In many societies, the aging of the population is becoming a major problem. This raises difficult issues for ethics and public policy. On what is known as the fair innings view, it is not impermissible to give lower priority to policies that primarily benefit the elderly. Philosophers have tried to justify this view on various grounds. In this article, I look at a consequentialist, a fairness-based, and a contractarian justification. I argue that all of them have implausible implications (...) and fail to correspond to our moral intuitions. I end by outlining a different kind of consequentialist justification that avoids those implications and corresponds better to our considered moral judgments. (shrink)

The fair innings argument maintains that for healthcare resources to be distributed fairly every person should receive sufficient healthcare to provide them with the opportunity to live in good health for a normal span of years. What constitutes a normal span of years is often defined as life expectancy at birth, but this criterion fails to provide adequate grounds for the equal distribution of healthcare across and between generations. A more suitable criterion for the normal life span is (...) the idea that the human life span is biologically limited. Many current gerontological theories argue that the biological limit to human life spans is related to the ageing process. If technological advances in medicine can retard the ageing process by treating and preventing the diseases and disorders associated with it, human longevity will be limited only by the developments in and the successful application of medicine. In consequence, the fair innings argument will no longer be able to justify denying people healthcare resources because they have lived longer than the normal life span. (shrink)

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

The fair innings argument (FIA) is frequently put forward as a justification for denying elderly patients treatment when they are in competition with younger patients and resources are scarce. In this paper I will examine some arguments that are used to support the FIA. My conclusion will be that they do not stand up to scrutiny and therefore, the FIA should not be used to justify the denial of treatment to elderly patients, or to support rationing of health (...) care by age.There are six issues arising out of the FIA which are to be addressed. First, the implication that there is such a thing as a fair share of life. Second, whether it makes sense to talk of a fair share of resources in the context of health care and the FIA. Third, that 'fairness' is usually only mentioned with regard to the length of a person's life, and not to any other aspect of it. Fourth, if it is sensible to discuss the merits of the FIA without taking account of the 'all other things being equal' argument. Fifth, the difference between what is unfair and what is unfortunate. Finally, that it is tragic if a young person dies, but only unfortunate if an elderly person does. (shrink)

This article provides a critical appraisal of the case for healthcare being rationed away from older patients to those who are younger. After sketching a metaphysics of elderliness and reviewing clinical and economic cases for healthcare rationing, the article looks in depth at the most challenging case for age rationing known as the ‘fair innings’ case. This article rejects that case and makes an alternative case that fairness actually dictates against age rationing in favour of allocation on the (...) basis of need. It concludes with a call for a renewed ‘covenant between generations’, founded on the virtue of pietas. (shrink)

This article provides a critical appraisal of the case for healthcare being rationed away from older patients to those who are younger. After sketching a metaphysics of elderliness and reviewing clinical and economic cases for healthcare rationing, the article looks in depth at the most challenging case for age rationing known as the ‘fair innings’ case. This article rejects that case and makes an alternative case that fairness actually dictates against age rationing in favour of allocation on the (...) basis of need. It concludes with a call for a renewed ‘covenant between generations’, founded on the virtue of pietas. (shrink)

This paper reviews the severe visual focus problems of health economists–they have developed a one-sided fixation with equity issues, neglecting the efficiency agenda. The problems of meeting need are not just about access–they will vary with cost and supply. Economists in fact developed a more balanced agenda in the 1970s but have failed to follow it up. The paper defines the triple nationalisation of the National Health Service , and presents evidence that pluralism, using the purchaser/provider split, has become more (...) efficient in long term care, home care and services for people with learning difficulties. Health economics has failed to explore options for using the dynamic forces of choice and competition for improving health services. The paper makes the case for a decision rule that “we should seek the process of health care service supply and development which maximises the delivery of high quality, lower cost user relevant services”. (shrink)

Financing innovative and costly treatments in various therapeutic fields entails a number of problems in countries where costs are covered by public services. Providing these drugs is forcing actors to define the maximum sums of money society is willing to spend for given health improvements. This raises the question of whether maximum financing should vary according individuals’ circumstances, such as the rareness of a disease, lifestyles, social inequalities experienced over a life time, etc. This article examines a particular priority, namely (...) that given to the youngest patients, such prioritising usually refers to the “fair innings argument”. We question what could justify such a prioritization criterion. Three arguments are considered. At first we consider that FIA could be justified by the objective of equalizing the opportunities of well-being. Next, we proposed justifying the fair innings argument with the aim of equalizing the time provided to individuals to achieve their plan of life, in accordance with Rawls’s theory of justice as fairness. Finally, we proposed considering the FIA as being justified because of the goal of equalizing the time provided to individuals to accept death. These three arguments, of course, have many limitations, some of which we have highlighted. This article doesn’t aim to convince about the superiority of one argument over the other ones. We seek to contribute to the discussions which could happen on prioritization criteria regarding health care, by making explicit what could justify one specific criterion: the age criterion. (shrink)

