In The Epistemology of Groups, Jennifer Lackey investigates the conditions for the possibility of groups telling lies. Central to this project is the goal of holding groups, and individuals within groups, accountable for their actions. I show that Lackey’s total account of group phenomena, however, may open up a means by which groups can evade accusations of having lied, thus allowing them to evade responsibility in precisely the way Lackey set out to avoid. Along the way, I also take note (...) of some interesting implications of Lackey’s view: that it makes groups uniquely susceptible to a lack of self-knowledge and that it creates an interesting mechanism by which groups can lie to themselves. (shrink)

Bad faith is commonly conceived as lying to oneself or self-deception. This folk definition is too simplistic as it undermines the rich ontological underpinnings of bad faith. While both simple self-deception and bad faith are opposed to the general phenomenon of lying (to others), for Sartre bad faith is also meant to explain both the working of consciousness and the ubiquity of pre-judicative nothingness. Together, consciousness and nothingness supply the special ontological foundation required for bad faith to (...) operate. To enter into bad faith is to escape from the anguish of the experience of insubstantiality and freedom into deterministic attitudes about the self, such as the deceiver/deceived bipolarity of Freudian psychoanalysis. Sartre rejects the thesis that there can be hidden motivations in consciousness by arguing for the reflexivity and the translucency of consciousness. Further, he would take the ubiquity of nothingness to explain the wide prevalence of bad faith as a state-of-being in the world. Bad faith cannot be equated with simple cases of self-deception as bad faith is sustained by a unique mix of ontological postulates. Sartre argues for this point cogently through his examples of bad faith in Being and Nothingness. In these examples, Sartre shows that sincerity, the purported anti-thesis of self-deception, causes one to fall even deeper into bad faith. (shrink)

A correction to this paper has been published: https://doi.org/10.1007/s40961-021-00239-5.

How, if at all, could a person intentionally persuade himself into believing something he knew to be false? Acting upon his intention would apparently require that he knowingly use his grasp of some truth in the very act of concealing that truth and in getting himself to believe the opposite falsehood. Sartre's elaboration of this problem as well as his examples of self-deception are widely acclaimed, yet too often the remainder of his account has been dismissed as hopelessly riddled with (...) paradox and obscure jargon. I first provide an exegesis of the account that displays its coherence and rich suggestiveness. Next I argue that the account falls short of fully resolving the problems to which it is addressed, but that nevertheless a satisfactory resolution of the problems does emerge from a close examination of Sartre's examples. (shrink)

One of the principal aims of Kant’s Metaphysics of Morals, especially of the Doctrine of Virtue, is to present a taxonomy of our duties as human beings. The basic division of duties is between juridical duties and ethical duties, which determines the division of the Metaphysics of Morals into the Doctrine of Right and the Doctrine of Virtue. Juridical duties are duties that may be coercively enforced from outside the agent, as by the civil or criminal laws, or other social (...) pressures. Ethical duties must not be externally enforced (to do so violates the right of the person coerced). Instead, the subject herself, through her own reason and the feelings and motives arising a priori from her rational capacities -- the feelings of respect, conscience, moral feeling and love of other human beings, must constrain herself to follow them (MS 6:399-404).1 Among ethical duties, the fundamental division is between duties to oneself and duties to others. Within each of these two main divisions of ethical duty, there is a further division between duties that are strictly owed, requiring specific actions or omissions, and whose violation incurs moral blame, and duties that are wide or meritorious, the specific actions not strictly owed, but deserving of moral credit or merit. Kant treats these latter as ‘duties’ (eschewing any category such as ‘supererogation’) because the actions in question are conceived as fit objects of self-constraint – things we can make ourselves do through the exercise of reason and the moral feelings arising from the application of practical reason to our faculty of desire. Regarding duties to oneself, this division is between ‘perfect’ and ‘imperfect’ duty; regarding duties to others, the strict or narrow... (shrink)

