On the eve of the presidential inauguration, the U.S. health system faces rising costs of care, growing numbers of uninsured, wide variations in quality of care, and mounting public dissatisfaction. Despite spending more on health care than any other country, a recent Commonwealth Fund Commission on a High Performance Health Care System National Scorecard reports that the United States is lagging far behind other major industrialized countries — all of which provide universal health insurance — in five key domains: healthy (...) lives, access, quality, equity, and efficiency. U.S. national performance is well below benchmarks of top performance set by other countries or high performing states, hospitals, or health plans within the United States, with broad disparities in experience depending on geographic location, income, race/ethnicity, and insurance coverage. National leadership is required to manage the growing health care crisis in the United States and improve care for all Americans. (shrink)

Policy officials often assert that the U.S. has the best health care system in the world, but a recent scorecard on U.S. health system performance finds that the U.S. achieves a score of only 65 out of a possible 100 points on key indicators of performance in five key domains: healthy lives, access, quality, equity, and efficiency, where 100 represents the best achieved performance in other countries or within the U.S. The U.S. should aim higher by adopting a set of (...) policies that will extend affordable health insurance to all; align financial incentives for health care providers to enhance value and achieve savings; organize the health care system around the patient to ensure that care is accessible and coordinated; meet and raise benchmarks for high-quality, efficient care; and ensure accountable national leadership and public-private collaboration. The incoming president and Congress should aspire to have the best health system in the world — not just assert it — and can do so by learning from examples of excellence within the U.S. and abroad. (shrink)

Du Châtelet’s 1740 text Foundations of Physics tackles three of the major foundational issues facing natural philosophy in the early eighteenth century: the problem of bodies, the problem of force, and the question of appropriate methodology. This paper offers an introduction to Du Châtelet’s philosophy of science, as expressed in her Foundations of Physics, primarily through the lens of the problem of bodies.

This article explores the relationship between pragmatic encroachment and epistemic permissiveness. If the suggestion that all epistemic notions are interest-relative is viable , then it seems that a certain species of epistemic permissivism must be viable as well. For, if all epistemic notions are interest relative then, sometimes, parties in paradigmatic cases of shared evidence can be maximally rational in forming competing basic doxastic attitudes towards the same proposition. However, I argue that this total pragmatic encroachment is not tenable, and, (...) thus, epistemic permissivism cannot be vindicated in this way. (shrink)

Volume 19, Issue 11, November 2019, Page 69-70.

In July 2018, the Nuffield Council on Bioethics released the report Genome editing and human reproduction: Social and ethical issues, concluding that human germline modification of human embryos for implantation is not ‘morally unacceptable in itself’ and could be ethically permissible in certain circumstances once the risks of adverse outcomes have been assessed and the procedure appears ‘reasonably safe’. The Nuffield Council set forth two main principles governing anticipated uses and envisions applications that may include health enhancements as a public (...) health measure. This essay provides a critique of three aspects in the Nuffield Council’s Report: its presumption of therapeutic efficacy, its inflation of parental rights to create a certain type of child, and its reliance on a specially commissioned report that appears to distort key definitions in international law. (shrink)

In this paper, I answer the question,how do we collaborate well with others?I first look at cases of good collaboration, contrasting them briefly with some cases of poor collaboration; I then describe the similarities between the good cases, such as shared aims, shared planning of projects, shared norms among collaborators. The conclusion is that collaborating well involves shared norms, derived both from societal norms and from a well‐ordered relationship between participants; a shared vision derived from shared knowledge and open communication (...) grounded in relationship; and open‐mindedness and thoughtful disagreement, which depend on mutual respect and trust between participants. (shrink)

