Progress towards Universal Health Coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the WHO Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases and how should one adjudicate between them when their demands conflict? This paper by some (...) members of the Consultative Group and a diverse group of health policy professionals addresses these questions. It considers three stylized versions of actual policy dilemmas. Each of these cases pertains to one of the three principal dimensions of progress towards UHC: which services to cover first, which populations to prioritize for coverage, and how to move from out-of-pocket expenditures to pre-payment with pooling of funds. Our cases are simplified to highlight common trade-offs. While we make specific recommendations, our primary aim is to demonstrate both the form and substance of the reasoning involved in striking a fair balance between competing interests on the road to UHC. (shrink)
The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies (...) show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for the worse off, and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. (shrink)
There is currently a consensus among comparative psychologists that nonhuman animals are capable of some forms of mindreading. Several philosophers and psychologists have criticized this consensus, however, arguing that there is a “logical problem” with the experimental approach used to test for mindreading in nonhuman animals. I argue that the logical problem is no more than a version of the general skeptical problem known as the theoretician’s dilemma. As such, it is not a problem that comparative psychologists must solve before (...) providing evidence for mindreading. (shrink)
We evaluate a common reasoning strategy used in community ecology and comparative psychology for selecting between competing hypotheses. This strategy labels one hypothesis as a “null” on the grounds of its simplicity and epistemically privileges it as accepted until rejected. We argue that this strategy is unjustified. The asymmetrical treatment of statistical null hypotheses is justified through the experimental and mathematical contexts in which they are used, but these contexts are missing in the case of the “pseudo-null hypotheses” found in (...) our case studies. Moreover, statistical nulls are often not epistemically privileged in practice over their alternatives because failing to reject the null is usually a negative result about the alternative, experimental hypothesis. Scientists should eschew the appeal to pseudo-nulls. It is a rhetorical strategy that glosses over a commitment to valuing simplicity over other epistemic virtues in the name of good scientific and statistical methodology. (shrink)
At least since the late Early Modern period, the Holy Grail of ethics, for many philosophers, has been to say how ethical values could have a kind of protagorean objectivity: values are to be both fully objective as values and yet depend on us by their very nature. More than any other contemporary foundational approach it is “constructivist” theories, such as those due to Rawls, Scanlon, and Korsgaard, which have consciously sought to explain how protagorean objectivity is a real possibility. (...) Yet there remains considerable uncertainty about what the various versions of constructivism have in common, what, if anything, “constructivism” as a general approach is supposed to accomplish, and whether, if it is a general approach, it amounts to a distinctive foundational view. (shrink)
This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Biomedical Informatics: We Are What We Publish", written by Peter L. Elkin, Steven H. Brown, and Graham Wright. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the Elkin et al. paper. In subsequent issues the discussion can continue through letters to the editor.
We argue that general intelligence, as presented in the target article, generates multiple distinct and non-equivalent characterisations. Clarifying this central concept is necessary for assessing Burkart et al.’s proposal that the cultural intelligence hypothesis is the best explanation for the evolution of general intelligence. We assess this claim by considering two characterisations of general intelligence presented in the article.
The provision of health care service in resource-poor settings is associated with a broad set of ethical issues. Devakumar's case discusses the ethical issues related to the inability to treat in a cholera clinic patients who do not have cholera. This paper gives a closer look on the context in which Devakumar's case took place. It also analyses the potential local and organizational factors that gives rise to ethical dilemmas and aggravate them. It also proposes a framework to help in (...) the proactive handling of the factors that leads to ethical dilemmas and resolving the ethical issues as they appear. It adopts the four principles of autonomy, beneficence, non-maleficence and justice as universal and prima facie principles, but with the inclusion of a local understanding of what of each of these principles means. It is based on a collaborative approach that involves the beneficiaries and other partners in the field to help share information and resources, as well as adopting the provision of a wider service to the whole community. This is done by asking three basic questions: (a) who are the relevant stakeholders? (b) what ought to be the ethical principles in place? and (c) how should we take, implement and follow the decision about service provision? (shrink)
BackgroundBioethics as a field related to the health system and health service delivery has grown in the second half of the 20th century, mainly in North America. This is attributed, the author argues, to mainly three kinds of development that took place in the developed countries at a pace different than the developing countries. They are namely: development of the health system; moral development; and political development.DiscussionThis article discusses the factors that impede the development of the field of bioethics from (...) an academic activity to a living field that is known and practiced by the people in the developing countries. They are quite many; however, the emphasis here is on role of the political structure in the developing countries and how it negatively affects the development of bioethics. It presents an argument that if bioethics is to grow within the system of health service, it should be accompanied by a parallel changes in the political mindsets in these countries.SummaryFor bioethics to flourish in developing countries, it needs an atmosphere of freedom where people can practice free moral reasoning and have full potential to take their life decisions by themselves. Moreover, bioethics could be a tool for political change through the empowerment of people, especially the vulnerable.To achieve that, the article is proposing a practical framework for facilitating the development of the field of bioethics in the developing countries. (shrink)
