This article addresses two components of the new governing architecture that help to reform the delivery of health care and to control costs of the health care system: the Center for Medicare and Medicaid Innovation and the Independent Payment Advisory Board. The republican controlled federal government has partially disassembled these two components, threatening the effectiveness of federal delivery system reform and cost control initiatives.

PPACA epitomizes comprehensive health care reform legislation. Public health, disease prevention, and wellness were integral considerations in its development. This article reveals the author's personal experiences while working on the framework for health care reform in the United States Senate and reviews activity in the United States House of Representatives. This insider's perspective delineates PPACA's positive effect on public health by examining the infrastructure Congress designed to focus on prevention, wellness, and public health, with a particular focus on the National (...) Prevention, Health Promotion and Public Health Council; the National Prevention, Health Promotion, Public Health, and Integrative Health Care Strategy; and the Prevention and Public Health Fund. The Council, strategy, and fund are especially important because they reflect compliance with some of the Institute of Medicine's recommendations to improve public health in the United States, as well as international health and human rights norms that protect the right to health. (shrink)

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act, a major piece of health care reform legislation. This comprehensive legislation includes provisions that focus on prevention, wellness, and public health. Some, including authors in this symposium, question whether Congress considered public health, prevention, and wellness issues as mere afterthoughts in the creation of PPACA. As this article amply demonstrates, they did not.This article documents the extent of congressional consideration on public health issues based on personal (...) experience working on the framework for health care reform — specifically, my experience as a Fellow for a member of the Health Subcommittee of the Senate Finance Committee from 2008-2009. I also include a review of congressional activity in the United States House of Representatives. Analysis of the congressional meetings and hearings reveals that Congress had a deep understanding about the critical need to reform the U.S. public health and prevention system. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S79-S82, March‐April 2022.

This paper explores the relationship between eugenics, disability, and dehumanization, with a focus on forms of eugenics beyond Nazi eugenics.

Drawing on the recognition that questions of discourse and power are vital components in analysing the public participation in environmental governance, this paper examines the ways in which dominant scientific discourses about the Earth's climate inform the types of public talk facilitated in and by mini-publics, particularly when they are 'scaled up' to address environmental issues such as climate change. World Wide Views on Global Warming (WWViews) serves as a case study. Conceived and organised by the Danish Board of Technology, (...) WWViews was a historically unprecedented public forum in which participants, invited from a range of nations, were given the opportunity to deliberate on key themes addressed in the negotiations taking place during the United Nations Convention on Climate Change in Copenhagen (COP 15). The overarching purpose of this analysis is to invite reflection on the practices and assumptions that serve to make up publics in relation to issues that have been framed, predominantly, as scientific, universal and global. (shrink)

Surveillance is essential for communicable disease prevention and control. Traditional notification of demographic and clinical information, about individuals with selected infectious diseases, allows appropriate public health action and is protected by public health and privacy legislation, but is slow and insensitive. Big data–based electronic surveillance, by commercial bodies and government agencies, which draws on a plethora of internet- and mobile device–based sources, has been widely accepted, if not universally welcomed. Similar anonymous digital sources also contain syndromic information, which can be (...) analysed, using customised algorithms, to rapidly predict infectious disease outbreaks, but the data are nonspecific and predictions sometimes misleading. However, public health authorities could use these online sources, in combination with de-identified personal health data, to provide more accurate and earlier warning of infectious disease events—including exotic or emerging infections—even before the cause is confirmed, and allow more timely public health intervention. Achieving optimal benefits would require access to selected data from personal electronic health and laboratory records and the potential to re-identify individuals found to be involved in outbreaks, to ensure appropriate care and infection control. Despite existing widespread digital surveillance and major potential community benefits of extending its use to communicable disease control, there is considerable public disquiet about allowing public health authorities access to personal health data. Informed public discussion, greater transparency and an ethical framework will be essential to build public trust in the use of new technology for communicable disease control. (shrink)

Doing Greek Philosophy conveys a vivid sense of dynamism and continuity of the Greek philosophical tradition and illustrates how interaction between Greek philosophers creates and sustains that tradition. It concentrates on a set of inter-related challenges and problems that emerged early in the tradition and moves on to the subsequent reactions to them.

