Parenthood is one of the best gifts nature and god has given to humans. Being a parent is a feeling that can be compared to none other but as a baby caretaker a nanny can do this. As a parent, we always strive to provide the best of everything to our children. This however often comes at a price. Mostly it means that both the parents have to be working in order to provide the best facilities and at the (...) same time secure the future of their children and Newborn Baby. Even if one of the parent chooses to sacrifice the career and stay at home, raising a child in a nuclear family set up is still a challenge. -/- This is when an experienced and gentle baby caretaker can be of utmost help. However such caretaker who can be entrusted with the care and security of your child is often hard to find. Especially in cities like NOIDA baby caretaker are available for your service. Well no more. -/- No more is the need to sacrifice your career or professional aspirations. You can peacefully leave to work, entrusting your lovely children in the hands of the baby caretaker. Majority of the time that your child will be spending is with the caretaker and it is therefore absolutely necessary that a baby caretaker possess all the qualities of a good parent. Benevolence, patience, care and attention, all these qualities can be found in the baby caretaker provided by us. Our caretaker ensures the welfare of the child, creating the environment for sound mental, emotional and health development of the children. -/- We need to guarantee that the caretaker has the child's best interest at heart and looks at the security of our child with the same eye as we do. We select the baby caretakers that view this profession as means of contentment and satisfaction in their lives and not just another menial job to earn their livelihood. Children have the inherent need to have somebody always around them in oder to feel secure and wanted, avoiding loneliness and boredom. A Caretaker for baby in Noida not only provides this companion but also ensures that the natural curiosity of a child is kept alive even in the absence of their parents. -/- Big cities with the diverse kind of population, mostly coming to work from various parts of the country, have had some history of violent cases. And that’s why precaution should be taken while hiring Best caretaker in Noida . With thorough background check and verified references, all such apprehensions can be laid to rest.+ . (shrink)

Morphological and morphometric study of umbilical cord of 50 newborn babies were carried out during January to December 1998 at Bangabandhu Sheikh Mujib Medical University, Dhaka to expand the knowledge of gross anatomy of the umbilical cord of Bangladesh. The length of the cords irrespective of sex was ranged from 28 to 93 cm with a mean (±SD) of 55.6 (±10.78).The length of the umbilical cord of male was significantly longer than female (P<0.001). The diameter of the cord irrespective of (...) sex varied from 1 to 1.9 cm with a mean (±SD) of 1.45 +0.31 cm. The mean circumference length percentage ratio index of umbilical cord was 8.31. Thirty-three (66%) cords were inserted eccentrically, all being paracentral in position. The rest were inserted centrally. False knots were more frequent (47; 94%). Only one (2%) showed a true knot in addition of false knot. In 2(4%) cases cord had not any true or false knot. It is concluded that the gross morphological and morphometrical features of the umbilical cord in Bangladesh appear to be similar to those described in western literature. -/- . (shrink)

The main claim of this article is that the plasticity of the human formation process does not consist in receiving passively an already-given shape, like hot wax stamped by a seal. Rather, it creates ever new shapes and makes a person overcome her own self-referential horizon. Furthermore, I argue that this formation process is directed by desire, meant as “hunger for being born completely” (Zambrano). The human being comes into the world without being born completely, and it is (...) precisely such hunger that directs human positioning into the world. (shrink)

In response to the COVID-19 pandemic, large-scale research and pharmaceutical regulatory processes have proceeded at a dramatically increased pace with new and effective, evidence-based COVID-19 interventions rapidly making their way into the clinic. However, the swift generation of high-quality evidence and the efficient processing of regulatory authorisation have given rise to more specific and complex versions of well-known research ethics issues. In this paper, we identify three such issues by focusing on the authorisation of Molnupiravir, a novel antiviral medicine aimed (...) at reducing the ability of SARS-CoV-2 to multiply in the body, for clinical use by the National Health Service in England and the concomitant testing of Molnupiravir through the large-scale PANORAMIC randomised control trial. By analysing the ways in which the authorisation and clinical use of Molnupiravir complicate standard approaches to clinical equipoise, standard of care, and participant consent in the PANORAMIC randomised control trial we will explain some of ethical implications for clinical trials that aim to study the efficacy and safety of new COVID-19 and other therapeutics when conditional authorisation has already been granted and when such treatments have already been made available to patients by national health providers. (shrink)

In this essay, I depart from the historical exclusion of trans women’s ethical insights from care ethics by focusing on trans literature as a source of knowledge expressed by trans women about care. I open up with the systematic denial of trans women as ethical knowers by analyzing Marilyn Frye's characterization of trans women as mindless servile robots under patriarchy. I then turn to trans literature to counter this portrayal. Specifically, I discuss short stories by Casey Plett and (...) Ryka Aoki as sources of knowledge about assumptive and futurebound practices of care. I begin by arguing that the work of Maria Lugones considers the spatial dimensions of love, and that this suggests that care involves giving space to another on their own terms. I then turn to Plett’s story “Other Women” to unpack assumptive care as a short-circuited form of caring in which a relationship to the other on their own terms is closed off by transphobic assumptions. I contrast this with Plett’s story “Winning,” which describes a futurebound care in which another’s space is kept open, permitting action that allows them to flourish on their own terms. After this, I discuss Aoki’s “To the New World” as an engagement with both racist assumptive care and futurebound care aimed at self-care. I conclude that these stories provide a rich space for considering trans ethical knowledge about care. (shrink)

The thesis of this paper is that – in order to avoid trivializations – a Philosophy of Birth needs to elaborate a precise concept of transformation and distinguish it carefully from that of adaptation. While transformation goes beyond the limited self-referential perspective of an individual and, on the social level, of the gregarious identity, adaptation aims at strengthening or preserving the old self-referential equilibrium. Transformation is driven by what Zambrano has called, with an exceptionally happy expression, the “hunger to be (...) born completely”. Such a hunger pushes one to continue one’s own birth through the encounter with the Other. Transformation has a creative feature that is made possible by two factors: the surplus of the effect over the cause, and the priority of the real over the possible. These premises lead to a radical questioning of the primacy of the possible on the real, at least as it has been conceived so far in mainstream Western philosophy, with few exceptions, such as Schelling, Bergson and Scheler. In the first part of this text, I shall consider a new Philosophy of Birth in the light of the concept of transformation and in this regard deal with several core themes such as the hunger to be born completely, the new beginning, creative time, the priority of the real over the possible, the limits of finalism, the surplus of effect over cause, and the creative force that expresses itself in the act of ideation. In the second part, I shall analyze the relation between birth and death and focus especially on their intimate and reciprocal connection by referring to the image of the seed that, after falling on the ground, germinates and breaks its own integument. (shrink)

