ABSTRACT The just distribution of benefits and burdens of healthcare, at least in the contemporary Philippine context, is an issue that gravitates towards two opposing doctrines of welfarism and ‘free enterprise.’ Supported largely by popular opinion, welfarism maintains that social welfare and healthcare are primarily the responsibility of the government. Free enterprise (FE) doctrine, on the other hand, maintains that social welfare is basically a market function and that healthcare should be a private industry that operates under competitive conditions with (...) minimal government control. I will examine the ethical implications of these two doctrines as they inform healthcare programmes by business and government, namely: (a) the Devolution of Health Services and (b) the Philippine Health Maintenance Organization (HMO). I will argue that these doctrines and the health programmes they inform are deficient in following respects: (1) equitable access to healthcare, (2) individual needs for premium healthcare, (3) optimal utilisation of health resources, and (4) the equitable assignment of burdens that healthcare entails. These respects, as considerations of justice, are consistent with an operational definition of ‘power’ proposed here as ‘access to and control of resources.’. (shrink)

Practical medical decisions are closely integrated with ethical and religious beliefs in the Philippines. This is shown in a survey of Filipino physicians' attitudes towards severely compromised neonates. This is also the reason why the ethical analysis of critical care practices must be situated within the context of local culture. Kagandahang loob and kusang loob are indigenous Filipino ethical concepts that provide a framework for the analysis of several critical care practices. The practice of taking-from-the-rich-to-give-to-the-poor in public hospitals is not (...) compatible with these concepts. The legislated definition of death and other aspects of the Philippine Law on Organ Transplants also fail to be compatible with these concepts. Many ethical issues that arise in a critical care setting have their roots outside the seemingly isolated clinical setting. Critical care need not apply only to individuals in a serious clinical condition. Vulnerable populations require critical attention because potent threats to their lives exist in the water that they drink and the air that they breathe. We cannot ignore these threa ts even as we move inevitably towards a technologically dependent, highly commercialized approach to health management. (shrink)

This chapter contains sections titled: Introduction Medical Migration and Moral Responsibility Lending Money to Developing Countries Culture and Religion Health Research and Resources Conclusions References.

We present here an approach to the fine structure of L based solely on elementary model theoretic ideas, and illustrate its use in a proof of Global Square in L. We thereby avoid the Lévy hierarchy of formulas and the subtleties of master codes and projecta, introduced by Jensen [3] in the original form of the theory. Our theory could appropriately be called ”Hyperfine Structure Theory”, as we make use of a hierarchy of structures and hull operations which refines the (...) traditional Lα -or Jα-sequences with their Σn-hull operations.§1. Introduction. In 1938, K. Gödel defined the model L of set theory to show the relative consistency of Cantor's Continuum Hypothesis. L is defined as a unionof initial segments which satisfy: L0 = ∅, Lλ = ∪α<λLα for limit ordinals λ, and, crucially, Lα + 1 = the collection of 1st order definable subsets of Lα. Since every transitive model of set theory must be closed under 1st order definability, L turns out to be the smallest inner model of set theory. Thus it occupies the central place in the set theoretic spectrum of models.The proof of the continuum hypothesis in L is based on the very uniform hierarchical definition of the L-hierarchy. The Condensation Lemma states that if π : M → Lα is an elementary embedding, M transitive, then some ; the lemma can be proved by induction on α. If a real, i.e., a subset of ω, is definable over some Lα,then by a Löwenheim-Skolem argument it is definable over some countable M as above, and hence over some, < ω1. This allows one to list the reals in L in length ω1 and therefore proves the Continuum Hypothesis in L. (shrink)

Using the Friedman-Koepke Hyperfine Structure Theory of [2], we provide a short construction of a gap 1 morass in the constructible universe.

We present here an approach to the fine structure of L based solely on elementary model theoretic ideas, and illustrate its use in a proof of Global Square in L. We thereby avoid the Lévy hierarchy of formulas and the subtleties of master codes and projecta, introduced by Jensen [3] in the original form of the theory. Our theory could appropriately be called ”Hyperfine Structure Theory”, as we make use of a hierarchy of structures and hull operations which refines the (...) traditional Lα -or Jα-sequences with their Σn-hull operations.§1. Introduction. In 1938, K. Gödel defined the model L of set theory to show the relative consistency of Cantor's Continuum Hypothesis. L is defined as a unionof initial segments which satisfy: L0 = ∅, Lλ = ∪α<λLα for limit ordinals λ, and, crucially, Lα + 1 = the collection of 1st order definable subsets of Lα. Since every transitive model of set theory must be closed under 1st order definability, L turns out to be the smallest inner model of set theory. Thus it occupies the central place in the set theoretic spectrum of models.The proof of the continuum hypothesis in L is based on the very uniform hierarchical definition of the L-hierarchy. The Condensation Lemma states that if π : M → Lα is an elementary embedding, M transitive, then some ; the lemma can be proved by induction on α. If a real, i.e., a subset of ω, is definable over some Lα,then by a Löwenheim-Skolem argument it is definable over some countable M as above, and hence over some, < ω1. This allows one to list the reals in L in length ω1 and therefore proves the Continuum Hypothesis in L. (shrink)

