Introduction Outbreaks of serious communicable infectious diseases remain a major global medical problem and force healthcare workers to make hard choices with limited information, resources and time. While information regarding physicians’ opinions about such dilemmas is available, research discussing students’ opinions is more limited. Methods Medical students were surveyed about their willingness to perform medical procedures on patients with communicable diseases as students and as physicians. Students were asked about their opinions regarding the duty to treat in such cases. Results (...) 74% of respondents felt that by deciding to enter medical school they were morally obliged to treat any patient despite the risks. Students’ willingness to treat as physicians is significantly higher than their willingness to treat as students. HIV was significantly the most tolerated disease with respect to performing mouth to mouth resuscitation. Among preclinical students, we found that willingness to treat during the later years is significantly greater than during the earlier years. Among clinical students, the opposite was observed. Discussion Students’ greater willingness to treat as physicians is mostly attributed to perceptions of higher obligations as a qualified doctor. There is greater but not total willingness to perform resuscitation on patients with HIV relative to other diseases. The increased willingness of preclinical students and the decreased willingness of clinical students both emphasise the importance of patient–physician communication and ethics studies during medical school. (shrink)

Introduction Outbreaks of serious communicable infectious diseases remain a major global medical problem and force healthcare workers to make hard choices with limited information, resources and time. While information regarding physicians’ opinions about such dilemmas is available, research discussing students’ opinions is more limited. Methods Medical students were surveyed about their willingness to perform medical procedures on patients with communicable diseases as students and as physicians. Students were asked about their opinions regarding the duty to treat in such cases. Results (...) 74% of respondents felt that by deciding to enter medical school they were morally obliged to treat any patient despite the risks. Students’ willingness to treat as physicians is significantly higher than their willingness to treat as students. HIV was significantly the most tolerated disease with respect to performing mouth to mouth resuscitation. Among preclinical students, we found that willingness to treat during the later years is significantly greater than during the earlier years. Among clinical students, the opposite was observed. Discussion Students’ greater willingness to treat as physicians is mostly attributed to perceptions of higher obligations as a qualified doctor. There is greater but not total willingness to perform resuscitation on patients with HIV relative to other diseases. The increased willingness of preclinical students and the decreased willingness of clinical students both emphasise the importance of patient--physician communication and ethics studies during medical school. (shrink)

I argue that extant accounts of harm all fail to account for important desiderata, and that we should therefore jettison the concept when doing moral philosophy.

Purposeful infection of healthy volunteers with a microbial pathogen seems at odds with acceptable ethical standards, but is an important contemporary research avenue used to study infectious diseases and their treatments. Generally termed ‘controlled human infection studies’, this research is particularly useful for fast tracking the development of candidate vaccines and may provide unique insight into disease pathogenesis otherwise unavailable. However, scarce bioethical literature is currently available to assist researchers and research ethics committees in negotiating the distinct issues raised by (...) research involving purposefully infecting healthy volunteers. In this article, we present two separate challenge studies and highlight the ethical issues of human challenge studies as seen through a well-constructed framework. Beyond the same stringent ethical standards seen in other areas of medical research, we conclude that human challenge studies should also include: independent expert reviews, including systematic reviews; a publicly available rationale for the research; implementation of measures to protect the public from spread of infection beyond the research setting; and a new system for compensation for harm. We hope these additions may encourage safer and more ethical research practice and help to safeguard public confidence in this vital research alternative in years to come. (shrink)

Strategies to increase influenza vaccination rates have typically targeted healthcare professionals and individuals in various high-risk groups such as the elderly. We argue that they should focus on increasing vaccination rates in children. Because children suffer higher influenza incidence rates than any other demographic group, and are major drivers of seasonal influenza epidemics, we argue that influenza vaccination strategies that serve to increase uptake rates in children are likely to be more effective in reducing influenza-related morbidity and mortality than those (...) targeting HCPs or the elderly. This is true even though influenza-related morbidity and mortality amongst children are low, except in the very young. Further, we argue that there are no decisive reasons to suppose that children-focused strategies are less ethically acceptable than elderly or HCP-focused strategies. (shrink)

Several critics of realist theories of political legitimacy have alleged that it possesses a problematic bias towards the status quo. This bias is thought to be reflected in the way in which these...

