In healthcare priority settings, early access to treatment before reimbursement decisions gives rise to problems of whether negative decisions for cost‐effectiveness reasons should result in withdrawing treatment, already accessed by patients. Among professionals there seems to be a strong attitude to distinguish between withdrawing and withholding treatment, viewing the former as ethically worse. In this article the distinction between withdrawing and withholding treatment for reasons of cost effectiveness is explored by analysing the doing/allowing distinction, different theories of justice, consequentialist and (...) virtue perspectives. The authors do not find any strong reasons for an intrinsic difference, but do find some reasons for a consequentialist difference, given present attitudes. However, overall, such a difference does not, all things considered, provide a convincing reason against withdrawal, given the greater consequentialist gain of using cost‐effective treatment. As a result, patients should be properly informed when given early access to treatment, that such treatment can be later withdrawn following a negative reimbursement decision. (shrink)

Background: Severity plays an essential role in healthcare priority setting. Still, severity is an under-theorised concept. One controversy concerns whether severity should be risk- and/or time-sensitive. The aim of this article is to provide a normative analysis of this question. Methods: A reflective equilibrium approach is used, where judgements and arguments concerning severity in preventive situations are related to overall normative judgements and background theories in priority-setting, aiming for consistency. Analysis, discussion, and conclusions: There is an argument for taking the (...) risk of developing a condition into account, and we do this when we consider the risk of dying in the severity assessment. If severity is discounted according to risk, this will ‘dilute’ severity, depending on how well we are able to delineate the population, which is dependent on the current level of knowledge. This will potentially have a more far-reaching effect when considering primary prevention, potentially the de-prioritisation of effective preventive treatments in relation to acute, less-effective treatments. The risk arguments are dependent on which population is being assessed. If we focus on the whole population at risk, with T 0 as the relevant population, this supports the risk argument. If we instead focus on the population of as-yet (at T 0 ) unidentified individuals who will develop the condition at T 1, risk will become irrelevant, and severity will not be risk sensitive. The strongest argument for time-sensitive severity (or for discounting future severity) is the future development of technology. On a short timescale, this will differ between different diagnoses, supporting individualised discounting. On a large timescale, a more general discounting might be acceptable. However, we need to also consider the systemic effects of allowing severity to be risk- and time-sensitive. (shrink)

'What is real?' has been one of the key questions of philosophy since its beginning in antiquity. But it is not just a question that philosophers ask. This Very Short Introduction discusses what reality is by looking at a variety of arguments, theories, and thought-experiments from philosophy, physics, and cognitive science.

_Seeking Understanding: The Lifelong Pursuit to Build the Scientific Mind_ explores the multiple ways in which the human mind grows in understanding of the self and the world as an essential dimension of transformative learning along the lifespan.

This paper briefly discusses the relations between logic and metalogic in history. Metalogic is understood as a reflection on logic in its various senses, particularly sensu stricto (formal, mathematical) and sensu largo (formal logic plus semantic plus methodology of science). It is shown that metalogic in its contemporary understanding arose after mathematical logic had become a mature discipline. Special passage is devoted to metalogic in Poland. The last part of the paper discussed so-called logocentric predicament.

Commentary on the Kleist’s Short Story “On the Marionette Theatre”.

This paper investigates the basis arguments of so-called legal logic and their relation to logic in its standard meaning. There is no doubt that legal arguments belong to logic in the wide sense (sensu largo), but their reduction to schemes of formal logic (logica sensu stricto) is a controversial issue. It can be demonstrated that only some legal arguments fall under explicit rules of formal logic, that is, having a deductive character. Most such reasoning is fallible, and its correctness depends (...) on appealing to extra-logical principles taken from legal norms. For instance, if we say, “If it is permitted more, then it is permitted less” (argumentum a maiori ad minus), we assume that the concepts expressed by the words “more” and “less” are already defined. (shrink)

The relevance of metamathematical researches for philosophy of math- ematics is an indubitable matter. In the paper I shall speak about impli- cations of metamathematics for general philosophy, especially for classical epistemological problems. Let us start with a historical observation con- cerning Hilbert's programme, the rst research programme in metamathe- matics as a separate study of formal systems. This programme was strongly in uence by epistemological considerations. In fact, Hilbert wanted to se- cure all classical mathematics against inconsistencies and this (...) aim had be achieved with the help of nitary consistency proof. Hilbert's claim is like the Cartesian project of reduction of all concepts to clarae et distinctae ideae. The epistemological commitment of original Hilbert's programme may be treated as a prelim- inary heuristic motivation for looking for epistemological implications of metamathematical results. It seems reasonable to examine in this respect three so-called limitative theorems: the rst Godel's incompleteness theo- rem , the second Godel's incom- pleteness theorem consistency of S, cannot be proved in S, providing that S is consistent) and Tarski's undenability theorem ; \S" stands for formal system containing elementary number theory. From the above-mentioned theorems we obtain an important, from philosophical point of view, conclusion: semantics of S cannot be expressed in S. Now, I shall present three applications of limitative theorems to the analysis of classical epistemological problems. (shrink)

In Multi Agent Systems it is often the case that individual preferences are not compatible and coalitions compete to achieve a given result. The paper presents a language to talk about the conflict between coalitional choices and it expresses deontic notions to evaluate them. We will be specifically concerned with cases where the collective perspective is at odds with the individual perspective.

