During the past three decades, there has been an ongoing debate on the quality of health care. Defining quality is an important part of it. This paper offers a review of definitions and a conceptual analysis in order to understand and explain the differences between them. The analysis results in a semantic rule, expressing the meaning of quality as an optimal balance between possibilities realised and a framework of norms and values. This rule is postulated as a formal criterion of (...) meaning, e.g. when (correctly) applied people understand each other. The rule suits the abstract nature of the term quality. Quality doesn't exist as such. It is constructed in an interaction between people. This interaction is guided by rules in order to transfer information, e.g. communicate on quality. The rule improves our ability to discuss the debate on quality and to develop a theory grounding actions such as quality assurance or quality improvement. (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 ...

"Neuroscience and Philosophy" begins with an excerpt from "Philosophical Foundations of Neuroscience," in which Maxwell Bennett and Peter Hacker question the ...

Throughout its long history metaphysics has been variously conceived. At its most sublime, it has been taken to be the study of the super‐sensible, in particular of the existence of a god, the nature of the soul, and the possibility of an afterlife. When the young Ludwig Wittgenstein entered the lists, it was entirely reasonable to conceive of metaphysics in this manner. Its subject matter was held to be the language‐independent and thought‐independent de re necessities of the world. The Tractatus (...) is dominated by three problems: first, the nature of logic and logical necessity; secondly, the essence of the proposition and hence the characterization of the general propositional form; and thirdly, the intentionality of the proposition. Logical propositions are combinations of elementary propositions by means of truth‐functional logical connectives. The metaphysics adumbrated in the Tractatus, Wittgenstein thought, was required for the possibility of representation and for the possibility of logic. (shrink)

Writing from a scientifically and philosophically informed perspective, the authors provide a critical overview of the conceptual difficulties encountered in many current neuroscientific and psychological theories.

Throughout much of human history most people conceived of death as a transitional event. An alternative, secular, conception of death is as the permanent cessation of all life‐sustaining biological functions. The death of the physical organism is the death of the person or human being. However death be conceived, human beings are the only creatures that are aware of their mortality. The death penalty is often thought to be the most severe punishment of all, far worse than life imprisonment. Attitudes (...) towards death vary according to the acceptance or rejection of belief in an afterlife. Death in old age is generally held to be less deplorable than death in one's prime. Premature death, however, is commonly deemed to be tragic, but not because merely being alive is a good of one kind or another, let alone good in itself. Lucretius exaggerated the symmetry between prenatal and post‐ mortem events. (shrink)

Entertainments and celebrations are meant to give audiences and participants pleasure. Pleasure and enjoyment are an integral part of flourishing human life, and the desire for pleasure and enjoyment is a distinctive aspect of human nature. Psychological hedonism is a descriptive doctrine concerned with giving an account of actual human motivation. Ethical hedonism is a prescriptive doctrine that advances the view that human beings ought to pursue pleasure and avoid pain, that prospective pleasure and pain are severally the only good (...) reasons for action. ‘Pleasure’, ‘enjoyment’, and ‘being pleased’ are three graces that stand at the intersection of psychology, axiology, and practical reasoning. The relation between pleasure and awareness or consciousness of pleasure is subtle and unlike the corresponding relation to having a pain. To live the life of a practical hedonist is to live a life guided by the pursuit of pleasure. (shrink)

The powers of intellect and will, possession of which is constitutive of having a mind, are not powers of the mind, but of the being that has a mind. The Platonic metaphysical conception of the soul is of great interest irrespective of its informing both ancient and Renaissance neo‐Platonist ideas about the soul and its immortality, and, via Augustine, ultimately moulding the misconceived Cartesian conception of the soul. The dividing line between the soul and the flesh is quite different from (...) that between the mind and the body. The soul is associated with aesthetic sensibility and with the appreciation of beauty and pathos, with which conscience has no connection. The evil‐doer commonly aims, explicitly or implicitly, to destroy the moral order of humanity and the moral restraints on behaviour that are constitutive of moral beings. Evil‐doers have to suppress the voice of conscience. (shrink)