Recent work on inheritance systems can be divided into inclusive conceptions, according to which genetic and non-genetic inheritance are both involved in the development and transmission of nearly all animal behavioral traits, and more demanding conceptions of what it takes for non-genetic resources involved in development to qualify as a distinct inheritance system. It might be thought that, if a more stringent conception is adopted, homologies could not subsist across two distinct inheritance systems. Indeed, it is commonly assumed that homology (...) relations cannot survive a shift between genetic and cultural inheritance systems, and substantial reliance has been placed on that assumption in debates over the phylogenetic origins of hominin behavioral traits, such as male-initiated intergroup aggression. However, in the homology literature it is widely accepted that a trait can be homologous—that is, inherited continuously in two different lineages from a single common ancestor—despite divergence in the mechanisms involved in the trait’s development in the two lineages. In this paper, we argue that even on an extremely stringent understanding of what it takes for developmental resources to form a separate inheritance system, homologies can nonetheless subsist across shifts between distinct inheritance systems. We argue that this result is a merit of this way of characterizing what it is to be an inheritance system, that it has implications for adjudicating between alternative accounts of homology, and that it offers an important cautionary lesson about how to reason with the homology concept, particularly in the context of cultural species. (shrink)

Background Moral resilience is the integrity and emotional strength to remain buoyant and achieve moral growth amid distressing situations. Evidence is still emerging on how to best cultivate moral resilience. Few studies have examined the predictive relationship of workplace well-being and of organizational factors with moral resilience. Research aims The aims are to examine associations of workplace well-being (i.e., compassion satisfaction, burnout, and secondary traumatic stress) and moral resilience, and to examine associations of workplace factors (i.e., authentic leadership and perceived (...) congruence of organizational mission and behaviors) and moral resilience. Research design This study uses a cross-sectional design. Participants and research context: Nurses practicing in a hospital in the United States were surveyed using validated instruments (N = 147). Individual factors were measured using demographics and the Professional Quality of Life Scale. Organizational factors were measured using the Authentic Leadership Questionnaire and a single item measuring organizational mission/behavior congruence. Moral resilience was measured using the Rushton Moral Resilience Scale. Ethical considerations The study was approved by an institutional review board. Findings Resilience was noted to have significant small correlations with burnout, secondary traumatic stress, compassion satisfaction, and organizational mission/behavior congruence. Burnout and secondary traumatic stress predicted less resilience, whereas compassion satisfaction and perceived congruence between organizational mission and behaviors predicted higher resilience. Discussion Burnout and secondary traumatic stress, increasingly experienced by nurses and other health professionals, have negative effects on moral resilience. Compassion satisfaction can increase resilience, which is especially important in nursing. Organizational practices promoting integrity and confidence can have positive effects on resilience. Conclusions Continued work to confront workplace well-being issues, especially burnout, is needed as a way of increasing moral resilience. Studies of organizational and work environment factors to bolster resilience are likewise needed to assist organizational leaders in devising the best strategies. (shrink)

Ciudad Cayalá in Guatemala brands itself as the country’s first private city. I turn to Hannah Arendt to show how and why Cayalá does not and cannot provide the space of appearance she argues is needed to support the possibility of political action. I show how Arendt provides two apparently distinct phenomenological accounts in The Human Condition—one historically-oriented and the other politically-oriented—that articulate how Cayalá fails in its aspiration to privatize the political. Yet the apparent divergence between her accounts raises (...) concern about her relevance for liberatory feminist projects. To demonstrate how and why Arendt’s political phenomenology is aligned with certain feminist aims, I also generate a Cayaláian reading of Arendt to demonstrate the coherence of her two phenomenological accounts through interpreting her thinking by way of Cayalá’s architecture. This article enacts a dialogue between Arendt and Cayalá, mediated by feminist and architectural theory, concerning why efforts toward the privatization of cities will fail. (shrink)

A who's who of Sartre scholars contribute to a collection of multidisciplinary perspectives from sociology, religion, and bioethics, on a hitherto neglected area of Sartre's philosophy.

Newton characterizes the reasoning of Principia Mathematica as geometrical. He emulates classical geometry by displaying, in diagrams, the objects of his reasoning and comparisons between them. Examination of Newton’s unpublished texts shows that Newton conceives geometry as the science of measurement. On this view, all measurement ultimately involves the literal juxtaposition—the putting-together in space—of the item to be measured with a measure, whose dimensions serve as the standard of reference, so that all quantity is ultimately related to spatial extension. I (...) use this conception of Newton’s project to explain the organization and proofs of the first theorems of mechanics to appear in the Principia. The placementof Kepler’s rule of areas as the first proposition, and the manner in which Newton proves it, appear natural on the supposition that Newton seeks a measure, in the sense of a moveable spatial quantity, of time. I argue that Newton proceeds in this way so that his reasoning can have the ostensive certainty of geometry. (shrink)

