In their recent book, Is Inequality Bad for Our Health?, Daniels, Kennedy, and Kawachi claim that to “act justly in health policy, we must have knowledge about the causal pathways through which socioeconomic (and other) inequalities work to produce differential health outcomes.” One of the central problems with this approach is its dependency on “knowledge about the causal pathways.” A widely held belief is that the randomized clinical trial (RCT) is, and ought to be the “gold standard” of evaluating the (...) causal efficacy of interventions. However, often the only data available are non-experimental, observational data. For such data, the necessary randomization is missing. Because the randomization is missing, it seems to follow that it is not possible to make epistemically warranted claims about the causal pathways. Although we are not sanguine about the difficulty in using observational data to make warranted causal claims, we are not as pessimistic as those who believe that the only warranted causal claims are claims based on data from (idealized) RCTs. We argue that careful, thoughtful study design, informed by expert knowledge, that incorporates propensity score matching methods in conjunction with instrumental variable analyses, provides the possibility of warranted causal claims using observational data. (shrink)

According to HealthCare.gov, by improving access to quality health for all Americans, the Affordable Care Act (ACA) will reduce disparities in health insurance coverage. One way this will happen under the provisions of the ACA is by creating a new health insurance marketplace (a health insurance exchange) by 2014 in which “all people will have a choice for quality, affordable health insurance even if a job loss, job switch, move or illness occurs”. This does not mean that everyone will have (...) whatever insurance coverage he or she wants. The provisions of the ACA require that each of the four benefit categories of plans (known as bronze, silver, gold and platinum) provides no less than the benefits available in an “essential health benefits package”. However, without a clear understanding of what criteria must be satisfied for health care to be essential, the ACA’s requirement is much too vague and open to multiple, potentially conflicting interpretations. Indeed, without such understanding, in the rush to provide health insurance coverage to as many people as is economically feasible, we may replace one kind of disparity (lack of health insurance) with another kind of disparity (lack of adequate health insurance). Thus, this paper explores the concept of “essential benefits”, arguing that the “essential health benefits package” in the ACA should be one that optimally satisfies the basic needs of the people covered. (shrink)

This book updates and adds to the classic Social Movements of the Sixties and Seventies, showing how social movement theory has grown and changed.

This volume contains an array of essays that reflect, and reflect upon, the recent revival of scholarly interest in the self and consciousness. Various relevant issues are addressed in conceptually challenging ways, such as how consciousness and different forms of self-relevant experience develop in infancy and childhood and are related to the acquisition of skill; the role of the self in social development; the phenomenology of being conscious and its metapsychological implications; and the cultural foundations of conceptualizations of consciousness. Written (...) by notable scholars in several areas of psychology, philosophy, cognitive neuroscience, and anthropology, the essays are of interest to readers from a variety of disciplines concerned with central, substantive questions in contemporary social science, and the humanities. (shrink)

African women farmers have an urgent need for adequate agricultural extension information. Training extension agents in gender related issues should have high priority, considering that the majority of farmers are women and have different roles, resources, constraints, and responsibilities from men. This paper examines the extent to which these issues are incorporated into the curriculum of the two Malawian institutions of agricultural education that train extensionists. It also considers the degree to which they are recruiting women officers into fields other (...) than home economics. Administrators and lecturers at both institutions express a desire to integrate gender matters into the curriculum and to recruit more females into agricultural extension; yet both fall far short in meeting these goals. The conclusion provides recommendations on how African institutions of higher learning that train extension personnel might better accomplish these goals and suggests that African MOAs need to employ more women in agricultural research, extension, training, and policy-making positions. (shrink)

