When thinking about population level healthcare priority setting decisions, such as those made by the National Institute for Health and Care Excellence, good medical ethics requires attention to three main principles of health justice: (1) cost-effectiveness, an aspect of beneficence, (2) non-discrimination, and (3) priority to the worse off in terms of both current severity of illness and lifetime health. Applying these principles requires consideration of the identified patients who benefit from decisions and the unidentified patients who bear the opportunity (...) costs. (shrink)

This article examines Sagoff's criticisms of 'Four Dogmas of Environmental Economies' and argues that none of them are fatal. Many of the criticisms appear to rest on general misunderstandings about welfare economics. One misunderstanding is that transaction costs are theoretically indistinguishable from regular production costs. The theoretical distinction is that transaction costs vary under alternative policies and institutions whereas production costs are fixed by tastes, technology and endowments. Another misunderstanding is that market failure concerns only Pareto efficiency. Market failure also (...) concerns social efficiency with respect to the 'social welfare function', a device for making explicit ethical judgments about the interpersonal distribution of welfare. A third misunderstanding is that the 'rationality assumption' drives economic theory. In fact, the explanatory power of economic models comes mainly from explicit assumptions about the constraints facing economic agents. A fourth misunderstanding is that welfare economics is used as a mechanism for making legal and political decisions. Rather, welfare economics is used as a method for informing legal and political decisions by evaluating their outcomes on the basis of individual welfare. Used properly, it can improve the democratic process by bringing hidden costs and difficult issues to the attention of both policy-makers and the wider public. (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.

The main aim of this paper is to investigate the views of healthcare professionals in Portugal about healthcare rationing, and compare them with the views of college students. A self-administered questionnaire was used to collect data from a sample of 60 healthcare professionals and 180 college students. Respondents faced a hypothetical rationing dilemma where they had to order four patients and justify their choices. Multinomial logistic regressions were used to test for differences in orderings, and content analysis to categorize the (...) written justifications. The findings suggest that both groups appeared to support three main rationing principles: health maximization, priority to the severely ill and priority to the young. However, professionals seemed to give less weight to the latter principle. In conclusion, professionals have similar views to students about healthcare rationing, though may be slightly less inclined to give priority to the young. (shrink)

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)

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.

The British Armed Nation, 1793?1815. By J. E. Cookson (Oxford: Oxford University Press, 1997) vi + 286 pp. £45.00/ $87.00 cloth. The Arming of Europe and the Making of the First World War. By David G. Herrmann (Princeton: Princeton University Press, 1997) 307 pp. $16.95 paper. State, Society and Mobilization in Europe during the First World War. John Horne, ed. (Cambridge U.K.: Cambridge University Press, 1997) xv + 292 pp. £35.00/ $59.95 cloth.

This paper compares and contrasts three different substantive principles of justice for making health care priority-setting or “rationing” decisions: need principles, maximising principles and egalitarian principles. The principles are compared by tracing out their implications for a hypothetical rationing decision involving four identified patients. This decision has been the subject of an empirical study of public opinion based on small-group discussions, which found that the public seem to support a pluralistic combination of all three kinds of rationing principle. In conclusion, (...) it is suggested that there is room for further work by philosophers and others on the development of a coherent and pluralistic theory of health care rationing which accords with public opinions. (shrink)

This book argues that the distinction between positive and negative freedom remains highly pertinent today, despite having fallen out of fashion in the late twentieth century. It proposes a new reading of this distinction for the twenty-first century, building on the work of Constant, Green and Berlin who led the historical development of these ideas. The author defends the idea that freedom is a dynamic interaction between two inseparable, yet sometimes fundamentally, opposed positive and negative concepts - the yin and (...) yang of freedom. Positive freedom is achieved when one succeeds in doing what is right, while negative freedom is achieved when one is able to advance one's wellbeing. In an environment of culture wars, resurging populism and challenge to progressive liberal values, recognising the duality of freedom can help us better understand the political dilemmas we face and point the way forward. The book analyses the duality of freedom in more philosophical depth than previous studies and places it within the context of both historical and contemporary political thinking. It will be of interest to students and scholars of liberalism and political theory. (shrink)

The Exchange of Words is a philosophical exploration of human testimony, specifically as a form of intersubjective understanding in which speakers communicate by making themselves accountable for the truth of what they say. This account weaves together themes from philosophy of language, moral psychology, action theory, and epistemology, for a new approach to this basic human phenomenon.