J. N. (Jitendra Nath) Mohanty (1928–2023). -/- Professor J. N. Mohanty has characterized his life and philosophy as being both “inside” and “outside” East and West, i.e., inside and outside traditions of India and those of the West, living in both India and United States: geographically, culturally, and philosophically; while also traveling the world: Melbourne to Moscow. Most of his academic time was spent teaching at the University of Oklahoma, The New School Graduate Faculty, and finally Temple University. Yet his (...) preeminent work in Husserlian phenomenology developed alongside his eminent work in Indian philosophy: describing his interests as “a fusion of disparate horizons.” -/- J. N. Mohanty was born September 26, 1928, in Cuttack (Odisha, East India). After graduating from high school, he went on to study both Indian and Western philosophy in Calcutta, earning bachelor’s and master’s degrees. There he read Whitehead and Kant’s First Critique; although he wanted to include mathematics in his curriculum, he was led instead to include Indian philosophy and Sanskrit. On the shelves of his teacher, Ras Vihar Das, he came upon a copy of the English translation (Ideas I, 1931) of Edmund Husserl’s classic Ideen I (1913), which presented Husserl’s ground-breaking conception of phenomenology. In 1952–1954 he left India for the first time, reaching Göttingen to study mathematics and philosophy, which earned him a doctorate in mathematics and “philosophy of mathematical sciences” (in his own words). In Göttingen, Mohanty found the powerful mathematical world that Husserl himself had earlier interacted with, where several Husserl students had formed the Göttingen school of phenomenology. During these years Mohanty studied primarily mathematics, alongside Kant and also Vedic Sanskrit. From his friend Günter Patzig, interpreter of Aristotle and Frege, Mohanty was drawn to Frege in relation to mathematical logic. He attended lectures of Heidegger, intrigued by his ontological thinking. Yet, despite the Husserlian legacy, Mohanty was completely self-taught in his studies of Husserl (as he has reported). With a doctorate in mathematics, and ideas from Kant and Frege in his philosophical background, Mohanty set about crafting his own conception of philosophy grounded in phenomenology, drawing on Husserl’s extensive work, critically sifting through Husserl’s texts and their emerging concepts of intentionality, meaning, subject, intersubjectivity, and world. In between he wrote his first book-length study: on phenomenological insights in Nicolai Hartmann and A. N. Whitehead (1958). -/- Over many decades Mohanty formulated and argued, in analytical detail, for a conception of phenomenology and its place in philosophy, later presented in a clear and concise book titled Transcendental Phenomenology: An Analytic Account (1989). Over these very decades the same scholar explored classical and recent Indian philosophy, thinking through kindred ideas of consciousness, self, and knowledge drawn from the Indian philosophical contexts. While writing on Nyāya theory of truth, he also pondered whether the world and finite individual are illusory or real, and whether Marx, Arendt, Gandhi (whom he heard speak in Calcutta), or Vinoba Bhave (with whom he marched across India for the land-grant movement) could best navigate post-Independent India’s social and svarāj or self-rule reforms. The two Mohantys, thinking through a vision of self and world, turned out to be “non-different” or “non-dual” as they each practiced critical phenomenology from both inside and outside the respective philosophical and cultural traditions. Numerous students, fellows, and colleagues or collaborators have benefited immensely from this infusion and unified approach to diversity in philosophical thought. In the 2000s, moving into retirement, Mohanty wrote two long books devoted to his understanding of Husserl and phenomenology and the calling of philosophy itself. This two-volume study shows Mohanty himself thinking through Husserl, critically, in The Philosophy of Edmund Husserl: A Historical Introduction (2008), and Edmund Husserl’s Freiburg Years: 1916–1938. As Mohanty worked on Husserl, he carefully indicated where he agreed and where he rejected or changed ideas, all part of his practice in phenomenology of “description and interpretation.” It was the same pattern he used in addressing the thought of Husserl vis-à-vis Kant or Frege or even Quine. -/- As Mohanty developed his understanding of phenomenology over the years, he wrote books on theory of meaning and the concept of intentionality, developing a model of ideal meaning and its foundation in intentionality, drawing on Husserl’s results. He followed these with the book Husserl and Frege (1982), linking the thought of those foundational figures for the “continental” and “analytic” traditions, respectively, in twentieth-century Western philosophy. Over his long career Mohanty addressed both traditions in his clear and accessible writing style. While developing his views on phenomenology, Mohanty regularly looked to “Husserl and his others,” evaluating views in Heidegger, Sartre, Merleau-Ponty, Ricoeur, and then Derrida and others in the wake of Husserl. With his background in Kant, Mohanty also looked toward Heidegger and Hegel in relation to Husserl’s later work in the Crisis (1935–38). Similarly, he looked to contemporary analytic philosophers, adjudicating his own, oft-wise Husserlian views in relation to Frege, Nagel, and others. Amid his active scholarly career, Mohanty co-founded the journal Husserl Studies, and was editorial advisor to Philosophy & Phenomenological Research, Philosophy East & West, Journal of Indian Philosophy, Sophia, among others. -/- Yet all this while Mohanty was also thinking and writing about Indian philosophy and its relation to phenomenology. In his own retrospective, Indian philosophy is “the permanent background” of his Husserlian thinking, while Kant is the recurrent Western background of his Husserlian phenomenology. Mohanty’s form of “transcendental phenomenology” evolved, in his own perspective, against the background of his studies of Navya-Nyāya on logic and Vedānta on consciousness, in Indian philosophy, and against the background of Kant’s First Critique on the transcendental, in Western philosophy. Accordingly, Mohanty’s study of logical form and of the intentionality of consciousness seeks a fusion of East and West in the conception of transcendental phenomenology. (Cf. Mohanty’s apt response to critics in The Empirical and the Transcendental (2000).) Even in the context of North American Husserl scholarship, Mohanty has exercised an earnest fusion of East and West. For the so-called East Coast and West Coast interpretations of Husserl’s crucial notion of noema both find a sympathetic spirit in J. N. Mohanty’s careful and nuanced interpretation of Husserlian transcendental phenomenology. With Mohanty the two faces of the noema are the logical (Fregean) and the phenomenal (Kantian), and these views of intentional structure join in consciousness—in a way resonant with Indian thought. -/- - David Woodruff Smith (UC Irvine) and Purushottama Bilimoria (SFSU, San Francisco; University of Melbourne) -/- For photo of Prof Mohanty visit APA online memorial_minutes2023 Courtesy of APA Memorial Minutes (& Proceedings) 2023 . (shrink)

Background: Health care practitioners are recognized to have a large influence in shaping uptake of vaccine in new borns, children, adolescents, as well as adults. Parents remain more secure in their decisions when health care practitioners communicate successfully with them about vaccine dangers and benefits, the value as well as necessity for vaccinations, as well as vaccine safety. Thus, immunization remain the foundation of the primary health care system, an indisputable human right as well as a global (...) health and development success story, saving millions of lives yearly. Recently, we have vaccines to prevent more than 20 life threatening diseases, helping people of all ages live longer, healthier lives. Yet despite tremendous progress, far too many people around the world, including nearly 20 million infants yearly have insufficient access to vaccines. In some countries, progress has stalled or even reversed, and there is a real risk that complacency will undermine past achievements. Purpose: The current study aimed to explores vaccine hesitancy, its barriers and impact studies regarding COVID-19 decision impacts. Also, to provides policy and decision makers and operational staff with evidence to inform decisions to promote vaccine uptake across Bayelsa State. Methods: A literature review tried to do a deep dive by using a variety of search engines such as Scopus, Research Gate, Mendeley, Summon, PubMed, Google Scholar, Hinari, Dimension, Academia, CAB Abstract, OARE Abstract, SSRN search strategy to retrieve research publications, “grey literature” and expert working group reports, including author’s field experience. Findings: Absence of uniform methods of organization in the various health care facilities upon which we were obliged to rely. Thus affecting the overall immunization programme and health system. Hence policy must urgently address these challenges with emphasis on policy clarity while continuously improving infrastructure. Conclusions: Bayelsa State is categorized as low/poor performing as the findings suggest that the involvement of community-based leaders can improve community participation and acceptance while enhancing and strengthening integrated disease surveillance and Adverse Events Following Immunization (AEFI) monitoring and reporting systems; and conducting integrated advocacy and communications activities to promote demand for vaccination as part of increasing overall demand and acceptability of all essential Primary Health Centers (PHC) services, thus, breaking barriers of vaccine hesitancy. (shrink)

Aims and objectives. Participant narratives from a feminist and queer phe- nomenological study aim to broaden current understandings of trauma. Examin- ing structural marginalisation within perinatal care relationships provides insights into the impact of dominant models of care on queer birthing women. More specifically, validation of queer experience as a key finding from the study offers trauma-informed strategies that reconstruct formerly disempowering perinatal relationships. Background. Heteronormativity governs birthing spaces and presents considerable challenges for queer birthing women who may (...) also have an increased risk of trauma due to structurally marginalising processes that create and maintain socially constructed differences. Design. Analysis of the qualitative data was guided by feminist and queer phe- nomenology. This was well suited to understanding queer women’s storied narra- tives of trauma, including disempowering processes of structural marginalisation. Methods. Semistructured and conversational interviews were conducted with a purposeful sample of thirteen queer-identified women who had experiences of birthing in rural Nova Scotia, Canada. Results. Validation was identified as meaningful for queer women in the context of perinatal care in rural Nova Scotia. Offering new perspectives on traditional models of assessment provide strategies to create a context of care that recon- structs the birthing space insofar as women at risk do not have to come out as queer in opposition to the expectation of heterosexuality. Conclusions. Normative practices were found to further the effects of structural marginalisation suggesting that perinatal care providers, including nurses, can challenge dominant models of care and reconstruct the relationality between queer women and formerly disempowering expectations of heteronormativity that govern birthing spaces. Relevance to clinical practice. New trauma-informed assessment strategies recon- struct the relationality within historically disempowering perinatal relationships through potentiating difference which avoids retraumatising women with re- experiencing the process of coming out as queer in opposition to the expectation of heterosexuality. (shrink)

In The Future of Human Nature, Jürgen Habermas raises the question of whether the embryonic genetic diagnosis and genetic modification threatens the foundations of the species ethics that underlies current understandings of morality. While morality, in the normative sense, is based on moral interactions enabling communicative action, justification, and reciprocal respect, the reification involved in the new technologies may preclude individuals to uphold a sense of the undisposability of human life and the inviolability of human beings that is necessary for (...) their own identity as well as for reciprocal relations. Engaging with liberal bioethics and Catholic approaches to bioethics, the article clarifies how Habermas’ position offers a radical critique of liberal autonomy while maintaining its postmetaphysical stance. The essay argues that Habermas’ approach may guide the question of rights of future generations regarding germline gene editing. But it calls for a different turn in the conversation between philosophy and theology, namely one that emphasizes the necessary attention to rights violations and injustices as a common, postmetaphysical starting point for critical theory and critical theology alike. In 2001, Jürgen Habermas published a short book on questions of biomedicine that took many by surprise.[1] To some of his students, the turn to a substantive position invoking the need to comment on a species ethics rather than outlining a public moral framework was seen as the departure from the “path of deontological virtue,”[2] and at the same time a departure from postmetaphysical reason. Habermas’ motivation to address the developments in biomedicine had certainly been sparked by the intense debate in Germany, the European Union, and internationally on human cloning, pre-implantation genetic diagnosis, embryonic stem cell research, and human enhancement. He turned to a strand of critical theory that had been pushed to the background by the younger Frankfurt School in favor of cultural theory and social critique, even though it had been an important element of its initial working programs. The relationship of instrumental reason and critical theory, examined, among others, by Max Horkheimer, Theodor W. Adorno, and Herbert Marcuse and taken up in Habermas’ own Knowledge and Interest and Theory of Communicative Action became ever-more actual with the development of the life sciences, human genome analysis, and genetic engineering of human offspring. Today, some of the fictional scenarios discussed at the end of the last century as “science fiction” have become reality: in 2018, the first “germline gene-edited” children were born in China.[3] Furthermore, the UK’s permission to create so-called “three-parent” children may create a legal and political pathway to hereditary germline interventions summarized under the name of “gene editing.”In this article, I want to explore Habermas’ “substantial” argument in the hope that philosophy and theology become allies in their struggle against an ever-more reifying lifeworld, which may create a “moral void” that would, at least from today’s perspective, be “unbearable”, and for upholding the conditions of human dignity, freedom, and justice. I will contextualize Habermas’ concerns in the broader discourse of bioethics, because only by doing this, his concerns are rescued from some misinterpretations.[1] Jürgen Habermas, The Future of Human Nature.[2] Ibid., 125, fn. 58. 8[3] Up to the present, no scientific publication of the exact procedure exists, but it is known that the scientist, Jiankui He, circumvented the existing national regulatory framework and may have misled the prospective parents about existing alternatives and the unprecedented nature of his conduct. Yuanwu Ma, Lianfeng Zhang, and Chuan Qin, "The First Genetically Gene‐Edited Babies: It's “Irresponsible and Too Early”," Animal Models and Experimental Medicine ; Matthias Braun, Meacham, Darian, "The Trust Game: Crispr for Human Germline Editing Unsettles Scientists and Society," EMBO reports 20, no. 2. (shrink)

