The medical humanities were organized, beginning in the late 1960s, by a small group of people who shared a critique of medical education and a commitment to vigorous action to change it. They proposed to create several demonstration programs in humanities education at American schools. Although the group began with a religious orientation, it soon acquired a broader, more secular mission. As a result of shrewd political organizing, the group attracted members from within medicine, and was awarded a grant to (...) promote the medical humanities. This paper describes these events and sets them in the context of the social and medical history of the 1960s and early 1970s. (shrink)

Today’s panel is about the expanding boundary of population health policy, what that expanding boundary has to do with law, and what kinds of challenges and opportunities come out of it. What I want to do for the next few minutes is talk to you about the notion of population health as it exists where law and policy are made, rather than where it exists in a spectacular international theoretical literature. Then I want to introduce our panelists. In the process, (...) I will explain why the Honorable John Nilson, is not with us, which tells you a great deal about not only the real world of the politics of population health, but also about the kind of trouble you can get into if you are a first class lawyer involved in population health. (shrink)

Book reviewed in this article: The Social Dimensions of AIDS: Method and Theory. By Douglas A. Feldman & Thomas M. Johnson AIDS: Ethics and Public Policy. By Christine Pierce and Donald VanDeVeer.

Baker and McCullough (2007) criticize a 1979 article by this author for insufficiently appreciating how physicians have appropriated ideas from moral philosophy. This rejoinder argues that the two articles are complementary. The 1979 article summarized evidence that leading physicians in the nineteenth and twentieth centuries appropriated ideas from moral philosophy and related disciplines that reinforced their political goals of self-regulation and dominance of the allocation of resources for health. In retrospect the 1979 article also urged bioethicists to appropriate ideas from (...) other disciplines, including moral philosophy, which would contribute to improving the health of populations. (shrink)

Book reviewed in this article: The Social Dimensions of AIDS: Method and Theory. By Douglas A. Feldman & Thomas M. Johnson AIDS: Ethics and Public Policy. By Christine Pierce and Donald VanDeVeer.

Today’s panel is about the expanding boundary of population health policy, what that expanding boundary has to do with law, and what kinds of challenges and opportunities come out of it. What I want to do for the next few minutes is talk to you about the notion of population health as it exists where law and policy are made, rather than where it exists in a spectacular international theoretical literature. Then I want to introduce our panelists. In the process, (...) I will explain why the Honorable John Nilson, is not with us, which tells you a great deal about not only the real world of the politics of population health, but also about the kind of trouble you can get into if you are a first class lawyer involved in population health. (shrink)

Changes in the scope of health policy in the United States are creating opportunities and obligations for lawmakers and the lawyers who advise them. These changes are the result of a new politics of policy for the health of populations. The new politics is connecting areas of policy that, because they have had separate histories, are governed by distinct, usually uncoordinated laws and regulations.The subject of the new politics of health policy is what the Iowa Senate President, speaking in a (...) plenary at the 2003 conference on Public Health Law in the 21st Century, called the “quality of life, what the people think is important.” An increasing number of leaders in general govemment–people who run for office and their staff–have practical reasons to make policy that acknowledges the expanding scope of what their constituents define as health policy. (shrink)

BackgroundNarrative medicine is a well-recognized and respected approach to care. It is now found in medical school curricula and widely implemented in practice. However, there has been no analysis of the perception and usage of narrative medicine across different medical specialties and whether there may be unique recommendations for implementation based upon specialty. The aims of this study were to explore these gaps in research.MethodsFifteen senior physicians who specialize in internal medicine, pediatrics, or surgery (5 physicians from each specialty) were (...) interviewed in a semi-structured format about the utilization, benefits, drawbacks (i.e., negative consequences), and roles pertaining to narrative medicine. Qualitative content analysis of each interview was then performed.ResultsThree themes emerged from our analysis: roles, practice, and outcomes. Through these themes we examined the importance, utilization, barriers, benefits, and drawbacks of narrative medicine. There was consensus that narrative medicine is an important tool in primary care. Primary care physicians (general internists and general pediatricians) also believed that narrative medicine is not as important for non-primary care providers. However, non-primary care providers (surgeons) generally believed narrative medicine is valuable in their practice as well. Within specialties, providers’ choice of language varied when trying to obtain patients’ narratives, but choice in when to practice narrative medicine did not differ greatly. Among specialties, there was more variability regarding when to practice narrative medicine and what barriers were present. Primary care physicians primarily described barriers to eliciting a patient’s narrative to involve trust and emotional readiness, while surgeons primarily described factors involving logistics and patient data as barriers to obtaining patients’ narratives. There was broad agreement among specialties regarding the benefits and drawbacks of narrative medicine.ConclusionsThis study sheds light on the shared and unique beliefs in different specialties about narrative medicine. It prompts important discussion around topics such as the stereotypes physicians may hold about their peers and concerns about time management. These data provide some possible ideas for crafting narrative medicine education specific to specialties as well as future directions of study. (shrink)

The proposal by Clarke and Beck offers a new explanation for the association between the approximate number system and math. Previous explanations have largely relied on developmental arguments, an underspecified notion of the ANS as an “error detection mechanism,” or affective factors. The proposal that the ANS represents rational numbers suggests that it may directly support a broader range of math skills.

