There are marked differences between countries with regard to reimbursement decision-making, yet few studies have tried to understand this process and its consequences by a detailed analysis of the local context and decision-making structure. This article describes reimbursement decision-making and subsequent prescribing patterns of new pharmaceuticals by means of a case study on glitazones in treatment of type 2 diabetes mellitus patients in Denmark. The study shows that institutional arrangements, providing the context in which evidence is used, are highly (...) important for understanding the reimbursement decision-making process. In particular the Danish Medicines Agency (DMA) has shaped the decision to reimburse glitazones on the basis of physician-mediated requests of individual patients. Relatively few patients have been prescribed glitazones since their introduction in 2000, suggesting that individual reimbursement may be an effective instrument in controlling overall expenditure of selected pharmaceuticals, although in the case of glitazones this has likely been achieved at the expense of equality in access to the products. The discussion focuses on the generalizability of the findings to both other pharmaceuticals in the individual reimbursement scheme in Denmark, and to other countries that are trying to balance the need to control overall pharmaceutical care expenditure with the need to secure equality in access to new drugs with therapeutic added value. (shrink)

Bunge (2000) distinguishes two main methodological approaches of holism and individualism, and associates with them policy prescriptions of centralism and laissez-faire. He identifies systemism as a superior approach to both the study and management of society. The present paper, seeking to correct and develop this line of thought, suggests a more complex relation between policy and methodology. There are two possible methodological underpinnings for laissez-faire: while writers such as Friedman and Lucas fit Bunge’s pattern, more sophisticated advocates of laissez-faire, such (...) as Smith and Hayek, base their policy prescription in a methodology quite divergent from the individualism Bunge describes. (shrink)

John Mackie’s moral error theory is so closely associated in people’s minds with his arguments from relativity and from queerness that one might overlook the fact that there may be numerous other, and possibly better, ways of establishing that metaethical position. Perhaps, indeed, there are even further resources for arguing for a moral error theory to be unearthed in Mackie’s own book. I have in mind Mackie’s thesis of moral objectification: that the “objective prescriptivity” with which our moral judgments are (...) imbued is the result of our “tendency to read our feelings into their objects” (1977: 42). Mackie invokes Hume’s famous projectivist image of the human mind’s “great propensity to spread itself on external objects,” and, indeed, it is in his book-length analysis of Hume’s moral theory (Mackie 1980) that the topic receives a more careful discussion than in Ethics: Inventing Right and Wrong. In both books he musters some considerations in favor of the thesis, and reveals to us that he thinks that “it is very largely correct” (1980: 72). (shrink)

Writing strategic documents is a major practice of many actors striving to see their educational ideas realised in the curriculum. In these documents, arguments are systematically developed to create the legitimacy of a new educational goal and competence to make claims about it. Through a qualitative analysis of the writing strategies used in these texts, I show how two of the main actors in the Czech educational discourse have developed a proof that a new educational goal is needed. I draw (...) on the connection of the relational approach in the sociology of education with Lyotard’s analytical semantics of instances in the event. The comparison of the writing strategies in the two documents reveals differences in the formation of a particular pattern of justification. In one case the texts function as a herald of pure reality, and in the other case as a messenger of other witnesses. This reveals different regimens of proof, although both of them were written as prescriptive directives – normative models of the educational world. (shrink)

Social scientists have expended substantial effort to identify group patterns of deviant behavior. Yet beyond the ill-conceived treatment of sexual minorities as inherently deviant, they have rarely considered how gendered sexual identities shape participation in deviance. We argue for the utility of centering theories of gender and sexuality in intersectional deviance research. We demonstrate how this intentional focus on gender and sexuality provides important empirical insights while avoiding past pitfalls of stigmatizing sexual minorities. Drawing on theories of hegemonic masculinity, (...) emphasized femininity, and minority stress together with criminological general strain theory, we demonstrate how societal expectations and constraints generate strains among GSI groups that may lead to distinctly patterned deviance, using the case of prescription drug misuse during sex. We employ thematic analysis of 120 in-depth interviews with people who misuse prescription drugs, stratified by GSI. We identify six themes highlighting distinct pathways from strain to misuse during sex for different GSI groups: intimacy management, achieving sexual freedom, regulating sexual mood, performance confidence, increased sense of control, and managing sexual identity conflict. In this article, we demonstrate the empirical and theoretical importance of centering gender and sexuality in deviance research and provide a roadmap for theoretical integration. (shrink)

This article contends that the enterprise of neuroleptic drug treatment of schizophrenia is conceptually and clinically - though not economically - bankrupt. Although new drugs spur hope and reinforce the dominant treatment paradigm, evidence from reports published during the last five years in leading psychiatric journals suggests that psychopharmacologists do not know what are the optimal doses of the most widely-used neuroleptics; that most patients do not "respond" to neuroleptic treatment; that toxic effects are routinely misdiagnosed; that prescribing guidelines may (...) have no impact on actual prescription patterns; that claims that the popular "atypical" neuroleptic clozapine is free of extrapyramidal symptoms are completely false; and finally, that penetration of the double-blind in studies of the effectiveness of psychotropics over placebos may be a common occurrence. In the light of these findings, it is argued that the field is in crisis and that major, paradigmatic change is absolutely necessary. (shrink)

Rationale In Belgium, several policies regulating reimbursement of acid suppressant drugs and evidence-based recommendations for clinical practice were issued in a short period of time, creating a unique opportunity to observe their effect on prescribing. Aims and objectives To describe the evolution of prescriptions for acid suppressants and explore the interaction of policies and practice recommendations with prescribing patterns. Method Monthly claims-based data for proton pump inhibitors (PPIs) and H-2-antihistamines by general practitioners, internists and "astroenterologists were obtained from the (...) Belgian national health insurance database (1997-2005). The evolution of reimbursed defined daily doses and expenses after introduction of reimbursement regulations and dissemination of practice recommendations was explored. Results Recommendations had no impact on prescribing. All changes can be related to concomitant policies. Lifting reimbursement restrictions for cheaper products did not control growth or save costs in the Iona term. Only restricting reimbursement of all PPIs managed to curb the growth. We observed an unintended increase of non-omeprazole PPIs by gastroenterologists. Conclusions Reimbursement policies influence prescribing, but their effect can be unintended. A dialogue between policymakers and guideline developers, and evidence-based policies that are linked to clinical guidelines, could be an effective way to pursue both cost-containment and quality of care. (shrink)