In his magnum opus, David Hume asserts that a person is “nothing but a bundle or collection of different perceptions, which succeed each other with an inconceivable rapidity, and are in a perpetual flux and movement.” (Treatise 252) Hume is clearly proud of his bold thesis, as is borne out by his categorical arguments and analyses on the self. Contributions like this will, in his opinion, help establish a new science of human nature, “which will not be inferior in certainty, (...) and will be much superior in utility to any other of human comprehension.” (Treatise xix) Unfortunately for Hume, the bundle theory of the self subsequently elicits substantial criticism and hostility from numerous critics, both philosophical and non-philosophical. As confident as the young Scot is about the merits of his theory when he first proposes it, the sharp critical responses to his thought on the self ultimately compel him to withdraw his controversial views from public scrutiny. The irony is that the author of the bundle theory of the self himself acknowledges that his account of the self is seriously defective. In his appendix to the Treatise, Hume decries the labyrinth that his views on the self have driven him into. Five years in the making, Hume's Labyrinth: A Search for the Self explores in detail both Hume's views on the self and his critical reservations on an account of the self that would subsequently become highly influential in the philosophy of mind. -/- Central to Hume's Labyrinth is the suggestion that a careful analysis of the appendix to the Treatise throws an invaluable light on a number of elements fundamental to Hume's views on the self, not least of which is the role of Berkeley s views on language. While Hume often acknowledges the significance of Berkeley's philosophy in the Treatise, the argument here is that Berkeley's account of terms is the foundation of Hume's philosophy of the mind, with its contentious bundle theory of the self. And when this influence is assayed a new dimension of Hume's views on the self emerges. For now it appears that the bundle theory of the self is nothing but a heuristic device adopted by Hume to help further philosophical investigations into the mind. In short, it turns out that Hume is a pragmatist, intent on presenting an account of the self that researchers interested in the problems of human nature will find useful. (shrink)

In this paper, I lay the groundwork for a new account of progress in metaphysics, the ‘tool building approach’. The account is born out of a response to the problem of theory-change for naturalistic metaphysics. Kerry McKenzie (2020) makes clear the problem of theory-change for naturalistic metaphysics. She argues that naturalistic metaphysical theories cannot make progress on the back of scientific theories because metaphysical theories cannot be approximately true. First, I apply a well-known account of scientific progress, the truthlikeness (...) account of progress, to theories in metaphysics in order to show that metaphysics can make progress on such an account. This account, however, will not fully address the issue of radically changing theories over theory-change. Then, I offer a new account of progress in metaphysics, the tool building approach, that specifies the progress metaphysics makes even if our best naturalistic theories in metaphysics radically change. (shrink)

This study has proven that the economic system is determined by various components, in particular, it includes the real sector of the economy, which is formed on mega-, macro, meso-, micro-and nano-levels. In addition, it was proved that the nano-level is determined by the activities of individuals whose economic activity begins with the birth and attitude of parents, attending various educational and upbringing institutions, and studying at university. A separate segment of the nano-level of the economic system is the (...) class='Hi'>baby industry responsible for the production of goods and services for children and future parents. All these aspects are indicators of the development of the baby economy. Such an economic category as the baby economy was separated and defined. The study uses the following methods: analysis, synthesis, structural analysis, systemic approach, observation, comparison, multifactor regression. These methods made it possible to achieve the results, which involve isolation of the baby economy as a component of nanoeconomy and definition of such components of the baby economic segment of nanoeconomy as a family or household economy, the baby industry, the economy of the educational process and upbringing. For this purpose, the value-institutional approach was applied. In addition, multifactorial analysis of the impact of indicators of the baby economy development on the population of a country with a transitive economy with incomes below the subsistence minimum was performed. This analysis identified a direct but minor relationship between these phenomena, which demonstrates the need to intensify and create a policy for the baby economy in similar states. The theoretical significance of the obtained results is determined by the introduction of a new economic category of "the baby economy" for the formation of a nano economic component within socio-economic systems. (shrink)

In resource-limited settings where healthcare services are limited and poverty is common, it is difficult to ethically conduct clinical research without providing patient-care. Therefore, integration of patient-care with clinical research appears as an attractive way of conducting research while providing patient-care. In this article, we discuss the ethical implications of such approach with perspectives from Papua New Guinea.

A definition of causation as probability-raising is threatened by two kinds of counterexample: first, when a cause lowers the probability of its effect; and second, when the probability of an effect is raised by a non-cause. In this paper, I present an account that deals successfully with problem cases of both these kinds. In doing so, I also explore some novel implications of incorporating into the metaphysical investigation considerations of causal psychology.

Technological developments involving robotics and artificial intelligence devices are being employed evermore in elderly care and the healthcare sector more generally, raising ethical issues and practical questions warranting closer considerations of what we mean by “care” and, subsequently, how to design such software coherently with the chosen definition. This paper starts by critically examining the existing approaches to the ethical design of care robots provided by Aimee van Wynsberghe, who relies on the work on the ethics of (...) care by Joan Tronto. In doing so, it suggests an alternative to their non-principled approach, an alternative suited to tackling some of the issues raised by Tronto and van Wynsberghe, while allowing for the inclusion of two orientative principles. Our proposal centres on the principles of autonomy and vulnerability, whose joint adoption we deem able to constitute an original revision of a bottom-up approach in care ethics. Conclusively, the ethical framework introduced here integrates more traditional approaches in care ethics in view of enhancing the debate regarding the ethical design of care robots under a new lens. (shrink)

Henry Richardson has recently published the first book ever devoted to ancillary care obligations, which roughly concern what medical researchers are morally required to provide to participants beyond what safety requires. In it Richardson notes that he has presented the ‘only fully elaborated view out there’ on this topic, which he calls the ‘partial-entrustment model’. In this article, I provide a new theory of ancillary care obligations, one that is grounded on ideals of communion salient in the African (...) philosophical tradition and is intended to rival and surpass Richardson’s model, which is a function of Western considerations of autonomy. I argue that the relational approach of the former has several virtues in comparison to the basic individualism of the latter. (shrink)

Migrant women are often stereotyped. Some scholars associate the feminization of migration with domestic work and criticize the “care drain” as a new form of imperialism that the First World imposes on the Third World. However, migrant women employed as domestic workers in Northern America and Europe represent only 2% of migrant women worldwide and cannot be seen as characterizing the “feminization of migration”. Why are migrant domestic workers overestimated? This paper explores two possible sources of bias. The first (...) is sampling: conclusions about “care drain” are often generalized from small samples of domestic workers. The second stems from the affect heuristic: imagining children left behind by migrant mothers provokes strong feelings of injustice which trump other considerations. The paper argues that neither source of bias is unavoidable and finds evidence of gender stereotypes in the “care drain” construal. (shrink)

In her Nobel speech in 2019, Olga Tokarczuk presented the category of tenderness as a new way of narrating the contemporary world. This article is a proposal for the analysis and interpretation of tenderness in ethical and aesthetic terms. (1) From an ethical perspective, tenderness is interpreted as an extension and complement of feminist relational ethics, i.e., the ethics of care. In the proposed approach, tenderness is a broader and more universal quality than care in the feminist understanding. (...) This article opens with a brief discussion of feminist interventions in ethics, with particular emphasis on the ethics of care. Next, the differences between care and tenderness are enumerated and described, in order to show how tenderness can serve as an extension and complement of the feminist ethic of care. These considerations are guided by the question of why tenderness is a better—more appropriate and more responsive to contemporary challenges—moral guidepost than care. (2) From the aesthetic perspective, tenderness is the negation of a contemplative, distanced, impersonal, and rational view of reality. As an aesthetic imperative, tenderness implies engaged experience of the beauty of reality in all of its manifestations. Therefore, in the last part of the article, existential tender attunement is described in aesthetic terms, as a position serving to sensitize others to the beauty and complexity of the post-anthropocentric world. (shrink)

Designer babies are often presented in the popular media as a kind of apocalyptical spectre of things to come in a brave new world where reproduction is the province of white coated scientists and potential parents in pursuit of trophy children. In this realm physical, intellectual, and social perfection is sought through the manipulation of genes and selection of favoured traits and attributes to the detriment of individuals who cannot compete and of society more generally through the loss of natural (...) selection. It is therefore a pleasure to discover a short readable book that sets out the discussion and its many nuances in concise and accurate terms that will be accessible to all and should help to dispel some of these science fiction myths through scholarly debate.This volume is part of a collection of books under the title Debating Matters that sprang out of a series of public debates organised by the Institute of Ideas. The conferences were intended to reinvigorate debate and the contestation of ideas and contemporary issues the Institute regards as “too frequently sidelined”. The arguments are presented by an authoritative who’s who of commentators who offer their own insightful readings of various aspects of the debate. Each essayist confirms the fact that the term “ designer babies ” is an inaccurate reflection of the current ability of science to actively fashion children with selected characteristics, and as a result …. (shrink)

