This book comprises an attempt to examine how we might set about an- swering the question: How much is society prepared to pay to reduce mortality: Or more brutally, what is the value of human life? The justification for attempting to answer such questions lies in the de- sirability of injecting increased explicitness and rationality into decision-making in those areas of the public sector which are con- cerned with life saving. Given that resources are already being de- ployed to such (...) activities as crash-barriers on motorways, helicopters for air-sea rescue, kidney machines and other life-saving measures - although such activities result only in a reduction in risk of death, not itsillimination, in the policy fields affected - this means that already at the present time, at least by implication, values are be- ing placed by decision-makers on the saving of life. (shrink)

Providing health care in the most cost-effective way has become a priority in recent years. This book tackles the important issue of the potential conflict between economic expediency and the welfare of individual patients. Contributors examine different attitudes to this complex problem, along with a variety of legal and historical perspectives. The book addresses particular aspects of health care, such as medical expert systems, general practice, medical education, and clinical decision-making where the direct involvement of doctors in allocating scarce and (...) expensive resources is perhaps most obvious. (shrink)

Equity in health and health care is animportant issue. It has been proposed that thepursuit of equity in health care is beinghampered by the dominance of individualism inhealth care practices. This paper explores theway in which communitarian ideals and practicesmight lend themselves to the pursuit of equity.Communitarians acknowledge, respect and fosterthe bonds that unite and identify communities.The paper argues that, to achieve equity inhealth care, these bonds need to be recognisedand harnessed rather than ignored. The notionof individual autonomy in the (...) context of thecommunity is examined. Alternative concepts ofautonomy – social autonomy and communityautonomy – are seen to be more respectful andnurturing of both the individual and thecommunity. Moreover, these concepts appeardesirable for the pursuit of health care equitygoals. The paper concludes with some thoughtsabout how equity in Australia's health caresystem can reasonably progress within acommunitarian vision. Disadvantaged communitiesare discussed throughout, in particular,Australian Aboriginal communities. (shrink)

Most of the debate surrounding standards in medical care, issues of medical audit and what constitutes benefit from health care assumes that what is obtained from health care is health and only that. This is an assumption which most health economists at least implicitly appear to endorse. This paper questions that assumption. There are various outcomes beyond health and there are various processes involved in health care about which patients are not indifferent. This paper calls for a fuller investigation as (...) to what it is that patients want from their health services and the adoption of a more pluralistic conception of health care benefits. It is further argued that the objectives of health care systems are those in which citizensqua citizens also have interests and which may be different from those of patients. It is yet less likely that citizens’ interests in health care will be restricted to health. (shrink)

This study is part of a programme to elicit and examine community preferences for health care in different contexts. Data were obtained from a group of predominantly Australian health care decision-makers. A short questionnaire contained six valuation questions and four demographic questions. The six valuation questions posed choices where equal health gains were to be allocated to different population groups based upon: age; sex; current health; socio-economic status; across time; and across different numbers of individuals. The results provide some evidence (...) that respondents were prepared to discriminate between health gains derived in different contexts especially where health gains were to be allocated between groups of different health status and over time. Further research is planned and the possible implications for health policy, and in particular for resource allocation in health care, are briefly discussed. (shrink)

This paper introduces this mini-series on vertical equity in health care. It reflects on the fact that by and large equity policies in health care have failed and that there is a need for positive discriminationto promote equity better in future. This positive discrimination is examined under the heading of`vertical equity'. The paper considers Varian's notion of 'envy' as a basis for equity in health care but concludes that this is not a helpful route to go down. Better it would (...) seem to pursue the idea from Sen of 'freedoms' and 'communitarian claims' (as raised previously by this author). While it is argued that procedural justice is to be preferred in the longer run as a basis for equity there are gains in adopting a short run goal of promoting distributive justice. Some preliminary evidence is presented on the weighting of health gains to reflect such vertical equity concerns. (shrink)

Effectiveness, efficiency and equity in health care are discussed in this article against the background of concerns that cost containment may lead to reductions in quality of care. It is suggested that effectiveness is best seen from the patient's point of view and that it relates to more than simply improved health status. Efficiency and equity are better viewed from a societal stance.The paper discusses the role of the medical profession in effectiveness, efficiency and equity and argues that the role (...) of medical doctors needs to be constrained. (shrink)

This paper argues that there is a need to move yet further than has already been suggested by some from the individual to the collective as a base for public health. A communitarian approach is one way to achieve this. This has the advantage of allowing not only the community’s voice to have a say in setting the values for public health but also more formally the development of a constitution on which public health might then be built. It also (...) sees public health as a social institution which can be valued in its own right. (shrink)

Most of the debate surrounding standards in medical care, issues of medical audit and what constitutes benefit from health care assumes that what is obtained from health care is health and only that. This is an assumption which most health economists at least implicitly appear to endorse. This paper questions that assumption. There are various outcomes beyond health and there are various processes involved in health care about which patients are not indifferent. This paper calls for a fuller investigation as (...) to what it is that patients want from their health services and the adoption of a more pluralistic conception of health care benefits. It is further argued that the objectives of health care systems are those in which citizensqua citizens also have interests and which may be different from those of patients. It is yet less likely that citizens’ interests in health care will be restricted to health. (shrink)

