When thinking about population level healthcare priority setting decisions, such as those made by the National Institute for Health and Care Excellence, good medical ethics requires attention to three main principles of health justice: (1) cost-effectiveness, an aspect of beneficence, (2) non-discrimination, and (3) priority to the worse off in terms of both current severity of illness and lifetime health. Applying these principles requires consideration of the identified patients who benefit from decisions and the unidentified patients who bear the opportunity (...) costs. (shrink)

This report by the WHO Consultative Group on Equity and Universal Health Coverage addresses how countries can make fair progress towards the goal of universal coverage. It explains the relevant tradeoffs between different desirable ends and offers guidance on how to make these tradeoffs.

The main aim of this paper is to investigate the views of healthcare professionals in Portugal about healthcare rationing, and compare them with the views of college students. A self-administered questionnaire was used to collect data from a sample of 60 healthcare professionals and 180 college students. Respondents faced a hypothetical rationing dilemma where they had to order four patients and justify their choices. Multinomial logistic regressions were used to test for differences in orderings, and content analysis to categorize the (...) written justifications. The findings suggest that both groups appeared to support three main rationing principles: health maximization, priority to the severely ill and priority to the young. However, professionals seemed to give less weight to the latter principle. In conclusion, professionals have similar views to students about healthcare rationing, though may be slightly less inclined to give priority to the young. (shrink)

La cobertura universal de salud está en el centro de la acción actual para fortalecer los sistemas de salud y mejorar el nivel y la distribución de la salud y los servicios de salud. Este documento es el informe fi nal del Grupo Consultivo de la OMS sobre la Equidad y Cobertura Universal de Salud. Aquí se abordan los temas clave de la justicia (fairness) y la equidad que surgen en el camino hacia la cobertura universal de salud. Por lo (...) tanto, el informe es pertinente para cada agente que infl uye en ese camino y en particular para los gobiernos, ya que se encargan de supervisar y guiar el progreso hacia la cobertura universal de salud. (shrink)

This report from the WHO Consultative Group on Equity and Universal Health Coverage offers advice on how to make progress fairly towards universal health coverage.

The British Armed Nation, 1793?1815. By J. E. Cookson (Oxford: Oxford University Press, 1997) vi + 286 pp. £45.00/ $87.00 cloth. The Arming of Europe and the Making of the First World War. By David G. Herrmann (Princeton: Princeton University Press, 1997) 307 pp. $16.95 paper. State, Society and Mobilization in Europe during the First World War. John Horne, ed. (Cambridge U.K.: Cambridge University Press, 1997) xv + 292 pp. £35.00/ $59.95 cloth.

This paper compares and contrasts three different substantive principles of justice for making health care priority-setting or “rationing” decisions: need principles, maximising principles and egalitarian principles. The principles are compared by tracing out their implications for a hypothetical rationing decision involving four identified patients. This decision has been the subject of an empirical study of public opinion based on small-group discussions, which found that the public seem to support a pluralistic combination of all three kinds of rationing principle. In conclusion, (...) it is suggested that there is room for further work by philosophers and others on the development of a coherent and pluralistic theory of health care rationing which accords with public opinions. (shrink)

This book offers a new phenomenological interpretation of T.H. Green's (1836-1882) philosophy and political theory. By analyzing his theory of human practice, the moral idea, the common good, freedom and human rights, the book demonstrates that Green joins the same tradition as Kantian and Husserlian transcendentalism. The book offers a reconstruction of Green's idealism and demonstrates its potential to address contemporary debates on the nature of moral agency, positive and negative freedom and on justifying human rights.

A selection of speeches and essays from the author's second decade as president of Yale University.

