While anti-exceptionalism about logic is now a popular topic within the philosophy of logic, there’s still a lack of clarity over what the proposal amounts to. currently, it is most common to conceive of AEL as the proposal that logic is continuous with the sciences. Yet, as we show here, this conception of AEL is unhelpful due to both its lack of precision, and its distortion of the current debates. Rather, AEL is better understood as the rejection of certain traditional (...) properties of logic. The picture that results is not of one singular position, but rather a cluster of often connected positions with distinct motivations, understood in terms of their rejection of clusters of the various traditional properties. In order to show the fruitfulness of this new conception of AEL, we distinguish between two prominent versions of the position, metaphysical and epistemological AEL, and show how the two positions need not stand or fall together. (shrink)

Purposeful infection of healthy volunteers with a microbial pathogen seems at odds with acceptable ethical standards, but is an important contemporary research avenue used to study infectious diseases and their treatments. Generally termed ‘controlled human infection studies’, this research is particularly useful for fast tracking the development of candidate vaccines and may provide unique insight into disease pathogenesis otherwise unavailable. However, scarce bioethical literature is currently available to assist researchers and research ethics committees in negotiating the distinct issues raised by (...) research involving purposefully infecting healthy volunteers. In this article, we present two separate challenge studies and highlight the ethical issues of human challenge studies as seen through a well-constructed framework. Beyond the same stringent ethical standards seen in other areas of medical research, we conclude that human challenge studies should also include: independent expert reviews, including systematic reviews; a publicly available rationale for the research; implementation of measures to protect the public from spread of infection beyond the research setting; and a new system for compensation for harm. We hope these additions may encourage safer and more ethical research practice and help to safeguard public confidence in this vital research alternative in years to come. (shrink)

Strategies to increase influenza vaccination rates have typically targeted healthcare professionals and individuals in various high-risk groups such as the elderly. We argue that they should focus on increasing vaccination rates in children. Because children suffer higher influenza incidence rates than any other demographic group, and are major drivers of seasonal influenza epidemics, we argue that influenza vaccination strategies that serve to increase uptake rates in children are likely to be more effective in reducing influenza-related morbidity and mortality than those (...) targeting HCPs or the elderly. This is true even though influenza-related morbidity and mortality amongst children are low, except in the very young. Further, we argue that there are no decisive reasons to suppose that children-focused strategies are less ethically acceptable than elderly or HCP-focused strategies. (shrink)

Given the plethora of competing logical theories of validity available, it’s understandable that there has been a marked increase in interest in logical epistemology within the literature. If we are to choose between these logical theories, we require a good understanding of the suitable criteria we ought to judge according to. However, so far there’s been a lack of appreciation of how logical practice could support an epistemology of logic. This paper aims to correct that error, by arguing for a (...) practice-based approach to logical epistemology. By looking at the types of evidence logicians actually appeal to in attempting to support their theories, we can provide a more detailed and realistic picture of logical epistemology. To demonstrate the fruitfulness of a practice-based approach, we look to a particular case of logical argumentation—the dialetheist’s arguments based upon the self-referential paradoxes—and show that the evidence appealed to support a particular theory of logical epistemology, logical abductivism. (shrink)

Three plausible views—Presentism, Truthmaking, and Independence—form an inconsistent triad. By Presentism, all being is present being. By Truthmaking, all truth supervenes on, and is explained in terms of, being. By Independence, some past truths do not supervene on, or are not explained in terms of, present being. We survey and assess some responses to this.

European Journal of Philosophy, EarlyView.

Some healthcare systems are said to be grounded in solidarity because healthcare is funded as a form of mutual support. This article argues that health care systems that are grounded in solidarity have the right to penalise some users who are responsible for their poor health. This derives from the fact that solidary systems involve both rights and obligations and, in some cases, those who avoidably incur health burdens violate obligations of solidarity. Penalties warranted include direct patient contribution to costs, (...) and lower priority treatment, but not typically full exclusion from the healthcare system. We also note two important restrictions on this argument. First, failures of solidary obligations can only be assumed under conditions that are conducive to sufficiently autonomous choice, which occur when patients are given ‘Golden Opportunities’ to improve their health. Second, because poor health does not occur in a social vacuum, an insistence on solidarity as part of healthcare is legitimate only if all members of society are held to similar standards of solidarity. We cannot insist upon, and penalise failures of, solidarity only for those who are unwell, and who cannot afford to evade the terms of public health. (shrink)

European Journal of Philosophy, Volume 30, Issue 3, Page 1110-1124, September 2022.

