This is the first book-length study of the thought of Sri Chinmoy (1931-2007) and his teaching of a dynamic spirituality of integral transformation. A straightforward and unembroidered account of his philosophy, it allows Sri Chinmoy to speak for himself in his own words, in poetry as much as in prose.

Aim: This study explores priority dilemmas in dialysis treatment and care offered elderly patients within the Norwegian public healthcare system.Background: Inadequate healthcare due to advanced age is frequently reported in Norway. The Norwegian guidelines for healthcare priorities state that age alone is not a relevant criterion. However, chronological age, if it affects the risk or effect of medical treatment, can be a legitimate criterion.Method: A qualitative approach is used. Data were collected through semistructured interviews and analysed through hermeneutical content analysis. (...) The informants were five physicians and four nurses from dialysis wards.Findings: Pressing priority dilemmas centre around decision-making concerning withholding and withdrawal of dialysis treatment. Advanced age is rarely an absolute or sole priority criterion. It seems, however, that advanced age appears to be a more subtle criterion in relation with, for example, comorbidity, functional status and cognitive impairment. Nurses primarily prioritise specialised dialysis care and not comprehensive nursing care. The complex needs of elderly patients are therefore often not always met.Conclusions: Clinical priorities should be made more transparent in order to secure legitimate and fair resource allocation in dialysis treatment and care. Difficult decisions concerning withholding or withdrawal of dialysis ought to be openly discussed within the healthcare team as well as with patients and significant others. The biomedical focus and limitations on comprehensive care during dialysis should be debated. (shrink)

Background: A fair distribution of healthcare services for older patients is an important challenge, but qualitative research exploring clinicians’ consideration in daily clinical prioritisation in healthcare services for the aged is scarce.Objectives: To explore what kind of criteria, values, and other relevant considerations are important in clinical prioritisations in healthcare services for older patients.Design: A semi-structured interview-guide was used to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis and template organising style.Participants: 20 (...) physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway.Results and interpretations: Important dilemmas relate to under-provision of community care and comprehensive approaches, and over-utilisation of certain specialised services. Overt ageism is generally not reported, but the healthcare services for the aged seem to be inadequate due to more subtle processes, for example, dominating considerations and ideals and operating conditions that do not pay sufficient attention to older patients’ needs and considerations of justice. Clinical prioritisations are described as being dominated by adapting traditional biomedical approaches to the operating conditions. Many of the clinicians indicate that there is a potential for improving end of life decisions and for reducing exaggerated use of life-prolonging treatment and hospitalisations.Conclusion: The interviews in this study indicate that considerations of justice and patients’ perspectives should be given more attention to strike a balance between specialised medical approaches and more general and comprehensive approaches in healthcare services for older patients. (shrink)

This review begins with a detailed focus on the Turnaway Study, which addresses associations among early abortion, later abortion, and denied abortion relative to various outcomes including mental health indicators. The Turnaway Study was comprised of 516 women; however, an exact percentage of the population is not discernable due to missing information. Extrapolating from what is known reveals a likely low of 0.32% to a maximum of 3.18% of participants sampled from the available the pool. Motivation for conducting the Turnaway (...) Study, methodological deficiencies (sampling issues and others), and bias are specifically addressed. Despite serious departures from accepted scientific practices, journals in psychology and medicine have published dozens of articles generated from the study’s data. The high volume of one-sided publications has stifled dialogue on potential adverse psychological consequences of this common procedure. Following a critical analysis of the Turnaway Study, an overview of the strongest studies on abortion and mental health is offered. This comprehensive literature comprised of numerous large-scale studies from across the globe has been largely overlooked by scientists and the public, while the Turnaway Study dominates the media, information provided to women, and legal challenges involving abortion restrictions. In the final section of this article, literature reviews by professional organizations are considered, demonstrating that the biased science characterizing the Turnaway Study is aligned with a pervasive and systemic phenomenon wherein deriving reliable and valid results via careful attention to methodology and scrutiny by the scientific community have been supplanted by politics. (shrink)

