Until very recently, the lack of health insurance has been viewed primarily as a problem of financial risk for uninsured individuals. This article documents far broader adverse effects, drawn from the work of the Institute of Medicine Committee on the Consequences of Uninsurance. It also synthesizes the Committee’s key findings, conclusions, and recommendations.In early 2004, following 3½ years of study, the IOM Committee on the Consequences of Uninsurance recommended that “...the President and Congress develop a strategy to achieve universal insurance (...) coverage and establish a firm and explicit schedule to reach this goal by 2010.” The Committee presented 5 principles to be used to assess various proposals for extending coverage or to guide the design of a new strategy, specifying that health care coverage should be universal, continuous, affordable to individuals and families, and affordable and sustainable for society. (shrink)

Until very recently, the lack of health insurance has been viewed primarily as a problem of financial risk for uninsured individuals. This article documents far broader adverse effects, drawn from the work of the Institute of Medicine Committee on the Consequences of Uninsurance. It also synthesizes the Committee’s key findings, conclusions, and recommendations.In early 2004, following 3½ years of study, the IOM Committee on the Consequences of Uninsurance recommended that “...the President and Congress develop a strategy to achieve universal insurance (...) coverage and establish a firm and explicit schedule to reach this goal by 2010.” The Committee presented 5 principles to be used to assess various proposals for extending coverage or to guide the design of a new strategy, specifying that health care coverage should be universal, continuous, affordable to individuals and families, and affordable and sustainable for society. (shrink)

Policy often focuses on reducing health care disparities through interventions at the patient and provider level. While unquestionably important, system-wide reforms to reduce uninsurance, improve geographic availability of services, increase workforce diversity, and promote clinical best practices are essential for progress in reducing disparities.

As this nation embarks on new efforts to reform the U.S. health system, we face a critical unfinished agenda from the mid- 1960s: persistent racial, ethnic, and socioeconomic disparities in health and health care. Medicaid, Medicare, and Community Health Centers — public programs with very different legislative histories and financing mechanisms — were the first federally funded, nationwide efforts to improve health care access for low-income and elderly Americans. Members of racial and ethnic minority groups also greatly benefited from these (...) efforts because recipients of federal funds, such as Medicare, were required to comply with the newly passed Civil Rights Act of 1964, which barred racial discrimination. Unquestionably, government played a major role in the gains in health care access that have occurred in the last half century. Yet today all Americans do not have the same opportunities for health, access to care, or quality of care when they receive it. (shrink)

This Introduction introduces readers to the concepts of political philosophy: authority, democracy, freedom and its limits, justice, feminism, multiculturalism, and nationality. Accessibly written and assuming no previous knowledge of the subject, it encourages the reader to think clearly and critically about the leading political questions of our time. THe book first investigates how politcial philosophy tackles basic ethical questions such as 'how should we live together in society?' It furthermore looks at political authority, discusses the reasons society needs politics in (...) the first place, explores the limitations of politics, and asks if there are areas of life that shouldn't be governed by politics. Moreover, the book explores the connections between political authority and justice, a constant theme in political philosophy, and the ways in which social justice can be used to regulate rather than destroy a market economy. In his travels through this realm, Miller covers why nations ar the natural units of government and wonders if the rise of multiculturalism and transnational co-operation will change all this, and asks in the end if we will ever see the formation of a world government. (shrink)

This chapter outlines the main ideas of my book National responsibility and global justice. It begins with two widely held but conflicting intuitions about what global justice might mean on the one hand, and what it means to be a member of a national community on the other. The first intuition tells us that global inequalities of the magnitude that currently exist are radically unjust, while the second intuition tells us that inequalities are both unavoidable and fair once national responsibility (...) is allowed to operate. This conflict might be resolved either by adopting a cosmopolitan theory of justice (which leaves no room for national responsibility) or by adopting a ?political? theory of justice (which denies that questions of distributive justice can arise beyond the walls of the sovereign state). Since neither resolution is satisfactory, the chapter defends the idea of national responsibility and proposes a new theory of global justice, whose main elements are the protection of basic human rights worldwide, and fair terms of interaction between independent political communities. (shrink)

