Three major trends in American health policy are intersecting in a fascinating way. First, managed care has grown to become the most dominant form of health-care delivery, leading to reductions in health-care costs as insurers are able to influence health-care providers with financial incentives. Second, the present growth of managed care has slowed, almost to a standstill, largely on account of consumers questioning what effects these financial incentives are having on the care of patients — questioning that has been expressed (...) in particular through lawsuits against managed care companies.Third, we are experiencing a renewed interest in the existence of medical error and how it may be reduced as a result of the Institute of Medicine’s report, To Err Is Human: Building a Safer Health System. The most important aspect of this renaissance in error reduction has been its emphasis on health care as a system that can be made better through system-oriented change. The most frustrating aspect is that the IOM did not endorse change in malpractice liability, which consistently puts the impetus for reducing medical error on the individual provider rather than the system as a whole. (shrink)

Three major trends in American health policy are intersecting in a fascinating way. First, managed care has grown to become the most dominant form of health-care delivery, leading to reductions in health-care costs as insurers are able to influence health-care providers with financial incentives. Second, the present growth of managed care has slowed, almost to a standstill, largely on account of consumers questioning what effects these financial incentives are having on the care of patients — questioning that has been expressed (...) in particular through lawsuits against managed care companies.Third, we are experiencing a renewed interest in the existence of medical error and how it may be reduced as a result of the Institute of Medicine’s report, To Err Is Human: Building a Safer Health System. The most important aspect of this renaissance in error reduction has been its emphasis on health care as a system that can be made better through system-oriented change. The most frustrating aspect is that the IOM did not endorse change in malpractice liability, which consistently puts the impetus for reducing medical error on the individual provider rather than the system as a whole. (shrink)

Michael A. Petersa and Fazal Rizvib aBeijing Normal University, Beijing, PR China; bMelbourne University, Melbourne, Australia Our minds are still racing back and forth, longing for a return to ‘no...

Book reviewed in this article: Just Doctoring: Medical Ethics in the Liberal State. By Troyen A. Brennan. The Ends of Human Life: Medical Ethics in a Liberal Polity. By Ezekiel J. Emanuel.

History and Systems of Psychology provides an engaging introduction to the rich story of psychology's past. Retaining the clarity and accessibility praised by readers of earlier editions, this classic textbook provides a chronological history of psychology from the pre-Socratic Greeks to contemporary systems, research, and applications. The new edition also features expanded coverage of Eastern as well as Western traditions, influential women in psychology, professional psychology in clinical, educational, and social settings, and new directions in twenty-first century psychology as a (...) cognitive and a positive science. Assuming little prerequisite knowledge, the authors discuss the people, places, and concepts that have shaped psychology's story, and show that we remain fascinated by the same enduring questions that confronted our ancestors - namely, our wonder at our subjectivity and consciousness of self. The seventh edition is fully supported by robust pedagogical features, instructor resources, and a companion website to aid student learning. (shrink)

The essays in this volume present versions of feminism that are explicitly liberal, or versions of liberalism that are explicitly feminist. By bringing together some of the most respected and well-known scholars in mainstream political philosophy today, Amy R. Baehr challenges the reader to reconsider the dominant view that liberalism and feminism are 'incompatible.'.

In this unique volume, some of today's most eminent political philosophers examine the thought of John Rawls, focusing in particular on his most recent work. These original essays explore diverse issues, including the problem of pluralism, the relationship between constitutive commitment and liberal institutions, just treatment of dissident minorities, the constitutional implications of liberalism, international relations, and the structure of international law. The first comprehensive study of Rawls's recent work, The Idea of Political Liberalism will be indispensable for political philosophers (...) and theorists interested in contemporary political thought. (shrink)

_Just Doctoring_ draws the doctor-patient relationship out of the consulting room and into the middle of the legal and political arenas where it more and more frequently appears. Traditionally, medical ethics has focused on the isolated relationship of physician to patient in a setting that has left the physician virtually untouched by market constraints or government regulation. Arguing that changes in health care institutions and legal attention to patient rights have made conventional approaches obsolete, Troyen Brennan points the way (...) to a new, more aware and engaged medical ethics. The medical profession is no longer isolated, even theoretically, from the liberal, market-dominated state. Old ideas of physician beneficence and altruism must make way for a justice-based medical ethics, assuming a relationship between equals more compatible with liberal political philosophy. Brennan offers clinical examples of many of today's most challenging medical problems—from informed consent to care rationing and the repercussions of the HIV epidemic—and gives his recommendation for a new ethical perspective. This lively and controversial plea for a rethinking of medical ethics goes right to the heart of medical care at the end of the twentieth century. (shrink)

