Aristotle claims, in his Nicomachean Ethics, that in addition to being, for example, just and courageous, and temperate, the virtuous person will also be witty. Very little sustained attention, however, has been devoted to explicating what Aristotle means when he claims that virtuous persons are witty or to justifying the plausibility of the claim that wittiness is a virtue. It becomes especially difficult to see why Aristotle thinks that being witty is a virtue once it becomes clear that Aristotle’s witty (...) person engages in what he calls ‘educated insolence’. Insolence, for Aristotle, is a form of slighting which, as he explains in the Rhetoric, generally causes the person slighted to experience shame and anger. In this paper, I attempt to bring some clarity to Aristotle’s claim that being witty is a virtue by examining why Aristotle thinks that the object of a witty person’s raillery will find this joking pleasant. (shrink)

Medical tourism (MT) can be conceptualized as the intentional pursuit of non-emergency surgical interventions by patients outside their nation of residence. Despite increasing popular interest in MT, the ethical issues associated with the practice have thus far been under-examined. MT has been associated with a range of both positive and negative effects for medical tourists' home and host countries, and for the medical tourists themselves. Absent from previous explorations of MT is a clear argument of how responsibility for the harms (...) of this practice should be assigned. This paper addresses this gap by describing both backward looking liability and forward looking political responsibility for stakeholders in MT. We use a political responsibility model to develop a decision-making process for individual medical tourists and conclude that more information on the effects of MT must be developed to help patients engage in ethical MT. (shrink)

Attempts to articulate the ways in which membership in socially subordinated social identities can impede one's autonomy have largely unfolded as part of the debate between different types of internalist theories in relation to the problem of internalized oppression. The different internalist positions, however, employ a damage model for understanding the role of social subordination in limiting autonomy. I argue that we need an externalist condition in order to capture the ways in which membership in a socially subordinated identity can (...) constrain one's autonomy, even if one is undamaged in one's autonomy competencies and self-reflexive attitudes. I argue that living among those practically empowered to harass, to engage in racial profiling, and to treat as expendable is incompatible with a freedom-condition required for unconstrained global self-determination. (shrink)

Medical tourism is a practice, whereby individuals travel across national borders with the intention of receiving medical care. Medical tourists are motivated to travel abroad by a number of factors, including the affordability of care abroad, access to treatments not available at home, and wait times for care at home. In this article, we share the findings of interviews conducted with 32 Canadian medical tourists with the aim of developing a better understanding of medical tourism, the ethical issues it raises (...) for public health within Canada and other source countries for medical tourists, and to identify research gaps and policy responses to this practice. While patient and academic perspectives overlap in several regards, we suggest areas in which academic consideration of the ethical issues raised by medical tourism can be informed by patient perspectives. (shrink)

Background: Medical tourism, thought of as patients seeking non-emergency medical care outside of their home countries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and many are helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in making international medical care arrangements for patients. As a key source of information for these patients, brokers are likely to play an important role in communicating the risks and benefits of undergoing (...) surgery or other procedures abroad to their clientele. This raises important ethical concerns regarding processes such as informed consent and the liability of brokers in the event that complications arise from procedures. The purpose of this article is to examine the language, information, and online marketing of Canadian medical tourism brokers' websites in light of such ethical concerns. Methods: An exhaustive online search using multiple search engines and keywords was performed to compile a comprehensive directory of English-language Canadian medical tourism brokerage websites. These websites were examined using thematic content analysis, which included identifying informational themes, generating frequency counts of these themes, and comparing trends in these counts to the established literature. Results: Seventeen websites were identified for inclusion in this study. It was found that Canadian medical tourism broker websites varied widely in scope, content, professionalism and depth of information. Three themes emerged from the thematic content analysis: training and accreditation, risk communication, and business dimensions. Third party accreditation bodies of debatable regulatory value were regularly mentioned on the reviewed websites, and discussion of surgical risk was absent on 47% of the websites reviewed, with limited discussion of risk on the remaining ones. Terminology describing brokers' roles was somewhat inconsistent across the websites. Finally, brokers' roles in follow up care, their prices, and the speed of surgery were the most commonly included business dimensions on the reviewed websites. Conclusion: Canadian medical tourism brokers currently lack a common standard of care and accreditation, and are widely lacking in providing adequate risk communication for potential medical tourists. This has implications for the informed consent and consequent safety of Canadian medical tourists. (shrink)

