U.S. Health Care System Essay Example for Free

U.S. Health Care System Essay Health care system in the United States is on an unsustainable way and in need of transformation. Even if, it has both private and public insurers like in other countries but the uniqueness of this system is dominant of the private component. The United States spends more on health care than any other nation but the nation is less healthy than the average population in other developed countries. Additionally, many people stay uninsured and do not have access to health care. There is a need for a deep change in the system of health care (Chua, 2006). This paper will identify and evaluate three forces that have affected the development of the health care system in the United States of America. Than, it will speculate whether or not these forces will continue to affect the health care system in the U.S. over the next decade including additional force impacting the health care system of the nation. Finally, it will evaluate the importance of technology in health care. Three Forces That Have Affected the Development of the Health Care System in the United States of America. The development of health care system in the U.S. has been affected by many different forces such social, economy, behavioral, political and technological issues. A very important factor affecting health care system is economy. The economy aspect in health care includes employment, health care cover and costs that allow people to have financial access to healthcare. In such an unstable economy as we have faced recently some employers drop or restrict coverage or prevent eligibility of its employees to continue coverage. Even more, they have a tendency to reduce costs of health care insurance by readjusting the benefits offered or sharing in the cost. Those with low income or those who lost their jobs are left uninsured. Moreover, employer-sponsored healthcare coverage has changed and some employees are no longer offering health care insurance coverage as a benefit. This will continue to be an issue in the health care system if the economy remains in recession (American Medical Association, 2005). In March 2010 the Affordable Care Act (ACA) was signed and supposed to increase quality and affordability of health insurance while reducing costs of health care for individuals and government but still is difficult to estimate if this act is going to bring real changes in health care field (Cembranelli, 2012). Another force affecting health care system in America is a social factor that interacts with the economy. The size and composition of population has a great influence on health services. Since the rate of births is higher than the number of deaths; the population has grown remarkably. Also, the constantly increasing number of immigrants affects the current population of the country. According to the data from by the census bureau, the aging population is healthier and lives longer then previous generations. Their way of live is more beneficial to health; they have more active lifestyles, social activities and cosmetic medicines. Such tendency impacts the health care system. The biomedical advances enhance longevity that leads to longer periods of economic and social dependency, while improving the quality of life. The aging population intensifies a burden on the younger workers and  will result to impact social policies, taxes, politics and life in general. In the same way, fertility, abortion trends, mortality trends affecting life expectancy, infant and maternal mortality impact the development of health care (Wiliams Torrens, 2010). Additional aspects influencing the development of health care systems in the U.S are behavioral factors. Many advances have been made in the field of disease preventions, treatments and lifestyle patterns. The rise of the AIDS woke up individuals to the fact that infectious diseases are still challenging. Controlling infectious disease has become a significant public health issue and is associated with an improvement in living conditions. Challenges in mortality are currently focused on chronic diseases and awareness to fight new outbreaks of infectious diseases play a major part. Threats of biological weapons in war terror, exposure to violence, vehicular accidents, and use of alcohol, drugs and tobacco products as well as infectious agents have an impact on behavior. Sexual behaviors have an impact on the widespread of sexually transmitted diseases resulting an increase in infertility, cancer and other complications. Moreover, intensified stress in daily life, workplace violence, issues in marriage, domestic abuse and many other problems brings breakdowns and deterioration of human immune system and affects morbidity and mortality that are linked to behavior and social interaction. The failure of the society to address social, behavioral and economics causes of disease will continue to affect the development of the healthcare system (Williams Torrens, 2010). How the Forces Will Affect the Health Care System in the United States of America Over the Next Decade, Including Additional Force-Medical Technology. All of the forces that affect the health care in the U.S. will continue over the next decade especially that there is a failure in addressing them. There is a chance that situation may even worsen and new challenges can arise. Even if, improvements of technology constantly increase efficiency, the cost of new tests and treatments will be greater than the savings based on mentioned previously economic, social and behavior factors. Health care will keep getting better in diagnosis and treating diseases lengthening patients  lives and at the same time increasing the number of people requiring care (Adams, Archbold, Munib, New, 2007). The U.S. health care system is dysfunctional and can no longer continue as it currently operates. With or without Affordable Care Act (ACA), there is a need for a deep change. The United States spends more money on health care because a nation is less healthy on the average than the rest of the developed world. The system is dysfunctional and ACA is fast-tracking the process of changes that will be faced by the economic and business challenges by health care organizations. The required adjustments to healthcare organizations operating budgets and methodologies for delivering medicine may become a big issue. Health care organizations will have to go from volume-based reimbursement in medicine based on the number of procedures done or patients seen to a value-based system that will give the same money for every patient regardless of the procedure performed. Health care organizations may have lower income since they will treat more patients. They may face cost-pressure factors such as the overall cost of medical care and the increased incidence of chronic disease, cost transparency and reference pricing, increased government role in paying for care, increased coverage and limited highly skilled medical workforce There is a prediction that forty million more people will be covered nationally, at reimbursement rates below the cost of providing that care (Adams et al., 2007). Among the economic, social and behavioral forces impacting development of the health care system is medical technology that brings a great change in the health care but it raises costs of health care. It impacts economy, organizations, industry as well as patients, insurance beneficiaries and social and governmental policy. Medical technology increases cost in health care on one hand but on the other hand improves diagnosing and treatment. Use of current medical technology allows health care organizations to develop new products and services and this way increase standards of offered services. As new technologies are developed, they bring new ethical and regulatory issues. Issues in technological advances will bring more challenges and affect the development of the health care services bringing  it into the new century (Etheredge, Jones, Lewin, 1996). The Importance of Technology in Health Care. Technology today plays an important role in health care because it improves quality of care. According to Williams and Torrens (2010), technology is the driving force of health care. It helps in the storing and organization of patient records or information and gives access to doctors to medical records. Use of technology in health care allows better and faster diagnosis and treatments. The technology is very beneficial