Overdose deaths involving prescription opioids killed more than 17,000 Americans in 2017, marking a five-fold increase since 1999. High prescribing rates of opioid analgesics have been a substantial contributor to prescription opioid misuse, dependence, overdose and heroin use. There was recognition approximately ten years ago that opioid prescribing patterns were contributing to this startling increase in negative opioid-related outcomes, and federal actions, including Medicare reimbursement reform and regulatory actions, were initiated to restrict opioid prescribing. The current manuscript (...) is a description of those actions, the effect of those actions on opioid prescribing and related patient outcomes. We also describe our proposal of methods of expanding these efforts as an important piece to further reduce opioid-related misuse, dependence, and overdose death. (shrink)

The aim of this study is to justify the belief that there are biological normative mechanisms that fulfill non-trivial causal roles in the explanations (as formulated by researchers) of actions and behaviors present in specific systems. One example of such mechanisms is the predictive mechanisms described and explained by predictive processing (hereinafter PP), which (1) guide actions and (2) shape causal transitions between states that have specific content and fulfillment conditions (e.g. mental states). Therefore, I am guided by a specific (...) theoretical goal associated with the need to indicate those conditions that should be met by the non-trivial theory of normative mechanisms and the specific models proposed by PP supporters. In this work, I use classical philosophical methods, such as conceptual analysis and critical reflection. I also analyze selected studies in the field of cognitive science, cognitive psychology, neurology, information theory and biology in terms of the methodology, argumentation and language used, in accordance with their theoretical importance for the issues discussed in this study. In this sense, the research presented here is interdisciplinary. My research framework is informed by the mechanistic model of explanation, which defines the necessary and sufficient conditions for explaining a given phenomenon. The research methods I chose are therefore related to the problems that I intend to solve. In the introductory chapter, “The concept of predictive processing”, I discuss the nature of PP as well as its main assumptions and theses. I also highlight the key concepts and distinctions for this research framework. Many authors argue that PP is a contemporary version of Kantianism and is exposed to objections similar to those made against the approach of Immanuel Kant. I discuss this thesis and show that it is only in a very general sense that the PP framework is neo-Kantian. Here we are not dealing with transcendental deduction nor with the application of transcendental arguments. I argue that PP is based on reverse engineering and abduction inferences. In the second part of this chapter, I respond to the objection formulated by Dan Zahavi, who directly accuses this research framework of anti-realistic consequences. I demonstrate that the position of internalism, present in the so-called conservative PP, does not imply anti-realism, and that, due to the explanatory role played in it by structural representations directed at real patterns, it is justified to claim that PP is realistic. In this way, I show that PP is a non-trivial research framework, having its subject, specific methods and its own epistemic status. Finally, I discuss positions classified as the socalled radical PP. In the chapter “Predictive processing as a Bayesian explanatory model” I justify the thesis according to which PP offers Bayesian modeling. Many researchers claim that the brain is an implemented statistical probabilistic network that is an approximation of the Bayesian 7 rule. In practice, this means that all cognitive processes are to apply Bayes' rule and can be described in terms of probability distributions. Such a solution arouses objections among many researchers and is the subject of wide criticism. The purpose of this chapter is to justify the thesis that Bayesian PP is a non-trivial research framework. For this purpose, I argue that it explains certain phenomena not only at the computational level described by David Marr, but also at the level of algorithms and implementation. Later in this chapter I demonstrate that PP is normative modeling. Proponents of the use of Bayesian models in psychology or decision theory argue that they are normative because they allow the formulation of formal rules of action that show what needs to be done to make a given action optimal. Critics of this approach emphasize that such thinking about the normativity of Bayesian modeling is unjustified and that science should shift from prescriptive to descriptive positions. In a polemic with Shira Elqayam and Jonathan Evans (2011), I show that the division they propose into prescriptivism and Bayesian descriptivism is apparent, because, as I argue, there are two forms of prescriptivism, i.e. the weak and the strong. I argue that the weak version is epistemic and can lead to anti-realism, while the strong version is ontic and allows one to justify realism in relation to Bayesian models. I argue that a weak version of prescriptivism is valid for PP. It allows us to adopt anti-realism in relation to PP. In practice, this means that you can explain phenomena using Bayes' rule. This does not, however, imply that they are Bayesian in nature. However, the full justification of realism in relation to the Bayesian PP presupposes the adoption of strong prescriptivism. This position assumes that phenomena are explained by Bayesian rule because they are Bayesian as such. If they are Bayesian in nature, then they should be explained using Bayesian modeling. This thesis will be substantiated in the chapters “Normative functions and mechanisms in the context of predictive processing” and “Normative mechanisms and actions in predictive processing”. In the chapter “The Free Energy Principle in predictive processing”, I discuss the Free Energy Principle (hereinafter FEP) formulated by Karl Friston and some of its implications. According to this principle, all biological systems (defined in terms of Markov blankets) minimize the free energy of their internal states in order to maintain homeostasis. Some researchers believe that PP is a special case of applying this principle to cognition, and that predictive mechanisms are homeostatic mechanisms that minimize free energy. The discussion of FEP is important due to the fact that some authors consider it to be important for explanatory purposes and normative. If this is the case, then FEP turns out to be crucial in explaining normative predictive mechanisms and, in general, any normative biological mechanisms. To define the explanatory possibilities of this principle, I refer to the discussion of its supporters on the issue they define as the problem of continuity and discontinuity between life and mind. A critical analysis of this discussion and the additional arguments I have formulated have allowed me to revise the explanatory ambitions of FEP. I also reject the belief that this principle is necessary to explain the nature of predictive mechanisms. I argue that the principle formulated and defended by Friston is an important research heuristic for PP analysis. 8 In the chapter “Normative functions and mechanisms in predictive processing”, I start my analyzes by formulating an answer to the question about the normative nature of homeostatic mechanisms. I demonstrate that predictive mechanisms are not homeostatic. I defend the view that a full explanation of normative mechanisms presupposes an explanation of normative functions. I discuss the most important proposals for understanding the normativity of a function, both from a systemic and teleosemantic perspective. I conclude that the non-trivial concept of a function must meet two requirements which I define as explanatory and normative. I show that none of the theories I have invoked satisfactorily meets both of these requirements. Instead, I propose a model of normativity based on Bickhard's account, but supplemented by a mechanistic perspective. I argue that a function is normative when: (1) it allows one to explain the dysfunction of a given mechanism; (2) it contributes to the maintenance of the organism's stability by shaping and limiting possible relations, processes and behaviors of a given system; and when (3) (according to the representational and predictive functions) it enables explaining the attribution of logical values of certain representations / predictions. In such an approach, a mechanism is normative when it performs certain normative functions and when it is constitutive for a specific action or behavior, despite the fact that for some reason it cannot realize it either currently or in the long-term. Such an understanding of the normativity of mechanisms presupposes the acceptance of the epistemic hypothesis. I argue that this hypothesis is not cognitively satisfactory, and therefore the ontic hypothesis should be justified, which is directly related to adopting the position of ontic prescriptivism. For this reason, referring to the mechanistic theory of scientific explanations, I formulate an ontical interpretation of the concept of a normative mechanism. According to this approach, a mechanism or a function is normative when they perform such and such causal roles in explaining certain actions and behaviors. With regard to the normative properties of predictive mechanisms and functions, this means that they are the causes of specific actions an organism carries out in the environment. In this way, I justify the necessity of accepting the ontic hypothesis and rejecting the epistemic hypothesis. The fifth chapter, “Normative mechanisms and actions in predictive processing”, is devoted to the dark room problem and the related exploration-exploitation trade-off. A dark room is the state that an agent could be in if it minimized the sum of all potential prediction errors. I demonstrate that, in accordance with the basic assumption of PP about the need for continuous and long-term minimization of prediction errors, such a state should be desirable for the agent. Is it really so? Many authors believe it is not. I argue that the test of the value of PP is the possibility of a non-trivial solution of this problem, which can be reduced to the choice between active and uncertainty-increasing exploration and safe and easily predictable exploitation. I show that the solution proposed by PP supporters present in the literature does not enable a fully satisfactory explanation of this dilemma. Then I defend the position according to which the full explanation of the normative mechanisms, and, subsequently, the solution to the dilemma of exploration and exploitation, involves reference to the existence of constraints present in the environment. The constraints 9 include elements of the environment that make a given mechanism not only causal but also normative. They are therefore key to explaining the predictive mechanisms. They do not only play the role of the context in which the mechanism is implemented, but, above all, are its constitutive component. I argue that the full explanation of the role of constraints in normative predictive mechanisms presupposes the integration of individual models of specific cognitive phenomena, because only the mechanistic integration of PP with other models allows for a non-trivial explanation of the nature of normative predictive mechanisms that would have a strong explanatory value. The explanatory monism present in many approaches to PP makes it impossible to solve the problem of the dark room. Later in this chapter, I argue that the Bayesian PP is normative not because it enables the formulation of such and such rules of action, but because the predictive mechanisms themselves are normative. They are normative because they condition the choice of such and such actions by agents. In this way, I justify the hypothesis that normative mechanisms make it possible to explain the phenomenon of agent motivation, which is crucial for solving the dark room problem. In the last part of the chapter, I formulate the hypothesis of distributed normativity, which assumes that the normative nature of certain mechanisms, functions or objects is determined by the relations into which these mechanisms, functions or objects enter. This means that what is normative (in the primary sense) is the relational structure that constitutes the normativity of specific items included in it. I suggest that this hypothesis opens up many areas of research and makes it possible to rethink many problems. In the “Conclusion”, I summarize the results of my research and indicate further research perspectives. (shrink)

