Universal Health Coverage: Solution or Siren? Some Preliminary Thoughts

In recent years, there has been a growing groundswell of support for the idea that universal health coverage should be provided even in the developing world. While I wholeheartedly agree with the eventual goal of attaining universal health coverage globally, and the sooner the better, I have worries as to whether the world's rich countries, or institutions like the World Health Organization, should be pushing the world's poorest countries to take whatever steps are necessary to achieve that goal. My fear is that universal health coverage in the developing world is an intoxicating, but potentially dangerous, idea whose time may not yet have come. This article's aim is not to settle the question of whether the developing world should be urged, or pushed, to adopt policies of universal health coverage. It is merely to explore some worries about the wisdom of such a tack. The article is divided into eight sections. In Section 1, I give a brief introduction. In Section 2, I provide some background for my topic. In Section 3, I discuss the notion of universal health coverage, and what the push for such a goal in the developing world seemingly involves. In Section 4, I raise some general worries I have about the push for universal health coverage in the developing world. In Section 5, I present a wide range of possible justifications for universal health coverage in the developing world. In Section 6, I discuss whether any of the purported justifications of universal health coverage in the developing world actually do so. In Section 7, I consider some comments, objections, and responses. Finally, in Section 8, I offer a brief conclusion.     

Breaking it or Faking it? Some Critical Thoughts on the Voluntary Suspension of Play and Six Proposed Revisions

The voluntary suspension of play (VSP) is a putative fair play norm that has emerged in the last 20 years in association football, though there is no reason in principle why it is limited to that sport. It occurs in football when an injury appears to have been sustained and another player deliberately puts the ball out of play so that the injury can receive rapid attention. It is widely understood as a positive development within the sport and philosophers have added their support on the basis that VSP is a way of players exercising autonomous moral responsibility. It is represented as a case of athletes putting care for their competitors before care for the contest. In this paper, however, it is argued that moral praise for VSP is misplaced. Attempts to induce a VSP almost always occur when a team is seeking to hold a position within a game. As a delaying tactic, it encourages the faking of injuries, which is all the more reprehensible because it exploits someone else's concern for that apparent injury. Conditions for the possibility of VSP within a sport are analysed as well as conditions for the abuse of VSP. VSP occurs because of a loophole, and ways in which this can be closed are presented. In an appendix, some initial empirical evidence is presented that backs the evaluative claims of the paper.     

Nonsense on Stilts? Wittgenstein,Ethics, and the Lives of Animals

Wittgenstein is often invoked in philosophical disputes over the ethical justifiability of our treatment of animals. Many protagonists believe that Wittgenstein's philosophy points to a quantum difference between human and animal nature that arises out of humans' linguistic capacity. For this reason – its alleged anthropocentrism – animal liberationists tend to dismiss Wittgenstein's philosophy, whereas, for the same reason, anti‐liberationists tend to embrace it. I endorse liberationist moral claims, but think that many on both sides of the dispute fail to grasp the import of Wittgenstein's philosophy. My argument proceeds through close engagement with Michael Leahy's Against Liberation, which makes extensive use of Wittgenstein's ‘notion of language‐games’ as an ‘essential methodological aid’ in its defence and justification of the moral status quo. Leahy's understanding and application of that method exemplifies an entrenched interpretative stance in the wider Wittgensteinian scholarship which I seek to counter. This enables me to show that far from entailing conservatism, as some of his critics and followers contend, Wittgenstein's philosophical method is just as conducive to radical moral and political critique as it is to any other normative position.     

Plato the Democrat？ Some Thoughts on the Politics of the Laws

In the Laws （which Plato calls his ＂second-best society＂） Plato asserts that the best attainable form of society will combine the better features of autocracy and democracy. The democracy will be one where aidos （＂respect＂） will be a prominent feature, as will be the rule of laws underpinned by the belief that God, not man, is the measure of all things. Unlike in the Republic, the accumulation of wealth and property will be the right of all citizens, including rulers. But it will operate under strict limits： a maximum of four quanta of property will be allowed by any citizen, while a minimum of one （which will provide a good life though perhaps not a rich one） will be guaranteed. The affinity of such a view with that of John Rawls is striking. The article ends with a brief interview between the reader and Plato, in which some of the above issues are discussed.     