Background: Ethical issues related to comparative effectiveness research, or research that compares existing standards of care, have recently received considerable attention. In this paper we focus on how Ethics Review Committees should evaluate the risks of comparative effectiveness research. Main text: We discuss what has been a prominent focus in the debate about comparative effectiveness research, namely that it is justified when “nothing is known” about the comparative effectiveness of the available alternatives. We argue that this focus may be misleading. (...) Rather, we should focus on the fact that some experts believe that the evidence points in favor of one intervention, whereas other experts believe that the evidence favors the alternative. We will then introduce a case that illustrates this point, and based on that, discuss how ERCs should deal with such cases of expert disagreement. Conclusion: We argue that ERCs have a duty to assess the range of expert opinions and based on that assessment arrive at a risk judgment about the study under consideration. We also argue that assessment of expert disagreement is important for the assignment of risk level to a clinical trial: what is the basis for expert opinions, how strong is the evidence appealed to by various experts, and how can clinical trial monitoring affect the possible increased risk of clinical trial participation. (shrink)

This paper analyses Steven Vogel's claim that his account of a post-natural environmental philosophy solves the dualism problem within the field. Through what I will call a novel critique of social constructionism, this paper examines whether Vogel's attempt succeeds or whether it reinforces the problem he wants to solve. Could the ontological foundations of social constructivism themselves be in conflict with Vogel's stated aim of overcoming the human/nature dualism? The last part of the paper focuses on the significance and role (...) of a post-natural environmental philosophy for the field of environmental philosophy in general. (shrink)

The World Medical Association’s revised Declaration of Helsinki endorses the view that all trial participants in every country are entitled to the worldwide best standard of care. In this paper the authors show that this requirement has been rejected by every national and international committee that has examined this issue. They argue that the consensus view now holds that it is ethically permissible, in some circumstances, to provide research participants less than the worldwide best care. Finally, the authors show that (...) there is also consensus regarding the broad conditions under which this is acceptable. (shrink)

With a specific example from Norway and inspiration from Sara Ahmed’s The Promise of Happiness, this article demonstrates how today’s educational rhetoric lacks the language and will to recognise a key pedagogical dimension in education: what happens when the normative ambitions of education and students meet. At best, teaching students life skills to mitigate their mental health issues is naive. Inspired by Ahmed, such an initiative might actually work against its purpose. At a time when educational outcomes are emphasised in (...) local and international political contexts, I argue that the task of philosophy of education should be 1) to reclaim the significance of the pedagogical dimension in education and 2) to philosophise on what negative emotions such as unhappiness require of education. (shrink)

Ethical issues related to comparative effectiveness research, or research that compares existing standards of care, have recently received considerable attention. In this paper we focus on how Ethics Review Committees should evaluate the risks of comparative effectiveness research. We discuss what has been a prominent focus in the debate about comparative effectiveness research, namely that it is justified when “nothing is known” about the comparative effectiveness of the available alternatives. We argue that this focus may be misleading. Rather, we should (...) focus on the fact that some experts believe that the evidence points in favor of one intervention, whereas other experts believe that the evidence favors the alternative. We will then introduce a case that illustrates this point, and based on that, discuss how ERCs should deal with such cases of expert disagreement. We argue that ERCs have a duty to assess the range of expert opinions and based on that assessment arrive at a risk judgment about the study under consideration. We also argue that assessment of expert disagreement is important for the assignment of risk level to a clinical trial: what is the basis for expert opinions, how strong is the evidence appealed to by various experts, and how can clinical trial monitoring affect the possible increased risk of clinical trial participation. (shrink)

This article explores possibilities for establishing dialogues between feminism and constructivism in the field of technology studies. Based on an overview of Norwegian feminist debates about technology, it indicates several points where feminism and constructivism meet and can mutually benefit from each other. The article critically examines feminist studies questioning the problems of technological determinism, social deternacnism, and essentialism. It criticizes constructivism for a lack of concern for gender and politics but holds that it is still possible to use theoretical (...) tools from constructivism in feminist analyses. Fruitful dialogues require the application of the principle of symmetry to the dcalogues and sharing some common ground and mutual recognation of each other's strengths and weaknesses. (shrink)

