Just health care (II): Is equality too much?

In a previous essay I criticized Engelhardt's libertarian conception of justice, which grounds the view that society's obligation to assure access to adequate health care for all is a matter of beneficence [1]. Beneficence fails to capture the moral stringency associated with many claims for access to health care. In the present paper I argue that these claims are really matters of justice proper, where justice is conceived along moderate egalitarian lines, such as those suggested by Rawls and Daniels, rather than strong egalitarian lines. Further, given the empirical complexity associated with the distribution of contemporary health care, I argue that what we really need to address the relevant policy issues adequately is a theory of health care justice, as opposed to an all-purpose conception of justice. Daniels has made an important start toward that goal, though there are some large policy areas which I discuss that his account of health care justice does not really speak to. Finally, practical matters of health care justice really need to be addressed in a ‘non-ideal’ mode, a framework in which philosophers have done little.     

Is continence enough?

The ideal of virtue demands not only right choice and right behavior but also right desire in the emotions. Homosexual desire, then, even if it does not result in overt homosexual behavior, is contrary to virtue, and the completion of virtue demands right desire. If a homosexual has no plan to marry, then right desire implies only the removal of homosexual desire and not the revival of heterosexual desire at which reorientation therapy aims. On the other hands, if a homosexual is married or plans to marry, then right desire includes heterosexual desire for one's spouse. If homosexual desire is viewed as an emotional disorder, and not merely as a moral defect, then it may require reorientation therapy to bring about heterosexual desire. The pursuit of virtue, then, may recommend reorientation therapy, but even this recommendation is fairly limited, since reorientation therapy may be burdensome and may not be that effective. In conclusion, married homosexuals or homosexuals planning to marry may have a limited moral obligation to pursue reorientation therapy.     

Texting and Driving: Is It Just Moral Panic?

Significant public efforts have been mounted to stop the perceived epidemic of texting and driving, especially among younger drivers. However, despite the taken-for-granted nature of these fears, cell phones are reported as a contributing factor in only about 1% of all crashes. This study examines 11 years of crash data from Kentucky to demonstrate that despite the exponential growth of cell phones in American culture, cell phone-related crashes have remained stable over time, and they represent far less of a public health risk than most people are led to believe. The conclusions are presented in the context of moral panic theory.     

Should we ration health care?

Journal of Medical Humanities - The paper begins by drawing a distinction between “allocation” — the distribution of resources between different categories, and...     

Is Dispositional Causation Just Mutual Manifestation?

Dispositional properties are often referred to as ‘causal powers’, but what does dispositional causation amount to? Any viable theory must account for two fundamental aspects of the metaphysics of causation – the causal complexity and context sensitivity of causal interactions. The theory of mutual manifestations attempts to do so by locating the complexity and context sensitivity within the nature of dispositions themselves. But is this theory an acceptable first step towards a viable theory of dispositional causation? This paper argues that the reconceptualization that the theory entails comes at too high a price, and is an unnecessary step in the wrong direction: these two central aspects concerning the metaphysics of causation can and should be accounted for in a dispositional account of causation without it.     

Who Is I?

Whilst it may seem strange to ask to whom I refers, we show that there are occasionswhen it is not always obvious. In demonstratingthis we challenge Kaplan's assumptionthat the utterer, agent and referent of I arealways the same person.We begin by presenting what weregard to be the received view about indexicalreference popularized by David Kaplan in hisinfluential 1972 Demonstratives before goingon, in section 2, to discuss Sidelle'sanswering machine paradox which may be thoughtto threaten this view, and his deferredutterance method of resolving this puzzle. Insection 3 we introduce a novel version of theanswering machine paradox which suggests that,in certain cases, Kaplan's identification ofutterer, agent and referent of I breaks down.In the fourth section we go on to consider arecent revision of Kaplan's picture by Predelliwhich appeals to the intentions of the utterer,before arguing that this picture is committedto unacceptable consequences and, therefore,should be avoided if possible. Finally, insection 5, we present a new revision ofKaplan's account which retains much of thespirit of his original proposal whilst offeringa intuitively acceptable way to explain all ofthe apparently problematic data. In doing so,we also show how this picture is able toexplain the scenario which motivated Predelli'saccount without appealing to speakerintentions.     

Water clubs in residential care: Is it the water or the club that enhances health and well-being?

Recent research suggests that establishing water clubs in care homes can counteract the dangers of dehydration and enhance residents’ health and well-being. This study provided an experimental test of this idea, and also explored the possibility that it is the social interaction that clubs provide which delivers health-related benefits. Consistent with this hypothesis, the study found no evidence that, on its own, increased focus on water consumption enhanced residents’ health or well-being. However, residents who took part in water clubs showed improved levels of perceived social support, and those who participated in water and control clubs showed beneficial outcomes in terms of the number of General Practitioner calls they required. Consistent with a social identity approach to health and well-being, a mediation analysis also indicated that clubs achieve these positive outcomes by providing social support that helps to build a shared sense of social identity among residents.     

Doping: Just Do It?

This paper provides a new philosophical argument against the lifting of the ban on doping in sports. It makes several assumptions for the sake of argument, one of which is, ironically, the moral justification of the lifting of the ban on sports doping. It is, then, a reductio ad absurdum against the claim that said ban should be lifted. Following this is a preliminary discussion concerning how doping athletes ought to be punished given that there ought to be a ban on doping due to the implausibility of the position to lift said ban. Considerations from responsibility and punishment theories are brought to bear in order to discern which punishments are most fitting for those athletes caught doping in designated clean sports competitions.     

