There is a long history of worrying about whether or not metaphysics is a legitimate philosophical discipline. Traditionally such worries center around issues of meaning and epistemological concerns. Do the metaphysical questions have any meaning? Can metaphysical methodology lead to knowledge? But these questions are, in my opinion, not as serious as they have sometimes (historically) been taken to be. What is much more concerning is another set of worries about metaphysics, which I take to the greatest threat to (...) metaphysics as a philosophical discipline. These worries, in effect, hold that the questions that metaphysics tries to answer have long been answered in other parts of inquiry, ones that have much greater authority. And if they haven’t been answered yet then one should not look to philosophy for an answer. What metaphysics tries to do has been or will be done by the sciences. There is nothing left to do for philosophy, or so the worry. Let me illustrate this with two examples, one of which is our main concern here. (shrink)

Objective Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians’ attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus. Design, Setting, Participants A survey of resident/fellow physicians and internal medicine (...) attendings at an academic medical center, May to August 2013. Measurements We used a 24-item, internet-based survey assessing physician-respondents’ demographic characteristics, knowledge, and attitudes regarding decisional authority for adult VA-ECMO. Qualitative narratives were also collected. Main Results A total of 179 physicians completed the survey (15 percent response rate); 48 percent attendings and 52 percent residents/ fellows. Only 32 percent of the respondents indicated that a surrogate’s consent should be required to discontinue VA-ECMO; 56 percent felt that physicians should have the right to discontinue VA-ECMO over a surrogate’s objection. Those who self-reported as “knowledgeable” about VA-ECMO, compared to those who did not, more frequently replied that there should not be presumed consent for VA-ECMO (47.6 percent versus 33.3 percent, p = 0.007), that physicians should have the right to discontinue VAECMO over a surrogate’s objection (76.2 percent versus 50 percent, p = 0.02) and that, given its cost, the use of VA-ECMO should be restricted (81.0 percent versus 54.4 percent, p = 0.005). Conclusions Surveyed physicians, especially those who self-reported as knowledgeable about VA-ECMO and/or were specialists in pulmonary/ critical care, favored a medical locus of decisional authority for VA-ECMO. VA-ECMO is complex, and the data may (1) reflect physicians’ hesitance to cede authority to presumably less knowledgeable patients and surrogates, (2) stem from a stewardship of resources perspective, and/or (3) point to practical efforts to avoid futility and utility disputes. Whether these results indicate a more widespread reversion to paternalism or a more circumscribed usurping of decisional authority occasioned by VA-ECMO necessitates further study. (shrink)

Many people object to genetically engineerehd (GE) food because they believe that it is unnatural or that its creation amounts to playing God. These objections are often referred to as intrinsic objections, and they have been widely criticized in the agricultural bioethics literature as being unsound, incompatible with modern science, religious, inchoate, and based on emotion instead of reason. Many of their critics also argue that even if these objections did have some merit as ethicalobjections, their quasi-religious nature means that (...) they are entirely irrelevant when interpreted aspolitical objections regarding what public policy ought to be. In this paper, we argue that this widespread view is false. Intrinsic objections have much more political import than has previously been recognized, and indeed the requirements of political liberalism and its associated idea of liberal neutrality, once properly understood, protect intrinsic objections from many of the most common objections. That is, policy-makers may not legitimately base public policy on grounds that are inconsistent with intrinsic objections, even when they believe those objections to be flawed in the ways mentioned above. This means that in the context of a political debate about GE food, the discussion should not center on the substantive merits of the intrinsic objections themselves but rather on the appropriate political norms for achieving democratically legitimate policy on issues that touch people’s deepest religious and moral beliefs. (shrink)

Since antiquity well into the beginnings of the 20th century geometry was a central topic for philosophy. Since then, however, most philosophers of science, if they took notice of topology at all, considered it as an abstruse subdiscipline of mathematics lacking philosophical interest. Here it is argued that this neglect of topology by philosophy may be conceived of as the sign of a conceptual sea-change in philosophy of science that expelled geometry, and, more generally, mathematics, from the central position (...) it used to have in philosophy of science and placed logic at center stage in the 20th century philosophy of science. Only in recent decades logic has begun to loose its monopoly and geometry and topology received a new chance to find a place in philosophy of science. (shrink)

Nothing that can be called thinking is formalized or formalizable; nor can it be likened to a mechanical process (Church's hypothesis). Rather, thinking sets into motion human imagination and passion.Having already written extensively on the imagination,' I will limit myself here to outlining its basic structure. At the two opposite poles of knowledge, as well as in its center, lies the creative power of the human being, that is, radical imagination. It is thanks to the imagination that the world is (...) presented in this form and not in some other: it is imagination that creates axioms, postulates, and the fundamental patterns that subtend the structures of knowledge; finally, it is imagination that both furnishes the hypothetical models and idea-images of knowledge, and makes possible their potential development and/or insight into them. This imagination, however, both in itself and in its essential operations – which include its social forms, experienced on this level as the creation of an anonymous collective force – is neither formalized nor formalizable. Obviously, the imagination contains – just as does everything else that exists – a totalizing, identity-bearing dimension (which for brevity's sake we have elsewhere called ensidiqt,ce)2; but this dimension of the imagination is not the essential one, neither in its operations nor its results, no more than the arithmetic relations between tones are the essential element of a Bach fugue. (shrink)

The standard approach to the ethics of reproductive technologies starts and ends with the parents’ procreative liberty. There's much more to think about. We should start with the relationship between parents and children.