Virtue epistemology is among the dominant influences in mainstream epistemology today. An important commitment of one strand of virtue epistemology – responsibilist virtue epistemology (e.g., Montmarquet 1993; Zagzebski 1996; Battaly 2006; Baehr 2011) – is that it must provide regulative normative guidance for good thinking. Recently, a number of virtue epistemologists (most notably Baehr, 2013) have held that virtue epistemology not only can provide regulative normative guidance, but moreover that we should reconceive the primary epistemic aim of all education as (...) the inculcation of the intellectual virtues. Baehr’s picture contrasts with another well-known position – that the primary aim of education is the promotion of critical thinking (Scheffler 1989; Siegel 1988; 1997; 2017). In this paper – that we hold makes a contribution to both philosophy of education and epistemology and, a fortiori, epistemology of education – we challenge this picture. We outline three criteria that any putative aim of education must meet and hold that it is the aim of critical thinking, rather than the aim of instilling intellectual virtue, that best meets these criteria. On this basis, we propose a new challenge for intellectual virtue epistemology, next to the well-known empirically-driven ‘situationist challenge’. What we call the ‘pedagogical challenge’ maintains that the intellectual virtues approach does not have available a suitably effective pedagogy to qualify the acquisition of intellectual virtue as the primary aim of education. This is because the pedagogic model of the intellectual virtues approach (borrowed largely from exemplarist thinking) is not properly action-guiding. Instead, we hold that, without much further development in virtue-based theory, logic and critical thinking must still play the primary role in the epistemology of education. (shrink)

European Journal of Philosophy, EarlyView.

Some healthcare systems are said to be grounded in solidarity because healthcare is funded as a form of mutual support. This article argues that health care systems that are grounded in solidarity have the right to penalise some users who are responsible for their poor health. This derives from the fact that solidary systems involve both rights and obligations and, in some cases, those who avoidably incur health burdens violate obligations of solidarity. Penalties warranted include direct patient contribution to costs, (...) and lower priority treatment, but not typically full exclusion from the healthcare system. We also note two important restrictions on this argument. First, failures of solidary obligations can only be assumed under conditions that are conducive to sufficiently autonomous choice, which occur when patients are given ‘Golden Opportunities’ to improve their health. Second, because poor health does not occur in a social vacuum, an insistence on solidarity as part of healthcare is legitimate only if all members of society are held to similar standards of solidarity. We cannot insist upon, and penalise failures of, solidarity only for those who are unwell, and who cannot afford to evade the terms of public health. (shrink)

European Journal of Philosophy, Volume 30, Issue 3, Page 1110-1124, September 2022.

The evil God challenge is an argumentative strategy that has been pursued by a number of philosophers in recent years. It is apt to be understood as a parody argument: a wholly evil, omnipotent and omniscient God is absurd, as both theists and atheists will agree. But according to the challenge, belief in evil God is about as reasonable as belief in a wholly good, omnipotent and omniscient God; the two hypotheses are roughly epistemically symmetrical. Given this symmetry, thesis belief (...) in an evil God and belief in a good God are taken to be similarly preposterous. In this paper, we argue that the challenge can be met, suggesting why the three symmetries that need to hold between evil God and good God – intrinsic, natural theology and theodicy symmetries – can all be broken. As such, we take it that the evil God challenge can be met. (shrink)

Efforts to promote equitable public policy with algorithms appear to be fundamentally constrained by the “impossibility of fairness” (an incompatibility between mathematical definitions of fairness). This technical limitation raises a central question about algorithmic fairness: How can computer scientists and policymakers support equitable policy reforms with algorithms? In this article, I argue that promoting justice with algorithms requires reforming the methodology of algorithmic fairness. First, I diagnose the problems of the current methodology for algorithmic fairness, which I call “formal algorithmic (...) fairness.” Because formal algorithmic fairness restricts analysis to isolated decision-making procedures, it leads to the impossibility of fairness and to models that exacerbate oppression despite appearing “fair.” Second, I draw on theories of substantive equality from law and philosophy to propose an alternative methodology, which I call “substantive algorithmic fairness.” Because substantive algorithmic fairness takes a more expansive scope of analysis, it enables an escape from the impossibility of fairness and provides a rigorous guide for alleviating injustice with algorithms. In sum, substantive algorithmic fairness presents a new direction for algorithmic fairness: away from formal mathematical models of “fair” decision-making and toward substantive evaluations of whether and how algorithms can promote justice in practice. (shrink)

