This essay examines the impact of the imposition of businesses techniques, in particular, those associated with Total QualityManagement, on the relationships of important components of the health care delivery system, including payers, managed care organizations, institutional and individual providers, enrollees, and patients. It examines structural anomalies within the delivery system and concludes that the use of Total Quality Management techniques within the health care system cannot prevent the shift of attention of other components away from the enrollee and the patient, (...) and may even contribute to it. It speculates that the organization ethics process may serve as a quality control mechanism to prevent this shift and so help eliminate some of the ethically problematic processes and outcomes within the health care delivery system. (shrink)

The prelims comprise: Introduction The Physician and the Provider Organization The Physician and the Payer Organization Dealing with Systems Conclusion Notes References.

The problem is a simple one. A placebo is “a substance provided to a patient that the physician believes has no specific pharmacological effect upon the condition being treated” (AMA 2007). 1 But i...

Most organizations and/or their sub-units like ethics programs want to acquire the knowledge, skills and other resources needed to achieve their goals efficiently and effectively. Thus, they want to acquire or develop needed capacity. But there are pre-conditions to building capacity that are often overlooked or forgotten, but which nevertheless, must be in place before capacity can be developed. This essay identifies these pre-conditions and discusses why they are necessary before attempts are made to enhance the capacity of any ethics (...) program. The essay closes by offering a series of questions that ethics program leaders/and or members can asked themselves to assess whether or not these pre-conditions exist. (shrink)

Bioethics, clinical ethics, and professional ethics are mature, well-developed fields of applied ethics that focus on medical research, patient autonomy and patient care, patient–healthcare professional relationships, and issues that arise in clinical and other medical settings. However, despite these developments, little attention has been paid to the organizational aspects of healthcare in these fields. This is surprising, because in the last 30 years healthcare has become more and more institutionalized in provider, management, and insurer organizations. Despite JCAHO's preoccupation with organizational (...) ethics during the last decade, the philosophical underpinnings of their requirements have been less explored in the literature. Clinical ethics remains preoccupied with clinical patient care and professional ethics with individual professional guidelines; even the American College of Healthcare Executives focuses primarily on healthcare managers, not on healthcare organizations. (shrink)

Human rights legislation pertaining to applications of human genetic science is still lacking at an international level. Three international human rights documents now serve as guidelines for countries wishing to develop such legislation. These were drafted and adopted by the United Nations Educational, Scientific and Cultural Organization, the Human Genome Organization, and the Council of Europe. It is critically important that the international nursing community makes known its philosophy and practice-based knowledge relating to ethics and human rights, and contributes to (...) the globalization of genetics. Nurses have particular expertise because they serve in a unique role at grass roots level to mediate between genetic science and its application to public health policies and medical interventions. As a result, nurses worldwide need to focus a constant eye on human rights ideals and interpret these within social, cultural, economic and political contexts at national and local levels. The purpose of this article is to clarify and legitimate the need for an international declaration on nursing, human rights, human genetics and public health policy. Because nurses around the world are the professional workforce by which genetic health care services and genetic research protocols will be delivered in the twenty-first century, members of the discipline of nursing need to think globally while acting locally. Above all other disciplines involved in genetics, nursing is in a good position to articulate an expanded theory of ethics beyond the principled approach of biomedical ethics. Nursing is sensitive to cultural diversity and community values; it is sympathetic to and can introduce an ethic of caring and relational ethics that listen to and accommodate the needs of local people and their requirements for public health. (shrink)

Genetic information and technologies are increasingly important in health care, not only in technologically advanced countries, but world-wide. Several global factors promise to increase future demand for morally conscious genetic health services and research. Although they are the largest professional group delivering health care world-wide, nurses have not taken the lead in meeting this challenge. Insights from feminist analysis help to illuminate some of the social institutions and cultural obstacles that have impeded the integration of genetics technology into the discipline (...) of nursing. An alternative model is suggested - the transdisciplinary model - which was developed initially by a nurse and introduced in the 1970s into the delivery of health care and social services for children with developmental disabilities. This holistic model enables all health care professionals to have an equal voice in determining how genetic health care will be globalized. (shrink)

