In this paper, we provide an overview of how the outcomes of the Uruguay Round affected the application of pharmaceutical intellectual property rights globally. Second, we explain how specific pharmaceutical policy tools can help developing states mitigate the worst effects of the TRIPS Agreement. Third, we put forward solutions that could be implemented by the World Bank to help overcome the divide between creating private incentives for research and development of innovative medicines and ensuring access of the poor to medicine. (...) Fourth, we evaluate these solutions on the basis of utilitarian considerations and urge that equitable pricing is morally preferable to the other solutions. (shrink)

In this paper, we provide an overview of how the outcomes of the Uruguay Round affected the application of pharmaceutical intellectual property rights globally. Second, we explain how specific pharmaceutical policy tools can help developing states mitigate the worst effects of the TRIPS Agreement. Third, we put forward solutions that could be implemented by the World Bank to help overcome the divide between creating private incentives for research and development of innovative medicines and ensuring access of the poor to medicine. (...) Fourth, we evaluate these solutions on the basis of utilitarian considerations and urge that equitable pricing is morally preferable to the other solutions. (shrink)

In GIVING WELL: THE ETHICS OF PHILANTHROPY, an accomplished trio of editors bring together an international group of distinguished philosophers, social scientists, lawyers and practitioners to identify and address the most urgent moral questions arising today in the practice of philanthropy.

Recent figures show that 151.7 million nonelderly Americans who had private insurance received that insurance from their employers (out of 167.5 million with private insurance). Employers who contract with health plans on behalf of their employees influence the health of their employees and, in turn, the nature and quality of the healthcare system in the United States. Despite the magnitude of their influence, they have been relatively free from both government and ethical guidance with respect to the specific substantive benefits (...) they offer their employees. Employers have enormous discretion with respect to what substantive benefits they include in employer health plans because they are governed by the Employment Retirement Security Act (ERISA). But the decisions that employers make when they choose benefits for their employees are just as much rationing decisions in need of bioethical analysis as are the rationing decisions that are made at the bedside by patients, physicians, and their families. Moreover, even strong discretion, of the kind employers have, is subject to ethical standards. (shrink)

In this paper, I claim that the doctor-patient relationship can be viewed as a vessel of trust. Nonetheless, trust within the doctor-patient relationship has been impaired by managed care. When we conceive of trust as social capital, focusing on the role that it plays in individual and social well-being, trust can be viewed as a public good and a scarce medical resource. Given this, there is a moral obligation to protect the doctor-patient relationship from the cost-containment mechanisms that compromise its (...) ability to produce trust. (shrink)

Although the right to health is universal, many nations that honor it fail to do so in the case of non-citizen immigrants. In this essay, we argue that the reasons typically given for not extending the right to health to immigrants are without merit and that there are good reasons for nations to protect, respect and fulfill the health right of all immigrants. Contrary to the standard view, we argue that health can be understood as a global public good. Two (...) important points follow: because health is non-excludable and non-rivalrous, it is in the health interests of nations to respect, protect and fulfill immigrants’ right to health. Furthermore, meeting the health needs of immigrants is an important way for receiving nations to meet the duties that may be generated by the benefits they incur as a result of health’s global public good dimension, thus ensuring that receiving nations are not free riders. We then argue that because citizens and immigrants dwell together, nations have duties of solidarity to immigrants with respect to health. Using the insights of social psychology, we show that solidarity among diverse people is both a reasonable expectation and a morally desirable one. (shrink)

Dr. Wayne proposes that an autonomy-based approach to the treatment and care of older patients with dementia be replaced with an agency-based approach. In this commentary, I suggest that such a shift is unnecessary and would undermine patients’ moral, legal, and human rights.