Background: Medical tourism involves patients travelling internationally to receive medical services. This practice raises a range of ethical issues, including potential harms to the patient's home and destination country and risks to the patient's own health. Medical tourists often engage the services of a facilitator who may book travel and accommodation and link the patient with a hospital abroad. Facilitators have the potential to exacerbate or mitigate the ethical concerns associated with medical tourism, but their roles are poorly understood. -/- (...) Methods: 12 facilitators were interviewed from 10 Canadian medical tourism companies. -/- Results: Three themes were identified: facilitators' roles towards the patient, health system and medical tourism industry. Facilitators' roles towards the patient were typically described in terms of advocacy and the provision of information, but limited by facilitators' legal liability. Facilitators felt they played a positive role in the lives of their patients and the Canadian health system and served as catalysts for reform, although they noted an adversarial relationship with some Canadian physicians. Many facilitators described personally visiting medical tourism sites and forming personal relationships with surgeons abroad, but noted the need for greater regulation of their industry. -/- Conclusion: Facilitators play a substantial and evolving role in the practice of medical tourism and may be entering a period of professionalisation. Because of the key role of facilitators in determining the effects of medical tourism on patients and public health, this paper recommends a planned conversation between medical tourism stakeholders to define and shape facilitators' roles. (shrink)

Medical tourism—the practice where patients travel internationally to privately access medical care—may limit patients’ regular physicians’ abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors’ typical involvement in patients’ informed decision-making is challenged when their patients engage in medical tourism.

Medical tourism is the practice of traveling across international borders with the intention of accessing medical care, paid for out-of-pocket. This practice has implications for preferential access to medical care for Canadians both through inbound and outbound medical tourism. In this paper, we identify four patterns of medical tourism with implications for preferential access to care by Canadians: Inbound medical tourism to Canada’s public hospitals; Inbound medical tourism to a First Nations reserve; Canadian patients opting to go abroad for medical (...) tourism; and Canadian patients traveling abroad with a Canadian surgeon. These patterns of medical tourism affect preferential access to health care by Canadians by circumventing domestic regulation of care, creating jurisdictional tensions over the provision of health care, and undermining solidarity with the Canadian health system. (shrink)

Although it is common for interpreters of Aristotle's De Anima to treat the soul as a specially related set of powers of capacities, I argue against this view on the grounds that the plausible options for reconciling the claim that the soul is a set of powers with Aristotle's repeated claim that the soul is an actuality cannot be unsuccessful. Moreover, I argue that there are good reasons to be wary of attributing to Aristotle the view that the soul is (...) a set of powers because this claim conflicts with several of his metaphysical commitments, most importantly his claims about form and substance. I argue that although there are passages in the De Anima in which Aristotle discusses the soul in terms of its powers or capacities, these discussions do not establish that the soul is a set of capacities. (shrink)

Spaces of Geographical Thought examines key ideas – like space and place - which inform the geographic imagination. The text: discusses the core conceptual vocabulary of human geography: agency: structure; state: society; culture: economy; space: place; black: white; man: woman; nature: culture; local: global; and time: space; explains the significance of these binaries in the constitution of geographic thought; and shows how many of these binaries have been interrogated and re-imagined in more recent geographical thinking. A consideration of these binaries (...) will define the concepts and situate students in the most current geographical arguments and debates. The text will be required reading for all modules on the philosophy of geography and on geographical theory. (shrink)

