Ethics: The Heart of Health Care - a classic ethics text in medical, health and nursing studies - is recommended around the globe for its straightforward introduction to ethical analysis. In this new edition David Seedhouse demonstrates tangibly and graphically how ethics and health care are inextricably bound together, and creates a firm theoretical basis for practical decision-making. He not only clarifies ethics but, with the aid of the acclaimed Ethical Grid, teaches an essential practical skill which can (...) be productively applied in day-to-day health care. This edition, which is even more readable than the first, includes additional case studies and teaching exercises, contains new material on ethical theory and offers two further decision-making tools - The Rings of Uncertainty and the Autonomy Test. The engaging new introduction reveals the genesis of the Ethical Grid, illuminates the intent and argument of the first edition, and explains why the book is needed today as much as ever. Intended for all who work in health care or health studies - indeed for anyone with an interest in health issues - this is a highly original, innovative and accessible work on a subject traditionally regarded as lofty and obscure. It clarifies a wide variety of complex ethical issues and will give the reader fresh inspiration and renewed confidence in dealing with the demands of modern health work. (shrink)

It is difficult to understand the meaning of ‘dignity’ in human rights, bioethics and nursing literature because the word is used so vaguely. Unless dignity’s meaning is spelt out it can disappear beneath more tangible priorities. In this article we define dignity and show how this can help health workers to maintain the dignity of people in their care.

Many leading health economists hold misconceived ideas about central components of their work. In particular, they assume that their methods are in principle valueneutral. This belief is demonstrably false. Health economic investigations incorporate mainly unexpressed theories of health. Unless this fact is recognised health economics will shortly reach a conceptual and practical dead end. The way to avoid this dead end is to express implicit theories of health, and explicitly to base philosophically and economically justifiable policy proposals on them.

Any attempt to describe a "best health service' must make political assumptions. For example, should it help everyone? Do different people have different entitlements to its support? Should its help be offered according to need, value for money or ability to benefit? These assumptions are not always clear to health service decision-makers immersed in clinical and economic technicalities, so HCA invited two philosophers --John Shand and David Seedhouse -- to engage in conversation about the political philosophy of health (...) care. (shrink)

This paper is in three parts. In Part One we briefly explain that an unsophisticated form of utilitarianism—economic rationalism (ER)—has become dominant in many health systems. Its proponents argue that one of ER’s most important effects is to increase consumer choice. However, evidence from New Zealand does not support this claim. Furthermore, the logic of ER requires the construction of systems which tend to restrict individual participation.In Part Two we argue that although some have advocated an ‘ethic of care’ in (...) an attempt to counteract ER’s utilitarianism, two decades of campaigning have had little influence on health policy. ER’s pro-care adversaries have failed to make an impact because they have not developed a taxonomy of care—they have not established a language compatible with, or as powerful as, ER’s.In Part Three, in an attempt to raise the conceptual and practical status of caring in contemporary health systems, we distinguish four different forms of care. In opposition to those who believe the ‘ethic of care’ can adequately direct health care practice, we demonstrate that care is a secondary notion. We show that in order for a carer to decide which form of care to adopt in different situations she requires a more powerful idea. We contend further that health care ought to be governed by a theory of health, and suggest that ‘the foundations theory of health’ should be adopted by planners searching for a more humane alternative to ER. We conclude that ER’s dominance can and must be challenged. However, only those arguments which offer detailed theoretical analyses of health care, as well as meticulously derived practical policies, have any chance of success. (shrink)

Those who would enquire into therelationship between health conceptions and health care consequences are faced with a formidable task. In order to make this challenge manageable it is necessary to define the scope of the task as precisely as possible. Are we, for instance, faced with a purely theoretical challenge; a task for applied philosophy, or must we employ multi-disciplinary methods?This paper argues that while philosophy has a central clarifying role, inquiry into the relationship between health conceptions and health care (...) organisation can be done properly only through the combined efforts of several disciplines. Unless we are to be concerned only with abstract models it is essential to take account of the reality of health care situations. Given this it is suggested that the study of health conceptions is only a part of a greater task (unless all conceptions are to count as health conceptions). What is needed is understanding of the possible and actual purposes of health care, and detailed study of their practical implications. (shrink)

ConclusionA map of mental health is admittedly the vaguest of speculations at the moment. It is nowhere near as precise as anything presently seen through the mental health microscope. Indeed it may well turn out to offer nothing at all. On the other hand, the truth remains that unless we beat our addiction to microscopes we will never get even a glimpse of mental health: you can’t read a map with a microscope.

