Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)

In liberal political theory, meaningful work is conceptualised as a preference in the market. Although this strategy avoids transgressing liberal neutrality, the subsequent constraint upon state intervention aimed at promoting the social and economic conditions for widespread meaningful work is normatively unsatisfactory. Instead, meaningful work can be understood to be a fundamental human need, which all persons require in order to satisfy their inescapable interests in freedom, autonomy, and dignity. To overcome the inadequate treatment of meaningful work by liberal political (...) theory, I situate the good of meaningful work within a liberal perfectionist framework, from which standpoint I develop a normative justification for making meaningful work the object of political action. To understand the content of meaningful work, I make use of Susan Wolf’s distinct value of meaningfulness, in which she brings together the dimensions of objectivity and subjectivity into the ‘bipartite value’ of meaningfulness (BVM) (Wolf, Meaning in life and why it matters, 2010). However, in order to be able to incorporate the BVM into our lives, we must become valuers, that is, co-creators of values and meanings. This demands that we acquire the relevant capabilities and status as co-authorities in the realm of value. I conclude that meaningful work is of first importance because it is a fundamental human need, and that society ought to be arranged to allow as many people as possible to experience their work as meaningful through the development of the relevant capabilities. (shrink)

This book provides an analysis of the debate surrounding cultural diversity, and attempts to reconcile the seemingly opposing views of "ethical imperialism," the belief that each individual is entitled to fundamental human rights, and cultural relativism, the belief that ethics must be relative to particular cultures and societies. The author examines the role of cultural tradition, often used as a defense against critical ethical judgments. Key issues in health and medicine are explored in the context of cultural diversity: the physician-patient (...) relationship, disclosing a diagnosis of a fatal illness, informed consent, brain death and organ transplantation, rituals surrounding birth and death, female genital mutilation, sex selection of offspring, fertility regulation, and biomedical research involving human subjects. Among the conclusions the author reaches are that ethical universals exist, but must not be confused with ethical absolutes. The existence of ethical universals is compatible with a variety of culturally relative interpretations, and some rights related to medicine and health care should be considered human rights. Illustrative examples are drawn from the author's experiences serving on international ethical review committees and her travels to countries in Africa, Asia, and Latin America, where she conducted educational workshops and carried out out her own research. (shrink)

A recent ontological variant of Cramer’s Transactional Interpretation, called “Possibilist Transactional Interpretation” or PTI, is extended to the relativistic domain. The present interpretation clarifies the concept of ‘absorption,’ which plays a crucial role in TI (and in PTI). In particular, in the relativistic domain, coupling amplitudes between fields are interpreted as amplitudes for the generation of confirmation waves (CW) by a potential absorber in response to offer waves (OW), whereas in the nonrelativistic context CW are taken as generated with certainty. (...) It is pointed out that solving the measurement problem requires venturing into the relativistic domain in which emissions and absorptions take place; nonrelativistic quantum mechanics only applies to quanta considered as ‘already in existence’ (i.e., ‘free quanta’), and therefore cannot fully account for the phenomenon of measurement, in which quanta are tied to sources and sinks. (shrink)

Readers of this book are sure to view the ethics of incentives in a new light.

It seems self-evident that people prefer painful experiences to be in the past and pleasurable experiences to lie in the future. Indeed, it has been claimed that, for hedonic goods, this preference is absolute (Sullivan, 2018). Yet very little is known about the extent to which people demonstrate explicit preferences regarding the temporal location of hedonic experiences, about the developmental trajectory of such preferences, and about whether such preferences are impervious to differences in the quantity of envisaged past and future (...) pain or pleasure. We find consistent evidence that, all else being equal, adults and children aged 7 and over prefer pleasure to lie in the future and pain in the past and believe that other people will too. They also predict that other people will be happier when pleasure is in the future rather than the past but sadder when pain is the future rather than the past. Younger children have the same temporal preferences as adults for their own painful experiences, but prefer their pleasure to lie in the past, and do not predict that others’ levels of happiness or sadness vary dependent on whether experiences lie in the past or the future. However, from the age of 7, temporal preferences were typically abandoned at the earliest opportunity when the quantity of past pain or pleasure was greater than the quantity located in the future. Past-future preferences for hedonic goods emerge early developmentally but are surprisingly flexible. (shrink)

