Contributors to this volume demonstrate how the ethics of care factors into a variety of social policies and institutions, and can indeed be useful in thinking about a number of different social problems. Divided into two sections, the first looks at care as a model for an evaluative framework that rethinks social institutions, liberal society, and citizenship at a basic conceptual level. The second explores care values in the context of specific social (...) practices or settings, as a framework that should guide thinking. (shrink)

Contributors to this volume demonstrate how the ethics of care factors into a variety of social policies and institutions, and can indeed be useful in thinking about a number of different social problems. Divided into two sections, the first looks at care as a model for an evaluative framework that rethinks social institutions, liberal society, and citizenship at a basic conceptual level. The second explores care values in the context of specific social (...) practices or settings, as a framework that should guide thinking. (shrink)

This paper argues for the necessity of universal health care (as well as universal free education) using a different argument than most that have been made heretofore. It is not meant to conflict with but to strengthen the arguments previously made by others. Using the second paragraph of the Declaration of Independence and the Preamble to the Constitution we argue that universal health care in this day and age has become a necessary condition if the ideals of life, (...) liberty and the pursuit of happiness are to be more than an empty promise and if the discussion of “promoting of general welfare” in the preamble is to have any meaning. (shrink)

Philoctetes was a good man and a good soldier. When he was on his way to Troy to fight alongside the Greeks, he had a terrible misfortune. By sheer accident he trespassed in a sacred precinct on the island of Lemnos. As punishment he was bitten on the foot by the serpent who guarded the shrine. His foot began to ooze with foul-smelling pus, and the pain made him cry out curses that spoiled the other soldiers' religious observances. They therefore (...) left him alone on the island, a lame man with no resources but his bow and arrows, no friends but the animals who were also his food. Ten years later, according to Sophocles' version of the story, they come to bring him back: for they have learned that they cannot win the war without him. The leaders of the expedition think of Philoctetes as a tool of their purposes; they plan to trick him into returning, with no empathy for his plight. The Chorus of soldiers, however, has a different response. Even before they see the man, they imagine vividly what it is like to be him– and they enter a protest against the callousness of the commanders: For my part, I pity him– thinking of how, with no living soul to care for him, seeing no friendly face, wretched, always alone, he suffers with a fierce affliction, and has no resources to meet his daily needs. How in the world does the poor man survive? (shrink)

Philoctetes was a good man and a good soldier. When he was on his way to Troy to fight alongside the Greeks, he had a terrible misfortune. By sheer accident he trespassed in a sacred precinct on the island of Lemnos. As punishment he was bitten on the foot by the serpent who guarded the shrine. His foot began to ooze with foul-smelling pus, and the pain made him cry out curses that spoiled the other soldiers' religious observances. They therefore (...) left him alone on the island, a lame man with no resources but his bow and arrows, no friends but the animals who were also his food. Ten years later, according to Sophocles' version of the story, they come to bring him back: for they have learned that they cannot win the war without him. The leaders of the expedition think of Philoctetes as a tool of their purposes; they plan to trick him into returning, with no empathy for his plight. The Chorus of soldiers, however, has a different response. Even before they see the man, they imagine vividly what it is like to be him– and they enter a protest against the callousness of the commanders: For my part, I pity him– thinking of how, with no living soul to care for him, seeing no friendly face, wretched, always alone, he suffers with a fierce affliction, and has no resources to meet his daily needs. How in the world does the poor man survive? (shrink)

This paper explores the possibilities of the recognition and valuation of care by implementing an unconditional basic income and presents a feminist redefinition of the concept of a UBI. The author proposes the notion of a caring revolutionary transformation as a process of institutionalising the social and economic conditions for recognition of care which is a cornerstone of struggles for women’s emancipation and gender equity. It is a process of practically realisable transformative steps which together with (...) their combined and mutually reinforcing effects enable more radical social changes beyond a mere reform. The author argues that these transformative steps have to address two conditions embedded in the institutionalised structures of late modern capitalist society: the limited understanding of meaningful work as paid employment; and the liberal ideal of the independent and autonomous individual. Whereas a UBI can challenge the first condition, a public model of care questions the second condition by shifting the primary responsibility of care from the family towards a social solidarity. While insufficient when introduced separately, the combination of these two remedies has the potential to radically alter social structures on which gendered inequalities rest. (shrink)

1. The Covid-19 pandemic has made strikingly visible both the essential role of care work in societies and worrying symptoms of a care crisis (Dowling 2021; Rao 2021). These symptoms have become ma...

