What is a just way of spending public resources for health and health care? Several significant answers to this question are under debate. Public spending could aim to promote greater equality in health, for example, or maximize the health of the population, or provide the worst off with the best possible health. Another approach is to aim for each person to have "enough" so that her health or access to health care does not fall under a critical level. This latter (...) approach is called sufficientarian. Sufficientarian approaches to distributive justice are intuitively appealing, but require further analysis and assessment. What exactly is sufficiency? Why do we need it? What does it imply for the just distribution of health or healthcare? This volume offers fresh perspectives on these critical questions. Philosophers, bioethicists, health policy-makers, and health economists investigate sufficiency and its application to health and health care in fifteen original contributions. (shrink)

This volume brings together a collection of ten original essays which present new analyses of social and relational equality in philosophy and political theory. The essays analyze the nature of social equality and its relationship with justice and with politics.

What kind of equality should we value and why? Current debate centres around whether distributive equality is valuable. However, it is not the only (potentially) morally significant form of equality. David Miller and T. M. Scanlon have emphasised the importance of social equality—a strongly egalitarian notion distinct from distributive equality, and which cannot be reduced to a concern for overall welfare or the welfare of the worst-off. However, as debate tends to focus on distribution, social equality has been neglected and (...) we do not have a clear understanding of what it is and why it might be valuable. This paper aims to address this gap. (shrink)

Much research is currently being conducted on health care practitioners' experiences of moral distress, especially the experience of nurses. What moral distress is, however, is not always clearly delineated and there is some debate as to how it should be defined. This article aims to help to clarify moral distress. My methodology consists primarily of a conceptual analysis, with especial focus on Andrew Jameton's influential description of moral distress. I will identify and aim to resolve two sources of confusion about (...) moral distress: the compound nature of a narrow definition of distress which stipulates a particular cause, i.e. moral constraint, and the distinction drawn between moral dilemma and moral distress, which implies that the two are mutually exclusive. In light of these concerns, I argue that the definition of moral distress should be revised so that moral constraint should not be a necessary condition of moral distress, and that moral conflict should be included as a potential cause of distress. Ultimately, I claim that moral distress should be understood as a specific psychological response to morally challenging situations such as those of moral constraint or moral conflict, or both. (shrink)

This chapter serves as an introduction to the collected volume. In the first section, we aim to provide background on important themes in social egalitarianism and to set the context for understanding which significant questions the chapters in this book pose and attempt to answer. In this section we focus especially on what could be said to characterize socially egalitarian relationships, on which relationships are of concern, and on what might make social egalitarianism distinct. In the second section, we provide (...) a brief explanation of the structure of the book and each of its chapters. (shrink)

What is a just way of spending public resources for health and health care? Several significant answers to this question are under debate. Public spending could aim to promote greater equality in health, for example, or maximize the health of the population, or provide the worst off with the best possible health. Another approach is to aim for each person to have "enough" so that her health or access to health care does not fall under a critical level. This latter (...) approach is called sufficientarian. Sufficientarian approaches to distributive justice are intuitively appealing, but require further analysis and assessment. What exactly is sufficiency? Why do we need it? What does it imply for the just distribution of health or healthcare? This volume offers fresh perspectives on these critical questions. Philosophers, bioethicists, health policy-makers, and health economists investigate sufficiency and its application to health and health care in fifteen original contributions. (shrink)

In this chapter, Fourie identifies and systematizes the impairments associated with having privilege and evaluates their implications for theories of relational equality and distributive justice. Having certain social privileges, for example, being a man in a patriarchal society, can also be damaging; in other words, there are “impairments of privilege.” Fourie delineates six kinds of impairments—epistemic, evaluative, emotional, health-related, affiliative, and moral. She then goes on to assess the implications of the impairments of privilege for two theories in (...) political philosophy. Relational egalitarianism, she argues, has the theoretical resources to identify and address the problems associated with these impairments, whereas distributive egalitarianism does not. Furthermore, she argues that assessing the impairments of privilege through relational egalitarianism helps to characterize a society of equals: we must address the causes of functional impairments, express respect for the worse off by not normalizing the experiences of the privileged, and minimize competitive positionality. (shrink)

In this chapter, I propose that conceptions of justice in bioethics must be feminist, meaning they must be able to capture how the domains of health, healthcare and medicine exacerbate the subordination of those perceived to be women and girls and how injustice impacts their health. After providing context in the first section, I identify three problems with conceptions of justice in the bioethics literature that interfere with their potential to be feminist. They tend to adopt the ahistoricism and distributivism (...) characteristic of theories of justice that have been dominant in political philosophy, and they often rely on gendered conceptions of health that result in troubling comparisons of men and women’s health. My argument is primarily “negative”: it is a critique of generalist conceptions of justice in bioethics. However, in the final section I present characteristics of what a feminist conception of justice needs to look like and indicate how feminist bioethicists are using such a conception in assessing issues of injustice in bioethics. I emphasize the centrality of actual structural injustices, relational egalitarianism, and the assessment of values in conceptions of health and the health sciences. (shrink)

Responding to the nurse’s moral distress in this case depends on a deeper understanding of the source. It is possible that there is concern that resuscitation is morally wrong—perhaps because it wo...

