In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesAustin Morris, Lisa P., Jeanne Kerwin, Jean Watson, Eve Makoff, Brent R. Carr, Anonymous One, Michelle Prong, Laura J. Hoeksema, Tracy R. Wilson, Frances Rieth Maynard, Laura A. Katers, and Maggie Taylor• Against Their Wishes: The Gift of a Goodbye• Lisa’s Story• Unbefriended• The Clinical Ethics Consult: Transforming Ambivalence to Action• Side Stepping The Issues: Disappointment With An Ethics Consult For A Medically High (...) Risk Patient• My Father Dies Alone• Whose Voice Matters? The Role of Ethics Consultation in Supporting the 16-Year-Old Healthcare Decision-Maker of a Critically Ill Neonate• The Healing Power of an Ethics Consult• Clinical Ethicists: Can They Help Families in Their Times of Need?• “It’s All Personal”• Fault Lines• Difficult, Difficult, Lemon, DifficultCopyright © 2024 Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Against Their Wishes: The Gift of a GoodbyeAustin MorrisThink back, if you can, to when you were once a 25-year-old young adult. Think back to your hopes, your dreams, your overall plan and expectations for life and where you think you would end up one day. Now imagine facing your own mortality; life as you have known rapidly approaching an end that you were not able to prepare for (...) prior to its arrival. Imagine the fear, the uncertainty; imagine how your family and friends would feel surrounding you on your deathbed.The above was the reality for one of my patients. He was a 25-year-old gentleman rapidly approaching the end of his life. As a physician, it is our duty to do no harm and provide the best standard of care to each patient we see on a day-to-day basis. In some cases, what truly constitutes the best standard of care is uncertain, and oftentimes, we find ourselves stepping out of medicine and into the world of medical ethics. Upon arrival to the hospital, this patient’s initial decision was to be made full “Do Not Resuscitate” and “Do Not Intubate.” This decision was made while the patient was suffering mild symptoms of alcohol withdrawal. He was evaluated by psychiatry, we reviewed every medical note we had to assess for signs of depression, and ultimately he was deemed competent, demonstrating a mental capacity to understand his current healthcare status and the ramifications of the decision he was making.As a 28-year-old resident physician, my experience with medicine may be limited relative to those surrounding me in the profession. My intuition, though, has been sharpened with numerous experiences over the last two years dealing with patients driven into depression following the COVID pandemic, finding solace in the use of hard liquor, and subsequently suffering the side-effects of its toxicity. This 25-year-old patient, upon initial assessment, appeared closer to the age of 40; his eyes were icteric, his skin was profoundly jaundiced, and his abdomen distended visibly underneath his hospital gown and blanket. His mother sat at his bedside, fully unaware of the severity of his condition. The patient was angry, questioning why he was admitted and shouting at his mom for forcing him to be evaluated. My initial review of his chart was as in-depth as it could be for having such a limited health history available. Despite that, I could see the path that this would head down over the next 48 hours. Withdrawal was inevitable. The likelihood of needing intubation within the next 24 hours was extremely high. The only bit of uncertainty I was left with was whether or not this patient would survive following these anticipated life-saving interventions. I had anticipated that this would be a long, tenuous, and challenging admission requiring the highest level of care both for myself as a physician and through the healthcare system within our hospital as a whole. But what I did not anticipate was discussing whether or not a 25-year-old should be a DNR/DNI patient.By day 2 of the patient’s admission, evaluation by hepatology confirmed my suspicions; this patient was suffering from fulminant liver failure, and without a transplant, he would surely die. However, we were not able to have this discussion with the patient, as his withdrawal had progressed to the point of disorientation and agitation. The brief episodes of consciousness were spaced through long [End Page 5] periods of unresponsiveness. Prior to this, as mentioned above, the patient was alert and oriented x3 and had expressed, in no uncertain terms, a DNR/DNI status; the confounding factor, though, was during his time awake, he had not been evaluated by hepatology and had not been diagnosed with fulminant liver failure. As such, the prospect of a liver transplant, which would provide life-saving treatment and potentially a path back to life as this patient knew it, had not existed then. Knowing that my time was limited before the patient would fail to protect his airway and would inevitably die, I reached back out to the patient’s mother... (shrink)

