Setting out to defend luck egalitarianism in matters of justice in health, Shlomi Segall outlines a pluralistic version of the luck egalitarian framework allowing egalitarian justice to be traded-off against other moral requirements. The suggested pluralism enables luck egalitarian justice to coexist with a concern for meeting everyone’s basic needs thereby avoiding Elizabeth Anderson’s ‘abandonment objection’. In this article, however, we present three objections to Segall’s luck egalitarian justice in health. Firstly, the account is vulnerable to the common objection that (...) luck egalitarianism becomes too expansive, and that Segall’s defence against this is inadequate. Secondly, Segall’s pluralist attempt to balance luck egalitarian justice and other moral requirements ends up compromising its own ideal of justice. Due to the fact that resource scarcity is the reality of health and health care distribution, this problem would often arise in actual health policy. Finally, the account has a way of intensifying blameworthy behaviour which seems contrary to luck egalitarian principles. Based on these three objections, we conclude that Segall’s luck egalitarian account of justice in health must either be rejected or qualified further. (shrink)

Questions on what it means to live and die well are raised and discussed in the hospice movement. A phenomenological lifeworld perspective may help professionals to be aware of meaningful and important dimensions in the lives of persons close to death. Lifeworld is not an abstract philosophical term, but rather the opposite. Lifeworld is about everyday, common life in all its aspects. In the writings of Cicely Saunders, known as the founder of the modern hospice movement, facets of lifeworld are (...) presented as important elements in caring for dying patients. Palliative care and palliative medicine today are, in many ways, replacing hospices. This represents not only a change in name, but also in the main focus. Hospice care was originally very much about providing support and comfort for, and interactions with the patients. Improved medical knowledge today means improved symptomatic palliation, but also time and resources spent in other ways than before. Observations from a Nordic hospice ward indicate that seriously ill and dying persons spend much time on their own. Different aspects of lifeworld and intersubjectivity in the dying persons’ room is presented and discussed. (shrink)

BackgroundAs part of the research project “End-of-life Communication in Nursing Homes. Patient Preferences and Participation”, we have studied how Advance Care Planning is carried out in eight Norwegian nursing homes. The concept of ACP is a process for improving patient autonomy and communication in the context of progressive illness, anticipated deterioration and end-of-life care. While an individualistic autonomy based attitude is at the fore in most studies on ACP, there is a lack of empirical studies on how family members’ participation (...) and involvement in ACP- conversations may promote nursing home patients’ participation in decisions on future treatment and end-of-life care. Based on empirical data and family ethics perspectives, the purpose of this study is to add insights to the complexity of ACP-conversations and illuminate how a family ethics perspective may improve the quality of the ACP and promote nursing home patients’ participation in advance care planning.MethodsParticipant observations of ACP-conversations in eight nursing homes. The observations were followed by interviews with patients and relatives together on how they experienced being part of the conversation, and expressing their views on future medical treatment, hospitalization and end-of-life issues.ResultsWe found that the way nursing home patients and relatives are connected and related to each other, constitutes an intertwined unit. Further, we found that relatives’ involvement and participation in ACP- conversations is significant to uncover, and give the nursing home staff insight into, what is important in the nursing home patient’s life at the time. The third analytical theme is patients’ and relatives’ shared experiences of the dying and death of others. Drawing on past experiences can be a way of introducing or talking about death.ConclusionsAn individual autonomy approach in advance care planning should be complemented with a family ethics approach. To be open to family ethics when planning for the patient’s future in the nursing home is to be open to diversity and nuances and to the significance of the patient’s former life and experiences. (shrink)

