One of the overriding interests of the literature on health care economics is to discover where personal choice in market economies end and corrective government intervention should begin. Our study addresses this question in the context of John Stuart Mill’s utilitarian principle of harm. Our primary objective is to determine whether public policy interventions concerning more than 35,000 online pharmacies worldwide are necessary and efficient compared to traditional market-oriented approaches. Secondly, we seek to determine whether government interference could enhance personal (...) utility maximization, despite its direct and indirect costs on medical e-commerce. This study finds that containing the negative externalities of medical e-commerce provides the most compelling raison d’etre of government interference. It asserts that autonomy and paternalism need not be mutually exclusive, despite their direct and indirect consequences on individual choice and decision-making processes. Valuable insights derived from Mill’s principle should enrich theory-building in health care economics and policy. (shrink)

The mismatch between the demand for, and supply of, health products has led to the increasing involvement of courts worldwide in health promotion and marketing. This study critically examines the implementation of one country’s Milk Code within the framework of the International Code of Marketing of Breast-Milk Substitutes, and the efficacy of the judicial process in balancing corporate marketing and state regulatory objectives. Drawing upon the Philippine experience with its own Milk Code, it evaluates the capacities of courts to determine (...) policy costs and risks against the benefits of delineating and containing corporate marketing strategies for milk substitutes and supplements. The study finds that the methodological and information-based challenges faced by courts in resolving multi-dimensional health issues may not be overcome without serious questions concerning the legitimacy of the judicial process itself. Despite the deficiencies of litigation and adjudication, the study notes the catalytic potential of a judicial decision in opening up vital policy space for future renegotiations among rival parties and interests. Third-party intervention is explored relative to this catalytic function. (shrink)

Combinatory logic and lambda-conversion were originally devised in the 1920s for investigating the foundations of mathematics using the basic concept of 'operation' instead of 'set'. They have now developed into linguistic tools, useful in several branches of logic and computer science, especially in the study of programming languages. These notes form a simple introduction to the two topics, suitable for a reader who has no previous knowledge of combinatory logic, but has taken an undergraduate course in predicate calculus and recursive (...) functions. The key ideas and basic results are presented, as well as a number of more specialised topics, and man), exercises are included to provide manipulative practice. (shrink)

Introduction Combinatory logic deals with a class of formal systems designed for studying certain primitive ways in which functions can be combined to form ...

Seminal essays on environmental philosophy from Indian, Chinese, and Japanese traditions of thought. Environmental Philosophy in Asian Traditions of Thought provides a welcome sequel to the foundational volume in Asian environmental ethics Nature in Asian Traditions of Thought. That volume, edited by J. Baird Callicott and Roger T. Ames and published in 1989, inaugurated comparative environmental ethics, adding Asian thought on the natural world to the developing field of environmental philosophy. This new book, edited by Callicott and James McRae, (...) includes some of the best articles in environmental philosophy from the perspective of Asian thought written more recently, some of which appear in print for the first time. Leading scholars draw from the Indian, Chinese, and Japanese traditions of thought to provide a normative ethical framework that can address the environmental challenges being faced in the twenty-first century. Hindu, Buddhist, Confucian, and Daoist approaches are considered along with those of Zen, Japanese Confucianism, and the contemporary philosophy of the Kyoto School. An investigation of environmental philosophy in these Asian traditions not only challenges Western assumptions, but also provides an understanding of Asian philosophy, religion, and culture that informs contemporary environmental law and policy. J. Baird Callicott is University Distinguished Research Professor of Philosophy at the University of North Texas and author and editor of many books, including Beyond the Land Ethic: More Essays in Environmental Philosophy, also published by SUNY Press. James McRae is Associate Professor of Philosophy and Religion at Westminster College in Missouri. He is the coeditor (with Robert Arp and Adam Barkman) of The Philosophy of Ang Lee. (shrink)