Efforts to promote equitable public policy with algorithms appear to be fundamentally constrained by the “impossibility of fairness” (an incompatibility between mathematical definitions of fairness). This technical limitation raises a central question about algorithmic fairness: How can computer scientists and policymakers support equitable policy reforms with algorithms? In this article, I argue that promoting justice with algorithms requires reforming the methodology of algorithmic fairness. First, I diagnose the problems of the current methodology for algorithmic fairness, which I call “formal algorithmic (...) fairness.” Because formal algorithmic fairness restricts analysis to isolated decision-making procedures, it leads to the impossibility of fairness and to models that exacerbate oppression despite appearing “fair.” Second, I draw on theories of substantive equality from law and philosophy to propose an alternative methodology, which I call “substantive algorithmic fairness.” Because substantive algorithmic fairness takes a more expansive scope of analysis, it enables an escape from the impossibility of fairness and provides a rigorous guide for alleviating injustice with algorithms. In sum, substantive algorithmic fairness presents a new direction for algorithmic fairness: away from formal mathematical models of “fair” decision-making and toward substantive evaluations of whether and how algorithms can promote justice in practice. (shrink)

Considerable attention recently has been paid to anti-exceptionalism about logic, the thesis that logic is more similar to the sciences in important respects than traditionally thought. One of AEL’s prominent claims is that logic’s methodology is similar to that of the recognised sciences, with part of this proposal being that logics provide explanations in some sense. However, insufficient attention has been given to what this proposal amounts to, and the challenges that arise in providing an account of explanations in logic. (...) This paper clarifies these challenges, and shows how the practice-based approach is best placed to meet them. (shrink)

There is significant controversy over whether patients have a ‘right not to know’ information relevant to their health. Some arguments for limiting such a right appeal to potential burdens on others that a patient’s avoidable ignorance might generate. This paper develops this argument by extending it to cases where refusal of relevant information may generate greater demands on a publicly funded healthcare system. In such cases, patients may have an ‘obligation to know’. However, we cannot infer from the fact that (...) a patient has an obligation to know that she does not also have a right not to know. The right not to know is held against medical professionals at a formal institutional level. We have reason to protect patients’ control over the information that they receive, even if in individual instances patients exercise this control in ways that violate obligations. (shrink)

This article explains and defends a novel idea about how people can be misled by a discussion topic, even if the discussion itself does not explicitly involve the making of false claims. The crucial aspect of this idea is that people are liable to infer, from the fact that a particular topic is being discussed, that this topic is important. As a result, they may then be led to accept certain beliefs about the state of the world they consider necessary (...) for the topic’s importance. What the article calls “importance misrepresentation” occurs when these beliefs about the state of the world are false or otherwise mistaken. The article explores different ways in which importance misrepresentation can occur, and it uses this idea to help clarify and strengthen some well‐known criticisms of the topic choices of academic philosophers. (shrink)

I introduce a distinction between health need and medical need, and raise several questions about their interaction. Health needs are needs that relate directly to our health condition. Medical needs are needs which bear some relation to medical institutions or processes. I suggest that the question of whether medical insurance or public care should cover medical needs, health needs, or only needs which fit both categories is a political question that cannot be resolved definitionally. I also argue against an overly (...) strict definition of medical need on the grounds that this presupposes, wrongly, that medical intervention should always be a last resort. (shrink)

Is or has economics ever been the imperial social science? Could or should it ever be so? These are the central concerns of this book. It involves a critical reflection on the process of how economics became the way it is, in terms of a narrow and intolerant orthodoxy, that has, nonetheless, increasingly directed its attention to appropriating the subject matter of other social sciences through the process termed "economics imperialism". In other words, the book addresses the shifting boundaries between (...) economics and the other social sciences as seen from the confines of the dismal science, with some reflection on the responses to the economic imperialists by other disciplines. Significantly, an old economics imperialism is identified of the "as if market" style most closely associated with Gary Becker, the public choice theory of Buchanan and Tullock and cliometrics. But this has given way to a more "revolutionary" form of economics imperialism associated with the information-theoretic economics of Akerlof and Stiglitz, and the new institutional economics of Coase, Wiliamson and North. Embracing one "new" field after another, economics imperialism reaches its most extreme version in the form of "freakonomics", the economic theory of everything on the basis of the most shallow principles. By way of contrast and as a guiding critical thread, a thorough review is offered of the appropriate principles underpinning political economy and its relationship to social science, and how these have been and continue to be deployed. The case is made for political economy with an interdisciplinary character, able to bridge the gap between economics and other social sciences, and draw upon and interrogate the nature of contemporary capitalism. (shrink)

