We all have beliefs, even strong convictions, about what is just and fair in our social arrangements. How should these beliefs and the theories of justice that incorporate them guide our thinking about practical matters of justice? This wide-ranging collection of essays by one of the foremost medical ethicists in the USA explores the claim that justification in ethics, whether of matters of theory or practice, involves achieving coherence between our moral and non-moral beliefs. Amongst the practical issues addressed in (...) the volume are the design of health-care institutions, the distribution of goods between the old and the young, and fairness in hiring and firing. In combining ethical theory and practical ethics this volume will prove especially valuable to philosophers concerned with ethics and applied ethics, political theorists, bioethicists, and others involved in the study of public policy. (shrink)

Healthcare (including public health) is special because it protects normal functioning, which in turn protects the range of opportunities open to individuals. I extend this account in two ways. First, since the distribution of goods other than healthcare affect population health and its distribution, I claim that Rawls's principles of justice describe a fair distribution of the social determinants of health, giving a partial account of when health inequalities are unjust. Second, I supplement a principled account of justice for health (...) and healthcare with an account of fair process for setting limits or rationing care. This account is provided by three conditions that comprise "accountability for reasonableness.". (shrink)

Applied a theory of information integration to decision making with probabilistic events. 10 undergraduates judged the subjective worth of duplex bets that included independent gain and lose components. The worth of each component was assumed to be the product of a subjective weight that reflected the probability of winning or losing, and the subjective worth of the money to be won or lost. The total worth of the bet was the sum of the worths of the 2 components. Thus, each (...) judgment required multiplying and adding operations. The multiplying model worked quite well in 4 experimental conditions. The adding model showed more serious discrepancies, though these were small in magnitude. The theory of functional measurement was applied to scale the subjective values of the probability and money stimuli. Subjective and objective values were nonlinearly related both for probability and for money. (shrink)

Many societies, and nearly all wealthy, developed countries, provide universal access to a broad range of public health and personal medical services. Is such access to health care a requirement of social justice, or is it simply a matter of social policy that some countries adopt and others do not? If it is a requirement of social justice, we should be clear about what kinds of care we owe people and how we determine what care is owed if we cannot (...) possibly meet every health need, as arguably no society can. We should be clear about what constitutes appropriate access to that care, given that there are diverse barriers to access. We must also be able to say why we owe these things as a matter of justice, and, of course, different accounts of social justice will bake and serve this cake in different ways. (shrink)

How can health plans make fair determinations about when “experimental” (and costly) treatments such as high dose chemotherapy with autologous bone marrow transplantation should be covered despite lack of clear clinical consensus about their benefits? Different models for managing “last chance” therapies evolving in some health plans offer promising examples of how issues of fairness and legitimacy in decisionmaking can be addressed.

Arnauld's criticisms as "a model of confusion confounded.” In a review of Wilson's book, R. McRae refers to "the difficult and not too coherent subject of material falsity. '' J. Cottingham describes the Descartes-Arnauld debate on the material falsity of adventitious ideas as "an involved and rather inconclusive exchange " and claims that the example of the material falsity of such ideas espoused by Descartes in Meditation III is "needlessly complicated. " A. Kenny, in turn, notes that several things are (...) "confusing in Descartes' account of false ideas. " Later reference is made to the fact that "Descartes appears confused. [...] and that "Descartes, it seems, cannot give a consistent answer. '' As will become clear, I take issue with each of these assessments. When Descartes' position on material falsity is understood in the light of late Scholastic sources, especially Suarez, whence it draws its strength and inspiration, the alleged confusion and incoherency vanishes. .. (shrink)

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.

There is a hoary tradition in moral philosophy that assumes we cannot determine which moral theory is acceptable or correct unless we have available a correct theory of human nature, or, in its more modern form, of the person. With such a theory of the person, however, we could at least narrow down the choice among competing ethical theories. A more recent tradition, at least in one of its standard interpretations, agrees it would be necessary to have a correct theory (...) of the person before we could determine an acceptable moral theory, but it denies there is a determinate nature of the person to be captured in such a theory. The plasticity of the person, according to this strand of Marxist theory, rules out the possibility of there being universal moral theory at all. In this paper, I would like to explore a view that treads an intermediate path. It agrees with the Marxist denial that there is a determinate nature of the person, a deep fact of the matter, that can be abstracted from the social matrix and made the subject of a theory of the person. And, it agrees with both traditions that moral theory depends on and embodies a theory of the person. But, by making the problem of arriving at an acceptable view of the person itself something that depends on overall theoretical considerations, including moral ones, the intermediary, view may be able to avoid the type of moral relativism associated with the Marxist view. (shrink)

Includes bibliographical references (p. [271]-285) and index.

James Rachels’ seminal paper “ Why Privacy Is Important ” (1975) remains one of the most influential statements on the topic. It offers a general theory that explains why privacy is important in relation to mundane personal information and situations. According to the theory, privacy is important because it allows us to selectively disclose personal information and to engage in behaviors appropriate to and necessary for creating and maintaining diverse personal relationships. Without this control, it is implied, the diversity of (...) relationships would diminish; relationships would “flatten out”, we might say. The aspect of the paper that addresses information flows (what I refer to as his information privacy theory) has been of particular interest to computer information privacy theorists. Despite its continued importance to computer privacy theorists, however, the information privacy theory appears to be contradicted by recent developments in computing. In particular, since the publication of Rachels’ paper we have seen an extensive amount of personal information collected. Further, recent developments in computing falling under the heading of social computing have brought about a new wave of personal information creation and collection. This paper will reassess and resituate Rachels’ information privacy theory in light of these developments. I will argue that the increasing collection of personal data will not flatten relationships as the information privacy theory predicts because such data lack contextual factors important to Rachels’ general theory. The paper will conclude by pointing to some areas where Rachels’ general theory and where his information privacy theory will continue to be relevant. (shrink)

To be Black means to have ancestors whose humanity has been de-nied by slavery, colonialism, neo-colonialism, and segregation, as well as by many theories elaborated in order to justify and intensify these modes of domination. To be Black also means having to face the enduring legacies of these systems and theories, which predomi-nantly manifest through overexposure to violence and death. Today, premature death and habituation to loss remain constitutive fea-tures of Black experience. Dignity, often de????ined as the inherent value of (...) every single human being, has been a core concept in ethics since Kant, at least. But in both philosophy and modern politics, the claim of respect for the dignity of people has coexisted with deep antiblack-ness. However, apart from the Western understanding of dignity stands another tradition. The concept of dignity is pervasive in Black radicalism, Caribbean philosophy, and African thought since the 18th century. This article draws inspiration from the legacy of these thinkers to elaborate an ethics centred on the speci????icities of racial-ized life. (shrink)