In 1964, the American Medical Association invited liberal theologian Abraham Joshua Heschel to address its annual meeting in a program entitled “The Patient as a Person” [1]. Unsurprisingly, in light of Heschel’s reputation for outspokenness, he launched a jeremiad against physicians, claiming: “The admiration for medical science is increasing, the respect for its practitioners is decreasing. The depreciation of the image of the doctor is bound to disseminate disenchantment and to affect the state of medicine itself” [1, p. 35]. Heschel’s (...) reference to “disenchantment” suggests that he may have been familiar with the work, or at least the outlook, of sociologist Max Weber, whose 1917 address “Science as a Vocation” portrays the modern world as disenchanted by the progress of rationalism. Heschel’s life’s vocation had been to uncover the inner meaning of religious faith and to translate that faith into principled action. Heschel saw disenchantment not as an inescapable aspect of modern life but rather as the byproduct of physicians’ conscious choices to seek worldly success and material comfort. Yet, because of their privileged position as witnesses to human vulnerability, physicians possess an obligation to develop their own personhood, to re-enchant medicine, and through medicine to spark a positive transformation in all of modern life. As Heschel says, “The doctor must realize the supreme nobility of his vocation, to cultivate a taste for the pleasures of the soul. … The doctor is a major source of moral energy affecting the spiritual texture and substance of the entire society” [1, pp. 34, 38]. While Heschel’s conception of the physician’s role is romanticized and idealized, changes in the organization and practice of medicine have validated his concerns. (shrink)

This passage from the most important of all our textual sources on Ancient-Egyptian shipbuilding has been discussed by me in my newly published Commentary. There I followed the traditional view whereby is translated as ‘thwarts’’, is taken to describe thwarts passing from one gunwale to the other in such a way that each end was placed ‘on top of the gunwale, and the sentence is understood to refer to caulking with papyrus. J. S. Morrison has in recent years on several (...) occasions offered a radically different translation under the influence of the Fourth-Dynasty boats interred beside the Great Pyramid of Gîza . His criticism of the old rendering seizes upon three points. (shrink)

Looks at the life and historical role of Louis Auguste Blanqui. Studies his philosophy, economic theories, and socialism.

The problematic nature of the relation between a politicized historical rhetoric and the presumed authority of brute fact was starkly outlined in the irreconcilable interpretations of the purge trials that tore apart the political Left in the 1930s. The conclusions of the Commission, headed by John Dewey, on the mock trial of Leon Trotsky in Mexico City in April 1937 rested on the evidence of the factual fabrications of key confessions. The critical contemporary responses were more or less predictable in (...) light of political partis pris. They either disparaged the entire procedure as a Trotskyite "court," where the driving purpose was to acquit Trotsky of guilt, deftly disposed of the key factual allegations, or saw the trial as attacking the Soviet system of justice itself, thus making irrelevant Trotsky's actual guilt or innocence. We now find the Commission's conclusions more persuasive than those of William Z. Foster, Malcolm Cowley, or F. L. Schuman not because of their superior tropological strategies, nor because of a skillful parade of rhetorical figures, nor because of the hermeneutic fusing of historical horizons, but because they satisfy familiar criteria of empirical inference and rational discourse. (shrink)

