It is well known that the emperor Julian plays a central role in the life and writings of the Antiochene sophist Libanius. As a commentator on the life and reign of the emperor Constantine, he is seldom taken into account, and if he is, he usually gets short shrift as being verbose and unreliable. This neglect is, I believe, hardly justified. Even if it were true that Libanius could not teach us anything about the historical Constantine, his testimony still (...) deserves attention as an example of the attitude of eastern pagans to Constantine. Moreover, although much of what Libanius has to say about Constantine was written down half a century after the events, Libanius himself, born in 314, was a contemporary of the latter part of Constantine's reign. Unlike Julian, born in 331/2,2 and Eunapius, born in 347/8,3 he was able to form a judgement on Constantine based on first-hand knowledge. (shrink)

It is well known that the emperor Julian plays a central role in the life and writings of the Antiochene sophist Libanius. As a commentator on the life and reign of the emperor Constantine, he is seldom taken into account, and if he is, he usually gets short shrift as being verbose and unreliable. This neglect is, I believe, hardly justified. Even if it were true that Libanius could not teach us anything about the historical Constantine, his testimony still (...) deserves attention as an example of the attitude of eastern pagans to Constantine. Moreover, although much of what Libanius has to say about Constantine was written down half a century after the events, Libanius himself, born in 314, was a contemporary of the latter part of Constantine's reign. Unlike Julian, born in 331/2,2and Eunapius, born in 347/8,3he was able to form a judgement on Constantine based on first-hand knowledge. (shrink)

According to the free energy principle all living systems aim to minimise free energy in their sensory exchanges with the environment. Processes of free energy minimisation are thus ubiquitous in the biological world. Indeed it has been argued that even plants engage in free energy minimisation. Not all living things however feel alive. How then did the feeling of being alive get started? In line with the arguments of the phenomenologists, I will claim that every feeling must be felt by (...) someone. It must have mineness built into it if it is to feel a particular way. The question I take up in this paper asks how mineness might have arisen out of processes of free energy minimisation, given that many systems that keep themselves alive lack mineness. The hypothesis I develop in this paper is that the life of an organism can be seen as an inferential process. Every living system embodies a probability distribution conditioned on a model of the sensory, physiological, and morphological states that are highly probably given the life it leads and the niche it inhabits. I argue for an ecological and enactive interpretation of free energy. I show how once the life of an organism reaches a certain level of complexity mineness emerges as an intrinsic part of the process of life itself. (shrink)

Following a brief reconstruction of Hutto & Satne’s paper we focus our critical comments on two issues. First we take up H&S’s claim that a non-representational form of ur-intentionality exists that performs essential work in setting the scene for content-involving forms of intentionality. We will take issue with the characterisation that H&S give of this non-representational form of intentionality. Part of our commentary will therefore be aimed at motivating an alternative account of how there can be intentionality without mental content, (...) which we have called skilled intentionality. Skilled intentionality is the individual’s selective openness and responsiveness to a rich landscape of affordances.A second issue we take up concerns the distinction between ur-intentionality and content-involving intentionality. We will argue that our notion of skilled intentionality as it is found in humans cuts across these two categories. Instead of distinguishing between different forms of intentionality we recommend focusing on how skilled intentionality takes different forms in different forms of life. (shrink)

Numerous high-profile ethics scandals, rising inequality, and the detrimental effects of climate change dramatically underscore the need for business schools to instill a commitment to social purpose in their students. At the same time, the rising financial burden of education, increasing competition in the education space, and overreliance on graduates’ financial success as the accepted metric of quality have reinforced an instrumentalist climate. These conflicting aims between social and financial purpose have created an existential crisis for business education. To resolve (...) this impasse, we draw on the concept of moral self-awareness to offer a system-theoretical strategy for crowding-in a culture of ethics within business schools. We argue that to do so, business schools will need to (1) reframe the purpose of business, (2) reframe the meaning of professional success, and (3) reframe the ethos of business education itself. (shrink)

If a doctor is trying to decide whether or not to provide a medical treatment, does it matter ethically whether that treatment has already been started? Health professionals sometimes find it harder to stop a treatment (withdraw) than to refrain from starting the treatment (withhold). But does that feeling correspond to an ethical difference? In this article, we defend equivalence—the view that withholding and withdrawal of treatment are ethically equivalent when all other factors are equal. We argue that preference for (...) withholding over withdrawal could represent a form of cognitive bias—withdrawal aversion. Nevertheless, we consider whether there could be circumstances in which there is a moral difference. We identify four examples of conditional nonequivalence. Finally, we reflect on the moral significance of diverging intuitions and the implications for policy. We propose a set of practical strategies for helping to reduce bias in end-of-life decision making, including the equivalence test. (shrink)

