The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies (...) show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for the worse off, and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. (shrink)

Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. Priority setting in developing countries is fraught with uncertainty due to lack of credible information, weak priority setting institutions, and unclear priority setting processes. Efforts to improve priority setting in these contexts have focused on providing information and tools. In this paper we argue that priority setting is a value laden and (...) political process, and although important, the available information and tools are not sufficient to address the priority setting challenges in developing countries. Additional complementary efforts are required. Hence, a strategy to improve priority setting in developing countries should also include: (i) capturing current priority setting practices, (ii) improving the legitimacy and capacity of institutions that set priorities, and (iii) developing fair priority setting processes. (shrink)

Priority setting remains a big challenge for health managers and planners, yet there is paucity of literature on evaluating priority setting. The purpose of this paper is to present a framework for evaluating priority setting in low and middle income countries. We conducted a qualitative study involving a review of literature and Delphi interviews with respondents knowledgeable of priority setting in low and middle income countries. Respondents were asked to identify the measures of successful priority setting in low and middle (...) income countries. Responses were grouped as: immediate internal or external/delayed internal or external. We also identified some pre-requisites for successful priority setting. The immediate internal measures included increased efficiency in decision making, improved quality of decisions and fairer priority setting. Immediate External measures included—improved public understanding and acceptance of decisions, increased public participation, increased trust. Delayed Internal measures included increased satisfaction, understanding, compliance, balanced budget, achievement of organization goals, and improved internal accountability. Delayed External measures include impact on policy and practice, improved population health and reduction of health inequalities, achievement of health system goals and strengthening of health care systems. Identified pre-requisites for successful priority setting included; the presence of credible priority setting institutions, incentives for participation and implementation and resources, capacity and political will to implement. These would be augmented in a conducive political, social and economic context. This framework, although not exhaustive, provides a practical basis for planning and evaluating priority setting in low and middle income countries. (shrink)

This report by the WHO Consultative Group on Equity and Universal Health Coverage addresses how countries can make fair progress towards the goal of universal coverage. It explains the relevant tradeoffs between different desirable ends and offers guidance on how to make these tradeoffs.

La cobertura universal de salud está en el centro de la acción actual para fortalecer los sistemas de salud y mejorar el nivel y la distribución de la salud y los servicios de salud. Este documento es el informe fi nal del Grupo Consultivo de la OMS sobre la Equidad y Cobertura Universal de Salud. Aquí se abordan los temas clave de la justicia (fairness) y la equidad que surgen en el camino hacia la cobertura universal de salud. Por lo (...) tanto, el informe es pertinente para cada agente que infl uye en ese camino y en particular para los gobiernos, ya que se encargan de supervisar y guiar el progreso hacia la cobertura universal de salud. (shrink)

Progress towards Universal Health Coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the WHO Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases and how should one adjudicate between them when their demands conflict? This paper by some (...) members of the Consultative Group and a diverse group of health policy professionals addresses these questions. It considers three stylized versions of actual policy dilemmas. Each of these cases pertains to one of the three principal dimensions of progress towards UHC: which services to cover first, which populations to prioritize for coverage, and how to move from out-of-pocket expenditures to pre-payment with pooling of funds. Our cases are simplified to highlight common trade-offs. While we make specific recommendations, our primary aim is to demonstrate both the form and substance of the reasoning involved in striking a fair balance between competing interests on the road to UHC. (shrink)

This report from the WHO Consultative Group on Equity and Universal Health Coverage offers advice on how to make progress fairly towards universal health coverage.