¿Qué cabida tienen, o pueden tener, las éticas y las políticas de la alteridad en el horizonte filosófico actual? En el contexto de la filosofía española reciente, la obra de Gabriel Bello Reguera (Dehesas, León, 1943) ha afrontado el reto ético-político que plantea el tomarse en serio la alteridad. Ha desarrollado su carrera académica en la Universidad de La Laguna como catedrático de Filosofía Moral y en su trayectoria cabría señalar tres giros fundamentales, si bien relacionados entre sí. El primero (...) podemos derivarlo del impacto de la lectura de la obra del neopragmatista Richard Rorty, que incidió en su crítica al fundamentalismo autoritario de la tradición filosófica despertó su interés por la narratividad, ligada a la conversación, como herramienta edificante de la ética. El segundo es debido a la influencia del pensamiento de Emmanuel Lévinas, a partir del cual problematiza las relaciones entre las categorías éticas de identidad, diferencia y alteridad. El tercero, y más reciente, le llevará al terreno del análisis de las migraciones internacionales en su contexto postcolonial como acuciante asunto necesitado, precisamente, de un nuevo marco filosófico, ético y político. En este libro colectivo, a través de la obra de Gabriel Bello, afrontamos con rigor la contextualización de las éticas y las políticas de la alteridad, proseguimos la discusión en torno a estas a la vez que elaboramos, conjuntamente, un balance crítico de una línea de investigación, de sus posibilidades y límites. Con todo ello, además, seguimos la tradición de prestar reconocimiento y gratitud a nuestros maestros y a nuestras maestras. En este caso, reconocemos la trayectoria docente e investigadora del Profesor Gabriel Bello Reguera y su dedicación rigurosa y concienzuda a la vida universitaria. Su obra, que, recorre cuatro décadas, es testimonio de cómo la filosofía en el contexto del Estado español, tras abandonar el erial instigado por el franquismo, participa de los debates transnacionales actuales en los que las éticas y las políticas de la alteridad, especialmente, plantean desafíos insoslayables. Hemos, pues, recreado el ritual académico del Homenaje, algo tan central en la filosofía alemana como la Festschrift, con el deseo de dotarlo del sentido más relevante que, a nuestro juicio, puede tener: el del debate intelectual crítico. (shrink)

Richard Rorty is well known as a propagandist of pragmatism and of a "post-philosophical" culture in which many traditional philosophical debates are dismissed as outrightly fruitless. The paper is mainly concerned with Rorty's dismissal of the realism-antirealism debate. The shift from argument to propaganda which is typical of much of Rorty's reasoning is critically investigated from different perspectives. In particular, it is argued that Rorty cannot convincingly establish a pragmatist position beyond realism and antirealism, and that (...) pragmatism seems to be inadequate with respect to scientific practice. Finally, the fruitfulness of the realism-antirealism debate is defended. (shrink)

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

This selection consists of extracts from writings of women concerned solely with the pursuit of abstract ideas, historically contextualized. The texts, for the most part, reflect issues widely debated in their contemporary societies. Extracts from lesser-known writers are also included, providing a diversity of arguments spanning four centuries and including some notable contemporary philosophers.

A leader in the modern commentary on ethics and philosophy, Mary Warnock casts a critical eye over her life and times.

How is hope to be found amid the ethical and political dilemmas of modern life? Writer and philosopher Mary Zournazi brought her questions to some of the most thoughtful intellectuals at work today. She discusses "joyful revolt" with Julia Kristeva, the idea of "the rest of the world" with Gayatri Spivak, the "art of living" with Michel Serres, the "carnival of the senses" with Michael Taussig, the relation of hope to passion and to politics with Chantal Mouffe and Ernesto (...) Laclau. A dozen stimulating minds weigh in with their visions of a better social and political order. The result is a collaboration - of writing, of thinking, and of politics - that demonstrates more clearly than any single-authored project could how ideas encountering one another can produce the vision needed for social change. (shrink)

All religion and much philosophy has been concerned with the contrast between the ephemeral and the eternal. Human beings have always sought ways to overcome time, and to prove that death is not the end. This book consists then in an exploration of certain closely related ideas: personal identity, time, history and our commitment to the future, and the role of imagination in life.

En este libro, la autora desarrolla su concepción del juicio reflexionante inspirada en Emmanuel Kant y en Hannah Arendt para concentrarse en cómo cierto tipo de narraciones modelan nuestras nociones de lo que consideramos moral. Lara nos ofrece distintas concepciones sobre el mal en su formulación histórica mediante los ejemplos de las tragedias griegas, las diferentes concepciones sobre el mal en la obra de Shakespeare, el uso literario de la metáfora en la obra de Joseph Conrad y en narraciones fílmicas (...) que describen la crueldad humana. Lara sugiere que el aprendizaje moral es un proceso en el que intervienen las instituciones sociales, la voluntad de los individuos y de las sociedades para comprometerse a un debate abierto y con ello modelar los juicios colectivos sobre el pasado. Lara enfatiza que el juicio reflexionante se da entre un evento, una narración de dicho evento y la recepción pública de dicha narrativa. En este libro se aportan importantes métodos para la comprensión del fenómeno moral del mal, porque introducen nuevas verdades desvelatorias acerca de eventos particulares que no pueden ser simplemente captados por medio de categorías conceptuales. Lara utiliza como fuentes a Jürgen Habermas, Walter Benjamin, Primo Levi, Giorgio Agamben y Ariel Dorfman para probar la conclusión de este tipo de narraciones: la acción (de crueldad) ata de manera definitiva al perpetrador con su víctima. (shrink)

Fundamental principles : the nature of the dispute -- Types of euthanasia -- Psychiatric assisted suicide -- Neonates -- Incompetent adults -- Human life is sacred -- The slippery slope -- Medical views -- Four methods of easing death and their effect on doctors -- Looking further ahead.