Some of human evil is a function of the historical stage of society. The evils and wickednesses of bureaucracy are as old as well‐developed bureaucratic hierarchies. Evil‐doers have character traits that may form recognizable patterns with explanatory weight. Evil‐doers produce reasons for their evil‐doing and offer justifications for their evil deeds. Psychological experiments may indeed establish important correlations and statistical probabilities that may be crucial for the formation of intelligent social policy. The greatest students of the place of evil in (...) human life and of the subjective psychology of evil in a complex social setting are great novelists, dramatists, and poets. From the late eighteenth century onwards ideological beliefs played a major role in stimulating evil, not for the greater glory of God but for the future glory of man. The first major social movement that bent an ideology to wholly evil policies were the Jacobins during the French Revolution. (shrink)

Global fatalism is an attitude towards life, an attitude of resignation and acceptance of what happens. Global fatalism in the form of predestinarianism is typically, but not exclusively, associated with monotheism rather than with polytheism, and in particular with Christianity and Islam. An individual form of fatalism consists in the belief that specific incidents in a person's life are preordained. Local fatalism appears to be common to many different cultures and societies. Individual fatalism is associated with other important events in (...) human life, such as meeting the person with whom one is destined to fall in love. The ubiquity of the various forms of individual fatalism suggests that they have a deep appeal to human sentiment. Descartes's successors, lumbered with dualism but rejecting causal interaction, struggled to preserve human freedom while acknowledging nomological determinism. Global nomological determinism is a picture, a preconception of the nature of change in all its forms. (shrink)

Happiness has been at the centre of philosophical reflection ever since Plato and Aristotle. Epicureans thought of happiness as the satisfaction of one's minimal needs and the absence of further desires. True happiness may be the love of another, or successful and virtuous public service recognized by society, or successful engagement in a favoured activity. Youthful happiness involves intensity of feeling, engagement with the passing moment, the discovery of first love and of sexuality, and the joys of dedication to a (...) beloved. The different forms of human engagement involve different kinds of happiness. Physical normality and good health are patently preconditions of happiness inasmuch as physical abnormalities and persistent diseases are barriers to leading a healthy and normal human life. A person's social conditions are highly relevant to the possibility of happiness. Happiness can be marred or shattered by a multitude of accidents of fate and by human malice, political upheavals, and economic disasters. (shrink)

The most common form of determinism in the first quarter of the twenty‐first century is neuroscientific determinism. Global neuroscientific determinism is a blank cheque on a non‐existent bank. Neuroscientists have discovered the character of the neural activity in the premotor cortex immediately antecedent to movement, and the nature of the neural impulses from the brain to the muscles in the relevant limb that will make them severally contract or relax. Being rational, being free, and being responsible for our actions and (...) omissions are essential species characteristics of mankind. Various forms of responsibility have been distinguished by philosophers and lawyers: causal responsibility, capacity responsibility, act responsibility, liability responsibility, role responsibility, and responsibility as a character trait. At the heart of the very idea of responsibility lies the notion of a normal rational human agent with normal human faculties. (shrink)

A life devoid of meaning is a life without happiness. But one may find meaning in one's life and in one's activities without being happy. Like pleasure and happiness, goodness and beauty, the meaningfulness one may find in one's life comes in degrees. Many achievements may mean something to a person without being of sufficient significance to lend meaning to their life, such as winning in some competitive activity or passing an important examination. Forms of illusory meaning, that is meaning (...) that rests on false or misconceived beliefs, can impart meaning to a person's life and make it genuinely meaningful, as long as it involves neither evil doing nor evil beliefs. The human condition as language‐using, self‐conscious social animals with limited capacities for good and evil, with highly competitive and killer instincts is anything but ludicrous, farcical, silly, or ridiculous. (shrink)

