In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 44.4 (2006) 623-634 MuseSearchJournalsThis JournalContents[Access article in PDF]Character and Evil in Kant's Moral AnthropologyPatrick FriersonIn the Metaphysics of Morals, Kant explains that moral anthropology studies the "subjective conditions in human nature that help or hinder [people] in fulfilling the laws of a metaphysics of morals" and insists that such anthropology "cannot be dispensed with" (6:217).1 But it is often difficult to find (...) clear evidence of this sort of anthropology in Kant's own works. In this paper, I discuss Kant's account of character as an example of Kantian moral anthropology.Kant's account of character is one of the most important parts of his Anthropology from a Pragmatic Point of View.2 Kant describes the character of the person, in particular, as the "distinguishing mark of the human being as a rational being endowed with freedom" and says that character "indicates what the human being is prepared to make of himself" (7:285). Recently, Kant commentators have gone even further. G. Felicitas Munzel, for example, claims that character is "the systematic link between the moral, aesthetic, and anthropological elements of Kant's works."3 This paper will not investigate the full richness of Kant's account of character. Instead, I focus on one particular problem that arises in Kant's discussion of character—an apparent conflict between the moral relevance of character and the possibility of evil character. By showing why there is an apparent conflict and why it is merely apparent, I show some of the ways in which a particular subjective condition in human nature can help, but not force, people to fulfill the laws of a metaphysics of morals. [End Page 623]1. The Problem: Moral Character and the Case of SullaWhen Kant introduces character in the Anthropology, he distinguishes between the character of the person, of the sex, of the nation, of the race, and of the species. Even within the character of the person, he distinguishes between "natural aptitude," "temperament," and "character purely and simply," all of which are different kinds of individual character. But only the last—the "character purely and simply"4 of a person—"is moral" and "shows what man is prepared to make of himself" (7:285).5 This paper focuses only on that general, moral character.At first, Kant seems to describe general character as morally good. Twice in his opening discussion of character, Kant describes "character" (Charakter) as "moral" (moralische) (7:285), and he insists that "character has an inner worth, and is beyond all price" (7:292). Though not decisive, these comments suggest that one with character has a good will. But Kant goes further, adding that the person with character "relies on principles that are valid for everyone" (7:293). This reference to universally valid principles is picked up later in a way that highlights its moral goodness.For character requires maxims that proceed from reason and morally-practical principles. Therefore one cannot rightly say that the malice of this human being is a quality of his character; for then it would be diabolic. The human being, however, never sanctions the evil in himself, and so there is actually no malice from principles; but only from the forsaking of them.(7:293–94)It seems that Kant could not be more explicit. Character seems to involve acting on the basis of principles that conform to and even flow from "morally-practical principles," which he seems to distinguish from anything evil. This seems quite close to Kant's account of the good will as a will "whose principle is the categorical imperative" (4:444). (Although Kant's precise account of the good will is complicated, for our purposes here it is sufficient to define a good will as a will that consistently acts out of respect for the moral law.6) To have character, it would seem, is to have a good will.But this apparent identification of character with good character does not fit the rest of... (shrink)

Historically associated with military service, conscientious objection has become a significant phenomenon in health care. Mark Wicclair offers a comprehensive ethical analysis of conscientious objection in three representative health care professions: medicine, nursing and pharmacy. He critically examines two extreme positions: the 'incompatibility thesis', that it is contrary to the professional obligations of practitioners to refuse provision of any service within the scope of their professional competence; and 'conscience absolutism', that they should be exempted from performing any action contrary (...) to their conscience. He argues for a compromise approach that accommodates conscience-based refusals within the limits of specified ethical constraints. He also explores conscientious objection by students in each of the three professions, discusses conscience protection legislation and conscience-based refusals by pharmacies and hospitals, and analyzes several cases. His book is a valuable resource for scholars, professionals, trainees, students, and anyone interested in this increasingly important aspect of health care. (shrink)

For years now, unionization has been under vigorous attack. Membership has been steadily declining, and with it union bargaining power. As a result, unions may soon lose their ability to protect workers from economic and personal abuse, as well as their significance as a political force. In the Name of Liberty responds to this worrying state of affairs by presenting a new argument for unionization, one that derives an argument for universal unionization in both the private and public sector from (...) concepts of liberty that we already accept. In short, In the Name of Liberty reclaims the argument for liberty from the political right, and shows how liberty not only requires the unionization of every workplace as a matter of background justice, but also supports a wide variety of other progressive policies. (shrink)