in overcoming communication barriers in health care. It has an impact in so many areas in the healthcare world such as economic, clinical, organization, and industrial impact as well as on patients and insurance beneficiaries, social, government and policy impact. It is a hope for a long, productive life for millions of people but it has to be properly implemented by trained individuals. Health care organizations must ensure that they hire the proper staff capable to implement it while providing security and protection of patients data. Proper implementation of technology allows capturing, track, record and recognizing illnesses quickly and treating them effectively. Technology lets people and communities to stay healthy by providing them access whenever it is needed. Moreover, it brings opportunities to wellness and will also be used to stabilize physiology, modify risky behaviors, design and field snap clinical trials advancing biomedical knowledge and care for individuals with health care challenges. Despite of all benefits that technology brings to health care, today some express a concern that innovation is being stifled, capital is unavailable for technology acquisition, and reimbursement is inadequate (Graham, Estrin, Horvitz, Kohane, Mynatt, 2011). Conclusion Health care system in the United States is struggling with high cost while trying to improve quality and increasing access for the health services. There are social, economy, behavioral, political and technological factors that affect development in health care system in the country. An important  role in this development plays technology that improves quality and efficiency of diagnosis and treatment on one hand but on the other hand increases significantly costs of health care. There is a deep need to transform the health care system by improving the experience of care and the health of populations at the same time reducing costs of health care. REFERENCES Adams, J., Archbold, B. L., Munib, E. L., New, D. (2007). _Healthcare 2015 and U.S. health plan. New roles, new competencies_. Retrieved January 21, 2014, from http://www.healthleadersmedia.com American Medical Association (2005). Socioeconomic Status in Health Reaserch. _The Journal of the American Medical Association, 294_(22), . doi:10.1001/jama.294..22.2879. Cembranelli, F. (). _What are the six forces that affect innovation in healthcare?_ Retrieved January 20, 2014, from http://empreendersaude.com Chua, K. P. (2006, February). _Overview of the U.S. Health Care System_. Retrieved January 20, 2014, from http://amsa.org/AMSA/Libraries/Committee_Docs/HealthCareasystemOvervi ew.sflb.ashx Etheredge, L., Jones, S. B., Lewin, L. (1996). What is driwving health system change? _Health Affairs, 4_, 93-104. doi:10.1377/hlthaff.15.4.93 Graham, S., Estrin, D., Horvitz, E., Kohane, I., Mynatt, E. (2011). _Information Technology Research Chalanges for Healthcare: From Discovery to Delivery_. Retrieved n.d., from http://www.cra.org/ccc/national-priorities/healthcare Wiliams, S. J., Torrens, P. R. (2010). _Introduction to Health Services_ (7  ed.). Mason: Cengage Learning.

Amylase Activity In Germinating Seeds

Amylase Activity In Germinating Seeds Amylase is an enzyme found in the germinating seeds. Imbibition process causes the release of growth plant (gibberelin) which stimulates the synthesis of amylase. Amylase activity is affected by many factors such as temperature, pH, enzyme concentration, substrate concentration, and the presence of any inhibitors or activators.  [1]  Amylase enzyme in the green bean seeds works best at specific range of temperature. The cotyledons store food for the use of embryo in the form of starch. Amylase enzyme breaks down starch into maltose, a chain of two glucose molecules Maltose then breaks down into glucose. Glucose is used for the growth of plumule and radicle. When this process happens, the seeds are said to undergo germination process. The emergence of plumule and radicle indicate that the seeds have germinated. In germinated seeds, the blue colour of the Benedicts solution change to brick-red precipitate indicating the presence of glucose while maintaining the yellowish-brown colo ur of the iodine solution indicating the absence of starch. However, in non-germinated seeds, the yellowish-brown colour of the iodine solution change to blue black indicating the presence of starch while maintaining the blue colour of the Benedicts solution indicating the absence of glucose. AIM : To investigate the amylase activity during seed germination RESEARCH QUESTION: How does amylase activity affect the rate of seed germination? HYPOTHESIS: The higher the amylase activity, the higher the rate of seed germination which is indicated by the higher changes in length of plumule and radicle. Hence, the area of starch agar that represents the absence of starch is bigger and the concentration of brick-red precipitate is lower indicating the presence of small amount glucose. VARIABLES: Units Range Independent Variable Different condition of the seeds Vary the conditions of the green bean seeds by boiling, soaking and drying Dependent Variable Change in length of radicle and plumule Measure the change in length of radicle and plumule by using the ruler cm Table 1 : The independent and dependent variable of the experiment and method to control. Control variables Units Range The temperature of the incubator Set the temperature of the incubator at 25 °C throughout the experiment  °C -10 110 The time taken for each plate to be left in the incubator Left each plate for 1 week The type of seed used Use the same type of seed which is green been seeds for each sterile starch agar plate The number of seed placed in each plate Place 5 green bean seeds in each of the sterile starch agar plate Table 2: The control variables of the experiment and method to control. MATERIALS AND APPARATUS : APPARATUS Apparatus Quantity Test tube 2 Beaker 2 Ruler 1 Microwave oven 1 Marker 1 Razor blade 1 Incubator 1 Pestle and mortar 1 set Table 3: The list of apparatus. MATERIAL Material Quantity Benedicts solution Some Iodine solution Some Disinfectant Some Distilled water 50 ml Green bean seeds 15 Sterile starch agar plate 3 Table 4: The list of material. PROCEDURE : A. PREPARING DIFFERENT CONDITIONS OF GREEN BEAN SEEDS. Soak 5 green bean seeds in distilled water for 24 hours. Heat 5 green bean seeds in the microwave oven at 35 °C for about 30 minutes. Boil 5 green bean seeds. B. INVESTIGATING THE AMYLASE ACTIVITY OF GREEN BEAN SEEDS. Label 3 sterile starch agar plates with A (boiled green bean seeds), B (soaked green bean seeds) and C (dried green bean seeds) Cut each seeds of different conditions into half to split the cotyledon by using the razor blade. Soak the split seeds into disinfectant solution for 10 minutes for sterilization and then rinse twice using the distilled water. Place 5 boiled green bean seeds in plate A, 5 soaked green bean seeds in B and 5 dried green bean seeds in C by using the forceps. Place all the labeled plates in the incubator at temperature of 25 °C for 1 week. After 1 week, retrieve all the plates. Take out the seeds from plate A and cut the radicle and plumule by using the razor blade. Measure and record the length of radicle and plumule by using the ruler. Pour iodine solution into sterile starch agar plate until it covers the whole agar for 3 minutes and observe the size of the area represents the absence of starch. Transfer the seeds including the plumule and radicle into the mortar. Put a spoonful of sand and 10 ml of distilled water into the mortar. Grind the mixture using the pestle until it becomes watery mixture. Pour some of the watery mixture obtained into a test tube and add 2 drops of Benedicts solution to test for the presence of glucose. Note the colour changes and record the data obtained. Record all the measurement and observation in a table. Repeat steps 7-14 for plate B and C. DATA COLLECTION : QUALITATIVE DATA Plate Condition of the seeds Observation A Boiled green bean seeds B Soaked green bean seeds C Dried green beans seeds Table 5: Observation on the change in the colour of iodine solution and Benedicts solution. QUANTITATIVE DATA Plate A (boiled green bean seeds) Plate B (soaked green bean seeds) Plate C (dried green beans seeds) Change in length of the radicle, cm ( ± 0.05) 1 2 3 4 5 6 7 8 9 10 Change in length of the plumule, cm ( ± 0.05) 1 2 3 4 5 6 7 8 9 10 Table 6: The change in length of the radicle and plumule.

