According to the person-affecting restriction, one distribution of welfare can be better than another only if there is someone for whom it is better. Extant problems for the person-affecting restriction involve variable-population cases, such as the nonidentity problem, which are notoriously controversial and difficult to resolve. This paper develops a fixed-population problem for the person-affecting restriction. The problem reveals that, in the presence of incommensurable welfare levels, the person-affecting restriction is incompatible with minimal requirements of impartial beneficence (...) even in fixed-population contexts. (shrink)

Expert knowledge about society and human nature is essential to governing human conduct. It figures in the formulation of the liberal and neoliberal rationalities of government that Foucault analyzed in his later work. It also figures in particular assemblages in which a governmental rationality is brought to bear on the definition of problems and the formulation of solutions. This article explores the use of expert knowledge in governmental assemblages directed towards optimizing relations between people and land in the global south. (...) Since colonial times liberal versions of these assemblages have highlighted cultural difference, and attempted to fix particular populations into non-market niches. Elements from liberal assemblages have been grafted into neoliberal ones, producing the curious figure of homo economicus minus the market, the collectivized and arborealized subject of contemporary conservation initiatives. (shrink)

Do doctors fix patients? Or do they heal them? For all of modern medicine’s many successes, discontent with the quality of patient care has combined with a host of new developments, from aging populations to the resurgence of infectious diseases, which challenge medicine’s overreliance on narrowly mechanistic and technical methods of explanation and intervention, or “fixing’ patients. The need for a better balance, for more humane “healing” rationales and practices that attend to the social and environmental aspects of health and (...) illness and the experiencing person, is more urgent than ever. Yet, in public health and bioethics, the fields best positioned to offer countervailing values and orientations, the dominant approaches largely extend and reinforce the reductionism and individualism of biomedicine. The collected essays in To Fix or To Heal do more than document the persistence of reductionist approaches and the attendant extension of medicalization to more and more aspects of our lives. The contributors also shed valuable light on why reductionism has persisted and why more holistic models, incorporating social and environmental factors, have gained so little traction. The contributors examine the moral appeal of reductionism, the larger rationalist dream of technological mastery, the growing valuation of health, and the enshrining of individual responsibility as the seemingly non-coercive means of intervention and control. This paradigm-challenging volume advances new lines of criticism of our dominant medical regime, even while proposing ways of bringing medical practice, bioethics, and public health more closely into line with their original goals. Precisely because of the centrality of the biomedical approach to our society, the contributors argue, challenging the reductionist model and its ever-widening effects is perhaps the best way to press for a much-needed renewal of our ethical and political discourse. (shrink)

This paper demonstrates that the property of Replication Invariance, generally considered to be an innocuous requirement for the extension of fixed-population poverty comparisons to variable-population contexts, is incompatible with other plausible variable- and fixed-population axioms. This fact raises questions about what constitutes an appropriate headcount assessment of poverty, in terms of whether one should focus on the proportion, or the absolute numbers, of the population in poverty. This observation, in turn, has important implications for (...) tracking poverty and setting targets for its reduction or elimination. (shrink)

This note demonstrates that the property of Replication Invariance, generally considered to be an innocuous requirement for the extension of fixed-population poverty comparisons to variable- population contexts, is incompatible with other plausible variable-population axioms in the presence of specific canonical fixed-population axioms.

According to prioritarianism, roughly, it is better to benefit a person, the worse off she is. This seems a plausible principle as long as it is applied only to fixed populations. However, once this restriction is lifted, prioritarianism seems to imply that it is better cause a person to exist at a welfare level of l than to confer l units on a person who already exists and is at a positive welfare level. Thus, prioritarianism seems to assign too (...) much weight to the welfare of possible future people. It is in this respect even more demanding than total utilitarianism. However, in this article, I argue that all told, it is not clear that prioritarian- ism is less plausible than total utilitarianism, even when it comes to Population Ethics. (shrink)