Age-based rationing remains highly controversial. This question has been paramount during the Covid-19 pandemic. Analyzing the practices, proposals, and guidelines applied or put forward during the current pandemic, three kinds of age-based rationing are identified: an age-based cut-off, age as a tiebreaker, and indirect age rationing, where age matters to the extent that it affects prognosis. Where age is allowed to play a role in terms of who gets treated, it is justified either because this is believed to maximize benefits (...) from scarce resources or because it is believed to be in accordance with the value of fairness understood as (a) fair innings, where less priority is given to those who have lived a full life or (b) an egalitarian concern for the worse off. By critically assessing prominent frameworks and practices for pandemic rationing, this article considers the balance the three kinds of age-based rationing strike between maximizing benefits and fairness. It evaluates whether elements in the proposals are, in fact, contrary to the justifications of these measures. Such shortcomings are highlighted, and it is proposed to adjust prominent proposals to care for the worse off more appropriately and better consider whether the acquired benefits befalls the young or the old. (shrink)

In the popular folklore three-score-years-and-ten is treated as a fair innings for people, and thereby serves as an informal reference point for judgements about distributive justice within a community. But length of life alone is an insufficient basis for such judgements - a person's health-related quality-of-life also needs to be taken into account. If one of the objectives of public policy is to reduce inequalities in lifetime health, it will be demonstrated that this is very likely to require (...) systematic discrimination against the older members of a community. The notion of community solidatity will also be tested, because a decision will need to be made as to whether the same fair innings applies to all members of the community, or whether some are entitled to more than others. The strength of the fair innings principle is that it brings these issues to the fore in a systematic way which should ais their resolition in a practical context. (shrink)

The COVID-19 pandemic put a large burden on many healthcare systems, causing fears about resource scarcity and triage. Several COVID-19 guidelines included age as an explicit factor and practices of both triage and ‘anticipatory triage’ likely limited access to hospital care for elderly patients, especially those in care homes. To ensure the legitimacy of triage guidelines, which affect the public, it is important to engage the public’s moral intuitions. Our study aimed to explore general public views in the UK on (...) the role of age, and related factors like frailty and quality of life, in triage during the COVID-19 pandemic. We held online deliberative workshops with members of the general public. Participants were guided through a deliberative process to maximise eliciting informed and considered preferences. Participants generally accepted the need for triage but strongly rejected ‘fair innings’ and ‘life projects’ principles as justifications for age-based allocation. They were also wary of the ‘maximise life-years’ principle, preferring to maximise the number of lives rather than life years saved. Although they did not arrive at a unified recommendation of one principle, a concern for three core principles and values eventually emerged: equality, efficiency and vulnerability. While these remain difficult to fully respect at once, they captured a considered, multifaceted consensus: utilitarian considerations of efficiency should be tempered with a concern for equality and vulnerability. This ‘triad’ of ethical principles may be a useful structure to guide ethical deliberation as societies negotiate the conflicting ethical demands of triage. (shrink)

Some empirical findings seem to show that people value health benefits differently depending on the age of the beneficiary. Health economists and philosophers have offered justifications for these preferences on grounds of both efficiency and equity. In this paper, I examine the most prominent examples of both sorts of justification: the defence of age-weighting in the WHO's global burden of disease studies and the fair innings argument. I argue that neither sort of justification has been worked out in (...) satisfactory form: age should not be taken into account in the framework of the burden of disease measure, and on the most promising formulations of the fair innings argument, it turns out to be merely an indicator of some other factor. I conclude by describing the role of age in theories of justice of healthcare resource allocation. (shrink)

La pandemia de la COVID-19 ha levantado sospechas de edadismo y gerontofobia en diversas prácticas de racionamiento sanitario. La edad es un criterio de triaje controvertido. En este artículo se esclarece la relevancia ética de la edad dentro de los sistemas de triaje, analizando particularmente su rol dentro de los principios de equidad y de eficiencia. La equidad requiere dar más oportunidades a aquellos que han cumplido menos ciclos vitales. La eficiencia tiene en cuenta la edad de manera subrepticia al (...) tratar de maximizar los beneficios a corto plazo (salvar vidas) y a largo plazo (salvar años de vida). Finalmente, la edad no debe ser la última ratio de las decisiones de triaje, aunque es una variable a tener en cuenta debido a su presencia implícita en principios fundamentales de priorización. The COVID-19 pandemic has raised suspicions of ageism and gerontophobia in various health rationing practices. Age is a controversial triage criterion. This article clarifies the ethical relevance of age within triage systems, particularly its role within the principles of fairness and efficiency. Fairness requires giving more opportunities to those who have completed fewer life cycles. Efficiency takes age into account surreptitiously when trying to maximize short-term (saving lives) and long-term (saving years of life) benefits. Finally, age should not be the final rationale in triage decisions, although it is a variable to be taken into account because of its implicit presence in fundamental principles of prioritization. (shrink)

A discussion with Roberto Andorno about global bioethics and biolaw, the Coronavirus pandemic, and its impact on human dignity and rights. Can we foresee the emerging new profile of global bioethics and biolaw in the post-Coronavirus era? How significant are they going to be in the future, after the enormous pressure that the Coronavirus pandemic has exercised on key political, legal, and ethical values? Must the voice of bioethicists -compared to the ‘hard’ scientific data- be louder in the future concerning (...) decisions about emergency social and medical measures? Is there a hope that public empowerment will support robust, global public engagement and meaningful deliberation? How much does Roberto Andorno’s view on human dignity reveal a supposed commitment to moral realism? The massive deaths of elderly people living in hospices of Sweden, Spain, and Italy, based on an implicit ‘fair innings’ view, has recently posed certain questions on the moral unacceptability of such practices. The same questions arise in the case of the legalization of euthanasia grounded on the implicit acceptance of the view that life is not worth living under certain circumstances. Is it possible that the human rights bodies worldwide will acquire executive power, and how could this become possible? How influential the ‘precautionary principle’ can become regarding clinical and research ethics in the future? How urgent is the importance of the introduction of bioethical education in the curricula of ‘hard’ empirical studies? Roberto Andorno discusses with us all these controversial and under heated public debate issues, giving sometimes provocative answers. (shrink)