Angels in America Essay -- Kushner Angels in America Essays

Angels in America Everyone has his or her own personal faults in life. Some are looked down upon more for their issues than others are. Homosexual relationships are considered sacrilegious and unethical, so much that we scrutinize persons having those relations. We as a society should not look down upon individuals whose sexual preference is different from our own. The 80's were a time of economic growth and global power. It is also the setting for Tony Kushner's play, "Angels in America". In Kushner's play it was at time of gay revelation. Reagan's reforms and policies gave homosexual people the power and courage to be more open sexually. Throughout this play, "coming out", is a very new evolution, one that Kushner bases his play on. In the story, many of his characters are homosexual, and the truth about their sexual preferences comes out. Roy Cohn is a successful lawyer in New York, who is dying of AIDS because of his sexual relationships. He keeps his love relationship separate from his professional life for the simple fact that if he were exposed to the wrong people it could damage his reputation. This information could be used against him in court. He lies to people, telling them he has cancer to conceal his homosexuality and prevent them from knowing about his sickness. Roy is facing disbarment and if they knew he was gay, he would easily be barred from being a lawyer. Roy tells his doctor, Henry, that "Roy Cohn is not a homosexual man. Roy Cohn is a heterosexual man, who fucks around w... ...er sexual preference, than we as society can accept this kind of relationship. The graphic details Kushner describes about living and dying with the AIDS disease, gives the audience both the view of a horrifying disease and hope for the future. In the beginning of this play, there is a feeling that homosexuality is despised, but as the play moves to the second part the mood changes. It changes to a very relaxed, almost understanding, and picture of how homosexuality is viewed. In contemporary America, homosexuality is becoming accepted as a sexual preference. Many interest groups, organizations and gay people have strived for this for years. It is not our right to judge others because of what sexual preference they choose, but it is our God given right to be proud of that choice.

Analysis of Little Red Riding Hood :: Little Red Riding Hood

Analysis of Little Red Riding Hood  Ã‚   The psychologist Sigmund Freud created many theories on how people are and why they do the things they do. His psychoanalytic theories are used today to for a better understanding of and to analyze literature. Freud’s three key zones of mental process are the id, the ego and the superego. The id is one of the most important of the three when talking about â€Å"Little Red Riding Hood† by Charles Perrault. The author tries to show that being impulsive and basically giving in to your id is not the best way to live one’s life.   In the beginning of â€Å"Little Red Riding Hood†, the little girl is happily skipping through the forest. â€Å"†¦she met a wolf, who wanted to eat her†¦Ã¢â‚¬  (Stories, 1066) and proceeds to have a friendly conversation with him. This is her first mistake. Being young and uninformed about the ways of the world, she thinks it is perfectly normal to talk to a big, scary wolf. â€Å"The poor child did not know how dangerous it is to chatter away to wolves†¦Ã¢â‚¬  (Stories, pg. 1066). Since the little girl is young and impressionable, she jumps on her impulses to talk to any stranger she comes across. She does not think of what could come of her informing the wolf of her every move. She is not concerned with what might happen due to her irrational choice of speaking with a similarly irrational wolf.   The wolf is also guilty of giving in to his amoral desires. When he first sees the little girl, he â€Å"†¦wanted to eat her but did not dare to because there were woodcutters working nearby.† (Stories, pg. 1066) He refrained from giving into his impulses only because he was afraid of being hurt by the people nearby. However, the wolf did not stay hungry for long. Giving into his animalistic desires, he beat the girl to her grandmother’s house and proceeded to eat her. He could not ignore his desires anymore. The wolf thinks with his stomach and not his mind. â€Å"The id is, in short, the source of all our aggressions and desires.† (HCAL, pg. 130)   The wolf shows the fundamental characteristics of the id. He relies on his aggression and desires to obtain what he wants.    At the end of the story, the irrationality of the main characters comes to an all time high.

