1. Justice, social contracts, and democracy -- 2. The democratic social contract -- 3. Economic justice and the democratic contract -- 4. The theory of democratic social contracts -- 5.The great transformation -- 6. Political democracy in the great society -- 7. Just returns in the great society -- 8. The sense of democratic justice.

Health systems that provide for universal patient access through a scheme of prepayments—whether through taxes, social insurance, or a combination of the two—need to make decisions on the scope of coverage that they secure. Such decisions are inherently controversial, implying, as they do, that some patients will receive less than comprehensive health care, or less than complete protection from the financial consequences of ill-heath, even when there is a clinically effective therapy to which they might have access.Controversial decisions of this (...) sort call for a public justification for covering or not covering a given treatment. Priority-setting agencies play a key role in providing such a justification. A recent... (shrink)

The political theory of the property-owning democracy can be seen as a way of overcoming the ideological conflict between individualism and collectivism. Rawls offers the contemporary reference-point for this theory. Rawls contrasted the ideal-type of the property-owning democracy with the ideal-type of a capitalist welfare state. However, the terms of that contrast are not well drawn and raise a number of questions, in particular regarding Rawls’s a priori specification of the welfare state. An inductively derived specification of ideal-typical welfare states (...) suggests that horizontal redistribution, in line with the principle of social savings, is more important than vertical redistribution. Rawls’s preference for a social dividend or negative income tax scheme can be contrasted with the use of social insurance, but the latter has a claim to instantiate Rawlsian ideals better than a social dividend. There is a potential problem with the pre-emption of private savings in the welfare state, but this turns out not to be troublesome empirically or conceptually. The irony of the discussion is that those who have interpreted Rawlsian theory as justifying the welfare state have the better of the argument, despite Rawls’s own views. (shrink)

There are two discourses that are used in connection with the provision of good healthcare: a rights discourse and a beneficial design discourse. Although the logical force of these two discourses overlaps, they have distinct and incompatible implications for practical reasoning about health policy. The language of rights can be interpreted as the ground of a well-designed healthcare system stressing the values of equality and inclusion, but it has less application when dealing with questions of cost-effectiveness. This difference reflects the (...) distinction between the deontological status of rights claims and a teleological approach presupposed in the language of beneficial design. However, the value of the separateness of persons contained in the discourse of rights can impose constraints on the adoption of a simple maximizing principle when thinking about the allocation of healthcare resources within a social contract for health. Throughout these issues are discussed by reference to the work of Peter Jones. (shrink)

Modern Social Contract Theory provides an exposition and evaluation of major work in social contract theory from 1950 to the present. It locates the central themes of that theory in the intellectual legacy of utilitarianism, particularly the problems of defining principles of justice and of showing the grounds of moral obligation. It demonstrates how theorists responded in a novel way to the dilemmas articulated in utilitarianism, developing in their different approaches a constructivist method in ethics, a method that aimed to (...) vindicate a liberal, democratic and just political order. A distinctive feature of the book is its comparative approach. By placing the works of Barry, Buchanan and Tullock, Harsanyi, Gauthier, Grice, Rawls, and Scanlon alongside one another, similarities and differences are brought out, most notably in the way in which principles are derived by each author from the contractual construction as well as the extent to which the obligation to adopt those principles can be rationally grounded. Each theory is placed in its particular intellectual context. Special attention is paid to the contrasting theories of rationality adopted by the different authors, whether that be utility theory or a deliberative conception of rationality, with the intention of assessing how far the principles advanced can be justified by reference to the hypothetical choices of rational contracting agents. The book concludes with a discussion of some principal objections to the enterprise of contract theory, and offers its own programme for the future of that theory taking the form of the empirical method. (shrink)

