Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the procedural fairness of health financing decisions. The Accountability for Reasonableness Framework (A4R), which (...) is widely applied to assess procedural fairness, has primarily been used in priority-setting for purchasing decisions, with revenue mobilization and pooling receiving limited attention. Furthermore, the sufficiency of the A4R framework’s four criteria (publicity, relevance, revisions and appeals, and enforcement) has been questioned. Moreover, research in political theory and public administration (including deliberative democracy), public finance, environmental management, psychology, and health financing has examined the key features of procedural fairness, but these insights have not been synthesized into a comprehensive set of criteria for fair decision-making processes in health financing. A systematic study of how these criteria have been applied in decision-making situations related to health financing and in other areas is also lacking. This paper addresses these gaps through a scoping review. It argues that the literature across many disciplines can be synthesized into 10 core criteria with common philosophical foundations. These go beyond A4R and encompass equality, impartiality, consistency over time, reason-giving, transparency, accuracy of information, participation, inclusiveness, revisability and enforcement. These criteria can be used to evaluate and guide decision-making processes for financing UHC across different country income levels and health financing arrangements. The review also presents examples of how these criteria have been applied to decisions in health financing and other sectors. (shrink)

Background The opioid epidemic has enabled rapid and unsurpassed use of big data on people with opioid use disorder to design initiatives to battle the public health crisis, generally without adequate input from impacted communities. Efforts informed by big data are saving lives, yielding significant benefits. Uses of big data may also undermine public trust in government and cause other unintended harms. Objectives We aimed to identify concerns and recommendations regarding how to use big data on opioid use in ethical (...) ways. Methods We conducted focus groups and interviews in 2019 with 39 big data stakeholders who had interest in or knowledge of the Public Health Data Warehouse maintained by the Massachusetts Department of Public Health. Results Concerns regarding big data on opioid use are rooted in potential privacy infringements due to linkage of previously distinct data systems, increased profiling and surveillance capabilities, limitless lifespan, and lack of explicit informed consent. Also problematic is the inability of affected groups to control how big data are used, the potential of big data to increase stigmatization and discrimination of those affected despite data anonymization, and uses that ignore or perpetuate biases. Participants support big data processes that protect and respect patients and society, ensure justice, and foster patient and public trust in public institutions. Recommendations for ethical big data governance offer ways to narrow the big data divide, enact shared data governance, cultivate public trust and earn social license for big data uses, and refocus ethical approaches. Conclusions Using big data to address the opioid epidemic poses ethical concerns which, if unaddressed, may undermine its benefits. Findings can inform guidelines on how to conduct ethical big data governance and in ways that protect and respect patients and society, ensure justice, and foster patient and public trust in public institutions. (shrink)

Involuntary civil commitment to treatment for opioid use disorder prevents imminent overdose, but also restricts autonomy and raises other ethical concerns. Using the Kass Public Health Ethics Framework, we identified ICC benefits and harms. Benefits include: protection of vulnerable, underserved patients; reduced legal consequences; resources for families; and “on-demand” treatment access. Harms include: stigmatizing and punitive experiences; heightened family conflict and social isolation; eroded patient self-determination; limited or no provision of OUD medications; and long-term overdose risk. To use ICC ethically, (...) it should be recognized as comprising vulnerable patients worthy of added protections; be a last resort option; utilize consensual, humanizing processes; provide medications and other evidence-based-treatment; integrate with existing healthcare systems; and demonstrate effective outcomes before diffusion. ICC to OUD treatment carries significant potential harms that, if unaddressed, may outweigh its benefits. Findings can inform innovations for ensuring that ICC is used in an ethically responsible way. (shrink)

Contemporary feminisms are ineluctably drawn into comparisons with historic discourses, forms of praxis and tactical repertoires. While this can underscore points of continuity and commonality in ongoing struggles, it can also result in nostalgia for a more unified and purposeful feminist politics. Kate Eichhorn argues that our interest in nostalgia should be to understand feminist temporalities, and in particular the specific context in which we experience such nostalgia. Accordingly, this article takes up the idea that neoliberalism and populism, which have (...) given rise to both neoliberal feminism and femonationalism, have produced a series of contestations regarding the purpose and nature of feminist politics, as expressed by white popular feminism in the United Kingdom. This article examines two dimensions of feminist nostalgia: first, nostalgia for a more radical form of feminist politics – one not co-opted by neoliberal forces, not individualistic and not centred around online activism; and second, a nostalgia for the idea of ‘sisterhood’ – a time before white feminists were called upon to engage with intersectionality or be inclusive of trans-women. We analyse these themes through analysis of white popular feminism produced in the United Kingdom between 2010 and 2020, cautioning against a feminist nostalgia which neglects to engage with the radical politics of intersectionality. (shrink)

