Which Orphans Will Find a Home? The Rule of Rescue in Resource Allocation for Rare Diseases.Emily A. Largent &Steven D.Pearson -2012 -Hastings Center Report 42 (1):27-34.detailsThe rule of rescue describes the moral impulse to save identifiable lives in immediate danger at any expense. Think of the extremes taken to rescue a small child who has fallen down a well, a woman pinned beneath the rubble of an earthquake, or a submarine crew trapped on the ocean floor. No effort is deemed too great. Yet should this same moral instinct to rescue, regardless of cost, be applied in the emergency room, the hospital, or the community clinic? (...) -/- In health care, the desire to save lives at any cost must be reconciled with the reality of resource scarcity. As one example, the estimated cost for prophylactic Factor VIII to treat one patient with hemophilia for one year is $300,000. Costs of this magnitude have been accepted by public and private insurers in the developed world, even though, in principle, these sums could provide greater overall health benefit if allocated to pay for the unmet health care needs of many other patients. Looking forward, however, broad application of the rule of rescue will be increasingly untenable. But the moral instinct will remain: the desire to help those weakest among us, especially when their small numbers allow us to see them as unique individuals. What, then, is the ethical framework that can guide coverage and reimbursement decisions for orphan drugs into the future? (shrink)
Persons pursuing goods:Steven D. Smith.Steven D. Smith -2007 -Legal Theory 13 (3-4):285-313.detailsJohn Finnis's powerfully and deservedly influential modern classic, Natural Law and Natural Rights, expounds a theory of law and morality that is based on a picture of “persons” using practical reason to pursue certain “basic goods.” While devoting much attention to practical reason and to the goods, however, Finnis says little about the nature of personhood. This relative inattention to what “persons” are creates a risk—one that Finnis himself notices—of assuming or importing an inadequate anthropology. This essay suggests that the (...) “new natural law” developed by Finnis suffers in places from the inadvertent adoption of a flawed anthropology—an anthropology under the thrall of modern individualistic commitments. To explain this suspicion, this article discusses three difficulties in his natural law theory: difficulties in accounting for the basic good of friendship, for obligations we owe to others, and for legal authority. These difficulties may seem disconnected, but this article suggests that they may all reflect an inadequate anthropology—one that Finnis does not exactly embrace but that is pervasive today and that in places may affect his theorizing. (shrink)
(1 other version)Luck Attributions and Cognitive Bias.Steven D. Hales &Jennifer Adrienne Johnson -2014 -Metaphilosophy 45 (4-5):509-528.detailsPhilosophers have developed three theories of luck: the probability theory, the modal theory, and the control theory. To help assess these theories, we conducted an empirical investigation of luck attributions. We created eight putative luck scenarios and framed each in either a positive or a negative light. Furthermore, we placed the critical luck event at the beginning, middle, or end of the scenario to see if the location of the event influenced luck attributions. We found that attributions of luckiness were (...) significantly influenced by the framing of the scenario and by the location of the critical event. Positively framing an event led to significantly higher lucky ratings than negatively framing the same exact event. And the closer a negative event was placed toward the end of a scenario, the more unlucky the event was rated. Overall, our results raise the possibility that there is no such thing as luck and thereby pose serious challenges to the three prominent theories of luck. We instead propose that luck may be a cognitive illusion, a mere narrative device used to frame stories of success or failure. (shrink)
Why Every Theory of Luck is Wrong.Steven D. Hales -2016 -Noûs 50 (3):490-508.detailsThere are three theories of luck in the literature, each of which tends to appeal to philosophers pursuing different concerns. These are the probability, modal, and control views. I will argue that all three theories are irreparably defective; not only are there counterexamples to each of the three theories of luck, but there are three previously undiscussed classes of counterexamples against them. These are the problems of lucky necessities, skillful luck, and diachronic luck. I conclude that a serious reevaluation of (...) the role of luck in philosophy is called for. (shrink)
