In lieu of an abstract, here is a brief excerpt of the content:Breaking the Readmission CycleBrian HattenI want to share the story of my difficult patient Ms. L. She has twenty-seven current medical issues. Thirty-five active prescriptions. Limited mobility requiring the use of a motorized scooter. Non-medical care gaps. And over twenty hospital admissions since 2020. I met Ms. L approximately five years ago as her hospital attending and have continued to care for her during her frequent hospitalizations. I could (...) recite this 77-year-old female's litany of medical problems. But sufficed to say, her history is complex, with her admitting diagnoses running the gambit from cellulitis to gastrointestinal bleeding to altered mental status. But, her diagnosis and frequent exacerbations of congestive heart failure (CHF) are particularly frustrating for us both and will be my focus today.CHF makes her susceptible to fluid overload leading to feelings of shortness of breath, which progresses to respiratory distress. Like other individuals with CHF, she uses diuretics to prevent herself from becoming fluid overloaded. And, like many individuals who take diuretics, she hates them. She (un)affectionately calls her water pills "the bomb" because the effect is sudden, profound, and explosive when they begin working. The combination of the diuretic effect and her limited mobility causes significant emotional stress for Ms. L, a woman who values presenting herself outwardly as in control, well-dressed, and put together. Her dislike of the medical effect of her diuretics has led to her either taking them less often or outright discontinuing them. So, while discontinuation avoids those frustrating effects, it leads to fluid accumulation, subsequent respiratory distress, and readmission to the hospital.Her medical records mention she has memory issues. It is unclear how much her mild cognitive impairment affects her frequent readmissions. We have had many conversations where I would never suspect something was amiss. But sometimes, she can be forgetful and does not recall our recent discussions. That being said, she knows the names and uses of her medications. She can report to me her home weights when she checks them and knows what her "dry" weight should be. Yet, she does not act when her scales begin reading heavier or when she develops leg swelling. Instead, she presents to the emergency department in extremis. When directly questioned about why she lets her situation deteriorate to such a state that she requires hospitalization, she demurs. She comments that she can often be stubborn, that the diuretic effect of "the bomb" is burdensome, but always reminds me she is honest in admitting she wasn't taking her water pills.During several admissions, I worried for her survival after she had self-discontinued her medications and showed up at the emergency department in respiratory failure. For any patient with recurrent admissions, I discuss their overall goals of care to ensure we are working together toward achievable medical ends. But this conversation was essential to have with Ms. L. The possibility existed that she would present to the hospital too late in her disease process, and we would not be able to correct her respiratory failure. I wanted to ensure that the hospital staff and I respected her wishes regarding her care. Despite raising my concerns, she would [End Page 22] decline to discuss her wishes. Even worse, attempting to have her complete advance care planning documents like advance directives or a Physician Orders for Life-Sustaining Treatment (POLST) form was a futile endeavor. Ms. L was always vague and non-committal. She simply did not want to engage in those types of conversations. When asked why she declined to discuss these issues, Ms. L would reply that she was doing okay, the discussion was unnecessary, and she had family members to make those decisions for her.Caring for her during her hospital stays was a source of professional frustration for me. Her recurrent admissions made me feel like I was failing her. During each hospital stay, we would go over her medications. We repeatedly discussed how she should check her weights daily and monitor for lower extremity edema. We created multiple action plans for when to call her physicians so we could head off another hospital visit. We completed all the... (shrink)

Not long ago, under the influence of Michel Foucault, one spoke of the conjunction of knowledge and power, but in this post-truth era power appears singularly uninterested in knowledge, even as the supporters of Donald Trump claim that he alone of all politicians speaks the truth. This essay proposes to examine the relations of power and knowledge under the present populist assault. This analysis begins in the work of Claude Lefort, who spoke of the separation of knowledge and power in (...) democracy’s symbolic regime, and is then counterposed to Ernesto Laclau’s understanding of ‘populist reason’ in order to explore the present torsion of this relation to the point where power can appear not just separated from, but opposed to knowledge. It will be argued that it is less a question of post-truth than of different forms of truth with different truth claims, borne by different imperatives, and tied to different forms of representation – truth claims that can, in relation to each other, be indifferent, complementary, or conflictual. With this in mind, the essay asks: what is the relation of the people to truth? Do those who claim to represent the people seek possession of a different kind of truth? What is the relation of populism to ideology? And what is populism’s relation to ‘post-modernism’? (shrink)