It is difficult to understand the meaning of ‘dignity’ in human rights, bioethics and nursing literature because the word is used so vaguely. Unless dignity’s meaning is spelt out it can disappear beneath more tangible priorities. In this article we define dignity and show how this can help health workers to maintain the dignity of people in their care.

A map of mental health is admittedly the vaguest of speculations at the moment. It is nowhere near as precise as anything presently seen through the mental health microscope. Indeed it may well turn out to offer nothing at all. On the other hand, the truth remains that unless we beat our addiction to microscopes we will never get even a glimpse of mental health: you can’t read a map with a microscope.

Declarations of the importance of dignity in health care are commonplace in codes of practice and other mission statements, yet these documents never clarify dignity’s meaning. Their vague aspirations are compared to comments from staff and patients about opportunities for and barriers against the promotion of dignity in elderly care institutions. These suggest that while nurses and health care assistants have an intuitive understanding of dignity, they either do not or cannot always bring it about in practice. Thus, despite stated (...) intentions to promote dignity, it appears that the circumstances of at least some elderly care institutions cause patients to experience avoidable indignities. Such institutions are “undignifying institutions” because they fail to acknowledge dignity’s basic components, focus excessively on quantifiable priorities, and have insufficient resources available to assure consistently dignifying care. As a partial solution, we argue that health workers should be taught to understand and specify the components of dignity, which will better prepare them to challenge undignifying practices and to recognise opportunities for dignity promotion. (shrink)

Beyond Human is an informative and accessible guide for all those interested in the developing sciences of genetic engineering, bioprinting, and human cloning. Illustrating the ideas with reference to well-known science fiction films and novels, the author provides a unique insight into and understanding of how genetic manipulation, cloning, and other novel bio-technologies will one day allow us to redesign our species. It also addresses the legitimate concerns about "playing God", while at the same time embracing the positive aspects of (...) the scientific trajectory that will lead to our transhuman future. (shrink)

David Hume's Enquiry concerning Human Understanding is the definitive statement of the greatest philosopher in the English language. His arguments in support of reasoning from experience, and against the "sophistry and illusion"of religiously inspired philosophical fantasies, caused controversy in the eighteenth century and are strikingly relevant today, when faith and science continue to clash. The Enquiry considers the origin and processes of human thought, reaching the stark conclusion that we can have no ultimate understanding of the physical world, or (...) indeed our own minds. In either sphere we must depend on instinctive learning from experience, recognizing our animal nature and the limits of reason. Hume's calm and open-minded skepticism thus aims to provide a new basis for science, liberating us from the "superstition" of false metaphysics and religion. His Enquiry remains one of the best introductions to the study of philosophy, and his edition places it in its historical and philosophical context. (shrink)

A leading political theorist’s groundbreaking defense of ideal conceptions of justice in political philosophy Throughout the history of political philosophy and politics, there has been continual debate about the roles of idealism versus realism. For contemporary political philosophy, this debate manifests in notions of ideal theory versus nonideal theory. Nonideal thinkers shift their focus from theorizing about full social justice, asking instead which feasible institutional and political changes would make a society more just. Ideal thinkers, on the other hand, question (...) whether full justice is a standard that any society is likely ever to satisfy. And, if social justice is unrealistic, are attempts to understand it without value or importance, and merely utopian? Utopophobia argues against thinking that justice must be realistic, or that understanding justice is only valuable if it can be realized. David Estlund does not offer a particular theory of justice, nor does he assert that justice is indeed unrealizable—only that it could be, and this possibility upsets common ways of proceeding in political thought. Estlund engages critically with important strands in traditional and contemporary political philosophy that assume a sound theory of justice has the overriding, defining task of contributing practical guidance toward greater social justice. Along the way, he counters several tempting perspectives, including the view that inquiry in political philosophy could have significant value only as a guide to practical political action, and that understanding true justice would necessarily have practical value, at least as an ideal arrangement to be approximated. Demonstrating that unrealistic standards of justice can be both sound and valuable to understand, Utopophobia stands as a trenchant defense of ideal theory in political philosophy. (shrink)

