Conflicts of interest are rampant in the American medical community. Today it is not uncommon for doctors to refer patients to clinics or labs in which they have a financial interest (40% of physicians in Florida invest in medical centers); for hospitals to offer incentives to physicians who refer patients (a practice that can lead to unnecessary hospitalization); or for drug companies to provide lucrative give-aways to entice doctors to use their "brand name" drugs (which are much more expensive than (...) generic drugs). In Medicine, Money and Morals, Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change. (shrink)

This paper explores the nature of the relationship between corporate social responsibility (CSR) and competitiveness. We start with the commonly held view that firm competitiveness is defined by the market. That is, the question of what are the critical competitiveness factors is answered by looking at how companies and financial analysts describe and evaluate a firm. To analyze this, we review the current state of the art on the relationship between CSR and competitiveness. Second, CSR criteria used by financial analysts (...) is identified and compared with company valuation methods. Third, the results of a multi-stakeholder dialogue on CSR and competitiveness of the European financial sector are presented. As a conclusion, we argue that CSR and competitiveness relate through a learning and innovation cycle, where corporate values, policies and practices are permanently defined and re-defined. Thus, we propose that learning takes place as CSR is embedded in business processes, and that once it has been integrated, in turn, it generates innovative practices, and finally, competitiveness. At the end of the paper, we propose that CSR in practice consists of managing inherent paradoxes generated by the tension between CSR and business policies. (shrink)

Group-identification and cognition: Why trivial conventions are more important than we think In existing (evolutionary) explanations for group formation and -identification, the function of cultural conventions such as social etiquette and dress codes is limited to providing group-markers. Group formation and identification itself is explained in terms of less arbitrary and more substantial phenomena such as shared norms and institutions. In this paper I will argue that, however trivial and arbitrary, cultural conventions fulfil an important cognitive function that makes them (...) essential to the formation of and identification with large groups. Complex role-division, both informal and institutional, is important in the functioning of any large group of people. Shared conventions enable a virtually automatic understanding of signals, scripts and rules that regulate the interaction of divided roles. They provide a cultural infrastructure within which we perceive e.g. specific behavior and clothing as a range of social-cultural affordances for role-interactions. Shared familiarity with this infrastructure is the foundation for the basic kind of trust of in-group strangers that is a requirement for the formation of large groups. This non-intellectualist view on group formation and group identification can contribute to new ways of dealing with problems in multicultural societies. (shrink)

This text discusses the impact of immersive technologies on our identity and relationship to digital and analogue modalities in a non-normative way. It references the work of Joseph Beuys, specifically his iconic performance of being confined with a coyote in a gallery space for three days, to construct connections between borders, edges, limits and identity, face presentation, representation and projection towards ourselves and our audiences. We reference the works of Marcel Duchamp and George Orwell and compare the immersive devices of (...) the nineteenth century to current technology. Various works of art and literature are used to illustrate the impact of technology on society and the individual’s relationship to the collective imagination. The text raises questions about the limits or nonlimits of exposure of identity through machinic and technological devices or processes in the context of privacy of expression in a contemporary networked world. (shrink)

Deleuze's readings of Hume, Spinoza, Bergson and Nietzsche respond to philosophical critiques of classical and modern empiricism. However, Deleuze's arguments against those critiques - by Kant, Hegel, Husserl and Heidegger - consolidate the philosophy of immanence that can be called 'transcendental empiricism'. Marc Rolli offers us a detailed examination of Gilles Deleuze's philosophy of transcendental empiricism. He demonstrates that Deleuze takes up and radicalises the empiricist school of thought developing a systematic alternative to the mainstreams of modern continental philosophy.

