In this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By “rationing through inconvenience” in the health sphere, we refer to a nonfinancial burden that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health-related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient. We argue that under (...) certain conditions, rationing through inconvenience may turn out to serve as a legitimate and, compared to direct rationing, even a preferable tool for rationing; we propose a research agenda to identify more precisely when that might be the case and when, alternatively, rationing through inconvenience remains ethically undesirable. After defining and illustrating rationing through inconvenience, we turn to its moral advantages and disadvantages over other rationing methods. We take it as a starting assumption that rationing, understood as scarce-resource prioritization, is inevitable and, in a society that has goals beyond optimizing health care for individual patients—such as improving societal health care, education, or overall welfare—prudent and fair. (shrink)

In this paper, I examine the case that has been made for origin essentialism and find it wanting. I focus on the arguments of Nathan Salmon and Graeme Forbes. Like most origin essentialists, Salmon and Forbes have been concerned to respect the intuition that slight variation in the origin of an artifact or organism is possible. But, I argue, both of their arguments fail to respect this intuition. Salmon's argument depends on a sufficiency principle for cross-world identity, which should be (...) rejected, if - as Salmon concedes - a given artifact might have been originally made from slightly different material. Similarly, Forbes's argument succeeds only if essentially the same argument can be used to establish a claim that - by his own admission - is too strong, namely that no variation, however slight, in an organism's origin is possible. (shrink)

Pt. I. Philosophy and cognitive-behavioral therapy (CBT) -- Ch. 1. The "philosophical origins" of CBT -- Ch. 2. The beginning of modern cognitive therapy -- Ch. 3. A brief history of philosophical therapy -- Ch. 4. Stoic philosophy and psychology -- Ch. 5. Rational emotion in stoicism and CBT -- Ch. 6 Stoicism and Ellis's rational therapy (REBT) -- Pt. II. The stoic armamentarium -- Ch. 7. Contemplation of the ideal stage -- Ch. 8. Stoic mindfulness of the "here and (...) now" -- Ch. 9. Self-analysis and disputation -- Ch. 10. Autosuggestion, premeditation, and retrospection -- Ch. 11. Preditatio malorum and mental rehearsal -- Ch. 12. Stoic fatalism, determination, and acceptance -- Ch. 13. The view from above and stoic metaphysics. (shrink)

Over two decades ago, Davids et al. (1994) and Handford et al. (1997) raised theoretical concerns associated with traditional, reductionist, mechanistic perspectives of movement coordination and skill acquisition for sport scientists interested in practical applications for training designs. These seminal papers advocated an emerging consciousness grounded in an ecological approach, signalling the need for sports practitioners to appreciate the constraints-led, deeply entangled and non-linear reciprocity between the organism (performer), task and environment subsystems. Over two decades later, the areas of skill (...) acquisition, practice and training design, performance analysis and preparation, and talent development in sport science have never been so vibrant in terms of theoretical modelling, knowledge generation and innovation, and technological deployment. Viewed at an ecological level of analysis, the work of sports practitioners has progressively transitioned toward the facilitation of an evolving relationship between an organism (athlete, team) and its environment (sports competition). This commentary sets out to explore how these original ideas from Davids et al. (1994) and Handford et al. (1997) have been advanced through the theoretical lens of Ecological Dynamics. Concurrently, we provide case study exemplars, from applied practice in high-performance sports organisations, to illustrate how these contemporary perspectives are shaping the work of sports practitioners (sport ecology designers) in practice and performance preparation. (shrink)

Abstract:The randomized response technique (RRT) is used to study the deceptive behavior of purchasing agents. We test the proposition that purchasing agents’ perceptions of organizational expectations influence their behavior. Results indicate that perceived pressure to perform and ethical ambiguity on the part of the firm are correlated with purchasing agents’ unethical behavior, in the form of acknowledged deception of suppliers.

Safe and effective methods of preconception gender selection through flow cytometric separation of X- and Y-bearing sperm could greatly increase the use of gender selection by couples contemplating reproduction. Such a development raises ethical, legal, and social issues about the impact of such practices on offspring, on sex ratio imbalances, and on sexism and the status of women. This paper analyzes the competing interests in preconception gender selection, and concludes that its use to increase gender variety in a family, and (...) possibly for selecting the gender of firstborn, might in many instances be ethically acceptable. (shrink)

The idea of splitting off cells from embryos to clone human beings sounds so bizarre and dangerous that one would think the practice should not be permitted. A closer look reveals its ethical acceptability.

Advance directives such as living wills are attractive in that they give us a sense of control over our futures. But they also tend to obscure conflicts between a patient's competent wishes and later, incompetent interests. They allow caregivers to avoid evaluating quality of life in assessing the best interests of incompetent patients.

Ethical and legal traditions recognize prenatal duties to avoid harm to offspring. However, applying the harm principle to pregnancy requires a careful balancing of a baby's welfare with a pregnant woman's interest in liberty and bodily integrity. In the case of maternal PKU the mother can prevent harm to her baby by returning to the admittedly unpleasant diet that prevented her from being retarded. Informing, counseling, and access to medical care should be the primary policy. Seizures and forced treatment cannot (...) be justified in this case, and only rarely in other situations. (shrink)

The research presented in this volume demonstrates that it is no longer reasonable to ask whether or not synesthesia is real--we must now ask how we can account ...

