Until very recently, the lack of health insurance has been viewed primarily as a problem of financial risk for uninsured individuals. This article documents far broader adverse effects, drawn from the work of the Institute of Medicine Committee on the Consequences of Uninsurance. It also synthesizes the Committee’s key findings, conclusions, and recommendations.In early 2004, following 3½ years of study, the IOM Committee on the Consequences of Uninsurance recommended that “...the President and Congress develop a strategy to achieve universal insurance (...) coverage and establish a firm and explicit schedule to reach this goal by 2010.” The Committee presented 5 principles to be used to assess various proposals for extending coverage or to guide the design of a new strategy, specifying that health care coverage should be universal, continuous, affordable to individuals and families, and affordable and sustainable for society. (shrink)

Until very recently, the lack of health insurance has been viewed primarily as a problem of financial risk for uninsured individuals. This article documents far broader adverse effects, drawn from the work of the Institute of Medicine Committee on the Consequences of Uninsurance. It also synthesizes the Committee’s key findings, conclusions, and recommendations.In early 2004, following 3½ years of study, the IOM Committee on the Consequences of Uninsurance recommended that “...the President and Congress develop a strategy to achieve universal insurance (...) coverage and establish a firm and explicit schedule to reach this goal by 2010.” The Committee presented 5 principles to be used to assess various proposals for extending coverage or to guide the design of a new strategy, specifying that health care coverage should be universal, continuous, affordable to individuals and families, and affordable and sustainable for society. (shrink)

Policy often focuses on reducing health care disparities through interventions at the patient and provider level. While unquestionably important, system-wide reforms to reduce uninsurance, improve geographic availability of services, increase workforce diversity, and promote clinical best practices are essential for progress in reducing disparities.

As this nation embarks on new efforts to reform the U.S. health system, we face a critical unfinished agenda from the mid- 1960s: persistent racial, ethnic, and socioeconomic disparities in health and health care. Medicaid, Medicare, and Community Health Centers — public programs with very different legislative histories and financing mechanisms — were the first federally funded, nationwide efforts to improve health care access for low-income and elderly Americans. Members of racial and ethnic minority groups also greatly benefited from these (...) efforts because recipients of federal funds, such as Medicare, were required to comply with the newly passed Civil Rights Act of 1964, which barred racial discrimination. Unquestionably, government played a major role in the gains in health care access that have occurred in the last half century. Yet today all Americans do not have the same opportunities for health, access to care, or quality of care when they receive it. (shrink)

A startling look at one of this century's most influential philosophers, the book chronicles every stage of Foucault's personal and professional odyssey, from his early interest in dreams to his final preoccupation with sexuality and the nature of personal identity.

This chapter outlines the main ideas of my book National responsibility and global justice. It begins with two widely held but conflicting intuitions about what global justice might mean on the one hand, and what it means to be a member of a national community on the other. The first intuition tells us that global inequalities of the magnitude that currently exist are radically unjust, while the second intuition tells us that inequalities are both unavoidable and fair once national responsibility (...) is allowed to operate. This conflict might be resolved either by adopting a cosmopolitan theory of justice (which leaves no room for national responsibility) or by adopting a ?political? theory of justice (which denies that questions of distributive justice can arise beyond the walls of the sovereign state). Since neither resolution is satisfactory, the chapter defends the idea of national responsibility and proposes a new theory of global justice, whose main elements are the protection of basic human rights worldwide, and fair terms of interaction between independent political communities. (shrink)

Exploring materialism and social relationships in modern culture Material Culture and Mass Consumption offers an in-depth exploration of objects, objectification, ideology, and materialism in modern society. Drawing from Hegel, Marx, Munn, and Simmel, the discussion delves into the physicality of the material world and attempts to understand materialism as a form of cultural expression. Targeting mass production as the root of mass consumption, rather than the result, this book positions material goods at odds with genuine social interaction and questions these (...) relationships from the abstract to the intensely specific. (shrink)

In this book, Daniel K. Miller articulates a new vision of human and animal relationships based on the foundational love ethic within Christianity. Framed around Jesus' parable of the Good Samaritan, Animal Ethics and Theologythoughtfully examines the shortcomings of utilitarian and rights-based approaches to animal ethics. By considering the question of animals within the Christian concept of neighbourly love, Miller provides an alternative narrative for understanding the complex relationships that humans have with other animals. This book addresses significant (...) theological questions such as: Does being created in the image of God present a meaningful distinction between humans and other animals? What does it mean for humans to have dominion over animals? Is meat eating a moral problem for Christians? In addition to drawing out the significance of Christian theology for field of animal ethics this book also engages environmental and feminist ethics. Miller brings a theological perspective to such questions as: Should care for animals be distinguished from care for the environment, and what role should human emotions play in our ethical dealings with other animals? As the title suggests, this book provides fresh insight into the theological significance of human relationships with other animals. mental and feminist ethics. Miller brings a theological perspective to such questions as: Should care for animals be distinguished from care for the environment, and what role should human emotions play in our ethical dealings with other animals? As the title suggests, this book provides fresh insight into the theological significance of human relationships with other animals. (shrink)

