While much of the debate around the practice of normothermic regional perfusion (NRP) is focused on the potential violation of the dead donor rule (DDR), another concern is whether allowing this pr...

Some ethicists assert that there is a consensus that maximising medical outcomes takes precedence as a principle of resource allocation in emergency triage of absolutely scarce resources. But the nature of the current severe acute respiratory syndrome-related coronavirus 2 pandemic and the history of debate about balancing equity and efficiency in resource allocation do not support this assertion. I distinguish a number of concerns with justice and balancing considerations that should play a role in critical care triage policy, focusing on (...) discrimination and on fundamental egalitarian and social justice concerns. (shrink)

Most philosophers writing about personal identity in recent years claim that what it takes for us to persist through time is a matter of psychology. In this groundbreaking new book, Eric Olson argues that such approaches face daunting problems, and he defends in their place a radically non-psychological account of personal identity. He defines human beings as biological organisms, and claims that no psychological relation is either sufficient or necessary for an organism to persist. Olson rejects several famous (...) thought-experiments dealing with personal identity. He argues, instead, that one could survive the destruction of all of one's psychological contents and capabilities as long as the human organism remains alive--as long as its vital functions, such as breathing, circulation, and metabolism, continue. (shrink)

The multi-disciplinary unit Social Responsibility in Action was developed for students with an interest in ethics who were completing undergraduate degrees in Arts, Commerce, Design or Science at an Australian research-intensive university. The academic objectives of this unit were to increase student awareness, knowledge, understanding and critical thinking skills related to various ethical issues. Lecturers from five disciplines collaborated in the design and delivery of SRA, which comprised lectures, tutorials and a research-based project. Anonymous surveys were administered at the start (...) and end of the semester to obtain feedback on student expectations and learning experience, respectively. Data across three student cohorts showed that at the start of semester, 80% of student comments indicated a desire to expand their interest of ethical matters, 59% a desire to gain understanding and knowledge and 59% to gain critical thinking or communication skills. SRA was extremely well received by students, with 98% of respondents indicating that this multi-disciplinary ethics unit had met their expectations. Students also found that the variety of teaching styles, unit content and multi-disciplinary approach stimulated learning. (shrink)

Are the small and indolent cancers found in abundance in cancer screening normal variations, risk factors, or disease? Naturalists in philosophy of medicine turn to pathophysiological findings to decide such questions objectively. To understand the role of pathophysiological findings in disease definition, we must understand how they mislead in diagnostic reasoning. Participants on all sides of the definition of disease debate attempt to secure objectivity via reductionism. These reductivist routes to objectivity are inconsistent with the Bayesian nature of clinical reasoning; (...) when they appeal to the sciences, they are inconsistent with what philosophy of biology tells us about its natural kinds. Proposals that we narrow the scope of our claims in the disease definition debates are useful, but paradigms can still distort our reasoning in particular cases, even when we are self-conscious about their status. (shrink)

This book discusses affective practices in performance through the study of four contemporary performers – Keith Hennessy, Ilya Noé, Caro Novella, and duskin drum – to suggest a tentative rhetoric of performativity generating political affect and permeating attempts at social justice that are often alterior to discourse. The first part of the book makes a case for the political work done alongside discourse by performers practising with materials that are not-known, in ways that are directly relevant to people carrying out (...) their daily lives. In the second part of the book, four case study chapters circle around figures of irresolvable paradox – hendiadys, enthymeme, anecdote, allegory – that gesture to what is not-known, to study strategies for processes of becoming, knowing and valuing. These figures also shape some elements of these performances that make up a suggested rhetorical stance for performativity. (shrink)