: Moral cognition research has in part been taken to be a problem for moral sentimentalists, who claim that emotions are sensitive to moral information. In particular, Joshua Greene can be understood to provide an argument against moral sentimentalism on the basis of neuropsychological evidence. In his argument he claims that emotions are an unreliable source of moral insight. However, the argument boils down to circular claims: Rationalistic factors are assumed to be the only morally relevant factors; Emotions are not (...) sensitive to these factors; Thus, Moral Sentimentalism is false, because only rationalistic factors are justified. While this circularity makes so-called sourcing-arguments fallacious if applied against moral sentimentalism, moral cognition research has much to contribute. Indeed, moral cognition research will be instrumental for clarifying the sentimentalist position, shedding light on the mental mechanics underlying emotional moral processing. After all, evidence from moral cognition points to substantial involvement of affective processes in human moral cognizing and their embodied nature; thus, challenging long held beliefs about morality. Keywords : Moral Cognition; Moral Sentimentalism; Emotions; Embodied Cognition; Moral Brain Emozioni, Esperimenti e il cervello morale. L’errore degli argomenti basati sulla cognizione morale contro il sentimentalismo morale Riassunto: Si è spesso ritenuto che la ricerca nell’ambito della cognizione morale costituisse, almeno in parte, un problema per il sentimentalismo morale, il quale sostiene che le emozioni sono sensibili all’informazione morale. In particolare, si può pensare che Joshua Greene abbia portato un argomento contro il sentimentalismo morale basato su evidenza neuropsicologica. Secondo il suo argomento le emozioni non costituiscono una fonte affidabile di comprensione morale. E tuttavia questo argomento fa leva su una circolarità: gli unici fattori qualificati come moralmente rilevanti sono quelli razionali; le emozioni non sono sensibili a questi fattori; pertanto, considerato che solo i fattori razionali sono giustificati, il sentimentalismo morale è falso. Tale circolarità rende fallaci i cosiddetti argomenti sorgente, laddove questi siano applicati al sentimentalismo morale. Al contempo, la ricerca sulla cognizione morale ha molto da dire su questo argomento perché può contribuire a chiarire la posizione sentimentalista, gettando luce sulla meccanica mentale sottostante i processi morali che fanno leva su emozioni. Anzi questa prospettiva di ricerca evidenzia che i processi di carattere affettivo sono coinvolti in maniera sostanziale nella cognizione morale umana e hanno una natura incarnata; in questo modo essa mette in discussione convinzioni di vecchia data sulla morale. Parole chiave : Cognizione morale; Sentimentalismo morale; Emozioni; Cognizione incarnata; Cervello morale. (shrink)

A comprehensive understanding of the ethics of the COVID-19 pandemic priorities must be sensitive to the influence of social inequality. We distinguish between ex-ante and ex-post relevance of social inequality for COVID-19 disadvantage. Ex-ante relevance refers to the distribution of risks of exposure. Ex-post relevance refers to the effect of inequality on how patients respond to infection. In the case of COVID-19, both ex-ante and ex-post effects suggest a distribution which is sensitive to the prevalence social inequality. On this basis, (...) we provide a generic fairness argument for the claim that welfare states ought to favour a healthcare priority scheme that gives particular weight to protecting the socially disadvantaged. (shrink)

In recent works, Shlomi Segall suggests and defends a luck egalitarian approach to justice in health. Concurring with G. A. Cohen’s mature position he defends the idea that people should be compensated for “brute luck”, i.e. the outcome of actions that it would be unreasonable to expect them to avoid. In his defense of the luck egalitarian approach he seeks to rebut the criticism raised by Norman Daniels that luck egalitarianism is in some way too narrow and in another too (...) wide to uphold justice in health and health care distribution. He points out that a pluralistic outline of luck egalitarianism taking into account the moral requirement of meeting everyone’s basic needs can avoid this line of criticism. In this article I argue against the application of such pluralistic luck egalitarianism in matters of health distribution. First of all, Segall has not shown that luck egalitarianism handles well health distributions above a threshold of basic needs. Secondly, his way of avoiding Elizabeth Anderson’s abandonment objection is theoretically problematic. Finally, I argue that luck egalitarianism in general fails to acknowledge the moral foundation of health and health care as a basic human entitlement. Thus I conclude that luck egalitarianism fails to take health needs seriously and that it cannot therefore uphold justice in health. (shrink)