Why do we form strong emotional attachments to unlikeable and immoral characters during our engagements with fictions? These pro-attitudes persist even as we realize that we would loathe these people if we were to encounter them in real-life. In this paper, I explore the implications of the sympathy for the devil phenomenon. I begin by considering several popular explanations, including simulation, aesthetic distancing, pre-focusing, and the ‘best of all characters’. I conclude that each one is inadequate. I then propose my (...) own explanation of the phenomenon, the fascinated attention approach. (shrink)

We must reconceive the ethical relationship between mothers and their newborn babies. The intertwinement of mother and baby does not disappear with birth but rather persists in the form of postpartum maternal tethering. Drawing upon three years of ethnographic fieldwork and training in the United States and China, I argue that dependencies associated with postpartum maternal tethering make it extremely difficult for postpartum mothers to act autonomously, even in the relational sense. Breaching this tether opens up new possibilities for thinking (...) about the bioethics of vulnerability, dependency, and care by denaturalizing and desanctifying the mother-baby relationship and diversifying newborn care. (shrink)

Metacognition – the ability to represent, monitor and control ongoing cognitive processes – helps us perform many tasks, both when acting alone and when working with others. While metacognition is adaptive, and found in other animals, we should not assume that all human forms of metacognition are gene-based adaptations. Instead, some forms may have a social origin, including the discrimination, interpretation, and broadcasting of metacognitive representations. There is evidence that each of these abilities depends on cultural learning and therefore that (...) cultural selectionmight shape humanmetacognition. The cultural origins hypothesis is a plausible and testable alternative that directs us towards a substantial new programme of research. (shrink)

Mental capacity and autonomy are often understood to be normatively neutral? the only values or other norms they may presuppose are those the assessed person does or would accept. We show how mental disorder threatens normatively neutral accounts of autonomy. These accounts produce false positives, particularly in the case of disorders (such as depression, anorexia nervosa and schizophrenia) that affect evaluative abilities. Two normatively neutral strategies for handling autonomy-undermining disorder are explored and rejected: a blanket exclusion of mental disorder, and (...) functional tests requiring consistency, expression of identity, reflective non-alienation or lack of compulsion. Finally, we suggest ways in which substantivist alternatives to neutrality can be made more promising through increased transparency, democratic contestability of conditions for capacity and autonomy, and a historically sensitive caution concerning restrictions of liberty. (shrink)

Part 1 of this article exposed a tension between Poincaré’s views of arithmetic and geometry and argued that it could not be resolved by taking geometry to depend on arithmetic. Part 2 aims to resolve the tension by supposing not merely that intuition’s role is to justify induction on the natural numbers but rather that it also functions to acquaint us with the unity of orders and structures and show practices to fit or harmonize with experience. I argue that in (...) this manner, intuition serves the epistemological function of warranting generalizations and justifying practices. In particular, it justifies the application of group-theoretic notions in geometry but not the use of set-theoretic notions in arithmetic. (shrink)

The Armidale State Forest is a pine plantation at the edge of the Armidale city in New South Wales, Australia. In 2000 and 2007 large parts of the forest were destroyed in clear-felling operations. This sparked community outrage which led to the formation of advocacy groups who have begun to restore the forest despite its controversial position as a “conifer invader” in Eucalypt country. In this paper I focus on the way personal memories are embodied in the pine forms to (...) challenge the native/invasive divide in Australian conservation discourse. I argue that the destruction of this devalued ecology caused a traumatic rupture to the Armidale communities’ connection to a forest which preserves their pasts. To heal this environmental and psychological damage, I propose a recuperative approach termed “ecological remembrance” that strives to repair severed connections between people and place. (shrink)

Health care providers’ interpretation of law can have intended and unintended effects on health care delivery in Canada. At times, health care providers encounter situations where they perceive the law to conflict with their sense of what is most ethically justified. In many cases, these health care providers feel especially torn because they assume that the legal requirements must dictate the decision, and cannot be explored or questioned. We challenge this assumption: the law is not as cut-and-dried as some assume; (...) therefore, its significance to health care decisions should be carefully considered. Within a systematic ethics process, legal considerations can be a source of values and information and can create opportunities for further dialogue. This approach is justified because it appropriately reflects the relationship of the law to ethics. This way of thinking about the law and ethics also avoids potentially harmful consequences of legalistic approaches to decision-making, such as breakdowns in communication, adversarial relationships, and a reduction of ethically complex decisions to simple rule following. (shrink)