The paper argues for the centrality of believing the speaker (as distinct from believing the statement) in the epistemology of testimony, and develops a line of thought from Angus Ross which claims that in telling someone something, the kind of reason for belief that a speaker presents is of an essentially different kind from ordinary evidence. Investigating the nature of the audience's dependence on the speaker's free assurance leads to a discussion of Grice's formulation of non-natural meaning in an epistemological (...) light, concentrating on just how the recognition of the speaker's self-reflexive intention is supposed to count for his audience as a reason to believe P. This is understood as the speaker's explicitly assuming responsibility for the truth of his statement, and thereby constituting his utterance as a reason to believe. (shrink)

In healthcare, a tension sometimes arises between the injunction to do as much good as possible with scarce resources and the injunction to rescue identifiable individuals in immediate peril, regardless of cost (the “Rule of Rescue”). This tension can generate serious ethical and political difficulties for public policy makers faced with making explicit decisions about the public funding of controversial health technologies, such as costly new cancer drugs. In this paper we explore the appropriate role of the Rule of Rescue (...) in public resource allocation decisions by health technology funding advisory bodies such as the National Institute for Health and Clinical Excellence. We consider practical approaches to operationalising the Rule of Rescue from Australia and the UK before examining the relevance of individual moral imperatives to public policy making. We conclude that that whilst public policy makers in a humane society should facilitate exceptional departures from a cost effectiveness norm in clinical decisions about identified individuals, it is not so obvious that they should, as a matter of national public policy, exempt any one group of unidentified individuals within society from the rules of opportunity cost at the expense of all others. (shrink)

In this volume Rorty offers a Deweyan account of objectivity as intersubjectivity, one that drops claims about universal validity and instead focuses on utility for the purposes of a community. The sense in which the natural sciences are exemplary for inquiry is explicated in terms of the moral virtues of scientific communities rather than in terms of a special scientific method. The volume concludes with reflections on the relation of social democratic politics to philosophy.

Richard Swinburne offers an original treatment of a question at the heart of epistemology: what makes a belief rational, or justified in holding? He maps the rival accounts of philosophers on epistemic justification ("internalist" and "externalist"), arguing that they are really accounts of different concepts. He distinguishes between synchronic justification (justification at a time) and diachronic justification (synchronic justification resulting from adequate investigation)--both internalist and externalist. He also argues that most kinds of justification are worth having because they are (...) indicative of truth; however, it is only justification of internalist kinds that can guide a believer's actions. Swinburne goes on to show the usefulness of the probability calculus in elucidating how empirical evidence makes beliefs probably true. (shrink)

ABSTRACT The paper challenges the general perception that the positive–negative freedom discourse privileges negative liberty. It demonstrates that Constant and Berlin’s dual freedom conceptual scheme contains the blueprint of a modern concept of positive freedom and it reveals the nature of negative freedom in an entirely new light. Constant’s ancient and modern liberties have many similarities with Berlin’s two concepts of freedom – positive and negative. The paper shows that these similarities warrant a parallel study and allow us to examine (...) the relation between the two sides of the freedom dichotomy by using the compound terms modern/negative and ancient/positive freedom. It is argued that understanding the relation between the two freedoms depends on accepting ancient/positive liberty as practiced by the participants of modern revolutions. Then we can see why this freedom can both violate and complement modern/negative freedom. The paper argues that the combined tension and mutual dependency of the two freedoms can be explained by tapping into a metaphysical study of human agency, where metaphysics is understood as conceptualisation of moral experience. This helps demonstrate why Constant’s modern liberty and Berlin’s negative liberty rely on satisfaction as a key category reflecting individuals’ capacity for subjective judgement. (shrink)

Richard Swinburne presents a powerful new case for substance dualism and for libertarian free will. He argues that pure mental events are distinct from physical events and interact with them, and claims that no result from neuroscience or any other science could show that interaction does not take place. Swinburne goes on to argue for agent causation, and claims that it is we, and not our intentions, that cause our brain events. It is metaphysically possible that each of us (...) could acquire a new brain or continue to exist without a brain; and so we are essentially souls. Brain events and conscious events are so different from each other that it would not be possible to establish a scientific theory which would predict what each of us would do in situations of moral conflict. Hence, we should believe that things are as they seem to be: that we make choices independently of the causes which influence us. It follows that we are morally responsible for our actions. (shrink)

This paper explores some aspects of the relation between different ways of achieving a consensus on the judgemental values of a group of indviduals; in particular, aggregation and deliberation. We argue firstly that the framing of an aggregation problem itself generates information that individuals are rationally obliged to take into account. And secondly that outputs of the deliberative process that this initiates is in tension with constraints on consensual values typically imposed by aggregation theory, at least when deliberation is modelled (...) as process of learning from others compatible with Bayesian updating principles. (shrink)

Atheism is a familiar kind of skepticism about religion. Moral error theory is an analogous kind of skepticism about morality, though less well known outside academic circles. Both kinds of skeptic face a "what next?" question: If we have decided that the subject matter (religion/morality) is mistaken, then what should we do with this way of talking and thinking? The natural assumption is that we should abolish the mistaken topic, just as we previously eliminated talk of, say, bodily humors and (...) unicorns. The fictionalist, however, offers a less obvious recommendation. According to the fictionalist, engaging in the topic in question provides pragmatic benefits that do not depend on its truth-in a way roughly analogous to engaging with a novel or a movie. The religious fictionalist maintains that even if we were atheists, we should carry on talking, thinking, and acting as if religion were true. The moral fictionalist maintains a similar view regarding moral talk, thought, and action. Both forms of fictionalism face serious challenges. Some challenges can be levelled at either form of fictionalism (or at any form of fictionalism), whereas others are problems unique to moral fictionalism or to religious fictionalism. There are important questions to be asked about the relationship between these two kinds of fictionalism. Could moral fictionalism be plausible even if religious fictionalism is not (or vice versa)? This is a volume of thirteen previously unpublished papers on the topics of religious fictionalism, moral fictionalism, and the relation between these views. (shrink)

