In their article, “Rare Disease, Advocacy and Justice: Intersecting Disparities in Research and Clinical Care,” Halley et al. (2023) use three case examples to describe challenges patients with rar...

Building trust between academic medical centers and certain communities they depend on in the research process is hard, particularly when those communities consist of minoritized or historically marginalized populations. Some believe that engagement activities like the creation of advisory boards, town halls, or a research workforce that looks more like community members will establish or reestablish trust between academic medical centers and racialized communities. However, without systematic approaches to dismantle racism, those well‐intended actions become public performativity, and trust building will (...) fail. In this essay, we draw upon foundational ethical principles of trust, distrust, and trust building; apply the concept of bounded justice to performative trust acts; and center the works of Black and Indigenous feminist bioethicists to revisit some of the wisdom and valuable lessons they have contributed. Rebuilding trust is hard to do because people and institutions are often not honest about how hard it is and there is no simple box‐checking task that can disentangle our society's injustices, but there are steps to take in this direction. Individuals and institutions can recognize valuable relevant work that has already been written, partake in critical reflection, and then apply insights gained to take both small and sustainable steps toward transformational change and deeper trust. (shrink)

Some ethicists assert that there is a consensus that maximising medical outcomes takes precedence as a principle of resource allocation in emergency triage of absolutely scarce resources. But the nature of the current severe acute respiratory syndrome-related coronavirus 2 pandemic and the history of debate about balancing equity and efficiency in resource allocation do not support this assertion. I distinguish a number of concerns with justice and balancing considerations that should play a role in critical care triage policy, focusing on (...) discrimination and on fundamental egalitarian and social justice concerns. (shrink)

In this interview, Cynthia Hammond sits down with Marc Lafrance in order to discuss the 30-year sketching practice that led to her exhibition, Drawings for a Thicker Skin, in 2012. In this practice, Hammond made small, quick drawings of the clothes she would need for trips or key professional events. As she explains, the drawings were not just essential to knowing what to pack; they were essential to being able to pack. While she never conceived of the practice (...) as art, when invited to exhibit the drawings she found a way to relate this idiosyncratic and private practice to a larger set of ontological concerns. Clothing as a second skin is the key idea here, as Hammond and Lafrance explore what it means to navigate identity, idealized self-image, professional ‘passing’ and the skin ego. (shrink)

Are the small and indolent cancers found in abundance in cancer screening normal variations, risk factors, or disease? Naturalists in philosophy of medicine turn to pathophysiological findings to decide such questions objectively. To understand the role of pathophysiological findings in disease definition, we must understand how they mislead in diagnostic reasoning. Participants on all sides of the definition of disease debate attempt to secure objectivity via reductionism. These reductivist routes to objectivity are inconsistent with the Bayesian nature of clinical reasoning; (...) when they appeal to the sciences, they are inconsistent with what philosophy of biology tells us about its natural kinds. Proposals that we narrow the scope of our claims in the disease definition debates are useful, but paradigms can still distort our reasoning in particular cases, even when we are self-conscious about their status. (shrink)

While much of the debate around the practice of normothermic regional perfusion (NRP) is focused on the potential violation of the dead donor rule (DDR), another concern is whether allowing this pr...

Systems of universal health coverage may aspire to provide care based on need and not ability to pay; the complexities of this aspiration call for normative analysis. This special issue arises in the wake of a judicial inquiry into preferential access in the Canadian province of Alberta, the Vertes Commission. I describe this inquiry and set out a taxonomy of forms of differential and preferential access. Papers in this special issue focus on the conceptual specification of health system boundaries and (...) on the normative questions raised by complex models of funding and delivery of care, where patients, providers, and services cross system boundaries. (shrink)