Economists, in stressing the prescriptive implications of their analysis, typically have ignored the potential contributions of their theorems and methodological principles to the understanding of human behavior as an end in itself. The purpose of the paper is to establish the principle, by detailed reference to the literature of economics, that the 'deductive pattern of explanation' constitutes a valid approach to the general study of human behavior. As such, it is a potentially useful method of analysis in the other social (...) sciences. Literature from the philosophy of social science bearing on the applicability of deductive theory to the study of human behavior is subjected to detailed critical analysis. (shrink)

A microaggression is a small insulting act made disproportionately harmful by its part in an oppressive pattern of similar insults. How should you respond when made the victim of a microaggression? In this paper I survey several morally salient factors, including effects upon victims, perpetrators, and third parties. I argue, contrary to popular views, that ‘growing a thicker skin’ is not good advice nor is expressing reasonable anger always the best way to contribute to confronting oppression. Instead, appropriately responding to (...) microaggression involves difficult application of practical wisdom that does not easily fall under a simple prescription. (shrink)

Many people claim that semantic content is normative, and that therefore naturalistic theories of content face a potentially insuperable difficulty. The normativity of content allegedly undermines naturalism by introducing a gap between semantic 'ought's and the explanatory resources of naturalism. I argue here that this problem is not ultimately pressing for naturalists. The normativity thesis, I maintain, is ambiguous; it could mean either that the content of a term prescribes a pattern of use, or that it merely determines which pattern (...) of use can be described as 'correct'. For the antinaturalist argument to go forward, content must be prescriptive. I argue, however, that it is not. Moreover, the thesis that content supplies standards for correct use is insufficient to supply a similar, a priori objection to naturalism. (shrink)

Causal judgments are widely known to be sensitive to violations of both prescriptive norms (e.g., immoral events) and statistical norms (e.g., improbable events). There is ongoing discussion as to whether both effects are best explained in a unified way through changes in the relevance of counterfactual possibilities, or whether these two effects arise from unrelated cognitive mechanisms. Recent work has shown that moral norm violations affect causal judgments of agents, but not inanimate artifacts used by those agents. These results have (...) been interpreted as showing that prescriptive norm violations only affect causal reasoning about intentional agents, but not the use of inanimate artifacts, thereby providing evidence that the effect of prescriptive norm violations arises from mechanisms specific to reasoning about intentional agents, and thus casting doubt on a unified counterfactual analysis of causal reasoning. Four experiments explore this recent finding and provide clear support for a unified counterfactual analysis. Experiment 1 demonstrates that these newly observed patterns in causal judgments are closely mirrored by judgments of counterfactual relevance. Experiment 2 shows that the relationship between causal and counterfactual judgments is moderated by causal structure, as uniquely predicted by counterfactual accounts. Experiment 3 directly manipulates the relevance of counterfactual alternatives and finds that causal judgments of intentional agents and inanimate artifacts are similarly affected. Finally, Experiment 4 shows that prescriptive norm violations (in which artifacts malfunction) affect causal judgments of inanimate artifacts in much the same way that prescriptive norm violations (in which agents act immorally) affect causal judgments of intentional agents. (shrink)

Appeals to ordinary thought and talk are frequent in philosophy, perhaps nowhere more than in contemporary epistemology. When an epistemological theory implies serious error in “commonsense” or “folk” epistemology, it is counted as a cost of the view. Similarly, when an epistemological theory respects or vindicates deep patterns in commonsense epistemology, it is viewed as a benefit of the view. Philosophers typically rely on introspection and anecdotal social observation to support their characterizations of commonsense epistemology. But recent experimental research (...) shows that philosophers employing these methods often seriously mischaracterize commonsense. Based on these findings, I propose a fundamental change to standard practice in the field. Whether the fundamental goal of epistemology is descriptive or prescriptive, experimentation is an integral part of the project. (shrink)