The current study uses a two-wave longitudinal survey to explores the influence mechanism of the family environment on adolescents’ academic achievement. The family environment is measured by parents and children’s reports, including family atmosphere, parent–child interaction, and family rules, to reveal the mediating effect of adolescents’ positive or negative peers between the family environment and academic achievement, and whether the gap between self- and parental educational expectation plays a moderating effect. This study uses the data of the China Education Panel (...) Study ; the survey samples include 9,449 eighth-grade students, establishing a multilevel moderated mediating effect model. The results showed the family environment and peer interaction quality can positively predict adolescents’ academic achievement. Using the KHB test, peer interaction quality plays a partial mediating role in the process of family environment positively affecting academic achievement, and the mediating ratio is 27.5%. The educational expectation gap moderates the effect of the family environment on academic achievement and also on peer interaction quality. Therefore, from the perspective of environment and important others, to correctly grasp the academic achievement of junior high school students in the process of socialization, it is necessary to recognize that the family environment, peer interaction quality, and educational expectation gap play an important role. (shrink)

ArgumentDuring the 1950s it became apparent that antibiotics could not conquer all microbes, and a series of tests were developed to assess the susceptibility of microbes to antibiotics. This article explores the development and standardization of one such testing procedure which became dominant in the Nordic region, and how the project eventually failed in the late 1970s. The standardization procedures amounted to a comprehensive scheme, standardizing not only the materials used, but also the methods and the interpretation of the results. (...) Focusing on Sweden and Norway in particular, the article shows how this comprehensive standardization procedure accounted for several co-dependent factors and demanded collaboration within and across laboratories. Whereas literature on standardization has focused mostly on how facts and artefacts move within and across laboratories, I argue for the importance of also attending to regions and territories. More particularly, while arguing that the practices, ideals, and politics related to what have been called the “Nordic welfare state” were contributing to the design of the standardized procedure in the laboratory, I also argue that Scandinavia was drawn together as a unified region with and by these very same practices. (shrink)

In this issue, Alex London and Kevin Zollman provide an analysis of an influential approach to the ethics of international research, known as the “fair benefits” approach. According to them, the fair benefits approach suffers from a fatal flaw: it is either too vague to be useful, or worse, is internally inconsistent. The fair benefits approach was developed based on a presentation I gave at a workshop organized in Malawi in March 2001 by the National Institutes of Health Clinical Center’s (...) Department of Bioethics. In this presentation, I made what I still think is a valid point, which was accepted by the diverse group of participants and formed the basis of the subsequent publications: One should not .. (shrink)

This article explores the relations between autobiography, fiction and history in the recent texts of Hélène Cixous. It examines the uses and limits of a range of generic categorizations in accounting for these relations. We suggest that most categorizations tend to rely on an underlying oppositionary and exclusive dynamic between autobiography and fiction in which one or the other may be privileged. Our contention is that Cixous's work should rather be understood within an inclusive dynamic in which all three elements, (...) the fictional, autobiographical and the historical coexist in a complex relation which cannot be disentangled. This inclusive dynamic, we suggest, is not only central to an understanding of the texts’ generic dimensions, but also to the specifics of the pact which Cixous establishes with her readers, as well as to the ethical thinking which underlies her oeuvre. (shrink)

The article analyses the debate on egg donation in Norway using source material from the parliamentary debate of amendments to the Biotechnology Law. In both policy documents on bioethics and the Biotechnology Law, gender is not a spoken issue, but bringing egg and sperm directly to the fore highlights how gender is implicated in bioethics debates. Gender perceptions affect the understanding of `what egg and sperm may do' at the same time as the debate sets established perceptions of gender in (...) motion. In Norway, gender equality is a valid and important premise within the general political debate. It is, however, contested as a valid argument in the context of egg donation, which therefore becomes a field of negotiations about the limits of equal opportunities. The article analyses the egg donation debate as a process of cultural co-production and asks how the Norwegian emphasis on gender equality influences the debate on egg donation and, vice versa, how debates of assisted reproductive technology reopen debates on gender in relation to reproduction and parenthood. (shrink)