Nearly all large policy decisions influence not only the quality of life for existing individuals but also the number-and even identities-of yet-to-exist individuals. Accounting for these effects in a policy evaluation framework requires taking difficult stances on concepts such as the value of existence. These issues are at the heart of a literature that sits between welfare economics and philosophical population ethics. Despite the inherent challenges of these questions, this literature has produced theoretical insights and subsequent progress on variable- (...) class='Hi'>population welfare criteria. A surprisingly bounded set of coherent alternatives exists for practitioners once a set of uncontroversial axioms is adopted from the better-studied welfare criteria for cases where populations are assumed to be fixed. Although consensus has not yet been reached among these remaining alternatives, their recommendations often agree. The space has been sufficiently restricted and well explored that applications of the theoretical insights are possible and underway in earnest. (shrink)

The goal of this paper is to present a succinct overview, from a clinician’s perspective, of the importance and implications of research on heart failure in African Americans. It first gives a brief outline of the rationale and results of the African-American Heart Failure Trial, which showed evidence for the effectiveness of fixed-dose combination of isosorbide dinitrate and hydralazine, marketed as BiDil, in this population. Finally, it underscores the necessity of treating African Americans with evidence-based medicine given that (...) humanistic physicians and other clinicians strive to provide holistic treatment to their patients.Most researchers and clinicians recognize the difficulty with utilizing race as a category for inclusion in trials. While race lacks any true biologic definition, it is potentially beneficial as a consideration in clinical studies, based on prior evidence of certain potential differences across self-identified racial/ethnic groups in morbidity and mortality and responses to medicine. Even though use of race as a classification is a problematic distinction, it should not be ignored. If clinical trials demonstrate significant improvement with targeted treatment in African Americans, clinicians should not withhold life-saving drugs that result from such studies. (shrink)

Philosophical discussions of prioritarianism, the view that we ought to give priority to those who are worse off, have hitherto been almost exclusively focused on cases involving a fixed population. The aim of this paper is to extend the discussion of prioritarianism to encompass also variable populations. I argue that prioritarianism, in its simplest formulation, is not tenable in this area. However, I also propose several revised formulations that, so I argue, show more promise.

We study the coupled dynamics of two populations of random replicators by means of statistical mechanics methods, and focus on the effects of relative population size, strategy correlations and heterogeneities in the respective cooperation pressures. To this end we generalise existing path-integral approaches to replicator systems with random asymmetric couplings. This technique allows one to formulate an effective dynamical theory, which is exact in the thermodynamic limit and which can be solved for persistent order parameters in a fixed-point (...) regime regardless of the symmetry of the interactions. The onset of instability can be determined self-consistently. We calculate quantities such as the diversity of the respective populations and their fitnesses in the stationary state, and compare results with data from a numerical integration of the replicator equations. -/- . (shrink)

This handbook presents up-to-date theoretical analyses of problems associated with the moral standing of future people in current decision-making. Future people pose an especially hard problem for our current decision-making, since their number and their identities are not fixed but depend on the choices the present generation makes. Do we make the world better by creating more people with good lives? What do we owe future generations in terms of justice? Such questions are not only philosophically difficult and important, (...) but also directly relevant to many practical decisions and policy issues, including on climate, health, population control and taxation. If we are to adequately assess such issues, we must be able to determine the value of differently sized populations. The aim of this handbook is to shed light on the value of population change and the nature of our obligations to future generations, and to offer practical guidance to policy-makers as to how our duties to future generations should be discharged. It contains an extensive and accessible introduction for those unfamiliar with the topic of population ethics as well as original work from key figures in academic debates on population ethics covering three main themes: ways out of the paradoxes of population ethics, questioning some philosophical and methodological assumptions underlying these paradoxes, and several applications of population ethics to real world issues. (shrink)

Where there is a fixed population (i.e., who exists does not depend on what choice an agent makes), the deontic version of anonymous Paretian egalitarianism holds that an option is just if and only if (1) it is anonymously Pareto optimal (i.e., no feasible alternative has a permutation that is Pareto superior), and (2) it is no less equal than any other anonymously Pareto optimal option. We shall develop and discuss a version of this approach for the variable (...) population case (i.e., where who exists does depend on what choice an agent makes). More specifically, we shall develop and discuss it in the context of a person-affecting framework—in which an option is just if and only if it wrongs no one according to certain plausible conditions on wronging. (shrink)

