Cost-effectiveness analysis suggests that a society should allocate its health care budget in order to achieve the greatest total health for its budget. However, in ‘rescue’ cases, where an individual’s life is in immediate peril, reasoning in terms of cost-effectiveness can appear inhumane. Hence considerations of cost-effectiveness and of rescue appear to be in tension. However, by attending to the division of labour in medical decision making it is possible to see how cost-effectiveness analysis and rescue-style reasoning are commonly combined (...) in an ethically acceptable fashion. (shrink)

This article examines criticisms of cost-benefit analysis and the contingent valuation method from methodological and moral philosophical perspectives. Both perspectives argue that what should be elicited for public decisions are attitudes or values, not preferences, and that respondents should be treated as citizens and not consumers. The moral philosophical criticism argues in favour of deliberative approaches over cost-benefit analysis. The methodological perspective is here criticized for overemphasizing the importance of protest responses and anomalies and biases in contingent valuation, and for (...) failing to provide the necessary information needed to make public decisions over the allocation of scarce goods. The moral philosophical perspective is criticized for: failing to provide criteria for distinguishing between values and preferences, assuming impartiality requires expression of values and not preferences; failing to recognize the diversity of forms of expression of values, including expression of values through monetary evaluation; and assuming that cost-benefit analysis is necessarily an implementation of a utilitarian political philosophy. The article concludes by showing that deliberative decision-making mechanisms can be overly demanding on citizens, and argues for greater openness in the potential moral justifications of cost-benefit analysis. Key Words: cost-benefit analysis • values • preference aggregation • democracy • willingness to pay. (shrink)

This is the first book to give a collective treatment of philosophical issues relating to tax. Given that the tax system is central to the operation of states and to the ways in which states interact with individual citizens, more interdisciplinary attention to conceptual and normative issues relating to tax is urgently needed.

Health‐related Quality of Life measures have recently been attacked from two directions, both of which criticize the preference‐based method of evaluating health states they typically incorporate. One attack, based on work by Daniel Kahneman and others, argues that ‘experience’ is a better basis for evaluation. The other, inspired by Amartya Sen, argues that ‘capability’ should be the guiding concept. In addition, opinion differs as to whether health evaluation measures are best derived from consultations with the general public, with patients, or (...) with health professionals. And there is disagreement about whether these opinions should be solicited individually and aggregated, or derived instead from a process of collective deliberation. These distinctions yield a wide variety of possible approaches, with potentially differing policy implications. We consider some areas of disagreement between some of these approaches. We show that many of the perspectives seem to capture something important, such that it may be a mistake to reject any of them. Instead we suggest that some of the existing ‘instruments’ designed to measure HR QoLs may in fact successfully already combine these attributes, and with further refinement such instruments may be able to provide a reasonable reconciliation between the perspectives. (shrink)

Axiomatic utility theory plays a foundational role in some accounts of normative principles. In this context, it is sometimes argued that transitivity of “better than” is a logical truth. Larry Temkin and Stuart Rachels use various examples to argue that “better than” is non–transitive, and that transitivity is not a logical truth. These examples typically involve some sort of “discontinuity.” In his discussion of one of these examples, John Broome suggests that we should reject the claim which involves “discontinuity.” We (...) can, I suggest, make sense of the examples which Temkin uses while sacrificing neither transitivity nor “discontinuity.” This response to Temkin's examples involves developing and modifying James Griffin's account of “discontinuity.” If the account of “discontinuity” seems implausible, that is because of a failure to allow for vagueness. A similar argument can be made in the context of the well-known “repugnant conclusion.” Footnotes1 This paper emerged from a discussion in one of John Broome's seminars. I am very grateful to John Broome, Erik Carlson, James Griffin, Wlodek Rabinowicz, Stuart Rachels, and Larry Temkin for allowing me to read various forthcoming manuscripts which are mentioned in the paper. I am also extremely grateful to Gustaf Arrhenius, Walter Bossert, Luc Bovens, John Broome, Richard Cookson, Robin Cubitt, James Griffin, Graham Loomes, Ben McQuillin, Shepley Orr, Wlodek Rabinowicz, Stuart Rachels, Bob Sugden, and two anonymous referees for comments on earlier versions. Any errors or omissions are mine. (shrink)