There is an ongoing increase in the use of mobile health technologies that patients can use to monitor health-related outcomes and behaviours. While the dominant narrative around mHealth focuses on patient empowerment, there is potential for mHealth to fit into a growing push for patients to take personal responsibility for their health. I call the first of these uses ‘medical monitoring’, and the second ‘personal health surveillance’. After outlining two problems which the use of mHealth might seem to enable us (...) to overcome—fairness of burdens and reliance on self-reporting—I note that these problems would only really be solved by unacceptably comprehensive forms of personal health surveillance which applies to all of us at all times. A more plausible model is to use personal health surveillance as a last resort for patients who would otherwise independently qualify for responsibility-based penalties. However, I note that there are still a number of ethical and practical problems that such a policy would need to overcome. The prospects of mHealth enabling a fair, genuinely cost-saving policy of patient responsibility are slim. (shrink)

The idea of using responsibility in the allocation of healthcare resources has been criticized for, among other things, too readily abandoning people who are responsible for being very badly off. One response to this problem is that while responsibility can play a role in resource allocation, it cannot do so if it will leave those who are responsible below a “sufficiency” threshold. This paper considers first whether a view can be both distinctively sufficientarian and allow responsibility to play a role (...) even for those who will be left with very poor health. It then draws several further distinctions that may affect the application of responsibility at this level. We conclude that a more plausible version of the sufficientarian view is to allow a role for responsibility where failure to do so will leave someone else who is not responsible below the sufficiency threshold. However, we suggest that individuals must exhibit “sufficient responsibility” in order for this to apply, involving both a sufficient level of control and an avoidable failure to respond adequately to reasons for action. (shrink)

Existing regulation of end-of-life care is flawed. Problems include poorly-designed laws, policies, ethical codes, training, and funding programs, which often are neither effective nor helpful in guiding decision-making. This leads to adverse outcomes for patients, families, health professionals, and the health system as a whole. A key factor contributing to the harms of current regulation is a siloed approach to regulating end-of-life care. Existing approaches to regulation, and research into how that regulation could be improved, have tended to focus on (...) a single regulatory instrument (e.g., just law or just ethical codes). As a result, there has been a failure to capture holistically the various forces that guide end-of-life care. This article proposes a response to address this, identifying “regulatory space” theory as a candidate to provide the much-needed holistic insight into improving regulation of end-of-life care. The article concludes with practical implications of this approach for regulators and researchers. (shrink)

A considerable literature has emerged around the idea of using ‘personal responsibility’ as an allocation criterion in healthcare distribution, where a person's being suitably responsible for their health needs may justify additional conditions on receiving healthcare, and perhaps even limiting access entirely, sometimes known as ‘responsibilisation’. This discussion focuses most prominently, but not exclusively, on ‘luck egalitarianism’, the view that deviations from equality are justified only by suitably free choices. A superficially separate issue in distributive justice concerns the two–way relationship (...) between health and other social goods: deficits in health typically undermine one's abilities to secure advantage in other areas, which in turn often have further negative effects on health. This paper outlines the degree to which this latter relationship between health and other social goods exacerbates an existing problem for proponents of responsibilisation (the ‘harshness objection’) in ways that standard responses to this objection cannot address. Placing significant conditions on healthcare access because of a person's prior responsibility risks trapping them in, or worsening, negative cycles where poor health and associated lack of opportunity reinforce one another, making further poor yet ultimately responsible choices more likely. It ends by considering three possible solutions to this problem. (shrink)

Pettigrew offers new axiomatic constraints on legitimate measures of inaccuracy. His axiom called ‘Decomposition’ stipulates that legitimate measures of inaccuracy evaluate a credence function in part based on its level of calibration at a world. I argue that if calibration is valuable, as Pettigrew claims, then this fact is an explanandum for accuracy-rst epistemologists, not an explanans, for three reasons. First, the intuitive case for the importance of calibration isn’t as strong as Pettigrew believes. Second, calibration is a perniciously global (...) property that both contravenes Pettigrew’s own views about the nature of credence functions themselves and undercuts the achievements and ambitions of accuracy-rst epistemology. Finally, Decomposition introduces a new kind of value compatible with but separate from accuracy-proper in violation of Pettigrew’s alethic monism. introduction. (shrink)