In his own writings, Rawls purposively used only a loose characterization of the basic structure, but two prominent misinterpretations highlight the current need for a more detailed account. First, G.A. Cohen argues that the Rawlsian focus on the basic structure is arbitrary due to the Rawlsian appeal to profound effects. Second, some theorists conflate the justification of coercion with the assessment of a basic structure by defining the basic structure as the coercive structure. Both misinterpretations can (...) be corrected by carefully specifying what social institutions are and explaining which social institutions come together to form the basic structure of society. (shrink)

A just social arrangement must guarantee a right to health care for all. This right should be understood as a positive right to basic human functional capabilities. The present article aims to delineate the right to health care as part of an account of distributive justice in health care in terms of the sufficiency of basic human functional capabilities. According to the proposed account, every individual currently living beneath the sufficiency threshold or in jeopardy (...) of falling beneath the threshold has a legitimate claim to justice. People's entitlements to health care should not be determined on the basis of brute luck and their efforts to maintain healthy lifestyles. The prioritization of competing claim-rights of individuals is guided by two allocation principles: number and benefit-size weighted sufficiency (among people beneath the threshold) and need-weighted utilitarianism (among people above the threshold). (shrink)

There are four basic models for health care systems: the private market insurance model, the national single-payer model, the national health service model, and the social insuranceSocial insurance model. The social justice debate over health care usually focuses on the comparative efficiency and quality of competitive private market insurance and the universal coverage and equity of national health care systems. It is a mistake, however, to think that a universal right to health care (...) services requires a single-payer, government-run, national health care system. The social insurance model of Germany, France, Japan, and many other countries, deserves more attention, as it incorporates the strengths of both market models and national health care models. (shrink)

ABSTRACT People who are paid to provide basic care for others are frequently undervalued, exploited and expected to reach often unrealistic standards of care. I argue that appropriate social recognition, support and fair pay for people who provide care for those who are disabled, frail and aged, or suffering ill health that impedes their capacity to negotiate daily activities without support, depends on a reconsideration of the paradigm of the citizen or and moral agent. I (...) argue that by drawing on the ideas of human vulnerability and dependency as central to our personhood, a more realistic conception of selves, citizens and persons can be developed that better recognises the inevitability of human dependency and the social value of care work. I also indicate the significance of this vulnerability‐focussed view for ethical evaluation of the emotional aspects of care relationships. (shrink)

Journal of Social Philosophy, EarlyView.

There are four basic models for health care systems: the private market insurance model, the national single-payer model, the national health service model, and the social insurance model. The social justice debate over health care usually focuses on the comparative efficiency and quality of competitive private market insurance and the universal coverage and equity of national health care systems. It is a mistake, however, to think that a universal right to health care services (...) requires a single-payer, government-run, national health care system. The social insurance model of Germany, France, Japan, and many other countries, deserves more attention, as it incorporates the strengths of both market models and national health care models. (shrink)

The issue of the policy of multiculturalism toward ethno-cultural minorities in contemporary Serbia has been reviewed within the project Regional and European Aspects of Integrative Processes in Serbia held by the Institute for Philosophy and Social Theory. The aim of this paper is directed toward examination of theoretical and empirical problems regarding the phenomenon of multiculturalism. In spite of the fact that multiculturalism is one of the striking characteristics of modern life in Serbia our social sciences pay a (...) little attention to this topic. Ethnicity as an important part of multicultural discourse is based on nonscientific knowledge and in this manner it presents basis for policy and practice for the protection of rights of minorities in the country. Problem politike multikulturalnosti prema etno-kulturnim manjinama u savremenoj Srbiji autor razmatra u okviru projekta Instituta za filozofiju i drustvenu teoriju "Regionalni i evropski aspekti integrativnih procesa u Srbiji: civilizacijske pretpostavke, stvarnost i izgledi za buducnost". Cilj rada na ovoj temi je usmeren ka razmatranju teorijskih i empirijskih problema u vezi sa fenomenom multikulturalnosti. Uprkos tome sto je multikulturalnost jedna od upecatljivijih karakteristika drustvenog zivota u Srbiji, u nasim drustvenim naukama malo paznje se posvecuje proucavanju ovog fenomena. Stavise, na neutemeljenim saznanjima o etnicitetu kao bitnom delu multikulturalnog diskursa eklekticki je osmisljena politika i konstruisana praksa zastite manjinskih prava u zemlji. (shrink)

The paper discusses the challenges faced by the theoretical thought and practice in Europe concerning the politics of. Though multiculturalism is a complex phenomenon assuming that many social diversities should be brought into accord, in the practice of the Central and Southeast European states it is reduced to the identification of the identities and the recognition of the ethno-cultural minorities' rights. In these regions the politics of multiculturalism meets the resistance of the majority as well as the barriers that (...) slow down their social development. The antagonists of multiculturalism find their allies in conservative though real opinions of the intellectuals and politicians in the West who are afraid that a too fast expansion of the European Union may jeopardize its economic development and disturb even more its political stability. U radu se razmatraju izazovi sa kojima se suocavaju teorijska misao i praksa u Evropi, u vezi sa politikom multikulturalnosti. Iako je multikulturalizam slozen fenomen koji podrazumeva uskladjivanje mnogih drustvenih razlicitosti u praksi drzava u Centralnoj i Jugoistocnoj Evropi on je redukovan na prepoznavanje identiteta i priznavanje prava etno-kulturnih manjina. U ovim regionima politika multikulturalnosti nailazi na otpor vecine i prepreke koje usporavaju njihov drustveni razvoj. Saveznike, neprijatelji multikulturalizma, nalaze u konzervativnim, ali aktuelnim misljenjima intelektualaca i politicara na Zapadu koji strahuju da ce prebrzo prosirenje Evropske unije ugroziti njen ekonomski razvoj i jos vise uzdrmati politicku stabilnost. (shrink)