PurposeSocial exclusion as a result of gender, race, and class inequality is perhaps one of the most pressing challenges associated with the development of a diverse information technology workforce. Women remain under represented in the IT workforce and college majors that prepare students for IT careers. Research on the under representation of women in IT typically assumes women to be homogeneous in nature, something that blinds the research to variation that exists among women. This paper aims to address these issues.Design/methodology/approachThe (...) paper challenges the assumption of heterogeneity by investigating how the intersection of gender, race, and class identities shape the experiences of Black female IT workers and learners in the USA.FindingsThe results of this meta‐analysis offer new ways of theorizing that provide nuanced understanding of social exclusion and varied emancipatory practices in reaction to shared group exposure to oppression.Originality/valueThis study on the under‐representation of women as IT workers and learners in the USA considers race and class as equally important factors for understanding variation among women. In addition, this paper provides rich insights into the experiences of Black women, a group that is largely absent from the research on gender and IT. (shrink)

Basileia and tyrannis: exploding myths -- Arete and the right to rule -- Ruling families -- Rulers in the polis -- Epilogue: Athens, ruling and arete.

Some argue that the concept of medical need is inadequate to inform the design of a universal health care system—particularly an institutional rather than a residual system. They argue that the concept contradicts the idea of comprehensiveness; leads to unsustainable expenditures; is too indeterminate for policy; and supports only a prioritarian distribution. I argue that ‘comprehensive’ understood as ‘including the full continuum of care’ and ‘medically necessary’ understood as ‘prioritized by medical criteria’ are not contradictory, and that UHC is a (...) solution to the problem of sustainability, not its cause. Those who criticize ‘medical need’ for indeterminacy are not transparent about the source of their commitment to their standards of determinacy: they promote standards that are higher than is necessary for legitimate policy, ignoring opportunity costs. Furthermore, the indeterminacy of concepts affects all risk-sharing systems and all systems that rely on medical standard of care. I then argue that the concept of need in itself does not imply a minimal sufficientist standard or a prioritarian distribution; neither does the idea of legitimate public policy dictate that public services be minimalist. The policy choice for a system of health care that is comprehensive and offers as good care as can be achieved when delivered on equal terms and conditions for all is a coherent option. (shrink)

Temkin asks how we should distribute resources between the social determinants of health and health care; Sreenivasan argues that if our goal is fair opportunity, funding universal health coverage is the wrong policy. He argues that social equality in health has not improved under UHC and concludes that fair opportunity would be better served by using the resources to address the SDOH instead. His criticism applies more broadly than he claims: it applies to any argument for UHC based on health (...) equity. However, neither his strong causal conclusion nor his stark policy proposal is justified. I review methodological challenges for establishing the relative causal contributions of health care and social policy, concluding that we may never have a robust causal account to support a consequentialist choice. Fortunately, we may not need to answer the allocation question as a dichotomy. Given what Sen calls the multidimensional nature of health equity and the role of UHC in cost containment, UHC may not be a threat to health equity. I also argue against Sreenivasan's claim that the data he discusses should not trouble sufficientists and prioritarians. The worst-off are not simply lagging in improvement; rather, their health status is stagnating or worsening. (shrink)

Verweij and Dawson claim that population health has a distributive dimension; Coggon argues that this presupposes a normative commitment to equity in the very definition of population health, which should, rather, be neutral. I describe possible sources of the distributive view, several of which do not presuppose egalitarian commitments. Two relate to the nature of health as a property of individuals ; two relate to the epistemology and pragmatics of public and population health. A fifth source of the distributive view (...) is a critical stance on the concept of population health; I contrast this with Coggon’s account of the public as a shared political imaginary. None of these views is ‘neutral’: they exhibit several different kinds of normativity and quasi-normativity, but this is not problematic. I argue that the critical stance appropriately distinguishes and relates social justice and public health. (shrink)

A very clear and powerfully argued defence of a most important and surprisingly neglected view."--Derek Parfit, All Souls College, Oxford. "If Dr. Olson is right, we are living animals and what goes on in our minds is wholly irrelevant to questions about our persistence through time....[Should] transform philosophical thinking about personal identity."--Peter van Inwagen, University of Notre Dame.

