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بایگانی‌های 1252 - خانه اخلاق پژوهان جوان
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Medicine, money, and morals

by Marc A. Rodwin

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Subject: Conflict Of Interests, Medical Care, Medical Care, Cost Of, Medical Ethics,

Marc A. Rodwin draws on his own experience as a health lawyer–and his research in health ethics, law, and policy–to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors’ decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor’s choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals –lawyers, government officials, and businessmen–all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians’ conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change.

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Affirmation Of Life

by Bernard Reginster

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Subject: Ethics, Life, Nihilism,

Among all the great thinkers of the past two hundred years, Nietzsche continues to occupy a special place–not only for a broad range of academics but also for members of a wider public, who find some of their most pressing existential concerns addressed in his works. Central among these concerns is the question of the meaning of a life characterized by inescapable suffering, at a time when the traditional responses inspired by Christianity are increasingly losing their credibility. While most recent studies of Nietzsche’s works have lost sight of this fundamental issue, Bernard Reginster’s book The Affirmation of Life brings it sharply into focus. Reginster identifies overcoming nihilism as a central objective of Nietzsche’s philosophical project, and shows how this concern systematically animates all of his main ideas. In particular, Reginster’s work develops an original and elegant interpretation of the will to power, which convincingly explains how Nietzsche uses this doctrine to mount a critique of the dominant Christian values, to overcome the nihilistic despair they produce, and to determine the conditions of a new affirmation of life. Thus, Reginster attributes to Nietzsche a compelling substantive ethical outlook based on the notions of challenge and creativity–an outlook that involves a radical reevaluation of the role and significance of suffering in human existence. Replete with deeply original insights on many familiar–and frequently misunderstood–Nietzschean concepts, Reginster’s book will be essential to anyone approaching this towering figure of Western intellectual history.

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Metaethics

by Simon Kirchin

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Subject: Ethics,

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Frontiers Of Justice

by Martha C. Nussbaum

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Subject: Animal Rights, Minorities, People With Disabilities, Philosophy / Political,

Theories of social justice are necessarily abstract, reaching beyond the particular and the immediate to the general and the timeless. Yet such theories, addressing the world and its problems, must respond to the real and changing dilemmas of the day. A brilliant work of practical philosophy, Frontiers of Justice is dedicated to this proposition. Taking up three urgent problems of social justice neglected by current theories and thus harder to tackle in practical terms and everyday life, Martha Nussbaum seeks a theory of social justice that can guide us to a richer, more responsive approach to social cooperation.The idea of the social contract–especially as developed in the work of John Rawls–is one of the most powerful approaches to social justice in the Western tradition. But as Nussbaum demonstrates, even Rawls’s theory, suggesting a contract for mutual advantage among approximate equals, cannot address questions of social justice posed by unequal parties. How, for instance, can we extend the equal rights of citizenship–education, health care, political rights and liberties–to those with physical and mental disabilities? How can we extend justice and dignified life conditions to all citizens of the world? And how, finally, can we bring our treatment of nonhuman animals into our notions of social justice? Exploring the limitations of the social contract in these three areas, Nussbaum devises an alternative theory based on the idea of “capabilities.” She helps us to think more clearly about the purposes of political cooperation and the nature of political principles–and to look to a future of greater justice for all.

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