Despite the prodigious inventiveness of the Middle Ages, the era is often characterized as deeply suspicious of novelty. But if poets and philosophers urged caution about the new, Patricia Clare Ingham contends, their apprehension was less the result of a blind devotion to tradition than a response to radical expansions of possibility in diverse realms of art and science. Discovery and invention provoked moral questions in the Middle Ages, serving as a means to adjudicate the ethics of invention (...) and opening thorny questions of creativity and desire. The Medieval New concentrates on the preoccupation with newness and novelty in literary, scientific, and religious discourses of the twelfth through sixteenth centuries. Examining a range of evidence, from the writings of Roger Bacon and Geoffrey Chaucer to the letters of Christopher Columbus, and attending to histories of children's toys, the man-made marvels of romance, the utopian aims of alchemists, and the definitional precision of the scholastics, Ingham analyzes the ethical ambivalence with which medieval thinkers approached the category of the new. With its broad reconsideration of what the "newfangled" meant in the Middle Ages, The Medieval New offers an alternative to histories that continue to associate the medieval era with conservation rather than with novelty, its benefits and liabilities. Calling into question present-day assumptions about newness, Ingham's study demonstrates the continued relevance of humanistic inquiry in the so-called traditional disciplines of contemporary scholarship. (shrink)

Taking inspiration from a famous manuscript illumination of Fortunes Wheel, this article argues for a reconsideration of diverse uses of repetition legible in accounts of medieval curiosity, and in the association of curiosity with the figure of the ape.

I argue that because bluffing, puffing, and spinning are features of corporate life, they are likely to characterize the doctor-patient relationship in managed care medicine. I show that managed-care organizations (MCOs) and the physicians who contract with them make liberal use of puffing and spinning. In this way, they create a context in which it is likely that patients will also use deceptive mechanisms. Unfortunately, patients risk their health when they deceive their doctors. Using the warranty theory of truth I (...) argue that although bluffing may be ethical in business because all participants agree to it and business has not warranted truth-telling, it is not ethical in a medical context because physicians and MCOs have warranted truth-telling and the quality of medical care depends on it. (shrink)

It is unclear that United States schools are doing sufficient work to identify and protect the interests of their LGB students this analysis, we rely on certain public-health research in social epidemiology to show that discrimination against LGB adolescents imposes morally significant harms to both adolescents and community. We apply "trust” and “social capital” to educational standards and practices as foundations for educational practices that work toward full equality of LGB students in regard to opportunity and other primary social goods.

In the dissertation I provide an account of action descriptions which emphasizes their role as explanations of consequences. By showing that consequences are ascribed to an action under a description, and only when that description can explain the consequence, I undermine the view that consequences are brute events. Roughly, I reason as follows. If consequences were brute events, then their ascription to an action wouldn't hinge on how we understand the action. We could, for instance, say in ordinary circumstances "John (...) tensed his finger" and as a consequence "Mary became a widow" without any untowardness at all. I show both that we do not do this and that we cannot do it. That we do not do it is supported primarily by linguistic intuitions; mainly I show that there is an infelicity in ascribing to an action a consequence which is not explained by that action. To support the claim that we cannot do this I argue that if there were no "fit" between action and consequence that would make communication difficult. ;I then use this characterization of action descriptions and consequences to serve as a criterion for identifying the privileged description of an action. Any one action may have several action descriptions. In light of this, there is a question raised about which, if any, of these descriptions is privileged. I show that within the wider social context there is a description of the action which is dominant. Then I argue that this description is and should be chosen in virtue of the explanatory power of action descriptions with respect to consequences. (shrink)

Offering a format that is significantly different than that offered by other books, Ethical Health Care beings by asking what is meant by health and how it is achieved. The book then proceeds to explore with care and context the nature of the relationship between patients and clinicians, health care providers and the societies in which they inhabit, and finally the relationship between the health care enterprise and the international community. By emphasizing the ethical issues that arise in the broad (...) quest to foster human health, and appreciating that health is not primarily a function of medical interventions, Ethical Health Care introduces students to problems such as the international distribution of pharmaceuticals and the dangers of reemerging infections. To a far greater extent than is done traditionally, Ethical Health Care provides an interdisciplinary perspective to bioethics, relying heavily upon the teachings of economics, law, and public health. (shrink)