Serious concerns about pervasive, persistent, and unjustified social inequalities have prompted a small—but growing—number of academic commentators to raise some hard and troubling questions for those who would like to legalize physician-assisted suicide. In various ways, these commentators have asked: In light of existing social inequalities—inequalities that operate, for example, along sometimes intersecting lines of race, class, age, sex, and disability—how persuasive are autonomy-based arguments in favor of legalization of assisted suicide when those arguments depend on a conception of autonomy (...) that either presupposes social equality or does not expressly account for its absence? How compelling are arguments that we ought to legalize assisted suicide out of feelings of mercy for the sick and dying, when such affective expressions may actually be the socially acceptable manifestation of private ambivalence that includes merciless discrimination? (shrink)

The scalar notion of collective intentionality has been used to characterize the evolution of largely uncollaborative apes to highly collaborative ones. This proposal covers human evolution up until and including the formation of hunter-gather groups. But can collective intentionality also explain the emergence of complex societies? I argue that it cannot. Instead of collective intentionality, collaboration in complex societies hinges on a set of non-strategic attitudes and standardized human interactions so that role divisions, institutions, norms and conventions can emerge as (...) group-level phenomena. This set, summarized as ‘conventionality’, is a product of group-level selection rather than of collectively intending minds. (shrink)

It is often thought that consciousness has a qualitative dimension that cannot be tracked by science. Recently, however, some philosophers have argued that this worry stems not from an elusive feature of the mind, but from the special nature of the concepts used to describe conscious states. Marc Champagne draws on the neglected branch of philosophy of signs or semiotics to develop a new take on this strategy. The term “semiotics” was introduced by John Locke in the modern period (...) – its etymology is ancient Greek, and its theoretical underpinnings are medieval. Charles Sanders Peirce made major advances in semiotics, so he can act as a pipeline for these forgotten ideas. Most philosophers know Peirce as the founder of American pragmatism, but few know that he also coined the term “qualia,” which is meant to capture the intrinsic feel of an experience. Since pragmatic verification and qualia are now seen as conflicting commitments, Champagne endeavors to understand how Peirce could (or thought he could) have it both ways. The key, he suggests, is to understand how humans can insert distinctions between features that are always bound. Recent attempts to take qualities seriously have resulted in versions of panpsychism, but Champagne outlines a more plausible way to achieve this. So, while semiotics has until now been the least known branch of philosophy ending in –ics, his book shows how a better understanding of that branch can move one of the liveliest debates in philosophy forward. (shrink)

The article looks at how the Internet can be imagined as a kind of psychedelic technology – in the sense of ‘manifesting’ new realities – through the lens of different ideas associated with Deleuze and Guattari. It considers a darker strain of their ideas and their reception, initially looking back to discussions from earlier cybertheory before taking as its case study the production of ‘microfascist’ subjectivities on the notorious website 4chan – arguably the point of origin of both the ‘alt-right’ (...) and ‘QAnon’. To unpack this case study, the article develops the idea of ‘weird mediation’ (in dialogue with Gilbert Simondon), as well as considering some ‘shamanic’ aspects from Deleuze and Guattari’s thought (in dialogue with Carlos Castenada), which together offer insights and warnings about the power of mind manifesting technologies. (shrink)

Introduction au numéro spécial "L'articulation de la phénoménologie et de l'herméneutique chez Paul Ricœur".

This paper explores the biographical and cultural sources that inspired the decision of Janusz Korczak to make his life’s vocation the education of young children from dysfunctional families. This decision emerged out of the radical version of humanism he embraced. His identification of children as the population his humanist ethos must serve, distinguishes it from other versions of humanism. The paper explores the role his sense of self and his identification with Poles, Jews, and humanity play in the composition of (...) this humanism. It identifies the hybridity of his cultural identifications as its heart. It proposes that the tensions between these identifications in general, and his non-Jewish Jewish identification that situated him as being ‘a part of’ and ‘apart from’ Polish society in particular, induced Korczak to create a universal religion of children in which religious, ethnic, or physical distinctions do not generate prejudice, intolerance, and violence. (shrink)

