Andy Ward

If the rhetorical and economic investment of educators, policy makers and the popular press in the United States is any indication, then unbridled enthusiasm for the introduction of computer mediated communication (CMC) into the educational process is wide-spread. In large part this enthusiasm is rooted in the hope that through the use of Internet-based CMC we may create an expanded community of learners and educators not principally bounded by physical geography. The purpose of this paper is to reflect critically upon whether students and teachers are truly linked together as a``community'' through the use of Internet-based CMC. The paper uses the writings of Kierkegaard, and Hubert Dreyfus's exploration of Kierkegaardian ideas, to look more closely at the prospects and problems embedded in the use of Internet-based CMC to create "distributed communities" of teachers and learners. It is argued that from Kierkegaard's perspective, technologically mediated communications run a serious risk of attenuating interpersonal connectivity. Insofar as interpersonal connectivity is an integral component of education, such attenuation bodes ill for some, and perhaps many instances of Internet-based CMC.

The goal of research in social epidemiology is not simply conceptual clarification or theoretical understanding, but more importantly it is to contribute to, and enhance the health of populations (and so, too, the people who constitute those populations). Undoubtedly, understanding how various individual risk factors such as smoking and obesity affect the health of people does contribute to this goal. However, what is distinctive of much on-going work in social epidemiology is the view that analyses making use of individual-level variables is not enough. In the spirit of Durkheim and Weber, S. Leonard Syme makes this point by writing that just “as bad water and food may be harmful to our health, unhealthful forces in our society may be detrimental to our capacity to make choices and to form opinions” conducive to health and well-being. Advocates of upstream (distal) causes of adverse health outcomes propose to identify the most important of these “unhealthful forces” as the fundamental causes of adverse health outcomes. However, without a clear, theoretically precise and well-grounded understanding of the characteristics of fundamental causes, there is little hope in applying the statistical tools of the health sciences to hypotheses about fundamental causes, their outcomes, and policies intended to enhance the health of populations. This paper begins the process of characterizing the social epidemiological concept of fundamental cause in a theoretically respectable and robust way.

According to HealthCare.gov, by improving access to quality health for all Americans, the Affordable Care Act (ACA) will reduce disparities in health insurance coverage. One way this will happen under the provisions of the ACA is by creating a new health insurance marketplace (a health insurance exchange) by 2014 in which “all people will have a choice for quality, affordable health insurance even if a job loss, job switch, move or illness occurs”. This does not mean that everyone will have whatever insurance coverage he or she wants. The provisions of the ACA require that each of the four benefit categories of plans (known as bronze, silver, gold and platinum) provides no less than the benefits available in an “essential health benefits package”. However, without a clear understanding of what criteria must be satisfied for health care to be essential, the ACA’s requirement is much too vague and open to multiple, potentially conflicting interpretations. Indeed, without such understanding, in the rush to provide health insurance coverage to as many people as is economically feasible, we may replace one kind of disparity (lack of health insurance) with another kind of disparity (lack of adequate health insurance). Thus, this paper explores the concept of “essential benefits”, arguing that the “essential health benefits package” in the ACA should be one that optimally satisfies the basic needs of the people covered

In their recent book, Is Inequality Bad for Our Health?, Daniels, Kennedy, and Kawachi claim that to “act justly in health policy, we must have knowledge about the causal pathways through which socioeconomic (and other) inequalities work to produce differential health outcomes.” One of the central problems with this approach is its dependency on “knowledge about the causal pathways.” A widely held belief is that the randomized clinical trial (RCT) is, and ought to be the “gold standard” of evaluating the causal efficacy of interventions. However, often the only data available are non-experimental, observational data. For such data, the necessary randomization is missing. Because the randomization is missing, it seems to follow that it is not possible to make epistemically warranted claims about the causal pathways. Although we are not sanguine about the difficulty in using observational data to make warranted causal claims, we are not as pessimistic as those who believe that the only warranted causal claims are claims based on data from (idealized) RCTs. We argue that careful, thoughtful study design, informed by expert knowledge, that incorporates propensity score matching methods in conjunction with instrumental variable analyses, provides the possibility of warranted causal claims using observational data.