Critical examination of Alchourrón and Bulygin’s set-theoretic definition of normative system shows that deductive closure is not an inevitable property. Following von Wright’s conjecture that axioms of standard deontic logic describe perfection-properties of a norm-set, a translation algorithm from the modal to the set-theoretic language is introduced. The translations reveal that the plausibility of metanormative principles rests on different grounds. Using a methodological approach that distinguishes the actor roles in a norm governed interaction, it has been shown that metanormative principles (...) are directed second-order obligations and, in particular, that the requirement related to deductive closure is directed to the norm-applier role rather than to the norm-giver role. The approach has been applied to the case of pure derogation yielding a new result, namely, that an independence property is a perfection-property of a norm-set in view of possible derogation. This paper in a polemical way touches upon several points raised by Kristan in his recent paper. (shrink)

In this article the relevance of the feminist ethic of care for current Dutch social policies is elaborated. It starts from the observation that Dutch society is witnessing two intertwined processes: the relocation of politics and the relocation of care. Together these processes result in the need for new normative frameworks for social policy. Care has to become part of the practices of active citizenship, which should be based on notions of relationality and interdependence. (...) class='Hi'>Basic moral concepts of the ethic of care, like attentiveness, responsibility, competence, responsiveness, trust and asymmetrical reciprocity are introduced. In the final part, the ethic of care is applied to two topical issues: policies on combining paid labour and care and generation-sensitive policies. Finally some norms are proposed to guide social policymaking. (shrink)

This article will examine the Catholic concept of global justice within a health care framework as it relates to women's needs for delivery doctors in the developing world and women's demands for assisted reproduction in the developed world. I will first discuss justice as a theory, situating it within Catholic social teachings. The Catholic perspective on global justice in health care demands that everyone have access to basic needs before elective treatments are offered to the wealthy. (...) After exploring specific discrepancies in global health care justice, I will point to the need for delivery doctors in the developing world to provide basic assistance to women who hazard many pregnancies as a priority before offering assisted reproduction to women in the developed world. The wide disparities between maternal health in the developing world and elective fertility treatments in the developed world are clearly unjust within Catholic social teachings. I conclude this article by offering policy suggestions for moving closer to health care justice via doctor distribution. (shrink)

Because medicine can preserve and restore health and function, it is widely acknowledged as a basic good that a just society owes its members. Yet there is controversy over the scope of what should be provided, to whom, how, when and why. This comprehensive and authoritative book - by well-known philosophers, doctors, lawyers, political scientists, and economists - lays a theoretical foundation for understanding the debate, assesses how health care is distributed in different countries and to various (...) class='Hi'>social groups, and analyzes practical issues in constructing a socially just health care system. (shrink)

Power, dominance, and hierarchy are prevalent analytical terms in social studies of health care. Power is often seen as residing in medical structures, institutions, discourses, or ideologies. While studies of medical power often draw on Michel Foucault, this understanding is quite different from his proposal to study in detail the “strategies, the networks, the mechanisms, all those techniques by which a decision is accepted” [Foucault, M. (1988). In Politics, philosophy, culture: Interviews and other writings 1977–84 (pp. 96–109). New (...) York: Routledge]. This suggestion turns power into a topic worth investigating in its own right rather than a basic analytical resource. It also suggests that technologies form an integral part of the networks and mechanisms, which produce and redistribute power in medical practice. The paper first engages critically with a number of recent discussions of technology and power in health care analysis. It then formulates an alternative conception of this relationship by drawing on Foucault and historian of science and technology Geoffrey C. Bowker’s notions of infrastructural inversion and information mythology. Illustration is provided through a case study of a wireless nursing call system in a Canadian hospital. (shrink)