Using the work of Robert A. Kagan's intellectual contribution on the intensification of law, leading authorities in the study of the politics of regulation and litigation examine the consequences of the expansion and intensification of law, both in the United States and the rest of the world. Part One considers bureaucratic legalism, a terrain in which popular and political discourse often conceives as a pitched battle between business and government, and in which claims about quantity—"too much" and "too little"—take center (...) stage. Here, the contributors examine the many ways in which regulators and the regulated cooperate, and the extent to which regulated entities internalize norms and practices associated with bureaucratic. Part Two considers adversarial legalism, a term that even among academics is often reduced to "litigiousness." The chapters in this section show that adversarial legalism is a much more complex, contingent, and multi-sided phenomenon than the popular debate over litigiousness suggests. Part III examines Kagan's core concepts in a comparative framework. Although some sometimes treat adversarial legalism as an American disease, scholars are increasingly finding it proliferating elsewhere, and debating whether it can take a prominent role in nations quite different in tradition and political structure from the United States. Across the globe, law and legalism in all its forms, bureaucratic and adversarial, is becoming more intense, and thus more central to politics, public policy and everyday life. The consequences are profound. Yet commentary is often stuck on old questions. Does the intensification of law reflect the withering of other social institutions? Is it a sign of moral decay? Or is it, on another account, signaling a new era of respect for universal human rights? The Politics of Legalism takes us instead in directions relatively unexplored by both scholars and popular commentators on law. Like Kagan's scholarship, it moves beyond stale debates about litigiousness and overregulation, and invites us to think more imaginatively about how the rise of law and legalism will shape politics and social life in the 21st Century. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Dialogue:Moving ForwardThomas Cattoi (bio) and Carol S. Anderson (bio)The San Francisco Bay Area is an interesting location in which to ponder Buddhist-Christian relations. The website UrbanDharma.org lists more than a hundred institutions affiliated with Buddhist organizations—a density higher than in the Beijing metropolitan area. Some of these centers have a clearly ethnic and denominational character, serving a predominantly immigrant population. Some, like many of the Tibetan organizations, (...) function as cultural centers but also attract a considerable Western clientele. Others, like the San Francisco Zen Center or Spirit Rock in Marin County, belong to the first wave of historical Buddhist centers established in the United States in the 1960s and 1970s. A few more are trying to establish new forms of enculturated Buddhist practice that are more suited to Western sensitivities and are only loosely affiliated with the cultures of traditional Buddhist societies. At the Graduate Theological Union in Berkeley, alongside schools training Jesuit priests, Dominican friars, and Protestant ministers of various denominations, the Institute of Buddhist Studies prepares students from different walks of life to work as Buddhist chaplains in hospitals and educational institutions. Buddhism, in its various forms and manifestations, is no longer an exotic import from a little known “elsewhere,” but is part and parcel of the local spiritual landscape.For students and scholars practicing in such a diverse environment, it is perhaps difficult to imagine that for the greatest part of its history, most of Christendom was largely unaware of the very existence of the Buddhist tradition. While Clement of Alexandria and Jerome do mention Buddhism, and references to its practice can be found in the writings of medieval travelers such as Marco Polo, most European Christians lived in a world where the role of the religious “other” was played by Judaism and Islam. It was only in the early modern era, with the beginning of the European colonization of Asia, that non-Abrahamic religious traditions gradually entered the intellectual horizon of Western intellectuals and scholars. Around the year 1740, a French Jesuit named Jean-François Pons (1688–1752), otherwise remembered as a pioneer of Sanskrit studies in the West, came to the startling realization that many of the religious practices that missionaries and travelers had come across in regions as far apart as China, Japan, Nepal, and Mongolia were actually all parts of the same religious tradition. In his correspondence with his fellow Jesuits in France, he coined the [End Page vii] term Bauddhamatham—teaching of the Buddha—to refer to what would eventually be known as Buddhism. In the early years of the nineteenth century, many Sanskrit and Tibetan texts started to be catalogued and translated into the major European languages, bringing about the first encounter between Europe’s intellectual elites and this utterly foreign religious tradition.The nineteenth century also saw the beginning of a more existential engagement with the Buddhism tradition, albeit one that was limited to intellectual elites who were highly critical of institutional Christianity. In his work The World as Will and Representation, Schopenhauer found in Buddhism many echoes of his own philosophical insights. Many of the members of the Pāli Text Society, established in London in 1871, had rejected Christianity and thought they would find in Buddhism a moral framework in a society where the normativity of the Christian tradition had already started to be questioned. At the same time, we also see the beginning of the first comparative studies, where Buddhism and Christianity are compared from a speculative and doctrinal perspective. In 1880, Ernest de Bunsen claimed that if one made an exception for the crucifixion, many of the fundamental moral teachings of Buddhism and Christianity were virtually identical. This was just the beginning of a slew of similar studies.While the Christian churches were initially uninterested or outright skeptical about engaging in dialogue with non-Christian religious traditions, this attitude started to shift in the decades following the Second World War. The Second Vatican Council, for instance, marked an important shift in the Catholic Church’s attitude toward other religions. Before the 1960s, Catholic theology departments did not offer courses on other religious traditions or on interreligious dialogue... (shrink)

In the eyes of his own contemporaries and successors, as well as many today, Giordano Bruno is something of an ‘outsider’ because of his views in metaphysics, ontology, cosmology, and theology. Concentrating on his central theses, I will show how, with an immense speculative energy, Bruno escaped the ordinary philosophical, scientific, and theological traditions. He conceived of himself, as it were, as a mirror reflecting an unending universe without a center, and through the power of language and ingenium transfers the (...) structure of this universe to the human mind. Bruno’s philosophy, which he himself referred to as ‘new’ or as a «philosophia nolana», required a semantic transformation of traditional terms, because he, no more than any other thinker, could start completely afresh. Although his views initially appear to place him outside of traditional discussions, they in fact touch, in each case, on central problems of traditional philosophical and theological discourse. (shrink)

As science learns more about how the brain works, and fails to work, the possibility for developing “cognition enhancers” becomes more plausible. And the demand for drugs that can help us think faster, remember more, and focus more keenly has already been demonstrated by the market success of drugs like Ritalin, which tames the attention span, and Prozac, which ups the competitive edge. The new drug Aricept, which improves memory, most likely will join them. Whether such (...) drugs are good for individuals, or for society, is an open question, one that demands far more public discussion. (shrink)

Traditional methods of instruction can fail to produce enduring ways of learning, especially in rapidly changing disciplines in the life sciences. Educators and funding agencies are thus calling for new, integrated teaching approaches to address the life sciences. Hierarchical frameworks are being proposed as ways to tackle curricula with large numbers of concepts. Comparing lecture‐based and interactive formats by measuring performance with pre‐ and post‐tests indicated significantly higher learning gains and better conceptual understanding in the more interactive course. Other (...) work has examined how the history of biology can be used to infuse relevance into the biology curriculum. In this paper, I describe a project at Stanford to create, implement, and evaluate an integrated curriculum in undergraduate stem cell education comprised of scientific, laboratory, and ELSI topics. (shrink)