This book was reconstructed by G. J. Warnock from notes Professor J. L. Austin prepared for a course of lectures he first gave in Oxford in Trinity Term, 1947, under the title ‘Problems of Philosophy’. The title was changed to ‘Sense and Sensibilia’ the following year. Mr Warnock deserves to be commended for a piece of work which must have been as difficult as its result is excellent. It is a considerable feat of sympathetic identification to have achieved the (...) kind of continuity and order of thought as well as the stylistic continuity found in the book from the sketchy lecture notes a practised lecturer like Austin would need. Mr Warnock assures the reader in his Foreword that ‘…in all points of substance his argument was the argument which this book contains’, and there can be no doubt whatever that Austin's thoughts have been recorded meticulously and with admirable clarity. (shrink)

In this textbook, Michael Morris offers a critical introduction to the central issues of the philosophy of language. Each chapter focusses on one or two texts which have had a seminal influence on work in the subject, and uses these as a way of approaching both the central topics and the various traditions of dealing with them. Texts include classic writings by Frege, Russell, Kripke, Quine, Davidson, Austin, Grice and Wittgenstein. Theoretical jargon is kept to a minimum and (...) is fully explained whenever it is introduced. The range of topics covered includes sense and reference, definite descriptions, proper names, natural-kind terms, de re and de dicto necessity, propositional attitudes, truth-theoretical approaches to meaning, radical interpretation, indeterminacy of translation, speech acts, intentional theories of meaning, and scepticism about meaning. The book will be invaluable to students and to all readers who are interested in the nature of linguistic meaning. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.3 (2002) 281-283 [Access article in PDF] This Is Not Here Katherine Morris How, if at all, are we to characterize psychiatric patients' (and others') descriptions of so-called depersonalization experiences? What exactly are they saying when they say, for example, "I have no self" or "I feel as if I don't belong to my own body" or "Nothing seems real"? Filip and Susanna Radovic (...) attempt to use a combination of conceptual and phenomenological analysis to answer this question. The importance of this, they suggest, is to enable a better definition of the depersonalization syndrome, better classification of symptoms as belonging or not belonging to this syndrome, and better theories of the relevant psychopathological processes.Their conceptual analysis focuses on ambiguities in the words unreal and feel, because "It feels unreal" is a characteristic expression of a depersonalization experience, and on the "as-if" element of these descriptions, because patients will often say "It feels as if everything is unreal." The phenomenological analysis consists in fleshing out some of these senses. These analyses are supplemented with a helpful table and a discussion section distinguishing expressions of depersonalization experiences from similar-sounding expressions from everyday life; for example, "existential reflections" on the one hand, and exclamations like "Did I win? I cannot believe it, it feels so unreal!" on the other. But I focus here on the analyses. Unreal and Feels So, first, they claim that the word unreal has at least three different uses: (1) "nonexistent", (2) "artificial, fake, or made up," and (3) "failing to satisfy some important criterion of the kind in question," which they also express as "not normal" or "unusual," and even "unfamiliar."Already this analysis seems to me to go importantly awry. As Austin famously argued, the word real has multiple senses, including the ones picked out here. 1 But, as he also argued, real, precisely, does not always contrast with unreal; hence an ambiguity in the word real does not imply an ambiguity in the word unreal. An artificial diamond is, indeed, not a real diamond (sense [2])—but it is not an unreal diamond! 2 Again, a friend who does not help you in your hour of need is a "false friend," that is, "not a real friend" (sense [3])—but he is not an unreal friend. Finally, they are surely wrong to equate the false friend's "failure to satisfy some important criterion of friendship" with his being "abnormal" or "unusual" (a fortiori "unfamiliar"). Someone who is "not a real friend" or "not a true friend" is not an unusual or an unfamiliar (sort of) friend!What of their analysis of the ambiguity in feels? (a) Sometimes, they imply, feels means roughly "is believed to be."" (b) At other times, it refers to a specific type of quasi-sensory experience. 3 Thus, I suppose, if I say "I feel ill," I may either mean that I believe myself to be ill or that I am experiencing some characteristic feeling like nausea or dizziness. Hence, feels unreal may either mean "is believed to be unreal" or characterize a specific type of experience.But, as they note, the (alleged) treble ambiguity in unreal means that feels unreal in sense (a) is itself trebly ambiguous, and they suggest that all [End Page 281] three senses may be relevant to characterizing depersonalization experiences. They primarily focus on sense (a3). The thought, as far as I understand it, is that just as a "real friend" is one who helps you in your hour of need, so a "real self" is (inter alia) one that experiences itself as an agent or author of its actions, and a "real world" one full of life and engaging. Thus to say that your self "feels unreal" in sense (a3) is to say that in not experiencing your self as agent or author you recognize that "real selves" do so, and to say that the world "feels unreal" is to say that in experiencing it as lifeless and unengaging you recognize that "real worlds" are not so experienced.So far, so good. But they... (shrink)

