Self-research becomes a starting point for the question about the human being in contemporary anthropological approaches. Accordingly, human life is not viewed anymore as the theoretical object of philosophical investigation, but as the concrete performative execution of the individual’s life. Following this existential paradigm, this paper shows, on the basis of Heidegger’s ‘analytic of Dasein’ and Angehrn’s ‘hermeneutic of the self,’ that the meaning of life can be identified with the process of self-realization much more than with (...) any possible meaningful achievements, engagements or qualities. In fact, understanding human being as a self-interpreting being, Heidegger grasps human life based on the analysis of the ‘understanding,’ the ‘mineness’ and the ‘potentiality-to-Being’ as one’s own reflexive process of self-reference. Angehrn discloses this process as an endless self-understanding process, during which the self forms itself, and defines it as the process that characterizes human being. In this sense, the human being is ‘condemned to meaning.’ By grasping man as such a process, one fundamental feature is expressed: his constitutive unfathomability. For the task of becoming, the self comes from the self that has to become. This means that the self is constantly in the process of becoming self-existent and exists only as this process and remains unfathomable to man in his completeness. In this infinite process of self-realization, in this task of becoming oneself consists the meaning of life. And here, its normative-reflexive character arises. For the ‘must’ to become self has its origin in the self that has to become. (shrink)

Modern medicine provides unprecedented opportunities in diagnostics and treatment. However, in some situations at the end of a patient’s life, many physicians refrain from using all possible measures to prolong life. We studied the incidence of different types of treatment withheld or withdrawn in 6 European countries and analyzed the main background characteristics.

In this paper I will try to subsume what Carl Schmitt referred to as the three types of juristic thought – positivism, decisionism and institutionalism – under the same 'signature of power’. With this expression I refer here to a general enunciative function that informs (legal) thought, forcing it to perform an (ex-ceptional) articulation of (form of) law and (force of) life. My suggestion is thus that it is possible to interpret the different approach to the law question of (...) two fatherly figures of modern jurisprudence – Hans Kelsen (positivism) and Carl Schmitt (decisionist-institutionalism) – in a way which, while mantaining that there is indeed a difference between their theories, points also towards a more fundamental partnership which concerns the very form (i.e. ex-ceptionality) of their questioning. The purpose of this paper is thus to show that the fundamental differences between these two approaches become indistinguishable if re-considered in the context of a broader problematisation of power which, following Giorgio Agamben’s reinterpretation of Foucault’s work on biopolitics, can here be defined as an ideology of govern-mentality according to which, simply put, sociality can be reduced to one, two-sided, operation: government/self-government through a decision on the form of law, to be perfomed at different levels, including thought. Legal theory as practiced by Kelsen and Schmitt is, in this respect, governmental or biopolitical, because it institutes a fictional threshold of indifferentiation between law (form) and life (force), whose preservation, by means of further (ex-ceptional) articulations (i.e. inclusive-exclusions), becomes the jurist’s fundamental task. Moreover, given the central role of both Kelsen’s positivism and Schmitt’s decisionist institutionalism for modern legal theory in general, a critical reflection on the act of (legal) theorising as such as an act of power is made possible. The modern tradition of legal theory can thus be interpreted – in spite of its increasing complexity and fragmentation (which was already reflected, at the beginning of the last century, in the fragmentation of legal theory into positivist, institutionalist and decisionist stances) – as preserving thought’s power to relate law and life. One possible alternative to a theory of (i.e. that belongs to) power is, I think, a practice of critical observation (a study) of the power of theory. (shrink)