The professionalization of science is a recent phenomenon. Before the mid-1800s, investigations of the natural world were largely performed by those hobbyists who had the leisure time to do so. Things are very different today. Open one of the over twenty thousand scientific journals currently in circulation, and you would be hard pressed to decipher the technical prose, much less the methodological and conceptual strategies being employed. This is changing, however. People are not only taking greater interest in how science (...) works, but choosing to actively participate in the process, whether this involves discovering new protein configurations , identifying and categorizing cancer cells from tissue samples , or analyzing the vocalizations of canids .Why start a review on what might seem like an academic book in contemporary philosophy of biology with a discussion of citizen science? Craver and Darden’s book, In Search of Mechanisms, is positi .. (shrink)
This article featuring Sudan constitutes one of five articles in a collection of essays on local capacity-building in research ethics by graduates from the University of Toronto’s Joint Centre for Bioethics MHSc in Bioethics, International Stream programme funded by the Fogarty International Center for Advanced Study in the Health Sciences (FIC). Research ethics is a relatively new area of practice in Sudan. In 2008, the National Health Research Council (NHRC) and health research ethics were clearly stated in the Public Health (...) Act, marking the first legislation rendering research misconduct as a legal offense. It also clearly stated that the NHRC is the focal body of health research in Sudan. Despite the difficulty in following the pace of newly-formed institutions and academies in Sudan, the NHRC’s Research Directorate assisted in the establishment of eight Research Ethics Committees (RECs) in two state ministries of health, two federal hospitals, the Sudan Medical Specialization Board (SMSB), and three universities. (shrink)
Die Studie macht das Verhältnis zwischen den Darstellungen des Gottes in der Bibel und jenen im Film zum Fokus. Auf welche Art und Weise wurde die Transzendenz präsentiert und wie die Christologie in der Filmproduktion erscheint, zu Zeiten, die sich als nachlässig gegenüber dem Religiösen sowie Transzendentalen zeigen, beziehungsweise beides auf eine Sache des menschlichen Intellekts zu reduzieren gedenken? Wie verschieden ist Christus in den Filmen Pasolinis, Zeffirellis und Gibsons? Kann Jesus Christus, der Heiland, durch einen populären Aktionsfilmhelden ersetzt werden? (...) Die Arbeit setzt sich mit der Religion aus einem anderen Blickwinkel auseinander, nämlich versuche ich festzustellen, ob die Religion tatsächlich aus dem öffentlichen Leben verschwunden ist wie mitunter angenommen. In welcher Manier wurden die Ideen von Gott von bestimmten Politikern und Führern gebraucht bzw. missbraucht, wie zum Beispiel Osama bin Laden, Saddam Hussein und George W. Bush? Was gilt es zu tun, wenn uns die Medien ermöglichen, wahrzunehmen, wie die Religion politisiert und die Politik religionisiert wird? (shrink)
In this article I bring together Jacques Derrida and Luce Irigaray's engagements with Sigmund Freud's vexed attempt to step beyond the pleasure principle. Derrida's speculations on the name, the house and the practice of Freud find him inadvertently rewriting the conditions of the autobiographical as that which erases as much as inscribes, while Irigaray requires a sexually different modelling of what we call language if the experience of the girl is to be addressed. Yet Irigaray uncannily repeats the teleological gesture (...) of laying claim to a legacy, diagnosed in Freud by Derrida, even as this legacy is newly imagined as that of the feminine to which Freud remained blind. I then interweave these revised stakes of the fort-da game as they are expressed in two experimental films; Lynn Hershman Leeson's feature Conceiving Ada (USA, 1997) and Hussein Chalayan's short Absent Presence (UK/Turkey, 2005). One self-consciously concerns the recovery of ‘lost’ women from history (da!), the other investigates the treatment of the foreigner staged with an all-female cast (in which the instability of foreign objects can secure no fortification for the scientific subject). The films differently engage fantasies concerning genetics, and differently engage the projection of a legacy as teleological ambition. Privileging Derrida's transformation of the pleasure into the postal principle as that which invokes ‘Tele–without telos’, I ask after the transmissibility of this ambition. (shrink)
Cet article propose de se pencher sur le projet de modernisation élaboré par Taha Hussein au xxe siècle. Ce projet porte sur le devenir de la société égyptienne, et à travers elle, sur celui du monde arabo-musulman pour les faire ainsi sortir de l’état de stagnation dans lequel ils se trouvaient à cette époque et les inciter à une participation active dans la civilisation humaine. Cet article conçoit le projet de Hussein comme intégré et transversal, englobant son œuvre (...) littéraire, critique, et son engagement socio-politique grâce aux multiples fonctions et responsabilités qu’il a assumées. Quatre composantes définissent ce projet : la modernisation de l’individu arabe ; la révolution du rapport au patrimoine ; une nouvelle perception de la culture locale et de celle d’autrui ; l’enseignement et la culture, levier de développement et de modernité sociétale. (shrink)
Despite legitimate concerns, Saddam Hussein has received an appropriate and fair trial, both in light of the specific details of the judicial proceedings and in light of the political nature of war crimes justice in an anarchic system of states.