The impressive variation amongst biological individuals generates many complexities in addressing the simple-sounding question what is a biological individual? A distinction between evolutionary and physiological individuals is useful in thinking about biological individuals, as is attention to the kinds of groups, such as superorganisms and species, that have sometimes been thought of as biological individuals. More fully understanding the conceptual space that biological individuals occupy also involves considering a range of other concepts, such as life, reproduction, and agency. There has (...) been a focus in some recent discussions by both philosophers and biologists on how evolutionary individuals are created and regulated, as well as continuing work on the evolution of individuality. (shrink)

We report on the case of a 2-year-old female, the youngest person ever to undergo ovarian tissue cryopreservation (OTC). This patient was diagnosed with a rare form of sickle cell disease, which required a bone-marrow transplant, and late effects included high risk of future infertility or complete sterility. Ethical concerns are raised, as the patient's mother made the decision for OTC on the patient's behalf with the intention that this would secure the option of biological childbearing in the future. Based (...) on Beauchamp and Childress's principlism approach of respect for autonomy, nonmaleficence, beneficence, and justice, pursing OTC was ethically justified. (shrink)

Der Wandel der kulturellen Verhältnisse führt zu einer Zuspitzung des Verhältnisses von Gesellschaft und Rechtssystem. In diesem Prozess gestaltet New Political Ecology (NPE) Umwelt und Rechtssystem und ist zugleich evolutiv ausgerichtet. NPE erfährt Evolution in der Zeit als Überfluss und in eigenartiger Vernetzung als knappes Gut. Diese Verbindung basiert auf Zusammenhängen, die bisher noch nicht systematisch bearbeitet worden sind. Dabei geht es ganz wesentlich auch um das Verhältnis von Staat und moderner Risikogesellschaft. Wissenschaftlicher Fortschritt erweist sich vor diesem Hintergrund selbst (...) als ein evolutiver Prozess. (shrink)

Drawing on a passage from Ramsey's Truth and Probability, we formulate a simple, plausible constraint on evaluating the accuracy of credences: the Calibration Test. We show that any additive, continuous accuracy measure that passes the Calibration Test will be strictly proper. Strictly proper accuracy measures are known to support the touchstone results of accuracy-first epistemology, for example vindications of probabilism and conditionalization. We show that our use of Calibration is an improvement on previous such appeals by showing how it answers (...) or sidesteps problems that have been raised for previous work in this area. (shrink)

Two cross-modal experiments provide partial support for O'Regan & Noë's (O&N's) claim that sensorimotor contingencies mediate perception. Differences in locating a target sound accompanied by a spatially disparate neutral light correlate with whether the two stimuli were perceived as spatially unified. This correlation suggests that internal representations are necessary for conscious perception, which may also mediate sensorimotor contingencies.

-/- CONCLUSION “The experience in California is clear. Affirmative action has helped to dismantle barriers such as "old boys' networks" that have excluded not only women and individuals of racial or ethnic minorities, but also white American men who did not belong to networks of privilege. Affirmative action has also worked to ensure that our schools, workplaces, and other social institutions fully use our diverse talents, thereby helping our government and social institutions to better serve their communities. -/- In short, (...) affirmative action has helped to bring out the best in us as a society. It challenges us to have the courage of our convictions that: (1) we do want a truly equal opportunity society; and (2) we believe that all Americans, including women and minorities, are competent individuals who have talents to contribute. Passing the CCRI would completely eliminate affirmative action, and thus have the same effect as "throwing the baby out with the bathwater." The "baby" —active and affirmative commitment to equal opportunity— is barely out of its infancy. We must not now abandon our commitment, just when we have taken our first steps towards creating a truly equal opportunity society.” -/- (This essay was written against the backdrop of legislative efforts in the mid 1990s, to overturn “affirmative action” policies at educational institutions, which had given more equal access to higher education for students from previously under-represented communities, particularly white women but also racialized communities. By mischaracterizing affirmative action programs as “gender or racial preferences”, opponents were able to pass the 1996 ballot measure, Proposition 209, the so-called “California Civil Rights Initiative” (CCRI). The ban on “preferences” gained the support of 54.6% of all California voters, including 58% of white women and 66% of white men voters. Use of language was key, as a slight majority of Americans approved of some affirmative actions but opposed racial preferences. The CCRI has had a huge toll on Latino and African American enrollment at UC Berkeley and UCLA, which has never recovered. State contracts for firms owned by women and minorities also dropped sharply. Similar initiatives failed in some states but succeeded elsewhere. See online Encyclopedia). (shrink)