Conscientious objections (CO) can be disruptive in a variety of ways and may disadvantage patients and colleagues who must step-in to assume care. Nevertheless, nurses have a right and responsibility to object to participation in interventions that would seriously harm their sense of integrity. This is an ethical problem of balancing risks and responsibilities related to patient care. Here we explore the problem and propose a nonlinear framework for exploring the authenticity of a claim of CO from the perspective of (...) the nurse and of those who must evaluate such claims. We synthesized the framework using Rest’s Four Component Model of moral reasoning along with tenets of the International Council of Nursing’s (ICN) Code of Ethics for Nurses and insights from relevant ethics and nursing ethics literature. The resulting framework facilitates evaluating potential consequences of a given CO for all involved. We propose that the framework can also serve as an aid for nurse educators as they prepare students for practice. Gaining clarity about the sense in which the concept of conscience provides a defensible foundation for objecting to legally, or otherwise ethically, permissible actions, in any given case is critical to arriving at an ethical and reasonable plan of action. (shrink)

Background: The law and literature about children’s consent generally assume that patients aged under-18 cannot consent until around 12 years, and cannot refuse recommended surgery. Children deemed pre-competent do not have automatic rights to information or to protection from unwanted interventions. However, the observed practitioners tend to inform young children s, respect their consent or refusal, and help them to “want” to have the surgery. Refusal of heart transplantation by 6-year-olds is accepted. Research question: What are possible reasons to explain (...) the differences between theories and practices about the ages when children begin to be informed about elective heart surgery, and when their consent or refusal begins to be respected? Research design, participants and context: Research methods included reviews of related healthcare, law and ethics literature; observations and conversations with staff and families in two London hospitals; audio-recorded semi-structured interviews with a purposive sample of 45 healthcare professionals and related experts; interviews and a survey with parents and children aged 6- to 15-years having elective surgery (not reported in this paper); meetings with an interdisciplinary advisory group; thematic analysis of qualitative data and co-authorship of papers with participants. Ethical considerations: Approval was granted by four research ethics committees/authorities. All interviewees gave their informed written consent. Findings: Interviewees explained their views and experiences about children’s ages of competence to understand and consent or refuse, analysed by their differing emphases on informed, signified or voluntary consent. Discussion: Differing views about children’s competence to understand and consent are associated with emphases on consent as an intellectual, practical and/or emotional process. Conclusion: Greater respect for children’s practical signified, emotional voluntary and intellectual informed consent can increase respectful understanding of children’s consent. Nurses play a vital part in children's practitioner-patient relationships and physical care and therefore in all three elements of consent. (shrink)

The role of metaphor in political discourse has received significant attention in recent years. Expanding on the cognitive theory of metaphor developed by Lakoff and Johnson, scholars in the fields of sociolinguistics and discourse analysis have examined politicians' use of metaphorical concepts to justify policies and define events. The metaphors examined in these studies frequently have attained the status of idioms; they consequently pass unnoticed while retaining their ability to frame perspectives. However, political discourse does not limit itself to (...) such lexicalized metaphors, but makes use of new metaphors as well. Such uses are specifically designed to attract attention, which may become problematic if the metaphor is rejected, resulting in a classic `failure to launch'. This article examines such a case. Through an analysis of the metaphors used to describe President Bush's military plan to increase US forces in Iraq, I explore the mechanisms by which the meanings of novel metaphors are negotiated in the political arena, and demonstrate that, although their vivid imagery can generate persuasive force in political language, this effect may backfire when they encounter resistance. (shrink)

A review article of the books "Aristotle: Philosopher, Teacher, and Scientist" by Sharon Katz Cooper; and "Socrates: Ancient Greek in Search of Truth" by Pamela Dell.

A review article of the books "Aristotle: Philosopher, Teacher, and Scientist" by Sharon Katz Cooper; and "Socrates: Ancient Greek in Search of Truth" by Pamela Dell.

I hope to show that, although belief is subject to two quite robust forms of agency, "believing at will" is impossible; one cannot believe in the way one ordinarily acts. Further, the same is true of intention: although intention is subject to two quite robust forms of agency, the features of belief that render believing less than voluntary are present for intention, as well. It turns out, perhaps surprisingly, that you can no more intend at will than believe at will.