This paper raises questions about the epistemological foundations of evidence-based medicine . We argue that EBM is based upon reliabilist epistemological assumptions, and that this is appropriate - we should focus on identifying the most reliable processes for generating and collecting medical knowledge. However, we note that this should not be reduced to narrow questions about which research methodologies are the best for gathering evidence. Reliable processes for generating medical evidence might lie outside of formal research methods. We also question (...) the notion of the knower that is assumed by EBM. We argue that EBM assumes an enlightenment conception of knowers as autonomous, substitutable individuals. This conception is troubled by the way that clinicians learn the role of anecdote in health care and the role of patient choice, all of which bring into play features of clinicians and patients as situated individuals with particular backgrounds and experiences. EBM's enlightenment conception of the knower is also troubled by aspects of the way evidence is produced. Given these limitations, we argue that EBM should retain its reliabilist bent, but should look beyond formal research methodologies in identifying processes that yield reliable evidence for clinical practice. We suggest looking to feminist epistemology, with its focus on the standpoints of individual situated knowers, and the role of social context in determining what counts as knowledge. (shrink)

Ethical scandals in business are all too common. Due to the increased public awareness of the transgressions of business executives and the potential costs associated with these transgressions, ethical leadership is among the top qualities sought by organizations as they hire and promote managers. This search for ethical leaders intersects with a labor force that is becoming more racially diverse than ever before. In this paper, we propose that the ethical leadership qualities of business leaders may be perceived differently depending (...) upon the race of the leader. Using two experimental studies in the USA, we examine the difference in ethical leadership perceptions between a Black hypocritical CEO and an ethical CEO. Next, we consider a Black ethically ambiguous CEO and an ethical CEO. The findings indicate that a Black leader faces larger negative impact in hypocritical and ambiguous conditions than a similar White leader. There were no significant race effects in the ethical conditions in which a leader demonstrated a personal commitment to ethics through words or actions. We discuss the implications of these findings. (shrink)

A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients’ perception of material risks, by trained interviewers. Patients’ demographics were obtained. Mann–Whitney U (...) test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education, being employed and younger age group are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea, Drowsiness and Surgical Wound Pain. Patients ranked Heart Attack, Death and Stroke as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist, instead of letting the doctor decide or deciding for themselves. Discussion with the anaesthetist is the preferred medium of communication compared to reading a pamphlet or watching a video. Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship. (shrink)

This paper was motivated by what we see as an inconsistency between a 1988 paper by Brennan and Buchanan expressing concern that public choice might erode public confidence in government and previous work by Buchanan, in particular Buchanan. The one advantage we saw with the 1988 paper was that it, all by itself, is all one needs to dismiss MacLean’s depiction of Buchanan as an ideologically rigid extremist. We also found the same inconsistency occurring simultaneously in Buchanan’s writing in 1979. (...) Yet, based on Wagner, we conclude that such inconsistencies may reflect a strength in Buchanan’s scholarship. (shrink)

Although little noticed by practicing theorists, narrative voice influences theoretical work. This essay presents a demonstration of voice as method, concentrating on brief segments of works by Garfinkel and Goffman. We attend to two methodological themes: how theorists use voice to establish intellectual autonomy, and how the use of voice influences credibility with readers. Garfinkel maximizes his autonomy by using narrative techniques that isolate him from his readers, and produce little common context with them as a result. Goffman maintains a (...) context for credibility with his readers by using a personal voice, but he uses this voice to request their indulgence as he follows his autonomous muse. Goffman's narrative self-indulgence prevents him from fashioning a coherent theoretical program for his readers, something Garfinkel's distant voice enables him to achieve. (shrink)

Because the main difference between combinatory weak equality and λβ-equality is that the rule \begin{equation*}\tag{\xi} X = Y \vdash \lambda x.X = \lambda x.Y\end{equation*} is valid for the latter but not the former, it is easy to assume that another way of defining combinatory β-equality is to add rule (ξ) to the postulates for weak equality. However, to make this true, one must choose the definition of combinatory abstraction in (ξ) very carefully. If one tries to use one of the (...) more common abstraction algorithms, the result will be an equality, = ξ , that is either equivalent to βη-equality (and so strictly stronger than β-equality) or else strictly weaker than β-equality. This paper will study the relations = ξ for several commonly used abstraction algorithms, distinguish between them, and axiomatize them. (shrink)

This book presents a collection of contemporary discourses that reconsider the relationship of democracy as a political ideology and American ideal and education as the foundation of preparing democratic citizens in America.

