The philosophy of patient-centred care has become widely embraced but its implementation is dependent on interrelated factors. A factor that has received limited attention is the role of policy tools. In Ontario, one method government can use to promote healthcare priorities is through health regulatory colleges, which set the standard of practice for health professionals. The degree to which government policy in support of patient-centered care has influenced the direction provided by health regulatory colleges to their members, and ultimately impacted (...) actual patient care, remains unclear. This study investigates the extent to which Ontario’s health regulatory colleges have provided explicit written guidance to members related to the importance of patient-centred care. It also explores applied and theoretical explanations that may further our understanding of why patient-centred care has not been more fully embraced. Findings reveal that guidance provided by Ontario’s health regulatory colleges varies widely. Institutional barriers and the choice of policy tools for disseminating government preferences may hinder full implementation of the principles of patient-centred care. More fully understanding the role health regulatory colleges’ play in facilitating the implementation of health policy will contribute positively to dialogue and to efforts to achieve positive health system reforms. (shrink)

The philosophy of patient-centred care has become widely embraced but its implementation is dependent on interrelated factors. A factor that has received limited attention is the role of policy tools. In Ontario, one method government can use to promote healthcare priorities is through health regulatory colleges, which set the standard of practice for health professionals. The degree to which government policy in support of patient-centered care has influenced the direction provided by health regulatory colleges to their members, and ultimately impacted (...) actual patient care, remains unclear. This study investigates the extent to which Ontario’s health regulatory colleges have provided explicit written guidance to members related to the importance of patient-centred care. It also explores applied and theoretical explanations that may further our understanding of why patient-centred care has not been more fully embraced. Findings reveal that guidance provided by Ontario’s health regulatory colleges varies widely. Institutional barriers and the choice of policy tools for disseminating government preferences may hinder full implementation of the principles of patient-centred care. More fully understanding the role health regulatory colleges’ play in facilitating the implementation of health policy will contribute positively to dialogue and to efforts to achieve positive health system reforms. (shrink)

Many medical services lack robust evidence of effectiveness and may therefore be considered “unnecessary” care. Proactively withdrawing resources from, or de-funding, such services and redirecting the savings to services that have proven effectiveness would enhance overall health system performance. Despite this, governments have been reluctant to discontinue funding of services once funding is in place. The focus of this study is to understand how the framing of an issue or problem influences government decision-making related to de-funding of medical services. To (...) achieve this, a framework describing how problem frames, or explanatory naratives, influence government policy decisions was developed and applied to actual cases. The two cases selected were the Ontario government’s decisions to de-fund the drug Oxycontin and blood glucose test strips used by patients with diabetes. A qualitative content analysis of public discourse surrounding these two resource withdrawal examples was conducted and described using the framework. In the framework, government decision-making is a partial reflection of the visibility of the policy issue and complexity of the causal story told within a problem frame. By applying this framework and considering these two key characteristics of problem frames, we can better understand, and possibly predict, the shape and timing of government policy decisions to withdraw resources from medical services. (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

The integrative memory model combines five core memory systems with an attributional system. We agree with Bastin et al. that this melding is the most novel aspect of the model. But we await further evidence that the model's substantial complexity informs our understanding of false memories or of the development of recollection and familiarity.

In the Deese-Roediger/McDermott paradigm, distinctive encoding of list items typically reduces false recognition of critical lures relative to a read-only control. This reduction can be due to enhanced item-specific processing, reduced relational processing, and/or increased test-based monitoring. However, it is unclear whether distinctive encoding reduces false recognition in a selective or global manner. To examine this question, participants studied DRM lists using a distinctive item-specific anagram generation task and then completed a recognition test which included both DRM critical lures and (...) either strongly related lures or weakly related lures. Compared to a read-control group, the generate groups showed increased correct recognition and decreased false recognition of all lure types. We then estimated the separate contributions of encoding and retrieval processes using signal-detection indices. Generation improved correct recognition by both increasing encoding of memory information for list words and by increasing memory monitoring at test. Generation reduced false recognition by reducing the encoding of memory information and by increasing memory monitoring at test. The reduction in false recognition was equivalent for critical lures and related lures, indicating that generation globally reduces the encoding of related non-presented items at study, while globally increasing list-theme-based monitoring at test. (shrink)

The binary remember/know task requires participants to dichotomize their subjective recognition experiences into those with recollection and those only with familiarity. Many variables have produced dissociative effects on remember/know judgments. In contrast, having participants make independent recollection/familiarity ratings has consistently produced parallel effects, suggesting the dissociations may be artifacts of using binary judgments. Bodner and Lindsay reported a test-list context effect with binary judgments: Increased remembering but decreased knowing for a set of critical items tested with a set of less-memorable (...) items. Here we report a parallel effect of test-list context on recollection and familiarity ratings, induced by a shift in response bias. We argue that independent ratings are preferable to binary judgments because they allow participants to directly report the co-occurrence of recollection and familiarity for each item. Implications for the measurement of self-reported recognition experiences, and for accounts of recognition memory, are discussed. (shrink)

