This essay examines the impact of the imposition of businesses techniques, in particular, those associated with Total QualityManagement, on the relationships of important components of the health care delivery system, including payers, managed care organizations, institutional and individual providers, enrollees, and patients. It examines structural anomalies within the delivery system and concludes that the use of Total Quality Management techniques within the health care system cannot prevent the shift of attention of other components away from the enrollee and the patient, (...) and may even contribute to it. It speculates that the organization ethics process may serve as a quality control mechanism to prevent this shift and so help eliminate some of the ethically problematic processes and outcomes within the health care delivery system. (shrink)

The prelims comprise: Introduction The Physician and the Provider Organization The Physician and the Payer Organization Dealing with Systems Conclusion Notes References.

The problem is a simple one. A placebo is “a substance provided to a patient that the physician believes has no specific pharmacological effect upon the condition being treated” (AMA 2007). 1 But i...

Most organizations and/or their sub-units like ethics programs want to acquire the knowledge, skills and other resources needed to achieve their goals efficiently and effectively. Thus, they want to acquire or develop needed capacity. But there are pre-conditions to building capacity that are often overlooked or forgotten, but which nevertheless, must be in place before capacity can be developed. This essay identifies these pre-conditions and discusses why they are necessary before attempts are made to enhance the capacity of any ethics (...) program. The essay closes by offering a series of questions that ethics program leaders/and or members can asked themselves to assess whether or not these pre-conditions exist. (shrink)

Bioethics, clinical ethics, and professional ethics are mature, well-developed fields of applied ethics that focus on medical research, patient autonomy and patient care, patient–healthcare professional relationships, and issues that arise in clinical and other medical settings. However, despite these developments, little attention has been paid to the organizational aspects of healthcare in these fields. This is surprising, because in the last 30 years healthcare has become more and more institutionalized in provider, management, and insurer organizations. Despite JCAHO's preoccupation with organizational (...) ethics during the last decade, the philosophical underpinnings of their requirements have been less explored in the literature. Clinical ethics remains preoccupied with clinical patient care and professional ethics with individual professional guidelines; even the American College of Healthcare Executives focuses primarily on healthcare managers, not on healthcare organizations. (shrink)

Human rights legislation pertaining to applications of human genetic science is still lacking at an international level. Three international human rights documents now serve as guidelines for countries wishing to develop such legislation. These were drafted and adopted by the United Nations Educational, Scientific and Cultural Organization, the Human Genome Organization, and the Council of Europe. It is critically important that the international nursing community makes known its philosophy and practice-based knowledge relating to ethics and human rights, and contributes to (...) the globalization of genetics. Nurses have particular expertise because they serve in a unique role at grass roots level to mediate between genetic science and its application to public health policies and medical interventions. As a result, nurses worldwide need to focus a constant eye on human rights ideals and interpret these within social, cultural, economic and political contexts at national and local levels. The purpose of this article is to clarify and legitimate the need for an international declaration on nursing, human rights, human genetics and public health policy. Because nurses around the world are the professional workforce by which genetic health care services and genetic research protocols will be delivered in the twenty-first century, members of the discipline of nursing need to think globally while acting locally. Above all other disciplines involved in genetics, nursing is in a good position to articulate an expanded theory of ethics beyond the principled approach of biomedical ethics. Nursing is sensitive to cultural diversity and community values; it is sympathetic to and can introduce an ethic of caring and relational ethics that listen to and accommodate the needs of local people and their requirements for public health. (shrink)

Genetic information and technologies are increasingly important in health care, not only in technologically advanced countries, but world-wide. Several global factors promise to increase future demand for morally conscious genetic health services and research. Although they are the largest professional group delivering health care world-wide, nurses have not taken the lead in meeting this challenge. Insights from feminist analysis help to illuminate some of the social institutions and cultural obstacles that have impeded the integration of genetics technology into the discipline (...) of nursing. An alternative model is suggested - the transdisciplinary model - which was developed initially by a nurse and introduced in the 1970s into the delivery of health care and social services for children with developmental disabilities. This holistic model enables all health care professionals to have an equal voice in determining how genetic health care will be globalized. (shrink)