Introduction: Clinical practice guidelines (CPGs) are an important source of justification for clinical decisions in modern evidence-based practice. Yet, we have given little attention to how they argue their evidence. In particular, how do CPGs argue for treatment with long-term medications that are increasingly prescribed to older patients? Approach and rationale: I selected six disease-specific guidelines recommending treatment with five of the medication classes most commonly prescribed for seniors in Ontario, Canada. I considered the stated aims of these CPGs and (...) the techniques employed towards those aims. Finally, I reconstructed and logically analysed the arguments supporting recommendations for pharmacotherapy. Analysis: The primary function of CPGs is rhetorical, or persuasive, and their means of persuasion include both a display of their credibility and their argumentation. Arguments supporting pharmacotherapy recommendations for the target population follow a common inductive pattern: statistical generalization from randomized controlled trial (RCT) and meta-analysis evidence. Two of the CPGs also argue their treatment recommendations for older patients in this style, while three fail to justify pharmacotherapy specifically for the older population. Discussion: The arguments analysed lack the auxiliary assumptions that would warrant making a generalization about the clinical effectiveness of medications for the older population. Guidelines reason using simple induction, while ignoring important inferential gaps. Future guidelines should aspire to be well-reasoned rather than simply evidence-based; argue from a plurality of evidence; be wary of hasty inductions; appropriately limit the scope of their recommendations; and avoid making law-like, prescriptive generalizations. (shrink)

This article develops an approach to ethical globalization based on a feminist, political ethic of care; this is achieved, in part, through a comparison with, and critique of, Thomas Pogge's World Poverty and Human Rights. In his book, Pogge makes the valid and important argument that the global economic order is currently organized such that developed countries have a huge advantage in terms of power and expertise, and that decisions are reached purely and exclusively through self-interest. Pogge uses an institutional (...) rights framework to argue that direct responsibility for global poverty and inequality lies with the citizens of developed countries, since suffering and death are caused by global economic arrangements designed and imposed by our governments. While this argument is certainly compelling, I have argued that it tells us little about the actual effects of globalization on the real people of the South - including women, children and the elderly. As a result, it can offer little in the way of real alternatives or policy prescriptions. As a moral orientation, a care ethic relies on a relational moral ontology, and leads us to consider different values in terms of human flourishing. Moreover, it pushes us to consider the normative implications of aspects of the global political economy which are usually not 'seen' at all, including the global distribution of care work and the corresponding patterns of gender and racial inequality, the underprovision of care and resources for caring work in both the developed and developing world, and the ways in which unpaid or low-paid caring work helps to sustain a cycle of exploitation and inequality on a global scale. (shrink)

The most prevalent modes of philosophy, educational theory, and philosophy of education currently extant in the United States represent a pronounced departure from the fundamental patterns of the Greek-Jewish- Christian tradition. Among the noteworthy characteristics of the more popular trends is a tendency toward the denial of, or an indifference regarding, the existence of a Transcendent Being. This feature alone has effected a radical departure from the scholarly traditions which are characterized by investigations into the relationships between theology and (...) philosophy. This factor, in turn, bears potentially strong influence upon the theory and practice of education. Partially in order to promote the revivification of a heritage not unrelated to that of many early American intellectual leaders, the main purpose of this paper is to exemplify the structure and an aspect of the substance of a theology-philosophy of Catholic education in accord with a selected passage from A New Catechism: Catholic Faith for Adults. The theological-philosophical dimension of this structure is represented by a developmental process entailing three stages of progression: from human love through an awareness of the “God of the philosophers” to belief in Christ. It is shown how theological and philosophical elements of this process bear upon the importance of early childhood religious education as well as of Catholic education somewhat more broadly conceived. It is noted that, although the theological-philosophical foundations allow for numerous options in education, there are bounds within which the direction of this education must be retained. The current importance of this kind of investigation lies in 1) the fundamentally empiricist approaches in philosophy of education so prominent today, 2) the inability of empiricist philosophies to confront prescriptive values in an authentically rational fashion, and 3) the necessity of a theological-philosophical approach for the Christian who wishes to think rationally about prescriptive values, and to formulate the kinds of educational plans which will prove to be effective in promoting authentic human happiness. Brief references to the practical efficacy of theoretical conceptions, and to teacher education, conclude the paper. (shrink)

Most management researchers pause at the threshold of objective right and wrong. Their hesitation is understandable. Values imply a “subjective,” personal dimension, one that can invite religious and moral interference in research. The dominant epistemological camps of positivism and subjectivism in management stumble over the notion of moral objectivity. Empirical research can study values in human behavior, but hard-headed scientists should not assume that one value can be objectively better than another. In this article, we invite management researchers to rethink (...) this presumption. We show how accepting at least a limited form of moral objectivity, namely, an epistemic orientation that seeks objective moral reasons, can benefit management research by 1. guiding research practice; 2. using patterns of moral objectivity as clues for formulating empirical hypotheses for psychological explanations; and 3. adding prescriptive power to empirical theories. (shrink)

Higher courts sometimes assess the constitutionality of law by working through a concrete case, other times by reasoning about the underlying question in a more abstract way. Prior research has found that the degree of concreteness or abstraction with which an issue is formulated can influence people's prescriptive views: For instance, people often endorse punishment for concrete misdeeds that they would oppose if the circumstances were described abstractly. We sought to understand whether the so-called ‘abstract/concrete paradox’ also jeopardizes the consistency (...) of judicial reasoning. In a series of experiments, both lay and professional judges sometimes reached opposite conclusions when reasoning about concrete cases versus the underlying issues formulated in abstract terms. This effect emerged whether participants reasoned with broad principles, such as human dignity, or narrow rules, and was largest among individuals high in trait empathy. Finally, to understand whether people reflectively endorse the discrepancy between abstract and concrete resolutions, we examined their reactions when evaluating both, either simultaneously or sequentially. These approaches revealed no single pattern across lay and expert populations, or exploratory and confirmatory studies. Taken together, our studies suggest that empathic concern plays a greater role in guiding the judicial resolution of concrete cases than in illuminating judges' professed standards—which may result in concrete decisions in violation of their own abstract principles. (shrink)

