Democracy is not self‐executing. We have to make it work, and to make it work we have to understand it…Not only external vigilance, but unending self‐examination must be the perennial price of liberty, because the work of self‐government never ceases.
This publication of the proceedings of the first of a new series of colloquia to be held at the University of Western Ontario contains an opening address on existence and quantification by W. V. Quine and three symposia. The paper discussed in the first of these symposia, "Descartes' Ontological Argument" by Anthony Kenny, follows closely one chapter of Kenny's recent book on Descartes. Kenny's paper contains both an interesting account of Descartes' views and some challenging remarks about ontological arguments in (...) general. His paper is discussed in separate commentaries by Norman Malcolm and Terence Penelhum. An interesting feature of this volume is that some comments from the floor are recorded and included along with the regular commentaries. Ernest Sosa and Bernard Williams comment on Kenny's paper along with Malcolm and Penelhum. Kenny responds to all four commentators. The other two symposia follow a similar format. The second, "On Events and Event-descriptions," features a paper by R. M. Martin which focuses on the logic of event descriptions and their role in scientific explanation. Events for Martin are extensional entities, unlike facts, but like facts they are "fictitious in the sense of being handled on virtually." His views are discussed by Donald Davidson, R. J. Butler and Wesley Salmon. In the third symposium on "Existence Assumptions in Practical Thinking," Stephan Körner elaborates on his view of effective choice, relating his account to those of Hume, Kant, and Peirce on the specific topic of the relationship of choice and natural necessity. The commentaries of J. J. Thomson and Bernard Williams are helpful here in getting Körner to clarify his interesting views. In sum, this first colloquium at the University of Western Ontario features genuine philosophical communication on some important issues.--R. H. K. (shrink)
Publicity for (and laterly increased economic stringency which makes more likely), failures of care in the NHS engender concern for care quality while its assurance remains the subject of a fragmented and unhelpful literature. A selective attempt is made to examine some underlying principles by posing and answering three questions. What is the quality of care? What basic principles must be followed in defining `standards'? How then may quality be assured? Any definition of care must be multi-faceted and in common (...) use pervaded with the patients' pre-occupation with a search for cures. Nevertheless, it is argued that there are gains in restricting the technical use of the term `care' to those systematic processes of health services and their culture which impinge on the personal experience of patients and which fashion their response. In contemporary society care ought to be designed to restore and enhance the independence, dignity and choice of the patient. Although there is a contrary tendency to abandon problems of care to the professionals, standards for care should be judged ultimately not from the specialised professional but from the viewpoint of lay people whose behaviour in the outside world fashions those norms by which independence, dignity and choice are judged. A number of difficulties in identifying and securing improvements in care are discussed. In particular, it is argued that such is the interdependence of the style of management of an institution and the style of care it provides that enforcement of high quality care is likley to be a contradiction in terms. Only trained and sensitive staff can act intuitively and pre-emptively to prevent even incipient deterioration in care. They cannot carefully foster at all times the independence and dignity of their patients unless they are treated in a similar way as professional employees. As an initial step in improving the quality of care a simple start is urged upon implementing an inventory of checks. These are designed to establish the identification and operation of health care policies and practices which give appropriate recognition to the characteristics of care that patients and public expect, coming as they do from a lay rather than professional world. The article concludes with an appropriate inventory of questions to be put to professionals by those laymen who are increasingly imported into health care management through community representation (in CHCs) and staff participation (in joint consultation) and whose interest and concern should be harnessed appropriately. (shrink)