Overpopulation is often identified as one of the key drivers of climate change. Further, it is often thought that the mechanism behind this is obvious: 'more people means more greenhouse gas emissions'. However, in light of the fact that climate change depends most closely on cumulative emissions rather than on emissions rates, the relationship between population size and climate change is more subtle than this. Reducing the size of instantaneous populations can fruitfully be thought of as spreading out a (...) fixed number of people more thinly over time, and (in light of the significance of cumulative emissions) it is not immediately clear whether or how such a 'spreading' would help with climate change. To bring the point into sharp relief, I first set out a simple model according to which population reduction would not lead to any climate-change-related improvement. I then critically examine the assumptions of the model. If population reduction would lead to a significant climate-change-related improvement, this must be because (i) population reduction would significantly reduce even cumulative emissions, and/or (ii) climate damages are, to a significant extent, driven by the pace of climate change, and not only the eventual extent of the change. (shrink)

According to Critical-Level Views in population axiology, an extra life improves a population only if that life’s welfare exceeds some fixed ‘critical level.’ An extra life at the critical level leaves the new population equally good as the original. According to Critical-Range Views, an extra life improves a population only if that life’s welfare exceeds some fixed ‘critical range.’ An extra life within the critical range leaves the new population incommensurable with the original. (...) -/- In this paper, I sharpen some old objections to these views and offer some new ones. Critical-Level Views cannot avoid certain Repugnant and Sadistic Conclusions. Critical-Range Views imply that lives featuring no good or bad components whatsoever can nevertheless swallow up and neutralise goodness or badness. Both classes of view entail that certain small changes in welfare correspond to worryingly large differences in contributive value. -/- I then offer a view that retains much of the appeal of Critical-Level and Critical-Range Views while avoiding the above pitfalls. On the Imprecise Exchange Rates View, the quantity of some good required to outweigh a given unit of some bad is imprecise. This imprecision is the source of incommensurability between lives and populations. (shrink)

and Overview In an earlier book, Weighing Goods1, John Broome gave a sophisticated defense of utilitarianism for the cases involving a fixed population. In the present book, Weighing Lives, he extends this defense to variable population cases, where different individuals exist depending on which choice is made. Broome defends a version of utilitarianism according to which there is a vague positive level of individual wellbeing such that adding a life with more than that level of wellbeing makes (...) things morally better and adding a life with less than that level makes things morally worse. This version of utilitarianism avoids the extreme—but perhaps not all— forms of the repugnant conclusion that the usual total version faces. As usual, Broome’s work combines logical rigor with deep philosophical insight. There is much to learn from it. Nonetheless, I shall identify some problematic conditions used by Broome to derive utilitarianism and suggest that Broome’s version of utilitarianism has implausible implications. (shrink)

Advances in technology have made it possible for us to take actions that affect the numbers and identities of humans and other animals that will live in the future. Effective and inexpensive birth control, child allowances, genetic screening, safe abortion, in vitro fertilization, the education of young women, sterilization programs, environmental degradation and war all have these effects. Although it is true that a good deal of effort has been devoted to the practical side of population policy, moral theory (...) has not dealt adequately with the new possibilities. The dilemma faced by moral theory is that traditional theories cannot answer moral questions involving the creation of people. Two related problems arise. The first concerns numbers: how many people should there be? The second asks what sort of people should live and what their levels of well-being should be. Conventional social-contract theories, including the work of Rawls (1971), are restricted to situations with a fixed number of individuals. Sumner (1978) attempts to extend a Rawlsian veil-of-ignorance approach to possible people but is aware of the difficulties involved. The main problem is that possible people must be thought to benefit when they move from non-existence to existence, a view that we reject (see Section 1, Heyd, 1992, Chapter 1; McMahan, 1996a; Parfit, 1984, Appendix G). Rights-based and duty-based theories suffer from a similar problem; there must be a person who has the right or a person to whom the duty is owed (see McMahan, 1981). (shrink)

Is the exemplar of modern ethical theory estranged from their intimates because the motive of duty dominates their motivational psychology? While this challenge against modern ethical theory is familiar, I argue that with respect to a certain strand of Kantian ethical theory, it does not so much as make sense. I explain the content and functional role of the motive of duty in the psychology of the moral exemplar, stressing in particular how that motive shapes and informs the content of (...) others, including those characteristic of intimacy. I argue that to the extent that a subject does not integrate their motive of duty with their other motives, their moral and intimate relationships are compromised, and on the same grounds, because intimate relationships are interpersonal relationships and the motive of duty just is the motive to respect another person as a separate person. (shrink)

