Older racialized minorities were particularly vulnerable during the last pandemic due to the interlocking influences of structural racism and ageism, which are often disregarded in public health planning. This oversight not only compromises the social justice and health equity goals of public health efforts but it also calls for a more inclusive approach that systematically addresses these deficiencies at every stage of a public health response. To achieve this, we propose Age- and Race-conscious Interventions done Equitably (ARIE), a novel analytical (...) framework grounded in critical race theory and critical gerontology. ARIE is based on a four-step approach, which aligns with different stages of public health interventions. It will help ensure that structural discrimination influencing access to healthcare resources during a biological event is not ignored, and that public health authorities work actively toward identifying and addressing ageist and racist biases in their response plans and interventions. (shrink)

Digital Pills are an innovative drug-device technology that permits to combine traditional medications with a monitoring system that automatically records data about medication adherence as well as patients’ physiological data. Although DP are a promising innovation in the field of digital medicine, their use has also raised a number of ethical concerns. These ethical concerns, however, have been expressed principally from a theoretical perspective, whereas an ethical analysis with a more empirically oriented approach is lacking. There is also a lack (...) of clarity about the empirical evidence available concerning the application of this innovative digital medicine. To map the studies where DP have been tested on patients and discuss the ethically relevant issues evident therein, we performed a scoping review of the empirical literature concerning DP. Our search allowed us to identify 18 papers reporting on studies where DP were tested on patients. These included studies with different designs and involving patients with a variety of conditions. In the empirical literature, a number of issues with ethical relevance were evident. At the patient level, the ethical issues include users’ interaction with DP, personal sphere, health-related risks and patients’ benefits. At the provider level, ethically relevant issues touch upon the doctor-patient relationship and the question of data access. At the societal level, they concern the benefits to society, the quality of evidence and the dichotomy device-medicine. We conclude that evidence concerning DP is not robust and that more research should be performed and study results made available to evaluate this digital medicine. Moreover, our analysis of the ethically relevant aspects within empirical literature underscores that there are concrete and specific open questions that should be tackled in the ethical discussion about this new technological solution. (shrink)

Precision medicine is an emerging approach to individualized care. It aims to help physicians better comprehend and predict the needs of their patients while effectively adopting in a timely manner the most suitable treatment by promoting the sharing of health data and the implementation of learning healthcare systems. Alongside its promises, PM also entails the risk of exacerbating healthcare inequalities, in particular between ethnoracial groups. One often-neglected underlying reason why this might happen is the impact of structural racism on PM (...) initiatives. Raising awareness as to how structural racism can influence PM initiatives is paramount to avoid that PM ends up reproducing the pre-existing health inequalities between different ethnoracial groups and contributing to the loss of trust in healthcare by minority groups. We analyse three nodes of a process flow where structural racism can affect PM’s implementation. These are: the collection of biased health data during the initial encounter of minority groups with the healthcare system and researchers, the integration of biased health data for minority groups in PM initiatives and the influence of structural racism on the deliverables of PM initiatives for minority groups. We underscore that underappreciation of structural racism by stakeholders involved in the PM ecosystem can be at odds with the ambition of ensuring social and racial justice. Potential specific actions related to the analysed nodes are then formulated to help ensure that PM truly adheres to the goal of leaving no one behind, as endorsed by member states of the United Nations for the 2030 Agenda for Sustainable Development. Structural racism has been entrenched in our societies for centuries and it would be naïve to believe that its impacts will not spill over in the era of PM. PM initiatives need to pay special attention to the discriminatory and harmful impacts that structural racism could have on minority groups involved in their respective projects. It is only by acknowledging and discussing the existence of implicit racial biases and trust issues in healthcare and research domains that proper interventions to remedy them can be implemented. (shrink)

This volume is the first collection of original essays on the related issues of gender and feminism approached phenomenologically.

