In the face of environmental crises such as climate change, pollution and biodiversity loss—which all adversely impact on health—Gils-Schmidt and Salloch explore whether physicians can be justified in taking climate issues into account in clinical care.1 While their approach centres on the ‘climate-sensitive’ decisions, physicians can carry out on the micro-level of clinical decision-making, they encourage further discussions on how climate-related issues can be included across different levels of decision-making in healthcare. We propose a list of tasks and a model (...) to assist with navigating the range of factors and structural elements an environmentally sensitive ethics must address. Stephen Gardiner’s notion of a perfect moral storm is central to understanding these issues.2 Gardiner describes how a perfect moral storm occurs in the centre of three overlapping conditions for human action and policymaking in the face of climate change. This storm is driven by: (1) a lack of interest among current generations to meet global needs and accommodate the well-being of future generations, (2) a lack of ecological concerns for other parts of nature than humans and (3) weak ethical and political theories and institutions shaping policy decisions on issues with severe implications across borders and generations. Moreover, these conditions are embedded in the existing, complex world of ethically unjustified power imbalances and social injustice. The growing awareness of healthcare’s climate footprint has amplified and accelerated global, grassroots action to make healthcare more environmentally friendly. This includes incorporating environmental impacts into quality improvement methodologies, building communities of practice to explore how to make …. (shrink)

Images are an important source of data and information in the agricultural sciences. The use of image-processing techniques has outstanding implications for the analysis of agricultural operations. Fruit and vegetable classification is one of the major applications that can be utilized in supermarkets to automatically detect the kinds of fruits or vegetables purchased by customers and to determine the appropriate price for the produce. Training on-site is the underlying prerequisite for this type of arrangement, which is generally caused by the (...) users having little or no expert knowledge. We explored various methods used in addressing fruit and vegetable classification and in recognizing fruit disease problems. We surveyed image-processing approaches used for fruit disease detection, segmentation and classification. We also compared the performance of state-of-the-art methods under two scenarios, i.e., fruit and vegetable classification and fruit disease classification. The methods surveyed in this paper are able to distinguish among different kinds of fruits and their diseases that are very alike in color and texture. (shrink)

When weighing up which inhaler to prescribe, a doctor may prioritise a patient’s preferences over the expected harms from the associated carbon emissions. Parker argues that this is wrong.1 Doctors have a pro-tanto duty to switch from a high-carbon metered-dose inhaler (MDI) to a low-carbon dry-powdered inhaler (DPI)—even though this provides no direct patient benefit—unless switching would undermine trust or significantly worsen a patient’s health. He goes on to state that even if DPIs are more expensive for the National Health (...) Service (NHS) then this is justified so long as it does not ‘significantly threaten’ the NHS’ ability to protect and promote health. This may appear to be a radical proposal, challenging the ethical principles of autonomy, health entitlements and justly distributed resources. However, we will claim that it is only radical in so far as one perceives (A) patient autonomy and healthcare entitlements as existing within a vacuum, unrelated to other foundational ethics concerns and (B) the health consequences of a given healthcare budget are limited solely to the designated recipients rather than all affected parties. Here, we test the claim that our responsibility for promoting patient autonomy …. (shrink)

The Norwegian Oil Fund (‘Government Pension Fund – Global’) is worth over NOK 10.6 trillion (USD 1.15 USD trillion)1 making it the largest sovereign wealth fund in the world (Norges Bank Investment...

I defend a relational account of difference in the moral status between fetuses and newborns. The difference in moral status between a fetus and a newborn is that the newborn baby is the proper object of ‘parental responsibility’ whereas the fetus is not. ‘Parental responsibilities’ are a moral dimension of a ‘parent-child relation’, a relation which newborn babies stand in, but fetuses do not. I defend this relational account by analyzing the concepts of ‘parent’ and ‘child’, and conclude that the (...) difference in the moral status between fetuses and newborns means one may claim abortion is morally permissible while also claiming infanticide is not morally permissible, without inconsistency between the two claims. (shrink)