ABSTRACT We argue that Roberts’s argument for the thesis that absolute velocity is not measurable in a Newtonian world is unsound, because it depends on an analysis of measurement that is not extensionally adequate. We propose an alternative analysis of measurement, one that is extensionally adequate and entails that absolute velocity is measured in at least one Newtonian world. If our analysis is correct, then this Newtonian world is a counterexample to the widely endorsed thesis that if a property varies (...) under the symmetries of a theory then, according to that theory, the property could not be measured. Thus, our paper shows that the debate over the measurability of symmetry-variant properties is more unsettled than previously supposed. (shrink)

This paper first offers a standard modal extension of dialetheic logics that respect the normal semantics for negation and conjunction, in an attempt to adequately model absolutism, the thesis that there are true contradictions at metaphysically possible worlds. It is shown, however, that the modal extension has unsavoury consequences for both absolutism and dialetheism. While the logic commits the absolutist to dialetheism, it commits the dialetheist to the impossibility of the actual world. A new modal logic AV is then proposed (...) which avoids these unsavoury consequences by invalidating the interdefinability rules for the modal operators with the use of two valuation relations. However, while using AV carries no significant cost for the absolutist, the same isn't true for the dialetheist. Although using AV allows her to avoid the consequence that the actual world is an impossible world, it does so only on the condition that the dialetheist admits that she cannot give a dialetheic solution to all self-refe.. (shrink)

Healthcare practitioners have access to a range of ethical guidance. However, the normative role of this guidance in ethical decision-making is underexplored. This paper considers two ways that healthcare practitioners could approach ethics guidance. We first outline the idea of deference to ethics guidance, showing how an attitude of deference raises three key problems: moral value; moral understanding; and moral error. Drawing on philosophical literature, we then advocate an alternative framing of ethics guidance as a form of moral testimony by (...) colleagues and suggest that a more promising attitude to ethics guidance is to approach it in the spirit of ‘critical engagement’ rather than deference. (shrink)

Conventional wisdom suggests that environmental pragmatists balk at the mere mention of intrinsic value. Indeed, the leading expositor of the pragmatic position in environmental philosophy, Bryan Norton, has delivered withering criticisms of the concept as it has been employed by nonanthropocentrists in the field. Nevertheless, I believe that Norton has left an opening for a recognition of intrinsic value in his arguments, albeit a version that bears little resemblance to most of its traditional incarnations. Drawing from John Dewey’s contextual approach (...) toward moral inquiry, I offer a reconstructed notion of intrinsic value that avoids the metaphysical pitfalls identified by Norton. I argue that this contextual understanding of noninstrumental claims has the advantage of turning our attention toward, and not away from, the critical realm of practice and policy, and that it is especially compatible with the norms of democratic deliberation. By way of example and in defense of my position, I conclude with a rejoinder to Holmes Rolston’s claims about the role of foundational intrinsic value commitments in settling the human-nature dilemma at Royal Chitwan National Park in Nepal. (shrink)

Greg Bognar has recently offered a prioritarian justification for ‘fair innings’ distributive principles that would ration access to healthcare on the basis of patients' age. In this article, I agree that Bognar's principle is among the strongest arguments for age-based rationing. However, I argue that this position is incomplete because of the possibility of ‘time-relative' egalitarian principles that could complement the kind of lifetime egalitarianism that Bognar adopts. After outlining Bognar's position, and explaining the attraction of time-relative egalitarianism, I suggest (...) various ways in which these two kinds of principle could interact. Since various options have very different implications for age-based rationing, proponents of such a rationing scheme must take a position on time-relative egalitarianism to complement a lifetime prioritarian view like Bognar's. (shrink)

Several recent articles have weighed in on the question of whether moral philosophers can be counted as moral experts. One argument denying this has been rejected by both sides of the debate. According to this argument, the extent of disagreement in modern moral philosophy prevents moral philosophers from being classified as moral experts. Call this the Argument From Disagreement. In this article, I defend a version of AD. Insofar as practical issues in moral philosophy are characterized by disagreement between moral (...) philosophers who are more or less equally well credentialed on the issue, non-philosophers have no good reasons to defer to their views. (shrink)

In this paper, I argue that, when it comes to explaining what can be described as “representational” properties of propositions, Soames’s new conception of propositions—on which the proposition that Seattle is sunny is the act of predicating the property being sunny of Seattle and to entertain that proposition is to perform that act—does not have an advantage over traditional ones.