The failure to recognize a correlation as spurious can lead people to adopt strategies to bring about a specific outcome that manipulate something other than a cause of the outcome. However, in a 2008 paper appearing in the journal Analysis, Bert Leuridan, Erik Weber and Maarten Van Dyck suggest that knowledge of spurious correlations can, at least sometimes, justify adopting a strategy aiming at bringing about some change. This claim is surprising and, if true, throws into question the claim of Nancy Cartwright and others that knowledge of laws of association is insufficient for distinguishing effective and ineffective strategies. This paper examines the nature of spurious correlations and their value in crafting strategies for change. The conclusion of the paper is that while knowledge of a spurious correlation may have practical value, the value depends on either having knowledge of the causal structure underlying the correlation or it depends on the use of ‘causal criteria’

Although charismatic leadership theorists have long argued that leader–follower value congruence plays a central role in the development of charismatic relationships, few studies have tested this proposition. Using data from two studies involving a total of 329 CEOs and 1807 members of their top management teams, we tested the hypothesis that value congruence between leaders and their followers is empirically linked to follower perceptions of the charisma of their leader. Consistent with a relational perspective on charismatic leadership, strong support was found for the hypothesis that perceived value congruence between leaders (CEOs) and their followers (members of their top management teams) is positively related to follower perceptions of the degree of charisma possessed by the leader. Conversely, only limited support was found for the hypothesis that actual value congruence is linked to perceptions of charismatic leadership. Implications of these findings for research and practice are discussed

The nature of health care, a multifaceted system of reimbursements, subsidies, levels of care, and trade-offs between economics, values and social goods, makes it both a problematic area of policy and critical to the well-being of society. In the United States, provision of health care is not a right as in some countries, but occurs as a function of a complex set of cross-subsidized mechanisms that, according to some analysts, exclude from coverage those who may be in the most need of it. Accordingly, this article examines some of the issues involved in making decisions on how to justly expand health insurance.

Nancy Cartwright begins her recent book, Hunting Causes and Using Them, by noting that while a few years ago real causal claims were in dispute, nowadays “causality is back, and with a vengeance.” In the case of the social sciences, Keith Morrison writes that “Social science asks ‘why?’. Detecting causality or its corollary—prediction—is the jewel in the crown of social science research.” With respect to the health sciences, Judea Pearl writes that the “research questions that motivate most studies in the health sciences are causal in nature.” However, not all data used by people interested in making causal claims come from experiments that use random assignment to control and treatment groups. Indeed, much research in the social and health science depends on non-experimental, observational data. Thus, one of the most important problems in the social and health sciences concerns making warranted causal claims using non-experimental, observational data; viz., “Can observational data be used to make etiological inferences leading to warranted causal claims?” This paper examines one method of warranting causal claims that is especially widespread in epidemiology and the health sciences generally—the use of causal criteria. It is argued that cases of complex causation generally, and redundant causation—both causal overdetermination and causal preemption—specifically, undermine the use of such criteria to warrant causal claims

On the standard reading of Hume, the belief that the necessity associated with the causal relation is “an entirely mind-independent phenomenon” in the world isunjustified. For example, Jonathan Bennett writes that necessary connections of the sort that Hume allows are not “relations which hold objectively between the ‘objects’ or events which we take to be causally related.” Similarly, Barry Stroud writes that, according to Hume, we believe falsely “that necessity is something that ‘resides’ in the relation between objects or events in the objective world.” In this paper I argue that this reading of Hume is mistaken and that there is a sense of justification (viz., justification qua “proof”) according to which human beings are justified in holding the belief that the necessity associated with the causal relation is “an entirely mind-independent phenomenon” in the world.

