In The Healer's Power, Howard Brody placed the concept of power at the heart of medicine's moral discourse. Struck by the absence of “power” in the prevailing vocabulary of medical ethics, yet aware of peripheral allusions to power in the writings of some medical ethicists, he intuited the importance of power from the silence surrounding it. He formulated the problem of the healer's power and its responsible use as “the central ethical problem in medicine.” Through the prism of power he (...) refracted a wide range of ethical problems, from informed consent to truth-telling, from confidentiality to futility, from the physician's fantasies to the physician's virtues. At times this prism shed new light on old problems, enabling us to see from an unexpected angle the elements of which the problem was composed. At other times it exposed issues of ethical significance that had been neglected in the bioethics literature. (shrink)

This article probes the relationship among constitutionalism, extra-legal prerogative power, and citizen judgment. While much has been written about the nature of Lockean prerogative, and while his theory serves as a direct inspiration for contemporary "normative extra-legalists," key participants in the debate over emergency powers, less attention has been paid to how the people judge prerogative. Attention to this issue is useful because an examination of the process of political judgment of extra-legalism in Locke leads to a complication of the (...) current extra-legalist vision of democratic mechanisms of accountability. The author argues that the extra-legal approach is right to consider the role of democratic publics in potentially constraining the exercise of emergency powers but wrong to formulate that role as one extra-constitutional power checking another extra-constitutional power. The author situates both prerogative power and citizen judgment of it at the threshold of the constitutional order. (shrink)

This essay systematically reformulates an earlier argument about Locke and new world slavery, adding attention to Indians, natural law, and Locke's reception. Locke followed Grotian natural law in constructing a just-war theory of slavery. Unlike Grotius, though, he severely restricted the theory, making it inapplicable to America. It only fit resistance to “absolute power” in Stuart England. Locke was nonetheless an agent of British colonialism who issued instructions governing slavery. Yet they do not inform his theory—or vice versa. This creates (...) hermeneutical problems and raises charges of racism. If Locke deserves the epithet “racist,” it is not for his having a racial doctrine justifying slavery. None of this makes for a flattering portrait. Locke's reputation as the champion of liberty would not survive the contradictions in which new world slavery ensnared him. Evidence for this may be found in Locke's reception, including by Southern apologists for slavery. (shrink)

Over the course of the last four decades, William Leon McBride has distinguished himself as one of the most esteemed and accomplished philosophers of his generation. This volume—which celebrates the occasion of his seventy-fifth birthday—includes contributions from colleagues, friends, and formers students and pays tribute to McBride’s considerable achievements as a teacher, mentor, and scholar.

Provides a firm theoretical grounding for the increasing movement of cognitive psychologists, neuropsychologists and their students beyond the laboratory, in an ...

Improving the health and life of individuals living in poverty requires new models and new approaches, moving healthcare away from today's medical mindset of acute care toward a conception of healthcare as value-based, which necessarily means connecting disparate impacts with the healthcare services that are delivered.

Bill New's (1999) thoughtful paper has performed the valuable service of clarifying the meaning and the policy implications of paternalism. His careful formulation delimits the domain of justified state paternalism. Having argued successfully, in our view, for a narrow ambit, New proceeds to identify situations that justify paternalism. This comment is written in the spirit of a friendly reformulation that refines and improves the specification of when paternalism is justified. Our argument is two-fold. First, we argue that New's formulation, properly (...) understood, will not readily permit the paternalistic interventions he argues are justified. Second, we identify a class of potentially justified interventions that have paternalistic aspects, but which are neither strictly paternalistic nor market-failure remedies. (shrink)

Motor proficiency reflects the ability to perform precise and coordinated movements in different contexts. Previous research suggests that different profiles of motor proficiency may be associated with different cognitive functioning characteristics thus suggesting an interaction between cognitive and motor processes. The current study investigated this interaction in the general population of healthy adults with different profiles of motor proficiency by focusing on error-related cognitive control and behavioral adaptation mechanisms. In addition, the impact of these processes was assessed in terms of (...) trait anxiety and worries. Forty healthy adults were divided into high and low motor proficiency groups based on an assessment of their motor skills. Using electroencephalography during a flanker task, error-related negativity was measured as the neural indicator of cognitive control. Post-error slowing was measured to represent behavioral adaptation. Participants also completed an anxiety assessment questionnaire. Participants in the high motor proficiency group achieved better task accuracy and showed relatively enhanced cognitive control through increased ERN. Contrastingly, individuals in the lower motor proficiency group achieved poorer accuracy whilst showing some evidence of compensation through increased PES. Trait anxiety reflecting general worries was found to be correlated with motor functioning, but the study could not provide evidence that this was related to cognitive or behavioral control mechanisms. The interaction between cognitive and motor processes observed in this study is unique for healthy and sub-clinical populations and provides a baseline for the interpretation of similar investigations in individuals with motor disorders. (shrink)