ABSTRACT:This paper examines the norms that should guide policies aimed at promoting happiness or, more broadly, well-being. In particular, we take up the question of which conception of well-being should govern well-being policy, assuming some such policies to be legitimate. In answer, we lay out a case for ‘pragmatic subjectivism’: given widely accepted principles of respect for persons, well-being policy may not assume any view of well-being, subjectivist or objectivist. Rather, it should promote what its intended beneficiaries see as good (...) for them: pleasure for hedonists, excellence for Aristotelians, etc. Specifically, well-being policy should promote citizens’ ‘personal welfare values’: those values—and not mere preferences—that individuals see as bearing on their well-being. Finally, we briefly consider how pragmatic subjectivism works in practice. While our discussion takes for granted the legitimacy of well-being policy, we suggest that pragmatic subjectivism strengthens the case for such policy. (shrink)

The author replies to a letter to the editor from Felicitas Sofia Holzer concerning Wenner’s article “The Social Value Requirement in Research: From the Transactional to the Basic Structure Model of Stakeholder Obligations,” in the Hastings Center Report’s January‐February 2019 issue.

Ethical oversight of clinical research is one of the primary means of ensuring that human subjects are protected from the natural bias of researchers and research institutions in favor of experimentation. At a minimum, effective oversight should ensure that risks are minimized and reasonable in relation to anticipated benefits, protect vulnerable subjects from potential coercion or undue influence, ensure full and informed consent, and promote the equitable distribution of the risks and benefits of research. Because these assessments often involve value (...) judgments for which there are no agreed-upon objective standards, we rely on deliberative procedures thought to have the greatest likelihood of producing the right or best outcomes. Concerns about the potential for improperly functioning IRBs to waste scarce human and institutional resources and impede biomedical progress have motivated a surge in empirical research assessing their procedures and outcomes. Yet within this literature, there has been minimal attention paid to the social scientific evidence regarding how individuals and deliberating groups make decisions, nor how those data might inform IRB practice. This essay seeks to fill that gap, locating recent empirical data on IRB composition and process within the context of data regarding what I call “deliberative pathologies,” or instances when deliberation fails to live up to one or more aspect of the deliberative ideal because of systematic biases in the ways participants interact. The paper goes on to make evidence-based recommendations to reduce the vulnerability of IRB deliberations to the kinds of pathologies discussed and indicate directions for future research. (shrink)

In this book Daniel Wegner offers a novel understanding of the relation of consciousness, the will, and our intentional and voluntary actions. Wegner claims that our experience and common sense view according to which we can influence our behavior roughly the way we experience that we do it is an illusion.