Platonists and nominalists disagree about whether mathematical objects exist. But they almost uniformly agree about one thing: whatever the status of the existence of mathematical objects, that status is modally necessary. Two notable dissenters from this orthodoxy are Hartry Field, who defends contingent nominalism, and Mark Colyvan, who defends contingent Platonism. The source of their dissent is their view that the indispensability argument provides our justification for believing in the existence, or not, of mathematical objects. This paper considers whether commitment (...) to the indispensability argument gives one grounds to be a contingentist about mathematical objects. (shrink)

Scientific consensus is widely deferred to in public debates as a social indicator of the existence of knowledge. However, it is far from clear that such deference to consensus is always justified. The existence of agreement in a community of researchers is a contingent fact, and researchers may reach a consensus for all kinds of reasons, such as fighting a common foe or sharing a common bias. Scientific consensus, by itself, does not necessarily indicate the existence of shared knowledge among (...) the members of the consensus community. I address the question of under what conditions it is likely that a consensus is in fact knowledge based. I argue that a consensus is likely to be knowledge based when knowledge is the best explanation of the consensus, and I identify three conditions—social calibration, apparent consilience of evidence, and social diversity, for knowledge being the best explanation of a consensus. (shrink)

In a recent paper, Barry Loewer attempts to defend Humeanism about laws of nature from a charge that Humean laws are not adequately explanatory. Central to his defense is a distinction between metaphysical and scientific explanations: even if Humeans cannot offer further metaphysical explanations of particular features of their “mosaic,” that does not preclude them from offering scientific explanations of these features. According to Marc Lange, however, Loewer’s distinction is of no avail. Defending a transitivity principle linking scientific explanantia to (...) their metaphysical grounds, Lange argues that a charge of explanatory inadequacy resurfaces once this intuitive principle is in place. This paper surveys, on behalf of the Humean, three strategies for responding to Lange’s criticism. The ready availability of these strategies suggests that Lange’s argument may not bolster anti-Humean convictions, since the argument rests on premises that those not antecedently sharing these convictions may well reject. The three strategies also correspond to three interesting ways of thinking about relations of grounding linking Humean laws and their instances, all of which are consistent with theses of Humean supervenience, and some of which have been heretofore overlooked. (shrink)

People increasingly form beliefs based on information gained from automatically filtered Internet ‎sources such as search engines. However, the workings of such sources are often opaque, preventing ‎subjects from knowing whether the information provided is biased or incomplete. Users’ reliance on ‎Internet technologies whose modes of operation are concealed from them raises serious concerns about ‎the justificatory status of the beliefs they end up forming. Yet it is unclear how to address these concerns ‎within standard theories of knowledge and justification. (...) To shed light on the problem, we introduce a ‎novel conceptual framework that clarifies the relations between justified belief, epistemic responsibility, ‎action, and the technological resources available to a subject. We argue that justified belief is subject to ‎certain epistemic responsibilities that accompany the subject’s particular decision-taking circumstances, ‎and that one typical responsibility is to ascertain, so far as one can, whether the information upon which ‎the judgment will rest is biased or incomplete. What this responsibility comprises is partly determined by ‎the inquiry-enabling technologies available to the subject. We argue that a subject’s beliefs that are ‎formed based on Internet-filtered information are less justified than they would be if she either knew how ‎filtering worked or relied on additional sources, and that the subject may have the epistemic ‎responsibility to take measures to enhance the justificatory status of such beliefs.‎. (shrink)

A startling look at one of this century's most influential philosophers, the book chronicles every stage of Foucault's personal and professional odyssey, from his early interest in dreams to his final preoccupation with sexuality and the nature of personal identity.