Motivations for Relativism as a Solution to Disagreements.Steven D. Hales -2014 -Philosophy 89 (1):63-82.detailsThere are five basic ways to resolve disagreements: keep arguing until capitulation, compromise, locate an ambiguity or contextual factors, accept Pyrrhonian skepticism, and adopt relativism. Relativism is perhaps the most radical and least popular solution to a disagreement, and its defenders generally think the best motivator for relativism is to be found in disputes over predicates of personal taste. I argue that taste predicates do not adequately motivate relativism over the other possible solutions, and argue that relativism looks like the (...) most promising approach when disputants cannot even agree on the meta-evidence for a contested proposition. (shrink)
Work and the Evolving Self: Theoretical and Clinical Considerations.Steven D. Axelrod -1999 - Routledge.detailsIn _Work and the Evolving Self_,Steven Axelrod begins to remedy this serious oversight by setting forth a comprehensive psychoanalytic perspective on work life. Consonant with his analytic perspective, Axelrod sets out to illuminate the workplace by examining the psychodynamic meaning of work throughout the life cycle. He begins by exploring the various dimensions of work satisfaction from a psychoanalytic perspective and then expands on the relationship between work life and the adult developmental process. This developmental perspective frames Axelrod's (...) central task: an examination of the typical work-related problems encountered in clinical practice, beginning with a psychodynamic definition of a "work disturbance." Moving on to treatment issues, Axelrod elaborates on the manner in which assessment, supportive, and exploratory interventions all enter into the treatment of work disturbances. Axelrod concludes by considering issues of career development that emerge in individual psychotherapy and exploring the psychological implications of dramatic changes now taking place in the workplace. As such, _Work and the Evolving Self_ is an impressive contribution to the task with which psychoanalytic therapists are increasingly engaged: that of broadening their identities and treatment approaches in a world that increasingly demands flexibility and innovation. (shrink)
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The Art of Nursing.Steven D. Edwards -1998 -Nursing Ethics 5 (5):393-400.detailsThis article discusses the question of whether, as is often claimed, nursing is properly described as an art. Following critical remarks on the claims of Carper, Chinn and Watson, and Johnson, the account of art provided by RG Collingwood is described, with particular reference to his influential distinction between art and craft. The question of whether nursing is best described as an art or a craft is then discussed. The conclusion is advanced that nursing cannot properly be described as an (...) art, given acceptance of Collingwood’s influential definition of art. Moreover, it is shown that, due to difficulties inherent in specifying the ‘ends’ of nursing, nursing is only problematically described as a craft. (shrink)
Nietzsche, Perspectivism, and Mental Health.Steven D. Hales &Rex Welshon -1999 -Philosophy, Psychiatry, Psychology 6 (3):173-177.detailsThis paper is a response to Ronald Lehrer's "Perspectivism and Psychodynamic Psychotherapy". Lehrer treats Nietzsche as promoting only a modest perspectivism according to which different cognitive strategies triangulate the truth. We argue that Nietzsche's perspectivism is much more radical, and defensible, than Lehrer admits. We also suggest that Nietzsche's bundle theory of the self has important implications for psychotherapy and the concept of mental health. According to this theory, the self is an aggregate of ever-changing drives and affects. The conditions (...) of health for such persons are similarly mutable, with no one standard applicable to all persons, or even to the same person over time. (shrink)
Why Sports Medicine is not Medicine.Steven D. Edwards &Mike McNamee -2006 -Health Care Analysis 14 (2):103-109.detailsSports Medicine as an apparent sub-class of medicine has developed apace over the past 30 years. Its recent trajectory has been evidenced by the emergence of specialist international research journals, standard texts, annual conferences, academic appointments and postgraduate courses. Although this field of enquiry and practice lays claim to the title ‘sports medicine’ this paper queries the legitimacy of that claim. Depending upon how ‘sports medicine’ and ‘medicine’ are defined, a plausible-sounding case can be made to show that sports medicine (...) is not in fact a branch of medicine. Rather, it is sometimes closer to practices such as non-therapeutic cosmetic surgery. The argument of the paper is as follows. It