Physicians are shaped by sociological and philosophical factors that often differ from those of their patients. This is of particular concern in pluralistic societies when navigating ethical disagreements because physicians often misunderstand or even dismiss patient perspectives as being irrational. This paper examines these factors and why many physicians approach ethics as they do while elucidating various patient perspectives and demonstrating how they make sense when considered from a different cultural worldview. Many physicians are trained in contexts that are WEIRD: (...) Western, educated, industrialized, rich, and democratic. These sociological characteristics tend to go hand in hand with the trio of individualism, secularism, and existentialism. These then shape an approach to ethics that focuses on the individual patient, makes no reference to the divine, and focuses on a patient’s personal desires. This contrasts significantly with many patients who are collectivistic or religious, and then make rational decisions based on other values. The social fact of pluralism implores physicians to temper confidence in their own cultures while considering others to promote mutual understanding and improved care. This paper concludes with a discussion of how bridges can be built across cultures without sliding into relativism, beginning with recognizing and communicating our shared moral intuitions. (shrink)

1) Introduction. 2) The key libertarian insight into property and orthodox libertarianism’s philosophical confusion. 3) Clearer distinctions for applying to what follows: abstract liberty; practical liberty; moral defences; and critical rationalism. 4) The two dominant (‘Lockean’ and ‘Hobbesian’) conceptions of interpersonal liberty. 5) A general account of libertarianism as a subset of classical liberalism and defended from a narrower view. 6) Two abstract (non-propertarian, non-normative) theories of interpersonal liberty developed and defended: ‘the absence of interpersonal initiated imposed constraints on want-satisfaction’, (...) abbreviated to ‘no initiated imposed costs’; and ‘no imposed costs’. 7) Practical implications for both main abstract conceptions of liberty derived and compared. 8) How this positive analysis relates to morals. 9) Concluding conjectures: the main abstract theory of liberty captures the relevant interpersonal conception; the new paradigm of libertarianism solves the old one’s problems. (shrink)

Epistemology is often a problem for libertarianism. Many libertarian texts assume that they need to do more than explain and defend the libertarian conjecture. Instead, they try to offer epistemological support for it (whether empirically or morally); which falsificationism and, more broadly, critical rationalism explains is not possible. Moreover, they often mistake this attempt at support for an explanation of libertarianism (which ought to include an abstract theory of liberty and how it relates to liberty in practice). Therefore, when a (...) criticism of falsificationism appears on a libertarian website it seems useful to reply to it (even though no discussion of libertarianism itself is involved). (shrink)

Physicians are shaped by sociological and philosophical factors that often differ from those of their patients. This is of particular concern in pluralistic societies when navigating ethical disagreements because physicians often misunderstand or even dismiss patient perspectives as being irrational. This paper examines these factors and why many physicians approach ethics as they do while elucidating various patient perspectives and demonstrating how they make sense when considered from a different cultural worldview. Many physicians are trained in contexts that are WEIRD: (...) Western, educated, industrialized, rich, and democratic. These sociological characteristics tend to go hand in hand with the trio of individualism, secularism, and existentialism. These then shape an approach to ethics that focuses on the individual patient, makes no reference to the divine, and focuses on a patient’s personal desires. This contrasts significantly with many patients who are collectivistic or religious, and then make rational decisions based on other values. The social fact of pluralism implores physicians to temper confidence in their own cultures while considering others to promote mutual understanding and improved care. This paper concludes with a discussion of how bridges can be built across cultures without sliding into relativism, beginning with recognizing and communicating our shared moral intuitions. (shrink)

Peter Singer’s famous and influential article is criticised in three main ways that can be considered libertarian, although many non-libertarians could also accept them: 1) the relevant moral principle is more plausibly about upholding an implicit contract rather than globalising a moral intuition that had local evolutionary origins; 2) its principle of the immorality of not stopping bad things is paradoxical, as it overlooks the converse aspect that would be the positive morality of not starting bad things and also thereby (...) conceptually eliminates innocence; and 3) free markets—especially international free trade—have been cogently explained to be the real solution to the global “major evils” of “poverty” and “pollution”, while “overpopulation” does not exist in free-market frameworks; hence charity is a relatively minor alleviant to the problem of insufficiently free markets. There are also various subsidiary arguments throughout. (shrink)

Until quite recently, it has appeared that eleutheric-conjectural libertarianism (ECL) could not avoid some degree of, very broad, interpersonal utility comparisons (IUCs). And this has been objected to by some of its libertarian critics, notably economists and propertarians. Indeed, this aspect does make the theory less compatible with economics than the rest of the theory and it is thereby a significant problem. This is because one of the main problems that ECL is intended to solve is how an abstract theory (...) of liberty can be compatible with the pro-free-market conclusions of many economists. Being more compatible with economics should make ECL theory more comprehensive, comprehensible, and cogent. (shrink)