The basic work for this book was carried out during the spring of 1989 in Edinburgh, where I had been granted a research position at The Institute for Advanced Studies in the Humanities. I should like to express here my indebtedness to the Institute for the opportunity thus afforded me. I should also like to say how very grateful I am for the stimulating conversations I had there with Professor Timothy Sprigge and Dr. Elizabeth Telfer. Dr. Telfers’s own treatise Happiness (...) has been a major influence on my view of the questions involved. The basic view of health and illness presented in this book is more fully set out in my On the Nature of Health. As in the case of my previous larger projects, I have received a great amount of support and may wise comments from Professor Ingmar Pörn, Helsinki. Three Danish experts – Anton Aggernaes, Erik Ostenfeld and Peter Sandøe – have made valuable comments. Professor Heng ten Have, Nijmegen, has improved my reading of the philosophy of Jeremy Bentham. I should also like to thank my colleagues at the Department of Health and Society, University of Linköping, for helping me to avoid a number of the pitfalls that can so easily stumble into when it comes to a treatise like this. Especially I should like to mentioned Per-Erik Liss, Ingemar Nordin and Bo Petersson, all three of whom have read and commented on the entire manuscript. A Swedish version of this book, Livskvalitet och hälsa, came out in 1991. I have been made quite a number of corrections and additions, one type of addition being replies to critical points made in reviews of the Swedish version. I should like to thank Malcolm Forbes for valuable help putting my English into publishable condition. Linköping, May 1993 Lennart Noredenfelt. (shrink)

Recent work in the psychology of happiness has led some to conclude that we are unreliable assessors of our lives and that skepticism about whether we are happy is a genuine possibility worth taking very seriously. I argue that such claims, if true, have worrisome implications for procreation. In particular, they show that skepticism about whether many if not most people are well positioned to create persons is a genuine possibility worth taking very seriously. This skeptical worry should not be (...) confused with a related but much stronger version of the argument, which says that all human lives are very bad and not worth starting. I criticize the latter stance, but take seriously the former stance and hope it can be answered in future work. (shrink)

While many have suggested that to withdraw medical interventions is ethically equivalent to withholding them, the moral complexity of actually withdrawing life supportive interventions from a patient cannot be ignored. Utilizing interplay between expository and narrative styles, and drawing upon our experiences with patients, families, nurses, and physicians when life supports have been withdrawn, we explore the changeable character of boundaries in end-of-life situations. We consider ways in which boundaries imply differences – for example, between cognition and (...) performance – and how the encounter with boundaries can generate altered meanings important for understanding decisions and actions in these contexts. We conclude that the reliance on mere roles to support the moral weight of withdrawing medical interventions is inadequate. Roles that lead us to such moments are exceeded by the responsibility encountered in such moments. And here, we suggest, is the momentous character of withdrawal: it presents the grave astonishment, the trembling awe, in the not-being-there of the other in death. (shrink)

This article defends a conception of philosophy popular outside the discipline but unpopular within it: that philosophy is unified by a concern with the meaning of life. First, it argues against exceptionalist theses according to which philosophy is unique among academic disciplines in not being united by a distinctive subject matter. It then presents a positive account, showing that the issue of the meaning of life is uniquely able to reveal unity between the practical and theoretical concerns of (...) philosophy, while meeting a range of desiderata for a typical specification of subject matter. After showing how recent analytic work on “the meaning of life” has conflated the traditional question with issues of social meaningfulness, it offers an explanation of why the traditional question has become marginalised in philosophy. The reasons are not good, however, so it concludes that philosophy should embrace its popular image. (shrink)

End-of-life decision making is fraught with ethical challenges. Withholding or withdrawing life support therapy is widely considered ethical in patients with high treatment burden, poor premorbid status, or significant projected disability even when such treatment is not ?futile.? Whether such withdrawal of therapy in the aftermath of attempted suicide is ethical is not well established in the literature. We provide a clinical vignette and propose criteria under which such withdrawal would be ethical. We suggest that it is appropriate (...) to withdraw life support, regardless of the cause of the critical illness or disability, when the following criteria are met: (1) Surrogates request withdrawal of care and the adequacy of surrogates is confirmed, (2) an external reasonability standard is met, (3) passage of time, perhaps 72 hours, to allow certainty regarding the patient's wishes, and (4) psychiatric morbidity should be considered as grounds for withdrawal only in truly treatment-refractory cases. Fundamentally, we believe the question to ask is, ?If this were not an attempted suicide, would a request to withdraw care be reasonable?? We believe that under these circumstances, such withdrawal of life support, even in an individual who has attempted suicide, does not constitute physician assistance with suicide and is distinct from physician aid-in-dying in several important respects. (shrink)

It is based on extensive use of the twelve volumes of Ortega's Obras completas, the eighty microfilm reels of his archive in the Library of Congress, and his private library of fifteen hundred volumes in Madrid.