In de vroege jaren tachtig van de vorige eeuw publiceerde Benjamin Libet de resultaten van experimenten waarmee hij volgens velen de illusie van een vrije wil aantoonde. Wat Libet liet zien, was dat hersenactiviteit te meten is die indicatief is voor een aankomende handeling kort voordat iemand de bewuste intentie vormt die handeling uit te voeren. Op het moment dat we bewust de ‘beslissing’ nemen een handeling uit te voeren, zijn onze hersenen al bezig geweest die handeling voor te bereiden; (...) de bewuste beslissing komt als mosterd na de maaltijd. (shrink)

Introduction au numéro spécial "L'articulation de la phénoménologie et de l'herméneutique chez Paul Ricœur".

The unorthodox life and ideas of Friedrich Nietzsche, the philosopher who defiantly claimed 'God is Dead', come alive in this documentary history. Here is a clear picture of the time in which the revolutionary philosopher lived as well as his famous love affairs, his theories of Superman, the Antichrist and nihilism. Nietzche's work had a major impact on the 20th century, including being manipulated and used by the Nazis to justify their cause during World War 2.

Amsterdam University Press is a leading publisher of academic books, journals and textbooks in the Humanities and Social Sciences. Our aim is to make current research available to scholars, students, innovators, and the general public. AUP stands for scholarly excellence, global presence, and engagement with the international academic community.

How the media influence the trust that citizens have in institutions such as politics and science seems more important than ever, given the decline of institutional trust in Western societies, and the increasingly diversified media landscape. This paper focuses on the relationship between media repertoires, institutional trust, and two socializing contexts (parents, social networks). Applying Latent Class Analysis, this paper examines (a) how parental socialization and social networks predict membership of media repertoires, and (b) how repertoires are associated with levels (...) of institutional trust. Outcomes reveal five distinct media repertoires, among which the emerging type of cross-media news consumers. Membership of repertoires is associated with both parental socialization and social networks. There are clear differences in the levels of institutional trust among media repertoires: Popular media omnivores and quality news consumers have the most trust; the non-print-oriented the least. (shrink)

Why do physicians have financial conflicts of interest? They arise because society expects physicians to act in their patients’ interest, while simultaneously, financial incentives encourage physicians to practice medicine in ways that promote their own interests or those of third parties. Because physicians’ clinical choices, referrals, and prescriptions affect the fortune of third parties, these third parties may offer physicians financial incentives to make income-driven clinical choices. In the past, physicians and scholars typically conceived of conflicts of interest as an (...) ethical issue to be resolved according to individual judgment or professional and organizational norms. However, society can mitigate or eliminate conflicts of interest by changing financial and organizational arrangements in medicine. Conflicts of interest, therefore, are as much matters of public policy and management as individual choices or social norms. (shrink)

Across the management, social science, and business ethics literatures, and in much of the philosophy literature, trust is characterized as a disposition to act given epistemic states—beliefs and/or expectations about others and about the risks involved. This characterization of trust is best thought of as epistemological because epistemic states distinguish trust from other dispositions. The epistemological characterization of trust is the amoral one referred to in the title of this paper, and we argue that this characterization is conceptually inadequate. We (...) outline and defend an alternative conception of trust as a moral phenomenon: when A trusts B to do something, A invites B to acknowledge and accept an obligation; when B accepts the invitation, B takes on an obligation; in that way trust creates an obligation. We conclude with an application, drawing out the difference between the epistemological conception of trust and our own in the context of Ghoshal et al.'s (Sloan Management Review 40:9—20, 1995, Academy of Management Learning & Education 4:75—91, 2005) critique of transaction cost theories of the firm. (shrink)

