The field of narrative medicine holds that personal narratives about illness have the potential to give illness meaning and to create order out of disparate facets of experience, thereby aiding a patient’s treatment and resisting universalizing medical discourse. Two narratives of bipolar disorder, Kay Redfield Jamison’s prose memoir An Unquiet Mind and Ellen Forney’s graphic memoir Marbles challenge these ideas. These writers demonstrate that one result of bipolar disorder is a rupture to their sense of identity, making straightforward and verbal (...) forms of narrative impossible. During periods of relative mood stability, reliable memories of mania or depression are equally impossible. As a result, these memoirists seek to develop sources of self-knowledge other than memory and introspection, long the foundations of personal narrative. Finally, An Unquiet Mind and Marbles return attention to questions of selfhood at a time when scholarship on memoir rejects interpretations of life stories as clear and reliable expressions of identity. (shrink)

_Tracing practical reason from its origins to its modern and contemporary permutations_ The Greek discovery of practical reason, as the skilled performance of strategic thinking in public and private affairs, was an intellectual breakthrough that remains both a feature of and a bug in our modern world. Countering arguments that rational choice-making is a contingent product of modernity, _The Greeks and the Rational_ traces the long history of theorizing rationality back to ancient Greece. In this book, Josiah Ober explores (...) how ancient Greek sophists, historians, and philosophers developed sophisticated and systematic ideas about practical reason. At the same time, they recognized its limits—that not every decision can be reduced to mechanistic calculations of optimal outcomes. Ober finds contemporary echoes of this tradition in the application of game theory to political science, economics, and business management. _The Greeks and the Rational_ offers a striking revisionist history with widespread implications for the study of ancient Greek civilization, the history of thought, and human rationality itself. (shrink)

What did democracy mean before liberalism? What are the consequences for our lives today? Combining history with political theory, this book restores the core meaning of democracy as collective and limited self-government by citizens. That, rather than majority tyranny, is what democracy meant in ancient Athens, before liberalism. Participatory self-government is the basis of political practice in 'Demopolis', a hypothetical modern state powerfully imagined by award-winning historian and political scientist Josiah Ober. Demopolis' residents aim to establish a secure, prosperous, (...) and non-tyrannical community, where citizens govern as a collective, both directly and through representatives, and willingly assume the costs of self-government because doing so benefits them, both as a group and individually. Basic democracy, as exemplified in real Athens and imagined Demopolis, can provide a stable foundation for a liberal state. It also offers a possible way forward for religious societies seeking a realistic alternative to autocracy. (shrink)

Democracy, as collective self-government by citizens, rests on citizens’ capacity to bargain in good faith with those whose interests are not their own. Fair bargains that ensure adequate security and welfare rest on an implicit agreement: Each citizen recognizes that sectional interests (including our conceptions of ideal justice) will never be fully realized, but they are better off inside the bargain than outside of it, and will bargain again another day. Striking and revising civic bargains depend on the education of (...) citizens: In aggregate, the citizenry must develop the requisite civic skills, political knowledge, and capacity for judgment. (shrink)

A request that an ethics committee or consultant analyze the ethical issues in a case, delineate ethical options, or make a recommendation need not automatically but often does elicit legal information. In a recent book in which ethics consultants described cases on which they had worked, almost all cited a legal case or statute that had shaped the consultation process. During a period of just a few months, case consultation done under the auspices of one university hospital ethics committee involved (...) interpretation of statutes on living wills, durable powers of attorney, competency, confidentiality, guardianship, AIDS testing, and disability. At another hospital, 30% of ethics consultations were thought to involve legal issues. Attorneys at a third hospital estimated that virtually every case involves legal issues. The notion that ethics consultation is an “amalgam” of medicine, ethics, interpersonal skills, and law is gaining currency. Ethics consultation has become a channel through which law enters the clinical setting. (shrink)

Volume 20, Issue 4, May 2020, Page 59-61.