Sen’s capabilities approach offers a radical generalisation of the conventional approach to welfare economics. It has been highly influential in development and many researchers are now beginning to explore its implications for health care. This paper contributes to the emerging debate by discussing two examples of such applications: first, at the individual decision making level, namely the right to die, and second, at the social choice level. For the first application, which draws on Nussbaum’s list of capabilities, it is argued (...) that many capabilities are ambiguously or indirectly related to the right to die, but the ability to form a concept of the good life and plan one’s own life provides a direct justification for such a right. In the second application, the focus is specifically on healthcare rationing and it is argued that, although not committed to age based rationing, the capabilities approach provides a more natural justification of age related access to health care than the fair innings argument, which is often used to justify the alleged ageism inherent in quality adjusted life years maximisation. (shrink)

At the height of the COVID-19 crisis in the Netherlands a shortness of intensive care beds was looming. Dutch professional medical organizations asked a group of ethicists for assistance in drafting guidelines and criteria for selection of patients for intensive care treatment in case of absolute scarcity, when medical selection criteria would no longer suffice. This article describes the Dutch context, the process of drafting the advice and reflects on the role of ethicists and lessons learned. We argue that timely (...) interaction between clinical and ethical expertise is necessary since the distinction between medical and non-medical considerations is not as clearcut as sometimes assumed. Furthermore, pragmatic considerations related to the specifics of an epidemic are of importance, for example, in relation to prioritizing health care workers. As a consequence, any protocol already present before the pandemic would need alterations to fit the current situation. The ‘fair innings’ criterion we proposed, rephrased as an argument of intergenerational solidarity, was considered reasonable by professionals as well as patient organizations. While it is desirable to draft ethical guidelines in ‘peacetime’ as a matter of pandemic preparedness, the pressure of an actual crisis facilitates decision-making, although it will also complicate a more democratic approach. (shrink)

Triage protocols can exclude older patients for the sake of effectiveness and this may be defended as the older have already had their fair share of life, which can mean fair amounts or complete lives. Nevertheless, if life is considered as a narrative, mentioning amounts might be nonsensical. Narratives have a quality of unity; so, life events are fragments whose meanings are dependent on the meaning of the whole. Thus, time units do not represent a reliable measure of (...) the content of life. In addition, people's experience is different from the external flow of time, making its significance relative. Moreover, to compare the completeness of lives qualitatively, it is necessary to have a common cultural understanding, which is improbable to agree on in a modern society. Therefore, basic assumptions of the accounts that refer to fair shares of lives are mistaken, and these accounts do not support age-based rationing. (shrink)

Some empirical findings seem to show that people value health benefits differently depending on the age of the beneficiary. Health economists and philosophers have offered justifications for these preferences on grounds of both efficiency and equity. In this paper, I examine the most prominent examples of both sorts of justification: the defence of age-weighting in the WHO's global burden of disease studies and the fair innings argument. I argue that neither sort of justification has been worked out in (...) satisfactory form: age should not be taken into account in the framework of the burden of disease measure, and on the most promising formulations of the fair innings argument, it turns out to be merely an indicator of some other factor. I conclude by describing the role of age in theories of justice of healthcare resource allocation. (shrink)

As the demand for healthcare rises, so does the need for priority setting in healthcare. In this paper, I consider a prominent priority-setting principle: proportional shortfall. My purpose is to argue that proportional shortfall, as a principle, should not be adopted. My key criticism is that proportional shortfall fails to consider past health.Proportional shortfall is justified as it supposedly balances concern for prospective health while still accounting for lifetime health, even though past health is deemed irrelevant. Accounting for this lifetime (...) perspective means that the principle may indirectly consider past health by accounting for how far an individual is from achieving a complete, healthy life. I argue that proportional shortfall does not account for this lifetime perspective as it fails to incorporate the fair innings argument as originally claimed, undermining its purported justification.I go on to demonstrate that the case for ignoring past health is weak, and argue that past health is at least sometimes relevant for priority-setting decisions. Specifically, when an individual’s past health has a direct impact on current or future health, and when one individual has enjoyed significantly more healthy life years than another.Finally, I demonstrate that by ignoring past illnesses, even those entirely unrelated to their current illness, proportional shortfall can lead to instances of double jeopardy, a highly problematic implication. These arguments give us reason to reject proportional shortfall. (shrink)

