Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the (...) contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization. (shrink)

Patient competence, defined as the ability to reason, appreciate, understand, and express a choice is rarely discussed in patients with obsessive compulsive disorder, and coercive measures are seldom used. Nevertheless, a psychiatrist of psychologist may doubt whether OCD patients who refuse treatment understand their disease and the consequences of not being treated, which could result in tension between respecting the patient’s autonomy and beneficence. The purpose of this article is to develop a notion of competence that is grounded in clinical (...) practice and corresponds with the experiences of patients with obsessions and/or compulsions. We present a naturalistic case study giving both the patient’s and the therapist’s perspective based on in-depth interviews and a narrative analysis. The case study shows that competence is not merely an assessment by a therapist, but also a co-constructed reality shaped by the experiences and stories of patient and therapist. The patient, a medical student, initially told her story in a restitution narrative, focusing on cognitive rationality. Reconstructing the history of her disease, her story changed into a quest narrative where there was room for emotions, values and moral learning. This fitted well with the therapist’s approach, who used motivational interventions with a view to appealing to the patient’s responsibility to deal with her condition. We conclude that in practice both the patient and therapist used a quest narrative, approaching competence as the potential for practical reasoning to incorporate values and emotions. (shrink)

Introduction Stored human samples and the establishment of biobanks are increasing in the world. Along with this there are the questions of ethics that arise such as the correct method of obtaining informed consent for research on stored samples and the policies involved in collaborative research using collected samples. This study is an attempt to evaluate the researchers, academics and policy makers' views on these ethical aspects. Methods This was an anonymised study involving a Sri Lankan population of researchers, ethics (...) committee members, and policy makers. A self administered questionnaire was utilised as the study instrument. The questionnaire captured four major areas of interest: demographic characteristics of respondents, their attitudes on informed consent policy, their opinion on rights of collaborating researchers, their attitudes on dealing with international differences in regulatory frameworks. Results The study included 55 responders with 40/55 agreeing that donors should receive the option of giving informed consent for future research, with 31/55 considering multiple- type consent options most appropriate. Regarding the issue of shared samples in collaborative research majority agreed that source country ethics review committee approval was necessary 53/55. Conclusion The study concludes that sample donors should be given the option of giving advance consent to unspecified future research provided that future research is approved by an ethics committee. In collaborative research, it is necessary to involve ethics committees from donor countries in the research approval process. (shrink)

1. The present paper is a continuation of my “Self-Ownership, World Ownership, and Equality,” which began with a description of the political philosophy of Robert Nozick. I contended in that essay that the foundational claim of Nozick's philosophy is the thesis of self-ownership, which says that each person is the morally rightful owner of his own person and powers, and, consequently, that each is free to use those powers as he wishes, provided that he does not deploy them aggressively against (...) others. To be sure, he may not harm others, and he may, if necessary, be forced not to harm them, but he should never be forced to help them, as people are in fact forced to help others, according to Nozick, by redistributive taxation. (shrink)

Some ways of defending inequality against the charge that it is unjust require premises that egalitarians find easy to dismiss—statements, for example, about the contrasting deserts and/or entitlements of unequally placed people. But a defense of inequality suggested by John Rawls and elaborated by Brian Barry has often proved irresistible even to people of egalitarian outlook. The persuasive power of this defense of inequality has helped to drive authentic egalitarianism, of an old-fashioned, uncompromising kind, out of contemporary political philosophy. The (...) present essay is part of an attempt to bring it back in. (shrink)

G. A. Cohen was one of the most gifted, influential, and progressive voices in contemporary political philosophy. At the time of his death in 2009, he had plans to bring together a number of his most significant papers. This is the first of three volumes to realize those plans. Drawing on three decades of work, it contains previously uncollected articles that have shaped many of the central debates in political philosophy, as well as papers published here for the first time. (...) In these pieces, Cohen asks what egalitarians have most reason to equalize, he considers the relationship between freedom and property, and he reflects upon ideal theory and political practice. Included here are classic essays such as "Equality of What?" and "Capitalism, Freedom, and the Proletariat," along with more recent contributions such as "Fairness and Legitimacy in Justice," "Freedom and Money," and the previously unpublished "How to Do Political Philosophy." On ample display throughout are the clarity, rigor, conviction, and wit for which Cohen was renowned. Together, these essays demonstrate how his work provides a powerful account of liberty and equality to the left of Ronald Dworkin, John Rawls, Amartya Sen, and Isaiah Berlin. (shrink)

First published in 1978, this book rapidly established itself as a classicof modern Marxism.