¿Qué cabida tienen, o pueden tener, las éticas y las políticas de la alteridad en el horizonte filosófico actual? En el contexto de la filosofía española reciente, la obra de Gabriel Bello Reguera (Dehesas, León, 1943) ha afrontado el reto ético-político que plantea el tomarse en serio la alteridad. Ha desarrollado su carrera académica en la Universidad de La Laguna como catedrático de Filosofía Moral y en su trayectoria cabría señalar tres giros fundamentales, si bien relacionados entre sí. El primero (...) podemos derivarlo del impacto de la lectura de la obra del neopragmatista Richard Rorty, que incidió en su crítica al fundamentalismo autoritario de la tradición filosófica despertó su interés por la narratividad, ligada a la conversación, como herramienta edificante de la ética. El segundo es debido a la influencia del pensamiento de Emmanuel Lévinas, a partir del cual problematiza las relaciones entre las categorías éticas de identidad, diferencia y alteridad. El tercero, y más reciente, le llevará al terreno del análisis de las migraciones internacionales en su contexto postcolonial como acuciante asunto necesitado, precisamente, de un nuevo marco filosófico, ético y político. En este libro colectivo, a través de la obra de Gabriel Bello, afrontamos con rigor la contextualización de las éticas y las políticas de la alteridad, proseguimos la discusión en torno a estas a la vez que elaboramos, conjuntamente, un balance crítico de una línea de investigación, de sus posibilidades y límites. Con todo ello, además, seguimos la tradición de prestar reconocimiento y gratitud a nuestros maestros y a nuestras maestras. En este caso, reconocemos la trayectoria docente e investigadora del Profesor Gabriel Bello Reguera y su dedicación rigurosa y concienzuda a la vida universitaria. Su obra, que, recorre cuatro décadas, es testimonio de cómo la filosofía en el contexto del Estado español, tras abandonar el erial instigado por el franquismo, participa de los debates transnacionales actuales en los que las éticas y las políticas de la alteridad, especialmente, plantean desafíos insoslayables. Hemos, pues, recreado el ritual académico del Homenaje, algo tan central en la filosofía alemana como la Festschrift, con el deseo de dotarlo del sentido más relevante que, a nuestro juicio, puede tener: el del debate intelectual crítico. (shrink)

Richard Rorty is well known as a propagandist of pragmatism and of a "post-philosophical" culture in which many traditional philosophical debates are dismissed as outrightly fruitless. The paper is mainly concerned with Rorty's dismissal of the realism-antirealism debate. The shift from argument to propaganda which is typical of much of Rorty's reasoning is critically investigated from different perspectives. In particular, it is argued that Rorty cannot convincingly establish a pragmatist position beyond realism and antirealism, and that (...) pragmatism seems to be inadequate with respect to scientific practice. Finally, the fruitfulness of the realism-antirealism debate is defended. (shrink)

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

In this volume Rorty offers a Deweyan account of objectivity as intersubjectivity, one that drops claims about universal validity and instead focuses on utility for the purposes of a community. The sense in which the natural sciences are exemplary for inquiry is explicated in terms of the moral virtues of scientific communities rather than in terms of a special scientific method. The volume concludes with reflections on the relation of social democratic politics to philosophy.

In his final work, Richard Rorty provides the definitive statement of his political thought. Rorty equates pragmatism with anti-authoritarianism, arguing that because there is no authority we can rely on to ascertain truth, we can only do so intersubjectively. It follows that we must learn to think and care about what others think and care about.

The assent of man, Michael Berube -- Getting rid of the appearance-reality distinction -- Universalist grandeur and analytic philosophy -- Romanticism, narrative philosophy, and human finitude.

