These range from merely good reads to really outstanding books. A raw ranking of them would be of little use to others, unless I explained why I gave them the ranks I did, and anyway I'd probably give different rankings by the time your read this. (When I know of an on-line review about a book which I agree with --- e.g., because I wrote it --- I've included a link; also some exceedingly short remarks about interesting cases.).

In this paper we distinguish two competing conceptions of dignity, one recognizably Hobbesian and one recognizably Kantian. We provide a formal model of how decision-makers committed to these conceptions of dignity might reason when engaged in an economic transaction that is not inherently insulting, but in which it is possible for the dignity of the agent to be called into question. This is a modified version of the ultimatum game. We then use this model to illustrate ways in which the (...) Kantian evaluative standpoint enjoys a kind of internal stability that the Hobbesian framework lacks. Our interpersonal argument shows that, under certain conditions, Hobbesians prefer to cultivate Kantian commitments in others and promote the presence of Kantians in the population. Our intrapersonal argument shows that agents who are conflicted between Kantian and Hobbesian commitments have powerful reasons not to resolve this commitment in favour of Hobbesian values. Our emulation argument illustrates that in repeated versions of the ultimatum game, the Hobbesian chooses to behave like a Kantian, including publicly repudiating her Hobbesian commitments. Here again, however, the Hobbesian is able to achieve a desired benefit only on the condition that there are genuine Kantians in the population. Finally, our social planning argument explores the reasons why a community of Hobbesians would opt to enshrine a Kantian conception of dignity into law. The paper concludes with some remarks about the policy implications of this work. The value or worth of a man is, as for all other things, his price, that is to say, so much as would be given for the use of his power; and therefore is not absolute, but a thing dependent on the need and judgement of another... The public worth of a man, which is the value set on him by the Common-wealth, is that which men commonly call DIGNITY. Hobbes, _Leviathan X_, 16. (shrink)

Within international development [1], public health [2], and clinical medicine [3]–[5], there is increasing interest in determining whether cash payments or other economic incentives can be used to influence the choices and behavior of individuals and groups in order to promote desired health goals. However, a number of complex issues affect the review and approval by research ethics committees of research studying the effectiveness of using financial incentives to promote desired health goals. Current ethical and regulatory frameworks regard the provision (...) of gifts or cash payments to participants in human research as potentially problematic. Specifically, these frameworks imply that such incentives may undermine the autonomy of participant choice, hinder the disclosure of medical information, exacerbate social inequalities, or result in the exploitation or degradation of vulnerable populations [6]–[9]. Typically, these frameworks provide guidance about payment to research participants to reimburse expenses, to compensate for time and effort, to provide insurance coverage, or as an incentive to participate in the research itself. However, the issue of payment as a component of the research intervention is relatively new. RECs thus lack explicit guidance about ethical issues surrounding research that evaluates the use of financial incentives as an intervention to promote health. (shrink)

Following the conclusion of a period of educational expansion during the last two decades, developing nations are now focusing attention upon adjusting some of those innovations made during the recent period of quantitative expansion. The paper examines how Trinidad and Tobago has responded to the need for adjustments in education provision during the current post‐expansionist period. In particular the paper analyzes Trinidad and Tobago's current reaction to the nation's system of double‐shift schooling, a device instituted during the 1970s as part (...) of Government's strategy for universal secondary education. Arguments both for and against the shift‐system are presented, and Trinidad and Tobago's insistence that the mechanism should be dismantled is critically examined. Explanations for the approach taken by Trinidad and Tobago towards the nation's double‐shift schooling are drawn from two sources: arguments about the state of the nation's economy, and policies regarding approaches to educational development planning in developing nations. (shrink)

La mayoría de interpretaciones sobre la noción de comunidad en Hannah Arendt, han pasado por alto el esfuerzo por parte de la autora de deslindarse de lo que ella considera -la tradición de la filosofía política-. Arendt encuentra que dicha tradición ha sido incapaz de reconocer la pluralidad y contingencia propias de los asuntos humanos. Este libro se propone buscar en el pensamiento de la autora una posible noción de Comunidad que conciba la pluralidad como -ley de la tierra-, y (...) vea en la acción esa puesta en escena de dicha pluralidad. (shrink)

