In this book, Daniel Shapiro argues that the dominant positions in contemporary political philosophy - egalitarianism, positive rights theory, communitarianism, and many forms of liberalism - should converge in a rejection of central welfare state institutions. He examines how major welfare institutions, such as government-financed and -administered retirement pensions, national health insurance, and programs for the needy, actually work. Comparing them to compulsory private insurance and private charities, Shapiro argues that the dominant perspectives in political philosophy mistakenly think that their (...) principles support the welfare state. Instead, egalitarians, positive rights theorists, communitarians, and liberals have misunderstood the implications of their own principles, which in fact support more market-based or libertarian institutional conclusions than they may realize. Shapiro's book is unique in its combination of political philosophy with social science. Its focus is not limited to any particular country; rather it examines welfare states in affluent democracies and their market alternatives. (shrink)

What is the value of having medical students engage in creative production as part of their learning? Creating something new requires medical students to take risks and even to fail--something they tend to be neither accustomed to nor comfortable with doing. “Making stuff” can help students prepare for such failures in a controlled environment that doesn’t threaten their professional identities. Furthermore, doing so can facilitate students becoming resilient and creative problem-solvers who strive to find new ways to address vexing questions. (...) Though creating something new can be fun, this is not the main outcome of interest. Rather, the principle reason we recommend devoting precious curricular time to creative endeavors is because it helps medical students become better doctors. (shrink)

Within the evidence-based medicine construct, clinical expertise is acknowledged to be both derived from primary experience and necessary for optimal medical practice. Primary experience in medical practice, however, remains undervalued. Clinicians’ primary experience tends to be dismissed by EBM as unsystematic or anecdotal, a source of bias rather than knowledge, never serving as the “best” evidence to support a clinical decision. The position that clinical expertise is necessary but that primary experience is untrustworthy in clinical decision-making is epistemically incoherent. Here (...) we argue for the value and utility of knowledge gained from primary experience for the practice of medicine. Primary experience provides knowledge necessary to diagnose, treat, and assess response in individual patients. Hierarchies of evidence, when advanced as guides for clinical decisions, mistake the relationship between propositional and experiential knowledge. We argue that primary experience represents a kind of medical knowledge distinct from the propositional knowledge produced by clinical research, both of which are crucial to determining the best diagnosis and course of action for particular patients. (shrink)

Too many patients are injured in the course of care. Clinicians may mistakenly cause new harm to a patient or fail to take established steps to improve the presenting condition. Medical institutions within which they work may lack mechanisms to reduce errors or prevent them from harming patients. Many, perhaps even most, injuries are preventable, probably numbering in the hundreds of thousands a year for hospital care alone. Long ignored by medical practitioners and health-care payers and little appreciated by the (...) public, the problem of medical injury is finally receiving high-level policy attention. Much credit goes to the Institute of Medicine for its landmark report of November 1999, which marshaled the evidence about medical injuries and highlighted new approaches to systematic improvement of safety within systems of care. (shrink)

Too many patients are injured in the course of care. Clinicians may mistakenly cause new harm to a patient or fail to take established steps to improve the presenting condition. Medical institutions within which they work may lack mechanisms to reduce errors or prevent them from harming patients. Many, perhaps even most, injuries are preventable, probably numbering in the hundreds of thousands a year for hospital care alone. Long ignored by medical practitioners and health-care payers and little appreciated by the (...) public, the problem of medical injury is finally receiving high-level policy attention. Much credit goes to the Institute of Medicine for its landmark report of November 1999, which marshaled the evidence about medical injuries and highlighted new approaches to systematic improvement of safety within systems of care. (shrink)

Using a survey of 393 employees who were natives and residents of China, Japan, and South Korea, we examined the extent to which employees from different countries within East Asia experience distributive justice when they perceived that their work outcomes relative to a referent other were equally poor, equally favorable, more poor, or more favorable. As predicted, we found that when employees perceived themselves relative to a referent other to be recipients of more favorable outcomes, Chinese and Korean employees were (...) less likely than Japanese employees to experience distributive injustice. We also found that these differences were partially mediated by employees’ level of materialism. Theoretical and practical implications of our findings are discussed. (shrink)

This book is a compendium of lesson plans for classroom exercises designed to foster philosophical inquiry with young people. It introduces the reader to a wide range of activities for exploring philosophical questions and problems with children from preschool age through high-school.

In order to arbitrate conflicting propositional knowledge claims—such as when two individuals claim to know the height of a tree in the yard—there is a “fact of the matter” about who is correct. Experiential, non-propositional knowledge, on the other hand, is not so obviously mediated. For one, experiential knowledge is—at least partially—subjective; one of its virtues is that it matters what a person’s background is, socially, etc., when determining the legitimacy of their claims. But this suggests a question: How do (...) we decide whose experience of an event is right, when two individuals differ in their accounts of a single event?In this paper I present the concept of experiential knowledge, asserting that this knowledge is frequently nonpropositional. I argue that accepting experiential knowledge is fundamental to issues of social justice, specifically when it is precisely the claims of those who have the least social or political “authority” who are in danger of having their experiences and the knowledge gained from those experiences, discounted. I address worries over the arbitration of experiential knowledge, and conclude that in cases where necessary, arbitration is both possible and often morally required. (shrink)

Regulation of the cytoplasmic stability of mRNAs has recetly been identified as a major control mechanism which governs mRNA levels in a variety of eukaryotic systems. In this review we discuss what is known about several experimental systems that exhibit regulated mRNA stability, describe the mechanisms that cells may use to achieve control of mRNA degradation, and suggest areas of future investigation likely to provide new insights into this process.