Tun und Können erläutert und diskutiert den Gründungstext der Modalontologie: das neunte Buch der Metaphysik des Aristoteles. Aristoteles' Thesen und Argumente werden zum ersten Mal in Gänze mit formalen analytischen Mitteln rekonstruiert und auf ihre Kohärenz und Gültigkeit geprüft. Erstmals verwendet der Autor dazu eine adverbiale Analyse von Ausdrücken des Könnens und des Vermögens als Prädikatmodifikatoren. Das Buch zeigt, dass Aristoteles' Theorie der Vermögen nicht nur eine konsistente, sondern auch eine leistungsfähige Analyse von Dispositionen und Dispositionsprädikaten bietet.
Wie können Philosoph/innen mit der Bedrohung der akademischen Freiheit umgehen, die von rechtspopulistischen Strömungen (in Deutschland, Europa und weltweit) und autoritären Staaten (wie der Türkei und Ungarn) ausgeht? – Diese Frage stand im Zentrum der Podiumsdiskussion „Bedrohtes Denken“, die während des DGPhil Kongresses in Berlin am Tag der Bundestagswahl 2017 stattfand. Es war eine Diskussion, deren Ende von der bedrückenden Nachricht überschattet wurde, die rechtsextreme AfD werde drittstärkste Kraft im neuen Bundestag. Angesichts dieses zutiefst beunruhigenden Wahlergebnisses glauben wir, dass es (...) wichtig ist, diese Diskussion weiterzuführen. Dieser Kommentar soll dazu einen Anstoß geben. (shrink)
Taking Thomas Aquinas's interpretation of the prologue of St John's gospel (in his Lectura super loannem Evangelium) as example, I first discuss eight differences between medieval biblical interpretation and modern exegesis, especially Aquinas's frequent use of philosophical opinions in interpreting the Bible, taken mostly from Aristotle. Second, I account for these differences by reconstructing Aquinas's hermeneutics, hinging, as is shown, upon the assumption that scripture was authored by God infallible and, therefore, only contains true statements. From this starting point Aquinas (...) is lead to a holistic hermeneutics: The interpretation of a biblical statement can be judged on only within the context of an entire theory of God, the world, and of the interpretation of the other biblical statements. Thirdly, this view is discussed systematically and critically. (shrink)
The widely agreed view that actions are events faces the problem of how to describe the “branches” in so-called action trees, i.e. actions which are done by doing other actions. Moreover, the view is also inconsistent with the existence of two familiar species of agency: omitting something and letting things happen. In this article, an alternative conception of action is proposed which takes letting happen as the paradigm of agency. Agency should be construed as an explanatory relation between agents and (...) things happening in the world. This relational view of agency can accommodate for all kinds of agency: doing, letting happen, omitting, prohibiting. And it also provides a satisfactory account of the ontological basis of action trees. We should at first say that to do something is to originate or to bring into existence, i.e., really, to cause, some not yet existing state either of ourselves or of someone else, or, again, of some body. (shrink)
Zusammenfassung Zahlreiche Fußballvereine der 1. und 2. Bundesliga sind aus Fusionen hervorgegangen, doch bislang ist kaum etwas über dieses Phänomen in der Sportwissenschaft bekannt. Ziel des Aufsatzes ist es, mittels einer organisationssoziologischen Brille den SC Paderborn 07, als Bundesligaverein, der aus mehreren Fusionen hervorgegangen ist und als solcher verschiedene Traditionslinien in sich vereint, zu beleuchten. Dabei werden insbesondere die sozialen Folgen in den Blick genommen.