Past studies have shown that women’s volunteer work benefits communities but that women themselves tend to minimize their efforts. Most of these studies, however, have been limited to women volunteering in suburban and urban contexts. Drawing on a study of women volunteers in rural Iowa, the authors find that women frame their volunteer experiences in three ways: as an expression of their maternal nature, as a way to socialize, and as a contribution to the local economy. The authors’ findings depart (...) from past research in that the women in their sample do not downplay the importance of their volunteer work; rather, they recognize the importance of their unpaid labor for the social and economic vitality of the community. The authors argue this recognition stems from the particular context in which their volunteerism takes place, namely, in a devastated rural economy in which future economic potential rests on women’s hospitality work. (shrink)

Households around the world have shifted structurally from a breadwinner/homemaker model to dual-income earning arrangements. What this trend means for marital power has been a contested issue among scholars. Most studies suggest that household power is determined by a complex interplay between each spouse's economic contributions to the household and existing gender norms. Few scholars, however, have examined how this interplay is worked out under particular political-economic conditions. Responding to the dearth of research on the developing world in this area, (...) the author examines a community in Costa Rica where neo-liberal economic restructuring has led to an increase in women's informal work and a decrease in men's income-earning power. Drawing from ethnographic and interview data on married life in Costa Rica, the author analyzes the effect that these trends have on marital power and the division of household labor. The author argues that changing economic circumstances may blur the traditional gender boundaries in Costa Rican households but they do not necessarily erase them. (shrink)

In this article, I explore displacement as a force that precludes dwelling. I do so in the context of the georgic mode, a literary tradition defined by dwelling and by the kind of agricultural endeavoring that Heidegger relates to “building.” As he explains in “Building Dwelling Thinking,” to build is not only to make or to construct, but also “to preserve and care for, specifically to till the soil, to cultivate the vine”. Thus, in addition to creation outright, Heidegger’s “building” (...) involves husbandry. His expansive definition multiplies the kinds of human activity described by building. When humans cultivate plants, they create a situation and environment wherein the crop can flourish. The generative force is nonhuman; growth comes from the plant itself. We cannot build a vineyard as we can a structure. In addition to placing humans in a caretaking role, the three terms in Heidegger’s title further indicate that the husbandman’s “building” requires his continual attention to his place and to his work. Building, in the agricultural sense of the word, requires prolonged physical presence and much thought. Heidegger’s choice of a vineyard underscores the importance of time to dwelling: as a perennial plant that requires years of investment before bearing fruit, the vineyard functions as a site where planning and labor, observation and care unfold across the seasons and over a period of years. The full scope of Heidegger’s dwelling, then, involves prolonged and productive agricultural thinking and laboring. My fundamental premise is that Heideggerian dwelling reaches a confluence with the georgic mode. (shrink)

This essay review of Margaret Atwood's Payback centers on the observation that the book does not dwell on the unnatural face of interest and finance. In this era of financialization, debt has been thoroughly uncoupled from the concept of payback. The least valuable debt is the one that is promptly repaid. It is this aspect of debt—the interest, not the principal—that has attracted the richest tradition of social condemnation. As stable forms of production and exchange were replaced by international arbitrage, (...) the link between debt and sorcery became evident to observers around the world. More profoundly, Atwood's widely shared commonsense impression that consumer debt is a measure of self-indulgence does not hold up empirically. It turns out that our unprecedented levels of household indebtedness were overwhelmingly a function of nondiscretionary spending. Even as Americans owed one hundred percent of GDP in individual debt in 2008, the real Faustian bargain was not a “enjoy now, pay later” scheme for “glitzy, short-term junk.” The truth is much scarier, and points toward a different set of cultural and theological references than the ones Atwood investigates. The dividing line between solvency and insolvency, it turns out, is not consumption but reproduction: the most certain route to financial disaster is having a child. (shrink)

Do cultural models facilitate particular ways of perceiving interactions in nature? We explore variability in folkecological principles of reasoning about interspecies interactions. In two studies, Indigenous Panamanian Ngöbe and U.S. participants interpreted an illustrated, wordless nonfiction book about the hunting relationship between a coyote and badger. Across both studies, the majority of Ngöbe interpreted the hunting relationship as cooperative and the majority of U.S. participants as competitive. Study 2 showed that this pattern may reflect different beliefs about, and perhaps different (...) awareness of, plausible interspecies interactions. Further probes suggest that these models of ecological interaction correlate with recognition of social agency in nonhuman animals. We interpret our results in terms of cultural models of nature and nonhuman agency. (shrink)

Bethany Henning argues that within the naturalistic strains of American philosophy, there is an implicit theory of the unconscious that finds its fullest expression within the work of John Dewey. Although the unconscious contributes to all experience, it plays a principal role in experiences that are emphatically aesthetic.

