The private sector has implemented many cost containment measures in efforts to control rising health care costs. However, these measures have not controlled costs in the long run, and can be expected not to succeed as long as business cannot control factors within the health care system which affect costs. Controlling private sector health care costs requires constraints on cost shifting which necessitates a unified financing system with expenditure limits. A unified financing system will involve a partnership between the public (...) and private sectors. (shrink)

This paper reports an experiment designed to investigate the potential influence of prior acts of self-control on subsequent prospective memory performance. College undergraduates performed either a cognitively depleting initial task or a less resource-consuming version of that task . Subsequently, participants completed a prospective memory task that required attentionally demanding monitoring processes. The results demonstrated that prior acts of self-control do not impair the ability to execute a future intention in college-aged adults. We conceptually replicated these results in three additional (...) depletion and prospective memory experiments. This research extends a growing number of studies demonstrating the boundary conditions of the resource depletion effect in cognitive tasks. (shrink)

As customer return rates increase, retailer bottom lines suffer from customers’ misuse of the policies and to the ethics of such practice. The purpose of this study is to explore customers’ orientation toward return behaviors, and to develop a return orientation assessing these dimensions. This research identified three dimensions relevant to consumer return behavior: the planned/unethical returner; the eager returner; and the reluctant/educated returner. A retest with another sample confirmed these three dimensions. Each dimension was analyzed for its relationship with (...) consumer ethical beliefs as measured by the Muncy–Vitell Consumer Ethics Scale, ethical philosophies and shopping behaviors. These relationships supported the ethical and unethical aspects of returner orientation. Results of this research imply that the core aspect of returner orientation is relevant to ethical behavior and misuse of retail return policies. The three return orientations identified partially support the Rosenbaum & Bitner-Olson research. (shrink)

This volume offers an analysis of ethical concepts based on positive legal principles and court decisions, describing what actually happens in practice, or where there are no precedents available, what is most likely to happen. Broadly, it deals with the wide range of potentially difficult situations in which the community, as represented by the law, may come into conflict with the medical profession.

This article revisits long-standing questions about consent, membership and emigration in Locke’s thought. Commentators such as A John Simmons have argued that Locke opens political membership to both express consenters and some kind of tacit consenters, and not just to the former, as some have suggested. Simmons’s reading seems to render Locke more sensible in that it does not exclude large numbers of people from membership or burden the few members with all the civic duties, and also in that it (...) allows at least tacit-consenting members the right to relocate, while this right is denied to express-consenting members. Against this reading, the article shows, by resolving seemingly conflicting claims in the text, that people become members only by express consent. It also responds to the criticism that the express-consent-only reading would limit membership to a few and so would render Locke’s account implausible from a practical point of view. The article then addresses the purported restriction Locke imposes on express consenters’ right to emigrate, arguing that the restriction concerns the change of membership and not the right to relocate. (shrink)

One aim of that type of transcendental argument known to us as the cogito is to reveal a self about which there can be no contention, neither about its existence nor its nature. Serious doubts are, of course, perennial over whether there is any such thing as the self, if that is meant to imply that all selves have some essence or structure in common, and whether selves are best understood in terms of their intrinsic nature or external influences. Here (...) is a dialectic that tosses us to and fro between everything and nothing: at one natural extreme is the view that the self is a vector product of social and cultural relations; at the other is the denial that the self has any nature at all, that it is entirely consumed in the project of inventing itself. Those who see self-construction as seriously environmentally conditioned will press to make these ends meet. Here I aim to show that a distinctive cogito can be produced for each of the various conceptions of self that punctuate this spectrum and what is common to them all. (shrink)

The central question of Aeschylus' Supplices has usually been taken to be the reason for the flight of the Danaids. The most exhaustive guide to the many theories, of varying plausibility, which have been developed to account for this flight is provided by A. F. Garvie's book on the Supplices. For present purposes, therefore, it is unnecessary to examine any but the two most acceptable theories in detail. Nevertheless, a brief summary, prior to this examination, of two other, initially attractive, (...) views might be helpful to students of this problem, the first simply because it is so attractive to so many eminent scholars, the second because, while it fails to provide an acceptable solution, it suggests a useful approach to the problem. (shrink)