This thesis addresses two enduring issues in legal theory-- rationality and its association with rule of law values--by offering detailed models of two patterns of legal reasoning. One is reasoning by analogy. The other is the inference process that legal reasoners use when they defer epistemically to scientific experts in the course of reaching legal decisions. Discussions in both chapters reveal that the inference pattern known as "abduction" is a deeply important element of many legal inferences, including analogy and (...) epistemic deference to experts--something that has been largely unrecognized in legal theory. After presenting a detailed model of analogy, Chapter 1 argues that legal reasoning by analogy, like analogical argument in logic, mathematics, and the natural sciences, possesses a great deal of rational force when properly executed. Chapter 2 investigates the reasoning process by which non-expert legal reasoners defer epistemically to the judgments of scientists. It presents five main conclusions or explanations. Every practical syllogism actually consists of two distinct chains of inference, and what is usually considered in writings on practical reasoning to be the minor premise of a practical syllogism is actually the conclusion of a separate chain of argument. When a practical reasoner defers epistemically to a theoretical expert, this separate chain of argument has a special structure, which is modeled in Chapter 2. The non-expert legal reasoner must always make a prescriptive practical judgment about the standard of epistemic appraisal and level of epistemic confidence that the reasoner requires of scientific evidence before it may be relied upon in reaching a legal decision. Legal systems should be committed to an emergent rule of law ideal identified and referred to as "intellectual due process" which condemns epistemically arbitrary reasoning processes insofar as they play a role in legal decisionmaking. Since non-arbitrariness is a necessary condition of both epistemic and legal legitimacy, we have compelling reason to doubt that the non-arbitrariness condition can be met when non-experts defer epistemically to scientific experts. (shrink)

This chapter distinguishes between several senses of “normativity”. For example, that we ought to abstain from causing unnecessary suffering is a normative, not descriptive, claim. And so is the claim that we have good reason, and ought to drive on the right, or left, side of the road because the law requires us to do that. Reasons and oughts are normative, by definition. Indeed, it may be that “[t]he normativity of all that is normative consists in the way it is, (...) or provides, or is otherwise related to reasons” (Raz 1999, 67) . That is what the “reasons-first” view holds, but there are also other views, and what is by definition a normative statement, or a normative fact if you like, depends on how we define normativity. -/- It may seem that requirements are also by definition normative. But it seems that there can also be requirements that one has no reason to meet: it is less clear whether such requirements are normative in the same sense that reasons and oughts are normative. This paper will go through various further phenomena, which are candidates for being normative in some other sense than normative reasons and oughts, defending however the view that not all of them are. But arguably four or so different senses of normativity can be distinguished. -/- The paper will accept the view that the normativity of reasons and oughts, which is here called normativity1, is central. It is an open question whether all requirements or expectations or socially constructed norms are normative in that sense. Arguably it depends on the contents and content-independent authority of the legislators, whether we have good reasons, or ought, to meet the requirements, obey the law, or to follow the etiquette, or to conform to others’ interpersonal expectations, requests, demands or prescriptions. Whether and when we do have such reasons is a difficult and important substantive question, which concerns the normativity1 of requirements of law. -/- In another sense, norms (intended to guide behavior) are trivially or by definition normative, and constitute normativity: some forms of behavior are ruled as acceptable (e.g. driving on the right) and others as unacceptable (e.g. driving on the left) in light of the norm. Even in the case of a bad norm (that we have no reason to follow, and which ought to be changed, and ought not prevail) classifies behaviours as acceptable or unacceptable in light of the norm. Surely norms are by definition normative? Call this conformity to social norms and actual expectations normativity2. It is not an open question whether social norms are normative in that sense – they are by definition normative2. But importantly, it is an open question whether one has good reasons, or sufficient reason, or ought, to follow any social norm – that is, whether the norm in question is normative1. -/- The first section of the article characterizes further the difference between these two senses of normativity, and additionally introduces various other candidate senses of “normativity”. These possible senses of “normativity” may be at stake in the debates about normative requirements of rationality , about so called ought-to-be -rules , about normativity of linguistic meaning , about “directions of fit” of beliefs and desires , about subjective authority of intentions and decisions and interpersonal authority or co-authority of concrete others. -/- In later sections these cases are discussed. Do they constitute separate senses of normativity? And are the later phenomena such that they give agents good reasons: do they include normativity1 – the core sense? A “normative power -model” is suggested as a framework for examining whether actual social norms, laws, expectations provide good reasons and oughts or not. Once we understand the relation between the first two senses of normativity, do the later phenomena follow the same pattern – is the “normative powers – model” relevant for them as well? (shrink)

In recent years an orthodox Marxist-Leninist ethics has been developing in the Soviet Union. It is metaphysically based, teleologically oriented, and objectivist in its claims. Soviet ethical writings encompass five different activities: description, interpretative classification, prescription, content-analysis, and refutation. Among the distinctive features of the new Soviet Moral Code are its requirement of devotion to the Communist cause, its exclusively social orientation, and its emphasis on work. Upon analysis it turns out to prescribe a completely externalized and provincial morality. (...) A comparison of Soviet ethics with recent ethical writings from other East-European countries, however, shows that Marxist ethics need not follow the Soviet pattern. (shrink)

In the present research we investigated gender-specific beliefs about emotional behaviour. In Study 1, 180 respondents rated the extent to which they agreed with different types of beliefs (prescriptive, descriptive, stereotypical, and contra-stereotypical) regarding the emotional behaviour of men and women. As anticipated, respondents agreed more with descriptive than with prescriptive beliefs, and more with stereotypical than with contra-stereotypical beliefs. However, respondents agreed more with stereotypical beliefs about the emotional behaviour of women than with those about men. These results were (...) replicated in Study 2 with a sample of 75 students and 80 nonstudents. In Study 3, a sample of 279 respondents rated the extent of agreement with the same items, this time with respect to then own emotional behaviour. A similar pattern of results was obtained, although agreement rates were higher than in Study 1 and 2. (shrink)