Many social gradients in health appear steeper for men than for women. I refer to this as the “Steepness Puzzle.” This paper explores the ethical implications of this Puzzle. First, it identifies potential explanations for the Steepness Puzzle, including methodological problems. Second, it highlights two harms associated with the methodological explanation: the consequences of biased epistemic practices and the marginalization of women. It also demonstrates how attempts to flatten the gradients in health could disproportionately favor men or reinforce troubling gendered (...) norms. Finally, I suggest ways to address the methodological problems underlying the Puzzle. (shrink)

In this paper I argue that certain ways in which the relationship among discrimination, emotions and health is presented can undermine equity. I identify a model of this relationship the discrimination-emotion-health model - and claim that while the model is important for understanding the detrimental impact that discrimination and oppression can have on emotions and health, certain implications of the model are troubling. I identify six critiques of the model, and show that equity could be undermined, for example, when stereotypes (...) of the oppressed are reinforced and the experiences of the privileged are normalized. I then assess the implications of my analysis of the model and its critique for a framework of health equity, demonstrating what such a framework would need to look like in order for it to best represent discrimination as a psychosocial determinant of health. (shrink)

One of the most controversial issues in many health care systems is health care rationing. In essence, rationing refers to the denial of - or delay in - access to scarce goods and services in health care, despite the existence of medical need. Scarcity of financial and medical resources confronts society with painful questions. Who should decide which medicine or new treatment will be covered by social security and on which criteria such decisions must be based? Can age, for example, (...) be justified as a selection criterion? Should decision-making be left to health care policymakers, hospital administrators, or rather, to treating physicians? And finally: is there a role for individual patients? These are difficult questions that suggest the need for transparent and democratic decision-making. In reality, however, the rationing debate occurs in a sub rosa world, based on imperfect information, distorted interpretations of effectiveness, and hidden cost concerns. This book explores these and other questions from various perspectives. Each of the book's contributors analyzes the debate from a different angle, in search of fair and just rationing decisions. (shrink)

Andrew Walton argues that, a Rawlsian property-owning democracy (POD) requires a fraternal ethos and certain forms of social interaction, such as high trade union membership. The basic structure objection could be used to challenge these claims as it indicates that Rawls’s principles of justice should only be applied to the basic structure of society, and not, for example, to an ethos. Walton has two responses to the objection: firstly, that it does not apply to his argument, and, secondly, even if (...) it were to apply, the objection itself is unconvincing. In this article I argue however that (1) the basic structure objection does apply as a fraternal ethos is difficult to reconcile with Rawls’s understanding of what should be included as part of the basis structure, and (2) although I do not defend the basic structure objection, it is not made explicit in Walton’s argument why the objection should be dismissed as unconvincing. (shrink)

Why Does Inequality Matter?, by ScanlonT.M.. New York: Oxford University Press, 2018. Pp. ix + 170.

Carina Fourie and Annette Rid, eds. What is Enough? Sufficiency, Justice, and Health. New York, Oxford University Press, 2017. 336 p.

Carina Fourie and Annette Rid’s edited volume What Is Enough? Sufficiency, Justice, and Health comprises fifteen original contributions which explore the possibility of a sufficientarian approach to healthcare priority setting and resource allocation. Sufficientarianism is a well-established theory of distributive justice, which tells us that justice requires that each person has “enough,” and assigns particular importance to a threshold level of goods under which no person must fall. Sufficiency is under-explored as a distributive principle in the healthcare context, (...) and this book makes a strong case for its inclusion among more familiar principles of justice such as utility, priority to the worst off, and equality. (shrink)

This review uses the excellent recent anthology, What Is Enough: Sufficiency, Justice, and Health, edited by Carina Fourie and Annette Rid, as a springboard for a discussion of a little-noticed problem for sufficientarian principles governing the distribution of health or health care. All sufficientarian principles must be assigned a scope: the set of individuals who are to be brought up to the level of sufficiency. When it comes to health and health care, sufficientarians will, rightly, want to reject (...) broad scopes, because they will entail that we are accountable for securing health care for, for example, wild animals. Unfortunately, any narrow scope will seem morally arbitrary, because it will imply that among all the individuals who could benefit from health care we are obligated to provide it only to some of them. But, I suggest here that such arbitrariness is no problem for narrow-scope sufficientarianism in health or health care as long as the principle is cast as a non-fundamental principle of public policy as opposed to a fundamental moral principle. (shrink)