Background Artificial intelligence (AI) has revolutionized various healthcare domains, where AI algorithms sometimes even outperform human specialists. However, the field of clinical ethics has remained largely untouched by AI advances. This study explores the attitudes of anesthesiologists and internists towards the use of AI-driven preference prediction tools to support ethical decision-making for incapacitated patients. Methods A questionnaire was developed and pretested among medical students. The questionnaire was distributed to 200 German anesthesiologists and 200 German internists, thereby focusing on physicians who (...) often encounter patients lacking decision-making capacity. The questionnaire covered attitudes toward AI-driven preference prediction, availability and utilization of Clinical Ethics Support Services (CESS), and experiences with ethically challenging situations. Descriptive statistics and bivariate analysis was performed. Qualitative responses were analyzed using content analysis in a mixed inductive-deductive approach. Results Participants were predominantly male (69.3%), with ages ranging from 27 to 77. Most worked in nonacademic hospitals (82%). Physicians generally showed hesitance toward AI-driven preference prediction, citing concerns about the loss of individuality and humanity, lack of explicability in AI results, and doubts about AI’s ability to encompass the ethical deliberation process. In contrast, physicians had a more positive opinion of CESS. Availability of CESS varied, with 81.8% of participants reporting access. Among those without access, 91.8% expressed a desire for CESS. Physicians' reluctance toward AI-driven preference prediction aligns with concerns about transparency, individuality, and human-machine interaction. While AI could enhance the accuracy of predictions and reduce surrogate burden, concerns about potential biases, de-humanisation, and lack of explicability persist. Conclusions German physicians frequently encountering incapacitated patients exhibit hesitance toward AI-driven preference prediction but hold a higher esteem for CESS. Addressing concerns about individuality, explicability, and human-machine roles may facilitate the acceptance of AI in clinical ethics. Further research into patient and surrogate perspectives is needed to ensure AI aligns with patient preferences and values in complex medical decisions. (shrink)

It is a common socio-moral practice to appeal to reasons as a guiding force for one’s actions. However, it is an intriguing possibility that this practice is based on fiction: reasons cannot or do not motivate the majority of actions—especially moral ones. Rather, pre-reflective evaluative processes are likely responsible for moral actions. Such a view faces two major challenges: i.) pre-reflective judgements are commonly thought of as inflexible in nature, and thus they cannot be the cause of the varied judgements (...) people rely on in everyday life, and ii.) if reflective reason-based judgements do not play a strong causative role in judgement, why do people rely on the articulation of reasons in their moral practices? We argue that the pre-reflective judgements motivating moral actions are embodied in nature. The experience of the rightness of an action that drives a person to act depends on the sensorimotor interactions that have cultivated an agent’s perspective on the world. These interactions are embedded in relational contexts, relative to which judgements are individuated. Because of this relational embeddedness they are more flexible than they are commonly thought to be, enabling us to explain the variety of human behavior by appealing to them. The Anglo-European practice of appealing to reason as if they were propositional belief-statements motivating actions can be accounted for as nothing more than an idiosyncratic way of constructing narratives to clarify and express the relational context of intentional actions. (shrink)

Telic sufficientarianism is the view that it is better, other things equal, if people are lifted above some sufficiency threshold of special moral importance. In a recent contribution, Shlomi Segall has raised the following objection to this position: The telic ideal of sufficiency can neither be grounded on any personal value, nor any impersonal value. Consequently, sufficientarianism is groundless. This article contains a rejoinder to this critique. Its main claim is that the value of autonomy holds strong potential for grounding (...) sufficiency. It argues, firstly, that autonomy carries both personal value for its recipient as well as impersonal value, and that both of these values are suitable for grounding sufficiency. It thus follows that we should reject both and. Secondly, although autonomy is presumably the strongest candidate for grounding sufficiency, the article provides some counterargument to Segall's rejection of the other candidates — the impersonal value of virtue; the personal value for the allocator; and the personal value for others. If the arguments are sound, they show that we need not worry about sufficientarianism being groundless. (shrink)

On the sesquicentennial of T. R. Malthus’s second and much enlarged edition of An Essay on the Principle of Population (1803), the retired doctor and public health official George F. McCleary publi...

