In a recent response to our paper on developing a philosophical framework to guide the design and delivery of a just health service, Sarela raises several objections. We feel that although Sarela makes points which are worthy of discussion, his critique does not undermine either the need for, or the worth of, our proposed model. First, the law does not negate the need for ethics in determining just healthcare policy. Reliance on legal processes can drive inappropriate focus on ensuring policies (...) avoid judicial review, as opposed to ensuring they are truly just; the law affords protection against unjust policies but does not put a commitment to avoiding them at the heart of policy-making. We defend the need for Scanlonian supplementation by emphasising the practical value of adding a step based on reasonable rejection, particularly in ensuring that the views of vulnerable stakeholders are robustly considered. We discuss the similarities and differences between the work of Daniels and Sen in considering the relationship between health and opportunity, concluding that Sen’s capability approach is both valuable and compatible with our proposed model. Finally, the practical use of our model requires consideration of what constitutes a reasonable person. Our model is explicitly intended to help develop a healthcare system which is just to all its users. With this in mind, we suggest that those involved in decision-making should meet Scanlon’s definition of reasonable: they should be motivated to justify their actions to, and seek agreement with, others. (shrink)

To practise ‘fairly and justly’ a clinician must balance the needs of both the many and the few: the individual patient in front of them, and the many unseen patients in the waiting room, and in the county. They must consider the immediate clinical needs of those in the present, and how their actions will impact on future patients. The good medical practice guidance ‘Make the care of your patient your first concern’ provides no guidance on how doctors should act (...) when they care for multiple patients with conflicting needs. Moreover, conflicting needs extend far past simply those between different patients. At an organisational level, financial obligations must be balanced with clinical ones; the system must support those who work within it in a variety of roles; and, finally, in order for a healthcare service to be sustainable, the demands of current and future generations must be balanced.The central problem, we propose, is that there is no shared philosophical framework on which the provision of care or the development of health policy is based, nor is there a practical, fair and transparent process to ensure that the service is equipped to deal justly with new challenges as they emerge. Many philosophers have grappled with constructing a set of principles which would lead to a ‘good’ society which is just to different users; prominent among them is Rawls.Four important principles can be derived using a Rawlsian approach: equity of access, distributive justice, sustainability and openness. However, Rawls’ approach is sometimes considered too abstract to be applied readily to policymaking; it does not provide clear guidance for how individuals working within existing institutions can enact the principles of justice. We therefore combine the principles derived from Rawls with Scanlonian contractualism: by demanding that decisions are made in a way which cannot be ‘reasonably rejected’ by different stakeholders, we ensure that conflicting needs are considered robustly.We demonstrate how embedding this framework would ensure just policies and fair practice. We illustrate this by using examples of how it would help prevent injustice among different socioeconomic groups, prevent intergenerational injustice and prevent injustice in a crisis, for example, as we respond to new challenges such as COVID-19.Attempts to help individual doctors practise fairly and justly throughout their professional lives are best focused at an institutional or systemic level. We propose a practical framework: combining Scanlonian contractualism with a Rawlsian approach. Adopting this framework would equip the workforce and population to contribute to fair policymaking, and would ultimately result in a healthcare system whose practice and policies—at their core—were just. (shrink)

This book is a collection of original, interdisciplinary essays on the topic of medical error. Given the complexities of understanding, preventing, and responding to medical error in ethically responsible ways, the scope of the book is fairly broad. The contributors include top scholars and practitioners working in bioethics, communication, law, medicine and philosophy. Their contributions examine preventable causes of medical error, disproportionate impacts of errors on vulnerable populations, disclosure and apology after discovering medical errors, and ethical issues arising in specific (...) medical contexts, such as radiation oncology, psychopathy, and palliative care. They also offer practical recommendations for respecting autonomy, distributing burdens and benefits justly, and minimizing injury to patients and other stakeholders. Ethics and Error in Medicine will be of interest to a wide range of researchers, students, and practitioners in bioethics, philosophy, communication studies, law, and medicine who are interested in the ethics of medical error. (shrink)

