Many western industrialized countries are currently suffering from a crisis in health human resources, one that involves a debate over the recruitment and licensing of foreign-trained doctors and nurses. The intense public policy interest in foreign-trained medical personnel, however, is not new. During the 1960s, western countries revised their immigration policies to focus on highly-trained professionals. During the following decade, hundreds of thousands of health care practitioners migrated from poorer jurisdictions to western industrialized countries to solve what were then deemed (...) to be national doctor and nursing 'shortages' in the developed world. Migration plummeted in the 1980s and 1990s only to re-emerge in the last decade as an important debate in global health care policy and ethics. This paper will examine the historical antecedents to this ethical debate. It will trace the early articulation of the idea of a 'brain drain', one that emerged from the loss of NHS doctors to other western jurisdictions in the 1950s and 1960s. Only over time did the discussion turn to the 'manpower' losses of 'third world countries', but the inability to track physician migration, amongst other variables, muted any concerted ethical debate. By contrast, the last decade's literature has witnessed a dramatically different ethical framework, informed by globalization, the rise of South Africa as a source donor country, and the ongoing catastrophe of the AIDS epidemic. Unlike the literature of the early 1970s, recent scholarship has focussed on a new framework of global ethics. (shrink)
Some people have supposed that utility is good in itself, non-in-strumentally good, as distinct from good because conducive to other good things. And in modern versions of this view, utility often means want-satisfaction, as distinct from pleasure or happiness. For your want that p to be satisfied, is it necessary that you know or believe that p, or sufficient merely that p is true? However that question is answered, there are problems with the view that want-satisfaction is a non-instrumental good. (...) What if you want something only because you have a false belief? What if the time at which you want that p is fifty or five hundred years before the time to which p itself refers? To meet these difficulties, qualifications have to be introduced, and much has been written about how exactly these qualifications are to be framed.1 There is however what may be a rather more serious objection to the view that want-satisfaction is a non-instrumental good, or rather to the combination of that view with the principle that it is sufficient for your want that p to be satisfied simply that p is true. The objection is that this combination forces you to give undue weight to the mere acquisition of desires when you come to make judgements about changes in the value of things. It forces you to say that for any true proposition p, which initially you do not want to be true, your mere acquisition of a desire that p will, other things being equal, make the world better. Non-instrumental value can be increased merely by multiplying desires, even though everything else remains the same. Surely, however, improving the world is not as easy as that. (shrink)
You have a body, but you are a soul or self. Without your body, you could still exist. Your body could be and perhaps is outlasted by the immaterial substance which is your soul or self. Thus the substance dualist. Most substance dualists are Cartesians. The self, they suppose, is essentially conscious: it cannot exist unless it thinks or wills or has experiences. In this paper I sketch out a different form of substance dualism. I suggest that it is not (...) consciousness but another immaterial feature which is essential to the self, a feature in one way analogous to a non-dispositional taste. Each self has moreover a different feature of this general kind. If this is right then simple and straightforward answers are available to some questions which prove troublesome to the Cartesian, consciousness-requiring type of substance dualist. I mean the questions, How can the self exist in dreamless sleep?, What distinguishes two simultaneously existing selves, and What makes a self the same self as a self which exists at some other time? (shrink)
I argue for two principles by combining which we can construct a sound cosmological argument. The first is that for any true proposition p's if ‘there is an explanation for p's truth’ is consistent then there is an explanation for p's truth. The second is a modified version of the principle that for any class, if there is an explanation for the non-emptiness of that class, then there is at least one non-member of that class which causes it not to (...) be empty. (shrink)
Beneath metaphysical problems there often lies a conflict between what we want to be true and what we believe to be true. Nathan provides a general account of the resolution of this conflict as a philosophical objective, showing that there are ways of thinking it through systematically with a view to resolving or alleviating it. The author also studies in detail a set of interrelated conflicts about the freedom and the reality of the will. He shows how difficult it (...) is to find a freedom either of decision or of action which is both an object of reflective desire and an object of rational belief. He also examines conflicts about volition as such, contending that the veridicality of volitional experience is no less easy to doubt than the veridicality of our experience of colors. In this context, arguments emerge for a voluntarist theory of the self. Nathan's important book will be essential reading for all philosophers interested in free will, volition, the self, and the methodology of metaphysics. (shrink)
A systematic study of rational or justified belief, which throws fresh light on current debates about foundations and coherence theories of knowledge, the validation of induction and moral scepticism. Dr Nathan focuses attention on the largely unsatisfiable desires for active and self-conscious assurance of truth liable to be engendered by philosophical reflection about total belief-systems and the sources of knowledge. He extracts a kernel of truth from the doctrine that a regress of justification is both necessary and impossible, contrasts (...) the resultant scepticism with more familiar complaints about the inapplicability of supposedly essential cognitive concepts and explores the feasibility of non-Humean modes of consolation. This is an original and carefully constructed book, which will interest professional philosophers and advanced students of epistemology. (shrink)
The Price of Doubt is an important contribution to the problem of scepticism. It offers a new standard for the appraisal of philosophical arguments. Nicholas Nathan confronts the sceptic. He questions the value of his argument and the knowledge it contains and provides a potential remedy to the frustrations of anti-sceptical epistemology.