Robert F. is an eighty-five-year-old who suffered a heart attack at home in a rural location some thirty minutes from any major hospital. By the time the paramedics arrived, he was unconscious and nonresponsive. After spontaneous return of circulation, they began their standard procedure of therapeutic hypothermia. Robert's core temperature was lowered using ice packs, and cold intravenous fluids were initiated. Soon afterward, Robert started to shiver when his body temperature reached 35.6° Celsius. He was then given a bolus of (...) vecuronium as a neuromuscular blockade, sedated, and intubated. He was also given a low-dose vasopressin for blood-pressure control. Shortly after Robert arrived in the emergency room, his daughter, his medical decision-maker, produced an advance directive documenting that her father has a do-not-resuscitate order, and she demanded that the breathing tube and any other life-sustaining treatments be withdrawn immediately. The medical staff is very reluctant to comply with this demand for immediate action. Until the neuromuscular blockade wears off, removing the ventilator will prevent Robert from breathing. Furthermore, it may take some time to reverse the therapeutic hypothermia procedure to the point that the patient is at normal temperature. In addition, therapeutic hypothermia itself often causes arrest, so the patient may need to be resuscitated again. Should the staff wait until the patient is warm or honor the decision of his daughter, who holds his medical power of attorney? (shrink)

Psychiatry has come up as one of the most dynamic branches of medicine in recent years. There are a lot of controversies regarding concepts, nosology, definitions and treatments in psychiatry, all of which are presently under a strict scanner. Differences are so many that even the meaning of psychiatry varies amongst individual psychiatrists. For us, it is an art to practice psychiatry and give the patient what he needs. Still, it should be practiced with great caution and utmost sincerity towards (...) the patient, based on scientific knowledge and not to be guided by individual conceptions alone. Ethics in psychiatry forms an integral part of its basic concept and meaning, and a tight balance should be maintained between professional advancement and patient benefit. In recent years, the scope of psychiatry has enlarged considerably, with wide ranging influences from Sociology, Anthropology and Philosophy on the one hand, and Neurology and Medicine on the other. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:MACINTYRE'S REPUBLIC J. K. SWINDLER Westminster College Fulton, Missouri CONTRARY TO HIS own evident intentions and perceptions, in After Virtue A'lasdair Macinty!l.·e is much more of a Ptlatonist 1than the A1 ristotelian he aims to be. I hase this judgment both on the positive evidence that Macintyre and Plato (in the Republic) m1gue for and against the same crucial theses and on the negative evidence that Plato has read (...) answers to the very issues which Macintyre finds 1 intractable from an AristoteHan point of viiew. My thesis can be made out in terms of a half dozen issues which Maclntyire takes as crucial to his case: (1) Can there he a science of government? (2) Is there an answer to the sophist's chaillenge to morality? (3) How oan the fragmentation of the modern self he theoretically overcome? (4) What are the hi1stocical and social determinants of morality? (5) Is there a unity of virtue in addition to individual virtues? (6) Can we reconcile ourselves to teleofogy, the absence of the polis, and the tragedy of human 1:ife? I will consider each of these in turn. I. Wisdom Plato defines wisdom as knowledge of how to rule, and Aristotle (in the Nichomachean Ethics) distinguishes between theoretical and practical wisdom, 1suggesting thereby an interesting ambiguity in Plato's view, an ambiguity of which Macintyre makes a great deal. One may rule eithecr hy law or by judgment. In his attack on the Enlightenment, MacIntyre showis quite clearly tha;t the idea of a social science that would p11ovide laws of human behavior, which could in 343 344 J. K. SWINDLER turn be used by il"ulers and managers to predict and therefore manipulate!human action, was an invention of the eighteenth century. He offers an extensive 1oritique o.f this conception of socirul science, grounded primarily in the claim that human.behavior is essentially unlawful, at least if we judge it by the standards of the physical sciences. There is in human affairs a farge 1and uneliminwble element of fortiuna which makes it impossrible rto.formulate laws of human nature or behavior that would he exceptionless and therefore underwrite predictions of behavior. For there is nothing to be done about the unpredictability of innovations or, from one's own point of view, of one's own future actions; nor can the uncertainties of gametheoretie decisions and 1 the general contingency of the outcomes of ruction,be remedied. There is therefore no possibility of a social science in the sense in which Hume tried to imitate Newton. So much for Marx and Weber and the horde of modern.social scientists. This is not to say that life is completely uncertain; on the contrary, there are genuine and general regularities in society, some natural, some social, ·some statistical, some causal, wihich make life bearable. But these provide a,ground for the Aristotelian idea, endorsed by MacIntyre, that the principles of conduct, such as they might be, hold only for the most part and not universa1ly. There is therefore in Maclntyre's view no justification for 1a mora;l oode in the modern sense, nor ev;en of moral principles of the kind we are used to from Kant ·and Mill, Rawls and Nozick, which purport to istand as a sufficient criterion of right in all cases. But, importantly, we do not find any such rules or codes in Pla.to either. For Plato, too, insists on the mixed reign of chaos and logos in the materia;l world and in our Jives and concludes that judgment is essential to· determining right conduct. He tellrs us that wise rule comes only &om good oharructer and good institutions, that legislating in such detaii1 as to eliminate judgment is "cut:ting off the heads of a hy:dra." One cannot help hut think that tMs (essentially Hemclitean) point is something Aristotle ~earned at his MACINTYRE'S REPUBLIC 345 master's knee. And both aspects of Plato's :point ~e ipresent in Aristotle, viz., that s~nce the:ve is chance in nature, there is luck (good 'and had) in life, and since no rule can capture the particularity of conorete situations right... (shrink)