How do we care well for a human being: ourselves or another? Non-Kantian scholars rarely identify the philosophy of Kant as a particularly useful resource with which to understand the full complexity of human care. Kant’s philosophy is often taken to presuppose that a philosophical analysis of good human life needs to attend only to how autonomous, rational agents—sprung up like mushrooms out of nowhere, without a childhood, never sick, always independent—ought to act respectfully, and how they can (...) be forced to interact rightfully. Questions involving aspects of human life captured by what Eva Kittay aptly phrased “the fact of dependency” (1999) —such as our vulnerable, fragile, and embodied social natures, asymmetrical care relations, and deep systemic injustices—are therefore commonly thought to be beyond the grasp of Kant and of Kantian philosophy. Against this historically prominent understanding of Kant’s practical philosophy, below I engage and draw upon recent Kant scholarship which shows both the inadequacy of such rationalist readings and the fruitfulness of using Kant’s practical philosophy to enhance our understanding of human care relations. After situating my approach in the existing, relevant secondary literature on Kant’s human agent, I explore key features of Kant’s accounts of human nature and the highest good. I pay special attention to his proposal that our human nature comprises reflective and unreflective aspects and patterns that we (ought to) strive to develop, transform, and integrate in wise ways through our faculty of desire. In addition, I emphasize the dangers that our ineradicable propensity to do bad things (evil) poses for our projects of self- and other- care. I proceed by outlining how Kant’s account of moral (ethical and legal) responsibility for self and others is developed through his theories of freedom, that is, through his theory of virtue (virtuous internal freedom with its account of perfect and imperfect duties) and his theory of right (rightful external freedom with its account of innate, private, and public right). On the conception I am advancing, we are pretty messy, fragile, and vulnerable beings whose projects of caring are difficult, ongoing, and complex. On the one hand, we (should) strive to care for ourselves (by striving to manage and heal badly functioning parts and by developing, transforming, and integrating immature or distinct parts of ourselves into good wholes) and for others (assisting them in their projects of management and healing and of developing, transforming, and integrating themselves into good wholes) in ways that are both respectful and attentive to the particular people we are—people with lives of our own to live—and the kinds of relationships we share. On the other hand, we should, and can, be forced to interact rightfully, meaning interaction consistent with one another’s basic (innate, private, and public) rights and, hence, contribute to reform projects that improve our inherited, imperfect legal-political systems with regard to care relations. Bringing Kant’s philosophy into dialogue with care theorists, I conclude, advances the insights of both traditions by showing one way to arrive at a multifaceted, yet unified account of human care relations where our embodied, social as well as our rational natures are given due consideration. (shrink)

How care can resist the stifling force of the neoliberal paradigm In a world brimming with tremendous wealth and resources, too many are suffering the oppression of precarious existences--and with no adequate relief from free market-driven institutions. Care Ethics in the Age of Precarity assembles an international group of interdisciplinary scholars to explore the question of care theory as a response to market-driven capitalism, addressing the relationship of three of the most compelling social and political subjects (...) today: care, precarity, and neoliberalism. While care theory often centers on questions of individual actions and choices, this collection instead connects theory to the contemporary political moment and public sphere. The contributors address the link between neoliberal values--such as individualism, productive exchange, and the free market--and the pervasive state of precarity and vulnerability in which so many find themselves. From disability studies and medical ethics to natural-disaster responses and the posthuman, examples from Māori, Dutch, and Japanese politics to the COVID-19 pandemic and the Black Lives Matter movement, this collection presents illuminating new ways of considering precarity in our world. Care Ethics in the Age of Precarity offers a hopeful tone in the growing valorization of care, demonstrating the need for an innovative approach to precarity within entrenched systems of oppression and a change in priorities around the basic needs of humanity. Contributors: Andries Baart, U Medical Center Utrecht, Tilburg U, and Catholic Theological U Utrecht, the Netherlands; Vrinda Dalmiya, U of Hawaii, Mānoa; Emilie Dionne, U Laval; Maggie FitzGerald, U of Saskatchewan; Sacha Ghandeharian, Carleton U; Eva Feder Kittay, Stony Brook U/SUNY; Carlo Leget, U of Humanistic Studies in Utrecht, the Netherlands; Sarah Clark Miller, Penn State U; Luigina Mortari, U of Verona; Yayo Okano, Doshisha U, Kyoto, Japan; Elena Pulcini, U of Florence. (shrink)

We intuitively think and talk about health care as a human right. Moreover, we tend to talk about health in the language of basic rights or human rights without a clear sense of what such rights mean, let alone whose duty it is to fulfill them. Additionally, in the care ethics literature, we tend to think of a dividing line between care and justice. In this dissertation I aim to draw care and justice together in (...) what I call care justice. To attend to care justice requires the reconceptualization of the value and practice of health care, and of the moral communities in which we enact care and justice. First, I argue for a strong right to health care, though not to health. Second, I argue that health care includes much more than mere medical care. On this account health care is special for the practices of care it values and communicates. Third, I establish a theoretical framework for why, and importantly how, health care entails other forms of care: social, economic and political. My approach engages a complicity framework to rethink moral community formation and participation, and the rights and responsibilities of individuals as participants in a collective moral community. I argue that it is within communities of membership, which I define as ethical homes, that we have duties to and expectations from others. The moral community as complicit ethical home provides a way to reimagine individual shared responsibility within moral communities, and particularly regarding responsibility for practices of care. (shrink)

The question of how to allocate scarce medical resources has become an important public policy issue in recent decades. Cost-Utility Analysis is the most commonly used method for determining the allocation of these resources, but this book counters the argument that overcoming its inherent imbalances is simply a question of implementing methodological changes. The Economics of Resource-Allocation in Healthcare represents the first comprehensive analysis of equity weighting in health care resource allocation that offers a fundamental critique of its (...) class='Hi'>basic framework. It offers a heterodox account of health economics, putting the discourse on economic evaluation into it broader socio-political context. Such an approach broadens the debate on fairness in health economics and ties it in with deeper rooted problems in moral philosophy. Ultimately, this interdisciplinary study calls for the adoption of a fundamentally different paradigm to address the distribution of scarce medical resources. This book will be of interest to policy makers, health care professionals or Post-Graduate students looking to broaden their understanding of the economics of the healthcare system. (shrink)

