Objectives Access to healthcare in most western societies is based on equality. Rapidly rising costs have fuelled debates about differentiation in access to healthcare. We assessed the public's perceptions and attitudes about differentiation in healthcare according to lifestyle behaviour. Methods A vignette study was undertaken in participants in a colorectal cancer screening pilot programme in the Netherlands. Screenees with a negative test result received a questionnaire in which nine hypothetical situations were described: three different healthcare settings (screening, lung cancer, chronic (...) obstructive pulmonary disease) combined with three forms of differentiation each: a difference in premium, waiting list ordering or copayment according to lifestyle. We evaluated the responses using a general hierarchical linear model. Results The percentage of participants in agreement with differentiation varied from 20% to 58% (overall mean of 40%). Significantly more participants were in favour of giving a premium discount to those who do not engage in unhealthy behaviour compared with supporters for higher payments for those who do. More differentiation was supported for non-smoking versus smoking cessation than for participation versus non-participation in screening. We observed in-group favouritism in smokers, but no significant effects of age or disease. There was no support for waiting list ordering based on lifestyle. Conclusions Results of this study show that Dutch citizens eligible for colorectal cancer screening are in favour of some form of financial differentiation in the distribution of healthcare, but that significant differences exist between type of setting and the type of behaviour. Our study can be used in the ongoing discussion about solidarity and behaviour in healthcare. (shrink)

BackgroundAlthough the number of reporting guidelines has grown rapidly, few have gone through an updating process. The STARD statement (Standards for Reporting Diagnostic Accuracy), published in 2003 to help improve the transparency and completeness of reporting of diagnostic accuracy studies, was recently updated in a systematic way. Here, we describe the steps taken and a justification for the changes made.ResultsA 4-member Project Team coordinated the updating process; a 14-member Steering Committee was regularly solicited by the Project Team when making critical (...) decisions. First, a review of the literature was performed to identify topics and items potentially relevant to the STARD updating process. After this, the 85 members of the STARD Group were invited to participate in two online surveys to identify items that needed to be modified, removed from, or added to the STARD checklist. Based on the results of the literature review process, 33 items were presented to the STARD Group in the online survey: 25 original items and 8 new items; 73 STARD Group members (86 %) completed the first survey, and 79 STARD Group members (93 %) completed the second survey.Then, an in-person consensus meeting was organized among the members of the Project Team and Steering Committee to develop a consensual draft version of STARD 2015. This version was piloted in three rounds among a total of 32 expert and non-expert users. Piloting mostly led to rewording of items. After this, the update was finalized. The updated STARD 2015 list now consists of 30 items. Compared to the previous version of STARD, three original items were each converted into two new items, four original items were incorporated into other items, and seven new items were added.ConclusionsAfter a systematic updating process, STARD 2015 provides an updated list of 30 essential items for reporting diagnostic accuracy studies. (shrink)

This major new study by one of the most penetrating and persistent critics of philosophical and scientific orthodoxy, returns to Aristotle in order to examine the salient categories in terms of which we think about ourselves and our nature, and the distinctive forms of explanation we invoke to render ourselves intelligible to ourselves. The culmination of 40 years of thought on the philosophy of mind and the nature of the mankind Written by one of the world’s leading philosophers, the co-author (...) of the monumental 4 volume _Analytical Commentary on the Philosophical Investigations_ Uses broad categories, such as substance, causation, agency and power to examine how we think about ourselves and our nature Platonic and Aristotelian conceptions of human nature are sketched and contrasted Individual chapters clarify and provide an historical overview of a specific concept, then link the concept to ideas contained in other chapters. (shrink)

... 243-) INTRODUCTION §§243- constitute the eighth 'chapter' of the book. Its point of departure is a natural query with respect to the conclusion of the ...

