Healthcare priority-setting institutions have good reason to want to demonstrate that their decisions are morally justified—and those who contribute to and use the health service have good reason to hope for the same. However, finding a moral basis on which to evaluate healthcare priority-setting is difficult. Substantive approaches are vulnerable to reasonable disagreement about the appropriate grounds for allocating resources, while procedural approaches may be indeterminate and insufficient to ensure a just distribution. In this paper, we set out a complementary, (...) coherence-based approach to the evaluation of healthcare priority-setting. Drawing on Rawls, we argue that an institutional priority-setter’s claim to moral justification can be assessed, in part, based on the extent to which its many normative commitments are mutually supportive and free from dissonance; that is, on the ability to establish narrow reflective equilibrium across the normative content of a priority-setter’s policy and practice. While we do not suggest that the establishment of such equilibrium is sufficient for moral justification, we argue that failure to do so might—like the proverbial canary in the coalmine—act as a generalised warning that something is awry. We offer a theoretical argument in support of this view and briefly outline a practical method for systematically examining coherence across priority-setting policy and practice. (shrink)

The World Health Assembly has encouraged WHO member-states to establish capacity in health technology assessment (HTA) as a support for achieving universal health coverage (UHC). Simultaneously, the WHO has stated that UHC is “a practical expression of the concern for health equity and the right to health.” This has prompted questions about potential tensions between priority-setting efforts and the right to health on the road to UHC. South Africa (SA) is an ideal setting in which to explore how the priority-setting (...) work of an HTA body may be integrated with an existing rights framework. (shrink)

Following the death on April 19, 2015 of Freddie Gray from injuries sustained while unarmed and in police custody, many citizens of Baltimore took to the streets and the National Guard was called into the city. A 2017 article published in the American Journal of Public Health measured the effect of this civil unrest on maternal and child health. I argue that this research does not acknowledge the full range of motivations, behaviors, aims and values that may have been inherent (...) in this unrest. I first describe the article’s characterization of Baltimore’s unrest as community violence. I then provide a negative argument against employing this characterization alone, before providing positive arguments for two alternative characterizations—as protest and apt anger. Finally, I discuss upshots of considering these alternatives. Broadly, while viewing civil unrest as community violence focuses exclusive attention on victims of unrest, these alternatives direct attention to unrest participants, with implications for public health research and practice. While I focus on Baltimore’s 2015 unrest, the proposals raised here apply wherever civil unrest occurs. (shrink)

Volume 19, Issue 6, June 2019, Page 71-73.

There is a special need for solidarity at the global level to address global health disparities. Ter Meulen argues that solidarity must complement justice, and is, in fact, more fundamental than justice to the arrangement of health care practices. We argue that PG/SHG, though a theory of justice, is fundamentally synergistic with solidarity. We relate PG/SHG to Jodi Dean’s conceptual work on reflective solidarity, contrasted with conventional solidarity, as an approach to transnational solidarity that dovetails with PG/SHG. We argue that (...) PG/SHG meets both the need for solidarity at the global level and the need for solidarity within theories of the arrangement of health care practices. (shrink)

Background As the UK’s main healthcare priority-setter, the National Institute for Health and Care Excellence (NICE) has good reason to want to demonstrate that its decisions are morally justified. In doing so, it has tended to rely on the moral plausibility of its principle of cost-effectiveness and the assertion that it has adopted a fair procedure. But neither approach provides wholly satisfactory grounds for morally defending NICE’s decisions. In this study we adopt a complementary approach, based on the proposition that (...) a priority-setter's claim to moral justification can be assessed, in part, based on the coherence of its approach and that the reliability of any such claim is undermined by the presence of dissonance within its moral system. This study is the first to empirically assess the coherence of NICE’s formal approach and in doing so to generate evidence-based conclusions about the extent to which this approach is morally justified. Methods The study is grounded in the theory, methods and standards of empirical bioethics. Twenty NICE policy documents were coded to identify and classify the normative commitments contained within NICE technology appraisal policy as of 31 December 2021. Coherence was systematically assessed by attempting to bring these commitments into narrow reflective equilibrium (NRE) and by identifying sources of dissonance. Findings Much of NICE policy rests on coherent values that provide a strong foundation for morally justified decision-making. However, NICE’s formal approach also contains several instances of dissonance which undermine coherence and prevent NRE from being fully established. Dissonance arises primarily from four sources: i) NICE’s specification of the principle of cost-effectiveness; ii) its approach to prioritising the needs of particular groups; iii) its conception of reasonableness in the context of uncertainty, and iv) its concern for innovation as an independent value. Conclusion At the time of analysis, the level of coherence across NICE policy provides reason to question the extent to which its formal approach to technology appraisal is morally justified. Some thoughts are offered on why, given these findings, NICE has been able to maintain its legitimacy as a healthcare priority-setter and on what could be done to enhance coherence. (shrink)