This paper describes a strategy for getting students interested in ancient, especially Hellenistic, philosophy. While the works of Aristotle, the Stoics, the Skeptics, and the Epicureans may strike students as impossibly distant in time and thus far removed from their own personal concerns, students are always interested in the topics of free will and moral responsibility. Teaching the transition from Hellenic to Hellenistic philosophy through an emphasis on treatments of these topics engages students and makes feasible the teaching of an (...) understudied, extremely important period in Western philosophy. The author advocates focusing specifically on the debate between Aristotle and the Stoics on whether “being able to do otherwise” is a necessary condition for freedom. After presenting a detailed overview of the arguments that comprise this debate, the author offers suggestions on how this strategy might be augmented and on how to apply this strategy to courses which do not focus exclusively on ancient philosophy. (shrink)

Background: The literature and research on nursing ethics and advocacy has shown that generally very few nurses and other clinicians will speak up about an issue they have witnessed regarding a patient advocacy concern and that often advocacy in nursing is not learned until after students have graduated and begun working. Objective: To evaluate the effectiveness of narrative pedagogy on the development of advocacy in student nurses, as measured by the Protective Nursing Advocacy Scale. Design: We tested the hypothesis that (...) use of a narrative pedagogy assignment related to ethics would improve student nurse’s perception of their advocacy role as measured by the Protective Nursing Advocacy Scale using a quasi-experimental nonrandomized study using a pre-test, intervention, post-test design. Data collection occurred during class time from October 2012 to December 2012. The Protective Nursing Advocacy Scale tool was administered to students in class to assess their baseline and was administered again at the completion of the educational intervention to assess whether narrative pedagogy was effective in developing the nursing student’s perception of their role as a patient advocate. Ethical considerations: Students were informed that their participation was voluntary and that the data collected would be anonymous and confidential. The survey was not a graded assignment, and students did not receive any incentive to participate. The institutional review board of the college determined the study to be exempt from review. Setting: School of Nursing at a small liberal arts college in the Northeastern United States. Participants: A consecutive, nonprobability sample of 44 senior-level nursing students enrolled in their final nursing semester was utilized. Findings: Results indicated significant differences in student nurse’s perception of their advocacy role related to environment and educational influences following an education intervention using an ethics digital story. Conclusion: Using the Protective Nursing Advocacy Scale, we were able to measure the effectiveness of narrative pedagogy on nursing student’s perception of the nurse’s advocacy role. (shrink)

This book is the recent addition to the Clarendon Later Ancient Philosophers series, and its greatest significance lies in its being the sole commentary on Against the Grammarians. It also provides the only English alternative to Bury’s 1949 translation in the Loeb edition. As such, it is a clear and readable translation, although, of course, there is no Greek text provided.

This Article doDespite obvious differences in the Aristotelian and Stoic theories of responsibility, there is surprisingly a deeper structural similarity between the two. The most obvious difference is that Aristotle is (apparently) a libertarian and the Stoics are determinists. Aristotle holds adults responsible for all our "voluntary" actions, which are defined by two criteria: the "origin" or cause of the action must be "in us" and we must be aware of what we are doing. An "involuntary" action, for which we (...) are not responsible, is one that fails to meet either one of these two criteria. Aristotle is a libertarian insofar as he insists that all voluntary actions are "in our power" to perform or not. As determinists the Stoics cannot admit this sort of freedom, but they still consider the agent to be a vital link in the chain of events, so they redefine what is "in our power" as what comes about "through us." The terminology is different, but I argue that these actions, for which the Stoics hold us responsible, are in fact coextensive with Aristotle's voluntary actions. An "impression" is the first necessary condition for action, and is a sort of visual image of the object stimulating one to act. The right sort of impression activates the agent's "impulse," an internal movement of soul or mind, which is the direct cause of action. But impulse is always accompanied by "assent," which is the mind's affirming the truth of the proposition that we ought to go after the object stimulating our impulse. Thus, since assent is a necessary condition for action, we always act knowing what we are doing. This means that all actions caused by our own impulse and assent are by Aristotle's criteria voluntary, where impulse provides the internal origin of the action and assent provides the awareness of what is being done. I conclude that the Stoic and Aristotelian classes of what one is responsible for are coextensive, their criteria defining responsible actions are nearly identical, and the only substantial difference is that Aristotle claims such actions are in our power to do or not do while the Stoics say that such actions are necessitated (by our internal nature as well as external factors). es not have an abstract. (shrink)

