The view that exertion of effort determines praiseworthiness for an achievement is implicit in ‘no pain, no praise’-style objections to biomedical enhancement. On such views, if enhancements were t...

While pharmaceutical industry involvement in producing, interpreting, and regulating medical knowledge and practice is widely accepted and believed to promote medical innovation, industry-favouring biases may result in prioritizing corporate profit above public health. Using diabetes as our example, we review successive changes over forty years in screening, diagnosis, and treatment guidelines for type 2 diabetes and prediabetes, which have dramatically expanded the population prescribed diabetes drugs, generating a billion-dollar market. We argue that these guideline recommendations have emerged under pervasive industry (...) influence and persisted, despite weak evidence for their health benefits and indications of serious adverse effects associated with many of the drugs they recommend. We consider pharmaceutical industry conflicts of interest in some of the research and publications supporting these revisions, and in related standard-setting committees and oversight panels. We raise concern over the long-term impact of these multifaceted involvements. Rather than accept industry conflicts of interest as normal, needing only to be monitored and managed, we suggest challenging that normalcy, and ask: what are the real costs of tolerating such industry participation? We urge the development of a broader focus to fully understand and curtail the systemic nature of industry’s influence over medical knowledge and practice. (shrink)

ABSTRACT The technological revolution has created enormous opportunities for the provision of affordable, accessible, and flexible mental healthcare. Yet it also creates complexities and ethical challenges. While some of these challenges may be similar to face-to-face care, their nuance in the online milieu is different, as relationships, identities and boundaries in this setting are fluid, and there is an absence of physical presence. In this paper we consider the specific ethical complexities involved in the provision of a social networking intervention (...) for depression and problematic alcohol use involving providers and peers. We present a case in which clinicians encountered a participant who repeatedly expressed suicidal thoughts in this online forum, and reflect on how this situation was managed. In analyzing this case, we use relational ethics—which proposes that interpersonal relationships are the fulcrum for ethical decision-making and action—together with actor-network theory—which highlights the power of technology to transform and mediate social and ethical relationships. Our analysis demonstrates the need to move beyond human-centric approaches, to recognize the role of both human and non-human actors in shaping moral decisions and behavior in the provision of e-mental healthcare. (shrink)

Kathryn Gines's book details Hannah Arendt 's racial and conceptual biases against Black people in the US and post-colonial Africa. Gines makes original and significant contributions to feminist philosophy by applying various feminist and anticolonial strategies, including standpoint theory and multidirectionality, to Arendt 's political essays and concepts. Feminist critiques of Arendt in general and racial critiques of "Reflections on Little Rock" in particular are not new; however, Hannah Arendt and the Negro Question offers a novel and comprehensive (...) racial critique of Arendt 's major writings. Gines offers a "sustained analysis of Arendt 's treatment of the Black experience in the United States", as well as racial violence within the contexts of the American, French, and Haitian Revolutions, and French and British imperialism and colonialism. In this review I will offer an overview of the book as a whole, before evaluating the extent of Gines's critique as it pertains to Arendt 's misguided judgments and her theory of judgment. (shrink)

Five leading thinkers on the concept of 'rights' in an era of rightlessness Sixty years ago, the political theorist Hannah Arendt, deprived of her German citizenship as a Jew and in exile from her country, observed that before people can enjoy any of the 'inalienable' Rights of Man--before there can be any specific rights to education, work, voting, and so on--there must first be such a thing as 'the right to have rights.' The concept received little attention at the (...) time, but in our age of refugee crises and extra-state war, the phrase has become the center of a crucial and lively debate. Here five leading thinkers from varied disciplines, including history, law, and politics, discuss the critical issue of the basis of rights and the meaning of radical democratic politics today. (shrink)

ABSTRACT This article develops an Arendtian conception of resentment and shows that resentment as a response to injustice is in fact only possible within a community of persons engaged in moral and recognitive relations. While Arendt is better known for her work on forgiveness—characterized as a creative rather than vindictive response to injury—this article suggests that Arendt provides a unique way of thinking about resentment as essentially a response to another human's subjectivity. But when injury is massive, so beyond the (...) pale that the possibility of face-to-face human interaction is annihilated, the space for resentment is thereby destroyed. Ironically, while the absence of resentment might at first seem to be an unproblematically good thing, Arendt shows us that the loss of resentment actually signals the loss of the properly human realm. (shrink)