The discipline of applied ethics already has a certain familiarity in the Anglo-Saxon world, above all through the work of Peter Singer. Applied ethics uses the tools of moral philosophy to resolve practical problems of the sort which arise, for example, in the running of hospitals. In the University at Buffalo (New York) there was organized on April 24-25 1998 the world's first conference on a new, sister discipline, the discipline of applied ontology. Applied ontologists seek to apply ontological tools (...) to solving practical problems of the sort which arise in various extra-philosophical domains, including law and government administration. (shrink)

Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth (...) are extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity. (shrink)

This paper identifies a new source that explains environmental behaviour: the presence of future tense marking in language. We predict that languages that grammatically mark the future affect speakers' intertemporal preferences and thereby reduce their willingness to address environmental problems. We first show that speakers of languages with future tense marking are less likely to adopt environmentally responsible behaviours and to support policies to prevent environmental damage. We then document that this effect holds across countries: future tense marking is an (...) important determinant of climate change policies and global environmental cooperation. The results suggest that there may be deep and surprising obstacles for attempts to address climate change. (shrink)

This collection of articles was written over the last 10 years and edited to bring them up to date (2017). The copyright page has the date of the edition and new editions will be noted there as I edit old articles or add new ones. All the articles are about human behavior (as are all articles by anyone about anything), and so about the limitations of having a recent monkey ancestry (8 million years or much less depending on viewpoint) and (...) manifest words and deeds within the framework of our innate psychology as presented in the table of intentionality. As famous evolutionist Richard Leakey says, it is critical to keep in mind not that we evolved from apes, but that in every important way, we are apes. If everyone was given a real understanding of this (i.e., of human ecology and psychology to actually give them some control over themselves), maybe civilization would have a chance. As things are however the leaders of society have no more grasp of things than their constituents and so collapse into anarchy is inevitable. The first group of articles attempts to give some insight into how we behave that is reasonably free of the theoretical delusions that are universal. In the next group, I show how these insights apply by reviewing some books in philosophy and psychology. Next I review books on science and religion and finally provide reviews and articles showing how understanding of both science and philosophy gives insight into the tragic delusions destroying the world. People believe that society can be saved by science, religion and politics, so I provide some suggestions as to why this is unlikely via short articles and reviews of recent books by well-known writers. It is critical to understand why we behave as we do and so the first section presents articles that try to describe (not explain as Wittgenstein insisted) behavior. I start with a brief review of the logical structure of rationality, which provides some heuristics for the description of language (mind, rationality, personality) and gives some suggestions as to how this relates to the evolution of social behavior. This centers around the two writers I have found the most important in this regard, Ludwig Wittgenstein and John Searle, whose ideas I combine and extend within the dual system (two ii systems of thought) framework that has proven so useful in recent thinking and reasoning research. As I note, there is in my view essentially complete overlap between philosophy, in the strict sense of the enduring questions that concern the academic discipline, and the descriptive psychology of higher order thought (behavior). Once one has grasped Wittgenstein’s insight that there is only the issue of how the language game is to be played, one determines the Conditions of Satisfaction (what makes a statement true or satisfied etc.) and that is the end of the discussion. Since philosophical problems are the result of our innate psychology, or as Wittgenstein put it, due to the lack of perspicuity of language, they run throughout human discourse and behavior, so there is endless need for philosophical analysis, not only in the ‘human sciences’ of philosophy, sociology, anthropology, political science, psychology, history, literature, religion, etc., but in the ‘hard sciences’ of physics, mathematics, and biology. It is universal to mix the language game questions with the real scientific ones as to what the empirical facts are. Scientism is ever present and the master has laid it before us long ago, i.e., Wittgenstein (hereafter W) beginning with the Blue and Brown Books in the early 1930’s. "Philosophers constantly see the method of science before their eyes and are irresistibly tempted to ask and answer questions in the way science does. This tendency is the real source of metaphysics and leads the philosopher into complete darkness." (BBB p18) The key to everything about us is biology, and it is obliviousness to it that leads millions of smart educated people like Obama, Chomsky, Clinton and the Pope to espouse suicidal utopian ideals that inexorably lead straight to Hell on Earth. As W noted, it is what is always before our eyes that is the hardest to see. We live in the world of conscious deliberative linguistic System 2, but it is unconscious, automatic reflexive System 1 that rules. This is the source of the universal blindness described by Searle’s The Phenomenological Illusion (TPI), Pinker’s Blank Slate and Tooby and Cosmides’ Standard Social Science Model. The astute may wonder why we cannot see System 1 at work, but it is clearly counterproductive for an animal to be thinking about or second guessing every action, and in any case, there is no time for the slow, massively integrated System 2 to be involved in the constant stream of split second ‘decisions’ we must make. As W noted, our ‘thoughts’ (T1 or the ‘thoughts’ of System 1) must lead directly to actions. iii It is my contention that the table of intentionality (rationality, mind, thought, language, personality etc.) that features prominently here describes more or less accurately, or at least serves as an heuristic for, how we think and behave, and so it encompasses not merely philosophy and psychology, but everything else (history, literature, mathematics, politics etc.). Note especially that intentionality and rationality as I (along with Searle, Wittgenstein and others) view it, includes both conscious deliberative System 2 and unconscious automated System 1 actions or reflexes. Thus, all the articles, like all behavior, are intimately connected if one knows how to look at them. As I note, The Phenomenological Illusion (oblivion to our automated System 1) is universal and extends not merely throughout philosophy but throughout life. I am sure that Chomsky, Obama, Zuckerberg and the Pope would be incredulous if told that they suffer from the same problem as Hegel, Husserl and Heidegger, (or that that they differ only in degree from drug and sex addicts in being motivated by stimulation of their frontal cortices by the delivery of dopamine (and over 100 other chemicals) via the ventral tegmentum and the nucleus accumbens), but it’s clearly true. While the phenomenologists only wasted a lot of people’s time, they are wasting the earth and their descendant’s futures. Many of the articles describe the ‘digital delusions’, which confuse the language games of System 2 with the automatisms of System 1, and so cannot distinguish biological machines (i.e., people) from other kinds of machines (i.e., computers). The ‘reductionist’ claim is that one can ‘explain’ behavior at a ‘lower’ level, but what actually happens is that one does not explain human behavior but a ‘stand in’ for it. Hence the title of Searle’s classic review of Dennett’s book (“Consciousness Explained”)— “Consciousness Explained Away”. In most contexts ‘reduction’ of higher level emergent behavior to brain functions, biochemistry, or physics is incoherent. Also for ‘reduction’ of chemistry or physics, the path is blocked by chaos and uncertainty. Anything can be ‘represented’ by equations, but when they ‘represent’ higher order behavior, it is not clear (and cannot be made clear) what the ‘results’ mean. Reductionist metaphysics is a joke, but most scientists and philosophers lack the appropriate sense of humor. Other digital delusions are that we will be saved from the pure evil (selfishness) of System 1 by computers/AI/robotics/ nanotech/genetic engineering created by System 2. The No Free Lunch principal tells us there will be serious and possibly fatal consequences. The adventurous may regard this principle as a higher order emergent expression of the Second Law of Thermodynamics. Hi-tech enthusiasts hugely underestimate the problems iv resulting from unrestrained motherhood, and of course it is neither profitable nor politically correct (and now with third world supremacism dominant, not even possible) to be honest about it. The last section describes various versions of the ‘altruism delusion’ that we are selected for cooperation, and that the euphonious ideals of Democracy, Diversity and Equality will lead us into utopia, if we just manage things correctly (the possibility of politics). Again, the No Free Lunch Principle ought to warn us it cannot be true, and we see throughout history and all over the contemporary world, that without strict controls, selfishness and stupidity gain the upper hand and soon destroy any nation that embraces it. In addition, the monkey mind steeply discounts the future, and so we cooperate in selling our descendant’s heritage for temporary comforts, greatly exacerbating the problems. I describe versions of this delusion (i.e., that we are basically ‘friendly’ if just given a chance) as it appears in some recent books on sociology/biology/economics. I end with an essay on the great tragedy playing out in America and the world, which can be seen as a direct result of our evolved psychology manifested as the inexorable machinations of System 1. Our psychology, eminently adaptive and eugenic on the plains of Africa from ca. 6 million years ago, when we split from chimpanzees, to ca. 50,000 years ago, when many of our ancestors left Africa (i.e., in the EEA or Environment of Evolutionary Adaptation), is now maladaptive and dysgenic and the source of our Suicidal Utopian Delusions. So, like all discussions of behavior (philosophy, psychology, sociology, biology, anthropology, politics, law, literature, history, economics, soccer strategies, business meetings, etc.), this book is about evolutionary strategies, selfish genes and inclusive fitness (kin selection). Many accept the delusion that we are selected for cooperation with people generally (group selection or altruism) and not just our immediate relatives (kin selection or inclusive fitness), so I spend some time in the essays of the last section demolishing this fantasy. One thing rarely mentioned by the group selectionists is the fact that, even were ‘group selection’ possible, selfishness is at least as likely (probably far more likely in most contexts) to be group selected for as altruism. Just try to find examples of true altruism in nature –the fact that we can’t (which we know is not possible if we understand evolution) tells us that its apparent presence in humans is an artefact of modern life concealing the facts, and that it can no more be selected for than the tendency to suicide (which in fact it is). One does not really need science or mathematics to grasp this – it is crushingly obvious that an v organism cannot be selected for behavior that decreases the frequency of its own genes in the next generation. One might also benefit from considering a phenomenon never (in my experience) mentioned by group selectionists -- cancer. No group has as much in common as the (originally) genetically identical cells in our own bodies-a 100 trillion cell clone-- but we are all born with thousands and perhaps millions of cells that have already taken the first step on the path to cancer and generate millions to billions of cancer cells in our life. If we did not die of other things first, we (and perhaps all multicellular organisms) would all die of cancer. Only a massive and hugely complex mechanism built into our genome that represses or derepresses trillions of genes in trillions of cells, and kills and creates billions of cells a second, keeps the majority of us alive long enough to reproduce. One might take this to imply that a just, democratic and enduring society for any kind of entity on any planet in any universe is only a dream, and that no being or power could make it otherwise. It is not only ‘the laws’ of physics that are universal and inescapable, or perhaps we should say that inclusive fitness is a law of physics. The great mystic Osho said that the separation of God and Heaven from Earth and Humankind was the most evil idea that ever entered the Human mind. In the 20th century an even more evil notion arose—that humans are born with rights, rather than having to earn privileges. Thus, every day the population increases by 200,000, who must be provided with resources to grow and space to live, and who soon produce another 200,000 etc. And one almost never hears it noted that what they receive must be taken from those already alive. Their lives diminish those already here in both major obvious and countless subtle ways. Every new baby destroys the earth from the moment of conception. There cannot be human rights without human wrongs. It cannot be more obvious, but one will never see the streets full of protesters against motherhood. America and the world are in the process of collapse from excessive population growth, most of it for the last century and now all of it due to 3rd world people. Consumption of resources and the addition of 4 billion more ca. 2100 will collapse industrial civilization and bring about starvation, disease, violence and war on a staggering scale. The earth loses about 2% of it’s topsoil every year, so as it nears 2100, most of it’s food growing capacity will be gone. Billions will die and nuclear war is all but certain. In America, this is being hugely accelerated by massive immigration and immigrant reproduction, combined with abuses made possible by democracy. Depraved human nature inexorably turns the dream of democracy and diversity into a vi nightmare of crime and poverty. China will continue to overwhelm America and the world, as long as it maintains the dictatorship which limits selfishness. The root cause of collapse is the inability of our innate psychology to adapt to the modern world, which leads people to treat unrelated persons as though they had common interests. This, plus ignorance of basic biology and psychology, leads to the social engineering delusions of the partially educated who control democratic societies. Few understand that if you help one person you harm someone else—there is no free lunch and every single item anyone consumes destroys the earth beyond repair. Consequently, social policies everywhere are unsustainable and one by one all societies without stringent controls on selfishness will collapse into anarchy or dictatorship. Without dramatic and immediate changes, there is no hope for preventing the collapse of America, or any country that follows a democratic system. The popular notions supported by the Democratic Party and Third World Supremacists are that Democracy, Diversity, Equality and Social Justice will produce a Utopia in America and the world, but it is clear as crystal that they unavoidably foster selfishness and divisiveness and are producing collapse. Hence my concluding essay “Suicide by Democracy”. The most basic facts, almost never mentioned, are that there are not enough resources in America or the world to lift a significant percentage of the poor out of poverty and keep them there. Even the attempt to do this is already bankrupting America and destroying the world. The earth’s capacity to produce food decreases daily, as does our genetic quality. And now, as always, by far the greatest enemy of the poor is other poor and not the rich. -/- My writings are available as paperbacks and Kindles on Amazon. -/- Talking Monkeys: Philosophy, Psychology, Science, Religion and Politics on a Doomed Planet - Articles and Reviews 2006-2017 (2017) ASIN B071HVC7YP. -/- The Logical Structure of Philosophy, Psychology, Mind and Language in Ludwig Wittgenstein and John Searle--Articles and Reviews 2006-2016 (2017) ASIN B071P1RP1B. -/- Suicidal Utopian Delusions in the 21st century: Philosophy, Human Nature and the Collapse of Civilization - Articles and Reviews 2006-2017 (2017) 2nd printing with corrections (Feb 2018) ASIN B0711R5LGX -/- Suicide by Democracy: an Obituary for America and the World (2018) ASIN B07CQVWV9C -/- . (shrink)