Importance Informed consent is essential to ethical, rigorous research and is important to recruitment and retention in cancer trials.Objective To examine cancer clinical trial (CCT) participants’ perceptions of informed consent processes and variations in perceptions by cancer type.Design and Setting and Participants Cross-sectional survey from mixed-methods study at National Cancer Institute–designated Northeast comprehensive cancer center. Open-ended and forced-choice items addressed: (1) enrollment and informed consent experiences and (2) decision-making processes, including risk-benefit assessment. Eligibility: CCT participant with gastro-intestinal or genitourinary, hematologic-lymphatic (...) malignancies, lung cancer, and breast or gynecological cancer (N = 334).Main Outcome Measures Percentages satisfied with consent process and information provided; and assessing participation’s perceptions of risks/benefits. Multivariable logistic or ordinal regression examined differences by cancer type.Results Most patient-participants felt well informed by the consent process (more than 90% overall and by cancer type) and. most (87.4%) reported that the consent form provided all the information they wanted, although nearly half (44.8%) reported that they read the form somewhat carefully or less. More than half (57.9%) said that talking to research staff (i.e., the consent process) had a greater impact on participation decisions than reading the consent form (2.1%). A third (31.1%) were very sure of joining in research studies before the informed consent process (almost half of lung cancer patients did—47.1%). Most patients personally assessed the risks and benefits before consenting. However, trust in physicians played an important role in the decision to enroll in CCT.Conclusions and Relevance Cancer patients rely less on written features of the informed consent process than on information obtained from the research staff and their own physicians. Research should focus on information and communication strategies that support informed consent from referring physicians, researchers, and others to improve patient risk-benefit assessment and decision-making. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Remembering Lewis E. HahnGeorge C. H. Sun, President, John Howie, Professor Emeritus, Thomas Alexander, Professor and Director of Graduate Studies, Kenneth W. Stikkers, Professor and Chair, Randall Auxier, Professor, Robert Hahn, Professor, Joseph Wu, Professor Emeritus, Elizabeth R. Eames, Professor Emeritus, Martin Lu, Professor of Philosophy, George Kimball Plochmann, Professor Emeritus, Matt Sronkoski, Philosophy Graduate and Academic Adviser, Dave Clarke, Professor Emeritus, Eugenie Gatens-Robinson, Professor Emerita, Hans H. (...) Rudnick, Professor Emeritus, Stephen Bickham, Professor EmeritusPresident, and Don Mikula (bio)The following testimonials were offered on the occasion of a memorial gathering for Dr. Lewis E. Hahn held on February 19, 2005, and were compiled for presentation here by Sharon (Hahn) Crowell.A Tribute to Dr. Lewis E. Hahn (1908-2004) from a Global PerspectiveGeorge C. H. Sun President, Thomé H. Fang Institute, Inc., Mobile, AlabamaAmong the philosophical community in both the East and the West, no word of introduction is needed for our beloved Master, who was the recipient of numerous distinctions and honors, with titles that included "Man of the Year in Philosophy" and "Award of Lifetime Achievement." The very name "Lewis E. Hahn" itself already stands now for genuineness, dedication, and fulfillment.A great work is a dialogue with eternity; a great person is such a work. In less than thirty years he succeeded in developing Carbondale from what had been a small college town in the Midwest into the Mecca of American philosophy. His most important achievements were the Dewey Center and the Pepper Archives that he helped install at SIUC These, among other such institutions, will remain a unique contribution, a glory of American philosophy, and a monument in the history of human thought.For posterity Lewis E. Hahn will remain an object of wonder and amazement. How is it possible for one human being to have accomplished so much, so well, and in so short a span of time—less than one century—in breadth, depth, and diversity? Some one hundred years ago, by bridging the gap between the New World and the Old, William James was hailed as the great genius of international friendship among philosophical thinkers, but we now find a greater genius in Lewis E. Hahn, who succeeded in bringing together the peoples of East and West from at least four continents: Europe, Australia, America (both North and Latin America), and Asia. To my knowledge, few of his predecessors and contemporaries have been half so widely read and liberal-minded as he was, in view of the range and scope of the Library of Living Philosophers that he helped continue after the passing of its founder, Dr. Paul A. Schilpp.What type of man was Hahn, our younger generation will wonder? Only a pluralist approach can help us understand the true character of such a legendary pluralist-contextualist. In short, he was "a full personality." As I recall, while working on my dissertation with him in the 1970s, we had a brief discussion on Confucius, the sage of ancient China. "A full personality!" was his laconic assessment. Suddenly I realized, to quote the Analects: "The Master is talking about himself!" For, as the Buddhists put it, only a Buddha can understand a Buddha. Or, as William James put it, only one who has philosophy can appreciate philosophy. Many friends [End Page 1] of my generation admire him so much; Te Chen of Hong Kong calls him "a great Confucian in America." Those who regret the loss of many precious Confucian virtues in China today have now rediscovered them in the person of Lewis E. Hahn! If Nietzsche called Kant "a great Chinese in Königsberg," it is simply because he had not encountered our own Master.A paradigm of academic leadership, Dr. Hahn is simply irreplaceable—this is a tribute I personally heard in Carbondale in the late 1960s. It is not an exaggeration to say that he was a superb administrator, and he could have been the best Secretary of the State we ever had, for he possessed more in the way of philosophical wisdom than all his predecessors put together! As a great teacher, he was no less "serene, good, learned, wise, and ardent" than... (shrink)

Vision is known to improve human postural responses to external perturbations. This study investigates the role of vision for the responses to continuous pseudorandom support surface translations in the body sagittal plane in three visual conditions: with the eyes closed, in stroboscopic illumination and with eyes open in continuous illumination with the room as static visual scene. In the frequency spectrum of the translation stimulus we distinguished on the basis of the response patterns between a low-frequency, mid-frequency, and high-frequency range. (...) With EC, subjects’ mean sway response gain was very low in the LFR. On average it increased with EO/SI and more so with EO/CI. In contrast, the average gain in the MFR decreased from EC to EO/SI and further to EO/CI. In the HFR, all three visual conditions produced, similarly, high gain levels. A single inverted pendulum model controlling center of mass balancing about the ankle joints formally described the EC response as being strongly shaped by a resonance phenomenon arising primarily from the control’s proprioceptive feedback loop. The effect of adding visual information in these simulations lies in a reduction of the resonance, similar as in the experiments. Extending the model to a double inverted pendulum suggested in addition a biomechanical damping effective from trunk sway in the hip joints on the resonance. (shrink)