Following the success of Hong Kong Corner Houses, German photographer Michael Wolf continues his collaboration with Hong Kong University Press to produce Small God, Big City. Wolf again uses his creative eye to draw attention to overlooked objects in the visually rich urban environment of Hong Kong. This time the object is the Earth God shrine, found commonly by the doorways of shops and homes throughout Hong Kong. Through his visually stimulating and thought-provoking photographs, Wolf challenges our sensitivity to (...) seemingly familiar everyday things. An interpretative text for the photographs is authored by two familiar names: Lee Ho Yin and Lynne DiStefano, who are well-known academics and practitioners of heritage conservation in Hong Kong. The text is a highly readable curatorial essay that leads readers to a better understanding of the topic and the meaning behind Wolf 's photographs of Earth God shrines in urban Hong Kong. The topic of this book is timely, given the vulnerability of traditional beliefs and practices in an increasingly urbanized Hong Kong. It is hoped that Small God, Big City will provoke deeper thoughts on who we are and what we believe in this modern world. (shrink)

According to the received account of guilt in the philosophical literature, one cannot feel guilt unless one takes oneself to have done something morally wrong. But ordinary people feel guilt in many cases in which they do not take themselves to have done anything morally wrong. In this paper, I focus on one kind of guilt without perceived wrongdoing, guilt about being merely causally responsible for a bad state-of-affairs. I go on to present a novel account of guilt that explains (...) guilt about mere causal responsibility, according to which guilt represents part of the self as bound up with what is bad. (shrink)

An Essay on Human Action seeks to provide a comprehensive, detailed, enlightening, and (in its detail) original account of human action. This account presupposes a theory of events as abstract, proposition-like entities, a theory which is given in the first chapter of the book. The core-issues of action-theory are then treated: what acting in general is (a version of the traditional volitional theory is proposed and defended); how actions are to be individuated; how long actions last; what acting intentionally is; (...) what doing one thing by doing another is; what basic action is; and what omitting to do something is. Attention is also given to the concepts of causation, intention, volition, deciding, choosing, and trying. Finally, a libertarian account of free action is tentatively proposed and defended. (shrink)

Our aim in this paper is to present the distinct ways in which Wolff, Baumgarten, and Kant understand the relationship between necessitation, constraint, and reluctant action in an effort to illustrate the subtle ways in which their conceptions of obligation differ from each another. Whereas Wolff conceives of natural or moral obligation as incompatible with constraint, Baumgarten holds that constraint and reluctant action are, in some instances, compatible with natural obligation. Kant departs from Baumgarten by conceiving of obligation as necessarily (...) involving constraint: as Kant’s reply to Schiller’s famous objection reveals, obligation must take on the character of constraint to reluctant action on account of the fact that human beings possess inclinations that always threaten to impel them in directions that oppose morality. (shrink)

What is the relation between small-scale collaborative plans and the execution of those plans within interactive contexts? I argue here that joint attention has a key role in explaining how shared plans and shared intentions are executed in interactive contexts. Within singular action, attention plays the functional role of enabling intentional action to be guided by a prior intention. Within interactive joint action, it is joint attention, I argue, that plays a similar functional role of enabling the agents to act (...) in a collaborative way such that their actions are rationally guided by a prior shared intention. This understanding of joint attention – as having a key functional role of enabling the rational guidance of joint intentional action by a prior shared intention – allows for an alternative understanding of the kind of minimal cooperation that infants can engage in. On this understanding, infants’ capacity to engage in joint actions is already an incipient capacity to engage in rational and intentional joint actions, albeit a capacity that is necessarily scaffolded by an adult rational co-partner. (shrink)

This a clear and concise introduction to Danish philosopher Soren Kierkegaard.ichael Watts uses Kierkegaard's own writings to introduce his theoriesbout living a truthfu; and spiritual life, while explaining the enormousnfluence of the philosopher's personal life on his work and beliefs. As theounder of 20th century existentialism, and the first philosopher to definehe idea of angst, Kierkegaard's profound influence on modern life is clearlyefined in accessible terms in this guide for students and general readers.

Common knowledge is ubiquitous in our lives and yet there remains considerable uncertainty about how to model or understand it. Standard analyses of common knowledge end up being challenged by either regress or circularity which then give rise to well-known paradoxes of practical reasoning, such as the Two Generals’ Paradox. This paper argues that the nature and utility of common knowledge can be illuminated by appeal to Wittgenstein’s Hinge Epistemology. It is argued that those things that we standardly think of (...) as being common knowledge in our lives are the same as those that Wittgenstein identified as hinge certainties. This identification of common knowledge with hinge certainties allows us to resolve the regress problem for common knowledge and explain how the Two Generals’ Paradox arises. (shrink)

It is a commonplace in economics that we should disregard sunk costs. The sunk cost effect might be widespread, goes the conventional wisdom, but we would be better off if we could rid ourselves of it. In this paper, I argue against the orthodoxy by showing that the sunk cost effect is often beneficial. Drawing on discussions of related topics in dynamic choice theory, I show that, in a range of cases, being disposed to honor sunk costs allows an agent (...) to mimic a resolute chooser, someone who adopts the best plan at the outset of a decision problem and sticks with it, even when resoluteness is unfeasible. I discuss several kinds of cases in which honoring sunk costs coincides with resolute choice. (shrink)