Humans have used arguments for defending or refuting statements long before the creation of logic as a specialized discipline. This can be interpreted as the fact that an intuitive notion of “logical consequence” or a psychic disposition to articulate reasoning according to this pattern is present in common sense, and logic simply aims at describing and codifying the features of this spontaneous capacity of human reason. It is well known, however, that several arguments easily accepted by common sense are actually (...) “logical fallacies”, and this indicates that logic is not just a descriptive, but also a prescriptive or normative enterprise, in which the notion of logical consequence is defined in a precise way and then certain rules are established in order to maintain the discourse in keeping with this notion. Yet in the justification of the correctness and adequacy of these rules commonsense reasoning must necessarily be used, and in such a way its foundational role is recognized. Moreover, it remains also true that several branches and forms of logic have been elaborated precisely in order to reflect the structural features of correct argument used in different fields of human reasoning and yet insufficiently mirrored by the most familiar logical formalisms. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:FEYERABEND'S EPISTEMOLOGY AND BRECHTS THEORY OF THE DRAMA by S. G. Couvalis In his early paper, "On the Improvement of the Sciences and the Arts," Feyerabend argues that, just as rival hypotheses show the shortcomings of entrenched scientific hypotheses, so theatre which presents hypotheses contrary to common beliefs about human beings shows the shortcomings of these beliefs. It develops understanding of human relations more effectively than intellectual debate because (...) it is a more complex medium whose elements can "represent the contrary hypotheses at the same time."1 He takes Brecht to be the first theorist of such a theatre. I shall argue that Brecht's epistemology is similar to Feyerabend's early epistemology and that his dramatic theory is a consequence of it.2 1 shall also argue, however, that Feyerabend is wrong in saying that Brechtian theatre presents contrary hypotheses at the same time, because plays, like descriptions, are theory-laden and Brecht, in any case, intends to show on stage that tragedies have social origins and not to present contrary hypotheses about human beings. According to Brecht, most people improperly assume that human behavior and social relations follow fixed patterns inherent in nature because they have been unable to compare the human behavior they know with that in other societies. They take what they experience to be typically human. Moreover, they interpret their social world as they have been taught: "A child, living in a world of old men... knows the run of things before he can walk."3 Feyerabend brings out the effect of such training very vividly: "The teaching procedures both shape the 'appearance,' or 'phenomenon' and establish a firm connection with words, so that finally the phenomena seem to speak for themselves...."4 Because these interpretations of the social world which children are taught are descriptive, explanatory, and prescriptive, they are more 117 118Philosophy and Literature complex and more dangerous than the interpretations of physical objects they are taught. For example, children learn different evaluations of precisely the same behavior in males and females through being taught how to describe it. In being taught to describe certain behavior as "manly" they are taught both that it arises from a male's nature and that it is laudable behavior for boys but not for girls. "Manly" behavior in a woman is not "confident" or "forthright," but "aggressive" or "pushy." In order to stop us from regarding traditional behavior patterns and social relations as unchangeable, and to enable us to question our descriptions of them, Brecht argues that the dramatist must cause us to cease to regard such patterns and social relations as familiar givens that can only be described in one way. To achieve this, he must not structure his plays on the Aristotelian model. The Aristotelian model makes audiences incapable of criticizing the dramatic message, imparts the view that the sources of tragedy lie in an inexplicable human essence, and presents social rules as if they were unquestionable natural laws. Instead, he should structure his plays to induce in audiences a scientific attitude to social relations and patterns of behavior. Like Feyerabend, Brecht realizes that a scientific attitude is not displayed by collecting descriptions of experience without considering whether the interpretations contained in the descriptions are correct. In Galileo, his view of those who mechanically describe experience in traditional terms is shown in Galileo's replies to the Aristotelian arguments of Andrea. When Andrea argues, "I can see that the sun's not in the same place in the evening and morning. So it can't stand still. It just can't," Galileo replies, "You 'W! What do you see? You see nothing at all. You're just gaping. Gaping isn't seeing." He then demonstrates to Andrea that the apparent motions of objects need not be their real motions because an apparent motion can be caused in more than one way. 5 Brecht shows that the central question for the scientist is not "How shall I collect descriptions of appearances?" but "What is it that I really perceive and how is it caused?" He argues elsewhere that "there's a vast difference between experiment and experience" because experiments are set up to test... (shrink)

Theorizing about political thinking -- Language, emotion, and political thought -- The arrogance of politics -- Ranking and the distribution of significance -- The scramble for acceptance : mobilizing and withholding support -- Stability, order, and disruption : discourses of balance and contention -- Visions and prescriptions : temptations and failures of political thinking -- Power patterns and power surges : organizing and intensifying speech acts.

Even though Corporate Social Responsibility (CSR) has become a widely accepted concept promoted by different stakeholders, business corporations' internal strategies, known as corporate self-regulation in most of the weak economies, respond poorly to this responsibility. Major laws relating to corporate regulation and responsibilities of these economies do not possess adequate ongoing influence to insist on corporate self-regulation to create a socially responsible corporate culture. This book describes how the laws relating to CSR could contribute to the inclusion of CSR principles (...) at the core of the corporate self-regulation of these economies in general, without being intrusive in normal business practice. It formulates a meta-regulation approach to law, particularly by converging patterns of private ordering and state control in contemporary corporate law from the perspective of a weak economy. It proposes that this approach is suitable for alleviating regulators' limited access to information and expertise, inherent limitations of prescriptive rules, ensuring corporate commitment, and enhance the self-regulatory capacity of companies. This book describes various meta-regulation strategies for laws to link social values to economic incentives and disincentives, and to indirectly influence companies to incorporate CSR principles at the core of their self-regulation strategies. It investigates this phenomenon using Bangladesh as a case study. (shrink)

Few empirical studies in the UK have examined the complex social patterns and values behind quantitative estimates of the prevalence of pharmacological cognitive enhancement. We conducted a qualitative investigation of the social dynamics and moral attitudes that shape PCE practices among university students in two major metropolitan areas in the UK. Our thematic analysis of eight focus groups suggests a moral ecology that operates within the social infrastructure of the university. We find that PCE resilience among UK university students (...) is mediated by normative and cultural judgments disfavoring competitiveness and prescription drug taking. PCE risk can be augmented by social factors such as soft peer pressure and normalization of enhancement within social and institutional networks. We suggest that moral ecological dynamics should be viewed as key mechanisms of PCE risk and resilience in universities. Effective PCE governance within universities should therefore attend to developing further understanding of the moral ecologies of PCE. (shrink)

In response to distant suffering, global civil society is being consumed by a generalized witnessing fever that converts public spaces into veritable machines for the production of testimonial discourses and evidence. However, bearing witness itself has tended to be treated as an exercise in truth-telling, a juridical outcome, a psychic phenomenon or a moral prescription. By contrast, this article conceives of bearing witness as a transnational mode of ethico-political labour, an arduous working-through produced out of the struggles of groups (...) and persons who engage in testimonial tasks in order to confront corresponding perils produced by instances of situational or structural violence; it is the work of witnessing, the normative and political substance generated through the performance of patterns of social action, which matters. Using Celan's allegory of the poem as a message in a bottle, I consider bearing witness as a web of cosmopolitan testimonial practices structured around five dialectically related tasks and perils: giving voice to mass suffering against silence ; interpretation against incomprehension ; the cultivation of empathy against indifference ; remembrance against forgetting ; and prevention against repetition. (shrink)

