Background Ethical principles behind prioritization in healthcare are continuously relevant. However, applying ethical principles during times of increased need, such as during the COVID-19 pandemic, is challenging. Also, little is known about nursing home nurses’ prioritizations in their work to achieve well-being and health for nursing home residents. Aim The aim of this study was to explore nursing home nurses’ priority-setting for older nursing home residents in Sweden during the COVID-19 pandemic. Research design, participants, and research context We conducted a (...) qualitative interview study. Data were collected through in-depth interviews (retrospective self-reports) between February and May 2021 with 21 nursing home nurses. To help respondents to recall their memories, we used the critical incident technique (CIT). We analyzed data within the theoretical framework and the methodological orientation of content analysis. Ethical considerations Written and verbal consent was obtained before the interviews, and information was given to participants informing them that participation was entirely voluntary. The Swedish Ethical Review Agency gave an advisory opinion stating that there were no ethical objections to the research project (Dnr. 2020-05649). Findings We identified an overarching theme—nursing home nurses struggling on multiple fronts, “just do it”—and seven categories: striving for survival and caring about a dignified death; responding sensitively to relatives’ expectations; ranking the urgency of needed care; responding to input from different actors; combating the spread of infection in unconventional ways; taking the lead and doing what is required; and following the ideals of person-centered nursing. Conclusions Nurses’ priority-setting for older nursing homes residents during the COVID-19 pandemic meant strain and struggle. In some cases, nurses had taken responsibility for priorities falling outside their statutory powers. Different demands and interests affected nurses’ priorities. Nursing home nurses need organizational and managerial support to prioritize. (shrink)

Michael Otsuka, Alex Voorhoeve and Marc Fleurbaey have challenged the priority view in favour of a theory based on competing claims. The present paper shows how their argument can be used to recast the priority view. All desert claims in distributive justice are comparative. The stronger a party’s claims to a given benefit, the greater is the value of her receiving it. Ceteris paribus, the worse-off have stronger claims on welfare, and benefits to them matter more. This can account for (...) intuitions that at first appear egalitarian, as the analysis of an example of Larry Temkin’s shows. The priority view, properly understood, is desert-adjusted utilitarianism under the assumption that no other claims pertain. (shrink)

'Everyone knows what attention is’ according to William James. Much work on attention in psychology and neuroscience cites this famous phrase only to quickly dismiss it. But James is right about this: ‘attention’ was not introduced into psychology and neuroscience as a theoretical concept. I argue that we should therefore study attention with broadly the same methodology that David Marr has applied to the study of perception. By focusing more on Marr's Computational Level of analysis, we arrive at a unified (...) answer to the question of what attention is, what role it plays in the mind, and why organisms like us have that capacity. I propose a methodology for studying attention at Marr's Computational Level that optimizes in a three-dimensional space: it should capture core aspects of our first-person experience of attention, be explanatorily powerful in psychology and neuroscience, and fertile in an interdisciplinary context. I show how this methodology leads to what I call the priority structure account of attention. Attention is what organizes current information to make it more useful for the organism. We can identify it by four features. Attention, in this way, helps a cognitive system to integrate its informational state with its current motivational state. I describe how this account improves on alternatives and shows why attention is a useful concept in many disciplines and for connecting them. -/- This article is categorized under: Philosophy > Psychological Capacities Psychology > Attention Philosophy > Foundations of Cognitive Science. (shrink)

I will defend two claims. First, Schaffer's priority monism is in tension with many research programs in quantum gravity. Second, priority monism can be modified into a view more amenable to this physics. The first claim is grounded in the fact that promising approaches to quantum gravity such as loop quantum gravity or string theory deny the fundamental reality of spacetime. Since fundamental spacetime plays an important role in Schaffer's priority monism by being identified with the fundamental structure, namely the (...) cosmos, the disappearance of spacetime in these views might undermine classical priority monism. My second claim is that priority monism can avoid this issue with two moves: first, in dropping one of its core assumptions, namely that the fundamental structure is spatio-temporal, second, by identifying the connection between the non-spatio-temporal structure and the derivative spatio-temporal structure with mereological composition. (shrink)

Michail Peramatzis presents a new interpretation of Aristotle's view of the priority relations between fundamental and derivative parts of reality, following ...

In recent work, Louis deRosset (Philosophical Studies 149:73–97, 2010) has argued that priority theorists, who hold that truths about macroscopic objects can be metaphysically explained without reference to such things, cannot meet an independently motivated constraint upon good explanation. By clarifying the nature of the priority theorist’s project, I argue that deRosset’s argument fails to establish its conclusion.

This paper looks at the state of research on churchstate relations in post-communist Romania in order to provide an outline of the most important questions which need to be addressed in the coming years. The article consists of two parts. First, a survey of academic studies published over the past two decades on the relationship between the country’s churches and state after 1990. Secondly, a breakdown of pressing churchstate issues today, accompanied by short discussions of existing studies and suggestions as (...) to what future research should probe into. (shrink)

The seven ethical issues and principles explored in the target article (i.e., privacy, responsibility, access, stigma, user control, family impact, enhancement) reflect important considerations for...