Background: Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians’ considerations in clinical prioritisation within this field is scarce. Objectives: To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. Design: A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. Participants: 20 physicians and 25 nurses working in public hospitals and nursing homes (...) in different parts of Norway. Results and interpretations: The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians’ role. Conclusion: Distributing healthcare services in a fair way is generally not described as integral to the clinicians’ role in clinical prioritisations. If considerations of justice are not included in clinicians’ role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions. (shrink)

With the increase in the costs of providing education and concerns about financial responsibility, heightened consideration of accountability and results, elevated awareness of the range of teacher skills and student learning styles and needs, more focus is being placed on the promises offered by online software and educational technology. One of the most heavily marketed, exciting and controversial applications of edtech involves the varied educational programs to which different students are exposed based on how big data applications have evaluated their (...) likely learning profiles. Characterized most often as ‘personalized learning,’ these programs raise a number of ethical concerns especially when used at the K-12 level. This paper analyzes the range of these ethical concerns arguing that characterizing them under the general rubric of ‘privacy’ oversimplifies the concerns and makes it too easy for advocates to dismiss or minimize them. Six distinct ethical concerns are identified: information privacy; anonymity; surveillance; autonomy; non-discrimination; and ownership of information. Particular attention is paid to whether personalized learning programs raise concerns similar to those raised about educational tracking in the 1950s. The paper closes with discussion of three themes that are important to consider in ethical and policy discussions. (shrink)

This is the introduction to Moretti, Luca and Nikolaj Pedersen (eds), Non-Evidentialist Epistemology. Brill. Contributors: N. Ashton, A. Coliva, J. Kim, K. McCain, A. Meylan, L. Moretti, S. Moruzzi, J. Ohlorst, N. Pedersen, T. Piazza, L. Zanetti.

The term “globalization” was popularized by Marshall McLuhan in War and Peace in the Global Village. In the book, McLuhan described how the global media shaped current events surrounding the Vietnam War [1] and also predicted how modern information and communication technologies would accelerate world progress through trade and knowledge development. Globalization now refers to a broad range of issues regarding the movement of goods and services through trade liberalization, and the movement of people through migration. Much has also been (...) written on the global effects of environmental degradation, population growth, and economic disparities. In addition, the pace of scientific development has accelerated, with both negative and positive implications for global health. Concerns for national health transcend borders, with a need for shared human security and an enhanced role for international cooperation and development [2]. These issues have significant bioethical implications, and thus a renewed academic focus on the ethical dimensions of public health is needed. Future developments in science and health policy also require a firm grounding in bioethical principles. These core principles include beneficence; nonmaleficence ; respect for persons and human dignity ; and attention to equity and social justice. According to the World Health Organization [3], global ethical approaches should monitor and update ethical norms for research, as necessary; anticipate ethical implications of advances in science and technology for health; apply internationally accepted codes of ethics; ensure that agreed standards guide future work on the human genome; and ensure that quality in health systems and services is assessed and promoted. (shrink)

This is the first edited collection entirely dedicated to non-evidentialist epistemology or non-evidentialism—the controversial view that evidence is not required in order for doxastic attitudes to enjoy a positive epistemic status. Belief or acceptance can be epistemically justified, warranted, or rational without evidence. The volume is divided into three section: the first focuses on hinge epistemology, the second offers a critical reflection about evidentialist and non-evidentialist epistemologies, and the third explores extensions of non-evidentialism to the fields of social psychology, psychiatry, (...) and mathematics. Contributors: N. Ashton, A. Coliva, J. Kim, K. McCain, A. Meylan, L. Moretti, S. Moruzzi, J. Ohlorst, N. Pedersen, T. Piazza, L. Zanetti. (shrink)

What is philosophy of mathematics and what is it about? The most popular answer, I suppose, to this question would be that philosophers should provide a justification for our presently most cherished mathematical theories and for the most important tool to develop such theories, namely logico-mathematical proof. In fact, it does cover a large part of the activity of philosophers that think about mathematics. Discussions about the merits and faults of classical logic versus one or other ‘deviant’ logics as the (...) logical basis for mathematical theories, ranging from intuitionist over modal logic to paraconsistent logic, typically belong to this area, as do debates about the natural-number concept, its ‘nature’, its properties, especially its uniqueness, and so on. No doubt sociologists of knowledge could explain why philosophers of mathematics came to select these particular problems and deal with them the way they do. What it does imply, however, is that the question is meaningful whether different kinds of philosophies of mathematics are possible, and—why not?—perhaps even desirable. To a certain extent, the answer is trivial: look at what, e.g., phenomenologists have to say about mathematics and you must notice it does not fit into the scheme sketched above.1 Rather, the question should be whether there are forms that, on the one hand, reinterpret the whole enterprise, and, on the other hand, somehow remain related to the work of ‘mainstream’ philosophers of mathematics today.The book under review here does precisely that. Let me be a bit more precise. The general proposal, present throughout all the contributions, is that even at a first, superficial, glance at what mathematicians do when they do mathematics, it is far more complex than ‘just thinking about and …. (shrink)