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In this stimulating work of political philosophy, acclaimed philosopher G. A. Cohen sets out to rescue the egalitarian thesis that in a society in which distributive justice prevails, peopleâes material prospects are roughly equal. Arguing against the Rawlsian version of a just society, Cohen demonstrates that distributive justice does not tolerate deep inequality. In the course of providing a deep and sophisticated critique of Rawlsâes theory of justice, Cohen demonstrates that questions of distributive justice arise not only for the state (...) but also for people in their daily lives. The right rules for the macro scale of public institutions and policies also apply, with suitable adjustments, to the micro level of individual decision-making. Cohen also charges Rawlsâes constructivism with systematically conflating the concept of justice with other concepts. Within the Rawlsian architectonic, justice is not distinguished either from other values or from optimal rules of social regulation. The elimination of those conflations brings justice closer to equality. (shrink)

This book presents G. A. Cohen's Gifford Lectures, delivered at the University of Edinburgh in 1996. Focusing on Marxism and Rawlsian liberalism, Cohen draws a connection between these thought systems and the choices that shape a person's life. In the case of Marxism, the relevant life is his own: a communist upbringing in the 1940s in Montreal, which induced a belief in a strongly socialist egalitarian doctrine. The narrative of Cohen's reckoning with that inheritance develops through a series of sophisticated (...) engagements with the central questions of social and political philosophy. In the case of Rawlsian doctrine, Cohen looks to people's lives in general. He argues that egalitarian justice is not only, as Rawlsian liberalism teaches, a matter of rules that define the structure of society, but also a matter of personal attitude and choice. Personal attitude and choice are, moreover, the stuff of which social structure itself is made. Those truths have not informed political philosophy as much as they should, and Cohen's focus on them brings political philosophy closer to moral philosophy, and to the Judeo-Christian ethical tradition, than it has recently been. (shrink)

In his Tanner Lecture of 1979 called ‘Equality of What?’ Amartya Sen asked what metric egalitarians should use to establish the extent to which their ideal is realized in a given society. What aspect of a person’s condition should count in a fundamental way for egalitarians, and not merely as cause of or evidence of or proxy for what they regard as fundamental?

The logical status of abstraction principles, and especially Hume’s Principle, has been long debated, but the best currently availeble tool for explicating a notion’s logical character—permutation invariance—has not received a lot of attention in this debate. This paper aims to fill this gap. After characterizing abstraction principles as particular mappings from the subsets of a domain into that domain and exploring some of their properties, the paper introduces several distinct notions of permutation invariance for such principles, assessing the philosophical significance (...) of each. (shrink)

‘No matter what the grievance, and I'm sure that the Palestinians have some legitimate grievances, nothing can justify the deliberate targeting of innocent civilians. If they were attacking our soldiers it would be a different matter.’ (Dr. Zvi Shtauber, Israeli Ambassador to the United Kingdom, BBC Radio 4, May 1, 2003).

I argued in Karl Marx's Theory of History that the central claims of historical materialism are functional explanations, and I said that functional explanations are consequence explanations, ones, that is, in which something is explained by its propensity to have a certain kind of effect. I also claimed that the theory of chance variation and natural selection sustains functional explanations, and hence consequence explanations, of organismic equipment. In Section I I defend the thesis that historical materialism offers functional or consequence (...) explanations, and I reject Jon Elster's contention that game theory can, and should, assume a central role in the Marxist theory of society. In Section II I contrast functional and consequence explanation, thereby revising the position of Karl Marx's Theory of History, and I question whether evolutionary biology supports functional explanations. Section III is a critique of Elster's views on functional explanation, and Sections IV and V defend consequence explanation against metaphysical and epistemological doubts. A concluding section summarizes my present understanding of the status of historical materialist explanations. (shrink)

This chapter contains section titled: I II III IV V VI VII VIII IX X XI XII Coda Appendix Acknowledgements.

George Boole published the pamphlet The Mathematical Analysis of Logic in 1847. He believed that logic should belong to a universal mathematics that would cover both quantitative and nonquantitative research. With his pamphlet, Boole signalled an important change in symbolic logic: in contrast with his predecessors, his thinking was exclusively extensional. Notwithstanding the innovations introduced he accepted all traditional Aristotelean syllogisms. Nevertheless, some criticisms have been raised concerning Boole’s view of Aristotelean logic as the solution of algebraic equations. In order (...) to circumvent such criticisms, we show here how Boole’s conclusions may be deduced from the axioms and inference rules proposed in his pamphlet, from which Aristotle’s deductions in Prior Analytics (including those that are completed through an impossibility) can be stated as theorems. We clarify his method for dealing with both universal and particular premises by means of his symbol v and demystify some criticisms concerning the way he expressed particular premises. Boole’s conclusions for some of those premises for which according to Aristotle there is no deduction are also discussed. The deductive system presented here has the potential to provide a new perspective on Boole’s approach to logic in The Mathematical Analysis of Logic. (shrink)

Open peer commentary on the article “Examining the Role of Re-Presentation in Mathematical Problem Solving: An Application of Ernst von Glasersfeld’s Conceptual Analysis” by Victor V. Cifarelli & Volkan Sevim. Upshot: The key philosophical premise of von Glasersfeld’s radical constructivism is not necessary to the insightful conceptual analysis presented by Cifarelli and Sevim, which could benefit from abandoning it.

The article studies the implications for historical materialism of the failure of the socialist project in the Soviet Union. The author demonstrates that the said failure broadly confirms central historical materialist theses, which would have been difficult to sustain if the Russian revolution had succeeded in its goal of superseding capitalism and establishing a socialist society.

Now, we stand outcast and starving,Mid the wonders we have made….I belong to a school of thought which has been called analytical Marxism. Some of the partisans of this position, and that includes me, are deeply engaged by questions in moral and political philosophy which have not, in the past, attracted the attention of Marxists. We are concerned with exactly what a commitment to equality requires, and with exactly what sort of obligations productive and talented people have to people who (...) are relatively unproductive, or handicapped, or in special need. We seek a precise definition of what exploitation is, and we want to know exactly why it is wrong. (shrink)