In this paper, the author argues that the requirement to conduct randomised clinical trials to inform policy in cases where one wants to identify a cheaper alternative to known effective but expensive interventions raises an important ethical issue. This situation will eventually arise whenever there are resource constraints, and a policy decision has been made not to fund an intervention on cost effectiveness grounds. It has been thought that this is an issue only in extremely resource poor settings. This paper (...) gives an example from the United Kingdom illustrating that this is also a problem faced by richer countries. (shrink)

The new reproductive technologies affect several of our conceptual distinctions, and most basically the one between nature and culture. This includes the understanding of reproduction as natural, biological processes and of the body as a product of nature. Nature and culture has been a basic conceptual distinction in western culture and it is paralleled in the division between sex, understood as nature, and gender, understood as culture. The process of reproduction is central to the understanding of sexual difference, in the (...) sense that the abilities to conceive and give birth to children are generally considered to be features that distinguish woman from man. Therefore changes in this process provide us with empirical material for exploring changes in people's understanding of sex and gender. The article explores reproductive technology as a provider of new cultural models for understanding the relationship between nature and culture and thereby the distinction of sex/nature and gender/culture. (shrink)

This article presents a case study from the history of cardiology, namely, the development towards the acceptance of the coronary theory of angina pectoris. I show that the arguments which were considered decisive against the theory were not answered at the time the theory was accepted. I also point out that the experimental and practical success of the theory cannot be used to support the initial choice because, in the subsequent development, the field researchers became preoccupied with new questions and (...) problems. In spite of this, there is a sense in which the field of angina research has progressed, but it remains a challenge to exactly characterise in what sense this is the case. (shrink)

Contemporary medical imaging technologies produce images on the level of human cells. As a result of such images, egg and sperm cells have become well-known artefacts of popular culture. Medical imaging technology has transformed these gametes from invisible matter integrated in biological processes within the body to identifiable objects. The visualisation of egg and sperm cells has literally lifted the process of human reproduction out of the female body and made the gametes appear as protagonists in the story of human (...) reproduction. The article argues that visualisation of the gametes and the central role they play in contemporary imaginations of reproduction may offer vital contributions to the rather rapid acceptance and normalisation of assisted reproduction. (shrink)

This paper gives an account of theory structure in the biomedical sciences with particular emphasis on cardiology. Rather than regarding theories as axiomatizable sets of statements (the so-called received view), theories are regarded as answers to questions which are accepted as legitimate and interesting by scientists within a field of investigation at a given time. This account of theory structure is used to distinguish between theories which are quite liable to be revised during the course of scientific investigation, here called (...) theories within the field, and theories which are more securely established, here called theories of the field. These latter theories can also be regarded as patterns of reasoning which are applied again and again to answer the questions of the field. It is argued that the distinction proposed in this paper fits our intuitive understanding of what it means for a theory to be securely established within a field of research. Several examples are given which show the problems of justifying clinical intervention solely on the basis of theories within the field. (shrink)