The federal government indirectly subsidizes the pharmaceutical industry by funding basic research, various tax credits and deductions, patent rules, grants of market exclusivity, and other means, in order to spur drug development, promote public health, and improve medical care. But today, the pharmaceutical industry often neglects these goals and sometimes even undermines them, due to what Lawrence Lessig refers to as institutional corruption — that is, widespread or systemic practices, usually legal, that undermine an institution’s objectives or integrity. A key (...) source of institutional corruption is improper dependence by the institution or its key actors on the actions of third parties that have fundamentally different interests. It is the health care system’s improper dependency on pharmaceutical firms that allows them to displace some public policy goals and to compromise the attainment of others. (shrink)

Improper dependencies slant policy over a drug's life span, biasing the development of new drugs, the testing and marketing approval for new drugs, and the monitoring of patient safety after drugs are marketed. This article examines five ways in which the public improperly depends on pharmaceutical firms that compromise the integrity of pharmaceutical policy. Today the public relies on pharmaceutical firms: (1) to set priorities on drug research and development; (2) to conduct clinical trials to test whether drugs are safe (...) and effective; (3) to decide what clinical trial data to disclose to the public; (4) to monitor post marketing drug safety; (5) to supply product information to physicians and to finance continuing medical education and other professional activities. The article suggests options to overcome each of these dependencies. (shrink)

The article « La Défenestration » by Belgian philosopher Marc Richir has been translated into Russian for the first time for this issue of the “Horizon. Studies in Phenomenology.” In his early work “The Defenestration” Richir raises the question of relation between the subject and conceivable world. Here, a philosopher is pictured contemplating the world through the window of his tower. In such detachment from the world the thinker finds himself according to all Modern philosophies of consciousness. Husserl’s phenomenology (...) inherits this detachment, since Husserl imposes the structure of transcendental ego as external to the world. Richir abolishes the concept of transcendental ego with the help of heideggerian Dasein, but analyzing Heidegger’s ontology he comes to the conclusion that the latter remains fixated on beings. Believing a person to live in the fundamental openness of Being, Heidegger places such a person in the secondary world of “truth.” In order to overcome the remains of traditional philosophy in Heidegger’s ontology Richir turns to Merleau-Ponty’ “cosmology of the visible.” The author takes the Merleau-Ponty’s thesis that everything visible has something fundamentally invisible in it. This allows him to discover the universe of “nothing”, which includes both the visible and what is “behind” it. As a result Richir overcomes the classical dualism of the sensual and the intelligible. The concept of defenestration places the subject and the world in the same universe. (shrink)

The heart of the matter -- The evolution of the French medicine -- Coping with physicians' conflicts of interest in France -- The rise of a protected medical market : the United States before 1950 -- The commercial transformation : the United States, 1950-1980 -- The logic of medical markets : the United States, 1980 to the present -- Coping with physicians' conflicts of interest in the United States -- The evolution of Japanese medicine -- Coping with physicians' conflicts of (...) interest in Japan -- Reforms -- Professionalism reconsidered. (shrink)

Through the 1960s, many people claimed that drug advertising was educational and physicians often relied on it. Continuing Medical Education (CME) was developed to provide an alternative. However, because CME relied on grants, industry funders chose the subjects offered. Now policymakers worry that drug firms support CME to promote sales and that commercial support biases prescribing and fosters inappropriate drug use. A historical review reveals parallel problems between advertising and industry-funded CME. To preclude industry influence and improve CME, we should (...) ensure independent funding by taxing medical industries, facilities and physicians. Independent public and professional authorities should create CME curricula. An independent agency should allocate all funds to educational institutions for approved curricula. (shrink)

The singular expertise of family physicians is the ability to manage complexity with pragmatism, both clinically and ethically. Telemedicine raises multiple questions about the nature of the patient‐physician relationship as manifested in clinical encounters. Some of these questions are concerning, underscoring the need to assess whether medical care is better with this new technology—or if it is just different or maybe even worse. It seems clear, however, that, regardless of its limitations, telemedicine is here to stay. The pragmatic complex ethical (...) question, then, is how all of us together—both medical professionals and society at large—will manage it. (shrink)