We present here an approach to the fine structure of L based solely on elementary model theoretic ideas, and illustrate its use in a proof of Global Square in L. We thereby avoid the Lévy hierarchy of formulas and the subtleties of master codes and projecta, introduced by Jensen [3] in the original form of the theory. Our theory could appropriately be called ”Hyperfine Structure Theory”, as we make use of a hierarchy of structures and hull operations which refines the (...) traditional Lα -or Jα-sequences with their Σn-hull operations.§1. Introduction. In 1938, K. Gödel defined the model L of set theory to show the relative consistency of Cantor's Continuum Hypothesis. L is defined as a unionof initial segments which satisfy: L0 = ∅, Lλ = ∪α<λLα for limit ordinals λ, and, crucially, Lα + 1 = the collection of 1st order definable subsets of Lα. Since every transitive model of set theory must be closed under 1st order definability, L turns out to be the smallest inner model of set theory. Thus it occupies the central place in the set theoretic spectrum of models.The proof of the continuum hypothesis in L is based on the very uniform hierarchical definition of the L-hierarchy. The Condensation Lemma states that if π : M → Lα is an elementary embedding, M transitive, then some ; the lemma can be proved by induction on α. If a real, i.e., a subset of ω, is definable over some Lα,then by a Löwenheim-Skolem argument it is definable over some countable M as above, and hence over some, < ω1. This allows one to list the reals in L in length ω1 and therefore proves the Continuum Hypothesis in L. (shrink)

The Metis research project aims at supporting maritime safety and security by facilitating continuous monitoring of vessels in national coastal waters and prevention of phenomena, such as vessel collisions, environmental hazard, or detection of malicious intents, such as smuggling. Surveillance systems such as Metis typically comprise a number of heterogeneous information sources and information aggregators. Among the main problems of their deployment lies their scalability with respect to a potentially large number of monitored entities. One of the solutions to the (...) problem is continuous and timely adaptation and reconfiguration of the system according to the changing environment it operates in. At any given timepoint, the system should use only a minimal set of information sources and aggregators needed to facilitate effective and early detection of indicators of interest. Here, we describe the Metis system prototype and introduce a theoretical framework for modelling scalable information-aggregation sys.. (shrink)

Recent history makes clear that the quantum leaps being made in technology are the leading edge of a groundswell of paradigm shifts taking place in science, politics, economics, social institutions, and the expression of cultural values. Indeed it is the simultaneity and interdependence of these changes occurring in every dimension of human experience and endeavor that makes the present so historically distinctive. The essays gathered here give voice to perspectives on the always improvised relationship between technology and cultural values from (...) Africa, the Americas, Asia, Australia, Europe, and the Pacific. Contributors: Syed Muhammad Naquib Al-Attas, Roger T. Ames,Yoko Arisaka, Carl Becker, Francesca Bray, James Buchanan, Arindam Chakrabarti, Frank W. Derringh, Rolf Elberfeld, Charles Ess, Andrew Feenberg, Susantha Goonatilake, H. Jiuan Heng, Peter Hershock, Thomas P. Kasulis, George Khushf, David Farrell Krell, Joel J. Kupperman, William R. LaFleur, Lois Ann Lorentzen, David Loy, Joseph Margolis, Hans-Georg Möller, Robert Cummings Neville, Peimin Ni, Monica Atieno Opole, Kuruvilla Pandikattu SJ, Helen Petrovsky, Ramon Sentmartí, Kristin Shrader-Frechette, Vasanthi Srinivasan, Marietta Stepaniants, Vyacheslav S. Stiopin, Henk ten Have, Paul B.Thompson, Mary Tiles, David B.Wong. (shrink)

V.1 Re-establishing an initial union among philosophy, science, and wisdom by recovering our understanding of philosophy, science : how philosophy, science, is, and always has been, chiefly a study of the one and the many -- v.2. An introduction to ragamuffin Thomism.