F. Scott Fitzgerald’s The Great Gatsby - The Power of Money Essay

In the preface to Major Barbara, the playwright George Bernard Shaw observes that "money is the most important thing in the world--it represents health, strength, honor, generosity and beauty," but, the poet continues, "it also destroys people as certainly as it fortifies and dignifies others" (Shaw 28). Shaw recognized that many people look toward money, the ultimate representation of materialism, in search of the power that enables them to live. But, money can play many parts in the drama of life. It can represent or give the illusion of wealth, prestige, nobility, and power. Those that seek to harness its powers must also strive to conquer its ability to destroy and corrupt. In F. Scott Fitzgerald's The Great Gatsby, the repeated image of money, no matter in what form or through whom it is portrayed, is used to such an extent that it becomes central to the development of the story. The abstract idea of money can be expressed in many ways. Perhaps the most straightforward way is through the acquisition of grand possessions. In the first chapter of the novel, Nick, the first-...

A “Janner” in the “smoke” Essay

As I step out of the carriage at Paddington station I feel a sensation that I feel every time I come back to this stunning and enchanting city that I love so much. The red telephone boxes, black taxis and the marvellous architecture. This visit I’m staying in one of the many travel inns in London, this one is situated the other side of the tower bridge which is a bit different to the kind of hotel that I normally stay in when I’m visiting London but this is no normal visit. This visit I am going to be a tourist and experience London from a different viewpoint. Now I have to find a taxi and drop off my bags. The taxi driver finds the hotel effortlessly and I am soon at reception checking in. My room is large and airy, decorated in standard â€Å"travel inn† style. I drop my bags and go down to the bar to find my friends, as tonight we are visiting the very popular Maxwell’s restaurant in Covent Garden. Well all I can say for the meal is superb! Burgers and chips may not sound very nice but they’ve ruined its greasy reputation. Now back in my hotel room I’m making my self a coffee from the mini bar and am running myself a pleasantly hot bath which I will lay in for a couple of hours. Today is Saturday and I will be visiting the famous Oxford Street with its many shops. The first one on my Itinerary will be Hamly’s toyshop, which I think is incredible and great for children of all ages! Also on this magnificent street is the Warner bros. Shop and Selfridges. Later on in the day I will stroll through St. James Park, which links on to Buckingham palace, any trip to London, shouldn’t be without this relaxing experience. Tremendous. Fantastic. In St. James Park the squirrels have become so used to humans that one came and ate out of my hand! I was astonished. Tonight I’m planning on staying in, ordering a pizza and watching the television, in order to re charge my batteries ready for another strenuous day. Its 7:00am and I’ve just been woken up by some couple next door having a row and I can’t get back to sleep so I’m going to set out earlier than expected go on a tour bus round main London. I’m on the tour bus now and its great. There are more people than I’d thought on the tour but most of them are foreigners. So far we’ve passed St. Paul’s Cathedral, Piccadilly Circus, Trafalgar square and many more magical and momentous tourist attractions. Next I will be visiting Covent Garden to do a spot of light shopping and watch the performers. Having a hot chocolate and a bun at a small coffee shop in Covent Garden and watching a street performer on a BMX doing flatland tricks that I didn’t think were possible. The one thing that I have noticed that all these performers have in common is that all use juggling in there shows whether they do it on bikes, with chain saws or other hazardous objects. In these 2 days I have already spent à ¯Ã‚ ¿Ã‚ ½120 on presents for other people! Toys, Clothes or food if I’ve seen it I’ve brought it. Tonight I’m having dinner in the oddly shaped building across the road from my hotel, which every time I walk pass I smell the most stunning smells ever. Spices and herbs, sweet smells of the elegant deserts and everyone who comes out, comes out smiling. Today is the day that I have been most looking forward to. Today I’m going to Madame Tussauds. The creepy looking figures look like they are alive. But first I have to wait in the long queue of anxious and restless people. There is a sign in front which says,† 2 HOURS FROM HERE†, which sounds ridiculous. Madame Tussauds. What can say it was worth the wait, which only came to an hour in the end. It smelt strange and the rooms were hot and sticky inside. Some Japanese tourist asked me to take their picture as they stood next to the Queen and prince Philip. But I fancy having mine taken with Madonna. You could spend all day here but unfortunately I don’t have that much time left. I’ve been lucky enough to secure some tickets to watch Chelsea F.C play at home so it is off to the station to catch the train to Stamford Bridge before catching the late train home to Plymouth. What will I remember most about this different trip to London? As a tourist I see how fast the city moves, how dusty, how sticky and how lonely city can be when you are on your own!