Do Hume and Kant hold strongly divergent views about the causal principle, viz. the principle that every event or change of state in nature must have a cause? It has traditionally been held that they do, and on the ground that while Hume claims that there is no justification for the principle’s acceptance, Kant claims that the principle can be shown to be necessary for the possibility of experience. However, I argue that, on Hume’s account of how we come to believe in the existence of external objects, it is not possible for us to perceive any external object that is changing its state randomly or acausally. Accordingly, Hume is no position to deny that the causal principle can be justified, given he acknowledges, like Kant, that we do believe ourselves capable of perceiving events, or changes of state, in nature. Equally, Kant is no position to claim to have answered Hume’s scepticism about the causal principle given he acknowledges, like Hume, that the objects of the senses are, in reality, merely appearances and not things in themselves.

The nature of health care, a multifaceted system of reimbursements, subsidies, levels of care, and trade-offs between economics, values and social goods, makes it both a problematic area of policy and critical to the well-being of society. In the United States, provision of health care is not a right as in some countries, but occurs as a function of a complex set of cross-subsidized mechanisms that, according to some analysts, exclude from coverage those who may be in the most need of it. Accordingly, this article examines some of the issues involved in making decisions on how to justly expand health insurance.

In a 2002 speech, Mark McClellan, a member of the Council of Economic Advisors at the White House, said that "[I]n the president's vision, all Americans should have access to high-quality and affordable healthcare." However, many healthcare researchers believe that a growing number of Americans are underinsured. Because any characterization of underinsurance will refer to the value judgments of people about what counts as "adequate" and "inadequate" healthcare, the goal of characterizing and measuring the underinsured is difficult to achieve. In this article, I examine the various dimensions of underinsurance, and propose a typology incorporating those dimensions.

On the standard reading of Hume, the belief that the necessity associated with the causal relation is “an entirely mind-independent phenomenon” in the world isunjustified. For example, Jonathan Bennett writes that necessary connections of the sort that Hume allows are not “relations which hold objectively between the ‘objects’ or events which we take to be causally related.” Similarly, Barry Stroud writes that, according to Hume, we believe falsely “that necessity is something that ‘resides’ in the relation between objects or events in the objective world.” In this paper I argue that this reading of Hume is mistaken and that there is a sense of justification (viz., justification qua “proof”) according to which human beings are justified in holding the belief that the necessity associated with the causal relation is “an entirely mind-independent phenomenon” in the world.

The attempt to base a standard for assessing the value of works of art upon sentiment was famously made by David Hume in his essay "Of the Standard of Taste." Hume's attempt is generally regarded as fundamentally important in the project of explaining the nature of value judgements in the arts by means of an empirical, rather than a priori, relation. Recently, Hume's argument has been strongly criticized by Malcolm Budd in his book Values of Art. Budd contends that Hume utterly fails to show how any given value judgement in the arts can be more warranted or appropriate than any other if aesthetic judgements are determined by sentiment. This is a remarkable charge, since Hume explicitly sets out to introduce an aesthetic standard for "confirming one sentiment and condemning another." I examine Budd's arguments and conclude that Hume's position-and the empiricist tradition that it inaugurated-can withstand them.

Michael Polanyi criticized the neo‐Darwinian synthesis on two grounds: that accidental hereditary changes bringing adaptive advantages cannot account for the rise of discontinuous new species, and that a Ideological ordering principle is needed to explain evolutionary advance. I commend the previous articles by John Apczynski and Richard Gelwick and also argue, more strongly than they, that Polanyi's critique of evolutionary theory is flawed. It relies on an inappropriate notion of progress and untenable analogies from the human process of scientific discovery and the fact that in physical systems minimal potential energy is most stable. Yet within a life of commitment to transcendent values humans can directly experience purpose and meaning, and in developing this notion Polanyi makes his greatest contribution to teleology.