What is the difference between a performance of Beethoven's Fifth Symphony and the symphony itself? What does it mean for musicians to be faithful to the works they perform? To answer this question, Goehr combines philosophical and historical methods of enquiry. She describes how the concept of a musical work emerged as late as 1800, and how it subsequently defined the norms, expectations, and behavior characteristic of classical musical practice. Out of the historical thesis, Goehr draws philosophical conclusions about the (...) normative functions of concepts and ideals. She also addresses current debates amongst conductors, early-music performers, and avant-gardists. (shrink)

This essay interrogates the motives of eighteenth-century European naturalists to alternately show and hide their laboring-class fossil suppliers. Focusing on rare moments of heightened visibility, I ask why gentlemen naturalists occasionally, deliberately, and even performatively made visible the marginalized science workers on whom they crucially depended but more typically ignored or effaced. Comparing archival fragments from elite works of natural history across a considerable stretch of time and space, including Italy, France, Switzerland, Britain, Ireland, Germany, Spain, and French, Spanish, and (...) British America, this essay sketches the contours of a disparate group of people I term ‘earth workers’: laborers of very low social rank, such as quarrymen, shepherds, ditch-diggers, and fieldworkers, whose daily labor in and on the earth enabled the discovery of subterranean specimens. At the same time, archival traces of laboring lives ultimately reveal more about the naturalists who created them than they do about the marginalized laborers whose lives they faintly record. Cultural norms of elite masculinity and scholarly self-presentation in the Republic of Letters help us to understand why some eighteenth-century naturalists felt they had to publicly disavow a form of labor that would come to be recognized as a crucial and skilled part of scientific fieldwork in the modern era. Compared to other kinds of invisible labor that historians of science have brought into view, the social meaning of earth work rendered it uniquely visible in some ways and uniquely invisible in others. (shrink)

Priority setting presents one of the biggest challenges policy makers in low-income countries have to deal with on a daily basis. Extreme lack of resources in these contexts introduces non-state stakeholders whose priorities may not necessarily reflect the national priorities. This raises concerns about the legitimacy of the non-state stakeholders' involvement in priority setting. To date, the meagre literature on priority setting in low-income countries has not focused on the question of the legitimacy of the non-state stakeholders, specifically, the development (...) partners. This article fills this gap in the literature. We provide an overview of some of the health sector priority setting approaches, of relevance to low-income countries, including the processes, the stakeholders and their roles, and the priority setting challenges. These factors are explored, in-depth, using the case of Uganda. The sources of legitimacy of development assistance partners' involvement in priority setting is assessed based on current literature on sources of legitimacy and legitimacy in priority setting. The article concludes that both the government and development assistance partners need to work together to foster and maintain their legitimacy through; having fair priority setting processes with wide representation of all relevant stakeholders, explicit priority setting processes and a balance of decision making powers with commitment to accountability and transparency. (shrink)

This book investigates the role of humor in the good life, specifically as discussed by three prominent French intellectuals who were influenced by Nietzsche's thought: Georges Bataille, Gilles Deleuze, and Clément Rosset. Lydia Amir begins by discussing Nietzsche's reception in France, and she explains why and how he came to be considered a "philosopher of laughter" in the French academe. Each of the subsequent three chapters focuses on the significance of humor and laughter in the good life as advocated (...) by Bataille, Deleuze, and Rosset. These chapters also explore the complex relationship between the comic and the tragic, and of humor and laughter to irony, satire, and ridicule. The Legacy of Nietzsche's Philosophy of Laughter makes an invaluable contribution to recent interpretive work done on Bataille and Deleuze, and offers further introduction to the relatively understudied Rosset. It illuminates the philosophies of these three thinkers, their connection to Nietzsche, and, overall, the significant role that humor plays in philosophy. (shrink)

This paper presents Agassi’s views of morality and ethics. Agassi proposes a non-reductive psychological theory of moral judgments, complemented by duties, and a psychological hypothesis regarding the psychological and social conditions that invite openness to criticism. His opposition to moralism, his objection to justification, his emphasis on red lines and grey areas, and his rejection of abstract moral debates in favor of public moralism result in a distinct approach to moral philosophy that is in conflict with most of the mainstream (...) work in this field. Following Socrates, he takes education for autonomy as the critical rationalist life-style. (shrink)

This paper argues that Protagoras’ great myth depicts human nature as both Promethean and Epimethean: human foresight depends on the condition of oversight. If Protagoras’ praise of foresight betrays his desire to overcome this condition, Socrates embraces it. While Protagoras repeats Epimetheus’ mistake of forgetting his own nature by aiming to overcome the risks of oversight, Socrates’ foresight recognizes that oversight and perplexity are intrinsic to human nature.