Scientism in medical education distracts educators from focusing on the content of learning; it focuses attention instead on individual achievement and validity in its measurement. I analyze the specific form that scientism takes in medicine and in medical education. The competencies movement attempts to challenge old “scientistic” views of the role of physicians, but in the end it has invited medical educators to focus on validity in the measurement of individual performance for attitudes and skills that medicine resists conceptualizing as (...) objective. Academic medicine should focus its efforts instead on quality and relevance of care. The social accountability movement proposes to shift the focus of academic medicine to the goal of high quality and relevant care in the context of community service and partnership with the institutions that together with medicine create and cope with health and with health deficits. I make the case for this agenda through a discussion of the linked histories of the opioid prescribing crisis and the professionalism movement. (shrink)

This paper is about the neglected question of what sort of things we are metaphysically speaking. It is different from the mind-body problem and from familiar questions of personal identity. After explaining what the question means and how it differs from others, the paper tries to show how difficult it is to give a satisfying answer.

The professionalism movement has animated medical education and practice; an extensive literature expresses and categorizes many interpretations of the concept (Hafferty 2006a; Hafferty and Levinson 2008). The inception of the current wave of the movement was in the American Board of Internal Medicine's Project Professionalism. In the face of threats from the growth of managed care and public concerns about conflict of interest, the ABIM's "Physician Charter" called for the profession to publically commit to values of patient welfare, social justice, (...) and respect for patient autonomy (Brennan et al. 2002). The concept of professionalism, or the physician as occupying the role of professional, has taken hold in .. (shrink)

Suppose a certain man, Dion, has his foot amputated, and lives to tell the tale. That tale involves a well-known metaphysical puzzle, for most of us assume that there was, before the operation, an object made up of all of Dion’s parts except those that overlapped with his foot-- ”all of Dion except for his foot”, we might say, or Dion’s “foot-complement”. Call that object Theon. (Anyone who doubts that there is such a thing as Dion’s undetached foot-complement may imagine (...) that ‘Theon’ is a name for Dion’s undetached head. Surely there is such a thing as Dion’s head? And surely Dion could, in principle, survive if his head were detached from the rest of him and kept alive?) It seems obvious that Theon, like Dion, continues to exist after the operation, for you cannot destroy an object merely by changing its surroundings--merely by removing something that was never a part of it. The puzzle, then (which might be called the problem of undetached parts), is how Dion and Theon are related after the operation. The most common answer to this question is that Dion and Theon come to occupy just the same region of space and to be made of just the same matter after the operation. The next-mostpopular answer is that Dion and Theon are made up of temporal parts, and while those of their temporal parts that “occur” before the operation only partly overlap, Dion and Theon have the very same post-operative temporal parts. Much as two roads can merge and have spatial parts in common, Dion and Theon merge and have temporal parts in common. Less popular accounts of the relation between Dion and Theon involve relativizing identity to concepts or times, and denying that there is such a thing as Theon. Michael Burke has recently proposed an intriguing new solution (or resurrected an ancient one) to the problem of undetached parts. [1] He argues that, despite appearances, Theon-- Dion’s foot-complement--ceases to exist when Dion’s foot is removed.. (shrink)

Diverse Nations, Diverse Responses provides a rich overview of the historical, demographic, and political forces that shape social cohesion. It also provides a comparative analysis of the policy goals that have been pursued, the programs that have been implemented, the ways that social cohesion has been defined and measured, and the effects of such issues on immigrants, minorities, and host communities. The volume provides a cross-national conversation on approaches to social cohesion and will appeal to researchers, policy-makers, and practitioners interested (...) in immigration, diversity management, and the factors that affect policy choice, diversity, and outcomes. (shrink)