The Challenge of the Exception is the key that unlocked the ideas of Carl Schmitt, a leading political theorist and jurist who influenced the thoughts of, among others, Hannah Arendt, Carl Joachim Friedrich, Otto Kirchheimer, Hans Morgenthau, Franz Neumann, and Leo Strauss. Professor Schwab clearly articulates Schmitt's key concepts and relates their centrality to politics and the state, to the political theory of liberalism, democracy and authoritarianism, and to international relations. When Schwab treats Schmitt's interpretations of constitutional questions, for (...) example, he shows how political theory in Germany is inextricably linked with constitutional law, legal theory, and the country's history. Not content to merely deal with Schmitt's profound contributions to twentieth-century thought, Schwab devotes considerable space to the unconscionable compromises that he made with the Third Reich. This, however, failed to help him become the political and legal theorist of Hitler's Germany. Schwab shows how the new Schmitt was suspect from the beginning and, by 1936, Schmitt the hunter had become Schmitt the hunted. Schwab's presentation of the multifaceted Carl Schmitt exposes the reader to a truly interdisciplinary excursion into the humanities and social sciences. (shrink)

Hitler had a dream to rule the world, not only with the gun but also with his mind. He saw himself as a "philosopher-leader" and astonishingly gained the support of many intellectuals of his time. In this compelling book, Yvonne Sherratt explores Hitler's relationship with philosophers and uncovers cruelty, ambition, violence, and betrayal where least expected—at the heart of Germany's ivory tower. Sherratt investigates international archives, discovering evidence back to the 1920s of Hitler's vulgarization of noble thinkers of the past, (...) including Kant, Nietzsche, and Darwin. She reveals how philosophers of the 1930s eagerly collaborated to lend the Nazi regime a cloak of respectability: Martin Heidegger, Carl Schmitt, and a host of others. And while these eminent men sanctioned slaughter, Semitic thinkers like Walter Benjamin and opponents like Kurt Huber were hunted down or murdered. Many others, such as Theodor Adorno and Hannah Arendt, were forced to flee as refugees. The book portrays their fates, to be dispersed across the world as the historic edifice of Jewish-German culture was destroyed by Hitler. Sherratt not only confronts the past; she also tracks down chilling evidence of continuing Nazi sympathy in Western Universities today. (shrink)

_A gripping account of the philosophers who supported Hitler's rise to power and those whose lives were wrecked by his regime_ Hitler had a dream to rule the world, not only with the gun but also with his mind. He saw himself as a "philosopher-leader" and astonishingly gained the support of many intellectuals of his time. In this compelling book, Yvonne Sherratt explores Hitler's relationship with philosophers and uncovers cruelty, ambition, violence, and betrayal where least expected—at the heart of Germany's (...) ivory tower. Sherratt investigates international archives, discovering evidence back to the 1920s of Hitler's vulgarization of noble thinkers of the past, including Kant, Nietzsche, and Darwin. She reveals how philosophers of the 1930s eagerly collaborated to lend the Nazi regime a cloak of respectability: Martin Heidegger, Carl Schmitt, and a host of others. And while these eminent men sanctioned slaughter, Semitic thinkers like Walter Benjamin and opponents like Kurt Huber were hunted down or murdered. Many others, such as Theodor Adorno and Hannah Arendt, were forced to flee as refugees. The book portrays their fates, to be dispersed across the world as the historic edifice of Jewish-German culture was destroyed by Hitler. Sherratt not only confronts the past; she also tracks down chilling evidence of continuing Nazi sympathy in Western Universities today. (shrink)

Science frequently gives us multiple, compatible ways of solving the same problem or formulating the same theory. These compatible formulations change our understanding of the world, despite providing the same explanations. According to what I call "conceptualism," reformulations change our understanding by clarifying the epistemic structure of theories. I illustrate conceptualism by analyzing a typical example of symmetry-based reformulation in chemical physics. This case study poses a problem for "explanationism," the rival thesis that differences in understanding require ontic explanatory differences. (...) To defend conceptualism, I consider how prominent accounts of explanation might accommodate this case study. I argue that either they do not succeed, or they generate a skeptical challenge. (shrink)

We argue that Hamiltonian mechanics is more fundamental than Lagrangian mechanics. Our argument provides a non-metaphysical strategy for privileging one formulation of a theory over another: ceteris paribus, a more general formulation is more fundamental. We illustrate this criterion through a novel interpretation of classical mechanics, based on three physical conditions. Two of these conditions suffice for recovering Hamiltonian mechanics. A third condition is necessary for Lagrangian mechanics. Hence, Lagrangian systems are a proper subset of Hamiltonian systems. Finally, we provide (...) a geometric interpretation of the principle of stationary action and rebut arguments for privileging Lagrangian mechanics. (shrink)