Understanding terrestrial carbon metabolism is critical because terrestrial ecosystems play a major role in the global carbon cycle. Furthermore, humans have severely disrupted the carbon cycle in ways that will alter the climate system and directly affect terrestrial metabolism. Changes in terrestrial metabolism may well be as important an indicator of global change as the changing temperature signal. Improving our understanding of the carbon cycle at various spatial and temporal scales will require the integration of multiple, complementary and independent methods (...) that are used by different research communities. Tools such as air sampling networks, inverse numerical methods, and satellite data allow us to study the strength and location of the global- and continental-scale carbon sources and sinks. Bottom-up studies provide estimates of carbon fluxes at finer spatial scales and examine the mechanisms that control fluxes at the ecosystem, landscape, and regional scales. Bottom-up approaches include comparative and process studies that provide the necessary mechanistic information to develop and validate terrestrial biospheric models. An iteration and reiteration of top-down and bottom-up approaches will be necessary to help constrain measurements at various scales. We propose a major international effort to coordinate and lead research programs of global scope of the carbon cycle. (shrink)

The issue of assessing priorities is one that has become the subject of much debate in the National Health Service particularly in the wake of various documents on priorities from central Government. It has become even more so with the prospect of real cuts in expenditure. Economists claim that their science, or perhaps more accurately art can assist in determining not only how best to achieve various ends but also whether and to what extent competing objectives should be pursued. Such (...) choices cannot be made in the absence of some ethical considerations and it is important that health service decision makers (and in particular the medical profession) are aware if the relationship between economics (and especially cost-benefit analysis) and medical ethics. (shrink)

The notion of whether people focus on the past, present or future, and how it shapes their behaviour is known as Time Perspective. Fundamental to the work of two of its earliest proponents, Zimbardo and Boyd (2008), was the concept of balanced time perspective and its relationship to wellness. A person with balanced time perspective can be expected to have a flexible temporal focus of mostly positive orientations (past-positive, present-hedonistic, and future) and much less negative orientations (past-negative and present-fatalistic). This (...) study measured deviation from balanced time perspective (DBTP: Zhang, Howell, and Stolarski, 2013) in a sample of 243 mature adults aged 45 to 91 years and explored relationships to Retirement Planning, Depression, Anxiety, Stress, Positive Mood, and Negative Mood. Results indicate that DBTP accounts for unexplained variance in the outcome measures even after controlling for demographic variables. DBTP was negatively related to Retirement Planning and Positive Mood and positively related to Depression, Anxiety, Stress and Negative Mood. Theoretical and practical implications regarding balanced time perspective are discussed. (shrink)

Recent theoretical developments in economic theory have attempted to relax the assumption that human behavior is guided by “tight calculation” of profit-maximization. Harvey Liebenstein's notion of X-efficiency is a particularly important development in this regard. This article argues, however, that X-efficiency theory does not go far enough in relaxing the assumptions of economic theory. The understanding of human behavior requires a recognition of variability in the ends or goals of action as well as variability in the means which are utilized (...) in the pursuit of these diverse ends. Max Weber's concepts of formal rationality and substantive rationality recognize this variability in the ends toward which action is oriented as well as the intrusion of habit or routine in the “calculatedness” of social and economic action. C. Wright Mills' ideal of craftship is used to represent a type of substantive rationality which contrasts with the formal rationality of calculation toward profit-maximization. The case is made that craftship is a particularly significant substantive rationality in American agriculture. It is argued that, among family farmers, other values, such as autonomy in one's work, often constitute alternative ends toward which action may be directed. Such ends may, in fact, conflict with the goal of profit-maximization. It is concluded that agricultural policy analysis and prescription which fails to consider the significant role of substantive rationalities, such as craftship, are likely to reproduce and enhance the conditions from which the present crisis in agriculture has developed. (shrink)

Professor Bonnie Steinbock writes ‘… I am not going to discuss rights, important as the issue is’; but she adds, en passant , ‘According to the view of rights held by H. L. A. Hart and S. I. Benn, infants do not have rights, nor do the mentally defective, nor do the insane, in so far as they all lack certain minimal conceptual capabilities for having rights’.

In a famous debate on jurisprudence held in 1958 between H. L. A. Hart and Lon Fuller, the protagonists argued about the nature of the law. On one side was H. L. A. Hart, who was a staunch defender of two ideas, first, that law was to be separated from morals, and secondly, that law as it is should be separated from law as it ought to be. These two ideas are subtly different. On the other side, is Fuller, who (...) argues that law cannot be understood apart from its reason for being formulated in the first place. In relation to Hart's two ideas, the paper shows how both rest upon an unstated hidden motivating assumptions, clues to which can be found in both "Positivism and the Separation of Law and Morals" and 'The Concept of Law'. This assumption is that Hart is committed to a distinctively liberal account of morality which finds expression in the rule of law. The paper argues that the project of finding a purely descriptive account of law is impossible in the Hartian sense since the descriptive/evaluative dichotomy is a false dichotomy. This is achieved by means of the Kovesian analysis of concept formation. (shrink)

The author joins the discussion on selection of patients in the face of life-saving resources initiated in the Journal by Parsons and Lock, Mooney and the editorial in the December 1980 issue. In this article several selection systems are discussed. The author is in favour of a `criteria-system'. The criteria for such a system are elaborated. On the basis of a sequence of values a sequence of criteria is proposed. Attention is also given to the procedural aspects.

