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.

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.

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)

Introduction to the Institutional Logics Perspective -- Precursors to the Institutional Logics Perspective -- Defining the Inter-institutional System -- The Emergence, Stability and Change of the Inter-institutional System -- Micro-Foundations of Institutional Logics -- The Dynamics of Organizational Practices and Identities -- The Emergence and Evolution of Field-Level Logics -- Implications for Future Research.

Overview -- Locke's internal sense and Kant's changing views -- Personal identity amd its problems -- Rationalist metaphysics of mind -- Consciousness, self-consciousness, and cognition -- Strands of Argument in the Duisburg Nachlass -- A transcendental deduction for a priori concepts -- Synthesis : why and how? -- Arguing for apperception -- The power of apperception -- "I-think" as the destroyer of rational psychology -- Is Kant's theory consistent? -- The normativity objection -- Is Kant's thinker (as such) a free (...) and responsible agent? -- Kant our contemporary. (shrink)

Many authors treat freedom and responsibility as interchangeable and simply apply conclusions about responsibility to freedom. This paper argues that the two are distinct, thus allowing for a “semi-compatibilist” view, on which responsibility but not freedom (in the sense of freedom to do otherwise) is compatible with determinism. It thereby avoids the implausible features of recent compatibilist accounts of freedom without alternative possibilities—as if one could make oneself free just by accepting the limitations on one’s choice. In particular, the paper (...) puts forth two main arguments that responsibility does not imply freedom: an argument from “the stakes,” meaning what is at stake in a given action, or how seriously wrong it is, as affecting responsibility more than freedom, and an argument from temporal standpoint, that responsibility is often assessed from a standpoint farther back in time, when the agent could have taken steps to prevent being unfree later, whereas freedom is typically assessed at the time of action. These arguments are applied to the well-known case of Robert Alton Harris as in Watson (1988), in contrast to a Watsonian account of psychopaths as lacking moral responsibility because of “moral blindness.” Instead, what makes responsibility moral is the reasons for our blame, not necessarily what motivates the agent we take to be blameworthy. (shrink)

This article presents the results of a qualitative study on the ethical aspects of inclusion practice for radiotherapy patients taking part in clinical research. The study focused on the standards and values of this process. Patients and physicians were interviewed about their views and experiences. Analysis of these interviews showed that candidate research participants need better protection from unwanted factors that could influence their choice about participation. Researchers need proper education about regulation, codes and directives in the field of research (...) ethics, and they should be aware of the underlying ethical concepts of these regulations. A sound institutional ethics policy is necessary in order to guide medical staff in decisions about the inclusion of patients in trials. (shrink)

Inwiefern kann Heidegger in Sein und Zeit seinem Anspruch gerecht werden, die Bewusstseinsphilosophie zu überwinden? 'Dasein' soll als Konzept den Begriff des Subjekts nicht ersetzen, sondern vielmehr die Subjekt-Objekt-Spaltung als solche unterlaufen. So bringt 'In-der-Welt-sein' paradigmatisch zum Ausdruck, dass 'Dasein' immer schon handelnd bei seiner Welt ist und alle epistemologische Reflexion demgegenüber sekundär. Trotzdem kann die Fundamentalontologie als eine Form von Transzendentalphilosophie gedeutet werden. Denn den Anderen als mir äußerlichen, nicht von mir konstituierten zu denken, ist von entscheidender Bedeutung für (...) besagte Intention Heideggers. Dass es ihm nicht gelingt, diese Unabhängigkeit konzeptionell zu fassen, spiegelt sich in den immanenten Problemen der Mitseinsanalyse, die selbst als - explizit im Sinne Kants - transzendentalphilosophische deutbar sind. (shrink)

Banded geckos (Coleonyx variegatus) were trained, at the rate of five daily trials, on eight intradimensional spatial shifts to a criterion of 80% correct per reversal. In contrast to several previously reported failures to obtain reversal learning, Coleonyx demonstrated significant improvement on both errors and trials to criterion. Their reversal performance compares favorably with that of birds and mammals and a common index of reversal ability, the mean total error, did not differentiate between taxa.