The paper argues that ‘All varieties of gratitude are only overall fitting when targeted towards agents,’ for instance that any variety of gratitude for the beautiful sunset is only overall fitting if a supernatural agent such as God exists. The first premise is that ‘Prepositional gratitude is overall fitting only when targeted towards agents.’ For this premise, intuitive judgments are offered. The second premise is that ‘Prepositional gratitude is the paradigmatic variety of gratitude.’ For this premise, an aspect of the (...) common consent of philosophers about gratitude is noted and the metaphysical basicness of prepositional gratitude is argued for. This gives the intermediate conclusion that ‘The paradigmatic variety of gratitude is overall fitting only when targeted towards agents.’ The fourth premise is that ‘If the paradigmatic variety of gratitude is overall fitting only when targeted towards agents, then all varieties of gratitude are overall fitting only when targeted towards agents.’ To supply the conditional of this premise, the Paradigmatic Fittingness Principle is offered, which states that ‘Paradigmatic emotions set the fittingness conditions for their non-paradigmatic varieties.’ This principle is argued for by noting that it vindicates some popular and plausible intuitive judgements and gives an error theory of why one might think that gratitude could be fittingly targeted towards non-agents, and by suggesting the absence of any other plausible source of fittingness conditions for non-paradigmatic emotions. (shrink)

Accounts of scientific explanation disagree about what’s required for a cause, law, or other fact to be a reason why an event occurs. In short, they disagree about the conditions for explanatory relevance. Nonetheless, most accounts presuppose that claims about explanatory relevance play a descriptive role in tracking reality. By rejecting the need for this descriptivist assumption, I develop an expressivist account of explanatory relevance and explanation: to judge that an answer is explanatory is to express an attitude ofbeing for (...) being satisfied by that answer. I show how expressivism vindicates ordinary scientific discourse about explanation, including claims about the objectivity and mind-independence of explanations. By avoiding commitment to ontic relevance relations, I rehabilitate an irrealist conception of explanation. (shrink)

The paper argues that ‘All varieties of gratitude are only overall fitting when targeted towards agents,’ for instance that any variety of gratitude for the beautiful sunset is only overall fitting if a supernatural agent such as God exists. The first premise is that ‘Prepositional gratitude is overall fitting only when targeted towards agents.’ For this premise, intuitive judgments are offered. The second premise is that ‘Prepositional gratitude is the paradigmatic variety of gratitude.’ For this premise, an aspect of the (...) common consent of philosophers about gratitude is noted and the metaphysical basicness of prepositional gratitude is argued for. This gives the intermediate conclusion that ‘The paradigmatic variety of gratitude is overall fitting only when targeted towards agents.’ The fourth premise is that ‘If the paradigmatic variety of gratitude is overall fitting only when targeted towards agents, then all varieties of gratitude are overall fitting only when targeted towards agents.’ To supply the conditional of this premise, the Paradigmatic Fittingness Principle is offered, which states that ‘Paradigmatic emotions set the fittingness conditions for their non-paradigmatic varieties.’ This principle is argued for by noting that it vindicates some popular and plausible intuitive judgements and gives an error theory of why one might think that gratitude could be fittingly targeted towards non-agents, and by suggesting the absence of any other plausible source of fittingness conditions for non-paradigmatic emotions. (shrink)

One strategy in recent discussions of theological fatalism is to draw on Harry Frankfurt’s famous counterexamples to the principle of alternate possibilities (PAP) to defend human freedom from divine foreknowledge. For those who endorse this line, “Frankfurt counterexamples” are supposed to show that PAP is false, and this conclusion is then extended to the foreknowledge case. This makes it critical to determine whether Frankfurt counterexamples perform as advertised, an issue recently debated in this journal via a pair of articles by (...) David Widerker and John Martin Fischer. I suggest that this debate can be avoided: divine foreknowledge is itself aparadigmatic counterexample to PAP, requiring no support from suspect Frankfurt counterexamples. (shrink)

