The use of platelet rich plasma as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013–16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented (...) in the context of a broader professional shift towards evidence based medicine within sports medicine. Many of the participants while accepting this shift are still committed to casuistic practices where clinical judgment is flexible and does not recognize a context-free hierarchy of evidentiary standards to ethically justifiable practice. We also discuss a tendency in the data collected to consider the use of deceptive, placebo-like, practices among the clinician participants that challenge dominant understandings of informed consent in medical ethics. We conclude that the complex relation between evidence and ethics requires greater critical scrutiny for this emerging specialism within the medical community. (shrink)

Traditional welfare states were based on passive solidarity. Able bodied, healthy minded citizens paid taxes and social premiums, usually according to a progressive taxation logic following the ability to pay principle. Elderly, fragile, weak, unhealthy and disabled citizens were taken care of in institutions, usually in quiet parts of the country. During the nineteen eighties and nineties of the twentieth century, ideas changed. Professionals, patients and policy makers felt that it would be better for the weak and fragile to live (...) in mainstream society, rather than be taken care of in institutions outside society. This might be cheaper too. Hence policy measures were taken to accomplish deinstitutionalization. This article discusses the implications of deinstitutionalization for distributive justice. It is argued that the weakest among the weak and fragile stand to lose from this operation. For able bodied citizens deinstitutionalization entails a move from passive to active solidarity. Rather than just pay taxes they have to actively care for and help the needy themselves. The move from passive to active solidarity tends to take advantage of benevolent citizens and burden the socioeconomically disadvantaged. This may be a reason to reconsider the policy move toward deinstitutionalization. (shrink)

In the first part of this paper it is argued that Vendler's classification of verbs into aspectual categories, called activities, accomplishments, achievements, and states, is better seen as classifying the meanings of sentences, and a recursive scheme for describing the aspectual character of sentences is presented.In the second part, this scheme is applied to the discussion of the epistemic and deontic meanings of the modal verbs must, will, and may. In particular, the relation between the “future” and “nonfuture” senses of (...) epistemic will is examined. (shrink)

Pufendorf's chief contribution to political thought is to be found in his dedicated effort to defend the modern state as a fundamental feature of humankind's moral development, and thus to reconcile the artificiality of civil association with its moral necessity. By exploring the state's moral character, Pufendorf helped move political discourse beyond a focus on the practical need for civil association and towards a search for a modern theory of political legitimacy, i.e., a theory that is both compelling enough to (...) demonstrate the moral legitimacy of political authority regardless of one's religious beliefs or moral convictions, and precise enough to permit insight into the nature and limits of this authority. (shrink)

I. Introduction Hegel's political philosophy is best understood as being both moderate and critical in character. While the recent scholarship is partially correct in its “centrist-reformist” image of Hegel's political philosophy, I argue that this image is incomplete. Hegel's project in the Philosophy of Right is moderate in the respect that it is a defense of his conceptualization of the modern state—it is the attempt to make explicit the implicit rationality of the modern state form. But his prescient critique of (...) the intractable contradictions of the open capitalist market and his identification of civil society with…. (shrink)

In this paper we examine ethical issues relevant to conducting mental health research with refugees and immigrant communities that have cultural orientations and social organisation that are substantially different to those of the broader Australian community, and we relate these issues to NH&MRC Guidelines. We describe the development and conduct of a mental health research project carried out recently in Melbourne with the Somali community, focusing on ethical principles involved, and relating these to the NH&MRC National Statement on Ethical Conduct (...) in Research Involving Humans, and the NH&MRC document Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research.The experience of conducting mental health research with the Somali community highlights the fact that the principles of inclusion and benefit enunciated in the NH&MRC document Values and Ethics are particularly pertinent when conducting research with refugees and immigrant communities that are culturally distant to those of the broader Australian community. These principles inform issues of research design and consent, as well as guiding respectful engagement with the participating community and communication of the research findings. (shrink)