We propose a principle of sustainability to complement established principles used for justifying healthcare resource allocation. We argue that the application of established principles of equal treatment, need, prognosis and cost-effectiveness gives rise to what we call negative dynamics: a gradual depletion of the value possible to generate through healthcare. These principles should therefore be complemented by a sustainability principle, making the prospect of negative dynamics a further factor to consider, and possibly outweigh considerations highlighted by the other principles. We (...) demonstrate how this principle may take different forms, and show that a commitment to sustainability is supported by considerations internal to the ethical principles already guiding healthcare resource allocation. We also consider two objections. The first of these, we argue, is either based on implausible assumptions or begs the question, whereas the second can be adequately accommodated by the principle we propose. (shrink)
We proposed adding a sustainability principle to the operational ethical principles guiding public healthcare resources allocation decisions. All our commentators acknowledge our core message: healthcare needs to pay attention to the future. They also strengthen our proposal by offering support by luck egalitarian and Rawlsian arguments, and helpfully point out ambiguities and gaps requiring attention in the further development of the proposal, and its practical implementation.
John Rawls’s ‘just savings’ principle is among the better-known attempts to outline how we should balance the claims of the present with the claims of the future generations on resources. A central element of Rawls’s approach involves endorsing a sufficientarian approach, where our central obligation is to ensure ‘the conditions needed to establish and to preserve a just basic structure’.1 This engaging paper by Christian Munthe, DavideFumagalli and Erik Malmqvist does not explicitly mention Rawls’s work on this (...) issue.2 Still, there are parallels in their aim to generate a ‘sustainability principle’ for healthcare systems. The authors defend the broadening of our focus to the relations between rounds—particularly, how decisions in one period can affect our choice range in the next, whereas current principles for allocating healthcare resources operate within ‘allocation rounds’. Where Rawls is concerned about future generations, the authors’ concern is with future sets of patients. Our present decisions may generate system ‘dynamics’ which are either positive—where ‘more resources per health need’ become available—or negative—where decisions taken now leave us with less bang for our buck in the future. The paper’s important and compelling central claim is that we have an obligation …. (shrink)
Christian Munthe, David Fumagalli and Erik Malmqvist argue that well-known healthcare resource allocation principles, such as need, prognosis, equal treatment and cost-effectiveness, should be supplemented with a principle of sustainability.1 Employing such a principle would entail that the allocation of healthcare resources should take into account whether a specific allocation causes negative dynamics, which would limit the amount of resources available in the future. As examples of allocation decisions, which may have such negative dynamics, they mention those who cause (...) a lack of vaccines, anti-bioethics resistance and drug shortages. Thus, the overall thought is that we can spend and allocate healthcare resources in a certain way at t1, which means that we will have fewer resources available at a later point, t2. The authors argue that we should include a principle of sustainability to justify allocations, which avoids or diminishes the negative dynamics. The authors argue that existing principles cannot sufficiently include proper regard for how our current decisions affect future allocation decisions and, therefore, the people who need healthcare resources in the future. I am sympathetic to the developed argument and believe that the authors are correct that negative dynamics provide reasons to take our ability to meet future health needs …. (shrink)
This classic edition presents the correspondence of one of the great thinkers of the 18th century, and offers a rich picture of the man and his age. This first volume contains David Hume's letters from 1727 to 1765. Hume's correspondents include such famous public figures as Jean-Jacques Rousseau, Adam Smith, James Boswell, and Benjamin Franklin.
In 'How Many Lives Has Schrödinger's Cat?' David Lewis argues that the Everettian no-collapse interpretation of quantum mechanics is in a tangle when it comes to probabilities. This paper aims to show that the difficulties that Lewis raises are insubstantial. The Everettian metaphysics contains a coherent account of probability. Indeed it accounts for probability rather better than orthodox metaphysics does.