PurposeSocial exclusion as a result of gender, race, and class inequality is perhaps one of the most pressing challenges associated with the development of a diverse information technology workforce. Women remain under represented in the IT workforce and college majors that prepare students for IT careers. Research on the under representation of women in IT typically assumes women to be homogeneous in nature, something that blinds the research to variation that exists among women. This paper aims to address these issues.Design/methodology/approachThe (...) paper challenges the assumption of heterogeneity by investigating how the intersection of gender, race, and class identities shape the experiences of Black female IT workers and learners in the USA.FindingsThe results of this meta‐analysis offer new ways of theorizing that provide nuanced understanding of social exclusion and varied emancipatory practices in reaction to shared group exposure to oppression.Originality/valueThis study on the under‐representation of women as IT workers and learners in the USA considers race and class as equally important factors for understanding variation among women. In addition, this paper provides rich insights into the experiences of Black women, a group that is largely absent from the research on gender and IT. (shrink)

The interrogation of Meletus in the Apology at 24c4–28al is not infrequently seen as a typical case of all that is intellectually and artistically dissatisfying in Plato's practice of the genre of philosophical dialogue: not only are we presented with a philosopher who makes some claim to being committed to setting a particularly stringent standard for honesty in argumentation making sophistical arguments, but we are presented also with a cardboard interlocutor who is forced by the hand of Plato to acquiesce (...) to those arguments in a fashion that is completely dissatisfying to the reader. The best anyone seems to do to save Plato from these charges of artistic incompetence and intellectual dishonesty is to appeal to such a level of historical accuracy for the text that the stupidity of Meletus' responses can be attributed to the stupidity of Meletus himself, or to point out features of the political and legal situation that might prevent Meletus from answering the questions by drawing on his true motivation—which is presumably more coherent. Taylor says of this passage: The humour of the situation is that the prosecutor cannot venture to say what he means by either of his charges without betraying the fact that, owing to the ‘amnesty’, the matters complained of are outside of the competency of the court… Hence, when Meletus is pressed to explain what he means, he has to take refuge in puerile nonsense. (shrink)

From the O.J. Simpson verdict to peace-making in the Balkans, the critical role of human judgement--complete with its failures, flaws, and successes--has never been more hotly debated and analyzed than it is today. This landmark work examines the dynamics of judgement and its impact on events that take place in human society, which require the direction and control of social policy. Research on social policy typically focuses on content. This book concentrates instead on the decision-making process itself. Drawing on 50 (...) years of empirical research in decision theory, Hammond examines the possibilities for wisdom and cognitive competence in the formation of social policies, and applies these lessons to specific examples, such as the space shuttle Challenger disaster and the health care debate. Uncertainly, he tells us, can seldom be fully eliminated; thus error is inevitable, and injustice for some unavoidable. But the capacity for make wise judgments increases to the extent that we understand the potential pitfalls and their origin. The judgment process for example involves an ongoing rivalry between intuition and analysis, accuracy and rationality. The source of this tension requires an examination of the evolutionary roots of human judgement and how these fundamental features may be changing as our civilization increasingly becomes an information and knowledge-based society. With numerous examples from law, medicine, engineering, and economics, the author dramatizes the importance of judgment and its role in the formation of social policies which affect us all, and issues the first comprehensive examination of its underlying dynamics. (shrink)

Causal reasoning and game-theoretic reasoning are fundamental topics in artificial intelligence, among many other disciplines: this paper is concerned with their intersection. Despite their importance, a formal framework that supports both these forms of reasoning has, until now, been lacking. We offer a solution in the form of (structural) causal games, which can be seen as extending Pearl's causal hierarchy to the game-theoretic domain, or as extending Koller and Milch's multi-agent influence diagrams to the causal domain. We then consider three (...) key questions: i) How can the (causal) dependencies in games - either between variables, or between strategies - be modelled in a uniform, principled manner? ii) How may causal queries be computed in causal games, and what assumptions does this require? iii) How do causal games compare to existing formalisms? To address question i), we introduce mechanised games, which encode dependencies between agents' decision rules and the distributions governing the game. In response to question ii), we present definitions of predictions, interventions, and counterfactuals, and discuss the assumptions required for each. Regarding question iii), we describe correspondences between causal games and other formalisms, and explain how causal games can be used to answer queries that other causal or game-theoretic models do not support. Finally, we highlight possible applications of causal games, aided by an extensive open-source Python library. (shrink)