This paper responds to two arguments that have been offered against the positing of ‘i-desires’, imaginative counterparts of desire supposedly involved in fiction, pretence, and mindreading. The Introspection Argument asks why, if there are both i-desires and desires, the distinction is so unfamiliar and hard to draw, unlike the relatively clear distinctions between perception and mental imagery, or belief and belief-like imagining. The Accountability Argument asks how it can make sense to treat merely imaginative states as revealing of someone’s psychology, (...) the way we do with responses to fiction. I argue that carefully considering the relationship between other states and their imaginative counterparts sheds light on how we should expect i-desires to differ from desires, and suggests that we may often be in states that are _indeterminate_, in limbo between the two categories. This indeterminacy explains why the distinction is often hard to draw, and why these states can be revealing about us even without (determinately) being real desires. (shrink)

I argue that the technique Socrates describes in the Meno at 86e-87c allows him to make progress without definitions, even while accepting that definitions are necessary for knowledge. Some contend that the technique involves provisionally accepting a claim. I argue, instead, that it provides a secure biconditional that one can use to reduce the question one cares care about to a new question that one thinks will be easier to answer.

This paper interprets the demonstrative retreat from public life and the promotion of self-improvement in Seneca’s later works as a political undertaking. Developing arguments by THOMAS HABINEK, MATTHEW ROLLER and HARRY HINE, it suggests that Seneca promoted the political vision of a cosmic community of progressors toward virtue constituted by a special form of progressor friendship, a theoretical innovation made in the Epistulae morales. This network of like-minded individuals spanning time and space is open to anyone who shares the other (...) members’ commitment to the improvement of one’s own self and that of others. By advertising such self-care and courting his readers as prospective friends, the author of the Epistulae morales aims to recruit new members for that community, in particular in the first nine letters. (shrink)

English law is unambiguous that legal personality, and with it all legal rights and protections, is assigned at birth. This rule is regarded as a bright line that is easily and consistently applied. The time has come, however, for the rule to be revisited. This article demonstrates that advances in fetal surgery and (anticipated) artificial wombs do not marry with traditional conceptions of birth and being alive in law. These technologies introduce the possibility of ex utero gestation, and/or temporary existence (...) ex utero, and consequently developing human beings that are novel to the law. Importantly, therefore, the concepts of birth and born alive no longer distinguish between human beings deserving of legal protection in the way originally intended. Thus, there is a need for reform, for a new approach to determining the legal significance of birth and what being legally alive actually encompasses. Investigating the law of birth is of crucial importance, because of the implications of affording or denying the subjects of new reproductive technologies rights and protections. A determination of the legal status of the subject of fetal surgery or an artificial womb will determine what can and cannot be done to each entity. Moreover, the status afforded to these entities will drastically impact on the freedoms of pregnant women. (shrink)

Abstract A COMPARISON OF THE VIEWS OF AUGUSTINE SHUTTE AND THADDEUS METZ ON AFRICAN PHILOSOPHY AND UBUNTU ETHICS In the theoretical study of Ethics much emphasis has traditionally been placed on established ethical theories, via approaches typified e.g. as deontological, divine command, utilitarian, virtue ethics and natural ethics. At UWC all these approaches, very much entrenched in the Western academic canon, have been taught, together with ethical views carried by the world religions. Over the last few years, however, an interest (...) in the study of African ideas (philosophy, theology, worldview studies, especially around the elusive but fascinating concept of Ubuntu) has grown. This study is an attempt to make a contribution towards a more serious exchange with African ethical ideas and their application in a global context. In this mini-thesis I compare the views of two academics, Augustine Shutte and Thaddeus Metz, who have actively and deliberately worked in the field of African philosophy and ethics. Through this comparative study of two rather different readings of Ubuntu philosophy, I wish to contribute to the growing interest in ethical views and discourse emanating from African ways of looking at the world and at humanity. The well-known, recently deceased, Augustine Shutte, a Catholic scholar of repute, taught Philosophy at the University of Cape Town, and published books such as Philosophy for Africa, The Mystery of Humanity; Ubuntu, An ethic for a New South Africa and The Quest for Humanity in Science and Religion, The South African Experience. The other scholar, the American born philosopher Thaddeus Metz, started teaching Philosophy at the University of Johannesburg and shifted his intellectual attention to African ideas and ethics. Coming from a rational Kantian approach, mixed with utilitarian ethical concerns, Metz discovered the difficulty of adding another “African mix” to main stream academia, based on the comprehensive scope of the very inclusive look at what it means to be human in the quite unique African worldview. He has published widely and in depth on many aspects of this “clash of cultures” while also holding on to enlightenment ideals and an ongoing conversation with science, especially also social science. These two authors thus share many concerns and interests, but also represent two different angles and approaches into African philosophy and ethics. The question for this limited study is formulated in the short introduction: How do Shutte and Metz connect the ethical implications of a widely shared “African worldview” with the core idea of Ubuntu, and which ethical implications do they draw from their reading of Ubuntu – for Africa and the world? These questions are addressed via five chapters: In the first an introduction to the research focus and question and the second of these the field of African Philosophy and Ethics is briefly covered via appropriate literature, thus providing a framework for comparing Shutte and Metz. The third chapter deals with Shutte’s search for an Ubuntu approach to South Africa’s problems within the African and global context - via his emphasis on an inclusive anthropology of caring and justice in which the pitfalls of individualism, materialism and consumerism can be avoided while promoting a sustainable work ethos and attunement with “science”. The fourth chapter focuses on Metz’ critical deontological approach, and his attempt to take the comprehensive African worldview seriously in conversation with utility, reason and science. In the fifth chapter the comparison of these two overlapping, but still quite different with an approach that can lead to a concrete ethical conclusion and application for South Africa, Africa and the world. (shrink)