This book offers fresh perspective on the role of phenomenology in the philosophy of physics which opens new avenues for discussion among physicists, "standard" philosophers of physics and philosophers with phenomenological leanings. Much has been written on the interrelations between philosophy and physics in the late 19th and early 20th century, and on the emergence of philosophy of science as an autonomous philosophical sub-discipline. This book is about the under-explored role of phenomenology in the development and the philosophical interpretation of (...) 20th century physics. Part 1 examines questions about the origins and value of phenomenological approaches to physics. Does the work of classical phenomenologists such as Husserl, Merleau-Ponty or Heidegger contain elements of systematic value to both the practice and our philosophical understanding of physics? How did classical phenomenology influence “standard” philosophy of science in the Anglo-American and other traditions? Part 2 probes questions on the role of phenomenology in the philosophies of physics and science: - Can phenomenology help to solve “Wigner’s puzzle”, the problem of the "unreasonable effectiveness" of mathematics in describing, explaining and predicting empirical phenomena? - Does phenomenology allow better understanding of the principle of gauge invariance at the core of the standard model of contemporary particle physics? - Does the phenomenological notion of “Lifeworld” stand in opposition to the “scientific metaphysics” movement, or is there potential for dialogue? Part 3 examines the measurement problem. Is the solution outlined by Fritz London and Edmond Bauer merely a re-statement of von Neumann’s view, or should it be regarded as a distinctively phenomenological take on the measurement problem? Is phenomenology a serious contender in continuing discussions of foundational questions of quantum mechanics? Can other interpretational frameworks such as quantum Bayesianism benefit from implementing phenomenological notions such as constitution or horizonal intentionality? (shrink)

Regulators rely on clinical trials for drug approval and labeling decisions. Health systems and clinicians rely on the evidence from trials to determine treatment, and patients rely on it to decide which courses of care to undertake. Many of these stakeholders presume that the careful review of individual studies is enough to address the ethical and scientific questions that arise in clinical trials. In what follows, however, we demonstrate that explicit consideration of trial portfolios—series of trials that are interrelated by (...) a common set of objectives—is crucial. the ethical acceptability and evidentiary probity of individual trials can change depending on the characteristics of the portfolios in which they are embedded. Second, how trial portfolios are composed, how well they are coordinated, and how efficiently they use information determines the balance of risks and benefits they present as well as their different prospects for generating socially valuable information; these three factors also raise distinct questions of justice. (shrink)

The 2016 CIOMS International ethical guidelines for health‐related research involving humans states that ‘health‐related research should form an integral part of disaster response’ and that, ‘widespread emergency use [of unproven interventions] with inadequate data collection about patient outcomes must therefore be avoided’ (Guideline 20). This position is defended against two lines of criticism that emerged during the 2014 Ebola outbreak. One holds that desperately ill patients have a moral right to try unvalidated medical interventions (UMIs) and that it is therefore (...) unethical to restrict access to UMIs to the clinical trial context. The second holds that clinical trials in contexts of high‐mortality diseases are morally suspect because equipoise does not exist between a standard of care that offers little prospect of clinical benefit and a UMI that might offer some clinical advantage. (shrink)

To judge from the rash of recent law review articles, it is a miracle that research with human subjects in the U.S. continues to draw breath under the asphyxiating heel of the rent-seeking, creativity-stifling, jack-booted bureaucrethics that is the current system of research ethics oversight and review. Institutional Review Boards, sometimes called Research Ethics Committees, have been accused of perpetrating “probably the most widespread violation of the First Amendment in our nation's history,” resulting in a “disaster, not only for academics, (...) but for the whole nation.” One member of the President's Council on Bioethics went so far as to assert, “There has been no greater damage to academic freedom in the United States in my lifetime. And my lifetime encompasses McCarthy and it encompasses political correctness, both.” Locked in the bureaucratic “iron cage” of IRB oversight, critics charge that researchers have been transformed into a vulnerable, exposed population, subject to domination, that has been likened in one case to a kind of “Tuskegee in reverse.”. (shrink)