The multi-disciplinary unit Social Responsibility in Action was developed for students with an interest in ethics who were completing undergraduate degrees in Arts, Commerce, Design or Science at an Australian research-intensive university. The academic objectives of this unit were to increase student awareness, knowledge, understanding and critical thinking skills related to various ethical issues. Lecturers from five disciplines collaborated in the design and delivery of SRA, which comprised lectures, tutorials and a research-based project. Anonymous surveys were administered at the start (...) and end of the semester to obtain feedback on student expectations and learning experience, respectively. Data across three student cohorts showed that at the start of semester, 80% of student comments indicated a desire to expand their interest of ethical matters, 59% a desire to gain understanding and knowledge and 59% to gain critical thinking or communication skills. SRA was extremely well received by students, with 98% of respondents indicating that this multi-disciplinary ethics unit had met their expectations. Students also found that the variety of teaching styles, unit content and multi-disciplinary approach stimulated learning. (shrink)

Scientism in medical education distracts educators from focusing on the content of learning; it focuses attention instead on individual achievement and validity in its measurement. I analyze the specific form that scientism takes in medicine and in medical education. The competencies movement attempts to challenge old “scientistic” views of the role of physicians, but in the end it has invited medical educators to focus on validity in the measurement of individual performance for attitudes and skills that medicine resists conceptualizing as (...) objective. Academic medicine should focus its efforts instead on quality and relevance of care. The social accountability movement proposes to shift the focus of academic medicine to the goal of high quality and relevant care in the context of community service and partnership with the institutions that together with medicine create and cope with health and with health deficits. I make the case for this agenda through a discussion of the linked histories of the opioid prescribing crisis and the professionalism movement. (shrink)

Some argue that the concept of medical need is inadequate to inform the design of a universal health care system—particularly an institutional rather than a residual system. They argue that the concept contradicts the idea of comprehensiveness; leads to unsustainable expenditures; is too indeterminate for policy; and supports only a prioritarian distribution. I argue that ‘comprehensive’ understood as ‘including the full continuum of care’ and ‘medically necessary’ understood as ‘prioritized by medical criteria’ are not contradictory, and that UHC is a (...) solution to the problem of sustainability, not its cause. Those who criticize ‘medical need’ for indeterminacy are not transparent about the source of their commitment to their standards of determinacy: they promote standards that are higher than is necessary for legitimate policy, ignoring opportunity costs. Furthermore, the indeterminacy of concepts affects all risk-sharing systems and all systems that rely on medical standard of care. I then argue that the concept of need in itself does not imply a minimal sufficientist standard or a prioritarian distribution; neither does the idea of legitimate public policy dictate that public services be minimalist. The policy choice for a system of health care that is comprehensive and offers as good care as can be achieved when delivered on equal terms and conditions for all is a coherent option. (shrink)

Lisa A. Eckenwiler, Long-term care, globalization, and justice, Baltimore: The Johns Hopkins University Press, 2012, reviewed by Lynette Reid.

In Capital in the Twenty-First Century, Thomas Piketty argues that markets, absent political intervention, tend toward economic divergence and that this has deleterious consequences for democratic ideals of equal voice and meritocracy. His goal is to foster a public conversation about what a society dominated by wealth—which we already beginning to experience as the twenty-first century begins—would look like if we wish to maintain an egalitarian ethos. His work will contribute to and further motivate several discussions in feminist bioethics, namely, (...) on the funding and organization of care labor, reproductive rights, global health, and commodification. (shrink)

In Capital in the Twenty-First Century, Thomas Piketty argues that markets, absent political intervention, tend toward economic divergence and that this has deleterious consequences for democratic ideals of equal voice and meritocracy. His goal is to foster a public conversation about what a society dominated by wealth—which we already beginning to experience as the twenty-first century begins—would look like if we wish to maintain an egalitarian ethos. His work will contribute to and further motivate several discussions in feminist bioethics, namely, (...) on the funding and organization of care labor, reproductive rights, global health, and commodification. (shrink)

