Lifestyle-induced diseases are becoming a burden on healthcare, actualizing the discussion on health responsibilities. Using data from the National Association for Heart and Lung Diseases ’s 2015 Health Survey, this study examined the public’s attitudes towards personal and social health responsibility in a Norwegian population. The questionnaires covered self-reported health and lifestyle, attitudes towards personal responsibility and the authorities’ responsibility for promoting health, resource-prioritisation and socio-demographic characteristics. Block-wise multiple linear regression assessed the association between attitudes towards health responsibilities and individual (...) lifestyle, political orientation and health condition. We found a moderate support for social responsibility across political views. Respondents reporting unhealthier eating habits, smokers and physically inactive were less supportive of health promotion policies. The idea that individuals are responsible for taking care of their health was widely accepted as an abstract ideal. Yet, only a third of the respondents agreed with introducing higher co-payments for treatment of ‘self-inflicted’ conditions and levels of support were patterned by health-related behaviour and left-right political orientation. Our study suggests that a significant support for social responsibility does not exclude a strong support for personal health responsibility. However, conditional access to healthcare based on personal lifestyle is still controversial. (shrink)

Unhealthy lifestyle contributes significantly to the burden of disease. Scarce medical resources that could alternatively be spent on interventions to prevent or cure sufferings for which no one is to blame, are spent on prevention or treatment of disease that could be avoided through individual lifestyle changes. This may encourage policy makers and health care professionals to opt for a criterion of individual responsibility for medical suffering when setting priorities. The following article asks whether responsibility-based reasoning should be accepted as (...) relevant for fair and legitimate healthcare rationing. The luck-egalitarian argument that inequalities in health expectancies that derive from unchosen features of people’s circumstances are unjust and should be compensated, while inequalities that reflect personal choices of lifestyle may not, is discussed. It seems that while a backward-looking interpretation of individual responsibility cannot be relevant as a criterion of priority setting, a forward-looking conception of responsibility may be approved.Within all modern societies healthcare authorities are facing difficult priority setting problems. Various criteria for rationing medical intervention have been proposed due to scarcity of resources. Until now, individual responsibility for medical suffering has been given little attention in the public or in academic debate. This is about to change. As Alexander Cappelen and Ole Norheim have pointed out in a recent article in this journal, unhealthy lifestyle contributes increasingly to the burden of disease. A better understanding of the responsibility argument is important for the assessment of policies aimed at meeting this challenge.1 In this article the following question is addressed: should responsibility-based arguments be accepted as relevant to meeting healthcare rationing fairly and legitimately? I will argue that while a backward-looking conception of individual responsibility should not be endorsed, a forward-looking notion of responsibility may be approved. (shrink)

While a number of jurisdictions internationally prohibit insuring companies to be able to use genetic information in their risk classification, a voluntary code of practice permits insurers the limited use of predictive genetic test results in the UK. Jonathan Pugh1 offers a pluralist justice-based argument in support of the UK practice. Pugh’s position is developed to avoid what he sees as flaws with the current debate on insurers’ access to genetic information, including an alleged reliance on idealised assumptions about the (...) predictive power of genetic test results, revisionary implications for the provision of insurance suggested in the debate and failings of commentators to engage adequately with a conception of justice that undergirds the status quo approach in the UK. Pugh suggests that a quasi-libertarian approach to justice is implicit within the terms of the present Code and should be phrased as a principle of equity. Further, he argues that basic egalitarian and non-comparative concerns should be captured in broad principles: equal access and need. This leaves him with three principles that should be balanced in order to guide protection insurance policy. When the argument is applied to review …. (shrink)