Evidence-based medicine (EBM) has thus far failed to adequately account for the appropriate incorporation of other potential warrants for medical decision making into clinical practice. In particular, EBM has struggled with the value and integration of other kinds of medical knowledge, such as those derived from clinical experience or based on pathophysiologic rationale. The general priority given to empirical evidence derived from clinical research in all EBM approaches is not epistemically tenable. A casuistic alternative to EBM approaches recognizes that five (...) distinct topics, 1) empirical evidence, 2) experiential evidence, 3) pathophysiologic rationale, 4) patient goals and values, and 5) system features are potentially relevant to any clinical decision. No single topic has a general priority over any other and the relative importance of a topic will depend upon the circumstances of the particular case. The skilled clinician must weigh these potentially conflicting evidentiary and non-evidentiary warrants for action, employing both practical and theoretical reasoning, in order to arrive at the best choice for an individual patient. (shrink)

"How, if at all, is responsibility possible," and "What kind of beings must we be if we are ever to be responsible for the results of our wills?". This study is not intended to guarantee final answers to these questions. What Wolf's study attempts to offer is insight into and a new perspective on the problem of the relationship between responsibility and freedom; it accomplishes this. After introducing us to the dilemma of autonomy as an issue germane to the problem, (...) Wolf embarks upon an examination and criticism of two standard positions: The Real Self View and the Autonomy View. While both of these contain plausible arguments, Wolf's examination exposes their inadequacies. According to the Real Self View, the actions of an agent are free and responsible if those actions arise out of one's own valuation system and are governed by the desires of the real self. The major difficulty is that if the real self is "deeply responsible" so as to deserve praise or blame, it leaves unanswered an explanation of why the real self is "deeply responsible" at all. Hence, the Real Self View fails to provide a solution. The Autonomy View is more radical and less defensible than the Real Self View. An autonomous agent can make choices on no basis, and is no more bound by reason than desire. To want autonomy is not only to want the ability to make choices when no choices exist, but to desire to be able to make choices for no reason, even if a reason exists. Wolf targets the vulnerability of the position. Prescinding from a cognitive perspective of reason, Wolf describes reason as a "normative faculty," or "whatever faculties are thought to be most likely to lead to true beliefs and good values". Concrete examples provide Wolf with supportive evidence that no responsible agent would want the ability to act contrary to reason. Like the Real Self View, the Autonomy View is inadequate. Wolf procedes to formulate her own theory in which reason plays a pivotal role. Her view is marked by a refreshing simplicity that does not undermine its philosophical soundness or its persuasiveness. According to Wolf's view, or the Reason View, the condition for responsibility is the ability to act in accordance with right reasons, the true, and the good. Philosophically, the true and the good are concepts that invite endless inquiry and debate. Wolf wisely avoids the pitfalls of many inquisitors and assumes a common sense, matter of fact approach to what constitutes the true and the good. There is objectivity in the world sufficient to yield empirical beliefs. Responsible agents are able to discern the true from the false and form value judgments that serve as a basis for action. Absolute metaphysical independence is not integral to responsible action, since there is always the presence of physical and psychological factors. But these factors are not so great as to deter or hinder responsible action. Whether or not an agent ultimately chooses to do that which is objectively better than something else does not alter the fact that one has the ability to act responsibly. Using the fundamental rational powers of perception, imagination, reflection, training, and logical thinking, the agent can recognize and appreciate the true and the good and act in accordance with them. The Reason View presumes that those whose intellectual and emotional capabilities fall within the range of normality are able to perceive what is objectively valid and morally good. Responsible action extends beyond the bounds of the moral sphere. Included under the category of responsible action are aesthetic, as well as personal, goals, and whatever else may be seen as good for the agent. What reason values as good has objective validity, albeit not absolute validity. What is good for the agent can never be judged apart from a given, determinate environment or from the psychological disposition of the agent that has its own normative competence. In its judgments, reason accommodates itself to both factors, and the responsible agent comes to see and appreciate the True and the Good. Wolf does not absolutize her theory; she offers it as working moral certitude for responsible agents. Her claim is that if the Reason View is correct, "It is important to cultivate and promote an open and active mind and an attitude of alertness and sensitivity to the world," so that one can come to "appreciate the True and Good" and "direct one's actions, in light of them". One can find little to discredit in Wolf's arguments, and her approach to the problem of the relationship between responsibility and freedom provides a relief from the tedious and convoluted debates that often take place when this issue is the topic.--Kathleen R. Madden, Chicago, Ill. (shrink)