This paper reviews current debates in social epistemology about the relations ‎between ‎knowledge ‎and consensus. These relations are philosophically interesting on their ‎own, but ‎also have ‎practical consequences, as consensus takes an increasingly significant ‎role in ‎informing public ‎decision making. The paper addresses the following questions. ‎When is a ‎consensus attributable to an epistemic community? Under what conditions may ‎we ‎legitimately infer that a consensual view is knowledge-based or otherwise ‎epistemically ‎justified? Should consensus be the aim of scientific inquiry, and (...) if so, what ‎kind of ‎consensus? How should dissent be handled? It is argued that a legitimate inference ‎that a ‎theory is correct from the fact that there is a scientific consensus on it requires taking ‎into ‎consideration both cognitive properties of the theory as well as social properties of ‎the ‎consensus. The last section of the paper reviews computational models of ‎consensus ‎formation.‎. (shrink)

Serena Olsaretti brings together new essays by leading moral and political philosophers on the nature of desert and justice, their relations with each other and with other values.

A Theory of Shopping offers a highly original perspective on one of our most basic everyday activities - shopping. We commonly assume that shopping is primarily concerned with individuals and materialism. But Miller rejects this assumption and follows the surprising route of analysing shopping by means of an analogy with anthropological studies of sacrificial ritual. He argues that the act of purchasing goods is almost always linked to other social relations, and most especially those based on love and care. (...) The ethnographic sections of the book are based on a year's study of shopping on a street in North London. This provides the basis for a sensitive description of the issues the shopper confronts when making decisions as to what to buy. Miller develops a theory to account for these observations, arguing that shopping typically consists of three major stages which reflect the three key stages of many rites of sacrifice. In both shopping and sacrifice the ultimate intention is to constitute others as desiring subjects. Finally the book examines certain historical shifts in both subjects and objects of devotion, in particular, ideals of gender and love. This treatment of shopping from the perspective of comparative anthropology represents a highly innovative approach to one of the most familiar tasks of our daily lives. Written in a clear and accessible manner, this book will be of interest to students and academics in anthropology, sociology and cultural studies, as well as anybody who wants to consider more deeply the nature of their own everyday activities. (shrink)

The Ethics of Need: Agency, Dignity, and Obligation argues for the philosophical importance of the notion of need and for an ethical framework through which we can determine which needs have moral significance. In the volume, Sarah Clark Miller synthesizes insights from Kantian and feminist care ethics to establish that our mutual and inevitable interdependence gives rise to a duty to care for the needs of others. Further, she argues that we are obligated not merely to meet others’ needs (...) but to do so in a manner that expresses "dignifying care," a concept that captures how human interactions can grant or deny equal moral standing and inclusion in a moral community. She illuminates these theoretical developments by examining two cases where urgent needs require a caring and dignifying response: the needs of the elderly and the needs of global strangers. Those working in the areas of feminist theory, women’s studies, aging studies, bioethics, and global studies should find this volume of interest. (shrink)

Miller analyzes the relationship between consent and autonomy by offering three pictures. For autonomy, Miller distinguishes between procedural, substantive, and weak substantive autonomy. The corresponding views of consent are what Miller has termed as consensual minimalism, consensual idealism, and consensual realism. The requirements of sexual consent under consensual minimalism are a voluntary informed agreement. However, feminist critiques reveal the inadequacies of this simple position. Consensual idealism, which corresponds with substantive autonomy, offers a robust picture where consent and (...) autonomy must be based on non-oppression. However, this view is considered too ideal and it ignores context. Weak substantive autonomy takes into account the context in the sexual domain. Correspondingly, consensual realism takes into account the context and still fulfills the requirements of consent. (shrink)

This essay explains some basic concepts about BDSM, and it responds to two important objections to it. The first is the psychological objection—that BDSM practitioners suffer from mental disorders—and the second is the ethical objection—that BDSM practitioners have morally compromised desires because of the kinds of activities they desire to participate in, especially ones that involve roles that dip into tortured oppressive histories (e.g., "rape" scenes, "master-and-slave" scenes). The paper argues that both objections fail, and, more specifically focusing on the (...) ethical objection, argues that BDSM desires are psychologically, conceptually, and phenomenologically different from their seeming counterpart real-life desires that are truly ethically defective. Finally, the paper argues that BDSM practitioners, in having to always understand, explore, and justify their desires (especially to a majority that is hostile to them), have an interesting chance to lead rich, flourishing lives. (shrink)