Many countries have imposed strict regulations on the genetic information to which insurers have access. Commentators have warned against the emerging body of legislation for different reasons. This paper demonstrates that, when confronted with the argument that genetic information should be available to insurers for health insurance underwriting purposes, one should avoid appeals to rights of genetic privacy and genetic ignorance. The principle of equality of opportunity may nevertheless warrant restrictions. A choice-based account of this principle implies that it is (...) unfair to hold people responsible for the consequences of the genetic lottery, since we have no choice in selecting our genotype or the expression of it. However appealing, this view does not take us all the way to an adequate justification of inaccessibility of genetic information. A contractarian account, suggesting that health is a condition of opportunity and that healthcare is an essential good, seems more promising. I conclude that if or when predictive medical tests (such as genetic tests) are developed with significant actuarial value, individuals have less reason to accept as fair institutions that limit access to healthcare on the grounds of risk status. Given the assumption that a division of risk pools in accordance with a rough estimate of people's level of (genetic) risk will occur, fairness and justice favour universal health insurance based on solidarity. (shrink)

The debate on responsibility for health takes place within political philosophy and in policy setting. It is increasingly relevant in the context of rationing scarce resources as a substantial, and growing, proportion of diseases in high-income countries is attributable to lifestyle. Until now, empirical studies of medical professionals' attitudes towards personal responsibility for health as a component of prioritisation have been lacking. This paper explores to what extent Norwegian physicians find personal responsibility for health relevant in prioritisation and what type (...) of risk behaviour they consider relevant in such decisions. The proportion who agree that it should count varies from 17.1% to 26.9%. Higher age and being male is positively correlated with acceptance. The doctors are more willing to consider substance use in priority setting decisions than choices on food and exercise. The findings reveal that a sizeable proportion have beliefs that conflict with the norms stated in the Norwegian Patient Act. It may be possible that the implementation of legal regulations can be hindered by the opposing attitudes among doctors. A further debate on the role personal responsibility should play in priority setting seems warranted. However, given the deep controversies about the concept of health responsibility and its application, it would be wise to proceed with caution.Design Nationally representative cross-sectional study. Setting Panel-data. Participants 1072 respondents, response rate 65%. (shrink)

Childhood obesity is an increasing health problem. Prior empirical research suggests that, although discussing lifestyle behaviours with parents could help prevent childhood obesity and its health-related consequences, physicians are reluctant to address parental responsibility in the clinical setting. Therefore, this paper questions whether parents might be responsible for their children’s obesity, and if so, whether parental responsibility ought to be addressed in the physician–patient/parent encounter. We illustrate how different ideal-typical models of the physician–patient/parent interaction emphasise different understandings of patient autonomy (...) and parental responsibility and argue that these models advocate different responses to an appeal for discussing parents’ role in childhood obesity. We suggest that responsibility should be attributed to parents because of their parental roles in providing for their children’s welfare. We also argue that whether, and how, this responsibility gives rise to a requirement to act depends on the parents’ capacities. A deliberative-oriented physician–patient/parent interaction best captures the current ideals of antipaternalism, patient autonomy, and shared and evidence-informed decision-making, and might facilitate parental role development. We conclude that, while not discussing parental responsibility for childhood obesity in the clinical setting can be warranted in particular cases, this cannot be justified as a general rule. (shrink)

BackgroundThe idea that individuals are responsible for their health has been the focus of debate in the theoretical literature and in its concrete application to healthcare policy in many countries. Controversies persist regarding the form, substance and fairness of allocating health responsibility to the individual, particularly in universal, need-based healthcare systems.ObjectiveTo examine how personal health responsibility has been framed and rationalised in Norwegian key policy documents on priority setting.MethodsDocuments issued or published by the Ministry of Health and Care Services between (...) 1987 and 2018 were thematically analysed. We developed a predefined conceptual framework that guided the analysis. The framework included: the subject and object of responsibility, the level of conceptual abstraction, temporality, normative justificatory arguments and objections to the application of personal health responsibility.ResultsAs an additional criterion, personal health responsibility has been interpreted as relevant if: the patient’s harmful behaviour is repeated after receiving treatment, and if the success of the treatment is conditional on the patient’s behavioural change. When discussed as a retrospective criterion, considerations of reciprocal fairness have been dominant. When discussed as a prospective criterion, the expected benefit of treatment justified its relevance.ConclusionPersonal health responsibility appears to challenge core values of equality, inclusion and solidarity in the Norwegian context and has been repeatedly rejected as a necessary criterion for priority setting. However, the responsibility criterion seems to have some relevance in particular priority setting decisions. (shrink)