Aus dem Inhalt: Views from the North: Hans Petter Graver: Law, Justice and the State: Nordic Perspectives u Jacob Dahl Rendtorff: The Danish Welfare State: Philosophical Ideals and Systemic Reality u Sigri!Dur *orgeirsdottir: Feminist Ethics and Feminist Politics u Kuellike Lengi: The Situation of Human Rights in Estonia u Einar Palsson: Pythagoras and Early Icelandic Law u Law, Discourse and Rationality: Mats Flodin: Internal and External Rationality of Legal Systems u Logi Gunnarsson: A Discourse About Discourse u Hjordi!s Hakonardottir: Legal (...) Language: A Tool of Justice u Ghita Holmstrom-Hintikka: On the Use of Expert Witness in Legal Reasoning and Inquiry u Law, State and Nation: Agust H. Ing*orsson: Democracy, Bureaucracy and Marginalization of the State u Aleksander Peczenik: Law-State, Legal Certainty and Legitimacy of Law u Ove K. Pedersen/Sverre Raffnsoe: Reorganizing Society u Juha Raikka: Mill on National Sentiment u Pall Skulason: Concepts of the State and Classes of Value u Problems of Law and Rights: Britt-Mari Blegvad: How to Cope With Uncertainty: Trust and Law u Jon Wetlesen: Animal Rights or Human Duties?. (shrink)

Rejectionists argue that collective belief ascriptions are best understood as instances of collective acceptance rather than belief. Margaret Gilbert objects to rejectionist accounts of collective belief statements. She argues that rejectionists rely on a questionable methodology when they inquire into the nature of collective belief ascriptions, and make an erroneous inference when they are led to believe that collectives do not really have beliefs. Consequently, Gilbert claims that collective belief statements are best understood as instances of belief. I critically examine (...) Gilbert’s criticisms of rejectionism. I argue that rejectionism is still a viable account of collective belief ascriptions. I also argue that Gilbert’s most powerful criticism provides important insight into what really stands between her and the rejectionists. Gilbert and the rejectionists do not yet agree about what background assumptions can be made in developing an account of collective belief ascriptions. (shrink)

Devitt has developed an interesting defense of realism against the threats posed by the Pessimistic Induction and the Argument from Unconceived Alternatives. Devitt argues that the best explanation for the success of our current theories, and the fact that they are superior to the theories they replaced, is that they were developed and tested with the aid of better methods than the methods used to develop and test the many theories that were discarded earlier in the history of science. It (...) is no surprise that theories developed earlier in the history of science needed to be replaced. But our current theories are different, having been developed and tested with the aid of these more recently developed superior methods. I critically analyze Devitt’s defense of realism. I argue that recent developments in methodology cannot support the claims Devitt makes. I present an argument I call the “Argument from Unconceived Methods.” Given the history of science, it seems likely that scientists will continue to develop new methods in the future. And some of these methods will enable scientists to generate data that cannot be reconciled with the currently accepted theories. Consequently, it seems that our current best theories are not immune from being replaced in the future by radically different theories. (shrink)

The Covid-19 pandemic creates an unprecedented threatening situation worldwide with an urgent need for critical reflection and new knowledge production, but also a need for imminent action despite prevailing knowledge gaps and multilevel uncertainty. With regard to the role of research ethics in these pandemic times some argue in favor of exceptionalism, others, including the authors of this paper, emphasize the urgent need to remain committed to core ethical principles and fundamental human rights obligations all reflected in research regulations and (...) guidelines carefully crafted over time. In this paper we disentangle some of the arguments put forward in the ongoing debate about Covid-19 human challenge studies (CHIs) and the concomitant role of health-related research ethics in pandemic times. We suggest it might be helpful to think through a lens differentiating between risk, strict uncertainty and ignorance. We provide some examples of lessons learned by harm done in the name of research in the past and discuss the relevance of this legacy in the current situation. (shrink)