This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the ‘AP‐physician‐family‐relationship’ and the dominant role Chinese families play in medical decision‐making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers from (...) Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives ‘weak’ family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re‐interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its ‘parens patriae’ power to defend the defenseless in society and the integrity of the medical profession. (shrink)

End-of-life decision-making is controversial. There are different views about when it is appropriate to limit life-sustaining treatment, and about what palliative options are permissible. One approach to decisions of this nature sees consensus as crucial. Decisions to limit treatment are made only if all or a majority of caregivers agree. We argue, however, that it is a mistake to require professional consensus in end-of-life decisions. In the first part of the article we explore practical, ethical, and legal (...) factors that support agreement. We analyse subjective and objective accounts of moral reasoning: accord is neither necessary nor sufficient for decisions. We propose an alternative norm for decisions – that of ‘professional dissensus’. In the final part of the article we address the role of agreement in end-of-life policy. Such guidelines can ethically be based on dissensus rather than consensus. Disagreement is not always a bad thing. (shrink)

In this paper, we consider three arguments for the irrelevance of the doctrine of double effect in end-of-life decision making. The third argument is our own and, to that extent, we seek to defend it. The first argument is that end-of-life decisions do not in fact shorten lives and that therefore there is no need for the doctrine in justification of these decisions. We reject this argument; some end-of-life decisions clearly shorten lives. The second is that the (...) doctrine of double effect is not recognized in UK law ; therefore, clinicians cannot use it as the basis for justification of their decisions. Against this we suggest that while the doctrine might have dubious legal grounds, it could be of relevance in some ways, e.g. in marking the boundary between acceptable and unacceptable practice in relation to the clinician's duty to relieve pain and suffering. The third is that the doctrine is irrelevant because it requires there to be a bad effect that needs justification. This is not the case in end-of-life care for patients diagnosed as dying. Here, bringing about a satisfactory dying process for a patient is a good effect, not a bad one. What matters is that patients die without pain and suffering. This marks a crucial departure from the double-effect doctrine; if the patient's death is not a bad effect then the doctrine is clearly irrelevant. A diagnosis of dying allows clinicians to focus on good dying and not to worry about whether their intervention affects the time of death. For a patient diagnosed as dying, time of death is rarely important. In our conclusion we suggest that acceptance of our argument might be problematic for opponents of physician-assisted death. We suggest one way in which these opponents might argue for a distinction between such practice and palliative care; this relies on the double-effect doctrine's distinction between foresight and intention. (shrink)

My aim in this essay is to lead the reader through the complexity of Hegel’s philosophical understanding of organic nature by highlighting its distinctive theoretical features and by examining these historically, both against the background of the approaches, achievements and trends of the empirical sciences of his time and in light of their scholarly reception.1 First, I focuss on Hegel’s definition of the ‘universal form’ of life, pointing to what the connection is, in his philosophy of nature, between the (...) structure of conceptual and living processes in the path to the individualization of matter. Second, since Hegel calls animal life “the truth of organics,” 2 I shall try to explain how in the philosophy of nature the Idea of life comes to differentiate itself into certain essential characteristics of immediate, finite and individual animals, passing through the stages of geological nature and vegetable organisms. (shrink)