I first pose a challenge which, it seems to me, any philosophical account of forgiveness must meet: the account must be articulate and it must allow for forgiveness that is uncompromising. I then examine an account of forgiveness which appears to meet this challenge. Upon closer examination we discover that this account actually fails to meet the challenge—but it fails in very instructive ways. The account takes two missteps which seem to be taken by almost everyone discussing forgiveness. At the (...) end, I sketch an alternative account of forgiveness, one that I think meets the challenge and avoids the missteps. (shrink)

In this chapter we consider the theories of embodied cognition and extended mind with respect to the human ability to engage in numerical cognition. Such an enquiry requires first distinguishing between our innate number sense and the sort of numerical reasoning that is unique to humans. We provide anthropological and linguistic research to defend the thesis that places the body at the center of our development of numerical reasoning. We then draw on archaeological research to suggest a rough date for (...) when ancient humans first were able to represent numerical information beyond the body and in enduring material artifacts. We conclude by briefly describing how these capacities for embodied and extended numerical cognition shaped our world. (shrink)

Moving effortlessly between symbolist poetry and Barbie dolls, artificial intelligence and Kleist, Kant, and Winnicott, Barbara Johnson not only clarifies ...

I will argue that making a certain assumption allows us to conceptualize more clearly our agency over our minds. The assumption is this: certain attitudes (most uncontroversially, belief and intention) embody their subject’s answer to some question or set of questions. I will first explain the assumption and then show that, given the assumption, we should expect to exercise agency over this class of attitudes in (at least) two distinct ways: by answering for ourselves the question they embody and by (...) acting upon them in ways designed to affect them according to our purposes—in roughly the way we exercise agency over most ordinary objects. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Negotiating Maternal IdentityAdrienne Rich’s Legacy for Inquiry into the Political-Philosophical Dimensions of Pregnancy and ChildbirthCandace JohnsonGiving birth has been described as the crossing of an imaginary threshold, which separates an independent maternal self from some sort of dual or subordinate existence. The metaphor of a border has also been employed to demonstrate this transformation, which may be liberating, oppressive, or some complex combination thereof (Weir 2006; Martinez 2004). What (...) happens, in psychic and sociopolitical terms, in the journey across this border? Can a woman, as an independent, autonomous being, preserve her identity, her selfhood as a mother? Is the transition to motherhood an expression of culture or nature? The answers to these questions are infinitely complex, yet are at the core of philosophical, political, and personal explorations of the maternal. Central to these explorations are academic critiques and personal responses to the biomedical mediation of the transition to motherhood. For some women, medical intervention in pregnancy and childbirth is inherently oppressive, whereas for other women such intervention is a marker of privilege. In a groundbreaking volume published in 1998, Margaret Lock and Patricia Kaufert argue that women respond to different biomedical interventions in pragmatic ways, which reflect their lived experiences. They claim that “it is more appropriate to understand women’s responses in medical settings as reflecting their daily experiences as part of a domestic group, a community, or a society” (19). [End Page 65]I would like to advance this analysis by suggesting that women respond to biomedical intervention in pregnancy and childbirth in ways that reflect not simply their practical needs and realities, but important details about inequality and identity. Women’s relative degrees of power and agency in society are expressed through their preferences for care during pregnancy and childbirth. In addition, and in connection with the (structural) dynamics of inequality, these preferences reflect the complexities of shifting, negotiated, maternal identities. In order to consider the ways in which women negotiate maternal identity through their preferences concerning care during pregnancy and childbirth, I will examine the contributions of Adrienne Rich, which effectively serve as the foundation for this and countless other areas of women’s and gender studies. In Of Woman Born, Rich dedicates two full chapters to childbirth, and explains in these chapters that the institution of childbirth has come to dominate and eclipse women’s experiences. Moreover, the patriarchal circumscription of childbirth is reinforced by the isolation of childbirth (and motherhood) from other life events. Rich demonstrates these problems through the metaphor of “giving birth to oneself ” (29), which has (at least) two distinct meanings: self actualization and self replacement.My investigation into these meanings will include an examination of Rich’s philosophical treatment of pregnancy and childbirth and an assessment of the sociopolitical implications of both conceptions of “giving birth to oneself.” I will then subject these conceptions to empirical testing, as Rich insists. Such empirical testing is crucial because the social and political dimensions of the institutions of childbirth and motherhood are complex and differ from one context to the next. Rich explains that[t]o hold power over others means that the powerful is permitted a kind of short-cut through the complexity of human personality. He does not have to enter intuitively into the souls of the powerless, or to hear what they are saying in their many languages, including the language of silence. Colonialism exists by virtue of this short-cut—how else could so few live among so many and understand so little?(65)This essay will avoid a similar shortcut often taken by theorists, which builds philosophical arguments without empirical support. The empirical cases to be considered in the context of philosophical debate include Canada, Honduras, and Cuba, and details of each case will be drawn from extensive interview data from a larger empirical study.1 In the Canadian context, resistance to the constraining effects of motherhood as institution is reduced to resistance to medical regulation of pregnancy and childbirth. The benefit indicated by this resistance is that women have found ways to expand their range of options and reinterpret the birthing event, thereby integrating it into other realms [End Page 66... (shrink)