I take another look at the history of science and offer some fresh insights into why the history of science is filled with discarded theories. I argue that the history of science is just as we should expect it to be, given the following two facts about science: theories are always only partial representations of the world, and almost inevitably scientists will be led to investigate phenomena that the accepted theory is not fit to account for. Together these facts suggest (...) that most scientific theories are apt to be discarded sometime, superseded by new theories that better serve scientists’ new research interests. Consequently, it is reasonable to expect that many of the theories we currently accept, despite their many impressive successes, will be discarded sometime in the future. But I also argue that discarded theories are not always aptly characterized as a sign of failure or as a sign of some sort of shortcoming with science. Theories are discarded because scientists are making advances in their pursuit of knowledge. Thus, discarded theories are often a sign of the good health of science. Scientists are responding to their changing research interests. (shrink)

People often discriminate based on negative or positive stereotypes about others. Important examples of this are highlighted by the theory of ambivalent sexism. This theory distinguishes sexist stereotypes that are negative (hostile sexism) from those that are positive (benevolent sexism). While both forms of sexism are considered wrong towards women, hostile sexism seems intuitively worse than benevolent sexism. In this article, we ask whether the difference between discriminating based on positive vs. negative stereotypes in itself makes a morally relevant difference. (...) We suggest that it does not. By examining a number of prominent accounts of what makes discrimination wrong, we defend the Moral Irrelevance View according to which stereotype valence is irrelevant to the moral evaluation of discrimination, all else equal. (shrink)

In this wide-ranging interview Priscilla Alderson discusses how she came to research parental and childhood consent and became a sociologist and how, late in her career, she became convenor of the critical realism group started by Roy Bhaskar at the Institute for Education in London. She discusses aspects of her seminal research over the years on multiple subjects, such as the rights of children, and reflects on what critical realism has added to her social research.

Structurally free logic LC was introduced in [4]. A natural extension of LC, in particular, in a sequent formulation, is by conjunction and disjunction that do not distribute over each other. We define a set theoretical semantics for these logics via constructing a representation of a lattice that we extend by intensional operations. Canonically, minimally overlapping filter-ideal pairs are used; this construction avoids the use of an equivalent of the axiom of choice and lends transparency to the structure. We also (...) discuss adapting the present semantics for substructural logics, as well as, the question of cannnonicity of LC+. (shrink)

Valorising the biocultural heritage of common goods could enable peasant farmers to achieve socially and economically inclusive sustainability. Increasingly appreciated by consumers, peasant heritage products offer small farmers promising opportunities for economic, social and territorial development. Identifying the obstacles and levers of this complex, multi-scale and multi-stakeholder objective requires an integrative framework. We applied the panarchy conceptual framework to two cases of participatory research with small quinoa producers: a local fair in Chile and quinoa export production in Bolivia. In both (...) cases, the “commoning” process was crucial both to bring stakeholders together inside their communities and to gain outside recognition for their production and thus achieve social and economic inclusion. Despite the differences in scale, the local fair and the export market shared a similar marketing strategy based on short value chains promoting quality products with high identity value. In these dynamics of biocultural heritage valorisation, the panarchical approach revealed the central place as well as the vulnerability of the community territory. As a place of both anchoring and opening, the community territory is the privileged space where autonomous and consensual control over the governance of common biocultural resources can be exercised. (shrink)