I provide an argument from consciousness for God’s existence. I first consider a version of the argument which is ultimately difficult to evaluate. I then consider a stronger argument, on which consciousness, given our worldly laws of nature, is rather substantial evidence for God’s existence. It is this latter argument the paper largely focuses on, both in setting it out and defending it from various objections.

In this article I defend a new argument against moralist theories of legitimacy and in favour of realist theories. Moralist theories, I argue, are vulnerable to ideological and wishful thinking because they do not connect the demands of legitimacy with the interests of rulers. Realist theories, however, generally do manage to make this connection. This is because satisfying the usual realist criteria for legitimacy – the creation of a stable political order that transcends brute coercion – is usually necessary for (...) rulers to preserve their rule. (shrink)

There is significant controversy over whether patients have a ‘right not to know’ information relevant to their health. Some arguments for limiting such a right appeal to potential burdens on others that a patient’s avoidable ignorance might generate. This paper develops this argument by extending it to cases where refusal of relevant information may generate greater demands on a publicly funded healthcare system. In such cases, patients may have an ‘obligation to know’. However, we cannot infer from the fact that (...) a patient has an obligation to know that she does not also have a right not to know. The right not to know is held against medical professionals at a formal institutional level. We have reason to protect patients’ control over the information that they receive, even if in individual instances patients exercise this control in ways that violate obligations. (shrink)

Virtue epistemology is among the dominant influences in mainstream epistemology today. An important commitment of one strand of virtue epistemology – responsibilist virtue epistemology – is that it must provide regulative normative guidance for good thinking. Recently, a number of virtue epistemologists have held that virtue epistemology not only can provide regulative normative guidance, but moreover that we should reconceive the primary epistemic aim of all education as the inculcation of the intellectual virtues. Baehr’s picture contrasts with another well-known position (...) – that the primary aim of education is the promotion of critical thinking. In this paper – that we hold makes a contribution to both philosophy of education and epistemology and, a fortiori, epistemology of education – we challenge this picture. We outline three criteria that any putative aim of education must meet and hold that it is the aim of critical thinking, rather than the aim of instilling intellectual virtue, that best meets these criteria. On this basis, we propose a new challenge for intellectual virtue epistemology, next to the well-known empirically-driven ‘situationist challenge’. What we call the ‘pedagogical challenge’ maintains that the intellectual virtues approach does not have available a suitably effective pedagogy to qualify the acquisition of intellectual virtue as the primary aim of education. This is because the pedagogic model of the intellectual virtues approach is not properly action-guiding. Instead, we hold that, without much further development in virtue-based theory, logic and critical thinking must still play the primary role in the epistemology of education. (shrink)

This article explains and defends a novel idea about how people can be misled by a discussion topic, even if the discussion itself does not explicitly involve the making of false claims. The crucial aspect of this idea is that people are liable to infer, from the fact that a particular topic is being discussed, that this topic is important. As a result, they may then be led to accept certain beliefs about the state of the world they consider necessary (...) for the topic’s importance. What the article calls “importance misrepresentation” occurs when these beliefs about the state of the world are false or otherwise mistaken. The article explores different ways in which importance misrepresentation can occur, and it uses this idea to help clarify and strengthen some well‐known criticisms of the topic choices of academic philosophers. (shrink)

I introduce a distinction between health need and medical need, and raise several questions about their interaction. Health needs are needs that relate directly to our health condition. Medical needs are needs which bear some relation to medical institutions or processes. I suggest that the question of whether medical insurance or public care should cover medical needs, health needs, or only needs which fit both categories is a political question that cannot be resolved definitionally. I also argue against an overly (...) strict definition of medical need on the grounds that this presupposes, wrongly, that medical intervention should always be a last resort. (shrink)