The Ethics of Need: Agency, Dignity, and Obligation argues for the philosophical importance of the notion of need and for an ethical framework through which we can determine which needs have moral significance. In the volume, Sarah Clark Miller synthesizes insights from Kantian and feminist care ethics to establish that our mutual and inevitable interdependence gives rise to a duty to care for the needs of others. Further, she argues that we are obligated not merely to meet others’ needs (...) but to do so in a manner that expresses "dignifying care," a concept that captures how human interactions can grant or deny equal moral standing and inclusion in a moral community. She illuminates these theoretical developments by examining two cases where urgent needs require a caring and dignifying response: the needs of the elderly and the needs of global strangers. Those working in the areas of feminist theory, women’s studies, aging studies, bioethics, and global studies should find this volume of interest. (shrink)

It has been a common assumption that words are substances that instantiate or have properties. In this paper, I question the assumption that our ontology of words requires posting substances by outlining a bundle theory of words, wherein words are bundles of various sorts of properties (such as semantic, phonetic, orthographic, and grammatical properties). I argue that this view can better account for certain phenomena than substance theories, is ontologically more parsimonious, and coheres with claims in linguistics.

Thorough and wide-ranging examination of the science of morals, reviving and defending the tradition of a scientific approach to ethics. Engages with recent debates on modernism and morality, demonstrating the contemporary relevance of Durkheim's ideas. This book is intended for social and political theory, philosophy of science and Durkheimian studies within sociology, philosophy and politics.

This paper argues for a particular view about in what metaphysical equivalence consists: namely, that any two metaphysical theories are metaphysically equivalent if and only if those theories are strongly hyperintensionally equivalent. It is consistent with this characterisation that said theories are weakly hyperintensionally distinct, thus affording us the resources to model the content of propositional attitudes directed towards metaphysically equivalent theories in such a way that non-ideal agents can bear different propositional attitudes towards metaphysically equivalent theories.

In this article we critique the collectivist approach to collective moral responsibility. According to philosophers of a collectivist persuasion, a central notion of collective moral responsibility is moral responsibility assigned to a collective as a single entity. In our critique, we proceed by way of discussing the accounts and arguments of three prominent representatives of the collectivist approach with respect to collective responsibility: Margaret Gilbert, Russell Hardin, and Philip Pettit. Our aims are mainly critical; however, this should not be taken (...) to imply that we do not ourselves support an alternative account of collective responsibility. We advocate an individualist account of collective responsibility. On this view of collective responsibility as joint responsibility, collective responsibility is ascribed to individuals. Each member of the group is individually morally responsible for the outcome of the joint action, but each is individually responsible jointly with the others. (shrink)

This book was written with three aims in mind. The first was to provide a reasonably concise account of Hume's social and political thought that might help students coming to it for the first time. The second aim was to say something about the relationship between philosophy and politics, with explicit attention to Hume, but implicit reference to a general issue. The third is to offer an integrated account of Hume's thought. The book accounts for the varying interpretation of the (...) conservative and liberalist traditions by arguing that the distinction between liberalism and conservatism had little application in mid-18th-century Britain. Hume's ideology contained elements that we should now identify as conservative and liberal respectively, and so by selective emphasis it is possible to make him seem a thoroughbred conservative or liberal according to choice. These two problems the relationship between Hume's philosophy and his politics, and the ideological character of his thought are pursued through the first and second parts of the book respectively. (shrink)

The cultures here in question are those of mathematics and of physics that I shall interpret with the goal of exploring different modes of creativity. As case studies I will consider two scientists who were exemplars of these cultures, the mathematician Henri Poincaré (1854-1912) and the physicist Albert Einstein (1879-1955). The modes of creativity that I will compare and contrast are their notions of aesthetics and intuition. In order to accomplish this we begin by studying their introspections.