In healthcare, a tension sometimes arises between the injunction to do as much good as possible with scarce resources and the injunction to rescue identifiable individuals in immediate peril, regardless of cost (the “Rule of Rescue”). This tension can generate serious ethical and political difficulties for public policy makers faced with making explicit decisions about the public funding of controversial health technologies, such as costly new cancer drugs. In this paper we explore the appropriate role of the Rule of Rescue (...) in public resource allocation decisions by health technology funding advisory bodies such as the National Institute for Health and Clinical Excellence. We consider practical approaches to operationalising the Rule of Rescue from Australia and the UK before examining the relevance of individual moral imperatives to public policy making. We conclude that that whilst public policy makers in a humane society should facilitate exceptional departures from a cost effectiveness norm in clinical decisions about identified individuals, it is not so obvious that they should, as a matter of national public policy, exempt any one group of unidentified individuals within society from the rules of opportunity cost at the expense of all others. (shrink)

KEY TO FOOTNOTE ABBREVIATIONS MM-P. Structure Phenomenology Sense Praise Signs Visible Themes Humanism Primacy Maurice Merleau-Ponty The Structure of ...

The renowned biologist and thinker Richard Dawkins presents his most expansive work yet: a comprehensive look at evolution, ranging from the latest developments in the field to his own provocative views. Loosely based on the form of Chaucer's Canterbury Tales, Dawkins's Tale takes us modern humans back through four billion years of life on our planet. As the pilgrimage progresses, we join with other organisms at the forty "rendezvous points" where we find a common ancestor. The band of pilgrims (...) swells into a vast crowd as we join first with other primates, then with other mammals, and so on back to the first primordial organism. Dawkins's brilliant, inventive approach allows us to view the connections between ourselves and all other life in a bracingly novel way. It also lets him shed bright new light on the most compelling aspects of evolutionary history and theory: sexual selection, speciation, convergent evolution, extinction, genetics, plate tectonics, geographical dispersal, and more. The Ancestor's Tale is at once a far-reaching survey of the latest, best thinking on biology and a fascinating history of life on Earth. Here Dawkins shows us how remarkable we are, how astonishing our history, and how intimate our relationship with the rest of the living world. (shrink)

The discussion of good and evil must not be confined to the sterile lecture halls of academics but related instead to ordinary human feelings, needs, and desires, says noted philosopher Richard Taylor. Efforts to understand morality by exploring human reason will always fail because we are creatures of desire as well. All morality arises from our intense and inescapable longing. The distinction between good and evil is always clouded by rationalists who convert the real problems of ethics into complex (...) philosophical puzzles. In the first part of Good and Evil, Taylor looks for a more meaningful conception by reexamining and rejecting the whole rationalistic tradition that dominates philosophical ethics. The second part provides an empirical explanation of good and evil, noting that one does not have to look too far to find prime examples of the failure of fixed moral rules. Including important commentary on Joseph Fletcher's groundbreaking situation ethics, and Aristotle's virtues (e.g., magnanimity and pride), Taylor rounds out the book by developing a philosophy of aspiration--personal worth as an ethical ideal--to replace the morality of duty. He offers a modified form of situation ethics to fit the contemporary problems we face. (shrink)

Orientalism and Religion offers us a timely discussion of the implications of contemporary post-colonial theory for the study of religion. Drawing on a variety of post-structuralist and post-colonial thinkers, including Foucault, Gadamer, Said, and Spivak, Richard King examines the way in which notions such as mysticism, religion, Hinduism and Buddhism are taken for granted, and shows us how religion needs to be redescribed along the lines of cultural studies.

This is the third edition of a classic book first published in 1960, which has sold thousands of copies in two paperback edition and has been translated into several foreign languages. Popkin's work ha generated innumerable citations, and remains a valuable stimulus to current historical research. In this updated version, he has revised and expanded throughout, and has added three new chapters, one on Savonarola, one on Henry More and Ralph Cudworth, and one on Pascal. This authoritative treatment of the (...) theme of scepticism and its historical impact will appeal to scholars and students of early modern history now as much as ever. (shrink)

Thinking through the body: educating for the humanities -- The body as background -- Self-knowledge and its discontents: from Socrates to somaesthetics -- Muscle memory and the somaesthetic pathologies of everyday life -- Somaesthetics in the philosophy classroom: a practical approach -- Somaesthetics and the limits of aesthetics -- Somaesthetics and Burke's sublime -- Pragmatism and cultural politics: from textualism to somaesthetics -- Body consciousness and performance -- Somaesthetics and architecture: a critical option -- Photography as performative process -- Asian (...) ars erotica and the question of sexual aesthetics -- Philosophy as awakened life : everyday aesthetics of embodiment in American transcendentalism and Japanese Zen practice -- Somatic style. (shrink)