As engineers propose constructing humanlike automata, the question arises as to whether such machines merit human rights. The issue warrants serious and rigorous examination, although it has not yet cohered into a conversation. To put it into a sure direction, this paper proposes phrasing it in terms of whether humans are morally obligated to extend to maximally humanlike automata full human rights, or those set forth in common international rights documents. This paper’s approach is to consider the ontology of humans (...) and of automata and whether ontological difference between them, that pertains to the very bases of human rights, affects the latter’s claims to full human rights. Considering common bases of human rights, can these bases tell us whether a certain ontological distinction of humans from automata—or a de facto distinction about humans tacitly acknowledged by full-rights-recognizing societies—makes a difference in whether humans are morally obligated to assign these entities full rights? Human rights to security also arise. The conclusion is that humans need not be under any moral obligation to confer full human rights on automata. The paper’s ultimate point is not to close the discussion with this ontological cap but to set a solid moral and legal groundwork for opening it up tout court. (shrink)

Good work in nursing is work that is scientifically effective as well as morally and socially responsible. The purpose of this study was to examine variables that sustain good work among entering nurses (with one to five years of experience) and experienced professional nurses despite the obstacles they encounter. In addition to role models and mentors, entering and experienced nurses identified team work, cohesiveness and shared values as levers for good work. These nurses used prioritization, team building and contemplative practices (...) to overcome obstacles. Entering professional nurses tended to avoid conflict in the work setting. Experienced nurses reported forming teams of decision makers who share similar values to resolve conflict. These findings have implications for nurse education and nursing practice. Reflection on the importance of values and virtue in sustaining good work is important. Entering professional nurses should be encouraged to seek positive role models and reflect on the lessons that can be learned from experienced exemplary nurses. (shrink)

Charney's dismissal of well-established methods in behavioral genetic research is misguided. He claims that studies of heritability and genetic association depend for their validity on six assumptions, but he cites no sources to support this claim. We explain why none of the six assumptions is strictly necessary for the utility of either method of genetic analysis.

Philosophers have recently argued, against a prevailing orthodoxy, that standards of knowledge partly depend on a subject’s interests; the more is at stake for the subject, the less she is in a position to know. This view, which is dubbed “Pragmatic Encroachment” has historical and conceptual connections to arguments in philosophy of science against the received model of science as value free. I bring the two debates together. I argue that Pragmatic Encroachment and the model of value-laden science reinforce each (...) other. Drawing on Douglas’ argument about the indispensability of value judgments in science, and psychological evidence about people’s inability to objectively reason about what they care about, I introduce a novel argument for Pragmatic Encroachment. (shrink)

While philosophy and psychoanalysis privilege language and conceptual distinctions and mistrust the image, the philosopher and psychoanalyst Julia Kristeva recognizes the power of art and the imagination to unblock important sources of meaning. She also appreciates the process through which creative acts counteract and transform feelings of violence and depression. Reviewing Kristeva's corpus, Elaine P. Miller considers the intellectual's "aesthetic idea" and "thought specular" in their capacity to reshape depressive thought on both the individual and cultural level. She revisits (...) Kristeva's reading of Walter Benjamin with reference to melancholic art and the imagination's allegorical structure; her analysis of Byzantine iconoclasm in relation to Freud's psychoanalytic theory of negation and Hegel's dialectical negativity; her understanding of Proust as an exemplary practitioner of sublimation; her rereading of Kant and Arendt in terms of art as an intentional lingering with foreignness; and her argument that forgiveness is both a philosophical and psychoanalytic method of transcending a "stuck" existence. Focusing on specific artworks that illustrate Kristeva's ideas, from ancient Greek tragedy to early photography, contemporary installation art, and film, Miller positions creative acts as a form of "spiritual inoculation" against the violence of our society and its discouragement of thought and reflection. (shrink)

This book offers a novel account of grace, framed in terms of Bruno Latour's "principle of irreduction.