I am grateful to Donald Ainslie, Lisa Austin, Michael Blake, Abraham Drassinower, David Dyzenhaus, George Fletcher, Robert Gibbs, Louis-Philippe Hodgson, Sari Kisilevsky, Dennis Klimchuk, Christopher Morris, Scott Shapiro, Horacio Spector, Sergio Tenenbaum, Malcolm Thorburn, Ernest Weinrib, Karen Weisman, and the Editors of Philosophy & Public Affairs for comments, and audiences in the UCLA Philosophy Department and Columbia Law School for their questions.

The late Victorian novelist George Gissing wrote: “I hate and fear ‘science’ because of my conviction that for a long time to come if not forever, it will be the remorseless enemy of mankind. I see it destroying all simplicity and gentleness of life, all beauty of the world; I see it restoring barbarism under the mask of civilization; I see it darkening men's minds and hardening their hearts; I see it bringing a time of vast conflicts which will pale (...) into insignicance ‘the thousand wars of old’, and, as likely as not, will whelm all the laborious advances of mankind in blood-drenched chaos”. The German philosopher Schelling protested against “that blind and thoughtless mode of investigating nature which has become generally established since the corruption of philosophy by Bacon and of physics by Boyle and Newton”. (shrink)

It is plausible to think that the epistemic benefit of having an explanation is understanding. My focus in this article is on the extent to which explanatory understanding, perhaps unlike knowledge, is compatible with certain forms of luck—the extent to which one can understand why something is the case when one is lucky to truly believe an explanatorily relevant proposition. I argue, contra Stephen Grimm ([2006]) and Duncan Pritchard ([2008], [2009]), that understanding quite generally is compatible with luckily believing a (...) true, explanatorily relevant proposition. My strategy is to argue that various intuitions that seem to rule against lucky understanding can be explained away, and thus do not compel us to reject the thesis that, in general, understanding tolerates luck. In arriving at this conclusion, I address some salient issues regarding the testimony of others, and also draw out the consequences of my discussions for the status of understanding as a cognitive achievement. (shrink)

Unable to answer the call of our patients: mental health nurses’ experience of moral distress When health practitioners’ moral choices and actions are thwarted by constraints, they may respond with feelings of moral distress. In a Canadian hermeneutic phenomenological study, physicians, nurses, psychologists and non‐professional aides were asked to identify care situations that they found morally distressing, and to elaborate on how moral concerns regarding the care of patients were raised and resolved. In this paper, we describe the experience of (...) moral distress related by nurses working in mental healthcare settings who believed that lack of resources (such as time and staff) leads to dispiritedness, lack of respect, and absence of recognition (for both patients and staff) which severely diminished their ability to provide quality care. The metaphors of flashlight and hammer are used to elaborate nurses’ possible responses to intolerable situations. (shrink)