Describe a successful classroom teaching tactic that could be replicated by other instructors. -/- The context: This activity was used in a required undergraduate introductory theology course at a Catholic college. I tried this exercise a month into class, at the start of a section on creation in Genesis. -/- The pedagogical purpose: The activity encourages students to deepen the skill of reading and understanding the Bible. It also invites students to use their imagination in recognizing the goodness and variety (...) of creation described in Genesis 1. It takes place mostly outdoors, in a natural setting that mirrors the richness of the text, and encourages students to observe their surroundings in light of the text. Doing this as a group creates a positive learning environ- ment; for example, the more active students act as role models of paying attention to detail, observing closely, and taking photos. The exercise mirrors the typical proclamation of Scripture within a communal context. (shrink)

One underappreciated aspect of the practice of nonviolence and just peace is the imperative for the Church to welcome those on the margins, including children and adults with physical and/or intellectual impairments who are vulnerable to dehumanization. Too many children and adults with impairments and their families have not been fully welcomed as sisters and brothers in their local parish. Catholics can draw on a rich theology of peacebuilding in Scripture, Tradition, and Church teaching to respond to these vulnerabilities. Such (...) ongoing transformation is a sign that the Church is being built up in peace and offers a model of communion among a diversity of people. (shrink)

One of the demands facing the church is the call for unity with Christians with profound intellectual and physical impairments. As the church becomes a community of justice with and for people with impairments, she is an instrument of God's shalom. However, too many of our sisters and brothers with impairments find themselves on the outside looking in. How can the church continue to move toward a more complete welcome and participation? Responding to this theological question precedes clinical or legal (...) concerns. The best the world has to offer is not what the church needs, though she can learn from reasonable professional approaches. The message and peace of Christ can undo the walls of separation that keep Christians with impairments out. Such a transformation would be a sign that the church is being built up in peace, and would offer a model of true communion among a diversity of people. (shrink)

This paper proposes a presentation and an analysis of the first philosophical writing of Paul Ricœur, on the problem of God in the reflexive philosophies of Lachelier and Lagneau. His principal aim is to situate this first writing in the context of Ricœur’s philosophical work, by underlining his belonging to the french reflexive tradition and his refusing of the absolute idealism of Lachelier and Lagneau. The author insists more precisely on the realistic and personalist thesis of the young Ricœur and (...) on the appearance of the problem of evil in his work.  . (shrink)

Dans le cadre du développement récent de la stylistique outillée, cet article propose une réflexion sur l’application de ce concept et de ses méthodes aux personnages de théâtre sur la base d’un corpus trilingue de tragédies : Euripide, Sénèque et Corneille. Pour mener la recherche, nous aborderons d’abord la question de la nature des rôles de théâtre entre unités textuelles recomposées et discours de personnages dans le cadre d’une performance sur scène. Ensuite, nous chercherons à définir si les caractéristiques de (...) ces unités peuvent être rapprochées de la notion de style. Nous en étudierons les apports pour la compréhension d’une œuvre de théâtre. Pour atteindre cet objectif, une attention particulière sera accordée au corpus de recherche (quelles œuvres choisir?), à sa constitution (comment diviser ce corpus et avec quel niveau de granularité?) et aux outils d’exploration (qualitative ou quantitative?). En stylistique outillée, le corpus devient lui-même un outil de recherche en tant qu’opérateur de contraste. Enfin, poursuivre cette enquête amène à questionner la frontière entre études du discours et stylistique outillée du point de vue de leurs objectifs et de leurs méthodes. (shrink)

Welcome precision is brought to the idea, history, types and motives of ethical investment in what will become an authoritative review of the subject. Marc Cooper is a postgraduate researcher at the European Business Management School, University of Wales, and Bodo Schlegelmilch, recently British Rail Professor of Marketing there, has recently been appointed Professor of Marketing at the American Graduate School of International Management (Thunderbird), Phoenix, Arizona.