Aan de hand van het meesterwerk van Bach reflecteert Kessels op zijn eigen leven. Hij verbindt de wendingen, kenteringen, harmonie en disharmonie uit Bachs muziek aan episodes uit zijn persoonlijke geschiedenis. Het gevolg van Kessels' zoektocht is dat de lezer onwillekeurig ook over het eigen leven gaat nadenken. Het ogenschijnlijk particuliere project van 'Het welgetemperde gemoed' krijgt zo een universele zeggingskracht.0Kessels laat zien hoe hij streeft naar harmonie en verzoening van tegenstellingen, zich verdiept in de klassieke filosofie, de ideeënleer ontdekt (...) en zich als filosoof op de markt begeeft om het 'ideeënkijken' in praktijk te brengen. Hij is een denker die doener wil zijn, een gespletene die een geheel wil worden, een sterveling die het goddelijke zoekt. Hij wil zelf muziek worden, het eigen gemoed en dat van anderen temperen, zoals Bach het getemperde klavier laat klinken. Maar uiteindelijk blijkt dat het zuivere ideaal nooit te realiseren is: mensen zijn nu eenmaal zot en troebel. Muziek kan alleen een spiegel zijn. (shrink)

The fruits of knowledge—such as books, data, and ideas—tend to generate far more attention than the ways in which knowledge is produced and acquired. Correcting this imbalance, Making Knowledge in Early Modern Europe brings together a wide-ranging yet tightly integrated series of essays that explore how knowledge was obtained and demonstrated in Europe during an intellectually explosive four centuries, when standard methods of inquiry took shape across several fields of intellectual pursuit. Composed by scholars in disciplines ranging from the history (...) of science to art history to religious studies, the pieces collected here look at the production and consumption of knowledge as a social process within many different communities. They focus, in particular, on how the methods employed by scientists and intellectuals came to interact with the practices of craftspeople and practitioners to create new ways of knowing. Examining the role of texts, reading habits, painting methods, and countless other forms of knowledge making, this volume brilliantly illuminates the myriad ways these processes affected and were affected by the period’s monumental shifts in culture and learning. (shrink)

Patterned after Strunk and White's classic The Elements of Style , this handy reference concisely summarizes the substantial existing research on the delicate balance of professional ethics. Johnson and Ridley reduce the wealth of published material on the topic to the seventy-five most important and pithy truths for supervisors in all fields. These explore questions of integrity, loyalty, justice, respect, and delivering one's best in the business environment. Succinct and comprehensive, this is a must-have for any professional or business (...) leader striving to create an ethical workplace. (shrink)

Using path-breaking discoveries of cognitive science, Mark Johnson argues that humans are fundamentally imaginative moral animals, challenging the view that morality is simply a system of universal laws dictated by reason. According to the Western moral tradition, we make ethical decisions by applying universal laws to concrete situations. But Johnson shows how research in cognitive science undermines this view and reveals that imagination has an essential role in ethical deliberation. Expanding his innovative studies of human reason in Metaphors (...) We Live By and The Body in the Mind, Johnson provides the tools for more practical, realistic, and constructive moral reflection. (shrink)