Using Schelling's philosophy, Ben Woodard examines how an expanded form of naturalism changes how we conceive of the division between thought and world, mathematics and motion, sense and dynamics, experiment and materiality, as well as speculation and pragmatism. Nature, in Schelling's eyes, is not the great outdoors or some authentic pastoral realm, but the various powers, processes and tendencies which run through biology, chemistry, physics and the very possibility of thought itself.

Conventional wisdom suggests that environmental pragmatists balk at the mere mention of intrinsic value. Indeed, the leading expositor of the pragmatic position in environmental philosophy, Bryan Norton, has delivered withering criticisms of the concept as it has been employed by nonanthropocentrists in the field. Nevertheless, I believe that Norton has left an opening for a recognition of intrinsic value in his arguments, albeit a version that bears little resemblance to most of its traditional incarnations. Drawing from John Dewey’s contextual approach (...) toward moral inquiry, I offer a reconstructed notion of intrinsic value that avoids the metaphysical pitfalls identified by Norton. I argue that this contextual understanding of noninstrumental claims has the advantage of turning our attention toward, and not away from, the critical realm of practice and policy, and that it is especially compatible with the norms of democratic deliberation. By way of example and in defense of my position, I conclude with a rejoinder to Holmes Rolston’s claims about the role of foundational intrinsic value commitments in settling the human-nature dilemma at Royal Chitwan National Park in Nepal. (shrink)

INTRODUCTION TO THE ARGUMENT AND ITS HISTORY PRIOR TO THE AND CENTURIES In the history of ideas, there is an argument that has been used repeatedly, ...

This paper argues for a theory of phenomenal intentionality (herein referred to as ‘Structuralism’), according to which perceptual experiences only possess intentional content when their phenomenal components are appropriately related to one another. This paper responds to the objections (i) that Structuralism cannot explain why some experiences have content while others do not, or (ii) why contentful experiences have the specific contents that they have. Against (i), I argue that to possess content, an experience must present itself as an experience (...) of something distinct from itself, and that only experiences whose components are suitably structured satisfy this requirement. Against (ii), I argue that Structuralists can provide a deeper explanation of perceptual content than other theories of phenomenal intentionality by showing how the content-determining relations among our experiences depend on the selection pressures under which our perceptual systems developed. (shrink)

A growing number of contributors to environmental philosophy are beginning to rethink the field’s mission and practice. Noting that the emphasis of protracted conceptual battles over axiology may not get us very far in solving environmental problems, many environmental ethicists have begun to advocate a more pragmatic, pluralistic, and policy-based approach in philosophical discussions abouthuman-nature relationships. In this paper, we argue for the legitimacy of this approach, stressing that public deliberation and debate over alternative environmental ethics is necessary for a (...) culture of democracy to be upheld in decision making and policy formulation. Then we argue for a democratically tempered environmental ethics that is grounded in a practical understanding of the character of moral claims regarding the natural world. We offer the results of an empirical study of environmental ethics held by the public to illustrate the diversity in their moral commitments to nature. Finally, we conclude with a discussion of the implications of this ethical pluralism for policy discussions about the management of American public lands. (shrink)

Research ethics guidelines grew out of several infamous episodes where research subjects were exploited. There is significant international synchronization of guidelines. However, indigenous groups in New Zealand, Canada and Australia have criticized these guidelines as being inadequate for research involving indigenous people and have developed guidelines from their own cultural perspectives. Whilst traditional research ethics guidelines place a lot of emphasis on informed consent, these indigenous guidelines put much greater emphasis on interdependence and trust. This article argues that traditional guidelines (...) are premised on relationships of equal power, and that often the researcher has more power that is not fully equalized by providing information. Where there is a relationship of unequal power, then focusing on interdependence and trust is more likely to achieve ethical safety. We illustrate this thesis by describing the detail of a research project looking at the use of interpreters, where we video-recorded live consultations and then interviewed the patient, interpreter and doctor. We conclude by suggesting that mainstream research ethics guidelines should pay more attention to the development of a trustworthy relationship between subject and researcher, and that, following the lead from clinical medicine, we should develop a culturally competent ethical framework for research on human subjects. (shrink)