A crisis continues to brew within the pharmaceutical research and development (R&D) enterprise: productivity continues declining as costs rise, despite ongoing, often dramatic scientific and technical advances. To reverse this trend, we offer various suggestions for both the expansion and broader adoption of modeling and simulation (M&S) methods. We suggest strategies and scenarios intended to enable new M&S use cases that directly engage R&D knowledge generation and build actionable mechanistic insight, thereby opening the door to enhanced productivity. What M&S requirements (...) must be satisfied to access and open the door, and begin reversing the productivity decline? Can current methods and tools fulfill the requirements, or are new methods necessary? We draw on the relevant, recent literature to provide and explore answers. In so doing, we identify essential, key roles for agent-based and other methods. We assemble a list of requirements necessary for M&S to meet the diverse needs distilled from a collection of research, review, and opinion articles. We argue that to realize its full potential, M&S should be actualized within a larger information technology framework—a dynamic knowledge repository—wherein models of various types execute, evolve, and increase in accuracy over time. We offer some details of the issues that must be addressed for such a repository to accrue the capabilities needed to reverse the productivity decline. (shrink)

For forty years, Harvey Mansfield has been worth reading. Whether plumbing the depths of MachiavelliOs Discourses or explaining what was at stake in Bill ClintonOs impeachment, MansfieldOs work in political philosophy and political science has set the standard. In Educating the Prince, twenty-one of his students, themselves distinguished scholars, try to live up to that standard. Their essays offer penetrating analyses of Machiavellianism, liberalism, and America., all of them informed by MansfieldOs own work. The volume also includes a bibliography of (...) MansfieldOs writings. (shrink)

Global security cannot be achieved until people view the world as a global community. Until such time, differences will continue to be perceived as threatening. These perceived “threats” are the primary threat to global security. This volume proposes methods for minimizing the “us versus them” mentality so that we can build a sense of global community.

Public health preparedness must use a comprehensive approach that includes both communities and public health systems. There are three basic questions that should be asked when evaluating public health preparedness in communities of color: 1) Is the community basically healthy?; 2) Does the community have access, to necessary information, resources and services?; and 3) Are the information, resources and services available and provided to the community in a nondiscriminatory manner?Racial-based health disparities is a well documented fact for many communities of (...) color. Individuals from these communities tend to have more morbidity and higher mortality. This health disparity is race based and not just a function of social class. Similarly, access to basic goods and health care is racialized and class based. (shrink)

Public health preparedness must use a comprehensive approach that includes both communities and public health systems. There are three basic questions that should be asked when evaluating public health preparedness in communities of color: 1) Is the community basically healthy?; 2) Does the community have access, to necessary information, resources and services?; and 3) Are the information, resources and services available and provided to the community in a nondiscriminatory manner?Racial-based health disparities is a well documented fact for many communities of (...) color. Individuals from these communities tend to have more morbidity and higher mortality. This health disparity is race based and not just a function of social class. Similarly, access to basic goods and health care is racialized and class based. (shrink)

The various efforts to put the idea of humanity on a secure ethical, political, and social base have not succeeded. The various post-humanist and transhumanist programs are inadequate. Our deep-seated suspicion of our deepest selves and motives is understandable in light of the barbarity of the twentieth century, but humanism is not to blame. The thought of Ernst Cassirer holds a framework for a new humanism, once it is rid of certain colonialist, triumphalist, and Eurocentric ideas that distorted Cassirer’s understanding (...) of the European role in creating the problems of civilization, especially its mistake of thinking that science was a progressive symbolic form of culture. I set out the basis of a new humanism based upon not the problem of knowledge, but the problem of genuine self-situating socialty, a personalist point of view. (shrink)

American health policy today faces dual problems of too little health coverage at too high a cost. The mix of public and private financing leaves about one seventh of the population without any insurance coverage. At the same time, the coverage Americans do have costs an ever-larger share of our country's productive capacity. This "paradox of excess and deprivation" results from the incremental approach the U.S. has taken to promoting incompatible policy goals of increasing health insurance coverage and medical quality (...) while trying to control costs, without squarely confronting tradeoffs. This essay examines the record of incremental developments and draws lessons for current efforts at reform. (shrink)

American health policy today faces dual problems of too little coverage at too high a cost. The mix of private and public financing leaves about one seventh of the population without any insurance coverage. At the same time, the coverage Americans do have costs an ever-larger share of our country’s productive capacity. The U.S. pays well above what other countries pay and what many people, health plans, businesses, and governments want to pay. This “paradox of excess and deprivation” results from (...) the incremental approach the U.S. has taken to promoting incompatible policy goals of increasing health insurance coverage and medical quality while trying to control costs, without squarely confronting tradeoffs. This essay examines the record of incremental developments and draws lessons for current efforts at reform. (shrink)

Preview: Bergson noted that the cinematographic image does not really move. It is, then as now, a series of still photographs. The real motion in such images is produced by machinery, which imparts a kinesis, an energy of movement, to the succession of fixed images. Our perception then endows such images with their “life,” insofar as they can be said to possess life. It is an illusion, it is “virtual” both as space and time. The real duration, as generated by (...) the machinery or as lived by the perceiver is part of a broader system of images that includes those still photographs and their succession. Images of images of images, by the time they are processed by our bodies and appear to our mind’s eye as inhibited acts we have not enacted. (shrink)

The edited collection Rorty and Beyond assesses and moves beyond Rorty’s legacy, bringing together leading international philosophers. The collection covers diverse territory, from his views about what we may hope for to his personal character, and everything in between.

