Background: Theoretically, the principle of justice is strong in healthcare priorities both nationally and internationally. Research, however, has indicated that questions can be raised as to how this principle is dealt with in clinical intensive care. Objective: The objective of this article is to examine how significant others may affect the principle of justice in the medical treatment and nursing care of intensive care patients. Method: Field observations and in-depth interviews with physicians and nurses in intensive care units (ICU). Emphasis (...) was placed on eliciting the underlying rationale for prioritisations in clinical intensive care with particular focus on clinicians’ considerations when limiting ICU treatment. Results: Significant others could induce an unintentional discrimination of ICU patients. Family members who were demanding received more time and attention for both the patient and themselves. Patients’ and families’ status and position and/or an interesting medical diagnosis seemed to govern the clinicians’ priorities of patients and families—consciously as well as unconsciously. The clinicians emphasised that patient information given through families was important. However, patients’ preferences and values conveyed to clinicians through their families were not always taken seriously. This even applied in cases with very serious prognoses and an explicit patient wish to forego life-prolonging treatment. Conclusion: The principle of justice was violated when qualified attention was given to significant others, and through this also to patients. Attention given to significant others was influenced by the healthcare workers’ professional and personal values, attitudes and interests. (shrink)

Normative theories of obligation, moral and nonmoral value, and meta-ethical issues and theories are considered.

This essay, one of the last that Frankena wrote, provides a scrupulously detailed exploration of the various possible meanings of one of Sidgwick's most famous footnotes in the Methods Long intrigued by what Sidgwick had in mind when he said that he would explain how it came about that for moderns it is not tautologous to claim that one's own good is one's only reasonable ultimate end, Frankena uses this note as a point of departure for a penetrating review of (...) Sidgwick's insights and ambiguities on the differences between ancient and modern ethics. (shrink)

I begin with a note about moral goodness as a quality, disposition, or trait of a person or human being. This has at least two different senses, one wider and one narrower. Aristotle remarked that the Greek term we translate as justice sometimes meant simply virtue or goodness as applied to a person and sometimes meant only a certain virtue or kind of goodness. The same thing is true of our word “goodness.” Sometimes being a good person means having all (...) the virtues, or at least all the moral ones; then goodness equals the whole of virtue. But sometimes, being a good person has a narrower meaning, namely, being kind, generous, and so forth. Thus, my OED sometimes equates goodness with moral excellence as a whole and sometimes with a particular moral excellence, viz., kindness, beneficence, or benevolence; and the Bible, when it speaks of God as being good sometimes means that God has all the virtues and sometimes only that he is kind, mereiful, or benevolent. When Jesus says, “Why callest thou me good: None is good, save one, that is God,” he seems to be speaking of goodness in the inclusive sense, but when the writer of Exodus has God himself say that he is “merciful and gracious, long-suffering, and abundant in goodness and truth,” God is using “goodness” in the narrower sense in which it means benevolence, for he goes on to make it clear that he is also just and severe. Similarly, “good will” may mean either “morally good will” in general, as it does in Kant, or it may mean only “benevolent will,” as it usually does; in “men of good will” it is perhaps ambiguous. (shrink)

This paper argues for the importance of approaching medicine, as a theoretical science, through values. The normative concepts of benefit and harm are held to provide a framework for the analysis of medicine which reflects the obligations of the doctor-patient relationship, suffices to define the key concept of medical relevance, yields a general necessary condition for the basic concepts of medicine, explains the role of such nonnormative conceptions as discomfort, dysfunction, and incapacity, and avoids the mistakes of other normative approaches (...) which hold that unhealthy conditions are disvaluable or should be treated. Neutralist analyses are criticized, especially those approaching health through proper functioning. (shrink)

This is the text of The Lindley Lecture for 1961, given by William K. Frankena, an American philosopher.

Taking reduction in the traditional deductive sense, the programmatic claim that most of genetics can be reduced by molecular genetics is defended as feasible and significant. Arguments by Ruse and Hull that either the relationship is replacement or at best a weaker form of reduction are shown to rest on a mixture of historical and logical confusions about the nature of the theories involved.

It is well known that Sidgwick finished his examination of “the methods of ethics” in some difficulty. Just what that difficulty was and how he came to be in it, we shall see in due course. This paper is written in the conviction that what he was doing is worth looking at again in the context of contemporary discussion.

I critically examine an argument, due to howard wettstein, purporting to show that sentences containing definite descriptions are semantically ambiguous between referential and attributive readings. Wettstein argues that many sentences containing nonidentifying descriptions--descriptions that apply to more than one object--cannot be given a Russellian analysis, and that the descriptions in these sentences should be understood as directly referential terms. But because Wettstein does not justify treating referential uses of nonidentifying descriptions differently than attributive uses of nonidentifying descriptions, his argument fails.

An expansion of 3 lectures presented by the author in 1978 at the University of Michigan.

This paper analyzes in some detail what an ethics of love would be like if interpreted rigorously as an ethics of being rather than of doing. It delineates the metaethical structure of such an ethics and suggests the characteristics of love appropriate to the structure. The author then indicates some problems that arise for such an ethical theory.