In this discussion note on Michal Pruski and Richard C. Playford’s “Artificial Wombs, Thomson and Abortion – What Might Change?,” I consider whether the prospect of ectogenesis technology would make abortion impermissible. I argue that a Thomson-style defense may not become inapplicable due to the right to life being conceived as a negative right. Further, if Thomson-style defenses do become inapplicable, those who claim that ectogenesis would be an obligatory alternative to abortion cannot do so without first showing that fetuses (...) have a right to life, something that Thomson assumed rather than argued for. I also include a discussion on ethical problems concerning what to do about children born from artificial wombs put there by those who looked to terminate their pregnancies because they sought to avoid parenthood. (shrink)

While the concepts of race and ethnicity have been abused historically, they are potentially invaluable in epidemiology and public health. Epidemiology relies upon variables that help differentiate populations by health status, thereby refining public health and health care policy, and offering insights for medical science. Race and ethnicity are powerful tools for doing this. The prerequisite for their responsible use is a society committed to reducing inequalities and inequities in health status. When this condition is met, it is irresponsible not (...) to utilize these concepts. (shrink)

This volume provides an overview of issues arising in work on the foundations of decision theory and social choice. The collection will be of particular value to researchers in economics with interests in utility or welfare, but also to any social scientist or philosopher interested in theories of rationality or group decision-making.

I examine social capital’s impact on financial reports. Based on the social capital literature, I predict that the quality of the financial reports is higher when a firm is headquartered in a region with high social capital. Consistent with this prediction, I find that the firms that are headquartered in this type of region in the USA have a lower probability of committing fraud by misrepresenting financial information. Further, I find that the firms in regions with high social capital have (...) lower levels of discretionary accruals and much more readable annual reports. (shrink)

This article explores Gypsy Travellers' changing views on their children's education. It highlights the positive means some schools use to encourage greater involvement of Gypsy Traveller parents. It argues that current educational policy needs to be re-developed to incorporate more effective and affirmative responses to interrupted and nomadic learning. It draws heavily on interviews with Gypsy Traveller families in an effort to give 'voice' to an under-represented community.

The Unified Medical Language System and the Gene Ontology are among the most widely used terminology resources in the biomedical domain. However, when we evaluate them in the light of simple principles for wellconstructed ontologies we find a number of characteristic inadequacies. Employing the theory of granular partitions, a new approach to the understanding of ontologies and of the relationships ontologies bear to instances in reality, we provide an application of this theory in relation to an example drawn from the (...) context of the pathophysiology of hypertension. This exercise is designed to demonstrate how, by taking ontological principles into account we can create more realistic biomedical ontologies which will also bring advantages in terms of efficiency and robustness of associated software applications. (shrink)

The hard problem of consciousness arises in most incarnations of present day physicalism. Why should certain physical processes necessarily be accompanied by experience? One possible response is that physicalism itself should be modified in order to accommodate experience: But, modified how? In the present work, we investigate whether an ontology derived from quantum field theory can help resolve the hard problem. We begin with the assumption that experience cannot exist without being accompanied by a subject of experience (SoE). While people (...) well versed in Indian philosophy will not find that statement problematic, it is still controversial in the analytic tradition. Luckily for us, Strawson has elaborately defended the notion of a thin subject—an SoE which exhibits a phenomenal unity with different types of content (sensations, thoughts etc.) occurring during its temporal existence. Next, following Stoljar, we invoke our ignorance of the true physical as the reason for the explanatory gap between present day physical processes (events, properties) and experience. We are therefore permitted to conceive of thin subjects as related to the physical via a new, yet to be elaborated relation. While this is difficult to conceive under most varieties of classical physics, we argue that this may not be the case under certain quantum field theory ontologies. We suggest that the relation binding an SoE to the physical is akin to the relation between a particle and (quantum) field. In quantum field theory, a particle is conceived as a coherent excitation of a field. Under the right set of circumstances, a particle coalesces out of a field and dissipates. We suggest that an SoE can be conceived as akin to a particle—a SelfOn—which coalesces out of physical fields, persists for a brief period of time and then dissipates in a manner similar to the phenomenology of a thin subject. Experiences are physical properties of selfons with the constraint (specified by a similarity metric) that selfons belonging to the same natural kind will have similar experiences. While it is odd at first glance to conceive of subjects of experience as akin to particles, the spatial and temporal unity exhibited by particles as opposed to fields and the expectation that selfons are new kinds of particles, paves the way for cementing this notion. Next, we detail the various no-go theorems in most versions of quantum field theory and discuss their impact on the existence of selfons. Finally, we argue that the time is ripe for a rejuvenated Indian philosophy to begin tackling the three-way relationship between SoEs (which may become equivalent to jivas in certain Indian frameworks), phenomenal content and the physical world. With analytic philosophy still struggling to come to terms with the complex worlds of quantum field theory and with the relative inexperience of the western world in arguing the jiva-world relation, there is a clear and present opportunity for Indian philosophy to make a worldcentric contribution to the hard problem of experience. (shrink)

