The aim of this study was to investigate the ethical dilemma of prioritising financial resources to expensive biological therapies. For this purpose, the four principles of biomedical ethics formulated by ethicists Tom Beauchamp and James Childress were used as a theoretical framework. Based on arguments of justice, Beauchamp and Childress advocate for a health care system organised in line with the Danish system. Notably, our study was carried out in a Danish setting.

The Danish healthcare system must meet the need for easy and equal access to healthcare for every citizen. However, investigations have shown unfair prioritization of cancer patients and unfair prioritization of resources for expensive medicines over care. What is needed are principles for proper prioritization. This article investigates whether American ethicists Tom Beauchamp and James Childress’s principle of justice may be helpful as a conceptual framework for reflections on prioritization of expensive biological therapies in the Danish healthcare system. We present (...) an empirical study exploring the principles for prioritizing new expensive biological therapies. This study includes qualitative interviews with key Danish stakeholders experienced in antibody therapy and prioritizing resources for expensive medicines. Beauchamp and Childress’s model only covers government-funded primary and acute healthcare. Based on the interviews, this study indicates that to be helpful in a Danish context this model should include equal access for citizens to government-funded primary and acute healthcare, costly medicine, and other scarce treatments. We conclude that slightly modified, Beauchamp and Childress’s principle of justice might be useful as a conceptual framework for reflections on the prioritization of expensive biological therapies in the Danish healthcare system. (shrink)

A new concept of cognition also implies a novel approach to the study of metaphor. This insight is the starting point of this article presenting two innovations to comprehending and analyzing metaphor, one theoretical and one in terms of methodology. On a theoretical level we argue for a new orientation to metaphor and metaphoricity based on enactive cognition and distributed language and cognition. In recent years enactive and distributed cognition have been developing a new concept of cognition as an inter-bodily (...) and ecologically afforded achievement, and in light of this theoretical development we propose an approach to metaphor as a multi-body, multi-party, and multi-timescale phenomenon. On a methodological level we demonstrate a new way of analyzing metaphoricity in multimodal social interaction based on in-depth video analyses of two real life examples in which we introduce metaphorical identification criteria focusing on doubleness in meaning, affordances for co-action, co-ordination, and co-exper.. (shrink)

Plausibility models are Kripke models that agents use to reason about knowledge and belief, both of themselves and of each other. Such models are used to interpret the notions of conditional belief, degrees of belief, and safe belief. The logic of conditional belief contains that modality and also the knowledge modality, and similarly for the logic of degrees of belief and the logic of safe belief. With respect to these logics, plausibility models may contain too much information. A proper notion (...) of bisimulation is required that characterises them. We define that notion of bisimulation and prove the required characterisations: on the class of image-finite and preimage-finite models, two pointed Kripke models are modally equivalent in either of the three logics, if and only if they are bisimilar. As a result, the information content of such a model can be similarly expressed in the logic of conditional belief, or the logic of degrees of belief, or that of safe belief. This, we found a surprising result. Still, that does not mean that the logics are equally expressive: the logics of conditional and degrees of belief are incomparable, the logics of degrees of belief and safe belief are incomparable, while the logic of safe belief is more expressive than the logic of conditional belief. In view of the result on bisimulation characterisation, this is an equally surprising result. We hope our insights may contribute to the growing community of formal epistemology and on the relation between qualitative and quantitative modelling. (shrink)

Plausibility models are Kripke models that agents use to reason about knowledge and belief, both of themselves and of each other. Such models are used to interpret the notions of conditional belief, degrees of belief, and safe belief. The logic of conditional belief contains that modality and also the knowledge modality, and similarly for the logic of degrees of belief and the logic of safe belief. With respect to these logics, plausibility models may contain too much information. A proper notion (...) of bisimulation is required that characterises them. We define that notion of bisimulation and prove the required characterisations: on the class of image-finite and preimage-finite models, two pointed Kripke models are modally equivalent in either of the three logics, if and only if they are bisimilar. As a result, the information content of such a model can be similarly expressed in the logic of conditional belief, or the logic of degrees of belief, or that of safe belief. This, we found a surprising result. Still, that does not mean that the logics are equally expressive: the logics of conditional and degrees of belief are incomparable, the logics of degrees of belief and safe belief are incomparable, while the logic of safe belief is more expressive than the logic of conditional belief. In view of the result on bisimulation characterisation, this is an equally surprising result. We hope our insights may contribute to the growing community of formal epistemology and on the relation between qualitative and quantitative modelling. (shrink)