In this article, we discuss the case of Michael Johnson, an African-American man who sought treatment for respiratory distress due to COVID-19, but who was adamant that he did not want to be intubated due to his belief that ventilators directly cause death. This case prompted reflection about the ways in which a false belief can create uncertainty and complexity for clinicians who are responsible for evaluating decision-making capacity (DMC). In our analysis, we consider the extent to which Mr. Johnson (...) demonstrated capacity according to each of Appelbaum’s criteria. Although it was fairly clear that Mr. Johnson lacked DMC on the basis of both understanding and appreciation, we found ourselves reflecting upon the false belief that seemed to motivate his refusal. This led us to further consider the ways in which our current social and political environment can complicate evaluations of patients’ preferences and reasons for declining life-sustaining interventions. In particular, we consider the impact of the role of misinformation and systemic racism in preparing the grounds for false beliefs. (shrink)

Individuals with disabilities face significant challenges, both physically and socially. To claim a disability, therefore, is not something one ought to do lightly. Pregnancy, however, presents a very difficult and interesting case. Pain, discomfort, and inconvenience are often daily aspects of pregnancy, and pregnancy itself can cause physical, as well as social, impediments that can substantially interfere with one's day-to-day work and life. In practice, based on our current laws concerning family leave, ailments brought on by pregnancy can be cited (...) as a temporary disability in certain circumstances. However, the kind of "pregnancyrelated disability" that is built into such leave policies and laws falls short of... (shrink)

In this chapter I explicate and evaluate the concept of medical error. Unlike standard philosophical approaches to analyzing medical phenom- ena in the abstract, I instead address medical error specifi cally within the context of an embodied social world. I illustrate how, as a deeply contex- tual concept, medical error is inextricably tied to the social conditions— and concrete, powerful interests—of the particulars in which it is found. -/- I begin with an analysis that demonstrates the relational quality of medi- (...) cal error, as a functional, outcome-oriented concept, evaluating the origin and context of the term’s emergence, and connecting it to a similarly contextual concept, “standard of care.” I move on to note the concern- ing implications of medical error identifi cation and measurement when viewed through an intersectional standpoint. To do so, I discuss what intersectional approaches can help reveal about our contemporary social world of medicine and public health. Intersectional approaches, as I will explain, focus on how intersections of social identity can unmask social structures that negatively impact groups and individuals. It appears, as -/- I will suggest, that disparities in social goods (e.g., social standing, edu- cation, wealth) complicate our identification of medical error, itself, and compound concerns of equity and access to medical goods for those who have diminished expectations for health. (shrink)

Supported decision making, as outlined by Peterson et al. highlights real-world challenges in the messy context of clinical care. We agree with Peterson et al. that patients...

Employees’ may view prohibitive voice—that is, expressing concerns about harmful practices in the workplace—as a moral yet interpersonally risky behavior. We, thus, predict that prohibitive voice is likely to be influenced by variables associated with moral and relational qualities. Specifically, we hypothesize that employees’ moral identity internalization—i.e., the centrality of moral traits in their self-concept—is positively associated with their use of prohibitive voice. Furthermore, we hypothesize that this association is stronger when employees enjoy a higher quality relationship with their leader. (...) In addition, drawing on the literature on moral symbolism, we hypothesize that workgroup moral identity symbolization—i.e., the extent to which workgroup members symbolically display moral traits—moderates the relationship between moral identity internalization and prohibitive voice in a compensatory manner. That is, workgroup moral identity symbolization enhances employees’ use of prohibitive voice when employees’ moral identity internalization is low. Data collected from hospital employees and their supervisors and coworkers support these hypotheses. These findings suggest new ways to promote prohibitive voice and, thereby, protect organizational stakeholders from harmful behaviors. (shrink)

Institutional investors are increasingly focusing on firms that prioritise Corporate Social Responsibility. In the absence of any objective measure of a firm's CSR Performance, their investment choices are largely guided by independent rating indices that rank firms according to their social performance metrics. As a result, firms looking to increase their attractiveness as targets of social investment focus their CSR efforts on increasing the visibility of activities that are recognised by such indices. However, the validity of these indices as accurate (...) measures of firms' actual social performance has repeatedly been called into question. This means that the ability of these indices to measure and report on firms' actual social impact cannot be ascertained with any degree of accuracy. The result is that firms are incentivised to engage in activities that cannot be said to improve social responsibility, and may even ultimately harm society. Thus, another method of measuring CSP must be found that enables firms to measure their true impact on society. We propose a new approach to measuring CSP that is integrated with stakeholder theory. Such an approach provides managers of firms with an interest in engaging in real social development for the purposes of ensuring firm survival with the ability to understand their social obligations, and the ability to measure the resulting benefit to society. (shrink)

