be useful in future research to settle the issue. I suggest that principles of memory representation determine what parts of the representation will be most prominent but that limits of attention (or of a memory store that includes only items that have been most recently attended) determine the 3- to 5-chunk capacity limit. (shrink)

Let me make it clear from the outset that my main point isnoteither of the following: one, that there should be more women economists and research on “women's issues”, or two, that women as a class do, or should do, economics in a manner different from men. My argument is different and has to do with trying to gain an understanding of how a certain way of thinking about gender and a certain way of thinking about economics have become intertwined (...) through metaphor – with detrimental results – and how a richer conception of human understanding and human identity could broaden and improve the field of economics for both female and male practitioners. (shrink)

The unique context of the rural setting provides special challenges to furnishing ethical healthcare to its approximately 62 million inhabitants. Although rural communities are widely diverse, most have the following common features: limited economic resources, shared values, reduced health status, limited availability of and accessibility to healthcare services, overlapping professional–patient relationships and care giver stress. These rural features shape common healthcare ethical issues, including threats to confidentiality, boundary issues, professional–patient relationship and allocation of resources. To date, there exists a limited (...) focus on rural healthcare ethics shown by the scarcity of rural healthcare ethics literature, rural ethics committees, rural focused ethics training and research on rural ethics issues. An interdisciplinary group of rural healthcare ethicists with backgrounds in medicine, nursing and philosophy was convened to explore the need for a rural healthcare ethics agenda. At the meeting, the Coalition for Rural Health Care Ethics agreed to a definition of rural healthcare ethics and a broad-ranging rural ethics agenda with the ultimate goal of enhancing the quality of patient care in rural America. The proposed agenda calls for increasing awareness and understanding of rural healthcare ethics through the development of evidence—informed, rural-attuned research, scholarship and education in collaboration with rural healthcare professionals, healthcare institutions and the diverse rural population. (shrink)

The hermeneutical tradition represented by Yorck, Heidegger, and Gadamer has distrusted Dilthey as suffering from the two sins of modernism: scientific “positivism” and individualistic and aesthetic “romanticism.” On the one hand, Dilthey’s epistemology is deemed scientistic in accepting the priority of the empirical, the ontic, and consequently scientific inquiry into the physical, biological, and human worlds; on the other hand, his personalist ethos and Goethean humanism, and his pluralistic life- and worldview philosophy are considered excessively aesthetic, culturally liberal, relativistic, and (...) subjective. This essay involves two tasks in response to this negative evaluation of Dilthey that has shaped our current understanding of his philosophical project; first, an interpretation of the issues at stake in Heidegger’s reception of and struggles with Dilthey. These issues touch upon language, historicity, and the nature of hermeneutics. Second, by pursuing this task in light of Guignon’s interpretation of Dilthey and Heidegger, I hope to question and challenge the “overcoming” of Dilthey’s epistemic and life-philosophical hermeneutics in the “ontological” or “philosophical” hermeneutics of Heidegger. (shrink)

Volume 20, Issue 2, February 2020, Page 66-68.