Recent literature on intrinsic value contains a number of disputes about the nature of the concept. On the one hand, there are those who think states of affairs, such as states of pleasure or desire satisfaction, are the bearers of intrinsic value (“Mooreans”); on the other hand, there are those who think concrete objects, like people, are intrinsically valuable (“Kantians”). The contention of this paper is that there is not a single concept of intrinsic value about which Mooreans and Kantians (...) have disagreed, but rather two distinct concepts. I state a number of principles about intrinsic value that have typically (though not universally) been held by Mooreans, all of which are typically denied by Kantians. I show that there are distinct theoretical roles for a concept of intrinsic value to play in a moral framework. When we notice these distinct theoretical roles, we should realize that there is room for two distinct concepts of intrinsic value within a single moral framework: one that accords with some or all of the Moorean principles, and one that does not. (shrink)

In this article I defend a new argument against moralist theories of legitimacy and in favour of realist theories. Moralist theories, I argue, are vulnerable to ideological and wishful thinking because they do not connect the demands of legitimacy with the interests of rulers. Realist theories, however, generally do manage to make this connection. This is because satisfying the usual realist criteria for legitimacy – the creation of a stable political order that transcends brute coercion – is usually necessary for (...) rulers to preserve their rule. (shrink)

In this paper, I set out and defend a new theory of value, whole-life welfarism. According to this theory, something is good only if it makes somebody better off in some way in his life considered as a whole. By focusing on lifetime, rather than momentary, well-being, a welfarist can solve two of the most vexing puzzles in value theory, The Badness of Death and The Problem of Additive Aggregation.

In recent years Mullins and Craig have argued that there is a problem for a timeless God creating, with Mullins formulating the argument as follows: (1) If God begins to be related to creation, then God changes. (2) God begins to be related to creation. (3) Therefore, God changes. (4) If God changes, then God is neither immutable nor timeless. (5) Therefore, God is neither immutable nor timeless. In this paper I argue that all the premises, (1), (2), and (4) (...) are false, and then provide a revised formulation of the argument which more clearly represents what Mullins and Craig wish to argue, given the explication and commentary they give when discussing this objection to timelessness. I then call into question this argument, and conclude by stating what I think Mullins and Craig should really be arguing given the specific views they have about creation ex nihilo and in virtue of what timelessness requires. (shrink)

In this paper, I consider intellectualist and anti-intellectualist approaches to knowledge-how and propose a third solution: a virtue-based account of knowledge-how. I sketch the advantages of a virtue-based account of knowledge-how and consider whether we should prefer a reliabilist or a responsibilist virtue-account of knowledge-how. I argue that only a responsibilist account will maintain the crucial distinction between knowing how to do something and merely being able to do it. Such an account, I hold, must incorporate ‘learning how to do (...) something’ as an essential part. Drawing on an argument by Craig, I hold that the function of the concept of knowing how is to mark out practical experts whom one can trust either to perform an action on one's behalf, or to teach one how to perform that action oneself. The best way to identify practical experts, I hold, is to discover what they have learned about performing the action in question. In arguing for the importance of the concept ‘learning’ to the field of knowledge-how, I argue for a new connection between the philosophy of education and virtue epistemology. (shrink)

There is an ongoing increase in the use of mobile health technologies that patients can use to monitor health-related outcomes and behaviours. While the dominant narrative around mHealth focuses on patient empowerment, there is potential for mHealth to fit into a growing push for patients to take personal responsibility for their health. I call the first of these uses ‘medical monitoring’, and the second ‘personal health surveillance’. After outlining two problems which the use of mHealth might seem to enable us (...) to overcome—fairness of burdens and reliance on self-reporting—I note that these problems would only really be solved by unacceptably comprehensive forms of personal health surveillance which applies to all of us at all times. A more plausible model is to use personal health surveillance as a last resort for patients who would otherwise independently qualify for responsibility-based penalties. However, I note that there are still a number of ethical and practical problems that such a policy would need to overcome. The prospects of mHealth enabling a fair, genuinely cost-saving policy of patient responsibility are slim. (shrink)