To explain the correct libertarian approach to immigration, a thought-experiment posits a minimal-state libertarian UK and then the introduction of several relevant anti-libertarian policies with their increasingly disastrous effects. It is argued that the reverse of these imagined policies, as far as is politically possible, must be the correct way forward. This framing is intended to counter the tendency for many articles to misapply libertarian principles to the current messy situation on the mistaken assumption that a state need only stop (...) interfering without rectifying or adjusting for its previous interferences. The relevant parts of various open-border texts are then criticised in light of this and for other errors, in particular for overlooking the likely huge scale of immigration as indicated by Gallup surveys. Additional criticisms are addressed in footnotes throughout. The conclusion outlines three broad options on immigration and suggests that directionally-libertarian policies are both more libertarian and practical than having states open their borders. The readers that might be interested in this subject matter include those engaging in libertarian philosophy, economics, and political theory. (shrink)

The review cites the “Open Society” twice in its title—and is clearly pro-Popperian—but then fails to mention the fourteen-point list, and surrounding discussion, that explicitly compares Popper’s critical rationalism with anarcho-libertarianism (strong similarities) and liberal democracy (strong dissimilarities); EfL, pp.135-142. If the review had engaged more closely with the arguments of EfL and been more informed by the relevant social scientific literature, then it would probably have found the anarcho-libertarian case to be far more robust and realistic than such a (...) cursory dismissal can hope to refute. (shrink)

The following essay responds to a draft article that criticises the theory of libertarian restitution in “Libertarian Rectification: Restitution, Retribution, and the Risk-Multiplier” (LR). The article was freely available to internet search engines. Hence, it seems fair and useful to reply to these very welcome objective criticisms. It is not intellectually relevant that its author might subsequently and subjectively have thought better of them, possibly as a result of the earlier version of this reply. Generally, the article misconstrues the position (...) on retribution in LR. Eventually, it makes apparent qualifications to its own position such that there does not seem to be any clear theoretical difference between the two on the central disputed issue. LR’s position is to explain and defend only the non-normative theory of libertarian restitution: full restoration or compensation to the damaged (initiatedly imposed on) party. But it is argued that this can include a retributive aspect if that is what the victim prefers. Moreover, such restitution will tend to act as a deterrent that maximises both overall interpersonal liberty (theorised as no initiated imposed costs) and human welfare (theorised as preference satisfaction). (shrink)

The reply begins by stating that responses to reviews of EfL are “taking criticism of their philosophical claims as personal attacks” and resorting to “hysterical ad hominems”. On the contrary, the responses to around fourteen—often highly positive—reviews have welcomed all their criticisms and simply replied to them. None of these replies appear to commit the ad hominem (to the man) fallacy: that of addressing the qualities of a person as a way of attempting to undermine or defend an argument or (...) assertion made by that person. (shrink)

Primarily using philosophy, but also some social science, Escape from Leviathan (EfL) explains and defends what it calls an extreme version of the implicit ‘classical liberal compatibility thesis’: liberty, welfare, and anarchy are overwhelmingly complementary in normal practice (rationality is added for its intimate theoretical connections to these categories). This is done using theories, not definitions, of each concept. This important thesis is entirely positive. Therefore, somewhat unusually, all normative issues are avoided as irrelevant distractions in this context. In addition, (...) the epistemology used is also unorthodox. A justificationist, or foundationalist, approach would be literally illogical: the self-refuting trilemma faced by ‘supporting justifications’ (as regards arguments and evidence) is of entailing infinite regresses, dogmatic starting points, or circularities. Consequently, critical rationalism is assumed: conjecture and criticism are all that is possible. Thus all aspects of the conjectured thesis are explained and defended from criticism as thoroughly as the book can encompass. It is concluded that the thesis has not been refuted and so may be critically preferred. (However, this could all still be viewed as a ‘justification’ by those thus inclined.) All of this is made clear enough in the short introductory chapter and repeated where relevant throughout. Yet some reviews do not have a firm grasp of the specific project and so reject it with unsound criticisms. We now turn to one such example. (shrink)