The foundations of research ethics are riven with fault lines emanating from a fear that if research is too closely connected to weighty social purposes an imperative to advance the common good through research will justify abrogating the rights and welfare of study participants. The result is an impoverished conception of the nature of research, an incomplete focus on actors who bear important moral responsibilities, and a system of ethics and oversight highly attuned to the dangers of research but largely (...) silent about threats of ineffective, inefficient, and inequitable medical practices and health systems. -/- In For the Common Good: Philosophical Foundations of Research Ethics, Alex John London defends a conception of the common good that grounds a moral imperative with two requirements. The first is to promote research that generates the information necessary to enable key social institutions to effectively, efficiently, and equitably safeguard the basic interests of individuals. The second is to ensure that research is organized as a voluntary scheme of social cooperation that respects its various contributors' moral claims to be treated as free and equal. Connecting research to the goals of a just social order grounds a framework for assessing and managing research risk that reconciles these requirements and justifies key oversight practices in non-paternalistic terms. Reconceiving research ethics as resolving coordination problems and providing credible assurance that these requirements are being met expands the issues and actors that fall within the purview of the field and provides the foundation for a more unified and coherent approach to domestic and international research. -/- This is an open access title available under the terms of a CC BY-NC-ND 4.0 license. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations. (shrink)

Before participants can be enrolled in a clinical trial, an institutional review board must determine that the risks that the research poses to participants are ‘reasonable.’ This paper examines the two dominant frameworks for assessing research risks and argues that each approach suffers from significant shortcomings. It then considers what issues must be addressed in order to construct a framework for risk assessment that is grounded in a compelling normative foundation and might provide more operationally precise guidance to the deliberations (...) of various stakeholders. The paper concludes by sketching the outlines of what is referred to as the ‘Integrative Approach’ to risk assessment and by highlighting some of the ways in which this approach may be more promising than current alternatives. (shrink)

Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)

Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)

: The debate over when medical research may be performed in developing countries has steered clear of the broad issues of social justice in favor of what seem more tractable, practical issues. A better approach will reframe the question of justice in international research in a way that makes explicit the links between medical research, the social determinants of health, and global justice.

Although decision‐making algorithms are not new to medicine, the availability of vast stores of medical data, gains in computing power, and breakthroughs in machine learning are accelerating the pace of their development, expanding the range of questions they can address, and increasing their predictive power. In many cases, however, the most powerful machine learning techniques purchase diagnostic or predictive accuracy at the expense of our ability to access “the knowledge within the machine.” Without an explanation in terms of reasons or (...) a rationale for particular decisions in individual cases, some commentators regard ceding medical decision‐making to black box systems as contravening the profound moral responsibilities of clinicians. I argue, however, that opaque decisions are more common in medicine than critics realize. Moreover, as Aristotle noted over two millennia ago, when our knowledge of causal systems is incomplete and precarious—as it often is in medicine—the ability to explain how results are produced can be less important than the ability to produce such results and empirically verify their accuracy. (shrink)

This is the first of four online Companions to Velmans, M. (ed.) (2018) Consciousness (Critical Concepts in Psychology), a 4-volume collection of Major Works on Consciousness commissioned by Routledge, London. Each of the Companions presents a pre-publication version of the introduction to one of the Volumes and, for Volume 1, it also sets the stage for the entire, printed collection. As the collection forms part of a Critical Concepts in Psychology series, this selection of major works focuses mainly on works (...) that have a direct psychological relevance. From the mid 19th Century onwards, psychology began to separate itself from philosophy, and the development of psychological thought about consciousness links intimately to the development of psychology itself. In order to trace this development, the four volumes of this collection follow a rough, historical sequence. Volume 1 deals with The Origins of Psychology and the Study of Consciousness. Volumes 2 and 3 deal with contemporary Cognitive and Neuropsychological Approaches to the Study of Consciousness. And Volume 4 focuses mainly on New Directions: Psychogenesis, Transformations of Consciousness and Non-reductive, Integrative Theories, which deal with issues likely to expand current, mainstream thought in potentially novel, and, sometimes, challenging directions. -/- The printed, 4-Volume collection presents 89 major readings (or salient extracts from major readings) drawn from the entire field of Consciousness Studies, along with these introductions and an extensive index. It also introduces 5 additional readings that were selected for inclusion, but could not be reprinted for the reason that reprint permissions were prohibitively expensive. Although these online Companions cannot substitute for the 2000 page hard copy, they do provide a wealth of additional resources in the form of online links to supplementary readings (marked in pink) and to the readings themselves (marked in blue). In many cases the online sources are freely available or available through institutional subscriptions. Links are also provided for some of the readings that require access to complex colour plates, thereby making the four Companions complementary to the collection itself. -/- This Companion to Volume 1 focuses on the selection criteria for the collection, the problems presented by consciousness and how to organize these into groups, the ancient history of thought about consciousness, mind and soul, the emergence of psychology as the empirical study of consciousness and mind, the emergence of behaviorism, cognitive psychology and the re-emergence of the study of mind, initial ideas about the role of consciousness in human information processing, the strengths of functionalist accounts of mind, the weaknesses of functionalist accounts of consciousness, competing psychological theories about the nature and function of consciousness, interdisciplinary influences, and the formation of Consciousness Studies. (shrink)