DNA databases have significant commercial value. Direct-to-consumer genetic testing companies have built databanks using samples and information voluntarily provided by customers. As the price of genetic analysis falls, there is growing interest in building such databases by paying individuals for their DNA and personal data. This paper maps the ethical issues associated with private companies paying for DNA. We outline the benefits of building better genomic databases and describe possible concerns about crowding out, undue inducement, exploitation, and commodification. While certain (...) objections deserve more empirical and philosophical investigation, we argue that none currently provide decisive reasons against using financial incentives to secure DNA samples. (shrink)

There has been considerable recent debate on the ethics of human enhancement. A number of prominent authors have been concerned about or critical of the use of technology to alter or enhance human beings, citing threats to human nature and dignity as one basis for these concerns. Frances Kamm has given a detailed rebuttal of Sandel's arguments, arguing that human enhancement is permissible. Nicholas Agar, in his book Liberal Eugenics, argues that enhancement should be permissible but not obligatory. He argues (...) that what distinguishes liberal eugenics from the objectionable eugenic practices of the Nazis is that it is not based on a single conception of a desirable genome and that it is voluntary and not obligatory. This article takes a more provocative position. It aims to argue that, far from its being merely permissible, we have a moral obligation or moral reason to enhance ourselves and our children. Indeed, we have the same kind of obligation as we have to treat and prevent disease. It begins by considering the current interests in and possibilities of enhancement. It then offers three arguments that we have very strong reasons to seek to enhance. (shrink)

_Changing the Subject_ is a classic critique of traditional psychology in which the foundations of critical and feminist psychology are laid down. Pioneering and foundational, it is still _the _groundbreaking text crucial to furthering the new psychology in both teaching and research. Now reissued with a new foreword describing the changes which have taken place over the last few years, _Changing the Subject _will continue to have a significant impact on thinking about psychology and social theory.

In Markets Without Limits and a series of related papers, Jason Brennan and Peter Jaworski argue that it is morally permissible to buy and sell anything that it is morally permissible to possess and exchange outside of the market. Accordingly, we should open markets in “contested commodities” including blood, gametes, surrogacy services, and transplantable organs. This paper clarifies some important aspects of the case for market boundaries and in so doing shows why there are in fact moral limits to the (...) market. I argue that the case for restricting the scope of the market does not turn on the idea that some things are constitutively non-market goods; it turns instead on the idea that treating some things according to market norms would threaten the realization of particular kinds of human interests. (shrink)

Genomic research can reveal ‘unsolicited’ or ‘incidental’ findings that are of potential health or reproductive significance to participants. It is widely thought that researchers have a moral obligation, grounded in the duty of easy rescue, to return certain kinds of unsolicited findings to research participants. It is less widely thought that researchers have a moral obligation to actively look for health-related findings. This paper examines whether there is a moral obligation, grounded in the duty of easy rescue, to actively hunt (...) for genomic secondary findings. We begin by showing how the duty to disclose individual research findings can be grounded in the duty of easy rescue. Next, we describe a parallel moral duty, also grounded in the duty of easy rescue, to actively hunt for such information. We then consider six possible objections to our argument, each of which we find unsuccessful. Some of these objections provide reason to limit the scope of the duty to look for secondary findings, but none provide reason to reject this duty outright. We argue that under a certain range of circumstances, researchers are morally required to hunt for these kinds of secondary findings. Although these circumstances may not currently obtain, genomic researchers will likely acquire an obligation to hunt for secondary findings as the field of genomics continues to evolve. (shrink)

We develop and test a model of pseudo-transformational leadership. Pseudo-transformational leadership is manifested by a particular combination of transformational leadership behaviors, and is differentiated from both transformational leadership and laissez-faire -leadership. Survey data from senior managers show differential outcomes of transformational, pseudo-transformational, and laissez-faire leadership. Possible extensions of the theoretical model and directions for future research are offered.