In this study, we used a word search puzzle paradigm to investigate age differences in the rate of information gain and the cues used to make patch-departure decisions in information foraging. The likelihood of patch departure increased as the profitability of the patch decreased generally. Both younger and older adults persisted past the point of optimality as defined by the marginal value theorem, which assumes perfect knowledge of the foraging ecology. Nevertheless, there was evidence that adults were rational in terms (...) of being sensitive to the change in RG for making the patch-departure decisions. However, given the limitations in cognitive resources and knowledge about the ecology, the estimation of RG may not be accurate. Younger adults were more likely to leave the puzzle as the long-term RG incrementally decreased, whereas older adults were more likely to leave the puzzle as the local RG decreased. However, older adults with better executive control were more likely to adjust their likelihood of patch-departure decisions to the long-term change in RG. Thus, age-dependent reliance on the long-term or local change in RG to make patch-departure decisions might be due to individual differences in executive control. (shrink)

Pickering & Garrod's (P&G's) call to study language processing in dialogue context is an appealing one. Their interactive alignment model is ambitious, aiming to explain the converging behavior of dialogue partners via both intra- and interpersonal priming. However, they ignore the flexible, partner-specific processing demonstrated by some recent dialogue studies. We discuss implications of these data.

_Just Doctoring_ draws the doctor-patient relationship out of the consulting room and into the middle of the legal and political arenas where it more and more frequently appears. Traditionally, medical ethics has focused on the isolated relationship of physician to patient in a setting that has left the physician virtually untouched by market constraints or government regulation. Arguing that changes in health care institutions and legal attention to patient rights have made conventional approaches obsolete, Troyen Brennan points the way (...) to a new, more aware and engaged medical ethics. The medical profession is no longer isolated, even theoretically, from the liberal, market-dominated state. Old ideas of physician beneficence and altruism must make way for a justice-based medical ethics, assuming a relationship between equals more compatible with liberal political philosophy. Brennan offers clinical examples of many of today's most challenging medical problems—from informed consent to care rationing and the repercussions of the HIV epidemic—and gives his recommendation for a new ethical perspective. This lively and controversial plea for a rethinking of medical ethics goes right to the heart of medical care at the end of the twentieth century. (shrink)

The search for 'ecological insights' in venerable Asian traditions of thought prompts questions about how such traditions understood humans in relation to nature. Answers which focus on philosophical and religious ideas may overlook culturally important understandings of people and places articulated within scientific and medical thinking. The paper tentatively explores the prospects for gleaning a form of ethics of place from the study of traditional Hindu and Chinese medical sources. Although there are serious problems with the idea that any unadulterated (...) assimilation from other traditions can take place, these sources can be thought of as incorporating a place-centred ethic. By looking closely at Francis Zimmerman's study of Hindu medicine, it is argued that a poetics of place can be ascribed to Ayurvedic discourses on health and disease. It may be possible to associate a similar poetics with classical Chinese medical worldviews, these being reconcilable with-though not the same as-contemporary ecological understandings of humans in relation to the world. Although no pristine reconstruction of Asian traditions of medical thought can be made, the conclusion of the present paper is that it would be wrong to dismiss these traditions as 'antienvironmental', based purely on the study of philosophical and religious texts. (shrink)

Work on dispositions focuses chiefly on dispositions that are manifested in dynamic causal processes. Williams, Neil. 2005. “Static and Dynamic Dispositions.” Synthese 146: 303–24 has argued that the focus on dynamic dispositions has been at the expense of a richer ontology of dispositions. He contends that we ought to distinguish between dynamic and static dispositions. The manifestation of a dynamic disposition involves some change in the world. The manifestation of a static disposition does not involve any change in the world. (...) In this paper, we concede that making a conceptual distinction between dynamic and static dispositions is useful and we allow that we can truthfully represent objects as manifesting static dispositions. However, we argue that the distinction is not ontologically deep. Rather, the truthmakers for our representations of static dispositions are actually dynamic dispositions to whose manifestations we may fail to be sensitive. (shrink)

There has been a strong tendency in recent years, in countries such as Australia and the United States, for governmental and corporate spokespersons to present advice and information that comes from independent scientific sources as if it were no better grounded than that from any other source. Such a leveling out of all advice and information into mere “opinion” has been a key strategy in the assertion of corporate and governmental control over public debate and policy. In this paper, we (...) aim to explore some of the factors that diminish the credibility and reliability of information within organizational structures, effectively undermining the value of that information; we argue for the importance of processes like those of peer review in maintaining the credibility and reliability of information that is so important to effective action and decision; and we also provide an analysis of the rationale that underpins such processes. One of our conclusions will be that processes like those of peer review succeed largely because of the way in which they depend upon, but also support, the dispersal of information and authority within an organizational structure so as to ensure both that information is accessible within the structure and also remains open to challenge and scrutiny. (shrink)

Parfit argues that survival, Not identity, Is the important thing in cases of personal resurrection, Fission, Etc. I argue that parfit's and dennett's well known cases--And fantasies about cloning and telecloning--Suggest a distinction between type and token persons, Memories, Intentions, Etc. Parfit is wrong, I suggest, To think survival more determinate than identity; with quine I hold that there is no objective matter to be right or wrong about.

_Exhausting Modernity_ is a bold new work on the exhaustion of our resources, both natural and human. Drawing on the insights of Marx and Freud, it provides a compelling analysis of the exhaustion pervading modern capitalism: environmental collapse, rising poverty levels and increasing global economic disparity. This is essential reading for political and social theorists, philosophers, economists, and all those interested in the environment.

