RESUMEN Largamente desatendida o malinterpretada, la noción de caos en la filosofía de Nietzsche es una pieza constitutiva de la particular concepción del ser que este autor habría dejado apenas esbozada. El artículo se propone elaborar este concepto en la obra nietzscheana, siguiendo algunas de las metáforas que lo iluminan. Desde allí se busca plantear los rasgos centrales de una ontologia del caos, de sesgo no metafísico, que, al afirmar el carácter acontecimental de la realidad, puede verse como precursora de (...) la ontología hermenéutica contemporánea. ABSTRACT The notion of chaos, which has long been neglected or misinterpreted, is a constitutive element of a peculiar conception of being that the philosopher only had time to outline. The objective of this article is to elaborate on this concept in Nietzschean philosophy, guided by some of the metaphors that shed light on it. This serves as the basis to set forth the main characteristics of a non-metaphysical ontology of chaos that asserts the eventful nature of reality and can thus be seen as a precursor of contemporary hermeneutic ontology. (shrink)

In his comprehensive book, A Theory of Subjective Wellbeing, Mark Fabian offers a holistic account of subjective wellbeing that aims to deal with some of the issues that arise in current subjective...

_Erich Reck* * and Georg Schiemer.** ** The Prehistory of Mathematical Structuralism. _Oxford University Press, 2020. Pp. 454. ISBN: 978-0-19-064122-1 ; 978-0-19-064123-8. doi: 10.1093/oso/9780190641221.001.0001.