This paper presents a novel account of focal stress and pitch contour in English dialogue. We argue that one should analyse and treat focus and pitch contour jointly, since (i) some pragmatic interpretations vary with contour (e.g., whether an utterance accepts or rejects; or whether it implicates a positive or negative answer); and (ii) there are utterances with identical prosodic focus that in the same context are infelicitous with one contour, but felicitous with another. We offer an account of two (...) distinct pitch contours that predicts the correct felicity judgements and implicatures, outclassing other models in empirical coverage or formality. Prosodic focus triggers a presupposition, where what is presupposed and how the presupposition is resolved depends on prosodic contour. If resolving the presupposition entails the proffered content, then the proffered content is uninteresting and hence the utterance is in-felicitous. Otherwise, resolving the presupposition may lead to an implicature. We regiment this account in SDRT. (shrink)

Genomic sequencing technologies (GS) pose novel challenges not seen in older genetic technologies, making traditional standards for fully informed consent difficult or impossible to meet. This is due to factors including the complexity of the test and the broad range of results it may identify. Meaningful informed consent is even more challenging to secure in contexts involving significant time constraints and emotional distress, such as when rapid genomic testing (RGS) is performed in neonatal intensive care units. In this article, we (...) propose that informed consent matters not for its own sake, but because obtaining it furthers a range of morally important goals, such as promoting autonomy, well‐being, and trust in medicine. These goals form the basis of a new framework [PROmoting Morally Important Consent Ends (PROMICE)] for assessing the ethical appropriateness of various informed consent models. We illustrate this framework with two examples: (a) a tiered and layered consent model for obtaining consent for GS, and (b) consent for RGS in critically ill newborns. We conclude that appropriately—rather than fully—informed consent provides the correct standard for genomic medicine and research. (shrink)

Neuroimaging studies of brain-damaged patients diagnosed as in the vegetative state suggest that the patients might be conscious. This might seem to raise no new ethical questions given that in related disputes both sides agree that evidence for consciousness gives strong reason to preserve life. We question this assumption. We clarify the widely held but obscure principle that consciousness is morally significant. It is hard to apply this principle to difficult cases given that philosophers of mind distinguish between a range (...) of notions of consciousness and that is unclear which of these is assumed by the principle. We suggest that the morally relevant notion is that of phenomenal consciousness and then use our analysis to interpret cases of brain damage. We argue that enjoyment of consciousness might actually give stronger moral reasons not to preserve a patient's life and, indeed, that these might be stronger when patients retain significant cognitive function. (shrink)

Extant research suggests that individuals employ traditional moral heuristics to support their observed altruistic behavior; yet findings have largely been limited to inductive extrapolation and rely on relatively few traditional frames in so doing, namely, deontology in organizational behavior and virtue theory in law and economics. Given that these and competing moral frames such as utilitarianism can manifest as identical behavior, we develop a moral framing instrument—the Philosophical Moral-Framing Measure (PMFM)—to expand and distinguish traditional frames associated and disassociated with observed (...) altruistic behavior. The validation of our instrument based on 1015 subjects in 3 separate real stakes scenarios indicates that heuristic forms of deontology, virtue-theory, and utilitarianism are strongly related to such behavior, and that egoism is an inhibitor. It also suggests that deontic and virtue-theoretical frames may be commonly perceived as intertwined and opens the door for new research on self-abnegation, namely, a perceived moral obligation toward suffering and self-denial. These findings hold the potential to inform ongoing conversations regarding organizational citizenship and moral crowding out, namely, how financial incentives can undermine altruistic behavior. (shrink)

In this paper, we offer a new account of disability. According to our account, some state of a person's biology or psychology is a disability if that state makes it more likely that a person's life will get worse, in terms of his or her own wellbeing, in a given set of social and environmental circumstances. Unlike the medical model of disability, our welfarist approach does not tie disability to deviation from normal species’ functioning, nor does it understand disability in (...) essentialist terms. Like the social model of disability, the welfarist approach sees disability as a harmful state that results from the interaction between a person's biology and psychology and his or her surrounding environment. However, unlike the social model, it denies that the harm associated with disability is entirely due to social prejudice or injustice. In this paper, we outline and clarify the welfarist approach, answer common objections and illustrate its usefulness in addressing a range of difficult ethical questions involving disability. (shrink)

In this paper I consider, in connection with dementia, two views of the person. One view of the person is derived from Locke and Parfit. This tends to regard the person solely in terms of psychological states and his/her connections. The second view of the person is derived from a variety of thinkers. I have called it the situated-embodied-agent view of the person. This view, I suggest, more readily squares with the reality of clinical experience. It regards the person as (...) embedded in a history and culture. The human person is also an embodied agent. I contend that this view encourages a more appropriate approach towards the ethical issues that arise in dementia and towards people with dementia. (shrink)