It is a remarkable fact about the development of medical ethics from the 1960s until today that there has been a dramatic shift from a position where it was taken for granted that the physician knows best, to a position where much greater emphasis is put on the patient’s treatment preferences. This shift is evident with regard to physician attitudes towards disclosing a cancer diagnosis. For example, in 1961, a survey of cancer physicians showed that almost 90% of the physicians (...) reported that their usual policy was not to tell their patients that they had cancer . The survey was repeated in 1979, and it showed a complete reversal in attitudes over this 20-year period. 90% reported that their usual policy was to tell their patients that they had cancer .One common way of justifying the new approach is to claim that patients have a right to make their own treatment decisions, referring to the basic value of patient autonomy. However, it is immediately obvious that physicians should not respect all choices made by patients. Consider the following case: A thirty-eight-year-old man with mild upper respiratory infection suddenly developed severe headache, stiff neck, and high fever. He went to an emergency room for help. The diagnosis was pneumococcal meningitis, a bacterial meningitis almost always fatal if not treated. If treatment is delayed, permanent neurological damage is likely. A physician told the patient that urgent treatment was needed to save his life and forestall brain damage. The patient refused to consent to treatment saying he wanted to be allowed to die .Very few, if any, physicians would respect this person’s treatment choice. The reason is that this patient is not competent to make his own decisions. Respect for autonomy only requires that the choices of patients who are competent to make their own decisions are honoured. Judgements about which patients are competent to make their own decisions therefore become crucial. (shrink)

Decision analysts sometimes use the results of clinical trials in order to evaluate treatment alternatives. I discuss some problems associated with this, and in particular I point out that it is not valid to use the estimates from clinical trials as the probabilities of events which are needed for decision analysis. I also attempt to show that an approach based on objective statistical theory may have advantages over commonly used methods based on decision theory. These advantages include the recognition of (...) uncertain data, the introduction of a third alternative, namely suspension of judgement, and the possibility of modifying the choice of probabilities based on a clinical trial with reference to other available knowledge. I have not, however, shown in detail how this modification is done, but I think the concept is sufficiently promising to be applied to an actual clinical decision problem. (shrink)

The emergence of key concepts in Reinhart Koselleck’s sense has been much discussed in conceptual history, but mainly for the eighteenth and nineteenth centuries. The article documents a post–World War II emergence of the concept of health, from relative anonymity to becoming a key concept, comparable to concepts such as politics, democracy, and culture. While previous research has emphasized conceptual mobility, this article focuses on conceptual aggregation, where the concept of health assembles and assimilates meanings, becoming essential to discourse. This (...) is explained with reference to the development of the welfare state and the political use of a positive, expanded health concept. The article utilizes a collocation analysis of Norwegian digitized newspapers 1950–2010, culled from the uniquely extensive database of the Norwegian National Library. (shrink)

All health care systems face problems of justice and efficiency related to setting priorities for allocating a limited pool of resources to a population. Because many of the central issues are the same in all systems, the United States and other countries can learn from the successes and failures of countries that have explicitly addressed the question of health care priorities. We review explicit priority setting efforts in Norway, Sweden, Israel, the Netherlands, Denmark, New Zealand, the United Kingdom and the (...) state of Oregon in the US. The approaches used can be divided into those centered on outlining principles versus those that define practices. In order to establish the main lessons from their experiences we consider the process each country used, criteria to judge the success of these efforts, which approaches seem to have met these criteria, and using their successes and failures as a guide, how to proceed in setting priorities. We demonstrate that there is little evidence that establishment of a values framework for priority setting has had any effect on health policy, nor is there evidence that priority setting exercises have led to the envisaged ideal of an open and participatory public involvement in decision making. (shrink)

Philosophers on Education offers us the most comprehensive available history of philosopher's views and impacts on the directions of education. As Amelie Rorty explains, in describing a history of education, we are essentially describing and gaining the clearest understanding of the issues that presently concern and divide us. The essays in this stellar collection are written by some of the finest comtemporary philosophers. Those interested in history of philosophy, epistemology, moral psychology and education, and political theory will find Philosophers on (...) Education to be both an engaging and fascinating read. (shrink)

What is the connection between dispositions and ethics? Some might think very little and those who are interested in dispositions tend to be metaphysicians whose interests are far from value. However, we argue in this paper that dispositions and dispositionality are central to ethics, indeed a precondition. Ethics rests on a number of notions that are either dispositional in nature or involve real dispositions or powers at work. We argue for a dispositional account of value that offers an alternative to (...) the traditional fact-value dichotomy. We explain the place of value within a structure that explains the possibility of ethics. Elsewhere in this structure, we argue that moral responsibility is a precondition for ethics and that it is a dispositional notion depending critically on what Mumford and Anjum have called the dispositional modality. Moral responsibility in turn depends on there being both agency and normativity. We argue that intentionality and agency are preconditions for agency and that value is a precondition of normativity. All these notions are dispositional and make best sense if there are real dispositions or causal powers of agents. (shrink)