According to certain normative theories in epistemology, rationality requires us to be logically omniscient. Yet this prescription clashes with our ordinary judgments of rationality. How should we resolve this tension? In this paper, I focus particularly on the logical omniscience requirement in Bayesian epistemology. Building on a key insight by Hacking :311–325, 1967), I develop a version of Bayesianism that permits logical ignorance. This includes: an account of the synchronic norms that govern a logically ignorant individual at any given time; (...) an account of how we reduce our logical ignorance by learning logical facts and how we should update our credences in response to such evidence; and an account of when logical ignorance is irrational and when it isn’t. At the end, I explain why the requirement of logical omniscience remains true of ideal agents with no computational, processing, or storage limitations. (shrink)

ABSTRACT The paper challenges the general perception that the positive–negative freedom discourse privileges negative liberty. It demonstrates that Constant and Berlin’s dual freedom conceptual scheme contains the blueprint of a modern concept of positive freedom and it reveals the nature of negative freedom in an entirely new light. Constant’s ancient and modern liberties have many similarities with Berlin’s two concepts of freedom – positive and negative. The paper shows that these similarities warrant a parallel study and allow us to examine (...) the relation between the two sides of the freedom dichotomy by using the compound terms modern/negative and ancient/positive freedom. It is argued that understanding the relation between the two freedoms depends on accepting ancient/positive liberty as practiced by the participants of modern revolutions. Then we can see why this freedom can both violate and complement modern/negative freedom. The paper argues that the combined tension and mutual dependency of the two freedoms can be explained by tapping into a metaphysical study of human agency, where metaphysics is understood as conceptualisation of moral experience. This helps demonstrate why Constant’s modern liberty and Berlin’s negative liberty rely on satisfaction as a key category reflecting individuals’ capacity for subjective judgement. (shrink)

The book begins with an overview that introduces the Theorem and the issues surrounding it, and explores how the essays that follow contribute to our understanding of those issues.

Conditionalization is one of the central norms of Bayesian epistemology. But there are a number of competing formulations, and a number of arguments that purport to establish it. In this paper, I explore which formulations of the norm are supported by which arguments. In their standard formulations, each of the arguments I consider here depends on the same assumption, which I call Deterministic Updating. I will investigate whether it is possible to amend these arguments so that they no longer depend (...) on it. As I show, whether this is possible depends on the formulation of the norm under consideration. (shrink)

If one compares various skeptical arguments about our perceptual beliefs with arguments against scientific realism one immediately notices important similarities. Skeptical arguments about perceptual beliefs are often based on the premise that all of our perceptual beliefs could be wrong. Our experience is consistent with many different states of affairs; some familiar examples are hallucination, an evil demon, and brains in a vat. Thus it is claimed we have no reason to believe that the perceptual beliefs we normally form are (...) true and alternative beliefs are false.One of the most powerful arguments against scientific realism is based on the claim that our data underdetermines our theory. There exist empirically equivalent theories, which means that there is no observation that could lead us to accept one and reject the other. Each member of a class of empirically equivalent theories will be equally supported by the evidence. (shrink)

The Desire-as-Belief thesis (DAB) states that any rational person desires a proposition exactly to the degree that she believes or expects the proposition to be good. Many people take David Lewis to have shown the thesis to be inconsistent with Bayesian decision theory. However, as we show, Lewis's argument was based on an Invariance condition that itself is inconsistent with the (standard formulation of the) version of Bayesian decision theory that he assumed in his arguments against DAB. The aim of (...) this paper is to explore what impact the rejection of Invariance has on the DAB thesis. Without assuming Invariance, we first refute all versions of DAB that entail that there are only two levels of goodness. We next consider two theses according to which rational desires are intimately connected to expectations of (multi-levelled) goodness, and show that these are consistent with Bayesian decision theory as long as we assume that the contents of 'value propositions' are not fixed. We explain why this conclusion is independently plausible, and show how to construct such propositions. (shrink)