The philosophy of science of Patrick Suppes is centered on two important notions that are part of the title of his recent book (Suppes 2002): Representation and Invariance. Representation is important because when we embrace a theory we implicitly choose a way to represent the phenomenon we are studying. Invariance is important because, since invariants are the only things that are constant in a theory, in a way they give the “objective” meaning of that theory. Every scientific theory gives a (...) representation of a class of structures and studies the invariant properties holding in that class of structures. In Suppes’ view, the best way to define this class of structures is via axiomatization. This is because a class of structures is given by a definition, and this same definition establishes which are the properties that a single structure must possess in order to belong to the class. These properties correspond to the axioms of a logical theory. In Suppes’ view, the best way to characterize a scientific structure is by giving a representation theorem for its models and singling out the invariants in the structure. Thus, we can say that the philosophy of science of Patrick Suppes consists in the application of the axiomatic method to scientific disciplines. What I want to argue in this paper is that this application of the axiomatic method is also at the basis of a new approach that is being increasingly applied to the study of computer science and information systems, namely the approach of formal ontologies. The main task of an ontology is that of making explicit the conceptual structure underlying a certain domain. By “making explicit the conceptual structure” we mean singling out the most basic entities populating the domain and writing axioms expressing the main properties of these primitives and the relations holding among them. So, in both cases, the axiomatization is the main tool used to characterize the object of inquiry, being this object scientific theories (in Suppes’ approach), or information systems (for formal ontologies). In the following section I will present the view of Patrick Suppes on the philosophy of science and the axiomatic method, in section 3 I will survey the theoretical issues underlying the work that is being done in formal ontologies and in section 4 I will draw a comparison of these two approaches and explore similarities and differences between them. (shrink)

In his defense of innateness in New Essays on Human Understanding (1704), Leibniz attributes innateness to concepts and principles which do not originate from the senses rather than to the ideas that we are born with. He argues that the innate concepts and principles can be known in two ways: through reason or natural light (necessary truths), and through instincts (other innate truths and principles). In this paper I will show how theoretical and moral reasoning differ from each other (...) in Leibniz, and compare moral reasoning and instincts as sources of knowledge in his practical philosophy. As the practical instincts are closely related to pleasure and passions, which are by nature cognitive, my emphasis will be on the affective character of instinctive moral action and especially deliberation which leads to moral action. I will argue that inclinations arising from moral instinct, which lead us to pleasure while avoiding sorrow, can direct our moral action and sometimes anticipate reasoning when conclusions are not readily available. Acting by will, which is related to moral reasoning, and acting by instincts can lead us to the same moral knowledge independently, but they can also complement each other. To illustrate the two alternative ways to reach moral knowledge, I will discuss the case of happiness, which is the goal of all human moral action for Leibniz. (shrink)

Abstract The values of the healthcare sector are fairly ubiquitous across the globe, focusing on caring and respect, patient health, excellence in care delivery, and multi-stakeholder collaboration. Many individual pharmacists embrace these core values. But their ability to honor these values is significantly determined by the nature of the system they work in. -/- The paper starts with a model of the prevailing pharmacist workforce model in Scotland, in which core roles are predominantly separated into hierarchically disaggregated jobs focused (...) on one professional ‘pillar’: Clinician /Practice Provider; Educator; Leader/Manager; and Researcher. This is the ‘Atomistic’ Model. This skills-segregation yields a workforce of individuals working in isolation rather than collaborating together, and lacking a shared information flow, purpose and identity. Key strategic flaws include suboptimal responsiveness to population and subpopulation needs, inconsistency and inequity of care, an erosion of professional agency, and lower job satisfaction. It is conjectured that this results from a lack of congruence between values, professional ethos, and organizational structure. ‘Atomism’ culminates in a syndrome of widespread professional-level cognitive dissonance. -/- The paper contrasts this with a new emerging workforce vision, The Collaborative Care Model. This new model defines a systems-first-approach, built on the principle that all jobs must include all four professional ‘pillars’. Vertical skills integration, involving education and task sharing, will support sustainability and succession planning. Horizontal skills integration (across practice, leadership and research) is included to improve responsiveness to population need and individual professional agency. The working conditions, supportive ethos, and career structure needed to make the model work are described. Moral theory and workforce theory are used to justify why the model may be more effective for population health, delivering greater job satisfaction for individuals and ultimately helping systematically realize and honor healthcare values. Finally, the paper sketches the first steps needed to implement the model at the national level, starting with the operationalization of new multi-pillar professional curricula across the career spectrum. Potential pitfalls and challenges are also discussed. -/- Co-Authors: 1. Paul Forsyth (PF) Lead Pharmacist Clinical Cardiology, Pharmacy, NHS Greater Glasgow & Clyde. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Writing - original draft (lead author), Writing - review & editing (lead author) 2. Andrew Radley (AR), Consultant in Public Health Pharmacy, NHS Tayside. Contribution: Conceptualization; Model curation; Model Theory; Writing - review & editing 3. Gordon Rushworth (GR), MPharm MSc FFRPS FRPharmS (Consultant). Programme Director, Highland Pharmacy Education & Research Centre, NHS Highland, Inverness. Contribution: Model curation; Writing - review & editing 4. Fiona Marra (FM) National Lead Clinician Scottish Infection and Immunology Network (SPAIIN) / Advanced Pharmacist HCV / HIV, NHS Greater Glasgow & Clyde. Contribution: Model curation; Writing - review & editing 5. Susan Roberts (SR) Associate Postgraduate Pharmacy Dean, NHS Education for Scotland. Contribution: Model curation; Writing - review & editing 6. Roisin O’Hare (RO) Lead Teacher Practitioner Pharmacist, Northern Ireland University Network, Southern Health and Social Care Trust. Contribution: Model curation; Writing - review & editing 7. Catherine Duggan (CD) Chief Executive Officer, International Pharmaceutical Federation (FIP). Contribution: Model curation; Writing - review & editing 8. Barry Maguire (BM) Senior Lecturer, School of Philosophy, Psychology and Life Sciences, The University of Edinburgh. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Supervision; Writing - original draft (senior academic supervisor), Writing - review & editing (senior academic supervisor) -/- . (shrink)

Adoption may be defined as ‘the legal process through which the state establishes a parental relationship, with all its attendant rights and duties, between a child and a (set of) parent(s) where there exists no previous procreative relationship’ . In adoptions from care, state intervention effectively converts an established, or nascent, adult– child relationship into ‘family’ in the legal sense. From the state’s perspective, adoption thus entails the transfer of parental responsibilities for a child in public care to (...) a private family unit, enabling the state to permanently delegate its duties towards a child to this new unit. This seemingly straightforward legal act raises deeper philosophical questions relating to such state ‘family creation’, particularly when the child’s perspective is taken. Such a child- centric approach normatively regards children as equal moral beings, who ought to be included in actions concerning them, regardless of their capacity to form and express an opinion. Accordingly, adoption from care can be described as a moral decision, aimed at doing what is in the child’s best interests. The purpose of this chapter is to explore a suspicion of a lack of child- centrism in adoption from care practice, and to illustrate how adopted children’s rights are inferior to those of their non- adopted peers. This will shed light on a practice currently lacking transparency and accountability and will increase our understanding of how we fail to treat children as equal moral individuals in decision- making that severely impacts children’s lives. (shrink)

The dissertation, comprising a clinical intervention and three supporting studies, aimed to assess if it is possible to prevent nonsynostotic plagiocephaly while promoting safe infant sleeping practices. Five individuals were trained to assess cranial asymmetry and then reliability-tested; the interpreted results indicate substantial strength of rater-agreement. Intervention participants were allocated to group. Only intervention group nurses participated in the continuing education on plagiocephaly developed for nurses. A survey compared information intervention and control group parents received from nurses; intervention group parents (...) were significantly more aware of recommendations than the controls. Nurse education was evaluated by asking intervention and control group nurses and parents two open-ended questions; the intervention group reported new re-positioning strategies. The effect of the intervention on cranial shape was evaluated by assessing asymmetry at 2, 4, and 12 months (176 intervention group; 92 controls). It was nine times more common that cranial asymmetry at two months reversed by four months when parents were aware of written recommendations from their nurse (OR = 9.09 [0.02; 0.48], p = 0.004) when adjusted for group. An infant’s risk of asymmetry persisting until 12 months was significantly reduced in the intervention group (RR = 0.35 [0.13; 0.94], p = 0.03). Preventing brachycephaly was difficult. Conclusions: the assessors were considered reliable; educating nurses promoted the integration of new recommendations in practice; the intervention was associated with early reversal of nonsynostotic plagiocephaly. (shrink)

ABSTRACT -/- In this dissertation I make a case for how mental health care, specifically disordered eating, is in need of an adjunctive field of discourse, that being theories on philosophy of consciousness, cosmology, and the new epistemology of science based on physics. Without psychological inquiry and education on new theories about consciousness and new perspectives on the nature of reality, mental health treatment is incomplete and outdated. I bring these topics to the eating disorder field in three ways: (...) by choosing the scientific and philosophical discourse to be added into treatment; by translating the complex and abstract topics into psychologically relevant, lay public coursework; and, finally, through the creation of actual processes that help bring the material into direct experience. The science and philosophy discourse topics that will transform disordered eating are presented through lecture, inquiry for consideration, and discussion options. Consciousness, cosmology, and the new epistemology of science based on physics is simplified with examples of how it can be implemented within individual sessions, group sessions, or workshops for disordered eating treatment and with application to other mental health problems. The psychological application of the material is further enhanced through my description of a variety of experiential processes, from writing assignments and guided visualizations to storytelling, rituals, encounters in nature, and embodiment activities. I have created the lectures, inquiry, and experiential processes within a dynamic body of work, named the Emergence Courses, that have been introduced to professionals treating disordered eating and to clients for use. (shrink)