continent. 1.4 (2011): 279—285. Concerning its Transitive Nature, the Conversion of Native Americans of Spanish Colonial California, Indoctrinated Catholicism, & the Creation There’s no direct archaeological evidence that Jesus ever existed. 1 I memorized the Act of Contrition. I don’t remember it now, except the beginning: Forgive me Father for I have sinned . . . This was in preparation for the Sacrament of Holy Reconciliation, where in a confessional I confessed my sins to Father Scott, who looked like Jesus, (...) at least in Western cultural representations of Jesus since the middle ages, and if Jesus put on a few pounds. Father Scott was long-haired, redheaded, bearded, chubby, and tall. When he left church with the procession of altar servers and Eucharistic ministers, yelling, “Sing a Good Song Unto the Lord,” he smiled, hands folded, and he gazed over his parishioners, and bounced along. For four months every year he lived among the Crow Nation in Montana, where towards the end of his tenure at Our Lady of Refuge, they adopted him as an honorary member of their tribe. * This is the prayer we chanted, holding hands, every night before dinner: Bless us oh Lord, for these our gifts, which we are about to receive, our bounty through Christ, our Lord, Amen. Then we all said, God bless the cook! When we were with my grandparents, Grandpa said, God bless Chicky, and Holly, and Harvey, and Boots—all the dead dogs. * My sister tells me that she sits next to a handsome man on a flight across the country. After chitchat, she withdraws her book. She’s reading Kevin Sampsell’s A Common Pornography . After a few moments, the handsome man also reads from his book—his leather-bound Bible. Sister thinks, Oh, Jesus—too bad. She falls asleep. Later, settled in Nashville, she opens her volume and out falls a Jesus-covered card that reads, You can still find God and Salvation! Because that handsome God-fearing young man saw that word— pornography . * I suppose Father Jim’s dark hair, beard, and glasses made me think doctoral-ly of him. He called while I was in the midst of a breakup, after I’d twice attempted suicide, and my mother was desperate for help. She somehow found and phoned him. And Jim, now years out of Our Lady of Refuge’s parish, twenty years since my baptism, years even since he’d left the priesthood and the Catholic faith, still made the effort to bring me back into the fold. He said, “Have you seen a priest?” I did not respond, as I was more shocked to hear his voice than anything, so I said, “How are you, Father Jim? Sorry, I guess I shouldn’t call you ‘Father.’” And I said, “Why did you leave the priesthood? Do you have a girlfriend?” He said that I should call him just “Jim.” He said, “Do you need someone to talk to?” I said, “Not really.” He said, “Call your mother; she’s worried about you.” That was the last time I talked to Father Jim. * Mother let me know just how disappointed Jesus was. I cried and cried, and said I was sorry. Into my hands she placed my missal, ordered forty Rosaries. She said next Saturday I would go to confession. I hated confession. Who wouldn’t? * I realize, of course, that this page is a kind of confessional. * The Kumeyaay, Ipai, Tipai, Chumash, Esselen, Rumsen—all Native Americans of Alta California—shared similarities in their religions. Southern Californian tribes made use of Datura, or jimpson weed, a hallucinogen, for religious rituals. In the creation, God made brother sky and sister earth. Brother and sister mated, and sister gave birth to all things on Earth, including people, but it was difficult to distinguish people from all other aspects of Earth because everything was alive: granite and obsidian, the Pacific and its waves, the San Diego and Los Angeles Rivers. Wiyot—a hero—was very powerful, born from lightning, the son of the Creator and a virgin. When Wiyot thought that human women’s legs were more beautiful than Frog’s, Frog became jealous and poisoned Wiyot. The dying Wiyot went to all the people’s villages, and he distributed his power among them. He said, “When I die, I should be cremated.” The people built the fire and funeral pyre. When the fire was ready, and the people about to place Wiyot’s body upon it, Coyote came and snatched away Wiyot’s heart. * My friend Nick told me once how he ate some jimpson weed and that he hallucinated for three days. His family took a road trip and, while driving over the Sierra Nevada mountains, he kept seeing dinosaurs roaming the open meadows and charging down snowy slopes. So it’s no wonder that Native Americans who ingested this plant would have developed religion. * Walking Castroville’s streets after school I got into fights but mostly watched other boys scrabbling on the asphalt. I went to Burger King for Whoppers. Me and my friends cussed. Antonio admonished me when I said, “damn,” while strutting a sidewalk alongside the church. He said, “Jaime”—pronounced Hi-May, which was what all the Mexicans called me—“you’re crazy, eh. Don’t cuss at the church.” He meant while at church, as in, within its vicinity. I said, “We’re not in church.” Once we’d crossed the street, Tony said, “Damn dude, you’re fuckin crazy!” * Blessed Father Fray Junípero Serra raised the Eucharistic goblet to his lips, and candlelight danced on the blood’s tiny waves. Incense clouded the church so completely that some of the Pame natives grew nauseous. So, too, felt Blessed Father Fray Junípero Serra later that night, as he bent over a ceramic bowl and vomited blood, not only the Lord’s, but his own, for poison had laced the sacred vessel into which he poured the sacrament. The physician tending to the sick prelate urged him to take the remedy he’d prepared. But Blessed Father Fray Junípero Serra refused, said that he would pray, for he had never taken any medicine in his life, and he never would. * The Chumash of El Valle de Los Osos called themselves the Stishni, separating themselves from Chumash of other regions, those varying tribes of the central California coast that spoke mutually unintelligible dialects of their Hokan language. This made learning their languages impossible for the Spanish friars, to say nothing of translating the Doctrina. Thus the priests baptized few natives, despite the help that the tribes offered the fledgling settlements in the form of meat and acorn meal, which the Spaniards found repugnant. Some from these cultures, feeling threatened by the newcomers, shot flaming arrows into the thatched roofs of the mission structures. And why wouldn’t they feel threatened when priests chastised them for performing, for example, their Coyote Dance, wherein a man donning a coyote-skin-and-skull costume dances while a singer sings his tale, which laments the human feces strewn imaginatively about the Earth? Coyote, meantime, tries to get an onlooker to lick his genitals, and finally engages in public sexual intercourse with a female tribe member or two, then ends the dance by defecating. Though the Franciscans called such forbidden acts devilry , the Chumash maintained their Datura cult religion, along with the enforced Christianity. For the Chumash, the Earth was made of two enormous snakes that caused earthquakes when they slithered past one another—a vast reptilian tectonics. In the 20th century, long after Blessed Father Fray Junípero Serra and his cohorts had died, when asked by an anthropologist about religious contradictions, conflating the Datura and Christian cults, a Chumash man replied, incredulous: “But these are two different religions.” * When Portolá ordered that if by March 19th, the feast day of St. Joseph, the San Antonio had not arrived in San Diego Bay to relieve them, the Sacred Expedition to Nueva California would be abandoned, Blessed Father Fray Junípero Serra prayed a novena for San José’s intercession. And lo, a lookout sighted the San Antonio ’s sails—what seemed to the priest a miracle—that very Saint’s feast day. Europeans would stay in California, and Blessed Father Fray Junípero Serra would continue to reap a great harvest of souls for the Lord. By the end of mission secularization in 1836—sixty-six years after the San Antonio rescued the Spaniards—Native American populations in California had declined by seventy-three percent. * When Peter the Aleut would not renounce his Eastern Orthodox faith the padre of San Francisco had a toe severed from each foot with each refusal, totaling ten. The native Ohlones employed in this gruesome task—their obsidian chiseled knives tearing through skin and grinding bone—continued as per their orders, and cut off also each of Peter’s fingers (equals a total of twenty refusals). They quartered the martyr, spilled his bowels, as if from bear attack, attack by a bear in the shape of a Catholic. * Blessed Father Fray Junípero Serra absolutely believed that the slow rate of conversion for the native people was due to the influence of the Devil, who had been outraged by the coming of the Catholics to California, this region that he