In order to show how Michel Serres’s work diverges from traditional Western philosophy, this article explores a multitude of texts and contexts against which Serres might be better understood. Most starkly, Serres’s work diverges from the eighteenth and nineteenth century Germanic tradition of Bildung, meaning cultivation through introspection, apolitical thought and character building through education. Serres’s moves away from ego-centric thought to eco-centric thought more akin to what Gregory Bateson called an ecology of mind. That is, Serres’s integrates—in a more (...) ecological fashion—poetry, science, the arts, ecology and politics to raise philosophical questions. Further, this author suggests that Serres’s reference to the nineteenth century poem Pierrot Lunaire ) serves as a trope for Serres’s over-arching philosophy. Pierrot is an artist, a sage, an outlier, a Hermes-like figure who breaks with tradition. Arnold Schoenberg’s atonal performance piece, spoken and sung, shattered the boundaries of classical music. Like Schoenberg’s work, Serres’s work, both in style and content, shatters the boundaries of traditional philosophy. Serres’s breaks open a new paradigm in philosophy. (shrink)

Collective trauma refers to psychological effects that are experienced by a group of people in response to shared traumatic conditions. Farmers represent a unique population that is chronically exposed to potentially traumatic events and conditions particular to the agricultural industry. Farming communities in Iowa have experienced the farm crisis of the 1980s, decades of extreme weather events, rapidly fluctuating markets, trade wars, rising input costs, farm bankruptcies and foreclosures, and high rates of farmer suicides. Exposure to such conditions can potentially (...) have dramatic effects on the people who experience them and the communities they live in. While research exists examining the behavioral health aspects of stress in farmers, no studies have examined the lived experiences of farmers within the framework of collective trauma and its effects on decision-making. To investigate how Iowa farmers perceive their own experiences of these potential types of collective trauma, this study conducted in-depth semi-structured interviews with farmers and farmer-oriented behavioral health experts. Particular focus is placed on how collective trauma affects individual farmers, their families, and their farming communities, as well as how this type of trauma impacts farm management decisions and sustainability outcomes. Qualitative data were analyzed using a grounded theory approach to develop a theoretical framework describing how collective trauma, in the form of environmental, financial, and community threats, impacts farm management decisions and, in turn, affects environmental, economic, and social sustainability outcomes. Potential implications for how agricultural policy can potentially address the effects and systemic causes of trauma are discussed. (shrink)

The moral distress of psychologists working in psychiatric and mental health care settings was explored in an interdisciplinary, hermeneutic phenomenological study situated at the University of Alberta, Canada. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychologists described specific incidents in which they felt their integrity had been compromised by such factors as institutional and interinstitutional demands, team conflicts, and interdisciplinary disputes. They described dealing with the resulting moral distress by such means as (...) silence, taking a stance, acting secretively, sustaining themselves through work with clients, seeking support from colleagues, and exiting. Recognizing moral distress can lead to a significant shift in the way we perceive moral choices and understand the moral context of practice. (shrink)

In 1837, Dirichlet proved that there are infinitely many primes in any arithmetic progression in which the terms do not all share a common factor. We survey implicit and explicit uses ofDirichlet characters in presentations of Dirichlet’s proof in the nineteenth and early twentieth centuries, with an eye toward understanding some of the pragmatic pressures that shaped the evolution of modern mathematical method.

When nurses have active and untreated addictions, patient safety may be compromised and nurse-health endangered. Genuine responses are required to fulfil nurses' moral obligations to their patients as well as to their nurse-colleagues. Guided by core elements of relational ethics, the influences of nursing organizational responses along with the practice environment in shaping the situation are contemplated. This approach identifies the importance of consistency with nursing values, acknowledges nurses interdependence, and addresses the role of nursing organization as moral agent. By (...) examining the relational space, the tension between what appears to be opposing moral responsibilities may be healed. Ongoing discourse to identify authentic actions for the professional practice issue of nursing under the influence is called upon. (shrink)