The mixed strategy response to Pascal’s Wager avoids Pascal’s conclusion by noting that there are ways to obtain infinite expected utility other than believing in God. We can, for instance, flip a coin and believe in God if the coin lands heads. Bradley Monton has recently argued that rationality requires us to apply mixed strategies repeatedly until we believe in God, and thus that mixed strategies do not evade the Wager. I offer three mixed strategies meet the requirements of rationality (...) but avoid Monton’s result. (shrink)

In the history of Archaic Greece no event stands out so clearly as the First Sacred War. The War took place in the years round 590 B.C., and ended with the capture and destruction of the great city of Crisa at the hands of a coalition of powers which included Sicyon, Athens, and Thessaly. Our sources provide a wealth of detail–the causes of the War, the names of half-a-dozen commanders and champions, the stages of the fighting, the victory celebrations and (...) dedications which ensued, certain Delphic oracles and Amphictyonic decrees. (shrink)

The President's Council on Bioethics (PCB) has deepened ethical and policy debates with its more conservative slant on bioethical issues. In the process it has elicited both brickbats and exasperat...

The record shows that Poseidon was once worshipped in every part of Greece as a god of general importance to the community. In the glimpse of Mycenaean ritual afforded by the Pylos tablets Poseidon is the chief deity, and the offerings and perhaps also the custom of ‘spreading the bed’ point to agrarian concerns. In each of the main districts of historical Greece he is rooted in tradition: Arcadia, that ancient landscape, is full of ancient cults of Poseidon; Ionia gathers (...) to honour Poseidon Helikônios; ‘all Boeotia is sacred to Poseidon’, according to Aristarchus , and here and in Thessaly he dominates mythical genealogy; the Dorian Peloponnesus is likewise ‘sacred to Poseidon’ , and at his shrine on Calaureia, the seat of an early amphictyony, Mycenaean antecedents come into question – as at few other shrines in Greece. Yet much of the testimony is antiquarian and retrospective; Poseidon's pre-eminence is more of a memory than a reality. In such a well-documented city as Athens Poseidon has a very small place indeed in public festivities. In Greek literature his authority is slight and his powers are narrow, being virtually confined to earthquakes and storms at sea; he is chivvied by Zeus and flouted by Odysseus, and the reparation which Odysseus is required to make, of establishing Poseidon's worship among landsmen who take an oar for a winnowing fan, is a mocking and belated tribute to his former domain. (shrink)

The Pittsburgh protocol is ethically and legally acceptable as written, but more research is needed to determine if it can be implemented in ways that will observe the procedures that make it ethically acceptable. If so, its desirability as public policy will depend on the number of organs it is likely to generate and its effects on public attitudes toward organ donation generally. In the final analysis, the controversial aspects of this protocol concern symbolic issues about respect for the dead (...) and near dead, rather than substantive concerns that real patient interests will be harmed. (shrink)

In vitro fertilization is now a well-established practice in the field of assisted reproduction. In 1995, over 41,000 IVF cycles were done in the United States, at a cost of more than $300 million. The overall success rate has risen to 22.8 deliveries per 100 egg-retrieval procedures. As the field has matured, the attention of policy-makers has shifted from questions about the ethical and legal status of human embryos to concerns about providing access and protecting consumers.Three such concerns have emerged. (...) One is the danger that IVF programs will disseminate misleading information about their success rates in order to attract patients. This problem, however, may be alleviated by the publication in late 1997 of the first of annual national and clinic specific reports, based on randomly audited data, by the Centers for Disease Control and Prevention, the American Society of Reproductive Medicine, the Society for Assisted Reproductive Technology, and RESOLVE, pursuant to the federal 1992 Fertility Clinic Success Rate and Laboratory Certification Act. (shrink)

In the context of 'Do-not-resuscitate' (DNR) decisions, there is a lack of information in the UK on the opinions of patients and prospective patients. Written anonymous responses to questionnaires issued to 322 out-patient subjects showed that 97 per cent would opt for cardiopulmonary resuscitation (CPR) in their current state of health. In the hypothetical circumstance of having advanced senile dementia only 10 per cent would definitely want CPR, with 75 per cent preferring not to have CPR. There were no significant (...) correlations between the responses and sex or age. Of 270 patients asked verbally if they found the questions disturbing, none said they did. These findings show that the great majority of patients would not wish CPR if severely senile, and that patients are not disturbed by questions relating to their choice for or against CPR. This should encourage further investigations of patients' opinions on CPR in a broader range of conditions, and greater use of DNR orders. (shrink)

This article offers an understanding of the law of negligence which explains its concern with both interpersonal justice and community welfare. It argues that close attention to the structure of the duty of care inquiry and the reasoning in duty cases suggests that the law of negligence has an underlying community welfare purpose, but that purpose is not to be found in notions of deterrence, compensation or the improvement of standards of behaviour. The community welfare purpose underlying the law of (...) negligence must be one that is more directly served by doing interpersonal justice. The best available explanation is that the law of negligence functions to maintain civil peace by providing an avenue of recourse for certain interpersonal wrongs. This analysis explains why the duty inquiry focuses primarily on considerations of interpersonal justice but, like other private law doctrines, also attends to the community welfare effects of imposing liability. (shrink)

This article examines Nietzsche’s influence on analytic philosophy, focusing on the field of analytic ethics. It presents some key rationales motivating his re-evaluation of values and, in particular, his critique of modern morality. To demonstrate his influence on the work of Charles Taylor, Alasdair Macintyre, and Bernard Williams, the role of Nietzsche’s genealogical method in his re-evaluative project is considered. This is followed by a discussion of Nietzsche’s critique of the value of moral values and its relation to similar objections (...) developed by more recent morality critics. (shrink)