This article challenges the use of social deprivation as a punishment, and offers a preliminary examination of the human rights implications of exile and solitary confinement. The article considers whether a human right against coercive social deprivation is conceptually redundant, as there are recognised rights against torture, extremely cruel, inhumane, or degrading treatment as well as rights to basic health care, education, and security, which might encompass what this right protects. The article argues that the right (...) is not conceptually redundant, but that, even if it were, there would be significant reasons to articulate it. (shrink)

This paper investigates the import for a conception of democratic socialism of Marx’s well-known principle “From each according to their abilities, to each according to their needs,” arguing that it is best taken together with another of his principles: “The free development of each is the condition for the free development of all.” It considers their implications for the near term rather than some possible ultimate form of communal society, and also brings in a principle that I have developed previously—equal (...) positive freedom—which in some ways synthesizes the other two. In analyzing the abilities and needs principle, the notion and extent of needs are explicated, seeing them as including not only material needs, but needs for recognition and for relationships. Marx’s crucial insight that distribution largely depends on the organization of the production process also comes into play. On these bases, the paper proposes that a system of democratically managed firms forms the centerpiece for democratic socialism, supplemented by some other institutions that would work to meet basic needs. The paper also proposes a role for the norms of reciprocity and solidarity, in addition to those of freedom and equality that are most evident in the three principles. Finally, the relative inattention to social reproduction in the early Marxist tradition is addressed with an interpretation of the notion of socializing care and a consideration of its import for institutional design, including cooperative ways of providing such care. Throughout, Marx’s distinctive notions of social individuality, socialized wealth, and the free development of individuals are appealed to for the guidance they can provide for interpreting the abilities/needs principle for the period ahead. (shrink)

The rapidly changing field of genetics affects society through advances in health-care and through implications of genetic research. This study addresses the impacts of new genetic discoveries and technologies on different segments of today's society. The book begins with a chapter on genetic complexity, and subsequent chapters discuss moral and ethical questions arising from today's genetics from the perspectives of health care professionals, the media, the general public, special interest groups and commercial interests.

Palliative care is provided at a certain timepoint, both in a person's life and in a societal context. What is considered to be a good death can therefore vary over time depending on prevailing social values and norms, and the person's own view and interpretation of life. This means that there are many interpretations of what a good death can actually mean for an individual. On a more general level, research in palliative care shows that individuals have (...) basic common needs, for example physical, mental, social and spiritual well‐being. Therefore, in today's pluralistic Western society, it becomes important that palliative care is person centred to enable individuals to receive, as far as can be achieved, care that promotes as good a life as possible based on the person's own needs and preferences, and in accordance with evidence and current laws. For many years a research group, consisting nurse researchers together with nurses working in palliative care, has developed a model for person‐centred palliative care, the 6S‐model. The model's central concept is Self‐image, where the starting point is the patient as a person and their own experience of the situation. The other concepts: Self‐determination, Symptom relief, Social relationships, Synthesis and Strategies are all related to the patient's self‐image, and often to each other. The model's development, value base and starting assumptions are reported here, as are examples of how the model is applied in palliative care in Sweden. The model has been, and still is, constantly evolving in a collaboration between researchers and clinically active nurses, and in recent years also with patients and close relatives. (shrink)

The aim of this study was to use ethical arguments to strengthen the relationship between the concepts of legitimacy and evaluation. The analysis is based on the ethics of Levinas and Buber and is motivated by a sense of responsibility using dialogical ideology as a mediator. The main questions in this study consider the following: Does caring science as an independent academic discipline have the moral responsibility to develop a theory for evaluating the quality of basic research? and Will (...) such a quality evaluation theory have a reasonable probability of introducing legitimization into caring science? On an ethical level, this study introduces a meaningful interaction inspired by social demands and is linked to the concept of research justification. Legitimization turns from an abstract idea to an achievable entity by an act. The act of evaluation has the likelihood of delegating legitimacy and empowers the foundation of caring science, which in turn will become a cornerstone of nursing. At this stage there is no intention to develop an evaluation theory, rather to create a meaningful discussion for the future development of an ethics-based theory. (shrink)