A few years ago, a Yemenite patient came to Maimonides Hospital in Brooklyn. The friendly, diminutive gentleman apologized for visiting the clinic in the first place because, as he explained, he was a devotee of Maimonides and invariably used the medical treatments recommended by him rather than current Western medicine. But for this patient’s problem, Maimonides had prescribed garlic. The patient told his doctor that if he ingested garlic, his wife would refuse contact with him. So, having no alternative, he (...) came to our clinic for consultation and to see if there were any other appropriate treatments.Moses Maimonides was one the most important Jewish scholars of all times. A popular folk saying.. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:270 HISTORY OF PHILOSOPHY The Prophets of Paris. By Frank E. Manuel. (Cambridge: Harvard University Press, 1962.) This perceptive and sophisticated contribution to the history of ideas is organized around the intellectual biographies of Turgot, Condorcet, Saint-Simon, the Saint-Simoniarts, Charles Fourier, and Auguste Comte. Professor Manuel's prophets were all Frenchmen and all, he believes, can be placed in a common tradition marked by their conviction that Paris was the (...) mount from which the new gospel had to be delivered, that love was the key to social organization, and that social and religious relationships were more significant than political forms. He presents them as prophets in the Old Testament sense--as unsparing moral critics, teachers and the "revealers of a divine historical design." They were philosophers of an age of crisis, convinced that theirs was the instant of a great human divide and therefore victims "of the anguish of futurity." The future they so confidently foretold to anyone who cared to listen, and to many who did not, has found many of their prophetic visions to be poor predictions, but for Manuel they cannot be dismissed as utopian cranks or frustrated totalitarians. Many of the issues they raised and problems they sensed have yet to be adequately confronted, and it is this prescience, particularly with regard to the psychological conditions of social existence, that Manuel wishes to emphasize. This treatment, as its author admits, is a "frank attempt at rehabilitation, to right the balance of historical judgement and bestow new worth upon thinkers who have often been treated with superficiality" (pp. 1-10). Manuel's approach to the history of ideas lends itself quite effectively to this purpose. He admits to a "romantic view of history-writing" which entails an effort to establish an intimacy with his subjects through an immersion in their manuscripts, in the "scribbled brouillons, the casual notes, the personal letters," as well as in the identity presented through their published works. His writing of history is romantic not only in this regard but much more profoundly in his historicism, which attempts an immediate empathetic confrontation with the total organic complex of his subject's life, ideas, and environment. Manuel's evident sympathy occasionally tempts him into apologetics, but essentially he is not arguing a brief for the defense but trying to understand what it was that made these men see so far, and yet with such myopic arrogance, and what it was they saw. It seemed to me that his approach is most successful with Fourier, and least so with Turgot. Charles Fourier, the self-taught travelling salesman from Besan~on, is often summarily dismissed as a cosmic crank with easy reference to his fantastic aberrations --his seas of lemonade and the copulation of the planets. Manuel helps us to understand not only the aberrations but the prescient insights by establishing the relationship between Fourier's personality and his ideas, as well as by tracing the connections between apparently contradictory conceptions. He does not misuse this technique of intellectual biography by patronizing or justifying a system of thought with reference to its psychological antecedents, but rather helps to illuminate a philosophy by examining the reasons for its expression. This works particularly well with Fourier, an obsessed and deprived personality, whose great contribution, according to Manuel, was the assimilation into a social doctrine of the fundamental needs and drives of mankind--its "manifold wants, its secret desires, and its obstinate fixations" (p. 203). Both Fourier and the SaintSimonians believe that it was pointless to tinker with the social environment without regard for permanent psychological realities, but the latter hoped to sublimate human passions through a social organization that redefined them, while Fourier wanted a social system that would provide for their total gratification (p. 226). Occasionally Manuel rather triumphantly unearths striking parallels with our present BOOK REVIEWS 271 concerns that do not demonstrate the vision of his seers into the future so much as his discovery of analogues in the past. Fourier's case is not particularly strengthened by the observation that his vision of a climate so benign under the regime of phalansteries as to render tire very poles inhabitable is "no longer as... (shrink)

On the 50th anniversary of the Willowbrook experiment's inception, in which Dr. Saul Krugman intentionally infected cognitively disabled children with hepatitis, it is worth reflecting on how our attitude toward research ethics of the past informs our current practices. In examining ethical violations in postwar medicine, we frequently turn to examples that shock and appall, thereby offering concomitant comfort as we measure their safe distance from our own medical context. And yet, which modern medical student has not heard a variation (...) of the phrase "This study would never have passed an ethics committee today" in reference to a classic experiment or a professor's very own work? Even with Nuremburg fresh in the .. (shrink)

There is a growing literature demonstrating a link between lower socioeconomic status (SES) and poorer neuroanatomical health, such as smaller total and regional gray and white matter volumes, as well as greater white matter lesion volumes. Little is known, however, about the relation between SES and white matter integrity. Here we examined the relation between SES and white matter integrity of the brain’s primary cortical regions, and evaluated potential moderating influences of age and self-identified race. Participants were 192 neurologically intact, (...) community-dwelling African American and White adults (mean age = 52 years; 44% male, 60% White, low SES = 52%) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) SCAN study. Participants underwent 3.0-T cranial magnetic resonance imaging. Diffusion tensor imaging was used to estimate regional fractional anisotropy (FA) to quantify the brain’s white matter integrity and trace to capture diffusivity. Multiple regression analyses examined independent and interactive associations of SES, age, and race with FA of the frontal, temporal, parietal, and occipital lobes bilaterally. Sensitivity analyses assessed the influence of several biopsychosocial risk factors on these associations. Exploratory analyses examined these relations with trace and using additional SES indicators. Results indicated there were no significant interactions of SES, age, and race for any region. Individuals with low SES had lower FA in all regions, and higher trace in the right and left frontal, right and left temporal, and left occipital lobes. Findings remained largely unchanged after inclusion of sensitivity variables. Older age was associated with lower FA and greater trace for all regions, except for the right temporal lobe with FA. No main effects were found for race in FA, and Whites had higher trace values in the parietal lobes. Novel findings of this study indicate that relative to the high SES group, low SES was associated with poorer white matter integrity and greater diffusivity. These results may, in part, reflect exposures to various biopsychosocial risk factors experienced by those of lower SES across the lifespan, and may help explain the preponderance of cognitive and functional disparities between socioeconomic groups. (shrink)