This paper develops a practice-based Theory of Generative Interactions across diversity that builds on empirical findings and conceptual frameworks from multiple fields of study. This transdisciplinary review draws on the disciplines of sociology, social psychology, organization studies, and communications. The Theory of Generative Interactions suggests that in order to facilitate inclusion, multiple types of exclusionary dynamics must be overcome through adaptive cognitive processing and skill development, and engagement in positive interactions must occur in order to facilitate inclusion that is created (...) and sustained by contextually relevant sets of organizational practices. The organizational practices provide the following conditions for generative interactions: pursuing an important, shared organizational purpose, mixing diverse members frequently over protracted periods of time, enabling differing groups to have equal standing and insider status in contributing to success, and providing collaborative interdependence, interpersonal comfort, and self-efficacy. These interactions are generative in that they help to challenge the guiding assumptions of the organizational culture, reconsider taken-for-granted aspects, and raise fundamental questions about organizations. We assert that such interactions, properly structured, can help organizations more fully address all stakeholders in creating value ethically, and ultimately creating equity for individuals and groups in the organization. (shrink)

The commitment to evidence-based practice in clinical psychology requires scientific investigation of the effects of treatment and mechanisms of change. Empirical evidence suggests that mindfulness-based treatments provide clinically meaningful improvement for people suffering from many important problems, including depression, anxiety, pain, and stress. However, the processes of change that produce these beneficial outcomes are not entirely clear. Central questions include whether mindfulness training leads to increases in the general tendency to respond mindfully to the experiences of daily life, and if (...) so, whether these changes are responsible for the improvements in mental health that are often observed. Answering these questions requires methods for assessing mindfulness. Several tools for this purpose are now available and early evidence suggests that they are useful and informative, despite shortcomings that require additional work. This paper summarizes the rationale for mindfulness questionnaires, the methods used to construct them, and research findings on their utility. Challenges related to maintaining consistency with Buddhist conceptions of mindfulness while applying psychological research methods to the study of its assessment are discussed. (shrink)

Like the National Commission and the President's Commission, the Advisory Committee on Human Radiation Experiments was formed to carry out specific ethical tasks. Yet the committee also had an “openness” mission, a charge to investigate allegations that the U.S. government secretly exposed Americans to environmental releases of radiation. Eighteen months later—and after sixteen public meetings, more than 200 interviews, and the review of about 400,000 documents—the committee delivered a 925‐page report to the president.

Connected Lives examines the account of human nature that is implicit in an ethics of care, a picture of human lives that emphasizes interdependency, embodiment, and social connectedness. The book makes important connections to the picture of human life found in theorists of love such as St. Augustine and Emmanuel Levinas, and shows that when care theory is articulated clearly, it provides resources for thinking through some of the difficult moral issues we face in the contemporary world, issues such as (...) assisted reproduction and the new genetic technologies. (shrink)

Extrait de la couverture : ""Here, for the first time, is a book that brings women's writings out of exile to rethink anthropology's purpose at the end of the century.... As a historical resource, the collection undertakes fresh readings of the work of well-known women anthropologists and also reclaims the writings of women of color for anthropology. As a critical account, it bravely interrogates the politics of authorship. As a creative endeavor, it embraces new Feminist voices of ethnography that challenge (...) prevailing definitions of theory and experimental writing.". (shrink)

This article discusses the status of transcripts in Conversation Analysis. Repeatedly, the function and the epistemic state of transcripts have been the subject of discussions and reflections in Conversation Analysis. Drawing on a range of empirical examples taken from various authors, this article discusses the question of how present forms of visuality and multi-modality in the data material or the handling of artifacts can be captured in transcripts and how the problem of ‘representation’ of complex and interactive situations can be (...) solved. It turns out that the evolution of recording media along with the medium shift in Conversation Analysis has altered the status of transcripts, effecting a twofold ‘in-between-ness’: transcripts inhabit the conceptual space between orality and literacy on the one hand and between artwork and figure on the other hand. This oscillating hybrid nature proves to be the central property of transcripts in present-day Conversation Analysis. Transcripts are described as scientific ‘objects of knowledge’ and discussed with respect to their methodological and epistemic status. (shrink)

A synthesis of rights and participatory approaches to citizenship, linked through the notion of human agency, is proposed as the basis for a feminist theory of citizenship. Such a theory has to address citizenship's exclusionary power in relation to both nation-state ‘outsiders’ and ‘insiders’. With regard to the former, the article argues that a feminist theory and politics of citizenship must embrace an internationalist agenda. With regard to the latter, it offers the concept of a ‘differentiated universalism’ as an attempt (...) to reconcile the universalism which lies at the heart of citizenship with the demands of a politics of difference. Embracing also the reconstruction of the public-private dichotomy, citizenship, reconceptualized in this way, can, it is argued, provide us with an important theoretical and political tool. (shrink)