Our rapidly increasing reliance on frictionless AI interactions may increase cognitive and emotional distance, thereby letting our adaptive resilience slacken and our ethical virtues atrophy from disuse. Many trends already well underway involve the offloading of cognitive, emotional, and ethical labor to AI software in myriad social, civil, personal, and professional contexts. Gradually, we may lose the inclination and capacity to engage in critically reflective thought, making us more cognitively and emotionally vulnerable and thus more anxious and prone to manipulation (...) from false news, deceptive advertising, and political rhetoric. In this article, I consider the overarching features of this problem and provide a framework to help AI designers tackle it through system enhancements in smartphones and other products and services in the burgeoning internet of things (IoT) marketplace. The framework is informed by two ideas: psychologist Daniel Kahneman’s cognitive dual process theory and moral self-awareness theory, a four-level model of moral identity that I developed with Benjamin M. Cole. (shrink)

In her excellent and comprehensive article, Friesen argues that utilising personal responsibility in healthcare is problematic in several ways: it is difficult to ascribe responsibility to behaviour; there is a risk of prejudice and bias in deciding which behaviours a person should be held responsible for; it may be ineffective at reducing health costs. In this short commentary, I will elaborate the critique of personal responsibility in health but suggest one way in which it could be used ethically. In doing (...) so, I will introduce the concepts of reasonable risk and golden opportunity. I previously argued that it is both difficult to disentangle responsibility and that we risk prejudice and bias in singling out behaviours that are socially disapproved of.1 So I am sympathetic to Friesen’s concerns. I also discussed another way in which ascribing personal responsibility for health is problematic which Friesen does not discuss and which, in my view, is the most concerning and further supports her arguments. It represents a back door assault on liberalism and neutrality towards concepts of the good life. Even if one were to accurately and in an unbiased way divine the personal contribution to disease, the greatest problem would remain: those who voluntarily take on risk would be penalised. That is, such a system would be risk-averse. Those lives which avoided risk would be prioritised, while those who chose to take on risky activities in their conception of the good life would be penalised. Yet risk is necessary, both for the good life, and social progress. Columbus, Edmund Hilary, Florence Nightingale, Ernest Hemingway and countless monumental figures in human history took risks in order to achieve something great. Should we aim for a society of trembling, teetotalling health nuts? Surely that prospect is horrific. It is horrific because it elevates health …. (shrink)

As a first approximation, it may be said that the central issue in the correspondence concerns whether semantical statements are essentially, albeit implicitly, mentalistic or psychological in character. In the language of the protagonists themselves, it concerns whether statements of the form.

I discuss a puzzle that shows there is a need to develop a new metaphysical interpretation of mathematical theories, because all well-known interpretations conflict with important aspects of mathematical activities. The new interpretation, I argue, must authenticate the ontological commitments of mathematical theories without curtailing mathematicians' freedom and authority to creatively introduce mathematical ontology during mathematical problem-solving. Further, I argue that these two constraints are best met by a metaphysical interpretation of mathematics that takes mathematical entities to be constitutively constructed (...) by human activity in a manner similar to the constitutive construction of the US Supreme Court by certain legal and political activities. Finally, I outline some of the philosophical merits of metaphysical interpretations of mathematical theories of this type. (shrink)

Public health policies often require individuals to make personal sacrifices for the sake of protecting other individuals or the community at large. Such requirements can be more or less demanding for individuals. This paper examines the implications of demandingness for public health ethics and policy. It focuses on three possible public health policies that pose requirements that are differently demanding: vaccination policies, policy to contain antimicrobial resistance, and quarantine and isolation policies. Assuming the validity of the ‘demandingness objection’ in ethics, (...) we argue that states should try to pose requirements that individuals would have an independent moral obligation to fulfil, and therefore that are not too demanding. In such cases, coercive measures are ethically justified, especially if the interventions also entail some benefits to the individuals; this is, for example, the case of vaccination policies. When public health policies need to require individuals to do something that is too demanding to constitute an independent moral obligation, states have an obligation to either provide incentives to give individuals non-moral reasons to fulfil a certain requirement – as in the case of policies that limit antibiotic prescriptions – or to compensate individuals for being forced to do something that is too demanding to constitute an independent moral obligation – as in the case of quarantine and isolation policies. (shrink)