This paper suggests that young people can explore moral philosophy in ways that will help them both think and act in ways that are consistent with good moral reasoning. It describes several games and exercises that allow children to explore various moral principles in their behavior toward others. Participating in activities that give children practice in making moral decisions helps them to appreciate the role of principles in moral reasoning. The author contends that it is important for young people to (...) examine ethical dilemmas from the “inside out”; that is, not by listening to the wisdom of philosophers telling them how to approach these issues, but by facing them head on themselves. (shrink)

Thesis (Master, Philosophy) -- Queen's University, 2009-11-25 16:01:42.585.

While in America most people think of “welfare” as means-tested programs such as Aid to Families with Dependent Children, in reality in the United States and other affluent democracies the heart of the welfare state is social insurance programs, such as health insurance, old-age or retirement pensions, and unemployment insurance. They are insurance programs in the sense that they protect against common risks of a loss of income if and/or when certain events come to pass ; they are “social” because (...) unlike market insurance they are not run on a sound actuarial basis, the premiums are not voluntarily incurred but compulsory, and there is very limited choice or flexibility concerning the type of policy one can purchase. Why have social insurance rather than market insurance? In this essay, I take up this question with regard to old-age or retirement pensions, which at present absorb around 9 percent of the gross domestic product and 25 percent of government spending of the affluent industrial countries comprising the Organization for Economic Cooperation and Development. My aim is to show that old-age or retirement social insurance is worse in virtually every relevant normative respect than its alternative, some form of market or private pensions. By relevant normative respect, I mean those values or principles which are used by contemporary political philosophers in their discussions and justifications of welfare-state policies, and which are applicable to assessments of different systems of old-age or retirement pensions. (shrink)

One of the aims of Ronald Dworkin's recent book, Taking Rights Seriously, is to provide a theory of natural rights. His theory is novel and interesting in two respects. First, Dworkin argues that the commonly held belief that liberty and equality are fundamentally opposed to one another is false. Rights to various liberties are themselves derived from a form of a right to equality — what Dworkin calls the right to equal concern and respect. Second, Dworkin thinks that the notion (...) of a general right to liberty, which can be opposed to egalitarian claims, is incoherent. (shrink)

Psychologists and psychiatrists recently started using electronic mail (e-mail) to conduct therapy. This article explores relevant ethical and legal issues including, among others, the nature of the professional relationship, boundaries of competence, informed consent, treating minors, confidentiality, and the duty to warn and protect. To illustrate these complex issues, two services currently operating are discussed. To address potential hazards to clients and the profession, a new ethical standard for e-mail therapists is offered.

A central idea of contemporary philosophical egalitarianism's theory of justice is that involuntary inequalities or disadvantages—those that arise through no choice or fault of one's own—should be minimized or rectified in some way. Egalitarians believe that the preferred institutional vehicle for fulfilling these obligations of justice is some form of a welfare state. Of course, contemporary egalitarians disagree about the best way to interpret or understand their theory of justice and institutions: Which inequalities are chosen and which are unchosen? What (...) form of a welfare state will best serve justice? However, no contemporary egalitarian denies that egalitarian justice requires a welfare state that will redistribute income and wealth to aid the involuntarily disadvantaged. (shrink)

Gender greatly impacts access to opportunities, potential, and success in corporate leadership roles. We begin with a general presentation of why such discussion is necessary for basic considerations of justice and fairness in gender equality and how the issues we raise must impact any ethical perspective on gender in the corporate workplace. We continue with a breakdown of the central categories affecting the success of women in corporate leadership roles. The first of these includes gender-influenced behavioral factors, such as the (...) requirements and expectations of gendered verbal and nonverbal communication styles as well as appearance. We move on to address the impact of family on corporate leadership opportunities and success, discussing the asymmetrical evaluation of an individual’s potential, authority, and competence based on gender stereotypes of familial obligations and expectations. Finally, we address how gender impacts access to networking and sponsorship opportunities and the long-term effects of systematic limitations on women’s inclusion in the upper echelons of corporate leadership. We conclude with a summary of the questions and issues raised by our discussion and direct individuals to consider how different ethical systems and moral requirements might influence their interpretations of gender and leadership in the corporate workplace. (shrink)

In the pursuit of a quality and well-rounded education with philosophy, Shapiro conducts an introductory lesson to students and teachers alike in order to develop deeper, more philosophical questions from their students. Academically, the article expands detail on tutoring in philosophy, analytical practices, and metaphysical activities.

Wilkinson's (1) critique of psychoanalysis and psychoanalytically oriented psychotherapy is weakened by inconsistent use of crucial terms, a systematically biased selectivity in reviewing empirical evidence and prior debates, and a failure to address issues crucial for a scientific understanding of psychotherapy.