We developed this study to examine the issue of parental refusal of treatment, looking at the issue through a cultural competence lens. Recent cases in Canada where courts have declined applications by clinicians for court orders to overrule parental refusal of treatment highlight the dispute in this area. This study analyses the 16 cases of a larger group of 24 cases that were selected by a literature review where cultural or religious beliefs or ethnic identity was described as important reasons (...) behind the refusal. The most significant finding was that nearly all of the cases cited unacceptable side effects as the main reason for declining treatment. We then analysed the detail of the cases and concluded that in the first instance a skilled clinical approach to develop an agreed management plan is by far the best approach. In the event that agreement cannot be reached we recommend engaging a mediator to help the clinician and parents/child to find an agreeable way forward. We argue that the option of se... (shrink)

This paper proposes an analysis of statements about universals according to which such statements assert nothing more than that the evidence we’d take to confirm them obtains, where this evidence is understood to consist solely of patterns in the behavior of particulars that cannot be explained by other regularities in the way things behave. On this analysis, to say that a universal exists is simply to say that there is such a pattern in the behavior of certain particulars, and for (...) any predicate F that is presumed to correspond to a universal, to say that a particular is F is simply to say that its behavior exhibits a pattern of this sort. I argue that there is no theoretical work that we want postulations and ascriptions of universals to do that they’d be unfit for if analyzed in this way, and consequently that there is no reason to treat such statements as asserting anything more than what the proposed analysis suggests. (shrink)

Many political realists endorse some notion of political normativity. They think that there are certain normative claims about politics that do not depend on moral premises. The most prominent moralist objections to political normativity have been metaethical: specifically, that political normativity is not genuinely normative; and that it is incapable of justifying normative claims. In this article, I criticize the latter metaethical objection. I argue that the objection presupposes a notion of ‘justification’ that renders it something that is no longer (...) necessarily valuable to realists. I then extend this argument to show that all metaethical objections to political normativity are unsuccessful. Furthermore, insofar as these metaethical objections purport to constrain the types of politics that realists endorse, realists should regard them as another expression of what Raymond Geuss calls ‘dead politics’. (shrink)

This article considers attempts to include the issues of ageing and ill health in a Rawlsian framework. It first considers Norman Daniels’ Prudential Lifespan Account, which reduces intergenerational questions to issues of intrapersonal prudence from behind a Rawslian veil of ignorance. This approach faces several problems of idealisation, including those raised by Hugh Lazenby, because it must assume that everyone will live to the same age, undermining its status as a prudential calculation. I then assess Lazenby's account, which applies Rawls’ (...) general theory of justice more directly to healthcare. Lazenby suggests that we should apply Rawls’ difference principle – which claims that any inequalities in social goods must benefit the worst off – to conclude that we should significantly prioritise treatment of young patients. I argue first that the existence of young terminally ill patients undermines a number of Rawlsian arguments for the difference principle. I then argue that the structure of ageing undermines the Rawlsian decision mechanism of the ‘veil of ignorance’ on which Lazenby relies. I conclude that age and terminal illness present significant problems for any comprehensive Rawlsian account of justice. (shrink)

Journal of Social Philosophy, EarlyView.

The notion of financialisation as the exploitation or expropriation of workers’ wages in the sphere of exchange is taken as a critical point of departure. In this way, financialisation is more deeply rooted in contemporary developments, including the slowdown preceding the current global crisis, and in Marx’s own theory of finance. Financialisation is seen to represent the increasing penetration of interest-bearing capital across economic and social reproduction and to be a key defining moment of neoliberalism.

Pickeringet al’s paper argues that the capacity of the decision-maker is the sole consideration in whether a decision should stand, and that the risk of the decision should not be considered. This argument ignores the existence of the player who is of the view that a decision is not wise. This paper argues that patient autonomy is not the sole determinant of whether a person is able to make an unwise decision, particularly in healthcare where there are always others affected (...) by the patient decision. Rather than asserting that patients have an unfettered autonomous choice on clinical decisions this paper argues that these decisions should be looked at through the lens of quality in health care that has proposed four parameters to be balanced; the patient experience, wise use of resources, the effect on public health and the clinician experience. (shrink)

Many of the leading contributors to the field of environmental ethics demonstrate a preference for foundationalist approaches in their theoretical justifications of environmentalism. In this paper, I criticise this tendency as it figures in the work of Holmes Rolston III, J. Baird Callicott, and Eric Katz. I illustrate how these writers' desire for philosophical absolutes leads them to reject the moral resources present within human culture; a move that carries with it a number of troubling philosophical and political problems. I (...) conclude that environmental theorists would be better served by taking a more contextual, social, and pragmatic approach to justifying their moral projects regarding nature, and that this mode of inquiry will ultimately lead toward a more philosophically sound and democratically authentic environmental ethics. (shrink)