?Power, not pity? is a demand articulated by the Poor People's Economic Human Rights Campaign in the United States. The article discusses the ways in which some poverty activists are deploying an ethical discourse of human rights as a way of thinking about, talking about and mobilising against poverty and as a way of articulating concrete demands. They are staking a claim to power and to recognition as well as redistribution. It concludes that as an ethical discourse human rights performs (...) an important symbolic and mobilising function but that its effectiveness as a political tool in combating poverty is yet to be proven. (shrink)

Solidarity has for a long time been referred to as the core value underpinning European health and welfare systems. But there has been debate in recent years about whether solidarity, with its alleged communitarian content, can be reconciled with the emphasis on individual freedom and personal autonomy. One may wonder whether there is still a place for solidarity, and whether the concept of justice should be embraced to analyse the moral issues regarding access to health care. In this article, I (...) will answer this question by analysing the normative foundations of the concept of justice, followed by a deeper examination of the concept of solidarity in continental philosophy. More specifically, I will compare the philosophical traditions rooted in Kant to approaches rooted in Hegel. In addition, I will present the work of Avishai Margalit on the decent society to criticize a predominantly liberal approach to access to health care. The importance of solidarity lies particularly in its emphasis on relational aspects and the role of recognition in care practices, which are usually ignored in liberal approaches to justice. However, the article will argue that solidarity is not an alternative to a rights-based concept of justice, but must be considered as a necessary complement to it. (shrink)

This quotation from the London Review of Books is an example of a turn—a different way of looking at things that involves a redefinition of the kind of thing higher education is and how it should be provided. It is a turn away from a public good perspective—the opposite, it might be said, of the kind of turn addressed in this article.

The objective of this paper is to understand from a sociological perspective how the moral question of euthanasia, framed as the “right to die”, emerges and is dealt with in society. It takes France and Germany as case studies, two countries in which euthanasia is prohibited and which have similar legislation on the issue. I presuppose that, and explore how, each society has its own specificities in terms of practical, social and political norms that affect the ways in which they (...) deal with these issues. The paper thus seeks to understand how requests for the “right to die” emerge in each society, through both the debate (analysis of daily newspapers, medical and philosophical literature, legal texts) and the practices (ethnographic work in three French and two German hospitals) that elucidate the phenomenon. It does so, however, without attempting to solve the moral question of euthanasia. In spite of the differences observed between these two countries, the central issue at stake in their respective debates is the question of the individual’s autonomy to choose the conditions in which he or she wishes to die; these conditions depend, amongst others, on the doctor-patient relationship, the organisation of end-of-life care in hospital settings, and more generally, on the way autonomy is defined and handled in the public debate. (shrink)

In view of a resurgence of concern about the measurement problem, it is pointed out that the Relativistic Transactional Interpretation remedies issues previously considered as drawbacks or refutations of the original TI. Specifically, once one takes into account relativistic processes that are not representable at the non-relativistic level, absorption is quantitatively defined in unambiguous physical terms. RTI therefore provides a well-defined terminus to what appears to be a necessary infinite regress concerning ‘absorption’ when only the non-relativistic level is considered. In (...) addition, specifics of the relativistic transactional model demonstrate that the Maudlin ‘contingent absorber’ challenge to the original TI cannot even be mounted: basic features of established relativistic field theories dictate that the ‘slow-moving offer wave’ required for the challenge scenario cannot exist. It is concluded that issues previously considered obstacles for TI are no longer legitimately viewed as such, and that reconsideration of the transactional picture is warranted in connection with solving the measurement problem. (shrink)

In 2016, a law came into force in France granting terminally ill patients the right to continuous deep sedation until death. This right was proposed as an alternative to euthanasia and presented as the ‘French response’ to problems at the end of life. The law draws a distinction between CDS and euthanasia and other forms of sympton control at the end of life. France is the first country in the world to legislate on CDS. This short report describes the particular (...) context and underlying social values that led to this piece of legislation, and explores its meaning in the wider French context. (shrink)

Traditionally, healthcare workers have had the right to refuse to participate in abortions or physician-assisted suicide, but more recently there has been a movement in white Evangelical circles to expand these rights to include the refusal of any treatment at all to same-sex couples or their children, transgender individuals, or others who offend the provider’s moral sensibilities. Religious freedom of conscience exists in an uneasy tension with laws protecting equal rights in a liberal polity, and it is a particularly fraught (...) question in the context of medicine, where providers’ consciences must be balanced against patients’ rights to access appropriate care. This article examines the refusal of care to classes of people, usually classes defined by various sexual issues with which the caregivers disagree. This expands conscientious refusals from the traditional concept of responses to actions and instead directs it at specific types of people. The article draws on Reformed thought to argue that such refusals are not justified and are, in fact, both a profound misreading of Christian morality and a new and dangerously expansive account of the right to conscientious refusal in medicine. (shrink)