I consider various principles which might explain our intuitive obligation to rescue people from imminent death at great cost, even when the same resources could produce more benefit elsewhere. Our obligation to rescue is commonly explained in terms of the identifiability of the rescuee, but I reject this account. Instead, I offer two considerations which may come into play. Firstly, I explain the seeming importance of identifiability in terms of an intuitive obligation to prioritise life-extending interventions for people who face (...) a high risk of an early death, and I explain this in turn with a fair innings-style principle which prioritises life-extending interventions for people expected to die young. However, this account is incomplete. It does not explain why we would devote the same resources to rescuing miners stuck down a mine even if they are elderly. We are averse to letting people die suddenly, or separated from friends and family. And so, secondly, I give a new account that explains this in terms of narrative considerations. We value life stories that follow certain patterns, classic patterns which are reflected in many popular myths and stories. We are particularly averse to depriving people of the opportunity to follow some such pattern as they approach death. This means allowing them to sort out their affairs, say goodbyes to family and friends, review their life, or come to terms with death itself. Such activities carry a lot of meaning as ways of closing our life story in the right way. So, for someone who has not been given much notice of their death, an extra month is worth much more than for other patients. Finally, I review the UK National Health Service's end of life premium, which gives priority to patients with short life expectancy. I suggest it falls short in terms of such considerations. For example, the NHS defines its timings in terms of how long the patient can expect to live as at the time of the treatment decision, whereas the timings should be specified in terms of time from diagnosis. (shrink)

The coronavirus pandemic has brought to public attention a variety of questions long debated in medical ethics, but now given both added urgency and wider publicity. Among these is triage, with its origins in deciding which individual lives are to be saved on a battlefield, but now also concerned with the allocation of scarce resources more generally. On the historical battlefield, decisions about whom to treat first – neither those who would survive without treatment, nor those who would not survive (...) even with treatment, but those who needed treatment to survive – was facilitated by military discipline and the limited effectiveness of treatments available. In the allocation of scarce resources today, by contrast, such decisions are subject to intense public and political scrutiny, and the range of effective treatments available has immeasurably diminished the proportion of ‘those who would not survive even with treatment’. If triage decisions are to be made, they now need to be justified in the arena of public opinion by moral arguments which are also politically persuasive. A number of different aspects of what is required for this endeavour are examined in the first five contributions to this issue of the Journal. In ‘Should age matter in COVID-19 triage? A deliberative study ’1, Kuylen and colleagues report on a deliberative study of public views in the UK, in which participants ‘generally accepted the need for triage but strongly rejected ’fair innings’ and ’life projects’ principles as justifications for age-based allocation,…preferring to maximise the number of lives rather than life years saved’; and concerned that in any resolution ‘utilitarian considerations of efficiency should be tempered with a concern for equality and vulnerability’. A similar concern to temper utilitarian considerations, in this case with an Aristotelian view of the common good as ‘the good life for …. (shrink)

Concern about the rapid ageing of all societies reaches alarming proportions as healthcare inequities are steeply rising, prompting the elderly to live longer but subject to insufficient social protection and healthcare in the wake of dwindling public resources. The aged population of developing nations are facing additional hardships due to the growing gap between needs and the financial reductions of public institutions, retirement funds, and the trend towards privatization of essential services turned into commodities. Current approaches to allocation of insufficient (...) resources without ageist discrimination are briefly discussed: individual self‐care aimed at successful, active and healthy ageing based on resourcefulness of the privileged elderly; utilitarian approaches founded on QALY and fair innings, and human rights focused on the plights of the elderly. These approaches cannot apply to resources poor nations, who need to engage in context‐bound bioethics dealing with the realities of their exposed ageing population. A developing world bioethics is needed to face the plights of the elderly in countries with low and middle‐income and insufficient social capital. Suggested are: 1) a phenomenological approach based on the interaction of bioethics and ethnology, furthering grass‐roots input from the elderly; 2) Create small communities –campus‐like boroughs– to simplify accessibility to social services and healthcare facilities, as an alternative to the high‐cost WHO proposal of age‐friendly large cities. (shrink)

The Government in the UK is encouraging consumerism within health care and is requiring Health Authorities to consult with the public on prioritisation of resources. Public consultation within the National Health Service (NHS) has had limited success in the past. Many of the techniques used are flawed. Despite the limited scope of the public surveys conducted so far, a number of themes have emerged: — a willingness to pay for experimental, ‘high‐tech’ life‐saving treatments rather than more cost‐effective treatments which will (...) improve quality of life, which are more likely to maximise utility from the scarce resources available; — preference for treating the young rather than the old; — preference for treating patients with dependants (e.g. spouse, children) rather than those who have none; — a willingness to discriminate against those patients who were partially responsible for their illness due to choice of `unhealthy' lifestyle (e.g. smoking cigarettes, drinking excess alcohol). These public preferences raise ethical problems. For example, is it just to spend more on heroic treatments which are likely to fail? Is there a right to health care irrespective of whether you have had ‘a fair innings’ or whether a patient is in part responsible for their illness due to an unhealthy lifestyle? If there are ethical concerns about these preferences, should health authorities consult with the public at all? Is human life and suffering incommensurable, and hence is it impossible to prioritise anyway? Some of the ethical consequences of using empirical data on public preferences are discussed. (shrink)