This book is the first comprehensive study of the meaning and measure of enforceability. While we have long debated what restraints should govern the conduct of our social life, we have paid relatively little attention to the question of what it means to make a restraint enforceable. Focusing on the enforceability of legal rights but also addressing the enforceability of moral rights and social conventions, Mark Reiff explains how we use punishment and compensation to make restraints operative in the (...) world. After describing the various means by which restraints may be enforced, Reiff explains how the sufficiency of enforcement can be measured, and he presents a unified theory of deterrence, retribution, and compensation that shows how these aspects of enforceability are interconnected. Reiff then applies his theory of enforceability to illuminate a variety of real-world problem situations. (shrink)

Within the evidence-based medicine construct, clinical expertise is acknowledged to be both derived from primary experience and necessary for optimal medical practice. Primary experience in medical practice, however, remains undervalued. Clinicians’ primary experience tends to be dismissed by EBM as unsystematic or anecdotal, a source of bias rather than knowledge, never serving as the “best” evidence to support a clinical decision. The position that clinical expertise is necessary but that primary experience is untrustworthy in clinical decision-making is epistemically incoherent. Here (...) we argue for the value and utility of knowledge gained from primary experience for the practice of medicine. Primary experience provides knowledge necessary to diagnose, treat, and assess response in individual patients. Hierarchies of evidence, when advanced as guides for clinical decisions, mistake the relationship between propositional and experiential knowledge. We argue that primary experience represents a kind of medical knowledge distinct from the propositional knowledge produced by clinical research, both of which are crucial to determining the best diagnosis and course of action for particular patients. (shrink)

This state-of-the-science volume brings together an array of leading authorities to comprehensively review theory and research in this burgeoning area.

In response to physicians who refuse to provide medical services that are contrary to their ethical and/or religious beliefs, it is sometimes asserted that anyone who is not willing to provide legally and professionally permitted medical services should choose another profession. This article critically examines the underlying assumption that conscientious objection is incompatible with a physician’s professional obligations (the “incompatibility thesis”). Several accounts of the professional obligations of physicians are explored: general ethical theories (consequentialism, contractarianism, and rights-based theories), internal morality (...) (essentialist and non-essentialist conceptions), reciprocal justice, social contract, and promising. It is argued that none of these accounts of a physician’s professional obligations unequivocally supports the incompatibility thesis. (shrink)

This study aims to find out the factors that hinder students in learning Integrated Art Education. A descriptive research design was utilized in the conduct of the study. The researcher prepared a questionnaire with 15 closed-ended- questions that could be answered objectively. The study discovered that the students would learn more when they feel that they belong to a certain group. Interests in a subject also matter, the more you are interested in a particular subject, the more you will (...) learn the material. Parent support marks an impact on the student's interest in learning Arts. Therefore, personal interest in a subject must be given attention and managed properly. Parent's support also plays a vital role in reinforcing the students on what to pursue in order to maintain their motivation. (shrink)

What is conscientious objection? -- Should conscientious objectors be accommodated? -- Assessing objectors' beliefs and reasons -- Accommodation and conscientious provision.

For a long time, economic growth has been seen as the most promising source of funds to use toward reducing economic inequality, as well as a necessity if we are aiming at achieving full employment. But one of the most troubling aspects of the recent exponential rise in economic inequality is that this rise has occurred despite continued economic growth. Increases in national income have gone almost exclusively to the super-rich, while real wages for almost everybody else have stagnated or (...) even declined. And while the unemployment rate dropped significantly before the coronavirus pandemic hit, good, permanent, high-wage jobs with benefits had by then often been replaced by temporary, part-time, low-wage jobs without benefits, leaving even the employed feeling economically insecure. And now, of course, unemployment is again skyrocketing, and it is unclear how long it might take to come down. As a result, we have now arrived at a point of reckoning: can we continue to believe that liberal capitalism is the most promising combination of economic and political ideologies for securing a prosperous and just future? If not, what might replace it? Is the problem capitalism, or is it liberalism? Are we up against economic forces that we cannot influence or control, or is it our political will and the liberal values we endorse that are being tested? This paper looks at all these questions, and suggests how we might think about the prospects for a liberal future. (shrink)