This study examines the impact of the level of religious observance on the attitudes toward end‐of‐life (EOL) decisions and euthanasia of Jews in Israel—where euthanasia is illegal—as compared to Jews living in the USA, in the states where euthanasia is legal. A self‐reporting questionnaire on religiosity and personal beliefs and attitudes regarding EOL care and euthanasia was distributed, using a convenience sample of 271 participants from Israel and the USA. Findings show that significant differences were found in attitudes between (...) Jews of different levels of religious observance with respect to patient autonomy, right to die with dignity, and dying in familiar and supportive surroundings. The USA and Israeli Jews have similar knowledge regarding EOL care and expressed similar attitudes and perceptions toward the issues of authority of medical staff and religious figures and patient's autonomy. Findings indicate that the level of religious observance has more potency in shaping their attitudes and perceptions of EOL decisions than the state law. We conclude by discussing the implications of our findings with regard to multicultural health systems and providing practical recommendations. (shrink)

This essay reviews the Roman Catholic moral tradition surrounding treatments at the end of life together with the challenges presented to that tradition by the Texas Advance Directives Act. The impact on Catholic health care facilities and physicians, and the way in which the moral tradition should be applied under this statute, particularly with reference to the provision dealing with conflicts over end-of-life treatments, will be critically assessed. I will argue, based on the traditional treatment of end-of-life (...) issues, that Catholic physicians and institutions should appeal to the conflict resolution process of the Advance Directives Act only under a limited number of circumstances. The implications, under the Texas statute, of varied interpretations of Pope John Paul II's recent allocution on artificial feeding and hydration in the persistent vegetative state will also be considered. (shrink)

If we understood the true role of money in our lives, writes philosopher Jacob Needleman, we would not think simply in terms of spending it or saving it. Money exerts a deep emotional influence on who we are and what we tell ourselves we can never have. Our long unwillingness to understand the emotional and spiritual effects of money on us is at the heart of why we have come to know the price of everything, and the value of nothing. (...) Money has everything to do with the pursuit of an idealistic life, while at the same time, it is at the root of our daily frustrations. On a social level, money has a profound impact on the price of progress. Needleman shows how money slowly began to haunt us, from the invention of coins in Biblical times (when money was created to rescue the community good, not for self gain), through its hypnotic appeal in our money-obsessed era. This is a remarkable book that combines myth and psychology, the poetry of the Sufis and the wisdom of King Solomon, along with Jacob Needleman's searching of his own soul and his culture to explain how money can become a unique means of self-knowledge. As part of the Currency paperback line, it includes a "User's Guide" an introduction and discussion guide created for the paperback by the author -- to help readers make practical use of the book's ideas. (shrink)

This is the first volume on the subject of the alleviation of world suffering. At the same time it is also the first book framing the fields of global socio-economic development, world health, human rights, peace studies, sustainability, and poverty within the challenge of alleviating suffering and improving quality of life. Both international studies and global development have become specialized and fragmented, whereas this work assembles all of these development fragments together in order to determine whether common ground exists (...) to make headway in reducing global suffering. Leading experts in these various fields of development and suffering have been recruited worldwide to give scholarly assessments of the major human problems and how they can be successfully tackled. (shrink)

To guide treatment decisions for incompetent patients who have no advance directives, health care institutions should look to the preferences of their own communities of patients. That is the best way to ensure that incompetent patients' wishes will be followed.

Reading is an affective and reflective relationship with a text, whether it is a new, groundbreaking monograph or one of those books that keeps getting pulled off the shelf year after year. Unlike traditional reviews, the pieces in this section may veer off in new directions as critical reading becomes an extended occurrence of thinking, being, and creation. The Highest Poverty: Monastic Rules and Form-of-Life, by Giorgio Agamben.Stanford: Stanford University Press, 2013.