How much by way of economic reward is due to health care providers?Although this problem usually presents itself as a practical matter of policy, it has buried within it a number of philosophical issues, for it can be regarded as a question in the theory of economic justice. The formal principle of justice is that we should render persons what is due to them. But on what consideration in the case of health care providers can we make an assessment of (...) what is due?The answer we give to this question has significant implications for the ethical appraisal of the allocation of resources in the health care system. Some of the most difficult issues of ethical appraisal emerge when we consider the problems of allocating potentially life-saving resources between different groups of patients. Many of the most significant current issues in medical ethics—the role of QALYs, the meaning of equality and the economic evaluation of life—find their point of reference in the ‘tragic choices’ that are created when there are insufficient resources to meet apparently legitimate medical need. Yet, as Robert Evans has pointed out, it is a simple matter of accounting identity that health care expenditures must equal health providers' incomes. So, in asking how we limit or allocate costly health care resources, we are implicitly offering an answer to the question of how much we should pay providers. I hope by seeking an answer explicitly to that question to throw light on the problems that are raised when considering ethically the allocation of health care resources. (shrink)

Is it possible to reconcile a classical liberal approach to economics with a concern for the environment? The contributors to Economics and the Environment: A Reconciliation contend that it is. But they fail to distinguish properly between classical liberalism and a widespread orthodoxy in environmental policy communities in Europe and North America to the effect that economic instruments for environmental policy need more serious attention than they have hitherto received. Once this orthodoxy is distinguished from classical liberalism, the latter is (...) seen to be implausible. In particular, the classical liberal approach fails to deal with the practical and administrative problems involved in enforcing private property rights solutions to problems of environmental protection, wrongly generalizes from the failures of U.S. environmental policy to the failure of public regulation as such, and fails to take into account the claim that nature should be accorded intrinsic value. (shrink)

John Horton has argued for an associative theory of political obligation in which such obligation is seen as a concomitant of membership of a particular polity, where a polity provides the generic goods of order and security. Accompanying these substantive claims is a methodological thesis about the centrality of the phenomenology of ordinary moral consciousness to our understanding of the problem of political obligation. The phenomenological strategy seems modest but in some way it is far-reaching promising to dissolve some long-standing (...) problems of political theory. However, it fails at just the point at which a theory of political obligation is needed, namely when individuals question the grounds of their political obligation. A principle of obligation is needed to provide individuals with a reason for compliance with authoritative social rules when the exercise of that obligation is irksome. It is at this point that we need to invoke the idea of society as an implicit social contract, in which obligations are seen as stemming from those terms that it would be in the interests of individuals to agree in a social contract. This is consistent with the method of reflective equilibrium. (shrink)

Brian Barry was the leading European normative political theorist of his generation, his intellectual influence being felt in Europe, North America, Australasia, and indeed wherever normative political theory in the analytical mode is practised. As well as being a Fellow of the British Academy, he was a Fellow of the American Academy of Arts and Sciences and the only Briton to have received the prestigious Johann Skytte prize from the University of Uppsala for achievement in the study of political science. (...) During his life Barry published seven single-authored books and five co-edited volumes, as well as over seventy articles and a large number of reviews and review essays, some of the latter being full-length and original articles in their own right. He had a deep and abiding commitment to the professionalization of the study of politics and was an inspiration to many younger scholars. (shrink)

Ganghof’s Beyond Presidentialism and Parliamentarianism advances three main claims: an innovative typology of comparative government, introducing the category of semi-parliamentarianism; an explication of two conceptions of majority rule, simple majoritarianism and complex majoritarianism; and a demonstration that there are viable systems of government embodying the political equality associated with each majoritarian conception. This paper explains these claims and identifies issues discussed in this symposium.

This report is about ethical thinking in the field of health and health care. But it is no abstract philosophical tract. It is designed to be of practical help to those struggling with the complex questions of allocating resources in health care and to encourage a wider involvement at all levels in health debates. The questions it raises stimulate new thinking about today's institutional structures. As we proceeded with our work, we became aware that it is easier to state problems (...) than to solve them. However, we were also aware of the opposite danger of oversimplification implicit in the view that there was a moral calculus to which decisionmakers could turn when they were confronted by an ethical problem in the allocation of resources, and which would yield mechanical solutions to human problems. (shrink)

The key difference between the two concepts is that power acts directly on the actions of others by providing incentives and penalties for action, whereas influence operates on beliefs. From this distinction it follows that the exercise of influence is not simply a sub-class of instances of the exercise of power. It can be perfectly reasonable to attribute influence where there is no power, as in the example of the influence of Cervantes on subsequent writers.