Ethics is enabling of agency, but also normative and conventional. At the moment a gendered ethics, or the gendering of ethics, is a helpful approach because it is concerned with issues to do with people often peripheral to and excluded from power. At the moment it can work to keep ethics responsive, but how do we halt the drift into the normative, both as prescriptive and as ideological? A feminist ethics maintains the responsive and undermines prescriptive categories, and is committed (...) to involving disempowered voices in the conversation. The article is particularly concerned with the articulation of the situated, and raises questions about attending to, learning how to listen to and learning how to speak, so that many people from different places can get involved in ethics. Otherwise ethics isn’t ethical. (shrink)

In Canada, laws and policies consistently reject the commodification of human organs and tissues, and Canadian practice is consistent with international standards in this regard. Until the Assisted Human Reproduction Act of 2004, gamete donation in Canada was an exception: Canadians could pay and be paid open market rates for gametes for use in in vitro fertilization. As sections of the AHR Act forbidding payment for gametes and permitting only reimbursement of receipted expenses gradually came into effect in 2005, Canada (...) did away with this anomaly. Medical practice and legal prohibitions in assisted human reproduction are now consistent with other areas of medicine where tissues and organs are taken from one person to benefit others: Altruistic donation, rather than selling and buying, will be the norm. (shrink)

The feminist in academe, says Paula Bennett, is like Procne married to Tereus, "inextricably wedded to the sources of her harm." An ethical justification of academic feminism can be found, not in cooperation and affiliation, but in the strategies currently necessary to ensure curricular and cultural diversity. Historically contextualized and strategically politicized, this ethic is founded on the claim that universities are places where we may all learn to know what is other than ourselves.

The seriousness of the risk that healthcare workers faced during SARS, and their response of service in the face of this risk, brings to light unrealistic assumptions about duty and risk that informed the debate on duty to care in the early years of HIV/AIDS. Duty to care is not based upon particular virtues of the health professions, but arises from social reflection on what response to an epidemic would be consistent with our values and our needs, recognizing our shared (...) vulnerability to disease and death. Such reflection underwrites a strong duty of care, but one not to be borne solely by the altruism and heroism of individual healthcare workers. (shrink)

Systems of universal health coverage may aspire to provide care based on need and not ability to pay; the complexities of this aspiration call for normative analysis. This special issue arises in the wake of a judicial inquiry into preferential access in the Canadian province of Alberta, the Vertes Commission. I describe this inquiry and set out a taxonomy of forms of differential and preferential access. Papers in this special issue focus on the conceptual specification of health system boundaries and (...) on the normative questions raised by complex models of funding and delivery of care, where patients, providers, and services cross system boundaries. (shrink)

In their article, “Rare Disease, Advocacy and Justice: Intersecting Disparities in Research and Clinical Care,” Halley et al. (2023) use three case examples to describe challenges patients with rar...

Written by some of the world's leading academics and professionals in the field, this collection of essays brings together two complementary views on child development - the role of society and the role of cognitive growth.

J.W. Olson addresses the Christian doctrine of revelation by asking how theological truth claims can possibly be rooted in God’s incarnational self-communication. Engaging with the phenomenology of Martin Heidegger, Olson offers an interpretation of the Eucharist that grounds Christian knowledge in an embodied understanding of the sacrament.

Personal identity deals with questions about ourselves qua people (or persons). Many of these questions are familiar ones that occur to everyone at some time: What am I? When did I begin? What will happen to me when I die? Discussions of personal identity go right back to the origins of Western philosophy, and most major figures have had something to say about it. (There is also a rich literature on personal identity in Eastern philosophy, which I am not competent (...) to discuss. Collins 1982 is a good source.). (shrink)

