While protection of autonomy is crucial to the practice of medicine, there is the persistent risk of a disconnect between the notion of self-determination and the need for a socially responsible medical system. An example of unbridled autonomy is the preferential use of costly medications without an appreciation of the impact of using these more expensive drugs on the resource pool of others. In the USA, costly medications of questionable incremental benefit are frequently prescribed with the complicity of both doctors (...) and patients. Limiting self-determination in medication choices via an appreciation of the principle of justice reaches a better moral balance, while at the same time acknowledging the goals of doing good and avoiding harm in patient care. (shrink)

The present debate on constitutional rights aims to protect the individual against the intrusive power of the state. Analysing the precarious relationship between art and money, the authors argue that constitutional rights need to be extended into the regimes of private governance. This requires four fundamental changes. (1) Constitutional rights can no longer be limited to the protection of individual actors. Instead, they need to be extended to guarantees of freedom of discourses. (2) The new experience of the twentieth century (...) is that totalizing tendencies have their origin not only in politics, but also in other fields of action, especially in technology, science, and the economy. Thus, a discursive concept of constitutional rights should be directed against any social system with totalizing tendencies. (3) Instead of concentrating on centres of economic and social power, constitutional rights in the private sphere should focus on the specific communicative medium of the expansionist social system involved. (4) This excludes the direct analogy of a ‘right’ as a quasispatial exclusion zone. More significant guarantees of discursive autonomy could be found in a ‘proceduralization’ of constitutional rights. (shrink)

Explanation is the name for both the process we use to answer questions raised by observed ambiguities and for the conclusion we offer others. This divergence hints at the many conflicting approaches used to create our contemporary understanding of explanation. Modes of Explanation is the first book in decades to attempt to bring these conflicting approaches together and to offer a compelling narrative to explore how those conflicts can converge. In May 2013, fifty philosophers of science, cognitive scientists, systems scientists, (...) cyberneticists, semioticians, and humanities scholars gathered for three full days of debate. These scholars - including the contributors to this volume - compared insights into a variety of conceptions of explanation and their associated worldviews. Through examples such as the creationism/evolution debate, this volume illustrates the major issues regarding explanation through the dual lenses of scientific realism and pragmatic constructivism. Modes of Explanation is about how we make sense of, and create results in, our world. (shrink)

The emphasis on duly in Kant's ethics is widely held to constitute a defect. Marcia W. Baron develops and assesses the criticism, which she sees as comprising two objections: that duty plays too large a role, leaving no room for the supererogatory, and that Kant places too much value on acting from duty. Clearly written and cogently argued, Kantian Ethics Almost without Apology takes on the most philosophically intriguing objections to Kant's ethics and subjects them to a rigorous yet (...) sympathetic assessment. (shrink)

Pretende-se discutir a produção da história especializada, da história midiatizada e da história ensinada na interlocução com a matriz disciplinar de Jörn Rüsen. Defende-se que deve haver a fundamentação científica também na construção do conhecimento histórico escolar, para que o senso comum se torne senso crítico. Contrapõe-se aos revisionismos que negam, silenciam, deturpam a história considerada “sobrecarregada” em relação aos indígenas, ao escravismo e à Ditadura Civil-Militar brasileira. Toma como exemplo de história midiática/pública os Guias Politicamente Incorretos, principalmente da História (...) do Brasil, escrito por Leandro Narloch. Conclui que apenas a história construída com base científica pode refletir sobre o presente vivido para interpretar o passado com vistas ao futuro transformado no sentido de afirmar uma sociedade democrática. (shrink)

American doctors in the 1990s are being asked to serve as "double agents," weighing competing allegiances to patients' medical needs against the monetary costs to society. This situation is a reaction to rapid cost increases for medical services, themselves the result of the haphazard development since the 1920s of an inherently inflationary, open-ended system for funding and delivering health care. The answer to an inefficient system, however, is not to stint on care, but rather to restructure the system to remove (...) the inflationary pressures. As long as we are spending enormous resources on an inherently inefficient and inflationary system we cannot justify asking doctors to withhold beneficial care to save money for third-party payers. Doing so serves a largely political agenda and endangers the patient-centered ethic that is central to medicine. (shrink)

When successful and ethical managers are alerted to possible organizational wrongdoing, they take corrective action before the problems become crises. However, recent research [e.g., Rynes et al. (2007, Academy of Management Journal50(5), 987–1008)] indicates that many organizations fail to implement evidence-based practices (i.e., practices that are consistent with research findings), in many aspects of human resource management. In this paper, we draw from years of research on whistle-blowing by social scientists and legal scholars and offer concrete suggestions to managers who (...) are interested in encouraging internal reporting of problems requiring attention, and to observers of questionable activity who are considering reporting it. We also identify ways that research suggests policy-makers can have a more positive influence. We hope that these suggestions will help foster evidence-based practice regarding whistle-blowing. (shrink)

Anniversaries and funding crises prompt periodic calls to reevaluate the mission and public perceptions of the U.S. Land-Grant University system. One such call was issued by the Kellogg Commission on the Future of State Colleges and Land Grant Universities in their 1999 report, “Returning to Our Roots: the Engaged Institution.” Written by leaders of state universities and land-grant colleges, this report urges these institutions to engage more authentically and equitably in two-way relationships with their local constituents. Twenty years later, Land-Grant (...) Universities continue to struggle with building widespread public support for their missions and equitable involvement in research, teaching, and extension functions across diverse constituencies. While largely discounted by the Kellogg Commission, a fresh look at the role originally envisioned for the extension arm of the trifold land-grant mandate suggests that we may be conceiving of this system too narrowly. The establishment of statewide extension systems was once seen as a way to ensure that Land-Grant Universities would be accessible and responsive to all of a state’s residents. Extension systems continue to offer a front-door to a major public university in almost every county of the United States, but they tend to be viewed primarily as a way to translate science or distribute information from the university to the public. This discussion uses a historical and modern lens to reimagine the role that Extension could potentially play in catalyzing reciprocal, co-learning relationships between Land-Grant Universities and their diverse local constituencies. (shrink)