Representing organizational reality in conceptual models is an important part of IS practice. In this paper we expose and challenge the taken-for-granted ontological and epistemological assumptions that underpin common accounts of conceptual modeling, using process modeling as an example. We argue that, due to an implicit commitment to a dualist ontology and representationalist epistemology, much literature regards the elicitation and representation of reality in the course of modeling as largely unproblematic. We draw on Martin Heidegger's holistic philosophy to give an (...) alternative analysis that brings to the fore challenges in 1) eliciting knowledge of routine activities, 2) capturing knowledge from domain experts and 3) representing organizational reality in authentic ways. As a result we come to see modeling as a practice that performs particular realities rather than simply representing a given reality. We hope to initiate a critical discussion on the implications of the current philosophical grounding of conceptual modeling. (shrink)

Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from (...) former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism. (shrink)

One current line of argument against the legalization of same-sex marriage, advocated primarily by the New Natural Lawyers, is that marriage is a pre-political institution that has, as an essential element, a bodily union requirement. They argue that same-sex couples cannot realize bodily union in their sexual activities and thus cannot meet the structural requirements of marriage. Accordingly, they argue that the same-sex marriage debate must be framed as a debate about what marriage is, and not, as it was in (...) the anti-miscegenation precedents, about who can get married. I argue that their position, which promulgates a set of pernicious stereotypes about same-sex couples, is, first of all, internally inconsistent. According to their own metaphysical principles about bodily union, they provide no rational basis for the claim that same-sex couples cannot realize bodily union and thus that same-sex couples cannot be married. Second, I argue for a deflationary account of the significance of bodily union. While same-sex couples, like heterosexual couples, can realize bodily union, this sort of union has no moral significance and thus cannot be the factor that distinguishes marriages from other sorts of relationships. Finally, I suggest that they have no basis for their claims about the inferiority of same-sex relationships. (shrink)

Although pioneering studies using statistical methods in geographical data analysis were published in the 1930s, it was only in the 1960s that their increasing use in human geography led to a claim that a ‘quantitative revolution’ had taken place. The widespread use of quantitative methods from then on was associated with changes in both disciplinary philosophy and substantive focus. The first decades of the ‘revolution’ saw quantitative analyses focused on the search for spatial order of a geometric form within an, (...) often implicit, logical positivist framework. In the first of three reviews of the use of quantitative methods in human geography, this progress report uncovers their origin with regard to the underlying philosophy, the focus on spatial order, and the nature of the methods deployed. Subsequent reports will outline the changes in all three that occurred in later decades and will chart the contemporary situation. (shrink)

BackgroundMedical tourism, the practice of persons intentionally travelling across international boundaries to access medical care, has drawn increasing attention from researchers, particularly in relation to potential ethical concerns of this practice. Researchers have expressed concern for potential negative impacts to individual safety, public health within both countries of origin for medical tourists and destination countries, and global health equity. However, these ethical concerns are not discussed within the sources of information commonly provided to medical tourists, and as such, medical tourists (...) may not be aware of these concerns when engaging in medical tourism. This paper describes the methodology utilized to develop an information sheet intended to be disseminated to Canadian medical tourists to encourage contemplation and further public discussion of the ethical concerns in medical tourism.MethodsThe methodology for developing the information sheet drew on an iterative process to consider stakeholder feedback on the content and use of the information sheet as it might inform prospective medical tourists’ decision making. This methodology includes a literature review as well as formative research with Canadian public health professionals and former medical tourists.ResultsThe final information sheet underwent numerous revisions throughout the formative research process according to feedback from medical tourism stakeholders. These revisions focused primarily on making the information sheet concise with points that encourage individuals considering travelling for medical tourism to do further research regarding their safety both within the destination country, while travelling, and once returning to Canada, and the potential impacts of their trip on third parties. This methodology may be replicated for the development of information sheets intending to communicate ethical concerns of other practices to providers or consumers of a certain service. (shrink)

INTRODUCTION: EXPLORING THE FUTURE OF GEOGRAPHY RJ Johnston Geographers, not for the first time, are undertaking a critical reappraisal of their discipline ...