This paper defends an account of moral worth. Moral worth is a status that some, but not all, morally right actions have. Unlike with merely right actions, when an agent performs a morally worthy action, she is necessarily creditworthy for doing the right thing. First, I argue that two dominant views of moral worth have been unable to fully capture this necessary connection. On one view, an action is morally worthy if and only if its agent is motivated by the (...) features of the action that make it right. On the other, an action is morally worthy if and only if its agent is motivated by the action’s rightness itself. Neither of these views captures the connection between moral worth and creditworthiness, because each view leaves room for cases of accidentally doing the right thing. Next, I develop a new account, which I call the Guise of Moral Reasons Account. On my account, morally worthy actions are right actions that are motivated by moral reasons as such. This account rules out cases of accidentally doing the right thing, thus capturing the necessary connection between moral worth and creditworthiness for doing the right thing. (shrink)

Autumn Fiester's “Neglected Ends: Clinical Ethics Consultation and the Prospects for Closure” (2015) demonstrates how a focus on recommendations in clinical ethics consultations (CECs) can fail to...

The Present Book Contains The Philosophy Of Organism Associated With The Teachings Of Prof. An Whitehead With Comparative Reference To Indian Philosophical Doctrines And Chinese Philosophy Of Change. In Part I The Author Deals With Sage Philosopher'S Conc.

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)

This chapter discusses some of Anscombe’s contributions to the philosophy of practical reason. It focuses particularly on Anscombe’s view of what it is to act for reasons. I begin by discussing the relationship between acting intentionally and acting for reasons in Anscombe's theory of action. I then further explicate her view by discussing her rejection of two related views about acting for reasons: causalism (the view that reasons are a kind of cause of actions) and psychologism (the view that reasons (...) are mental states like desires and beliefs). In the process, I try to show that Anscombe’s rejection of these theses does not leave us with mystery, but rather sheds light on an interesting and serious heterodox view of acting for reasons. I conclude by suggesting that though Anscombe's views have been taken sufficiently seriously by philosophers of action, they should be taken more seriously by philosophers of practical reason. (shrink)

Recently, Kit Fine's (1994) view that modal truths aretrue in virtue of,grounded in, orexplained byessentialist truths has been under attack. In what follows we offer two responses to the wave of criticism against his view. While the first response is pretty straightforward, the second is based on the distinction between, what we call,Reductive Finean EssentialismandNon-Reductive Finean Essentialism. Engaging the work of Bob Hale onNon-Reductive Finean Essentialism, we aim to show that the arguments against Fine's view are unconvincing, while we acknowledge (...) the presence of a deep standoff between the two views. (shrink)

Many medicines currently available on the market are simply too expensive for millions around the world to afford. Many medicines available in the developing world are only available to a small percentage of the population due to economic inequities. The profit-seeking behavior of pharmaceutical companies exacerbates this problem. In most cases, the price reductions required to make drugs affordable to a broader class of people in the developing world are not offset by the resultant increase in sales volume. Simply stated, (...) in most of the developing world, it is more profitable to sell drugs to the very wealthy at high prices than it is to sell cheaper drugs to a greater number of people. As a result, medicines remain unaffordable for the vast majority of people in many parts of the world. While this might be an acceptable outcome for certain commodities, such as luxury goods, it is completely unacceptable for life-saving medicines. Therefore, in order to effectively address the global lack of access to medicines, the role pharmaceutical companies play in the international intellectual property regime must be critically examined. (shrink)