This paper attempts to demonstrate Max Scheler’s anticipation of and continued relevance to a burgeoning trend of essence-based accounts of modality, chief among them being Kit Fine’s landmark 1994 “Essence and Modality.” I argue that Scheler’s account of the material a priori not only anticipates the picture of essence-based modality suggested by Fine, but moreover offers resources with the potential to resolve key challenges for the Finean program. In particular, Fine’s account runs into problems in explaining how formal logical necessities (...) are to be grounded in essences, challenges that put pressure on the essentialist to adopt a non-propositional account of the nature of logical principles. I argue that one such account can be found in Scheler’s notion of the material a priori, according to which all necessary propositional truth is grounded in a realm of experientially given yet a priori "phenomenological facts." After showing the general rapprochement between Scheler’s and Fine’s accounts of regional modality, I then turn to address Scheler’s attempt to ground formal logical principles in essences. On Scheler’s picture, propositions expressing formal logical truths are true in virtue of the domain of essences in two senses: In terms of what Scheler calls objective necessity, they are true insofar as they coincide with the essential facts and interconnections shared by all possible regions of being; In terms of what he calls subjective necessity, they are true in virtue of these same essential facts and interconnections insofar as they have become “functionalized” into law-like patterns of cognition. (shrink)

This book offers an interdisciplinary approach to concepts of the self associated with the development of humanism in England, and to strategies for both inclusion and exclusion in structuring the early modern nation state. It addresses writings about rhetoric and behavior from 1495–1660, beginning with Erasmus’ work on sermo or the conversational rhetoric between friends, which considers the reader as an ‘absent audience’, and following the transference of this stance to a politics whose broadening democratic constituency needed a legitimate structure (...) for governance-at-a-distance. Unusually, the book brings together the impact on behavior of these new concepts about rhetoric, with the growth of the publishing industry, and the emergence of capitalism and of modern medicine. It explores the effects on the formation of the ‘subject’ and political legitimation of the early liberal nation state. It also lays new ground for scholarship concerned with what is left out of both selfhood and politics by that state, studying examples of a parallel development of the ‘self’ defined by friendship not only from educated male writers, but also from women writers and writers concerned with socially ‘middling’ and laboring people and the poor. (shrink)

In Canada, laws and policies consistently reject the commodification of human organs and tissues, and Canadian practice is consistent with international standards in this regard. Until the Assisted Human Reproduction Act of 2004, gamete donation in Canada was an exception: Canadians could pay and be paid open market rates for gametes for use in in vitro fertilization. As sections of the AHR Act forbidding payment for gametes and permitting only reimbursement of receipted expenses gradually came into effect in 2005, Canada (...) did away with this anomaly. Medical practice and legal prohibitions in assisted human reproduction are now consistent with other areas of medicine where tissues and organs are taken from one person to benefit others: Altruistic donation, rather than selling and buying, will be the norm. (shrink)

Reflecting on Smith (2021) in this issue, this commentary extends our consideration of issues in carceral health and questions the dehumanizing language we sometimes use—including in public health and public health ethics—to talk about persons held in incarceration. Even the language we use for the carceral system itself (such as ‘criminal justice system’) is fraught: it casts a laudatory light on the system and papers over its role in compounding racial health inequities and in sustaining colonialism. A host of issues (...) call out for ethical analysis, using lenses that can encompass the tensions and contradictions experienced by people within the system who deliver healthcare and those within the system trying to access that care. Beyond access to health care (promotion, prevention, treatment and palliation), the societal commitment to dealing with social issues by depriving people of many key social determinants of health is at the heart of many of these tensions and contradictions. (shrink)