In reply to Mawson, I accept that each and every religion includes the self-referential belief that it is true. I seek to show that this admission does not entail that the rest of the beliefs of religions track the truth or that they are not better explained through the religion-as-fiction hypothesis. If that hypothesis is well-grounded, it gives us good reason not to take arguments for religions' non-self-referential beliefs seriously. (Published Online August 11 2004).

Michael Scott attacks my use of likelihood in assessing two explanations for human religion. He assumes that I rely on likelihood alone. He is attacking a straw man. We have no alternative but to rely on likelihood when the probabilities of two competing hypotheses are identical, as I charitably assumed with respect to the hypotheses I discussed. His other criticisms likewise miss the mark.

For Karl Marx, ideological forms of consciousness are false, but how and in what respects? Ideologies must include some beliefs in order to be false, even if not all the beliefs that are inferentially related in the ideology are false, and even if there are (causally) related attitudes in the ideology that are neither true nor false. “Ideological” beliefs, however, are not simply false; their falsity has the specific property of not being in the interests of the agents who accept (...) the ideology. One can make two kinds of mistakes about interests. One can mistake what is in one’s intrinsic interest or one can mistake what is in one’s extrinsic interest (that is, the means required to realize one’s intrinsic interests). Marx is mostly, but not exclusively, focused on mistakes about extrinsic interests; this is important in understanding how “morality” (which is not a matter of beliefs, but attitudes) can be ideological for Marx. I illustrate this analysis with some of Marx’s paradigmatic examples of ideological mistakes and offer an account of Marx’s conception of “interests.”. (shrink)

This project is a convergence of environmental philosophy and variant strains of continental philosophy. The aim is to make the familiar a bit unfamiliar, partly by understanding the road as an event, and partly by experimentally downplaying the significance of human intentions, particularly given that originary tracks were frequently the result of simple useage. We humans are always on the road, which in a fundamental sense is going nowhere or, alternatively, is possibly heading toward a dead-end.

