The passage of the Patient Protection and Affordable Care Act on March 23, 2010, significantly changes the health care landscape. But even with the considerable expansion of insurance, many people will still lack coverage. When fully implemented, the act is designed only to cover about thirty-two million of the forty-six million uninsured Americans. Illegal aliens are specifically excluded. For others, implementation is not immediate; the so-called individual mandate, for example, does not take effect until 2014, and there are exceptions for (...) people for whom available policies are still too expensive, or who have religious objections. Once in effect, the mandate has limited penalties, and some people will choose .. (shrink)
The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit (...) for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received. (shrink)
In July, the Department of Health and Human Services and the Office of Science and Technology Policy published an advance notice of proposed rulemaking (ANPRM) proposing sweeping changes to the rules governing oversight of research on human subjects—changes aimed at “better protect[ing] human subjects who are involved in research, while facilitating valuable research and reducing burden, delay, and ambiguity for investigators.”1 The process is likely to amend not only the core regulation on human-subjects research (known as the “common rule”), but (...) also regulations governing vulnerable subjects, IRB registration requirements, research regulations of the Food and Drug Administration, and the “privacy rule” of the .. (shrink)
This essay considers the potential role of bioethics in disaster response planning and preparedness. Bioethicists can make substantial contributions, by ensuring that decision-making and distribution of resources during crises is carried out in a fair and just manner, as well as by examining the assumptions upon which disaster planning are based. Bioethicists should also be aware of potential pitfalls of overly-hasty engagement with this new field.
The computer revolution has had an enormous effect on all aspects of the practice of medicine, yet little thought has been given to the role of social media in identifying treatment choices for incompetent patients. We are currently living in the ?Internet age? and many people have integrated social media into all aspects of their lives. As use becomes more prevalent, and as users age, social media are more likely to be viewed as a source of information regarding medical care (...) preferences. This article explores the ethical and legal issues raised by the use of social media in surrogate decision making. (shrink)
Contents: Preface. Johannes BRANDL: Semantic Holism Is Here To Stay. Michael DEVITT: A Critique of the Case for Semantic Holism. Georges REY: The Unavailability of What We Mean: A Reply to Quine, Fodor and LePore. Joseph LEVINE: Intentional Chemistry. Louise ANTHONY: Conceptual Connection and the Observation/Theory Distinction. Gilbert HARMAN: Meaning Holism Defended. Kirk A. LUDWIG: Is Content Holism Incoherent? Anne BEZUIDENHOUT: The Impossibility of Punctate Mental Representations. Takashi YAGISAWA: The Cost of Meaning Solipsism. Alberto PERUZZI: Holism: The Polarized Spectrum. Jonathan (...)BERG: Inferential Roles, Quine, and Mad Holism. Jerry FODOR & Ernest LEPORE: Replies. (shrink)
Jonathan Berg argues for the Theory of Direct Belief, which treats having a belief about an individual as an unmediated relation between the believer and the individual the belief is about. After a critical review of alternative positions, Berg uses Grice's theory of conversational implicature to provide a detailed pragmatic account of substitution failure in belief ascriptions and goes on to defend this view against objections, including those based on an unwarranted "Inner Speech" Picture of Thought. The work (...) serves as a case study in pragmatic explanation, dealing also with methodological issues about context-sensitivity in language and the relation between semantics and pragmatics. (shrink)
In this paper we investigate Accardi's claim that the "quantum paradoxes" have their roots in probability theory and that, in particular, they can be evaded by giving up Bayes' rule, concerning the relation between composite and conditional probabilities. We reach the conclusion that, although it may be possible to give up Bayes' rule and define conditional probabilities differently, this contributes nothing to solving the philosophical problems which surround quantum mechanics.
Genetic testing is currently subject to little oversight, despite the significant ethical issues involved. Repeated recommendations for increased regulation of the genetic testing market have led to little progress in the policy arena. A 2005 Internet search identified 13 websites offering health-related genetic testing for direct purchase by the consumer. Further examination of these sites showed that overall, biotech companies are not providing enough information for consumers to make well-informed decisions; they are not consistently offering genetic counseling services; and some (...) sites even offer tests with little evidence of clinical value. This article aims to raise company and consumer awareness about the ethical concerns surrounding the direct-to-consumer marketing of health-related genetic tests. It also suggests ways that biotech companies can bring their services to the public in an ethically responsible manner, without increased regulatory oversight. (shrink)
Jerry Fodor and Ernie LePore argue against inferential role semantics on the grounds that either it relies on an analytic/synthetic distinction vulnerable to Quinean objections, or else it leads to a variety of meaning holism frought with absurd consequences. However, the slide from semantic atomism to meaning holism might be prevented by distinctions not affected by Quine's arguments against analyticity; and the absurd consequences Fodor and LePore attribute to meaning holism obtain only on an implausible construal of inferential roles.
