The current concern with reforming and regulating managed care under the general rubric of “patients' rights” has eclipsed the more fundamental need to legislate the human rights of those without adequate access to any healthcare. To characterize the regulatory activity as a “rights” movement inflates its moral dimension. The concept of “rights” carries a serious and powerful moral force that is currently inappropriately applied to the parochial concerns of a segment of the population privileged to have health insurance coverage. By (...) contrast, the language of “rights” refers to a high level of universality for the most rudimentary of human concerns. If there was a universal right to become a patient equal to other patients, a concept of patients' rights would have legitimacy. As it is, however, the central determinant of this “right” is how much the insurance policy costs and what is covered. To so diminish the meaning of “right” within the miasma of managed care is to lose sight of the real possibilities of applying a positive “right” to healthcare and, in the long run, is to diminish the ethics of healthcare. (shrink)

The rock climber and the law share in a common etymological allusion when each reaches a steep, high, and hard place. The climber “appeals” to the mountain by inching down on a rope and the law's “rappel” is similarly a route to more comfortable footing. Each step in this common process is germane to the eventual resolution, for it is to be found in the rappel process itself and in the meaning of each appeal.

Has the private body of biethics become a microcosm of the body politic? Politics is ethics writ large. Ethics is politics writ small. However we turn it, the practice of bioethics is increasingly attuned to developments in public policy. The establishment of a “Health Policy Watch” in these pages is an invitation for research and reflection on these issues.

The challenge of determining that therapeutic intervention is futile is a recurrent ethical theme in critical care medicine. The process by which that determination is reached often involves demanding collaborative and interdisciplinary conversation and deliberation within the context of hospital policy, including ethics committee guidelines. The subsequent decision as to what happens next depends on resources, such as palliative care services, hospice, other hospital protocols, and, of course, family support.

A common tale of moral cacophony and euphemism on the city streets:Each day, an owner of a small business decides, “once and for all,” how to respond to the “homeless person” panhandling for “spare change” as she makes her way to work in the morning. Today, she looks the other way and holds more tightly to her purse. Nearby, a building contractor waits impatiently for the traffic light to change as his van is approached by a small and shabby band (...) of “street people” demanding to clean his windshield. He turns his wipers on to signal them away. Sometimes this works. At the next light, a woman carrying an infant swaddled to her torso offers a tube of three roses for a dollar. The driver smiles pleasantly, but does not stop. The businesswoman, now close to work, buys two tubes of roses and does not wait for the change from the five-dollar bill she earnestly presses into the mother's hand. (shrink)

Ongoing legislative proposals to overhaul United States immigration policy look very much like a new wave of nativism is sweeping the Congress. The movement, mounted in early 1995, is in full swing to limit immigrant populations from arriving, settling, producing, and benefiting as our parents' generations have done. Legislators and the courts are now considering the most complete antiimmigration social legislation since the decades following the First World War.

The era of managed care has arrived with portents of a new calculus to integrate cost and quality in health services. These devises such as “report cards” and “outcome measures” place performance against expectations and thus are expected to gauge the value of specific elements of healthcare delivery. From such measures and comparisons, the public will be able to better judge the appropriate, effective, and attractive place to seek their medical services. What is now widely used by utilization review, guiding (...) reimbursement decisions and allowances for the length of hospital stays, will soon have a more prosperous future as general guidelines built into the very framework of managed care agreements. (shrink)

The ideal of universal human rights is arguably the most potent moral concept marking the modern world. Its accelerated fruition in the last half of the twentieth century has created a powerful political force, laying the groundwork for future generations to extend and apply. Whereas anything resembling international legal status for human rights had to wait for the post-Nazi era, the bold proclamations of the Universal Declaration of Human Rights (UDHR, 1948) loosened a revolutionary force with endless potential for application (...) to the full range of human endeavors. The roots of this movement can be traced to each and every era in which the vulnerable and powerless sought justification to oppose arbitrary domination. Its roots are, therefore, deep and wide. (shrink)

The classic formulation of situation ethics in the 1960s was the result of the contention that the deductive application of general rules and principles in ethics was inherently flawed by the uniqueness of every situation. Quite often, ethical problems are problems precisely because existing rules do not apply four square to the singular situation at hand. There is a need, the argument ran, to assert the primacy of the special situation and to formulate a resolution of the unsettling circumstances appropriately (...) attuned to it. Situation ethics is, in a sense, a moral theory equivalent to case law in a legal system devoid of rule by law. (shrink)

Was this just another incendiary sound bite, headline news banner attacking the airwaves? Getting it wrong? Overstating some small technicality for the sake of getting attention? No, to all of the above: the most incendiary aspect of the blurb was that it was accurate. And it did get attention.