Negative Concord (NC) constructions such as the news anchor didn’t warn nobody about the floods (meaning ‘the news anchor warned nobody’), in which two syntactic negations contribute a single semantic one, are stigmatized in English, while their Negative Polarity Item (NPI) variants, such as the news anchor didn’t warn anybody about the floods, are prescriptively correct. Equating acceptability with grammaticality, this pattern has led linguists to treat NC as ungrammatical in “Standard” or standardized English (SE). However, it is possible that (...) SE grammars do generate NC sentences, and their low incidence and acceptability is instead due to social factors. To explore this question, and the relationship between NC and NPI constructions, we compared the acceptability of overtly negative noun phrases (e.g. nobody), NPIs (e.g. anybody), and bare plurals (e.g. people), in negative contexts and in conditionals. Negative items were followed by a consequence which supported their single negative meaning, while conditional items were followed by a consequence compatible with the NPI and the bare plural but not the negative noun phrase. Acceptability ratings of the critical NC sentences were reliably lower than constructions with NPIs and bare plurals, but the consequences for all three of these sentence types were rated highly. This reflects an asymmetry in participants’ acceptance of NC and their readiness to interpret it in context. A follow-up study with only conditionals revealed that speakers can also find NPIs infelicitous in conditional contexts with consequences that are compatible with a negative interpretation of the NPI, and that negative arguments are felicitous in these same contexts. Taken together, the results support the hypothesis that speakers who do not accept NC have grammars that generate both NC and NPI constructions, and further, that these speakers have two underlying structures for any-NPIs in English. (shrink)

This paper addresses the question of how it is to be explained that an action or object X counts as Y. I argue that John Searle's notion of a constitutive rule should not be employed because it involves a confusion. Instead, I propose an explanatory framework containing the following three elements: 1) The X-action or object is involved in certain social practices. 2) These practices confer properties on the X-items, in addition to their physical properties. 3) In virtue of these (...) additional properties the X-items fall under the Y-concept. Moreover, I stress that the social practices mentioned under 1) look differently from case to case and involve various constellations of prescriptive rules and interpersonal patterns of intentions. To illustrate and corroborate these claims, I discuss several cases of socially constituted actions and objects, in particular, the case of money, where I reject Searle's claim that something counts as money in virtue of giving its owner the right to buy something. (shrink)

Jan Österberg (Self and Others, 1988) argues that the most defensible form of egoism should not only tell each of us what to do but also tell us what we ought to do. He also claims that collective norms should take precedence over individual ones. An individual ought to do one's part in an action pattern that is prescribed for the group - provided that other members of the group do their part. question This paper questions Österberg's claim that Collective (...) Egoism, unlike other forms of egoism, avoids violations of the principles which he takes to be analytical adequacy criteria for ethical theories: the principles of "deontic consequence" and "joint satisfiability". Furthermore, it questions his argument that Collective Egoism yields the "right" prescriptions in its main test-case: Prisoners' Dilemma. The improved version of Collective Egoism is able to deal with the two-person Prisoners' Dilemma, but it still misbehaves when we move to the many-persons cases. A certain type of "free rider"-problems proves to be especially troublesome. (shrink)

This article examines the ideological implications of different interpretations of the statement "Humans are animals." It contrasts theories that regard humans as literally sophisticated animals with those who interpret the statement metaphorically. Sociobiological theories, bolstered by metaphors in the dictionary of English emphasize competitiveness and aggression as features shared by humans and nonhuman animals. Other theories emphasize symbiosis and cooperation. Some of these theories are prescriptive—metaphor patterns in English reflect the strong tendency to regard animal behavior as something for (...) humans to avoid. Conversely, sociobiologists suggest it is natural and right to behave like animals, the naturalistic fallacy. Other cultural theories suggest that the statement is only metaphorical; our differences from animals are what make us most human. The article notes the tendency to metaphorically project the values and structures of current human society onto the animals being studied, serving the interest of those who, in power, benefit from the status quo. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Naturalistic Empiricism as Process TheologyGary Dorrien (bio)The founders of the Chicago School of Theology sought to develop a fully modernist theology, the first one by their standard. They swept aside the a prioris of Kant and Schleiermacher, declaring that nothing is given and no norm from the past holds legitimate authority. Theologian Shailer Mathews, philosopher of religion George Burman Foster, church historian Shirley Jackson Case, and psychologist of religion (...) Edward Scribner Ames were the founders. They agreed with Ernst Troeltsch that Ritschlian historicism is not true historicism and with William James that lingering over the mystery of subjectivity is a loser for theology and philosophy. Theology had to change to deserve the modernist name. Instead of claiming that religious knowledge is a product of religious experience, theologians should say that religious knowledge is a product of disciplined empirical reflection on experience, especially the experience of external relations. Moreover, the Ritschlian approach of employing a Christian framework to get a Christian answer is illegitimate. The only way to make theology truly modern is to make it as scientific as chemistry, or at least, sociology.The Chicago School had a quintessential figure in each of its first three generations. Mathews was the emblematic founder, Henry Nelson Wieman defined the second generation, and Bernard Meland defined the third generation. Each generation had a process orientation that distinctly ventured theological claims. Mathews led the Divinity School as dean from 1908 to 1933, crafting a socio-historical theology of evolutionary process, functional patterns, value theory, and cultural progress. Wieman developed a theological behaviorism that touted its empirical objectivity and opened the door to the organic metaphysical system of Alfred North Whitehead, though Wieman subsequently tried to close the door. One stream of Wieman’s protégés stuck with his approach and another stream tacked back to Whitehead. Meland synthesized the history of the Chicago School, pulled it in Whitehead’s direction, and later regretted that Whitehead, philosopher Charles Hartshorne, and process theology were too scholastic. Process theology, Meland believed, should be more theopoetic, more culturally attuned, and less scholastic—a prescription with an ample future once feminist theology entered this field. [End Page 5]I. Shailer Mathews and the Early Chicago SchoolThe University of Chicago was the product of John D. Rockefeller’s money, Midwest Baptist anxieties about falling behind other denominations, and William Rainey Harper’s vision of a modern Baptist university. Harper, a Hebrew Bible scholar, and a phenomenally enterprising administrator, founded the university in 1890, stocking it with faculty stars he plucked mostly from New England colleges and universities. Mathews was not a star, or thought to be brilliant. Raised in the staid, thoroughly middle-class, evangelical ethos of Portland, Maine, he was educated at Colby College in Maine, befriending sociologist Albion Small, who became Colby’s president in 1888. Small opened a succession of doors for Mathews—seminary at Newton Theological Institution, a faculty position at Colby in public speaking, graduate study in sociology at the University of Berlin, teaching sociology at Colby, and in 1894, two years after Small moved to Chicago to found the nation’s first sociology department, following Small to Chicago. Harper chaired the Old Testament Department, Mathews’s former teacher at Newton, Ernest DeWitt Burton, chaired the New Testament Department, and Mathews was hired to teach New Testament history, never mind that he had no training in it except whatever Burton had taught him. Burton told Mathews not to worry—his Berlin training in sociology should apply just fine to New Testament history. The University of Chicago had a mission to make religion relevant again, and Mathews could help with that.1Harper enlisted him to serve as an extension of himself in Harper’s numerous endeavors. Mathews was really good at representing Harper, speaking for him on the road, hustling back to Chicago for classes, and enjoying his dual role. To ground himself in his acquired field, Mathews wrote a series of articles on “Christian Sociology” that became his first book, The Social Teaching of Jesus (1897). Christian sociology, he explained, was the use of social science to explicate the objective meaning of Christianity, an overdue enterprise. A scientific reading... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:SuspenseDonald BeecherSuspense is one of those workaday terms so integrated into the discussion of literature that definition would hardly seem necessary. It does receive pro forma entries in most literary handbooks, but never provokes more than a statement of the self-evident: that it is a "state of uncertainty, anticipation and curiosity as to the outcome of a story or play, or any kind of narrative in verse or prose,"1 (...) that such anticipations arise "particularly as they affect a character for whom one has sympathy," and that plot types vary in ways that affect the ethos of suspense: those situations in which the outcome is uncertain and readers are concerned with how they will be resolved, and those in which the outcome is inevitable and readers, in their fear, concentrate merely on knowing when the catastrophe will be complete.2 Indicatively, Roger Fowler's A Dictionary of Modern Critical Terms gives it a pass altogether.3 But even these generic representations of the concept must venture such quizzical terms as "state" and "sympathy," both of which are seen to inhere not in texts and narratives, but in spectators and readers. Suspense, then, must have two sides: that which is invested in the design of the story as an emotion prompt; and that which is a feature of mind.This critical divide can be stated in many ways. One could say that evaluating the emotionality embedded in a text is an act of literary criticism, while the study of the emotionality aroused by literature belongs to cognitive psychology. These are, of course, two sides to the proverbial coin worthy of critical alignment—namely that which authors know about organizing narratives to produce suspense, and that which readers "know" through the constitution of their brains about responding to situations of alarm or disorientation involving themselves or others, and the compelling limbic reinforcement that impels them toward ends [End Page 255] that will release them from incertitude or danger. The critical challenge at this juncture is to decide whether a study of suspense should begin in narratology or psychology, for without the récit of events in time there are no prompts, even though suspense as experience does not reside in texts but in psyches.Wolfgang Iser calls for a balanced approach to literary study in general that "lays full stress on the idea that, in considering a literary work, one must take into account not only the actual text, but also, in equal measure, the actions involved in responding to that text."4 But that does not help in determining whether suspense should be defined according to a minimum prescription of narrative procedures and characteristics, or as a literary subset of a human, genetically-conditioned response mechanism selectively engineered to meet a range of stressors in the environment.The first question in the creation of a rapprochement between these domains must deal with the very capacity for mind states to be emotionally moved by literary configurations, insofar as literary suspense borrows from the vocabulary of limbic arousal responses. The second question pertains to what readers are brought to feel more particularly for make-believe persons in make-believe situations of danger. Are these also make-believe emotions, for then it must be determined what an exclusively literary emotion might be. Subsequent questions must deal with the range of suspense arousing situations, whether they involve only protagonists, their desires and prospects, or whether suspense applies to any motivated pursuit of information deemed vital to mental satisfaction. These distinctions and their relationship will prove critical.Almost universally, in the limited number of critical studies that exist, literary suspense entails liked characters under duress whose futures are perilous and uncertain—futures about which readers hold strong preferences. This perspective stands in opposition to potentially broader definitions that include curiosity, problem-solving sequences, cognitive jags, or pattern completion. One obstacle is that problem-solving activities appear to exceed the capacities of minds already absorbed in the events of fictive worlds, arriving merely as distractions from the conditions of high, dramatic suspense. They can be said to fall outside the fictive representation altogether, particularly as they pertain to the patterns of fiction, or a... (shrink)