Approximately two billion people lack access to medicines globally. People living with HIV, cancer patients, those suffering from tuberculosis or malaria, and other populations in desperate need of life-saving medicines are increasingly unable to access existing preventative, curative, and life-prolonging treatments. In many cases, treatment may be unavailable or inaccessible for even some of the most common and readily treatable health concerns, such as hypertension. In the developing world, many of the factors that contribute to making the world’s most vulnerable (...) and marginalized populations particularly susceptible to illness also operate to restrict their access to medicines. As a result of dramatic economic inequities and widespread poverty, it is not profitable for most originator pharmaceutical companies to develop new medicines for sale in developing markets or to lower the cost of existing drugs so that they are affordable for the majority of these populations. (shrink)

Our concern in this paper lies with a common argument from racial discrimination to realism about races: some people are discriminated against for being members of a particular race (i.e., racial discrimination exists), so some people must be members of that race (i.e., races exist). Error theorists have long responded that we can explain racial discrimination in terms of racial attitudes alone, so we need not explain it in terms of race itself. But to date there has been little detailed (...) discussion of whether it is better to explain racial discrimination in terms of race or in terms of racial attitudes alone. Our goal is to offer a novel and detailed argument in defense of explaining racial discrimination in terms of racial attitudes alone, by attending to the neglected phenomenon of misperception discrimination, which involves differential treatment due to misperceived race. We argue that the discriminatory action in misperception cases must be explained in the same way as cases where (according to the realist) the victim’s race is accurately perceived. Thus, the victim’s actual race cannot provide the best explanation. The main upshot of our argument is that explanatory arguments from racial discrimination to realism about race fail. (shrink)

Introduction: An ethnographer among the anthropologists -- The world at hand: between scientific and literary inquiry -- A method of experience: reading, writing, teaching, fieldwork -- For the humanity yet to come: politics, art, fiction, ethnography -- Coda: The anthropologist as critic.

The sixteenth-century Marathi poet-saint Eknāth is better known for his devotional songs and allegorical drama-poems than his “philosophical” writings. These writings include commentaries on and distillations of Sanskrit texts that feature a highly localized form of Advaita, or non-dualist Vedānta. Rather than consider them vernacular translations of the classical traditions of Advaita, I propose to read Eknāth’s philosophical works as embedded in a local context of non-dualist thought that filtered into the elite world of Sanskrit knowledge-systems. I provide examples from (...) his Marathi commentary on the Sanskrit Hastāmalaka Stotra, a brief versified teaching on Advaita Vedānta. I also look at the para-textual material bracketing the content and some of the accompanying manuscript record, in order to understand the context for circulation and transmission of this material among Eknāth’s various readers over generations. My general attempt is to understand how ideas and practices belonging to local, vernacular networks filter into elite Sanskrit systems of knowledge—that is, not just into flexible genres like purāṇa but into disciplines, like Vedānta, that are generally viewed as impervious to the world around them. From my perspective, all knowledge is local, even that articulated in such cosmopolitan languages as Sanskrit. In Eknāth’s vernacular Advaita, we find evidence for a much wider scope for the movement of ideas, one that moves not from top-down but bottom-up. (shrink)

There are three theories in the epistemology of modality that have received sustained attention over the past 20 years: conceivability-theory, counterfactual-theory, and deduction-theory. In this paper we argue that all three face what we call the problem of modal epistemic friction. One consequence of the problem is that for any of the three accounts to yield modal knowledge, the account must provide an epistemology of essence. We discuss an attempt to fend off the problem within the context of the internalism (...) versus externalism debate about epistemic justification. We then investigate the effects that the PMEF has on reductive and non-reductive theories of the relation between essence and modality. (shrink)

