Andrew Edgar

As I pass the editorship of Health Care Analysis to the very capable hands of Dr. John Coggon, I can perhaps be indulged in a few moments of reflection on the last 8 years. I have strived to make the journal a forum within which scholars can articulate a diverse range of concerns about health care, both from a theoretical perspective, and from a practical one. The journal has attracted contributions from around the world, and from both established scholars and, I am proud to say, young scholars just beginning their careers, but with new and exciting contributions to make.Reviewing the papers I have published, I see that a number of long-standing concerns have received new and profound treatments. These include the nature of health and wellbeing; the problem of limiting access to health care and securing justice; the challenges that new technologies, not least in reproductive and genetic medicine, pose; questions of patient autonomy and empowerment; and the roles and responsibilities of

Hermeneutics is the exploration of the process of textual interpretation. As such, it has long been recognised as an important component within the humanities and social sciences, whether one deals with actual texts or with other the products of meaningful human activity, including social actions and utterances. Here, we offer a brief overview of the contribution that hermeneutics might make to the philosophy of sport. If sports and sporting events are seen to be the results of meaningful human interactions, then they are meaningful phenomena that lend themselves to interpretation. It can thus be argued that a hermeneutics of sport is a valid and important discipline, worthy of consideration and development. We offer a review of the nature and history of hermeneutics in general, briefly exploring the place of key figures such as Schleiermacher, Heidegger, Gadamer and Riceour, as well as key concepts such as that of the hermeneutic circle. In addition, we suggest the importance of a hermeneutics of suspicion, grounded in the work of Marx, Freud and Nietzsche. In the second part of our introduction, we briefly comment on each of the papers that comprise the current volume, and that reflect the diversity of approaches that a hermeneutics of sport might embrace.

The purpose of this paper is to provide a normative model for the assessment of the exercise of power by Big Pharma. By drawing on the work of Steven Lukes, it will be argued that while Big Pharma is overtly highly regulated, so that its power is indeed restricted in the interests of patients and the general public, the industry is still able to exercise what Lukes describes as a third dimension of power. This entails concealing the conflicts of interest and grievances that Big Pharma may have with the health care system, physicians and patients, crucially through rhetorical engagements with Patient Advocacy Groups that seek to shape public opinion, and also by marginalising certain groups, excluding them from debates over health care resource allocation. Three issues will be examined: the construction of a conception of the patient as expert patient or consumer; the phenomenon of disease mongering; the suppression or distortion of debates over resource allocation

The purpose of this paper is to explore the impact that developments in transhumanist technologies may have upon human cultures, and to do so by exploring a potential debate between Habermas and the transhumanists. Transhumanists, such as Nick Bostrom, typically see the potential in genetic and other technologies for positively expanding and transcending human nature. In contrast, Habermas is a representative of those who are fearful of this technology, suggesting that it will compound the deleterious effects of the colonisation of the lifeworld, further constraining human autonomy and undermining the meaningfulness of the lifeworld by expanding the technological control and manipulation of humanity. It will be argued that these opposed positions are grounded in fundamentally different understandings of the consequences of scientific and technological advance. On one level, the transhumanists remain confident that the lifeworld has within it the resources necessary to find meaning and purpose in a society deeply infused by genetic technology. Habermas disagrees. On another level, the difference is articulated by Horkheimer and Adorno in Dialectic of Enlightenment, primarily by challenging what may be understood as a Baconian faith in science as a project for the domination of nature. While the transhumanists broadly embrace this faith, Habermas returns to something akin to Horkheimer and Adorno’s pessimistic scepticism

In the Olympic Art Competitions (1912–1948) Pierre de Coubertin expresses his conception of both sport and art as instruments of moral renewal. In this paper, this conception is criticised for failing to appreciate art and sport as necessary manifestations of modernism. The Art Competitions were informed by a traditionalist aesthetic, and thus played a highly conservative role within Olympism. A modernist art about sport, in contrast, would have been a source of critical reflection, potentially protecting the Olympic movement from corrupting exploitation by commercial and nationalistic interests. The conclusion defends the need for Cultural Olympiads, as a source of such critical reflection, that are at once modernist in conception and yet, unlike their current expression, are centrally about sport.

This paper falls into three parts. In the first part I will briefly review the current process of reform that the United Kingdom National Health Service is undergoing. Two fundamental motivations for reform, the desire for increased efficiency and for an increased responsiveness to patients' needs and preferences will be discussed in greater detail. The second part attempts to provide a perspective on the moral debate concerning health care reform by introducing the distinction between ‘civil association’ and ‘enterprise association’ as proposed by the political philosopher Michael Oakeshott. In the final part, this distinction will be used to analyze the moral and political constitution of the National Health Service, in order to establish the relevance and scope of concerns with efficiency and patient and public accountability. A framework within which the current reforms can be assessed is thereby outlined. Keywords: access to health care, civil association, enterprise association, freedom of choice, health care reform, United Kingdom National Health Service CiteULike Connotea Del.icio.us What's this?