ABSTRACTIn The Netherlands, the public funding of a number of health care services is controversial. What can we learn from this about the moral concerns that underlie these judgements? And, if there is anything to learn, can we use this improved understanding to scrutinise the adequacy of particular decisions concerning the public funding of health care services? In the present paper, I will analyse three cases: corrective surgey, In Vitro Fertilisation and liver transplantation. I will summarise the arguments that have (...) been used to support or to challenge the public funding of these services. I will then assess the merits of Daniels’fair equality of opportunity account of justice in health care. Can this account improve our understanding of the moral concerns underlying our judgements about the public funding of these services? Can it serve to scrutinise the adequacy of particular decisions that are made concerning the public funding of health care services? My answer to both questions will be a qualified yes. Daniels’account can provide guidance, but not because we can deductively infer from it what is right and what is wrong. Instead, I will argue for a more casuistic use of the concept of fair equality of opportunity. (shrink)

ABSTRACT In The Netherlands, the public funding of a number of health care services is controversial. What can we learn from this about the moral concerns that underlie these judgements? And, if there is anything to learn, can we use this improved understanding to scrutinise the adequacy of particular decisions concerning the public funding of health care services? In the present paper, I will analyse three cases: corrective surgey, In Vitro Fertilisation and liver transplantation. I will summarise the arguments that (...) have been used to support or to challenge the public funding of these services. I will then assess the merits of Daniels’fair equality of opportunity account of justice in health care. Can this account improve our understanding of the moral concerns underlying our judgements about the public funding of these services? Can it serve to scrutinise the adequacy of particular decisions that are made concerning the public funding of health care services? My answer to both questions will be a qualified yes. Daniels’account can provide guidance, but not because we can deductively infer from it what is right and what is wrong. Instead, I will argue for a more casuistic use of the concept of fair equality of opportunity. (shrink)

Let R be a relational variable of arity m, and let ¯ x be an m-tuple of variables. Let φ be a first order formula that is positive in R, i.e., all occurrences of R in φ are in the scope of an even number of negations. Then λRλ¯.

The recent progress in the development of autonomous cars has seen ethical questions come to the forefront. In particular, life and death decisions regarding the behavior of self-driving cars in trolley dilemma situations are attracting widespread interest in the recent debate. In this essay we want to ask whether we should implement a mandatory ethics setting for the whole of society or, whether every driver should have the choice to select his own personal ethics setting. While the consensus view seems (...) to be that people would not be willing to use an automated car that might sacrifice themselves in a dilemma situation, we will defend the somewhat contra-intuitive claim that this would be nevertheless in their best interest. The reason is, simply put, that a PES regime would most likely result in a prisoner’s dilemma. (shrink)

Modern societies are characterized by a division of epistemic labor between laypeople and epistemic authorities. Authorities are often far more competent than laypeople and can thus, ideally, inform their beliefs. But how should laypeople rationally respond to an authority’s beliefs if they already have beliefs and reasons of their own concerning some subject matter? According to the standard view, the beliefs of epistemic authorities are just further, albeit weighty, pieces of evidence. In contrast, the Preemption View claims that, when one (...) discovers what an authority believes, it is not permissible to rely on any of one’s own reasons concerning the subject matter. The original version of this view, as proposed by Linda Zagzebski, has recently been severely criticized for recommending blind trust and for abandoning even minimal standards for critical thinking. In our paper, we defend a new version of the Preemption View—Defeatist Preemptionism—in a way that differs radically from Zagzebski’s. We argue that our view can be derived from certain widely accepted general epistemic principles. In particular, we claim that preemption can be identified as a special case of source sensitive defeat. Moreover, we argue that Defeatist Preemptionism does not lead to the undesirable consequences that critics ascribe to the Preemption View. The paper thus articulates the foundations and refinements of the Preemption View, such that it adequately captures the phenomenon of epistemic authority and the rational requirements related to it. (shrink)

This chapter focuses on the development of Gerhard Gentzen's structural proof theory and its connections with intuitionism. The latter is important in proof theory for several reasons. First, the methods of Hilbert's old proof theory were limited to the “finitistic” ones. These methods proved to be insufficient, and they were extended by infinitistic principles that were still intuitionistically meaningful. It is a general tendency in proof theory to try to use weak principles. A second reason for the importance of intuitionism (...) for proof theory is that the proof-theoretical study of intuitionistic logic has become a prominent part of logic, with applications in computer science. (shrink)

1. Die erste Hälfte des Kommentars, mit Ausnahme der Kapitel über die Weltseele.