In the Caribbean as in many other areas costly biomedical resources and personnel are limited, and more and more people are turning to alternative medicine and folk practitioners for health care. To meet the goal of providing health care for all, research on nonbiomedical therapies is needed, along with legal recognition of folk practitioners to establish standards of practice.

In order to create sustainable health systems, many countries are introducing ways to prioritize health services underpinned by a process of health technology assessment. While this approach requires technical judgments of clinical effectiveness and cost-effectiveness, these are embedded in a wider set of social (societal) value judgments, including fairness, responsiveness to need, non-discrimination and obligations of accountability and transparency. Implementing controversial decisions faces legal, political and public challenge. To help generate acceptance for the need for health prioritization and the resulting (...) decisions, the purpose of this paper is to develop a novel way of encouraging key stakeholders, especially patients and the public, to become involved in the prioritization process. (shrink)

According to the priority view, or prioritarianism, it matters more to benefit people the worse off they are. But how exactly should the priority view be defined? This article argues for a highly general characterization which essentially involves risk, but makes no use of evaluative measurements or the expected utility axioms. A representation theorem is provided, and when further assumptions are added, common accounts of the priority view are recovered. A defense of the key idea behind the priority view, the (...) priority principle, is provided. But it is argued that the priority view fails on both ethical and conceptual grounds. (shrink)

Throughout this paper PJ Kearney attempts to balance the risks and benefits of different approaches in paediatric oncology. Decisions have to be considered both in the short and the long term. Where religious beliefs, such as those held by Jehovah's Witnesses in relation to blood transfusions, conflict with normal medical practice the decision is often removed from the doctor, parents or patient to the courts. This sort of solution can be counter-productive, especially as good health care and subsequent recovery rely, (...) to a large extent, on good relationships between and among the parties concerned. Destruction of these relationships, for whatever reason, often has a detrimental effect on the patient, in whose best interest everyone believes they are acting. (shrink)

This paper proposes a Capabilities -based Approach to guide hazard mitigation efforts. First, a discussion is provided of the criteria that should be met by an adequate framework for formulating public policy and allocating resources. This paper shows why a common decision-aiding tool, Cost-benefit Analysis, fails to fulfill such criteria. A Capabilities -based Approach to hazard mitigation is then presented, drawing on the framework originally developed in the context of development economics and policy. The focus of a Capabilities -based Approach (...) is protecting and promoting the well-being of individuals. Capabilities are dimensions of well-being and specified in terms of functionings. Functionings capture the various things of value an individual does or becomes in his or her life, including being alive, being healthy, and being sheltered. Capabilities refer to the real achievability of specific functionings. In the context of hazard mitigation, from a Capabilities -based Approach, decision- and policy-makers should consider the acceptability and tolerability of risks along with the affectability of hazards when determining policy formulation and resource allocation. Finally, the paper shows how the proposed approach satisfies the required criteria, and overcomes the limitations of Cost-benefit Analysis, while maintaining its strengths. (shrink)

Many moral theories are committed to the idea that some kinds of moral considerations should be respected, whatever the cost to ‘lesser’ types of considerations. A person's life, for instance, should not be sacrificed for the trivial pleasures of others, no matter how many would benefit. However, according to the decision-theoretic critique of lexical priority theories, accepting lexical priorities inevitably leads us to make unacceptable decisions in risky situations. It seems that to operate in a risky world, we must (...) reject lexical priorities altogether. This paper argues that lexical priority theories can, in fact, offer satisfactory guidance in risky situations. It does so by equipping lexical priority theories with overlooked resources from decision theory. (shrink)

This paper motivates and develops a new theory of time: priority presentism. Priority presentism is the view according to which (i) only present entities exist fundamentally and (ii) past and future entities exist, but they are grounded in the present. The articulation of priority presentism is an exercise in applied grounding: it draws on concepts from the recent literature on ontological dependence and applies those concepts in a new way, to the philosophy of time. The result, as I will argue, (...) is an attractive position that can do much of the same work in satisfying our intuitions about time as presentism, but without the ontological cost. (shrink)

The combination of panpsychism and priority monism leads to priority cosmopsychism, the view that the consciousness of individual sentient creatures is derivative of an underlying cosmic consciousness. It has been suggested that contemporary priority cosmopsychism parallels central ideas in the Advaita Vedānta tradition. The paper offers a critical evaluation of this claim. It argues that the Advaitic account of consciousness cannot be characterized as an instance of priority cosmopsychism, points out the differences between the two views, and suggests an alternative (...) positioning of the Advaitic canon within the contemporary debate on monism and panpsychism. (shrink)

Priority monism is roughly the view that the universe is the only fundamental object, that is, a concrete object that does not depend on any other concrete object. Schaffer, the main advocate of PM, claims that PM is compatible with dependence having two different directions: from parts to wholes for subcosmic wholes, and from whole to parts for the cosmic whole. Recently it has been argued that this position is untenable. Given plausible assumptions about dependence, PM entails that dependence has (...) only one direction, it always goes from wholes to parts. One such plausible assumption is a principle of Isolation. I argue that, given all extant accounts of dependence on the market, PM entails No Isolation. The argument depends upon a particular feature of the dependence relation, namely, necessitation and its direction. In the light of this, I contend that the argument is important, insofar as it suggests that we should distinguish dependence from other cognate notions, e.g. grounding. Once this distinction is made, I suggest we should also distinguish between two different notions of fundamentality that might turn out to be not-coextensive. (shrink)

Volume 20, Issue 7, July 2020, Page 187-190.