What is the relation between joint attention and common knowledge? On the one hand, the relation seems tight: the easiest and most reliable way of knowing something in common with another is for you and that other to be attentively aware of what you are together experiencing. On the other hand, they couldn’t seem further apart: joint attention is a mere perceptual phenomena that infants are capable of engaging in from nine months of age, whereas common knowledge is a cognitive (...) phenomenon involving (so it seems) complex, overlapping metarepresentational states that require the kind of sophisticated mindreading skills that developmental psychology has shown to be beyond the capabilities of young children. In 'The Shared World: Perceptual Common Knowledge, Demonstrative Communication, and Shared Social Space', Axel Seemann attempts, inter alia, to makensense of this conundrum. (shrink)

Using William Shakespeare’s Hamlet and the play-within-the play, The Murder of Gonzago, as a case study, this essay argues that theatrical utterances constitute a special case of language usage not previously elucidated: the utterance of a statement with propositional content in theatre functions as an event. In short, the propositional content of a particular p (e.g. p1, p2, p3 …), whether or not it is true, is only understood—and understood to be true—if p1 is uttered in a particular time, place, (...) and situation (i.e. during a theatrical event); otherwise, the propositional content in those theatrical utterances can either be false or contingently true. (shrink)

A particular feature of this book is substantial "Stretch and Challenge" material throughout which allows students to develop further.

Concepts and Cases in Nursing Ethics is an introduction to contemporary ethical issues in health care, designed especially for Canadian audiences. The book is organized around six key concepts: beneficence, autonomy, truth-telling, confidentiality, justice, and integrity. Each of these concepts is explained and discussed with reference to professional and legal norms. The discussion is then supplemented by case studies that exemplify the relevant concepts and show how each applies in health care and nursing practice. This new fourth edition includes an (...) added chapter on end-of-life issues, and it is revised throughout to reflect the latest developments on topics such as global health ethics, cultural competence, social media, and palliative sedation. (shrink)

Als Philosoph, Literat, Prediger und Pädagoge gehört Herder zu den bedeutendsten Vertretern der Weimarer Klassik. Diese aktuelle und kenntnisreiche Biografie bringt Leben und Werk Herders einem breiteren Publikum nahe.

Concepts and Cases in Nursing Ethics maps the ethical landscape of contemporary nursing. The book is the product of a collaboration between philosopher-ethicist Michael Yeo, nurse-ethicist Anne Moorhouse, and six representatives of various areas of professional nursing. It thus combines philosophical and ethical analysis with nursing knowledge and experience in a manner that is both understandable and relevant. The book is organized around six main concepts in nursing ethics: beneficence, autonomy, confidentiality, truth-telling, justice, and integrity. A chapter is devoted (...) to the elucidation of each of these concepts. In each chapter, historical background and conceptual analysis are supplemented by case studies that exemplify issues and show how the concept applies in nursing practice. In this new edition, the materials in each chapter have been updated to reflect recent developments in nursing and more generally in health care. In addition, a totally new chapter on ethical theory has been added. Complete with bibliographies and study questions for further analysis of cases, this book is ideally suited for textbook use. It will help both practitioners and students to deal better with the clinical problems and issues that are encountered in the field. However, it's simple prose and clear exposition of complex issues will make Concepts and Cases in Nursing Ethics attractive to anyone concerned about health care. (shrink)

I show that the common reading of Thomson, that she argues by analogy for the conclusion that abortion is permissible, is mistaken. The correct reading of Thomson is that she argues by counterexample, showing that arguments against abortion are unsound. The remainder of the paper highlights the lessons learned from Thomson once we read her aright.

This paper discusses the notion of epistemic circularity, supposedly different from logical circularity, and evaluates Ernest Sosa’s claim that this specific kind of circular reasoning is virtuous rather than vicious. I attempt to determine whether or not the conditions said to make epistemic circularity a permissible instance of begging the question could make other instances of circular reasoning equally permissible.

Telling a patient that the outcome of his illness is not good, or even hopeless, requires sensitivity and the ability to communicate with him in the setting of a hospital which is an unnatural environment divorced from family and friends. It is a task which must be taught and learned by doctors and nurses.

From the concrete experience of war, Michael S. Yandell constructs a phenomenology of “negative revelation” in which false or distorted claims of goodness and justice disintegrate and become meaningless, adding depth to the term moral injury.

AbstractIn this extended case study, we examine how business leaders translate a responsible leadership mindset into practice. By studying the leadership team and stakeholders of a large US college dining provider, we found that organization executives leverage the lenient market category of local food to successfully connect with and satisfy the interests of different stakeholder groups. We show that lenient categories, those with ambiguity and unclear boundaries, could be used by organizations as strategic devices to integrate the diverse needs of (...) their stakeholders and foster positive stakeholder relationships. Based on our findings, we develop a theoretical model to illustrate how responsible leaders take advantage of meaning structures of the market category they have adopted to achieve both financial and social benefits for a broad range of stakeholders. (shrink)