In summary, the discussion by Professors Helmchen and Müller-Oerlinghausen of the morality of clinical trials has emphasized a point that is frequently overlooked. It is an essential to consider those situations in which it might be unethical not to conduct a trial as it is to be concerned about the ways in which trials might restrict the rights of the individuals taking part in them. They and I have dealt mainly with the first of these two issues because it has (...) been relatively neglected. The second is, of course, equally important and has rightly received much attention. Both matters deserve further public discussion. (shrink)

It has been asserted that there is no one universal proposition with which all philosophers would agree, including this one. The pre dicament has rarely been recognized and almost never accepted, although neither has it been successfully challenged. If the claim holds true for philosophy taken by itself, how much more must it of religion, the hold for crossfield interests, such as the philosophy philosophy of science and many others. The philosophy of educa tion is a particular case in point. (...) The topic of education itself is generally regarded as a dull af fair, a charge not entirely without substance. The blame for this usually falls on the fact that it has no inherent subject matter. The teachers of history teach history, the teachers of biology teach biology; but what do the teachers of education teach? Presumably how to teach; but this simply will not do because every topic requires its own sort of instruction. (shrink)

In recent years a novel picture of Mably's thought has begun to emerge within Anglo-American scholarship, suggesting perhaps a constructive alternative to both the �radical� and the �conservative� interpretations. On this reading, Mably should be seen as neither a proto-socialist nor a reactionary thinker, but as a republican -- a classical republican, in fact, whose writing represents a later Gallic contribution to the political tradition founded by Machiavelli and Harrington.3 In fact, nothing is more obvious to any reader than the (...) absolute centrality of the reference to Graeco-Roman antiquity in his writings, from beginning to end -- with precisely that celebration of the �mixed governments� of Sparta and Rome, and intense preoccupation with the politics of �virtue�, that we have come to associate with the civic humanist tradition. The object of this essay is to provide a brief introduction to this �new� Mably. It will do so chiefly through an examination of a single work, albeit a pivotal one in Mably's career. Entretiens de Phocion, a dialogue first published in 1763, introduced in print for the first time most of the major themes of his mature thought; and it remained by far the most popular work to appear in his lifetime. A brief look at it should give us the opportunity to test the cogency of the civic humanist reading of Mably's thought, as well as to suggest something of thespecific character of the French contribution to the �Atlantic republican tradition�. (shrink)

Recent scholarship on technology-induced ‘conceptual disruption’ has spotlighted the notion of a conceptual gap. Conceptual gaps have also been discussed in scholarship on epistemic injustice, yet up until now these bodies of work have remained disconnected. This article shows that ‘gaps’ of interest to both bodies of literature are closely related, and argues that a joint examination of conceptual disruption and epistemic injustice is fruitful for both fields. I argue that hermeneutical marginalization—a skewed division of hermeneutical resources, which serves to (...) diminish the experiences of marginalized folk—does not only transpire because of conceptual gaps, but also because of two other kinds of conceptual disruption: conceptual overlaps and conceptual misalignments. Hence, there are multiple kinds of conceptual disruption that can be usefully studied through the normative lens of epistemic injustice. Technology can play different roles vis-a-vis epistemic injustices, both as a causal trigger of conceptual disruption, but also as a mediator of hermeneutical resources. Its role is normatively significant, in particular because socially disruptive technologies can have different epistemic implications for different groups: they may amplify the epistemic resources of some groups, while diminishing those of others. (shrink)