Some ethical dilemmas in health care, such as over the use of age as a criterion of patient selection, appeal to the notion of life expectancy. However, some features of this concept have not been discussed. Here I look in turn at two aspects: one positive — our expectation of further life — and the other negative — the loss of potential life brought about by death. The most common method of determining this loss, by counting only the period of (...) time between death and some particular age, implies that those who die at ages not far from that one are regarded as losing very little potential life, while those who die at greater ages are regarded as losing none at all. This approach has methodological advantages but ethical disadvantages, in that it fails to correspond to our strong belief that anyone who dies is losing some period of life that he or she would otherwise have had. The normative role of life expectancy expressed in the ‘fair innings’ attitude arises from a particular historical situation: not the increase of life expectancy in modern societies, but a related narrowing in the distribution of projected life spans. Since life expectancy is really a representation of existing patterns of mortality, which in turn are determined by many influences, including the present allocation of health resources, it should not be taken as a prediction, and still less as a statement of entitlement. (shrink)

Medical resource allocation is a controversial topic, because in the end it prioritises some peoples’ medical problems over those of others. This is less controversial when there is a clear clinical reason for such a prioritisation, but when such a reason is not available people might perceive it as deeming certain individuals more important than others. This article looks at the role of social utility in medical resource allocation, in a situation where the clinical outcome would be identical if either (...) person received the treatment. This situation is explored with a focus on the United Kingdom, but its conclusions have wider applications to any system where healthcare is tax-payer funded. The article proposes an experience adjusted life years system, and discusses its strengths and weaknesses. (shrink)

Some philosophers and segments of the public think age is relevant to healthcare priority-setting. One argument for this is based in equity: “Old” patients have had either more of a relevant good than “young” patients or enough of that good and so have weaker claims to treatment. This article first notes that some discussions of age-based priority that focus in this way on old and young patients exhibit an ambiguity between two claims: that patients classified as old should have a (...) low priority, and that patients classified as young should have high priority. The author next argues, drawing on a problem raised by Christine Overall, that equity cannot justify giving “old” patients low priority, since there is wide variety in the total lifetime experiences of older people, partly influenced by gender, race, class, and disability injustice. Finally, the author suggests that there might be a limited role for age-based prioritization in the context of infant and childhood death, since those who die in childhood are always and uncontroversially among the worst-off. (shrink)

Recent disputes over whether older people should pay more for health insurance, or receive lower priority for transplantable organs, highlight broader disagreements regarding the legality of using age-based criteria in health care. These debates will likely intensify given the changing age structure of the American population and the turmoil surrounding the financing of American health care. This Article provides a comprehensive examination of the legality and normative desirability of age-based criteria. I defend a distributive justice approach to age-based criteria and (...) contrast it with two prevailing theoretical approaches to age-based criteria, nondiscrimination and discretion. I propose a detailed normative framework for the use of age-based criteria in health care, the lifetime justice approach, that considers the future life patients can gain from treatment and the past years of life they already have experienced. -/- This paper is available by open access from the Boston College Law School Digital Commons. (shrink)

Causation has traditionally been analyzed either as a relation of nomic dependence or as a relation of counterfactual dependence. I argue for a third program, a physicalistic reduction of the causal relation to one of energy-momentum transference in the technical sense of physics. This physicalistic analysis is argued to have the virtues of easily handling the standard counterexamples to the nomic and counterfactual analyses, offering a plausible epistemology for our knowledge of causes, and elucidating the nature of the relation between (...) causation and physical science. (shrink)

Este artículo investiga los vínculos entre el sujeto y la estructura en el transcurso de la teoría política de Ernesto Laclau, integrando sus aspectos teóricos, onto-epistemológicos y axiológico-normativos. A través de la sistematización de sus principales trabajos escritos durante el período 1977-2014, se indaga en sus contribuciones al debate Agente-Estructura y se propone una periodización compleja de su obra. Mediante una articulación pragmática de conceptos del (pos)estructuralismo, el psicoanálisis, la deconstrucción, la fenomenología, el marxismo y la filosofía posanalítica, a partir (...) de su ruptura onto-epistemológica con el esencialismo de los años 80 Laclau construyó una innovadora teoría discursiva del sujeto, superadora tanto del subjetivismo como del objetivismo, y convergente con una estrategia socialista y radicalmente democrática. La razón populista aportó nuevas herramientas que destacaron la capacidad del agente de articular (parcialmente) lo social. Sin embargo, este trabajo marcó un quiebre en su obra, que dejó de lado el análisis retroductivo de las transformaciones históricas más recientes en la estructura social y en las identidades y su conexión con la creciente fragmentación y proliferación de las luchas sociales. Al mismo tiempo, relegó la centralidad de la categoría de articulación para amalgamar la pluralidad de luchas sociales en el capitalismo complejo actual, para priorizar la construcción (tendencial) de un antagonismo binario y una lógica de simplificación y reducción conceptual del espacio social. Desde el plano axiológico, la teoría formal del populismo Laclau abandonó la iniciativa socialista y el desarrollo de los contenidos ético-políticos críticos, inherentes a la teoría posgramsciana de la hegemonía. Se concluye que ―más allá de estas inconsistencias― la teoría posfundacional del sujeto de Laclau realizó aportes innovadores, relevantes y valiosos que contribuyen a superar la falsa disyunción sujeto-estructura, a complejizar el análisis político y social, y a fortalecer la lucha hegemónica, desde una perspectiva antiesencialista. (shrink)

La teoría post-marxista y post-estructuralista de Ernesto Laclau representa, actualmente, una de las perspectivas más relevantes para el análisis filosófico de la política. Sin embargo, mantiene un elevado nivel de abstracción y de complejidad conceptual, promoviendo una multiplicidad de interpretaciones divergentes. Sin asumir la defensa de un objetivismo, el presente trabajo se propone analizar algunos mitos y creencias vinculados a la obra laclausiana. De este modo, se busca contribuir a estimular el debate y la crítica sobre sus principales postulados.