While philosophers tend to consider a single type of causal history, biologists distinguish between two kinds of causal history: evolutionary history and developmental history. This essay studies the peculiarity of development as a criterion for the individuation of biological traits and its relation to form, function, and evolution. By focusing on examples involving serial homologies and genetic reprogramming, we argue that morphology (form) and function, even when supplemented with evolutionary history, are sometimes insufficient to individuate traits. Developmental mechanisms bring in (...) a novel aspect to the business of classification—identity of process-type—according to which entities are type-identical across individuals and natural kinds in virtue of the fact that they form and develop through similar processes. These considerations bear important metaphysical implications and have potential applications in several areas of philosophy. (shrink)
This essay presents a model-theoretic account of dispositional properties, according to which dispositions are not ordinary properties of real entities; dispositions capture the behavior of abstract, idealized models. This account has several payoffs. First, it saves the simple conditional analysis of dispositions. Second, it preserves the general connection between dispositions and regularities, despite the fact that some dispositions are not grounded in actual regularities. Finally, it brings together the analysis and the explanation of dispositions under a unified framework.
This essay is concerned with concentrations of entities, which play an important—albeit often overlooked—role in scientific explanation. First, I discuss an example from molecular biology to show that concentrations can play an irreducible causal role. Second, I provide a preliminary philosophical analysis of this causal role, suggesting some implications for extant theories of causation. I conclude by introducing the concept of causation by concentration, a form of statistical causation whose widespread presence throughout the sciences has been unduly neglected and which (...) deserves to be studied in more depth. 1 Introduction2 Solving Lillie's Paradox: Lysogenic Induction in Phage λ3 Repressor Concentration and the Tuning of the Switch4 Concentration and Causality5 Preemption in Concentrations: Analysis and Implications6 Causation by Concentration: General Definition, Refinements, and Further Applications. (shrink)
Biologists employ a suggestive metaphor to describe the complexities of molecular interactions within cells and embryos: cytological components are said to be part of “ecosystems” that integrate them in a complex network of relations with many other entities. The aim of this essay is to scrutinize the molecular ecosystem, a metaphor that, despite its longstanding history, has seldom be articulated in detail. I begin by analyzing some relevant analogies between the cellular environment and the biosphere. Next, I discuss the applicability (...) of the molecular ecosystem concept in actual scientific practice. (shrink)
There is an apparent problem in identifying a basis for equality. This problem vanishes if what I call the ‘intuited response’ is successful. According to this response, there is no further explanation of the significance of the feature in virtue of which an individual matters, beyond the bare fact that it is the feature in virtue of which an individual matters. I argue against this claim, and conclude that if the problem of identifying a basis for equality is to be (...) resolved, it is necessary to defend a substantive account of the independent significance of some feature. (shrink)
I argue that intentionalism in aesthetics and in legal interpretation is vulnerable to a different sort of criticism than is found in the voluminous literature on the topic. Specifically, a kind of paradox arises for the intentionalist out of recognition of a second-order intention embedded in the social practices that characterize both art and law. The paper shows how this second-order intention manifests itself in each of the two enterprises, and argues that its presence entails the overriding centrality of the (...) public text, and hence a rejection of the interpretive stance distinctive of intentionalism itself. (shrink)