Critical care society guidelines recommend that ethics committees mediate intractable conflict over potentially inappropriate treatment, including Do Not Resuscitate status. There are, however, limited data on cases and circumstances in which ethics consultants recommend not offering cardiopulmonary resuscitation despite patient or surrogate requests and whether physicians follow these recommendations. This was a retrospective cohort of all adult patients at a large academic medical center for whom an ethics consult was requested for disagreement over DNR status. Patient demographic predictors of ethics (...) consult outcomes were analyzed. In 42 of the 116 cases, the patient or surrogate agreed to the clinician recommended DNR order following ethics consultation. In 72 of 74 of the remaining cases, ethics consultants recommended not offering CPR. Physicians went on to write a DNR order without patient/surrogate consent in 57 of those cases. There were no significant differences in age, race/ethnicity, country of origin, or functional status between patients where a DNR order was and was not placed without consent. Physicians were more likely to place a DNR order for patients believed to be imminently dying. The median time from DNR order to death was 4 days with a 90-day mortality of 88.2%. In this single-center cohort study, there was no evidence that patient demographic factors affected ethics consultants’ recommendation to withhold CPR despite patient/surrogate requests. Physicians were most likely to place a DNR order without consent for imminently dying patients. (shrink)

Harrowing stories reported in the media describe Covid‐19 ravaging through families. This essay reports professional experiences of this phenomenon, family clustering, as encountered during the pandemic's spread across Southern California. We identify three ethical challenges following from it: Family clustering impedes shared decision‐making by reducing available surrogate decision‐makers for incapacitated patients, increases the emotional burdens of surrogate decision‐makers, and exacerbates health disparities for and the suffering of people of color at increased likelihood of experiencing family clustering. We propose that, in (...) response to these challenges, efforts in advance care planning be expanded, emotional support offered to surrogates and family members be increased, more robust state guidance be issued on ethical decision‐making for unrepresented patients, ethics consultation be increased in the setting of conflict following from family clustering dynamics, and health care professionals pay more attention to systemic and personal racial biases and inequities that affect patient care and the surrogate experience. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Remembering Lewis E. HahnGeorge C. H. Sun, President, John Howie, Professor Emeritus, Thomas Alexander, Professor and Director of Graduate Studies, Kenneth W. Stikkers, Professor and Chair, Randall Auxier, Professor, Robert Hahn, Professor, Joseph Wu, Professor Emeritus, Elizabeth R. Eames, Professor Emeritus, Martin Lu, Professor of Philosophy, George Kimball Plochmann, Professor Emeritus, Matt Sronkoski, Philosophy Graduate and Academic Adviser, Dave Clarke, Professor Emeritus, Eugenie Gatens-Robinson, Professor Emerita, Hans H. (...) Rudnick, Professor Emeritus, Stephen Bickham, Professor EmeritusPresident, and Don Mikula (bio)The following testimonials were offered on the occasion of a memorial gathering for Dr. Lewis E. Hahn held on February 19, 2005, and were compiled for presentation here by Sharon (Hahn) Crowell.A Tribute to Dr. Lewis E. Hahn (1908-2004) from a Global PerspectiveGeorge C. H. Sun President, Thomé H. Fang Institute, Inc., Mobile, AlabamaAmong the philosophical community in both the East and the West, no word of introduction is needed for our beloved Master, who was the recipient of numerous distinctions and honors, with titles that included "Man of the Year in Philosophy" and "Award of Lifetime Achievement." The very name "Lewis E. Hahn" itself already stands now for genuineness, dedication, and fulfillment.A great work is a dialogue with eternity; a great person is such a work. In less than thirty years he succeeded in developing Carbondale from what had been a small college town in the Midwest into the Mecca of American philosophy. His most important achievements were the Dewey Center and the Pepper Archives that he helped install at SIUC These, among other such institutions, will remain a unique contribution, a glory of American philosophy, and a monument in the history of human thought.For posterity Lewis E. Hahn will remain an object of wonder and amazement. How is it possible for one human being to have accomplished so much, so well, and in so short a span of time—less than one century—in breadth, depth, and diversity? Some one hundred years ago, by bridging the gap between the New World and the Old, William James was hailed as the great genius of international friendship among philosophical thinkers, but we now find a greater genius in Lewis E. Hahn, who succeeded in bringing together the peoples of East and West from at least four continents: Europe, Australia, America (both North and Latin America), and Asia. To my knowledge, few of his predecessors and contemporaries have been half so widely read and liberal-minded as he was, in view of the range and scope of the Library of Living Philosophers that he helped continue after the passing of its founder, Dr. Paul A. Schilpp.What type of man was Hahn, our younger generation will wonder? Only a pluralist approach can help us understand the true character of such a legendary pluralist-contextualist. In short, he was "a full personality." As I recall, while working on my dissertation with him in the 1970s, we had a brief discussion on Confucius, the sage of ancient China. "A full personality!" was his laconic assessment. Suddenly I realized, to quote the Analects: "The Master is talking about himself!" For, as the Buddhists put it, only a Buddha can understand a Buddha. Or, as William James put it, only one who has philosophy can appreciate philosophy. Many friends [End Page 1] of my generation admire him so much; Te Chen of Hong Kong calls him "a great Confucian in America." Those who regret the loss of many precious Confucian virtues in China today have now rediscovered them in the person of Lewis E. Hahn! If Nietzsche called Kant "a great Chinese in Königsberg," it is simply because he had not encountered our own Master.A paradigm of academic leadership, Dr. Hahn is simply irreplaceable—this is a tribute I personally heard in Carbondale in the late 1960s. It is not an exaggeration to say that he was a superb administrator, and he could have been the best Secretary of the State we ever had, for he possessed more in the way of philosophical wisdom than all his predecessors put together! As a great teacher, he was no less "serene, good, learned, wise, and ardent" than... (shrink)

This paper develops an account of how the implementation of ML models into healthcare settings requires revising the methodological apparatus of philosophical bioethics. On this account, ML models are cognitive interventions that provide decision-support to physicians and patients. Due to reliability issues, opaque reasoning processes, and information asymmetries, ML models pose inferential problems for them. These inferential problems lay the grounds for many ethical problems that currently claim centre-stage in the bioethical debate. Accordingly, this paper argues that the best (...) way to make progress in remedying these ethical problems is to distil their epistemic core and to identify appropriate epistemic norms as guardrails. The viability of this approach will be highlighted based on four key issues: trust, responsibility, paternalism, and fairness. In that respect, the paper also contributes to a more pronounced view of the specific methodological challenges for ethical theorizing, when the point of reference are complex statistical models that make predictions, rather than individual agents, acting for reasons. (shrink)