This comment on Professor ter Meulen's paper, "Solidarity and Justice in Health Care," offers additional perspectives on solidarity's importance for health. Noting the findings of social epidemiology, the paper explains that health has important public good dimensions. It is both non-rivlalrous because one person's health does not diminish another's, and it is largely determined by non-excludable access goods, including social networks, social determinants, and public health efforts. The public good dimension of health underscores the mutual dependence and shared stake that (...) people have with respect to health, and highlights the importance of coming together in solidarity for the sake of health. This is not to say that solidarity cannot also foster exclusionary tendencies; however, the recognition of mutual dependency with respect to health can foster an inclusive solidarity for the health of all people. (shrink)

In his well‐researched new book, Solidarity and Justice in Health and Social Care, Ruud ter Meulen traces the history of the concept of solidarity and describes the important role that it can play in health care. He contrasts solidarity with other normative concepts, such as autonomy and justice. According to ter Meulen, solidarity entails a commitment and willingness to help others who are “in need of it due to circumstances out of their control” (p. 170). Thus, solidarity exists when people (...) act for the sake of other people who are vulnerable in some way. Ter Meulen treats solidarity as a distinct normative concept and believes that it is critical for health care. No doubt insofar as social ties and cohesion are good for health, so is solidarity. (shrink)

Machine generated contents note: -- Acknowledgements -- Introduction -- Overcoming Indifference -- Social Capital -- Ethics for Enduring Social Capital -- Social Capital and Happiness -- Social Capital and Law -- Giving Back -- Global People -- Bibliography -- Index.

Soon after its publication, Readings in Ancient Greek Philosophy was hailed as the favourite to become "the 'standard' text for survey courses in ancient philosophy. Over twenty years later that prediction has been borne out: Readings in Ancient Greek Philosophy still stands as the leading anthology of its kind. It is now stronger than ever: This 5th Edition features a completely revised Aristotle unit, with new translations, as well as a newly revised glossary. The Plato unit offers new translations of (...) the Meno and Republic. In the latter, indirect dialogue is cast into direct dialogue for greater readability. The Presocratics unit has been re-edited and streamlined, and the pages of every unit have been completely reset. (shrink)

Scientists seeking hard evidence of prayer's curative powers misunderstand the nature of prayer in the Western theistic traditions. Yet theistically consonant ways in which religious belief may influence health do not figure as they should in current professional practice.

In the early 2000s, the development of local food systems in advanced industrial countries has expanded beyond creation and support of farmers’ markets and community supported agriculture farms and projects to include targeted Buy Local Food campaigns. Non-governmental groups in many U.S. places and regions have launched such campaigns with the intent of motivating and directing consumers toward more local food purchasing in general. This article examines the current manifestations and possibilities for social justice concerns in Buy Local Food campaigns, (...) by considering them within the more general category of “selective patronage“ campaigns. Historical campaign examples, such as Buy Union, Buy American, and Buy Black campaigns, offer instructive comparisons to contemporary consumer campaigns promoting local food. Through examining the construction of threats, intended beneficiaries, products to be avoided, and those to be preferentially selected, the paper demonstrates how selective patronage campaigns have emphasized social justice needs and concerns for designated groups in ways that have been potentially exclusionary of other disadvantaged groups and thus undermining of social justice more broadly. As a contemporary instance of “selective patronage,“ Buy Local Food campaigns exhibit similar contradictory impulses, which are intensified by the conceptual and practical pitfalls in designating “local.“ The article concludes by considering how the challenges and prospects for commitments to social justice in local food consumer campaigns reinforce the importance of emerging initiatives centered on domestic fair trade. (shrink)

Essays in Memory of Richard Helgerson: Laureations brings together new essays by leading literary scholars of the British and European middle ages and early modern period who have been influenced by the groundbreaking scholarship of Richard Helgerson. The contributors evince the ongoing impact of Helgerson's work in critical debates including those of nationalism, formal analysis, and literary careerism.

