There are marked differences between countries with regard to reimbursement decision-making, yet few studies have tried to understand this process and its consequences by a detailed analysis of the local context and decision-making structure. This article describes reimbursement decision-making and subsequent prescribing patterns of new pharmaceuticals by means of a case study on glitazones in treatment of type 2 diabetes mellitus patients in Denmark. The study shows that institutional arrangements, providing the context in which evidence is used, are highly important (...) for understanding the reimbursement decision-making process. In particular the Danish Medicines Agency (DMA) has shaped the decision to reimburse glitazones on the basis of physician-mediated requests of individual patients. Relatively few patients have been prescribed glitazones since their introduction in 2000, suggesting that individual reimbursement may be an effective instrument in controlling overall expenditure of selected pharmaceuticals, although in the case of glitazones this has likely been achieved at the expense of equality in access to the products. The discussion focuses on the generalizability of the findings to both other pharmaceuticals in the individual reimbursement scheme in Denmark, and to other countries that are trying to balance the need to control overall pharmaceutical care expenditure with the need to secure equality in access to new drugs with therapeutic added value. (shrink)

Philosopher Judith Butler has influenced how people talk about vulnerable bodies and sees vulnerability as universal, existential, and relational. Being vulnerable is part of the human condition. The main theoretical areas that run across Butler’s work; power, knowledge and subjectivity, performativity, and ethics—are of particular relevance to nursing practice. This review aims to explore how Butler’s theoretical work is reflected in research literature within a nursing context. We conducted a scoping review guided by Arksey and O’Malley’s methodological framework. A systematic (...) literature search of CINAHL (EBSCOhost), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and Web of Science identified 15 papers. Butler’s theoretical work was applied at an individual and social level in research literature within a nursing context. Nurses need to reflect on their clinical practice and role as health professionals in relation to power and performativity in encounters with patients who are marginalized. Nurses’ working conditions, recognition, and understanding are strongly influenced by society, and calling nurses heroes undermines their capacity to challenge and resist the hero identity. The healthcare system’s impact on patient-nurse encounters challenges patients’ and nurses’ subjectivity, performativity, and power relations. The review allowed us to describe how Butler’s theoretical work can facilitate a reflection on nursing practice which is a prerequisite for caring, ethical relationships, and working conditions within a nursing context. Butler’s concepts can provide useful perspectives on how nurses understand, communicate with, and care for patients, as well as a nuanced understanding of the nursing role and power relations and structures. (shrink)

The aim of this study was to compare the acute effects of performing a lower body resistance training program in one long or two shorter sessions in 1 day on training volume and affective measures. Employing a randomized-crossover design, 23 resistance-trained women performed two training days consisting of one long or two short sessions separated by 3.5–5 h. Each training day was separated by 4-6 days and consisted of three sets to failure for six exercises. Training volume were recorded during (...) the sessions. Rating of perceived exertion for effort, rating of perceived exertion for discomfort, session displeasure/pleasure and exercise enjoyment were measured 10 min after each session. Participants also completed a readiness to train questionnaire, 24 h after each session, and which training protocol they preferred, 48 h after the last session. The long session led to higher RPE, RPD and sPDF compared to the short sessions. There was no difference in EES. The short sessions had 3% higher training volume than the long session. There were no differences in perceived readiness to train 24 h after the sessions. Twenty-two participants preferred the long session, while one preferred the short sessions. In conclusion, performing a longer, lower body, resistance training session led to greater perceptions of effort, discomfort and session pleasure than splitting the same program into two shorter sessions among resistance-trained women. However, two shorter sessions led to a greater training volume. (shrink)

A core value of Judaism is leading an ethical life. The Talmud, an authoritative source on Jewish law and tradition, has a number of discussions that deal with honesty in business and decision-making. One motive that can cause individuals to be unscrupulous is the presence of a conflict of interest. This paper will define, discuss, and review five Talmudic concepts relevant to conflict of interest. They are (1) Nogea B’Davar (being an interested party), (2) V’hiyitem N’keyim (behaving to ensure that (...) one is above suspicion) (3) Lifnei Iver (placing a stumbling block before the blind), (4) Shokhad (accepting a bribe), and (5) Geneivat Da’at (deception and undeserved goodwill). Case examples will be used to apply these Talmudic principles to contemporary business practice. This will include discussion of these Talmudic concepts as it applies to specific contemporary business examples relevant to the boardroom, accounting firms, investment banking, politics, and government. It may be impossible to eliminate all conflicts of interest. However, knowledge and awareness of these Talmudic principles can help individuals in business settings better address the ethical issues that they confront. (shrink)