Strangers, Gods and Monster is a fascinating look at how human identity is shaped by three powerful but enigmatic forces. Often overlooked in accounts of how we think about ourselves and others, Richard Kearney skillfully shows, with the help of vivid examples and illustrations, how the human outlook on the world is formed by the mysterious triumvirate of strangers, gods and monsters. Throughout, Richard Kearney shows how strangers, gods and monsters do not merely reside in myths or fantasies (...) but constitute a central part of our cultural unconscious. Above all, he argues that until we understand better that the Other resides deep within ourselves, we can have little hope of understanding how our most basic fears and desires manifest themselves in the external world and how we can learn to live with them. (shrink)

In this sequel to his classic study The History of Scepticism from Erasmus to Descartes, Popkin examines the important role played by the revival and reformulation of classical scepticism in eighteenth-century philosophy.

Hilbert’s program was an ambitious and wide-ranging project in the philosophy and foundations of mathematics. In order to “dispose of the foundational questions in mathematics once and for all,” Hilbert proposed a two-pronged approach in 1921: first, classical mathematics should be formalized in axiomatic systems; second, using only restricted, “finitary” means, one should give proofs of the consistency of these axiomatic systems. Although Gödel’s incompleteness theorems show that the program as originally conceived cannot be carried out, it had many partial (...) successes, and generated important advances in logical theory and metatheory, both at the time and since. The article discusses the historical background and development of Hilbert’s program, its philosophical underpinnings and consequences, and its subsequent development and influences since the 1930s. (shrink)

Most recent accounts of will-power have tried to explain it as reducible to the operation of beliefs and desires. In opposition to such accounts, this paper argues for a distinct faculty of will-power. Considerations from philosophy and from social psychology are used in support.

Most individuals realise that we have a moral obligation to avoid the evils of war. But this realization raises a host of difficult questions when we, as responsible individuals, witness harrowing injustices such as ""ethnic cleansing"" in Bosnia or starvation in Somalia. With millions of lives at stake, is war ever justified? And, if so, for what purpose? In this book, Richard J. Regan confronts these controversial questions by first considering the basic principles of just-war theory and then applying (...) those principles to historical and ongoing conflicts. Part One presents two opposing viewpoints: first, that war is not subject to moral norms and, second, that war is never morally permissible. The author rejects both perspectives, and moves to define the principles of just-war theory. He evaluates the roles of the president, Congress and, most importantly, the UN Security Council in determining when long-term US military involvement is justified. The moral limits of war conduct and the moral problem of using, or threatening to use, nuclear weapons are also discussed. On the just cause to wage war, Regan argues that defense of nations and nationals - whether in self-defense or in defense of others - remains the ""only"" classical cause that in the modern world would justify resorting to war. With respect to military intervention in secessionist and revolutionary wars, he contends that such intervention might be justified, but that prudence dictates extreme caution. In considering acceptable war conduct, Regan elaborates the specific principle of discrimination and proportionality; he maintains that civilians uninvolved in the enemy's war should not be directly targeted and that the costs of military action must be proportionate to the anticipated benefits of destroying military targets. The second part of the book presents case studies of eight historical wars - World War I, the Vietnam War, the Falklands War, the revolution and civil war in Nicaragua, the civil war in El Salvador, the Gulf War, the intervention in Somalia, and the Bosnian War - and poses several provocative questions about each. It invites readers and students to apply just-war principles to complex war-related situations and to understand the factual contingencies involved in moral judgements about war decisions. The book should be of particular interest to students of the moral issues of international relations and to readers interested more generally in philosophy, theology and political science. (shrink)

This book gives a descriptive analysis of specific Madhyamika texts. It compares the ideology of Kumarajiva (a translator of the four Madhyamika treatises 400 A.D.) with the ideologies of the three Chinese contemporaries - HuiYuan, Seng-Jui and Seng-Chao. It envisages an intercultural transmission of religious and philosophical ideas from India to China.