Research and Practice in Talent Identification and Development—Some Thoughts on the State of Play

Although there has been considerable growth in talent identification and development research in sport over the last 20 years, in this commentary we argue that the mixed quality (e.g., the uncritical employment of retrospective and autobiographical data) and lack of applied focus of much of this research, together with organizational inertia, means that relatively little has changed in the applied landscape at the systems level. In an effort to clarify and redirect work in this important area, we propose the Performance-Outcome-Process continuum, a structure that examines ideas based on what and how they contribute to the talent development process and the multiple approaches that exist. Reflecting a pracademic focus, and the need to generate effective and applicable answers, we also highlight the importance of understanding the processes and underlying mechanisms of development-focused constructs to best support the integration of these ideas into applied talent development procedures. To close the research–practice divide, we conclude by suggesting a pragmatic approach that prioritizes both the quality of research and the importance of applied impact, at least in research that claims to be for sport.     

Bulimia: New Mental Health Problem on the Campus?

Thomas Hohenshil and Rodney K. Goodyear : Special Assignment Editors Regina C. Casper, Elke D. Eckert, Katherine A. Halmi, Solomon C. Goldberg, and John M. Davis, Bulimia: Its Incidence and Clinical Importance in Patients with Anorexia Nervosa. Archives of General Psychiatry, 1980, 37, 1030–1035. Paul E. Garfinkel, Harvey Moldofsky, and David M. Garner, The Heterogeneity of Anorexia Nervosa: Bulimia as a Distinct Subgroup. Archives of General Psychiatry, 1980, 37, 1036–1040.     

Role Ethics or Ethics of Role-Play? A Comparative Critical Analysis of the Ethics of Confucianism and the Bhagavad Gītā

Both Confucianism and the Bhagavad Gītā emphasize the moral authority of social roles. But how deep does the likeness between these ethical philosophies run? In this essay I focus upon two significant points of comparison between the role-based ethics of Confucianism and the Gītā: (1) the interrelation between formalized social roles and family feeling, and (2) the religious dimension of moral action. How is it that Confucians ground their social roles in family feeling, while the Gītā emphasizes rupture between role and sentiment? Furthermore, are we to understand Confucianism as presenting a social philosophy that eschews religious concerns, whereas the Gītā denies the moral significance of family feeling in lieu of obtaining soteriological freedom? Examining the aesthetic and religious dimensions of the ethics of Confucianism and the Gītā clarifies a key distinction that both views implicitly make, albeit for divergent reasons: the difference between living one’s roles and playing one’s roles.     

Parents’ Perception of the Effects of Church Involvement on Adolescent Substance Use

The study utilized qualitative methods to study protective factors among middle school students who were at risk for substance use. Three focus groups (consisting of 6–7 parents each) were conducted to learn more about parent’s perceptions of protective factors within the neighborhood, school, family, and the individual. In terms of spirituality, parents stressed the importance of church involvement in preventing high-risk behaviors. These findings will be highlighted to provide information that may serve as a basis for further examining church involvement and spirituality as protective factors in adolescent substance use.     

Use or misuse of the selection task? Rejoinder to Fiddick,Cosmides, and Tooby

Sperber, Cara, and Girotto (Cognition 52 (1995) 3) argued that, in Wason's selection task, relevance-guided comprehension processes tend to determine participants' performance and pre-empt the use of other inferential capacities. Because of this, the value of the selection task as a tool for studying human inference has been grossly overestimated. Fiddick, Cosmides, and Tooby (Cognition 77 (2000) 1) argued against Sperber et al. that specialized inferential mechanisms, in particular the "social contract algorithm" hypothesized by Cosmides (Cognition 31 (1989) 187), pre-empt more general comprehension abilities, making the selection task a useful tool after all. We rebut this argument. We argue and illustrate with two new experiments, that Fiddick et al. mix the true Wason selection task with a trivially simple categorization task superficially similar to the Wason task, yielding methodologically flawed evidence. We conclude that the extensive use of various kinds of selection tasks in the psychology of reasoning has been quite counter-productive and should be discontinued.     

