Recent discussions of the doctrine of double effect have contained improved versions of the doctrine not subject to some of the difficulties of earlier versions. There is no longer one doctrine of double effect. This essay evaluates four versions of the doctrine: two formulations of the traditional Catholic doctrine, Joseph Boyle's revision of that doctrine, and Warren Quinn's version of the doctrine. I conclude that all of these versions are flawed. Keywords: double effect, intention, Joseph Boyle, medical ethics, Warren Quinn (...) CiteULike Connotea Del.icio.us What's this? (shrink)

The contribution of food and diet to health is much disputed in the background culture in the US. Many commercial or ideological advocates make claims, sometimes with health as a primary goal, but often accompanied by commercial or ideological interests. These compete culturally with authoritative recommendations made by publicly funded groups. For public policy concerning diet and health to be legitimate, not only should it not be inconsistent with the scientific evidence, but also it should not be inconsistent with the (...) political environment. Healthy Eating Policy and Political Philosophy (HEPPP), by Barnhill and Bonotti (2022), addresses how policy in this complex area might be justified. In the present essay I highlight some important strengths of their work and also make some points about how it might be clarified or enlarged in scope. The great strength of HEPPP is that it emphasizes the role of a political philosophy in evaluating the legitimacy of public policy. They presume a well-off liberal democratic state, and specifically they draw on Rawls’ political liberalism, as developed in Political Liberalism (PL). One of several interlocking technical concepts developed in this book, public reason speaks to the boundaries of what should be acceptable in public deliberation about constitutional essentials and basic justice. HEPPP explores the application of an extension of public reason to the justification of policies related to “healthy eating.“ Public reason has two components, both of which pertain to a common understanding among citizens: (1) a common understanding of the principles and ideals that are the foundation of the political society, and (2) a common understanding of the standards that govern reason and evidence, including common sense. HEPPP argues that even though for diet and health the complexity of the scientific evidence goes far beyond anything like common sense for a typical citizen, the technical idea of “accessibility” of the scientific evidence justifies reliance on it within the concept of public reason. I question this accessibility argument about scientific evidence and public reason because the nature of the population-level epidemiological evidence about diet and health is that it often includes judgments that are based on arguable interpretations, framing incidence in terms of risk and prevention; thus the issue is more than one of potential accessibility of scientific evidence. Nevertheless, evaluation and consideration of the scientific evidence is of obvious practical importance in policy deliberation concerning policy related to what Rawls call “ordinary legislation.“ Even though public reason applied to healthy eating policy may not be as pertinent as it is for constitutional essentials and basic justice, and even though it is unlikely to result in a “correct outcome,“ invoking reasons based on political values and principles held in common has important value even in these deliberations about more ordinary questions. That value applies not to the specifics of the particular issue, but to the larger context for the particular policy being deliberated, as a potential contribution to an overlapping consensus that is stable for the right reasons. If this vision of political liberalism were achieved, then contentious debate about health eating policy and its scientific basis could occur within that context and be resolved within the basic political structure. Because public health and political liberalism have a common concern for a good at the population level, they have an underlying affinity. Healthy eating policies could be evaluated in two not-unrelated ways: based on their instrumental contribution to the good of the public body of citizens as population-level health, and according to their stabilizing contribution to an overlapping consensus among citizens. In this latter way a policy would contribute to a conditional integral common good a la Sulmasy, one that has the prospect of conditioning a political system, and by doing so create the conditions of the possibility of a constitutive integral common good that is constituted on the right reasons for allegiance to an overlapping consensus. To conclude with reference to HEPPP, public reason may play an important function with respect to the political common good, even as debates about the weight and meaning of scientific evidence from epidemiology play out in deliberation of ordinary legislation concerning healthy eating. (shrink)

Whatever scholarly and intellectual reasons are given for the regression to the Pre-Socratics in contemporary philosophy, the regression itself is part of philosophy's effort to recover vitality and imagination spent withstanding onslaughts that sought to dispense with it, or at least reduce it to an accessory role in the service of science. Where philosophy was once handmaiden to theology, it is now pressed into the service of natural science, as a clarifier of concepts, a purifier of perception, and, in general, (...) a jack-of-all-trades, but one trustworthy only with petty tasks, viz., logical not experimental. (shrink)