This major study examines the most fundamental categories in terms of which we conceive of ourselves, critically surveying the concepts of substance, causation, agency, teleology, rationality, mind, body and person, and elaborating the conceptual fields in which they are embedded. The culmination of 40 years of thought on the philosophy of mind and the nature of the mankind Written by one of the world’s leading philosophers, the co-author of the monumental 4 volume _Analytical Commentary on the Philosophical Investigations_ Uses broad (...) categories, such as substance, causation, agency and power to examine how we think about ourselves and our nature Platonic and Aristotelian conceptions of human nature are sketched and contrasted Individual chapters clarify and provide an historical overview of a specific concept, then link the concept to ideas contained in other chapters. (shrink)

This major new study by one of the most penetrating and persistent critics of philosophical and scientific orthodoxy, returns to Aristotle in order to examine the salient categories in terms of which we think about ourselves and our nature, and the distinctive forms of explanation we invoke to render ourselves intelligible to ourselves. The culmination of 40 years of thought on the philosophy of mind and the nature of the mankind Written by one of the world’s leading philosophers, the co-author (...) of the monumental 4 volume _Analytical Commentary on the Philosophical Investigations_ Uses broad categories, such as substance, causation, agency and power to examine how we think about ourselves and our nature Platonic and Aristotelian conceptions of human nature are sketched and contrasted Individual chapters clarify and provide an historical overview of a specific concept, then link the concept to ideas contained in other chapters. (shrink)

The concept of normal is so familiar that it can be hard to imagine contemporary life without it. Yet the term entered everyday speech only in the mid-twentieth century. Before that, it was solely a scientific term used primarily in medicine to refer to a general state of health and the orderly function of organs. But beginning in the middle of the twentieth century, normal broke out of scientific usage, becoming less precise and coming to mean a balanced condition to (...) be maintained and an ideal to be achieved. In Normality, Peter Cryle and Elizabeth Stephens offer an intellectual and cultural history of what it means to be normal. They explore the history of how communities settle on any one definition of the norm, along the way analyzing a fascinating series of case studies in fields as remote as anatomy, statistics, criminal anthropology, sociology, and eugenics. Cryle and Stephens argue that since the idea of normality is so central to contemporary disability, gender, race, and sexuality studies, scholars in these fields must first have a better understanding of the context for normality. This pioneering book moves beyond binaries to explore for the first time what it does—and doesn’t—mean to be normal. (shrink)

This fourth and final volume of the monumental commentary on Wittgenstein's Philosophical Investigations covers pp 428-693 of the book. Like the previous volumes, it consists of philosophical essays and exegesis.

Incorporating significant editorial changes from earlier editions, the fourth edition of Ludwig Wittgenstein's _Philosophical Investigations_ is the definitive _en face_ German-English version of the most important work of 20th-century philosophy The extensively revised English translation incorporates many hundreds of changes to Anscombe’s original translation Footnoted remarks in the earlier editions have now been relocated in the text What was previously referred to as ‘Part 2’ is now republished as _Philosophy of Psychology – A Fragment_, and all the remarks in it (...) are numbered for ease of reference New detailed editorial endnotes explain decisions of translators and identify references and allusions in Wittgenstein's original text Now features new essays on the history of the _Philosophical Investigations_, and the problems of translating Wittgenstein’s text. (shrink)

Law, Morality and Society Essays in Honour of H.L.A Hart.

This volume collects P. M. S. Hacker's papers on Wittgenstein and related themes written over the last decade. Hacker provides comparative studies of a range of topics--including Wittgenstein's philosophy of psychology, conception of grammar, and treatment of intentionality--and defends his own Wittgensteinian conception of philosophy.

This paper canvasses recent arguments in favor of commercial markets in human transplant kidneys, raising objections to those arguments on grounds of the role of injustice, exploitation, and coercion in compromising the autonomy of those most likely to sell a kidney, namely, the least well off members of society.

The concept of consciousness has been the source of much philosophical, cognitive scientific and neuroscientific discussion for the past two decades. Many scientists, as well as philosophers, argue that at the moment we are almost completely in the dark about the nature of consciousness. Stuart Sutherland, in a much quoted remark, wrote that.

This chapter contains section titled: The Emergence of the Philosophers' Self The Illusion of the Philosophers' Self The Body The Relationship Between Human Beings and Their Bodies.

Throughout its history philosophy has been thought to be a member of a community of intellectual disciplines united by their common pursuit of knowledge. It has sometimes been thought to be the queen of the sciences, at other times merely their under-labourer. But irrespective of its social status, it was held to be a participant in the quest for knowledge – a cognitive discipline.