Since his contribution to the field of personal identity in 1738 Hume’s theory has been debated thoroughly. Throughout the years there have been multiple critiques of Hume’s theory, but despite the fact that all of these generally appear unsatisfactory, Hume’s theory of personal identity is far from being a popular one in the field. I believe the blame partly falls on Hume himself. Hume’s appendix to Treaties is most often read as expressing a deep concern regarding his own theory, and (...) this concern, I believe, is to blame for his theory never gaining the respect it deserves. After all, why should we listen to Hume if he himself found his theory lacking? It is, however, a mistake to judge Hume’s theory of personal identity, based on the appendix to Treaties. The appendix is far too ambiguity for any real conclusion and it offers nothing that cannot be found in the original chapter on personal identity from Treaties. (shrink)

This paper discusses limitarianism in light of three popular objections to the redistribution of extreme wealth: (i) that such redistribution legitimizes envy, which is a morally objectionable attitude; (ii) that it disincentivizes the wealthy to invest and work, leading to a diminished social product, and, thereby, making everyone worse-off; and (iii) that it undercuts the pursuit and achievement of human excellence by depriving successful people of resources through which they may otherwise excel. We argue that these objections fail to undermine (...) limitarianism. An elaborated defence against them, rather, reveals how the Standard Defence of limitarianism may be expanded and strengthened by relying explicitly on the importance of preventing a society of envy, avoiding harm to non-rich citizens, and ensuring that humans are given the opportunities to excel in ways that go beyond those that allow for the amassment of wealth. (shrink)

An amendment to this paper has been published and can be accessed via the original article.

It is generally accepted that morally justified healthcare rationing must be non-discriminatory and cost-effective. However, given conventional concepts of cost-effectiveness, resources spent on disabled people are spent less cost-effectively, ceteris paribus, than resources spent on non-disabled people. Thus, it is reasonable to assume that standard cost-effectiveness discriminates against the disabled. Call this thedisability discrimination problem.Part of the disability discrimination involved in cost-effectiveness stems from the way in which health-related quality of life is accounted for and measured. This paper offers and (...) defends a patient-sensitive account of health-related quality of life, which can effectively make cost-effectiveness less discriminatory against the disabled and thus more morally justified. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 63.2 (2002) 303-321 [Access article in PDF] "The Peak on Which Abraham Stands": The Pregnant Moment of Søren Kierkegaard's Fear and Trembling Lasse Horne Kjaeldgaard When Søren Kierkegaard in the 1840s began his one-man crusade against the predominant philosophy of his time and place—the right Hegelianism that was en vogue among his contemporaries in Copenhagen—he chose his weapons with great circumspection. The (...) indirect form of communication, which he later advocated in more direct terms in his "Point of View," 1 was not only a maieutic means that helped the reader conceive of the latent and strictly private messages of the texts; it was also a strategy for Kierkegaard's undercover assaults on the Hegelian turn of the Geistesleben around him. By interweaving many of the Hegelian platitudes and self-confident pronouncements that circulated in the intellectual life of the day into the pseudonymous writings, Kierkegaard contested them with parody rather than argumentation. This is the local background against which these texts are structured and to which they are addressed in multiple and very subtle ways. That also goes for that of the pseudonymous writings which has become the best known but which may also be regarded as the most private and most secretive of them all, Fear and Trembling, published pseudonymously in 1843.Secrecy, silence, and unspeakable messages are abundantly thematized in Fear and Trembling, as one could expect from the name of the narrator, Johannes de Silentio. Silentio is a prominent member of the choir of pseudonymous figures Kierkegaard invented to communicate indirectly with his audience and in [End Page 303] the name of which he published his most celebrated works. The silence that Silentio speaks of is that of Abraham of the Old Testament, who was commanded by God to sacrifice his only son on Mount Moriah. Although Genesis 22 includes fragments of the dialogue between Abraham and Isaac on their way to the mountain, Silentio insists that Abraham remained silent on the essential issue: the command he acts upon. The unmediated message Abraham had received from God could not be conveyed, and he was therefore barred from communication and bereft of his community as he journeyed to the Mountain. Yet Silentio's discourse upon this silence in Fear and Trembling has given impetus to innumerable pages of commentary. The questions and answers he poses in his reflections upon Abraham's ordeal have called for critical attention and controversy since the time of its publication. His obsession with the biblical narrative certainly seems to have been passed on to many readers of Fear and Trembling, which, a recent commentator has remarked, "continues to haunt us like no other of [Kierkegaard's] writings." 2 So far, it would seem, then, that Kierkegaard was right when he predicted, in an undated journal entry, that "Fear and Trembling will be enough to immortalise my name." It has indeed been "read and translated into foreign languages," as he foresaw it would. 3Even so, what has passed unnoticed in its long history of reception is the significance of the titles that the manuscript text bore before it came to be called Fear and Trembling. On the title page the definitive appellation is placed together with two alternatives with less suggestion of pathos: "Movements and Postures" (Bevægelser og Stillinger) and "Between-each-other" (Mellemhver-andre). 4 Not much can be discerned from these unpeculiar phrases in isolation. However, tracing their history and significance through Kierkegaard's writings and beyond, will make it clear that Fear and Trembling was also dispatched to the narrow Hegelian community in Copenhagen for the purpose of questioning their literary and visual aesthetics and philosophy of history. Into the guerrilla warfare against them Fear and Trembling introduces a weapon of such sophistication that it has remained undetected so far: the power of the "pregnant moment." My aim here will be to demonstrate the way in which Fear and Trembling appropriates a principle of selection intended for the... (shrink)