In this article, readers are presented with an analysis of some of the problems that became the center of discussion at the XXI International Likhachev Scientific Readings held in May 2023 at the St. Petersburg Humanitarian University of Trade Unions. The readings were held under the general title "Dialogues and conflicts of cultures in a changing world", combining the traditional theme of dialogue with the problems of conflict that have arisen in recent years. This review focuses on two significant issues, (...) one of which determined the course of the plenary discussion, and the other became the main one for the breakout session devoted to the values and trends of the modern world. The main issue of the plenary session was the consideration of the conflict between the unipolar and multipolar world. Both domestic and foreign participants actively spoke out on this issue. The speakers who spoke at the Readings adhered to the idea of prioritizing the values of a multipolar world, pointing to the undemocratic nature of unipolarity. Analyzing this aspect of the discussion, the author of the review notes that in modern society the same value attitudes develop to the limits where they lead to opposite conclusions. The idea of unipolarity implies the uniqueness of the democratic model. From the idea of multipolarity, there are many different development scenarios, which looks like a more democratic position. It can be concluded that the value attitude coincides, but the basis of the ideological conflict is a political conflict. Nevertheless, the final value discrepancy is very acute. The philosophical and cultural section of the conference was devoted to this. Noting the sharpness of the criticism expressed by the speakers to the "new ethics" and the "culture of cancellation", the author of the review points out that in this criticism there is a desire to "cancel" the criticized, which again unites both positions, but does not provide grounds for a constructive dialogue. To overcome the contradiction, a rational analysis of the ideological and historical foundations, as well as the dynamics of the development of opposing value positions, is necessary. (shrink)

The purpose of this paper is to investigate the changes in managers’ moral attitudes, stakeholder orientation and economic interests from 1994 to 2004. Dataare presented concerning 8-10 stakeholder groups and 50-58 moral issues.

Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today’s severity criteria in (...) Norway and Sweden. The Scandinavian perspective on severity might be conducive to the international discussion, given its long-standing use as a priority setting criterion, despite having reached rather different conclusions so far. We then argue that severity can be viewed as a multidimensional concept, drawing on accounts of need, urgency, fairness, duty to save lives, and human dignity. Such concerns will often be relative to local mores, and the weighting placed on the various dimensions cannot be expected to be fixed. Thirdly, we present what we think are the most pertinent questions to answer about severity in order to facilitate decision making in the coming years of increased scarcity, and to further the understanding of underlying assumptions and values that go into these decisions. We conclude that severity is poorly understood, and that the topic needs substantial further inquiry; thus we hope this article may set a challenging and important research agenda. (shrink)

In recent years there has been a good deal of discussion of equality’s place in the best account of distribution or distributive justice. One central question has been whether egalitarianism should give way to a principle requiring us to give priority to the worse off. In this article, I shall begin by arguing that the grounding of equality is indeed insecure and that the priority principle appears to have certain advantages over egalitarianism. But I shall then claim that the priority (...) principle itself is ungrounded and that the priority principle should itself give way to a sufficiency principle based — indirectly, via the notion of an impartial spectator — on compassion for those who are badly off. (shrink)

This paper raises a challenge to Jonathan Schaffer's priority monism. I contend that monism may be true at the actual world but fail to hold as a matter of metaphysical necessity, contrary to Schaffer's view that monism, if true, is necessarily true. My argument challenges Schaffer for his reliance on contingent physical truths in an argument for a metaphysically necessary conclusion. A counterexample in which the actual laws of physics hold but the physical history of the universe is different shows (...) that priority monism is contingently true at best. I suggest some general lessons for discussion of metaphysical dependence. (shrink)

John Rawls’s thesis that a certain package of basic liberties should be given lexical priority is of great interest for legal and political philosophy, but it has received relatively little defense from Rawls or his supporters. In this paper, I examine three arguments for the thesis: the first is based on the two ‘moral powers’; the second, on the social bases of self-respect; and the third, on a Kantian notion of autonomy. I argue none of these accounts successfully establishes 1) (...) the distinct claim of lexical priority, 2) for the complete package of basic liberties, on the basis of reasons that are appropriately public. In turn, I propose an alternative argument, in support of those two claims, based on the social or ‘relational’ conception of equality. (shrink)