Why do societies collapse? We use an individual-based evolutionary model to show that, in environmental conditions dominated by low-frequency variation (“red noise”), extirpation may be an outcome of the evolution of cultural capacity. Previous analytical models predicted an equilibrium between individual learners and social learners, or a contingent strategy in which individuals learn socially or individually depending on the circumstances. However, in red noise environments, whose main signature is that variation is concentrated in relatively large, relatively rare excursions, individual learning (...) may be selected from the population. If the social learning system comes to lack sufficient individual learning or cognitively costly adaptive biases, behavior ceases tracking environmental variation. Then, when the environment does change, fitness declines and the population may collapse or even be extirpated. The modeled scenario broadly fits some human population collapses and might also explain nonhuman extirpations. Varying model parameters showed that the fixation of social learning is less likely when individual learning is less costly, when the environment is less red or more variable, with larger population sizes, and when learning is not conformist or is from parents rather than from the general population. Once social learning is fixed, extirpation is likely except when social learning is biased towards successful models. Thus, the risk of population collapse may be reduced by promoting individual learning and innovation over cultural conformity, or by preferential selection of relatively fit individuals as models for social learning. © 2009 Elsevier Inc. All rights reserved. (shrink)

Allen Buchanan has argued for a linking of the ethics of human enhancement to the ethics of development more generally. The promise of the ‘enhancement enterprise' is that it may help develop society, just as other technological advances have in the past. He proposes a framework of intellectual property rights, government action to ensure the poor can access the enhancements, an international organization to administer the diffusion of new enhancement technologies from the West to poor countries, and the diffusion within (...) countries to the poorer populations. I take seriously his proposal of discussing biomedical enhancement in terms of the ethics of development. On these grounds of assessment, I argue that his proposal is politically conservative. To make the case, I distinguish conservatism in ethics from conservatism in politics; and I contextualize the proposal against the background of development economics and the neoliberal approach to development. (shrink)

Sigmoid functions have been applied in many areas to model self limited population growth. The most popular functions; General Logistic (GL), General von Bertalanffy (GV), and Gompertz (G), comprise a family of functions called Theta Logistic ( $$ \Uptheta $$ L ). Previously, we introduced a simple model of tumor cell population dynamics which provided a unifying foundation for these functions. In the model the total population ( N ) is divided into reproducing ( P ) and (...) non-reproducing/quiescent ( Q ) sub-populations. The modes of the rate of change of ratio P / N was shown to produce GL, GV or G growth. We now generalize the population dynamics model and extend the possible modes of the P / N rate of change. We produce a new family of sigmoid growth functions, Trans-General Logistic (TGL), Trans-General von Bertalanffy (TGV) and Trans-Gompertz (TG)), which as a group we have named Trans-Theta Logistic ( T $$ \Uptheta $$ L ) since they exist when the $$ \Uptheta $$ L are translated from a two parameter into a three parameter phase space. Additionally, the model produces a new trigonometric based sigmoid ( TS ). The $$ \Uptheta $$ L sigmoids have an inflection point size fixed by a single parameter and an inflection age fixed by both of the defining parameters. T $$ \Uptheta $$ L and TS sigmoids have an inflection point size defined by two parameters in bounding relationships and inflection point age defined by three parameters (two bounded). While the Theta Logistic sigmoids provided flexibility in defining the inflection point size, the Trans-Theta Logistic sigmoids provide flexibility in defining the inflection point size and age. By matching the slopes at the inflection points we compare the range of values of inflection point age for T $$ \Uptheta $$ L versus $$ \Uptheta $$ L for model growth curves. (shrink)

Some things, but only some things, are by nature subject to standards. Why? I explain and develop what I call nature-first constitutivism, which says that what something is determines what it should be. Nature is the basis of normativity. I explain this view in terms of a unique type of property which particulars of a genus can lack even though those properties partially determines the nature of the genus. Such properties partially describe the nature of a genus and are thereby (...) normative for the particulars of that genus. Particulars of genera with such essential properties are by nature subject to standards with respect to those properties. Particulars of genera without such properties are not by nature subject to standards. (shrink)