Critics of commodification object to sales but not gifts of some goods, such as human blood or human organs, on grounds that such trade wrongly coerces, morally corrupts, and crowds out altruism. This essay takes issues with each of these claims. It disputes Micheal Sandel’s claim that voluntary exchange coerces, arguing that he confuses what is unfair with what is unfree. It argues, where trade does create moral costs, that these costs should be weighed against the moral costs of trade (...) bans, such as the loss of human life, and the harms endemic to illegal markets. The essay also quarrels with Richard Titmuss’s The Gift Relationship, arguing that compensation for blood need not crowd out blood donation, that compensation does not preclude a charitable impulse, and that some important gift relationship posses elements of altruism and exchange.Ceux qui critiquent la marchandisation sont contre la vente mais pas contre le don de certains biens comme le sang ou les organes humains parce qu’un tel commerce exercerait une contrainte, corromprait morallement, et ne laisserait pas de place à l’altruisme. Ce papier traite de chacune de ces affirmations. Il consteste l’affirmation de Micheal Sandel selon laquelle l’échange volontaire exerce une contrainte, en suggérant qu’il confond ce qui injuste avec ce qui n’est pas libre. Si le commerce entraîne des coûts moraux, cet essai suggère que ces coûts devraient être comparés avec les coûts moraux associés aux interdictions de commerce tels que la perte de la vie humaine et ceux associés aux maux endémiques des marchés illégaux. Il critique aussi l’ouvrage de Richard Titmuss, “The Gift Relationship” en suggérant que les compensations monétaires en échange d’un don de sang n’évincent pas nécessairement le don de sang, qu’elles n’empêchent pas les impulsions charitables, et que d’importants actes de don comportent des éléments d’altruisme et d’échange. (shrink)

This study examined the effects of emotional subject matter and descriptive style in short story excerpts on text (e.g. rich in meaning) and reader response-oriented (e.g. liking) ratings. Forty-eight subjects, including equal numbers of trained and novice male and female students, read two examples of each text twice and either generated or received interpretations between readings in a within-subjects design. In general, intellectual challenge slowed the pace of reading, whereas suspense-based arousal increased it. Emotional subject matter had a more powerful (...) effect than descriptive style on both cognitive (challenging, rich in meaning) and affective (expressive, personally relevant) scales and were read more quickly. Generating interpretations fostered subjective reactions to the Emotional excerpts (images), whereas Descriptive texts were less amenable to subjective responses. Consistent effects were also found for background and gender. As in everyday life, subject matter had a dominant effect in engaging a person's involvement. (shrink)

Evidence-based medicine (EBM), by its ability to decrease irrational variations in health care, was expected to improve healthcare quality and outcomes. The utility of EBM principles evolved from individual clinical decision-making to wider foundational clinical practice guideline applications, cost containment measures, and clinical quality performance measures. At this evolutionary juncture one can ask the following questions. Given the time-limited exigencies of daily clinical practice, is it tenable for clinicians to follow guidelines? Whose or what interests are served by applying performance (...) assessments? Does such application improve medical care quality? What happens when the best interests of vested parties conflict? Mindful of the constellation of socially and clinically relevant variables influencing health outcomes, is it fair to apply evidence-based performance assessment tools to judge the merits of clinical decision-making? Finally, is it fair and just to incentivize clinicians in ways that might sway clinical judgment? To address these questions, we consider various clinical applications of performance assessment strategies, examining what performance measures purport to measure, how they are measured and whether such applications demonstrably improve quality. With attention to the merits and frailties associated with such applications, we devise and defend criteria that distinguish between justice-sustaining and justice-threatening performance-based clinical protocols. (shrink)

This article shares reflections from members of the community of philosophers of education in the United States and Canada who were invited to express their insights in response to the theme ‘Snaps...