The Ethics of Need: Agency, Dignity, and Obligation argues for the philosophical importance of the notion of need and for an ethical framework through which we can determine which needs have moral significance. In the volume, Sarah Clark Miller synthesizes insights from Kantian and feminist care ethics to establish that our mutual and inevitable interdependence gives rise to a duty to care for the needs of others. Further, she argues that we are obligated not merely to meet others’ needs (...) but to do so in a manner that expresses "dignifying care," a concept that captures how human interactions can grant or deny equal moral standing and inclusion in a moral community. She illuminates these theoretical developments by examining two cases where urgent needs require a caring and dignifying response: the needs of the elderly and the needs of global strangers. Those working in the areas of feminist theory, women’s studies, aging studies, bioethics, and global studies should find this volume of interest. (shrink)

Richard Miller presents a bold new program for international justice. He argues for new standards of responsible conduct by governments, firms, and individuals in developed countries, to govern trade, investment, environmental policy, and the use of force. He offers an urgently needed strategy for moving humanity toward genuine global co-operation.

Abstract Theories are metaphysically equivalent just if there is no fact of the matter that could render one theory true and the other false. In this paper I argue that if we are judiciously to resolve disputes about whether theories are equivalent or not, we need to develop testable criteria that will give us epistemic access to the obtaining of the relation of metaphysical equivalence holding between those theories. I develop such ?diagnostic? criteria. I argue that correctly inter-translatable theories are (...) metaphysically equivalent, and what we need are ways of determining whether a putative translation is correct or not. To that end I develop a number of tools we can employ to discern whether a translation is a correct one. (shrink)

Many research ethics guidelines now oblige researchers to offer research participants the results of research in which they participated. This practice is intended to uphold respect for persons and ensure that participants are not treated as mere means to an end. Yet some scholars have begun to question a generalised duty to disclose research results, highlighting the potential harms arising from disclosure and questioning the ethical justification for a duty to disclose, especially with respect to individual results. In support of (...) this view, we argue that current rationales for a duty of disclosure do not form an adequate basis for an ethical imperative. We review policy guidance and scholarly commentary regarding the duty to communicate the results of biomedical, epidemiological and genetic research to research participants and show that there is wide variation in opinion regarding what should be disclosed and under what circumstance. Moreover, we argue that there is fundamental confusion about the notion of “research results,” specifically regarding three core concepts: the distinction between aggregate and individual results, amongst different types of research, and across different degrees of result veracity. Even where policy guidance and scholarly commentary have been most forceful in support of an ethical imperative to disclose research results, ambiguity regarding what is to be disclosed confounds ethical action. (shrink)

I argue that Schaffer’s recent defence of Spinozan Monism—the thesis that the cosmos is the only substance, or the only fundamental and integrated thing— fails to establish that the universe is uniquely fundamental. In addition, Schaffer’s own defence of his thesis offers the pluralist about fundamentality a model for responding to Schaffer’s criticism of pluralism.

T he O bject of this paper is the development of a view of punishment which incorporates what is of importance in retributive and utilitarian justifications of the practice of punishment. This proposed theory was noted and referred to as the plene esse , but not fully worked out, in the course of a discussion paper in which my concern was to offer an alternative view, to that of Mr Anthony Quinton, by construing ‘the right to punishment’ as meaning that (...) ‘the offender has the right to be regarded as responsible for his actions’. (shrink)

Durkheim, in his very role as a "founding father" of a new social science has become like a figure in an old religious painting, enshrouded in myth and encrusted in layers of thick, impenetrable varnish. This book undertakes detailed, up-to-date investigations of Durkheim's work in an effort to restore its freshness and reveal it as originally created. These investigations explore his particular ideas, within an overall narrative of his initial problematic search for solidarity, how it became a quest for the (...) sacred, and how, at the end of his life, he embarked on a project for a new great work on ethics. A theme running through this is his concern with a modern world in crisis and a hope in social and moral reform. Accordingly, the book concludes with a set of essays on modern times and on a crisis that Durkheim thought would pass but which now seems here to stay. (shrink)

Here are some intuitions we have about the nature of space and time. There is something fundamentally different about the past, present, and future. What is definitive of the past is that the past events are fixed. What is definitive of the future is that future events are not fixed. What is definitive of the present is that it marks the objective ontological border between the past and the future and, by doing so, instantiates a particularly salient phenomenological property of (...) nowness. Call the combination of these intuitions according to which there exists an objective present, a fixed past, and an open future, the intuitive view. I argue that, given the intuitive view, the possibility of backwards causation—and hence, for instance, backwards time travel—is problematic. (shrink)