The Wigner--Eckart theorem is central to the application of symmetry principles throughout atomic, molecular, and nuclear physics. Nevertheless, the theorem has a puzzling feature: it is dispensable for solving problems within these domains, since elementary methods suffice. To account for the significance of the theorem, I first contrast it with an elementary approach to calculating matrix elements. Next, I consider three broad strategies for interpreting the theorem: conventionalism, fundamentalism, and conceptualism. I argue that the conventionalist framework is unnecessarily pragmatic, while (...) the fundamentalist framework requires more ontological commitments than necessary. Conceptualism avoids both defects, accounting for the theorem's significance in terms of how it epistemically restructures the calculation of matrix elements. Specifically, the Wigner--Eckart theorem modularizes and unifies matrix element problems, thereby changing what we need to know to solve them. (shrink)

Early in Peter Abelard's Dialogue between a Philosopher, a Jew, and a Christian, the philosopher and the Christian easily come to agreement about what the point of ethics is: “[T]he culmination of true ethics … is gathered together in this: that it reveal where the ultimate good is and by what road we are to arrive there.” They also agree that, since the enjoyment of this ultimate good “comprises true blessedness,” ethics “far surpasses other teachings in both usefulness and worthiness.” (...) As Abelard understood them, both fundamental elements of his twelfth-century ethical culture — Greek philosophy and Christian religion — held a common view of the nature of ethical inquiry, one that was so obvious to them that his characters do not even state it in a fully explicit way. They take for granted, as we take the ground we stand on, the premise that the most important function of ethical theory is to tell you what sort of life is most desirable, or most worth living. That is, the point of ethics is that it is good for you, that it serves your self-interest. (shrink)

Health professionals are involved in humanitarian assistance and development work in many regions of the world. They participate in primary health care, immunization campaigns, clinic- and hospital-based care, rehabilitation and feeding programs. In the course of this work, clinicians are frequently exposed to complex ethical issues. This paper examines how health workers experience ethics in the course of humanitarian assistance and development work. A qualitative study was conducted to consider this question. Five core themes emerged from the data, including: tension (...) between respecting local customs and imposing values; obstacles to providing adequate care; differing understandings of health and illness; questions of identity for health workers; and issues of trust and distrust. Recommendations are made for organizational strategies that could help aid agencies support and equip their staff as they respond to ethical issues. (shrink)

The use of deception and dishonesty is widely accepted as a fact of life in policing. This paper thus defends a counterintuitive claim: Good faith is a normative foundation for the police as a political institution. Good faith is a core value of contracts, and policing is contractual in nature both broadly (as a matter of social contract theory) and narrowly (in regard to concrete encounters between law enforcement officers and the public). Given the centrality of good faith to policing, (...) dishonesty and deception on par with fraud are justified only as a narrowly circumscribed investigative tool that is constrained by institutional commitments to the fair distribution of security and the rule of law. The practical upshot is the preclusion of most dishonest and deceptive police tactics on par with fraud, leading to an institution that is less proactive and more reactive. (shrink)

It is argued that God cannot be a fitting target of prepositional gratitude. The first premise is that if someone cannot be benefited, then they cannot be a fitting target of prepositional gratitude. The second premise is that God cannot be benefited. Concerning the first premise, it is argued that a necessary component of prepositional gratitude is the desire to benefit one’s benefactor. Then it is argued that such a desire is fitting only if one’s benefactor can in fact be (...) benefited. Concerning the second premise, it is noted that classical theism widely attributes blessedness to God. It is argued that if God is blessed then God necessarily has as much well-being as it is possible for God to have, and hence God cannot be benefited. Also noted are some ways in which God’s blessedness is compatible with less orthodox ideas about God’s passibility. The argument is then defended against eight objections. (shrink)

The aim of this review is to show the fruitfulness of using images of facial expressions as experimental stimuli in order to study how neural systems support biologically relevant learning as it relates to social interactions. Here we consider facial expressions as naturally conditioned stimuli which, when presented in experimental paradigms, evoke activation in amygdala–prefrontal neural circuits that serve to decipher the predictive meaning of the expressions. Facial expressions offer a relatively innocuous strategy with which to investigate these normal variations (...) in affective information processing, as well as the promise of elucidating what role the aberrance of such processing might play in emotional disorders. (shrink)

This paper argues that it cannot be fitting to blame God. I show that divine immutability, even on a weak conception, implies that God's ethical character cannot change. I then argue that blame aims at a change in the ethical character of the one blamed. This claim is directly intuitive, explains a wide set of intuitions about when blame is unfitting, and is implied by most of the theories blame offered in the philosophical literature. Since blame targeted at God aims (...) to change God's ethical character, an impossibility, such blame is not fitting. I then draw on this conclusion to sketch a new theodicy. I argue that a necessary condition on being blameworthy is that one can be blamed under some possible condition. So, God cannot be blameworthy. Further, I argue that if someone cannot be blameworthy, then they cannot do wrong. Wrong actions tend to make us blameworthy, but since God cannot be blameworthy nothing can tend to make him blameworthy – God cannot do wrong. (shrink)