De senere år har pleie- og omsorgstjenesten i mange norske kommuner startet med ulike former for etikkarbeid, oftest initiert av KS’ prosjekt “Samarbeid om etisk kompetanseheving”. Hensikten med vår studie var å evaluere innsatsen i de kommunene som deltok i prosjektet fra starten av, med vekt på hvilke tiltak som var iverksatt, hvilke virksomheter dette omfattet, og om tiltakene har fortsatt utover prosjektperioden. Studien har et kvalitativt design. Materialet er hovedsakelig basert på telefonintervjuer med kontaktpersoner for etikksatsingen i 34 kommuner. (...) Det transkriberte materialet er analysert ved kvalitativ innholdsanalyse. Med unntak av fem kommuner som aldri kom i gang med etikkarbeidet, hadde de fleste startet etikkrefleksjon innenfor flere tjenester, oftest i sykehjem og hjemmetjenester. Noen kommuner hadde imidlertid ikke klart å videreføre etikkarbeidet utover en prosjektperiode. Det var stor variasjon både i etikkarbeidets forankring i kommunen, omfang, hyppighet og metoder. Et gjennomgående funn er vektlegging av behovet for etikkkompetanse og oppfølging av dem som skal lede etikkarbeidet. Flertallet av kommunene som fortsatt gjennomfører etikkrefleksjon, tar utgangspunkt i egen praksis, men et mindretall anvender strukturerte metoder. Dersom etikkarbeidet i kommunen skal være levedyktig over tid, bør arbeidet forankres på flere nivåer i organisasjonen, og de som skal lede dette arbeidet, bør få styrket sin kompetanse i etikk og etikkrefleksjon.Nøkkelord: etikk, evaluering, kommunehelsetjenestenEnglish summary: Building ethical competence in Norwegian municipalities: What has been done and what has been sustainable?“Cooperation for building ethics competence” is a national project aimed to stimulate moral reflection and build competence in ethics in community health services in Norway. This article is based on an evaluation of the activities implemented by the first 34 participating municipalities, exploring which measures were implemented, which services and employees were involved, and if the measures are sustainable. The study has a qualitative design, and the data mainly consists of telephone interviews with “key” persons in 34 municipalities. With the exception of five municipalities that never really started ethics work, the majority had implemented ethical reflection in several areas, most often in nursing homes and home care services. There was great variation with regard to the implementation. Many had tried a variety of reflection models, and only a minority of the municipalities were using a structured method of ethical reflection. A consistent finding is the need for more competence; many of those who run ethical reflection are reported to need more competence both in ethics and methods for systematic reflection. There were also great variations in how well the ethics projects were anchored within the municipality. To make ethical interventions sustainable, this study indicates the importance of strong anchoring within the municipality, the need for ethical competence, as well as good methods for structuring ethical reflection. (shrink)

Fourteen experienced psychiatric nurses participated in a pilot study aimed at describing the experiential aspect of making decisions for the patient. In-depth interviews focused on conflicts, were transcribed, coded, and categorized according to the Grounded Theory method. The theoretical construct, 'modifying autonomy' and its dimensions, such as being aware of the patient's vulnerability, caring for and caring about the patient, were identified. The findings in this study make clear the need for further research into the experiential aspect of ethical decision-making (...) in psychiatric practice. (shrink)

Magie a estetika odkouzlení u Collingwooda = Magic and the aesthetics of disenchantment in Collingwood / Jakub Stejskal -- Americký trávník jako cvičiště občanské ctnosti = American lawn as a training ground for civic virtue / Jan Hlávka -- Patočkova raná filosofie umění = Patočka's early philosophy of art / Jan Josl -- Koncepce a priori Mikela Dufrenna = Mikel Dufrenne's concept of the a priori / Felix Borecký -- A priori imaginace = The a priori of imagination / Mikel (...) Dufrenne. (shrink)

It is well documented that the higher the socioeconomic status (SES) of patients, the better their health and life expectancy. SES also influences the use of health services—the higher the patients' SES, the more time and specialised health services provided. This leads to the following question: should clinicians give priority to individual patients with low SES in order to enhance health equity? Some argue that equity is best preserved by physicians who remain loyal to ‘ordinary medical fairness’ in non-ideal circumstances (...) when health disparities persist; ie, doctors should allocate care according to needs only and treat everyone with equal regard by being neutral with respect to patients' SES. This paper furthers a discussion of this view by questioning how equitable needs relate to SES. To clarify, it distinguishes between four versions of ‘healthcare need’ and approaches an acceptable conceptualisation of the notion supported by Norman Daniels' theory on health equity. It concludes that doctors should remain neutral to patients' SES in cases in which several patients require the same health care. However, equitable health care requires considerations of the impact of socioeconomic factors (SEF) on patients' capacity to benefit from the care. Remaining neutral towards patients' SES in this respect does not promote equal regard. It follows that priority setting on the basis of SEF is required in fair clinical distribution of care, eg, through allocating more time to patients with low SES. In order to advance equity accurately, the concept of ordinary medical fairness should be amplified according to this clarification. (shrink)