Social Facts and Collective Intentionality is a combination of terms that refers to a new field of basic research. Written mainly in the mood and by means of analytical philosophy, at the very heart of this new approach is conceptual explication of all the various versions of social facts and collective intentionality and its ramifications. This approach tackles the topics of traditional social philosophy using new conceptual methods, including techniques of formal logic, computer simulations, and artificial (...) intelligence. Such research also addresses careful research relating to ontological, epistemological, normative and--last but not least-- methodological questions. This volume represents the state of the art in this new field. The volume and its contributors tackle a series of vexing issues in the social sciences: (1) the sense of affiliation to large in contrast to small groups, (2) whether collective membership is the same as common knowledge, (3) the worth of information exchange based on faulty data, (4) the difference between standards of information and transfer of information, and (5) whether reliability is grounded in personal experience or as members in epistemic communities or networks. Contributors to this volume have a strong commitment to the social or collective character and mutual interplay of scientific information. "Collective Intentionality" is the term chosen by researchers working in this cross-disciplinary field. The group is currently conducting research in areas such as artificial intelligence, linguistics, logic, and the philosophy of the social sciences. Its work is distinguished by issues of collective behavior such as jointness, groupness, we and us. The present volume covers the state of the art of collective analysis, while fully appreciating that it is a stepping stone, albeit an important one, in redirecting the attention of basic philosophy away from the individual to the collective mode of exact analysis. Georg Meggle is professor for philosophical foundations of anthropology and of cognitive sciences at the University of Leipzig, Germany. He is a key contributor to Realism in Action with a study of Common Belief and Common Knowledge, and author of an earlier study of theoretical foundations of semantics. (shrink)

In his multi-faceted attack on Rawls’s account of justice, G.A. Cohen has argued that the notion of basic structure is necessarily insensitive to the importance of informal social norms to social justice. The paper argues that the most plausible account of the basic structure is not blind to informal social norms in any meaningful sense. Whereas informal, non-legally coercive institutions are not part of the basic structure as such, their careful consideration is necessary for (...) the assessment of whether the basic structure itself is indeed just. This claim is based on an account of what it means for normative principle to apply to institutions, which I expound in detail throughout the paper. Principles apply to institutions, I argue, not in that they restrain their conduct, but in that they indicate which social conditions they should bring about. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Health Care Ethics: A Comprehensive Christian Resource by James R. ThobabenPaul D. SimmonsHealth Care Ethics: A Comprehensive Christian Resource by James R. Thobaben Downers Grove, IL: Intervarsity Press, 2009. 429pp. $28.00In recent years, a stir has been created by the vocal and aggressive involvement of evangelicals in such issues as abortion, homosexuality, and end-of-life decisions. James Thobaben, the dean of Asbury Seminary, provides what he calls (...) a [End Page 203] “comprehensive resource” for evangelicals, and promises better understandings of their perspectives and commitments for those who are baffled or frustrated by the actions and claims of those on the religious right.Thobaben casts a wide net when defining those he includes as “evangelicals”—Southern Baptists, members of Campus Crusade, Pentecostals, the Holiness movement, neoevangelicals, charismatics, and Anabaptists. These diverse groups are evangelicals because of their “consistency on moral choices,” doctrinal orientation, and styles of social advocacy (24). Although they differ in a number of ways, they all share having been influenced in some way by John and Charles Wesley, Jonathan Edwards, and the Reformation. All stress conversion in that “one must say yes to the divine Jesus Christ” and become identified with the community of faithful believers (57). And in recent decades, they have become a potent political force with regard to the issues of abortion and homosexuality.Thobaben covers a wide range of topics in this book: from a general discussion of theodicy and healing to bioethics, disability, sickness, family and congregational care, professional truthfulness, managing care, end-of-life decisions, assisted reproduction, organ donation, and death. Yet, although he claims to provide a “comprehensive resource” on evangelical Christian health care ethics, he fails to provide a thorough examination of his subject matter. For example, Thobaben pays little attention to the historic beginnings of the religious right. One misses any mention of political action groups or the coalitions formed with or by conservative Christian groups to pursue social reforms, or of why such disparate groups have cooperated for political or social goals under the same umbrella. He focuses solely on identifying and articulating the consensus among those who embrace certain moral values on the current scene. Thobaben’s uncritical approach to his subject matter leaves the impression that this book is essentially an apology for evangelical, right-wing Christian social thought. One searches in vain for any critical discussion of the beliefs and values he presents or any thoughtful engagement with those who might view the stances he presents as an assault against women’s rights or an attack on the rights of gays, lesbians, and transsexuals.Moreover, in a book like this, one would have expected a more careful assessment of biblical passages and historical precedents. Thobaben does not provide much rationale for his method for moving from the Bible to current social issues. For example, no prohibition against abortion is found in the Bible and the few passages about homosexual practices hardly add up to the fierce opposition to gays found among strident evangelicals. Moreover, Thobaben does not mention that in 1965 laws against contraceptives were declared unconstitutional by the Griswold vs. Connecticut decision, the Supreme Court’s rejection of a ban supported by an evangelical crusade led by Anthony Comstock. [End Page 204]It is interesting to note that Thobaben holds a strongly qualified commitment to religious liberty and only a “thin” version of the social contract basic to the Bill of Rights (37). He argues that in at least some situations “intolerance is not only morally understandable but strongly preferable,” as in the examples of the “abolition of slavery and prolife/antiabortion advocacy” (29) or, in another context—where he distinguishes between tolerance toward those outside the church and intolerance toward those within it—with regard to homosexuality and alcohol intoxication (30).The task of Christian ethics is to enlighten believers and the general citizenry by a careful exposition of the sources of wisdom available to those who want to think and think morally about issues of importance to human flourishing. That task is especially important in an age of demagogic hostility toward unpopular groups. Sadly, this book does not engage such critical questions. It may prove... (shrink)