This paper proposes an analytical framework for the analysis of organizational cognition that borrows from distributed and ecological cognition. In so doing, we take a case study featuring a decision on the topic of agreeing on a set point in the agenda of a meeting. It is through the analysis of a few minutes of video-recording used in the case that enables us to demonstrate the power of applying distributed and ecological cognition to organizing processes. Cognitive mechanism, resources, and processes (...) are identified within this combined framework. Mechanisms are described as “socio-material” —where “people” and “artifacts” are the related cognitive resources—and as “conceptual” —with “group” identity, “topic” understanding, meaning of “procedures,” and perception of “time” as resources. Processes are defined as “coupling,” “de-coupling,” and “un-coupled” depending on the type of relation in place. Finally, the paper presents an agent-based computational simulation to demonstrate the potentials of operationalizing this approach. (shrink)

This paper investigates an unexplored indexical dimension inherent in the mapping structure of metaphor. The empirical focus is on the metaphor of stain but the scope of indexicality in relation to...

The translational research community, in general, and the Clinical and Translational Science Awards (CTSA) community, in particular, share the vision of repurposing EHRs for research that will improve the quality of clinical practice. Many members of these communities are also aware that electronic health records (EHRs) suffer limitations of data becoming poorly structured, biased, and unusable out of original context. This creates obstacles to the continuity of care, utility, quality improvement, and translational research. Analogous limitations to sharing objective data in (...) other areas of the natural sciences have been successfully overcome by developing and using common ontologies. This White Paper presents the authors’ rationale for the use of ontologies with computable semantics for the improvement of clinical data quality and EHR usability formulated for researchers with a stake in clinical and translational science and who are advocates for the use of information technology in medicine but at the same time are concerned by current major shortfalls. This White Paper outlines pitfalls, opportunities, and solutions and recommends increased investment in research and development of ontologies with computable semantics for a new generation of EHRs. (shrink)

This paper offers a novel, qualitative approach to evaluating the outcomes of integrating humanities and ethics into a newly revised pre-clerkship medical education curriculum. The authors set out to evaluate medical students’ perceptions, learning outcomes, and growth in identity development. Led by a team of interdisciplinary scholars, this qualitative project examines multiple sources of student experience and perception data, including student essays, end-of-year surveys, and semi-structured interviews with students. Data were analyzed using deductive and inductive processes to identify key categories (...) and recurring themes. Results suggest that students not only engaged with the curricular content and met the stated learning objectives but also acknowledged their experience in the humanities and ethics curriculum as an opportunity to reflect, expand their perceptions of medicine (and what it means to be “in” medicine), connect with their classmates, and further cultivate their personal and professional identities. Results of this qualitative study show how and in what ways the ethics and humanities curriculum motivates students past surface-level memorization of factual knowledge and encourages thoughtful analysis and evaluation about how the course material relates to and influences their thinking and how they see themselves as future doctors. The comprehensive qualitative approach reflects a holistic model for evaluating the integration of humanities and ethics into the pre-clerkship medical education curriculum. Future research should examine if this approach provides a protective factor against the demonstrated ethical erosion and empathy decrease during clinical training. (shrink)

The contact hypothesis has dominated work on prejudice reduction and is often described as one of the most successful theories within social psychology. The hypothesis has nevertheless been criticized for not being applicable in real life situations due to unobtainable conditions for direct contact. Several indirect contact suggestions have been developed to solve this “application challenge.” Here, we suggest a hybrid strategy of both direct and indirect contact. Based on the second-person method developed in social psychology and cognition, we suggest (...) working with an engagement strategy as a hybrid hypothesis. We expand on this suggestion through an engagement-based intervention, where we implement the strategy in a theater performance and investigate the effects on prejudicial attitudes toward people with physical disabilities. Based on the results we reformulate our initial engagement strategy into the Enact hypothesis. To deal with the application challenge, this hybrid hypothesis posits two necessary conditions for prejudice reduction. Interventions should: work with engagement to reduce prejudice, and focus on the second-order level of attitudes formation. Here the aim of the prejudice reduction is not attitude correction, but instead the nuancing of attitudes. (shrink)

Thomas Nagel recognizes that it is commonly believed that people can neither be held morally responsible nor morally assessed for what is beyond their control. Yet he is convinced that although such a belief may be intuitively plausible, upon reflection we find that we do make moral assessments of persons in a large number of cases in which such assessments depend on factors not under their control. Of such factors he says: (p. 26).