_An exploration of philosophical and religious ideas about humor in modern philosophy and their secular implications._.

This article brings to light how AI research has benefited from post-Wittgensteinian philosophy. My research shows that Wittgenstein’s work began to engage the attention of AI researchers not only in the 1970s down to the present but right from the early beginnings of computational research in the 1950s. More specifically, his later philosophy inspired a group of researchers called the Cambridge Language Research Unit (CLRU) to start one of the first programs in machine translation, information retrieval, mechanical abstracting, and knowledge (...) representation technologies in the early 1950s, all of which have later been claimed for AI and cognitive science. I focus on the philosophical work of CLRU founder Margaret Masterman and her extraordinary but forgotten contributions to ordinary language philosophy. (shrink)

Nurses and midwives are the majority of healthcare professionals globally, including Africa, and they provide care at all levels of the health system including community levels. Nurses and midwives contribute to the care of patients with rigid or dogmatic religious beliefs or those with suicidal ideations. This review paper discusses acute and chronic diseases that have suicidal tendencies such as terminal cancer, diseases with excruciating pain, physical disability, stroke, end-stage renal failure, and diabetics who are amputated. It was reiterated that (...) nurses and midwives taking care of these patients should be alert and observant to identify their suicidal tendencies. The paper also discusses religious or spiritual inclinations that negatively affect healthcare access and adherence, especially to biomedical or western medicine. It was emphasized that some religious beliefs do not allow their followers to employ biomedical treatment and nurses and midwives should not impose their faith on patients and their families. The paper ends with a discussion on the specific roles of nurses and midwives in the care of patients with suicidal ideations such as assessment, counseling, administering medication, observation, social interaction, ensuring safety measures, and providing an enabling environment for the family to part of the care and for the observation of religious coping strategies. Nurses and midwives should enhance their knowledge and skills on suicide and increase public education on suicide prevention and identification of those at risk. (shrink)

The aim of this study is to examine moral reasoning in a cross cultural Islamic context. The moral reasoning of female business students in the United Arab Emirates is described based on Kohlberg’s theory of Cognitive Moral Development (CMD). Business students were asked to participate in a brief individual interview which involved reading three moral dilemmas and answering open-ended questions. Results were analyzed based on each dilemma as well as acrossall three. Most students made their decisions at the first two (...) levels of Kohlberg’s stages, prioritizing how their decision would secure rewards for themselves and compliance with rules to maintain the social order. However, a fairly large percentage also scored at the highest stage of reasoning. Results are explored based on the sociocultural context and implications for ethics education are outlined, including an emphasis on examining conflicting cultural values and the use of context-specific dilemmas for teaching ethics. (shrink)

Examining changing role models for masculine identity--from cowboy in the 1950s to Terminator in the 1990s, from flesh-and-blood man to machine--this book suggests that men need new role models and that sufficient room needs to be left for the expression of male vulnerability, a psychic space that would accept attitudes and behaviors traditionally labeled as "feminine." This new model, Badinter argues, may reduce the profound effects of homophobia and misogyny.

This paper investigates the claim that artificial Intelligence Systems cannot be held morally responsible because they do not have an ability for agential self-awareness e.g. they cannot be aware that they are the agents of an action. The main suggestion is that if agential self-awareness and related first person representations presuppose an awareness of a self, the possibility of responsible artificial intelligence systems cannot be evaluated independently of research conducted on the nature of the self. Focusing on a specific account (...) of the self from the phenomenological tradition, this paper suggests that a minimal necessary condition that artificial intelligence systems must satisfy so that they have a capability for self-awareness, is having a minimal self defined as ‘a sense of ownership’. As this sense of ownership is usually associated with having a living body, one suggestion is that artificial intelligence systems must have similar living bodies so they can have a sense of self. Discussing cases of robotic animals as examples of the possibility of artificial intelligence systems having a sense of self, the paper concludes that the possibility of artificial intelligence systems having a ‘sense of ownership’ or a sense of self may be a necessary condition for having responsibility. (shrink)