Communication and Conflict Management Training for Clinical Bioethics Committees Content Type Journal Article Pages 341-349 DOI 10.1007/s10730-009-9116-7 Authors Lauren M. Edelstein, Johns Hopkins Medicine’s Howard County General Hospital 5755 Cedar Lane Columbia MD 21044 USA Evan G. DeRenzo, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Elizabeth Waetzig, Change Matrix Inc. 485 Maylin St. Pasadena CA 91105 USA Craig Zelizer, Georgetown University Department of Government 3240 Prospect St. Washington, D.C. NW 20057 USA Nneka (...) O. Mokwunye, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume 21, Number 4. (shrink)

Within any organization (e.g. a hospital or clinic) the perception of the way things operate may vary dramatically as a function of one’s location in the organizational hierarchy as well as one’s professional discipline. Interorganizational variability depends on organizational coherence, safety, and stability. In this four-nation (Canada, Ireland, Australia, and Korea) qualitative study of 42 nurses, we explored their perception of how ethical decisions are made, the nurses’ hospital role, and the extent to which their voices were heard. These nurses (...) suggested that their voices were silenced (often voluntarily) or were not expressed in terms of ethical decision making. Finally, they perceived that their approach to ethical decision making differed from physicians. (shrink)

In this paper I argue that Gareth Evans’ famous proof of the impossibility of de re indeterminate identity fails on a counterpart-theoretic interpretation of the determinacy operators. I attempt to motivate a counterpart-theoretic reading of the determinacy operators and then show that, understood counterpart-theoretically, Evans’ argument is straightforwardly invalid.

Fundamental problems of environmental sustainability, including climate change and fisheries management, require collective action on a scale that transcends the political and cultural boundaries of the nation-state. Rational, self-interested neoclassical economic theories of human behavior predict tragedy in the absence of third party enforcement of agreements and practical difficulties that prevent privatization. Evolutionary biology offers a theory of cooperation, but more often than not in a context of discrimination against other groups. That is, in-group boundaries are necessarily defined by those (...) excluded as members of out-groups. However, in some settings human’s exhibit behavior that is inconsistent with both rational economic and group driven cooperation of evolutionary biological theory. This paper reports the results of a non-cooperative game-theoretic exercise that models a tragedy of the commons problem in which groups of players may advance their own positions only at the expense of other groups. Students enrolled from multiple universities and assigned to different multi-university identity groups participated in experiments that repeatedly resulted in cooperative outcomes despite intergroup conflicts and expressions of group identity. We offer three possible explanations: students were cooperative because they were in an academic setting; students may have viewed their instructors as the out-group; or the emergence of a small number of influential, ethical leaders is sufficient to ensure cooperation amongst the larger groups. From our data and analysis, we draw out lessons that may help to inform approaches for institutional design and policy negotiations, particularly in climate change management. (shrink)

We discuss arguments against the thesis that the world itself can be vague. The first section of the paper distinguishes dialectically effective from ineffective arguments against metaphysical vagueness. The second section constructs an argument against metaphysical vagueness that promises to be of the dialectically effective sort: an argument against objects with vague parts. Firstly, cases of vague parthood commit one to cases of vague identity. But we argue that Evans' famous argument against will not on its own enable one (...) to complete the reductio in the present context. We provide a metaphysical premise that would complete the reductio, but note that it seems deniable. We conclude by drawing general morals from our case study. (shrink)

This text of Elizabeth Fox-Genovese's is published posthumously in the context of pieces dedicated to her memory. It is unclear whether she intended it for eventual publication or whether she had intended it as a lecture; nor is there decisive evidence for a date of composition. In it, she reviews the stance of feminist literary criticism toward religion and finds it to be generally negative. She regrets that feminist critics see in religion mostly a means of subordinating women to (...) men, given that most of the writers whose work they explicate were themselves fervently religious. She then examines the feminization of religion in nineteenth-century America and the growing idea at the time of female moral stewardship. After examining the contrasting approaches taken to the process of feminization by Harriet Beecher Stowe and Elizabeth Cady Stanton, Fox-Genovese then takes as her main case Augusta Jane Evans's novels Beulah and St. Elmo. She argues that feminist critics, in concentrating on questions about the marriage or independence of Evans's characters miss Evans's central concern, which was the loss and recovery of her characters' faith. The feminist critics (given their hostility to religion) misunderstand that Evans's stance was not one against female individualism, but rather (given her commitment as a Christian) a stance against the unbridled individualism of modern American society. (shrink)

