Antimicrobial resistance is one of the greatest public health crises of our time. The natural biological process that causes microbes to become resistant to antimicrobial drugs presents a complex social challenge requiring more effective and sustainable management of the global antimicrobial commons—the common pool of effective antimicrobials. This special issue of Health Care Analysis explores the potential of two legal approaches—one long-term and one short-term—for managing the antimicrobial commons. The first article explores the lessons for antimicrobial resistance that can be (...) learned from recent climate change agreements, and the second article explores how existing international laws can be adapted to better support global action in the short-term. (shrink)

An international legal agreement governing the global antimicrobial commons would represent the strongest commitment mechanism for achieving collective action on antimicrobial resistance (AMR). Since AMR has important similarities to climate change—both are common pool resource challenges that require massive, long-term political commitments—the first article in this special issue draws lessons from various climate agreements that could be applicable for developing a grand bargain on AMR. We consider the similarities and differences between the Paris Climate Agreement and current governance structures for (...) AMR, and identify the merits and challenges associated with different international forums for developing a long-term international agreement on AMR. To be effective, fair, and feasible, an enduring legal agreement on AMR will require a combination of universal, differentiated, and individualized requirements, nationally determined contributions that are regularly reviewed and ratcheted up in level of ambition, a regular independent scientific stocktake to support evidence informed policymaking, and a concrete global goal to rally support. (shrink)

Antimicrobial resistance (AMR) is an urgent threat to global public health and development. Mitigating this threat requires substantial short-term action on key AMR priorities. While international legal agreements are the strongest mechanism for ensuring collaboration among countries, negotiating new international agreements can be a slow process. In the second article in this special issue, we consider whether harnessing existing international legal agreements offers an opportunity to increase collective action on AMR goals in the short-term. We highlight ten AMR priorities and (...) several strategies for achieving these goals using existing “legal hooks” that draw on elements of international environmental, trade and health laws governing related matters that could be used as they exist or revised to include AMR. We also consider the institutional mandates of international authorities to highlight areas where additional steps could be taken on AMR without constitutional changes. Overall, we identify 37 possible mechanisms to strengthen AMR governance using the International Health Regulations, the Agreement on the Application of Sanitary and Phytosanitary Measures, the Agreement on Trade-Related Aspects of Intellectual Property Rights, the Agreement on Technical Barriers to Trade, the International Convention on the Harmonized Commodity Description and Coding System, and the Basel, Rotterdam, and Stockholm conventions. Although we identify many shorter-term opportunities for addressing AMR using existing legal hooks, none of these options are capable of comprehensively addressing all global governance challenges related to AMR, such that they should be pursued simultaneously with longer-term approaches including a dedicated international legal agreement on AMR. (shrink)

As support for clinical ethics committees in the UK grows, care must be taken to define their function, membership and method of working and the status of their decisions.The modern practice of medicine raises a plethora of complex issues—medical, ethical and legal. Doctors and other healthcare professionals increasingly must try to resolve these and may sometimes have to do so in the face of contrary opinion expressed by patients and/or their surrogates. While clearly qualified in the medical arena, and although (...) there is now more ethics teaching in the medical curriculum, healthcare professionals are seldom qualified to adjudicate on ethical or legal matters, or even, perhaps, to recognise them when they arise. Yet, as Doyal says, “clinical life must go on and moral and legal indeterminacy within medicine cries out for practical resolution.”1 Meanwhile, the expectations of patients and their families—and, indeed, of wider society—are that decisions about patient care, resources and therapeutic regimes should be soundly based on appropriate ethicolegal, as well as scientific, principle.Recognition of these additional burdens on healthcare professionals has generated some interest in the provision of ethics consultation. In the USA this has been undertaken by a variety of tribunals and individuals. Hospital ethics committees and ethics consultants feature in many US hospitals and perform a variety of roles. In Europe, a number of countries have also established clinical ethics committees and they are becoming more common in the UK—primarily in England and Wales for the moment. Whereas, however, “[i]n North America, CECs have … become an integral part of the organisational infrastructure of hospitals ...”,1 in the United Kingdom they remain essentially ad hoc bodies, generated for a variety of reasons and with different goals, structures, membership, methods of working and functions. The initial impetus for the …. (shrink)

