Due to society's need to control health care costs and to the failure of legislated health care reform, managed care is expanding at a rapid rate and will soon be the predominate form of health care delivery. Plans by Congress to bring Medicare and Medicaid under managed care will further consolidate this trend. Barring some legislative fiat, managed care is here to stay.The term managed care describes a diverse set of organizational forms. Wide variations in approach, financing, physician involvement, and (...) philosophy exist among the different types of managed care organizations. While many articles on the ethics of managed care acknowledge this variety, most analyses focus on the for-profit entities, paying less attention to the ethical distinctions among the different forms of managed care. This paper discusses the key distinctions among MCO types, in particular the difference between for-profit and non-profit plans; the relationship of the physician to the MCO; the incentives used to control costs; the incentives that improve patient care; and the organizational features that nurture the principled practice of medicine. (shrink)

Due to society's need to control health care costs and to the failure of legislated health care reform, managed care is expanding at a rapid rate and will soon be the predominate form of health care delivery. Plans by Congress to bring Medicare and Medicaid under managed care will further consolidate this trend. Barring some legislative fiat, managed care is here to stay. The term managed care describes a diverse set of organizational forms. Wide variations in approach, financing, physician involvement, (...) and philosophy exist among the different types of managed care organizations. While many articles on the ethics of managed care acknowledge this variety, most analyses focus on the for-profit entities, paying less attention to the ethical distinctions among the different forms of managed care. This paper discusses the key distinctions among MCO types, in particular the difference between for-profit and non-profit plans; the relationship of the physician to the MCO; the incentives used to control costs; the incentives that improve patient care; and the organizational features that nurture the principled practice of medicine. (shrink)

In The Myth of Morality Richard Joyce presents a simple and very influential argument for the truth of moral error theory. In this paper I point out that the argument does not have the form Joyce attributes to it, the argument is not valid in an extensional propositional logic and on the most natural way of explicating the meanings of the involved terms, it remains invalid. I conclude that more explanation is needed if we are to accept this particular argument (...) for moral error theory. (shrink)

All of us in the computing community understand the importance of recognizing and promoting ethical behavior in our profession. Instruction in ethics is rapidly becoming a part of most computing-related curricula, whether as a stand-alone course or infused into existing courses. Both Computing Curricula 2005 and the current discussions on Computing Curricula 2013 recognize the significance of ethics, generally considering it a core topic across the various computing disciplines. Additionally, in their criteria for the accreditation of computing programs, ABET specifies (...) that a student must attain by the time of graduation an understanding of ethical issues and responsibilities. What has been missing is a formal rite-of-passage ceremony to prompt student recognition and self-reflection on the transition from being a student to a computing professional. In 2009, seventeen faculty members and industry representatives from a wide range of institutions began to address this open problem by forming The Pledge of the Computing Professional [1], [2]. The Pledge exists to promote and recognize the ethical and moral behavior and responsibilities in graduates of computing-related degree programs as they transition to careers of service to society. The Pledge does not seek to define or enforce ethics --- this is the role of other organizations. Specifically, The Pledge is modeled after the Order of the Engineer [3] and provides a rite-of-passage ceremony at the time of graduation. (shrink)

Owen Griffiths has recently argued that Etchemendy’s account of logical consequence faces a dilemma. Etchemendy claims that we can be sure that his account does not overgenerate, but that we should expect it to undergenerate. Griffiths argues that if we define the relationship between formal and natural language as being dependent on logical consequence, then Etchemendy’s claims are not true; and if we define the relationship as being independent of logical consequence, then we cannot assess the truth of the claims (...) without further information. I argue that Griffiths misconstrues Etchemendy’s theory and overstates the first horn of the dilemma: Etchemendy does see the relationship as being dependent on logical consequence, but that does not mean that his claims are not true. (shrink)

In eukaryotes, folate metabolism is compartmentalized between the cytoplasm and organelles. The folate pathways of mitochondria are adapted to serve the metabolism of the organism. In yeast, mitochondria support cytoplasmic purine synthesis through the generation of formate. This pathway is important but not essential for survival, consistent with the flexibility of yeast metabolism. In plants, the mitochondrial pathways support photorespiration by generating serine from glycine. This pathway is essential under photosynthetic conditions and the enzyme expression varies with photosynthetic activity. In (...) mammals, the expression of the mitochondrial enzymes varies in tissues and during development. In embryos, mitochondria supply formate and glycine for purine synthesis, a process essential for survival; in adult tissues, flux through mitochondria can favor serine production. The differences in the folate pathways of mitochondria depending on species, tissues and developmental stages, profoundly alter the nature of their metabolic contribution. BioEssays 28: 595–605, 2006. © 2006 Wiley Periodicals, Inc. (shrink)

