The illiberality of perfectionist enhancement

With the rapid advance of bio-genetic technology, it will soon be possible for parents to design children who are born with certain genetic traits. This raises the question whether parents should be allowed to use this technology to engineer their children as they please. In this context it is often thought and argued that liberalism, which has a reputation for being permissive of all kinds of practices, grants parents the right to do so. However, I will argue that, on an understanding of liberalism that is identical to the one used by the defenders of genetic design, liberals should wary of such practices. Liberalism, in its most general form, requires that any time individuals exercise power over others they justify it without relying on any particular conception of what a good life is. When we design children to have certain traits that are only useful for realising some conceptions of the good life, we are implicitly endorsing those conceptions. Hence this practice cannot be justified in neutral terms, and liberals should be sceptical of it. Only when we engineer our children to have traits that are useful for all conceptions of the good life can liberals allow the use of this new technology. Indeed, liberalism holds that this is morally required.

Psychotherapy and distributive justice: a Rawlsian analysis

In this paper I outline an approach to the distribution of resources between psychotherapy modalities in the context of the UK’s health care system, using recent discussions of Cognitive Behavioural Psychotherapy as a way of highlighting resourcing issues. My main goal is to offer an approach that is just, and that accommodates the diversity of different schools of psychotherapy. In order to do this I draw extensively on the theories of Justice and of Political Liberalism developed by the late John Rawls, and adapt these to the particular requirements of psychotherapy resourcing. I explore some of the implications of this particular analysis, and consider how the principles of Rawlsian justice might translate into ground rules for deliberation and decision-making.     

Physician resistance and the forging of public healthcare: a comparative analysis of the doctors' strikes in Canada and Belgium in the 1960s

Organized medicine in a number of advanced industrial countries resisted the post-war trend toward more state involvement in the funding and organisation of medical care. While there were eight doctors' strikes during the peak of reform efforts in the 1960s, two of the most prolonged and bitter struggles took place in Canada and Belgium. This comparative analysis of the two strikes highlights the philosophy, motives, and strategies of organised medicine in resisting state-led reform efforts. Although historical and institutional contexts in the two countries differed, organised medicine in Canada and Belgium thought and responded in very similar ways to the perceived threat of medical insurance reform. While the perception of who won and who lost the respective doctors' strikes differed, the ultimate impact on the trajectory of public healthcare on the medical profession was remarkably similar. In both countries, the strike would have a long-standing impact on future reform efforts, particularly efforts to reform physician remuneration in order to facilitate more effective primary healthcare.     

Nudge: a new and better way to improve health?

Nudging, or libertarian paternalism, is presented as a new and ethically justified way of improving people's health. It has proved influential and is currently taken up by the governments in the US, the UK and France. One may question the claim that the approach is new, in any case it has many similarities with the idea of “making healthy choices easier”. Whether the approach is better from an ethical perspective depends on the ethical principles one holds. From a paternalistic perspective there could be no objections, but from a libertarian, there are several. Contrary to what the authors state, libertarian paternalism is an oxymoron.     

Psychosis and the Desire for Externalization in the Individual Psyche and Neo‐Liberal Society

Psychoanalysts have written about working with psychotic and severely disturbed people, but most of this work comes from the 1970s. Since then, there has been a notable absence of this pioneering clinical work. Reflecting on why this may have occurred, the author also suggests that many of these valuable theories around psychosis and its causes, such as trauma or unrecognized trans‐generational pain, are applicable to some of the current political and social malaise that confronts our time.     

论欧盟国家卫生制度设计的团结安排及变化趋势

团结思想是欧洲卫生公平和卫生政策的重要基础,但正不断受到个人责任、自由主义、私营化改革等新理念冲击,在部分欧洲国家甚至存在因资源匮乏而加大个人自付弱化团结的危险。但团结仍然是欧洲卫生体制安排最具标志的价值观之一,并继续成为欧洲政府对卫生安排的政治承诺和问责的道德基础。在从大政府走向大社会这一全球医改浪潮中,欧洲多国政府通过加强精细化监管来进一步实现卫生系统团结。