Purpose Although surrogate decision-making is prevalent in intensive care units and concerns with decision quality are well documented, little is known about how clinicians help family members understand the surrogate role. We investigated whether and how clinicians provide normative guidance to families regarding how to function as a surrogate. Subjects and methods We audiorecorded and transcribed 73 ICU family conferences in which clinicians anticipated discussing goals of care for incapacitated patients at high risk of death. We developed and applied a (...) coding framework to identify normative statements by clinicians regarding what considerations should guide surrogates’ decisions, including whether clinicians explained one or more of Buchanan and Brock’s three standard principles of SDM to family members. Results Clinicians made at least one statement about how to perform the surrogate role in 24 conferences ). We observed three general types of normative guidance provided to surrogates, with some conferences containing more than one type of guidance: counselling about one or more standard principles of SDM ; counselling surrogates to make decisions centred on the patient as a person, without specifying how to accomplish that ; and counselling surrogates to make decisions based on the family’s values. Conclusions Clinicians did not provide normative guidance about the surrogate role in two-thirds of family conferences for incapacitated patients at high risk for death. When they did, clinicians’ guidance was often incomplete and sometimes conflicted with standard principles of SDM. Future work is needed to understand whether providing explicit guidance on how to perform the surrogate role improves decision-making or mitigates surrogates’ psychological distress. (shrink)

This article pays tribute to Mabogo Percy More by exploring his salience to recent calls for “critical phenomenology”. The notion of critical phenomenology is explored through Lisa Guenther’s influential advocacy and Elisa Magrì and Paddy McQueen’s effort to offer an overview and definition of the field. I contend that the most laudable aspects of critical phenomenology are achieved in More’s phenomenological work on antiblack racism and black consciousness, but that More’s work nonetheless points to limitations in what (...) its advocates have articulated critical phenomenology to be. I argue against Guenther’s case that critical phenomenology must abandon the transcendental for the “quasi-transcendental”, showing that More’s focus on contingency and its significance in the phenomenology of Jean-Paul Sartre means that his work is ultimately transcendental existential phenomenology. I then extend the issue of contingency in relation to Magrì and Paddy McQueen’s suggestion of critical phenomenology as centring corporeality. Taking seriously More’s emphasis on the contingency of embodiment points to the matter of what I term “paracorporeal embodiment”, which suggests phenomenological questions that go beyond many of the articulations of critical phenomenology in the contemporary literature. (shrink)

ABSTRACTFrom 1797 to 1801 a controversy played out on the pages of the Medical Repository, the first scientific journal published in the United States. At its centre was the well-known feud between the followers of Antoine Lavoisier and Joseph Priestley, the lone supporter of the phlogiston model. The American debate, however, had more than two sides. The Americans chemists, Samuel Latham Mitchill and Benjamin Woodhouse, who rushed to support Priestley did not defend his scientific views. Rather, as citizens (...) of a republic, they defended his right to have them. They also castigated the assertions of the “French chemists,” whose claims that the new chemistry obviated debate seemed unsettlingly similar to the dictatorial ambitions of the French state. Using the Medical Repository, Mitchill and Woodhouse sought a compromise that validated the new chemistry, but united it with a more egalitarian form of discourse. The desired balance eluded them. Priestley proved too stubborn, and as the French Revolution descended into dictatorship and war, Mitchill and Woodhouse came more to realize that truly prising French chemistry from the culture of the revolutionary era. The episode left Mitchill and Woodhouse disillusioned with chemistry and hoping to redirect scientific enthusiasm to more pious ends. (shrink)

Ideological indoctrination is explicit and pervasive in China, with the school curriculum used to mould the spirit and character of adolescents, fulfilling ideological and political purposes. But the exact content varies over time. Comparing two versions of textbooks published in 1997 and 2005, this paper depicts the continuities and change in the curricular discourses centred on the notion of ‘good citizen’. While keeping the official status of socialism and the Party leadership untouched, the new textbooks soften the presentation and packaging (...) of the ideological content, very much in tandem with the soft authoritarianism practised since the post‐Deng era when China has been deeply involved in the processes of marketisation, liberalisation and globalisation. The new textbooks also adopt a stance of greater reconciliation with human rights and global citizenship. While being granted more autonomy and rights, young citizens are still expected to shoulder the mission of national revival and socialist modernisation—very much derived from official policies. (shrink)

Who is speaking in the history of social thought? The question of the authentic voice of social thought is typically posed in terms that tend to be either ambitiously theoretical or carefully methodological. Thus histories of social thought frequently offer either a résumé of general ideas about society (say from Montesquieu to Parsons) or a survey which gets bogged down in a rather tedious, nit-picking debate about empirical methodology. This paper is something of a preview of a pro jected attempt (...) on the part of the authors to capture the voice of social thought in rather different terms. Our three theses are: (1) that those who speak 'in the name of society' have just as frequently been doctors and bureaucrats as opposed to 'social philosophers' or professional sociologists; correlatively, (2) that the creative voice of social thought has more often been technical, problem-centred and tied up with par ticular rationalities of government as opposed to being either exclu sively theoretical or merely responsive to 'objective problems' in society; and, (3) that if sociology today struggles for a voice in which to speak this may be in some part due to the ways in which the past history of social thought has typically been conceived. (shrink)

Students of culture have been increasingly concerned with the ways in which cultural values are 'inscribed' on the body. These essays go beyond this passive construal of the body to a position in which embodiment is understood as the existential condition of cultural life. From this standpoint embodiment is reducible neither to representations of the body, to the body as an objectification of power, to the body as a physical entity or biological organism, nor to the body as an inalienable (...) centre of individual consciousness. This more sensate and dynamic view is applied by the contributors to a variety of topics, including the expression of emotion, the experience of pain, ritual healing, dietary customs, and political violence. Their purpose is to contribute to a phenomenological theory of culture and self - an anthropology that is not merely about the body, but from the body. (shrink)