What explains why we are subjects for whom objects can have value, and what explains which objects have value for us? Axiologicians say that the value of humanity is the answer. I argue that our value, no matter what it is like, cannot perform this task. We are animals among others. An explanation of the value of objects for us must fit into an explanation of the value of objects for animals generally. Different objects have value for different animals. Those (...) differences depend on differences in animal natures and, in particular, on the diverse characteristic capacities of different animals. Once we invoke animal natures, there is nothing for the value of animality, including the value of humanity, to explain. (shrink)

Intellectualism is the widespread view that practical reason is a species of theoretical reason, distinguished from others by its objects: reasons to act. I argue that if practical reason is a species of theoretical reason, practical judgments by nature have nothing to do with action. If they have nothing to do with action, I cannot act from my representation of reasons for me to act. If I cannot act from those representations, those reasons cannot exist. If they cannot exist, neither (...) can a species of theoretical reason about them. Intellectualism is thus self-undermining. (shrink)

The possibility of error conditions the possibility of normative principles. I argue that extant interpretations of this condition undermine the possibility of normative principles for our action because they implicitly treat error as a perfection of an action. I then explain how a constitutivist metaphysics of capacities explains why error is an imperfection of an action. Finally, I describe and defend the interpretation of the error condition which follows.

Properly understood, the instrumental rule says to take means that actually suffice for my end, not, as is nearly universally assumed, to intend means that I believe are necessary for my end. This alternative explains everything the standard interpretation can—and more, including grounding certain correctness conditions for exercises of our will unexplained by the standard interpretation.

Practical cognitivism is the view that practical reason is our will, not an intellectual capacity whose exercises can influence those of our will. If practical reason is our will, thoughts about how I am to act have an essential tie to action. They are intentions. Thoughts about how others are to act, though, lack such a tie to action. They are beliefs, not intentions. How, then, can these thoughts form a unified class? I reject two answers which deny the differences (...) between such thoughts about myself and those about others, one of which says that all such thoughts are intentions, the other that all are beliefs. I then reject a shared assumption which says that a class of thoughts is unified only if all its elements are all of one type of thought. I instead argue that this class is unified even though some elements are intentions, others beliefs, because such beliefs depend on those intentions in various ways. (shrink)

Vaccination complacency occurs when perceived risks of vaccine-preventable diseases are sufficiently low so that vaccination is no longer perceived as a necessary precaution. Disease outbreaks can once again increase perceptions of risk, thereby decrease vaccine complacency, and in turn decrease vaccine hesitancy. It is not well understood, however, how change in perceived risk translates into change in vaccine hesitancy. -/- We advance the concept of vaccine propensity, which relates a change in willingness to vaccinate with a change in perceived risk (...) of infection—holding fixed other considerations such as vaccine confidence and convenience. (shrink)

Practical cognitivism is the view that practical reason is the self-conscious will and that practical cognition is self-conscious volition. This essay addresses two puzzles for practical cognitivism. In akratic action, I act as I understand is illegitimate and not as I understand is legitimate. In permissible action, I act as I understand is legitimate and also do not act as I understand is legitimate. In both types of action, practical cognition seems to come apart from volition. How, then, can practical (...) reason be our will and practical cognition be volition? Practical cognitivists can solve these puzzles because the claims that practical reason is our will and that practical cognition is volition are about the nature of a capacity, and the nature of a capacity establishes standards of correctness for its exercises. Akratic action is a type of erroneous exercise of practical reason as tripping is an erroneous exercise our capacity to walk. Permissible action is a successful exercise of practical reason as stepping first with my right foot rather than my left is a successful exercise of my capacity to walk. The puzzles of akratic and permissible action do not refute practical cognitivism. (shrink)