We live in a time of erotic dysfunction: In 2020, and again in 2023, there was a brief media frenzy in the wake of studies published by UCLA that concluded that Gen Z is having statistically less sex than millennials did in their formative years. The generational angle made for good headlines, but the same surveys indicated that people of all ages are having less sex than they used to (Herbenick et al.; Wellingham). We needn't work hard to identify likely (...) factors that might have led us here. The pandemic undoubtedly shifted our tolerance for closeness and contact, which has only reinforced the proliferation of technological commodities (devices, apps, platforms) that have made isolation ever more convenient. These... Read More. (shrink)

In this study, Bethany Somma argues for a dichotomous interpretation of human desire developed by late ancient Greek and medieval Islamic philosophers in response to an ambiguity in Aristotle’s account of desire.

The dubious relation of “subjective” experience to “objective” reality finds its correlate in the opposition we often suppose between culture and nature. Twentieth century theorists, most notably Freud, have claimed various methods for interpreting the illusions of one realm that hide the truths of the other. Ricœur has famously called the psychoanalytic method of dream interpretation a “hermeneutics of suspicion,” which he sees as a threat to the “mytho-poetic core of imagination.” John Dewey regarded the binary opposition between culture/nature as (...) particularly dubious, preferring to see them as reciprocal phases of a continuous process; if cultural life is an interpretation of the biophysical environment, that environment surely has its say. However, in the century since Freud, the tactics of suspicion have proven themselves to be indispensable for developing of critiques that reveal the subtle operations of anti-democratic ideologies, perhaps at the expense of democratic faith. This paper considers if there are less suspicious, more Deweyan possibilities for the interpreting and sharing of dreams, not for the benefit of the psychic health of the individual dreamer, but for the sake of a recovery of democratic life. (shrink)

Recent ethics literature suggests that issues involved in non-heart-beating organ procurement are both highly charged and rather urgent. Some fear that NHB is a public relations disaster waiting to happen or that it will create a backlash against organ donation. The purpose of the study described below was to assess ethics committees' current level of involvement in and readiness for addressing the difficult issues that NHB organ retrieval raises—either proactively through policy development or concurrently through ethics consultation.

This paper explores the connection of offshoring and outsourcing to nonconsensual global pharmaceutical trials in low-income countries. After discussing reasons why the topic of nonconsensual offshored clinical trials may be overlooked in bioethics literature, I suggest that when pharmaceutical corporations offshore clinical trials today, nonconsensual experiments are often foreseeable and not simply the result of aberrant ethical conduct by a few individuals. Offshoring of clinical trials is structured so that experiments can be presented as health care in a unique form (...) of outsourcing from the host country to pharmaceutical corporations. Bioethicists’ assessments of the risks and potential benefits of offshore corporate pharmaceutical trials should therefore systematically include not only the hoped for benefits and the risks of the experimental drug but also the risk that subjects will not have consented, as well as the broader international consequences of nonconsensual experimentation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hyper-Abjects:Finitude, “Sustainability,” and the Maternal Body in the AnthropoceneBethany DoaneThe concept of the Anthropocene prioritizes a new paradigmatic scale that seems to outweigh that of “the political”: imagining deep time or the death of the human species as a result of climate change tends to negate the (relatively speaking) smaller-scale concerns of race, class, gender, or capitalism. While feminist critique is often circumscribed by this political scale, and thus (...) may seem to be dwarfed or rendered obsolete by the geological, deep-time scale of the Anthropocene, examining issues of feminist concern from this geological perspective has profound implications for thinking not only of gender politics but also of how to construct something like the political at all in this new era. Suggesting a new and normative global politics is, of course, beyond the scope of this article, but perhaps we might begin to conceive of a political schema that would function more appropriately in light of this grander scale. At the very least we may begin to think the borders or limits of the species as it has existed in the modern era in a way that neither environmentalism nor posthumanism has yet been able to sufficiently tackle.The Anthropocene marks the epoch in which human activities have caused global environmental changes that will leave their mark in the geological strata of the earth itself.1 While the specific moments of its onset are contested, its beginnings are generally associated with the industrial age; Crutzen and Stoermer mark its onset at roughly 1800 with the beginnings [End Page 251] of the industrial revolution. (Timothy Morton pinpoints it more specifically with the invention of the steam engine in 1794.) The changes made in this era of geological, technological, and climate convergence have accelerated in the last seventy years or so in what scientists call the Great Acceleration, which began around 1940 and quickened anthropogenic impact with events like the testing/dropping of atomic bombs, the homogenization of biodiversity, mass extinctions as a result of human activity, and various types of drilling and mining.2 In the era broadly conceived as modernity, the steady march of “progress” that has so shaped the paradigm of the period has been made possible only through its own abjections: those phenomena that mark the era as limited, limiting, and unsustainable. In other words, the “birth of the modern world” was made possible only through devastating acts of violence: institutionalized inequalities like slavery, oppression, colonization, and war. These acts of violence translate as cannibalization at the global scale: the exploitation of most members of the species and the consumption of their resources for the benefit and luxury of the few. While these forms of violence have been criticized and confronted by political and theoretical movements since at least the middle of the twentieth century, thinking of them in terms of the Anthropocene and deep time allows us to consider their consequences in a new light. Our present awareness of the Anthropocene makes visible phenomena like climate, global warming, earth, and the “anthropos” that present us with the very real eventuality of species finitude. Species finitude calls into question not just the practices of modernity that have brought about the Anthropocene (the exploitation of the many for the benefit of the few), but the entire paradigm of global thinking that is invested in progress, growth, and even in any environmentalism that calls for stewardship of the earth. The notion of care for an entity like “nature” or “the environment” only reinforces the separation between the human and its milieu, a separation that is impossible to maintain in light of the absolute inextricability that the Anthropocene brings to light.At the heart of this essay are two theoretical concepts: Julia Kristeva’s abjection, and Timothy Morton’s hyperobjects, both of which stand for a sort of insufficiency or impossibility of discourse (politics, the Symbolic, etc.) in managing some Real object or phenomenon. Kristeva’s abject is generally thought of as functioning at two levels or scales: the personal, in which an individual must cast off the abject of the maternal body in order to become a proper subject; and the social or... (shrink)