Kant and Equality Essay

Some readers of this essay will have become impatient by now; because they believe that the problem that perplexes me has been definitively solved by Immanuel Kant. It is certainly true that Kant held strong opinions on this matter. In an often-quoted passage, he reports a personal conversion from elitism: â€Å"I am myself a researcher by inclination. I feel the whole thirst for knowledge and the eager unrest to move further on into it, also satisfaction with each acquisition. There was a time when I thought this alone could constitute the honor of humanity and despised the know nothing rabble. Rousseau set me straight. This delusory superiority vanishes, I learn to honor men, and I would find myself more useless than a common laborer if I did not believe this observation could give everyone a value which restores the rights of humanity. †What Kant learned from Rousseau was the proposition that the basis of human equality is the dignity that each human person possesses in virtue of the capacity for autonomy (moral freedom). This moral freedom has two aspects, the capacity to set ends for oneself according to one’s conception of what is good, and the capacity to regulate one’s choice of ends and of actions to achieve one’s ends by one’s conception of what morality requires. According to Kant’s psychology, brute animals are determined to act as instinct inclines them, but a rational being has the power to interrogate the inclinations it feels, to raise the question what it is reasonable to do in given circumstances, and to choose to do what reason suggests even against all inclinations. The question arises whether Kant’s psychology is correct, or remotely close to correct. Perhaps something like the conflict between conscience and inclination is experienced by social animals other than humans. Perhaps the freedom that Kant imputes to human on metaphysical grounds can be shown to be either empirically nonexistent or illusory. For our purposes we can set these questions aside and simply presume that the human psychological complexity envisaged by Kant does describe capacity we possess, whether or not it is shared with other animals. My question is whether Kant’s characterization, if it was correct, would have the normative implication she draws from it. It might seem that the Kantian picture helps to show how moral freedom is arrange concept, which does not significantly admit of degrees. If one has the capacity to set an end for oneself, one does not possess this freedom to a lesser extent just because one cannot set fancy ends, or because other persons can set fancier ends. If one has the power to regulate choice of ends by one’s sense of what is morally right, one does not possess this freedom to a lesser extent because one cannot understand sophisticated moral considerations, or because other persons can understand more sophisticated moral considerations. Moreover, one might hold that it is having or lacking the freedom which is important, not having or lacking the capacity to exercise the freedom in fancy ways. But the old worries lurk just around the corner. The Kantian view is that there are indeed capacities that are crucial for the ascription of fundamental moral status that do not vary in degree. One either has the capacity or one does not, and that’s that. If the crucial capacities have this character, then the problem of how to draw a no arbitrary line on a continuum and hold all beings on one side of the line full persons and all beings on the other side of the line lesser beings does not arise. The line separating persons and nonpersons will be non arbitrary, and there will be no basis for further differentiation of moral status. One is either a person or not, and all persons are equal. Consider the capacity to set an end, to choose a goal and decide on an action to achieve it. One might suppose that all humans have this capacity except for the permanently comatose and the anencephalic. So all humans are entitled to a fundamental equal moral status. This view is strengthened by noting that there are other capacities that do admit of degrees that interact with the no degree capacities. Individuals who equally have the capacity to set an end may well differ in the quality of their end-setting performances. Some are able to set ends more reasonably than others. But these differences in performance do not gainsay the fundamental equal capacity. It is just that having a high or low level of associated capacities enables or impedes successful performance. So the fact that individuals differ in their abilities to do arithmetic and more complex mathematical operations that affect their ability to make rational choices should have no tendency to obscure the more basic and morally status-conferring equality in the capacity of each person to make choices. In response: First of all, if several of these no degree capacities were relevant to moral status, one must possess all to be at the top status, and some individuals possess more and others fewer of the relevant capacities, a problem of hierarchy, though perhaps a manageable one, would emerge anew. More important, I doubt there is a plausible no degree capacity that can do the work this argument assigns to it. Take the capacity to set ends and make choices. Consider a being that has little brain power, but over the course of its life can set just a few ends and make just a few choices based on considering two or three simple alternatives. It sets one end (lunch, now) per decade three times over the course of its life. If there is a capacity to set ends, period, not admitting of degrees, this being possesses it. The point is that it is clearly not merely the capacity to set ends, but something more complex that renders a being a person in our eyes. What matters is whether or not one has the capacity to set sensible ends and to pick among alternative end at a reasonable pace, sorting through complex considerations that bear on the choice of ends and responding in a rational way to these considerations. But this capacity, along with any similar or related capacity that might be urged as a substitute for it, definitely admits of degrees. The same point would hold if we pointed to free will or moral autonomy as the relevant person-determining capacity. It is not the ability to choose an end on ground of consideration for moral considerations merely, but the ability to do this in a nuanced and fine-grained responsive way, that is plausibly deemed to entitle a being to personhood status. In general, we single out rationality, the ability to respond appropriately to reasons, as the capacity that is pertinent to personhood, by itself or in conjunction with related abilities, and rationality so understood admits of degrees. Kant may well have held that the uses of reason that are required in order to have a well-functioning conscience that can tell right from wrong are not very sophisticated and are well within the reach of all non crazy non feebleminded humans. Ordinary intelligence suffices. His discussions of applying the categorical imperative test certainly convey this impression. But commentators tend to agree that there is no simple all-purpose moral test that easily answers all significant moral questions. Thus Christine Korsgaard cautions that the categorical imperative test is not a â€Å"Geiger counter† for detecting the presence of moral duties, and Barbara Herman observes that the application of the categorical imperative test to cases cannot be a mechanical procedure but relies on prior moral understanding by the agent and on the agent’s capacity to make relevant moral discriminations and judgments and to characterize her own proposed maxims perspicuously. These comments confirm what should be clear in any event: Moral problems can be complex and difficult, and there is no discernible upper bound to the complexity of the reasoning required to master and perhaps solve them. But suppose I do the best I can with my limited cognitive resources, I make a judgment as to what is morally right, however misguided, and I am conscientiously resolved to do what I take to be morally right. The capacity to do what is right can be factored