Escape from Leviathan (EfL) is a first attempt at explaining a somewhat complex philosophical theory of libertarianism. The theory is far from being as clear as it has subsequently become possible to make it. Consequently, most reviews have misunderstood it to varying degrees. What is striking is the great confidence with which some of these reviews assume they have completely understood it and refuted it. This is odd because it does not seem entirely reasonable to suppose that EfL’s errors are (...) quite as obvious and naïve as the reviews often assume. And only a slightly more careful reading of the text might have disabused them of their misapprehensions. With the article about to be discussed, we have another clear example of this phenomenon. But what is particularly interesting about it is that it does not itself fully understand the basic conception of liberty that most libertarians assume. And as this is, strangely, not that uncommon even among libertarian philosophers, it is certainly worth responding to as clearly as possible. (shrink)

Readers of “Falsificationism Redux” (the rejoinder) may have found it to be another waffling non-explanation of induction and the alleged falsity of falsificationism—or even self-refuting, as its title indicates (redux: brought back, revived, restored). However, it seems worth another round of replies if only because the arguments are fairly typical of the would-be ‘inductivist’ and it might help some people who have yet to see how these arguments fail.

What is my thesis? It is not that radical experimentation by the state, rather than liberal democracy, is more in accord with the spirit and logic of Popper’s ‘revolutionary’ epistemology. It is the opposite criticism, that full anarchic libertarianism (individual liberty and the free market without any state interference) better fits Popper’s epistemology and scientific method.

I thank Professor Otteson for his review of Escape from Leviathan (EfL). His exposition of what I wrote is relatively accurate. I shall here do my best to correct any misunderstandings and reply to his welcome criticisms, ignoring our various points of agreement and his generous praise.

(Revised 31-10-17) This is only one view on the topic; other views may be rather different. It starts at the more philosophical end and then becomes more empirical, and possibly easier to understand, as it proceeds.

This essay examines sections relevant to libertarianism in Will Kymlicka’s Contemporary Political Philosophy: An Introduction (2nd ed.), making and explaining the following criticisms. Kymlicka’s “preface” misconstrues political philosophy’s progress, purpose, and its relation to libertarianism. In his “introduction”, his “project” mistakes libertarianism as “right-wing”, justice as compromise among “existing theories”, and equality as the “ultimate value.” His “a note on method” in effect takes as axioms, beyond philosophical examination, various alleged desiderata and the necessary moral role of the state. Moreover, (...) his “ultimate test” being “our considered convictions” amounts to a conservative and illogical justificationism at odds with radical and coherent critical rationalism. Kymlicka’s chapter on “libertarianism” mistakes it as, inherently and unavoidably, free-marketist, anti-consequentialist, deontological, Nozickian, requiring “a foundational moral premiss, without objective content, unmaximisable, indistinguishable from license, equality-based, anti-anarchist, “self-defeating”, indefensibly “unfair”, impractically “philosophical”, and without influence. A different version of libertarianism easily withstands all Kymlicka’s antipathetic criticisms. (shrink)

This paper argues for a non-moral interpretation of the libertarian conception of interpersonal liberty as ‘the absence of imposed cost.’ In the event of a clash of imposed costs, observing such liberty entails ‘minimising imposed costs’. Three fundamental criticisms are examined: strictly interpreted, this would logically imply genocide in practice; it is impractically unclear and moralised; it could entail mob rule of some kind. Self-ownership and private property are then non-morally derived merely from applying this formula in a state of (...) nature. Various subsidiary issues arise throughout. (shrink)

Private-property anarchy is better than the state in the enhancement of liberty and welfare. Strictly speaking, market exchange is one aspect of private-property anarchy. But I here focus on market-anarchy as that is a main source of confusion and debate. Similarly, pluralism is another aspect of private-property anarchy. I focus on pluralism as an example of a currently popular topic where private-property anarchy is misunderstood. ‘Pluralism’ here means ‘(tolerating) different ways of life’. ‘The market’ means ‘voluntary exchange’. ‘Anarchy’ means ‘no (...) rule’. Both interpersonal liberty and private property are inherently anarchic: no one is ruled to the extent that these exist. They are also naturally pluralist. The state, by contrast, coercively imposes ultimate control and is thus inherently illiberal and naturally Procrustean. Democratic prejudice obscures these facts. (shrink)