begins with a brief statement concerning methodology. We then identify and subscribe to a plausible defining goal of medicine taken from a recognised authority in the field. Then two representative, authoritative, definitions of sports medicine are discussed. It is then shown that acceptance of these definitions of sports medicine generates a problem in that if they are accepted, no necessary commitment to the defining goal of medicine is present within sports medicine. It seems to follow that sports medicine is not medicine. In the final part of the paper a critical response to that conclusion is presented and rebutted. The response is one which rejects the identification of the defining goal of medicine upon which our argument rests. (shrink)
Is there a distinctive care ethics?Steven D. Edwards -2011 -Nursing Ethics 18 (2):184-191.detailsIs it true that an ethics of care offers something distinct from other approaches to ethical problems in nursing, especially principlism? In this article an attempt is made to clarify an ethics of care and then to argue that there need be no substantial difference between principlism and an ethics of care when the latter is considered in the context of nursing. The article begins by considering the question of how one could in fact differentiate moral theories. As is explained, (...) this cannot be done merely in light of the moral judgements they defend, nor their ontological commitments (e.g. their view of the nature of persons). Following these methodological beginnings, care-based ethics is described and critically discussed. It is shown that ontological commitments embraced within care ethics do not themselves show that care ethics is distinct from other approaches. The idea of ‘psychological care’ is also discussed, which stems from the work of Margaret Little. Her claim that the ‘gestalts’ of justice and care cannot be combined is rejected in favour of an approach that does just that and which has been developed by Joan Tronto. It is then claimed that the moral commitments of principlism are certainly not incompatible with those of an ethics of care in the nursing context. A challenge to the idea that principlism and ethics of care might be compatible is anticipated in the work of Eva Feder Kittay. This challenge is responded to and it is concluded that care considered as a moral orientation and the moral values embedded in principlism are best combined in the nursing context. Care provides a moral orientation over which the obligations referred to in principlism can be laid. (shrink)
Relativism and the Foundations of Philosophy.Steven D. Hales -2006 - MIT Press.detailsThe grand and sweeping claims of many relativists might seem to amount to the argument that everything is relative--except the thesis of relativism. In this book,Steven Hales defends relativism, but in a more circumscribed form that applies specifically to philosophical propositions. His claim is that philosophical propositions are relatively true--true in some perspectives and false in others. Hales defends this argument first by examining rational intuition as the method by which philosophers come to have the beliefs they do. (...) Analytic rationalism, he claims, has a foundational reliance on rational intuition as a method of acquiring basic beliefs. He then argues that there are other methods that people use to gain beliefs about philosophical topics that are strikingly analogous to rational intuition and examines two of these: Christian revelation and the ritual use of hallucinogens. Hales argues that rational intuition is not epistemically superior to either of these alternative methods. There are only three possible outcomes: we have no philosophical knowledge ; there are no philosophical propositions ; or there are knowable philosophical propositions, but our knowledge of them is relative to doxastic perspective. Hales defends relativism against the charge that it is self-refuting and answers a variety of objections to this account of relativism. Finally, he examines the most sweeping objection to relativism: that philosophical propositions are not merely relatively true, because there are no philosophical propositions--all propositions are ultimately empirical, as the naturalists contend. Hales's somewhat disturbing conclusion--that intuition-driven philosophy does produce knowledge, but not absolute knowledge--is sure to inspire debate among philosophers. (shrink)
Externalism in the Philosophy of Mind.Steven D. Edwards -1994 - Avebury.detailsSets out to show that externalism is a more plausible theory of intentional content than internalism. The book describes a physicalist version of externalism, and explains the individuation conditions of demonstrative thoughts and thoughts which concern natural kinds.