Although he did not lengthily critique St. Thomas's philosophy, Richard Rorty tagged him along with Plato as a foundationalist thinker, i.e., someone who is preoccupied with underlying principles or ultimate standards of truth. It is unfortunate, however, that Rorty's sweeping critique is obviously based on superficial and inadequate reading of the Dominican saint. Marie- Dominique Chenu, a less known yet very serious Thomist scholar, has shown that the mode of argumentation in the thought of St. Thomas has an (...) underlying conversational goal. In other words, St. Thomas's method of rational inquiry is not divisive but collaborative which is highlighted by the effort to reconcile initially opposing views by means of the intellectual tool of distinction, a tool which Rorty himself employed in dealing with criticisms hurled against his apparently nihilistic neopragmatic thought. St. Thomas consistently employed the tool of distinction in disputatio, or argumentation with the goal of pursuing collaboration with different thinkers whether they are Christians or Muslims, pagans or believers, in the pursuit of truth. (shrink)

The works of Mary Wollstonecraft (1759-1797) ranged from the early _Thoughts on the Education of Daughters_ to _The Female Reader_, a selection of texts for girls, and included two novels. But her reputation is founded on _A Vindication of the Rights of Woman_ of 1792. This treatise is the first great document of feminism—and is now accepted as a core text in western tradition. It is not widely known that the germ of Wollstonecraft’s great work came out of an (...) earlier and much shorter vindication—A Vindication of the Rights of Men (1790), written in the context of the issues raised by the French Revolution. This edition, which follows the model of other Broadview Editions in including a range of materials that help the reader to see the work in the context of its era out of which it emerged, is arranged chronologically, opening with Wollstonecraft’s “other vindication.” It also includes a wide range of other documents in appendices, as well as a comprehensive and authoritative introduction, chronology, and full index. (shrink)

Nature and Mortality is a challenging look at some of the major public issues of our time through the eyes of one of our most influential and probing liberal humanists. It is a frank account on where we stand today on such controversial matters as human embryology, genetic engineering, euthanasia and abortion. Warnock's views may seem like a red rag to a bull to some, but her contribution to the debate is always stimulating. Enlivened by autobiographical anecdote and some delicious (...) side-swipes, Nature and Mortality is Mary Warnock at her most perceptive, wise and entertaining. (shrink)

Western philosophical orthodoxy places many aspects of other people's lives outside the scope of our knowledge. Demonstrating an alternative to this view, however, this book argues that Jean-Paul Sartre's application of his unique psychoanalytic method to Gustave Flaubert is the culmination of his project to show that it is possible to know everything there is to know about another person. It examines how Sartre aims to revolutionize our way of thinking about others by presenting his existential psychoanalysis as the means (...) to knowledge of both ourselves and others. By so doing, it highlights how his determination to solve the longstanding philosophical conundrum about other minds drives him not only to incorporate insights from Descartes, Hegel, Husserl, Freud, Marx, and Beauvoir into his philosophy, but also to supplement and enhance his philosophy through the development and application of a new form of psychoanalysis. -/- Sartre's Existential Psychoanalysis integrates, for the first time, Sartre's psychoanalysis into his overarching philosophical project. By offering a critical interrogation of the role his psychoanalytical studies played in the development of his existentialism, Mary Edwards uncovers the overlooked philosophical significance of his existential psychoanalysis and brings it into a new and productive dialogue with current research in the fields of philosophy, psychology, and psychotherapy. (shrink)

This chapter first distinguishes between originality and creativity. True originality is rare, whether in art, science, or LEGO, because to be truly original means to have done something that no one has ever done before, and that no one could have anticipated. Most LEGO creations will not meet that condition, for with the exception of serious hobbyists who undertake massive builds, most players who make original creations are making creations that are commonplace. Painting or remolding or placing stickers on the (...) bricks counts against the spirit of LEGO creation. The chapter then discusses The LEGO Movie embodies the paradox that presents three conflicting models of creative LEGO play, illustrated by the Master Builders, Finn's father, and Emmet. The movie's creators were deliberately playing around with conflicting popular conceptions of creativity: creativity as madness, creativity as thinking outside the box, and creativity as vision. (shrink)

The contributors to this volume have approached the problem of characterizing and classifying emotions from the perspectives of neurophysiology, psychology, and ...

The unity of aesthetic and teleological judgment, the third and earlier Critiques, is based on Kant′s discovery of a “heuristic method” for applying judgments regarding sense phenomena to abstract thought, a “second attention” which enables an “idea of the whole”. Synthetic judgment, basis for cognition and human action, depends on efficacy of non-empirical insights: the transcendental standpoint, “regulative” ideas, consciousness of “ought” and the reality of freedom, universality of natural mechanism, the principle of “fortuitous” purposiveness. The activity of reflective judgment (...) in the encounter with the beautiful, sublime, living, and two paradigmatic types of explanation, inspired by Spinoza′s distinction of extensio and cogitatio, permit Kant to bridge the gap between freedom and necessity, theoretical knowledge and morality. (shrink)

The philosopher must inform himself of the relevant empirical investigation to arrive at a definition, and the scientist cannot afford to be naive about the..