Opposing the tendency to read Thucydides as a strong realist, committed to a theory of behaviour that assumes rationality as expected utility maximization, Ned Lebow and Clifford Orwin emphasize Thucydides’ attentiveness to deviations from rationality by individuals and states. This paper argues that Thucydides grasped the principles underlying contemporary prospect theory, which explains why people over-weight small probabilities and under-weight near certain ones. Thucydides offers salient examples of excessive risk-aversion in the face of probable gains and excessive risk-seeking by decision-makers (...) faced with high probability losses. Thucydides suggests that in a democracy, leaders’ rhetoric can limit or exacerbate the political effects of bias in risk assessment. (shrink)

Max Weber, the grandfather of organizational theory, recognized the close association between health care organizations and law. When he introduced the concept of a legallaw-saturated,rational bureaucracies, healthcare organizations have highly formalized rules and procedures. They pay a great deal of attention to legal criteria in decisionmaking, and some have entire departments devoted to legal risk management.

Environmental problems often outstrip the abilities of any single scientist to understand, much less address them. As a result, collaborations within, across, and beyond the environmental sciences are an increasingly important part of the environmental science landscape. Here, we explore an insufficiently recognized and particularly challenging barrier to collaborative environmental science: value pluralism, the presence of non-trivial differences in the values that collaborators bring to bear on project decisions. We argue that resolving the obstacles posed by value pluralism to collaborative (...) environmental science requires detecting and coordinating the underlying problematic value differences. We identify five ways that a team might coordinate their problematic value differences and argue that, whichever mode is adopted, it ought to be governed by participatory virtues, pragmatic resolve, and moral concern. Relying on our experiences with the Toolbox Dialogue Initiative, as well as with other dialogical approaches that support team inquiry, we defend the claim that philosophical dialogue among collaborators can go a long way towards helping teams of environmental scientists and fellow travelers detect their problematic value differences. Where dialogical approaches fare less well is in helping teams coordinate these differences. We close by describing several principles for augmenting philosophical dialogue with other methods, and we list several of these methods in an appendix with brief descriptions and links for further learning. Overall, the article makes three main contributions to the research collaboration and values in science literatures: It deepens our understanding of problematic value pluralism in team science; It provides actionable guidance and methods for improving values-oriented philosophical dialogue interventions; and It demonstrates one way of doing engaged philosophy. (shrink)

Treatment of military-related posttraumatic stress disorder is a major public health care concern. Since 2001 over 2.5 million troops have been deployed to Iraq or Afghanistan, many of whom have experienced direct combat and sustained threat. Estimates of PTSD rates related to these wars range from 8% to over 20%, or 192,000 to 480,000 individuals. Already, nearly 250,000 service members of Operations Enduring Freedom, Iraqi Freedom, and New Dawn have sought VA health care services for PTSD. This recent increased need (...) for mental health services comes in addition to the ongoing needs of Vietnam-era and other veterans who continue to suffer from PTSD. PTSD is related to high co-morbidities of other mental health difficulties, poorer physical health status, and increased medical care utilization. Such high demand for services is an important contributor to the large cost associated with combat-related PTSD. Accordingly, promoting successful, cost-effective treatment strategies for PTSD is a chief public health care priority. (shrink)