‘The Static-99R is one of the most commonly used risk assessment instruments for individuals convicted of sexual offenses. It has been validated for use on many populations, but few studies specifically target and describe individuals with mental disorders. Additionally, research on the discriminative properties of the instrument over longer follow-up periods is scarce. This article evaluated the validity of the Static-99R using a cohort of individuals with mental disorders convicted of sexual offenses in Sweden with fixed 5-year, 10-year, 15-year, (...) and 20-year follow-up periods. A Static-99R cut score of 6 demonstrated the highest Youden index, maximizing sensitivity and specificity, with 25.8% of recidivists correctly assumed to reoffend sexually and 95.7% of non-recidivists correctly assumed not to. The Static-99R instrument demonstrated adequate discrimination, with only marginal differences for 10-, 15-, and 20-year fixed follow-up. Calibration was acceptable, with the routine sample norms displaying a decisively better fit to the study cohort compared to the high-risk/high-need sample norms. The results affirm the recommendation that, when in doubt and where there is no recent local norm group large enough available, the Static-99R routine sample found in the evaluators’ workbook should be used. (shrink)

Understanding recreational experiences is a longstanding research tradition and key to effective management. Given the complexities of human experience, many approaches have been applied to study recreational experience. Two such approaches are the experiential approach (based in a positivistic paradigm) and emergent experience (based in an interpretive paradigm). While viewed as being complementary, researchers have not offered guidance for incorporating the approaches into a common model of recreational experience. This study utilized longitudinal, qualitative data to examine aspects of recreational experience (...) posited by these two approaches. Results provided a framework for synthesizing across the two approaches. Respondents had clear pre-activity expectations, and most respondents realized their expected outcomes. This supports the experiential approach. Of the 48 activity narratives, 27 experienced something unexpected, and 45 described process-oriented, intrinsic motivation, suggesting evidence of emergent and unique characteristics specific to an individual’s realization of recreational experience. This supports the application of the emergent experience approach to understand how individuals create meaning from recreational engagements. The paper proposes a model for integrating results of the two approaches. While not advocating for any specific approach, the findings can serve as an example of building a holistic model of the outdoor recreation experience. The purpose of the model is to allow for a more complete understanding of how individuals create recreation experiences, more complete documentation of the benefits of outdoor recreation for both researchers and managers, and better synthesis across studies. (shrink)

Gustav Theodor Fechners (1801-1887) philosophische, ethische und ästhetische Überlegungen, die anders als seine naturwissenschaftlichen Arbeiten der Öffentlichkeit weniger bewußt sind, werden in diesem Band, Ergebnis eines zu seinem 200. Geburtstag an der Universität Leipzig veranstalteten interdisziplinären Kolloquiums, in ihren Wirkungen auf die Geisteswissenschaften des 20. Jahrhunderts aus philosophischer, theologischer, linguistischer, kultur- und literaturwissenschaftlicher sowie wissenschaftshistorischer Sicht erörtert - mit Blick auf seine interdisziplinäre Leistung und unter Einbeziehung biographischer Aspekte.

Die erkenntnistheoretisch und wissenschaftsgeschichtlich orientierte Denkstiltheorie Ludwik Flecks (1896-1961) wird seit einigen Jahren verstärkt in verschiedenen Disziplinen rezipiert. Der von einer internationalen Gruppe von Sprachwissenschaftlerinnen und Sprachwissenschaftlern konzipierte Band erschliesst Flecks Ansatz erstmals als methodisches Instrumentarium zur Beschreibung und Analyse wichtiger Bausteine der neueren Sprachwissenschaftsgeschichte. Die theoretisch angelegte Einleitung und die neun Einzelbeiträge stellen die Entstehung, das Nebeneinander, die Überlagerung, aber auch die Ablösung verschiedener Denkstile in der germanistischen Sprachwissenschaft dar.

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and medicine, (...) truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

Extensive measurement is the standard measurement-theoretic approach for constructing a ratio scale. It involves the comparison of objects that can be concatenated in an additively representable way. This paper studies the implications of extensively measurable welfare for social choice theory. We do this in two frameworks: an Arrovian framework with a fixed population and no interpersonal comparisons, and a generalized framework with variable populations and full interpersonal comparability. In each framework we use extensive measurement to introduce novel domain (...) restrictions, independence conditions, and constraints on social evaluation. We prove a welfarism theorem for these domains and characterize the social welfare functions that satisfy the axioms of extensive measurement at both the individual and social levels. The main results are simple axiomatizations of strong dictatorship in the Arrovian framework and classical utilitarianism in the generalized framework. (shrink)