We investigated whether memories are selected for the life story based on event characteristics. Sixty-one students completed weekly diaries over their first term at university. They described, dated and rated two events each week. Three months after the end of the term they completed an unexpected memory test. They recalled three memories from the diary period that were important to their life story. Three randomly selected events scoring low on importance to the life story functioned as control memories. Life story (...) memories were rated higher on goal relevance, emotional intensity, importance and rehearsal in the diary and maintained their higher ratings at the test session, while ratings for control memories dropped off. Life story memories’ content was less consistent over time but they were more accurately dated than control memories. The results suggest that event characteristics play an important role for the selection of life story memories. (shrink)

In this collection of interviews, Derrick Jensen discusses the destructive dominant culture with ten people who have devoted their lives to undermining it. Whether it is Carolyn Raffensperger and her radical approach to public health, or Thomas Berry on perceiving the sacred; be it Kathleen Dean Moore reminding us that our bodies are made of mountains, rivers, and sunlight; or Vine Deloria asserting that our dreams tell us more about the world than science ever can, the activists and (...) philosophers interviewed in How Shall I Live My Life? each bravely present a few of the endless forms that resistance can and must take. (shrink)

*Tackles the Thomistic debate surrounding the inherent good and evil of human actions*.

Contemporary commentators on the history of ethics have devoted little attention to the ethical theory of Thomas Reid. The main reason for this neglect concerns the perspective from which they are very likely to view his theory. Roughly, this perspective is as follows. Eighteenth century ethics tends to be viewed as consisting mainly in the prolonged dispute concerning the nature of the moral faculty. In identifying Reid’s part in this dispute it should be noted that his Essays on the (...) Active Powers of the Human Mind, his major work on ethics, was published in 1788. It was therefore preceded by the works of such early rational intuitionists as Cudworth, Clarke, Balguy, and Wollaston and by the criticisms directed against them by such defenders of the moral sense position as Shaftesbury, Hutcheson, and Hume. Moreover, it was preceded by the intuitionistic counterattack directed against the latter by Richard Price, a near contemporary of Reid, who has often been described as the greatest of the intuitionists and whose prominence is such that his ethical theory has tended to eclipse that of Reid. The result is that there are in Reid a large number of pages devoted to restatements of an intuitionistic position which a contemporary reader has already encountered in earlier writers and which he is therefore likely to find rather boring. Even those who have maintained correctly that Reid is the founder of the Scottish school of common sense and that his ethical theory is to be seen in the context of his defense of common sense have added little to this perspective, since, generally speaking, they have found no significant differences between his ethical theory as seen in this context and intuitionism. Viewed from this perspective, Reid’s ethics might well be deserving of neglect and of the comment made by Alasdair MacIntyre that “the successors of Hume and Adam Smith in Scottish philosophy have little to say to us. Thomas Reid was a rationalist in the spirit of Price.”. (shrink)

In this impassioned polemic, radical environmental philosopher Derrick Jensen debunks the near-universal belief in a hierarchy of nature and the superiority of humans. Vast and underappreciated complexities of nonhuman life are explored in detail--from the cultures of pigs and prairie dogs, to the creative use of tools by elephants and fish, to the acumen of caterpillars and fungi. The paralysis of the scientific establishment on moral and ethical issues is confronted and a radical new framework for assessing the intelligence (...) and sentience of nonhuman life is put forth. Jensen attacks mainstream environmental journalism, which too often limits discussions to how ecological changes affect humans or the economy--with little or no regard for nonhuman life. With his signature compassionate logic, he argues that when we separate ourselves from the rest of nature, we in fact orient ourselves against nature, taking an unjust and, in the long run, impossible position. Jensen expresses profound disdain for the human industrial complex and its ecological excesses, contending that it is based on the systematic exploitation of the earth. Page by page, Jensen, who has been called the philosopher-poet of the environmental movement, demonstrates his deep appreciation of the natural world in all its intimacy, and sounds an urgent call for its liberation from human domination. (shrink)

The problem -- The text -- Inclinations -- Good -- Nature -- The will -- Ought -- Obligation -- Principles -- Action.