Due to the economic and social effects of globalization democracy is currently in crisis in many states around the world. This book suggests that solving this crisis requires rethinking democratic education. It argues that educational public policy must cultivate democratic relationships not only within but also across and between states, and that such policy must empower citizens to exercise democratic control in domestic as well as in inter- and transnational politics. -/- Democratic Education in a Globalized World articulates and defends (...) democratic conceptions of global citizenship education and educational justice on the basis of a democratic understanding of global justice. It will be of interest to researchers across the fields of education, political theory, philosophy, development and postcolonial studies. (shrink)

The aim of this essay is to analyze the ideas about commercial society among Spanish and Spanish American intellectuals from the second half of the eighteenth century to the first decades of the following century. Special attention is paid to some relevant concepts like “amor propio” or “interés”. We are also specially interested in the knowledge of political economy and its moral implications for the idea of commercial society. My proposal is to consider the possibilities of a Catholic enlightenment as (...) the expression of the combination of some intrinsic principles of the enlightened thought with Catholic confessionalism. This is significant not only for the understanding of the enlightenment in the Spanish World but also for a correct interpretation of the first constitutionalism. (shrink)

Between 1934 and 1942 Heidegger delivered three series of lectures on Hölderlin's poetry. The discussion of “Der Ister” was the last of these, although Heidegger continued to think and write about Hölderlin into the 1960s (see GA 4). William McNeill and Julia Davis's recent translation of the “Ister”—volume (GA 53)—is the first of the Hölderlin lectures to appear in English.

The Journal of Aesthetics and Art Criticism, Volume 78, Issue 1, Page 85-90, Winter 2020.

Many have argued that individuals should receive income in proportion to their contribution to society. Others have believed that it would be fairer if people received income in proportion to the effort they expend in so contributing, since people have much greater control over their level of effort than their productivity. I argue that those who believe this are normally also committed, despite appearances, to increasing the social product — which undermines any sharp distinction between effort- and productivity-based distributive proposals. (...) However, effort-based proposals do emphasise more the importance of people having control over factors affecting their income. The second set of problems I consider is how to implement policies which hold true to this emphasis. I show that there are major problems with the accuracy of using any objective criteria to measure the level of effort a person is expending. Moreover, once any such criteria are employed the problem of ‘moral hazard’arises because people modify their behaviour in such a way as to maximise their income while minimising their effort. This violates the original motivation for using effort. Because of this and other empirical considerations, I argue that productivity may well be a better criterion on which to distribute income even if one is motivated by the same concerns which have prompted effort-based proposals. (shrink)

We examine the philosophical and ethical issues associated with conjoined twins and their surgical separation. In cases in which there is an extensive sharing of organs, but nevertheless two distinguishable functioning brains, there are a number of philosophical and ethical challenges. This is because such conjoined twins: 1. give rise to puzzles concerning our identity, about whether we are identical to something psychological or biological;2. force us to decide whether what matters from an ethical point of view is the biological (...) life of our organisms or the existence of our consciousness or mind; 3. raise questions concerning when, if ever, it is morally acceptable to sacrifice one of us to save another;4. force us to reflect on the conditions for ownership of organs and the justification of removal of organs for transplantation which causes the death of the donor; 5. raise questions about who should take decisions about life-risking treatments when this cannot be decided by patients themselves.We examine and suggest answers to these questions. (shrink)

Discrimination is typically understood to be a comparative phenomenon: S is discriminated against on the basis of trait T if she would not have been treated in the same way if she did not possess T. But the comparative test for discrimination may hide from view some important cases: associational discrimination and stereotype policing. These cases show more clearly what is true of discrimination in general: that it involves a vicarious wrong, that is, an action which wrongs someone other than (...) the primary object of disregard. This suggests why philosophers disagree whether discrimination is wrong because it causes harm or because it expresses disrespect. Paradigmatic cases of discrimination involve both harm and disrespect, but direct the harm and the disrespect towards different targets by treating the harmed individual as a mere representative of the targeted group. Discrimination is dehumanizing, and morally distinctive, precisely because of this fact. (shrink)

This case takes place in the context of a small to medium-sized retail clothing firm. It examines the latest trends in social media marketing technology and the potential ethical issues regarding privacy infringement and behavioral control of teenagers and young adults that such technology presents. The scenario invites students to consider how much, if at all, such marketing practices should be resisted going forward.