Author of "Kubla Khan" and the epic "The Rime of the Ancient Mariner," Samuel Taylor Coleridge is remembered principally for his contributions as a romantic poet. This innovative reconsideration of Coleridge's thought and career not only demonstrates his importance as a philosopher but also recovers romanticism as both an aesthetic and a political movement. Pamela Edwards radically departs from classic theories of Coleridge's development and reads his writing within the framework of a constantly shifting political and social landscape. Drawing (...) on the ideology, rhetoric, and institutional theory at the turn of the late British Enlightenment, Edwards unearths the fundamental continuities in Coleridge's writing during the revolutionary period of 1794 to 1834, paying particular attention to the rhetoric of Coleridge's pamphlet and miscellaneous writings, the journalism of the Napoleonic years, his philosophical and ultimately political treatises within the contexts of his notebooks and letters, and his readings and intellectual friendships. What emerges is a clearer understanding of Coleridge's political philosophy and his contributions to the origins and ideology of British Liberalism. Coleridge's interest in history, nature, and law as inherently interconnected projects producing an ideal or scientific reading of society reveals a developed progressive social and cultural state theory anchored in individual conscience, moral autonomy, and a civic and participatory human agency. If the Statesman could understand and finally master this scientific view of the world, he would be able not only to adjust political and social institutions to comprehend the historical contingencies of the moment but to see through the problem of the moment to the dynamic of change itself. (shrink)

Is it ethical to treat a death row inmate only to stabilize him or her for eventual execution? What happens when a military provider receives highly sensitive intelligence from a client? How can clinicians refuse costly gifts from clients without damaging the therapeutic relationship? Should a therapist disclose a client's suicidal intent to the authorities? In Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice, these and other real-life scenarios constitute a comprehensive and definitive ethics casebook for mental health professionals. (...) Inspired by the many difficult situations they themselves have faced, an eminent group of accomplished mental health clinicians provide first-hand accounts of ethical problems that defy boilerplate solutions. Each chapter begins with a compelling and ethically complex case followed by an illustrative yet succinct analysis of the key ethical issues present and a personal reflection on the case itself, along with the process of ethical reasoning used to arrive at a final decision. Every case concludes with key recommendations for promoting ethical practice within an often challenging work setting. Highlighting the human aspect of ethics in mental health practice through the use of mesmerizing narratives while also provoking the reader to reflect upon what is the "right" thing to do, Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice offers trainees and seasoned professionals alike invaluable informative models for dealing with ethical dilemmas, as well as the inspiration to confront seemingly insurmountable clinical problems. (shrink)

The genetic modification of pigs as a source of transplantable organs is one of several possible solutions to the chronic organ shortage. This paper describes existing ethical tensions in xenotransplantation (XTx) that argue against pursuing it. Recommendations for lifelong infectious disease surveillance and notification of close contacts of recipients are in tension with the rights of human research subjects. Parental/guardian consent for pediatric xenograft recipients is in tension with a child’s right to an open future. Individual consent to transplant is (...) in tension with public health threats that include zoonotic diseases. XTx amplifies concerns about justice in organ transplantation and could exacerbate existing inequities. The prevention of infectious disease in source animals is in tension with the best practices of animal care and animal welfare, requiring isolation, ethologically inappropriate housing, and invasive reproductive procedures that would severely impact the well-being of intelligent social creatures like pigs. (shrink)

Roughly speaking, classical statistical physics is the branch of theoretical physics that aims to account for the thermal behaviour of macroscopic bodies in terms of a classical mechanical model of their microscopic constituents, with the help of probabilistic assumptions. In the last century and a half, a fair number of approaches have been developed to meet this aim. This study of their foundations assesses their coherence and analyzes the motivations for their basic assumptions, and the interpretations of their central concepts. (...) The most outstanding foundational problems are the explanation of time-asymmetry in thermal behaviour, the relative autonomy of thermal phenomena from their microscopic underpinning, and the meaning of probability. A more or less historic survey is given of the work of Maxwell, Boltzmann and Gibbs in statistical physics, and the problems and objections to which their work gave rise. Next, we review some modern approaches to (i) equilibrium statistical mechanics, such as ergodic theory and the theory of the thermodynamic limit; and to (ii) non-equilibrium statistical mechanics as provided by Lanford's work on the Boltzmann equation, the so-called Bogolyubov-Born-Green-Kirkwood-Yvon approach, and stochastic approaches such as `coarse-graining' and the `open systems' approach. In all cases, we focus on the subtle interplay between probabilistic assumptions, dynamical assumptions, initial conditions and other ingredients used in these approaches. (shrink)

Examines the relationship between making objects and knowing nature in Europe from the mid-15th to mid-19th centuries.