In “Theories of Justification,” Richard Fumerton begins an overview of several prominent positions on the nature of justification by isolating epistemic justification from nonepistemic justification. He also distinguishes between “having justification for a belief” and “having a justified belief,” arguing that the former is conceptually more fundamental. Fumerton then addresses the possibility that justification is a normative matter, suggesting that this possibility has little to offer as a concept of epistemic justification. He also critically examines more specific attempts to (...) capture the structure and content of epistemic justification. These include traditional foundationalism and variants thereof, externalist versions of foundationalism, contextualism, coherentism, and “mixed” theories which combine aspects of coherentism and foundationalism. (shrink)

If aesthetics is both surface and depth, impassioned immediacy yet also critical distance of judgment, how can this doubleness be held together in one ...

In this paper I defend what I call the argument from epistemic reasons against the moral error theory. I argue that the moral error theory entails that there are no epistemic reasons for belief and that this is bad news for the moral error theory since, if there are no epistemic reasons for belief, no one knows anything. If no one knows anything, then no one knows that there is thought when they are thinking, and no one knows that they (...) do not know everything. And it could not be the case that we do not know that there is thought when we believe that there is thought and that we do not know that we do not know everything. I address several objections to the claim that the moral error theory entails that there are no epistemic reasons for belief. It might seem that arguing against the error theory on the grounds that it entails that no one knows anything is just providing a Moorean argument against the moral error theory. I show that even if my argument against the error theory is indeed a Moorean one, it avoids Streumer's, McPherson's and Olson's objections to previous Moorean arguments against the error theory and is a more powerful argument against the error theory than Moore's argument against external world skepticism is against external world skepticism. (shrink)

A comprehensive exploration of the philosophical issues raised by mysticism. This work is a comprehensive study of the philosophical issues raised by mysticism. Mystics claim to experience reality in a way not available in normal life, a claim which makes this phenomenon interesting from a philosophical perspective. Richard H. Jones’s inquiry focuses on the skeleton of beliefs and values of mysticism: knowledge claims made about the nature of reality and of human beings; value claims about what is significant and (...) what is ethical; and mystical goals and ways of life. Jones engages language, epistemology, metaphysics, science, and the philosophy of mind. Methodological issues in the study of mysticism are also addressed. Examples of mystical experience are drawn chiefly from Buddhism and Advaita Vedanta, but also from Christianity, Judaism, Islam, and Daoism. “This is a significant extension of the seminal work by Walter Stace, Mysticism and Philosophy. That work has stimulated much literature, all of which Jones manages to review here. He critically extends Stace’s universal core and embeds it in a sophisticated discussion of the extent, range, and metaphysical implications of mysticism.” — Ralph W. Hood, Jr., coauthor of The Psychology of Religion: An Empirical Approach. (shrink)

Parkinson's disease (PD) is generally sporadic but a number of genetic diseases have parkinsonism as a clinical feature. Two dominant genes, α‐synuclein (SNCA) and leucine‐rich repeat kinase 2 (LRRK2), are important for understanding inherited and sporadic PD. SNCA is a major component of pathologic inclusions termed Lewy bodies found in PD. LRRK2 is found in a significant proportion of PD cases. These two proteins may be linked as most LRRK2 PD cases have SNCA‐positive Lewy bodies. Mutations in both proteins are (...) associated with toxic effects in model systems although mechanisms are unclear. LRRK2 is an intracellular signaling protein possessing both GTPase and kinase activities that may contribute to pathogenicity. A third protein, tau, is implicated as a risk factor for PD. We discuss the potential relationship between these genes and suggest a model for PD pathogenesis where LRRK2 is upstream of pathogenic effects through SNCA, tau, or both proteins. (shrink)

What system of morals should rational people select as the best for society? Using a contemporary psychological theory of action and of motivation, Richard Brandt's Oxford lectures argue that the purpose of living should be to strive for the greatest good for the largest number of people. Brandt's discussions range from the concept of welfare to conflict between utilitarian moral codes and the dictates of self-interest.