Something is good insofar as it achieves its end, so says a neo-Aristotelian view of goodness. Powers/dispositions are paradigm cases of entities that have an end, so say many metaphysicians. A question therefore arises, namely, can one account for neo-Aristotelian goodness in terms of an ontology of powers? This is what I shallbeginto explore in this paper. I will first provide a brief explication of both neo-Aristotelian goodness and the metaphysics of powers, before turning to investigate whether one can give (...) an account of neo-Aristotelian goodness in terms of powers. I will suggest that the answer to this question is yes. (shrink)

There is an objection to divine timelessness which claims that timelessness shouldn’t be adopted since on this view evil is never “destroyed,” “vanquished,” “eradicated” or defeated. By contrast, some divine temporalists think that presentism is the key that allows evil to be destroyed/vanquished/eradicated/defeated. However, since presentism is often considered to be inconsistent with timelessness, it is thought that the presentist solution is not available for defenders of timelessness. In this paper I first show how divine timelessness is consistent with a (...) presentist view of time and then how defenders of Presentist-Timelessness can adopt the presentist solution to the removal of evil. After this, I conclude the paper by showing that it’s far from clear that the presentist solution is successful and that unless one weakens what is meant by the destruction/vanquishing/eradication/defeat of evil, one can only make the presentist solution work by adopting a number of additional assumptions that many will find unattractive. (shrink)

The idea of using responsibility in the allocation of healthcare resources has been criticized for, among other things, too readily abandoning people who are responsible for being very badly off. One response to this problem is that while responsibility can play a role in resource allocation, it cannot do so if it will leave those who are responsible below a “sufficiency” threshold. This paper considers first whether a view can be both distinctively sufficientarian and allow responsibility to play a role (...) even for those who will be left with very poor health. It then draws several further distinctions that may affect the application of responsibility at this level. We conclude that a more plausible version of the sufficientarian view is to allow a role for responsibility where failure to do so will leave someone else who is not responsible below the sufficiency threshold. However, we suggest that individuals must exhibit “sufficient responsibility” in order for this to apply, involving both a sufficient level of control and an avoidable failure to respond adequately to reasons for action. (shrink)

Whilst God is said to be omnipresent, some religions also claim that God is specially present, or more present at/in certain locations. For example, a claim of special presence shared by Christians and Jews is that God was specially present at/in the first Temple. The chapter canvases various ways in which one can make sense of this claim whilst still affirming the omnipresence of God. This includes offering different accounts of special presence relying on derivative notions of presence, and offering (...) other views of special presence that rely upon fundamental accounts of presence. The chapter itself does not argue for one view in particular, but instead offers a map of possible options and future areas for research. (shrink)

A considerable literature has emerged around the idea of using ‘personal responsibility’ as an allocation criterion in healthcare distribution, where a person's being suitably responsible for their health needs may justify additional conditions on receiving healthcare, and perhaps even limiting access entirely, sometimes known as ‘responsibilisation’. This discussion focuses most prominently, but not exclusively, on ‘luck egalitarianism’, the view that deviations from equality are justified only by suitably free choices. A superficially separate issue in distributive justice concerns the two–way relationship (...) between health and other social goods: deficits in health typically undermine one's abilities to secure advantage in other areas, which in turn often have further negative effects on health. This paper outlines the degree to which this latter relationship between health and other social goods exacerbates an existing problem for proponents of responsibilisation (the ‘harshness objection’) in ways that standard responses to this objection cannot address. Placing significant conditions on healthcare access because of a person's prior responsibility risks trapping them in, or worsening, negative cycles where poor health and associated lack of opportunity reinforce one another, making further poor yet ultimately responsible choices more likely. It ends by considering three possible solutions to this problem. (shrink)