Anti-poverty policies and attitudes of distrust toward the needy share a long history. From the narratives of de Quevedo’s El Buscón, in which beggars are presented as able-bodied individuals making a concerted effort to take advantage of others, to the invasive physical tests and “workhouses” that were part of the English Poor Laws, the poor have long been regarded as deserving careful oversight. Although in increasingly subtle ways, this history continues as part of a popular set of policies in Latin (...) America called “Conditional Cash Transfers,” which make income support conditional on certain behavioral changes. This paper argues that this resumption in recent times is normatively problematic because it harms the beneficiaries’ self-esteem, leading to stereotypes and sociological errors that reproduce social hierarchies. Alternatively, the paper advances a comparative defense of Basic Income on the basis of its lesser-known affinity with non-discriminatory attitudes. (shrink)

This book fills a long standing need for a basic introduction to Cognitive Grammar that is current, authoritative, comprehensive, and approachable. It presents a synthesis that draws together and refines the descriptive and theoretical notions developed in this framework over the course of three decades. In a unified manner, it accommodates both the conceptual and the social-interactive basis of linguistic structure, as well as the need for both functional explanation and explicit structural description. Starting with the fundamentals, essential (...) aspects of the theory are systematically laid out with concrete illustrations and careful discussion of their rationale. Among the topics surveyed are conceptual semantics, grammatical classes, grammatical constructions, the lexicon-grammar continuum characterized as assemblies of symbolic structures, and the usage-based account of productivity, restrictions, and well-formedness. The theory's central claim - that grammar is inherently meaningful - is thereby shown to be viable. The framework is further elucidated through application to nominal structure, clause structure, and complex sentences. These are examined in broad perspective, with exemplification from English and numerous other languages. In line with the theory's general principles, they are discussed not only in terms of their structural characterization, but also their conceptual value and functional motivation. Other matters explored include discourse, the temporal dimension of language structure, and what grammar reveals about cognitive processes and the construction of our mental world. (shrink)

This paper examines the movement for independent living among the Japanese with disabilities from the perspective of multiculturalism and human rights. The IL movement questions the conventional idea, widely held by Japanese without disabilities, that disabled people are in need of special care and cannot live independently in ordinary communities. The IL movement advocates: 1) the reinterpretation of “disability” as mere “difference”, 2) the equal right to autonomy and social participation for the disabled, and 3) the unique right (...) to care and support that enable the disabled to be autonomous. The IL movement thus projects a new “disability culture” that assigns different meanings to disability and calls for radical change in social relationships. The IL movement then is one of many forces that celebrates diversity and advocates pluralism in Japanese society in defiance of the myth of a “homogeneous monocultural” Japan. The IL movement highlights the right to care as a basic human right which is a precondition for the right to autonomy. Consequently, the IL movement reinterprets the notion of autonomy and enriches the concept of “human rights.”. (shrink)

Scientific progress in the areas of health and biological science is phenomenal. Still, current health policies limit optimal benefit for our peoples. Our present system costs too much, delivers too little, is not comprehensive, coherent, or cost-effective, does not allow choice, is not equitable, and is not universal. We must overcome many crises if we are to create a healthy people fro the twenty-first century in the US. We will need to use multiple strategies to achieve the nation's goals of (...) Healthy People 2010, which are to: 1) increase the quality and years of healthy live; 2) eliminate health disparities; 3) provide access to primary preventive care for all citizens. We are the richest country in the world and the only industrialized country that does not provide health care for its entire people. Health care costs are escalating and insurance is out of reach for many. Public policy changes are necessary to provide universal access to basic health care. We have advances in sciences; now we need the science delivered to our people in an equitable way. Politicians will respond proportionately to the insistence of the people. Healthcare professionals and scientists should lead the way. (shrink)

Peaceful protests and strikes are a basic human right as stated in the United Nations’ universal declaration on human rights. But for doctors, their proximity to life and death and the social contract between a doctor and a patient are stated as the reasons why doctors are valued more than the ordinary beings. In Pakistan, strikes by doctors were carried out to protest against lack of service structure, security and low pay. This paper discusses the moral and ethical (...) concerns pertaining to the strikes by medical doctors in the context of Pakistan. The author has carefully tried to balance the discussion about moral repercussions of strikes on patients versus the circumstances of doctors working in public sector hospitals of a developing country that may lead to strikes. (shrink)

