Rethinking the digital divide: from philanthropy to isonomia..

The digital divide has been, at least until very recently, a major theme in policy as well as interdisciplinary academic circles across the world, as well as at a collective global level, as attested by the World Summit on the Information Society. Numerous research papers and volumes have attempted to conceptualise the digital divide and to offer reasoned prescriptive and normative responses. What has been lacking in many of these studies, it is submitted, is a rigorous negotiation of moral and political philosophy, the result being a failure to situate the digital divide - or rather, more widely, information imbalances - in a holistic understanding of social structures of power and wealth. In practice, prescriptive offerings have been little more than philanthropic in tendency, whether private or corporate philanthropy. Instead, a theory of distributive justice is required, one that recovers the tradition of emancipatory, democratic struggle. This much has been said before. What is new here, however, is that the paper suggests a specific formula, the Rawls-Tawney theorem, as a solution at the level of analytical moral-political philosophy. Building on the work of John Rawls and R. H. Tawney, this avoids both the Charybdis of Marxism and the Scylla of liberalism. It delineates some of the details of the meaning of social justice in the information age. Promulgating a conception of isonomia, which while egalitarian eschews arithmetic equality (the equality of misery), the paper hopes to contribute to the emerging ideal of communicative justice in the media-saturated, post-industrial epoch.

Health-related quality of life: implications for critical care interventional studies and why we need to collaborate with patients.

Purpose of review: Health-related quality of life (HRQoL) is an important patient-reported outcome measure following critical illness. ‘Validated’ and professionally endorsed generic measures are widely used to evaluate critical care intervention and guide practice, policy and research. Although recognizing that they are ‘here to stay’, leading QoL researchers are beginning to question their ‘fitness for purpose’. It is therefore timely to review critiques of their limitations in the wider healthcare and social science literatures and to examine the implications for critical care research including, in particular, emerging interventional studies in which HRQoL is the primary outcome of interest. Recent findings: Generic HRQoL measures have provided important yet limited insights into HRQoL among survivors of critical illness. They are rarely developed or validated in collaboration with patients and cannot therefore be assumed to reflect their experiences and perspectives. Summary: Collaboration with patients is advocated in order to improve the interpretation and utility of such data. Failure to do so may result in important study effects being overlooked and the dismissal of potentially useful interventions.