The two books offer a contextual reinterpretation of Rawlsian and post-Rawlsian liberalism. Nelson’s main thesis is that debates in liberal political theory re-enact theological debates about theod...

The two books offer a contextual reinterpretation of Rawlsian and post-Rawlsian liberalism. Nelson’s main thesis is that debates in liberal political theory re-enact theological debates about theodicy going back to the Pelagian controversy. This claim is criticized for its historical inaccuracy. Nelson’s invocation of theodicy as a refutation of luck egalitarianism and the Rawlsian rejection of desert rest on a claim of possibility that is too weak to uphold a plausible refutation. Forrester locates Rawls’s rejection of desert in the thinking (...) of his contemporaries. She not only shows the development of Rawls’s thought but also details its broad influence. However, her thesis that the role of economic planning in a theory of justice remained undeveloped by Rawls ignores the intrinsic difficulties of designing a system of economic planning. The persistent antinomies of grace and free will in metaphysics, and of planning and the price mechanism in economics, show the continuing relevance of meaning beyond context. (shrink)

This paper identifies and responds to four critiques of democratic contractarianism, as advocated in Democratic Justice and the Social Contract, to be found in this symposium. The first is that, as a contingent practice-dependent account of justice, democratic contractarianism lacks the capacity to explain civic cooperation. The second is that, despite its intentions, Democratic Justice does not lay out an authentic contractarian theory. The third is that the theory is incompatible with our considered judgements about justice. And the fourth is (...) that the ambition of Democratic Justice to use the empirical method to compensate for the failures of hypothetical contract theory fails because all social science needs interpretation. To each of these critiques, replies are offered, drawing attention to the way in which democratic contractarianism exemplifies a logic of social cooperation to mutual advantage that is compatible with justice provided the cooperation emerges from a bargaining situation of roughly equal power. (shrink)

Populism sees representative government as intrinsically elitist, preferring to think about democracy in terms of the will of the people, expressed through devices such as referendums. However, this view is not one that can be made sense of and seeking to pursue the will of the people is dangerous to democracy. Citizen engagement is important in a representative democracy, but this is best conceived on a model of civil society organizations undertaking practical public deliberation. A philosophical model of deliberation leading (...) to choice is introduced, and the argument that such a theory is itself elitist is considered but found wanting. (shrink)

Chiara Cordelli’s The Privatized State is a book that should be widely read for many reasons.1 In the first place, it engages with an important set of issues in governance and public administration...

In order to create sustainable health systems, many countries are introducing ways to prioritize health services underpinned by a process of health technology assessment. While this approach requires technical judgments of clinical effectiveness and cost-effectiveness, these are embedded in a wider set of social (societal) value judgments, including fairness, responsiveness to need, non-discrimination and obligations of accountability and transparency. Implementing controversial decisions faces legal, political and public challenge. To help generate acceptance for the need for health prioritization and the resulting (...) decisions, the purpose of this paper is to develop a novel way of encouraging key stakeholders, especially patients and the public, to become involved in the prioritization process. (shrink)

(2012). Introduction: The value and limits of rights: essays in honour of Peter Jones. Critical Review of International Social and Political Philosophy: Vol. 15, The Value and Limits of Rights: Essays in Honour of Peter Jones, pp. 387-394. doi: 10.1080/13698230.2012.699394.