The most extensive descriptions of Gog and Magog in the Hebrew Bible appear in Ezekiel 38–39. At various stages of their political career, both Reagan and Bush have linked Gog and Magog to the bêtes noires of the USA, identifying them either as the ‘communistic and atheistic’ Russia or the ‘evil’ Iraq. Biblical scholars, however, seek to contextualise Gog of Magog in the historical literary setting of the ancient Israelites. Galambush identifies Gog in Ezekiel as a cipher for Nebuchadnezzar, the (...) Babylonian king, who acted as Judah’s oppressor in the 6th century BCE. More recently, Klein concludes that Gog, along with his companions, is ‘eine Personifikation aller Feinde, die Israel im Buch Ezechiel gegenüberstehen’. Despite their differences in detail, these scholars, such as Reagan and Bush, work with a dualism that considers only the features of Judah’s enemies incorporated into Gog’s characteristics. Via an analysis of the semantic allusions, literary position and early receptions of Ezekiel 38–39, this article argues that Gog and his entourage primarily display literary attributes previously assigned to Judah’s political allies. (shrink)

.As editor of the National Anti-Slavery Standard in the early 1840s, Lydia Maria Child was responsible for keeping the abolitionist movement in the United States informed of relevant news. She also used her editorial position to philosophize. Her column entitled “Letters from New York” is particularly philosophical, including considerations of infinity, free will, time, nature, art, and history. She especially turned to German philosophers and intellectuals such as Kant, Schiller, Bettina von Arnim, Karoline von Günderrode, Jean Paul, Herder, and (...) Hegel in an attempt to guide her readers to a rejection of slavery for the right philosophical reasons. I consider the influence of German philosophy on three particular themes in her writings: a Romantic-Spinozistic view of humans and nature; a Kantian conception of conscience; and a Hegelian description of the philosophy of history. (shrink)

This article evaluates the significance of the personal liberation that Santayana offers in relation to previous proposals in Western modern philosophy. These include the ideas of liberation present in the philosophies of Spinoza, Schopenhauer, and Nietzsche. I argue that Santayana endorses Spinoza’s project, as Schopenhauer and Nietzsche did, of a philosophic redemption as an alternative to an established religion. Yet, he also follows Schopenhauer in rectifying Spinoza’s attempt of recapturing the philosophic truth of Christianity, a project undertaken in Medieval times (...) for Judaism and Islam, but not for Christianity. The result is an explicit philosophic reconstruction of the esoteric truth of Christianity. This, I argue, is the content of the lay religion and the deliverance it provides that Santayana sees as genuine philosophy and that is exemplified by the work of his hero and master, Spinoza. (shrink)

Arguments for the effectiveness, and even the indispensability, of mathematics in scientific explanation rely on the claim that mathematics is an effective or even a necessary component in successful scientific predictions and explanations. Well-known accounts of successful mathematical explanation in physical science appeals to scientists’ ability to solve equations directly in key domains. But there are spectacular physical theories, including general relativity and fluid dynamics, in which the equations of the theory cannot be solved directly in target domains, and yet (...) scientists and mathematicians do effective work there (McLarty 2023, Elder 2023). Building on extant accounts of structural scientific explanation (Bokulich 2011, Leng 2021), I argue that philosophical accounts of the role of equations in scientific explanation need not rely on scientists’ ability to solve equations independently of their understanding of the empirical or experimental context. For instance, the process of formulating solutions to equations can involve significant appeal to information about experimental contexts (Curiel 2010) or of physically similar systems (Sterrett 2023). Working from a close analysis of work in fluid mechanics by Martin Bazant and Keith Moffatt (2005), I propose an account of heuristic structural explanation in mathematics (Einstein 1921, Pincock 2021), which explains how physical explanations can be constructed even in domains where basic equations cannot be solved directly. (shrink)

The COVID-19 pandemic swept through New York City swiftly and with devastating effect. The crisis put enormous pressure on all hospital services, including the clinical ethics consultation team. This report describes the recent experience of the ethics consultants and Columbia University Irving Medical Center during the COVID-19 surge and compares the case load and characteristics to the corresponding period in 2019. By reporting this experience, we hope to supplement the growing body of COVID-19 scientific literature and provide details of the (...) human toll the virus took on our hospitals and communities. We also aim to highlight the role of the clinical ethics consultant as well as areas of policy and law that may need to be addressed in order to be better prepared for a future public health crisis. (shrink)

