In the last fifty years, average overall health status has increased more or less in parallel with a much celebrated decline in mortality, attributed mostly to poverty reduction, sanitation, nutrition, housing, immunization, and improved medical care. It is becoming increasingly clear, however, that these achievements were not equally distributed. In most countries, while some social groups have benefited significantly, the situation of others has stagnated or may even have worsened.If health is a prerequisite to a person functioning as an agent, (...) inequalities in health constitute inequalities in people's capability to function -- a denial of equality of opportunity. So why should a concern with health equity be singled out from the pursuit of social justice more generally? Can existing theories of justice provide an adequate account of health equity? And what ethical problems arise in evaluating health inequalities? These are some of the important questions that this book addresses in building an interdisciplinary understanding of health equity. With contributions from distinguished philosophers, anthropologists, economists, and public-health specialists, it centres on five major themes: what is health equity?; health equity and social justice; responsibilities for health; ethical issues in health evaluation; and anthropological perspectives. (shrink)

This volume provides an overview of issues arising in work on the foundations of decision theory and social choice. The collection will be of particular value to researchers in economics with interests in utility or welfare, but also to any social scientist or philosopher interested in theories of rationality or group decision-making.

I examine social capital’s impact on financial reports. Based on the social capital literature, I predict that the quality of the financial reports is higher when a firm is headquartered in a region with high social capital. Consistent with this prediction, I find that the firms that are headquartered in this type of region in the USA have a lower probability of committing fraud by misrepresenting financial information. Further, I find that the firms in regions with high social capital have (...) lower levels of discretionary accruals and much more readable annual reports. (shrink)

When weighing up which inhaler to prescribe, a doctor may prioritise a patient’s preferences over the expected harms from the associated carbon emissions. Parker argues that this is wrong.1 Doctors have a pro-tanto duty to switch from a high-carbon metered-dose inhaler (MDI) to a low-carbon dry-powdered inhaler (DPI)—even though this provides no direct patient benefit—unless switching would undermine trust or significantly worsen a patient’s health. He goes on to state that even if DPIs are more expensive for the National Health (...) Service (NHS) then this is justified so long as it does not ‘significantly threaten’ the NHS’ ability to protect and promote health. This may appear to be a radical proposal, challenging the ethical principles of autonomy, health entitlements and justly distributed resources. However, we will claim that it is only radical in so far as one perceives (A) patient autonomy and healthcare entitlements as existing within a vacuum, unrelated to other foundational ethics concerns and (B) the health consequences of a given healthcare budget are limited solely to the designated recipients rather than all affected parties. Here, we test the claim that our responsibility for promoting patient autonomy …. (shrink)

Culture and Psyche is a collection of Sudhir Kakar's essays on cultural psychology, which analyses various facets of Indian identity and sexuality through sources as diverse as case studies, Indian myths and legends, and popular cinema. The second edition of this classic includes a new introduction and three additional essays which explore issues like riots, the psychology of Islamist terrorism, among others.

Kakar goes beyond the traditional psychoanalytic interpretation of Ramakrishna's mystical visions and practices. He clarifies their contribution to the psychic transformation of a mystic and offers fresh insight into the relation between sexuality and ecstatic mysticism. Through a comparison of the healing techniques of the mystical guru and those of the analyst, Kakar highlights the difference in their healing objectives and reveals the positive psychological aspects of the religious experience.

The Unified Medical Language System and the Gene Ontology are among the most widely used terminology resources in the biomedical domain. However, when we evaluate them in the light of simple principles for wellconstructed ontologies we find a number of characteristic inadequacies. Employing the theory of granular partitions, a new approach to the understanding of ontologies and of the relationships ontologies bear to instances in reality, we provide an application of this theory in relation to an example drawn from the (...) context of the pathophysiology of hypertension. This exercise is designed to demonstrate how, by taking ontological principles into account we can create more realistic biomedical ontologies which will also bring advantages in terms of efficiency and robustness of associated software applications. (shrink)

Alongside scholarly and societal dimensions of research impact, the meaningfulness of research, emerging from the link to context, is crucial. Authentic inclusion of Global South scholars based in the Global South aids these objectives.