This study investigated the proficiency of CPAs in recognizing and evaluating ethical and unethical situations. In addition, CPAs provided attitudes on ethics education. Respondents were asked to evaluate the ethical acceptability of CPA behavior as presented in six vignettes involving a variety of ethical dilemmas from questions of conflict of interest to questions of personal honor. The results tend to signify that CPAs can, to a degree, distinguish ethical and unethical behaviors. It appears that ethical behaviors and very specific unethical (...) behaviors were more easily identified by practitioners. This may reveal uncertainty and apprehension as to exactly what constitutes unethical behavior since, in many circumstances, this resolution is made on a case-specific basis rather that via a universal rule. In addition, it is interesting to note that CPAs tend to picture themselves as more ethically-oriented than their peers.With respect to ethics education, the CPAs indicated that instruction in ethical concepts and literacy was important and should definitely be embodied in the accounting curriculum as well as at all educational levels. However, the CPAs were remarkably uncertain and ambivalent as to the qualifications of university faculty to provide this instruction and guidance. (shrink)

This book takes a bold new look at ways of exploring the nature, origins, and potentials of consciousness within the context of science and religion.

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n (...) = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (shrink)

In the last few years, off-line simulation has become an increasingly important alternative to standard explanations in cognitive science. The contemporary debate began with Gordon (1986) and Goldman's (1989) off-line simulation account of our capacity to predict behavior. On their view, in predicting people's behavior we take our own decision making system `off line' and supply it with the `pretend' beliefs and desires of the person whose behavior we are trying to predict; we then let the decision maker reach a (...) decision on the basis of these pretend inputs. Figure 1 offers a `boxological' version of the off-line simulation theory of behavior prediction.(1). (shrink)

Virtue theorists have recently been focusing on the important question of how virtues are developed, and doing so in a way that is informed by empirical research from psychology. However, almost all of this recent work has dealt exclusively with the moral virtues. In this paper, we present three empirically-informed accounts of how virtues can be developed, and we assess the merits of these accounts when applied specifically to intellectual (or epistemic) virtues.

Both science and spirituality search for “ultimate truths.” God, the Big Bang, nirvana, the theory of evolution, relativity, quantum mechanics—these are some of the concepts that have been articulated as a result of that search. But the human capacity for exploring these ultimate sources of truth—the one thing that unites science and spirituality—is often overlooked. Embracing Mind argues (1) that science has hobbled itself by ignoring its unique source of inspiration—the mind—and (2) that the schism between science and spirituality is (...) unnecessary. In language accessible to any intelligent reader, Embracing Mind first explores the veracity of major scientific “myths,” then presents a viable science of the mind emanating from contemplative spirituality, including Hindu, Christian, Sufi, and Buddhist views. (shrink)

Adults who are incapacitated and alone, having no surrogates, may be known as “unbefriended.” Decision-making for these particularly vulnerable patients is a common and vexing concern for healthcare providers and hospital ethics committees. When all other avenues for resolving the need for surrogate decision-making fail, patients who are incapacitated and alone may be referred for “public guardianship” or guardianship of last resort. While an appropriate mechanism in theory, these programs are often under-staffed and under-funded, laying the consequences of inadequacies on (...) the healthcare system and the patient him or herself. We describe a qualitative study of professionals spanning clinical, court, and agency settings about the mechanisms for resolving surrogate consent for these patients and problems therein within the state of Massachusetts. Interviews found that all participants encountered adults who are incapacitated and without surrogates. Four approaches for addressing surrogate needs were: work to restore capacity; find previously unknown surrogates; work with agencies to obtain surrogates; and access the guardianship system. The use of guardianship was associated with procedural challenges and ethical concerns including delays in care, short term gains for long term costs, inabilities to meet a patient’s values and preferences, conflicts of interest, and ethical discomfort among interviewees. Findings are discussed in the context of resources to restore capacity, identify previously unknown surrogates, and establish improved surrogate mechanisms for this vulnerable population. (shrink)