Abstract In Restoring the Lost Constitution, Randy Barnett defends the idea that judges should interpret the U.S. Constitution according to its original public meaning, for in his view the Constitution, rightly understood, satisfies the appropriate normative criterion for determining when a constitution is legitimate and should be followed. As it turns out, however, even if the Constitution did mean what Barnett says it does, it would not meet his criterion of legitimacy, and therefore should not be followed. Moreover, Barnett is (...) just as guilty of reading certain clauses out of the Constitution as are his critics. Given the lack of a persuasive reason to follow the original Constitution consistently, judges must turn to sources of authority other than the Constitution in deciding constitutional cases. (shrink)

Deals with the question of whether there is a use of ‘is true’ that is the primary or generic name for that which at bottom we are always saying ‘is true’. Austin discusses the views that truth is primarily a property of beliefs and of true statements. He goes on to argue that the word ‘true’ denotes the validity of an intended correspondence between a representation and what it represents, and dismantles confusions about the meaning of the words that (...) underlie such a view, such as ‘fact that’ and ‘corresponds’. (shrink)

In writing his metaphysics in the form of “meditations,” Descartes specifically rejects two other forms: “synthesis,” the form of a deductive proof common in ancient geometry, and “disputation,” the form of a dialectical defense of a thesis against an antithesis. Both forms, Descartes argues, impede a reader’s ability to discover the material “as if for herself” and endanger instilling in her a cynicism towards philosophy. Descartes instead chose the form of “analysis” for the presentation of his metaphysics, which he asserts (...) is the “best and truest method of instruction.” What can philosophy teachers learn from these claims? We too rely on pedagogical forms that are broadly synthetic and disputative, and we too can recognize a student’s sudden suspicion of philosophy. I argue that Descartes’s pedagogical comments offer a solution to help us avoid this classroom danger of misology. (shrink)

Self-defeating and self-justifying expressions are reflexive insofar as they pertain to themselves. However, the reflexivity involved is often pragmatic, i.e., does not entirely depend upon the logical properties of what is expressed but also upon the expressive act. In this paper I present a general account of pragmatic reflexivity and apply it to some familiar self-defeating and self-justifying expressions in epistemology. This application indicates some important, if often neglected features of the epistemological issues involved. The account I defend suggests that (...) epistemology is particularly sensitive to pragmatic reflexivity since what epistemologists do, i.e., inquire, theorize, and defend theories, is also the subject of the inquiry and resultant theories. (shrink)

Artists often think of themselves as engaged in a project of understanding things. Many of those who look at, listen to, or read works of art think that they emerge from the experience with their understanding enriched. The aim of this paper is to explain what kind of understanding representational art can provide.

This chapter examines so-called body image disorders, focusing on body dysmorphic disorder, anorexia nervosa, bulimia nervosa, and binge eating disorder. These disorders have been studied extensively by psychologists and psychiatrists from both the "body image" and "body shame" research orientations. Body image disorders have also proved, for feminist thinkers mindful of the gender imbalance in many of these disorders, to be an important locus for cultural criticism, including criticism of psychological and psychiatric perspectives. Those philosophers and anthropologists with a phenomenological (...) bent, particularly those with an interest in the lived body and embodiment, have also found a fruitful terrain in body image disorders. These different disciplines and approaches provide multiple perspectives which are often complementary, occasionally in some tension with one another, but always mutually enriching, and all of them are sketched here. (shrink)

The discovery of the first intracellular substrate for insulin, IRS‐1, redirected the field of diabetes research and has led to many important advances in our understanding of insulin action. Detailed analysis of IRS‐1 demonstrates structure/function relationships for this modular docking molecule, including mechanisms of substrate recognition and signal propagation. Recent work has also identified other structurally similar molecules, including IRS‐2, the Drosophila protein, DOS, and the Grb2‐binding protein, Gab1, suggesting that this intracellular signalling strategy is conserved evolutionarily and is utilized (...) by an expanding number of receptor systems. In fact, IRS‐1 itself has been shown to be important in other growth factor and cytokine signalling systems, including growth hormone and several interleukins. Analysis of mice lacking IRS‐1 confirms an important physiological role for this protein in glucose metabolism and general cell growth in the intact animal. Disregulation of the signalling pathways integrated by the IRS proteins may contribute to the pathophysiology of non‐insulin‐dependent diabetes mellitus or other diseases. (shrink)