It is argued that God cannot be a fitting target of prepositional gratitude. The first premise is that if someone cannot be benefited, then they cannot be a fitting target of prepositional gratitude. The second premise is that God cannot be benefited. Concerning the first premise, it is argued that a necessary component of prepositional gratitude is the desire to benefit one’s benefactor. Then it is argued that such a desire is fitting only if one’s benefactor can in fact be (...) benefited. Concerning the second premise, it is noted that classical theism widely attributes blessedness to God. It is argued that if God is blessed then God necessarily has as much well-being as it is possible for God to have, and hence God cannot be benefited. Also noted are some ways in which God’s blessedness is compatible with less orthodox ideas about God’s passibility. The argument is then defended against eight objections. (shrink)

Brian Ellis has argued that the assigning of forces is, in the final analysis, a matter of convention. This conclusion is backed by the premises (1) that forces and force-effects are necessary and sufficient for each other, and (2) that the classification of some state of affairs as a force-effect is at least partly conventional. We argue that the first premise is false, that the second premise is ambiguous as between several senses of "conventional," and finally that he has not (...) established that force-effects are conventional in the sense required for the conclusion he wishes to draw. (shrink)

Healthcare user fees present an important barrier for accessing services for the poorest (indigents) in Burkina Faso and selective removal of fees has been incorporated in national healthcare planning. However, establishing fair, effective and sustainable mechanisms for the removal of user fees presents important challenges. A participatory action-research project was conducted in Ouargaye, Burkina Faso, to test mechanisms for identifying those who are indigents, and funding and implementing user fee removal. In this paper, we explore stakeholder perceptions of ethical considerations (...) relating to participation and partnership arising in the action-research. (shrink)

Alan Baker’s enhanced indispensability argument supports mathematical platonism through the explanatory role of mathematics in science. Busch and Morrison defend nominalism by denying that scientific realists use inference to the best explanation to directly establish ontological claims. In response to Busch and Morrison, I argue that nominalists can rebut the EIA while still accepting Baker’s form of IBE. Nominalists can plausibly require that defenders of the EIA establish the indispensability of a particular mathematical entity. Next, I argue that IBE cannot (...) establish that any particular mathematical entity is indispensable. Mathematical entities do not compete with each other in the way physical unobservables do. This lack of competition enables alternative formulations of scientific explanations that use different, but compatible, mathematical entities. The compatibility of these explanations prevents IBE from establishing platonism. (shrink)

Period homeostasis is the defining characteristic of a biological clock. Strict period homeostasis is found for the ultradian clocks of eukaryotic microbes. In addition to being temperature-compensated, the period of these rhythms is unaffected by differences in nutrient composition or changes in other environmental variables. The best-studied examples of ultradian clocks are those of the ciliates Paramecium tetraurelia and Tetrahymena sp. and of the fission yeast, Schizosaccharomyces pombe. In these single cell eukaryotes, up to seven different parameters display ultradian rhythmicity (...) with the same, species- and strain-specific period. In fission yeast, the molecular genetic analysis of ultradian clock mechanisms has begun with the systematic analysis of mutants in identified candidate genes. More than 40 “clock mutants” have already been identified, most of them affected in components of major regulatory and signalling pathways. These results indicate a high degree of complexity for a eukaryotic clock mechanism. BioEssays 22:16–22, 2000. ©2000 John Wiley & Sons, Inc. (shrink)

Hobbes is known for bridging natural and political philosophy, but less attention has been given to how this distinguishes the Hobbesian conception of the self from individualist strands of liberalism. First, Hobbes’s determinism suggests a conception of the self in which externalities determine the will and what the self is at every moment. Second, there is no stable conception of the self because externalities keep it in a constant state of flux. The metaphysical underpinnings of his project downplay the notion (...) of a purely individualistic conception of the self, pointing to a positivist theory of criminology relying upon external forces. This theory is especially prescient with respect to twentieth-century variants of positivism that focus upon how social organization affects personality. In a sense, then, modern criminological theory is indebted to Hobbes’s focus upon the connections between externalities and the self; a focus that illuminates new ways of viewing responsibility and accountability. (shrink)

