This article’s aim is to understand if and how the efforts to accumulate and organize clinical data transformed the regulation of pharmaceutical care. The authors analyze how the employment of databases by collectives of physicians and researchers shape both clinical and policy practice—and thereby reshape the relation between clinical work and policy. Since the late 1990s, Dutch government has supported the development of clinical databases for specific expensive medicines to gain oversight about actual medicine use. To be able to produce (...) evidence for appropriate medicine use, the collectives set regulations in clinical practice. These internal regulations provide a framework for establishing “appropriate medicine use”, steering reimbursement decisions. However, internal regulation and policy rules differ in how quickly they can change. While the employment of databases in clinical practices results in a constant adjustment of the protocols, policy makers require the databases to provide for static moments of “proven appropriate medicine use” in order to account for and define a fixed and closed formulary. Subsequently, the employment of the databases did not deliver on the promise of oversight and control due to different clinical and policy requirements. Nevertheless, the databases did stimulate appropriate medicine use and reimbursement in clinical practice. (shrink)

Background When anti-cancer treatments have been given market authorization, but are not (yet) reimbursed within a healthcare system, physicians are confronted with ethical dilemmas. Arranging access through other channels, e.g., hospital budgets or out-of-pocket payments by patients, may benefit patients, but leads to unequal access. Until now, little is known about the perspectives of physicians on access to non-reimbursed treatments. This interview study maps the experiences and moral views of Dutch oncologists and hematologists.Methods A diverse sample of oncologists and hematologists (...) (n = 22) were interviewed. Interviews were analyzed thematically using Nvivo 12 qualitative data software.Results This study reveals stark differences between physicians’ experiences and moral views on access to anti-cancer treatments that are not (yet) reimbursed: some physicians try to arrange other ways of access and some physicians do not. Some physicians inform patients about anti-cancer treatments that are not yet reimbursed, while others wait for reimbursement. Some physicians have principled moral objections to out-of-pocket payment, while others do not.Conclusion Oncologists and hematologists in the Netherlands differ greatly in their perspectives on access to expensive anti-cancer treatments that are not (yet) reimbursed. As a result, they may act differently when confronted with dilemmas in the consultation room. Physicians working in different healthcare systems may face similar dilemmas. (shrink)

A model for the ideal state includes discussions of the nature and application of justice, the role of the philosopher in society, the goals of education, and the effects of art upon character.

In "Realism and Reason" Hilary Putnam has offered an apparently strong argument that the position of metaphysical realism provides an incoherent model of the relation of a correct scientific theory to the world. However, although Putnam's attack upon the notion of the "intended" interpretation of a scientific theory is sound, it is shown here that realism may be formulated in such a way that the realist need make no appeal to any "intended" interpretation of such a theory. Consequently, it can (...) be shown that realism is immune to Putnam's criticism and that attempts at reformulating this criticism are not likely to meet with success. (shrink)

The influence of Nazism on German culture was a key concern for many Anglo-American writers, who struggled to reconcile the many contributions of Germany to European civilization, with the barbarity of the new regime. In _German Literature Through Nazi Eyes_, H.G. Atkins gives an account of how the Nazis undertook a re-evaluation of German literature, making it sub-ordinate to their own interests. All reference to Jewish writers and influence was virtually eliminated, and key writers such as Goethe and Lessing were (...) re-interpreted. What was left was a military history that was avowedly militant and propagandist. (shrink)

1. "The map of logic." Comparatively recently, Kant's words to the effect that in the two thousand years since Aristotle logic had made "not a single step forward and, all things considered, it seems to be a fully finished and completed discipline" used to be quoted widely and not unsympathetically. Today, however, there are works about logic in which the listing of logical disciplines runs into the dozens. In this regard the attempt by the American logician N. Rescher to compile (...) a diagram or "map of logic," in which the list of the branches of logic takes up several pages, is noteworthy. Also characteristic is the following statement by one of the major modern representatives of mathematical logic, S. Kleene: "Since the discovery of non-Euclidean geometries by Lobachevsky and Bolyai , it has become clear that different systems of geometries are conceptually equally possible…. Identically, there are different logics.". (shrink)

G. H. Bird; Discussions: Kantian Myths, Proceedings of the Aristotelian Society, Volume 96, Issue 1, 1 June 1996, Pages 245–252, https://doi.org/10.1093/aristot.

G. H. Bird; Discussions: Kantian Myths, Proceedings of the Aristotelian Society, Volume 96, Issue 1, 1 June 1996, Pages 245–252, https://doi.org/10.1093/aristot.

G H Bantock; The Parochialism of the Present: some reflections on the history of educational theory, Journal of Philosophy of Education, Volume 13, Issue 1, 30.