Prevention and control of chronic conditions are global healthcare challenges. Patient self-management has been deemed essential for treating chronic conditions and improving the quality of patient life. However, the current Japanese system for supporting patient self-management of chronic conditions has received little ethical assessment. The first aim of this article is to provide an ethical analysis of current Japanese support for self-management of chronic conditions with reference to international discussions concerning self-management, developed mainly in western societies such as Europe, (...) the United States. The second aim is to clarify the challenges faced by Japanese biomedical ethics concerning selfmanagement support by focusing on the ethical concepts of quality of life and autonomy. This article identifies the following two challenges: [1] dispelling conceptual confusion concerning basic ethical concepts such as quality of life and autonomy, and [2] exploring the conceptual relationship between these ethical concepts, as they relate to providing support for chronically ill patients. By addressing these challenges and constructing a theoretical basis for radical change in support mechanisms, bioethics in Japan could contribute to efforts to construct a comprehensive support system for patients with chronic conditions, which organize variety kinds of supports, such as medical professional supports, supports from patient’s groups, local community supports, familial supports, support in patients’ workplace, and supports for patients’ family members as well. (shrink)

In the ideology of capitalism, problems of standard of living and consumption are treated in isolation from the content of social relationships. An example of this is provided by the works of Galbraith, who speaks of the "affluent society," defined by the level and volume of consumption, as a higher level of social development. His interpretation - and it is shared by many bourgeois ideologists - does not deal with the question of on what the achievement of an abundance of (...) various goods and services, and hence abundance in consumption, is based. Left out of consideration is the fact that it is because of particular historical conditions that the capitalist states of our day have at their disposal a developed base in technology, while such a base is lacking over most of the globe, inasmuch as its creation is an as-yet uncompleted task in the so-called developing countries. If we were to judge the essence of social development without considering the concrete class structure of society and the vagaries of historical development, without analyzing the existing base in technology and science, etc., we would be unable to go beyond the bounds of very vague abstractions. (shrink)

This paper draws upon Deleuze and Guattari's ideas to suggest a different kind of reading of a narrative of a mother of a child with severe disability, and thus a different kind of ethical response to them. This reading gives readers the possibility of opening up experiences of parents and children with disability, rather than compartmentalising such stories. The reader becomes, is transformed, through reading these narratives and through engaging with the intensities which are recognised in the text, asking the (...) question ‘Does it work for me?’ This is what Gilles Deleuze calls ‘reading with love’. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Background: Mental healthcare needs person-tailored interventions. Experience Sampling Method (ESM) can provide daily life monitoring of personal experiences. This study aims to operationalize and test a measure of momentary reward-related Quality of Life (rQoL). Intuitively, quality of life improves by spending more time on rewarding experiences. ESM clinical interventions can use this information to coach patients to find a realistic, optimal balance of positive experiences (maximize reward) in daily life. rQoL combines the frequency of engaging in (...) a relevant context (a ‘behavior setting’) with concurrent (positive) affect. High rQoL occurs when the most frequent behavior settings are combined with positive affect or infrequent behavior settings co-occur with low positive affect. Methods: Resampling procedures (Monte Carlo experiments) were applied to assess the reliability of rQoL using various behavior setting definitions under different sampling circumstances, for real or virtual subjects with low-, average- and high contextual variability. Furthermore, resampling was used to assess whether rQoL is a distinct concept from positive affect. Virtual ESM beep datasets were extracted from 1058 valid ESM observations for virtual and real subjects. Results: Behavior settings defined by Who-What contextual information were most informative. Simulations of at least 100 ESM observations are needed for reliable assessment. Virtual ESM beep datasets of a real subject can be defined by Who-What-Where behavior setting combinations. Large sample sizes are necessary for reliable rQoL assessments, except for subjects with low contextual variability. rQoL is distinct from positive affect. Conclusion: rQoL is a feasible concept. Monte Carlo experiments should be used to assess the reliable implementation of an ESM statistic. Future research in ESM should asses the behavior of summary statistics under different sampling situations. This exploration is especially relevant in clinical implementation, where often only small datasets are available. (shrink)

