This essay seeks to characterise the essential features of an equitable health care system in terms of the classical Aristotelian concepts of horizontal and vertical equity, the common language of “need” and the economic notion of cost-effectiveness as a prelude to identifying some of the more important issues of value that policy-makers will have to decide for themselves; the characteristics of health that can cause policy to be ineffective ; the information base that is required to support a policy directed (...) at securing greater equity, and the kinds of research that are needed to underpin such a policy. (shrink)

I first characterize a moral mistake in coercion. The principle of independence with which I criticize coercion seems also to condemn exchange. I propose an account of exchange from which it follows that exchange upholds independence after all. In support of that account I argue that, of the accounts of exchange that occur to me, only this one has the consequence that, on general assumptions, a person can take part in exchange while acting, intending, and believing with sufficient reason. I (...) argue that the hiring of very poor people by very rich people for labor from which the rich draw a substantial surplus does not give rise to an exchange of this kind. These instances of the wage labor relation resemble coercion insofar as they violate independence. (shrink)

This editorial provides a review of the current ways in which health economics is impacting on policy and reviews some of the key ethical and value-judgmental issues that commonly arise in and as a result of the work of economists. It also briefly highlights the contributions of the authors of this special issue of the journal, all of which illustrate how economists have approached ethical issues in health service policy , and some of which explore the major methodological matters that (...) arise and go on to discuss their potential as sources of conflict or harmony with other approaches to the same questions. (shrink)

A comprehensive treatment of selected aspects of developmental reading. Based on a mastery teaching philosophy and a diagnostic-prescriptive approach, this book relies heavily on the authors' practical experience in working with teachers, principals, and supervisors in many states and in Canada.

According to the acousmatic thesis defended by Roger Scruton and others, to hear sounds as music is to divorce them from the source or cause of their production. Non-acousmatic experience involves attending to the worldly cause of the sound; in acousmatic experience, sound is detached from that cause. The acousmatic concept originates with Pythagoras, and was developed in the work of 20th century musique concrète composers such as Pierre Schaeffer. The concept yields important insights into the nature of musical experience, (...) but Scruton's version of the acousmatic thesis cannot overcome objections arising from timbral and spatial aspects of music, which seem to relate sounds to the circumstances of their production. These objections arise in part from music's status as a performing art rooted in human gesture and behaviour. Hence I defend a two-fold thesis of "hearing-in", which parallels Richard Wollheim's concept of "seeing-in": both acousmatic and.. (shrink)

La nature de la conscience est au centre de la discussion actuelle sur la personne humaine. Bien que certains philosophes fassent de la conscience la clef fondamentale et de toute l'épistémologie, la plupart des scientifiques la réduisent aux intéractions complexes du cerveau. Le présent article tire sa matière de l'analyse que saint Thomas d'Aquin fait de cette notion dans son De Veritate . Il caractérise la conscience en termes de connaissance et d'application de la connaissance à l'agir. L'A. cherche à (...) donner une définition pour montrer que la conscience dépend directement d'un syllogisme pratique. (shrink)

Harris’ reply to our defence of the National Institute for Clinical Excellence’s (NICE) current cost-effectiveness procedures contains two further errors. First, he wrongly draws a conclusion from the fact that NICE does not and cannot evaluate all possible uses of healthcare resources at any one time and generally cannot know which National Health Service (NHS) activities would be displaced or which groups of patients would have to forgo health benefits: the inference is that no estimate is or can be made (...) by NICE of the benefits to be forgone. This is a non-sequitur. Second, he asserts that it is a flaw at the heart of the use of quality-adjusted life years (QALYs) as an outcome measure that comparisons between people need to be made. Such comparisons do indeed have to be made, but this is not a consequence of the choice of any particular outcome measure, be it the QALY or anything else. (shrink)