The aim of the study was to compare the acute effects of traditional resistance training and superset training on training duration, training volume and different perceptive measures. Twenty-nine resistance-trained participants performed a whole-body workout traditionally and as supersets of exercises targeting different muscle groups, in a randomized-crossover design. Each session was separated by 4–7 days, and consisted of eight exercises and three sets to failure. Training duration and number of repetitions lifted were recorded during the sessions. Rate of perceived exertion (...) for effort, rate of perceived exertion for discomfort, session displeasure/pleasure, and exercise enjoyment were measured 15 min after each session. Forty-eight hours after the final session participants reported which session they preferred. The superset session led to significantly higher values for RPE and RPD and tended to be higher for sPDF, i.e., more pleasurable, compared to the traditional session. There was no difference in EES. The traditional session led to significantly increased training volume and lasted 23 min longer than the superset session. Eighteen of the participants preferred the superset session, while 11 preferred the traditional session. In conclusion, performing a whole-body workout as a superset session was more time-efficient, but reduced the training volume and was perceived with greater exertion for effort and discomfort than a traditional workout. (shrink)

This essay explores the metaphorical use of the area of nonlinear dynamics popularly known as “chaos theory,” surveying its use in one particular field: legal theory. After sketching some of the mistakes encountered in these efforts, I outline the possibility of the fruitful use of nonlinear dynamics for thinking about our legal system. I then offer some general lessons to be drawn from these examples—both cautionary maxims and a limited defense of cross-disciplinary borrowing. I conclude with some reflections on the (...) nature of arguments that seek to establish intellectual authority or epistemic merit by analogical reasoning. (shrink)

The reputation and influence of an author depends to a large extent on the predilections of a specific society. One and the same person may be esteemed for different aspects of his work in various countries. Edmund Burke is chiefly known for his aesthetics on the continent, and not for his political philosophy as in this country. Georg Simmel, on the other hand, is famous on the continent foremost as a philosopher, but is known in the Anglo–Saxon world only as (...) a sociologist. The Americans even speak of “Simmelism” meaning thereby a sociology analysing the psychological forms of social interaction such as conflict and subordination. The disregard of his philosophical work is a pity, for Simmel was a most stimulating thinker, almost French in his style, a truly European mind belonging with Bergson, Croce and Ortega to a group of philosophical essayists who are the salt of the earth whatever the “scientific” philosophers may say against them. A collection of his essays referring to history, religion, art and society, published under the title Brücke und Tür may be recommended as an introduction. It contains papers, most of them unpublished, of uneven value, but all are characteristic of the most dynamic philosopher I ever met. His thought arose in immediate response to anything which aroused his interest, be it an object, a person or a sociological fact. (shrink)

Operative Logic and Mathematics would appear to be a new venture. Only a few weeks before his premature death Hermann Weyl, one of the most original mathematicians of our time, the author of a Philosophy of Mathematics and Natural Science and also of a stimulating book on Symmetry, drew my attention to Paul Lorenzen's Einführung in die operative Logik und Mathematik. This book had given him new hope, since GÖdel had discouraged his endeavour to find the foundations of mathematics. “Perhaps,” (...) he added, “Lorenzen's approach promises a way of arriving at reliable foundations.”. (shrink)

In the fall of 1996 I taught a course at Fudan University in Shanghai dealing with medical ethics in America. As part of the course we spent some time on the heated American debate about abortion. The reaction of Chinese students was revealing.

L'auteur distingue entre la vérité constatante et la vérité vécue. Ces deux vérités sont qualitativement distinctes, et elles sont des ennemies archanées, dès qu'elles se trouvent en présence l'une de l'autre. De nos jours elles se combattent sous les noms de rationalisme et antirationalisme. Pourtant elles peuvent sans aucun compromis se transformer en une synthèse. Et cette synthèse se réalise lorsque la vérité constatante aboutit à sa suprême subtilité: l'observation introspective d'idées à tendance universelle (cette observation s'exprime en définitions exactes) (...) et l'introspection du mouvement de ces idées (qui s'exprime en logique exacte). Cette ultime introspection est la tâche de la philosophie. Le sens véritable de la philosophie est donc d'invoquer logiquement l'intuition postlogique. Cette intuition succède nécessairement à la pure logique philosophique et révèle aussi la valeur universelle des idées logiques par une rétrospection clarifiaǹte. (shrink)