Antimicrobial resistance (AMR) is an urgent, global threat to public health. The development and implementation of effective measures to address AMR is vitally important but presents important ethical questions. This is a policy area requiring further sustained attention to ensure that policies proposed in National Action Plans on AMR are ethically acceptable and preferable to alternatives that might be fairer or more effective, for instance. By ethically analysing case studies of coercive actions to address AMR across countries, we can better (...) inform policy in a context-specific manner. In this article, I consider an example of coercive antimicrobial stewardship policy in Canada, namely restrictions on livestock farmers' access to certain antibiotics for animal use without a vet's prescription. I introduce and analyse two ethical arguments that might plausibly justify coercive action in this case: the harm principle and a duty of collective easy rescue. In addition, I consider the factors that might generally limit the application of those ethical concepts, such as challenges in establishing causation or evidencing the scale of the harm to be averted. I also consider specifics of the Canadian context in contrast to the UK and Botswana as example settings, to demonstrate how context-specific factors might mean a coercive policy that is ethically justified in one country is not so in another. (shrink)

A good number of people currently thinking and writing about reasons identify a reason as a consideration that counts in favor of an action or attitude.1 I will argue that using this as our fundamental account of what a reason is generates a fairly deep and recalcitrant ambiguity; this account fails to distinguish between two quite different sets of considerations that count in favor of certain attitudes, only one of which are the “proper” or “appropriate” kind of reason for them. (...) This ambiguity has been the topic of recent discussion, under the head “the wrong kind of reasons problem.”2 I will suggest that confusion about “the wrong kind of reason” will be dispelled by changing our account of what a reason is. While I agree both that reasons are considerations and that certain.. (shrink)

Many assume that we can be responsible only what is voluntary. This leads to puzzlement about our responsibility for our beliefs, since beliefs seem not to be voluntary. I argue against the initial assumption, presenting an account of responsibility and of voluntariness according to which, not only is voluntariness not required for responsibility, but the feature which renders an attitude a fundamental object of responsibility (that the attitude embodies one’s take on the world and one’s place in it) also guarantees (...) that it could not be voluntary. It turns out, then, that, for failing to be voluntary, beliefs are a central example of the sort of thing for which we are most fundamentally responsible. (shrink)

I here press an often overlooked question: Why does the fairness of a sanction require an adequate opportunity to avoid it? By pressing this question, I believe I have come to better understand something that has long puzzled me, namely, what philosophers (and others) might have in mind when they talk about “true moral responsibility,” or the “condemnatory force” of moral blame, or perhaps even “basic desert.” In presenting this understanding of “condemnation” or of “basic desert,” I am presenting an (...) idea that I do not, myself, endorse—one to which I am, myself, opposed. I present and defend it, hoping that, if what I say accurately captures what people have in mind, it will also show how condemnation or desert, in this sense, can be left behind. (shrink)

I consider Paulina Sliwa’s fruitful account of “taking responsibility” as “owning the normative footprint” of a wrong. Unlike most, Sliwa approaches the topic without concern for what I call “responsible agency.” I raise the possibility that this is virtue. I then question whether the “footprint” is simply given with the wrong or whether it must instead be made determinate through subsequent interaction, perhaps through conversation. I next distinguish two different kinds of conversation: a cooperative negotiation and a low-level power struggle. (...) The later is often part of what I call “the blame game.” I suggest that the “blame” of the blame game is the blame of ordinary life, to be distinguished from the technical term in the current philosophical literature, and I give an account of it. I note that one may sometimes opt out of the blame game simply by owning a generous interpretation of the footprint, something Sliwa discusses. I note that doing so is sometimes, but not always, virtuous. (shrink)