Lacan was not an ahistorical post-structuralist. Starting from this controversial premiss, Teresa Brennan tells the story of a social psychosis. She begins by recovering Lacan's neglected theory of history which argued that we are in the grip of a psychotic's era which began in the seventeenth century and climaxes in the present. By extending and elaborating Lacan's theory, Brennan develops a general theory of modernity. Contrary to postmodern assumptions, she argues, we need general historical explanation. An understanding of (...) historical dynamics is essential if we are to make the connections between the outstanding facts of modernity - ethnocentrism, the relationship between the sexes and ecological catastrophe. (shrink)

In this landmark collection of original essays, outstanding feminist critics in Britain, France, and the United States present new perspectives on feminism and psychoanalysis, opening out deadlocked debates. The discussion ranges widely, with contributions from feminists identified with different, often opposed views on psychoanalytic criticism. The contributors reassess the history of Lacanian psychoanalysis and feminism, and explore the significance of its institutional context. They write against the received views on 'French feminism' and essentialism. A remarkable restatement of current positions within (...) psychoanalysis and feminism, the volume as a whole will change the terms of existing debates, and make its arguments and concerns more generally accessible. (shrink)

the standard reading of plato's Republic is that justice is predicated of the ideal city and of the philosophers, and that all other constitutions, both psychic and political, that are mentioned in the course of the dialogue are in some way or another defective and unjust. A non-standard reading appears to be gaining traction, however. Unorthodox Plato commentators such as Silverman, Jonas, Nakazawa, Braun, and Rowe argue that the ideal city—lovingly named 'Kallipolis'—is not just, that it is merely an improvement (...) upon, but not a complete cure for, the Luxurious City that is described immediately before it.1 If we want to gaze upon a just city, these unorthodox commentators propose, look no farther than the City of... (shrink)

Rousseau’s account of the “legislator” or “lawgiver” is commonly regarded as one of the most far-fetched, ominous, and baffling parts of his teaching in the Social Contract. In brief, Rousseau’s lawgiver seems to be a proto-totalitarian figure whose self-appointed mission is to found a political community by “denaturing” people at a single stroke and who may be a mere figment of Rousseau’s overheated imagination. Accordingly, this part of the Social Contract threatens to make a mockery of Rousseau’s claim to be (...) “taking men as they are and laws they can be,” as well as his claim that the combination of “ freedom and equality” is “the greatest good” in the civil state. Following and extending Rousseau’s own method of teaching by examples, however, this essay argues that Benjamin Franklin’s influence over the American republic—especially through his posthumous Autobiography—offers a prosaic example of the apparently fantastical phenomenon sketched by Rousseau. In fact, I argue that Franklin’s case corresponds more fully to Rousseau’s description than do any of Rousseau’s own examples (such as Moses, Lycurgus, and Numa) and that Franklin showed in practice what Rousseau suggested in theory: that a lawgiver can succeed without relying on coercion and without undercutting the equality that underlies a just society. Franklin’s denaturing influence, I suggest, has been crucial for the durability of republicanism in the United States, given the country’s size and diversity. (shrink)

How does trust operate under conditions of oppression? Little attention has been paid to how distrust may be both necessary and costly to its bearer. Distrust is clearly warranted under certain conditions, but do those conditions contribute to a reduction in one's overall well-being? More importantly, is there something about distrust itself (rather than the conditions that warrant it) that contributes to this reduction in well-being? In this essay, I explore these questions in depth. I explain what the costs of (...) distrust are and how they impede our well-being. I argue that the weakened development of trust through oppression has some important downstream consequences: namely, it requires the cultivation of skepticism as a virtue of distrust, which I argue should be included as one of Lisa Tessman's burdened virtues—those that are required for survival but that do not necessarily lead to the agent's flourishing. (shrink)

Attacks on ?closest continuer? and ?best candidate? theories of identity have something correct in them while still failing to discredit the theories they oppose. What follows from Noonan's and Wiggins's objections to such theories is that they need to be so formulated as not to deny the necessity of identity. The best metaphysics for best?candidate theories to adopt is one in which everyday objects are taken to transcend, in a certain sense, their life histories in given worlds. This metaphysics also (...) has the potential for solving problems about contingent identity, transworld identity, and the issue of haecceitism or individual essence. To develop the metaphysics, it is only necessary to follow through the analogy between worlds and times suggested by writers like Plantinga and Schlesinger. (shrink)

This article surveys recent feminist contributions to moral philosophy with an emphasis on those works which engage with debates within mainstream ethics. The article begins by examining a tension said to arise from the two criteria a theory must meet if it is to count as feminist moral theory: the women's experience requirement and the feminist conclusion requirement. Subsequent sections deal with feminist relational theories of rights, feminist work on responsibility and feminist contractarian approaches to ethics. A final section looks (...) at the application of some feminist moral theories to the problem of abortion. (shrink)