My object in this paper is to suggest a few reflections on some themes in Bentham's work which others as well as I have noted, without perhaps developing them as fully as might with advantage be done. There will be nothing like full development in the limited compass of what is said here, but what is said may at least indicate possible directions for further exploration. The greater part of the paper will be concerned with the notion of natural authority; (...) but I want to begin by taking a broader, though no doubt rather superficial, view of the role in Bentham's thinking of the concepts of ‘nature’ and ‘the natural’. (shrink)

The object of this article is to examine, with the work of Jeremy Bentham as the principal example, one strand in the complex pattern of European social theory during the second half of the eighteenth century. This was of course the period not only of the American and French revolutions, but of the culmination of the movements of thought constituting what we know as the Enlightenment. Like all great historical episodes, the Enlightenment was both the fulfilment of long-established processes and (...) the inauguration of new processes of which the fulfilment lay in the future. Thus the seminal ideas of seventeenth-century rationalism realized and perhaps exhausted their potentialities in the eighteenth-century Enlightenment. The ideas with which this article is concerned, however—conveniently grouped and labelled as the ideas of utilitarianism—only began to achieve systematic development in these later decades of the eighteenth century. Within that period—during the first half and more of Bentham's long life—attempts to apply those ideas to the solution of social problems met largely with failure and frustration. Yet unrealized potentialities remained, the realization of which was reserved for a time when the world of the philosophes no longer existed. The movements for social and political reform which have played so large a part in modern history since the French Revolution may be judged in widely differing ways; but whatever the verdict, these movements surely cannot be understood without due consideration of that part of their origins which lies in eighteenth-century utilitarianism. (shrink)

The Responsible Self was H. Richard Niebuhr's most important work in Christian ethics. In it he probes the most fundamental character of the moral life and it stands today as a landmark contribution to the field. The Library of Theological Ethics series focuses on what it means to think theologically and ethically. It presents a selection of important and otherwise unavailable texts in easily accessible form. Volumes in this series will enable sustained dialogue with predecessors though reflection on classic works (...) in the field. (shrink)

On Islamic practices, doctrines and on Islamic ethics.

Like many people these days, I believe there is no general moral obligation to obey the law. I shall explain why there is no such moral obligation – and I shall clarify what I mean when I say there is no moral obligation to obey the law – as we proceed. But also like many people, I am unhappy with a position that would say there was no moral obligation to obey the law and then say no more about the (...) law's moral significance. In our thinking about law in a resonably just society, we have a strong inclination to invest law with a sort of moral halo. It does not feel right to suggest that law is a morally neutral social fact, nor to suggest that law is merely a useful social technique. In this essay, I shall try to account in part for law's moral halo. Because I share the widespread inclination to invest law with this halo, I shall not be interested in a merely historical account of how we come to see law with a halo – a pure “error theory” of law's halo, if you will. I want to justify the halo. On the other hand, the main way to justify the halo is to get clear just what law's moral significance is. It is unlikely that at the end of the process of clarification the halo will have exactly the shape or luminance that it had at the beginning. (shrink)

P. O. Bodunrin, in his 1981 essay, asks: ‘Is there an African Philosophy, and if there is, what is it?’ This question has occupied centre stage among younger African intellectuals for about a decade now. The most articulate among these intellectuals, who are themselves philosophers, are Bodunrin , Kwasi Wiredu , H. Odera Oruka , Marcien Towa and Eboussi Boulaga , and Paulin Hountondji . These philosophers among others are in dialogue with one another and currently are seen to be (...) the principal architects of a new orientation in African thought. (shrink)

On the teachings of Prophet Muḥammad, d. 632 with reference to humanity.

Byzantine Empire; economic and social conditions; history.

According to familiar accounts, Rousseau held that humans are actuated by two distinct kinds of self love: amour de soi, a benign concern for one's self-preservation and well-being; and amour-propre, a malign concern to stand above other people, delighting in their despite. I argue that although amour-propre can (and often does) assume this malign form, this is not intrinsic to its character. The first and best rank among men that amour-propre directs us to claim for ourselves is that of occupying (...) 'man's estate'. This does not require, indeed it precludes, subjection of others. Amour-propre does not need suppression or circumscription if we are to live good lives; it rather requires direction to its proper end, not a delusive one. (shrink)