This introductory article discusses the contributions to this number in the light of some general issues arising out of recent writing on utopia. It notes the wide variety of views on the question of definition of utopia, ranging from the anti-utopian dismissal of it as totalitarianism to a broad and flexible vehicle of desire. It traces the shifting accents of utopia consequent on the move beyond modernity - a shift from time to space and from content to process. Only a (...) flexible approach reflected in the variety of articles in this collection can offer glimpses of the most elusive utopia, the transcendence of loss and longing. (shrink)

Lewis’s view of the way conventions are passed on may have some especially interesting consequences for the study of language. I’ll start by briefly discussing agreements and disagreements that I have with Lewis’s general views on conventions and then turn to how linguistic conventions spread. I’ll compare views of main stream generative linguistics, in particular, Chomsky’s views on how syntactic forms are passed on, with the sort of view of language acquisition and language change advocated by usage-based or construction grammars, (...) which seem to fit better with Lewis’s ideas. Then I will illustrate the interest of Lewis’s perspective on the dissemination of conventions with a variety of linguistic examples. (shrink)

This paper presents the results of a qualitative interview study exploring English and French physicians’ moral perspectives and attitudes towards end-of-life decisions when patients lack capacity to make decisions for themselves. The paper aims to examine the importance physicians from different contexts accord to patient preferences and to explore the role of advance directives in each context. The interviews focus on problems that emerge when deciding to withdraw/-hold life-sustaining treatment from both conscious and unconscious patients; decision-making procedures and the participation (...) of proxies/relatives; previous experience with ADs and views on their usefulness; and perspectives on ways in which the decision-making processes in question might be improved. The analysis reveals differences in the way patient preferences are taken into consideration and shows how these differences influence the reasons physicians in each country invoke to justify their reluctance to adhering to ADs. Identifying cultural differences that complicate efforts to develop the practical implementation of ADs can help to inform national policies governing ADs and to better adapt them to practice. (shrink)

There is an extensive philosophical literature on the interrelated issues of identity, individuality, and distinguishability in quantum systems. A key consideration is whether quantum systems are subject to a strong form of individuality termed ``haecceity'' (from the Latin for ``this-ness''). I argue that the traditional, strong form of haecceity does not apply at the quantum level, but that in order to properly account for the need for symmetrization in quantum systems, a weaker kind of haecceity must be involved, which I (...) call quantum haecceity. In the process, I also question some generally accepted tenets of the current debate, such as the idea that symmetrization of states for identical quanta must be postulated and reflects permutation invariance. Instead, I note that a perturbative Hamiltonian is required for exchange effects, which suggests that the need for symmetrization arises from specific physical conditions. (shrink)

This paper considers the reputation of William Morris's News From Nowhere and its evaluation as a utopia. It argues that there is a discrepancy between scholarly estimations of the book's importance and its treatment as a utopia relevant to socialism. Whilst scholars have for many years almost unanimously praised News From Nowhere as Morris's crowning achievement, most have also attempted to argue that Morris did not intend his work to be used as a serious model for socialism. After reviewing some (...) of the secondary literature and distinguishing between a variety of different interpretations of Morris's work, I suggest that the relevance of News From Nowhere might be assessed by the standards which Morris applied to Thomas More's Utopia. Considering Morris's work in this framework of utopianism, I argue that the relevance of Morris's utopia lies in what Norman Geras has called its ?maximum? vision. (shrink)

Notions of recognition and difference do not inform the mainstream debate about welfare reform, which is, instead, dominated by a dichotomous discourse of active modernization vs passive ‘welfare dependency’. The article challenges this dichotomy within the context of New Labour’s welfare reform agenda in the UK. It argues, first, that welfare reform should treat improvements in social security benefits not as promoting ‘passive’ welfare but as complementary to labour market activation policies. Second, it redefines active welfare to incorporate notions of (...) active citizenship, which construct welfare subjects as actors in the political process of welfare policy-making and delivery. As a framework for this position, the article discusses three ‘R’s of welfare reform, risk protection, redistribution and recognition, together with the further two ‘R’s of rights and responsibilities. It concludes by emphasizing the importance of a rights agenda both to tackling poverty and exclusion and to recognition politics. (shrink)

The book brings together social philosophy and educational theory. Liberalism's unresolved tensions between freedom and equality, public and private good, individual and state, etc., are illuminated by controversies in educational theory and policy.