(Report assembled for the Workshop of the AMIA Working Group on Formal Biomedical Knowledge Representation in connection with AMIA Symposium, Washington DC, 2005.) Best practices in ontology building for biomedicine have been frequently discussed in recent years. However there is a range of seemingly disparate views represented by experts in the field. These views not only reflect the different uses to which ontologies are put, but also the experiences and disciplinary background of these experts themselves. We asked six questions related (...) to biomedical ontologies to what we believe is a representative sample of ontologists in the biomedical field and came to a number conclusions which we believe can help provide an insight into the practical problems which ontology builders face today. (shrink)

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

Variations in levels of apolipoprotein E have been tied to the risk and progression of Alzheimer's disease . Our group has previously compared and contrasted the promoters of the mouse and human ApoE gene promoter sequences and found notable similarities and significant differences that suggest the importance of the APOE promoter's role in the human disease. We examine here three specific single-nucleotide polymorphisms within the human APOE promoter region, specifically at -491 , -427 , and at -219 upstream from the (...) +1 transcription start site. The -219 and -491 polymorphic variations have significant association with instance of AD, and -491AA has significant risk even when stratified for the APOEepsilon4 allele. We also show significant effects on reporter gene expression in neuronal cell cultures, and, notably, these effects are modified by species origin of the cells. The -491 and -219 polymorphisms may have an interactive effect in addition to any independent activity. DNA-protein interactions differ between each polymorphic state. We propose SP1 and GATA as candidates for regulatory control of the -491 and -219 polymorphic sites. This work's significance lies in drawing connection among APOE promoter polymorphisms' associations with AD to functional promoter activity differences and specific changes in DNA-protein interactions in cell culture-based assays. Taken together, these results suggest that APOE expression levels are a risk factor for AD irrespective of APOEepsilon4 allele status. (shrink)

This book assesses how Vatican II opened up the Catholic Church to encounter, dialogue, and engagement with other world religions. Opening with a contribution from the President of the Pontifical Council for Interreligious Dialogue, Cardinal Jean-Louis Tauran, it next explores the impact, relevance, and promise of the Declaration Nostra Aetate before turning to consider how Vatican II in general has influenced interfaith dialogue and the intellectual and comparative study of world religions in the postconciliar decades, as well as the contribution (...) of particular past and present thinkers to the formation of current interreligious and comparative theological methods. Additionally, chapters consider interreligious dialogue vis-à-vis theological anthropology in conciliar documents; openness to the spiritual practices of other faith traditions as a way of encouraging positive interreligious encounter; the role of lay and new ecclesial movements in interreligious dialogue; and the development of Monastic Interreligious Dialogue. Finally, it includes a range of perspectives on the fruits and future of Vatican’s II’s opening to particular faiths such as Judaism, Islam, Hinduism, and Buddhism. (shrink)

In the management and business ethics literatures, stakeholder engagement has been demonstrated to lead to more ethical management practices. However, there may be limits on the extent to which stakeholder engagement can, as currently conceptualized, resolve some of the more difficult ethical challenges faced by managers. In this paper we argue that stakeholder engagement, when seen as a way of reducing five types of knowledge problems—risk, ambiguity, complexity, equivocality, and a priori irreducible uncertainty—can aid managers in resolving such ethical challenges. (...) Using a practical illustration of the ethical challenges surrounding the development and application of genetic modification technologies, we demonstrate how stakeholder engagement enables managers to better address these knowledge problems, thereby to manage more ethically. In this way, we suggest that stakeholder engagement has an even more crucial role to play in business ethics research and practice. (shrink)

This book, sure to become a standard reference work, is a comprehensive, lucid, and systematic commentary on Kant's practical philosophy. Kant is arguably the most important moral philosopher of the modern period. Using as nontechnical a language as possible, Professor Sullivan offers a detailed, authoritative account of Kant's moral philosophy - including his ethical theory, his philosophy of history, his political philosophy, his philosophy of religion, and his philosophy of education - and demonstrates the historical, Kantian origins of such important (...) notions as 'autonomy', 'respect for persons', 'rights', and 'duties'. An invaluable resource, this book will be extremely useful to advanced undergraduates, graduates, and professional philosophers alike. (shrink)