Three recent research reports by Topping and Trickey, by Fair and colleagues, and by Gorard, Siddiqui and Huat See have produced data that support the conclusion that a Philosophy for Children program of one-hour-per-week structured discussions has a marked positive impact on students. This article presents data from a follow up study done three years after the completion of the study reported in Fair et al.. The data show that the positive gains in scores on the Cognitive Abilities (...) Test were still present and had not faded after three years. Given the strength of these confirmations of the positive durable impact of the P4C program of structured discussions and given the relatively low cost of implementing the P4C program, it is recommended that it become a standard part of the school curriculum. (shrink)

In this article we report the findings of a randomised control clinical trial that assessed the impact of a Philosophy for Children program and replicated a previous study conducted in Scotland by Topping and Trickey. A Cognitive Abilities Test was administered as a pretest and a posttest to randomly selected experimental groups and control groups. The students in the experimental group engaged in philosophy lessons in a setting of structured, collaborative inquiry in their language arts classes for one hour per (...) week for a number of weeks. The control group received the standard language arts curriculum in that one hour. The study found that the seventh grade students who had experienced the P4C program showed significant gains relative to those in the seventh grade control group at a high level of statistical significance, but the eighth grade students in the experimental group did not show such gains over the eighth grade control group. It was discovered that the seventh grade teachers started the program early in the school year and continued it for a period of 22 to 26 weeks, while the eighth grade teachers started much later and used the program for only 4 to 10 weeks. Our findings suggest that the P4C program must involve students in activities for a significant period of time before the program shows results, but that a meaningful impact on students’ cognitive abilities can be achieved in about 24 weeks of lessons, less than half the time evidenced by the study by Topping and Trickey. (shrink)

In this article we report the findings of a randomised control clinical trial that assessed the impact of a Philosophy for Children program and replicated a previous study conducted in Scotland by Topping and Trickey. A Cognitive Abilities Test was administered as a pretest and a posttest to randomly selected experimental groups and control groups. The students in the experimental group engaged in philosophy lessons in a setting of structured, collaborative inquiry in their language arts classes for one hour per (...) week for a number of weeks. The control group received the standard language arts curriculum in that one hour. The study found that the seventh grade students who had experienced the P4C program showed significant gains relative to those in the seventh grade control group at a high level of statistical significance, but the eighth grade students in the experimental group did not show such gains over the eighth grade control group. It was discovered that the seventh grade teachers started the program early in the school year and continued it for a period of 22 to 26 weeks, while the eighth grade teachers started much later and used the program for only 4 to 10 weeks. Our findings suggest that the P4C program must involve students in activities for a significant period of time before the program shows results, but that a meaningful impact on students’ cognitive abilities can be achieved in about 24 weeks of lessons, less than half the time evidenced by the study by Topping and Trickey. (shrink)

Three recent research reports by Topping and Trickey, by Fair and colleagues, and by Gorard, Siddiqui and Huat See have produced data that support the conclusion that a Philosophy for Children program of one-hour-per-week structured discussions has a marked positive impact on students. This article presents data from a follow up study done three years after the completion of the study reported in Fair et al.. The data show that the positive gains in scores on the Cognitive Abilities (...) Test were still present and had not faded after three years. Given the strength of these confirmations of the positive durable impact of the P4C program of structured discussions and given the relatively low cost of implementing the P4C program, it is recommended that it become a standard part of the school curriculum. (shrink)

Three recent research reports by Topping and Trickey, by Fair and colleagues, and by Gorard, Siddiqui and Huat See have produced data that support the conclusion that a Philosophy for Children program of one-hour-per-week structured discussions has a marked positive impact on students. This article presents data from a follow up study done three years after the completion of the study reported in Fair et al.. The data show that the positive gains in scores on the Cognitive Abilities (...) Test were still present and had not faded after three years. Given the strength of these confirmations of the positive durable impact of the P4C program of structured discussions and given the relatively low cost of implementing the P4C program, it is recommended that it become a standard part of the school curriculum. (shrink)