The most predominant and usual interpretations amongst Leibniz’s scholars, as far as his conception of space is concerned, draw from the Leibniz-Clarke correspondence, and thereby, they argue for the relativist/idealist Leibnizian notion of space contra to the absolutist/realist Newtonian thesis In the present paper I intend to expand Leibniz’s conception of space, which, in our view, is much broader and fertile than the relativistic/idealistic interpretation. The main reason for the above mentioned accounts of the Leibnizian thesis on space lies on (...) the restrictive interpretation of space, i.e. only in terms of the monad’s relative perceptions of the coexistence of its compossible monadic relations, which thereby extrapolates the perspectivist/relativistic character of the monad from its simultaneous embeddedness within the objective/realist living tissue of the organic plenum of the universe. Instead, our argument is sustained by incorporating in the previous account Leibniz’s critique of the Cartesian res extensa, and mainly, his powerful idea that each monad is a perpetual, living mirror of the Universe. This would lead us beyond an one-sided relativistic and subjectivist notion of space, which, in fact, seems at odds with Leibniz’s cosmo-oriented frame of thought, since it reduces Leibniz’ conception of space to the Kantian abstract/geometrical and subjectivist conception of an apriori intuition of the external world; instead, through our interpretation we attain the alignment of Leibniz’s notion of space with his whole dynamic, organic and ensouled account of the Universe. (shrink)

_Background:_ Breast Cancer susceptibility genes 1 and 2 are implicated in hereditary breast and ovarian cancer and women can test for the presence of these genes prior to developing cancer. The goal of this study is to examine psychological distress, quality of life, and active coping mechanisms in a sample of women during the pre-test stage of the genetic counseling process, considering that pre-test distress can be an indicator of post-test distress. We also wanted to identify if subgroups of (...) women, defined based on their health status, were more vulnerable to developing distress during the genetic counseling process. _Methods:_ This study included 181 female participants who accessed a Cancer Genetic Counseling Clinic. The participants were subdivided into three groups on the basis of the presence of a cancer diagnosis: Affected patients, Ex-patients, and Unaffected participants. Following a self-report questionnaire, a battery of tests was administered to examine psychological symptomatology, quality of life, and coping mechanisms. _Results:_ The results confirm that the genetic counseling procedure is not a source of psychological distress. Certain participants were identified as being more vulnerable than others; in the pre-test phase, they reported on average higher levels of distress and lower quality of life. These participants were predominantly Ex-patients and Affected patients, who may be at risk of distress during the counseling process. _Conclusions:_ These findings highlight that individuals who take part in the genetic counseling process are not all the same regarding pre-test psychological distress. Attention should be paid particularly to Ex-patients and Affected patients by the multidisciplinary treating team. (shrink)

This article offers a critical presentation of Jan Patočka's philosophy by focusing mainly on his lecture series published as Body, Community, Language, World, where he outlined his phenomenological project of re-instating the body in philosophy. Taking the body and its invariable situatedness as a starting point and identifying useful precursors in European philosophy, Patočka delineates three movements of human life: an affective movement consisting of creating roots, identified as primarily aesthetic and interested in the past; an ascetic movement consisting (...) of work and self-expansion, identified with the world of production and related to the present; and, a transcendent, philosophical movement peculiar to the realization of human existence and linked to the future. I examine certain ellipses and complications in Patočka's description of these movements, and suggest elaborations that are consistent with his overall project. Finally, turning to Patočka's Plato and Europe, I argue that the third movement is accomplished via both philosophical reflection and artistic practice. (shrink)

The paper gives an analysis of the theoretical-methodological principles of the philosophy of J. Pato?ka not only as a historian of philosophy, but also as a historian of science, especially of its revolutionary periods. The aim of the paper is to show that following the general context of his works here also Pato?ka consistently deals with the central issue of his philosophy, namely the life-world . In Pato?ka's view it was already the rise of ancient philosophy, and especially of (...) the mathematical natural science that destroyed the original uniform picture of the universe, splitting man's world into the natural world on one hand and the world construed by the mathematical natural science on the other hand. Further, the paper shows Pato?ka's view of phenomenology, which he has seen as a means, with the help of which this dichotomy could be resolved, as well as Pato?ka's criticism of the original Husserlian concept of phenomenology, which failed to avoid its subjectivist and solipsist tendencies. The problem of lifeworld led Pato?ka not only to the principles of non-subjective phenomenolog, but it also became the basis of his philosophy of the history of philosophy. (shrink)