The development of clinical ethic support in the UK arguably brings with it a series of legal questions, which need to be addressed. Most particularly, these concern questions of due process and formal justice, which I argue are central to the provision of appropriate ethical advice. In this article, I will compare the UK position with the more developed system in the USA, which often provides a template for development in the UK. While it is not argued that the provision (...) of clinical ethics support in the UK will necessarily follow the path mapped in the USA, there are lessons that can be learned from the US experience – particularly in terms of attention to process – from which UK clinical ethics support service might well benefit. (shrink)

The rapid rise of varieties of historicism in Germany, during the mid- to late-nineteenth century, and subsequently in England and America, resulted in a radical transformation of the principles of coherence and methods of analysis within biblical studies.1This paper will argue that the foundational ‘subject/object’ metaphysics of historicism has been subverted over the past century. For this reason, historical positivism should no longer be accorded the status of ‘normative paradigm’ and ‘gatekeeper’ over and against other interpretive approaches. This paper next (...) lays out five principles for a renewed practice of historical inquiry. It argues, first, that historical inquiry continues to serve a vital function within biblical studies in its ability to call attention to historical difference, and, thereby, to contribute to a strategy of resistance to ideology and to totalizing theories; second, that the traditional appeal to historical ‘context’ and ‘author’ in the interpretation of texts continues to be a useful practice – despite the provisional and constructed nature of both – as a way of taking into account extra-lingual reference and of avoiding presentism; third, that the substitution of new ‘grand narratives’ of Christian origins in place of the (quasi-theological) ‘historical’ narrative of traditional Christianity – under the claim of historical objectivity – should be abandoned because the very concept of ‘origins’ is the result of a literalizing of a metaphor. Such totalizing narratives always reduce history's inherent polycentricism. Fourth, I will argue that the continued use of historicism in the antiquarian attempt to reconstruct the past, disconnected from both a quest for social justice and a desire for personal self-creation, represents a form of thought that alienates scholars from themselves and from their real material contexts. Finally, and following on the previous point, this paper submits that the practice of historical analysis has an ethical dimension by virtue of the fact that the personhood of the biblical historian is indissolubly linked to other dimensions of life including the social and ethical aspects of life. These added dimensions complicate the making of choices, which is implicit within all practices of interpretation. These five principles are here suggested as points of departure for the reconceptualization of the scope and function of historical inquiry within the discipline of New Testament studies. (shrink)

The patient-doctor relationship has recently come under intense scrutiny, resulting in a re-evaluation of the basis of that relationship. The papers by Glannon and Ross, and McKay seek to identify the sources of authority in the patient-doctor relationship by evaluating it in terms of the concept of altruism. In this paper I argue that the analysis of Glannon and Ross, and of McKay is unnecessary and that the analysis offered by the latter is also flawed. I do acknowledge, however, that (...) Glannon and Ross's description of doctors' responsibilities and patients' roles has much to commend it. (shrink)

The new regulations on xenotransplantation pay insufficient attention to the broad ethical problems raised by this technique and that the abandonment of a national body with overall regulatory authority in this area is a mistake.Following reports from the Nuffield Council on Bioethics1 and, most importantly, the Advisory Group on the Ethics of Xenotransplantation2 , the UK Xenotransplantation Interim Regulatory Authority was established in 1997. The existence of a national body to govern xenotransplantation was deemed to be of critical importance by (...) the Kennedy report given the practical and ethical issues associated with xenotransplantation. Indeed, the Kennedy report recommended that ultimately UKXIRA should be placed on a statutory footing.2 The remit of UKXIRA was to advise the Secretary of State on particular applications, gather information on issues such as safety, and assess whether the preconditions identified by the Kennedy report had been met.3In December 2006, UKXIRA was quietly disbanded, and the Department of Health issued a statement of guidance, the terms of which now govern xenotransplantation in the UK. This document superseded procedures that had been in place since 1998, which had placed the overall regulation of applications to conduct xenotransplantation in the hands of UKXIRA and, ultimately, the Secretary of State.4 The revised guidance defines xenotransplantation as being: “… any procedure that involves the transplantation, implantation, or infusion into a human recipient of either live tissues or organs retrieved from animals, or, human body fluids, cells, tissue or organs that have undergone ex vivo contact with live non-human animal cells, tissues or organs.”5 . Given the range and nature of the procedures covered by the guidance, it is surprising, not to say a little worrying, that it is so …. (shrink)

An essential and neglected distinction between contract and administrative law is in how each conceives of the Crown as a juristic person. This article explores the extent of this distinction, and its implications for the rule of law and the separation of powers. It offers explanations—historical, jurisprudential and pragmatic—for why contract law conceives of the Crown as a corporation aggregate with the powers and liberties of a natural person, and why administrative law disaggregates the State into named officials.