Kant is well known for his restrictive conception of proper science. In the present paper I will try to explain why Kant adopted this conception. I will identify three core conditions which Kant thinks a proper science must satisfy: systematicity, objective grounding, and apodictic certainty. These conditions conform to conditions codified in the Classical Model of Science. Kant’s infamous claim that any proper natural science must be mathematical should be understood on the basis of these conditions. In order to substantiate (...) this reading, I will show that only in this way it can be explained why Kant thought (1) that mathematics has a particular foundational function with respect to the natural sciences and (2) as such secures their scientific status. (shrink)
In this paper the importance of public affairs management in multinational corporations in India will be examined. After briefly discussing the state of the art in international business and society literature, a conceptual framework for public affairs management in multinational corporations will be developed. This framework serves as the theoretical basis for an empirical study among German multinational corporations in India. In the main part of this paper the results of this study will be presented and discussed. The (...) paper ends with a critical assessment and some major implications for future studies. (shrink)
The axiom of choice ensures precisely that, in ZFC, every set is projective: that is, a projective object in the category of sets. In constructive ZF (CZF) the existence of enough projective sets has been discussed as an additional axiom taken from the interpretation of CZF in Martin-Löf’s intuitionistic type theory. On the other hand, every non-empty set is injective in classical ZF, which argument fails to work in CZF. The aim of this paper is to shed some light on (...) the problem whether there are (enough) injective sets in CZF. We show that no two element set is injective unless the law of excluded middle is admitted for negated formulas, and that the axiom of power set is required for proving that “there are strongly enough injective sets”. The latter notion is abstracted from the singleton embedding into the power set, which ensures enough injectives both in every topos and in IZF. We further show that it is consistent with CZF to assume that the only injective sets are the singletons. In particular, assuming the consistency of CZF one cannot prove in CZF that there are enough injective sets. As a complement we revisit the duality between injective and projective sets from the point of view of intuitionistic type theory. (shrink)
This paper studies Sentence 16 of Porphyry's Pathways to the Intelligible . It is argued that it should be understood against the background of Plotinus' discussions of the similes of the waxen block and the aviary from Plato's Theaetetus . The first part of the paper concentrates on Plotinus' reception of these similes. In the second part of the paper Plotinus' discussions of the two similes are used to shed light on Sentence 16, in particular on the term προχείρισις. Furthermore (...) it is argued that Porphyry does not reject Plotinus' claim that, pace Aristotle, intellection does not require imaging. (shrink)
Given free information and unlimited processing power, should decision algorithms use as much information as possible? A formal model of the decision-making environment is developed to address this question and provide conditions under which informationally frugal algorithms, without any information or processing costs whatsoever, are optimal. One cause of compression that allows optimal algorithms to rationally ignore information is inverse movement of payoffs and probabilities (e.g., high payoffs occur with low probably and low payoffs occur with high probability). If inversely (...) related payoffs and probabilities cancel out, then predictors that correlate with payoffs and consequently condition the probabilities associated with different payoffs will drop out of the expected-payoff objective function, severing the link between information and optimal action rules. Stochastic payoff processes in which rational ignoring occurs are referred to as compressed environments, because optimal action depends on a reduced-dimension subset of the environmental parameters. This paper considers benefits and limitations of economic models versus other methods for studying links between environmental structure and the real-world success of simple decision procedures. Different methods converge on the normative proposition of ecological rationality, as opposed to axiomatic rationality based on informational efficiency and internal consistency axioms, as a superior framework for comparing the effectiveness of decision strategies and prescribing decision algorithms in application. (shrink)
This is a presentation of Bolzano's ideas on logic, logical semantics, ontology, proof theory, the foundations of mathematics, and certain aspects of the philosophy of nature. Bolzano's world view was a universal one in the sense that philosophy, mathematics, physics, and metaphysics should build upon the same logical foundation. In the pursuit of this encyclopaedic point of view he already recognized many of the essential things to come in logic and the foundations of mathematics.