The key to a perspicuous overview of axiology is the realization that all values arise from life. This chapter provides a brief overview of von Wright's categories, or ‘varieties’, of goodness. Medical goodness is the most elemental variety of natural value and disvalue. Any language‐using creature that has the skills to make and to use tools, instruments, and other artefacts is going to need the concepts of artefactual goodness and its subcategory of instrumental goodness. Morality is essentially a social phenomenon (...) – it is an aspect of the form of life of a community. In evolved societies, it overlaps with and fades into law, into social mores or small morals, and into individual critical morality. Virtue, or moral goodness, as well as the moral virtues, which are moral character traits, are attributes of social beings who are, and who identify themselves as being, members of a community, people, or nation. (shrink)

Von Wright argued that moral goodness is a derivative form of goodness. He proceeded to give an account of the moral goodness of an act, in terms of the good of man. Philosophical anthropology must render the phenomenon of morality intelligible. This chapter suggests that the roots of moral value lie in human sympathy, in maternal love, in intuitive recognition of the humanity of others, and in the nature of loving friendship. The sentiment of sympathy is virtually ubiquitous, but sympathetic (...) propensities vary from person to person, being partly a function of their imagination. Sympathy is an emotional tap‐root of moral reasons and a presupposition of moral reasoning. Kant's argument in support of a requirement of equal formal respect for human beings as moral agents is problematic. The explicit emergence of the idea of formal respect is one of the great advances in our evolving understanding of human nature and our conception of ourselves. (shrink)

Humans are caught – in their lives, in their thoughts, in their hungers and ambitions, in their avarice and cruelty, and in their kindness and generosity too – in a net of good and evil. Natural evils are simply natural catastrophes that destroy human life, property, crops, and means of livelihood such as earthquakes, tsunamis, volcanic eruptions, avalanches, floods, and droughts. Some people may never recover from such evils and be incapable of leading a normal human life. The evil of (...) evil‐doers can therefore be explained away by showing that they themselves are victims. The existence of human evil is explained by reference to the wickedness of those who choose of their own will to do evil. The idea that evil is privative, that is, it consists in the absence of good, stripped of its theological trappings, is unconvincing. (shrink)

Modern utilitarianism has its roots in the eighteenth century, its philosophical blossom in the works of Bentham and the Mills, and its practical fruit in the works of nineteenth‐century radical legal and political utilitarian reformers. Utilitarians held that pleasure, and hence too happiness, are sensations. Human beings are in effect mere pleasure or happiness receptacles or desire‐satisfying mechanisms. The idea of a science of happiness appealed to some economists and social theorists who rightly felt increasingly ill at ease about measuring (...) national welfare and progress in terms of growth in gross national product. The goal of profit maximization dominated economic science. One stimulus for the development of a putative science of happiness was dissatisfaction with economists’ attempts to evaluate the success of an economic system and the progress of a society by measuring gross national product. In a happy society alienation is minimal, and freedom and dignity are respected and preserved. (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)

Hybridization is a method invented by Arthur Prior for extending the expressive power of modal languages. Although developed in interesting ways by Robert Bull, and by the Sofia school , the method remains little known. In our view this has deprived temporal logic of a valuable tool.The aim of the paper is to explain why hybridization is useful in temporal logic. We make two major points, the first technical, the second conceptual. First, we show that hybridization gives rise to well-behaved (...) logics that exhibit an interesting synergy between modal and classical ideas. This synergy, obvious for hybrid languages with full first-order expressive strength, is demonstrated for a weaker local language capable of defining the Until operator; we provide a minimal axiomatization, and show that in a wide range of temporally interesting cases extended completeness results can be obtained automatically. Second, we argue that the idea of sorted atomic symbols which underpins the hybrid enterprise can be developed further. To illustrate this, we discuss the advantages and disadvantages of a simple hybrid language which can quantify over paths. (shrink)