Brian Leftow has argued in significant detail for a timeless conception of God. However, his work has been interacted with less than one might expect, especially given that some have contended that divine timelessness should be put to death and buried. Further, the work that has critically interacted with Leftow does a very poor job at discrediting it, or so I will contend. As we shall see, the main reason for this is either because what is central to Leftow’s view (...) is not affected by the objection, or because Leftow provides another way of getting his theory off the ground. Why, then, do so many objections miss the mark? I suspect it’s because many struggle to understand Leftow’s view and what is central to it. As such, one of the main goals of this paper will be to make Leftow’s account more accessible and to elucidate the main elements of the theory, whilst also providing responses to the main objections raised against his view. The overall result of this, I hope, will be a more fruitful examination of Leftow’s view in the future. (shrink)

Current debates regarding justice in university admissions most often approach the question of access to university from a technical, policy-focussed perspective. Despite the attention that access to university receives in the press and policy literature, ethical discussion tends to focus on technical matters such as who should pay for university or which schemes of selection are allowable, not the question of who should go to university in the first place. We address the question of university admissions—the question of who should (...) go to university—from an ethical perspective. We find that most discussions draw on a generic conception of what the university is good for that is too thin to provide deliberative guidance and hold that a full account of the ethics of admissions needs to take into account the distinctive good that the university provides—knowledge and understanding. This view, we hold, does not imply that measures should not be taken to widen access to university; however, the basis for such measures should be grounded in that distinctive good in the first instance. (shrink)

Since the heyday of analytic philosophy of education, a chill has come over the relationship between the philosophy of education and analytic epistemology. Wher.

Emch, G.G., Liu, C.: The Logic of Thermostatistical Physics. Springer, Berlin/ Heidelberg (2002) 11. Frigg, R., Werndl, C.: Entropy – a guide for the perplexed. Forthcoming in: Beisbart, C., Hartmann, S. (eds.) Probabilities in Physics. Oxford  ...

Healthcare practitioners have access to a range of ethical guidance. However, the normative role of this guidance in ethical decision-making is underexplored. This paper considers two ways that healthcare practitioners could approach ethics guidance. We first outline the idea of deference to ethics guidance, showing how an attitude of deference raises three key problems: moral value; moral understanding; and moral error. Drawing on philosophical literature, we then advocate an alternative framing of ethics guidance as a form of moral testimony by (...) colleagues and suggest that a more promising attitude to ethics guidance is to approach it in the spirit of ‘critical engagement’ rather than deference. (shrink)

Greg Bognar has recently offered a prioritarian justification for ‘fair innings’ distributive principles that would ration access to healthcare on the basis of patients' age. In this article, I agree that Bognar's principle is among the strongest arguments for age-based rationing. However, I argue that this position is incomplete because of the possibility of ‘time-relative' egalitarian principles that could complement the kind of lifetime egalitarianism that Bognar adopts. After outlining Bognar's position, and explaining the attraction of time-relative egalitarianism, I suggest (...) various ways in which these two kinds of principle could interact. Since various options have very different implications for age-based rationing, proponents of such a rationing scheme must take a position on time-relative egalitarianism to complement a lifetime prioritarian view like Bognar's. (shrink)

In this critique of longtermism, I attack its Heart, the idea that there is intrinsic value in the addition of each new happy being to the world. I provide new responses to longtermists' two main arguments for the Heart (The Argument from Extinction and The Argument from Miserable Beings). I then sketch an alternative view to longtermism, which I call Future Sentimentalism, a view that does a better job of explaining our future-regarding reasons. Finally, I consider an important objection to (...) my critique. (shrink)

Research ethics guidelines grew out of several infamous episodes where research subjects were exploited. There is significant international synchronization of guidelines. However, indigenous groups in New Zealand, Canada and Australia have criticized these guidelines as being inadequate for research involving indigenous people and have developed guidelines from their own cultural perspectives. Whilst traditional research ethics guidelines place a lot of emphasis on informed consent, these indigenous guidelines put much greater emphasis on interdependence and trust. This article argues that traditional guidelines (...) are premised on relationships of equal power, and that often the researcher has more power that is not fully equalized by providing information. Where there is a relationship of unequal power, then focusing on interdependence and trust is more likely to achieve ethical safety. We illustrate this thesis by describing the detail of a research project looking at the use of interpreters, where we video-recorded live consultations and then interviewed the patient, interpreter and doctor. We conclude by suggesting that mainstream research ethics guidelines should pay more attention to the development of a trustworthy relationship between subject and researcher, and that, following the lead from clinical medicine, we should develop a culturally competent ethical framework for research on human subjects. (shrink)