During the course of its short history the discipline concerned with the origin of life has given birth to several scientific programmes in the Lakatosian sense, two of the most prominent and widespread being those initiated by Oparin (life began from protein entities) and Muller-Haldane (life began from genetic entities). The present paper sets down the bases for the rational reconstruction of both views by identifying their hard core and some of their successive developments. An assessment is (...) made of the various stages in the evolution of these programmes with respect to the crucial Lakatosian notions of progressivity and regressivity and of how their arguments stand up against one another. This epistemological analysis also establishes the internal reasons why the RNA version of the genotype programme (developed in particular by L. Orgel and S. Spiegelman) has today taken on a progressive character and enjoys recognition by the international scientific community. (shrink)

It seems to be important to recollect that if there were no names in the history of philosophy except those belonging to the creators of new systems, this would mean the extermination of culture, and thereby the death of philosophy itself. The very word "culture" and the inherent meaning in philosophy presuppose a continuity. For this reason they evoke disciples, imitators and followers who weave a living and indestructible chain. In other words, a tradition is sown, the fruits of which (...) are perpetually gathered in values, reassuring man of the ultimate and eternal harmony of all being, reaffirming the truth that nothing finally that is contingent or fleeting, nothing that is exclusively material or functional within life can sustain life, and reestablishing that only from that which lies beyond the phenomena can mankind gain access to all the abundance of spiritual resources indispensable for dealing with life. And it is tradition that constitutes an everlasting re-dedication to the life and the immortality of the spirit. Such re-dedication is Mumford's fruitful contribution to the philosophy of history and of ideas. He keeps the concept alive. (shrink)

BackgroundThe safety of sleeping pills has increased dramatically during the last 100 years, from barbiturates to bensodiazepines to modern day so-called Z-drugs.MethodsThe circumstances of prescribing sleeping pills in the early 20th century are illustrated by summarizing the main storyline of a novel by Swedish writer Vilhelm Moberg. This is followed by a thought experiment and a theoretical discussion.ResultsIn his 1937 novel Sömnlös (Swedish for sleepless) Vilhelm Moberg portrayed existential and relational distress in relation to insomnia. In a thought experiment, past (...) progresses in sleeping pills safety are projected into the future. Thereby, it is claimed that important issues in the area of philosophy of medicine come to the fore. This leads to a theoretical discussion about broader questions concerning the role of the physician, the goals of medicine (as described by Lennart Nordenfelt), the concept of pharmaceuticalisation (as described notably by sociologist of sleep Simon J. Williams and co-workers), and health enhancement (c.f. Carl Elliott and the alleged wish to be better than well).ConclusionInsomnia is a prism through which important philosophical and sociological questions related to the practice of medicine can be asked. (shrink)

Patient-and-family-centered care (PFCC) is critical in end-of-life (EOL) settings. PFCC serves to develop and implement patient care plans within the context of unique family situations. Key components of PFCC include collaboration and communication among patients, family members and healthcare professionals (HCP). Ethical challenges arise when the burdens (e.g., economic, psychosocial, physical) of family members and significant others do not align with patients’ wishes. This study aims to describe the concept of vulnerability and the ethical challenges faced by HCPs in (...) these circumstances. Further, it assesses the contribution of clinical ethics consultation (CEC) in assisting HCPs to face these difficult ethical conundrums. Two clinical cases are analyzed using the Circle Method of CEC. The first regards the difficulty faced by the doctor in justifying treatments previously agreed upon between the patient and his/her friends. The second regards the patient’s concern about being a burden on their family. Family burdens in EOL settings challenge PFCC in that patient autonomy may be disregarded. This compromises shared decision-making between the patient, family and HCPs as a core component of PFCC. In their ability to promote a collaborative approach, CECs may assist in the successful implementation of PFCC. (shrink)

Autobiographical introduction.--Philosophical theory.--Applications: the three shadows, sickness, sorrow and sin, and the right to life, property and reputation.--Applications: the ethics of the family, the state, the international relations, etc.