This paper aims to consider Peirce and Eco’s approach to signs and semiotics in order to assess their relation to Peirce’s mature pragmatism. Both thinkers attempted to set out a truly general theory of signs, and ran into difficulties on similar points. I show that the responses of Peirce and Eco to the difficulties that arose in seeking a truly general theory of signs were quite different. And yet, the differences are not so deep as to prevent us from thinking (...) of both Peirce and Eco as pragmatists, and perhaps of a similar stripe. (shrink)

At the centenary of Frank H. Knight’s Risk, Uncertainty, and Profit, we explore the continuing relevance of Knightian uncertainty to the theory and practice of entrepreneurship. There are three challenges facing such assessment. First, RUP is complex and difficult to interpret. The key but neglected element of RUP is that Knight’s account is not solely about risk and uncertainty as states of nature, but about how an agent’s beliefs about uncertain outcomes and confidence in those beliefs guide their choices. Second, (...) RUP is Knight’s only effort in this area. His subsequent career led elsewhere, so he did not engage with subsequent interpretations of this work. Third, much of the current literature emphasizes that decisions must be different under the two states of nature with a consequent misunderstanding of entrepreneurial agency. This paper addresses each challenge in sequence. First, we explicate Knight’s approach and explain why that approach is murky. Second, as a complement to Knight’s interpretation, we examine Frank P. Ramsey’s approach to subjective probabilities to help clarify Knight’s murky approach. What links Knight and Ramsey is a shared pragmatism about entrepreneurial agency under uncertainty that depends upon the beliefs about, and confidence in, their judgments of possible outcomes. This Knight-Ramsey approach does not require actor’s behaviors to be determined by the class of uncertain environment they face. We focus on the response by the entrepreneur to the existence of uncertainty in all its forms. We argue that this reductive account provides a foundation to examine common problems in management, including managerial hubris, the interaction between entrepreneurs and venture capitalists, and the need for experimentation in advance of new product and venture launches. Third, we critique current literature that favors epistemic purism about the ontology of risk and uncertainty and ignores Knight-Ramsey pragmatism in meeting uncertainty, such as using formal and informal institutions for uncertainty mitigation. Our account locates Frank Knight’s subtleties in entrepreneurial behavior firmly in the literature on entrepreneurial agency a century later. (shrink)

In 1922 Charles Hartshorne, then an aspiring young philosopher, wrote to Edgar Sheffield Brightman, a preeminent philosopher of religion for twenty-three subsequent years and, remarkably, almost every letter was preserved. In their introductory essays, editors Randall Auxier and Mark Davies place the unusually rich and intensive correspondence in its intellectual context and address the relationship between personalism and process philosophy/theology in metaphysics, epistemology, ethics, and social philosophy.

Usually philosophers worry about the existence of mind, or consciousness, or persons, or other difficult-to-explain phenomena. Having posited matter or nature, or fields, they wonder where can person or consciousness originate? This kind of thinking is backward. Only persons ask such questions. Persons exist. I turn the tables on the traditional problem of person by asking whether anything impersonal really exists. I argue that the impersonal almost exists, using the theory of feeling of Max Scheler and supplementing it with insights (...) from Alfred North Whitehead and Josiah Royce. Even though feeling almost succeeds in divesting itself of the pre-supposed act of the person, but its concrete actuality blocks such complete self-abstraction. (shrink)

In the first of two essays on the ontological ground of otherness, and its phenomenological availability, we argue that what we call the “occasion” within the encounter of others are sources as well as re-sources for disclosing the results of a construction and concealment of a secret identity, one we keep from ourselves even though we have created it. Yet, individuals are capable of returning their encounters to the well of sensus communis, and that sensus communis is as natural as (...) it is cultural. Human beings are not compelled to interpret strangeness as threat, even if we are culturally compelled to interpret strangeness itself. Narrative lives in our sensus communis, and it is open, revisable, even danceable. Immediacy is person, the person that is community, and it is sublime, is both liked and disliked. (shrink)

George Holmes Howison’s 1895 essay entitled “The Limits of Evolution,” argued that there are four things evolutionary theory does not explain. In examining whether 11 decades have made a difference in these four, I argue that the arrogance of scientists over the past century in refusing to distinguish between full explanations and explanatory hypotheses is in some ways responsible for the fundamentalist backlash against evolutionary science. A scientific community that is honest and forthcoming about its limitations is to be sought. (...) The best response to Intelligent Design, Creation Science, and other current trends in pseudoscience is to be very clear about the limits of evolutionary theory and the scope of scientific explanation. (shrink)