Research teams have made considerable progress in treating absolute uterine factor infertility through uterus transplantation, though studies have differed on the choice of either deceased or living donors. While researchers continue to analyze the medical feasibility of both approaches, little attention has been paid to the ethics of using deceased versus living donors as well as the protections that must be in place for each. Both types of uterus donation also pose unique regulatory challenges, including how to allocate donated organs; (...) whether the donor / donor's family has any rights to the uterus and resulting child; how to manage contact between the donor / donor's family, recipient, and resulting child; and how to track outcomes moving forward. (shrink)

Anthropology of Consciousness, EarlyView.

Kant hat bewiesen, dass reine Vernunftnotwendigkeit der einzige nicht zufällige, also unbedingte Geltungsgrund von Ethos und Recht ist. Dazu bedarf Vernunftnotwendigkeit der Anwendung auf die menschliche Praxisdisposition und wird dadurch zum Sittengesetz. Es begründet das untergeordnete Verhältnis von Recht und Moral. Die menschliche Freiheit hat in der Notwendigkeit des Sittengesetzes ihren absoluten Grund und ihr Kriterium. Daher kann es nicht in unserem Belieben stehen, soziale, ethische und rechtliche Regeln aufzustellen, sondern es ist unabweisbare Menschenpflicht, sich nur Regeln zu geben, die (...) dem Sittengesetz gemäß sind. Auch die Geltung staatlicher Gesetze ist von dieser Übereinstimmung abhängig.Kant has shown that pure rational necessity is the single non-contingent and thus unconditional basis for the validity of law and ethics. In addition, rational necessity requires application to human practical disposition and thereby becomes moral law. The moral law provides the basis for the subordinate relationship of law and ethics. Human freedom finds its absolute foundation and its criterion in the necessity of the moral law. Accordingly, it cannot be within our discretion to establish social, ethical, and juridical rules, bur instead it is an imperative duty for human beings to adopt rules that accord with the moral law. The validity of state legislation is also dependent on this accordance. (shrink)

Extending literature on health information to entertainment television, we analyze the prostate cancer narrative presented in the police drama, NYPD Blue. We explain how the physician-patient interaction depicted on the show followed (and sometimes did not follow) the medical dialogue model. Findings reveal that the producers of this show advocate a more dialogic model of medical interaction. Portrayals of incompetent, ineffective physicians are contrasted with the superior, effective efforts of other physicians. The audience learns that a non-dialogic approach characterizes “bad (...) doctors,” while the dialogic method typifies “good doctors.” Likewise, medical professionals can use such texts to enhance physician-patient interaction. (shrink)

Modern feminist movements run the risk of being appropriated by capitalist agenda and commodified for mass appeal, thus stripping them of their revolutionary potential. I would propose that in order for feminism to challenge this, movements may want to consider the subversion of subjectivity. Deleuze and Guattari's notions of becoming-animal and becoming-woman emphasise a subjectivity not confined by rigid identity, such as man/woman. However, feminists have challenged this theory, suggesting it is difficult to both fight for and dispel the very (...) same notion, that is, woman. I argue that in first considering the feminine subject via the Lacanian understanding of ‘Woman’, it can be argued that feminine subjects can engage with becoming-animal to destabilise the notion of ‘Woman’. Riot Grrls, FEMEN and Pussy Riot all demonstrate tactics which could be said to utilise becoming-animal and have had varying success in avoiding commodification. (shrink)

What I propose in this article is application of existing dispute resolution practices that take place outside the courtroom to the negotiating that takes place between health providers and families when they try to reach agreement about the limits of medical care that arguably is futile. Specifically, I focus on a bargaining paradigm that is associated with divorce proceedings, and suggest how this paradigm is at work in the conflict about futile treatment. At issue are not the well-publicized aspects of (...) high profile cases, but the rather unpublicized bargaining that goes no further than the clinical setting.Physicians and families who disagree about the futility of medical treatments frequently engage in give-and-take exchanges about whether to start disputed treatments, about what period of time might comprise a reasonable trial period if a treatment is to be administered, and about when and how to transfer a patient to another facility if the dispute cannot be resolved. (shrink)

(2010). The Pitfalls of Misreading: What Does “Industry Funding of Medical Education” Actually Say? The American Journal of Bioethics: Vol. 10, No. 1, pp. 24-25.