This is a community based research project using a case study of 20 people living in middle America who are food insecure, but do not use food pantries. The participants’ rate of actual hunger is twice that of food insecure community members who use food pantries. Since most of the participants are not poor, the Asset Vulnerability Framework is used to classify causes of food insecurity. The purpose of the study is to identify why participants are food insecure and why (...) they do not use food pantries. Findings reveal that the participants restrict the quality and quantity of food eaten as a strategy to manage their budget. Following AVF, this strategy allows them to offset lower returns to labor assets, cover rising costs of human capital investment, protect their two most important productive assets of housing and transportation, and compensate for household relationships that increase their vulnerability. In addition, food insecurity itself inhibited social capital formation, further increasing vulnerability. The main reasons the participants do not use food pantries is to protect their social capital assets: almost all of the participants hid their hunger from colleagues, friends, relatives, and even the people they lived with. The participants described fear of societal shaming and blaming as motivations for hiding their hunger. However, using food pantries could reduce their food insecurity. Therefore, there was a feedback loop between food insecurity and social capital: food insecurity reduced social capital and efforts to protect social capital prevented participants from improving food security by using food pantries. (shrink)

Dignity is man’s creation, not respected by nature or life. It is part of what has been sometimes considered as dangerous hubris or human pride. The inevitable fall from hubris leads either to humility or to humiliation – a middle stage between hubris and humility. When pride is hurt and dignity impaired by the very nature of indomitable, indif­ferent and secretive life, awareness of humiliation as a preferred stage is crucial. It is crucial because it permits to avoid humility, for (...) all those who feel that humility is beyond their power or below their will, while keeping the fighting and ambitious spirit of hubris. Moreover, awareness of our humiliation enables us to apprehend an important, though painful, truth about the human condition. (shrink)

As an introduction to the six essays written in honor of Joseph Agassi’s last book, I explain the book structure and Agassi’s purpose in writing it. To the contrary of what I had in mind when I invited Agassi to pen this manuscript—his Cynic- and Zen-like educational practices, on which I have elaborated elsewhere and which required further clarification—Agassi chose to write on the intersection of the philosophy of life with academic philosophy. Following Socrates, he called for an active collaboration (...) of both. By explaining why “philosophy is nothing … if it is not the advocacy of reason,” Agassi summed up his entire philosophy in what turned out to be his clearest and most insightful work, his testament. (shrink)

As editor of the National Anti-Slavery Standard in the early 1840s, Lydia Maria Child was responsible for keeping the abolitionist movement in the United States informed of relevant news. She also...

Physicians, philosophers, and theologians consider how to address death and dying for a diverse population in a secularized century.Most of us are generally ill-equipped for dying. Today, we neither see death nor prepare for it. But this has not always been the case. In the early fifteenth century, the Roman Catholic Church published the Ars moriendi texts, which established prayers and practices for an art of dying. In the twenty-first century, physicians rely on procedures and protocols for the efficient management (...) of hospitalized patients. How can we recapture an art of dying that can facilitate our dying well? In this book, physicians, philosophers, and theologians attempt to articulate a bioethical framework for dying well in a secularized, diverse society.Contributors discuss such topics as the acceptance of human finitude; the role of hospice and palliative medicine; spiritual preparation for death; and the relationship between community, and individual autonomy. They also consider special cases, including children, elderly patients with dementia, and death in the early years of the AIDS epidemic, when doctors could do little more than accompany their patients in humble solidarity.These chapters make the case for a robust bioethics—one that could foster both the contemplation of finitude and the cultivation of community that would be necessary for a contemporary art of dying well.ContributorsJeffrey P. Bishop, Lisa Sowle Cahill, Daniel Callahan, Farr A. Curlin, Lydia S. Dugdale, Michelle Harrington, John Lantos, Stephen R. Latham, M. Therese Lysaught, Autumn Alcott Ridenour, Peter A. Selwyn, Daniel Sulmasy. (shrink)