Dispositional optimism and luck attributions: Implications for philosophical theories of luck.Steven D. Hales &Jennifer Adrienne Johnson -2018 -Philosophical Psychology 31 (7):1027-1045.detailsABSTRACTWe conducted two studies to determine whether there is a relationship between dispositional optimism and the attribution of good or bad luck to ambiguous luck scenarios. Study 1 presented five scenarios that contained both a lucky and an unlucky component, thereby making them ambiguous in regard to being an overall case of good or bad luck. Participants rated each scenario in toto on a four-point Likert scale and then completed an optimism questionnaire. The results showed a significant correlation between optimism (...) and assignments of luck: more optimistic people rated the characters in the ambiguous scenarios as more lucky while more pessimistic people rated the same characters in the same scenarios as more unlucky. Study 2 separated the good and bad luck components of the study 1 scenarios and presented the components individually to a new group of participants. Participants rated the luckiness of each component on the same four-point scale and then completed the optimism questionnaire. We found... (shrink)
A problem for moral luck.Steven D. Hales -2015 -Philosophical Studies 172 (9):2385-2403.detailsThe present paper poses a new problem for moral luck. Defenders of moral luck uncritically rely on a broader theory of luck known as the control theory or the lack of control theory. However, there are are two other analyses of luck in the literature that dominate discussion in epistemology, namely the probability and modal theories. However, moral luck is nonexistent under the probability and modal accounts, but the control theory cannot explain epistemic luck. While some have posited that “luck” (...) is ambiguous, so that one theory of luck is operative with epistemic luck and a different theory works for moral luck, there are both semantic and philosophical reasons to reject luck ambiguity. Defenders of moral luck must engage with the broader literature on luck and either provide a comprehensive defense of the control theory or concede that moral luck is not a genuine thing in its own right. (shrink)
Can supervising self-harm be part of ethical nursing practice?Steven D. Edwards &Jeanette Hewitt -2011 -Nursing Ethics 18 (1):79-87.detailsIt was reported in 2006 that a regime of ‘supervised self harm’ had been implemented at St George’s Hospital, Stafford. This involves patients with a history of self-harming behaviour being offered both emotional and practical support to enable them to do so. This support can extend to the provision of knives or razors to enable them to self-harm while they are being supervised by a nurse. This article discusses, and evaluates from an ethical perspective, three competing responses to self-harming behaviours: (...) to prevent it; to allow it; and to make provision for supervised self-harm. It is argued that of these three options the prevention strategy is the least plausible. A tentative conclusion is offered in support of supervised self-harm. (shrink)
Schiller as Philosopher: A Re-Examination (review).Steven D. Martinson -2007 -Journal of the History of Philosophy 45 (4):663-664.detailsSteven D. Martinson - Schiller as Philosopher: A Re-Examination - Journal of the History of Philosophy 45:4 Journal of the History of Philosophy 45.4 663-664 Muse Search Journals This Journal Contents Reviewed bySteven D. Martinson University of Arizona Frederick Beiser. Schiller as Philosopher: A Re-Examination. Oxford: Clarendon Press, 2005. Pp. xiv + 283. Cloth, $74.00. Beiser offers a sound and sensible account of the philosophical work of Friedrich Schiller . He invites philosophers to take Schiller's philosophy much (...) more seriously than they have in the past. The call is compelling since, as the author argues, only very rarely in the history of philosophy "has such sophisticated theory been.. (shrink)
A Relativist’s Rejoinder.Steven D. Hales -2008 -International Journal of Philosophical Studies 16 (2):271 – 278.detailsThis article is my author's response in a book symposium on my book Relativism and the Foundations of Philosophy. I reply to criticisms raised by Otavio Bueno, Henry Jackman, and Jonathan Weinberg.
Reply to Shogenji on relativism.Steven D. Hales -1997 -Mind 106 (424):749-750.detailsIn this note I rebut the criticisms Professor Shogenji makes of the analysis of absolute and relative truth I originally presented in "A Consistent Relativism.".
