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.

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)

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)

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)

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)

The abstract structure of inquiry - the process of acquiring and changing beliefs about the world - is the focus of this book which takes the position that the "pragmatic" rather than the "linguistic" approach better solves the philosophical problems about the nature of mental representation, and better accounts for the phenomena of thought and speech. It discusses propositions and propositional attitudes (the cluster of activities that constitute inquiry) in general and takes up the way beliefs change in response to (...) potential new information, suggesting that conditional propositions should be understood as projections of epistemic policies onto the world.Robert C. Stalnaker is a professor in the Sage School of Philosophy at Cornell University. A Bradford Book. (shrink)

Winner of the 1975 National Book Award, this brilliant and widely acclaimed book is a powerful philosophical challenge to the most widely held political and social positions of our age--liberal, socialist, and conservative.

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)

Robert B. Brandom is one of the most original philosophers of our day, whose book Making It Explicit covered and extended a vast range of topics in metaphysics, epistemology, and philosophy of language--the very core of analytic philosophy. This new work provides an approachable introduction to the complex system that Making It Explicit mapped out. A tour of the earlier book's large ideas and relevant details, Articulating Reasons offers an easy entry into two of the main themes of Brandom's work: (...) the idea that the semantic content of a sentence is determined by the norms governing inferences to and from it, and the idea that the distinctive function of logical vocabulary is to let us make our tacit inferential commitments explicit. Brandom's work, making the move from representationalism to inferentialism, constitutes a near-Copernican shift in the philosophy of language--and the most important single development in the field in recent decades. Articulating Reasons puts this accomplishment within reach of nonphilosophers who want to understand the state of the foundations of semantics. Table of Contents: Introduction 1. Semantic Inferentialism and Logical Expressivism 2. Action, Norms, and Practical Reasoning 3. Insights and Blindspots of Reliabilism 4. What Are Singular Terms, and Why Are There Any? 5. A Social Route from Reasoning to Representing 6. Objectivity and the Normative Fine Structure of Rationality Notes Index Displaying a sovereign command of the intricate discussion in the analytic philosophy of language, Brandom manages successfully to carry out a program within the philosophy of language that has already been sketched by others, without losing sight of the vision inspiring the enterprise in the important details of his investigation ' Using the tools of a complex theory of language, Brandom succeeds in describing convincingly the practices in which the reason and autonomy of subjects capable of speech and action are expressed. --J'rgen Habermas. (shrink)

Winner of the Los Angeles Times Book Prize With a new preface by the author In his most powerful and important book, renowned psychiatrist Robert Jay Lifton presents a brilliant analysis of the crucial role that German doctors played in the Nazi genocide. Now updated with a new preface, The Nazi Doctors remains the definitive work on the Nazi medical atrocities, a chilling exposé of the banality of evil at its epitome, and a sobering reminder of the darkest side of (...) human nature. (shrink)

In a new retelling of the romantic rationalist adventure of ideas that is Hegel's classic The Phenomenology of Spirit, Robert Brandom argues that when our self-conscious recognitive attitudes take Hegel's radical form of magnanimity and trust, we can overcome a troubled modernity and enter a new age of spirit.

This paper revisits some foundational questions concerning the abstract representation of a discourse context. The context of a conversation is represented by a body of information that is presumed to be shared by the participants in the conversation – the information that the speaker presupposes a point at which a speech act is interpreted. This notion is designed to represent both the information on which context-dependent speech acts depend, and the situation that speech acts are designed to affect, and so (...) to be a representation of context that is appropriate for explaining the interaction of context and the contents expressed in them. After reviewing the motivating ideas and the outlines of the apparatus, the paper responds to a criticism of the framework, and considers the way it can help to clarify some phenomena concerning pronouns with indefinite antecedents. (shrink)

This collection of papers (including three completely new ones) by one of the foremost philosophers in epistemology transcends two of the most widely misunderstood positions in philosophy--foundationalism and coherentism. Audi proposes a distinctively moderate, internalist foundationalism that incorporates some of the virtues of both coherentism and reliabilism. He develops important distinctions between positive and negative epistemic dependence, substantively and conceptually naturalistic theories, dispositional beliefs and dispositions to believe, episodically and structurally inferential beliefs, first and second order internalism, and rebutting as (...) opposed to refuting skepticism. These contrasts are applied not only to rational belief, but to rational action and the rationality of desires and intentions. The overall position is a pluralist, moderately rationalistic, internalist theory of justification and a partly externalist conception of knowledge. However, by virtue of offering a theory of rationality as well as an account of knowledge and justified belief, it will interest philosophers of ethics, science, and the social sciences and teachers and students of epistemology. (shrink)