Market events of the past few years have resurrected long unheeded calls for the professionalization of the occupation of business manager, not in terms of increased technical proficiency, but in terms of a renewed vigor to shape the practice of management and the education of those who will fill its ranks along the lines of the “ideal of service” which characterizes socially established professions like law and medicine. In this paper I argue that the push to professionalize business management can (...) be grounded in an ISCT (Integrative Social Contracts Theory) treatment of the “vulnerable values” argument which itself has served as a source for the professionalization of medicine and law. Additionally, I offer a sketch of an argument that once business managers are considered to be members of a profession, we can begin to develop an account of “business malpractice” which would, when it occurs, represent an ethical violation of the “publicpledge” that members of all professions make to serve the broader good of society. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Moral Traditions: An Introduction to World Religious Ethics, and: Understanding Religious Ethics, and: Moral Struggle and Religious Ethics: On the Person as Classic in Comparative Theological ContextsBrian D. BerryMoral Traditions: An Introduction to World Religious Ethics Mari Rapela Heidt Winona, Minn.: Anselm Academic, 2010. 138 pp. $22.95.Understanding Religious Ethics Charles Mathewes Malden, Mass.: Wiley-Blackwell, 2010. 277 pp. $41.95.Moral Struggle and Religious Ethics: On the Person as Classic in (...) Comparative Theological Contexts David A. Clairmont Malden, Mass.: Wiley-Blackwell, 2011. 245 pp. $99.95These three texts each make significant contributions to comparative religious ethics, a relatively recent discipline that reflects the rise of religious pluralism and globalization. Taken together, these books raise questions about what comparative religious ethics is, how it should be done, and why it should be done. What makes comparative religious ethics “comparative” and to what extent can comparative religious ethics be made genuinely “theological”?Mari Rapela Heidt, who holds a PhD in theological ethics from Marquette University and currently lectures in the religious studies department at the University of Dayton, has written a well-organized and highly accessible introduction to the ethics of the world religions for beginning undergraduate students. Each of the main chapters in her book surveys a major world religion (Hinduism, Buddhism, Judaism, Christianity, Islam, and the Chinese moral tradition) through four lenses: a brief review of the tradition; the moral world of the religion; values, principles, or virtues in the tradition; and the religious tradition on a particular moral issue (e.g., Hinduism on abortion, Buddhism on wealth and poverty, Judaism on the environment, Christianity on war and peace, Islam on men and women, and China’s one-child [End Page 202] policy). The book also includes opening chapters that introduce students to the study of ethics and religious ethics; a final chapter on additional religious moral traditions (Sikhism, Jainism, Bahá’í, and Shinto); sidebars highlighting major religious figures, texts, or events (e.g., Gandhi, Thich Nhat Hanh, Elie Wiesel, the Charter of Medina, and the Cultural Revolution); and discussion questions, bibliography (including visual media), footnotes, a glossary, and an index.Although this book briefly discusses the discipline of comparative religious ethics and some of its descriptive and conceptual methods in its opening chapters, its broad scope and concise treatment mean that the actual task of comparing the similarities and differences in the ethics of the world religions is kept to a minimum. The few detailed comparisons that are made focus largely on Hindu, Buddhist, and Christian understandings of the concepts of reincarnation (29, 34, 64), dharma (18–19, 23–24, 34–35, 64), karma (18–19, 21–23, 35–36, 64), and ahimsa (25–27, 38, 70–71). While the main chapters are organized in a way that facilitates comparison, and discussion questions are included that invite students to observe similarities and differences, the book would be strengthened by giving greater attention to comparison throughout and adding a concluding chapter that summarizes its comparative content. It ends somewhat abruptly with a discussion of the Shinto moral tradition.Charles Mathewes, associate professor of religious studies at the University of Virginia, has written a book that, while limited to Judaism, Christianity, and Islam, achieves much greater comparative sophistication. The text is based on a course he has taught for more than ten years called “Religious Ethics and Moral Problems,” and it bears the marks of a seasoned teacher whose primary audience is advanced undergraduate students, both religious and secular. Mathewes writes from a Protestant Christian perspective “having a strong apocalyptic dimension which is focused on the next life,” acknowledging that Roman Catholics and Eastern Orthodox may find his views “odd or confused” (53). Part 1 discusses the relationship between God and morality and provides an overview of the ethics of each of the three Abrahamic religions. Parts 2 and 3 then examine not only the moral positions but “the arguments animating the traditions” (3) on a wide range of personal and social matters (e.g., friendship, sexuality, marriage and family, lying, forgiveness, capital punishment, war, and the environment). Part 4 turns to the even more ordinary topics of labor, leisure, and life and the more... (shrink)

Australasian Journal of Philosophy, Volume 89, Issue 2, Page 379-380, June 2011.

This paper argues that the church should give especial care to the needs of older folk in their communities, needs that are often neglected. It analyses why such folk have especial needs in our contemporary society and suggests practical ways that churches can and should respond. It summarises particular approaches to learning to grow old, and to die well, given by various authors who have had experience in these areas. It considers the problem of pain and suffering and suggests a (...) dualistic approach that can give comfort. (shrink)