The hard problem of consciousness arises in most incarnations of present day physicalism. Why should certain physical processes necessarily be accompanied by experience? One possible response is that physicalism itself should be modified in order to accommodate experience: But, modified how? In the present work, we investigate whether an ontology derived from quantum field theory can help resolve the hard problem. We begin with the assumption that experience cannot exist without being accompanied by a subject of experience (SoE). While people (...) well versed in Indian philosophy will not find that statement problematic, it is still controversial in the analytic tradition. Luckily for us, Strawson has elaborately defended the notion of a thin subject—an SoE which exhibits a phenomenal unity with different types of content (sensations, thoughts etc.) occurring during its temporal existence. Next, following Stoljar, we invoke our ignorance of the true physical as the reason for the explanatory gap between present day physical processes (events, properties) and experience. We are therefore permitted to conceive of thin subjects as related to the physical via a new, yet to be elaborated relation. While this is difficult to conceive under most varieties of classical physics, we argue that this may not be the case under certain quantum field theory ontologies. We suggest that the relation binding an SoE to the physical is akin to the relation between a particle and (quantum) field. In quantum field theory, a particle is conceived as a coherent excitation of a field. Under the right set of circumstances, a particle coalesces out of a field and dissipates. We suggest that an SoE can be conceived as akin to a particle—a SelfOn—which coalesces out of physical fields, persists for a brief period of time and then dissipates in a manner similar to the phenomenology of a thin subject. Experiences are physical properties of selfons with the constraint (specified by a similarity metric) that selfons belonging to the same natural kind will have similar experiences. While it is odd at first glance to conceive of subjects of experience as akin to particles, the spatial and temporal unity exhibited by particles as opposed to fields and the expectation that selfons are new kinds of particles, paves the way for cementing this notion. Next, we detail the various no-go theorems in most versions of quantum field theory and discuss their impact on the existence of selfons. Finally, we argue that the time is ripe for a rejuvenated Indian philosophy to begin tackling the three-way relationship between SoEs (which may become equivalent to jivas in certain Indian frameworks), phenomenal content and the physical world. With analytic philosophy still struggling to come to terms with the complex worlds of quantum field theory and with the relative inexperience of the western world in arguing the jiva-world relation, there is a clear and present opportunity for Indian philosophy to make a worldcentric contribution to the hard problem of experience. (shrink)

A yearning towards universality -- The skull of Descartes -- Darkness and light -- Landscapes of Utopia -- The ideals of science -- To the left, and to the right -- The sum of their parts -- Interlude: new paths to the present -- Freedom and domination -- Writing for everybody -- The end of history -- The closing of the French mind -- Anxiety and optimism.

Autumn Fiester's “Neglected Ends: Clinical Ethics Consultation and the Prospects for Closure” (2015) demonstrates how a focus on recommendations in clinical ethics consultations (CECs) can fail to...

India Analysed recounts the life and ideas of Sudhir Kakar in his own words and, in the process, gives readers an insight into the psychological make-up of modern Indian.

Most of the theories of rights propounded by philosophers, right from the beginning till the twentieth century, conceive rights either as a claim against the state or an obligation upon the state. Certainly such a conception has had something to do with the prevailing social, political and economic systems of the time concerned. Social, political and economic systems also had a particular relationship amongst them. Change in individual and social perspectives, values, priorities and beliefs has affected the philosophy of right. (...) From the ages of Locke and Hobbes when natural right was taken in obvious terms to the times of communitarians like Michael Sandel and thinkers like Ronald Dworkin the term “Right” has earned many dimensions. Progress and changing arrangements of systems complicates the status of a philosophical theory of rights propounded at a particular time, in the sense that its losses its teeth in any new found milieu. This paper evaluates the notion of abstract universalism of individual rights in the light of Gandhian notion of duty. (shrink)

Automobility, or the myriad institutions that foster car culture, has rarely if ever been put under the lens of liberal political theory, even though driving is one of the most common and widely accepted features of daily life in modern societies. When its implied promise of guaranteeing both freedom and equality is examined more closely, however, it appears that the ethical implications of driving may be darker than initially supposed. Automobility may indeed be in violation of both the Kantian categorical (...) imperative and Gewirth’s principle of generic consistency, even though there has thus far been remarkably little ethical analysis to reveal these possibilities. It is conceivable that liberal political theory has turned a blind eye to automobility precisely because the latter has naturalized us into accepting what Roberto Unger has called a routine of “false necessity,” so that driving is now virtually imperceptible as a social fact worthy of critical analysis. (shrink)

Sen’s capabilities approach offers a radical generalisation of the conventional approach to welfare economics. It has been highly influential in development and many researchers are now beginning to explore its implications for health care. This paper contributes to the emerging debate by discussing two examples of such applications: first, at the individual decision making level, namely the right to die, and second, at the social choice level. For the first application, which draws on Nussbaum’s list of capabilities, it is argued (...) that many capabilities are ambiguously or indirectly related to the right to die, but the ability to form a concept of the good life and plan one’s own life provides a direct justification for such a right. In the second application, the focus is specifically on healthcare rationing and it is argued that, although not committed to age based rationing, the capabilities approach provides a more natural justification of age related access to health care than the fair innings argument, which is often used to justify the alleged ageism inherent in quality adjusted life years maximisation. (shrink)