In lieu of an abstract, here is a brief excerpt of the content:Is Bioethics Applied Ethics?Robert M. VeatchBioethics is often referred to as a kind of applied ethics. The term applied ethics can be controversial if it is taken to imply that ethical theory from philosophy or religious ethics has to be the starting point for ethical analysis of some practical field such as medicine or law or politics. The term can be understood as requiring some premises from an ethical (...) theory that are then "applied" to some problem area, as a "top down" way of doing the work of moral reflection in a way that axioms in geometry are applied to present proofs of mathematical claim.The publication of an important work in the history of medical ethics, A History of Medical Ethics, provides an opportunity to reflect more carefully on what applied ethics means. That massive multi-authored volume edited by Robert Baker and Laurence McCullough (2007) is scheduled for publication this fall. With the permission of the Press, we have asked Baker and McCullough to prepare an article-length version of one of the central essays in that work. Their paper challenges the idea that ethical theory should be "applied" to medicine or other fields, putting forth an alternative of the "appropriation" of an ethical theory by the formulation of concepts, principles, moral rules, or other specifications that may turn out to be unique or at least modified for the particular field in question.In this issue of the Kennedy Institute of Ethics Journal, we publish the Baker-McCullough article together with five critical commentaries. We include two medical historians who have a sustained commitment to studying the history of ethics in medicine, two systematic ethicists who have an unusual level of commitment to studying ethics historically, and a physician with unusual sensitivity to the history of medical ethics. Each comments on the Baker-McCullough thesis and offers an alternative view of the link between ethical theory and the field of biomedical ethics.Daniel Fox triggered some of the initial reflection on the history of medical ethics in the 1970s. His work is discussed by Baker and McCullough. Fox is sympathetic with the Baker-McCullough appropriation thesis, viewing their position as complementary to his own, although he [End Page 1] urges more attention to the political aspects of medicine, professional dominance, and professional control of medical resources.Ulf Schmidt, a specialist on the historical aspects of research during the Nazi era, focuses on Baker and McCullough's use of that historical example of the appropriation of medical ethics.The two ethicists who comment both have had many years experience with historical aspects of medical ethics, and both worked on the historically important Belmont Report of the National Commission for the Protection of Human Subjects. Both question whether Baker and McCullough overstate the problem of the relation between application and appropriation. Albert Jonsen, as a member of the National Commission, concentrates on the Belmont Report, showing how he sees the report appropriating philosophical ethics.Tom Beauchamp, who was the primary staff person responsible for the report, provides a somewhat different read on the report and particularly on the role of Kantian ethics in the report's discussion of autonomy. Beauchamp accuses Baker and McCullough of having too narrow an understanding of the meaning of the term "applied," claiming that no people doing medical ethics today would simply apply ethical theory in a deductivist manner.Finally, Jeremy Sugarman, the physician ethicist, is, in a somewhat surprising turn, the cautious defender of the application that Baker and McCullough challenge. Although he ends up sympathetic with the appropriation that implies going beyond straight-forward top-down application, he outlines the value of ethical theory for the practical analysis of ethical problems in fields such as medicine.ReferenceBaker, Robert, and McCullough, Laurence, eds. 2007. A History of Medical Ethics. New York: Cambridge University Press, in press. [End Page 2]Google ScholarCopyright © 2007 Johns Hopkins University Press... (shrink)

This book offers a comprehensive overview of the structure, strategy and methods of assessment of orthodox theoretical economics. In Part I Professor Hausman explains how economists theorise, emphasising the essential underlying commitment of economists to a vision of economics as a separate science. In Part II he defends the view that the basic axioms of economics are 'inexact' since they deal only with the 'major' causes; unlike most writers on economic methodology, the author argues that it is the rules that (...) economists espouse rather than their practice that is at fault. Part III links the conception of economics as a separate science to the fact that economic theories offer reasons and justifications for human actions, not just their causes. With its lengthy appendix introducing relevant issues in philosophy of science, this book is a major addition to philosophy of economics and of social science. (shrink)

Dan Haybron presents an illuminating examination of well-being, drawing on important recent work in the science of happiness. He shows that we are remarkably prone to error in judgements of our own personal welfare, and suggests that we should rethink traditional assumptions about the good life and the good society.

In ordinary circumstances, human actions have a myriad of unintended and often unforeseen consequences for the lives of other people. Problems of pollution are serious examples, but spillovers and side effects are the rule, not the exception. Who knows what consequences this essay may have? This essay is concerned with the problems of justice created by spillovers. After characterizing such spillovers more precisely and relating the concept to the economist's notion of an externality, I shall then consider the moral conclusions (...) concerning spillovers that issue from a natural rights perspective and from the perspective of welfare economics supplemented with theories of distributive justice. I shall argue that these perspectives go badly awry in taking spillovers to be the exception rather than the rule in human interactions. I. Externalities Economists have discussed spillovers under the heading of “externalities.” To say this is not very helpful, since there is so much disagreement concerning both the definition and significance of externalities. (shrink)

Most methodological writing on economics is by economists. Although the bulk is produced by lesser members of the profession, almost all leading economists have at one time or another tried their hand at methodological reflection. The results are usually poor. If one read only their methodology, one would have a hard time understanding how Milton Friedman or Paul Samuelson could possibly win Nobel Prizes. It thus is less surprising that the economics profession professes such scorn for philosophizing than that its (...) members spend so much of their time doing it.Methodological reflections on economics pose other puzzles, too. Although this literature is heavily influenced by philosophy—both current and, especially, out-dated—, it is cut off from philosophical discourse. This quasi-autonomy is puzzling, since this literature is concerned with questions that appear to be instances of, if not the same as the questions with which philosophers of science are concerned. (shrink)