As health policy-makers around the world seek to make progress towards universal health coverage, they must navigate between two important ethical imperatives: to set national spending priorities fairly and efficiently; and to safeguard the right to health. These imperatives can conflict, leading some to conclude that rights-based approaches present a disruptive influence on health policy, hindering states’ efforts to set priorities fairly and efficiently. Here, we challenge this perception. We argue first that these points of tension stem largely from inadequate (...) interpretations of the aims of priority setting as well as the right to health. We then discuss various ways in which the right to health complements traditional concerns of priority setting and vice versa. Finally, we set out a three-step process by which policy-makers may navigate the ethical and legal considerations at play. (shrink)

One rationale policy-makers sometimes give for declining to fund a service or intervention is on the grounds that it would be ‘unaffordable’, which is to say, that the total cost of providing the service or intervention for all eligible recipients would exceed the budget limit. But does the mere fact that a service or intervention is unaffordable present a reason not to fund it? Thus far, the philosophical literature has remained largely silent on this issue. However, in this article, we (...) consider this kind of thinking in depth. Albeit with certain important caveats, we argue that the use of affordability criteria in matters of public financing commits what Parfit might have called a ‘mistake in moral mathematics’. First, it fails to abide by what we term a principle of ‘non-perfectionism’ in moral action: the mere fact that it is practically impossible for you to do all the good that you have reason to do does not present a reason not to do whatever good you can do. And second, when used as a means of arbitrating between which services to fund, affordability criteria can lead to a kind of ‘numerical discrimination’. Various attendant issues around fairness and lotteries are also discussed. (shrink)

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

How do otherwise considerate human beings do cruel things and still live in peace with themselves? Drawing on his agentic theory, Dr. Bandura provides a definitive exposition of the psychosocial mechanism by which people selectively disengage their moral self-sanctions from their harmful conduct. They do so by sanctifying their harmful behavior as serving worthy causes; they absolve themselves of blame for the harm they cause by displacement and diffusion of responsibility; they minimize or deny the harmful effects of their actions; (...) and they dehumanize those they maltreat and blame them for bringing the suffering on themselves. Dr. Bandura's theory of moral disengagement is uniquely broad in scope. Theories of morality focus almost exclusively at the individual level. He insightfully extends the disengagement of morality to the social-system level through which large-scale inhumanities are perpetrated...Moral disengagement will transform your thinking about how otherwise considerate people can behave inhumanely and still feel good about themselves." -- Book jacket. (shrink)

This book is an attempt to get to the bottom of an acute and perennial tension between our best scientific pictures of the fundamental physical structure of the world and our everyday empirical experience of it. The trouble is about the direction of time. The situation (very briefly) is that it is a consequence of almost every one of those fundamental scientific pictures--and that it is at the same time radically at odds with our common sense--that whatever can happen can (...) just as naturally happen backwards. Albert provides an unprecedentedly clear, lively, and systematic new account--in the context of a Newtonian-Mechanical picture of the world--of the ultimate origins of the statistical regularities we see around us, of the temporal irreversibility of the Second Law of Thermodynamics, of the asymmetries in our epistemic access to the past and the future, and of our conviction that by acting now we can affect the future but not the past. Then, in the final section of the book, he generalizes the Newtonian picture to the quantum-mechanical case and (most interestingly) suggests a very deep potential connection between the problem of the direction of time and the quantum-mechanical measurement problem. The book aims to be both an original contribution to the present scientific and philosophical understanding of these matters at the most advanced level, and something in the nature of an elementary textbook on the subject accessible to interested high-school students. Table of Contents: Preface 1. Time-Reversal Invariance 2. Thermodynamics 3. Statistical Mechanics 4. The Reversibility Objections and the Past-Hypothesis 5. The Scope of Thermodynamics 6. The Asymmetries of Knowledge and Intervention 7. Quantum Mechanics Appendix: Gedankenexperiments with Heat Engines Index Reviews of this book: The foundations of statistical mechanisms are often presented in physics textbooks in a rather obscure and confused way. By challenging common ways of thinking about this subject, Time and Chance can do quite a lot to improve this situation. --Jean Bricmont, Science Albert is perfecting a style of foundational analysis that is uniquely his own...It has a surgical precision...and it is ruthless with pretensions. The foundations of thermodynamics is a topic that has accumulated a good deal of dead wood; this is a fire that will burn and burn. --Simon W. Saunders, Oxford University As usual with Albert's work, the exposition is brisk and to the point, and exceptionally clear...The book will be an extremely valuable contribution to the literature on the subject of philosophical issues in thermodynamics and statistical mechanics, a literature which has been thin on the ground but is now growing as it deserves to. --Lawrence Sklar, University of Michigan. (shrink)