Objective To assess parental permission for a neonate's research participation using the MacArthur competence assessment tool for clinical research (MacCAT-CR), specifically testing the components of understanding, appreciation, reasoning and choice. Study Design Quantitative interviews using study-specific MacCAT-CR tools. Hypothesis Parents of critically ill newborns would produce comparable MacCAT-CR scores to healthy adult controls despite the emotional stress of an infant with critical heart disease or the urgency of surgery. Parents of infants diagnosed prenatally would have higher MacCAT-CR scores than parents (...) of infants diagnosed postnatally. There would be no difference in MacCAT-CR scores between parents with respect to gender or whether they did or did not permit research participation. Participants Parents of neonates undergoing cardiac surgery who had made decisions about research participation before their neonate's surgery. Methods The MacCAT-CR. Results 35 parents (18 mothers; 17 fathers) of 24 neonates completed 55 interviews for one or more of three studies. Total scores: magnetic resonance imaging (mean 36.6, SD 7.71), genetics (mean 38.8, SD 3.44), heart rate variability (mean 37.7, SD 3.30). Parents generally scored higher than published subject populations and were comparable to published control populations with some exceptions. Conclusions The MacCAT-CR can be used to assess parental permission for neonatal research participation. Despite the stress of a critically ill neonate requiring surgery, parents were able to understand study-specific information and make informed decisions to permit their neonate's participation. (shrink)
Six recently discussed problems in discrete probabilistic sample space, which have been found puzzling and even paradoxical, are reexamined. The importance is stressed of a sharp distinction between the formalization of mathematical problems and their formal solution that, applied to probability theory, must lead through the explicit partitioning of a sample space. If this approach is consistently followed, such problems reveal themselves to be either inherently ambiguous, and therefore without solution, or quite straightforward. In both cases nothing remains of any (...) sense of paradox. (shrink)
Direct Realists believe that perception involves direct awareness of an object not dependent for its existence on the perceiver. Howard Robinson rejects this doctrine in favour of a Sense-Datum theory of perception. His argument against Direct Realism invokes the principle ‘same proximate cause, same immediate effect’. Since there are cases in which direct awareness has the same proximate cerebral cause as awareness of a sense datum, the Direct Realist is, he thinks, obliged to deny this causal principle. I suggest that (...) although Direct Realism is in more than one respect implausible, it does not succumb to Robinson’s argument. The causal principle is true only if ‘proximate cause’ means ‘proximate sufficient cause’, and the Direct Realist need not concede that there is a sufficient cerebral cause for direct awareness of independent objects. (shrink)
In "Warrant and Proper Function" Plantinga argues that atheistic Naturalism is self-defeating. What is the probability that our cognitive faculties are reliable, given this Naturalism and an evolutionary explanation of their origins? Plantinga argues that if the Naturalist is modest enough to believe that it is irrational to have any belief as to the value of this probability, then he is irrational even to believe his own Naturalism. I suggest that Plantinga's argument has a false premise, and that even if (...) his argument were sound there would be reasons for doubting whether the Naturalist should respond to it by abandoning his Naturalism. (shrink)
When do two mental items belong to the same life? We could be content with the answer -just when they have certain volitional qualities in common. An affinity is noted between that theory and Berkeley's early doctrine of the self. Some rivals of the volitional theory invoke a spiritual or physical owner of mental items. They run a risk either of empty formality or of causal superstition. Other rivals postulate a non-transitive and symmetrical relation in the set of mental items. (...) They must allow in consequence either for joint ownership of one and the same mental item, or for incompatible simultaneous decisions by one and the same person, or for new forms of death. This makes them disquieting. Another rival invokes a transitive and symmetrical relation defined in terms of co-consciousness. Even that allows for incongruous simultaneities. The volitional theory is free from such disadvantages. (shrink)
Some people believe that God made it a condition for His forgiveness even of repentant sinners that Jesus died a sacrificial death at human hands. Often, in the New Testament, this doctrine of Objective Atonement seems to be implied, as when Jesus spoke of his blood as ‘shed for many for the remission of sins’ , or when St Paul said that ‘Christ died for our sins according to the scriptures’ . And for many centuries the doctrine was indeed accepted (...) by most if not all Christian theologians. It seems in fact to be an essential part of Christianity, which adherents of that religion cannot reject without undermining the authority both of their scriptures and of a very long tradition. It looks then as if objections to the doctrine are objections to the Christian scheme itself. Here is one of them. As the Gospels present it Jesus was murdered, by one or more of Pilate, the Sanhedrin and the Jewish mob. Given Objective Atonement, God ordained the sacrificial death of Jesus, and so, as it seems, this murder. Murder requires freedom on the killer's part. And many have doubted that an action can be both free and ordained by God. Leave that aside. A good God would in any case not make it a condition for our forgiveness that someone acquired the guilt of murder. (shrink)