Jonathan Mann was a pioneer in establishing communication between the world of public health and that of human rights activism. At the very start, he strongly believed that although each of these two fields was in the midst of separate paradigm shifts, these shifts are essential, perhaps causal, to the combined health and human rights movement.

A 68-year-old gentleman is brought into a New York City ER at 2:30 P.M. by the squad in response to a 911 call from his neighbor, who found him unconscious in his bed. The cause of his condition is not known, but the man is unresponsive and requires immediate life support, including intubation, IV fluids, and pressors. Within minutes, his son arrives and attempts to deny permission for the LSMTx, claiming that his father is in end-stage ALS and has an (...) advance directive stipulating that he should not be invaded with LSMTx at this last moment in his life. The copy of the directive he produces is nonspecific in this context, because it qualifies refusal of LSMTx for “ … irreversible conditions …” and no one is sure if this situation is reversible. The advance directive names a daughter as proxy, and she is on her way from Maine, a 10-hour drive. (shrink)

As the concept of universal access to healthcare comes to America, an ethical paradox emerges. “Access” is the code word for being assured that sick people without financial resources get appropriate medical care. There is an ethical imperative to provide care for the sick – whether paying or not – and this value ought to give direction to any reformed system.

In this case, the patient's mother repeatedly asked about the health of any prospective child and whether she would be assured some custodial role. She also questioned the role of the prospective recipient. The committee facilitated obtaining the necessary information, sharing this information with the surrogate, and assisted the surrogate and two of her daughters to share both their feelings and additional information they possessed.

This article recounts the development of the Professional/problem-based Ethics Program, the original physicians’ professional ethics remediation course. Since 1992, more than 1,200 healthcare professionals of many disciplines have been mandated to attend ProBE by licensing boards and other oversight entities. Using a small-group, interprofessional setting, the ProBE Program assists participants to discover and articulate ethical underpinnings violated by their misconduct; appreciate professional responsibilities that are societal, regulatory, and ethical; and recommit to professional ideals. The authors describe the rationale for developing (...) ProBE, its curriculum, participant demographics, and infractions and reconsider medical professionalism in light of two decades of ProBE. (shrink)

In this short text, a distinguished philosopher turns his attention to one of the oldest and most fundamental philosophical problems of all: How it is that we are able to sort and classify different things as being of the same natural class? Professor Armstrong carefully sets out six major theories—ancient, modern, and contemporary—and assesses the strengths and weaknesses of each. Recognizing that there are no final victories or defeats in metaphysics, Armstrong nonetheless defends a traditional account of universals as the (...) most satisfactory theory we have.This study is written for advanced students, but as Armstrong goes considerably beyond his earlier work on this topic, it will interest professional scholars as well. Carefully plotted and clearly written, Universals is both a paradigm of exposition and a case study on the value of careful analysis of fundamental issues in philosophy. (shrink)

In this important study D. M. Armstrong offers a comprehensive system of analytical metaphysics that synthesises but also develops his thinking over the last twenty years. Armstrong's analysis, which acknowledges the 'logical atomism' of Russell and Wittgenstein, makes facts the fundamental constituents of the world, examining properties, relations, numbers, classes, possibility and necessity, dispositions, causes and laws. All these, it is argued, find their place and can be understood inside a scheme of states of affairs. This is a comprehensive and (...) rigorously this-worldly account of the most general features of reality, argued from a distinctive philosophical perspective, and it will appeal to a wide readership in analytical philosophy. (shrink)

This chapter explores the debate between contemporary projectivists or expressivists, and the advocates of sensibility theory. Both positions are best viewed as forms of sentimentalism — the theory that evaluative concepts must be explicated by appeal to the sentiments. It argues that the sophisticated interpretation of such notions as “true” and “objective” that are offered by defenders of these competing views ultimately undermines the significance of their meta-ethical disputes over “cognitivism” and “realism” about value. Their fundamental disagreement lies in moral (...) psychology; it concerns how best to understand the emotions to which sentimentalist theories must appeal. (shrink)

A substantial guide providing an overview of both physicalism and metaphysical naturalism, reviewing both questions of formulation and justification for both doctrines. Includes a diagnostic strategy for understanding talk of naturalism as a metaphysical thesis.

