Geoffrey Rose’s prevention paradox points to a tension between two prima facie plausible moral principles: that we should save the greater number and that weshould save the most at risk. This paper argues that a novel moral theory, ex-ante contractualism, captures our intuitions in many prevention paradox cases, regardless of our interpretation of probability claims. However, it goes on to show that it might be impossible to square ex-ante contractualism with all of our moral intuitions. It concludes that even if (...) ex-ante contractualism cannot furnish an entire ethics of risk, it does identify important considerations for any such theory. (shrink)

While there is significant consensus that undergraduate medical education should include bioethics training, there is widespread debate about how to teach bioethics to medical students. Educators disagree about course methods and approaches, the topics that should be covered, and the effectiveness and metrics for UME ethics training. One issue that has received scant attention is the timing of bioethics education during medical training. The existing literature suggests that most medical ethics education occurs in the pre-clinical years. Follow-up studies indicate that (...) medical students in their clinical rotations have little recall or ability to apply ethics concepts that were learned in their pre-clinical training. Trainees also report a desire for medical ethics to be taught in the context of practical application, which would suggest that the timing of pre-clinical ethics education is flawed. However, moving bioethics training to the clinical years should not be assumed to be the solution to the problems of recall and theory application. We argue that the effectiveness of timing bioethics education will depend on when medical students witness or experience particular categories of ethical dilemmas during their training. Our overarching hypothesis is that ethics education will be most effective when the bioethics training on a particular topic correlates to experiential exposure to that ethical issue. The purpose of our current study was to describe medical students exposure to particular categories of ethical conflicts, dilemmas, or issues. Our results may help bioethics educators better strategize about the most effective timing of medical ethics training in UME. (shrink)

Tom Shakespeare’s important new book includes, among other topics, a persuasive critique of the social model of disability. A key component in his case against that model consists in an argument against the impairment/disability distinction as this is understood within the social model. The present paper focuses on the case Shakespeare makes against that distinction. Three arguments mounted by Shakespeare are summarised and responded to. It is argued that the responses adequately rebut Shakespeare’s case on this specific issue. Moreover, as (...) the engagement with Shakespeare’s argument illustrates, his claim to employ a critical realist perspective appears to be in considerable tension with the case he offers against the impairment/disability distinction. (shrink)

The practice of prenatal screening for disability is sometimes objected to because of the hurt and offence such practices may cause to people currently living with disabilities. This objection is commonly termed “the expressivist objection”. In response to the objection it is standardly claimed that disabilities are analogous to illnesses. And just as it would be implausible to suppose reduction of the incidence of illnesses such as flu sends a negative message to ill people, so it is not plausible to (...) suppose prevention of disability sends a negative message to disabled people. The expressivist objection hinges, however, upon a view of the relationship between disability and self identity which sees disability as part of the identity of the disabled person, in a way in which illnesses such as flu cannot be. This possibility is generally not considered in critiques of the expressivist objection. In this paper, an “identity claim” to the effect that disabilities can be identity constituting is accepted and the force of the expressivist argument is reconsidered in the light of its acceptance. It is concluded that even when such an identity claim is accepted, the expressivist objection is still not morally compelling. (shrink)

Eupolis’ fragmentary Demes has traditionally been placed in 412 bc, after the failure of the Sicilian Expedition but before the oligarchic coup of 411. Ian Storey has recently argued that the play belongs instead in 417 or perhaps 416 bc, while Mario Telò and Leone Porciani put it in 410 bc. This article demonstrates that both alternative dates face decisive objections, and suggests that Demes is better kept in 412 bc. I then briefly consider the role of late 5th-century Athenian (...) “political” comedy generally, and in particular the sort of popular sentiment that Eupolis’ comedy must have been exploiting or echoing when it was conceived in the first half of 413. (shrink)

A recent exchange on Benatar’s book Better never to have been between Doyal and Benatar discusses Benatar’s bold claim that people should not be brought into existence. Here, I expand the discussion of original position that the exchange focused on. I also discuss the asymmetries, between benefit and harm and between existence and non-existence, upon which Benatar’s bold claim rests. In both discussions, I show how Benatar’s bold claim can be rejected.

The present study explores the Bianchi type I universe in the frame work of f theory of gravity by considering strange quark matter attached to string cloud and domain walls in the presence and absence of magnetism. Field equations are solved by choosing a constant curvature method. It is found that obtained cosmological models are relevant to the early era of evolution of the universe. The strange quark matter may be a source of string cloud and domain walls.

In this paper the coherence of the precautionary principle as a guide to public health policy is considered. Two conditions that any account of the principle must meet are outlined, a condition of practicality and a condition of publicity. The principle is interpreted in terms of a tripartite division of the outcomes of action . Such a division of outcomes can be justified on either “consequentialist” or “deontological” grounds. In the second half of the paper, it is argued that the (...) precautionary principle is not necessarily opposed to risk–cost–benefit analysis, but, rather, should be interpreted as suggesting a lowering of our epistemic standards for assessing evidence that there is a link between some policy and “special bad” outcomes. This suggestion is defended against the claim that it mistakes the nature of statistical testing and against the charge that it is unscientific or antiscientific, and therefore irrational. (shrink)

Persistence theories of causation – such as transference theory, conserved-quantity theory, and Douglas Ehring's theory – attempt to analyzecausation in terms of some persisting entityconnecting cause and effect. While mostpersistence accounts are intended as empiricaltheories, this article develops a persistenceanalysis of the concept of causation. The basic idea is that the central concept ofdirect causation can be analyzed in terms ofproperty acquisition. The analysis cohereswith our ordinary causal judgments andprovides a straightforward explanation of thedirection of causation. It also explains whybackwards (...) causation is conceptually problematic. (shrink)

The current Medicare prospective payment system has many positive incentives for hospitals to control costs. Hospitals are increasing outpatient surgery, decreasing admissions, decreasing length of stay, and decreasing use of ancillary services. These are just the effects that Congress and the Health Care Financing Administration hoped for to save the Medicare trust fund. However, there has been evidence of some adverse outcomes including premature discharge, “dumping” sicker patients and patients without insurance, and adverse impact on hospitals with specialty centers. We (...) examine these issues and present a possible solution based on a new Computerized Severity Index. (shrink)

The moral status accorded to an individual (or class of individuals) helps to account for the weight of the moral obligations considered due to an individual (or class of individuals). Strong arguments can be given to indicate that the moral status accorded, justly or unjustly, to individuals with intellectual disabilities is less than that accorded to those considered intellectually able. This paper suggests that such a view of the moral status of intellectually disabled individuals derives from individualism. Ontological and normative (...) components of individualism are identified. It is shown that individualistic, ontological criteria for personhood compromise the integrity of “dependent” individuals. And it is shown that the normative component of individualism further compromises the integrity of intellectually disabled individuals. An alternative view of the self is outlined in which dependence features centrally. It is tentatively suggested that such a view of the self may prove more congenial to enhancing the moral status of individuals with intellectual disabilities. (shrink)

An investigation into some of the literary features of the book of Malachi reveals that each unit is structured in a twofold way. The macrostructure of the book also shows that the book can be divided into two parts. The results of this investigation strengthens the recent trend in the research of Malachi that it is unlikely that the book underwent an extensive redactional process over a period of time and that it is rather more likely that the book was (...) written in a relatively short period of time. (shrink)