This article argues for the elimination of the concept of life worth living from philosophical vocabulary on three complementary grounds. First, the basic components of this concept suffer from multiple ambiguities, which hamper attempts to ground informative evaluative and classificatory judgments about the worth of life. Second, the criteria proposed to track the extension of the concept of life worth living rest on unsupported axiological assumptions and fail to identify precise and plausible referents for this concept. And third, the concept (...) of life worth living is not shown to serve any major evaluative or classificatory purpose besides those served by already available axiological concepts. By eliminating the concept of life worth living, philosophers will free themselves of the task of addressing ill-posed axiological questions and ground reflection about the worth of life on more rigorous conceptual foundations. (shrink)
David and Mary Norton present the definitive scholarly edition of Hume's Treatise, one of the greatest philosophical works ever written. This set comprises the two volumes of texts and editorial material, which are also available for purchase separately. -/- David Hume (1711 - 1776) is one of the greatest of philosophers. Today he probably ranks highest of all British philosophers in terms of influence and philosophical standing. His philosophical work ranges across morals, the mind, metaphysics, epistemology, religion, and aesthetics; he (...) had broad interests not only in philosophy as it is now conceived but in history, politics, economics, religion, and the arts. He was a master of English prose. -/- The Clarendon Hume Edition will include all of his works except his History of England and minor historical writings. It is the only thorough critical edition, and will provide a far more extensive scholarly treatment than any previous editions. This edition (which has been in preparation since the 1970s) offers authoritative annotation, bibliographical information, and indexes, and draws upon the major advances in textual scholarship that have been made since the publication of earlier editions - advances both in the understanding of editorial principle and practice and in knowledge of the history of Hume's own texts. (shrink)
It is widely assumed that the normativity of conceptual judgement poses problems for naturalism. Thus John McDowell urges that 'The structure of the space of reasons stubbornly resists being appropriated within a naturalism that conceives nature as the realm of law' (1994, p 73). Similar sentiments have been expressed by many other writers, for example Robert Brandom (1994, p xiii) and Paul Boghossian (1989, p 548).
David Wallace argues that we should take quantum theory seriously as an account of what the world is like--which means accepting the idea that the universe is constantly branching into new universes. He presents an accessible but rigorous account of the 'Everett interpretation', the best way to make coherent sense of quantum physics.
David Bohm is one of the foremost scientific thinkers of today and one of the most distinguished scientists of his generation. His challenge to the conventional understanding of quantum theory has led scientists to reexamine what it is they are going and his ideas have been an inspiration across a wide range of disciplines. _Quantum Implications_ is a collection of original contributions by many of the world' s leading scholars and is dedicated to David Bohm, his work and the issues (...) raised by his ideas. The contributors range across physics, philosophy, biology, art, psychology, and include some of the most distinguished scientists of the day. There is an excellent introduction by the editors, putting Bohm's work in context and setting right some of the misconceptions that have persisted about the work of David Bohm. (shrink)
University of Arizona Philosopher David Schmidtz discusses the nature and features of corruption, and how concentrated power may aggravate corruption problems.
The priority view has become very popular in moral philosophy, but there is a serious question about how it should be formalized. The most natural formalization leads to ex post prioritarianism, which results from adding expected utility theory to the main ideas of the priority view. But ex post prioritarianism entails a claim which is too implausible for it to be a serious competitor to utilitarianism. In fact, ex post prioritarianism was probably never a genuine alternative to utilitarianism in the (...) first place. By contrast, ex ante prioritarianism is defensible. But its motivation is very different from the usual rationales offered for the priority view. Given the untenability of ex post prioritarianism, it is more natural for most friends of the priority view to revert to utilitarianism. (shrink)
Second part of the translation into Spanish of David Lewis' "New Work for a Theory of Universals", corresponding to the last sections of the original paper. || Segunda parte de la traducción al español del trabajo de David Lewis "New Work for a Theory of Universals", correspondiente a últimas secciones del artículo original. Artículo original publicado en: Australasian Journal of Philosophy, Vol. 61, No. 4, Dec. 1983, pp. 343-377.
David and Mary Norton present the definitive scholarly edition of Hume's Treatise, one of the greatest philosophical works ever written. This volume contains their account of how the Treatise was written and published; an explanation of how they established the text; an extensive set of annotations; and a detailed bibliography and index.