Philosophy and Poetry is the 33rd volume in the Midwest Studies in Philosophy series. It begins with contributions in verse from two world class poets, JohnAshbery and Stephen Dunn, and an article by Dunn on the creative processthat issued in his poem. The volume features new work from an internationalcollection of philosophers exploring central philosophical issues pertinent topoetry as well as the connections between the two domains.

Waar de een zijn leven geeft voor een goed geweten, haalt de ander zijn schouders erover op. Het geweten: een achterhaald begrip of hard toe aan herwaardering?

This book challenges the presupposition among professional philosophers that René Descartes is the Father of Modern Philosophy. It demonstrates by intensive textual analysis of Descartes's Discourse and Meditations that he inaugurated a new type of sophistry rather than a new way of conducting philosophy. Transcendental Sophistry is a synthesis of Renaissance humanism and Christian theology, especially the theology of creation. This striking re-evaluation of the achievement of Descartes opens the history of Western philosophy to radical reinterpretation.

Peter Kwasniewski shows that St. Thomas contemplates the nature of ecstasy at key stages in the development of his thought and that it plays a crucial role in his doctrine of love. St. Thomas recognized that all love involves ecstatic transcendence, whether it be the creature's self-oblation to the Creator, the reverence of an inferior for a superior, a superior's generosity toward an inferior, or the mutual affection and help of equals joined in friendship. Love of persons for their (...) own sake generates an ecstatic love in which the self is borne as a gift to another subject by sharing a common life aspiring to common goods. Kwasniewski also examines Aquinas on the question of whether or not God experiences ecstasy, and if so, in what ways. (shrink)

Through a radical reinterpretation of classical philosophy as an organizational psychology, The Moral Psychology of St. Thomas: An Introduction to Ragamuffin Ethics just as radically reinterprets St. Thomas Aquinas's moral teaching to be a behavioristic psychology chiefly designed to synthesize right reason and right pleasure to help a person excel at living life as a whole. In the process of so doing, this work demonstrates how the skill of prudential living is a necessary condition for becoming a grand master of (...) leadership in any and every profession. (shrink)

Emerging neuroscientific insights are changing our understanding of what it means to be human. The resulting reconceptualization continues to impact law and the fit between law and morality. This book takes account of those developments and suggests that normative theory, particularly in its non-instrumental iterations, will be challenged, most profoundly. If we are, as the science suggests, nothing more than the coincidence of mechanical forces, then law and normative theory that depend on the immaterial and that would draw distinctions between (...) the "mental" or "emotional" and the more manifestly physical are misguided, so misguided that they would actually undermine human thriving. Indeed, they already do. The ramifications of that conclusion are profound. Trialectic posits and investigates the impact of those ramifications on law. (shrink)

Scientists engaged in global health research are increasingly faced with barriers to access and use of human tissues from the developing world communities where much of their research is targeted. In part, the problem can be traced to distrust of researchers from affluent countries, given the history of 'scientific-imperialism' and 'biocolonialism' reflected in past well publicized cases of exploitation of research participants from low to middle income countries. To a considerable extent, the failure to adequately engage host communities, the opacity (...) of informed consent, and the lack of fair benefit-sharing have played a significant role in eroding trust. These ethical considerations are central to biomedical research in low to middle income countries and failure to attend to them can inadvertently contribute to exploitation and erode trust. A 'tissue trust' may be a plausible means for enabling access to human tissues for research in a manner that is responsive to the ethical challenges considered. Preventing exploitation and restoring trust while simultaneously promoting global health research calls for innovative approaches to human tissues research. A tissue trust can reduce the risk of exploitation and promote host capacity as a key benefit. (shrink)

Many of us are inclined to accept something like the following principle: We can only be properly morally assessed for what is in our control. And yet our ordinary practices seem to frequently violate this principle. The resulting tension, and the attempt to resolve it, is the problem of moral luck. For example, we tend to punish and think worse of the negligent driver who kills a child than we do the equally negligent driver who was lucky there was no (...) child in his path. Thus, the lucky outcomes of our actions do seem to affect the extent to which we hold and are held responsible, but these are not things over which we exercise control. And, as Thomas Nagel famously illustrated in his response to Bernard Williams (the two of which papers form the founding documents of the moral luck debate), the influence of luck is not limited to outcomes. For the circumstances in which we find ourselves and, indeed, our very constitution are also shaped by luck. Since the publication of Williams's and Nagel's papers, the existence and breadth of moral luck has been hotly debated. This debate is not a mere intellectual trifle but, as the essays in this volume illustrate, a debate which lies at the heart of free will, responsibility, identity, causation, and self-creation. (shrink)