Health care professionals who travel from their home countries to participate in humanitarian assistance or development work experience distinctive ethical challenges in providing care and services to populations affected by war, disaster or deprivation. Limited information is available about organizational practices related to preparation and support for health professionals working with non-governmental organizations. In this article, we present one component of the results of a qualitative study conducted with 20 Canadian health care professionals who participated in international aid work. The (...) findings reported here relate to expatriate clinicians’ experiences and perceptions of ethics preparation, training and support. The strategies examined include pre-departure training and preparation, in-field supports and retrospective debriefing of ethical issues. Participants experienced a range of training and supports as beneficial for addressing ethical challenges in humanitarian assistance and development work. Participants also expressed ambivalence or scepticism about the benefits offered by specific modalities. This analysis can contribute to informing discussions of how organizations and individual practitioners can best develop, implement and utilize ethics training and support for international aid work. (shrink)

Prima facie, rule-consequentialism as a moral theory would correlate with the concerns of an omnibenevolent being should one exist. Indeed, such a being would be divine, and under the lenses of the three Abrahamic religions, would inter alia, also be omnipotent and omniscient. In this paper, I consider the attitude of such a being to rule-consequentialism in human society. I argue, from a probabilistic perspective, that the evidence of Abrahamic scripture confirms, to a degree, that God would judge rule-consequentialism to (...) be a sound moral theory in different societies. I also consider a similar argument from a secular perspective. (shrink)

The traditional doctrine of divine omniscience ascribes to God the fully exercised power to know all truths. but why is God’s excellence with respect to knowing not treated on a par with his excellence with respect to doing, where the latter requires only that God have the power to do all things? The prima facie problem with divine ”omni-knowledgeability’ -- roughly, being able to know whatever one wants to know whenever one wants to know it -- is that knowledge requires (...) an internal representation, whereas mere ”knowledgeability’ does not. I argue to the contrary that knowledge does not require an internal representation, and that even if it did, an omni-knowledgeable God would satisfy this requirement. omni-knowledgeability therefore represents a distinct understanding of God’s cognitive excellence while satisfying the traditional insistence on full omniscience. (shrink)

The paper investigates whether imaginative states about propositions can be assessed in terms of fittingness (also known as correctness, appropriateness, aptness). After characterizing propositional imaginings and explaining the idea of fittingness, I present some considerations in favour of the no conditions view: imagining seems to be the sort of action that cannot be done unfittingly, and imaginings have no external cognitive nor conative goals in light of which they could be unfitting. I then examine the local conditions view, that there (...) can be fittingness conditions on imaginings, but that these are inherited from the mental projects in which imaginings can play a role. Given that there are virtues of the imagination such as creativity and spontaneity, and given that imaginings are subject to purposive mechanisms, and given that there are cases in which it is unfitting to fail to imagine, I endorse the general conditions view, on which imaginings have a goal, and therefore fittingness conditions, even outside the context of mental projects. I then examine 4 versions of the general conditions view and argue that imaginings aim to make contents available to mental projects. (shrink)

Gerald Cohen's critique of John Rawls's theory of justice is that it is concerned only with the justice of social institutions, and must thus arbitrarily draw a line between those inequalities excluded and those allowed by the basic structure. Cohen claims that a proper concern with the interests of the least advantaged would rule out 'incentives' for 'talented' individuals. I argue that Rawls's assumption that the subject of justice is the basic structure of society does not arbitrarily restrict the concerns (...) of political justice, as Cohen claims. Further, I argue that it does not allow 'deep' inequalities within a just basic structure. When properly understood, Rawls's theory of justice is strongly egalitarian, taken as a theory of fairness in the way the burdens and benefits of social cooperation are distributed, even if it is not as egalitarian as Cohen wishes. (shrink)

Social, legal and health-care changes have created an increasing need for ethical review within end-of-life care. Multiprofessional clinical ethics committees (CECs) are increasingly supporting decision-making in hospitals and hospices. This paper reports findings from an analysis of formal summaries from CEC meetings, of one UK hospice, spanning four years. Using qualitative content analysis, five themes were identified: timeliness of decision-making, holistic care, contextual openness, values diversity and consensual understanding. The elements of an engaged clinical ethics in a hospice context is (...) not generally acknowledged nor its elements articulated. Findings from this study have the potential to explain some of the most challenging ethical problems and to contribute to their resolution. It may also guide future deliberation and raise CEC members' awareness of the recurrent issues and values of their CEC practice. (shrink)