A substantial reason behind the Confucian canonization of the Yijing can be located in some underlying patterns of thinking common to both the Yijing and The Analects; especially relevant here is the doctrine of rectification of names. In particular, I analyze the fundamental structure of the Yijing by means of the names and symbols standing in unique semantic/semiotic relations to the world, and I go on to suggest that this is what is importantly entailed by the doctrine of the (...) rectification of names when the latter is understood by means of the perlocutionary function of the prescriptive language. (shrink)

Over the last quarter-century, China has experienced dramatic changes associated with its development of a market economy. The character of clinical practice is also profoundly influenced by the ways in which reimbursement scales are established in public hospitals. The market distortions that lead to the over-prescription of drugs and the medically unindicated use of more expensive drugs and more costly high-technology diagnostic and therapeutic interventions create the most significant threat to patients. The payment of red packets represents a black-market (...) attempt to circumvent the non-market constraint on physicians' fees for services. These economic and practice pattern changes are taking place as China and many Pacific Rim societies are reconsidering the moral foundations of their professional ethics and their bioethics. The integrity of the medical profession and the trust of patients in physicians can only be restored and protected if the distorting forces of contemporary public policy are altered. (shrink)

This dissertation develops a reading of Arthur Schopenhauer’s theory of agency and autonomy that centers on the notion of the acquired character. I argue for a non-homuncular functionalist reading of Schopenhauerian self-government. On my reading, to be self-governing in Schopenhauer’s sense is just for a certain organizational structure to obtain between one’s individual character and one’s motivation. This structure is put in place through the hard-fought achievement of acquiring genuine self-knowledge of one’s characteristic patterns of acting, evaluative commitments, and, (...) most importantly, one’s volitional necessities. This is the achievement of what he calls the 'acquired character'. My reading also stresses the importance of the phenomena of self-expression and sublimation for Schopenhauer's view of autonomy. I also explore the overlap between Schopenhauer's views and contemporary non-homuncular models of agency, particularly Harry Frankfurt’s hierarchical model of agency, on the one hand, and Michael E. Bratman’s planning theory of autonomous self-governance, on the other. Whereas others have been skeptical of the very idea of Schopenhauerian autonomy, I argue that these reservations rest on a failure to recognize the non-homuncular option. An exploration of contemporary philosophical work on agency helps make this point stick. In the final chapter, I propose that we can see Nietzsche's famous prescription that we ‘give style' to our character as carrying forward certain elements of Schopenhauer's view of autonomy, particularly its aesthetic dimensions. This accomplishes two things. First, it shows that Schopenhauer's influence on Nietzsche goes deeper into the latter's ethical thought than many tend to think. Second, it points towards an elaboration of the view of Schopenhauerian autonomy that I establish earlier on. With the aesthetic dimensions of agency in view, acquired character can be seen as a process through which an agent develops an individual style of acting; it is a process through which one comes to fully act within themselves by embodying their character, just as the best stage and screen actors do. (shrink)