Gideon Rosen (2014) has drawn our attention to cases of duress of a particularly interesting sort: the person's ‘mind is not flooded with pain or fear’, she knows exactly what she is doing, and she makes a clear-headed choice to act in, as Rosen says, ‘awful ways’. The explanation of why we excuse such actions cannot be that the action was not voluntary. In addition, although some duress cases could also be viewed as necessity cases and thus as justified, Rosen (...) wisely sets aside that complicating factor by zeroing in on those cases where the action clearly is not justified. So why do we excuse in these cases, where the action is not justified and the agent acted voluntarily?Rosen thinks the key lies in the ‘ill will’ condition, ‘the idea that an act is blameworthy only if it manifests insufficient concern or regard for those affected’. He says this is relatively uncontroversial; much of my paper is taken up with calling the ‘ill will’ condition into question. I also take issue with Rosen on just how justifications and excuses differ. I argue in favour of understanding justifications (in a context where we are asking how justifications and excuses differ) as not requiring truth, but only reasonable belief. (shrink)

Purpose: To determine the relative value that patients place on consent for procedures in the emergency department (ED) and to define a set of procedures that fall in the realm of implied consent. Methods: A questionnaire was administered to a convenience sample 134 of 174 patients who were seen in the ED of a Midwestern teaching hospital. The questionnaire asked how much time they believed was necessary to give consent for various procedures. Procedures ranged from simple (venipuncture) to complex (procedural (...) sedation). Results: Participants valued a simple blood draw at a low mean of 1.02 minutes of extra time and a lumbar puncture at a high mean of 7.78 minutes. Of all participants 52% and 48% noted a time-value of ?0? time on blood draw and intravenous line starts, respectively, indicating that they desire no additional consent for these procedures. Conclusion: Defining a set of ED procedures covered under implied consent will be difficult because many patients value formal consent for even the simplest procedure. (shrink)

During the past decade ethical theory has been in a lively state of development, and three basic approaches to ethics - Kantian ethics, consequentialism, and virtue ethics - have assumed positions of particular prominence.

Justifications and excuses are defenses that exculpate. They are therefore much more like each other than like such defenses as diplomatic immunity, which does not exculpate. But they exculpate in different ways, and it has proven difficult to agree on just what that difference consists in. In this paper I take a step back from justification and excuse as concepts in criminal law, and look at the concepts as they arise in everyday life. To keep the task manageable, I focus (...) primarily on excuses and excusing activities, distinguishing them from justifications as well as from other close relatives, in particular, forgiving and pardoning. I draw upon J.L. Austin’s classic A Plea for Excuses, but expand on his account, suggesting that we offer excuses for reasons besides those he mentions. My hope is that my examination of excuses and excusing activities will help us rethink our views on just how justifications and excuses differ, views which often are worked out without much attention to how these concepts function in everyday life and to the connection between offers of excuses and justifications and the rules of civility. (shrink)

Roche, Marcia Sectarianism has been defined as 'adherence or excessive devotion to a particular religious denomination or sect'.1 However, as Kildea notes, dictionary definitions of the term fail to square with its 'distinctive' meaning in the Australian context.2A more accurate representation of the Australian connotation is conveyed by Hogan, who says that it refers to 'the hostility between different churches or "sects" which has manifested itself in the wider arena of social and political conflict'.3 The social, political and economic (...) discrimination and exclusion that has existed in Australia between Catholics and Protestants was most intense from the beginning of European settlement until the 1960s, when the Catholic Church's endorsement of ecumenism offered a means of positive engagement with members of other Christian denominations. (shrink)

Este artigo pretende analisar a impossibilidade do conhecimento do infinito e, conseqüentemente, a impossibilidade do conhecimento de Deus na filosofia hobbesiana. Ao contrário de Descartes, que prova a existência de Deus pelos efeitos, na assim chamada prova ontológica, Hobbes não admite qualquer prova da existência de Deus, além de recusar-se a atribuir-lhe qualquer funcão política ou epistemológica. Deste modo, Deus será objeto de crença e não de ciência na filosofia hobbesiana.

Cavell elaborates the view, traceable from Wittgenstein to Davidson, that there is no thought, and thus no meaning, without language, and shows how this concurs ...

1. Stoicism in classical Latin literature -- 2. Stoicism in Christian Latin thought through the sixth century.

In this article, we describe the social and economic changes that have contributed to contemporary problems of work—family conflict, gender inequality, and risks to children's healthy development. We draw on feminist welfare state scholarship to outline an institutional arrangement that would support an earner—carer society—a social arrangement in which women and men engage symmetrically in paid work and unpaid caregiving and where young children have ample time with their parents. We present a blueprint for work—family reconciliation policies in three areas—paid (...) family-leave provisions, working-time regulations, and early childhood education and care—and we identify key policy design principles. We describe and assess these work—family reconciliation policies as they operate in six European countries widely considered to be policy exemplars: Denmark, Finland, Norway, Sweden, Belgium, and France. We close with an analysis of potential objections to these policies. (shrink)