Patient and public involvement is widely thought to be important in the improvement of health care delivery and in health equity. Purpose: The article examines the role of experiential knowledge in service co-production in order to develop opiate substitution treatment services (OST) for high-risk opioid users. Method: Drawing on social representations theory and the concept of social identity, we explore how experts’ by experience and registered nurses’ understandings of OST contain discourses about the social representations, identity, and citizenship of (...) the participants and the effects these may have on developing or hindering inclusive and bottom-up forms of patient and public involvement. Results: The meeting sessions that potentially offer room for creativity and problem-solving fail to provide any new propositions for fixing the system. The health care professionals primarily identify themselves as regulators who protect the correctness of their actions and show little interest in considering experiential knowledge on opioid addiction. Conclusion: The participation of patients has been one of the prominent reforms implemented in health care. The goal of client-centered thinking is often emphasised; however, the implementation is not simple due to the strongly institutionalised knowledge and related working patterns and practices in health care. (shrink)

Since before we can remember, humanity aims to overcome its biological limitations; such a goal has certainly played a key role in the advent of technique. However, despite the benefits that technique may bring, the people who make use of it will inevitably be under risk of harm. Even though human technical wisdom consists in attaining the best result without compromising anybody’s safety, misuses are always a possibility in the horizon. Nowadays, technology can be used for more than just improving (...) human capacities, preserving and restoring health or promoting human well-being. It also enables us to overcome human limitations and reach way beyond our "natural design". That being said, what could possibly justify the fear for these new directions of biotechnology? Should medicine and health care change their traditional goals and begin searching for artificial improvements to wellness in human nature? In this paper, I will hereby present and briefly discuss the main topics of the contemporary issue of human enhancement: the therapy-enhancement distinction, the possibility of cognitive enhancements and better physical performances, the fight against senescence, the arguments for and against human eugenics, the search for perfection, the quest of moral enhancement, the problem of public priorities, and some questions on medical ethics. Then, finally, I will want to present some realist perspectives on the subject. (shrink)

In her provocative discussion of the challenge posed to the traditional impartialist, justice-focused conception of morality by the new-wave care perspective in ethics, Annette Baier calls for ‘a “marriage” of the old male and newly articulated female... moral wisdom,’ to produce a new ‘cooperative’ moral theory that ‘harmonize[s] justice and care.’ I want in this paper to play matchmaker, proposing one possible conjugal bonding: a union of two apparently dissimilar modes of what Nel Noddings calls ‘meeting the other (...) morally,’ a wedding of respect and care. (shrink)

Pets are truly great companions. Some individuals feel that owning a pet can help them prepare for a growing family by giving them a taste of what it would be like to have children. This study also looks into the psychological well-being and life experiences of LGBT fur parents. Employing the Interpretative Phenomenological Analysis, the findings of this study were: (1) With the presence of fur babies, participants had the ease to overcome stressful events, especially the ones that affect their (...) mental health. With these, they have the desire to take care of their fur babies under all circumstances because they see their fur babies as family members. Fur babies are excellent sources of motivation, confidence, and happiness for fur parents. They are treated as family members because they contribute to the mental and emotional aspects of fur parents. Moreover, the majority of respondents valued their pets far more than their actual family members, however, some didn't spend as much time with their relatives and friends. This study comes to the conclusion that a stronger bond with one's dog was also linked to higher anxiety about being unloved and rejected by family members and people surrounding us, which was linked to a heavier impact on one's psychological well-being. In reality, fur parents, especially LGBT parents, offer their fur babies a lot of love and attention compared to other things. (shrink)

The Formalist tradition in late-scholastic philosophy has gone unnoticed in standard historiography. This article’s overall objective is to add the Formalist tradition to what we know about Renaissance philosophy. I first show how the Formalist tradition was born out of some innovative considerations of hierarchies of distinctions in the wake of the Franciscan John Duns Scotus’s teaching on the formal distinction in the beginning of the fourteenth century (especially Francis of Meyronnes’s model of four distinctions and Petrus Thomae’s more (...) elaborate doctrine of seven kinds of distinctions). I then trace how Formalist literature developed from being an exclusively Franciscan affair to becoming a much more widespread phenomenon. Thus, from the decades up to 1500 and onwards, authors from various late-scholastic schools (Thomism, Lullism, Averroism, and others) produced Formalist literature, i.e., treatises on multiple kinds of distinctions. I highlight particularly how one Franciscan philosopher of the sixteenth century, Jean Du Douet, proposed to view the Formalist preoccupation with distinctions as a discipline in its own right, a proper scientia formalitatum. I finally argue that while this proposal met with dismissive reactions, Du Douet’s idea does in fact reflect the role Formalism played in the scholastic curriculum in the late sixteenth century, at least in Franciscan milieus. (shrink)

The outbreak of SARS-CoV-2 has exposed a shared condition of vulnerability on a global scale. How can we use vulnerability as an effective paradigm in order to foster collective political initiatives? This essay claims that the idea of care is key to understand the vulnerability framework as being both an epistemic and a political resource to address ethical issues. The first half of the essay recollects several arguments in Adriana Cavarero’s and Judith Butler’s most recent works, insofar as both (...) theorists have insisted on the notion of vulnerability in order to interpret contemporary political mobilizations. The second part of the essay retraces a constellation of practices of care in the works of several Black and decolonial feminist thinkers situated in different socio-political contexts. Whereas for Christina Sharpe and Saidiya Hartman the focus is on the matter of Blackness and Black lives in their constitutive vulnerability, both Cristina Rivera Garza’s and Sayak Valencia’s works remarkably insist on the specific socio-political context of today’s Mexico. These authors urge the readers to adopt a critical posture when encountering official narratives, also because in their texts they exhibit their own vulnerability. For them, writing, their writing is an ethical demand to imagine alternatives and to foster new entanglements between bodies persisting on the margins, at the limits of the norms that regulate legibility. (shrink)

This special issue contributes to a grounded understanding about 'sustainability' in a range of rural contexts and in so doing sheds light on accompanying tensions and implications for the future of rural areas in Europe. It also brings attention to how the rural might be changing as a result of this new focus on sustainability. The 17 contributions bring to light crucial dimensions of sustainability: (1) the imperative of wellbeing, belonging and care; (2) dimensions of power and identity; (3) (...) the apprehension of time and space - in other words, sustainability as a process and always in transition; (4) social and spatial justice; and (5) the question of knowledge production on the rural and on sustainability. (shrink)

This essay critically examines a suggestion proposed by some Confucianists that Confucianism and Care Ethics share striking similarities and that feminism in Confucian societies might take “a new form of Confucianism.” Aspects of Confucianism and Care Ethics that allegedly converge are examined, including the emphasis on human relationships, and it is argued that while these two perspectives share certain surface similarities, moral injunctions entailed by their respective ideals of ren and caring are not merely distinctive but in fact (...) incompatible. (shrink)

Excerpt: 1. Introduction This chapter provides insight into the diverse ethical debates on genetics and epigenetics. Much controversy surrounds debates about intervening into the germline genome of human embryos, with catchwords such as genome editing, designer baby, and CRISPR/Cas. The idea that it is possible to design a child according to one’s personal preferences is, however, a quite distorted view of what is actually possible with new gene technologies and gene therapies. These are much more limited than the editing (...) and design metaphors suggest. Such metaphors are therefore highly problematic phrases in the context of new gene technologies, for two reasons. On one hand, to design a child of choice by modifying the genome would require modifying any gene of choice, which is more than can be done with current gene technologies, such as CRISPR/Cas. On the other hand, a modification of genes would need to be enough to create any characteristic of choice in the future child. The latter presupposes the assumption of genetic determinism. Moreover, the CRISPR/Cas technology can not only be used in a potentially therapeutic manner at the germline level. In addition, there is the (more likely) scenario of a future clinical therapeutic use of these new gene technologies for modifying the DNA sequence of other cells of the body (somatic genome editing). There is also the option of modifying the epigenome, that is, the spatial configuration of DNA (epigenome editing) (see table 1). Like genetics and genome editing, epigenetics has been at the center of recent popular scientific and ethical discourse as well as scientific debates. The concept of epigenetics has given rise to very different notions of inheritability and responsibility for health, which, however, are oftentimes based on scientifically controversial basic assumptions. That there continues to be covert genetic determinism in the form of epigenetic determinism (see table 2) in debates about epigenetics has been pointed out in ethical analyses of epigenetics. Neither genetic determinism nor epigenetic determinism has been confirmed scientifically. It is therefore important to recognize the concepts that are discussed (and sometimes harshly criticized) in debates about genome editing and epigenetics—for example, concepts about the causal role of DNA for our own life course. This importance is based on the fact that if we understand such controversial concepts, we will be able to remain critical when evaluating scientific knowledge and ethical arguments about genome editing and epigenetics. This chapter, therefore, explains some of these concepts. For an ethical analysis of epigenetics as well as of genome editing, it is necessary to understand and critically reflect upon the underlying concepts of genetic determinism and other, related -isms. The following section offers a detailed introduction to these -isms (section 2; see also table 2). Section 3 provides an ethical analysis of genome editing and epigenetics based on the explanations in section 2. Section 3 focuses on inheritability and responsibility, justice, safety, the problem of consent, and the effects of genome editing and epigenetics on embryos and future generations. This section does not discuss in detail further points that can be found in ethical debates about epigenetics as well as in ethical debates about genome editing. These points include (among others): • fear that the findings of epigenetics and that the methods of genome editing are misused—this also with respect to eugenics and enhancement; • naturalness—an issue we mention in passing a few times in the following analysis; • a possible connection between the genome/epigenome and the concept of human dignity, and the derived danger of instrumentalization and infringement of autonomy when intervening in the genome or epigenome. Since current discourse about ethical issues associated with genome editing focuses mainly on germline interventions, which are, for instance, interventions into a human embryo’s genome, we mainly focus on germline interventions when comparing the debates on genome editing and on epigenetics in section 3. (shrink)