The population of women farm operators continues to increase in the U.S. That growth, however, is mediated by research showing that women in agriculture experience persistent barriers to equality with men. The Feminist Agriculture Food Theory (FAST) developed by Sach et al. (The Rise of Women Farmers and Sustainable Agriculture, University of Iowa Press, Iowa City, (Sachs et al., The rise of women farmers and sustainable agriculture, University of Iowa Press, 2016) posits that in the face of these barriers, women (...) farmers in the Northeast are engaging in six strategies to increase their success. These include (1) increasing gender equality on their farms, (2) asserting an identity as a farmer, (3) gaining greater access to resources, (4) shaping new food and farming systems, (5) negotiating roles in agricultural organizations, and (6) forming women-centered farming organizations. While researchers have applied FAST to Michigan, it has not been examined at a national level. In this paper, then, we use the 2017 Census of Agriculture Data to measure how women in agriculture in the U.S. are faring on each aspect of FAST we can measure (strategies 1–5). We compare women to men farmers across these FAST strategies and across three different farm types: Non-Organic Non-Value-Added Farms, Organic Farms, and Value-Added Farms. Our findings suggest for FAST strategies 1 and 2 there is an increase in equity and ability to identify as a farmer for women on organic and value-added farms. However, our findings also suggest that for FAST strategies that require more institutional and structural resources (I.e. strategies 3–5), inequities persist across farm types. (shrink)

Kant’s Mathematical World (KMW) is a strikingly original, richly detailed account of Kant’s philosophy of mathematics as a reckoning with the long-held understa.

This article represents conversations with the American composer Libby Larsen in which she described her beliefs about music, music education, and the dilemmas that our current system faces as we seek to provide relevant and meaningful music education to our students. Our conversation explores such topics as cognitive psychology, music theory, cultural practices and developments in American culture, and current music education practices. Larsen brought up many questions about music education in America, providing some suggestions for the future and posing (...) problems for which the solution may require a great deal of imagination by music education teachers. The article is structured as a Socratic dialogue, in which Larsen constructs an inductively strong argu- ment for making radical changes to current music education practice. (shrink)

This chapter contains section titled: Reading Wittgenstein Wittgenstein and Waismann Further Directions: History of Philosophy Envoi: AWittgensteinian Reading of Wittgenstein?

Gamete donation offers a unique opportunity to compare men and women's relationships to reproductive decision-making, unlike other reproductive processes, which typically involve women's bodies much more asymmetrically. I address medical and reproductive decision-making by examining how a gamete donor's partner may be involved in the donation process. Some countries explicitly involve a donor's partner by legally requiring spousal consent for donation, but this is not the case for the U.S. In the absence of any formal regulation, what are the expectations (...) for involving a donor's partner? Through a content analysis of materials from donation programs across the U.S., I examine how donation programs configure the partner's role. Overall, I find that there are quite different expectations for partner involvement in egg versus sperm donation. Such differences, I argue, both stem from and reinforce existing issues navigating boundaries between intimate relationships and women's medical and reproductive autonomy. (shrink)

What might seem like a small ethical transgression by an individual can lead to a series of subsequent decisions, and result in serious fraud. This can not only impact the individuals involved and their organizations, but also erode public trust in firms and institutions. When Brian Sweet left a position with the Public Company Accounting Oversight Board (PCAOB), an organization that oversees the inspection of audits, and went to work for KPMG, one of the large accounting firms whose audits he (...) had inspected, he took with him confidential information that he thought could prove useful in his new position. Sweet subsequently shared confidential information with his new employer, and over the next two years acquired additional confidential information through contacts at PCAOB. Debra Kaufmann, a KPMG audit partner, was faced with a decision about how to react when Sweet shared confidential information that she believed neither she nor KPMG should have. (shrink)