The pervasiveness of lying -- Why the lie? The reasons and justifications for lying -- How and why different types of people lie -- Taking the Lie-Q test : learning where you fit -- Everyday social lies -- Lying in public -- Lying at work -- Lying in business -- Lying to friends & relatives -- When men & women lie-the dating game -- Lies with husbands, wives, & intimate others -- The lies of (...) parents & children -- Lying to oneself -- The strategy of deceiving and perceiving (or how to detect when someone is lying) -- Conclusion (or how to deal with different kinds of lies and liars). (shrink)

This is a discussion of the reaction to the recent research article publication in the journal Protein & Cell by a group of scientists at Sun Yat-sen University using the CRISPR/Cas9 technique on editing non-viable human zygotes. Many commentators condemned the Chinese scientists for overstepping ethical boundaries long accepted in Western countries and accused China of having lax regulations on genomic research in general. We argue that not only did this research follow strict ethical standards and fully comply with current (...) regulations, but China also has a well-developed regulatory framework governing such research comparable to many developed countries. We see the reactions among Western commentators as a misunderstanding of the current situation and an expression of a lack of willingness to acknowledge China as an equal partner in the international debate about proper limits to the development of new biotechnologies. (shrink)

This article tries to present a broad view on the values and ethicalissues that are at stake in efforts to rationalize health policy on thebasis of economic evaluations (like cost-effectiveness analysis) andrandomly controlled clinical trials. Though such a rationalization isgenerally seen as an objective and `value free' process, moral valuesoften play a hidden role, not only in the production of `evidence', butalso in the way this evidence is used in policy making. For example, thedefinition of effectiveness of medical treatment or (...) health care serviceis heavily dependent on dominant individual or social views about thegoals of the particular treatment or service. There is also a concernthat a reliance on EBM in health policy will occur at the expense ofwidely shared social values like equity and solidarity. Moreover, thereis a concern that when economic considerations and rational proceduresbecome more influential, various `outside' groups third parties likeinsurance companies and policy makers will get a stronger influence onmedical practice which may lead to a change in the patient-providerrelationship. The authors conclude that social values and patientpreference should be explicitly addressed when health policy making isbased on economic and other scientific evidence. (shrink)

Obligations of global justice rest mainly on the global rich but also to a lesser extent on the global poor. The governments of poor countries are obliged to fulfill requirements of non-aggression, good governance and decency, along with all other requirements which facilitate the achievement of global justice. So far, obligations of poor countries seem to be taken as given yet the behavior of governments in poor countries and occurrences therein attest to the contrary;this suggests a need to mainstream these (...) obligations in discussions about global justice. If poor countries do not live up to these requirements obstacles arise to the realization of global justice; and they act unjustly in relation to citizens of rich countries which provide them with aid. Uganda is taken as a case in point. (shrink)

Obligations of global justice rest mainly on the global rich but also to a lesser extent on the global poor. The governments of poor countries are obliged to fulfill requirements of non-aggression, good governance and decency, along with all other requirements which facilitate the achievement of global justice. So far, obligations of poor countries seem to be taken as given yet the behavior of governments in poor countries and occurrences therein attest to the contrary;this suggests a need to mainstream these (...) obligations in discussions about global justice. If poor countries do not live up to these requirements obstacles arise to the realization of global justice; and they act unjustly in relation to citizens of rich countries which provide them with aid. Uganda is taken as a case in point. (shrink)