The history of the interpretations of The Merchant of Venice, both on the stage and in critical comment, and of the reactions it has evoked in its readers or viewers, is surely unique in the Shakespeare canon. Interpretations of Hamlet are numberless, but the contentions expend themselves within the intellectual realm. The Merchant of Venice reaches down into deep emotional levels, involving commitments and shrouded reticences of the soul. When conscience and the play come together, a drama takes place. Sigurd (...) Burckhardt has clearly perceived the problem, without exploring it. “Audiences,” he writes, “persist in feeling distressed by Shylock's final treatment, and no amount of historical explanation helps them over their unease.” We cannot join unreservedly in the joyful harmonies of the last act. “Shylock spooks in the background, an unappeased ghost.”. (shrink)

The most relevant and plausible conceptions of economic rationality, interpersonal liberty, human welfare, and private-property anarchy do not conflict in theory or practice. Using philosophy and social science, Escape from Leviathan defends this bold, non-normative, thesis from contrary positions in the scholarly literature. Writers considered include David Friedman, John Gray, R. M. Hare, Robert Nozick, Karl Popper, John Rawls, Murray Rothbard, Alan Ryan, Amartya Sen, and Bernard Williams. *** The rationality assumptions of neoclassical and Austrian School economics are reconciled and (...) related to liberty and welfare. A new pre-propertarian theory of interpersonal liberty as the absence of (initiated or proactively) imposed cost is argued to be libertarian. Human welfare is defended as the satisfaction of unimposed wants. Practical anarchy is simply unconstrained private property. Related topics include free will, weakness of will, the nature of moralizing, intellectual property, and restitution and retribution. Critical-rationalist epistemology (theories can only be criticized and tested, not justified or supported) is applied throughout. This is a ground-breaking work that is also an excellent introduction to libertarianism and social thought. (shrink)