This book brings together twenty articles giving a comprehensive view of the work of the Aristotelian commentators.... The importance of the commentators is partly that they represent the thought and classroom teaching of the Aristotelian and Neoplatonist schools and partly that they provide a panorama of a thousand years of anicient Greek philosophy, revealing many original quotations from lost works. Even more significant is the profound influence... that they exert on later philosophy, Islamic and Western. Not only did they preserve (...) anti-Aristotelian marterial which helped inspire Medieval and Renaissance science, but they presented Aristotle in a form that made him acceptable to the Christian Church. It is not Aristotle, but Aristotle transformed and embedded in the philosophy of the commentators, that so often lies behind the views of later thinkers. --From book jacket. (shrink)

Philosophy and literature enjoy a close, complex relationship. Elucidating the connections between these two fields, this book examines the ways philosophy deploys literary means to advance its practice, particularly as a way of life that extends beyond literary forms and words into physical deeds, nonlinguistic expression, and subjective moods and feelings.

_Heidegger_ is a classic introduction to Heidegger's notoriously difficult work. Truly accessible, it combines clarity of exposition with an authoritative handling of the subject-matter. Richard Polt has written a work that will become the standard text for students looking to understand one of the century's greatest minds.

This classic, provocative introduction to classical metaphysical questions focuses on appreciating the problems, rather than attempting to proffer answers.

The book begins with an overview that introduces the Theorem and the issues surrounding it, and explores how the essays that follow contribute to our understanding of those issues.

Richard Kilvington (ca. 1302-1361) was one of the most original and influential thinkers among the Oxford Calculators. His impact on late medieval philosophy and theology remains unquestionable. His physical, logical, and ethical solutions were extensively debated and referred to, paving the way for new approaches in philosophy and theology. This volume presents a critical edition of question 4 from Kilvington's Quaestiones super libros Sententiarum, complete with an introduction to the edition and a guide to Kilvington's theological concepts.

The sixteen essays in this volume confront the current debate about the relationship between philosophy and its history. On the one hand intellectual historians commonly accuse philosophers of writing bad - anachronistic - history of philosophy, and on the other, philosophers have accused intellectual historians of writing bad - antiquarian - history of philosophy. The essays here address this controversy and ask what purpose the history of philosophy should serve. Part I contains more purely theoretical and methodological discussion, of such (...) questions as whether there are 'timeless' philosophical problems, whether the issues of one epoch are commensurable with those of another, and what style is appropriate to the historiography of the subject. The essays in Part II consider a number of case-histories. They present important revisionist scholarship and original contributions on topics drawn from ancient, early modern and more recent philosophy. All the essays have been specially commissioned, and the contributors include many of the leading figures in the field. The volume as a whole will be of vital interest to everyone concerned with the study of philosophy and of its history. (shrink)

This Element, written for researchers and students in philosophy and the behavioral sciences, reviews and critically assesses extant work on number concepts in developmental psychology and cognitive science. It has four main aims. First, it characterizes the core commitments of mainstream number cognition research, including the commitment to representationalism, the hypothesis that there exist certain number-specific cognitive systems, and the key milestones in the development of number cognition. Second, it provides a taxonomy of influential views within mainstream number cognition research, (...) along with the central challenges these views face. Third, it identifies and critically assesses a series of core philosophical assumptions often adopted by number cognition researchers. Finally, the Element articulates and defends a novel version of pluralism about number concepts. (shrink)

Disagreement is common: even informed, intelligent, and generally reasonable people often come to different conclusions when confronted with what seems to be the same evidence. Can the competing conclusions be reasonable? If not, what can we reasonably think about the situation? This volume examines the epistemology of disagreement. Philosophical questions about disagreement arise in various areas, notably politics, ethics, aesthetics, and the philosophy of religion: but this will be the first book focusing on the general epistemic issues arising from informed (...) disagreement. Ten leading philosophers offer specially written essays which together will offer a starting-point for future work on this topic. (shrink)

Thinking through the body: educating for the humanities -- The body as background -- Self-knowledge and its discontents: from Socrates to somaesthetics -- Muscle memory and the somaesthetic pathologies of everyday life -- Somaesthetics in the philosophy classroom: a practical approach -- Somaesthetics and the limits of aesthetics -- Somaesthetics and Burke's sublime -- Pragmatism and cultural politics: from textualism to somaesthetics -- Body consciousness and performance -- Somaesthetics and architecture: a critical option -- Photography as performative process -- Asian (...) ars erotica and the question of sexual aesthetics -- Philosophy as awakened life : everyday aesthetics of embodiment in American transcendentalism and Japanese Zen practice -- Somatic style. (shrink)

Richard Kilvington s commentary on Aristotle s Nicomachean Ethics (14th century) offers a unique perspective of argumentation by applying concepts and terminology from the fields of logic and physics to ethical dilemmas.".