BackgroundPatients not attending their appointments without giving notice burden healthcare services. To reduce non-attendance rates, patient non-attendance fees have been introduced in various settings. Although some argue in narrow economic terms that behavioural change as a result of financial incentives is a voluntary transaction, charging patients for non-attendance remains controversial. This paper aims to investigate the controversies of implementing patient non-attendance fees.ObjectiveThe aim was to map out the arguments in the Norwegian public debate concerning the introduction and use of patient (...) non-attendance fees at public outpatient clinics.MethodsPublic consultation documents (2009–2021) were thematically analysed (n=84). We used a preconceived conceptual framework based on the works of Grant to guide the analysis.ResultsA broad range of arguments for and against patient non-attendance fees were identified, here referring to the acceptability of the fees’ purpose, the voluntariness of the responses, the effects on the individual character and institutional norms and the perceived fairness and comparative effectiveness of patient non-attendance fees. Whereas the aim of motivating patients to keep their appointments to avoid poor utilisation of resources and increased waiting times was widely supported, principled and practical arguments against patient non-attendance fees were raised.ConclusionA narrow economic understanding of incentives cannot capture the breadth of arguments for and against patient non-attendance fees. Policy makers may draw on this insight when implementing similar incentive schemes. The study may also contribute to the general debate on ethics and incentives. (shrink)

This theory accords to volitions the status of basic mental actions, maintaining that these are spontaneous exercises of the will--a "two-way" power which ...

ABSTRACTThe Norwegian government implemented a comprehensive welfare reform in 2012 to better manage an increasingly care-demanding patient demography while meeting budgetary constraints. This article discusses interdiscursive relationships between policy strategies and language use among rehabilitation professionals. It is based on a synthesis of textual analyses of policy documents and of transcribed interviews to produce complex insights into current rehabilitation discourse. The synthetic product is expressed in the form of two nodal discourses which subsume and articulate in particular ways the constituent (...) discourses of the policies and interviews. One nodal discourse approaches rehabilitation as a clinical practice; the other concerns rehabilitation as a management practice. These discourses serve different purposes. One is based in traditional medical science as a means for political action and relates to the body as an object of government policies and practices. The other relies on the individual... (shrink)

Durkheim écrit ce livre avec un but double : d'abord il voulait expliquer ce qui crée une société, ce qui la tient ensemble ; ensuite il voulait éclaircir l'influence qu'a la société sur la pensée logique. Pour Durkheim, la religion est la clé utilisée pour déverrouiller ces deux problématiques.Dans ce livre, Durkheim argumente que les représentations religieuses sont en fait des représentations collectives : l'essence du religieux ne peut être que le sacré. Il est une caractéristique qui se trouve universellement (...) dans toutes les religions. Le sacré, être collectif et impersonnel, représente ainsi la société elle-même. Ensuite il argumente que la société a un impact majeur dans la genèse de la pensée logique. C'est la société qui fournit à l'individu les catégories (le temps, l'espace, le nombre etc.) et les concepts nécessaires pour la pensée logique. (shrink)

There is a long tradition in philosophy and literary theory defending the view that engagement with literature promotes readers’ empathy. Until the last century, few of the empirical claims adduced in that tradition were investigated experimentally. Recent work in psychology and neuropsychology has now shed new light on the interplay of empathy and literature. This article surveys the experimental findings, addressing three central questions: What is it to read empathically? Does reading make us more empathic? What characteristics of literature, if (...) any, affect readers’ empathy? While experimental studies have delivered no conclusive answers to these questions, it has exposed their psychological complexity and constructed a more nuanced picture of the diverse ways in which literature interacts with our empathic capacities. (shrink)