In this paper I sketch an account of moral blame and blameworthiness. I begin by clarifying what I take blame to be and explaining how blameworthiness is to be analyzed in terms of it. I then consider different accounts of the conditions of blameworthiness and, in the end, settle on one according to which a person is blameworthy for φ-ing just in case, in φ-ing, she violates one of a particular class of moral requirements governing the attitudes we bear, and (...) our mental orientation, toward people and other objects of significant moral worth. These requirements embody the moral stricture that we accord to these others a sufficient level of respect, one that their moral worth demands. This is a familiar theme which has its roots in P. F. Strawson’s pioneering views on moral responsibility. My development of it leads me to the conclusion that acting wrongly is not a condition of blameworthiness: violating a moral requirement to perform, or refrain from performing, an action is neither necessary nor sufficient for being blameworthy. All we are ever blameworthy for, I will argue, are certain aspects of our mental bearing toward others. We can be said to be blameworthy for our actions only derivatively, in the sense that those actions are the natural manifestations of the things for which we are strictly speaking blameworthy. (shrink)

There is a debate in normative ethics about whether or not our moral obligations depend solely on either our evidence concerning, or our beliefs about, the world. Subjectivists maintain that they do and objectivists maintain that they do not. I shall offer some arguments in support of objectivism and respond to the strongest argument for subjectivism. I shall also briefly consider the significance of my discussion to the debate over whether one’s future voluntary actions are relevant to one’s current moral (...) obligations. (shrink)

We study the proof-theoretic strength and effective content of the infinite form of Ramsey's theorem for pairs. Let RT n k denote Ramsey's theorem for k-colorings of n-element sets, and let RT $^n_{ denote (∀ k)RT n k . Our main result on computability is: For any n ≥ 2 and any computable (recursive) k-coloring of the n-element sets of natural numbers, there is an infinite homogeneous set X with X'' ≤ T 0 (n) . Let IΣ n and BΣ (...) n denote the Σ n induction and bounding schemes, respectively. Adapting the case n = 2 of the above result (where X is low 2 ) to models of arithmetic enables us to show that RCA 0 + IΣ 2 + RT 2 2 is conservative over RCA 0 + IΣ 2 for Π 1 1 statements and that $RCA_0 + I\Sigma_3 + RT^2_{ , is Π 1 1 -conservative over RCA 0 + IΣ 3 . It follows that RCA 0 + RT 2 2 does not imply BΣ 3 . In contrast, J. Hirst showed that $RCA_0 + RT^2_{ does imply BΣ 3 , and we include a proof of a slightly strengthened version of this result. It follows that $RT^2_{ is strictly stronger than RT 2 2 over RCA 0. (shrink)

This volume, an expanded edition of the philosophy of language issue of the journal Midwest Studies in Philosophy (1977), includes essays by some of the ...

David Lewis has offered a reply to the standard argument for the claim that the truth of determinism is incompatible with anyone’s being able to do otherwise than she in fact does. Helen Beebee has argued that Lewis’s compatibilist strategy is untenable. In this paper I show that one recent attempt to defend Lewis’s view against this argument fails and then go on to offer my own defense of Lewis’s view.

In this lucid and penetrating book, Peter A. Schouls considers Locke's major writings in terms of the closely related ideas of freedom, progress, mastery, reason, and education.

Despite its current popularity, “emergence” is a concept with a venerable history and an elusive, ambiguous standing in contemporary evolutionary theory. This paper briefly recounts the history of the term and details some of its current usages. Not only are there radically varying interpretations about how to define emergence but “reductionist” and “holistic” theorists hold very different views about the issue of causation. However, these two seemingly polar positions are not irreconcilable. Reductionism, or detailed analysis of the parts and their (...) interactions, is essential for answering the “how” question in evolution—how does a complex living system work? But holism is equally necessary for answering the “why” question—why did a particular arrangement of parts evolve? In order to answer the “why” question, a broader, multi-leveled paradigm is required. The reductionist approach to explaining emergent complexity has entailed a search for underlying “laws of emergence.” In contrast, the “Synergism Hypothesis” focuses on the “economics”—the functional effects produced by emergent wholes and their selective consequences in evolutionary change. This paper also argues that emergent phenomena represent, in effect, a subset of a larger universe of cooperative, synergistic effects in the natural world. (shrink)

