Three major trends in American health policy are intersecting in a fascinating way. First, managed care has grown to become the most dominant form of health-care delivery, leading to reductions in health-care costs as insurers are able to influence health-care providers with financial incentives. Second, the present growth of managed care has slowed, almost to a standstill, largely on account of consumers questioning what effects these financial incentives are having on the care of patients — questioning that has been expressed (...) in particular through lawsuits against managed care companies.Third, we are experiencing a renewed interest in the existence of medical error and how it may be reduced as a result of the Institute of Medicine’s report, To Err Is Human: Building a Safer Health System. The most important aspect of this renaissance in error reduction has been its emphasis on health care as a system that can be made better through system-oriented change. The most frustrating aspect is that the IOM did not endorse change in malpractice liability, which consistently puts the impetus for reducing medical error on the individual provider rather than the system as a whole. (shrink)

Three major trends in American health policy are intersecting in a fascinating way. First, managed care has grown to become the most dominant form of health-care delivery, leading to reductions in health-care costs as insurers are able to influence health-care providers with financial incentives. Second, the present growth of managed care has slowed, almost to a standstill, largely on account of consumers questioning what effects these financial incentives are having on the care of patients — questioning that has been expressed (...) in particular through lawsuits against managed care companies.Third, we are experiencing a renewed interest in the existence of medical error and how it may be reduced as a result of the Institute of Medicine’s report, To Err Is Human: Building a Safer Health System. The most important aspect of this renaissance in error reduction has been its emphasis on health care as a system that can be made better through system-oriented change. The most frustrating aspect is that the IOM did not endorse change in malpractice liability, which consistently puts the impetus for reducing medical error on the individual provider rather than the system as a whole. (shrink)

History and Systems of Psychology provides an engaging introduction to the rich story of psychology's past. Retaining the clarity and accessibility praised by readers of earlier editions, this classic textbook provides a chronological history of psychology from the pre-Socratic Greeks to contemporary systems, research, and applications. The new edition also features expanded coverage of Eastern as well as Western traditions, influential women in psychology, professional psychology in clinical, educational, and social settings, and new directions in twenty-first century psychology as a (...) cognitive and a positive science. Assuming little prerequisite knowledge, the authors discuss the people, places, and concepts that have shaped psychology's story, and show that we remain fascinated by the same enduring questions that confronted our ancestors - namely, our wonder at our subjectivity and consciousness of self. The seventh edition is fully supported by robust pedagogical features, instructor resources, and a companion website to aid student learning. (shrink)

Michael A. Petersa and Fazal Rizvib aBeijing Normal University, Beijing, PR China; bMelbourne University, Melbourne, Australia Our minds are still racing back and forth, longing for a return to ‘no...

Book reviewed in this article: Just Doctoring: Medical Ethics in the Liberal State. By Troyen A. Brennan. The Ends of Human Life: Medical Ethics in a Liberal Polity. By Ezekiel J. Emanuel.

In this unique volume, some of today's most eminent political philosophers examine the thought of John Rawls, focusing in particular on his most recent work. These original essays explore diverse issues, including the problem of pluralism, the relationship between constitutive commitment and liberal institutions, just treatment of dissident minorities, the constitutional implications of liberalism, international relations, and the structure of international law. The first comprehensive study of Rawls's recent work, The Idea of Political Liberalism will be indispensable for political philosophers (...) and theorists interested in contemporary political thought. (shrink)

Exhausting Modernity is a bold and exciting new work on the exhaustion of our resources, both natural and human. Brennan marshalls the insights of Marx and Freud to provide a compelling analysis of the pervading modern capitalism: environmental collapse, rising poverty levels, and the increased global economic disparity. Linking the consumption of environmental resources to our own depleted psychic life, she shows that modernity must be rethought if we are to find a sustainable future for both the environment and (...) our own psychic life. (shrink)

_Just Doctoring_ draws the doctor-patient relationship out of the consulting room and into the middle of the legal and political arenas where it more and more frequently appears. Traditionally, medical ethics has focused on the isolated relationship of physician to patient in a setting that has left the physician virtually untouched by market constraints or government regulation. Arguing that changes in health care institutions and legal attention to patient rights have made conventional approaches obsolete, Troyen Brennan points the way (...) to a new, more aware and engaged medical ethics. The medical profession is no longer isolated, even theoretically, from the liberal, market-dominated state. Old ideas of physician beneficence and altruism must make way for a justice-based medical ethics, assuming a relationship between equals more compatible with liberal political philosophy. Brennan offers clinical examples of many of today's most challenging medical problems—from informed consent to care rationing and the repercussions of the HIV epidemic—and gives his recommendation for a new ethical perspective. This lively and controversial plea for a rethinking of medical ethics goes right to the heart of medical care at the end of the twentieth century. (shrink)

The essays in this volume present versions of feminism that are explicitly liberal, or versions of liberalism that are explicitly feminist. By bringing together some of the most respected and well-known scholars in mainstream political philosophy today, Amy R. Baehr challenges the reader to reconsider the dominant view that liberalism and feminism are 'incompatible.'.