The sixteen essays in this volume confront the current debate about the relationship between philosophy and its history. On the one hand intellectual historians commonly accuse philosophers of writing bad - anachronistic - history of philosophy, and on the other, philosophers have accused intellectual historians of writing bad - antiquarian - history of philosophy. The essays here address this controversy and ask what purpose the history of philosophy should serve. Part I contains more purely theoretical and methodological discussion, of such (...) questions as whether there are 'timeless' philosophical problems, whether the issues of one epoch are commensurable with those of another, and what style is appropriate to the historiography of the subject. The essays in Part II consider a number of case-histories. They present important revisionist scholarship and original contributions on topics drawn from ancient, early modern and more recent philosophy. All the essays have been specially commissioned, and the contributors include many of the leading figures in the field. The volume as a whole will be of vital interest to everyone concerned with the study of philosophy and of its history. (shrink)

In this volume, thirteen philosophers contribute new essays analyzing the criteria for personal identity and their import on ethics and the theory of action: it presents contemporary treatments of the issues discussed in Personal Identity, edited by John Perry (University of California Press, 1975).

Philosophers suffer from a peculiar occupational hazard; people are always coming up and asking them just what it is that they do and how they do it. This is not the sort of question that biologists or economists or musicians get asked; people know, pretty well, what they do, and they may or may not be interested in the details. But a philosopher is different - it is very hard to imagine just what he does with his time.

The essays in this volume form a commentary on Descartes' Meditations. Following the sequence of the meditational stages, the authors analyze the function of each stage in transforming the reader, to realize his essential nature as a rational inquirer, capable of scientific, demonstrable knowledge of the world. There are essays on the genre of meditational writing, on the implications of the opening cathartic section of the book on Descartes' theory of perception and his use of skeptical arguments; essays on the (...) theory of ideas and their role of Descartes' reconstructive analytic method; essays on the proofs for the existence of God, on the role of the will in the formation and malformation of judgments; and the essays on the foundations of the science of extension and on Descartes' account of the union of mind and body. (shrink)

Although he did not lengthily critique St. Thomas's philosophy, Richard Rorty tagged him along with Plato as a foundationalist thinker, i.e., someone who is preoccupied with underlying principles or ultimate standards of truth. It is unfortunate, however, that Rorty's sweeping critique is obviously based on superficial and inadequate reading of the Dominican saint. Marie- Dominique Chenu, a less known yet very serious Thomist scholar, has shown that the mode of argumentation in the thought of St. Thomas has an (...) underlying conversational goal. In other words, St. Thomas's method of rational inquiry is not divisive but collaborative which is highlighted by the effort to reconcile initially opposing views by means of the intellectual tool of distinction, a tool which Rorty himself employed in dealing with criticisms hurled against his apparently nihilistic neopragmatic thought. St. Thomas consistently employed the tool of distinction in disputatio, or argumentation with the goal of pursuing collaboration with different thinkers whether they are Christians or Muslims, pagans or believers, in the pursuit of truth. (shrink)

The contributors to this volume have approached the problem of characterizing and classifying emotions from the perspectives of neurophysiology, psychology, and ...

Aristotle's _Nicomachean Ethics_ deals with character and its proper development in the acquisition of thoughtful habits directed toward appropriate ends. The articles in this unique collection, many new or not readily available, form a continuos commentary on the _Ethics_. Philosophers and classicists alike will welcome them.

What are the conditions under which one biological object is a part of another biological object? This paper answers this question by developing a general, systematic account of biological parthood. I specify two criteria for biological parthood. Substantial Spatial Inclusionrequires biological parts to be spatially located inside or in the region that the natural boundary of t he biological whole occupies. Compositional Relevance captures the fact that a biological part engages in a biological process that must make a necessary contribution (...) to a condition that is minimally sufficient to one or more of the characteristic behaviors of the biological whole. Instead of emphasizing the diversity of part-whole relations in the biological world, this paper asks what biological part-whole relations have in common and what constrains their existence, in general. After presenting the two criteria for biological parthood I discuss in how far my account can cope with hard cases (e.g., redundant parts) and I reveal the merits and limits of monism. (shrink)

This chapter contains section titled: Introduction.