Within the Anglo-American world, economic liberalism is generally viewed as having only one progenitor—Adam Smith—and one offspring—neoliberalism. But it actually has two. The work of G. W. F. Hegel was also very influential on the development of economic liberalism, at least in the German-speaking world, and the most powerful contemporary instantiation of economic liberalism within that world is not neoliberlaism, but ordoliberalism, although this is generally unknown and certainly unacknowledged outside of Continental Europe. Accordingly, what I am going to be (...) doing in this piece is trying to bring ordoliberalism more directly into the light—I will argue that by comparing and contrasting the views of Smith and Hegel or at least between how Smith and Hegel tend to be currently (mis)understood, we can better understand both the roots and the nature of these two contemporary incarnations of economic liberalism, and the light this sheds, in turn, brings some interesting and important features of these two contemporary theories into view. From Smith, for example, neoliberals took the idea of the invisible hand, although I am going to argue that contemporary advocates of invisible hand theory have largely misconstrued or at the very least overstated the significance of this metaphor. From Hegel, in contrast, ordoliberals took the idea of the civil society, and I will argue that the civil society is a much better metaphor not only for Hegel's but also for Smith's views. Indeed, I will argue that ordoliberalism, not neoliberalism, is a better and more coherent instantiation of economic liberalism than neoliberalism could ever be. (shrink)

Terrorism is commonly viewed as a form of war, and as a form of war, the morality of terrorism seems to turn on the usual arguments regarding the furtherance of political objectives through coercive means. The terrorist argues that his options for armed struggle are limited, and that the use of force against civilians is the only way he can advance his cause. But this argument is subject to a powerful response. There is the argument from consequences, which asserts that (...) terrorism is almost always counterproductive, even assuming the terrorist’s political objectives are legitimate. There is the argument from rights, which claims that terrorism violates the basic human rights of (at least) its civilian victims, and is therefore morally objectionable regardless of its consequences. And there is the argument from virtue, which notes that slaughtering civilians requires no skill or courage and therefore generates no honor or glory, making the terrorist not a virtuous warrior but a vicious one. But terrorism is not only a means of political coercion. It is also, in the view of many terrorists, a means of retribution. It is a means of exacting punishment on a political community the terrorist believes is collectively responsible for grievous wrongs certain members of that community have committed. And viewed as a means of retribution, the usual arguments made against terrorism-as-coercion have no moral force. To explain why terrorism-as-retribution is morally wrong, we must attack the notion of collective responsibility on which the terrorist relies. (shrink)

Spiritual Traditions and the Virtues provides a philosophical appreciation of the spiritual life, showing how a certain conception of spiritual well-being, rooted in Thomas Aquinas's account of the virtues, can generate a distinctive vision of human life, and the possibilities for spiritual fulfilment.

Some theorists believe that there is a plurality of values, and that in many circumstances these values are incommensurable, or at least incomparable. Others believe that all values are reducible to a single super-value, or that even if there is a plurality of irreducible values these values are commensurable. But I will argue that both sides have got it wrong. Values are neither commensurable nor incommensurable, at least not in the way most people think. We are free to believe in (...) incommensurability or not, depending on what particular conception of morality we want to embrace. Incommensurability is accordingly not a theory about value. It is a presupposition that provides a necessary background condition for a certain kind of value to exist. It is therefore not the kind of view that can be morally true or false. As a presupposition, it can only be accepted or rejected on grounds that do not presuppose that morality already exists. Incommensurability is, like the rejection of hard determinism, one of the presuppositions on which morality as we know it happens to be based. (shrink)