Systematic study of the intersection of ethics consultation services and solid organ transplants and recipients can identify and illustrate ethical issues that arise in the clinical care of these patients, including challenges beyond resource allocation. This was a single-centre, retrospective cohort study of all adult ethics consultations between January 1, 2007, and December 31, 2017, at a large academic medical centre in the north-eastern United States. Of the 880 ethics consultations, sixty (6.8 per cent ) involved solid organ (...) transplant, thirty-nine (65.0 per cent) for candidates and twenty-one (35.0 per cent ) for recipients. Ethics consultations were requested for 4.3 per cent of heart, 4.9 per cent of lung, 0.3 per cent of liver, and 0.3 per cent of kidney transplant recipients over the study period. Nurses were more likely to request ethics consultations for recipients than physicians (80.0 per cent vs 20.0 per cent, p = 0.006). The most common reason for consultation among transplant candidates was discussion about intensity of treatment or goals of care after the patient was not or was no longer a transplant candidate. The most common reason for ethics consultation among transplant recipients was disagreement between transplant providers and patients/families/non-transplant healthcare professionals over the appropriate intensity of treatment for recipients. Very few consultations involved questions about appropriate resource allocation. Ethics consultants involved in these cases most often navigated communication challenges between transplant and non-transplant healthcare professionals and patients and families. (shrink)

As frequently pointed out in this discussion, one of the most characteristic features of Mayr's approach to the history of biology stems from the fact that he is dealing to a considerable degree with his own professional history. Furthermore, his main criterion for the selection of historical episodes is their relevance for modern biological theory. As W. F. Bynum and others have noted, the general impression of his reviewers is that “one of the towering figures of evolutionary biology has now (...) written a towering history of his discipline.”138 Bynum is here referring to The Growth of Biological Thought, but this observation holds equally true for Mayr's other historical writings: One must surely read this book [One Long Argument] not only for its content in itself, but for what it tells of its author. And certainly as one does so, one comes away full-handed. Many, if not all, of the disputes and controversies that have driven Mayr through his long intellectual life reappear, stated as forcefully and elegantly as ever.139Up to this point, most reviewers agree; the bone of contention is, rather, how to evaluate Mayr's historical work, considering this observation. The two related characteristics of his work-I will call them subjectivity and presentism-stand in opposition to a widespread approach in the history of science exemplified by Kuhn's suggestion that “insofar as possible..., the historian should set aside the science that he knows. His science should be learned from the textbooks and journals of the period he studies.”140 There are, however, historians who consider the close connection between Mayr and the subject matter of his historical studies to be an advantage.141On the other hand, it is assumed that the connection between past and present must result in a distortion of the historical truth and lead to a historiographical fallacy, commonly referred to as “Whig history”. Herbert Butterfield, who in 1931 gave the term its now generally accepted meaning, believed that “real historical understanding is not achieved by the subordination of the past to the present, but rather by our making the past our present and attempting to see life with the eyes of another century than our own”142. Unfortunately, Butterfield's definition of what he considers Whig history remains somewhat vague, and modern authors have emphasized what they consider most important. Butterfield's “subordination of the past to the present” is referred to in respect to the selection of subjects (there are more biographies of Charles Darwin than of, let's say, Louis Agassiz),143 to the evaluation of historical authors,144 or, more generally, to all kinds of histories “with one eye, so to speak, upon the present.”145 The underlying tendency of Whig historians is to produce a “historical account told from the viewpoint of those in power,”146 leading to a “glorification of the present.”147 It is obvious that Mayr's strongly presentist approach to the history of biology can be called Whiggish, if we apply the criteria of “selection” or “reference.” However, it might be worth mentioning that the program of writing a strictly historicist account of the history of science is challenged by various authors.148 For Mayr, it is not only legitimate but necessary to compare the present situation with the past. “Whiggish” is only the evaluation of an author in terms of our time.149I cannot discuss the Whit/anti-Whig controversy in any detail here, apart from saying that Mayr has defended himself rather extensively against the charges of being Whiggish.150 Nevertheless, it may be useful to touch on some of the criticisms that are predominant in reviews of his writings. First, we encounter the notion that historians can write a true and convincing historical account only if they have no personal interest or interpretation of their own; Mayr, on the other hand, because he “has such strong interpretations of his own, ... cannot possibly convince everyone that he is right about everything.”151 It makes one wonder, what historian has ever been able to convince everyone that he or she is right about everything? But apart from this peculiar idea, it unquestionably poses certain dangers if the subject matter of historical scrutiny and the author are identical. At the same time, this identity brings certain advantages with it, especially firsthand experiences of the period in discussion. Whether these personal memories ultimately result in a distorted picture of the past has to be decided in every particular instance. The notion that a scientific study can be conducted by a completely detached observer from a neutral standpoint has been shown to be impossible in physics, and it is also an illusion in historiography. The question is not whether, but which kind of interest are the underlying motivation for a historian. At this point, Mayr is ahead of his critics when he suggests that our understanding of the past always has a subjective component: The main reason, however, why histories are in constant need of revision is that at any given time they merely reflect the present state of understanding; they depend on how the author interpreted the current zeitgeist of biology and on his own conceptual framework and background. Thus, by necessity the writing of history is subjective and ephemeral.152Second, the temporal proximity between the event and the historical analysis makes difficulties inevitable and will finally result in certain false assessments. But this applies to all historians when they discuss recent problems, regardless of whether they are personally involved or not: As long as the battle between Darwinism and Lamarckism was raging, it was quite impossible to undertake an unbiased evaluation of Lamarck. ...[The] definite refutation of Lamarck's theory of evolutionary causation clears the air. We can now study him without bias and emotion and give him the attention that this major figure in the history of biology clearly deserves.153Third, Mayr is primarily interested in biological problems and not, for instance, historiographical, sociological, or psychological questions. Several authors have remarked that since the beginning of the professionalization of the history of science in the 1960s, a rift between two groups has developed, resulting from the heterogeneous professional backgrounds and interests of the people involved: the authors who were originally biologists and became interested in the history of their discipline only later on, and the authors who were trained as historians.154 Whereas the first group, the “biologists,” tend to be laymen in history proper, the “historians” are in most cases laymen in biology. Different professional backgrounds obviously shape the historical perspective in both groups, but neither approach is necessarily superior. The great number of important books in the history of biology written by “biologist” documents how valuable this point of view can be. On the other hand, it cannot be denied that the writings of biologists in the history of science tend to have a strong “internalist” tendency and often neglect the professional, cultural, and political context of science. Mayr's approach is that of a “biologist”; it is “internalist,” and typical for scientists who turn to the history of their discipline.I want to conclude my analysis with a quotation from a review by Douglas J. Futuyma, which gives a perceptive glimpse of Mayr's personality and style: One cannot help standing in awe of the germanic capacity for vast, allembracing synthesis: consider the lifelong devotion of Goethe to Faust, or Wagner's integration of the arts into a Gesamtkunstwerk in which all of human history and experience is wrought into epic myth. It is perhaps in this tradition that Ernst Mayr's The Growth of Biological Thought stands: a history of all of biology, a Ring des Nibelungen complete with leitmotivs such as the failures of reductionism, the struggle of biology for independence from physics, and the liberation of population thinking from the bounds of essentialism.155 Within this style of thinking Mayr has “to offer...nothing less than a vision of biology that places neodarwinian evolutionary theory firmly at the centre.”156 There may be other visions of biology, but few of them have as indefatigable and able representatives as Darwinism has in Ernst Mayr. (shrink)