The zetetic turn in epistemology raises three questions about epistemic and zetetic norms. First, there is the relationship question: what is the relationship between epistemic and zetetic norms? Are some epistemic norms zetetic norms, or are epistemic and zetetic norms distinct? Second, there is the tension question: are traditional epistemic norms in tension with plausible zetetic norms? Third, there is the reaction question: how should theorists react to a tension between epistemic and zetetic norms? Drawing on an analogy to practical (...) philosophy, I develop a focal point view to resolve these motivating questions. On the focal point view, traditional epistemic norms and zetetic norms answer different types of normative questions. There is nevertheless a familiar type of evaluative tension between traditional epistemic norms and zetetic norms, but this tension is an unavoidable feature of the normative landscape and not a sign that traditional epistemic norms need revision. But if traditional epistemic norms are not zetetic norms, then in what sense is zetetic epistemology a project for epistemologists? I conclude by articulating a sense in which some nontraditional epistemic norms are zetetic norms, and in which zetetic epistemology is an important part of the study of theoretical rationality. (shrink)

One of the enduring concerns of moral philosophy is deciding who or what is deserving of ethical consideration. Much recent attention has been devoted to the "animal question" -- consideration of the moral status of nonhuman animals. In this book, David Gunkel takes up the "machine question": whether and to what extent intelligent and autonomous machines of our own making can be considered to have legitimate moral responsibilities and any legitimate claim to moral consideration. The machine question poses a (...) fundamental challenge to moral thinking, questioning the traditional philosophical conceptualization of technology as a tool or instrument to be used by human agents. Gunkel begins by addressing the question of machine moral agency: whether a machine might be considered a legitimate moral agent that could be held responsible for decisions and actions. He then approaches the machine question from the other side, considering whether a machine might be a moral patient due legitimate moral consideration. Finally, Gunkel considers some recent innovations in moral philosophy and critical theory that complicate the machine question, deconstructing the binary agent--patient opposition itself. Technological advances may prompt us to wonder if the science fiction of computers and robots whose actions affect their human companions could become science fact. Gunkel's argument promises to influence future considerations of ethics, ourselves, and the other entities who inhabit this world. (shrink)

This book is an attempt to get to the bottom of an acute and perennial tension between our best scientific pictures of the fundamental physical structure of the world and our everyday empirical experience of it. The trouble is about the direction of time. The situation (very briefly) is that it is a consequence of almost every one of those fundamental scientific pictures--and that it is at the same time radically at odds with our common sense--that whatever can happen can (...) just as naturally happen backwards. Albert provides an unprecedentedly clear, lively, and systematic new account--in the context of a Newtonian-Mechanical picture of the world--of the ultimate origins of the statistical regularities we see around us, of the temporal irreversibility of the Second Law of Thermodynamics, of the asymmetries in our epistemic access to the past and the future, and of our conviction that by acting now we can affect the future but not the past. Then, in the final section of the book, he generalizes the Newtonian picture to the quantum-mechanical case and (most interestingly) suggests a very deep potential connection between the problem of the direction of time and the quantum-mechanical measurement problem. The book aims to be both an original contribution to the present scientific and philosophical understanding of these matters at the most advanced level, and something in the nature of an elementary textbook on the subject accessible to interested high-school students. Table of Contents: Preface 1. Time-Reversal Invariance 2. Thermodynamics 3. Statistical Mechanics 4. The Reversibility Objections and the Past-Hypothesis 5. The Scope of Thermodynamics 6. The Asymmetries of Knowledge and Intervention 7. Quantum Mechanics Appendix: Gedankenexperiments with Heat Engines Index Reviews of this book: The foundations of statistical mechanisms are often presented in physics textbooks in a rather obscure and confused way. By challenging common ways of thinking about this subject, Time and Chance can do quite a lot to improve this situation. --Jean Bricmont, Science Albert is perfecting a style of foundational analysis that is uniquely his own...It has a surgical precision...and it is ruthless with pretensions. The foundations of thermodynamics is a topic that has accumulated a good deal of dead wood; this is a fire that will burn and burn. --Simon W. Saunders, Oxford University As usual with Albert's work, the exposition is brisk and to the point, and exceptionally clear...The book will be an extremely valuable contribution to the literature on the subject of philosophical issues in thermodynamics and statistical mechanics, a literature which has been thin on the ground but is now growing as it deserves to. --Lawrence Sklar, University of Michigan. (shrink)

By means of an example, shows the possibility of beliefs that are separately rational whilst together inconsistent.