Stated briefly, the problem of this thesis centers around Jonathan Edwards' interpretation and meaning of freedom of the will and the contrast of this to the meaning employed by St. Thomas. Jonathan Edwards was a defender of the doctrines of John Calvin. His work, The Freedom of the Will, is directed to a defense of two particular Calvinistic doctrines, primarily the absolute sovereignty of the divine will and secondarily the predestination of man, by showing that freedom of the will is (...) no~ incompatible with this absolute sovereignty and predestination. However, in the presentation of his defense, the author feels that the solutions to the conflicts and problems which necessarily arise in the discussion of such a difficult topic present considerable variation to views held by St. Thomas. It is the purpose of this thesis to analyze the solutions to these conflicts and problems and to indicate any differences that may be discovered between Edwards' interpretation of the freedom of the will and that of St. Thomas. It should be.noted that the original work of Jonathan Edwards bore the title: A careful and strict Enquiry into The modern prevailing Notions Of That FREEDOM OF WILL, Which is supposed to be essential To Moral Agency, Virtue and Vice, Reward and Punishment, Praise Blame. Since that time, the title has been considerably shortened so that the work has come to be known simply as the Freedom of the Will, and is often referred to, for brevity, simply as the Inquiry. Edwards' work was written in 1754 and first published in that ea.me year in Boston by S. Kneeland. The text used in this paper is one edited by Paul Ramsey from this original edition. One precautionary warning must be given. Because of the several changes that occur in a language over a long period of time, some one hundred to two hundred years in this case, the reader will note what appear to be errors in grammar, spelling and punctuation, not only in the works of Edwards himself, but also in related writing by subsequent authors. No attempt has been made by the author of this present work, to change any such "apparent" errors. Excerpts used have been quoted as they appeared in the works cited. Any structural changes that may have been made in the writings of Edwards were the doings of those who edited them. In view of the brevity of such a work as this in contrast to the profundity and depth of the man, Jonathan Edwards, whose Freedom of the Will is the fulcrum of this paper, no consideration can be given to the personality behind the writings. Consequently, any criticisms or refutations that may occur are to be referred only to what Edwards said, as expressed in his writings and in the reviews of others, and in no way are to be interpreted as a defamation of his character. Jonathan Edwards was an upright man of firm belief and constant devotion and dedication to his cause. The present work is not a character analysis or investigation. It seeks only to illuminate what the man said and to view this in the ever-awing light of truth. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 33.2 (2000) 182-186 [Access article in PDF] Book Review Rhetoric and Community: Studies in Unity and Fragmentation Rhetoric and Community: Studies in Unity and Fragmentation. Studies in Rhetoric/Communication. Ed. J. Michael Hogan. Series ed. Thomas W. Benson. Columbia, SC: U of South Carolina P, 1998. Pp. xxxviii + 315. $39.95. Based on papers and critical responses presented at the Fourth Biennial Public Address Conference, which was (...) held at Indiana University in 1994, this collection of fourteen essays by leading rhetoric scholars concentrates on the relationships among rhetoric, community, and fragmentation. Organized into three broad sections entitled "Race, Gender, and Community," "War and Community," and "Artistic and Scientific Community," the book contributes to ongoing conversations about the roles of language, symbolism, differences, metaphors, myths, hegemony, economic class, pluralism, and multiple consciousness in unifying the United States. A preface and a conclusion by J. Michael Hogan, who edited the collection, provides an orientation and summary for this new volume in the University of South Carolina Press series devoted to Studies in Rhetoric/Communication.The preface frames the book's contribution as a response to a belief that "a growing number of social and political commentators fear that the United States has lost all sense of 'community'--that repository of shared purpose, values, and traditions which historically has defined the American character" (xii). Hogan amplifies, "The signs of stress and fragmentation appear everywhere, not just in our national political and cultural dialogue but in all of the various communities that define our social lives--our families, our neighborhoods, our towns and cities, our professions, and our social and cultural associations" (xii). The preface situates the book in this concern about a "lost" unity that once upon a time typified the United States. But this "lost" community is a mythic representation of a past that has never existed in the United States, except possibly in the imaginations of people habituated to dominant roles. Stephen H. Browne's comments about restoration projects in general are germane: "The work of restoration has [End Page 182] never come easy for Americans, not least of all because it presumes a state that never existed and the appeal to which is almost always self-interested" (75).Describing the fourteen contributors as sharing "a common bond," Hogan asserts, "recognizing that communities are largely defined, and rendered healthy or dysfunctional, by the language they use to characterize both themselves and others, all share an abiding concern with how communities are constituted and sustained--or, in some cases, threatened and disrupted--by the words their leaders choose to characterize both themselves and others" (xv). Hogan emphasizes a question that he reiterates with slight changes in the conclusion: "Can feminist or ethnic and racial communities successfully sustain and celebrate their own identities without alienating themselves from the larger community?" (295; similarly, xxiii). But if all members of a community are responsible for unity and fragmentation, if we are unwilling to assign responsibility for fragmentation to subordinated community members, it may be necessary, consciously, to reverse the dynamics of power implicit in Hogan's question, by asking: "Can groups that have had a history of dominating others--both beyond and within the borders--sustain their own identities and still relate productively to the community?" In addition, because the English language is a communal inheritance, it may be revealing to ask, in a reversal of the book's focus on "community," how are notions of individualism sustained in the United States?Roderick P. Hart's introduction, "Community by Negation--An Agenda for Rhetorical Inquiry," focuses on a rhetoric of hate as practiced by both the political right and the political left. Hart inquires "whether it is possible to have community without hate" (xxv). This question is necessary in any serious discussion of rhetoric, fragmentation, and community; yet calculated opportunism and economic exploitation may be misnamed and obfuscated in language depicting a rhetoric of "hate." Indeed, Lu-in Wang, a legal scholar, suggests that these other motives may be more common than animus in so-called "hate crimes." Live interviews with convicted killers... (shrink)

This is an excellent though largely uncritical introduction to, and defence of, Robert Nozick‟s Anarchy, State and Utopia (New York: Basic Books, 1974). It is also quite a good introduction to libertarianism. It is full of good arguments. I shall confine myself to critical remarks. My responses are mainly in the order that matters arise in the book.

This book has many arguments doing an excellent job of dismantling the positions of those who would have the state do considerably more than defend the national realm. Thus far, it is hard for me to fault it—which is more difficult when one is already in agreement: the ideologically opposed can often provide more useful criticisms. But, as the book‟s title indicates, it does not go all the way to anarcho-liberalism (in fact, it does not even fully embody certain basic (...) tenets of classical liberalism). And as its criticisms of anarcho-liberalism—or private-property anarchy—are those to which I am ideologically opposed, I shall mainly concentrate on those. (shrink)