Throughout his writings, Hume extols the benefits of an attribute he calls “Strength of Mind,” which he defines as the “prevalence of the calm passions over the violent” (T 2.3.3.10). But there is some question as to how he thought a person could attain this important trait. Contemporary scholars have committed Hume to the view that only indirect and social methods, such as state punishment or sympathetic pressure, could effectively cultivate it. Yet a closer examination of Hume’s corpus reveals a (...) more direct approach applicable at the individual level. Though rarely achieved and difficult to execute, self-government of the passions is possible according to Hume. The key to success lies in harnessing the power of habit. In its most sophisticated form, the process centrally involves cultivating a certain transformative connoisseurship, the ability to appreciate regularities in one’s own mental activity and thereby alter it. (shrink)

In medical ethics, business ethics, and some branches of political philosophy (multi-culturalism, issues of just allocation, and equitable distribution) the literature increasingly combines insights from ethics and the social sciences. Some authors in medical ethics even speak of a new phase in the history of ethics, hailing "empirical ethics" as a logical next step in the development of practical ethics after the turn to "applied ethics." The name empirical ethics is ill-chosen because of its associations with "descriptive ethics." Unlike descriptive (...) ethics, however, empirical ethics aims to be both descriptive and normative. The first question on which I focus is what kind of empirical research is used by empirical ethics and for which purposes. I argue that the ultimate aim of all empirical ethics is to improve the context-sensitivity of ethics. The second question is whether empirical ethics is essentially connected with specific positions in meta-ethics. I show that in some kinds of meta-ethical theories, which I categorize as broad contextualist theories, there is an intrinsic need for connecting normative ethics with empirical social research. But context-sensitivity is a goal that can be aimed for from any meta-ethical position. (shrink)

Sartre importe à l'histoire vivante de la philosophie sous plusieurs angles. Héritier de Hegel qui le hante, il conteste celui-ci dans sa conviction « totaliste ». S'il reste fidèle au dynamisme hégélien, à l'interrogation constante du vécu, il les traduit pourtant par nos langages présents.

_Time_'s 'Man of the Century', Albert Einstein is the unquestioned founder of modern physics. His theory of relativity is the most important scientific idea of the modern era. In this short book Einstein explains, using the minimum of mathematical terms, the basic ideas and principles of the theory which has shaped the world we live in today. Unsurpassed by any subsequent books on relativity, this remains the most popular and useful exposition of Einstein's immense contribution to human knowledge.

From the author of Quantum Mechanics and Experience, a hugely influential book that challenged key assertions by Niels Bohr and other founders of quantum mechanics, A Guess at the Riddle provides a major metaphysical overhaul of one of physics' most intractable problems-the quest to bridge quantum and classical physics in order to understand the nature of reality.

Despite the expansion of post-school education and incentives to participate in lifelong learning, institutions and labour markets continue to interlock in shaping life chances according to starting social position, family and private resources. The dominant view that the economic and social returns to public investment in adult learning are too low to warrant large-scale public funding has been challenged by recent LLAKES research that shows significant returns to participants in lifelong learning with improvements in both their employability and employment prospects. (...) It is argued that, under conditions of growing social polarisation and economic uncertainty, lifelong learning can have a significant protective effect by keeping adults close to a changing labour market. In this paper we review research from different disciplinary and epistemological traditions, providing evidence of the beneficial effects of lifelong learning, especially when taking into account the dynamics of the life course. Transitions and turning-points in youth and in adult life are markers of diversification of the life course; how far these diversifications amount to 'de-standardisation' of the life course is debated. They involve biographical negotiation, in which any decision is consequential upon previous decisions and involves the exercise of contextualised preferences as well as the calculations of 'rational choice'. Gaining a better understanding of how changing demands are negotiated at different life stages offers a new perspective, moving from narrow versions of rational choice theory towards models of biographical negotiation as promising avenues for effective policy-making. (shrink)

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.