Using longitudinal, ethnographic data, the authors examine how the pursuit of self-sufficiency in the context of welfare reform may unintentionally encourage some women to develop alternative dangerous dependencies on abusive or potentially abusive men. In this article, the authors document how women ended up relying on men who have been abusive to them either for instrumental assistance or for more direct financial assistance as they struggled to move from welfare to work. The authors also document how some extremely disadvantaged and (...) vulnerable women became enmeshed in even more dangerous dependencies as they hit time limits and fell through public and private safety nets into drug addiction and sex work. The authors frame this discussion of dangerous dependencies with the recognition that dependency relations are necessary and inevitable components of carework. They argue that the discourse of self-sufficiency should acknowledge the fact that careworkers are productive citizens to the same extent as paid laborers and grapple with the question of the means through which they can support that productivity when personal resources are limited and paid labor is temporarily or permanently impossible. (shrink)

This article argues that lingering uncertainty about the normative foundations of research ethics is perpetuated by two unfounded dogmas of research ethics. The first dogma is that clinical research, as a social activity, is an inherently utilitarian endeavor. The second dogma is that an acceptable framework for research ethics must impose constraints on this endeavor whose moral force is grounded in role-related obligations of either physicians or researchers. This article argues that these dogmas are common to traditional articulations of the (...) equipoise requirement and to recently articulated alternatives, such as the non-exploitation approach. Moreover, important shortcomings of these approaches can be traced to their acceptance of these dogmas. After highlighting these shortcomings, this article illustrates the benefits of rejecting these dogmas by sketching the broad outlines of an alternative called the "integrative approach" to clinical research. (shrink)

Recent debates over the use of sham surgery as a control for studies of fetal tissue transplantation for Parkinson’s disease have focused primarily on rival interpretations of the US federal regulations governing human-subjects research. Using the core ethical and methodological considerations that underwrite the equipoise requirement, we nd strong prima facie reasons against using sham surgery as a control in studies of cellular-based therapies for Parkinson’s disease and more broadly in clinical research. Additionally, we believe that these reasons can be (...) generalized to apply to the use of other placebo controls that carry signi cant risks of positive harms in and of themselves. As a result, our arguments are centrally relevant to the emerging drive to subject therapies with a surgical component to the same rigorous standards of evaluation as those governing the approval of new pharmaceuticals. (shrink)

In crafting our paper on addressing the ethical challenges in HIV prevention research with people who inject drugs,1 we had hoped to stimulate further discussion and deliberation about the topic. We are pleased that three commentaries on our paper have begun this process.2 3 4 The commentaries rightly bring up important issues relating to community engagement and problems in translating research into practice in the fraught environments in which PWID face multiple risks. These risks include acquisition of HIV as well (...) as criminalisation, stigma and lack of access to needed healthcare, prevention and social services. We take this opportunity to respond to the excellent points raised by the commentators. All of the commentaries support our emphasis on robust community engagement with PWID and other stakeholders in designing and conducting HIV prevention research, but urge us to go farther. Wolfe highlights the difficulty of even engaging with community members in oppressive settings, where authorities severely restrict civil liberties of PWID so that even discussing issues related to drug use and enforcement may place individuals at risk. To overcome such limitations, he appropriately suggests interviewing confidentially those who have previously been detained in closed settings as part of the community engagement process. Similarly, Wolfe observes that critical issues can be overlooked with a narrow focus on study procedures if contextual factors before, during or after a study are ignored. For example, he cites the risk of overdose for study participants who have been abstinent during a study and subsequently resume injecting when the study concludes. These kinds of risks may not be obvious …. (shrink)

To find more information on Rowman & Littlefield titles, please visit us at www.rowmanlittlefield.com.