We perceive smells as perduring complex entities within a distal array that might be conceived of as smellscapes. However, the philosophical orthodoxy of Odor Theories has been to deny that smells are perceived as having a distal location. Recent challenges have been mounted to Odor Theories’ veracity in handling the timescale of olfactory perception, how it individuates odors as a distal entities, and their claim that olfactory perception is not spatial. The paper does not aim to dispute these criticisms. Rather, (...) what will be shown is that Molecular Structure Theory, a refinement of Odor Theory, can be further developed to handle these challenges. The theory is further refined by focusing on distal perception that requires considering the perceptual object as mereologically complex persisting odor against a background scene conceived of as a smellscape. What will be offered is an expansion of Molecular Structure Theory to account for distal smell perception within natural environments. (shrink)

Inside What Would Plato Do?, you'll find the basics of philosophy, written in an easy, digestible way we can all understand, along with questions to help you apply these important theories to your own life. So, after you've learned about a philosophical concept, you'll then be challenged to test yourself and see how the results can impact your daily life. For instance, after learning about Kant's theory of morality and the importance of intention you're challenged with questions like: Can good (...) people do bad things? Was there a time when you intended to do something helpful that ended up being hurtful? Does that make you a good person (because you intended to do good) or a bad person (because the results were bad)? What Would Plato Do? will not only help you better understand some of the greatest thinkers ever but will also help you think of the world around you in a whole new way! (shrink)

This paper is a review of the influence that lógos has had on ancient Greek, Jewish, and Christian writings. During the philosophical era known as Middle Platonism, the concept/ontology of the lógos played a unique role in enabling Pagan, Jewish, and Christian intellectuals to communicate on a small space of common ground.

Reflection Principles are commonly thought to produce only strong axioms of infinity consistent with V = L. It would be desirable to have some notion of strong reflection to remedy this, and we have proposed Global Reflection Principles based on a somewhat Cantorian view of the universe. Such principles justify the kind of cardinals needed for, inter alia , Woodin’s Ω-Logic.

When it originated in the late 19th century, psychometrics was a field with both a scientific and a social mission: psychometrics provided new methods for research into individual differences, and at the same time, these psychometric instruments were considered a means to create a new social order. In contrast, contemporary psychometrics - due to its highly technical nature and its limited involvement in substantive psychological research - has created the impression of being a value-free discipline. In this article, we develop (...) a contrasting characterization of contemporary psychometrics as a value-laden discipline. We expose four such values: that individual differences are quantitative (rather than qualitative), that measurement should be objective in a specific sense, that test items should be fair, and that utility of a model is more important than its truth. Our goal is not to criticize psychometrics for employing these values, but rather to bring them into the open and to show that these values are not inevitable and are in need of systematic evaluation. (shrink)

We are immersed within an odorous sea of chemical currents that we parse into individual odors with complex structures. Odors have been posited as determined by the structural relation between the molecules that compose the chemical compounds and their interactions with the receptor site. But, naturally occurring smells are parsed from gaseous odor plumes. To give a comprehensive account of the nature of odors the chemosciences must account for these large distributed entities as well. We offer a focused review of (...) what is known about the perception of odor plumes for olfactory navigation and tracking, which we then connect to what is known about the role odorants play as properties of the plume in determining odor identity with respect to odor quality. We end by motivating our central claim that more research needs to be conducted on the role that odorants play within the odor plume in determining odor identity. (shrink)

The central insight of Darwin's Origin of Species is that evolution is an ecological phenomenon, arising from the activities of organisms in the 'struggle for life'. By contrast, the Modern Synthesis theory of evolution, which rose to prominence in the twentieth century, presents evolution as a fundamentally molecular phenomenon, occurring in populations of sub-organismal entities - genes. After nearly a century of success, the Modern Synthesis theory is now being challenged by empirical advances in the study of organismal development and (...) inheritance. In this important study, D. M. Walsh shows that the principal defect of the Modern Synthesis resides in its rejection of Darwin's organismal perspective, and argues for 'situated Darwinism': an alternative, organism-centred conception of evolution that prioritises organisms as adaptive agents. His book will be of interest to scholars and advanced students of evolutionary biology and the philosophy of biology. (shrink)

First collected in Italy in 1985, _Art's Claim to Truth_ is considered by many philosophers to be one of Gianni Vattimo's most important works. Newly revised for English readers, the book begins with a challenge to Plato, Aristotle, Kant, and Hegel, who viewed art as a metaphysical aspect of reality rather than a futuristic anticipation of it. Following Martin Heidegger's interpretation of the history of philosophy, Vattimo outlines the existential ontological conditions of aesthetics, paying particular attention to the works of (...) Kandinsky, which reaffirm the ontological implications of art. Vattimo then builds on Hans-Georg Gadamer's theory of aesthetics and provides an alternative to a rationalistic-positivistic criticism of art. This is the heart of Vattimo's argument, and with it he demonstrates how hermeneutical philosophy reaffirms art's ontological status and makes clear the importance of hermeneutics for aesthetic studies. In the book's final section, Vattimo articulates the consequences of reclaiming the ontological status of aesthetics without its metaphysical implications, holding Aristotle's concept of beauty responsible for the dissolution of metaphysics itself. In its direct engagement with the works of Gadamer, Heidegger, and Luigi Pareyson, _Art's Claim to Truth_ offers a better understanding of the work of Vattimo and a deeper knowledge of ontology, hermeneutics, and the philosophical examination of truth. (shrink)

This is a book grounded in the real ethical challenges of modern business practice, with a world-religious perspective so necessary in an era of globalization.