The Nanoessence project aims to examine life at a sub-cellular level, re-examining space and scale within the human context. A single HaCat skin cell is analysed with an Atomic Force Microscope (AFM) to explore comparisons between, life and death at a nano level. The humanistic discourse concerning life is now being challenged by nanotechnological research that brings into question the concepts of what constitutes living. The Nanoessence project research is based on data gathered as part of a residency at SymbioticA, (...) Centre of Excellence in Biological Arts, University of Western Australia and the Nanochemistry Research Institute, (NRI) Curtin University of Technology. The space of the body can be seen at an atomic level as having no defining boundaries. More generally, molecular self-assembly seeks to use concepts of supramolecular chemistry, and molecular recognition in particular, to cause single-molecule components to automatically arrange themselves into some useful conformation (reference Wikipedia). Nano assembly, or bottom-up approach, is the construction of a supramolecular chemistry by the assembly of nanoscopic particles, or even atoms and molecules. The proposal for nanotechnology to reshape nature atom by atom develops an interesting debate as to the constitution of life. The Nanoessence project aims to construct a physical experience to examine this scientific and metaphysical world. Nanoessence is an interactive audio-visual installation. In the Nanoessence installation the viewer will interface with the visual and sonic presentation through his or her own breath. In the context of the project breath has a strong conceptual and metaphorical link to a Biblical inception of life. The project attempts to maintain a high quality of authentic data to engage the viewer in a sensorial qualitative experience of quantitative data. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On Thomas Aquinas’s Two Approaches to Female RationalityElisabeth Uffenheimer-LippensAlthough the female human being was never at the center of his daily and intellectual attention, Thomas Aquinas as a religious thinker had no choice but to consider her in a wide range of different contexts. She is found in theoretical-speculative discussions (about creation, original sin and its punishment, resurrection) and in more practical ones (about marriage, reproduction, (...) ordination of women, women as teachers, as witnesses). Thomas’s ideas about the female human being have been investigated by theologians, philosophers, and historians. Often, but not always, the research has been inspired and even distorted by one form or another of feminism.In this article I shall not discuss all the different aspects of the topic “woman” as they can be found in Thomas’s works, but limit myself to one of them, namely, his understanding of female rationality. I have become intrigued by the fact that he thought about the rationality of woman in two different ways which he never integrated or explicitly connected. In the majority of his texts Thomas describes woman’s rationality as “inferior” in comparison to the “superior” male rationality. This justifies her subordination to the male human being and is expressed in her inability to control her passions. There are, however, other texts in which Thomas discusses the human mind in general, without specifying whether he means the mind of the male or the female human being. He recognizes in the human mind two aspects or functions of rationality, namely, a ratio superior which he labels symbolically “masculine” and a ratio inferior which he calls “feminine.” The meaning of this is [End Page 191] that woman’s rationality is not of an inferior kind, but includes both aspects of rationality.The thesis underlying this article is that not enough attention has been paid to the fact that two fundamentally different ways of understanding female rationality can be found in the work of Thomas Aquinas. His symbolic use of male and female has too often been confused with what one could call the “real” relationship between man and woman. The aim of this article is to present these two different understandings in Thomas, without making any detailed attempt to trace their historical origins. In addition, I want to show the new perspectives that are opened up by his second approach.The first part of this article will focus on the “inferior rationality” of women and try to understand what is meant by inferiority. The discussion will develop around an analysis of the words mollis and mollities. This will lead me to the relationship between inferior rationality and bodily weakness on the one hand, and between inferior rationality and the passions on the other hand. The practical consequences of woman’s inferior rationality shall also be treated. The second part of this article will focus on the human mind, and on the difference between ratio inferior and ratio superior. The definition of these two functions of human rationality will be followed by an analysis of texts where Thomas describes original sin as a paradigm for concrete sin, and where he connects ratio inferior to woman/feminine and ratio superior to man/male. The discussion will be completed by a study of the relationship between the ratio inferior and the vis cogitativa. This will allow me to bring out the importance of this second understanding of female rationality.I. Woman’s Inferior RationalityWoman’s intellectual capacity is repeatedly described by Thomas with the unflattering comparatives debilior (debilis meaning, among other things, “disabled, infirm, feeble, frail, [End Page 192] weak”)1 and inferior. Almost every woman does not have a “firm judgment of reason”; she is “unstable of reason.”2 She does not possess “sufficient strength of mind” (to resist concupiscence).3 There is clearly a “deficiency of reason”4 because she has an overall “weakness of nature.”5These descriptions of female rationality can only be understood insofar as they stand over and against the male rationality which is described in almost bodily comparatives as fortior, firmior, robustior. The male has more “strength of soul.”6 In him “the discretion... (shrink)

This paper argues that the current discourse on epistemic injustice in social epistemology itself perpetuates epistemic injustice, namely hermeneutic injustice with regards to class and classism. The main reason is that debates on epistemic injustice have foremost focussed on issues related to gender, race, and disability while mostly ignoring class issues. I suggest that this is due to (largely unwarranted) fears about looming class reductionism. More importantly, this is omission is not innocuous, but problematic insofar as it has an (...) unlikely ally in neoliberal propaganda which features as one main goal stifling class consciousness. While this “allyship” is unwitting, this presents grounds for the discourse of epistemic injustice to consider re-centring class issues and classism. (shrink)