Memory and Mathesis: For a Topological Approach to Psychology.Steven D. Brown -2012 -Theory, Culture and Society 29 (4-5):137-164.detailsThe ‘mathematical imaginary’ at work in psychology is central to the contingent history of the discipline, but is also responsible for considerable confusion and ambiguity around the ontological assumptions of psychological theories and models. Rather than reject the mathematical altogether, this article argues for an alternative form of mathematical description in psychology through the use of topology. Drawing on DeLanda’s topological account of the virtual, the relationship between psychology and ontology is progressively questioned in relation to memory. Henri Bergson’s conception (...) of duration and the pure past is juxtaposed with the topological psychology of Kurt Lewin and its notion of life space as a manifold with n-dimensions. Using a diagrammatic strategy developed by Mullarkey, an actualist account of the virtual is used to hold these distinct bodies of work together. Psychological events may be given a ‘thick description’ through the identification of topological relations and invariants. The interplay between the actual entities that are afforded in experience can be seen to be virtualized as planes of irreality. A topological approach to psychology offers the opportunity of replacing the taxonomy of essences common to the discipline with a dynamic account of invariance through homeomorphism. (shrink)
Turning a Drug Target into a Drug Candidate: A New Paradigm for Neurological Drug Discovery?Steven D. Buckingham,Harry-Jack Mann,Olivia K. Hearnden &David B. Sattelle -2020 -Bioessays 42 (9):2000011.detailsThe conventional paradigm for developing new treatments for disease mainly involves either the discovery of new drug targets, or finding new, improved drugs for old targets. However, an ion channel found only in invertebrates offers the potential of a completely new paradigm in which an established drug target can be re‐engineered to serve as a new candidate therapeutic agent. The L‐glutamate‐gated chloride channels (GluCls) of invertebrates are absent from vertebrate genomes, offering the opportunity to introduce this exogenous, inhibitory, L‐glutamate receptor (...) into vertebrate neuronal circuits either as a tool with which to study neural networks, or a candidate therapy. Epileptic seizures can involve L‐glutamate‐induced hyper‐excitation and toxicity. Variant GluCls, with their inhibitory responses to L‐glutamate, when engineered into human neurons, might counter the excitotoxic effects of excess L‐glutamate. In reviewing recent studies on model organisms, it appears that this approach might offer a new paradigm for the development of candidate therapeutics for epilepsy. (shrink)
(1 other version)The Development of Jerome's Views on the Ascetic Life.Steven D. Driver -1995 -Recherches de Theologie Et Philosophie Medievales 62:44-70.detailsJerome's writings constitute one of the earliest and most extensive sources for the development of asceticism in the Latin West. His correspondence and his many other works span the crucial decades of the late fourth and early fifth centuries, a time in which loosely organized and somewhat anomalous groups of ascetics blossomed into coherent, regular monastic communities. Various forms of ascetic literature, each playing a vital role in the milieu in which it arose, came to be read by many of (...) the larger body of believers. Jerome's literary endeavors attest the hunger of many Christians, both ascetic and worldly, for accounts of monks and for articulations of the principles by which they lived. His writings, and particularly the correspondence which spans his long and controversial career, chart the spiritual growth of an individual whose quest for and understanding of the perfect Christian life was influenced by his own experiences and by currents within wider ascetic movements. (shrink)
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An Argument in Support of Suicide Centres.Steven D. Edwards -2010 -Health Care Analysis 18 (2):175-187.detailsIn the UK and elsewhere suicide presents a major cause of death. In 2008 in the UK the topic of suicide rarely left the news. Controversy surrounding Daniel James and Debbie Purdy ensured that the problem of assisted suicide received frequent media discussion. This was fuelled also by reports of a higher than usual number of suicides by young people in South Wales. Attention attracted by cases such as that of Daniel James and Debbie Purdy can lead to a neglect (...) of the problem of how to respond to the vast majority of suicides, in which there is no obvious accompanying health problem. This paper seeks to redress that balance to some degree. Its focus is primarily on the provision of assisted suicide when the person seeking such assistance has no accompanying health problem. It is argued that a network of suicide centres (SCs) should be established, the purpose which in certain circumstances, will extend to assisting suicide in cases where a competent person has a definite, sustained intention to end their own life. Arguments in support of this proposal are provided, focusing on respect for autonomy, relief of suffering and respect for the ‘life-plan’ of a person. Considerations relating to reduction of harms to third parties are also recruited. Eight responses to the proposal are considered. But none is found compelling, nor are they found jointly compelling. (shrink)