Was sind wir? Wie immer man sich zu dieser Frage stellt, eines scheint offenkundig: Wir sind Tiere, genauer gesagt: menschliche Tiere, Mitglieder der Art Homo sapiens. Dabei mag es überraschen, daß viele Philosophen diese vermeintlich banale Tatsache abstreiten. Plato, Augustinus, Descartes, Locke, Berkeley, Hume, Kant und Hegel, um nur einige herausragende zu nennen, waren alle der Meinung, wir seien keine Tiere. Es mag zwar sein, daß unsere Körper Tiere sind. Doch sind wir nicht mit unseren Körpern gleichzusetzen. Wir sind etwas (...) anderes als Tiere. Kaum anderer Meinung sind Denker nicht-westlicher Traditionen. Und rund neun von zehn Philosophen, die heutzutage über Probleme der personalen Identität nachdenken, vertreten Ansichten, die ausschließen, daß wir Tiere sind. (shrink)

The Greek polis has been arousing interest as a subject for study for a long time, but recent approaches have shown that it is a subject on which there are still important questions to be asked and worthwhile issues to be explored. This book contains a selection of essays which embody the results of the latest research. Beyond the historical development of the Greek polis , the contributors ask questions about the civic institutions of ancient Greece as a whole and (...) their relationships to each other. Questions of power or the significance of a written code of law are discussed as well as the nature of Greek overseas settlements. Development of the Greek Polis presents up-to-date research and asks up-to-date questions on various aspects of an important topic. (shrink)

_Critiques of Knowing_ explores what happens to science and computing when we think of them as texts. Lynette Hunter elegantly weaves together vast areas of thought: rhetoric, politics, AI, computing, feminism, science studies, aesthetics and epistemology. _Critiques of Knowing_ shows us that what we need is a radical shake-up of approaches to the arts if the critiques of science and computing are to come to any fruition.

Many moral error theorists hold that moral facts are irreducibly normative. They also hold that irreducible normativity is metaphysically queer and conclude that there are no irreducibly normative reasons and consequently no moral facts. A popular response to moral error theory utilizes the so-called ‘companions in guilt’ strategy and argues that if moral reasons are irreducibly normative, then epistemic reasons are too. This is the Parity Premise, on the basis of which critics of moral error theory draw the Parity Conclusion (...) that if there are no irreducibly normative reasons, there are no moral reasons and no epistemic reasons. From the Parity Conclusion and Epistemic Realism (the view that there are epistemic reasons), it follows that it is false that there are no irreducibly normative reasons. In this paper, I argue that the Parity Premise and the Parity Conclusion can both plausibly be rejected. (shrink)

From the time of Locke, discussions of personal identity have often ignored the question of our basic metaphysical nature: whether we human people are biological organisms, spatial or temporal parts of organisms, bundles of perceptions, or what have you. The result of this neglect has been centuries of wild proposals and clashing intuitions. What Are We? is the first general study of this important question. It beings by explaining what the question means and how it differs from others, such as (...) questions of personal identity and the mind-body problem. It then examines in some depth the main possible accounts of our metaphysical nature, detailing both their theoretical virtues and the often grave difficulties they face. The book does not endorse any particular account of what we are, but argues that the matter turns on more general issues in the ontology of material things. If composition is universal--if any material things whatever make up something bigger--then we are temporal parts of organisms. If things never compose anything bigger, so that there are only mereological simples, then we too are simples--perhaps the immaterial substances of Descartes--or else we do not exist at all (a view Olson takes very seriously). The intermediate view that some things compose bigger things and others do not leads almost inevitably to the conclusion that we are organisms. So we can discover what we are by working out when composition occurs. (shrink)

The prosaic content of these sayings is that events change from future to present and from present to past. Your next birthday is in the future, but with the passage of time it draws nearer and nearer until it is present. 24 hours later it will be in the past, and then lapse forever deeper into history. And things get older: even if they don’t wear out or lose their hair or change in any other way, their chronological age is (...) always increasing. These changes are universal and inescapable: no event could ever fail to be first future, then present, then past, and no persisting thing can avoid growing older. We call this process time’s passage. (shrink)

What is lying? -- Why do people lie? -- Little lies -- Lying hurts! -- When someone lies to you -- What if you tell a lie? -- What if you get caught? -- Making it right -- Put an end to lying -- Start telling the truth.