David Lewis is widely credited with the first formulation of common knowledge and the first rigorous analysis of convention. However, common knowledge and convention entered mainstream game theory only when they were formulated, later and independently, by other theorists. As a result, some of the most distinctive and valuable features of Lewis' game theory have been overlooked. We re-examine this theory by reconstructing key parts in a more formal way, extending it, and showing how it differs from more recent game (...) theory. In contrast to current theories of common knowledge, Lewis' theory is based on an explicit analysis of the modes of reasoning that are accessible to rational individuals and so can be used to analyse the genesis of common knowledge. Lewis' analysis of convention emphasises the role of inductive reasoning and of salience in the maintenance of conventions over time. Footnotes Earlier versions of this paper were presented at the 13th Amsterdam Colloquium at the University of Amsterdam, at a workshop on social norms at Wissenschaftskolleg zu Berlin, and at seminars at Tilburg University and the University of Bristol. We are grateful for comments from participants at those meetings, from two anonymous referees, and from Michael Bacharach, Nick Bardsley, Cristina Bicchieri, Luc Bovens, Simon Grant, David McCarthy, Shepley Orr, Brian Skyrms, Peter Vanderschraaf, Peter Wakker and Jörgen Weibull. Robert Sugden's work was supported by the Leverhulme Trust. (shrink)

Orr argues that the latest attack on evolution is cleverly argued, biologically informed — and wrong. This is his review of Behe's book, Darwin's Black Box: The Biochemical Challenge to Evolution.‘Just don't pull the knot tight before being certain that you have got hold of the right end.’ Wittgenstein.

In the literature on conspiracy theories, the least contentious part of the academic discourse would appear to be what we mean by a “conspiracy”: a secretive plot between two or more people toward some end. Yet what, exactly, is the connection between something being a conspiracy and it being secret? Is it possible to conspire without also engaging in secretive behavior? To dissect the role of secrecy in con- spiracies – and thus contribute to the larger debate on the epistemology (...) of conspir- acy theories – we dene the concepts of “conspiracy,” “conspirator,” and “secret,” and argue that while conspirators might typically be thought to commit to keeping secrets once their conspiracy is underway, the idea that conspiracies are necessarily secretive to start with is not as obvious as previously thought. (shrink)

Thinking in Translation posits the Hebrew Bible as the fulcrum of the thought of Franz Rosenzweig (1886-1929), underpinning a unique synthesis between systematic thinking and biblical interpretation. Addressing a lacuna in Rosenzweig scholarship, the book offers a critical evaluation of his engagement with the Bible through a comparative study of The Star of Redemption and his Bible translation with Martin Buber. The book opens with Rosenzweig's rejection of German Idealism and fascination with the sources of Judaism. It then analyzes the (...) unique hermeneutic approach he developed to philosophy and scripture as a symbiosis of critique and cross-fertilization, facilitated by translation. An analysis of the Star exposes Rosenzweig's employment of translation in grafting biblical verses unto the philosophical discussion. It is followed by a reading that demonstrates how his Bible translation reflects an attempt to re-valorize the Tanakh as a distinctively Jewish scripture, over and against Christian appropriations. Thinking in Translation recasts Rosenzweig's life's work as a project of melding Judaism and modernity in an attempt to secure their spiritual and intellectual survival. (shrink)

A physician’s long-established right to refuse to provide a requested service based on his or her moral beliefs is being challenged. Some authors suggest that physicians should not be licensed if they are unwilling to provide all legal services. Others would grant them the right to refuse, but require them to refer to a willing professional. What are the limits of a physician’s right to refuse? When such a right is claimed on moral grounds, what residual obligations does the physician (...) have to the patient? How should the profession (or society) decide when a moral claim to a right to refuse is justified? (shrink)