The concepts of adaptation and fitness have such an appeal that they have been used in other scientific domains, including the social sciences. One particular aspect of this theory transfer concerns the so-called fitness landscape models. At first sight, fitness landscapes visualize how an agent, of any kind, relates to its environment, how its position is conditional because of the mutual interaction with other agents, and the potential routes towards improved fitness. The allure of fitness landscapes is first and foremost (...) that it represents a complex story about adaptation and fitness in one coherent image. Different accounts of fitness landscapes in different domains in the social sciences suggest that the properties and functions of fitness landscapes are attributed rather freely. These differences are testimony of the model’s versatility. At the same time, one will notice that the different approaches can also create ambiguity about the exact meaning and role of fitness landscapes in the social sciences. This article presents an extensive literature survey of the diverging interpretations and uses of fitness landscapes in the social sciences and discusses the implications in terms of how these models inform scientific inquiry. (shrink)

Prioritarianism pertains to the generic idea that it matters more to benefit people, the worse off they are, and while prioritarianism is not uncontroversial, it is considered a generally plausible and widely shared distributive principle often applied to healthcare prioritisation. In this paper, I identify social justice prioritarianism, severity prioritarianism and age-weighted prioritarianism as three different interpretations of the general prioritarian idea and discuss them in light of the effect of pandemic consequences on healthcare priority setting. On this analysis, the (...) paper arrives at the following three conclusions: that we have strong prioritarian reasons for special concern about the vulnerable and socially disadvantaged in reference to pandemic effects, that severity of illness is an important factor in identifying the worse off in priority setting but that this must not over-ride the special priority to the socially disadvantaged and that the maximisation rationale of the age-weighted view runs against the core prioritarian idea, and the age-weighted prioritarianism is thus unfitting as a prioritarian response to the COVID-19 case. (shrink)

Here are Holsteins as they've rarely been depicted before—abstractions in black and white, artist's models with long-lashed liquid eyes, soulful individuals and sisters of the herd, the fecund embodiments of mother's milk, tenants of the land, spirits and myths. Fine art photographer Paul Thoresen captures the very essence of cows with his camera. He has been artfully photographing Holstein cattle for more than five decades, mostly on three family farms within a mile of his home near Paoli, Wisconsin. Cows: (...) A Closer Look contains more than seventy photographs in both black-and-white and color. (shrink)

Many methods are used in research on complexity. One of these is qualitative comparative analysis. Although many authors allude to the relationships between complexity and QCA, these links are rarely made explicit. We propose that one way of doing so is by using critical realism as a meta-framework. This article discusses the viability of this approach by examining the extent to which QCA is a complexity-informed method. This question is answered in three steps. First, we discuss the nature of complexity (...) and its epistemological implications. Second, we focus on Bhaskar’s perspective on critical realism and show how it can be used as a framework for understanding social complexity. Third, we examine the ontological and epistemological assumptions underlying QCA and synthesize these with our critical realist approach to complexity. We argue that complex reality is non-decomposable, contingent, non-compressible and time-asymmetric. We conclude that, although QCA is inevitably reductive and partial, its core premises are built upon the notions of contingency and time-asymmetry. Therefore, it is not only a powerful method for doing complexity-informed research, but is also a complexity-informed method by itself. (shrink)