Pickering & Garrod's (P&G's) call to study language processing in dialogue context is an appealing one. Their interactive alignment model is ambitious, aiming to explain the converging behavior of dialogue partners via both intra- and interpersonal priming. However, they ignore the flexible, partner-specific processing demonstrated by some recent dialogue studies. We discuss implications of these data.

_Just Doctoring_ draws the doctor-patient relationship out of the consulting room and into the middle of the legal and political arenas where it more and more frequently appears. Traditionally, medical ethics has focused on the isolated relationship of physician to patient in a setting that has left the physician virtually untouched by market constraints or government regulation. Arguing that changes in health care institutions and legal attention to patient rights have made conventional approaches obsolete, Troyen Brennan points the way (...) to a new, more aware and engaged medical ethics. The medical profession is no longer isolated, even theoretically, from the liberal, market-dominated state. Old ideas of physician beneficence and altruism must make way for a justice-based medical ethics, assuming a relationship between equals more compatible with liberal political philosophy. Brennan offers clinical examples of many of today's most challenging medical problems—from informed consent to care rationing and the repercussions of the HIV epidemic—and gives his recommendation for a new ethical perspective. This lively and controversial plea for a rethinking of medical ethics goes right to the heart of medical care at the end of the twentieth century. (shrink)

The search for 'ecological insights' in venerable Asian traditions of thought prompts questions about how such traditions understood humans in relation to nature. Answers which focus on philosophical and religious ideas may overlook culturally important understandings of people and places articulated within scientific and medical thinking. The paper tentatively explores the prospects for gleaning a form of ethics of place from the study of traditional Hindu and Chinese medical sources. Although there are serious problems with the idea that any unadulterated (...) assimilation from other traditions can take place, these sources can be thought of as incorporating a place-centred ethic. By looking closely at Francis Zimmerman's study of Hindu medicine, it is argued that a poetics of place can be ascribed to Ayurvedic discourses on health and disease. It may be possible to associate a similar poetics with classical Chinese medical worldviews, these being reconcilable with-though not the same as-contemporary ecological understandings of humans in relation to the world. Although no pristine reconstruction of Asian traditions of medical thought can be made, the conclusion of the present paper is that it would be wrong to dismiss these traditions as 'antienvironmental', based purely on the study of philosophical and religious texts. (shrink)

In History After Lacan, Teresa Brennan argues that Jacques Lacan was not an ahistorical post-structuralist. She tells the story of a social psychosis, beginning with a discussion of Lacan's neglected theory of history which argued that we are in the grip of a psychotic's era which began in the seventeenth century and climaxes in the present. By extending and elaborating on Lacan's theory, Brennan develops a general theory of modernity. Contrary to postmodern assumptions, she argues, we need a (...) general historical explanation. An understanding of historical dynamics is essential if we are to make the connections between the outstanding facts of modernity--ethnocentrism, the relation between the sexes, and ecological catastrophe. A challenging feminist, interdisciplinary study, History After Lacan will be essential reading for social, cultural, and political theorists, historians, psychoanalysts, and literary theorists. (shrink)

In this study, we used a word search puzzle paradigm to investigate age differences in the rate of information gain and the cues used to make patch-departure decisions in information foraging. The likelihood of patch departure increased as the profitability of the patch decreased generally. Both younger and older adults persisted past the point of optimality as defined by the marginal value theorem, which assumes perfect knowledge of the foraging ecology. Nevertheless, there was evidence that adults were rational in terms (...) of being sensitive to the change in RG for making the patch-departure decisions. However, given the limitations in cognitive resources and knowledge about the ecology, the estimation of RG may not be accurate. Younger adults were more likely to leave the puzzle as the long-term RG incrementally decreased, whereas older adults were more likely to leave the puzzle as the local RG decreased. However, older adults with better executive control were more likely to adjust their likelihood of patch-departure decisions to the long-term change in RG. Thus, age-dependent reliance on the long-term or local change in RG to make patch-departure decisions might be due to individual differences in executive control. (shrink)

Work on dispositions focuses chiefly on dispositions that are manifested in dynamic causal processes. Williams, Neil. 2005. “Static and Dynamic Dispositions.” Synthese 146: 303–24 has argued that the focus on dynamic dispositions has been at the expense of a richer ontology of dispositions. He contends that we ought to distinguish between dynamic and static dispositions. The manifestation of a dynamic disposition involves some change in the world. The manifestation of a static disposition does not involve any change in the world. (...) In this paper, we concede that making a conceptual distinction between dynamic and static dispositions is useful and we allow that we can truthfully represent objects as manifesting static dispositions. However, we argue that the distinction is not ontologically deep. Rather, the truthmakers for our representations of static dispositions are actually dynamic dispositions to whose manifestations we may fail to be sensitive. (shrink)