This paper explores some aspects of the concept 'logic' and its relation to moral voice, and argues that Menssen uses it too narrowly in her respone to Orr's "Just the Facts. Ma'am" and the work of Carol Gilligan. Grounded in the work of the later Wittgenstein, it is argued that formalized logic misses much of natural logic: the concept of 'moral talk' is developed to theorize Gilligan's ethic of care; it is argued that this form of moral deliberation is not (...) argumentation in the formal sense; and the relationship between logic and epistemology is explored through the consideration of moral talk as a language-game which is woven into gendered forms of life. Finally, it is argued that the notion of a universal logic is the product of an oppressivc patriarchal culture and should not be defended by feminists. (shrink)

In its approach to AIDS and HIV the law has to protect two conflicting interests; it must recognise the right of the public to be protected against the disease and it must recognise the right of the individual not to be unfairly restricted by having or being at risk of the disease. Consequently the law must make some compromise which while protecting public health also protects the individual so that the individual will feel free to come forward for available treatment. (...) In this way prevention of spread of the disease is encouraged. How this compromise is or might be affected by British and American law is examined in several areas, including medico-legal matters, criminal and tort law, employment, insurance and education. (shrink)

Requests by patients or their families for treatment which the patient's physician considers to be "inappropriate" are becoming more frequent than refusals of treatment which the physician considers appropriate. Such requests are often based on the patient's religious beliefs about the attributes of God (sovereignty, omnipotence), the attributes of persons (sanctity of life), or the individual's personal relationship with God (communication, commands, etc). We present four such cases and discuss some of the basic religious tenets of the three Abrahamic faith (...) traditions as they relate to such requests. We suggest that religious reasons for requesting "inappropriate" treatment are "special" and deserve serious consideration. We offer guidance to assist clinicians and clinical ethicists as they attempt to resolve these conflicts, emphasising the importance of understanding the religious beliefs of the patient/surrogate and suggesting the assistance of a religious interpreter. We suggest open discussion with patients and families of both the clinical situation and the theological basis for these requests. We also suggest that clinicians use additional religious doctrines or principles from patients' own traditions to balance the reasons behind the requests. We conclude that most persistent requests for "inappropriate" treatment should be honoured. (shrink)

Clinical ethics is a relatively new discipline within medicine, generated not so much by the Can we . . . ? questions of fact and prognosis that physicians ...

Orr and Dentith argue that a recurrent problem in much of the wider academic literature on conspiracy theories is either conceptual confusion or a refusal to put theory before practice. Orr and Dentith show that a naive empiricism pervades much of the social science literature when it comes to these things called ‘conspiracy theories’ which not only runs at odds with the philosophical literature but also the general tenor of the social sciences over the latter part of the 20th Century (...) and beyond. Orr and Dentith argue that central to these confusions or refusals is not just a lack of philosophical rigour when it comes to defining and presenting views, but an active disinterest in such conceptual work. (shrink)

Deliberative democratic theory emphasises the importance of informed and reflective discussion and persuasion in political decision-making. The theory has important implications for constitutionalism - and vice versa - as constitutional laws increasingly shape and constrain political decisions. The full range of these implications has not been explored in the political and constitutional literatures to date. This unique Handbook establishes the parameters of the field of deliberative constitutionalism, which bridges deliberative democracy with constitutional theory and practice. Drawing on contributions from world-leading (...) authors, this volume will serve as the international reference point on deliberation as a foundational value in constitutional law, and will be an indispensable resource for scholars, students and practitioners interested in the vital and complex links between democratic deliberation and constitutionalism. (shrink)

Despite the growing interest in Aristotelian approaches to contemporary philosophy of science, few metaphysicians have engaged directly with the question of how a neo-Aristotelian metaphysics of nature might change the landscape for theological discussion concerning theology and naturalism, the place of human beings within nature, or the problem of divine causality. The chapters in this volume are collected into three thematic sections: Naturalism and Nature, Mind and Nature, and God and Nature. By pushing the current boundaries of neo-Aristotelian metaphysics to (...) recover the traditional notion of substantial forms in physics, reframe the principle of proportionality in biology, and restore the hierarchy of being familiar to ancient philosophy, this book advances a metaphysically unified framework that accommodates both scientific and theological knowledge, enriching the interaction between science, philosophy and theology. Neo-Aristotelian Metaphysics and the Theology of Nature will be of interest to scholars and advanced students working in metaphysics, philosophy of science, natural theology, philosophical theology, and analytic theology. (shrink)