This book is written for middle and high school students, for teachers and for those with a passion for math, containing 150+1 problems (which are followed by solutions) to make it more accessible to the reader. The last problem (150+1), a very interesting one, leaves some space for comments and generalizations. The book is a collaboration between a multi-awarded student at Romania’s National Mathematics Olympiad (Carina Maria Viespescu, student in year 10 at Liceul International of Informatics Bucuresti), a teacher (...) from Colegiul National “Fratii Buzesti” din Cravoia and prof. Dr. Emeritus Florentin Smarandache from the University of New Mexico. A couple of problems are proposed by colleagues, and their names indicated in footnotes. (shrink)

In 1932, John von Neumann argued for the equivalence of the thermodynamic entropy and −Trρlnρ, since known as the von Neumann entropy. Meir Hemmo and Orly R. Shenker recently challenged this argument by pointing out an alleged discrepancy between the two entropies in the single-particle case, concluding that they must be distinct. In this article, their argument is shown to be problematic as it allows for a violation of the second law of thermodynamics and is based on an incorrect calculation (...) of the von Neumann entropy. (shrink)

The effects of the COVID-19 pandemic have rippled across the United States’ (US) agri-food system, illuminating considerable issues. US seed systems, which form the foundation of food production, were particularly marked by panic-buying and heightened safety precautions in seed fulfillment facilities which precipitated a commercial seed sector overwhelmed and unprepared to meet consumer demand for seed, especially for non-commercial growers. In response, prominent scholars have emphasized the need to support both formal (commercial) and informal (farmer- and gardener-managed) seed systems to (...) holistically aid growers across various contexts. However, limited attention to non-commercial seed systems in the US, coupled with a lack of consensus surrounding what exactly a resilient seed system looks like, first warrants an exploration into the strengths and vulnerabilities of existing seed systems. This paper seeks to examine how growers navigated challenges in seed sourcing and how this may reflect the resilience of the seed systems to which they belong. Using a mixed-methods approach which includes data from online surveys (n = 158) and semi-structured interviews (n = 31) with farmers and gardeners in Vermont, findings suggest that growers were able to adapt – albeit through different mechanisms depending on their positionality (commercial or non-commercial) within the agri-food system. However, systemic challenges emerged including a lack of access to diverse, locally adapted, and organic seeds. Insights from this study illuminate the importance of creating linkages between formal and informal seed systems in the US to help growers respond to manifold challenges, as well as promote a robust and sustainable stock of planting material. (shrink)

Se analizará el papel de la iglesia católica como detentora de poder en el siglo X, sus íntimas relaciones con la forma de construcción del poder político, permitiendo su fortalecimiento en un tiempo de fragmentación territorial. Se perseguirá la interpretación de la interrelación poder temporal-esp..

The adaptation-by-binding account and the arousal-biased competition model suggest that emotional arousal increases binding effects for transient links between stimuli and responses. Two highly-powered, pre-registered experiments tested whether transient stimulus-response bindings are stronger for high versus low arousing stimuli. Emotional words were presented in a sequential prime-probe design in which stimulus relation, response relation, and stimulus arousal were orthogonally manipulated. In Experiment 1 (N = 101), words with high and low arousal levels were presented individually in prime and probe displays. (...) In Experiment 2 (N = 170), a high arousing affective word was presented simultaneously with a neutral word during the prime display; in the subsequent probe display, either the arousing or the neutral word repeated or a different high versus low arousal word was shown. Data from both experiments did not demonstrate a modulation of SRBR effects by stimulus arousal and SRBR effects were of equal magnitude for word stimuli of high and low arousal levels. These null results are not in line with binding accounts that hypothesise a modulatory influence of emotional arousal on perception-action binding. (shrink)

The origin and evolutionary dynamics of the spatial heterogeneity in genomic base composition have been debated since its discovery in the 1970s. With the recent availability of numerous genome sequences from a wide range of species it has been possible to address this question from a comparative perspective, and similarities and differences in base composition between groups of organisms are becoming evident. Ample evidence suggests that the contrasting dynamics of base composition are driven by GC‐biased gene conversion (gBGC), a process (...) that is associated with meiotic recombination. In line with this hypothesis, base composition is associated with the rate of recombination and the evolutionary dynamics of the recombination landscape, therefore, governs base composition. In addition, and at first sight perhaps surprisingly, the relationship between demography and genomic base composition is in agreement with the gBGC hypothesis: organisms with larger populations have higher GC content than those with smaller populations. (shrink)