In April 1999, Dr. Curt Freed of the University of Colorado in Denver and Dr. Stanley Fahn of Columbia Presbyterian Center in New York presented the results of a four-year, $5.7 million government-financed study using tissue from aborted fetuses to treat Parkinson’s disease at a conference of the American Academy of Neurology. The results of the first government-financed, placebo-controlled clinical study using fetal tissue showed that the symptoms of some Parkinson’s patients had been relieved. This research study involved forty subjects, (...) nineteen women and twenty-one men; all suffered from Parkinson’s disease for an average of 13.5 years. In the study, each subject underwent neurosurgery: “four tiny burr holes, drilled through the wrinkle lines above the eyebrows into the skull, to clear a pathway to the brain. But only half received injections of fetal cells into the putamen, the region of the brain that controls movement; the other half received nothing. One year later, three members of the placebo group said their symptoms had improved.” In two-thirds of the transplant recipients, the fetal tissue took hold and seemed to establish a new network to produce the missing neurochemical dopamine. (shrink)

Theorists have hypothesized that skill in critical thinking is positively correlated with the consistent internal motivation to think and that specific critical thinking skills are matched with specific critical thinking dispositions. If true, these assumptions suggest that a skill-focused curriculum would lead persons to be both willing and able to think. This essay presents a researchbased expert consensus definition of critical thinking, argues that human dispositions are neither hidden nor unknowable, describes a scientific process of developing conventional testing tools to (...) measure cognitive skills and human dispositions, and summarizes recent empirical research findings that explore the possible relationship of critical thinking skill and the consistent internal motivation, or disposition, to use that skill. Empirical studies indicate that for all practical purposes the hypothesized correlations are not evident. It would appear that effective teaching must include strategies for building intellectual character rather than relying exclusively on strengthening cognitive skills. (shrink)

Many health care decisions depend not only upon medical facts, but also on value judgments—patient goals and preferences. Until recent decades, patients relied on doctors to tell them what to do. Then ethicists and others convinced clinicians to adopt a paradigm shift in medical practice, to recognize patient autonomy, by orienting decision making toward the unique goals of individual patients. Unfortunately, current medical practice often falls short of empowering patients. In this article, we reflect on whether the current state of (...) medical decision making effectively promotes patients' health care goals. We base our reflections, in part, on research in which we observed physicians making earnest efforts to partner with patients in making treatment decisions, but still struggling to empower patients—failing to communicate clearly to patients about decision-relevant information, overwhelming patients with irrelevant information, overlooking when patients' emotions made it hard to engage in choices, and making recommendations before discussing patients' goals. (shrink)

ABSTRACTMother‐to‐child transmission of HIV represents a particularly dramatic aspect of the HIV epidemic with an estimated 600,000 newborns infected yearly, 90% of them living in sub‐Saharan Africa. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. MTCT is responsible for 90% of these infections. Two‐thirds of the MTCT are believed to occur during pregnancy and delivery, and about one‐third through breastfeeding. As the number of women of child bearing age infected with (...) HIV rises, so does the number of infected children. It is apparent that voluntary testing in Botswana has made some valuable inroads in decreasing perinatal HIV transmission, but the statistics showing the increased rate of HIV infection among women 15–24 years of age are not very promising. After reviewing all the pertinent scientific data it is clear that mandatory HIV testing of all pregnant women in conjunction with the implementation of a full package of interventions would save thousands of lives – mothers, newborns and others who could be infected as a result of these women not being aware of their HIV status. If the protection and preservation of human life is a priority in Botswana, then it is time to allow for mandatory HIV testing of all pregnant women, before it is too late for those who are the most vulnerable. To do less would be medically inappropriate and ethically irresponsible. (shrink)

Although knowledge of torture and physical and psychological abuse was widespread at both the Guantanamo Bay detention facility and Abu Ghraib prison in Iraq, and known to medical personnel, there was no official report before the January 2004 Army investigation of military health personnel reporting abuse, degradation, or signs of torture. Mounting information from many sources, including Pentagon documents, the International Committee of the Red Cross, Amnesty International, Human Rights Watch, etc., indicate that medical personnel failed to maintain medical records, (...) conduct routine medical examinations, provide proper care of disabled and injured detainees, accurately report illnesses and injuries, and falsified medical records and death certificates. Medical personnel and medical information was also used to design and implement psychologically and physically coercive interrogations. The United States military medical system failed to protect detainee's human rights, violated the basic principles of medical ethics and ignored the basic tenets of medical professionalism. (shrink)