Blaming Drunk Victims: Is It Just World or Sex Role Violation?

Richardson and Campbell (1980, 1982), in studying attributions of blame and responsibility for violent interactions, found that intoxicated victims were blamed more and held more responsible for their victimization than their sober counterparts. Two alternative explanations were proposed to account for this finding: the just world hypothesis and the effects of sex role violation. The present study was designed to test these explanations. One hundred twenty-nine males and 93 females read scenarios that varied the sex of the victim and the level of intoxication of the victim and the aggressor. Participants rated the responsibility of the aggressor, victim, and situation for the action and evaluated the aggressor and victim. Although strong support for neither of the hypotheses was demonstrated, more support was found for the effect of sex role violation than for the just world hypothesis.     

A blessing in disguise? Empowering Catholic health care institutions in the current health care environment.

Health care institutions, including Roman Catholic institutions, are in a time of crisis. This crisis may provide an important opportunity to reinvigorate Roman Catholic health care. The current health care crisis offers Roman Catholic health care institutions a special opportunity to rethink their fundamental commitments and to plan for the future. The author argues that what Catholic health care institutions must first do is articulate the nature of their identity and their commitments. By a renewed commitment to the praxis of health care on their own distinctive terms, Roman Catholic health care institutions may reestablish a vision of human nature and human service in an increasingly secular society. Health care could then reclaim its place as a powerful setting for the expression of Roman Catholic faith, life and witness.     

Sexual assault on college campuses: Is an ounce of prevention enough?

This article provides a construct-by-construct review of the effectiveness of sexual asault prevention programs in modifying sexual assault-related attitudes, cognitions, emotions, and behaviors. This article also discusses variables that may moderate program effectiveness, variables that may mediate program effectiveness, methodological issues, programs for special populations, and iatrogenic effects. In general, sexual assault prevention programs have been shown to be effective in producing short-term reductions in rape-supportive attitudes. There is insufficient evidence, however, to conclude that such programs are effective in reducing the incidence of sexual assault.     

Children and the Test of Memory Malingering: Is one trial enough?

There is a growing body of research suggesting that the first trial of the TOMM may provide an accurate screener of effort in children. During neuropsychological assessments, some circumstances result in only one completed trial of the TOMM. Research on adults reflects that passing scores on Trial 1 (based on Trial 2 cutoff) are highly predictive of passing scores on Trial 2 and the TOMM overall. Pediatric research found that 100% of children and adolescents who passed Trial 1 of the TOMM also passed Trial 2. Our research hypothesis is that children who pass Trial 1 will also pass Trial 2. Data from 75 clinically diagnosed children (ages 6–18 years) found that 64% performed above the published adult TOMM cutoff on Trial 1. All children who passed Trial 1 also passed Trial 2 suggesting support for the research hypothesis. Sensitivity was 1.0, specificity was 0.72, positive predictive value was .33, and negative predictive value was 1.0. These findings suggest that in this sample, the children who performed above the Trial 2 cutoff on Trial 1 also all passed Trial 2 (so there were no false negatives, thus a perfect sensitivity and negative predictive value). Of the 36% of children who did not pass the Trial 1 cutoff, 67% passed on Trial 2. Data clearly support that children passing Trial 1 have a high likelihood of passing Trial 2, thus drawing conclusions about performance validity after passing Trial 1. Conclusions after failing Trial 1 require further investigation.     

Sexual assault on college campuses: Is an ounce of prevention enough?

This article provides a construct-by-construct review of the effectiveness of sexual asault prevention programs in modifying sexual assault-related attitudes, cognitions, emotions, and behaviors. This article also discusses variables that may moderate program effectiveness, variables that may mediate program effectiveness, methodological issues, programs for special populations, and iatrogenic effects. In general, sexual assault prevention programs have been shown to be effective in producing short-term reductions in rape-supportive attitudes. There is insufficient evidence, however, to conclude that such programs are effective in reducing the incidence of sexual assault.     

What Is “I”?

Two responses to the nature-nurture-will issue are set forth in this essay. A devil's-advocate defense of the reductionist position is built on the thesis that the nature of a person is entirely a reflection of genetic and environmental influences; thus, eventually all thought, emotions, and actions would be explained by physicochemical effects of genes and environmental influences. The second position is based on subjective, though non-scientific, truth revealed experientially. This produces a paradox: objectively I am part of a determinism, but subjectively I can have a revelation that there is a Creator who has made me creative and given me a spirit. Subjective truth cannot be explained by science.     

Computer technology in mental health care: “Toys” or tools?

An argument is made that applications of on-line computer technology which are truly relevant to decision making constitute the new “tools of the trade” in mental health care delivery.     

Roman Catholic health care identity and mission: does Jesus language matter?

This article examines the current use of Jesus language in a convenience sample of twenty-five mission statements from Roman Catholic hospitals and health care systems in the United States. Only twelve statements specifically use the words "Jesus" or "Christ" in their mission statements. The author advocates the use of explicit Jesus language and modeling. While the witness of Jesus in the Gospel healing narratives is not only the corrective to current abuses in the health care delivery system, it is foundational to the integrity of Roman Catholic health care identity and mission. An analysis of Gospel healing narratives is used to illustrate the prophetic dimension of Jesus' wisdom, word, and witness.