Early in Peter Abelard's Dialogue between a Philosopher, a Jew, and a Christian, the philosopher and the Christian easily come to agreement about what the point of ethics is: “[T]he culmination of true ethics … is gathered together in this: that it reveal where the ultimate good is and by what road we are to arrive there.” They also agree that, since the enjoyment of this ultimate good “comprises true blessedness,” ethics “far surpasses other teachings in both usefulness and worthiness.” (...) As Abelard understood them, both fundamental elements of his twelfth-century ethical culture — Greek philosophy and Christian religion — held a common view of the nature of ethical inquiry, one that was so obvious to them that his characters do not even state it in a fully explicit way. They take for granted, as we take the ground we stand on, the premise that the most important function of ethical theory is to tell you what sort of life is most desirable, or most worth living. That is, the point of ethics is that it is good for you, that it serves your self-interest. (shrink)

Edmund D. Pellegrino has played a central role in shaping the fields of bioethics and the philosophy of medicine. His writings encompass original explorations of the healing relationship, the need to place humanism in the medical curriculum, the nature of the patient’s good, and the importance of a virtue-based normative ethics for health care. In this anthology, H. Tristram Engelhardt, Jr., and Fabrice Jotterand have created a rich presentation of Pellegrino’s thought and its development. Pellegrino’s work has been dedicated to (...) showing that bioethics must be understood in the context of medical humanities, and that medical humanities, in turn, must be understood in the context of the philosophy of medicine. Arguing that bioethics should not be restricted to topics such as abortion, third-party-assisted reproduction, physician-assisted suicide, or cloning, Pellegrino has instead stressed that such issues are shaped by foundational views regarding the nature of the physician-patient relationship and the goals of medicine, which are the proper focus of the philosophy of medicine. This volume includes a preface by Dr. Pellegrino and a comprehensive Introduction by the editors. Of interest to medical ethicists as well as students, scholars, and physicians, _The Philosophy of Medicine Reborn_ offers fascinating insights into the emergence of a field and the work of one of its pioneers. “After a long period of dormancy, philosophy of medicine has blossomed with new life. The single most important physician-philosopher in that rebirth has been Edmund Pellegrino. His contributions to virtue theory, the concept of beneficence, the dispute over the internal and external sources of a morality for medicine, and the role of the Hippocratic tradition are all critical. The essays collected in this volume have changed the history of the philosophy of medicine. He shows that philosophy of medicine can be done with both passion and compassion.” —_Robert M. Veatch, Kennedy Institute of Ethics, Georgetown University_ “Edmund Pellegrino's words have helped medical students, faculty, scholars and patients address the challenges they encounter in medicine and medical practice. His personal support has also been critical for many of us in developing programs in medical ethics and philosophy of medicine in our universities. Dr. Pellegrino combines the wisdom of a great physician with those of a great philosopher to produce a body of writing that will continue to inspire us all. This volume contains some of his best and most influential work.” —_Loretta Kopelman, The Brody School of Medicine, East Carolina University_ _ _ “Edmund Pellegrino has been a leading light in the philosophy of medicine for a generation. He was instrumental in the birth of bioethics, founded one of the leading journals, and provided able leadership in organizing early activities of the profession. He has served as department chairman, dean, and university president. Most recently, he chairs the President’s Council on Bioethics. In all this, first and foremost, he has been a physician. Those who are ill and suffering make a claim upon him. To respond to this claim, Pellegrino creatively brings together the worlds of science and of the humanities. For him, that is what medicine is about, making it the most scientific of the humanities and the most humane of the sciences. Fortunately for us, Pellegrino brings these worlds together in thought, as well as in practice. In this selection from his writings, Engelhardt and Jotterand have captured the heart of Pellegrino’s project, both in depth and breadth, so we can also hear that claim of the ill and so we can see what worlds must come together if we are to respond in the appropriate way.” —_George Khushf, University of South Carolina_ “Pellegrino’s work is both a treasure and important for understanding bioethics. His work in philosophy of medicine addresses the crucial questions that are so important to understanding the practice of medicine and the ethics of health care.” —_Kevin Wildes, President, Loyola University_ _ _. (shrink)

In his book on Karl Barth Professor T. F. Torrance spoke at one point of ‘the great watershed of modern theology’. ‘There are,’ he wrote, 1 ‘two basic issues here. On the one hand, it is the very substance of the Christian faith that is at stake, and on the other hand, it is the fundamental nature of scientific method, in its critical and methodological renunciation of prior understanding, that is at stake. This is the great watershed of modern theology: (...) either we take the one way or the other – there is no third alter native… one must go either in the direction taken by Barth or in the direction taken by Bultmann.’. (shrink)

Theological anthropology in Islam, philosophy of Islamic education and aspects of success.

H. Tristram Engelhardt, Jr., Joseph Boyle, John Peppin, David Solomon; Christian Bioethics, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Vol.