Traditionally many systems subjected public employees to a separate and more restrictive labour law regime than their private sector counterparts. However, these status-based restrictions were generally modified or abandoned during the 1960s and 1970s. Greater homogeneity of treatment of public and private sector workers was also subsequently reflected in employment practices in Britain and elsewhere as a product of the «marketization» of public services, a strategy which involved replacing centralized regulation by greater local determination in accordance with «business» needs. More (...) radically, the provision of some public services was removed from the public sector altogether, either by contracting out particular elements of the service or by wholesale privatization, subject to some form of regulatory regime. These changes may appear to render otiose discussion of the case for special treatment of the employment relation in public services. This article expounds the proposition that, on the contrary, public services possess distinctive qualities which necessitate regulation of the employment relationship within those services in areas beyond those covered by the general law, and aims to provide a framework within which the justification for specific additional measures can be assessed. The article also considers the further questions which need to be addressed if the framework it proposes is accepted, including, in particular, the appropriate mechanisms for imposing and enforcing regulation. (shrink)

French poststructuralist philosopher Michel Serres writes about knowledge production throughout his work. He is of particular importance to educationists because the production of knowledge...

Philosophy at its best is an activity more than a body of knowledge. In an ancient sense, done right, it is a healing art. It’s intellectual self-defense. It’s a form of therapy. But it’s also much more. Philosophy is map-making for the soul, cartography for the human journey. It’s an important navigational tool for life that too many modern people try to do without. _Philosophy For Dummies_ is for anyone who has ever entertained a question about life and this world. (...) In a conversational tone, the book's author – a modern-day scholar and lecturer – brings the greatest wisdom of the past into the challenges that we face now. This refreshingly different guide explains philosophical fundamentals and explores some of the strangest and deepest questions ever posed to human beings, such as How do we know anything? What does the word _good_ mean? Are we ever really free? Do human beings have souls? Is there life after death? Is there a God? Is happiness really possible in our world? This book is chock full of all those questions you may have long wanted to think about and talk with someone about, but have never had the time or opportunity to tackle head on. _Philosophy For Dummies_ invites you to discuss the issues you find in the guide, share perspectives, and compare thoughts and feelings with someone you respect. You'll find lots of material to mull over with your friends or spouse, including thoughts on When to doubt, and when to doubt our doubts The universal demand for evidence and proof The four dimensions of human experience Arguments for materialism Fear of the process of dying Prayers and small miracles Moral justification for allowing evil The ancient philosopher Socrates thought that, when it comes to the Ultimate Questions, we all start off as dummies. But if we are humbly aware of how little we actually know, then we can really begin to learn. _Philosophy For Dummies_ will put you on the path to wising up as you steer through the experience called life. (shrink)

Sylvère Lotringer’s life been celebrated as a ‘total work’ – a lived embodiment of the radical theories he did so much work to disseminate and promote. His commitment to an art of living, his embodiment and dissemination of thought, and his cultural experimentation have been widely affirmed – with the ‘primary text’ of his life often eclipsing his published work; as Gayatri Spivak put it: ‘an example of how this kind of philosophy is also an act of the mind, of (...) life, of how to actually live philosophically rather than simply think in a certain way’.1 Semiotext(e) press is also celebrated as his great life’s work – although the singular approach and sensibility that he instilled in it makes it impossible to understand as an individual creation. Like so much of his work, Semiotext(e) is a shared project, as Sylvère would often insist. This situation also allowed him to perform a kind of disappearing act on himself. The many tributes that have appeared following his death have shown his multiplicity, but his ‘personal’ writings and projects (about which he would no doubt have said that there is nothing ‘personal’) have to some extent disappeared from view. The ‘total’ lifework can obscure the work in which he was energetically engaged throughout his life. (shrink)