BackgroundInternationally, patient access to notes is increasing. This has been driven by respect for patient autonomy, often recognised as a primary tenet of medical ethics: patients should be able to access their records to be fully engaged with their care. While research has been conducted on the impact of patient access to outpatient and primary care records and to patient portals, there is no such review looking at access to hospital medical records in real time, nor an ethical analysis of (...) the issues involved in such a change in process.MethodsThis study employed a systematic review framework in two stems, to integrate literature identified from two searches: Medline, CINAHL and Scopus databases were conducted, (for (1) hospitalised patients, patient access to records and its effects on communication and trust within the doctor-patient relationship; and (2) patient access to medical records and the ethical implications identified). The qualitative and quantitative results of both searches were integrated and critically analysed.Results3954 empirical and 4929 ethical studies were identified; 18 papers representing 16 studies were identified for review (12 empirical and 6 ethical). The review reveals a consensus that our current approach to giving information to patients – almost exclusively verbally – is insufficient; that patient access to notes is a welcome next step for patient-centred care, but that simply allowing full access, without explanation or summary, is also insufficient. Several ethical implications need to be considered: increased information could improve patient trust and knowledge but might transfer an (unwelcome) sense of responsibility to patients; doctors and patients have conflicting views on how much information should be shared and when; sharing written information might increase the already significant disparity in access to health care, and have unforeseen opportunity costs. The impact on medical practice of sharing notes in real time will also need to be evaluated.ConclusionsThe review presents encouraging data to support patient access to medical notes. However, sharing information is a critical part of clinical practice; changing how it is done could have significant empirical and ethical impacts; any changes should be carefully evaluated. (shrink)

Communicative Understandings of Women's Leadership Development: From Ceilings of Glass to Labyrinth Paths, edited by Elesha L. Ruminski and Annette M. Holba, weaves the disciplines of communication studies, leadership studies, and women's studies to offer theoretical and practical reflection about women's leadership development in academic, organizational, and political contexts. This work claims a space for women's leadership studies and acknowledges the paradigmatic shift from discussing women's leadership using the glass ceiling to what Eagly and Carli identify as the labyrinth of (...) leadership. (shrink)

This volume contains invited and contributed papers delivered at a symposium on the occasion of Professor Glauber's 60th birthday. The papers, many of which are authored by world leaders in their fields, contain recent research work in quantum optics, statistical mechanics and high energy physics related to the pioneering work of Professor Roy Glauber; most contain original research material that is previously unpublished. The concepts of coherence, cooperativity and fluctuations in systems with many degrees of freedom are a common base (...) for all of Professor Glauber's research initiatives and, in fact, for much of contemporary physics. His role in shaping these cconcepts is reflected and honoured in the papers contained in this book. (shrink)

The editors of the JRE collected short essays from scholars of religion in response to a recent incident at Hamline University that made national headlines. Last fall, Hamline University administrators refused to extend a contract to an adjunct professor of art history after a Muslim student accused her of Islamophobia for showing a 14th‐century image of Mohammad in an online class. The event provoked intense conversations about issues of academic freedom, religious diversity, the status of contingent faculty, and race. These (...) essays bring together scholarly and personal reflections about the incident at Hamline and what it means for the pedagogy of religious studies. (shrink)