The philosophy of family‐centered care (FCC) promotes partnerships between families and staff to plan, deliver, and evaluate services for children and has been officially adopted by a majority of pediatric hospitals throughout North America. However, studies indicated that many parents have continued to be dissatisfied with their decision‐making roles in their child's care. This is particularly salient for parents of children with chronic ongoing complex health problems. These children are dependent upon medical technology and require frequent hospitalizations during which parents (...) must contribute to difficult decisions regarding their child's care. Given this clinical issue, an alternative theoretical perspective was explored to redress this problem. Pierre Bourdieu's theoretical concepts of field, capital, and habitus were used to analyze the hierarchical relationships in pediatric acute care hospitals and to design a briefing intervention aimed at improving parents' satisfaction with decision making in that health care setting. (shrink)

Abstract:This essay responds to Patricia Werhane’s 1994 Ruffin Lecture address, “Moral Imagination and the Search for Ethical Decision-making in Management,” using institutional theory as an analytical framework to explore conditions that either inhibit or promote moral imagination in organizational problem-solving. Implications of the analysis for managing organizational change and for business ethics theory development are proposed.

Abstract:This essay responds to Patricia Werhane’s 1994 Ruffin Lecture address, “Moral Imagination and the Search for Ethical Decision-making in Management,” using institutional theory as an analytical framework to explore conditions that either inhibit or promote moral imagination in organizational problem-solving. Implications of the analysis for managing organizational change and for business ethics theory development are proposed.

:This essay responds to Patricia Werhane’s 1994 Ruffin Lecture address, “Moral Imagination and the Search for Ethical Decision-making in Management,” using institutional theory as an analytical framework to explore conditions that either inhibit or promote moral imagination in organizational problem-solving. Implications of the analysis for managing organizational change and for business ethics theory development are proposed.

In this article, we evaluate the capacity of liberal egalitarianism to rebut what we call the libertarian challenge of charity. This challenge states that coercive redistributive taxation is neither needed nor justified, since those who endorse redistribution can give charitably, and those who do not endorse redistribution cannot justifiably be coerced. We argue that contemporary developments in liberal political thought render liberalism more vulnerable to this libertarian challenge. Many liberals have, in recent years, sought to recast liberalism such that it (...) is more hospitable to cultural, religious, and ethnic diversity. This move has resulted in increased support for the claim that liberalism should be understood as a political rather than comprehensive doctrine, and that liberal institutions should draw their legitimacy from agreements made among members of an appropriately conceived deliberative community, rather than from controversial liberal principles like individual autonomy. We argue that, while this move may indeed make liberalism more compatible with cultural diversity, it also makes it more vulnerable to the libertarian challenge of charity. Not all versions of liberalism are troubled by the challenge, but those that are troubled by it are increasingly dominant. We also discuss G.A. Cohen's claim that liberal equality requires an ‘egalitarian ethos’ and argue that, if Cohen is right, it is difficult to see how there can be an adequate response to the libertarian challenge of charity. In general, our argument can be summarised as follows: the more that liberalism is concerned accurately to model the actual democratic wishes and motivations of the people it governs, the less it is able to justify coercively imposing redistributive principles of justice. (shrink)

This collection of essays has the advantages and disadvantages of having been given, for the most part, as lectures. At their best, the voices are lively and fresh. Ted Cohen's essay on the artistic merit of television, in particular, the effect of watching baseball on television, is quite good. He sets philosophers the task of describing television's transformation of character and of time and space. He cautions against looking at television shows as if we were seeing movies, for that (...) looking ignores the special requirements of the tube. Cohen claims that philosophers cannot make final judgments about aesthetic quality because television is still working itself out. Witness the advent of continuing and controversial shows such as "Twin Peaks," which bring into question some of the assumed limits of the form. (shrink)