In lieu of an abstract, here is a brief excerpt of the content:NOTES AND DISCUSSIONS 95 OCKHAM ON INTUITIVE COGNITION t In the first part of what follows, I try to locate Ockham's theory of intuitive cognition in the context of one set of philosophical problems rather than another. The device I use is to emphasize the major error Ockham wants to avoid: "platonism" rather than scepticism. In the second part, I try to show how difficulties raised by some recent (...) commentary result from the wrong orientation. This very limited project involves neither exposition nor assessment of Ockham's proposed solutions for the philosophical problems. But hopefully it will prove useful or at least suggestive for others working in this or related areas in Ockham. According to Ockham, 2 someone can be said to hold to or cognize a proposition evidently when he knows it to be true. The paradigm of knowing something to be true is seeing that it follows from the premisses in a demonstrative syllogism. However, first principles, or any proposition per se nota, can also be known to be true or cognized evidently. And, what is most important for our purposes, contingent propositions can be cognized evidently when, as one might say, they are known in experience. When someone is looking at a white wall, to ~se one of Ockham's examples, he can cognize evidently the proposition "The wall is white." 3 i Aside from a few quotations, I have given only the location of references in Ockham. Only very extensive quotations would make the article self-sufficient or, for that matter, even be helpful to the reader. My effort is both tentative and parasitic on earlier commentary and can, perhaps, be excused from providing logistic support that would far exceed its own weight. Moreover, I have tried to direct the reader to the most convenient materials, using fairly common or obvious abbreviations for Ockham's writings and the symbols given in the brackets for each of these sources. [Baudry] L Baudry, Lexique philosophique de Guillaume d'Ockham (Paris, 1958). [McKeon] R. McKeon, Selections /tom Medieval Philosophers, Vol. II (New York, 1929). This almost literal translation of selected Quodlibeta is sufficient for my present purposes. The Strasbourg edition of 1491, of course, is not more readily available m the reimpression from Louvain, Editions de la Biblioth~que Sd., 1962. [OPW] P. Boehner, Ockham: Philosophical Writings (New York, 1957). The page numbers given are from the Nelson edition, containing both Latin and English. The Library of Liberal Arts (Bobbs-Merrill) edition which consists only of the English text runs from one to sixteen pages ahead as a result of numbering the blank pages at the beginning of each section. [Ordinatio] Opera Philosophica et Theologica (St. Bonaventure, N.Y., 1967). Vol. I: Scripture in Librum Primum Sententiarum Ordinatio, Prologus et Distinctio Prima, edited by G. Gal and S. Brown. The lines referred to are given as superscripts to the page numbers. a Expos. Physicorum, Prologue ([OPW] pp. 4-5). See also [Baudry] under scire and evidens. a The issue of translation raises a host of problems of varying degrees of philosophical importance. I am not settled in my own mind about the best English equivalents for many important terms, and in my translations and commentary I have not tried for consistency. In principle, I prefer odd or quaint terms, since they bear their faults on their 96 HISTORY OF PHILOSOPHY At one point, Ockham gives this description: Whoever knows some proposition evidently cannot dissent from that proposition by the power of the will alone, but it is necessary that he be persuaded by an argument more strongly moving his intellect to dissent, or it is necessary that he have forgotten something evidently known.4 Let me call your attention to the un-Cartesian way in which Ockham removes the judgement of some contingent (and all necessary) propositions from the (total) dominion of the will. I may remain silent or talk of something else, or I may avail myself of questions and conditionals, but if I intend to deal head-on with equals added to equals or (while looking at the white wall) with walls and whiteness, I cannot but assert that equals added to equals are equal or... (shrink)

I consider the intertextuality between Chinese and Western thought by exploring how images, metaphors, and ideas from the texts associated with Zhuangzi and Laozi were appropriated in early twentieth-century German philosophy. This interest in “Lao-Zhuang Daoism” encompasses a diverse range of thinkers including Buber and Heidegger. I examine how the problematization of utility, usefulness, and “purposiveness” in Zhuangzi and Laozi becomes a key point for their German philosophical reception; how it is the poetic character of the Zhuangzi that hints at (...) an appropriate response to the crisis and loss of meaning that characterizes technological modernity and its instrumental technological rationality; that is, how the “poetic” and “spiritual” world perceived in Lao-Zhuang thought became part of Buber's and Heidegger's critical encounter and confrontation with technological modernity; and how their concern with Zhuangzi does not signify a return to a dogmatic religiosity or otherworldly mysticism; it anticipates a this-worldly spiritual or poetic way of dwelling immanently within the world. (shrink)