This set reprints a wide range of key articles exploring the role of feminists in the development of post-Enlightenment thought. Including groundbreaking work from the 1970s, 1980s and 1990s, with pieces by Sandra Harding, Julia Kristeva, Gayatri Chakravorty Spivak, Elizabeth Spelman, and other internationally-esteemed scholars, the collection features an original introduction and comprehensive index, making this an invaluable resource for women's studies students in a wide range of subject areas. For a full listing of contents, visit www.routledge-ny.com and type (...) the isbn into the search engine. (shrink)

Elizabeth Barnes and Robert Williams have developed a theory of metaphysical indeterminacy, via which they defend the theoretical legitimacy of vague objects. In this paper, we argue that while the Barnes–Williams theory supplies a viable account of genuine metaphysical vagueness, it cannot underwrite an account of genuinely vague objects. First we clarify the distinction between these two key theses. Then we argue that the Barnes–Williams theory of metaphysical vagueness not only fails to deliver genuinely vague objects, it in fact (...) provides grounds for rejecting them. (shrink)

I explore how rational belief and rational credence relate to evidence. I begin by looking at three cases where rational belief and credence seem to respond differently to evidence: cases of naked statistical evidence, lotteries, and hedged assertions. I consider an explanation for these cases, namely, that one ought not form beliefs on the basis of statistical evidence alone, and raise worries for this view. Then, I suggest another view that explains how belief and credence relate to evidence. My view (...) focuses on the possibilities that the evidence makes salient. I argue that this makes better sense of the difference between rational credence and rational belief than other accounts. (shrink)

In this paper, I argue that the relationship between belief and credence is a central question in epistemology. This is because the belief-credence relationship has significant implications for a number of current epistemological issues. I focus on five controversies: permissivism, disagreement, pragmatic encroachment, doxastic voluntarism, and the relationship between doxastic attitudes and prudential rationality. I argue that each debate is constrained in particular ways, depending on whether the relevant attitude is belief or credence. This means that epistemologists should pay attention (...) to whether they are framing questions in terms of belief or in terms of credence and the success or failure of a reductionist project in the belief-credence realm has significant implications for epistemology generally. (shrink)

Why our workplaces are authoritarian private governments—and why we can’t see it One in four American workers says their workplace is a “dictatorship.” Yet that number almost certainly would be higher if we recognized employers for what they are—private governments with sweeping authoritarian power over our lives. Many employers minutely regulate workers’ speech, clothing, and manners on the job, and employers often extend their authority to the off-duty lives of workers, who can be fired for their political speech, recreational activities, (...) diet, and almost anything else employers care to govern. In this compelling book, Elizabeth Anderson examines why, despite all this, we continue to talk as if free markets make workers free, and she proposes a better way to think about the workplace, opening up space for discovering how workers can enjoy real freedom. (shrink)

Belief-credence dualism is the view that we have both beliefs and credences and neither attitude is reducible to the other. Pragmatic encroachment is the view that practical stakes can affect the epistemic rationality of states like knowledge or justified belief. In this paper, I argue that dualism offers a unique explanation of pragmatic encroachment cases. First, I explain pragmatic encroachment and what motivates it. Then, I explain dualism and outline a particular argument for dualism. Finally, I show how dualism can (...) explain the intuitions that underlie pragmatic encroachment. My basic proposal is that in high-stakes cases, it is not that one cannot rationally believe that p; instead, one ought not to rely on one's belief that p. One should rather rely on one's credence in p. I conclude that we need not commit ourselves to pragmatic encroachment in order to explain the intuitiveness of the cases that motivate it. (shrink)

Permissivism is the view that there are evidential situations that rationally permit more than one attitude toward a proposition. In this paper, I argue for Intrapersonal Belief Permissivism (IaBP): that there are evidential situations in which a single agent can rationally adopt more than one belief-attitude toward a proposition. I give two positive arguments for IaBP; the first involves epistemic supererogation and the second involves doubt. Then, I should how these arguments give intrapersonal permissivists a distinct response to the toggling (...) objection. I conclude that IaBP is a view that philosophers should take seriously. (shrink)