Many medicines currently available on the market are simply too expensive for millions around the world to afford. Many medicines available in the developing world are only available to a small percentage of the population due to economic inequities. The profit-seeking behavior of pharmaceutical companies exacerbates this problem. In most cases, the price reductions required to make drugs affordable to a broader class of people in the developing world are not offset by the resultant increase in sales volume. Simply stated, (...) in most of the developing world, it is more profitable to sell drugs to the very wealthy at high prices than it is to sell cheaper drugs to a greater number of people. As a result, medicines remain unaffordable for the vast majority of people in many parts of the world. While this might be an acceptable outcome for certain commodities, such as luxury goods, it is completely unacceptable for life-saving medicines. Therefore, in order to effectively address the global lack of access to medicines, the role pharmaceutical companies play in the international intellectual property regime must be critically examined. (shrink)

Approximately two billion people lack access to medicines globally. People living with HIV, cancer patients, those suffering from tuberculosis or malaria, and other populations in desperate need of life-saving medicines are increasingly unable to access existing preventative, curative, and life-prolonging treatments. In many cases, treatment may be unavailable or inaccessible for even some of the most common and readily treatable health concerns, such as hypertension. In the developing world, many of the factors that contribute to making the world’s most vulnerable (...) and marginalized populations particularly susceptible to illness also operate to restrict their access to medicines. As a result of dramatic economic inequities and widespread poverty, it is not profitable for most originator pharmaceutical companies to develop new medicines for sale in developing markets or to lower the cost of existing drugs so that they are affordable for the majority of these populations. (shrink)

On psychoanalysis and culture with relations to works by Sudhir Kakar, Indian psychoanalyst and writer; contributed articles in his honor.

The Norwegian Oil Fund (‘Government Pension Fund – Global’) is worth over NOK 10.6 trillion (USD 1.15 USD trillion)1 making it the largest sovereign wealth fund in the world (Norges Bank Investment...

Introduction: An ethnographer among the anthropologists -- The world at hand: between scientific and literary inquiry -- A method of experience: reading, writing, teaching, fieldwork -- For the humanity yet to come: politics, art, fiction, ethnography -- Coda: The anthropologist as critic.

Periurban bypasses are enclaves that appear to be left behind of conventional spatial and technological processes. With the focus on cities and their development, the hinterland serves as a resource that barely makes its appearance in mainstream policy debates. Hidden even further in the periurban are areas whose inhabitants are marginalised in many ways. Developing an ethical framework for assessing periurban bypasses is rendered difficult by the complexity of attribution of harm to particular agents. Nevertheless, by using multiple modes of (...) interpretation and assessment of periurban bypasses, it is possible to create ethical profiles that identify social agents and elite networks for generating these harms. (shrink)

The sixteenth-century Marathi poet-saint Eknāth is better known for his devotional songs and allegorical drama-poems than his “philosophical” writings. These writings include commentaries on and distillations of Sanskrit texts that feature a highly localized form of Advaita, or non-dualist Vedānta. Rather than consider them vernacular translations of the classical traditions of Advaita, I propose to read Eknāth’s philosophical works as embedded in a local context of non-dualist thought that filtered into the elite world of Sanskrit knowledge-systems. I provide examples from (...) his Marathi commentary on the Sanskrit Hastāmalaka Stotra, a brief versified teaching on Advaita Vedānta. I also look at the para-textual material bracketing the content and some of the accompanying manuscript record, in order to understand the context for circulation and transmission of this material among Eknāth’s various readers over generations. My general attempt is to understand how ideas and practices belonging to local, vernacular networks filter into elite Sanskrit systems of knowledge—that is, not just into flexible genres like purāṇa but into disciplines, like Vedānta, that are generally viewed as impervious to the world around them. From my perspective, all knowledge is local, even that articulated in such cosmopolitan languages as Sanskrit. In Eknāth’s vernacular Advaita, we find evidence for a much wider scope for the movement of ideas, one that moves not from top-down but bottom-up. (shrink)

There are three theories in the epistemology of modality that have received sustained attention over the past 20 years: conceivability-theory, counterfactual-theory, and deduction-theory. In this paper we argue that all three face what we call the problem of modal epistemic friction. One consequence of the problem is that for any of the three accounts to yield modal knowledge, the account must provide an epistemology of essence. We discuss an attempt to fend off the problem within the context of the internalism (...) versus externalism debate about epistemic justification. We then investigate the effects that the PMEF has on reductive and non-reductive theories of the relation between essence and modality. (shrink)

It is widely understood that protein functions can be exhaustively described in terms of no single parameter, whether this be amino acid sequence or the three-dimensional structure of the underlying protein molecule. This means that a number of different attributes must be used to create an ontology of protein functions. Certainly much of the required information is already stored in databases such as Swiss-Prot, Protein Data Bank, SCOP and MIPS. But the latter have been developed for different purposes and the (...) separate data-structures which they employ are not conducive to the needed data integration. When we attempt to classify the entities in the domain of proteins, we find ourselves faced with a number of cross-cutting principles of classification. Our question here is: how can we bring together these separate taxonomies in order to describe protein functions? Our proposed answer is: via a careful top-level ontological analysis of the relevant principles of classification, combined with a new framework for the simultaneous manipulation of classifications constructed for different purposes. (shrink)