In this paper, we start by comparing the two agents, Ann and Bob, who are involved in two car crashes. Whereas Ann crashes her car through no fault of her own, Bob crashes as a result of reckless driving. Unlike Ann, Bob is held criminally responsible, and the insurance company refuses to cover the car’s damages. Nonetheless, Ann and Bob both receive emergency hospital treatment that a third party covers, regardless of any assessment of personal responsibility. What warrants such apparent (...) exceptionalism with respect to personal responsibility in the healthcare context? We turn our attention to an understudied aspect of the debate on personal health responsibility, namely, the conceptualisation of the person in need of emergency hospital treatment. Drawing on the research of Joshua Knobe and Shaun Nichols, we propose that a context-dependent conceptualisation of the person may help explain a reluctance to ascribe responsibility to the individual for negative health outcomes. (shrink)

The Spinoza party -- The Tractatus Theologico-Politicus: a democratic manifesto -- The Tractatus Politicus: a science of the state -- The Ethics: a political anthropology -- Politics and communication.

Издание содержит: хрестоматия; философы; психологи; литературоведы, искусствоведы; мастер изобразительного искусства и др.

With special emphasis on Foucault's many recently published lecture series this book provides an updated, comprehensive presentation of his most important diagnoses, his many ground-breaking analytical concepts as well as a systematic account of his unique conception of philosophy.

When we perceive an object, we perceive the object from a perspective. As a consequence of the perspectival nature of perception, when we perceive, say, a circular coin from different angles, there is a respect in which the coin looks circular throughout, but also a respect in which the coin's appearance changes. More generally, perception of shape and size properties has both a constant aspect—an aspect that remains stable across changes in perspective—and a perspectival aspect—an aspect that changes depending on (...) one's perspective on the object. How should we account for the perspectival aspect of spatial perception? We present a framework within which to discuss the perspectival aspect of perception and put forward three desiderata that any account of the perspectival aspect of perception should satisfy. We discuss views on which the perspectival aspect of perception is analyzed in terms of constitutively mind-dependent appearance properties as well as views on which the perspectival aspect of perception is analyzed in terms of representations of mind-independent perspectival properties. (shrink)

First published in 1818, The World as Will and Representation contains Schopenhauer's entire philosophy, ranging through epistemology, metaphysics, philosophy of mind and action, aesthetics and philosophy of art, to ethics, the meaning of life and the philosophy of religion, in an attempt to account for the world in all its significant aspects. It gives a unique and influential account of what is and is not of value in existence, the striving and pain of the human condition and the possibility of (...) deliverance from it. This new translation of the first volume of what later became a two-volume work reflects the eloquence and power of Schopenhauer's prose and renders philosophical terms accurately and consistently. It offers an introduction, glossary of names and bibliography, and succinct editorial notes, including notes on the revisions of the text which Schopenhauer made in 1844 and 1859. (shrink)

We argue that the trend toward providing users with feasible and actionable explanations of AI decisions—known as recourse explanations—comes with ethical downsides. Specifically, we argue that recourse explanations face several conceptual pitfalls and can lead to problematic explanation hacking, which undermines their ethical status. As an alternative, we advocate that explanations of AI decisions should aim at understanding.

In his Treatise, Hume confronted the tensions between his project of uncovering the causal operations of the human mind and the extreme skeptical tendencies of his system. Louis Loeb argues that Hume overreaches, and he advances a controversial interpretation of Hume's epistemological framework that shows how Hume could have avoided the more destructive positions in his work.