1. Kant on the “Conditions of the Possibility” of Experience -- Claude Piché // 2. Plato and Kantian Transcendental Constructivism -- Tom Rockmore // 3. Kant and Fichte on the Notion of (Transcendental) Freedom -- Violetta L. Waibel // 4. Fichte, Transcendental Ontology, and the Ethics of Belief -- Steven Hoeltzel // 5. Transcendental Philosophy as “Therapy of the Mind”: Fichte’s “Facts of Consciousness” Lectures -- Benjamin D. Crowe // 6. From Transcendental Philosophy to Hegel’s Developmental Method -- William F. (...) Bristow // 7. How Transcendental Is Cohen’s Critical Idealism? -- Halla Kim // 8. Heidegger’s Failure to Overcome Transcendental Philosophy -- Eric S. Nelson // 9. Others as the Ground of Our Existence: Levinas, Løgstrup, and Transcendental Arguments in Ethics -- Robert Stern // 10. Raising Validity Claims for Reasons: Transcendental Reflection in Apel’s Argumentative Discourse -- Matthias Kettner // 11. Transcendental Arguments Based on Question-Answer Contradictions -- Yukio Irie // 12. Consequences of the Transcendental-Pragmatic Consensus Theory of Truth -- Michihito Yoshime // 13. On Jürgen Habermas’s Cognitive Theory of Morality -- Yasuyuki Funaba . (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Just Share: Justice and Fairness in Resource Allocation*Pat Milmoe Mccarrick (bio) and Martina Darragh (bio)Each of us has some basic sense of what the words “fair” or “just” or “fairness” or “justice” mean. Each of us probably also has an idea of what is “fair” in health care. The attempt by the state of Oregon in the mid-1980s to quantify this notion made a previously private exercise a (...) public one. This transition has been chronicled in the bioethics literature that focuses on resource allocation. These works examine both theories of justice and concepts of “health”; the fair distribution of health resources has been of continuing interest since the beginning of bioethics in the 1960s. Early writing on justice includes authors Tom L. Beauchamp, Robert H. Blank, James F. Childress, H. Tristram Engelhardt, Paul T. Menzel, Paul Ramsey, and Robert M. Veatch (VII).During the 1980s, bioethicists such as Daniel Callahan and Norman Daniels proposed thinking of health care decisions not as moments of personal crisis but as choices that span a lifetime, possibly involving tradeoffs in other areas of one’s life, e.g., education. The Oregon experience added another dimension to the discussion. The initial rank-ordering of health services by cost produced a skewed list—for example, surgery for life-threatening conditions ranked below minor, elective procedures. For the project to make sense, the ranking algorithm could not be based on cost alone, but rather on a combination of costs and benefits both to individuals and to the community—“concatenations of individual and group goods” (I, Jecker and Jonsen 1995). Various metaphors have been used in the literature to facilitate discussion of this shift from individual to individual/community trade-offs: medical services as a “commons” (I, Asch 1995, Jecker and Jonsen 1995, Michels 1994); resource allocation as a “lifeboat” (I, Campbell 1995; III, Kaveny 1994); medical care as “shares” in a community health (III, Nelson 1992, Ford and Kissick 1995; II, Anderson 1993); and rationing as traveling through the desert with one jug of water for two people (a story from the Halachah literature) (I, Zoloth-Dorfman 1995). [End Page 81]Such metaphors do not promote any one “theory of justice” but rather draw from the work of a number of bioethicists as well as from theological, sociological, economic, and business literature. The five major conceptions of justice that are referenced most frequently are: “(1) a libertarian conception, which takes liberty to be the ultimate political ideal; (2) a socialist conception, which takes equality to be the ultimate political ideal; (3) a welfare liberal conception, which takes contractual fairness or maximal utility to be the ultimate political ideal; (4) a communitarian conception, which takes the common good to be the ultimate political ideal; and (5) a feminist conception, which takes a gender-free society to be the ultimate political ideal” (I, Sterba 1995).The use of new metaphors also draws on expanded concepts of “health.” “As health care is currently practiced, the most powerful symbols for public and professional alike are those that promise the defeat of time” (I, Campbell 1995). When medical care is perceived as an unrelated series of individual cures, the fact that health care resources are finite cannot be addressed.Reflections concerning the difficulties in limiting the use of health care resources have an ancient lineage and reveal a tight bond with the obsession to postpone death at all costs. Plato in Book 3 of the Republic recognizes the quandary of infinite expectations and finite resources that characterizes the challenge of health care choices. (I, Engelhardt 1996)The proliferation of expensive medical technologies and the loss of autonomy by health care professionals further complicates perceptions of the crucial issues at hand. Some have said that Americans place too much emphasis on individualism to address these issues. Daniels et al. believe that this is too pessimistic a view and that the American commitment to protecting equal opportunity for all provides a firm basis for developing a public consensus on what is fair in health care (III, Daniels, Light, and Caplan 1996). Finally, several authors suggest that the nature of all four principles of medical ethics, not justice alone, must be... (shrink)