This article advances a tentative theory of skill in relation to eSports. This conjectural theory of skill rests on hypothesizes informed by assumptions from watching 100+ hours of eSport events on Twitch, YouTube, and AfreecaTV and is supported by discussions, reflections and evaluations with eSport players. The case material of this article includes the games Clash Royale (CR), StarCraft 2 (SC2), Counter-Strike: Global Offensive (CS:GO), and online battle arenas (mobas) such as League of Legends (LOL) and Defense of the Ancient (...) 2 (DOTA2). This inferred theory of skill is conjoined and composed of seven strands, which provide a framework for explaining how to understand skill in eSport. These seven strands are presented under the headings: (1) knowledge about game objects, (2) insights into game systems, (3) understanding metagaming, (4), yomi: ‘reading’ the opponent, (5) ability to execute, (6) emotional discipline, and finally (7) team coherency (depending upon whether the skill is associated with a one-versus-one or team-versus-team game). In conclusion, the proposed theory of skill will expose its explanatory power and reach by providing an example of how it can both be implemented to create profiles of players’ skill, and how these profiles in turn can serve as guides to help players improve their skill levels in eSport. (shrink)

In this paper, I ask what is wrong with sufficiency. I formulate a generic sufficiency principle in relation to which I discuss possible problems for sufficientarianism. I argue against the arbitrariness–concern, that sufficiency theory need only to identify a possible space for determining a plausible threshold, and I argue against the high–low threshold dilemma concern, that multiple-threshold views can solve this dilemma. I then distinguish between currency-pluralist and currency-monist multiple-threshold views and test them against two different versions of the widely (...) shared ‘ignorance of inequality objection’ to sufficientarianism—a benefit-driven and a burden-driven version. I argue that currency-pluralist sufficiency views are better capable of responding to the former than currency-monist views. However, I show that no existing sufficiency view can provide a plausible response to the burden-driven version. Hence, I conclude that the problem of unequal distribution of burdens above the thresholds represents an overlooked threat to the sufficiency view, in any version. (shrink)

This article claims that the protection of children’s capability for play is a central social-political goal. It provides the following three-premise argument in defense of this claim: we have strong and wide-ranging normative reasons to be concerned with clusters of social deficiency; particular fertile functionings play a key role for tackling clusters of social deficiency; and finally the capability for childhood play is a crucial, ontogenetic prerequisite for the development of those particular fertile functionings. Thus, in so far as we (...) consider it a central political goal to tackle social deficiency, we should be concerned with protection of childhood play capability. This conclusion raises new insights on the importance – for global development policy as well as for welfare states’ aim to secure social justice – of protecting children’s capability to engage in playful activities. (shrink)

This paper explores the role individual responsibility plays in contemporary political theory. It argues that the standard luck egalitarian view—the view according to which distributive justice is ensured by holding people accountable for their exercise of responsibility in the distribution of benefits and burdens—obscures the more fundamental value of being responsible. The paper, then, introduces an account of ‘self-creative responsibility’ as an alternative to the standard view and shows how central elements on which this account is founded has been prominently (...) defended in the history of Western political thought but are comparatively neglected in contemporary political theory. Relying on this account, the paper argues that society should hold persons responsible when, and only when, doing so enables them to lead responsible lives, and only on the condition that doing so does not infringe other persons’ equivalently valuable ability to lead responsible lives. The account of self-creative responsibility, the paper concludes, plausibly captures the intuitive attraction of holding responsible while respecting the value of being responsible. (shrink)

The work of prominent analytical Marxist G. A. Cohen provides a vision of socialism which has distributive justice and community at its core. While Cohen's view of distributive justice has been hugely influential, much less has been said about community. This article argues that community plays three distinct roles in Cohen's socialism. One is as an independent value, the second is as a necessary adjacent counterpart to justice, which serves both to restrict and facilitate distributive equality, and the third is (...) as a critique of the liberal contractualist view of humanity. We argue that each of these are distinct and valuable elements in Cohen's thought, each of which must be recognized to understand the range and implications of Cohen's socialism. (shrink)