Initiated by Robert Wesson, _Evolution and Human Values_ is a collection of newly written essays designed to bring interdisciplinary insight to that area of thought where human evolution intersects with human values. The disciplines brought to bear on the subject are diverse - philosophy, psychiatry, behavioral science, biology, anthropology, psychology, biochemistry, and sociology. Yet, as organized by co-editor Patricia A. Williams, the volume falls coherently into three related sections. Entitled Evolutionary Ethics, the first section brings contemporary research to an area (...) first explored by Herbert Spencer. Evolutionary ethics looks to the theory of evolution by natural selection to find values for human living. The second section, Evolved Ethics, discusses the evolution of language and religion and their impact on moral thought and feeling. Evolved ethics was partly Charles Darwin's subject in _The Descent of Man._ The last section bears the title Scientific Ethics. A nascent field, scientific ethics asks about the evolution of human nature and the implications of that nature for ethical theory and social policy. Together, the essays collected here provide important contemporary insights into what it is - and what it may be - to be human. (shrink)

The paper offers an analysis of Protagoras’ fr. DK 80 B 1 and rejects the traditional reading of Protagoras as relativist. By considering the ipsissima verba that Protagoras makes use of in his passage, it is argued that alternative interpretations are possible, of which epistemological reism and psychological individualism are proposed. On a more general level, it is discussed to what extent Protagoras’ fragment contains descriptive rather than normative claim.

In Europe ≈15,000 patients receive larval therapy for wound treatment annually. Over the past few years, clinical studies have demonstrated the success of larvae of Lucilia sericata as debridement agents. This is based on a combination of physical and biochemical actions. Laboratory investigations have advanced our understanding of the biochemical mechanisms underlying the beneficial effects of larval secretions, including removal of dead tissue, reduction of the bacterial burden, and promotion of tissue regeneration. The present article summarizes our current understanding of (...) the microbiological, immunological, and wound healing actions of larval therapy, and the molecules involved in these beneficial effects. Future studies will focus on the isolation, identification, and (pre)clinical testing of the effective molecules of L. sericata larvae. These molecules may be candidates for the development of new agents for the treatment of several infectious and inflammatory diseases, including chronic wounds. (shrink)

Die Meisterwerke der Moralistik haben Millionen von Menschen als philosophische Lebensbegleiter gedient. Doch worum geht es in der Moralistik eigentlich? 0Die Moralistik befasst sich mit der Natur des Menschen und mit Möglichkeiten kluger, individueller Selbstbehauptung. Sie führt die antiken Ansätze einer philosophischen Klugheitslehre fort und besetzt damit einen in der neuzeitlichen Ethik vernachlässigten Teil der praktischen Philosophie. Ihre Meisterwerke vermitteln uns Menschenkenntnis und soziale Orientierung und stehen uns auf dem Weg eines gelingenden Lebens beratend zur Seite. In ihnen liegt der (...) Ursprung der modernen Philosophie der Lebenskunst. Das Buch stellt sowohl die Entwicklung der Moralistik als auch ihr philosophisches Anliegen anschaulich und gut lesbar dar. (shrink)

This paper offers an overview of "the species problem", arguing for a view of species as homeostatic property cluster kinds, positioning the resulting form of realism about species as an alternative to the claim that species are individuals and pluralistic views of species. It draws on taxonomic practice in the neurosciences, especially of neural crest cells and retinal ganglion cells, to motivate both the rejection of the species-as-individuals thesis and species pluralism.

In the good old days, when general philosophy of science ruled the Earth, a simple division was often invoked to talk about philosophical issues specific to particular kinds of science: that between the natural sciences and the social sciences. Over the last 20 years, philosophical studies shaped around this dichotomy have given way to those organized by more fine-grained categories, corresponding to specific disciplines, as the literatures on the philosophy of physics, biology, economics and psychology--to take the most prominent four (...) examples--have blossomed. In general terms, work in each of these areas has become increasingly enmeshed with that in the corresponding science itself, increasingly naturalistic (in at least one sense of that term), and in my view, increasingly interesting. (shrink)