Permissivism is the thesis that, for some body of evidence and a proposition p, there is more than one rational doxastic attitude any agent with that evidence can take toward p. Proponents of uniqueness deny permissivism, maintaining that every body of evidence always determines a single rational doxastic attitude. In this paper, we explore the debate between permissivism and uniqueness about evidence, outlining some of the major arguments on each side. We then consider how permissivism can be understood as an (...) underdetermination thesis, and show how this moves the debate forward in fruitful ways: in distinguishing between different types of permissivism, in dispelling classic objections to permissivism, and in shedding light on the relationship between permissivism and evidentialism. (shrink)

Face perception, perhaps the most highly developed visual skill in humans, is mediated by a distributed neural system in humans that is comprised of multiple, bilateral regions. We propose a model for the organization of this system that emphasizes a distinction between the representation of invariant and changeable aspects of faces. The representation of invariant aspects of faces underlies the recognition of individuals, whereas the representation of changeable aspects of faces, such as eye gaze, expression, and lip movement, underlies the (...) perception of information that facilitates social communication. The model is also hierarchical insofar as it is divided into a core system and an extended system. The core system is comprised of occipitotemporal regions in extrastriate visual cortex that mediate the visual analysis of faces. In the core system, the representation of invariant aspects is mediated more by the face-responsive region in the fusiform gyrus, whereas the representation of changeable aspects is mediated more by the face-responsive region in the superior temporal sulcus. The extended system is comprised of regions from neural systems for other cognitive functions that can be recruited to act in concert with the regions in the core system to extract meaning from faces. (shrink)

I. Causal Thesis: Dispositions have a causal basis. II. Distinctness Thesis: Dispositions are distinct from their causal basis. III. Impotence Thesis: Dispositions are not causally active.

In this article, I argue that faith’s going beyond the evidence need not compromise faith’s epistemic rationality. First, I explain how some of the recent literature on belief and credence points to a distinction between what I call B-evidence and C-evidence. Then, I apply this distinction to rational faith. I argue that if faith is more sensitive to B-evidence than to C-evidence, faith can go beyond the evidence and still be epistemically rational.

Many think that Pascal’s Wager is a hopeless failure. A primary reason for this is because a number of challenging objections have been raised to the wager, including the “many gods” objection and the “mixed strategy” objection. We argue that both objections are formal, but not substantive, problems for the wager, and that they both fail for the same reason. We then respond to additional objections to the wager. We show how a version of Pascalian reasoning succeeds, giving us a (...) reason to pay special attention to the infinite consequences of our actions. (shrink)

I defend belief-credence dualism, the view that we have both beliefs and credences and both attitudes are equally fundamental. First, I explain belief, credence, and three views on their relationship. Then, I argue for dualism. I do so first by painting a picture of the mind on which belief and credence are two cognitive tools that we use for different purposes. Finally, I respond to two objections to dualism. I conclude that dualism is a promising view, and one that both (...) epistemologists and philosophers of mind should take seriously. (shrink)