Natural disasters, technological disasters, and terrorist attacks have an extensive aftermath, often involving society’s institutions such as the legal system and the police. Victims’ perceptions of institutional trustworthiness may impact their potential for healing. This cross-sectional study investigates institutional trust, health, and social support in victims of a disaster that occurred in 1990. We conducted face-to-face interviews with 184 survivors and bereaved, with a 60% response rate 26 years after the disaster. Levels of trust in the police and in the (...) justice system were compared with general population data. We assessed the relationships between institutional trust and current psychological distress, social support, and quality of life. The levels of trust in the police and in the justice system were notably lower in survivors and bereaved than in the general population. Among the victims, low institutional trust was associated with more mental health problems, poorer social support, more barriers to seeking social support, and a lower quality of life. Lost trust in the aftermath of a disaster may perhaps never be restored and the lack of trust may act to strengthen or maintain health problems. An exclusively individualistic approach to trauma and disaster may miss out on the opportunities for promoting health and wellbeing that lies within the larger societal structures. Decision-makers should take this information into account, and acknowledge the potential long-term consequences of institutional performance in the aftermath of a disaster. (shrink)

This article identifies value‐satiability sufficientarianism as a distinctive version of the sufficiency view, which has been ignored in the literature on distributive justice. This is unfortunate because value‐satiability sufficientarianism is much better equipped than alternative sufficiency views to cope with the standard objections against sufficiency. Most often, sufficientarianism refers to satiability as a feature of moral principles and reasons. But value‐satiability sufficientarianism also invokes satiability in the space of value‐theory, as it determines the sufficiency threshold at the point where justice‐relevant (...) values have been completely fulfilled. The article gives examples of how this view is widely apparent in the literature, and it provides some reasons in its favour. It then presents the two standard objections against sufficientarianism – the threshold objection and the indifference objection – and argues that these critiques do not apply to value‐satiability sufficientarianism. The general argument of the article therefore proves sufficientarianism more difficult to refute than is commonly credited. (shrink)

Age rationing is a central issue in the health care priority‐setting literature, but it has become ever more salient in the light of the Covid‐19 outbreak, where health authorities in several countries have given higher priority to younger over older patients. But how is age rationing different under outbreak circumstances than under normal circumstances, and what does this difference imply for ethical theories? This is the topic of this paper. The paper argues that outbreaks such as that of Covid‐19 involve (...) special circumstances that change how age should influence our prioritization decisions, and that while this shift in circumstances poses a problem for consequentialist views such as utilitarianism and age‐weighted consequentialism, contractualism is better equipped to cope with it. The paper then offers a contractualist prudential account of age rationing under outbreak circumstances. (shrink)

Uses poststructuralist theory to connect inclusion, exclusion and identity, using real-world case studies from British culture, politics and lawLasse Thomassen applies a fresh, poststructuralist approach to reconcile the theoretical and practical issues surrounding inclusion, exclusion and representation. He opens up debates and themes including Britishness, race, the nature and role of Islam in British society, homelessness and social justice. Thomassen argues that the politics of inclusion and identity should be viewed as struggles over how these identities are represented. He develops (...) this argument through careful analysis of cases from the last four decades of British multiculturalism, including public debates about the role of religion in British society, Gordon Brown and David Cameron's contrasting versions of Britishness, legal cases about religious symbols and clothing in schools, and the Nick Hornby novel How to Be Good. (shrink)

Ernesto Laclau introduced the category of heterogeneity into his theory of hegemony in the late 1990s. He did so as a way to capture the limits of representation, and the argument was fully developed in On Populist Reason in 2005. The chapter argues that heterogeneity should be a central category of hegemony and discourse analysis, and that antagonism can be seen as a strategy of ideological closure that suppresses heterogeneity. I show the limitations of Laclau’s concept of antagonism, and how (...) antagonism must be relativized. I then turn to examine the concept of heterogeneity. I end by discussing the usefulness of the category of heterogeneity in the wider context of how to do discourse theory and how to conceptualize the limits of representation. (shrink)