into two components, the ability to decide what is right and the ability to dispose oneself to do what one thinks is right. One might hold the latter capacity to be the true locus of human dignity and worth. Resisting temptation and doing what one thinks is right is noble and admirable even if one’s conscience is a broken thermometer. However, one might doubt that being disposed to follow one’s conscience is unambiguously good when one’s conscience is seriously in error. For one thing, moral flaws such as a lazy indisposition to hard thinking and an obsequious deference toward established power and authority might play a large role in fixing the content of one’s judgments of conscience. A conceited lack of healthy skepticism about one’s cognitive powers might be a determinant of one’s strong disposition to do whatever one thinks to be right. Even if Kant is correct that the good will, the will directed unfailingly at what is truly right, has an absolute and unconditional worth, it is doubtful that the would-be good will, a will directed toward what it takes to be right on whatever flimsy or solid grounds appeal to it, has such worth. Take an extreme case: Suppose a particular person has a would-be good will that is always in error. This could be strong or righteous, so that the agent always does what he thinks is right, or weak and corrupt, so that the agent never does what she thinks is right. If the will is always in error, the odds of doing the right thing are increased if the would-be good will is weak and corrupt. Some might value more highly on consequential grounds the weak and corrupt erroneous will, even though the strong and righteous invariably erroneous will always shines like a jewel in its own right. And some might hold that quite aside from the expected consequences, acting on a seriously erroneous judgment of right is inherently of lesser worth than acting on correct judgment of right. Even if the disposition to do what one thinks morally right is unassailable, its purported value does not provide a sound basis for asserting the equal worth and dignity of human persons. The capacity to act conscientiously itself varies empirically across persons like any other valued capacity. A favorable genetic endowment and favorable early socialization experiences bestow more of this capacity on some persons and less on others. If we think of an agent’s will as disposed more or less strongly to do what she conscientiously believes to be right, different individuals with the same disposition will experience good and bad luck in facing temptations that exceed their resolve. Even if we assume that agents always have freedom of the will, it will be difficult to different degrees for different persons to exercise their free will as conscience dictates. Moreover, individuals will vary in their psychological capacities to dispose their will to do what conscience dictates. One might retreat further to the claim that all persons equally can try to dispose their will to do what is right, even if they will succeed in this enterprise to different degrees. But the ability to try is also a psychological capacity that we should expect would vary empirically across persons. At times Kant seems to appeal to epistemic grounds in reasoning from the goodness of the good will to the equal worth and dignity of all human persons. We don’t know what anyone’s inner motivations are, even our own, so the judgment that anyone is firmly disposed to do what is right can never be confirmed. But surely the main issue is whether humans are so ordered that we ought to accord them fundamental equal moral status, not whether, given our beliefs, it is reasonable for us to act as if they are so ordered. The idea that there is a threshold of rational agency capacity such that any being with a capacity above the threshold is a person equal in fundamental moral status to all other persons prompts a worry about how to identify this threshold non arbitrarily. It might seem that only the difference between nil capacity and some capacity would preclude the skeptical doubt that the line set at any positive level of capacity could just as well have been set higher or lower. Regarding the proposal to identify any above-zero capacity as qualifying one for personhood, we imagine a being with barely a glimmer of capacity to perceive the good and the right and to dispose its will toward their attainment. The difference between none and some might be infinitesimal, after all. However, a threshold need not be razor-thin. Perhaps there is a line below which beings with rational capacities in this range are definitely not persons and a higher level such that all beings with capacities above this level are definitely persons. Beings with rational capacities that fall in the middle range or gray area between these levels are near-persons. The levels can be set sufficiently far apart that the difference between scoring at the lower and the higher levels is undeniably of moral significance. But the difference between the rational capacities of the beings just above the higher line, call them marginal persons, and the beings at the upper end of the scale who have saintly genius capacities, is not thereby shown to be insignificant. At the lower end we might imagine persons like the villains depicted in the Dirty Harry Clint Eastwood movies. These unfortunates are not shown as having moral capacities which they are flouting, but rather as bad by nature, and perhaps not entitled to full human rights. No doubt this is a crass outlook, but the question remains whether the analysis we can offer of the basis for human equality generates a refutation of it. Suppose someone asserts that the difference between the rational agency capacities of the most perceptive saints and the most unreflective and animalistic villains defines a difference in fundamental moral status that is just as important for morality as the difference between the rational agency capacities of near-persons and marginal persons. What mistake does this claim embody? COMMENTS ON KANT’S ETHICAL THEORY Because we so commonly take it for granted that moral values are intimately connected with the goal of human well-being or happiness, Kant’s insistence that these two concepts are absolutely independent makes it difficult to grasp his point of view and easy to misunderstand it. The following comments are intended to help the you to avoid the most common misunderstandings and appreciate the sort of outlook that characterizes what Kant takes to be the heart of the ethical life. Kant’s ethical theory is often cited as the paradigm of a deontological theory. Although the theory certainly can be seriously criticized, it remains probably the finest analysis of the bases of the concepts of moral principle and moral obligation. Kant’s endeavor to ground moral duty in the nature of the human being as essentially a rational being marks him as the last great Enlightenment thinker. In spite of the fact that his critical philosophy in epistemology and metaphysics brought an end to The Age of Reason, in ethics his attempt to derive the form of any ethical duty from the very nature of a rational being is the philosophical high water mark of the Enlightenment’s vision of humanity as essentially and uniquely rational. What Kant aims to provide is a â€Å"metaphysics of morals† in the sense of an analysis of the grounds of moral obligation in the nature of a rational being. In other words, Kant aims to deduce his ethical theory purely by a priori reasoning from the concept of what it is to be a human person as a rational agent. The fact that people have the faculty of being able to use reason to decide how to act expresses the fundamental metaphysical principle -the basis or foundation in the nature of reality- on which Kant’s ethical theory is erected. Kant begins his treatise, The Fundamental Principles of the Metaphysics of Morals with the famous dramatic sentence: â€Å"Nothing can possibly be conceived in the world, or even out of it, which can be called good without qualification, except a good will. † 1. What does Kant mean by â€Å"good without qualification†? Obviously people try to seek and avoid many different sorts