I develop the foundation for cosmopolitan care, an underexplored variety of moral cosmopolitanism. I begin by offering a characterization of contemporary cosmopolitanism from the justice tradition. Rather than discussing the political, economic or cultural aspects of cosmopolitanism, I instead address its moral dimensions. I then employ a feminist philosophical perspective to provide a critical evaluation of the moral foundations of cosmopolitan justice, with an eye toward demonstrating the need for an alternative account of moral cosmopolitanism as cosmopolitan care. After providing (...) an explanation of how care ethics in connection with Kantian ethics generates a duty to care, I consider one main feature of cosmopolitan care, namely the theory of obligation it endorses. In developing this account, I place special emphasis on the practical ramifications of the theory by using it to analyze gender violence in conflict zones. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Incoherence of Determining Death by Neurological Criteria: A Commentary on Controversies in the Determination of Death, A White Paper by the President’s Council on Bioethics*Franklin G. Miller** (bio) and Robert D. Truog (bio)Traditionally the cessation of breathing and heart beat has marked the passage from life to death. Shortly after death was determined, the body became a cold corpse, suitable for burial or cremation. Two technological changes (...) in the second half of the twentieth century prompted calls for a new, or at least expanded, definition of death: the development of intensive care medicine, especially the use of mechanical ventilators, and the advent of successful transplantation of vital organs. Patients with profound neurological damage, leaving them incapable of breathing on their own and in an irreversible coma, could be maintained for some period of time with the aid of mechanical ventilation. The situation of these patients posed two ethical questions. Is it appropriate to stop life-sustaining treatment? If so, is it acceptable to retrieve vital organs for transplantation to save the lives of others before stopping treatment?In 1968, the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death proposed that death could be determined on the basis of neurological criteria, thus providing a positive answer to these two questions (Ad Hoc Committee 1968). According to the position of this committee, patients diagnosed with the cessation of brain function are dead, despite the fact that they breathe and circulate blood with the aid of mechanical ventilation. [End Page 185] Because they are dead, it is appropriate, indeed imperative, to stop mechanical ventilation. And because they are dead, it becomes ethical to procure vital organs for transplantation before stopping what otherwise would be life-sustaining treatment. Remarkably, this innovative neurological determination of death became, with little debate or controversy, the established position in medical ethics and the law throughout the United States.The Harvard Committee articulated the diagnosis of “irreversible coma,” but merely asserted that this condition constituted death. No explanatory rationale was provided. It fell to the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research to provide an authoritative rationale in its 1981 report, Defining Death. The second paragraph of the report set the stage as follows: “The question addressed here is not inherently difficult or complicated. Simply, it is whether the law ought to recognize new means for establishing that the death of a human being has occurred” (President’s Commission 1981, p. 3). The Commission claimed that “death is a unitary phenomenon” (p. 7) and that the determination of death by neurological criteria, in terms of the absence of all brain function, is consistent with the traditional conception of death as the cessation of vital functioning of the organism as a whole. The key issue is the integrative functioning of the human organism, which ceases to exist, according to the Commission, when the whole brain, including higher cortical areas and the brain stem, fails to function. Although “brain-dead” patients do not appear to be dead—i.e., the reality of their death is “masked” by the activity of mechanical ventilation—the patient’s body has irreversibly lost all capacity for integrative functioning. In the words of the Commission: “When artificial means of support mask this loss of integration as measured by the old methods [cessation of respiration and heart beat], brain-oriented criteria and tests provide a new window on the same phenomenon” (p. 33). The President’s Commission was instrumental in developing and establishing “The Uniform Definition of Death Act”: “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead” (p. 2).Although the question posed by the President’s Commission was easy to articulate, the answer, over time, has proved complicated and controversial. The coherence and cogency of determining death by neurological criteria has been challenged. Various experts have demonstrated that “brain-dead” patients maintained on mechanical ventilation display a range of vital, integrative, functioning, which conflicts with the judgment that they are dead (Truog and... (shrink)

_The Ethics of Need: Agency, Dignity, and Obligation_ argues for the philosophical importance of the notion of need and for an ethical framework through which we can determine which needs have moral significance. In the volume, Sarah Clark Miller synthesizes insights from Kantian and feminist care ethics to establish that our mutual and inevitable interdependence gives rise to a duty to care for the needs of others. Further, she argues that we are obligated not merely to meet others’ needs (...) but to do so in a manner that expresses "dignifying care," a concept that captures how human interactions can grant or deny equal moral standing and inclusion in a moral community. She illuminates these theoretical developments by examining two cases where urgent needs require a caring and dignifying response: the needs of the elderly and the needs of global strangers. Those working in the areas of feminist theory, women’s studies, aging studies, bioethics, and global studies should find this volume of interest. (shrink)

Cosmopolitanism, originally a doctrine of world citizenship, has come in recent political philosophy to mean simply an ethical outlook in which every human being is equally an object of moral concern. However ethical cosmopolitans slide from this moral truism to deny, controversially, that as agents we have special duties of limited scope. Political communities create relations of reciprocity between their citizens and pursue projects that reflect culturally specific values and beliefs, generating special duties among fellow-members. Strong cosmopolitanism would require the (...) creation of a world government, and this could only be an imperialist project in which existing cultural differences were either nullified or privatised. (shrink)