John Foster’s book, The Nature of Perception, is written to defend his Idealist, or Berkeleyan, theory of perception. One view that he is concerned to reject is what he usefully calls the ‘Cognitivist’ theory of perception. I am named as one of its defenders. His critique of the theory serves me as a good starting point and as a stimulus for a new defense of the theory.

In Nicomachean Ethics X.7–8, Aristotle defends a striking view about the good for human beings. According to Aristotle, the single happiest way of life is organized around philosophical contemplation. According to the narrowness worry, however, Aristotle's contemplative ideal is unduly Procrustean, restrictive, inflexible, and oblivious of human diversity. In this paper, I argue that Aristotle has resources for responding to the narrowness worry, and that his contemplative ideal can take due account of human diversity.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Transcendental Phenomenology as Human Possibility: Husserl and Fink on the Phenomenologizing Subject by Denis DŽANIĆD. J. HobbsDŽANIĆ, Denis. Transcendental Phenomenology as Human Possibility: Husserl and Fink on the Phenomenologizing Subject. Cham: Springer, 2023. x + 236 pp. Cloth, $119.99Denis Džanić’s Transcendental Phenomenology as Human Possibility, despite its superficially historical focus on a specific period of collaboration between Edmund Husserl and his somewhat wayward protégé Eugen Fink, addresses key (...) systematic issues in transcendental phenomenology, namely, how the act of phenomenologizing should be understood in connection with the specific human beings who aim to become phenomenologists, and what the answer to this question tells us about both the genuine subject of phenomenology and the motivation for phenomenologizing. These questions are important for our understanding of not only the historical development of phenomenology but also the practice and goals of phenomenology—specifically, for a conception of phenomenologizing as a project in which we, as particular, historical, empirical figures, might want to engage.Much of the book focuses on laying the groundwork for understanding these complicated issues both historically and systematically. Džanić does an admirable job of tracing the rapidly evolving interactions between Husserl and Fink, both as intellectual collaborators on this philosophical project and as a pair of very human figures who ultimately found themselves pursuing quite different solutions to the problems of the subject and origin of phenomenology. He focuses particularly on the Sixth Cartesian Meditation, Fink’s attempt to extend Husserl’s famous text to include a phenomenology of the act of phenomenologizing itself (including Husserl’s marginal comments on the text), although he draws on a number of other significant texts and manuscripts (mostly Husserl’s, albeit with an extended aside on Heidegger) wherever they are helpful for explicating the complex evolution of Husserl’s thought on the subject. Admittedly, the book thus takes on a challenging task—both because of the difficult nature of this topic and because of the obscurity of the technical terms required to discuss it. However, despite the necessarily enigmatic character of the relevant language, Džanić’s attempts to explore the main outlines of this issue are worthwhile, particularly due to his ability to resist the temptation to view Husserl’s thought here as monolithic.In the early chapters, Džanić explicates in detail the rather complicated solution that Fink proposed to this difficulty, namely, the abandonment (to some extent) of the ultimately human origin of phenomenology in favor of a fundamentally nonhuman (and eventually meontic) conception of the transcendental ego, which generated a great deal of elaborate and (at least in the Sixth Meditation) inadequately supported speculation. For Fink, both the motivation to phenomenologize and the act of phenomenologizing itself ultimately stem from a source that is fundamentally prior to—in a(n onto)logical rather than temporal sense—any empirical ego or empirical act of phenomenologizing, a source that merely “enworlds” itself (in various complicated senses that Džanić does [End Page 145] an admirable job of clarifying) in the apparently anthropologistic, everyday world of individual phenomenologists. Džanić calls this interpretation of phenomenology Fink’s “epistemological anti-humanism,” and it serves as the basis for one potential (radically anti-Heideggerian but nevertheless somewhat disappointing) solution to the question of why we should phenomenologize at all. As Džanić notes, this solution was at least briefly taken up by Fink’s mentor Husserl himself, although the degree to which Husserl actually endorsed this path beyond the level of a fleeting flirtation remains questionable. Ultimately, as Džanić rightly highlights and as becomes abundantly clear in Husserl’s (often rather scathing) notes on Fink’s Sixth Cartesian Meditation, he abandoned this interpretation.Accordingly, in the later chapters of the book, Džanić traces Husserl’s ultimate development of a quite different solution to the problems of the origin and motivation of phenomenology—a solution that, unlike his brief foray into Finkian grandeur, views the act of phenomenologizing as essentially rooted in human possibility (that is, as part of the famous lifeworld that features so prominently in Husserl’s work, especially in the Crisis and other late texts). After his collaboration with and... (shrink)