What are words? What makes two token words tokens of the same word-type? Are words abstract entities, or are they (merely) collections of tokens? The ontology of words tries to provide answers to these, and related questions. This article provides an overview of some of the most prominent views proposed in the literature, with a particular focus on the debate between type-realist, nominalist, and eliminativist ontologies of words.

It has been a common assumption that words are substances that instantiate or have properties. In this paper, I question the assumption that our ontology of words requires posting substances by outlining a bundle theory of words, wherein words are bundles of various sorts of properties (such as semantic, phonetic, orthographic, and grammatical properties). I argue that this view can better account for certain phenomena than substance theories, is ontologically more parsimonious, and coheres with claims in linguistics.

_The Ethics of Need: Agency, Dignity, and Obligation_ argues for the philosophical importance of the notion of need and for an ethical framework through which we can determine which needs have moral significance. In the volume, Sarah Clark Miller synthesizes insights from Kantian and feminist care ethics to establish that our mutual and inevitable interdependence gives rise to a duty to care for the needs of others. Further, she argues that we are obligated not merely to meet others’ needs (...) but to do so in a manner that expresses "dignifying care," a concept that captures how human interactions can grant or deny equal moral standing and inclusion in a moral community. She illuminates these theoretical developments by examining two cases where urgent needs require a caring and dignifying response: the needs of the elderly and the needs of global strangers. Those working in the areas of feminist theory, women’s studies, aging studies, bioethics, and global studies should find this volume of interest. (shrink)

(2008). A response. Critical Review of International Social and Political Philosophy: Vol. 11, Nationalism and Global Justice – David Miller and His Critics, pp. 553-567. doi: 10.1080/13698230802415961.

This chapter considers the view that a central concern of metaphysics is what is possible. That is, the idea is that, unlike science, metaphysics studies not only what is actual, but the ways that reality could be. This view, if right, provides metaphysics with a distinct subject matter from that of science, and, depending on what modal epistemology we adopt, a distinct methodology too. In this chapter, I first provide an overview of the view, before highlighting some of the most (...) prominent objections, and possible routes of response. (shrink)

Religious violence may trigger feelings of repulsion and indignation, especially in a society that encourages toleration and respect, but rejection contradicts the principles of inclusion that define a democracy and its core moral values. How can we think ethically about religious violence and terrorism, especially in the wake of such atrocities as 9/11? Known for his skillful interrogation of ethical issues as they pertain to religion, politics, and culture, Richard B. Miller returns to the basic tenets of liberalism to (...) divine an ethical response to religious extremism. He questions how we should think about the claims and aspirations of political religions, especially when they conflict so deeply with liberal norms and practices, and he suggests how liberal critics can speak confidently in ways that respect cultural and religious difference. Miller explores other concerns within these investigations as well, such as the protection of human rights and a liberal democratic commitment to multicultural politics. In relating religion and ethics, he develops a new lens for viewing political religions and their moral responsibilities. This probing inquiry also forces us to rethink our response to 9/11. (shrink)

Used as the basis of the program at the Equinox Holistic Alternative School in Toronto, The Holistic Curriculum advocates for an integrative approach to teaching and learning with a focus on developing a deep connection between mind and body.