Deliberative democracy grounds its legitimacy largely in the ability of speakers to participate on equal terms. Yet theorists and practitioners have struggled with how to establish deliberative equality in the face of stark differences of power in liberal democracies. Designers of innovative civic forums for deliberation often aim to neutralize inequities among participants through proportional inclusion of disempowered speakers and discourses. In contrast, others argue that democratic equality is best achieved when disempowered groups deliberate in their own enclaves before entering (...) the broader public sphere. Borrowing from each perspective, the authors argue that there are strong reasons to incorporate enclave deliberation among the disempowered within civic forums. They support this claim by presenting case study evidence showing that participants in such forums can gain some of the same benefits of deliberation found in more heterogeneous groups, can consider a diversity of viewpoints rather than falling into groupthink and polarization, and can persuade external stakeholders of the legitimacy of the group’s deliberations. (shrink)

The essays in this volume, first published in 1986, examine the philosophical foundations of social choice theory. This field, a modern and sophisticated outgrowth of welfare economics, is best known for a series of impossibility theorems, of which the first and most crucial was proved by Kenneth Arrow in 1950. That has often been taken to show the impossibility of democracy as a procedure for making collective decisions. However, this interpretation is challenged by several of the contributors here. Other central (...) issues discussed in the volume include the possibility of making interpersonal comparisons of utility, the question of whether all preferences are equally to be valued, and the normative individualism underlying the theoretical tradition. Criticisms of social choice theory are advanced and suggestions for alternative approaches are developed. (shrink)

Temkin asks how we should distribute resources between the social determinants of health and health care; Sreenivasan argues that if our goal is fair opportunity, funding universal health coverage is the wrong policy. He argues that social equality in health has not improved under UHC and concludes that fair opportunity would be better served by using the resources to address the SDOH instead. His criticism applies more broadly than he claims: it applies to any argument for UHC based on health (...) equity. However, neither his strong causal conclusion nor his stark policy proposal is justified. I review methodological challenges for establishing the relative causal contributions of health care and social policy, concluding that we may never have a robust causal account to support a consequentialist choice. Fortunately, we may not need to answer the allocation question as a dichotomy. Given what Sen calls the multidimensional nature of health equity and the role of UHC in cost containment, UHC may not be a threat to health equity. I also argue against Sreenivasan's claim that the data he discusses should not trouble sufficientists and prioritarians. The worst-off are not simply lagging in improvement; rather, their health status is stagnating or worsening. (shrink)

Verweij and Dawson claim that population health has a distributive dimension; Coggon argues that this presupposes a normative commitment to equity in the very definition of population health, which should, rather, be neutral. I describe possible sources of the distributive view, several of which do not presuppose egalitarian commitments. Two relate to the nature of health as a property of individuals ; two relate to the epistemology and pragmatics of public and population health. A fifth source of the distributive view (...) is a critical stance on the concept of population health; I contrast this with Coggon’s account of the public as a shared political imaginary. None of these views is ‘neutral’: they exhibit several different kinds of normativity and quasi-normativity, but this is not problematic. I argue that the critical stance appropriately distinguishes and relates social justice and public health. (shrink)

From the O.J. Simpson verdict to peace-making in the Balkans, the critical role of human judgement--complete with its failures, flaws, and successes--has never been more hotly debated and analyzed than it is today. This landmark work examines the dynamics of judgement and its impact on events that take place in human society, which require the direction and control of social policy. Research on social policy typically focuses on content. This book concentrates instead on the decision-making process itself. Drawing on 50 (...) years of empirical research in decision theory, Hammond examines the possibilities for wisdom and cognitive competence in the formation of social policies, and applies these lessons to specific examples, such as the space shuttle Challenger disaster and the health care debate. Uncertainly, he tells us, can seldom be fully eliminated; thus error is inevitable, and injustice for some unavoidable. But the capacity for make wise judgments increases to the extent that we understand the potential pitfalls and their origin. The judgment process for example involves an ongoing rivalry between intuition and analysis, accuracy and rationality. The source of this tension requires an examination of the evolutionary roots of human judgement and how these fundamental features may be changing as our civilization increasingly becomes an information and knowledge-based society. With numerous examples from law, medicine, engineering, and economics, the author dramatizes the importance of judgment and its role in the formation of social policies which affect us all, and issues the first comprehensive examination of its underlying dynamics. (shrink)