Book Reviws in this ArticleThe Human Body and the Law, 2nd edition by D.W. Meyers, Edinburgh University Press, 1990Classic Cases in Medical Ethics by Gregory E. Pence. New York: McGraw‐Hill Publishing Co. 1990Changing Values in Medical and Health Care Decision Making, edited by Uffejuul Jensen and Gavin Mooney. Chichester: John Wiley & Sons, 1990IVF and Justice by Teresa Iglesias, London: The Linacre Centre For Health Care Ethics, 1990The Practical, Moral and Personal Sense of Nursing: A Phenomenon‐ological Philosophy of (...) Practice by Anne H. Bishop and John R. Scudder, Jr. New York: State University of New York Press, 1990A Companion to Ethics, edited by Peter Singer. Oxford and Cambridge, Mass: Basil Blackwell, 1991.Ethics and Law in Health Care and Research edited by Peter Byrne, Chichester, UK: 1990The Human Embryo edited by G.R. Dunstan, Exeter: Exeter University Press, 1990Everyday Ethics: Resolving Dilemmas in Nursing Home Life by Rosalie A. Kane and Arthur L. Caplan. N.Y.: Springer Publishing Company, 1990Psychiatric Ethics, 2nd edition, edited by S. Bloch and P. Chodoff. Oxford, Oxford University Press, 1991Health Care and Gender by Charlotte Muller. New York: Russell Sage Foundation, 1990. (shrink)

A first in English, this book engages with the ways in which Hegel and Sartre answer the difficult questions: What is it to be human? What place do we have in the world? How should we live? What can we be?

Prince of Networks is the rst treatment of Bruno Latour speci cally as a philosopher. Part One covers four key works that display Latour’s underrated contributions to metaphysics: Irreductions, Science in Action, We Have Never Been Modern, and Pandora’s Hope. Harman contends that Latour is one of the central gures of contemporary philosophy, with a highly original ontology centred in four key concepts: actants, irreduction, translation, and alliance.

This book explores the diverse understandings of the archaeological record in both historical and contemporary perspective, while also serving as a guide to reassessing current views. Gavin Lucas argues that archaeological theory has become both too fragmented and disconnected from the particular nature of archaeological evidence. The book examines three ways of understanding the archaeological record - as historical sources, through formation theory, and as material culture - then reveals ways to connect these three domains through a reconsideration of (...) archaeological entities and archaeological practice. Ultimately, Lucas calls for a rethinking of the nature of the archaeological record and the kind of history and narratives written from it. (shrink)

Contemporary metaphysics is dominated by the view that every object belongs to a kind permanently in the sense that it cannot cease to belong to that kind without thereby ceasing to exist. For example, some philosophers think that a person is destroyed if they cease to be a person, a statue is destroyed if it ceases to be a statue, and so on. I believe that this standard view is false. Being a person, or a statue, or etc., is like (...) being a child: just as I did not cease to exist when I ceased to be a child, so people and statues need not cease to exist when they cease to be people and statues. Borrowing a term from Daniel Korman (who uses it in a similar but perhaps not identical way), I call this view phasalism because it entails that the kind-properties which ordinary objects instantiate are phase sortal properties, i.e., kind-properties that an object can instantiate for a temporary phase of its career. This dissertation is a partial defense of phasalism. I develop a phasalist metaphysics in detail, highlighting its virtues and rebutting objections along the way. After some stage-setting (Chapter 1), I defend a phasalist criterion of identity over time for ordinary objects (Chapter 2), as well as a phasalist account of the role that sortal properties play in the identity over time of ordinary objects (Chapter 3). Then I defend a phasalist-friendly approach to the identity over time of lumps, hunks, pieces, etc. of matter (Chapter 4). The material in these chapters amounts to a phasalist solution to certain material coincidence puzzles, such as the puzzle of the statue and the piece of clay. I go on to show that familiar puzzles about undetached parts (Chapter 5) and fission (Chapter 6) can be solved within the confines of my phasalist metaphysics as well. (shrink)

Unravels the philosophical, literary, and personal theaters of faith, self-deception, communion, difficult reality, and existential crisis in texts by Kierkegaard, Melville, Henry Bugbee, and others.

With stories, anecdotes, and a discussion about the strong connection between theory and best practices, this guide will help you understand the value of applying your knowledge of educational theory to your work as you refine your practices, create thoughtful curriculum, and do your best to raise the standards of early childhood education.

Subjectivity: exposure, care, response -- On self, others, goods, and final faith -- On style and pseudonymity -- A faith that defies self-deception -- On reflexivity, vision, and the self -- On faith, the maternal, and postmodernism -- Socratic self-sufficiency, Christian dependency -- On authenticity -- The garden of death: faith as interpersonal -- When is death?.