1. The ideal of spatio-temporally unrestricted generalisation, which marks all post-mythological thinking about nature, marks no more than the continuity of totemism in political casuistry. No unrestricted principle of Socialism or Conservatism or Liberal Democracy is defensible unless it is accorded a moral ultimacy which almost no one fully conscious of what he was about would actually want to accord it. If this bare platitude is to be fully assimilated, it needs both concrete exemplification and support of the systematic kind. (...) Liberal principles are well provided for in these respects: J. F. Stephen showed in brilliant detail that, from a utilitarian point of view, the question whether liberty even in advanced societies is irrespective of time and place a good or a bad thing is an irrational question—”as irrational as the question whether fire is a good or a bad thing.” But demonstrations and illustrations of the restricted nature of our other popular political principles are not so easily come by, and the critical survey of standard prodemocratic arguments, which makes up Part III of this paper, is meant to supply a part of the deficiency. (shrink)
I argue for two principles by combining which we can construct a sound cosmological argument. The first is that for any true proposition p's if 'there is an explanation for p's truth' is consistent then there is an explanation for p's truth. The second is a modified version of the principle that for any class, if there is an explanation for the non-emptiness ofthat class, then there is at least one non-member ofthat class which causes it not to be empty.
Some Christians combine a doctrine about Christ which implies that there is more than one divine self with the doctrine that God revealed to the Jews a monotheism according to which there is just one divine self. I suggest that it is less costly for such Christians to achieve consistency by abandoning the second of these doctrines than to achieve it by abandoning the first.
[Colour is king in our innate quality space, but undistinguished in cosmic circles.] Most philosophers would agree with at least the second half of Quine's dictum. It is indeed on the general view wrong to believe that, as qualities, colours are extra-mentally actual in even the humblest role. Mind-independent material things have on the general view powers to cause sensations of red or blue, but if, in [sensations of red or blue], [red] and [blue] name qualities, we are not to (...) believe that these qualities are possessed by things causing the sensations. My first thesis, defended in section 2, is that partly because we do count colours as eminent among qualities, we would on reflection want it to be true that some things have such qualities when they are not perceived. It would therefore be sad subsequently to discover the wrongness of believing that this is how things are. My second thesis, defended in sections 3 and 4, is that there is in fact no danger as yet of this kind of disappointment. So far, the philosophers have not shown that, if we believe that colour qualities exist as contents of experience, we ought not also to believe that things have these qualities when they are not perceived. One might of course deny that colour qualities exist even as contents of experience, so that the desire for them to be mind-independently exemplified evaporates on the realization that it lacks an intelligible object. Our pre-scientific concept of red, according to Armstrong, is, apart from being the concept of something falling under a determinable, [all blank or gap]. (shrink)
Jaynes contends that in many statistical problems a seemingly indeterminate probability distribution is made unique by the transformation group of necessarily implied invariance properties, thereby justifying the principle of indifference. To illustrate and substantiate his claims he considers Bertrand's Paradox. These assertions are here refuted and the traditional attitude is vindicated.
Common probabilistic fallacies and putative paradoxes are surveyed, including those arising from distribution repartitioning, from the reordering of expectation series, and from misconceptions regarding expected and almost certain gains in games of chance. Conditions are given for such games to be well-posed. By way of example, Bernoulli's "Petersburg Paradox" and Hacking's "Strange Expectations" are discussed and the latter are resolved. Feller's generalized "fair price, in the classical sense" is critically reviewed.