In recent work, Peter Hanks and Scott Soames argue that propositions are types whose tokens are acts, states, or events. Let’s call this view the type view. Hanks and Soames think that one of the virtues of the type view is that it allows them to explain why propositions have semantic properties. But, in this paper, we argue that their explanations aren’t satisfactory. In Section 2, we present the type view. In Section 3, we present one explanation—due to Hanks (2007, (...) 2011) and Soames (2010)—of why propositions have semantic properties. We criticize this first explanation in Section 4. In Section 5, we present another explanation—due to Soames (2104)—of why propositions have semantic properties. We criticize this second explanation in Section 6. (shrink)

This is the first detailed study to explore the little-understood notions of "knowing who someone is," "knowing a person's identity," and related locutions. It locates these notions within the context of a general theory of believing and a semantical theory of belief- and knowledge-ascriptions.The books's main contention is that what one knows, when one knows who someone is, is not normally an identity in the numerical sense of "a = b," but rather a certain sort of predication to know who (...) someone is is just to know that that person is F, where "F" is a predicate that is "important," in a technical sense defined by the authors, for the purposes determined by context. Their book offers a rigorous formal semantics for ascriptions of knowing and of knowing-who in particular, solving such well-known problems and paradoxes as Kripke's Puzzle, and Quines difficulties with de re belief, along the way.The authors apply their analysis to each of several important issues in philosophy of language, philosophy of mind, and ethical theory in which the previously unexamined notion of "knowing who" has loomed large-the mechanics of linguistic referring, the foundations of epistemic logic, problems of self-knowledge and self-regarding belief, universalizability and "Golden Rule" arguments in ethics, and moral "personalism" versus "impartialism."Stephen Boër is Professor of Philosophy at the Ohio State University. William Lycan is Professor of Philosophy at the University of North Carolina and author of Logical Form in Natural Language. A Bradford Book. (shrink)

Steven Crowell has been for many years a leading voice in debates on twentieth-century European philosophy. This volume presents thirteen recent essays that together provide a systematic account of the relation between meaningful experience and responsiveness to norms. They argue for a new understanding of the philosophical importance of phenomenology, taking the work of Husserl and Heidegger as exemplary, and introducing a conception of phenomenology broad enough to encompass the practices of both philosophers. Crowell discusses Husserl's analyses of first-person (...) authority, the semantics of conscious experience, the structure of perceptual content, and the embodied subject, and shows how Heidegger's interpretation of the self addresses problems in Husserl's approach to the normative structure of meaning. His volume will be valuable for upper-level students and scholars interested in phenomenological approaches to philosophical questions in both the European and the analytic traditions. (shrink)

An introduction to and critique of the latest trends in critical theory.

The so-called genetics revolution rests on a history which at its least can be described as controversial. Modern genetics needs to bear this history in mind. In particular, as with the past, the area of reproductive choice seems particularly vulnerable to potential abuse. Courts in the UK and elsewhere have already shown themselves willing to interfere with the choices of women in the management of their pregnancies. Medical advance, perhaps particularly the capacity to visualise the developing foetus, has added complexity (...) to the question of whether the health care provider has one patient or two patients . Additionally, pregnancy is thoroughly monitored in modern medical practice and genetics may provide a further impetus or incentive to mandate increased policing of pregnancy. Gene therapy, once offered, will add further to the desire to ensure that women make the ‘right’ choice, especially when the invasion required is relatively minimal. Further, genetic information is at best predictive, but may, because of its scientific nature, appear to those receiving it to be certain. Thus, the provision of genetic information may reduce rather than enhance choice, unless carefully and sensitively provided. A mature and sophisticated debate about the role of genetics in reproduction is required—engaging rather than bypassing the public—if the real potential of genetics is to be vindicated. (shrink)