Philosophy is a dangerous profession, risking censorship, prison, even death. And no wonder: philosophers have questioned traditional pieties and threatened the established political order. Some claimed to know what was thought unknowable; others doubted what was believed to be certain. Some attacked religion in the name of science; others attacked science in the name of mystical poetry; some served tyrants; others were radical revolutionaries. This historically based collection of philosophers' reflections--the letters, journals, prefaces that reveal their hopes and hesitations, their (...) triumphs and struggles, their deepest doubts and convictions--allow us to witness philosophical thought-in-process. It sheds light on the many--and conflicting--aims of philosophy: to express skepticism or overcome it, to support theology or attack it, to develop an ethical system or reduce it to practical politics. As their audiences differed, philosophers experimented with distinctive rhetorical strategies, writing dialogues, meditations, treatises, aphorisms. Ranging from Plato to Hannah Arendt, with contributions from 44 philosophers (Augustine, Maimonides, AlGhazali, Descartes, Pascal, Leibniz, Voltaire, Rousseau, Hobbes, Hume, Kant, Nietzsche, Kierkegaard, Wittgenstein, among others) this remarkable collection documents philosophers' claim that they change as well as understand the world. In her introductory essay, "Witnessing Philosophers," Amelie Rorty locates philosophers' reflections in the larger context of the many facets of their other activities and commitments. (shrink)

It has been suggested that focusing on procedures when setting priorities for health care avoids the conflicts that arise when attempting to agree on principles. A prominent example of this approach is “accountability for reasonableness.” We will argue that the same problem arises with procedural accounts; reasonable people will disagree about central elements in the process. We consider the procedural condition of appeal process and three examples of conflicts over coverage decisions: a patients’ rights law in Norway, health technologies coverage (...) recommendations in the UK, and care withheld by HMOs in the US. In each case a process is at the center of controversy, illustrating the difficulties in establishing procedures that are widely accepted as legitimate. Further work must be done in developing procedural frameworks. (shrink)

The main topic of this article is Otto Frank's forgotten notion of the pressure-volume diagram of the cardiac ventricle as a means to assess the external mechanical work of the heart. Developed by Frank at the end of the 19th century, this idea was reenvisioned as pressure-volume area about 70 to 80 years later by Hiroyuki Suga. This notion now serves as a perspective for defining cardiac contractility and thus enabling the controlled clinical application of cardiac assist devices. We begin (...) our discussion, however, with the work of Ernest H. Starling, whose dominant influence on the thinking of cardio-physiologists led to a neglect of some of the fundamental insights of Frank's... (shrink)

This is the first anthology to present the full range of the many forms evil. Amelie Rorty has assembled a collection of readings that include not only the most common forms of evil, such as vice, sin, cruelty and crime, but also some which are less well known, such disobedience and willfulness. The readings are drawn from a rich array of historical, philosophical, theological, literary, dramatic, psychological and legal perspectives. Amelie Rorty's introductions to the readings sets each one in context (...) and makes the anthology essential reading for anyone interested in the philosophy of evil. (shrink)

There is a growing interest in comparison of international health care data with the hope that such studies will enable individual systems to learn from other systems. Such comparisons, however, presuppose that there exist common criteria for evaluating health care systems. The main thesis of this paper is that these comparative studies are misleading because they employ inappropriate operationalizations of these criteria because the operarionalizations are based upon mistaken global conceptualizations of the criteria in question. The essay provides a methodological (...) critique of what has been done and sets a new agenda for future research. (shrink)