This paper surveys and critically assesses existing theories of evidence with respect to four desiderata. A good theory of evidence should be both a theory of evidential support (i.e., be informative about what kinds of facts speak in favour of a hypothesis), and of warrant (i.e., be informative about how strongly a given set of facts speaks in favour of the hypothesis), it should apply to the non-ideal cases in which scientists typically find themselves, and it should be ‘descriptively adequate’, (...) i.e., able to adequately represent typical episodes of evidentiary reasoning. The theories surveyed here—Bayesianism, hypotheticodeductivism,satisfaction theories, error statistics as well as Achinstein’s and Cartwright’s theories—are all found wanting in important respects. I finally argue that a deficiency all these theories have in common is a neglect or underplaying of the epistemic context in which the episode of evidentiary reasoning takes place.Este artículo describe y valora críticamente diversas teorías de la evidencia en relación a cuatro desiderata. Una buena teoría de la evidencia debería ser tanto una teoría sobre el apoyo evidencial [evidential support] (ser informativa sobre qué tipos de hechos hablan a favor de la hipótesis) como sobre la justificación [warrant]; debería aplicarse en las situaciones no ideales en las que normalmente se encuentran los científicos; y debería ser ‘descriptivamente adecuada’, esto es, capaz de representar correctamente episodios típicos de razonamiento evidencial. Las teorías aquí revisadas—bayesianismo, hipotético-deductivismo, teorías de la satisfacibilidad, la estadística del error, así como las propuestas de Achinstein y Cartwright—se consideran deficientes en aspectos básicos. Argumentaré que un defecto común en todas ellas es que olvidan, o minusvaloran, el contexto epistémico en el que el episodio de razonamiento evidencial tiene lugar. (shrink)

The knowledge norm of assertion is the subject of a lively debate on when someone is in a position to assert something. However, not much has been said about the logic that underlies such debate. In this paper, I propose a formalisation of the knowledge norm in a deontic logic that aims to be explanatory and conceptually sound. Afterwards, I investigate some problems that this formalisation makes visible. This reveals some significant limitations of the underlying logic: it can neither contain (...) Axiom 4 nor Axiom C4. Moreover, sentences of the form p and I have not asserted that p appear to licence a violation of deontic rules. (shrink)

In their recent paper in this journal, Zümrüt Alpinar-Şencan and colleagues review existing dignity-based objections to organ markets and outline a new form of dignity-based objection they believe has more merit: one grounded in a social account of dignity. This commentary clarifies some aspects of the social account of dignity and then shows how this revised account can be applied to other perennial issues in bioethics, including the ethics of human embryo research and the ethics of creating part-human chimeras.

This is the first instalment of a two-part paper on the counterfactual theory of causation. It is well known that this theory is ridden with counterexamples. Specifically, the following four features of the theory suffer from problems: it understands causation as a relation between events; counterfactual dependence is understood using a metric of similarity among possible worlds; it defines a non-discriminatory concept of causation; and it understands causation as transitive. A number of philosophers have recently proposed that causation is contrastive (...) because making contrasts explicit defuses counterexamples. A contrastive causal claim has the following form: C rather than C* causes E rather than E*, where C* and E* are alternative or contrast events. In this paper, I show that making contrasts explicit does indeed defuse some counterexamples. However, I also argue that the examples discussed in the literature all share a common feature, viz. that the original causal judgement is ambiguous in one way or another. Contrasting does not help with counterexamples that do not have this feature. Part II of this paper then takes up the hard cases. (shrink)

In intensive care, disputes sometimes arise when patients or surrogates strongly desire treatment, yet health professionals regard it as potentially inappropriate. While professional guidelines confirm that physicians are not always obliged to provide requested treatment, determining when treatment would be inappropriate is extremely challenging. One potential reason for refusing to provide a desired and potentially beneficial treatment is because (within the setting of limited resources) this would harm other patients. Elsewhere in public health systems, cost effectiveness analysis is sometimes used (...) to decide between different priorities for funding. In this paper, we explore whether cost-effectiveness could be used to determine the appropriateness of providing intensive care. We explore a set of treatment thresholds: the probability threshold (a minimum probability of survival for providing treatment), the cost threshold (a maximum cost of treatment), the duration threshold (the maximum duration of intensive care), and the quality threshold (a minimum quality of life). One common objection to cost-effectiveness analysis is that it might lead to rationing of life-saving treatment. The analysis in this paper might be used to inform debate about the implications of applying cost-effectiveness thresholds to clinical decisions around potentially inappropriate treatment. (shrink)