This chapter uses feminist standpoint theory to investigate Diotima’s epistemic advantage in Plato’s Symposium. Scholars have wondered why Diotima – a woman speaking about the role of erōs in gestation, childbirth, and childrearing – voices the view that Plato privileges most among all the symposiasts (Halperin 1990, Evans 2006, Hobbs 2007). Feminist standpoint theory is useful in developing a novel answer to this question; it supposes that oppressed groups, because they occupy different social locations, often develop epistemic privileges over their (...) dominant counterparts, especially with respect to finding lacunae in dominant narratives (cf. Hartsock 1987, Collins 1990, Harding 1987 and 1993, and Intemann 2016). This chapter proposes that Diotima’s unique social location – she is an older, non-Athenian woman, well versed in gestation, childbirth, and childrearing – disposes her to know something about erōs that the dominant group, the Athenian pederasts, do not. What she knows is that having erōs for something does not merely inspire one to pursue or possess it; by attending to how erōs affects women, she argues that it also manifests as a desire to reproduce what is beloved and care for it. Diotima’s standpoint is epistemically revelatory, then, because it establishes that love is far more than the pursuit of beauty; it is a creative and laborious act. Moreover, her standpoint is ethically revelatory, since she argues that the highest form of love entails fostering and nourishing virtue in others. Understood in this way, Diotima is espousing something like a protofeminist ethics of care. (shrink)

Classical American pragmatism: the pragmatist -- Enlightenment-and its problematic semantics -- Analyzing pragmatism: pragmatics and pragmatisms -- A Kantian rationalist pragmatism: pragmatism -- Inferentialism, and modality in Sellars's arguments against -- Empiricism -- Linguistic pragmatism and pragmatism about norms: an arc of -- Thought from Rorty's eliminative materialism to his pragmatism -- Vocabularies of pragmatism: synthesizing naturalism and -- Historicism -- Towards an analytic pragmatism: meaning-use analysis -- Pragmatism, expressivism, and anti-representationalism: -- Local and global possibilities.

This is a paradigmatic work of contemporary philosophy.

Greatly aided by an information age in which protesting laborers in a remote offshore outpost can capture front page headlines around the globe, theSarbanes-Oxley Act of 2002 (SARBOX) has made corporate transparency the linchpin for good corporate governance. Under a SARBOX-enhancedregulatory framework, publicly traded corporations are required to rapidly disclose material changes in their financial conditions or operations—changes such as impairments to goodwill, a trademark, or some other intangible corporate asset. Especially challenging for multinational corporations (MNCs) with far-flung corporate empires (...) is the need to stay abreast of the ebb and flow of goodwill, at a time when transnational human rights groups are aggressively mobilizing world opinion against the sweatshop labor conditions that abound at the offshore production sites favored by MNCs. The author explains why the convergence of a digital age of free-flowing information and the advent of SARBOX, a legislative enactment of paraenetic design, is causing the boards of MNCs to more critically evaluate the long-term costs of their offshore operations. (shrink)

Robert John Ackermann deals decisively with the problem of relativism that has plagued post-empiricist philosophy of science. Recognizing that theory and data are mediated by data domains (bordered data sets produced by scientific instruments), he argues that the use of instruments breaks the dependency of observation on theory and thus creates a reasoned basis for scientific objectivity. Originally published in 1985. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist (...) of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

We argue for the need for a new language for business – one that is capable of changing the current business decision-making frame of wins and losses to a frame of community and social learning. This paper outlines a classroom exercise about Nelson Mandela’s leadership, involving movies, case studies and poetry, and shows how the more holistic approach helps shift student views of the triple bottom line. Since neuroscience literature has shown that poetry can help enhance learning, students carefully study (...) “Invictus,” a poem written by Victorian-era poet Henley and revered by Mandela. As students dig deeper into the case study through classroom discussion, they begin to see Mandela’s leadership through a new frame, and in doing so broaden their own views. This more holistic approach to studying leadership may allow decision makers to adjust both their goals and the focus of their analysis to go beyond monetary outcomes to include socially and environmentally sustainable outcomes. (shrink)