Background. Despite common recognition of joint responsibility for global health by all countries particularly to ensure justice in global health, current discussions of countries’ obligations for global health largely ignore obligations of developing countries. This is especially the case with regards to obligations relating to health financing. Bearing in mind that it is not possible to achieve justice in global health without achieving equity in health financing at both domestic and global levels, our aim is to show how fulfilling the (...) obligation we propose will make it easy to achieve equity in health financing at both domestic and international levels. Discussion. Achieving equity in global health financing is a crucial step towards achieving justice in global health. Our general view is that current discussions on global health equity largely ignore obligations of Low Income Country governments and we recommend that these obligations should be mainstreamed in current discussions. While we recognise that various obligations need to be fulfilled in order to ultimately achieve justice in global health, for lack of space we prioritise obligations for health financing. Basing on the evidence that in most LICs health is not given priority in annual budget allocations, we propose that LIC governments should bear an obligation to allocate a certain minimum percent of their annual domestic budget resources to health, while they await external resources to supplement domestic ones. We recommend and demonstrate a mechanism for coordinating this obligation so that if the resulting obligations are fulfilled by both LIC and HIC governments it will be easy to achieve equity in global health financing. Summary. Although achieving justice in global health will depend on fulfilment of different categories of obligations, ensuring inter- and intra-country equity in health financing is pivotal. This can be achieved by requiring all LIC governments to allocate a certain optimal per cent of their domestic budget resources to health while they await external resources to top up in order to cover the whole cost of the minimum health opportunities for LIC citizens. (shrink)

Background: Although health is a right of all individuals without any distinction, the realisation of this right has remained very difficult for the marginalised populations of poor countries. Inequitable distribution of health opportunities globally is a major factor in explaining why this is the case. Whereas the Protection, Promotion and Fulfilment of the health rights of poor country citizens are a joint responsibility of both domestic and external governments, most governments flout their obligations. So far disproportionate effort has been dedicated (...) to reaffirming and interpreting these obligations as opposed to investigating the fundamental question regarding why these obligations have nevertheless remained largely unfulfilled. Further the normative question regarding what ought to be done about the shortcomings of current obligations has been largely ignored. Methods: We conduct a critical content analysis of existing literature on efforts towards the realisation of the health rights of marginalised populations in our attempt to ascertain their capacity to guarantee basic health opportunities to marginalised populations. In our analysis we treat issues of ‘health rights’ and ‘justice in global health’ as having unity of purpose – guaranteeing basic health opportunities to the marginalised populations. Results: We identify two sets of reasons for the failure of present obligations for global distributive justice in general: a set of ‘superficial reasons’ and a set of ‘fundamental reasons’ which account for the superficial reasons. Discussion: In order to overcome these reasons we propose a strategy which consists in specifying a number of minimum and less-demanding obligations for both external and domestic governments to guarantee to all individuals a certain threshold of health goods and services. We argue that these minimum obligations can be freely accepted and fully complied with or enforced with “a thin system of enforcement” without significant threat to national sovereignty and autonomy. Conclusion: The futility of countries’ obligations for the health rights of the global poor as is the case with global distributive injustice is because of lack of political will to specify and enforce such obligations. Minimum obligations should be specified and enforced with a “thin system” which is consistent with principles of national sovereignty and autonomy. (shrink)

Psychological safety is important for the well-being and productivity of people in the workplace. Psychological safety becomes even more important and even more difficult to maintain in times of uncertainty. Previous research mainly focused on the influence of and on interpersonal relationships. This study applies an individual perspective by investigating what is needed on an individual level in order to build psychological safety. The expectation was that self-compassion induces an individual to experience higher positive affect, and this advances the development (...) of positive relations and social acceptance. Moreover, we assumed that the mediation of the relationship between self-compassion and positive relations and social acceptance by positive affect is moderated by the level of basic need satisfaction. Participants from the Netherlands and Belgium completed an online questionnaire about their level of self-compassion, basic need satisfaction, positive affect and positive relations and social acceptance. Using hierarchical regression analyses for moderated mediation analysis, results showed that self-compassion and positive affect had a significant positive effect on positive relations and social acceptance. Positive affect significantly mediated the relationship between self-compassion and positive relations and social acceptance, when basic need satisfaction was low, but not when basic need satisfaction was high. Our research showed that individuals need either their basic needs satisfied or self-compassion so they can build the high-quality relations needed to stimulate psychological safety. This finding shifts attention from the dyadic relationship to the individual and highlights important factors at the individual level which advance the development of high-quality relationships with others. (shrink)