As with other fields of applied ethics, philosophers engaged in business ethics struggle to carry out substantive philosophical reflection in a way that mirrors the practical reasoning that goes on within business management itself. One manifestation of the philosopher’s struggle is the field’s division into approaches that emphasize moral philosophy and those grounded in the methods of social science. I claim here that the task for those who come to business ethics with philosophical training is to avoid unintentionally widening the (...) gap between philosophical theory and business management by emphasizing the centrality of practical wisdom to both good managment and to the moral life. Distinguishing my own approach from recent emphases on phronesis in management literature, I draw on the concepts of social practice and of narrative to tie practical reasoning to a company’s unique story. Practical reason, social practices and narrative are employed together to give an account of the art of management at Patagonia. The essay hopes to both provide a way for philosophers engaged with business ethics to see family resemblances between their practices and those of business management and to offer a pedagogical example useful for those in any discipline interested in viewing businesses ethically. (shrink)

A US Department of Health and Human Services Final Rule, Protecting Statutory Conscience Rights in Health Care, and a proposed bill in the British House of Lords, the Conscientious Objection Bill, may well warrant a concern that—to borrow a phrase Daniel Callahan applied to self-determination—conscientious objection in health care has “run amok.” Insofar as there are no significant constraints or limitations on accommodation, both rules endorse an approach that is aptly designated “conscience absolutism.” There are two common strategies to counter (...) conscience absolutism and prevent conscientious objection in medicine from running amok. One, non-toleration, is to decline to accommodate physicians who refuse to provide legal, professionally accepted, clinically appropriate medical services within the scope of their clinical competence. The other, compromise or reasonable accommodation, is to impose constraints on accommodation. Several arguments for non-toleration are critically analyzed, and I argue that none warrants its acceptance. I maintain that non-toleration is an excessively blunt instrument to prevent conscientious objection in medicine from running amok. Instead, I defend a more nuanced contextual approach that includes constraints on accommodation. (shrink)

When faced with multiple claims to a particular good, what does distributive justice require? To answer this question, we need a substantive moral theory that will enable us assign relative moral weights to the parties' claims. But this is not all we need. Once we have assessed the moral weight of each party's claim, we still need to decide what method of distribution to employ, for there are two methods open to us. We could take the winner-take-all approach, and award (...) the good to the party with the strongest claim. On the other hand, we could divide the good proportionally, according to the relative strength of each party's claim. Because the choice between these two methods of distribution can have a dramatic impact on the resulting pattern of distribution, the choice presents a question of justice. But this is a question of justice that is often overlooked. As a result, we currently employ the principle of proportionality far less often than justice actually requires. If we focus on the question of distributive method, however, we are not only better able to understand how certain reasons enter into our all-things-considered moral judgments, we are also able to explain some perplexing but common aspects of our moral beliefs: how rights can be said to have peremptory force, yet still be balanced against other important interests; how justice can sometimes require compromise, yet sometimes require victory; and how a moral theory can avoid being too demanding while still being demanding enough. Key Words: autonomy • equality • indivisibility • inviolability • weighted lotteries • rights. (shrink)

There are many different kinds of libertarianism. The first is right libertarianism, which received its most powerful expression in Robert Nozick’s Anarchy, State and Utopia (1974), a book that still sets the baseline for discussions of libertarianism today. The second, I will call faux libertarianism. For reasons I will explain in this paper, most ‘man-on-the-street’ libertarians and most politicians who claim to be libertarians are actually this kind of libertarian. And third, there is left libertarianism, which is what I shall (...) spend most of this paper explicating. But I will not simply be surveying the views of those who identify as left libertarians and put this forth as if I were engaged in an exegetical exercise. Instead, what I shall set forth is a kind of manifesto, a statement of why I consider myself a left libertarian, one that takes this approach to political morality well beyond where it was left around the end of the last century by the previous generation of left libertarians. My hope is to provide those who find certain left libertarian ideas attractive a guide by which they can explain and harmonise their own views, recognise left libertarianism as a distinct comprehensive political doctrine, and feel more open to identify themselves as left libertarian too. (shrink)

Liberalism is today under attack. This attack is being fought along two fronts, and so appears to be coming from different directions, but it is actually coming exclusively from the right. One source is Islamic fundamentalism, and the other is American neo-conservatism, which in turn unites elements of Christian fundamentalism with elements of neo-Platonic political philosophy and neo-Aristotelian moral theory. Both Islamic fundamentalism and American neo-conservatism are perfectionist views, and while perfectionist attacks on liberalism are nothing new, there is a (...) special danger in the position that liberalism currently finds itself. Although bitterly opposed to each other and divided by utterly incompatible substantive views, these two sources of attack share many similarities at a more fundamental level of political theory. The purpose of this paper is accordingly to focus our attention on the similarities between these seemingly opposing perfectionist views, and to defend liberalism against one of the most serious accusations that perfectionists from both camps make against it—the claim that liberalism leads to nihilism. (shrink)

