This paper offers critical reflection on the contemporary tendency to approach health care in instrumentalist terms. Instrumentalism is means-ends rationality. In contemporary society, the instrumentalist attitude is exemplified by the relationship between individual consumer and a provider of goods and services. The problematic nature of this attitude is illustrated by Michael Oakeshott’s conceptions of enterprise association and civil association. Enterprise association is instrumental; civil association is association in terms of an ethically delineated realm of practices. The latter offers a richer (...) ethical conception of the relation between person and society than instrumentalism does. Oakeshott’s conception is further illustrated by reflection on the connection between morality and religion that he explores in an early essay concerning “religious sensibility”. Religious sensibility turns on the acknowledgement of the vulnerability of the self to the vicissitudes of life. This vulnerability cannot be bargained over instrumentally without imperilling the self. Religious sensibility is thus a valuable resource for criticising instrumentalist attitudes. It allows for the cultivation of ethical self-understanding that is essential to comprehending the conditions in virtue of which genuine civil life is possible. These conditions need to be taken into account in health care. Health care is not simply about substantive wants. It also necessarily concerns the universal and constant condition of being prey to illness that is the common lot of all citizens. (shrink)

Cognitive therapy has traditionally assumed that the therapy relationship provides a necessary context for intervention but is insufficient alone to produce therapeutic change. This assumption is reviewed in the light of up-to-date evidence from research studies of cognitive therapy and recommendations are made for further research. Mechanisms by which the therapy relationship may influence outcome and factors influencing the quality of the relationship are briefly discussed and the need for further research highlighted. Implications for the practice of cognitive therapy are (...) suggested. (shrink)

This paper explores the theoretical Islamic legal framework and methodology used by Islamic religo-legal authorities in issuing rulings regarding contemporary medico-ethical issues of concern to Muslim minorities, health professionals and policy makers in Britain. The author demonstrates that the guiding principle used by Islamic religo-legal authorities related to medico-ethical issues in Britain is the Quranic precept of, “Enjoin the good, prevent the harmful”. In particular, the Islamic legal instrument of maslaha is used to arrive at rulings in a process in (...) which the role of the muftī is crucial. The author shows that the muftī is able to legitimately function in a contemporary liberal society such as Britain because of the private nature of his authority that has historically been vested in this position. The paper also explores how the operation of the sharī’a in Britain may potentially intersect with the British legal system and some of the consequences that arise from this potentiality. The author concludes by reflecting upon what the issues raised in this paper indicate for the broader themes related to the integration of Muslims into contemporary liberal societies. (shrink)