It is extraordinary, when one thinks about it, how little attention has been paid by theorists of the nature and justification of punishment to the idea that punishment is essentially a matter of self-defense. H. L. A. Hart, for example, in his famous “Prolegomenon to the Principles of Punishment,” is clearly committed to the view that, at bottom, there are just three directions in which a plausible theory of punishment can go: we can try to justify punishment on purely consequentialist (...) grounds, which for Hart, I think, would be to try to construct a purely utilitarian justification of punishment; we can try to justify punishment on purely retributive grounds; or we can try to justify punishment on grounds that are some sort of shrewd combination of consequentialist and retributive considerations. Entirely absent from Hart's discussion is any consideration of the possibility that punishment might be neither a matter of maximizing the good, nor of exacting retribution for a wrongful act, nor of some imaginative combination of these things, but, rather, of something altogether different from either of them: namely, the exercise of a fundamental right of self-protection. Similarly, but much more recently, R. A. Duff, despite the fact that he himself introduces and defends an extremely interesting fourth possibility, begins his discussion by writing as though, apart from his contribution, there are available to us essentially just the options previously sketched by Hart. Again, there is no mention here, any more than in Hart's or any number of other recent discussions, of the possibility that we might be able to justify the institution of punishment on grounds that are indeed forward-looking, to use Hart's famous term, but that are not at all consequentialist in any ordinary sense of the word. (shrink)

This book is about preferences, principally as they figure in economics. It also explores their uses in everyday language and action, how they are understood in psychology and how they figure in philosophical reflection on action and morality. The book clarifies and for the most part defends the way in which economists invoke preferences to explain, predict and assess behavior and outcomes. Hausman argues, however, that the predictions and explanations economists offer rely on theories of preference formation that are in (...) need of further development, and he criticizes attempts to define welfare in terms of preferences and to define preferences in terms of choices or self-interest. The analysis clarifies the relations between rational choice theory and philosophical accounts of human action. The book also assembles the materials out of which models of preference formation and modification can be constructed, and it comments on how reason and emotion shape preferences. (shrink)

Are we the robots? This question surfaces often in current psychological re- search, as various kinds of robot parts-automatic actions, mental mechanisms, even neural circuits-keep appearing in our explanations of human behavior. Automatic processes seem responsible for a wide range of the things we do, a fact that may leave us feeling, if not fully robotic, at least a bit nonhuman. The complement of the automatic process in contemporary psychology, of course, is the controlled process (Atkinson & Shiffrin, 1968; Bargh, (...) 1984; Posner & Snyder, 1975; Shiffrin & Schnieder, 1977), and it is in theories of controlled processes that vestiges of our humanity reappear. Controlled processes are viewed as conscious, effortful, and intentional. and as drawing on more sources of information than automatic processes. With this power of conscious will, controlled processes seem to bring the civilized quality back to psychological explanation that automatic processes leave out. Yet by reintroducing this touch of humanity, the notion of a controlled process also brings us within glimpsing range of a fatal theoretical error-the idea that there is a controller. (shrink)

This book, by one of the pre-eminent philosophers of science writing today, offers the most comprehensive account available of causal asymmetries. Causation is asymmetrical in many different ways. Causes precede effects; explanations cite causes not effects. Agents use causes to manipulate their effects; they don't use effects to manipulate their causes. Effects of a common cause are correlated; causes of a common effect are not. This book explains why a relationship that is asymmetrical in one of these regards is asymmetrical (...) in the others. Hausman discovers surprising hidden connections between theories of causation and traces them all to an asymmetry of independence. This is a major book for philosophers of science that will also prove insightful to economists and statisticians. (shrink)

Drawing on theories of William James, Freud, and Dewey, as well as on studies in mood control, cognitive therapy, and artificial intelligence, this...

An anthology of works on the philosophy of economics, including classic texts and essays exploring specific branches and schools of economics. Completely revamped, this edition contains new selections, a revised introduction and a bibliography. The volume contains 26 chapters organized into five parts: Classic Discussions, Positivist and Popperian Views, Ideology and Normative Economics, Branches and Schools of Economics and Their Methodological Problems and New Directions in Economic Methodology. It includes crucial historical contributions by figures such as Mill, Marx, Weber, Robbins, (...) Knight, and Veblen and works by most of the leading contemporary figures writing on economic methodology, including five Nobel Laureates in Economics. (shrink)

We often consciously will our own actions. This experience is so profound that it tempts us to believe that our actions are caused by consciousness. It could also be a trick, however – the mind’s way of estimating its own apparent authorship by drawing causal inferences about relationships between thoughts and actions. Cognitive, social, and neuropsychological studies of apparent mental causation suggest that experiences of conscious will frequently depart from actual causal processes and so might not reflect direct perceptions of (...) conscious thought causing action. (shrink)