Would primary care services benefit from the aid of a clinical ethics committee (CEC)? The implementation of CECs in primary care in four Norwegian municipalities was supported and their activities followed for 2.5 years. In this study, the CECs’ structure and activities are described, with special emphasis on what characterizes the cases they have discussed. In total, the four CECs discussed 54 cases from primary care services, with the four most common topics being patient autonomy, competence and coercion; professionalism; cooperation (...) and disagreement with next of kin; and priority setting, resource use and quality. Nursing homes and home care were the primary care services most often involved. Next of kin were present in 10 case deliberations, whereas patients were never present. The investigation indicates that it might be feasible for new CECs to attain a high level of activity including case deliberations within the time frame. It also confirms that significant, characteristic and complex moral problems arise in primary care services. (shrink)

Many consider play a natural part of childhood, and although there is disagreement in the literature on what essentially defines “play” in childhood, philosophical theories of play tend to support this initial consideration. But is childhood play also something we owe each other within a framework of educational justice? This is a question yet to be addressed. In this paper, I answer this question affirmatively. I take off from a generic account of educational justice and argue that childhood play should (...) be considered a central entitlement of this account. I then argue in line with the capability approach that if we ought to protect childhood play, it should be children’s capability for play rather than the functioning of play that needs protection. I end by offering an account of the capability for childhood play. (shrink)

This paper argues in defence of sufficientarianism that there is a general flaw in the most common critiques against it. The paper lays out sufficientarianism and presents the problems of indifference, of outweighing priority, and of discontinuity. Behind these problems is a more general objection to the abruptness of the sufficiency threshold relying upon an assumption regarding arithmeticism about value. The paper argues that sufficientarians need not accept arithmeticism about value and that the commonly held critiques of sufficientarianism are in (...) fact instances of the numbers fallacy pertaining to the construction of numerical counterexamples that gain intuitive traction from ‘empty numbers’ – numbers without meaningful content in reference to the view under investigation. The paper concludes that we should remain sceptical about such use of numerical counterexamples, and while this does not by itself prove sufficientarianism correct, it is an important and novel contribution to its justification. (shrink)

Visual attention evolved as an adaptive mechanism allowing us to cope with a rapidly changing environment. It enables the facilitated processing of relevant information, often automatically and governed by implicit motives. However, despite recent advances in understanding the relationship between consciousness and visual attention, the functional scope of unconscious attentional control is still under debate. Here, we present a novel masking paradigm in which volunteers were to distinguish between varying orientations of a briefly presented, masked grating stimulus. Combining signal detection (...) theory and subjective measures of awareness, we show that performance on unaware trials was consistent with visual selection being weighted towards repeated orientations of Gabor patches and reallocated in response to a novel unconsciously processed orientation. This was particularly present in trials in which the prior feature was strongly weighted and only if the novel feature was invisible. Thus, our results provide evidence that invisible orientation stimuli can trigger the reallocation of history-guided visual selection weights. (shrink)

Over the last years, there has been a steady stream of books published on deconstruction and the work of Jacques Derrida in addition to the many books by Derrida himself. Derrida’s death on 8 October 2004 in no way stopped this wealth of publications, including texts on Derrida, deconstruction, and politics. There have been a number of books on Derrida,1 including edited volumes,2 and there is now a Derrida journal, Derrida Today. This is in addition to posthumously published works by (...) Derrida himself, of which The Beast and the Sovereign will be of most interest to this journal’s readers.3 Much of this literature links deconstruction and Derrida’s writings to politics. This may be in part because of Derrida’s own engagement with political concepts and institutions in his later work, but may also be a reaction to the emergence of new political phenomena (e.g. international terrorism of the al-Qaeda type) which in turn creates a need to rethink traditional concepts (e.g. sovereignty). Interestingly much of this literature on deconstruction and politics comes not from political scientists, but from other disciplines, including philosophy, comparative literature, and law. This includes the two books under review here*Mustapha Che´rif ’s Islam and the West and Martin McQuillan’s Deconstruction After 9/114*neither of which is written by a political scientist. As is the case with many other contemporary texts on Derrida, these two books examine how Derrida and deconstruction can help us understand contemporary political phenomena. The two books both address issues related to the signifiers ‘9/11,’ ‘Islam,’ and ‘the West,’but they also question the received meanings of those signifiers, for instance, the idea of ‘Islam’ as a monolith and as the Other of ‘the West.’ (Published: 4 December 2009) Citation: Ethics & Global Politics, Vol. 2, No. 4, 2009, pp. 383–388. DOI: 10.3402/egp.v2i4.2108. (shrink)