had long held in his dominion. * In his reception speech for the Nobel Prize for Literature, John Steinbeck said, “Man himself has become our greatest hazard and our only hope. So that today, St. John the Apostle may well be paraphrased: In the end is the Word, and the Word is Man—and the Word is with Men.” * In 1602, when Sebastián Vizcaíno and his friars sang mass on Catalina Island, as many as a hundred Pimungans witnessed the rite, asking by signs what it was about. According to Vizcaíno’s records, the Californians marveled not a little at the idea of Heaven and at the image of Jesus crucified. * Vizcaíno was brought to a prairie on Santa Catalina Island where the Pimungans worshipped their sun god. Upon the prairie they had placed an icon, a headless figure with horns protruding from the body, a figure that Vizcaíno predictably described as a demon. The Pimungans urged Vizcaíno not to approach the image of their deity, but he ignored them. He placed his crucifix against the wooden figurine and prayed the Our Father. Vizcaíno told the natives that his prayer was from Heaven, and that their god was the Devil. Vizcaíno held out his crucifix, encouraging the Pimungans to touch it and receive Jesus. He pointed at the sky and indicated Heaven. The Pimungans worshipped a sun deity, so they were impressed with this white man and his description of his god, for their gods seemed to be one and the same. It’s no wonder then that Vizcaíno’s diary reports the natives being pleased with this exchange. “Surely,” the diary says, “they will be converted to our Holy Faith.” * The Miwok women wailed and scratched at their faces when their men consorted with Sir Francis Drake and the other Englishmen who had landed on California’s coast in the summer of 1579. “The blood streaming downe along their brests, besides despoiling the upper parts of their bodies of those single coverings . . .they would with furie cast themselves upon the ground . . . on hard stones, knobby hillocks, stocks of wood, and pricking bushes.” Drake and his men fell themselves to their knees in prayer, their eyes Heavenward, so that the natives might see they prayed to God and they too might worship God then their eyes that had been so blinded by the deceiver might be opened. * Father Fray Antonio de la Ascención—Carmelite friar in Vizcaíno’s party—writes that the Indians of California can “easily and with very little labor be taught our Holy Catholic faith, and that they would receive it well and lovingly.” He calls for two hundred older and honorable soldiers to ensure brotherhood during the conquest, so that peace and love—the best tools to pacify pagans—should reign. The religious, the friar says, should likewise be wise and loving to easily quell animosities between Spaniards and the heathen, and therefore avoid war. The Spaniards should bring with them trinkets—beads, mirrors, knives—to distribute amongst the gentiles, so that they might come to love the Christians, and see “that they are coming to their lands to give them that of which they bring, and not to take away the Indians’ possessions, and may understand that they are seeking the good of their souls.” No women are to accompany the conquest, says Father Fray Antonio, “to avoid offenses to God.” * In 1955 Wallace Stevens admitted himself to St. Francis Hospital in Hartford, Connecticut. There, it’s rumored he converted to Catholicism before dying of stomach cancer, exclaiming to his priest after the baptism, “Now I am in the fold.” Stevens’s late-career poems seem less cynical, more in awe of being and death (read “Metaphor as Degeneration” from The Auroras of Autumn ). He could have chosen from at least three secular hospitals in Hartford at the time. * I was reading Stevens’s Collected Poems when I joined eHarmony and listed that as my “currently reading” book among the “more than twelve” books a year that I would read. I fell in love with my wife when she said, “Are you sending your work out to literary journals?” Prior to this, the first girl I talked to on the phone, when I explained my doctoral exams, said, “So, you’re like, reading Stephen King and stuff?” When I said not exactly she responded defensively: “He must be doing something right, since he makes all that money.” * Mom walked me, my brother, and sister, through the Stations of the Cross. We did this on Ash Wednesdays, or whenever she thought we needed extra God after church. It might’ve happened before church, though that’s unlikely because we were always late. Anyway, it’s easiest to walk the Stations of the Cross when there’s no one else around. To walk the actual Stations means one goes to Jerusalem and walks the Via Dolorosa to the Church of the Holy Sepulchre. So the Stations elsewhere—usually paintings, or low-relief sculptures upon church walls—serve as a kind of virtual Dolorosa. Mom held our hands and started from the rear of Our Lady of Refuge: the First Station. Mom said we should say a prayer at each Station and to think of all the pain Jesus went through so that we could go to Heaven. It was hard to keep thinking about that one thing for so long. My mind went to that Saturday’s little league game, to the donut and chocolate milk (our after-church reward from Castroville Bakery), and as I grew older I thought about girls. When you’re thirteen you can’t not think about the girl’s butt in the pew in front of yours as she kneels and stands to pray throughout mass. * It grew increasingly juvenile to lie awake at night daring myself to utter a simple sentence. Even if I said I didn’t believe in God, wouldn’t He know the truth? He was omniscient, like a narrator. Even the idea of Him as a him ceased making sense. Not only did this come with a budding realization of my paternalistic culture, but due to the simple question of why? If God was everything, everywhere, all knowing, then why would he be a man? There’s that question: If God is a man then God must have a penis, and if so, what for? * The Catholic Church incorporates some modern scientific research into its dogma concerning the formation of the Universe, Solar System, and Earth, as well as evolution. According to Catholic doctrine, in approximately the fifth millennia BCE, humans began to worship the one true God. Those humans were Adam and Eve, though the Church says humans had been around for thousands of years prior to Adam and Eve. The Church claims to be infallible. Every time the Church changes its doctrine it remains infallible. * One Catholic writer, Tom Meagher, writes that “Modernism[—]the idea that we come to our beliefs individually through emotional or personal experiences[—]has crept into our Catholic schools.” * Catholics believe that evil spirits, given power through Original Sin, can imbue ordinary inanimate objects of everyday use. Thus, such objects should be blessed in order to induce in them the desire to serve the good. Such objects are not limited to, but include, “new ships and boats, railways and trains, bridges, fountains, wells, cornmills, limekilns, smelting furnaces, telegrams, steam engines, and machines for providing electricity.” * In The Sound of Music Julie Andrews and Christopher Plummer sing together: “Nothing comes from nothing, nothing ever could...” * To explain competing theories on the very early universe, and pre-verse would be another book. What was the inflaton? Did (mem)branes collide, initiating the Big Bang, as opposed to Lemaître’s primordial atom, a singularity? Without a unified theory there’s gravity hanging out there, fucking everything up. We cannot make sense of the mechanics of the Planck Epoch—0-10-34 seconds into the Universe’s creation—named for Max Planck, who stumbled into the discovery of quantum mechanics in the early twentieth century. * My students often ask if I believe in God, since I espouse evolution, the Big Bang, Science, reject a strictly biblical or creationist theory of the Universe. I tell them that yes, I believe in God, though not the God that they imagine one must believe in. * When questioned regarding the rumor that, before his death, founder of quantum mechanics Max Planck had converted to Catholicism, he replied that he did not believe “in a personal God, let alone a Christian God.” * Physicist and Catholic priest George Lemaître, who formulated the theory and wrote the 1946 book The Primeval Atom Hypothesis , was made a household name by then-detractor Fred Hoyle, who pejoratively referred to the idea as a “Big Bang.” * Suicide is a mortal sin. To end one’s own life one must have despair, which is to lose hope, which is to lose faith, and to disbelieve in God. * Archaeology has uncovered graffiti in all of California’s missions—Indian pictographs inscribed into the adobe, covered with layers of whitewash. Native deities and depictions of cultural practices show that tribespeople never fully gave up their native traditions even after baptism and coming to the missions. There was something inside Native Californians that would never die. (shrink)