Retrieval efficiencies of paper-based references in journals and other serials containing 10 scientific names of fossil amphibians were determined for seven major search engines. Retrievals were compared to the number of references obtained covering the period 1895—2006 by a Comprehensive Search. The latter was primarily a traditional library-based search which involved intensive work from 2002—2007. Only a few references originally obtained by search engines were included. Retrieval efficiencies were calculated by comparison to the number obtained through the Comprehensive Search (assumed (...) to be 100%). All percent retrievals were quite low (mean = 11.3%, range = 4.0—22.9%). For all seven search engines combined (duplicate references excluded), the percent retrieval was only 40.7%. There was also retrieval inefficiency and bias of the search engines in: sampling over time, the top five journals containing the most references, the top five most prolific authors, and non-English references. Consequently, all seven search engines were unsatisfactory for retrieval of references for our scientific research. (shrink)

Ethical objections to the use of mass media and the internet help explain why the Plain People of North America avoid new communication technologies. Each subgroup of plain folk-including Amish, Mennonites, and Brethren adopt differing amounts of new technology, and the use variesfrom region to region or even,from community to community. Old media such as the radio and telephone and newer media such as television and the internet introduce diferent and unwelcome moral values into plain communities, although the telephone is (...) often a borderline case. The ethical systems of the Old Order groups provide a unique and pragmatic critique of the widespread acceptance of mass media and the internet in the larger social world. (shrink)

The term natural is effective in the marketing of a wide variety of foods. This ambiguous term carries important meaning in Western culture. To challenge an uncritical understanding of natural with respect to food and to explore the ambiguity of the term, the development of Western ideas of nature is first discussed. Personification and hypostasization of nature are given special emphasis. Leo Marx’s idea of the pastoral design in literature is then used to explore the meaning of natural as applied (...) to food, emphasizing Marx’s distinction between a sentimental and a complex pastoral. The latter is applied to natural as a means of collapsing a dichotomy of man and nature to the idea of second nature. From this perspective an understanding of the industrialization of the food system and the importance of local and organic food are considered. The extent to which processed foods might properly be considered natural is raised and discussed for several common foods. Although marketing of natural foods might make us think that we consume nature, I suggest that what is consumed is more appropriately second nature. I suggest that in order to maintain a critical perspective about one’s relationship to the natural world, everyone should make an attempt to experience the complex pastoral with respect to at least something that is consumed as food. When nature is understood as second nature in the context of a complex pastoral, the question of whether a food or ingredient is to be considered natural is replaced by deliberative thought based on our best knowledge and judgment, and the result will be less constrained by ideology. (shrink)

Publicity for (and laterly increased economic stringency which makes more likely), failures of care in the NHS engender concern for care quality while its assurance remains the subject of a fragmented and unhelpful literature. A selective attempt is made to examine some underlying principles by posing and answering three questions. What is the quality of care? What basic principles must be followed in defining `standards'? How then may quality be assured? Any definition of care must be multi-faceted and in common (...) use pervaded with the patients' pre-occupation with a search for cures. Nevertheless, it is argued that there are gains in restricting the technical use of the term `care' to those systematic processes of health services and their culture which impinge on the personal experience of patients and which fashion their response. In contemporary society care ought to be designed to restore and enhance the independence, dignity and choice of the patient. Although there is a contrary tendency to abandon problems of care to the professionals, standards for care should be judged ultimately not from the specialised professional but from the viewpoint of lay people whose behaviour in the outside world fashions those norms by which independence, dignity and choice are judged. A number of difficulties in identifying and securing improvements in care are discussed. In particular, it is argued that such is the interdependence of the style of management of an institution and the style of care it provides that enforcement of high quality care is likley to be a contradiction in terms. Only trained and sensitive staff can act intuitively and pre-emptively to prevent even incipient deterioration in care. They cannot carefully foster at all times the independence and dignity of their patients unless they are treated in a similar way as professional employees. As an initial step in improving the quality of care a simple start is urged upon implementing an inventory of checks. These are designed to establish the identification and operation of health care policies and practices which give appropriate recognition to the characteristics of care that patients and public expect, coming as they do from a lay rather than professional world. The article concludes with an appropriate inventory of questions to be put to professionals by those laymen who are increasingly imported into health care management through community representation (in CHCs) and staff participation (in joint consultation) and whose interest and concern should be harnessed appropriately. (shrink)