"The compiling of a bibliography requires both a thorough knowledge of the subject . . . and the ability to discriminate effectively. Success depends as much on the clear definition of focus as on the evaluation of the texts considered. Orr succeeds on each count, thereby rendering an invaluable service to students and scholars alike. . . . Particularly interesting is the inclusion of works devoted to the interrelatedness of existentialism and the political and social sciences. And extremely helpful are (...) the notations referring the researcher to sections of a work either of particular significance or pertinent to a specific point of view. An excellent introduction emphasizes the movement away from the fundamental (ontological) concerns of existential thought. . . . Orr's effort to resituate the research within the original dimensions of existentialism and phenomenology as exploratory processes, as opposed to intellectual systems, is most commendable."FRENCH REVIEW. (shrink)

Summary Heidegger’s jeremiads against metaphysics are amongst the most influential and iconoclastic in the annals of continental philosophy; and none is more trenchant than the Destruktion of Descartes’ ontology of self with which Sein und Zeit begins. Yet for all the intellectual energy he expends on attempting to uncover the social texture of Dasein’s being-in-the-world, many remain convinced that Heidegger simply transposes the Cartesian ego into a phenomenological key. One of the first thinkers to arouse these suspicions was an erstwhile (...) colleague of Heidegger, the Jewish-born phenomenologist and Carmelite spiritual writer, Edith Stein, in an unjustly neglected work, Martin Heideggers Existentialphilosophie. What sets Stein’s critique apart from more influential treatments is that in the course of diagnosing weaknesses in Heidegger’s account from within his own methodological constraints, she reaches some strikingly theological conclusions. The task of the present study is to offer an assessment of her dissection of the status and function of sociality in the Daseinsanalytik. After setting out Stein’s early phenomenology of empathy, I examine Stein’s argument that Heidegger’s tacit and mistaken appeal to theological categories ironically collapses his account of sociality back into the very subjectivism his Destruktion had been directed against. I conclude that Stein deftly reverses Heidegger’s strategy of atheological expropriation strategies by taking up a central theme in his own thought to articulate the theological unity of all finite existents. For Stein, unity at the level of fundamental ontology is most plausibly analysed by reference to the creaturely participation in the plenitude of Trinitarian being. (shrink)

SummarySince first appearance, reviews and accounts of The Fresh-Water Fishes of Great Britain (1828–1838) have been surprisingly few. All agree that this rare work is remarkable for its illustrations. Its importance as a whole in the history of ichthyology, however, is largely unknown, or ignored. This article therefore constitutes the first study of the textual and contextual significance of The Fresh-Water Fishes of Great Britain. By examining in chronological order where, and by whom, the work was first reviewed and referenced (...) until the 1860s, the extraordinary contributions that its author, Sarah Bowdich, made to ichthyology at the forefront of the field in the late 1820s can better be appreciated. Indeed, this multiple evidence demonstrates Sarah Bowdich's merits as an ichthyologist of the first order, and as the first woman ichthyologist. But establishing the significance of The Fresh-Water Fishes of Great Britain for the history of ichthyology then raises a further question. Why has it and its author been so ignored or forgotten? By returning for answers to the fields of ichthyology already considered, the article proposes that Sarah Bowdich's different angles on fish offer lines of investigation that are still important for the field today. (shrink)

It is possible to retrieve viable sperm from a dying man or from a recently dead body. This sperm can be frozen for later use by his wife or partner to produce his genetic offspring. But the technical feasibility alone does not morally justify such an endeavour. Posthumous semen retrieval raises questions about consent, the respectful treatment of the dead body, and the welfare of the child to be.We present two cases, discuss these three issues, and conclude that such requests (...) should generally not be honoured unless there is convincing evidence that the dead man would want his widow to carry and bear his child. Even with consent, the welfare of the potential child must be considered. (shrink)