This article points out, descriptive moral psychology of human behavior patterns in the handling, in fact, from the outset exceed the boundaries of philosophy, and Cole tried to resort to ethics Fort formalism in order to avoid this problem in practice, can not be established. • Henry Rachael is further motivation for ethical behavior and the psychological concept of Cole Castle together. Although this is certainly an important contribution to the Fort Cole, but Cole Fort critical reflection on the lack (...) of methodology adopted only; secondly that the ideology behind their psychological factors; finally made ​​sense to remedy in the treatment program: to give up on life and psychological describe their condition or results of work. Authors propose a new proposal of psychology, first identified the relationship between psychologists and their research object, this object is, as the subject of people; secondly, from the possibility of speech. Description, either by himself or a third person described in the description, will be replaced by speech interaction. Authors proposed the concept of an interactive framework of doctrine, in which Cole and Rachael • Fort Henry's theory of language games can get a different position. This article attempts to demonstrate that the descriptive psychology, in its treatment of ethical problems, seems to have transgressed the boundary line against philosophy. This problematic situation cannot be circumvented by resorting to an ethical formalism-as L. Kohlberg does in his research program. Rachael M. Henry pushes one step forward to tie the psychodynamic aspect of moral behavior with Kohlberg's concept. The present author, all in affirming the important contribution of Kohlberg to psychology, indicates the insufficiency of a mere reflection of methods in Kohlberg's works. Then he dissects the ideologemes behind Kohlberg's psychology. At last he suggests a therapeutic proposal: the demand for describing psychic life, its conditions or effects, shall be dropped. The author proposes instead a program of new psychology that derives first from the relation of psychologist to his object, the human as subject; and second, from the possibilities of speech in communicative interaction. Description, whether made by oneself or by a third person, shall be substituted by speech interactions. These interactions are considered as successful when the partners in a discussion declare themselves to be understood. Within the framework of this interactionist concept, Kohlberg's and Rachael M. Henry 's theories could assume the status of various language-games. (shrink)

Pour interpréter les paroles d’institution, et notamment la phrase attribuée au Christ « ceci est mon corps », les réformateurs ont utilisé la rhétorique de leur temps. De même, les éléments de la Cène ont été compris par eux comme des signes, à la lumière d’une « sémiotique » de leur époque et en anticipant des réflexions qui se répandront dans les siècles ultérieurs. Dès lors il est tentant de relire le débat réformateur au sujet de la Cène à la (...) lumière de certains éléments de linguistique du XXe siècle, pour dégager certains enjeux théologiques d’une compréhension du langage. Le présent article fait donc état du versant linguistique du conflit sacramentel entre luthériens et réformés, en essayant de voir le lien entre le langage et la manière de se situer devant Dieu qui est en jeu. La question de la figure rhétorique utilisée par le Christ ayant d’abord été posée par les réformés, l’article propose pour commencer l’étude de la doctrine de Calvin avant de passer à Luther et son anticipation de la notion contemporaine de « parole performative », pour terminer sur différents enjeux du contexte actuel.To interpret the words of institution, and especially the phrase attributed to Christ “This is my body,” the reformers used the rhetoric of their day. The elements of the Last Supper were likewise understood by them as signs, in the light of a “semiotic” of the era and in analysing reflections that would continue to develop in later centuries. It is tempting to reread the reformer’s debate concerning the Last Supper in the light of certain elements of 20th century linguistics, to open up certain theological problems that involve the comprehension of language. The present article, then, takes into account the linguistic dimension of the sacramental debate between Lutherans and Reformists in trying to see the connection between language and the manner one positions himself before God Who is the issue. As to the question of the rhetorical figure used by Christ first proposed by the Reformists, this article begins by studying Calvin’s doctrine, then moves on to Luther and his anticipation of the contemporaneous notion of the “performative word,” and ends with the various issues in today’s context. (shrink)

In the wake of Albrecht Dieterich, in this paper I try to show how the overall arrangement of the hymns in the Orphic hymn book follows the progression of a nocturnal ritual. I insist on the frequency with which the hymns talk about the fear of meeting a divinity or a phasma that would be in an unkind and violent state and could drive the initiates into madness. Thus, the hymns construct the mystery experience as an event that is, at (...) least in part, dangerous and frightening. This concern with madness as a possible negative result of the initiatory experience is just one aspect of the role Bacchic initiation played in healing madness sent by evil demons, and it conveys a seriousness to these rites that makes them into something very different from the hobby of some placid burghers. Far from being only the songs that accompanied the tryphé of a Bacchic social event, the hymns point to the emotional complexity and seriousness of Bacchic mystery cults.Dans le sillage d’Albrecht Dieterich, cette étude entend montrer comment l’arrangement global des pièces reprises dans le recueil des hymnes orphiques épouse la progression d’un rituel nocturne. On insiste sur la récurrence, dans les hymnes, du motif de la crainte de rencontrer une divinité ou un phasma qui pourrait être malveillant, violent, et frapperait les initiés de folie. Ainsi, les hymnes construisent l’expérience mystérique comme un événement qui est, au moins pour une part, dangereux et effrayant. Ce souci pour la folie comme résultat négatif potentiel de l’expérience initiatique n’est qu’un des aspects du rôle que l’initiation bachique jouait dans la folie curative envoyée par de mauvais démons, et cela confère du sérieux à ces rituels qui étaient quelque chose de bien différent d’un passe-temps pour petits bourgeois placides. Loin d’être seulement les chants qui accompagnaient la truphê d’un moment de sociabilité bachique, les hymnes renvoient à la complexité émotionnelle et au caractère sérieux des cultes à mystères bachiques. (shrink)

