I end with another parable, but it is also a true story. Harvey Gushing, the famous surgeon after whom the Gushing Lectures are named, made an international reputation in his allegiance to quality. He badgered his profession to a higher standard of self-effacement and railed against the debasement of clinical skills and overemphasis on research and pursuit of personal gain. We honor him to this day because those were, and remain, important points. Yet, Harvey Gushing served as a surgeon during (...) World War I and at Ypres. Although the Allied mortality was as much as 50,000 soldiers a day, not counting the wounded, Gushing refused to operate on any more than two patients each day, arguing that to do so would have lowered his standard of care for his patients a – standard that made sense in one time but that became strikingly insensitive, and I suggest even unethical, in another when confronted with a different reality. (shrink)

President Clinton, already facing formidable obstacles in reforming the health care system, denies that it will involve any rationing. This is politically understandable, but wrong. Infinite needs are rapidly overtaking finite resources. Most health providers recognize that the genius of modern medicine has outpaced our ability to pay. But the public still has unlimited expectations and a blind faith that everything can be provided to everyone by simply eliminating "waste, fraud, and abuse." Rationing is inherent in any health care system. (...) As government undertakes to define what is "medically necessary or appropriate," it will unavoidably undertake a series of rationing decisions. Health care is being transformed from a private good to a public good. Government, when it reforms the health care system, must inevitably ask: How do we buy the most health for the public? Keywords: Clinton Health Plan, public good, rationing CiteULike Connotea Del.icio.us What's this? (shrink)

The single greatest challenge facing managers in the developed countries of the world is to raise the productivity of knowledge and service workers. This challenge, which will dominate the management agenda for the next several decades, will ultimately determine the competitive performance of companies. Even more important, it will determine the very fabric of society and the quality of life of every industrialized nation. … Unless this challenge is met, the developed world will face increasing social tensions, increasing polarization, increasing (...) radicalization, possibly even class war. (shrink)

Too often, the limits of our language are the limits of our thinking. “If thought corrupts language, language can also corrupt thought,” warned George Orwell. How we label something too often controls how we think about it. We get particular concepts in our head and they are hard to change. They govern how we think and how we act. “Disease” and “death” used to be considered as “God's will,” and it took hundreds of years and no small number of martyrs (...) to get that corrected. It was very hard to develop modern medicine when so many subjects were thought of as outside of human control. Similarly, the number of children a woman had was thought to be “God's will,” and that has made the development of contraception controversial to this day. Human control over any part of human destiny is usually opposed vigorously. Humankind has the tendency to confuse the familiar with the necessary. (shrink)

Richard Lamm is an eloquent and insistent advocate for healthcare reform. In his paper, he argues that if reform is to be effective, a radical metamorphosis in the values underlying our present system must take place. “New realities” have made the “old values” unsustainable. Unless they are replaced by “new values,” we face a future of disastrous overspending, gross inequities in accessibility, poorer health for many, and more expensive dying.

How are group-based identities related to intergroup conflict? When and how do ethnic, religious, and national identities lead to oppression, violence, rebellion, war, mass-murder, and genocide? How do intergroup conflicts change people's identities? How might social identity be harnessed in the service of reducing conflict between groups? The chapters in this book present a sophisticated and detailed interdisciplinary analysis of the most topical and fundamental issues involved in understanding identity and conflict.

By a thorough study of the Posterior Analytics and related Aristotelian texts, Richard McKirahan reconstructs Aristotle's theory of episteme--science. The Posterior Analytics contains the first extensive treatment of the nature and structure of science in the history of philosophy, and McKirahan's aim is to interpret it sympathetically, following the lead of the text, rather than imposing contemporary frameworks on it. In addition to treating the theory as a whole, the author uses textual and philological as well as philosophical material (...) to interpret many important but difficult individual passages. A number of issues left obscure by the Aristotelian material are settled by reference to Euclid's geometrical practice in the Elements. To justify this use of Euclid, McKirahan makes a comparative analysis of fundamental features of Euclidian geometry with the corresponding elements of Aristotle's theory. Emerging from that discussion is a more precise and more complex picture of the relation between Aristotle's theory and Greek mathematics--a picture of mutual, rather than one-way, dependence. Originally published in 1992. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

Richard Ryder, one of the founding fathers of the modern animal rights movement, here explains his latest thinking about morality.

The so-called “mind-brain” problem affords the greatest opportunity for the cooperation of philosophy and science in the advancement of knowledge. In this paper we will outline pertinent facts already learned about the human mind from neurological disciplines, and, using some hypotheses from outstanding workers in neurobiology, we will relate this material to some important philosophical problems. Our proposal is to examine these problems in the light of knowledge gathered from the scientific disciplines, and we hope to demonstrate how this method (...) may eventually clarify some of the confusion and suggest certain solutions. (shrink)

Ethical Practice in the Human Services by Richard D. Parsons and Karen L. Dickinson moves beyond addressing ethical issues and principles to helping readers actually practice ethical behavior through awareness of their personal morals, values, and choices. With coverage of ethical standards from six different associations, the text addresses ethical issues and principles in social work, counseling, psychology, and marriage and family therapy. Robust pedagogy includes case illustrations and guided exercises to give readers a deeper understanding of the underlying (...) moral principles and values that serve as a foundation for the various ethical codes. (shrink)

Since its publication in 1994, Richard McKirahan's _Philosophy Before Socrates_ has become the standard sourcebook in Presocratic philosophy. It provides a wide survey of Greek science, metaphysics, and moral and political philosophy, from their roots in myth to the philosophers and Sophists of the fifth century. A comprehensive selection of fragments and testimonia, translated by the author, is presented in the context of a thorough and accessible discussion. An introductory chapter deals with the sources of Presocratic and Sophistic texts (...) and the special problems of interpretation they present. In its second edition, this work has been updated and expanded to reflect important new discoveries and the most recent scholarship. Changes and additions have been made throughout, the most significant of which are found in the chapters on the Pythagoreans, Parmenides, Zeno, Anaxagoras, and Empedocles, and the new chapter on Philolaus. The translations of some passages have been revised, as have some interpretations and discussions. A new Appendix provides translations of three Hippocratic writings and the Derveni papyrus. (shrink)

In the second of our two articles focusing on the war in Iraq, Richard Ryder looks at a range of possible justifications, and finds them all wanting.

An astounding project of analysis on more than one hundred translations of ancient philosophical texts, this index of words found in the Ancient Commentators on Aristotle series comprises some 114,000 entries. It forms in effect a unique dictionary of philosophical terms from the post-Hellenistic period through to late antiquity and will be an essential reference tool for any scholar working on the meaning of these ancient texts. As traditional dictionaries have usually neglected to include translation examples from philosophical texts of (...) this period, scholars interested in how meanings of words vary across time and author have been ill served. This index fills a huge gap, therefore, in the lexical analysis of ancient Greek and has application well beyond the reading of ancient philosophical commentaries. Bringing together the full indexes from 110 of the volumes published in Bloomsbury's Ancient Commentators on Aristotle series, McKirahan has combined each word entry and analysed how many times particular translations occur. He presents his findings numerically so that each meaning in turn has a note as to the number of times it is used. For meanings that are found between one and four times the volume details are also given so that readers may quickly and easily look up the texts themselves. (shrink)