In this paper I tee off from a footnote in prichard's article, "is moral philosophy based on a mistake?" in it he contrasts living under the aegis of moral obligation and moral goodness with living under the aegis of virtue. Using prichard's terms I try to say what an ethics of virtue as versus one of duty and moral goodness would be like. Then I try to see what prichard's case against the former and for the latter would be like, (...) And to indicate my own sympathies in the matter. (shrink)

The debate over the central issue confronted in Closing--the role of the university and the liberal arts in the United States--has become increasingly urgent and contentious. The goal of this collection of essays is to consider what we can learn about the dilemmas confronting American culture through a consideration of both The Closing of the American Mind and the debate it has aroused. The contributors differ among themselves as to the validity of both the diagnoses and the solutions Bloom offers, (...) yet they do not engage in "Bloom-bashing" or hero-worship. The goal of the book is to place the debate over Closing into the larger context than can be achieved in a book review format. To provide the historical perspective that has been missing in the controversy over Bloom, included in this volume is Christopher Lasch's "The Great Experiment: Where Did it Go Wrong?" Also included are essays by other leading critics: John K. Roth, Frank Caucci, William K. Buckley, Milton R. Stern, Susan Bourgeois, Margaret C. Jones, Daniel Zins, Kenneth Alan Hovey, Bonnie A. Hain, John Peacock, Patricia L. Lundberg, Peter Siedlecki, Mark W. Roche, William Thickstun, Lorraine Clark, and Gerald Graff. This volume of essays does much to illuminate the issue surrounding The Closing of the American Mind. (shrink)

This paper examines the statistical properties of random quantum states, for four different kinds of random state:(1) a pure state chosen at random with respect to the uniform measure on the unit sphere in a finite-dimensional Hilbert space;(2) a random pure state in a real space;(3) a pure state chosen at random except that a certain expectation value is fixed;(4) a random mixed state with fixed eigenvalues. For the first two of these, we give examples of simple states of a (...) model system, the kicked top, which have the statistical properties of random states. Interestingly, examples of both kinds of randomness can be found in the same system. In studying the last two kinds of random state, we obtain new results concerning the application of information theory to quantum systems. (shrink)

First steps are taken toward a formulation of quantum mechanics which avoids the use of probability amplitudes and is expressed entirely in terms of observable probabilities. Quantum states are represented not by state vectors or density matrices but by “probability tables,” which contain only the probabilities of the outcomes of certain special measurements. The rule for computing transition probabilities, normally given by the squared modulus of the inner product of two state vectors, is re-expressed in terms of probability tables. The (...) new version of the rule is surprisingly simple, especially when one considers that the notion of complex phases, so crucial in the evaluation of inner products, is entirely absent from the representation of states used here. (shrink)

Japan’s economy has stagnated since the bursting of the twin real estate and stock bubbles in 1990. Construction employment rose after the bubbles burst despite a real estate glut.Systemic corruption is delaying recovery. The key is thedango—Japan’s system of bid rigging, which is pervasive in public construction. The firms rotate who will win the “competitive” bid. The bureaucrats leak the highest price bid that will be accepted in return for favors from the industry and lucrative sinecures when they retire. The (...) ruling politicians get kickbacks and ensure the adoption of enormous public construction programs.The result is that Japanese public and private capital flows are corruptly routed to uses that are not simply inefficient, but outright harmful to society. Pervasive corruption is the primary obstacle to Japanese economic health and political reform. (shrink)

Japan’s economy has stagnated since the bursting of the twin real estate and stock bubbles in 1990. Construction employment rose after the bubbles burst despite a real estate glut.Systemic corruption is delaying recovery. The key is the dango—Japan’s system of bid rigging, which is pervasive in public construction. The firms rotate who will win the “competitive” bid. The bureaucrats leak the highest price bid that will be accepted in return for favors from the industry and lucrative sinecures when they retire (...) (amakudari—“descent from heaven”). The ruling politicians (the “construction tribes”) get kickbacks and ensure the adoption of enormous public construction programs.The result is that Japanese public and private capital flows are corruptly routed to uses that are not simply inefficient, but outright harmful to society. Pervasive corruption is the primary obstacle to Japanese economic (and environmental) health and political reform. (shrink)

Japan’s economy has stagnated since the bursting of the twin real estate and stock bubbles in 1990. Construction employment rose after the bubbles burst despite a real estate glut.Systemic corruption is delaying recovery. The key is the dango—Japan’s system of bid rigging, which is pervasive in public construction. The firms rotate who will win the “competitive” bid. The bureaucrats leak the highest price bid that will be accepted in return for favors from the industry and lucrative sinecures when they retire (...) (amakudari—“descent from heaven”). The ruling politicians (the “construction tribes”) get kickbacks and ensure the adoption of enormous public construction programs.The result is that Japanese public and private capital flows are corruptly routed to uses that are not simply inefficient, but outright harmful to society. Pervasive corruption is the primary obstacle to Japanese economic (and environmental) health and political reform. (shrink)

Indonesia’s weak labor movement transformed local wage councils from institutions of wage restraint into institutions that delivered generous wage increases. This article argues that the arrival of direct elections created an opportunity for unions to leverage elections to alter the balance of power on the wage councils. Activating that leverage required increased contentiousness and coordination among unions. As unions mobilized around wages, conflict with capital intensified and produced disruptive protests that led incumbents to side with workers. Unions also developed innovative (...) tactics to sustain momentum in nonelection years. As unions turned the wage councils in their favor, employers fought back by shifting the scale of the conflict to the national level; the result was the recentralization of wage setting and more modest increases. In a global context of ever weakening organized labor, the Indonesian case shows how weak unions can gain power by mobilizing politically at the local level. (shrink)