Moral realism and antirealist-expressivism are of course incompatible positions. They disagree fundamentally about the nature of moral states of mind, the existence of moral states of affairs and properties, and the nature and role of moral discourse. The central realist view is that a person who has or expresses a moral thought is thereby in, or thereby expresses, a cognitive state of mind; she has or expresses a belief that represents a moral state of affairs in a way that might (...) be accurate or inaccurate. The view of antirealist-expressivism is that such a person is in, or expresses, a conative state of mind, one that consists in a certain kind of attitude or motivational stance toward something, such as an action or a person. Realism holds that moral thoughts have truth conditions and that in some cases these truth conditions are satisfied so that our moral thoughts are true. Antirealist-expressivism holds, to a first approximation, that the distinctive moral content of a moral thought does not have truth conditions. (shrink)
Central to the still-nascent normative literature on counterspeech is the widespread belief that citizens should engage discursively with haters and the effects of hate speech. It is also increasingly clear that discursive engagement with intolerant members of society should be understood as a continuous and extended series of different and connected actions. Much less has been said about the ways that attempts in persuasion and direct responses to hate speech relate to one another and about when specific counterspeech actions should (...) happen. This essay advances a more expansive and refined account of counterspeech, which is understood as a combination of continuous discursive engagement with intolerant members of society and acts of distancing from haters. After reconsidering discursive agency distribution around public hate speech, I show that continuous discursive engagement with intolerant members of society should be interrupted by visible acts of distancing when haters make hateful representative claims. (shrink)
Does morality override self-interest? Or does self-interest override morality? These questions become important in situations where there is conflict between the overall verdicts of morality and self-interest, situations where morality on balance requires an action that is contrary to our self-interest, or where considerations of self-interest on balance call for an action that is forbidden by morality. In situations of this kind, we want to know what we ought simpliciter to do. If one of these standpoints over-rides the other, then (...) there is a straightforward answer. We ought simpliciter to act on the verdict of the overriding standpoint. For purposes of this essay, I assume that there are possible cases in which the overall verdicts of morality and self-interest conflict. I will call cases of this kind “conflict cases.” The verdict of morality in a conflict case would be a proposition as to what we ought morally to do, or as to what we have the most moral reason to do; the verdict of self-interest would be a proposition as to what we ought to do in our self-interest, or as to what action is best supported by reasons or considerations of self-interest. These propositions are action-guiding or normative in a familiar sense. The conflict between morality and self-interest in conflict cases is there-fore a normative conflict; it is a conflict between the overall verdicts of different normative standpoints. I take it that the question of whether morality overrides self-interest is the question of whether the verdicts of morality are normatively more important than the verdicts of self-interest. In due course, I will explain the idea of normative importance as well as the ideas of a normative proposition and of a reason. (shrink)
First part of the translation into Spanish of David Lewis' "New Work for a Theory of Universals", corresponding to the introduction and the first two sections of the original paper. || Primera parte de la traducción al español del trabajo de David Lewis "New Work for a Theory of Universals", correspondiente a la introducción y las dos primeras secciones del artículo original. Artículo original publicado en: Australasian Journal of Philosophy, Vol. 61, No. 4, Dec. 1983, pp. 343-377.
Consequentialism is often criticized for failing to accommodate impersonal constraints and personal options. A common consequentialist response is to acknowledge the anticonsequentialist intuitions but to argue either that the consequentialist can, after all, accommodate the allegedly recalcitrant intuitions or that, where accommodation is impossible, the recalcitrant intuition can be dismissed for want of an adequate philosophical rationale. Whereas these consequentialist responses have some plausibility, associational duties represent a somewhat different challenge to consequentialism, inasmuch as they embody neither impersonal constraints nor (...) personal options, but rather personal constraints. Our intuitions about associational duties resist capture within the intellectual net of consequentialism, and such duties do admit of a philosophical rationale at least as plausible as anything the consequentialist has to offer. (shrink)
David and Mary Norton present the definitive scholarly edition of Hume's Treatise, one of the greatest philosophical works ever written. The first volume contains the critical text of David Hume's Treatise of Human Nature, followed by the shortand concluding with A Letter from a Gentleman to his Friend in Edinburgh.
David and Mary Norton present the definitive scholarly edition of Hume's Treatise, one of the greatest philosophical works ever written. This set comprises the two volumes of texts and editorial material, which are also available for purchase separately.
This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps, and other notations in the work. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may (...) freely copy and distribute this work, as no entity has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)
The Limits of Thought is a series of penetrating dialogues between the great spiritual leader, J. Krishnamurti and the renowned physicist, David Bohm. The starting point of their engaging exchange is the question: If truth is something different than reality, then what place has action in daily life in relation to truth and reality? We see Bohm and Krishnamurti explore the nature of consciousness and the condition of humanity. These enlightening dialogues address issues of truth, desire awareness, tradition, and love. (...) Limits of Thought is an important book by two very respected and important thinkers. Anyone interested to see how Krishnamurti and Bohm probe some of the most essential questions of our very existence will be drawn to this great work. (shrink)