There has been a strong tendency in recent years, in countries such as Australia and the United States, for governmental and corporate spokespersons to present advice and information that comes from independent scientific sources as if it were no better grounded than that from any other source. Such a leveling out of all advice and information into mere “opinion” has been a key strategy in the assertion of corporate and governmental control over public debate and policy. In this paper, we (...) aim to explore some of the factors that diminish the credibility and reliability of information within organizational structures, effectively undermining the value of that information; we argue for the importance of processes like those of peer review in maintaining the credibility and reliability of information that is so important to effective action and decision; and we also provide an analysis of the rationale that underpins such processes. One of our conclusions will be that processes like those of peer review succeed largely because of the way in which they depend upon, but also support, the dispersal of information and authority within an organizational structure so as to ensure both that information is accessible within the structure and also remains open to challenge and scrutiny. (shrink)

This paper describes the general structure of an environmental philosophy. There can be many such philosophies, and those with their roots in economic theory have been extensively studied recently. Specific examples cited in the paper include the work of David Pearce and Robert Goodin. Economics-based philosophies can founder on the issue of externalities and a misplaced attempt to provide a comprehensive approach to valuing nature as a bundle of goods and services. It is argued that it is dangerously easy to (...) slide from considering nature as a standing reserve of processes and objects that have the potential to satisfy human desires to the idea that it is nothing more than that. In general, the consequentialist basis of economics limits its usefulness in contributing to informed environmental decisions. But there is room for a sensitive use of institutional environmental economics as a partial guide for our reflections and choices. Any such development should take on board the existence of a plurality of perspectives on fundamental issues and the pluralism of values that can be found within moral theory itself. (shrink)

Parfit argues that survival, Not identity, Is the important thing in cases of personal resurrection, Fission, Etc. I argue that parfit's and dennett's well known cases--And fantasies about cloning and telecloning--Suggest a distinction between type and token persons, Memories, Intentions, Etc. Parfit is wrong, I suggest, To think survival more determinate than identity; with quine I hold that there is no objective matter to be right or wrong about.

The paper mobilizes Adam Smith’s treatment of the division of labour in relation to the production, consumption and exchange of knowledge. One aspect of this mobilization deals with the epistemic demands that exchange makes on its participants. The other deals with increasing returns in the provision of knowledge itself, treating knowledge creation as just another example of specialization and exchange. These two aspects come together in relation to the epistemic demands associated with assessing knowledge quality. These demands differ according to (...) whether the knowledge is embodied in products or whether the knowledge is an object for its own sake. It is argued that disciplines play a critical role as institutions for meeting the epistemic demands that the division of labour creates in the ‘knowledge’ case. (shrink)

Attacks on ?closest continuer? and ?best candidate? theories of identity have something correct in them while still failing to discredit the theories they oppose. What follows from Noonan's and Wiggins's objections to such theories is that they need to be so formulated as not to deny the necessity of identity. The best metaphysics for best?candidate theories to adopt is one in which everyday objects are taken to transcend, in a certain sense, their life histories in given worlds. This metaphysics also (...) has the potential for solving problems about contingent identity, transworld identity, and the issue of haecceitism or individual essence. To develop the metaphysics, it is only necessary to follow through the analogy between worlds and times suggested by writers like Plantinga and Schlesinger. (shrink)

A survey of Stoic views on religion, with an emphasis on their proofs of the existence and nature of Zeus.

This article surveys recent feminist contributions to moral philosophy with an emphasis on those works which engage with debates within mainstream ethics. The article begins by examining a tension said to arise from the two criteria a theory must meet if it is to count as feminist moral theory: the women's experience requirement and the feminist conclusion requirement. Subsequent sections deal with feminist relational theories of rights, feminist work on responsibility and feminist contractarian approaches to ethics. A final section looks (...) at the application of some feminist moral theories to the problem of abortion. (shrink)

The article focuses on surfing to consider the attractiveness of using the sublime to describe experiences and emotions in nature sports. The sublime is shown to be a red herring in scholarship as it fails to account for many of the valuable experiences available to nature sports enthusiasts. The article draws on the work of Genevieve Lloyd to propose that wonder is a more suitable concept that gets to the heart not only of the terror and awe that nature can (...) inspire, but also to the orientation towards our finitude, difference, and the stimulation of growth and practical knowledge that nature sports also inspire (and that are not accounted for in the sublime). (shrink)

AtCharmides163, Critias attempts to extricate himself from refutation by proposing a Prodicean distinction betweenpraxisandpoiēsis. I argue that this distinction leads him further into contradictions.

the standard reading of plato's Republic is that justice is predicated of the ideal city and of the philosophers, and that all other constitutions, both psychic and political, that are mentioned in the course of the dialogue are in some way or another defective and unjust. A non-standard reading appears to be gaining traction, however. Unorthodox Plato commentators such as Silverman, Jonas, Nakazawa, Braun, and Rowe argue that the ideal city—lovingly named 'Kallipolis'—is not just, that it is merely an improvement (...) upon, but not a complete cure for, the Luxurious City that is described immediately before it.1 If we want to gaze upon a just city, these unorthodox commentators propose, look no farther than the City of... (shrink)