A close reading of the poem of Parmenides, with focal attention to the way the proem situates Parmenides' insight in relation to Hesiod and Anaximander and provides the context for the thought of "... is". I identify three pointed ambiguities, in the direction of the journey to the gates of the ways of Night and Day, in the way the gates swing open before the waiting traveler, and in the character of the "chasm" that their opening makes, and I suggest (...) ways in which these ambiguities at once complicate and determine the significance of the thought of "... is" and its implications for the status of the opinions of mortals. (shrink)

Drawing primarily from the cultural traditions and beliefs of the Muscogee peoples, I will provide an account of how harmony can play a foundational role in providing a structure to morality. In the process of providing this account, I will begin (§2) by defining two key Muscogee concepts: ‘energy’ (§2.1) and ‘harmony’ (§2.2). I will also explain how the relationship between these two concepts can provide a structure for morality. Then I will explain the conditions that make promoting harmony a (...) normative principle (§3) by explaining why promoting harmony is relevant to humans (§3.1) as well as a providing a prudential reason to promote harmony (§3.2). Finally, I will explain how harmony can be achieved (§4) by explaining two examples that highlight the importance of non-moral knowledge in promoting harmony. I will then conclude with some remarks about how the Muscogee concept of harmony relates to some contemporary metaethical concerns (§5). (shrink)

Empirical work has lately confirmed what many philosophers have taken to be true: people are ‘biased toward the future’. All else being equal, we usually prefer to have positive experiences in the future, and negative experiences in the past. According to one hypothesis, the temporal metaphysics hypothesis, future-bias is explained either by our beliefs about temporal metaphysics—the temporal belief hypothesis—or alternatively by our temporal phenomenology—the temporal phenomenology hypothesis. We empirically investigate a particular version of the temporal belief hypothesis according to (...) which future-bias is explained by the belief that time robustly passes. Our results do not match the apparent predictions of this hypothesis, and so provide evidence against it. But we also find that people give more future-biased responses when asked to simulate a belief in robust passage. We take this to suggest that the phenomenology that attends simulation of that belief may be partially responsible for future-bias, and we examine the implications of these results for debates about the rationality of future-bias. (shrink)

Semantic realism, as I shall understand it it in this paper, is the combination of the views that sentential understanding is constituted by grasp of truth conditions and that the notion of truth which figures therein is essentially epistemically unconstrained. In a single slogan, understanding a sentence consists in some cases in grasp of potentially recognition-transcendent truth conditions. For example, a semantic realist about the past holds that our understanding of 'Caesar sneezed fifteen times on his 19th birthday' consists in (...) grasp of its truth condition, where this is capable of obtaining even though there is no guarantee that we shall be able, even in principle, to recognize that that is so. (shrink)

In the Statesman , Plato brings together--only to challenge and displace--his own crowning contributions to philosophical method, political theory, and drama. In his 1980 study, reprinted here, Mitchell Miller employs literary theory and conceptual analysis to expose the philosophical, political, and pedagogical conflict that is the underlying context of the dialogue, revealing that its chaotic variety of movements is actually a carefully harmonized act of realizing the mean. The original study left one question outstanding: what specifically, in the metaphysical (...) order of things, motivated the nameless Visitor from Elea to abandon bifurcation for his consummating non-bifurcatory division of fifteen kinds at the end of the dialogue? Miller addressed in a separate essay, first published in 1999 and reprinted here. In it, he opens the horizon of interpretation to include the new metaphysics of the Parmenides , the Philebus , and the "unwritten teachings." "This study demonstrates how the Statesman is the culminating expression of Plato's lifelong effort, both in Athens and in the Academy, to bring metaphysical insight to the unending political crisis of his times."The Philosopher in Plato's Statesman a trail-blazing work. While not every reader will agree with the lessons Miller himself draws from this approach, none should fail to be impressed by its interpretive power. All this is exciting stuff. The interpretive pathway on which Miller has embarked has the potential for changing the face of scholarship on the late Platonic dialogues. Parmenides [Publishing] is to be commended for making these two important contributions available under a single cover." -- Kenneth Sayre, Professor of Philosophy, University of Notre Dame "Miller casts considerable light on virtually every aspect of the dialogue. . . . All in all, this book is an outstanding contribution to our understanding of the Statesman." -- Stanley Rosen, Borden Parker Bowne Professor of Philosophy, Boston University MITCHELL MILLER is Professor of Philosophy at Vassar College. He is the author of Plato's Parmenides. (shrink)