We argue for the addition of trauma informed awareness, training, and skill in clinical ethics consultation by proposing a novel framework for Trauma Informed Ethics Consultation (TIEC). This approach expands on the American Society for Bioethics and Humanities (ASBH) framework for, and key insights from feminist approaches to, ethics consultation, and the literature on trauma informed care (TIC). TIEC keeps ethics consultation in line with the provision of TIC in other clinical settings. Most crucially, TIEC (like TIC) is systematically sensitive (...) to culture, history, difference, power, social exclusion, oppression, and marginalization. By engaging a neonatal intensive care ethics consult example, we define our TIEC approach and illustrate its application. Through TIEC we argue it is the role of ethics consultants to not only hold open moral spaces, but to furnish them in morally habitable ways for all stakeholders involved in the ethics consultation process, including patients, surrogates, and practitioners. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:AQUINAS AND THE LIBERATIONIST CRITIQUE OF MARITAIN'S NEW CHRISTENDOM I. RADITIONALLY CHRISTIANS have understood hat God's Kingdom is not of this world. It is not surprising, then, that history evinces some Christian difficulty in relating to thi's world. One aittitude takes ·a merely indirect interest in the world. Temporal activity is directed to the Church and its mission of saving souls. In this attitude the world has only an (...) instrumental value.1 Another attitude consists in a naive and innocent forgetfulness of temporal exigencies.2 A final one encompaisses 1 a disdain for temporal involvement.8 With its need for economic and political reform, the present century calls for a radical temporal engagement. For example, an indirect engagement by Catholics in the interest of the Church will not suffice. The Church shows an ability, even a resiliency, to exist in quite deficient temporal regimes. If the deficiencies of the present are to be remedied, it will be through the efforts of persons ·acknowledging more than an instrumental value to the temporal. Jacques Maritain, a Catholic layman, labored to establish the intellectual underpinnings for a radical Catholic engagement in the temporal. The masterpiece of this work is his In1 See Gustavo Gutierrez, A Theology of Liberation, trans. by Caridad Inda and John Eagleson (New York: Orbis Books, 1973), pp. 53-54. Jacques Maritain understands this "Political Augustinianism" as an unfortunate false inference from a medieval non-interest in the material order; see Integral Humanism, trans. by Joseph W. Evans (Notre Dame: University of Notre Dame Press, 1973), p. 12. As will be seen, Maritain wishes to transcend a merely instrumental valuation of the world; for example, see, ibid., pp. 176-7. 2 Maritain, op. oit., pp. 14-15, so characterizes the Middle Ages. 8 Ibid., pp. 102-3. 247 248 JOHN F. X.!{NASAS tegral HumaniMn. The text understands" humanism" in terms of a this-worldly perfection. Maritian says, Humanism tends essentially to render man more truly human, and to manifest his original greatness by having him participate in all that which can enrich him in nature and in history...; it at once demands that man develop the virtualities contained within him, his creative forces and the life of reason, and work to make the forces of the physical world instruments of his freedom.4 That human nature contains such temporal capacities, Maritain later calls the "ontosophic truth." In his Peasant of the Garonne, Maritain speaks of the natural end of the world. By " world " Maritain especially understands " our human universe, the universe of man, of culture and history in their development here below." 5 The end of this world is three-fold.6 First is the mastery of nature by man and also the securement of freedom from servitude to other men. Second is the development of the spiritual activities of man, especially knowledge in the forms of wisdom and natural Finally, of " the manifestation of all the potentialities of human nature." How does a Christian come to make a radical commitment to the realization of these temporal capacities? It is not through any forsaking of his eternal destiny. Rather, for Maritain the temporal engagement follows in and through a deeper appreciation of that eternal destiny. The focus of this deeper appreciation is Christian sanctity. For Maritain only the saint is the true humanist. Why? Maritain concedes that sanctity is first and foremost a love of God. But because God has made 4 Ibid., p. 2. 5.Jacques Maritain, The Peasamt of the Garonne, trans. by Michael O'uddih(Y and Elizabeth Hughes (New York: Holt, Rinehart and Winston, 1968), p. 39. 6 Ibid., pp. 40-1. See also Maritain's, On the Philosophy of History (New York: Charles Scribner's Sons, 1957), pp. 125-7. Another apparent reference to the ontosophic truth is Maritain's discussion of "felicite en mouvement," or "l'imparfaite felicite," in N euf Legons sur les Notions Premieres de la Philosophie Morale (Paris: Chez Pierre Tequi, 1949), pp. 99-102. For a diagrammatic rendering of the temporal and eternal planes, see Maritain, On Philosophy of History, p. 129. LIBERATIONIST CRITIQUE OF MARITAIN'S CHRISTENDOM 249 all in his likeness, the saint's... (shrink)

A popular objection to theistic commitment involves the idea that faith is irrational. Specifically, some seem to put forth something like the following argument: (P1) Everyone (or almost everyone) who has faith is epistemically irrational, (P2) All theistic believers have faith, thus (C) All (or most) theistic believers are epistemically irrational. In this paper, I argue that this line of reasoning fails. I do so by considering a number of candidates for what faith might be. I argue that, for each (...) candidate, either (P1) is false or (P2) is false. Then, I make two positive suggestions for how faith can be epistemically rational but nonetheless have a unique relationship to evidence: one, that Jamesian self-justifying attitudes describe a distinctive kind of faith in oneself and others, and two, that faith is not solely based on empirical evidence. (shrink)

What is the work ethic? Does it justify policies that promote the wealth and power of the One Percent at workers' expense? Or does it advance policies that promote workers' dignity and standing? Hijacked explores how the history of political economy has been a contest between these two ideas about whom the work ethic is supposed to serve. Today's neoliberal ideology deploys the work ethic on behalf of the One Percent. However, workers and their advocates have long used the work (...) ethic on behalf of ordinary people. By exposing the ideological roots of contemporary neoliberalism as a perversion of the seventeenth-century Protestant work ethic, Elizabeth Anderson shows how we can reclaim the original goals of the work ethic, and uplift ourselves again. Hijacked persuasively and powerfully demonstrates how ideas inspired by the work ethic informed debates among leading political economists of the past, and how these ideas can help us today. (shrink)