Within contemporary philosophy of religion there are three main ways in which God is conceptualised in relation to personhood:God is a person and so personal. God is non-personal, and so is not a person. God is a personal non-person. The first two of these options will be familiar to many, with held by most contemporary monotheist philosophers of religion and mainly by those who are pantheists., however, is a view some may not have come across, despite its proponents claiming it (...) was the view of great philosophical theologians from the past. However, within recent times has become more popular. On the face of it, it might not be clear what the difference between and is, and whether debate had between the two positions is substantive. The goal of this paper is therefore to clarify the debate and assess whether the many claims advocates of make as to why God cannot be a person stand up to scrutiny or are persuasive. My suggestion will be that on the whole they do and are not. As such, defenders of will either need to defend these reasons in more detail or focus on the area I suggest the debate really rests on. (shrink)

Many political realists reject the idea that the first task for political philosophy is to justify the existence of coercive political institutions. Instead, they say, we should begin with the factual existence of CPIs, and ask how they ought to be structured. In holding this view, they adopt a form of political naturalism that is broadly Aristotelian in character. In this article, I distinguish between two forms that this political naturalism might take - what I call a ‘strong’ form, and (...) a ‘weak’ form - and argue that both ought to be rejected. (shrink)

My students sometimes worry that if eternalism is true then they can’t have libertarian freedom. They aren’t alone, as this sentiment is also expressed, albeit typically briefly, by various philosophers. However, somewhat surprisingly, those working within the free will literature have largely had nothing to say about libertarianism’s relationship to time, with this also being similar in the case of those working in the philosophy of time, apart from some work which has mainly focused on nonlibertarian views of freedom. In (...) this short paper I note why I’m currently unconvinced that there’s an incompatibility between eternalism and libertarianism, and in doing so one will see why I think they are compatible. (shrink)

We developed this study to examine the issue of parental refusal of treatment, looking at the issue through a cultural competence lens. Recent cases in Canada where courts have declined applications by clinicians for court orders to overrule parental refusal of treatment highlight the dispute in this area. This study analyses the 16 cases of a larger group of 24 cases that were selected by a literature review where cultural or religious beliefs or ethnic identity was described as important reasons (...) behind the refusal. The most significant finding was that nearly all of the cases cited unacceptable side effects as the main reason for declining treatment. We then analysed the detail of the cases and concluded that in the first instance a skilled clinical approach to develop an agreed management plan is by far the best approach. In the event that agreement cannot be reached we recommend engaging a mediator to help the clinician and parents/child to find an agreeable way forward. We argue that the option of se... (shrink)

Recent empirical literature suggests that some of the most prominent environmental policies that the Chinese government has pursued have involved at least some measure of participation from citizen...

The non-identity problem is that some actions seem morally wrong even though, by affecting future people’s identities, they are worse for nobody. In this paper, I further develop and defend a lesser-known solution to the problem, one according to which when such actions are wrong, it is not because of what they do or produce, but rather just because of why they were performed. In particular, I argue that the actions in non-identity cases are wrong just when and because they (...) result from, or reflect in those who have performed them, a morally dubious character trait. (shrink)

Pickeringet al’s paper argues that the capacity of the decision-maker is the sole consideration in whether a decision should stand, and that the risk of the decision should not be considered. This argument ignores the existence of the player who is of the view that a decision is not wise. This paper argues that patient autonomy is not the sole determinant of whether a person is able to make an unwise decision, particularly in healthcare where there are always others affected (...) by the patient decision. Rather than asserting that patients have an unfettered autonomous choice on clinical decisions this paper argues that these decisions should be looked at through the lens of quality in health care that has proposed four parameters to be balanced; the patient experience, wise use of resources, the effect on public health and the clinician experience. (shrink)