The seriousness of the risk that healthcare workers faced during SARS, and their response of service in the face of this risk, brings to light unrealistic assumptions about duty and risk that informed the debate on duty to care in the early years of HIV/AIDS. Duty to care is not based upon particular virtues of the health professions, but arises from social reflection on what response to an epidemic would be consistent with our values and our needs, recognizing our shared (...) vulnerability to disease and death. Such reflection underwrites a strong duty of care, but one not to be borne solely by the altruism and heroism of individual healthcare workers. (shrink)

Critiques of Knowing explores what happens to science and computing when we think of them as texts. Lynette Hunter elegantly weaves together such vast areas of thought as rhetoric, politics, AI, computing, feminism, science studies, aesthetics and epistemology. This book shows us that what we need is a radical shake-up of approaches to the arts if the critiques of science and computing are to come to any fruition.

This chapter is particularly concerned with the status of history, dance history especially, within Dance Studies. It asks what has befallen the more recent status of history, once an epistemological support at a critical stage in Dance Studies’s early development, now that Dance Studies is better established, relatively speaking, within the academy. Is history so much scaffolding which, having fulfilled its purpose in enabling the disciplinary plant to take root, is to be dismantled and, if not actually discarded, at least (...) demoted? Three factors will be identified and proposed as having particular significance in this connection, imbuing this chapter with a tri-partite structure. The first concerns the already noted strong imprint of Cultural Studies on Dance Studies and the possible bearing of this imprint on dance history’s status within Dance Studies. For the particular manner in which Dance Studies has construed Cultural Studies may, this chapter will suggest, have impacted upon dance history’s standing within communities of dance scholarship. The second factor has to do with the implications, for dance history, of a particular critique based in a branch of dance scholarship, that perceives phenomenology, which it deems a good fit for dance inquiry, as inherently antithetical to history. In particular, this critique takes the work of Michel Foucault - which it identifies closely with, and as, historical practice - as incompatible with dance enquiry. Incompatibility is staked on the twin grounds of Foucault’s break with, and supposed resulting and enduring antipathy towards, phenomenology; and his perceived embrace of history which is, itself, also understood to result from such a break. In effect, then, this critique questions the very suitability, for dance research, of approaches based in history-focussed inquiry. The ability to call this critique into question, in the ways that the present discussion, in seeking to rehabilitate Foucault, and so history, needs to demonstrate, constitutes the third factor. This final factor makes two particular, further demands of this chapter. Namely that the interrelated questions of Foucault, phenomenology, and dance; and of the position which phenomenology has itself adopted in relation to history, be re-visited and re-evaluated to the extent that space reasonably allows. Fortunately, these interrelated questions are ones which have - relatively recently - preoccupied scholarship on Foucault, and on phenomenology, respectively. This preoccupation may in and of itself be one possible indicator that there is indeed more at stake, and so to consider, regarding both questions, than the lines drawn by the aforementioned critique might suggest. (shrink)

Egon Brunswik is one of the most brilliant, creative and least understood and appreciated psychologists/philosophers of the 20th century. This book presents a collection of Brunswik's most important papers together with interpretive comments by prominent scholars who explain the intent and development of his thought. This collection and the accompanying diverse examples of the application of his ideas will encourage a deeper understanding of Brunswik in the 21st century than was the case in the 20th century. The 21st century already (...) shows signs of acceptance of Brunswikian thought with the appearance of psychologists with a different focus; emulation of physical science is of less importance, and positive contributions toward understanding behavior outside the laboratory without abandoning rigor are claiming more notice. As a result, Brunswik's theoretical and methodological views are already gaining the attention denied them in the 20th century. The plan of this book is to provide, for the first time, in one place the articles that show the origins of his thought, with all their imaginative and creative spirit, as well as thoughtful, scholarly interpretations of the development, meaning and application of his ideas to modern psychology. Thus, his views will become more understandable and more widely disseminated, as well as advanced through the fresh meaning given to them by the psychologists of the 21st century. (shrink)