"Ce volume propose l'analyse de la place qu'occupent les cinq sens dans cette période de transition qui conduit du Moyen Âge à la Renaissance, soit les XVe et XVIe siècles. L'approche en est résolument interdisciplinaire et confronte la théologie, la littérature, les arts figurés et les sciences. Il s'agit d'apprécier les sens dans les modes de pensée et les représentations, ainsi que leurs balances : la vue, l'ouïe et les sens réputés moins nobles, comme le goût, l'odorat et le toucher, (...) qui entretiennent des relations complexes et variables. Comment, en d'autres termes, s'opère le partage du sensible? La pensée analogique, héritée de la tradition patristique, montre à l'aube de la Renaissance des signes de faiblesse : sources du plaisir, du bonheur, voire de la béatitude, ouverture sur le monde et la beauté, les sens ne sont plus simplement des occasions de pécher, ils sont aussi l'objet d'enjeux esthétiques et jouent un rôle actif dans la création artistique grâce aux liens qui les unissent à l'imaginaire."--Page 4 of cover. (shrink)

Sans perdre de vue la centralité des luttes handies dans l’élaboration d’une pensée anti-validiste l’article détaille les mutations sociotechniques qui affectent les corps humains et en fixent la validité et la disponibilité : il explore les tensions politiques et épistémiques s’éveillant au contact des expériences d’indisposition, d’indisponibilité, et d’indisposabilité. Mais ces corps indociles produisent plus qu’une usure de ce système de mise à disposition : ils développent un autre imaginaire du corps, et de son usage, que nous qualifions de passage (...) de la fRiction, à la fiction. (shrink)

L’histoire du Cogito ergo sum de Descartes montre la problématique de l’esprit moderne. Leibniz et Kant ont insisté sur le conditionnement empirique de la proposition. Fichte l’a défendue, en la rapportant au moi supra- individuel. Schelling et Hegel ont combattu le Cogito, qui a introduit le dualisme moderne entre l’esprit et la nature. La critique la plus pressante est celle de Schelling ; cependant Hegel et lui ont reconnu comme un grand événement historique la séparation, opérée par Descartes, entre la (...) philosophie et l’autorité. (shrink)

Review of New Waves in Metaethics, edited by Michael Brady; and New Waves in Truth, edited by Cory D. Wright and Nikolaj J.L.L. Pedersen.

Hardy’s non-locality paradox is a proof without inequalities showing that certain non-local correlations violate local realism. It is ‘possibilistic’ in the sense that one only distinguishes between possible outcomes (positive probability) and impossible outcomes (zero probability). Here we show that Hardy’s paradox is quite universal: in any (2,2,l) or (2,k,2) Bell scenario, the occurrence of Hardy’s paradox is a necessary and sufficient condition for possibilistic non-locality. In particular, it subsumes all ladder paradoxes. This universality of Hardy’s paradox is not true (...) more generally: we find a new ‘proof without inequalities’ in the (2,3,3) scenario that can witness non-locality even for correlations that do not display the Hardy paradox. We discuss the ramifications of our results for the computational complexity of recognising possibilistic non-locality. (shrink)