Recognition of conscientious objection seems reasonable in relation to controversial and contentious issues, such as physician assisted suicide and abortion. However, physicians also advance conscience‐based objections to actions and practices that are sanctioned by established norms of medical ethics, and an account of their moral force can be more elusive in such contexts. Several possible ethical justifications for recognizing appeals to conscience in medicine are examined, and it is argued that the most promising one is respect for moral integrity. It (...) is also argued that an appeal to conscience has significant moral weight only if the core ethical values on which it is based correspond to one or more core values in medicine. Finally, several guidelines pertaining to appeals to conscience and their ethical evaluation are presented. (shrink)

For years now, public education, and especially public higher education has been under attack. Funding has been drastically reduced, fees increased, and the seemingly irresistible political force of ever-tightening austerity budgets threatens to cut it even more. But I am not going to take the standard line that government financial support for public higher education should be increased. I view that battle as already lost. What I am going to propose is that we stop arguing about the allocation or reallocation (...) of ever more scarce public resources and think of another way to fund public higher education. It's time for a new approach, one that satisfies the left's claim that higher education should be affordable for all, yet one that does not involve increasing expenditure of public funds or commit the government to entitlement programs that it cannot now or at least cannot long afford. What we need is a new proposal that is acceptable to both sides if we are to bring public education into the twenty-first century. And this is what this paper is devoted to providing. (shrink)

Exploitation and Economic Justice in the Liberal Capitalist State offers the first new, liberal theory of economic justice to appear in more than 30 years. The theory presented is designed to offer an alternative to the most popular liberal egalitarian theories of today and aims to be acceptable to both right and left libertarians too.

Electronegativity, described by Linus Pauling described as “The power of an atom in a molecule to attract electrons to itself” (Pauling in The nature of the chemical bond, 3rd edn, Cornell University Press, Ithaca, p 88, 1960), is used to predict bond polarity. There are dozens of methods for empirically quantifying electronegativity including: the original thermochemical technique (Pauling in J Am Chem Soc 54:3570–3582, 1932), numerical averaging of the ionisation potential and electron affinity (Mulliken in J Chem Phys 2:782–784, 1934), (...) effective nuclear charge and covalent radius analysis (Sanderson in J Chem Phys 23:2467, 1955) and the averaged successive ionisation energies of an element’s valence electrons (Martynov and Batsanov in Zhurnal Neorganicheskoi Khimii 5:3171–3175, 1980), etc. Indeed, there are such strong correlations between numerous atomic parameters—physical and chemical—that the term “electronegativity” integrates them into a single dimensionless number between 0.78 and 4.00 that can be used to predict/describe/model much of an element’s physical character and chemical behaviour. The design of the common and popular medium form of the periodic table is in large part determined by four quantum numbers and four associated rules. However, adding electronegativity completes the construction so that it displays the multi-parameter periodic law operating in two dimensions, down the groups and across the periods, with minimal ambiguity. (shrink)

The case for reparations for grievous acts of historical injustice has been getting a lot of attention lately. But I aim to broaden the discussion in two ways. First, I am not only going to talk about reparations as a means of rectifying the injuries inflicted by slavery and the genocide of indigenous peoples, the theft of their land, and the ongoing ripple effects of these historic wrongs. I am also going to talk about reparations for a wider variety of (...) historical injustices, including, most importantly, the long-term economic oppression of women, and the historical exploitation of labor. Second, I am not going to base my argument on the principle of equality, as most people currently do, but on the principle of liberty, as it is understood by libertarians on both the right and the left, at least as long as they believe what they say they believe. Not because I think that egalitarian demands for reparations are wrong. Rather, my point is that the principle of liberty, which is often raised as a defense to claims based on the principle of equality, actually leads to exactly the same place. Finally, I will discuss one possible form of reparations that has largely been ignored, but which has a special connection to libertarian principles, and I will show how it can provide some real relief without provoking the opposition that society-wide redistributive remedies usually face. (shrink)