of things; those things which they seek they call â€Å"good,† while those they try to avoid, they call â€Å"bad†. These â€Å"goods† which people seek may be divided into those which are sought as means to some further end and those which they seek as good as ends in themselves. Obviously some things may be â€Å"good† as means to one end and â€Å"bad† as means to some other end. Different persons, motivated by different ends, will thus find different things â€Å"good† and â€Å"bad† (relative to their different ends). More food is â€Å"good† to a starving man, but it is â€Å"bad† to one overweight. In order for something to be good â€Å"without qualification† it must not be merely â€Å"good† as means to one end but â€Å"bad† as means to some other end. It must be sought as good totally independently of serving as a means to something else; it must be â€Å"good in-itself. † Furthermore, while one thing may be good as means relative to a particular end, that â€Å"end† becomes a â€Å"means† relative to some other â€Å"end†. So a college diploma may be sought as â€Å"good† as a means for the end of a higher-paying job. And a higher-paying job may be â€Å"good† as a means to increased financial security; and increased financial security may be â€Å"good† as a means to obtaining the necessities of life as well as a few of its luxuries. However, if we seek A only for the sake of B, and B only for the sake of C, etc. , then there is never a justification for seeking A at the beginning of such a series unless there is something at the end of that series which we seek as a â€Å"good in-itself† not merely as means to some further end. Such an â€Å"ultimate† end would then be an â€Å"absolute† rather than a â€Å"relative† good. Kant means that a good will is â€Å"good without qualification† as such an absolute good in-itself, universally good in every instance and never merely as good to some yet further end. 2. Why is a â€Å"good will† the only thing which is universally absolutely good? Kant’s point is that to be universally and absolutely good, something must be good in every instance of its occurrence. He argues that all those things which people call â€Å"good† (including intelligence, wit, judgment, courage, resolution, perseverance, power, riches, honor, health, and even happiness itself) can become â€Å"extremely bad and mischievous if the will which is to make use of them†¦ is not good. † In other words, if we imagine a bad person (i. e. one who willed or wanted to do evil), who had all of these so-called â€Å"goods† (intelligence, wit, etc. ), these very traits would make only that much worse his will to do what is wrong. (We would get the â€Å"criminal master-mind† of the comic books. ) Even â€Å"health† often also cited as a â€Å"good in- itself† may serve to make a person insensitive and indifferent to the lack of good health in others. 3. Isn’t â€Å"happiness† such a universal, absolute good in-itself? Kant answers clearly, â€Å"No. † However, many philosophers (the ones we call â€Å"eudaemonists†) have assumed the obvious answer to be â€Å"Yes. † All ancient eudaemonistic ethical theories as well as modern utilitarian theories virtually define â€Å"happiness† as the absolute end of all ethical behavior. Such eudaemonistic ethical theories are attractive because of the fact that they make it easy to answer the question â€Å"Why should I do what is morally right? † For any eudaemonistic theory the answer will always be â€Å"Because the morally right action is always ultimately in the interest of your own happiness. † Since these theories generally assume that people really are motivated by a desire for their own happiness, their only problem is to show that the morally right action really does serve as the best means to obtain the end of happiness. Once you are led to see this, so such theories assume, the question â€Å"Why should I do what is morally right? † is automatically answered. Kant totally rejects this eudaemonistic way of ethical theorizing; he calls decisions made according to such a calculation of what produces your own happiness â€Å"prudential† decisions and he distinguishes them sharply from ethical decisions. This is not because Kant thinks we are not motivated by a desire for happiness, in fact like the ancient philosophers, he takes it for granted that we are; however, such motivation cannot be that which makes an action ethically right or wrong. The fact that an action might lead to happiness cannot be the grounds of moral obligation. Kant regards the notion of â€Å"happiness† as both too indefinite and too empirical to serve as the grounds for moral obligation – why we ought to do something. In the first place it is â€Å"too indefinite† because all people have very different sorts of talents, tastes and enjoyments which mean in effect that one person’s happiness may be another person’s misery. This is because the concept is â€Å"empirical† in the sense that the only way you can know whether what you seek will actually serve to bring you happiness is by experience. As Kant points out, â€Å"†¦ it is impossible that the most clear-sighted [man] should frame to himself a definite conception of what he really wills in this†¦. † Since we cannot know a priori before an action whether it really will be conducive to our happiness (because the notion is so indefinite that even the most clear-sighted amongst us cannot know everything that must form part of his own happiness) the desire for our own happiness cannot serve as a motive to determine our will to do this or that action. Moreover, Kant observes that even â€Å"†¦ the general well-being and contentment with one’s condition that is called happiness, can inspire pride, and often presumption, if there is not a good will to correct the influence of these on the mind†¦. † In other words happiness cannot be good without qualification for if we imagine it occurring in a person totally devoid of the desire to do what is right, it could very well lead to all sorts of immoral actions. 4. What does Kant mean by a â€Å"good will†? To act out of a â€Å"good will† for Kant means to act out of a sense of moral obligation or â€Å"duty†. In other words, the moral agent does a particular action not because of what it produces (its consequences) in terms of human experience, but because he or she recognizes by reasoning that it is morally the right thing to do and thus regards him or herself as having a moral duty or obligation to do that action. One may of course as an added fact get some pleasure or other gain from doing the right thing, but to act morally, one does not do it for the sake of its desirable consequences, but rather because one understands that it is morally the right thing to do. In this respect Kant’s view towards morality parallels the Christian’s view concerning obedience to God’s commandments, according to which the Christian obeys God’s commandments simply because God commands them, not for the sake of rewards in heaven after death or from fear of punishment in hell. In a similar way, for Kant the rational being does what is morally right because he recognizes himself as having a moral duty to do so rather than for anything he or she may get out of it. 5. When does one act from a motive of doing one’s duty? Kant answers that we do our moral duty when our motive is determined by a principle recognized by reason rather than the desire for any expected consequence or emotional feeling which may cause us to act the way we do. The â€Å"will† is defined as that which provides the motives for our actions. Obviously many times we are motivated by specific desires or emotions. I may act the way I do from a feeling of friendship for a particular individual, or from desire for a particular consequence. I may also be motivated by particular emotions of fear, or envy, or pity, etc. When I act in these ways, I am motivated by a desire for a particular end; in Kant’s vocabulary I am said to act out of â€Å"inclination. † Insofar as an action is motivated by inclination, the motive to do it is contingent upon the desire for the particular end which the action is imagined to produce. Thus as different rational agents might have different inclinations, there is no one motive from inclination common to all rational beings. Kant distinguishes acts motivated by inclination from those done on principle. For example someone may ask why I did a certain thing, and point out that it brought me no gain, or perhaps even made life a bit less pleasant; to which I might reply, â€Å"I know I do not stand to gain by this action, but I do it because of the principle of the thing. † For Kant, this sort of state of mind is the essence of the moral consciousness. When I act on principle the sole factor determining my motive is that this particular action exemplifies a particular case falling under a general law or â€Å"maxim. â€Å" For Kant the mental process by which the actor understands that a particular case falls under a certain principle is an exercise in â€Å"reasoning,† or to be more precise, what Kant called â€Å"practical reason,† reason used as a guide to action. (â€Å"Pure Reason† is reason used to attain certainty, or what Kant called â€Å"scientific knowledge. â€Å") Since to have moral worth an action must be done on principle, and to see that a certain principle applies to a particular action requires the exercise of reason, only rational beings can be said to behave morally. 