Egon Brunswik is one of the most brilliant, creative and least understood and appreciated psychologists/philosophers of the 20th century. This book presents a collection of Brunswik's most important papers together with interpretive comments by prominent scholars who explain the intent and development of his thought. This collection and the accompanying diverse examples of the application of his ideas will encourage a deeper understanding of Brunswik in the 21st century than was the case in the 20th century. The 21st century already (...) shows signs of acceptance of Brunswikian thought with the appearance of psychologists with a different focus; emulation of physical science is of less importance, and positive contributions toward understanding behavior outside the laboratory without abandoning rigor are claiming more notice. As a result, Brunswik's theoretical and methodological views are already gaining the attention denied them in the 20th century. The plan of this book is to provide, for the first time, in one place the articles that show the origins of his thought, with all their imaginative and creative spirit, as well as thoughtful, scholarly interpretations of the development, meaning and application of his ideas to modern psychology. Thus, his views will become more understandable and more widely disseminated, as well as advanced through the fresh meaning given to them by the psychologists of the 21st century. (shrink)

This conceptual review seeks to reframe the view of academic integrity as something to be enforced to an academic skill that needs to be developed. The authors highlight how practices within academia create an environment where feelings of inadequacy thrive, leading to behaviours of unintentional academic misconduct. Importantly, this review includes practical suggestions to help educators and higher education institutions support doctoral students’ academic integrity skills. In particular, the authors highlight the importance of explicit academic integrity instruction, support for the (...) development of academic literacy skills, and changes in supervisory practices that encourage student and supervisor reflexivity. Therefore, this review argues that, through the use of these practical strategies, academia can become a space where a culture of academic integrity can flourish. (shrink)

Basileia and tyrannis: exploding myths -- Arete and the right to rule -- Ruling families -- Rulers in the polis -- Epilogue: Athens, ruling and arete.

Contentivo de las memorias del "III Seminario de Filosofía y Derecho Contemporáneo", en homenaje al profesor Günther Jakobs, en el cual se analizan algunos de los componentes del derecho penal al tenor de la filosofía del derecho. Esta obra retoma los conceptos de Günther Jakobs, Jaime Bernal Cuéllar, Manuel Cancio Meliá y Teresa Manso Porto, entre otros.

In "Public Health and Precarity," Michael Doan and Ami Harbin have done important work extending Sherwin's concept of relational autonomy to encompass relational agency—including agents such as communities and states. This opens up new ways of thinking about responsibility for public health in long-standing debates about the role of the state in public health.The case studies Doan and Harbin analyze are also important for thinking of the account of relational solidarity that Sherwin developed together with Baylis and Kenny, one element (...) of relational public health. The discussion may even open the space for a reformulation of relational solidarity. I will use the... (shrink)

In bioethics and health policy, we often discuss the appropriate boundaries of public funding; how the interface of public and private purchasers and providers should be organized and regulated receives less attention. In this paper, I discuss ethical and regulatory issues raised at this interface by three medical practice models in which physicians provide insured services while requiring or requesting that patients pay for services or for the non-insured services of the physicians themselves or their associates. This choice for such (...) practice models is different from the decision to design an insurance plan to include or exclude user fees, co-payments and deductibles. I analyze the issues raised with regards to familiar health care values of equity and efficiency, while highlighting additional concerns about fair terms of access, provider integrity, and fair competition. I then analyze the common Canadian regulatory response to block fee models, considering their extension to wellness clinics, with regards to fiduciary standards governing the physician–patient relationship and the role of informed consent. I close by highlighting briefly issues that are of common concern across different fundamental normative frameworks for health policy. (shrink)