Many people have been enraged lately by the enormous increases in certain generic prescription drugs. But free marketeers defend these prices by arguing that they simply represent what the market will bear, and in a capitalist society there is accordingly nothing wrong with charging them. This paper argues that such a defense is actually contrary to the very principles that free marketeers claim to embrace. These prices are not only unjust and exploitative, but government interference with them would not render (...) the market less free, at least if what it means for a market to be “free” is properly understood. Everyone, even free marketeers with a libertarian or neoliberal bent, should accordingly be against this kind of profiteering. (shrink)

Typically, a refusal to provide a medical service is an instance of conscientious objection only when the medical service is legal, professionally accepted, and clinically appropriate. That is, conscientious objection typically occurs only when practitioners reject prevailing norms or practices. Insofar as refusing to provide antibiotics for a viral infection does not violate prevailing clinical norms, there is no need for the physician in Case 1 to justify his refusal to provide antibiotics by appealing to his conscience.1 By contrast, insofar (...) as emergency contraception is legal and does not violate prevailing norms of good medical practice, the physician in Case 6 cannot justify his refusal to provide EC by... (shrink)

It is argued that the primary aim of institutional management is to protect the moral integrity of health professionals without significantly compromising other important values and interests. Institutional policies are recommended as a means to promote fair, consistent, and transparent management of conscience-based refusals. It is further recommended that those policies include the following four requirements: (1) Conscience-based refusals will be accommodated only if a requested accommodation will not impede a patient’s/surrogate’s timely access to information, counseling, and referral. (2) Conscience-based (...) refusals will be accommodated only if a requested accommodation will not impede a patient’s timely access to health care services offered within the institution. (3) Conscience-based refusals will be accommodated only if the accommodation will not impose excessive burdens on colleagues, supervisors, department heads, other administrators, or the institution. (4) Whenever feasible, health professionals should provide advance notification to department heads or supervisors. Formal review may not be required in all cases, but when it is appropriate, several recommendations are offered about standards and the review process. A key recommendation is that when reviewing an objector’s reasons, contrary to what some have proposed, it is not appropriate to adopt an adversarial approach modelled on military review boards’ assessments of requests for conscientious objector status. According to the approach recommended, the primary function of reviews of objectors’ reasons is to engage them in a process of reflecting on the nature and depth of their objections, with the objective of facilitating moral clarity on the part of objectors rather than enabling department heads, supervisors, or ethics committees to determine whether conscientious objections are sufficiently genuine. (shrink)

Process physics2 is, like all physics, a model of reality. However, unlike traditional substance-based versions, process physics implements many process philosophical concepts, perhaps most notably, the notion of internal relations. It argues that the universe can best be understood in terms of selfreferential semantic information that is remarkably similar to mathematical stochastic neural networks research in biology. It argues that information patterns generate new information through causal efficacy and, ultimately, internal integration, generating self-organising patterns of relationships. These patterns or relations (...) have an intrinsic value inherent in their self-actualisation and thereby experience a subjective unity in response to influences from the totality of their past. The result is an internally related self-organising stream of experiences that provides a defining essence objectively distinguishable in abstraction and as exhibiting all the characteristics of a quantum space and quantum matter. In process physics, therefore, quantum phenomena emerge where no prior assumption regarding their existence is made or prescribed at the start. Rather, they are internally generated as an inherent feature of an experientially becoming reality, growing in size over time and thus having an observable key feature — i.e. a ‘defining essence’ — of an expanding universe. Reality itself is now understood — and modeled — as having a primitive form of self awareness. By this we mean that it has, in the process philosopher Alfred North Whitehead’s words, prehensions of other actualities as objects in terms of their ‘provocation of some special activity within the subject’.3 In more biologically complex information systems these ultimately lead to experiential integration as conscious discrimination of contrasts in prior experiences. Reality is, ultimately, not about the identification of isolated individuals through externality, but related individuals through internality. The purpose of this paper is to arrive at a point whereby we might apply these ultimate principles of reality to management. To do this, we shall start by considering Whitehead’s own renderings of management issues, before turning to the use management studies has or has not made of his work. In the light of this discussion, we shall question the principle of deconstructive postmodernism that underpins this body of work. We shall then ask whether and to what extent Whiteheadian principles might help explain organisations as ‘event fields’ 4 within which ‘persons-in-communities’5 reside. This will then allow us to consider organisations in terms of a process reinterpretation of physics. In so doing, we shall uncover a final contradiction, between Whitehead’s understanding of organisation and his principles concerning the application of metaphysics, to which we shall at least indicate a solution. (shrink)