Resumen: Este artículo analiza cómo se encadenan los planos de lo ontológico y lo óntico en la Teoría Política del Discurso de Ernesto Laclau. Se concluye que, desde el plano ontológico, la hegemonía constituye una forma político-discursiva de articulación y universalización relativa, precaria, contingente y parcial de los particularismos en significantes vacíos que actúan como puntos nodales. Desde el nivel fenoménico-político, Laclau pone en juego estos conceptos para mostrar el desplazamiento y contaminación discursiva entre lo particular y lo universal en (...) la operación hegemónica, que transforma las identidades políticas y construye un orden comunitario y un nuevo sentido común. Desde el nivel ético-político, la conceptualización de la hegemonía se articula a la construcción discursiva de una estrategia socialista y a una democracia radical. Este proyecto político lucha contra los esencialismos y las formas de explotación y opresión social y por un horizonte de liberación que amalgame las luchas de los grupos subordinados y reconozca las diferencias y particularidades como constitutivas y deseables. La teoría formal del populismo presenta algunas inconsistencias óntico-ontológicas en este esquema. Sin embargo, su sobredeterminación simbólica disuelve las disyunciones tajantes entre la lógica y el análisis histórico-político y entre la forma y el contenido. Ello pone de manifiesto el mutuo anudamiento entre lo óntico y lo ontológico y la centralidad de la noción gramsciana de hegemonía para el análisis político y crítico de fenómenos y procesos históricos contemporáneos.: This article analyzes how the ontological and ontic planes are interconnected in Laclau’s political discourse theory. It is concluded that, on the ontological level, hegemony constitutes a political-discursive form of relative, precarious, contingent and partial universalization and articulation of particularities in empty signifiers that act as nodal points. On the phenomenological-political level, Laclau shows the displacement and discursive contamination between the particular and the universal in the hegemonic operation which transforms political identities and builds a communitarian order and a new commonality. On the ethical-political level, the conceptualization of hegemony is articulated as the discursive construction of a socialist strategy and a radical democracy. This political project fights against essentialisms and forms of exploitation and social oppression of subordinate groups, and in favor of a horizon of liberation that recognizes conflicts and differences as constitutive and desirable. The formal theory of populism presents some ontic-ontological inconsistencies in this scheme. However, its symbolic overdetermination dissolves the disjunctions between logic and historical-political analysis and between form and content. This reveals the mutual interconnection between the ontic and the ontological, and the central relevance of the Gramscian notion of hegemony for the political and critical analysis of contemporary historical phenomena and processes. (shrink)

An insight, Central to platonism, That the objects of pure mathematics exist "in some sense" is probably essential to any adequate account of mathematical truth, Mathematical language, And the objectivity of the mathematical enterprise. Yet a platonistic ontology makes how we can come to know anything about mathematical objects and how we use them a dark mystery. In this paper I propose a framework for reconciling a representation-Relative provability theory of mathematical truth with platonism's valid insights. Besides helping to clarify (...) the ontology of pure mathematics, I think this approach suggests a novel philosophical interpretation of some central results of modern mathematics, Including godel's incompleteness theorems and the independence theorems for the continuum hypothesis. (shrink)

In this article I explore two accounts of the Fallacy of Many Questions made famous by the question "Have you stopped beating your wife?" The accounts are from the works of Lennart Aqvist and Noel Belnap, and the two authors differ in their accounts of the fallacy. Then I give my own account based on understanding a facet of erotetic logic, i. e., the logic of questions.

Recently, unrestrained consequentialism has been defended against the charge that it leads to unacceptable trade-offs by showing a tradeoff accepted by many of us is not justified by any of the usual nonconsequenlist arguments. The particular trade-off involves raising the speed limit on the Interstate Highway System. As a society, we seemingly accept a trade-off of lives for convenience. This defense of consequentialism may be a tu quoque, but it does challenge nonconsequentialists to adequately justify a multitude of social decisions. (...) Work by the deontologist Frances Kamm, conjoined with a perspective deployed by several economists on the relation between social costs and lives lost, is relevant. It provides a starting point by justifying decisions which involve trading lives only for other lives. But the perspective also recognizes that using resources in excess of some figure to save a life causes us to forego other live-saving activities, thus causing a net loss of life. Setting a speed limit as low as 35 miles per hour might indeed save some lives, but the loss of productivity due to the increased time spent in travel would cost an even greater number of lives. Therefore, many trade-offs do not simply involve trading lives for some lesser value, but are justified as allowing some to die in order to save a greater number. (shrink)