Does Religion Buffer the Effects of Discrimination on Mental Health? Differing Effects by Race

Much research has shown that experiences of discrimination are negatively related to mental health. In this study, a national probability survey of whites and African Americans at midlife is used to examine whether attendance at religious services and religious comfort seeking protect people from the effects of discrimination on mental health, and if the protective power of religion varies by race. Results show that reports of discrimination are related to greater negative affect and less positive affect, but only attendance at religious services moderates this relationship, and then only for African Americans' negative affect. The historical involvement of African-American religious bodies in combating discrimination may help to explain the specificity of these moderating effects.     

Institutional Values of Managed Mental Health Care: Efficiency or Oppression?

The authors suggest that many managed mental health care (MMHC) practices have oppressive effects on members of cultural and ethnic minority groups. They examine the dissonance between institutional practices and cultural traditions that reflect insensitivity and forced conformity, particularly regarding time, pace, and intervention uniformity as applied to clients and commonly required in the MMHC industry. Los autores sugieren que muchas prácticas del cuidado administrado de la salud mental (MMHC, por sus siglas en inglés) tienen efectos opresivos sobre los miembros de grupos de minorías étnicas y culturales. Examinan también la disonancia entre prácticas institucionales y tradiciones culturales que reflejan insensibilidad y una conformidad forzada, sobre todo en lo referente a tiempo, ritmo y uniformidad de intervención tal y como se aplica a clientes y normalmente requeridos por la industria de MMHC.     

Those Were the Best of Times,and Then…

ABSTRACT

Rachel T. Hare-Mustin describes a career of feminist activism in academic life, the professions, and clinical practice in the 1970s and 1980s. She has been an advocate for changes in professional ethics and improving conditions for women. Her primary areas of influence have involved applying feminist theory to the study of gender and pointing out that the sex role model of gender differences has an inherent bias that overlooks the gender hierarchy. Women’s voices are silenced, not only in the process of therapy, but in the wider society as well.     

Aristotle,Kant, and …Facebook? A Look at the Implications of Social Media on Ethics

The purpose of this study was to explore if and how social media might come to bear on people’s understanding of ethics. Participants were asked to complete online surveys regarding social media interaction and respond to 14 scenarios depicting ethical dilemmas. Our results suggest that social media and people’s perceptions of ethics do share a relationship. Specifically, we found that people who reported being exposed to ethical violations on social media were more likely to find our unethical scenarios to be personally unacceptable, to be of lower ethicality, and to react negatively to the content. These findings suggest that mere exposure to ethical violations is enough to produce awareness in people regarding ethical issues, which carries significant implications for ethics education.     

Politics on the Couch? Psychotherapy and Society—Some Possibilities and Some Limitations

The ideas and practices of psychotherapy, together with fresh thinking from many other sources, can help to revitalize Western politics which seem broken and moribund. The author describes various professional experiences of his own at the interface of politics and psychotherapy. These include consulting with mainstream and activist politicians and groupings. He discusses how politics in the West is changing in the general direction of what he calls “transformative politics.” He also asks if psychotherapists can make a difference in the political world today, explaining that, though enthusiastic about the prospect, he is also skeptical about it because the record of psychotherapists' involvement in politics is not very good. The paper includes an experiential and personally oriented section (“The Inner Politician”) that looks at how the political self is formed in culture, family, and the inner world. The notion of differing political styles as a source of conflict is explained and explored. The author concludes with some reflections on the relations between psychotherapy, politics, and spirituality.     

Can the Effects of Religion and Spirituality on Both Physical and Mental Health be Scientifically Measured? An Overview of the Key Sources,with Particular Reference to the Teachings of Said Nursi

Within Western secular societies, everything has to be substantiated by empirical evidence; this means it has to be quantifiable and measurable. Research, particularly quantitative research, then, is the criterion by which everything, including religion, is either accepted or rejected. The separation of religion from science began with the Renaissance, the Reformation and the advent of the Enlightenment. It was perceived that religion did not match the language of science and that there was no logical proof or empirical evidence for the existence of God. Religion therefore, due to its inability to be measured and quantified, has since been largely marginalised. In recent times, in order to integrate ‘religion’ into everyday life, attempts have been made to argue and bring in scientific proof for the effectiveness of religion for improved health and well-being. The psychiatrist Harold Koenig has been one of the key people whose collation of research evidence has shown that religion has a positive effect on both physical and mental health. By looking firstly at the definitions of religion and spirituality and then discussing various opinions from both secular and religious perspectives, including those of Said Nursi, this paper aimed to determine whether religion and spirituality can indeed be measured.