The distribution of voting rights in the UK is an artefact of history rather than a product of clear legal or philosophical principles. Consequently, some resident aliens have the right to vote in all UK elections; others can vote in local elections but are excluded from national elections; still others are excluded from all elections. In England and Wales alone, roughly 2.3 million immigrants are excluded from voting in national elections. This exclusion is inconsistent with the founding principle of democracy (...) and distorts political discourse. What if all immigrants could vote in national elections? We estimate that up to ninety-five parliamentary seats could have been won by a different party in the 2015 general election. More substantially, enfranchising all immigrants would require re-drawing UK constituency boundaries. The new electoral map would increase the relative power of urban constituencies and would incentivise some political entrepreneurs and parties to temper anti-immigration rhetoric. (shrink)

Although pioneering studies using statistical methods in geographical data analysis were published in the 1930s, it was only in the 1960s that their increasing use in human geography led to a claim that a ‘quantitative revolution’ had taken place. The widespread use of quantitative methods from then on was associated with changes in both disciplinary philosophy and substantive focus. The first decades of the ‘revolution’ saw quantitative analyses focused on the search for spatial order of a geometric form within an, (...) often implicit, logical positivist framework. In the first of three reviews of the use of quantitative methods in human geography, this progress report uncovers their origin with regard to the underlying philosophy, the focus on spatial order, and the nature of the methods deployed. Subsequent reports will outline the changes in all three that occurred in later decades and will chart the contemporary situation. (shrink)

This article notes the significance of the contribution that literary researchers - who must see themselves as `researchers-as-artists' - make in the area of policy and politics. The `researcher-as-artist' chooses words aesthetically to tell stories that construct new stages for debate and discussion, and that inspire governments and policy-makers, They push intellectual boundaries; they challenge; they stimulate and confer visibility on creative ideas; they provoke - artistically, educationally and morally; and make connections. They encourage new ways of looking and seeing. (...) Thus, for example, they can contribute to discussions of soap operas and connect them to folk-tales - tales of the folk, endlessly repeated variations on common themes. Using a literary optic in this way demonstrates not only the evolutionary powers of literature, but the vital role of literary researchers and of the stories they tell. (shrink)

Medical tourism, the practice of persons intentionally travelling across international boundaries to access medical care, has drawn increasing attention from researchers, particularly in relation to potential ethical concerns of this practice. Researchers have expressed concern for potential negative impacts to individual safety, public health within both countries of origin for medical tourists and destination countries, and global health equity. However, these ethical concerns are not discussed within the sources of information commonly provided to medical tourists, and as such, medical tourists (...) may not be aware of these concerns when engaging in medical tourism. This paper describes the methodology utilized to develop an information sheet intended to be disseminated to Canadian medical tourists to encourage contemplation and further public discussion of the ethical concerns in medical tourism. The methodology for developing the information sheet drew on an iterative process to consider stakeholder feedback on the content and use of the information sheet as it might inform prospective medical tourists’ decision making. This methodology includes a literature review as well as formative research with Canadian public health professionals and former medical tourists. The final information sheet underwent numerous revisions throughout the formative research process according to feedback from medical tourism stakeholders. These revisions focused primarily on making the information sheet concise with points that encourage individuals considering travelling for medical tourism to do further research regarding their safety both within the destination country, while travelling, and once returning to Canada, and the potential impacts of their trip on third parties. This methodology may be replicated for the development of information sheets intending to communicate ethical concerns of other practices to providers or consumers of a certain service. (shrink)

Descriptive set theory and computability theory are closely-related fields of logic; both are oriented around a notion of descriptive complexity. However, the two fields typically consider objects of very different sizes; computability theory is principally concerned with subsets of the naturals, while descriptive set theory is interested primarily in subsets of the reals. In this paper, we apply a generalization of computability theory, admissible recursion theory, to consider the relative complexity of notions that are of interest in descriptive set theory. (...) In particular, we examine the perfect set property, determinacy, the Baire property, and Lebesgue measurability. We demonstrate that there is a separation of descriptive complexity between the perfect set property and determinacy for analytic sets of reals; we also show that the Baire property and Lebesgue measurability are both equivalent in complexity to the property of simply being a Borel set, for $\boldsymbol {\Sigma ^{1}_{2}}$ sets of reals. (shrink)