This article presents a response to Richard Rorty's paper "Is Philosophy Relevant to Business Ethics?" The author questions Rorty's views on the depreciation of the role of philosophy in applied ethics, and outlines four reasons why philosophy retains its relevance. The author addresses the role of moral reasoning in the development of the moral imagination. The author also concludes that humans have the means necessary to make moral progress and are capable of moral reasoning, and need only to develop a (...) strong moral imagination. (shrink)

The ways in which knowledge relates to power have been much discussed in radical education theory. New emphasis on the role of gender and the growing debate about subjectivity have deepened the discussion, while making it more complex. In Getting Smart , Patti Lather makes use of her unique integration of feminism and postmodernism into critical education theory to address some of the most vital questions facing education researchers and teachers.

This important book proposes a new account of the nature of language, founded upon an original interpretation of Wittgenstein. The authors deny the existence of a direct referential relationship between words and things. Rather, the link between language and world is a two-stage one, in which meaning is used and in which a natural language should be understood as fundamentally a collection of socially devised and maintained practices. Arguing against the philosophical mainstream descending from Frege and Russell to Quine, Davidson, (...) Dummett, McDowell, Evans, Putnam, Kripke and others, the authors demonstrate that discarding the notion of reference does not entail relativism or semantic nihilism. A provocative re-examination of the interrelations of language and social practice, this book will interest not only philosophers of language but also linguists, psycholinguists, students of communication and all those concerned with the nature and acquisition of human linguistic capacities. (shrink)

Abstract:During recent years, the principle and practice of employment-at-will have been under attack. While progress has been made in eroding the practice, the principle still governs the philosophical assumptions underlying employment practices in the United States, and, indeed, EAW has been promulgated as one of the ways to address economic ills in other countries. This paper will briefly review the major critiques of EAW. Given the failure of these arguments to erode the underpinnings of EAW, we shall suggest new avenues (...) for approaching employment issues to achieve the desirable goal of employee dignity and respect. (shrink)

How does Kant understand the representation of an empirical self? For Kant, the sources of the representation must be both a priori and a posteriori. Several scholars claim that the a priori part of the ‘self’ representation is supplied by the category of ‘substance,’ either a regular substance (Andrew Chignell), a minimal substance (Karl Ameriks) or a substance analog (Katharina Kraus). However, Kant opens the Paralogisms chapter by announcing that there is a thirteenth ‘transcendental’ concept or category: “We now come (...) to a concept that was not entered in the above general list of transcendental concepts, and that must yet be classed with them … This is the concept – or, if one prefers, the judgment – I think.” (A341/B399). I argue that it is the ‘I think’ that provides the a priori framework for the representation of the empirical self. (shrink)

Biopolitics and Utopia explores the intersection of biopolitics and utopian thought. As an interdisciplinary work, it addresses many salient biopolitical issues (state and medical interventions in the body, fears over scientific progress, resistance to state biopower, and ethical concerns), while also engaging in the utopian drive behind biopolitical efforts. The book is structured into four main sections: Actions, Speculations, Reactions, and Reflections. The chapters in Actions examine the practices of direct, medical intervention to 'normalize' citizens' bodies. The next section, Speculations, (...) approaches the intersection of utopia and biopolitics through a literary lens, reviewing science fiction texts as expressions of cultural and social fears about scientific progress. Reactions outlines potential acts of resistance in the face of biopower. Finally, Reflections offers a more philosophical essay, which engages the reader in the potential for creating an ethics for scientific standards. (shrink)

Current treatments of practical rationality understand reasons as considerations counting in favor of or against some practical option, treating the positive and the negative case as symmetrical. Typically the focus is on examples of positive reasons. However, I want to shift the spotlight to negative reasons, as making a tighter or more direct link to rationality — and ultimately to morality, which is what much of the current interest in reasons is meant to clarify. Recognizing a positive/negative asymmetry in normative (...) force will let us reconcile the view of moral or other requirements as based on reasons with the denial that reasons as such, even all-thingsconsidered reasons, yield requirements — or as I like to put it, rationally compel. (shrink)