BackgroundOur aim was to understand how digital readiness within general practice varies between different technologies and to identify how demographic, workplace and external factors affect this. The technologies considered include electronic patient records, telehealth (text messaging and video consultations), patient online access, patient clinical apps and wearables, and social media.MethodA digital readiness survey tool was developed and used in one area of southern England during Spring 2020. Semistructured qualitative interviews were also carried out with some practice staff and digital technology company representatives.ResultsGPs, nurses and non-clinical staff submitted 287 responses from 27 general practices (out of 33 invited).Staff digital readiness differs significantly between technologies. The mean perceived digital competency scores on 0–100 scale (high is good) were electronic patient records (75.7), telehealth (64.2), patient online access (65.8), patient clinical apps and wearables (50.8), and social media (51.2).Younger general practice staff, those in post for 5 or less years are more digitally competent and confident than older staff. This applies to both clinical and non-clinical staff. Older patient population, rurality and smaller practice size are associated with lower digital readiness. Readiness to use digital technology may have improved since the start of the COVID-19 pandemic but barriers remain in poor IT and mobile infrastructure, software usability and interoperability, and concerns about information governance.ConclusionsImproving digital readiness in general practice is complex and multifactorial. Issues may be alleviated by using dedicated digital implementation teams and closer collaboration between stakeholders (GPs and their staff, patients, funders, technology companies and government).

This article raises a puzzle about luck and meaning in life. The puzzle shows that, in certain cases involving luck, standard intuitions about the meaningfulness of various lives conflict with basic theoretical assumptions about the nature of meaning. After setting out the puzzle, several options for resolving it are developed and evaluated.

t is commonly held that all deontological moral theories are agent-relative in the sense that they give each agent a special concern that she does not perform acts of a certain type rather than a general concern with the actions of all agents. Recently, Tom Dougherty has challenged this orthodoxy by arguing that agent-neutral deontology is possible.1 His argument is simple: he posits a moral rule that he claims is both agent-neutral and deontological. In this article I show that the rule Dougherty posits cannot be both agent-neutral and deontological. The problem is that the rule has several possible interpretations and, although on some interpretations it is an agent-neutral rule, and on some interpretations it is a deontological rule, there are no interpretations in which it is both agent-neutral and deontological. I conclude by considering an alternative rule inspired by Dougherty's approach that looks like it might be both agent-neutral and deontological and showing that it too fails because it has core commitments that are incompatible with deontology.

In traditional consequentialism the good is position-neutral. A single evaluative ranking of states of affairs is correct for everyone, everywhere regardless of their positions. Recently, position-relative forms of consequentialism have been developed. These allow for the correct rankings of states to depend on connections that hold between the state being evaluated and the position of the evaluator. For example, perhaps being an agent who acts in a certain state requires me to rank that state differently from someone else who lacks this connection. In this chapter several different kinds of position-relative rankings related to agents, times, physical locations, and possible worlds are explored. Arguments for and against adopting a position-relative axiology are examined, and it is suggested that position-relative consequentialism is a promising moral theory that has been underestimated.

The agent-relative/agent-neutral distinction is one of the most important in contemporary moral theory. Yet providing an adequate formal account of it has proven to be difficult. In this article I defend a new formal account of the distinction, one that avoids various problems faced by other accounts. My account is based on an influential account of the distinction developed by McNaughton and Rawling. I argue that their approach is on the right track but that it succumbs to two serious objections. I then show how to formulate a new account that follows the key insights of McNaughton and Rawling's approach yet avoids the two objections.