Este trabajo explora algunos usos innovadores de la figura del nudo borromeo de la teoría lacaniana con el objetivo de complejizar y fortalecer la investigación social desde el Análisis Político del Discurso. En la primera parte: se distinguen tres modalidades discursivas de anudamiento borromeico que entrelazan lo Real, lo Simbólico y lo Imaginario a nivel espacial y temporal; se distingue entre los tipos de anudamientos, su extensión, su intensidad y su tiempo de estructuración y sedimentación social; se analiza la dinámica (...) discursiva de anudamiento borromeico entre Real, Simbólico e Imaginario, a través de los modos de identificación imaginarios en las fantasías ideológicas, los acontecimientos fuertemente dislocadores y los síntomas que simbolizan lo Real mediante el orden significante. En la segunda parte, se proponen algunas estrategias analíticas útiles para el estudio de identidades, fenómenos y procesos políticos y sociales y se ilustra con algunos ejemplos. En la última parte, se examinan las implicancias epistemológicas y axiológicas del uso de esta herramienta lacaniana para fortalecer la investigación social crítica desde la Teoría Política del Discurso. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhism, Christianity, and Modern Science:A Response to Masao AbeFrank FairAfter number of years of teaching philosophy of science, a few years ago I took up the challenge of teaching philosophy of religion. As one might imagine, it has always seemed to me to be important that our religious convictions harmonize with our best scientific knowledge of how the world works, and this became a more interesting issue when the (...) change in my teaching assignment brought me into contact with the work of Masao Abe, the eminent Japanese Buddhist scholar. His essay "Religion and Science in the Global Age—Their Essential Character and Mutual Relationship" (Abe 1985: 241–248) challenged me to expand my thinking to consider not only how theistic religions such as Christianity relate to science, but also to consider how nontheistic religions, such as Buddhism, might fare when interacting with modern science.In his essay on religion and science Abe expressed his agreement with the thought of Keiji Nishitani in this way:1. It is necessary for each religion to re-examine the basis of its world view. For any religion its world view is not like clothes that one can change whenever one pleases. A world view is to religion what water is to a fish. It is the indispensable condition through which religion can actually come into existence. Water is neither the life of the fish as such, nor its body, yet it is fundamentally linked to both. For a religion to change its world view is a matter no less fatal to it than for a fish to change from salt water to fresh.2. What is even more crucial and important is that each religion re-examine and reinterpret that tradition's understanding of God or the 'ultimate' and His or its relation to human beings and the world. With regard to this second point, Buddhism which is fundamentally non-theistic, is in a somewhat different situation from Christianity, which is basically theistic. (Abe 1985: 244–245)Abe continues: "Theistic answers to the question 'why' in Christianity, such as the 'will of God' and the 'rule of God' are incompatible with modern scientific answers to the question 'how.' This is because the former strongly emphasize the personality of the ultimate while the latter is essentially impersonal" (Abe 1985: 245). In this [End Page 67] discussion, I will follow Abe's lead and consider the question of whether Buddhism is more compatible with modern science than Christianity.Christianity and Modern Science: Tensions and HarmoniesOne set of issues causing tension between modern science and Christianity has to do with history. Briefly, ideas about the creation of the universe, about the special creation of humankind, and about miracles, as in the claims about the resurrection of Jesus, are ideas about the action of God in history. These ideas relate the stance that Abe attributed to Christianity as involving an attempt to answer "why" questions about meaning and purpose, an attempt which he feels brings Christianity into conflict with modern science. I will give a brief account of what I take to be the current state of the discussion about each of these matters, and my point is to argue that Abe's conclusion about the relative superiority of Buddhism over Christianity in relation to modern science is premature at best.The Creation of the UniverseThe rise of the Big Bang theory, which traces the origin of the universe back to a tremendously powerful event several billion years ago, at first gave comfort to traditional ideas of divine creation. However, it soon became apparent that this comfort was ambiguous at best. It was not clear, for instance, that one could really prove on the basis of observational evidence that there was an absolute starting point those many billions of years ago, or whether the totality of things could be going through a huge set of cycles. Then there is the issue that even if there is a "First Cause" responsible for the Big Bang, this does not automatically give evidence that the First Cause is a personal being who cares about us or has any immediate involvement in our lives. The First Cause... (shrink)

En este trabajo se intenta elaborar una indagación epistemológica crítica que contribuya a enriquecer al debate sobre la posibilidad o imposibilidad de abordar los fenómenos de las ciencias sociales y humanísticas de una manera neutral y/o objetiva.. A partir de un enfoque centrado en la teoría post-estructuralista francesa y, más específicamente, en los aportes brindados por el psicoanálisis lacaniano, se concluirá que el psicoanálisis, en su vertiente lacaniana, y retomado de un modo distinto por otros autores, como Zizek, ha mostrado (...) de una manera consistente que este supuesto objetivismo no es más que un imposible. La realidad objetiva no puede ser más que una utopía, en tanto toda realidad es construida por un lenguaje, un orden simbólico, que es contingente y, por lo tanto, relativo. Sin caer en un mero relativismo de los actuales enfoques “posmodernos”, que no exista la Verdad con mayúscula no implica que no existan verdades a medias, “minoradas”, como las denomina Lacan en su obra.Palabras clave: Objetividad, neutralidad valorativa, pos-estructuralismo lacaniano, ciencia sociales y humanísticas.This work tries to elaborate a critical epistemological inquiry that enriches the debate about the possibility or impossibility of approaching social and human science phenomena in a neutral and/or objective way. Starting from a view based on French post-structuralist theory, and more specifically, on contributions from Lacanian psychoanalysis, conclusions will be that psychoanalysis, at least Lacanian psychoanalysis, taken up again in a different way by other authors such as Zizek, has consistently shown that this supposed objectivism is impossible. Objective reality can be no more than a utopia, because all reality is constructed by a language, a symbolic order which is contingent, therefore relative. Without falling into postmodern relativism, the fact that there is no Truth with a capital letter does not imply that there are no truths.Key words: Objectivity, valuative neutrality, Lacanian post-structuralism, social and human sciences. (shrink)

En los últimos 30 años asistimos a un drástico proceso de cambio que ha modificado profundamente los parámetros con los que se guiaba la relación entre el Estado y la Sociedad civil. Este proceso, ligado a la hegemonización mundial del neoliberalismo, ha generado intensas transformaciones en los diversos campos. Este artículo se propone indagar en esas transformaciones. Para ello, examina las características principales que definen a este paradigma, dando cuenta de la apropiación que han hecho sus principales teóricos del concepto (...) de globalización. En segundo término, analiza los efectos que sus políticas han provocado en la política, la economía, la cultura y la sociedad. Se sostiene que el éxito del “sistema global neoliberal” reside en que ha logrado despolitizar en gran medida a la sociedad y a su propio discurso. En este sentido, se coloca el eje en sus efectos de despolitización, en particular durante la década del noventa, fase critica del sistema. En el tramo final, se pregunta acerca de las alternativas surgidas en las nuevas democracias latinoamericanas al modelo de globalización neoliberal. (shrink)