This essay argues, following an insight of Burckhardt, that the philosophy of history is a ‘centaur’, and that it has a tendency to hinder rather than to encourage the practice of history. It challenges many of the presuppositions of Bevir's study, demonstrating that The Logic of the History of Ideas is not, in any meaningful sense, an historically minded work. The ‘logic’ of the essay looks to the arts, especially literature and music, as providing genuinely illuminating parallels to the discipline (...) involved in the practice of intellectual history. History cannot be understood as a process of philosophical abstraction; pertinent examples are of its essence, and plurality is therefore central to its richly textured nature. It still has much to learn from the reflexive procedures of anthropology. By examining the idea of ‘tradition’ the essay demonstrates that ‘the past’ is never dead, and that the relationship between texts is a living process: the intellectual historian is him/herself an artist, and his/her task is no less demanding than that of the creative artist, and it is always humblingly provisional. (shrink)

According to one recent account, in the “preliberal epoch” before the seventeenth century people did not think of individuals “as possessing inalienable rights to anything — much less life, liberty, property, or even the pursuit of happiness.” The statement is not true, but it is excusable. Compared with the flood of writing on the classical rights theories of the early modern period, there has been only a thin trickle of work on medieval ideas concerning individual natural rights, or human rights (...) as we say nowadays, rights inhering in the human person as such. Some modern authors see the seventeenth-century rights theories as a radical departure from ancient and medieval ways of thought; they are content to explain the ideas of Hobbes and Locke and Pufendorf by reference to some aspect of the intellectual, political, or economic life of the seventeenth century itself. C. B. MacPherson, for instance, emphasizing economic factors, inaugurated a minor academic industry when he interpreted Locke's teaching that everyone had a property right in his own person as a reflection of the possessive individualism of early-modern capitalism. (shrink)

The accelerating disruption of the Earth's climate systems is the defining issue of our time. The persistent failure of international climate diplomacy has encouraged local, regional, and some national-level solutions and spurred an emerging global movement for climate justice, mainly rooted in communities that bear disproportionate impacts from climate change. This article discusses the ways in which movements from below, seeking economic and energy democracy, are shaping our responses to the crisis. How can the imperative for immediate climate action and (...) the ethical agenda of climate justice be furthered by movements seeking democratic alternatives and a more genuinely ecological future? (shrink)

This dissertation focuses on the philosophical psychology of a little-studied author, Dominic of Flanders, as elaborated upon in a work that has received no attention in the scholarly literature thus far—viz., his Expositio super libros de anima. No modern editions of Dominic’s works exist. Born in the County of Flanders during the first half of the fifteenth century, Dominic was first educated at the University of Paris, but then made his intellectual home in Italy, where he entered the Dominican Order, (...) teaching at the studia of his order, as well as at the University of Florence. This study attempts to place Dominic within the broader context of Aristotelianism to which he belongs, recognizing his place within the school of Thomism that was thriving in Italy at the time, especially in Bologna. We have provided an account of his life and works, exhaustively examining available bibliographical literature, and have situated the composition of his Expositio during his period of Bologna following his entrance into the Order. In particular, we have studied the third book of his Expositio, which takes up the philosophical topics related to cognition and intellectual understanding. We have given attention to the themes of the cognition or knowledge of particulars, as well as the theory of abstraction, which is required for universal understanding. Beyond the fact that the theory of the internal senses is taken up at the outset of Dominic’s third book, it is our contention that a treatment of the internal senses is necessary for a proper understanding of particular knowledge. Dominic is firmly rooted in the Aristotelian tradition, and so for him there is no intellectual cognition without phantasms. Further, the role of the agent intellect is both to abstract from phantasms, as well as to turn back towards phantasms. In this study, we have shown the Flemish master’s reliance upon the thought and writings of Thomas Aquinas; we also have uncovered a silent source of Dominic’s Expositio—viz., the De anima commentary of John Versoris. Versoris’ commentary has been equally unstudied in the relevant scholarly literature. This Versoris had been Dominic’s teacher at Paris. The results of this research also include an edition of Latin text of the third book of Dominic’s Expositio super libros de anima. This edition is based on the four surviving manuscripts of the work, as well as three selected early modern editions ; this edition is presented in the dissertation as an appendix. (shrink)