The intersection between virtue and care ethics is underexplored in contemporary moral philosophy. This thesis approaches care ethics from a neo-Aristotelian virtue ethical perspective, comparing the two frameworks and drawing on recent work on care to develop a theory thereof. It is split into seven substantive chapters serving three major argumentative purposes, namely the establishment of significant intertheoretical agreement, the compilation and analysis of extant and new distinctions between the two theories, and the synthesis of care (...) ethical insights with neo-Aristotelianism to generate a virtue ethical theory of care. In the first two chapters, I outline virtue ethics and care ethics, and argue for considerable agreement over central premises. Chapter 2 summarises the foundational commitments of care ethics, focusing particularly on their relational ontology and its links to the other ethical claims care ethicists universally ascribe to, namely particularism, partialism, the moral salience of emotions, and the rejection of hard public/private distinctions. Chapter 3 lays out the central concepts in neo-Aristotelian virtue ethics, including eudaimonism, virtue, and character traits, and drawing a number of comparisons between virtue and care ethics specifically with regard to relational ontology and the meta-ethical commitments it underpins. In addition to doing the necessary expository work for the remainder of the thesis, Chapters 2 and 3 also argue that care ethics and virtue ethics have much more in common than is typically acknowledged – the first major contribution of this thesis to the literature. Chapters 2 and 3 to provide at least a prima facie justification for pursuit of the questions I confront in the remainder of the thesis. In Chapter 4, I ask what differentiates these two ethical theories. I survey some of the differences which philosophers in either camp have identified and offer some of my own. I suggest that several of those differences either rest on misunderstandings of one ethic or the other, or that in erecting a divide between virtue and care ethics they also disunify ethics of care. I do, however, identify two differences which seem defensible. Specifically, they are that virtue ethics seems to lack an account of care, which I define minimally as a response or responsiveness to need, and that virtue and care ethics organise their meta-ethical and normative concepts differently. This chapter thus presents a second contribution to the literature: a study of the differences between virtue ethics and care ethics. It also serves to set the trajectory for the remaining chapters, where I respond to the claim that virtue ethics lack an account of care. I spend the remainder of the thesis constructing what I take to be a satisfying foundation for a virtue ethical theory of care. In Chapter 5, I offer three initially viable means of incorporating care into virtue ethics, all of which treat care as a virtue. These are the analogical approach, according to which care is analogous to an existing virtue; the additive approach, according to which care is a novel virtue; and the bundling approach, according to which care is a bundle of virtues. I also offer and evaluate reasons to reject the claim that care is a virtue, concluding that the claim is indeed a viable one so long as the concept of care is sufficiently thick, and I contend that analogical approaches, and particularly analogies with charity, outperform the others. Chapter 5 therefore serves two ends. First, it proffers a novel meta-analysis of concepts of care as a virtue, and thus makes a third contribution to the literature. In doing so, it makes an inroad into the second: the development of a neo-Aristotelian theory of care. Chapter 6 continues this project. I attempt to show how care can be construed as an act-type and a practice. I argue in this chapter that practices are a subcategory of actions, and that care qualifies as an Anscombean act-type which aims at the meeting of needs relating to the care-recipient’s flourishing. I go on to consider the implications of this account for ethics which deploy care as a moral concept, maintaining that it not only offers a better account of consequences than theories of care which include success criteria, but also that it affords us interesting insights into the distinction between ‘caring about’ and ‘caring for’ which allow us to make sense of certain tenets of neo-Aristotelianism. This represents a contribution to both discourses, since neither care nor virtue ethicists working at the intersection of their respective normative theories have delved very deeply into the philosophy of action. Chapter 7 discusses caring relations, suggesting that a virtue ethical theory of caring relations can lean on the work care ethicists have done, and adding some necessary refinements, such as a distinction between ideal and non-ideal caring relations, and a theory of caring relations as reasons for action. This final chapter also draws these three concepts of care together by arguing that virtuous caregivers who are invested in the flourishing of those for whom they care are also sensitive to the relations those care-recipients bear to their institutional environment. I argue that because they are caring participants in caring relations, virtuous agents are characteristically motivated by states of need and dependency to engage in certain sorts of conventionally political practices. In other words, the virtue or virtues of caring characteristically manifest in certain sorts of political or social practices, relating specifically to those areas of moral life. This allows us to build upon recent work in feminist virtue ethics of the sort offered by Tessman and Friedman. I also offer a novel analysis of migration, suggesting that the account of care presenting here is analytically useful both when it comes to historical cases of migration such as the underground railroads and escapes from Nazi-occupied Europe, but also for contemporary issues such as the migrations occurring in the Southern United States and in much of Europe. I thus conclude not only that virtue ethicists ought to incorporate care into their normative framework, and that the theory of care presented here is a coherent one, but that this leads us naturally into applied topics such as virtue politics. I conclude the thesis by considering some its implications and by identifying some further avenues for research. (shrink)

An important artistic topic of Italian Renaissance painting was the rendering of the human figure. As leading actors in a painted narrative, figures had to convince beholders of the reality of the matter depicted with appropriated attitudes and gestures. This article is about two ways of drawing or rather constructing the human figure artists developed to achieve this goal. The first was only an adaptation to an old method: because of the rather simple and coarse elements used, constructions often resulted (...) in faulty pictures and were for that matter often criticized. As this article will show, the second method involved a new and very successful drawing skill, which not just required a different kind of knowledge of visual forms but of procedures of moving the hand, too. (shrink)

Iris Marion Young’s classic paper on the phenomenology of pregnancy chronicles the alienating tendencies of technology-ridden maternal care, as the mother’s subjective knowledge of the pregnancy gets overridden by the objective knowledge provided by medical personnel and technological apparatuses. Following Fredrik Svenaeus, the authors argue that maternal care is not necessarily alienating by looking specifically at the proper attention paid by sonographers in maternal care when performing ultrasound examinations. Using Martin Heidegger’s philosophy as a theoretical lens, the (...) authors argue that sonographers who cultivate technical mastery, build patient rapport, explain the process and significance of the ultrasound, and understand the patient’s world are able to provide excellent patient care. The authors utilize Hans-Georg Gadamer’s hermeneutics to show how sonographers can frame the ultrasound in a way that acknowledges both the subjective knowledge of the mother and the objective data obtained by the sonographer through the use of technology. Ultimately, the authors argue that the common practice of framing the ultrasound as the chance to “meet the baby” is inappropriate, as it exacerbates the tendency to regard objective knowledge as the only legitimate knowledge in medical contexts. They recommend a more balanced approach that elicits a fusion of horizons between the patient’s subjective knowledge and the objective data that is obtained by the sonographer via the ultrasound, thus respecting and bolstering patient autonomy. (shrink)

After a review of situation theory and previous attempts at 'computational' situation theory, we present a new programming environment, BABY-SIT, which is based on situation theory. We then demonstrate how problems requiring formal temporal reasoning can be solved in this framework. Specifically, the Yale Shooting Problem, which is commonly regarded as a canonical problem for nonmonotonic temporal reasoning, is implemented in BABY-SIT using Yoav Shoham's causal theories.

Death can be bad for an individual who has died, according to the “deprivation approach,” by depriving that individual of goods. One worry for this account of death’s badness is the Lucretian symmetry argument: since we do not regret having been born later than we could have been born, and since posthumous nonexistence is the mirror image of prenatal nonexistence, we should not regret dying earlier than we could have died. Anthony Brueckner and John Martin Fischer have developed (...) a response to the Lucretian challenge by arguing that it is rational to have asymmetric attitudes toward posthumous and prenatal nonexistence. Recently, Jens Johansson has criticized the Brueckner/Fischer position, claiming that it is irrelevant whether it is actually rational to care about future pleasures but not past pleasures. What matters, according to Johansson, is whether it would be rational for us to care about past pleasures had we come into existence earlier. In this paper, I add to the conversation between Johansson and Brueckner/Fischer by suggesting a way to defend the latter side’s position in a way that has not yet been suggested. I do this by considering a suggestion of Johansson’s for interpreting the Brueckner/Fischer position and by arguing that Johansson’s worry for the position I consider is actually incoherent. (shrink)

The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA’s provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I argue that the ACA is (...) neither uniformly hostile nor uniformly friendly to efforts to set priorities in ways that promote cost and quality. Second, I argue that the ACA does not take a single, unified approach to priority setting; rather, its guidance varies depending on the aspect of the health care system at issue (Patient Centered Outcomes Research Institute, Medicare, essential health benefits) and the factors being excluded from priority setting (age, disability, life expectancy). Third, I argue that cost-effectiveness can be achieved within the ACA's constraints, but that doing so will require adopting new approaches to cost-effectiveness and priority setting. By limiting the use of standard cost-effectiveness analysis, the ACA makes the need for workable rivals to cost-effectiveness analysis a pressing practical concern rather than a mere theoretical worry. (shrink)