The health care systems in Austria, Germany and Switzerland owe their institutional structure to different historical developments. While Austria and Germany voted for the Bismarck-Model of social health insurance,Switzerland adopted a voluntary system of health insurance. In all three countries, until very recently, the different challenges which the healthcare sector faced were met by piecemeal approaches and by stop and go policies, which, in the long run were not very successful either in containing costs or in improving efficacy and efficiency. (...) During the 1990 more fundamental reforms in the health care systems of all three countries took place. Germany and Switzerland chose the path of deregulation of the health insurance system, which consequently strengthened the competition between the insurance companies, and, to some extent between the suppliers of medical services. While this can be seen as an essential part of the reform process for these two countries, Austria favors a state-oriented and interventionist approach in order to meet the challenges. (shrink)
We defend the reliability of Hurlburt's Descriptive Experi-ence Sampling method against some of Schwitzgebel's attacks. But we agree with Schwitzgebel that the method could be used much more widely than it has been, helping to answer questions about the nature and structure of consciousness in addition to cataloguing the latter's contents. We sketch a number of potential lines of further enquiry.
Edmund Pellegrino considered medicine as a skill, art, and perhaps most importantly, a moral enterprise. In this essay, I attempt to exemplify how the legacy and contributions of Edmund Pellegrino, as a teacher and a physician, could allow for a renaissance of medical practice in which physicians engage intellectual and moral virtue to both effect sound care, and do so in a humanitarian way, rather than in simple accordance with a business model of medicine. The virtues are viewed in a (...) renewed light as being key characteristics of physicians, and important to patient centered care. (shrink)
Key historical landmark research malpractice scandals that shocked the international community were the origin of the institution of ethics review prior to carrying out research involving humans. Nonetheless, it is plausible that unethical research is ongoing or may have been conducted in recent times that has escaped public notice, especially in the vulnerable low- and middle-income country contexts. The basic constitution of these committees at some point has not been clearly defined, with most scientists declaring political maneuvers at times. These (...) committees today are characterized by bureaucratic bottlenecks, financial interests, inadequate training in research ethics, and lack of control and coordination of their functions. Compulsory and adequate research ethics training for researchers and ethical committee members could guarantee trust, and appreciation of the utmost importance... (shrink)
BackgroundPrevention of mother to child transmission of HIV remains a key public health priority in most developing countries. The provider Initiated Opt – Out Prenatal HIV Screening Approach, recommended by the World Health Organization lately has been adopted and translated into policy in most Sub – Saharan African countries. To better ascertain the ethical reasons for or against the use of this approach, we carried out a literature review of the ethics literature.MethodsPapers published in English and French Languages between 1990 (...) and 2015 from the following data bases were searched: Pubmed, Cochrane literature, Embase, Cinhal, Web of Science and Google Scholar. After screening from 302 identified relevant articles, 21 articles were retained for the critical review.DiscussionMost authors considered this approach ethically justifiable due to its potential benefits to the mother, foetus and society. The breaching of respect for autonomy was considered acceptable on the grounds of libertarian paternalism. Most authors considered the Opt - Out approach to be less stigmatizing than the Opt - In. The main arguments against the Opt - Out approach were: non respect of patient autonomy, informed consent becoming a meaningless concept and the HIV test becoming compulsory, risk of losing trust in health care providers, neglect of social and psychological implications of doing an HIV test, risk of aggravation of stigma if all tested patients are not properly cared for and neglect of sociocultural peculiarities.ConclusionsThe Opt – Out approach could be counterproductive in case gender sensitive issues within the various sociocultural representations are neglected, and actions to offer holistic care to all women who shall potentially test positive for HIV were not effectively ascertained. The Provider Initiated Opt – Out Prenatal HIV Screening option remains ethically acceptable, but deserves caution, active monitoring and evaluation within the translation of this approach into to practice. (shrink)
My topic is personal identity, or rather, our identity. There is general, but not, of course, unanimous, agreement that it is wrong to give an account of what is involved in, and essential to, our persistence over time which requires the existence of immaterial entities, but, it seems to me, there is no consensus about how, within, what might be called this naturalistic framework, we should best procede. This lack of consensus, no doubt, reflects the difficulty, which must strike anyone (...) who has considered the issue, of achieving, just in one's own thinking, a reflective equilibrium. The theory of personal identity, I feel, provides a curious contrast. On the one side, it seems highly important to know what sort of thing we are, but, on the other, it is hard to find any answer which has a ‘solid’ feel. (shrink)
It is fortunate for my purposes that English has the two words ‘almighty’ and ‘omnipotent’, and that apart from any stipulation by me the words have rather different associations and suggestions. ‘Almighty’ is the familiar word that comes in the creeds of the Church; ‘omnipotent’ is at home rather in formal theological discussions and controversies, e.g. about miracles and about the problem of evil. ‘Almighty’ derives by way of Latin ‘omnipotens’ from the Greek word ‘ pantokratōr ’; and both this (...) Greek word, like the more classical ‘ pankratēs ’, and ‘almighty’ itself suggest God's having power over all things. On the other hand the English word ‘omnipotent’ would ordinarily be taken to imply ability to do everything; the Latin word ‘omnipotens’ also predominantly has this meaning in Scholastic writers, even though in origin it is a Latinization of ‘ pantocratōr ’. So there already is a tendency to distinguish the two words; and in this paper I shall make the distinction a strict one. I shall use the word ‘almighty’ to express God's power over all things, and I shall take ‘omnipotence’ to mean ability to do everything. (shrink)
The contributions of the great physicist Ludwig Boltzmann to philosophy and biology are not known sufficiently. In philosophy, he was a realist, and much opposed to his colleague's, Mach's, positivism, but also to Berkeley's, Kant's, Hegel's and Schopenhauer's idealisms. In biology, Boltzmann was a passionate Darwinist and tried to explain on the basis of evolution the meaning of photosynthesis as well as the origin of life and of the mind. Boltzmann argued for evolutionary epistemology. Opposing Kant, he derived the fundamental (...) ideas of space, time and causality from the experience of mankind and its ancestors. The laws of thought were acquired in evolution. While they must be broadly true they need not be faultless. Antinomies arise when thought overshoots the mark, i. e. exceeds the limits of the area for which it evolved. As for Boltzmann the experience of the organism in the course of evolution is the only and exclusive source of knowledge, he may be called an absolute Darwinist. A short account of Boltzmann's Darwinian ideas on the origin of morality, on the sense of beauty and on happiness is also given. (shrink)
A comprehensive, self-contained survey of the theory and applications of differential games, one of the most commonly used tools for modelling and analysing economics and management problems which are characterised by both multiperiod and strategic decision making. Although no prior knowledge of game theory is required, a basic knowledge of linear algebra, ordinary differential equations, mathematical programming and probability theory is necessary. Part One presents the theory of differential games, starting with the basic concepts of game theory and going on (...) to cover control theoretic models, Markovian equilibria with simultaneous play, differential games with hierarchical play, trigger strategy equilibria, differential games with special structures, and stochastic differential games. Part Two offers applications to capital accumulation games, industrial organization and oligopoly games, marketing, resources and environmental economics. (shrink)
Hardy’s paradox was originally presented as a demonstration, without inequalities, of the incompatibility between quantum mechanics and the hypothesis of local causality. Equipped with newly developed tools that allow for a quantitative assessment of realism, here we revisit Hardy’s paradox and argue that nonlocal causality is not mandatory for its solution; quantum irrealism suffices.