6. Why does Kant believe that to have moral worth an action must be done on principle rather than inclination? Kant’s argument here may seem strange to the contemporary outlook, for it assumes that everything in nature is designed to serve a purpose. Now it is an obvious fact that human beings do have a faculty of â€Å"practical reason,† reason applied to the guidance of actions. (Kant is of course fully aware the people often fail to employ this faculty; i. e. they act non-rationally (without reason) or even irrationally (against what reason dictates); but he intends that his ethical theory is normative, prescribing how people ought to behave, rather than descriptive of how they actually do behave.) If everything in nature serves some purpose then the faculty of practical reason must have some purpose. Kant argues that this purpose cannot be merely the attainment of some specific desired end, or even the attainment of happiness in general, for if it were, it would have been far better for nature simply to have endowed persons with an instinct to achieve this end, as is the case with the non- rational animals. Therefore, the fact that human beings have a faculty of practical reason cannot be explained by claiming that it allows them to attain some particular end. So the fact that reason can guide our actions, but cannot do so for the sake of achieving some desired end, leads Kant to the conclusion that the function of practical reason must be to allow humans as rational beings to apply general principles to particular instances of action, or in other words to engage in moral reasoning as a way of determining one’s moral obligation: what is the â€Å"right† action to do. Thus we act morally only when we act rationally to apply a moral principle to â€Å"determine† the motive of our action. 7. Do all persons have the same moral duties? According to Kant only rational beings can be said to act morally. Reason for Kant (as for all the Enlightenment thinkers) is the same for all persons; in other words there isn’t a poor man’s reason versus a rich man’s reason or a white man’s reason versus a black man’s reason. All persons are equal as potentially rational beings. Therefore, if reason dictates that one person, in a particular situation, has a moral duty to do a particular thing, then any person, in that same situation, would equally well have a duty to do that same thing. In this sense Kant’s reasoning parallels the way in which stoicism led Roman lawyers to the conclusion that all citizens are equal before the law. Thus Kant is a moral â€Å"absolutist† in the sense that all persons have the same moral duties, for all persons are equal as rational beings. But this â€Å"absolutism† does not mean that Kant holds that our moral duties are not relative to the situation in which we find ourselves. Thus it is quite possible for Kant to conclude that in one particular situation I may have a duty to keep my promise, but in another situation (in which, for example, keeping a promise conflicts with a higher duty) I may equally well be morally obligated to break a promise. 8. Why is it that actions done for the sake of some end cannot have moral worth? Since what one’s moral duties are in a particular situation are the same for all persons, one’s moral duties must be independent of the particular likes and dislikes of the moral agent. Now any action which is motivated by the desire for some particular end presupposes that the agent has the desire for that end. However, from the simple concept of a â€Å"rational being† it is not possible to deduce that any particular rational being would have any particular desired ends. Most people, of course, desire to seek pleasure and avoid pain, but there is no logical contradiction involved in the notion of a â€Å"rational being who does not desire pleasure† or perhaps who desires pain. Thus reason does not dictate that any particular rational being has any particular end. But if the desire for a particular end gave an action its moral worth, then only those rational beings who happened in fact to desire that end would regard such actions as â€Å"good,† while those that desired to avoid such an end, would regard the action as â€Å"bad. † (Thus for example eudaemonistic theories which assume the end of achieving happiness is what gives an action its moral value, would serve to induce only those beings who happened to have the desire for happiness to behave morally. For those rational beings who happened to desire to avoid happiness, there would be no incentive to behave morally and what appears â€Å"good† to the happiness-seeker will appear positively â€Å"bad† to one who seeks to avoid happiness. ) But, as we have seen above, Kant’s absolutism reaches the conclusion that moral obligation is the same for all persons. Thus the ground of moral obligation, what makes an action a moral duty, cannot lie in the end which that act produces. 9. What does reason tell us about the principle that determines the morally dutiful motive? Since Kant has ruled out the ends (i. e. the â€Å"consequences†) which an act produces as well as any motive but those determined by the application of principle as determining moral duty, he is faced now with the task of deriving the â€Å"fundamental principles† of his ethical theory solely from the concept of what it is to be a rational being. He now argues (in a very obscure manner) that from this notion of what is demanded by being rational, he can deduce that it would be irrational to act on any principle which would not apply equally to any other actor in the same situation. In other words, Kant claims that reason dictates that the act we are morally obligated to do is one which is motivated by adherence to a principle which could, without inconsistency, be held to apply to any (and all) rational agents. This fundamental ethical principle, which is commonly called â€Å"The Categorical Imperative,† Kant summarizes with the statement that â€Å"I am never to act otherwise than so that I could also will that my maxim become a universal law. † Kant’s claim that Reason demands the moral agent to act on a universal law thus in many ways parallels Jesus’ dictum that God commands that those who love Him obey â€Å"The Golden Rule. † 10. What is a â€Å"categorical imperative†? Any statement of moral obligation which I make the principle of my action (my â€Å"maxim† in Kant’s vocabulary), in the context of a specific situation, constitutes an â€Å"imperative. † I might, in such a situation, choose to act on a statement of the form, â€Å"If I desire some specific end (e. g. happiness, maximum pleasure, power, etc. ), then I ought to do such and such an action. † In doing so I would be acting on what Kant calls â€Å"a hypothetical imperative. † However, Kant has already ruled out ends as the grounds for moral obligation; thus hypothetical imperatives cannot serve as the basis for determining my moral duty. However, if I act on a principle which has the form, â€Å"In circumstances of such and such a character, I ought to.