Both and are guaranteed by the London scholia , so the gap is reduced to the tantalizingly small one of a monosyllabic feminine noun in the accusative case, most probably of four letters. The number of possibilities cannot be unlimited. My own suggestion must necessarily remain in limbo in the present state of our knowledge concerning the poet or poets whom Callimachus is talking about, but at least it seems to me less bizarre than other restorations currently in the field.

Global debates in approaches to HIV/AIDS control have recently moved away from a uniformly strong human rights-based focus. Public health utilitarianism has become increasingly important in shaping national and international policies. However, potentially contradictory imperatives may require reconciliation of individual reproductive and other human rights with public health objectives. Current reproductive health guidelines remain largely nonprescriptive on the advisability of pregnancy amongst HIV-positive couples, mainly relying on effective counselling to enable autonomous decision-making by clients. Yet, health care provider values and (...) attitudes may substantially impact on the effectiveness of nonprescriptive guidelines, particularly where social norms and stereotypes regarding childbearing are powerful, and where providers are subjected to dual loyalty pressures, with potentially adverse impacts on rights of service users. Data from a study of user experiences and perceptions of reproductive and HIV/AIDS services are used to illustrate a rights analysis of how reproductive health policy should integrate a rights perspective into the way services engage with HIV-positive persons and their reproductive choices. The analysis draws on recognised tools developed to evaluate health policies for their human rights impacts and on a model developed for health equity research in South Africa to argue for greater recognition of agency on the part of persons affected by HIV/AIDS in the development and content of policies on reproductive choices. We conclude by proposing strategies that are based upon a synergy between human rights and public health approaches to policy on reproductive health choices for persons with HIV/AIDS. (shrink)

The President, Council and Fellows of the Royal Society of London for Improving Natural Knowledge, the so-called Royal Society, was founded in 1660. Charles II granted a royal charter in 1662 const...

In crafting our paper on addressing the ethical challenges in HIV prevention research with people who inject drugs, 1 we had hoped to stimulate further discussion and deliberation about the topic. We are pleased that three commentaries on our paper have begun this process. 2 3 4 The commentaries rightly bring up important issues relating to community engagement and problems in translating research into practice in the fraught environments in which PWID face multiple risks. These risks include acquisition of HIV (...) as well as criminalisation, stigma and lack of access to needed healthcare, prevention and social services. We take this opportunity to respond to the excellent points raised by the commentators. All of the commentaries support our emphasis on robust community engagement with PWID and other stakeholders in designing and conducting HIV prevention research, but urge us to go farther. Wolfe highlights the... (shrink)

Volume 24, Issue 6, September 2019, Page 680-682.

Following a boom in investment and overinflated expectations in the 1980s, artificial intelligence entered a period of retrenchment known as the “AI winter.” With advances in the field of machine learning and the availability of large datasets for training various types of artificial neural networks, AI is in another cycle of halcyon days. Although medicine is particularly recalcitrant to change, applications of AI in health care have professionals in fields like radiology worried about the future of their careers and have (...) the public tittering about the prospect of soulless machines making life‐and‐death decisions. Medicine thus appears to be at an inflection point—a kind of Groundhog Day on which either AI will bring a springtime of improved diagnostic and predictive practices or the shadow of public and professional fear will lead to six more metaphorical weeks of winter in medical AI. (shrink)

Through extensive textual analysis, this book concludes that the prevailing opinion about the nature of modern and contemporary philosophy is wrong. It maintains that almost all modern and contemporary philosophy is deconstructed, secularized, Augustinian theology, not philosophy. The work is divided into eight chapters, a guest Foreword by Herbert I. London notes, bibliography, and an index. Chapter 1 considers Cartesian thought, Hobbes, and Newton. Chapter 2 examines Locke, Berkeley, and Hume. Chapter 3 investigates Lessing and Rousseau. Chapters 4 and 5 (...) treat Kant. Chapters 6 and 7 deal with Hegel. Chapter 8 concludes that a lack of philosophical and historical experience coupled with a widespread inability to read philosophical texts according to the intention of the author causes us to mistake secularized theology for philosophy and is a main cause for the decline of contemporary universities. (shrink)

The “fair benefits” approach to international research is designed to produce results that all can agree are fair without taking a stand on divisive questions of justice. But its appealing veneer of collaboration masks ambiguities at both a conceptual and an operational level. An attempt to put it into practice would look a lot like an auction, leaving little reason to think the outcomes will satisfy even minimal conditions of fairness.