This article explores how the intellectual and spiritual sensibilities of the French Catholic literary critic, Charles Du Bos (1882-1939), provide an insight into the construction of a particular "third-way" Catholic intellectual form of engagement during the interwar period. It is argued that the intellectual disposition underpinning Du Bos's third way rests fundamentally upon an accommodation of the "tragic." The evolving concept of tragedy in Du Bos's life and thought, before his conversion to Catholicism and beyond, facilitates his embrace of an (...) "ethic of responsibility," which is deployed in his third-way politico-ethical position on the Munich crisis of 1938. (shrink)

Dialogue, as a philosophical form, enables the exploration of the conditions, limits, and consequences of understanding arguments. Two philosophers who undertook to write dialogues—Plato and Heidegger—feature moments in philosophical conversation in which understanding, on its own, fails to convince an interlocutor of an argument. In this article, I examine the philosophical stakes of the collisions which unfold in Plato’s Gorgias, between Socrates and Callicles, and in Heidegger’s “Triadic Conversation,” between the Guide and the Scientist. Plato’s Socrates is ostensibly unsuccessful in (...) persuading Callicles to adopt his position while Heidegger’s Guide is able to support the Scientist in learning a new way of thinking. I argue that it is Heidegger’s attention to feeling as a philosophically significant phenomenon which can overcome trans-rational resistance which may persist even after truth has been determined. (shrink)

In the United States at this time, no uniform federal law exists regarding commercial surrogacy, and state statutory schemes vary vastly, ranging from criminalization to legal recognition with contract enforcement. The authors examine how commercial surrogacy agencies utilize the Internet as a means for attracting parents and surrogates by employing emotional cultural rhetoric. By inducing both parents and surrogates to their jurisdiction, agencies circumvent vast discrepancies in state statutory regulative schemes and create a distinct interstate business, absent an efficient regulatory (...) framework or legal recourse in some circumstances. The authors propose a uniform federal regulatory scheme premised upon regulating interstate business transactions to create accountability and legal remedies for both the parents and the surrogate. (shrink)

Congenital deafness is one of the most common birth defects reported. Approximately 70% of congenital deafness is non-syndromic, and approximately 80% of non-syndromic hearing loss results from a genetic cause. Middleton et al.’s1998 study highlighted the negative attitudes of culturally Deaf individuals towards genetic testing for genes known to cause hearing loss. While studies concerning genetic testing for deafness genes reference Middleton’s study, to our knowledge a re-evaluation of the attitudes of Deaf individuals towards genetic testing has not been conducted (...) recently. The purpose of this study is to re-establish attitudes of Deaf individuals towards genetic testing of genes known to cause hearing loss. A computer-based questionnaire was distributed to members of the Deaf community. Responses of participants were recorded and analyzed. The primary investigator then attended Deaf community events and the 2015 Alabama Association of the Deaf Conference, and recruited individuals interested in participating in the study. The surveys were distributed to these individuals and their anonymous responses were analyzed. Our results show there are more positive attitudes within the Deaf community towards genetic counseling, genetic testing, and prenatal testing of genes known to cause hearing loss than were previously documented, although negative attitudes are still present. Additionally, our study shows there is a desire among members of the Deaf community to learn more about and potentially receive these services, despite the fact they are rarely offered by healthcare providers. (shrink)

10. Ägyptologische Tempeltagung: Ägyptische Tempel zwischen Normierung und Individualität. Edited by Martina Ullmann. Königtum, Staat und Gesellschaft Früher Hochkulturen, vol. 3.5. Wiesbaden: Harrassowitz Verlag, 2016. Pp. xiii + 194, illus. €48.

Over the past two decades, stories of world-ending catastrophe have featured prominently in film and television. Zombie apocalypses, climate disasters, alien invasions, global pandemics and dystopian world orders fill our screens-typically with a singular figure or tenacious group tasked with saving or salvaging the world. Why are stories of End Times crisis so popular with audiences? And why is the hero so often a white man who overcomes personal struggles and incredible obstacles to lead humanity toward a restored future? This (...) book examines the familiar trope of the hero and the recasting of contemporary anxieties in narratives like The Walking Dead, Snowpiercer and Mad Max: Fury Road. Some have familiar roots in Western cultural traditions yet many question popular assumptions about heroes and heroism to tell new and fascinating stories about race, gender and society and the power of individuals to change the world. (shrink)