I trace Shlomit Schuster’s main ideas about the practice of philosophy, and fol­low with a critical characterization of her thought which bears on philosophy’s relation to psychology and psychiatry, on the one hand, and to religion, on the other, as well as on her basis of claiming philosophy’s suitability for non-philosophers. I argue that Shlomit could be unnecessarily uncompromising in implementing her either/or yet not sufficiently discerning of philosophy’s difference with religion. The most conspicuous tenet of Shlomit’s thought – the (...) relation between philosophy and the therapeutic disciplines – has been abundantly debated within the practical philosophy movement. As far as I know, the tacit assumption of her thought regarding the relation of religion with philosophy and its prac­tice, in contradistinction, has not been addressed within this movement. Shlomit’s life and death urges us to tackle this delicate yet significant subject. (shrink)

Laughter is a significant topic for Renaissance and seventeenth‐century philosophers. Still, the latter rarely approved of laughter but endorsed it as useful mockery for theological or philosophical purposes. Benedict Spinoza’s view of laughter stands out as an exception to this attitude as well as to previous and later ones. Spinoza differentiates between mockery and laughter, denounces the former as evil, and characterizes the latter as “pure joy”: laughter is about oneself rather than another and originates in noticing something good, rather (...) than base or ugly. In contrast to melancholy, cheerfulness is “always good” and is a precondition of our liberation as it furthers the use of reason. Not only is Spinoza’s view original, but it is an important source of the eighteenth‐century notions of good‐natured laughter and good humor through a more than probable influence on their proponent, the Earl of Shaftesbury. Whilst Spinoza’s view of cheerfulness is briefly addressed in recent studies, his view of laughter goes unnoticed in most commentaries and is misrepresented in humor studies. Contrary to what is assumed in the philosophy of laughter, I argue that the most important defense of laughter comes not from a British Enlightenment thinker, but from the Dutch Jewish seventeenth‐century philosopher. (shrink)

The last decade has seen a slow but steady increase in the number of postdoctoral scholars employed in faculties of education. In this article, seven postdoctoral scholars who worked in the same Ca...

What happens to philosophy when philosophical activities migrate to the AI lab? My article explores the philosophical work that has gone into the machine simulations of language and understanding after Alan Turing. The early experiments by AI practitioners such as Karen Spärck Jones, Richard Richens, Yorick Wilks, and others at the Cambridge Language Research Unit (CLRU) led to the creation of the machine interlingua, semantic networks, and other technological innovations central to the development of AI in the 1950s–1970s. I attempt (...) to show how, in the midst of their computational work, the CLRU pioneers engaged with Ludwig Wittgenstein, Ferdinand de Saussure, Rudolf Carnap, and other philosophers and developed startling new ways of formulating fundamental questions about language and human understanding. More significantly, their philosophical activities on the machine present an inclusive and culturally diverse picture of the world that profoundly negates the ethnocentric metaphysics of human-machine conundrums that John Searle and his critics represent in the Chinese Room debate. The familiar legacy of that debate has long distorted the narrative of AI origins through its simultaneous reiteration and repudiation of the Turing test. My study seeks to clarify those origins, but my primary goal is to demonstrate what it is like to practice philosophy on the machine and how the critique of metaphysics is made possible in the AI lab. (shrink)

Philosophical practice or counseling has been described as a cluster of meth­ods for treating everyday problems and predicaments through philosophical means. Not­withstanding the variety of methods, philosophical counselors seem to share the following tenets: 1. The counselee is autonomous; 2. Philosophical counseling differs from psychological counseling and 3. Philosophical counseling is effective in solving predicaments. A critical examination shows these to be problematic at both theoretical and practical levels. As I believe that philosophical practice is a valuable contribution both to (...) philosophy and to psychology, though not devoid of potential dangers and misuses, I suggest that philosoph­ical counselors reconsider the theoretical and empirical validity of their tenets. Using my experience as a philosophical counselor, I attempt in this paper to contribute to this task while introducing the reader to what are, in my opinion, the main problems in the field. (shrink)