The controversies in Bristol, Alder Hey and elsewhere in the UK surrounding the removal and retention of human tissue and organs have led to extensive law reform in all three UK legal systems. This paper reports a short study of the reactions of a range of health professionals to these changes. Three main areas of ethical concern were noted: the balancing of individual rights and social benefit; the efficacy of the new procedures for consent; and the helpfulness for professional practice (...) of the new legislation and regulation. Recognition of these concerns may help in forging a new partnership between professionals and patients and their families. (shrink)

Winner of 2002 Edward Goodwin Ballard Prize In a penetrating and lucid discussion of the enigmatic relationship between the work of Edmund Husserl and Martin Heidegger, Steven Galt Crowell proposes that the distinguishing feature of twentieth-century philosophy is not so much its emphasis on language as its concern with meaning. Arguing that transcendental phenomenology is indispensable to the philosophical explanation of the space of meaning, Crowell shows how a proper understanding of both Husserl and Heidegger reveals the distinctive contributions (...) of each to that ongoing phenomenological project. (shrink)

How do minds emerge from developing brains? According to the representational features of cortex are built from the dynamic interaction between neural growth mechanisms and environmentally derived neural activity. Contrary to popular selectionist models that emphasize regressive mechanisms, the neurobiological evidence suggests that this growth is a progressive increase in the representational properties of cortex. The interaction between the environment and neural growth results in a flexible type of learning: minimizes the need for prespecification in accordance with recent neurobiological evidence (...) that the developing cerebral cortex is largely free of domain-specific structure. Instead, the representational properties of cortex are built by the nature of the problem domain confronting it. This uniquely powerful and general learning strategy undermines the central assumption of classical learnability theory, that the learning properties of a system can be deduced from a fixed computational architecture. Neural constructivism suggests that the evolutionary emergence of neocortex in mammals is a progression toward more flexible representational structures, in contrast to the popular view of cortical evolution as an increase in innate, specialized circuits. Human cortical postnatal development is also more extensive and protracted than generally supposed, suggesting that cortex has evolved so as to maximize the capacity of environmental structure to shape its structure and function through constructive learning. (shrink)

Winner of 2002 Edward Goodwin Ballard Prize In a penetrating and lucid discussion of the enigmatic relationship between the work of Edmund Husserl and Martin Heidegger, Steven Galt Crowell proposes that the distinguishing feature of twentieth-century philosophy is not so much its emphasis on language as its concern with meaning. Arguing that transcendental phenomenology is indispensable to the philosophical explanation of the space of meaning, Crowell shows how a proper understanding of both Husserl and Heidegger reveals the distinctive contributions (...) of each to that ongoing phenomenological project. (shrink)

This article argues that thinking about entrepreneurship as a potential instrument for relief from endemic poverty and disadvantage, especially among the Indigenous, has all too often been captive to a concept of entrepreneurship that is built out of constrained economic and cultural assumptions. The authors develop this argument from a critical discussion of contributions by Karl Polanyi and Robert Heilbroner. The result is that approaches to venture have been encouraged that are sometimes a poor fit for the circumstances of those (...) they are meant to benefit, and other forms that could have considerable promise have gone unexplored. This article outlines some features of Indigenous culture and build on the analysis of David Harper to construct an improved notion of entrepreneurship that allows for these distinctive features. The article concludes that research and policy making concerning entrepreneurship as an instrument of development among the Indigenous need to be undertaken with this reconstructed understanding of entrepreneurship that is a better fit for the realities of Indigenous culture. (shrink)