Race and ethnicity are closely related, contentious concepts that have been abused and misinterpreted through history, but have a vast potential for good, at least in the health sciences. This article is not intending to elaborate on the conceptual foundations of race and ethnicity; I have addressed that elsewhere and summarized my stance in the glossary reprinted below in the Appendix. The terminology used here follows the glossary. Assuming that the conceptual foundations of my stance are reasonable, the questions addressed (...) here focus on public health and its primary health science, epidemiology, in a European context. The questions are simple ones:1.In epidemiology and public health what are we trying to achieve when we use the concepts of race and ethnicity?2.What would we lose by rejecting these concepts?3.If we do not reject them, how do we put the concepts into operation to help achieve our goals?4.What practical actions can result from the application of these concepts in order to improve the health and well-being of populations? (shrink)

It is widely understood that protein functions can be exhaustively described in terms of no single parameter, whether this be amino acid sequence or the three-dimensional structure of the underlying protein molecule. This means that a number of different attributes must be used to create an ontology of protein functions. Certainly much of the required information is already stored in databases such as Swiss-Prot, Protein Data Bank, SCOP and MIPS. But the latter have been developed for different purposes and the (...) separate data-structures which they employ are not conducive to the needed data integration. When we attempt to classify the entities in the domain of proteins, we find ourselves faced with a number of cross-cutting principles of classification. Our question here is: how can we bring together these separate taxonomies in order to describe protein functions? Our proposed answer is: via a careful top-level ontological analysis of the relevant principles of classification, combined with a new framework for the simultaneous manipulation of classifications constructed for different purposes. (shrink)

"A rough spade for a rugged landscape" : on savage selves and more civil places -- "What remains of the harvest when the fence grazes the crop?" : on the proper violence of agrarian citizenship -- "The life of the thief leaves the belly always boiling" : on the nature and restraint of the criminal animal -- "Millets sown yield millets, evil sown yields evil" : on the moral returns of agrarian toil -- "Let the water for the paddy also (...) irrigate the grass" : on the sympathies of an aqueous self. (shrink)

Outcomes research in healthcare has been a topic much addressed in recent years. Efforts in this direction have been supplemented by work in the areas of guidelines for clinical practice and computer-interpretable workflow and careflow models.In what follows we present the outlines of a framework for understanding the relations between organizations, guidelines, individual patients and patient-related functions. The derived framework provides a means to extract the knowledge contained in the guideline text at different granularities, in ways that can help us (...) to assign tasks within the healthcare organization and to assess clinical performance in realizing the guideline. It does this in a way that preserves the flexibility of the organization in the adoption of the guidelines. (shrink)

Ancient and modern cosmopolitanisms -- The rise of economic individualism and the development of the commercial community -- Martha Nussbaum and the individual at the center: liberties and capabilities, theory and practice -- Jürgen Habermas and the individual in community: freedom and responsibility in the nation-state -- David Held: freedom and accountability beyond the nation-state -- Cosmopolitan virtues for a modern world -- Cosmopolitanism law -- Conclusion: our futures, together.

Breaking from prevailing conceptions of ethics and morality as matters of moral rule or principle, this volume calls attention to ethical life in South Asia—the moral dispositions at work in lived experience, and the embodied practices of ethical engagement through which such dispositions may be cultivated and shared. Taking up themes such as the transmission of tradition, ethical engagements with modernity, ethical practices of the self, and moral relations between self and others, this volume puts South Asian traditions of ethical (...) life into conversation with the Aristotelian, Christian, and liberal traditions that have been so consequential for ethical life in the West. (shrink)

We introduce and study the notions of a PAC-substructure of a stable structure, and a bounded substructure of an arbitrary substructure, generalizing [10]. We give precise definitions and equivalences, saying what it means for properties such as PAC to be first order, study some examples (such as differentially closed fields) in detail, relate the material to generic automorphisms, and generalize a "descent theorem" for pseudo-algebraically closed fields to the stable context. We also point out that the elementary invariants of pseudo-algebraically (...) closed fields from [6] are also valid for pseudo-differentially closed fields. (shrink)