In Liberalism with Excellence, Matthew Kramer makes an argument for how excellence may enter in into liberalism, despite liberalism’s strong commitment to neutrality. Kramer seeks to challenge not only the uncompromising rejection of this position by liberals such a Jonathan Quong, but also the so-called “blended” approach of “soft-perfectionist” scholars such as Joseph Raz and George Sher. In this essay, I do not so much challenge Kramer’s approach as offer an alternative for accomplishing the same thing. Under my proposal, certain (...) forms of excellence and neutrality can both be accommodated as long as state support for the form of excellence at issue is proportional to the support for such a form of excellence within the relevant polity, competing forms of excellence are non-rivalrous, and no one is forced to embrace a form of excellence with which they disagree. My proposal is therefore not what Ronald Dworkin derogatively characterized as “a checkerboard solution.” Rather than allowing the state to support contrary moral positions at one and the same time, it is a solution that takes morally compatible but nevertheless competing conceptions of excellence seriously, and exhibits neutrality by giving them proportional rather than full support. This neither forces anyone to pursue the particular forms of excellence the state supports nor prevents them from pursuing some other form of excellence entirely or, if they wish, no form of excellence at all. (shrink)

: This paper examines the obligations of pharmacy licensees and pharmacists in the context of conscience-based objections to filling lawful prescriptions for certain types of medications—e.g., standard and emergency contraceptives. Claims of conscience are analyzed as means to preserve or maintain an individual's moral integrity. It is argued that pharmacy licensees have an obligation to dispense prescription medications that satisfy the health needs of the populations they serve, and this obligation can override claims of conscience. Although efforts should be made (...) to respect the moral integrity of pharmacists and accommodate their claims of conscience, it is argued that the health needs of patients and the professional obligations of pharmacists limit the extent to which pharmacists may refuse to assist patients who have lawful prescriptions for medically indicated drugs. (shrink)

While the importance of mechanisms in determining causality in medicine is currently the subject of active debate, the role of mechanistic reasoning in clinical practice has received far less attention. In this paper we look at this question in the context of the treatment of a particular individual, and argue that evidence of mechanisms is indeed key to various aspects of clinical practice, including assessing population-level research reports, diagnostic as well as therapeutic decision making, and the assessment of treatment effects. (...) We use the pulmonary condition bronchiectasis as a source of examples of the importance of mechanistic reasoning to clinical practice. (shrink)

Discussions of appeals to conscience by healthcare professionals typically focus on situations in which they object to providing a legal and professionally permitted service, such as abortion, sterilization, prescribing or dispensing emergency contraception, and organ retrieval pursuant to donation after cardiac death. “Negative claims of conscience” will designate such appeals to conscience. When healthcare professionals advance a negative claim of conscience, they do so to secure an exemption from ethical, professional, institutional, and/or legal obligations or requirements to provide a healthcare (...) service. (shrink)

In this thoughtful and literate study, Schwehn argues that Max Weber and several of his contemporaries led higher education astray by stressing research--the making and transmitting of knowledge--at the expense of shaping moral character. Schwehn sees an urgent need for a change in orientation and calls for a "spiritually grounded education in and for thoughtfulness." The reforms he endorses would replace individualistic behavior, the "doing my own work" syndrome derived from the Enlightenment, with a communitarian ethic grounded in Judeo-Christian spirituality. (...) Schwehn critiques philosophies of higher education he considers misguided, from Weber and Henry Adams to Derek Bok, Allan Bloom, and William G. Perry Jr. He draws out valid insights, always showing the theological underpinnings of the so-called secular thinkers. He emphasizes the importance of community, drawing on both the secular communitarian theory of Richard Rorty and that of the Christian theorist Parker Palmer. Finally, he outlines his own prescription for a classroom-centered spiritual community of scholars. Schwehn's study will interest all those concerned with higher education in America today: faculty, students, parents, alumni, administrators, trustees, and foundation officers. (shrink)