A complex interaction of ideological, financial, social, and moral factors makes the financial sustainability of health care systems a challenge across the world. One difficulty is that some of the moral commitments of some health care systems collide with reality. In particular, commitments to equality in access to health care and to fair equality of opportunity undergird an unachievable promise, namely, to provide all with the best of basic health care. In addition, commitments to (...) fair equality of opportunity are in tension with the existence of families, because families are aimed at advantaging their own members in preference to others. Because the social-democratic state is committed to fair equality of opportunity, it offers a web of publicly funded entitlements that make it easier for persons to exit the family and to have children outside of marriage. In the United States, in 2008, 41% of children were born outside of wedlock, whereas, in 1940, the percentage was only 3.8%, and in 1960, 5%, with the further consequence that the social and financial capital generated through families, which aids in supporting health care in families, is diminished. In order to explore the challenge of creating a sustainable health care system that also supports the traditional family, the claims made for fair equality of opportunity in health care are critically reconsidered. This is done by engaging the expository device of John Rawls’s original position, but with a thin theory of the good that is substantively different from that of Rawls, one that supports a health care system built around significant copayments, financial counseling, and compulsory savings, with a special focus on enhancing the financial and social capital of the family. This radical recasting of Rawls, which draws inspiration from Singapore, is undertaken as a heuristic to aid in articulating an approach to health care allocation that can lead past the difficulties of social-democratic policy. (shrink)

The main purpose of this paper is to clarify some senses of dignity that are particularly relevant for the treatment and care of the elderly. I make a distinction between two quite different ideas of dignity, on the one hand the basic kind of dignity possessed by every human being, and on the other hand the dignity which is the result of a person's merits, whether these be inherited or achieved. Common to both these ideas is that having (...) a dignity entails having a set of rights, in the case of basic dignity the set of rights which we call human rights, the rights which the United Nations, among others, has tried to determine. The dignities of merit also provide some rights, although normally rights with limited scope covering, for instance, a professional area. This observation gives my preliminary answer to the fundamental question of what distinguishes dignity from other high values that could be attached to humans. I discuss further a kind of value that might be mistaken for a kind of dignity, viz. what I call public status. This status is to be distinguished from social status (the status of e.g. kings, governors, and officials) that I take to be a proper dignity of merit. The public status is the status gained solely via public perception and not directly via any merits on the part of the dignified. Finally, I turn to the topic of the dignity of the elderly and try to determine whether there is some dignity peculiar to the elderly, and which is over and above the basicMenschenwrde. My two preliminary proposals are the following: the elderly have a dignity of wisdom and they have a highly general dignity of merit, which results from their life-long efforts and achievements, and for this they deserve our gratitude. (shrink)

A complex interaction of ideological, financial, social, and moral factors makes the financial sustainability of health care systems a challenge across the world. One difficulty is that some of the moral commitments of some health care systems collide with reality. In particular, commitments to equality in access to health care and to fair equality of opportunity undergird an unachievable promise, namely, to provide all with the best of basic health care. In addition, commitments to (...) fair equality of opportunity are in tension with the existence of families, because families are aimed at advantaging their own members in preference to others. Because the social-democratic state is committed to fair equality of opportunity, it offers a web of publicly funded entitlements that make it easier for persons to exit the family and to have children outside of marriage. In the United States, in 2008, 41% of children were born outside of wedlock, whereas, in 1940, the percentage was only 3.8%, and in 1960, 5%, with the further consequence that the social and financial capital generated through families, which aids in supporting health care in families, is diminished. In order to explore the challenge of creating a sustainable health care system that also supports the traditional family, the claims made for fair equality of opportunity in health care are critically reconsidered. This is done by engaging the expository device of John Rawls's original position, but with a thin theory of the good that is substantively different from that of Rawls, one that supports a health care system built around significant copayments, financial counseling, and compulsory savings, with a special focus on enhancing the financial and social capital of the family. This radical recasting of Rawls, which draws inspiration from Singapore, is undertaken as a heuristic to aid in articulating an approach to health care allocation that can lead past the difficulties of social-democratic policy. (shrink)

The purpose of this paper is not to provide an overall picture of care ethics, but, rather, to reflect upon the concept of care, which has gained significance in particular scientific contexts. Undoubtedly, the importance of the subject of care represents a challenge on the level of fundamental philosophical positions and a diversified look into the occurring forms of the psychological and social suffering, dependency, and vulnerability. I will shed light on tenets that are considered central (...) to the care ethics and that have led to the setting up of the relationship between care and democracy. By introducing the basic aspects of Carol Gilligan’s and Joan Tronto’s theories, I will emphasize their vocation to be politically relevant. A discussion on the relationship between care and justice on the one hand, and needs and rights on the other, will follow. Can hearing voices of care make democracy more just? How can care ethics provide a concrete support for democracy? On the political level, care ethics builds on the assumptions of the necessary relatedness and equality between individuals who are decisive in the light of the welfare state perspective. Upon closer examination, one may see that the setting up of these relationships is not new to the liberal perspective. Liberalism is historically rooted in the fundamental interconnection between freedom and equality. Virtues such as care and meekness can be formulated in the language of politics, but they still remain unpolitical. On the one hand, engaging in a critical reflection upon such virtues might be an indispensable measuring instrument for distinguishing a good democracy from a bad one. On the other hand, care ethics does not prove to be a real alternative to the ethics of justice. In this regard, care ethics seems to show its feet of clay. (shrink)

Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and (...) the education of medical students. The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine — prevention of disease, relief of suffering, care of the ill, and avoidance of premature death — and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health. The Goals of Medicine clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless. (shrink)