NOTE TO THE READER - December, 2021 ●●●●● -/- After a long period of time devoted to research in other areas, the author returned to the subject of this paper in a book-length study, CRITIQUE OF IMPURE REASON: Horizons of Possibility and Meaning. In this book (Chapter 11, “The Metalogic of Meaning”), the position developed in the 1982 paper, "Referential Consistency as a Criterion of Meaning", has been substantively revised and several important corrections made. It is recommended that readers read (...) the revised and corrected version that appears in the book, CRITIQUE OF IMPURE REASON. ●●●●● -/- The book is available in a printed edition, ISBN 978-0-578-88646-6, from online booksellers such as Barnes & Noble, Amazon, and through independent bookstores. The book is also available as a freely downloadable _corrected second edition_ eBook, DOI: 10.5281/zenodo.5458352, through PhilSci, PhilPapers, HAL, and other online archives. ●●●●● -/- In addition to the above-mentioned book, readers may find "A Primer on Bartlett's CRITIQUE OF IMPURE REASON" to be useful as a guide to the nearly 900-page CRITIQUE. The primer is available as a free download through PhilPapers. ●●●●● -/- "Referential Consistency as a Criterion of Meaning" describes a logically compelling criterion of meaning — that is, a necessary condition of meaning, one which is non-arbitrary and compelling. One cannot _not_ accept the proposed criterion without self-referential inconsistency. This “metalogical” variety of self-referential inconsistency is new, opening a third category beyond semantical and pragmatical forms of self-referential inconsistency. ●●●●● -/- It is argued that such a criterion of meaning can serve as an instrument of internal criticism for any theoretical framework that permits reference to a class of objects. The paper combines the concern of the logical empiricists to formulate a rigorous meaning criterion, with the analytical interest in identifying and eliminating self-defeating statements through an analysis of the referential structure of theories. ●●●●● -/- The paper is followed by a list of other publications by the author that further develop and extend the ideas presented here. (shrink)

Philosophers have not resisted temptation to transgress against the logic of their own conceptual structures. Self-undermining position-taking is an occupational hazard. Philosophy stands in need of conceptual therapy. The author describes three conceptions of philosophy: the narcissistic, disputatious, and therapeutic. (i) Narcissistic philosophy is hermetic, believing itself to contain all evidence that can possibly be relevant to it. Philosophy undertaken in this spirit has led to defensive, monadically isolated positions. (ii) Disputatious philosophies are fundamentally question-begging, animated by assumptions that philosophical (...) adversaries reject. (iii) The intention of therapeutic philosophy is to study philosophical positions from the standpoint of their internal consistency, or lack of it. In particular, its interest is in positions that either compel assent, because they cannot be rejected without self-referential inconsistency, or self-destruct because self-referential inconsistency cannot be avoided. The article's focus is on the latter. Several examples of self-undermining positions are drawn from the history of philosophy, exemplifying two main varieties of self-referential inconsistency: pragmatical and projective. (shrink)

Drawing on interviews with 140 young British males, this article explores the ways in which men talk about their own bodies and bodily practices, and those of other men. The specific focus of interest is a variety of body modification practices. We argue, however, that the significance of this analysis extends beyond the topic of body modification. In discussing the appearance of their bodies, the men we interviewed talked less about muscle and skin than about their own selves located within (...) particular social, cultural and moral universes. This article shows that, in talking about seemingly trivial questions such as whether to have one’s nose pierced or join a gym, men are actively engaged in regulating normative masculinity. Our analysis lends support to the claim that the body has become a new (identity) project in high/late/post-modernity, but shows how fraught with difficulties this project is for young men who must simultaneously work on and discipline their bodies while disavowing any (inappropriate) interest in their own appearance. The analysis highlights the pervasive individualism of young men’s discourses, and the absence of alternative ways of making sense of embodied experiences. (shrink)

Under what conditions do you have a reason to perform some action? Do you only have reason to do what you want to do? Reasons-motives internalism is the appealingly simple view that unless an agent is, or could be, motivated to act in a certain way, he has no normative reason to act in that way. Thus, according to reasons-motives internalism, facts about an individual’s motivational psychology constrain what is rational for that agent to do. This article canvasses several ways (...) of formulating the view and considers some advantages and disadvantages of each. (shrink)

John Harsanyi has offered an argument grounded in Bayesian decision theory that purports to show that John Rawls's original position analysis leads directly to utilitarian conclusions. After explaining why a prominent Rawlsian line of response to Harsanyi's argument fails, I argue that a seemingly innocuous Bayesian rationality assumption, the continuity axiom, is at the heart of a fundamental disagreement between Harsanyi and Rawls. The most natural way for a Rawlsian to respond to Harsanyi's line of analysis, I argue, is to (...) reject continuity. I then argue that this Rawlsian response fails as a defence of the difference principle, and I raise some concerns about whether it makes sense to posit the discontinuities needed to support the other elements of Rawls's view, although I suggest that Rawls may be able to invoke discontinuity to vindicate part of his first principle of justice. (shrink)