Possible distributive justice frameworks for providing health care by general practitioners are discussed. The ethical considerations before and after the recent changes to the British National Health Service are contrasted, with particular emphasis on a possible ethical divide that has been produced between fund-holding and non-fund-holding general practitioners. It is argued that general practitioners in non-fund-holding practices can continue as ethical advocates for their patients and distribute health care within an egalitarian framework. However, those in fund-holding practices may now be (...) seen as interest advocates and may have to practise utilitarian distributive justice. Patient groups may be needed to ensure that these general practitioners are seen to act justly in the distribution of the health care resources for which they are now responsible. (shrink)

Last year's meetings of the leaders of the party and government with groups of creative artists caused a stir in the field of esthetics, placed in the foreground discussion of questions concerning the theory of the realistic image, and led to an examination of the experience accumulated in the party's struggle for socialist realism. In recent years, as a consequence of the spread of mathematical methods of research into the social sciences and even into creative work, old doubts with respect (...) to the specific significance of the creative image in art have again arisen. For several years now, efforts have been made in esthetics to emphasize, as distinctive features of art, other factors in artistic creativity, more accessible to study by the techniques of the natural sciences. (shrink)

Joachim Schulte’s introduction provides a distinctive and masterful account of the full range of Wittgenstein’s thought. It is concise but not compressed, substantive but not overloaded with developmental or technical detail, informed by the latest scholarship but not pedantic. Beginners will find it accessible and seasoned students of Wittgenstein will appreciate it for the illuminating overview it provides.

This article is an attempt to evaluate the Oregon plan from the perspective of a Scandinavian national health care system. The Nordic welfare states are marked by a strong emphasis on equality. As an example of an egalitarian system we present the Norwegian health care model in part one. In part two, the arguments in favor of a one tier system in Norway are presented and compared to Oregon's two tier system. Although we argue, in part three, that a comparison (...) of the degree of explicitness in the prioritization process shows that Norway has much to learn from Oregon, we do believe that the Norwegian system has some attractive elements that may function as an important corrective. In part four we present the Norwegian Guidelines for priority-setting and discuss the weight assigned to the severity of disease criterion. It is argued that the exclusion of information about the severity of disease partly explains the counterintuitive ranking of treatment-condition pairs in Oregon's initial method based on the principle of health maximization. A normative analysis of the conflicting norms of efficiency and equality of results is called for. The final part of the paper is devoted to the problem of rigidity. Henry J. Aaron has argued that the Oregon system is insensitive to inter-individual variations within each diagnosis-treatment pair. This objection is a severe one, since the system might end up treating patients unfairly on the individual level. To overcome this problem, we suggest a selection rule that should be more capable of dealing with the problem of rigidity. (shrink)

In the anthropology of Gregory of Elvira there converge different lines of thought. On the one hand he is very dependent on Origen, on the other there is to be found in him the mental framework of Irenaeus and he quotes word for word long passages from Tertullian. The article attempts to determine to what extent, starting from those influences he encountered, Gregory has developed a personal vision of the relationship between Adam and Christ along the double line of the (...) Pauline parallel : sin and grace, initial creation and eschatological fulfilment. If some characteristic passages stress much this second aspect, the majority of the texts analyzed concentrate primarily on the theme of redemption. The reason for the prefiguration of Christ in the creation of Adam, so important for Irenaeus and Tertullian, does not have in Gregory the prominent place which one might have expected to find. (shrink)

The relation between Jesus and the Spirit appears in diverse occasions and in different contexts in Gregory. Jesus has sanctified the waters in his baptism, from his body springs the Spirit whom he has received in the Jordan, he is the «anointed», the «Christ» par excellence who gives the Holy Spirit to people at Pentecost. The theology of the baptism of the Lord calls for special attention; it takes place at an interesting moment of transition. On the one hand, the (...) effusion of the Spirit on the humanity of Jesus does not create any problem for Gregory who distinguishes it clearly from the incarnation of the Son. On the other hand, the initiative of the Father in this unction is not paid special attention to, nor does it seem that it has a special significance for Jesus himself and the beginning of his mission in the world. However, much stress is given to the ecclesiological dimension of the descent of the Spirit in the baptism of Christ. On him comes the Spirit in fullness, as he will also abide in fullness in the whole Church which is his Body. Each of the Christians receives only a partial gift which must contribute to the perfection of the whole. (shrink)

In recent years interest in studies of the interrelation of the categories of quality and property has risen in the Soviet philosophical literature. Indeed, this cardinal problem requires further study. The concepts of "quality" and "property" are so close to each other in content in a number of meanings that they are sometimes used as synonyms.1 For further theoretical inquiry it is necessary to define the philosophical meaning of these categories accurately, since otherwise, as Francis Bacon wrote, they will become (...) idols and give rise to errors in our thinking instead of preventing them. (shrink)

The concept of alienation has taken firm root in the field of esthetics. One cannot say that its content is identical in everything one reads. Nonetheless, employment of this concept is always for the purpose, so to speak, of "clarification." It is often employed on the assumption that its use permits one to make clear whatever may be incomprehensible in the form and content of a work of art. It has become customary to have recourse to the concept of alienation (...) in esthetic analysis of modern foreign works of literature and art. As an example, we may cite the international discussion around the work of Franz Kafka, many participants in which hold that Kafka is a "product of alienation," "a prisoner of alienation," and that his work either expresses "his self-alienation" or involves depiction of the "consequences of alienation.". (shrink)