Pró logo de Ana Marí a Gonzá lez Garza Tal como lo hizo Aristó teles con Nicó maco, o Savater con Amador, Hé ctor Sevilla ofrece un libro de é tica a Sofí a. No se trata de un conjunto de reglas para vivir de manera moral, sino de una invitació n a reflexionar con libertad. No se necesita ser Sofí a, ser mujer o transitar la adolescencia para encontrar provecho en las ideas vertidas en cada una de las cartas. (...) Valentí a, prudencia, cuidado de sí, solidaridad, desapego, resiliencia, gratitud y perseverancia, son solo algunos de los tó picos que se abordan con sencillez y soltura. Este cariñ oso legado pretende hablar en nombre de todos los padres, incluso de aquellos que han partido. (shrink)

Ezezkoa dirudi izenburuko galderari eman behar zaion erantzuna, gutxienez iraultza zientifikoa geroztik, Natura hizkuntza matematikoan idatzita dagoen liburu bat omen denetik. Ikuspegi hori aurrera egingo du eta XX. menderako harridura alaia deitu dudana ekarriko du, Wigner 1960-en kasuan eta beste batzuenean ikusten denez. Jarrera hori biologiaren hainbat arloetan aurkitu ditzazkegunekin alderatzen dut eta hor lilura hori ez da inondik agertzen eta, gehienez, oso ikuspegi utilitarista bat hartzen da. Bukatzeko, biologiaren erdian bertan daukagun mugagabetasunaren kasu natural agian aipagarriena azaltzen dut modu (...) laburrean: eboluzio mugagabea.The answer to the title questions appears to be in the negative, at least since the scientific revolution when nature began to be seen as a book written in the language of mathematics. This approach is going to develop further and, by the xxth century, brings forward what I will call a cheerful amazement as exemplified in Wigner 1960 and others. I contrast this attitude with those we my find in several areas of biology where the charm is clearly absent and, as much, a very utilitarian approach is taken. I end up with a brief mention to open-ended evolution as a material case of infinity right at the center of biology. (shrink)

Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS I. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[i] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[ii] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. II. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[iii] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[iv] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[v] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[vi] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[vii] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[viii] In democratic societies, one must take into consideration community morals and values.[ix] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[x] III. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[xi] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[xii] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[xiii] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[xiv] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. IV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[xv] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[xvi] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[xvii] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[xviii] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[xix] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[xx] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[xxi] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. VI. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[xxii] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[xxiii] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[xxiv] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. VII. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [i] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [ii] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [iii] Moss, p. 1295-1298. [iv] Moss, p. 1296. [v] Moss, p. 1295-1298. [vi] Moss, p. 1295-1298. [vii] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [viii] Cohen, p. 1299-1301. [ix] Moss, p. 1297. [x] Cohen, p. 1300. [xi] Cappelen, p. 478-480. [xii] Cappalen, p. 478-480. [xiii] Cappelen, p.479. [xiv] Cappelen, p. 479. [xv] Cappelen, p. 479 [xvi] Cohen, p. 1301. [xvii] Cappelen, p. 478. [xviii] Cohen, p. 1299-1301. [xix] Cohen, p. 1301. [xx] Cappelen, p. 476-480. [xxi] Cappelen, p. 476-480. [xxii] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [xxiii] Kawachi, p. 18-33. [xxiv] Kawachi, p. 18-33. (shrink)

Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS l. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[1] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[2] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. ll. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[3] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[4] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[5] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[6] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[7] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[8] In democratic societies, one must take into consideration community morals and values.[9] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[10] lll. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[11] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[12] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[13] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[14] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. lV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[15] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[16] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[17] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[18] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[19] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[20] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[21] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. Vl. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[22] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[23] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[24] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. Vll. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [1] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [2] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [3] Moss, p. 1295-1298. [4] Moss, p. 1296. [5] Moss, p. 1295-1298. [6] Moss, p. 1295-1298. [7] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [8] Cohen, p. 1299-1301. [9] Moss, p. 1297. [10] Cohen, p. 1300. [11] Cappelen, p. 478-480. [12] Cappalen, p. 478-480. [13] Cappelen, p.479. [14] Cappelen, p. 479. [15] Cappelen, p. 479 [16] Cohen, p. 1301. [17] Cappelen, p. 478. [18] Cohen, p. 1299-1301. [19] Cohen, p. 1301. [20] Cappelen, p. 476-480. [21] Cappelen, p. 476-480. [22] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [23] Kawachi, p. 18-33. [24] Kawachi, p. 18-33. (shrink)

RusnockPaul* * and ŠebestíkJan. _ Bernard Bolzano: His Life and His Work. _Oxford University Press,2019. Pp. xxxiii + 667. ISBN: 978-0-19-882368-1 ; 978-0-19-255683-7 ; 978-0-19-255684-4. doi.org/ 10.1093/oso/9780198823681.001.0001.

BOOK REVIEW Patrick Todd, OPEN FUTURE: WHY FUTURE CONTINGENTS ARE ALL FALSE, Oxford University Press, United Kingdom, 2021 Print ISBN: 9780192897916, Online ISBN: 9780191919497, DOI: https://doi.org/10.1093/oso/9780192897916.001.0001 Hardcover, $70.00, e-book, $69.99.

Otávio Bueno* * and Steven French.** ** Applying Mathematics: Immersion, Inference, Interpretation. Oxford University Press, 2018. ISBN: 978-0-19-881504-4 978-0-19-185286-2. doi:10.1093/oso/9780198815044. 001.0001. Pp. xvii + 257.

EbertPhilip A and RossbergMarcus, eds.* * _ Essays on Frege’s Basic Laws of Arithmetic_. Oxford: Oxford University Press, 2019. Pp. xii + 673. ISBN: 978-0-19-871208-4 ; 978-0-19-102005-6, 978-0-19-178024-0. doi: 10.1093/oso/9780198712084.001.0001.

This essay deals with the problem of religious transformation in Tanabe Hajime. In his Philosophy as Metanoetics, Tanabe examines this transformation through the relationship between vows of the Buddhas as described in the writings of the Pure Land Buddhist thinker Shinran. For Tanabe, each vow expresses a moment of the religious transformation. Furthermore,he argues against all possibility of immediacy in human existence and sets out to demonstrate that the meaning of existence is mediated by the transformation of self-power into Other-power, (...) wherein the drive to affirm the self is transformed into a radical return to the world in which the self becomes a medium for the salvation of others. This is where Tanabe locates the deepest power of nothingness: in negating every effort of the self to ground itself and to make human being an upāya, a skillful means to a greater end. This is possible, in turn, because being itself, in all its manifestations, is upāya. (shrink)