'Trade in Health is a timely reflection on the interface of economics with the ethics and public policy facets of the international movement of patients. Health issues such as these are at the forefront of modern political economy."National" health is increasingly less so. Reisman's previous scholarship in this area is brought to bear in an insightful and eminently readable and engaging fashion. In an area where uncovering the facts is more difficult than "decyphering the Dead Sea Scrolls", such a reflective (...) work on the critical aspects of political economy helps to fill a void in considering whether such trade is likely to be in the interests of patients, nations and the global community. In addition to the rosy picture of healthy and wealthy tourists having a sojourn for medical care during a vacation, Reisman is not afraid to tackle the thorny issues concerning trade in organs, eggs and even death, in this sobering and comprehensive volume. It is a rare skill to bring the luminaries of Smith, Marshall, Mill and Confucius to bear on such a contemporary tale! International travel by patients is at the nexus of a revolution in global health. It is driving and affecting aspects of foreign investment, health worker migration and e-health provision. Reisman skilfully links these foundations of health care, and as such provides critical text for consideration by those seeking to build and strengthen future health systems. Trade in Health is an excellent overview. It provides critical insights for those new to the area as well as new information and challenges for those of us involved for a number of years.' - Richard Smith, Professor of Health Ssytem Economics and Dean of Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, UK. Once exports and imports meant agriculture and industry. In the global economy and the electronic age, trade is also expanding into the service sector. This timely book closely examines trade in health. It documents the growth of a cross-national service that in the past was mainly consumed at home. Following from his highly successful book Health Tourism, Professor David Reisman offers a comprehensive and searching multidisciplinary account of the way in which medical services, patients, capital and professionals are making up a global healthcare economy that crosses borders. He reflects on their pursuit of lower prices, better quality and a differentiated product, and suggests that public policy is essential if the ethical capital of interdependent societies is not to be eroded by the international market in health and care. Written in a concise and lucid form, this original book will be of great interest to all people interested in the internationalization of health care. Combining theory and empirical evidence from economics, tourism and medical care, scholars involved in health policy and social administration will find much of significance in this authoritative study. (shrink)

This book argues that the Fourth Gospel offers a potentially transformative response to the question of suffering and the human compulsion to blame. By engaging with the symbols of light, vision, and the Good Shepherd, readers can experience a theodical spirituality that transforms resentment and rage through divine forgiveness.

Respect for patient autonomy can apply at two levels: ensuring that patient care reflects their considered values and wishes and honoring patient preferences about how to make momentous decisions. Caregivers who seek to respect patient autonomy in the context of some end-of-life decisions face a dilemma. Because these decisions are fraught, patients may prefer to approach them sequentially, only making decisions at the time they arise. However, respecting patients’ preferences for a sequential approach can increase the likelihood that surrogates and (...) care teams wind up in situations in which they lack information needed to ensure patients receive care that conforms to their considered values after they are no longer competent to make decisions for themselves. Sequential decision-making can thus conflict with the goal of ensuring care reflects the wishes of patients. After illustrating how this dilemma can arise in the use of life-sustaining “bridge” technologies, we argue that care teams may be warranted in requiring patients to articulate their wishes in an advance care plan before treatment begins. In some cases, care teams may even be permitted to refuse to undertake certain courses of care, unless patients articulate their wishes in an advance care plan. (shrink)

This paper examines the concept of a 'standard of care' as it has been used in recent arguments over the ethics of international human-subjects research. It argues that this concept is ambiguous along two different axes, with the result that there are at least four possible standard of care arguments that have not always been clearly distinguished. As a result, it has been difficult to assess the implications of opposing standard of care arguments, to recognize important differences in their supporting (...) rationales, and even to locate the crux of the disagreement in some instances. The goal of the present discussion, therefore, is to disambiguate the concept of a 'standard of care' and to highlight the areas of genuine disagreement among different standards. In the end it is argued that one standard of care argument in particular is more complex than either its proponents or its critics may have recognized and that understanding this possibility opens up a potentially promising avenue of inquiry that remains to be carefully explored. (shrink)