In this book, T. M. Scanlon offers new answers to these questions, as they apply to the central part of morality that concerns what we owe to each other.

This volume celebrates the remarkable career of Dr. Preston King, an African American political philosopher with an international reputation. King's first degree was from Fisk University (1956). He moved directly to the London School of Economics (LSE), completing his M.Sc. (Econ) in 1958 with a Mark of Distinction. He taught at LSE for the next two years. A scrap with Jim Crow America kept him in exile for the next 40 years. Major friends and influences at LSE were Professors Sir (...) Karl Popper, Michael Oakeshott, and Dr Bernard Crick. King took up subsequent lectureships at the Universities of Keele, Ghana, and Sheffield. He was Senior Research Assistant at the Acton Society Trust (London), then professor at the Universities of Nairobi, New South Wales (Sydney), Lancaster, returning at last to the USA as joint Woodruff Professor at Emory and Distinguished Professor at Morehouse. The essays comprising this volume are by internationally renowned figures. They creatively explore History, Toleration, and Friendship, as three seminal themes running through Preston King's sizeable oeuvre. This book's first third consists of essays on Time and History, with brilliant contributions by Professors Browning, Lawson, Moore, and Cherribi. The second third consists of essays on Time and Toleration, with memorable and penetrating analyses by Professors Jones, Read, Modood/Dobbernak, and Brown. The third part consists of essays on Time and Friendship, with offerings - both charming and insightful - by Professors Devere, Smith, and Coleman. The book concludes with a novel and captivating chapter by King himself, on the philosophy of time, which constitutes the substratum of so much of his work and reflection. (shrink)

This volume brings together for the first time a significant number of Reid's manuscript papers on natural history, physiology and materialist metaphysics. An important contribution not only to Reid studies but also to our understanding of eighteenth-century science and its context.

This volume outlines a Deleuzian approach to analyzing science, culture and politics.

Ethical decision making is of concern to researchers across all fields. However, researchers typically focus on the biases that may act to undermine ethical decision making. Taking a new approach, this study focused on identifying the most common compensatory strategies that counteract those biases. These strategies were identified using a series of interviews with university researchers in a variety of areas, including biological, physical, social, and health as well as scholarship and the performing arts. Interview transcripts were assessed with two (...) scoring procedures, an expert rating system and computer-assisted qualitative analysis. Although the expert rating system identified Understanding Guidelines, Recognition of Insufficient Information, and Recognizing Boundaries as the most frequently used compensatory strategies across fields, other strategies, Striving for Transparency, Value/norm Assessment, and Following Appropriate Role Models, were identified as most common by the computer-assisted qualitative analyses. Potential reasons for these findings and implications for training and practice are identified and discussed. (shrink)

The increasing interconnectedness of academic research and external industry has left research vulnerable to conflicts of interest. These conflicts have the potential to undermine the integrity of scientific research as well as to threaten public trust in scientific findings. The present effort sought to identify themes in the perspectives of faculty researchers regarding conflicts of interest. Think-aloud interview responses were qualitatively analyzed in an effort to provide insights with regard to appropriate ways to address the threat of conflicts of interest (...) in research. Themes in participant responses included disclosure of conflicts of interest, self-removal from situations where conflict exists, accommodation of conflict, denial of the existence of conflict, and recognition of complexity of situations involving conflicts of interest. Moral disengagement operations are suggested to explain the appearance of each identified theme. In addition, suggestions for best practices regarding addressing conflicts of interest given these themes in faculty perspectives are provided. (shrink)

This introduction to the history, philosophy and methodology of human geography explores complex ideas in an intelligible and accessible style. It takes into account the new developments in geographical thought and methods.

Sensation -- Skepticism -- Internal senses -- The emotions -- Mechanism -- Materialism and dualism -- Hylomorphism -- The problem of universal knowledge -- Reason -- Immortality -- Freedom -- The will -- Free decision -- Purpose.