This article critically examines the competitive, adversarial nature of the Western neoliberal style of democracy. Specifically, this article focuses on Amartya Sen’s notion of a “universal democracy” as a means of addressing socio-economic inequalities through Sen’s capability approach. Sen’s capability theory has become an acclaimed and widely used theory to evaluate and understand development and inequalities. However, we employ a distinctive critique by engaging Amartya Sen through Herbert Marcuse’s analysis of one dimensionality and the adversarial nature of Western democracy. We (...) further highlight how contemporary neoliberal society employ a particular, adversarial form of public participation. Through this, we underline the various neoliberal problemata, such as Western idealism, political passivity, and a “flattening of choice,” within contemporary democracies and locate how their competitive, winner-take-all nature has become essential to contemporary, Western democratic models. Consequently, we argue that democracy, as a functional concept and form of public engagement, should be fundamentally re-examined in order to address inequalities. (shrink)

This article explores safety and politics of space in two ways. First, it reviews research on women’s fear and calls for safer cities, identifying four contradictions in the geography of fear discourse. Second, it elaborates on how including various forms of fear may repoliticize the contemporary depoliticized and co-opted safety discussion by focusing on sexist and racist threats rather than exclusively on the white middle classes. Here, threats to veiled Muslim women and their experiences in public spaces are, in particular, (...) emphasized as exemplifying fears that are neglected in the safety debate. The article concludes that, rather than the whole safety issue being dismissed as ‘neoliberal’, there is an urgent need to strengthen the analysis of power and illuminate experiences of pain and fear in sexist and racist violence. (shrink)

Word co‐occurrence patterns in language corpora contain a surprising amount of conceptual knowledge. Large language models (LLMs), trained to predict words in context, leverage these patterns to achieve impressive performance on diverse semantic tasks requiring world knowledge. An important but understudied question about LLMs’ semantic abilities is whether they acquire generalized knowledge of common events. Here, we test whether five pretrained LLMs (from 2018's BERT to 2023's MPT) assign a higher likelihood to plausible descriptions of agent−patient interactions than to minimally (...) different implausible versions of the same event. Using three curated sets of minimal sentence pairs (total n = 1215), we found that pretrained LLMs possess substantial event knowledge, outperforming other distributional language models. In particular, they almost always assign a higher likelihood to possible versus impossible events (The teacher bought the laptop vs. The laptop bought the teacher). However, LLMs show less consistent preferences for likely versus unlikely events (The nanny tutored the boy vs. The boy tutored the nanny). In follow‐up analyses, we show that (i) LLM scores are driven by both plausibility and surface‐level sentence features, (ii) LLM scores generalize well across syntactic variants (active vs. passive constructions) but less well across semantic variants (synonymous sentences), (iii) some LLM errors mirror human judgment ambiguity, and (iv) sentence plausibility serves as an organizing dimension in internal LLM representations. Overall, our results show that important aspects of event knowledge naturally emerge from distributional linguistic patterns, but also highlight a gap between representations of possible/impossible and likely/unlikely events. (shrink)

This article conveys some of the findings from a hermeneutic-phenomenological study on lived experiences of school failure. The informants were students in Swedish senior high schools and teenagers in Swedish juvenile institutions. Contrary to the common belief that school failure is related to low grades or failing exams, the students’ descriptions of lived experiences of failure had little to do with intellectual shortcomings. The students’ interpretation of my research question did not encompass cognitive deficiencies. They rarely spoke of failure to (...) understand, or failure to meet scholastic demands. Instead, the students offered stories about failure to behave according to expectations and the way in which they experienced their teachers’ reactions to this ‘deviant’ behaviour. Thus, the question of school failure did not revolve around the students’ cognitive knowledge and proficiency – or lack of thereof – but around the hidden curriculum. The feelings the students lived through while experiencing failure included lack of trust, confidence, belief, joyfulness, patience, hope, and serenity. The study has moral implications for pedagogical practice and the formative relationship between teachers and students. Indo-Pacific Journal of Phenomenology , Volume 12, Special Edition May 2012. (shrink)

El presente trabajo conceptualiza la categoría de sufrimiento o dolor social desde un enfoque relacional y constructivista sobre la vida social y escolar. Particularmente, focalizamos en los desarrollos del psicoanálisis de Silvia Bleichmar, la sociología figuracional de Norbert Elias y el interaccionismo simbólico de David Le Breton. Sus perspectivas poseen una serie de puntos de confluencia: a) interpretan al sufrimiento como una emoción que imbrica procesos psico y sociogenéticos; b) conciben que el dolor remite a la relación entre cuerpo y (...) subjetividad; c) sostienen que el debilitamiento o la ausencia de lazos sociales significativos se encuentra en la base de las experiencias de padecimiento. (shrink)