This book takes a philosophical approach to questions concerning violence, war, and justice in human affairs. It offers the reader a broad introduction to underlying assumptions, values, concepts, theories, and the historical contexts informing much of the current discussion worldwide regarding these morally crucial topics. It provides brief summaries and analyses of a wide range of relevant belief systems, philosophical positions, and policy problems. While not first and foremost a book of advocacy, it is clearly oriented throughout by the ethical (...) preference for nonviolent strategies in the achievement of human ends and a belief in the viability of a socially just—and thus peaceful—human future. It also maintains a consistently skeptical stance towards the all-too-easily accepted apologies, past and present, for violence, war, and the continuation of injustice. (shrink)

Revenge has been a subject of concern in most intellectual traditions throughout history, and even when social norms regard it as permissible or even obligatory, it is commonly recognised as being more counterproductive than beneficial. In this book, Kit R. Christensen explores this provocative issue, offering an in-depth account of both the nature of revenge and the causes and consequences of the desire for this kind of retaliatory violence. He then develops a version of eudaimonistic consequentialism to argue that vengeance (...) is never morally justified, and applies this to cases of intergroup violence where the lust for revenge against a vilified 'Them' is easily incited and often exploited. His study will interest a wide range of readers in moral philosophy as well as social philosophers, legal theorists, and social/behavioural scientists. (shrink)

In this paper, I review the Thanks for Typing conference held at Oxford University in March 2019, which explored the experiences of women who worked as literary helpmeets for famous men. I also give some details from the papers presented there. In my paper ‘“Jumped-up Typists”: Two secretaries who became guardians of the flame’, I discussed how two literary wives, Sophia Mumford, wife of the American historian and philosopher Lewis Mumford, and Valerie Eliot, second wife of T. S. Eliot, found (...) their identities in supporting, and later defending, their husbands’ work. I also looked at the consequences of their devotion as they grew older. It was clear from the papers presented at Thanks for Typing that the contributions of the women who surround powerful or influential men—not only as typists but as assistants, muses, and even managers of their husbands’ affairs—are often hidden and suppressed. The full acknowledgment of those who contribute to creative and intellectual work is a subject that needs further attention from both men and women. (shrink)

Explores the possibilities and limitations of a "virtue ethics" relevant to our times, within the theoretical framework provided by historical materialism and the critique of ideology.

The patient was a woman in her 30s who, until the rapid progression of an ultimately fatal neurologic disease, had been a very successful professional, enjoying athletics and an active social life. In the 6 months of swift deterioration, she had gone from being extremely vibrant and energetic to being totally unable to care for her personal needs. There had been no loss of intellectual capacity. Her sister later recounted to Dr. J., the emergency department physician, that she had found (...) the patient unconscious and unresponsive at home and had immediately called the patient's neurologist in a neighboring city. He directed her to call the paramedics. (shrink)

As the structure of healthcare delivery undergoes a breathtaking transformation, many ethics committees are wondering how and if they will be affected. Although the impact has not yet been widely felt, hospital-based ethics committees cannot avoid the pressures and upheaval caused by the reorganization of healthcare. This article will briefly review some of the factors contributing to the transformation of medicine, and suggest a number of ways in which ethics committees can respond proactively.

Oregon is the only state in the United States where a physician may legally prescribe a lethal dose of barbiturate for a patient intending suicide. The Oregon Death with Dignity Act was passed by voters in 1994 and came into effect after much legal wrangling in October of 1997. At the same time, a cabinetmaker named Pat Matheny was struggling with progressive weakness from amyotrophic lateral sclerosis, or ALS. I met with Pat and his family for a lengthy interview in (...) October 1998 in Coos Bay, Oregon, for a television news report on his decision to get a lethal prescription. Below is an extract from that interview. On the day this introduction was written, 10 March 1999, Pat took the prescribed lethal overdose of barbiturates and died at home. His illness was taking his voice, he could not move his hands or legs, and breathing was becoming very difficult. His mother told me he knew that was for him. (shrink)