Hume's claim that a state is a belief is often intertwined—though without his remarking on this fact—with epistemic approval of the state. This requires explanation. Beliefs, in Hume's view, are steady dispositions (not lively ideas), nature's provision for a steady influence on the will and action. Hume's epistemic distinctions call attention to circumstances in which the presence of conflicting beliefs undermine a belief's influence and thereby its natural function. On one version of this interpretation, to say that a belief is (...) justified, ceteris paribus, is to say that for all that has been shown the belief would be steady in its influence under suitable reflection. On a second version, it is to say that prima facie justification is an intrinsic property of the state, in virtue of its steadiness. These versions generate different understandings of the relationship between Parts iii and iv of Book I of the Treatise. (shrink)

A dialogue between a foreign philosopher and a powerful statesman outline Plato's reflections on the family, the status of women, property rights, and criminal law.

The Anthropocene is heralded as a new epoch distinguishing itself from all foregoing eons in the history of the Earth. It is characterized by the overarching importance of the human species in a number of respects, but also by the recognition of human dependence and precariousness. A critical human turn affecting the human condition is still in the process of arriving in the wake of an initial Copernican Revolution and Kant's ensuing second Copernican Counter-revolution. Within this landscape, issues concerning the (...) human - its finitude, responsiveness, responsibility, maturity, auto-affection and relationship to itself - appear rephrased and re-accentuated as decisive probing questions. In this book Sverre Raffnsøe explores how the change has ramifications for the kinds of knowledge that can be acquired concerning human beings and for the human sciences as a study of human existential beings in the world. (shrink)

Qu'appelons-nous " modernité "? Cette question est travaillée selon une triple orientation philologique, épistémologique et historique, en prenant pour fils conducteurs l'auto-énonciation du sujet, la constitution du " nous " communautaire, l'aporie de l'institution judiciaire. L'interprétation défendue pose que les processus opposés du devenir-citoyen du sujet et du devenir-sujet du citoyen en viennent à se recouvrir. C'est aussi le moment où le rapport du commun à l'universel devient un écart politique au sein de l'universel lui-même. Le " jugement des autres (...) " doit être rapporté à un " jugement de soi-même " attestant pour chacun sa propre normalité. Dès lors, l'humain ne peut coïncider avec l'institution du politique qu'à la condition de se retrancher de soi-même, dans la forme des " différences anthropologiques ". Le citoyen-sujet ne peut se comprendre indépendamment de son envers, qui le conteste et le défie. (shrink)

Criticism on Bhagavadgītā, Hindu sacred work.

This article critically reflects on the research portfolio by the ecological economist Clive Spash who has helped pinpoint specific and systemic blindspots in a political-economic system that prioritises myopic development trajectories divorced from ecological reality. Drawing on his published work and collaborations it seeks to make sense of the slow, or absent, progress in averting global warming and ecological destruction. Three strands of key concern and influence are identified and discussed with reference to their orientation and explicit expression regarding Ontology, (...) Epistemology and Axiology. Some complementary points about indeterminacy and holism are presented to further strengthen the arguments for a transition towards a social-ecological economic system that puts values and principles back into focus. While Clive Spash's work has made a strong case within the economic community and appealing to ecology professionals, the value-myopia or value-vacuum has to be tackled across all disciplines, politics and society for a meaningful and urgently required transformation in decision making. Hence, the article finishes with some suggestions for the (higher) education system, and highlights the importance of simplicity and sufficiency, as well as strong sustainability-driven citizen and community action as necessary catalysts of change in this social-ecological transformation. (shrink)

Etienne Gilson Reason and Revelation in the Middle Ages, first delivered as the Richard Lectures in 1937, was published in 1938 and became an immediate success. Not only does it contribute to a major question of debate in Christian, Jewish, and Islamic philosophy and religion in the medieval period but it also insists on the validity of truth obtainable through reason as well as revelation, on rational argument alongside religious faith. This message is as important in the twenty-first century as (...) it was in the fourth century of the young Augustine, the thirteenth of St Thomas Aquinas, and the twentieth of the mature Gilson. (shrink)