This Paper identifies seven positive elements of an _ethics system_, or framework, for public officials - namely, (1) the culture and values prevailing in a country; (2) codes and laws and their enforcement; (3) new institutions to uphold ethics in public life; (4) audit, public accountability and openness; (5) guiding principles and motivation to encourage good conduct; (6) external and internal education and training for public life; and (7) the views of the public in regard to their call for greater (...) trust, honesty, and integrity in public life. The Paper next discusses in detail each of these seven elements of an _ethics system_ in the context of British Central Government. However, these seven elements are deemed appropriate for the Public Service of any country seeking to strengthen its standards of conduct and uphold its ethical responsibilities. Finally, this Paper concludes with a reference to business companies and the relevance to them of an _ethics system_. For example, there is a defence in the new UK Bribery Act of 2010 (to be implemented on 1st July 2011 and applicable also to foreign corporations doing business in the UK) that, if a business company has procedures in place to prevent corruption (that is, an _ethics system_), it will be treated more leniently. (shrink)

Autism research is increasingly moving to a view centred around sensorimotor atypicalities instead of traditional, ethically problematical, views predicated on social-cognitive deficits. We explore how an enactivist approach to autism illuminates how social differences, stereotypically associated with autism, arise from such sensorimotor atypicalities. Indeed, in a state space description, this can be taken as a skewing of sensorimotor variables that influences social interaction and so also enculturation and habituation. We argue that this construal leads to autism being treated on a (...) par with other sensorimotor atypicalities such as blindness or atypical height. This leads to our conclusion that, insofar there is an ethical call to inclusion in our public sphere regardless of contingent bodily difference, an enactivist take on autism naturally leads to extending such inclusion to autism. Moreover, our analysis suggests a concrete way forward to achieve inclusion of autistics: by being more attentive to autistic sensorimotor specifics. (shrink)

Available from UMI in association with The British Library. ;This thesis traces endeavours in the twentieth century to provide the 'intellectual' foundations for general medical practice as an independent, autonomous clinical discipline. The empirical focus of the study is upon the application of psychological and 'person-centred' approaches to general practice; above all, in the work of Michael Balint, and the Royal College of General Practitioners in the post-war period. The thesis is guided by two predominant theoretical concerns. First, to highlight (...) the complex strategies and the wide range of means and resources that have been required to give substance to the claim that general practice is 'by nature' a person-centred endeavour. Second, to consider--and to question--certain influential approaches to medical power in general, and to the social consequences of 'emancipatory'--person-centred--forms of medicine in particular. Specifically, the 'power/knowledge' approach to medical sociology is contested both with regard to its empirical findings and in relation to its basis in the work of Michel Foucault . ;The study which follows is intended neither as a narrative history of general practice nor as a history of ideas about general practice. Its empirical concern is more specific than either of these. Focusing upon the twentieth century and above all the post-war period, it seeks to analyse some of the ways in which general practitioners have sought to autonomise their discipline by giving it an 'intellectual' basis. If the 'general practitioner' has long existed as a professional label then nevertheless notions of what unifies the general practitioner's activities have undergone a degree of mutation. It is these 'models' of general practice--physiological, epidemiological, psychological--which will be investigated here. As such, the purpose behind the study is partly of a 'methodological' order. The study seeks to show that what counts in evolving a coherent model of general practice is not just the provision of a 'representation' of the general practitioner's activities but a construction on several levels. (shrink)

This paper shows how solidarity is one of the founding principles in Thomas More's Utopia. In the fictional republic of Utopia described in Book II, solidarity has a political and a moral function. The principle is at the center of the communal organization of Utopian society, exemplified in a number of practices such as the sharing of farm work, the management of surplus crops, or the democratic elections of the governor and the priests. Not only does solidarity benefit (...) the individual Utopian, but it is a prerequisite to ensure the prosperity of the island of Utopia and its moral preeminence over its neighboring countries. However, a limit to this principle is drawn when the republic of Utopia faces specific social difficulties, and also deals with the rest of the world. In order for the principle of solidarity to function perfectly, it is necessary to apply it exclusively within the island or the republic would be at risk. War is not out of the question then, and compassion does not apply to all human beings. This conception of solidarity, summed up as “Utopia first!,” could be dubbed a Machiavellian strategy, devised to ensure the durability of the republic. We will show how some of the recommendations of Realpolitik made by Machiavelli in The Prince correspond to the Utopian policy enforced to protect their commonwealth. (shrink)

Arguments for the provision of foreign aid to help relieve the blight of developing countries have traditionally centred on obligations of benevolence and a duty to help those less fortunate.1 However, the War on Terror has resulted in a significant shift in how foreign aid is perceived. International prosperity and stability are now recognized as key elements in a fight to ameliorate the conditions that give rise to terrorism. Public support for foreign aid in general, normally unpopular, has increased since (...) 11 September 2001 due to greater public understanding of its role in combating terrorism.2 In particular, the need to address attitudes of foreign civilians toward the United States has become more widely recognized as a key component of efforts to reduce the ferment of the terrorist mindset. These strategies have assumed particular importance in light of the non-traditional nature of the threat posed by contemporary terrorism: a threat posed not by states or armies, but by individuals and groups who blend into, garner both the implicit and explicit support of, and are recruited from general civilian populations. (shrink)

'For if once a man indulges himself in murder, very soon he comes to think little of robbing; and from robbing he comes next to drinking and Sabbath-breaking, and from that to incivility and procrastination' Thomas De Quincey's three essays 'On Murder Considered as One of the Fine Arts' centre on the notorious career of the murderer John Williams, who in 1811 brutally killed seven people in London's East End. De Quincey's response to Williams's attacks turns morality on (...) its head, celebrating and coolly dissecting the art of murder and its perfections. Ranging from gruesomely vivid reportage and brilliantly funny satiric high jinks to penetrating literary and aesthetic criticism, the essays had a remarkable impact on crime, terror, and detective fiction, as well as on the rise of nineteenth-century decadence. The volume also contains De Quincey's best-known piece of literary criticism, 'On the Knocking at the Gate in Macbeth', and his finest tale of terror, 'The Avenger', a disturbing exploration of violence, vigilantism, and religious persecution. ABOUT THE SERIES: For over 100 years Oxford World's Classics has made available the widest range of literature from around the globe. Each affordable volume reflects Oxford's commitment to scholarship, providing the most accurate text plus a wealth of other valuable features, including expert introductions by leading authorities, helpful notes to clarify the text, up-to-date bibliographies for further study, and much more. (shrink)

Since the 19th century, innocence has been a hallmark of childhood. The innocence of children is seen as both a sanctity worth defending and a feature that excuses the unavoidable mistakes of adolescence. While beneficial in many settings, notions of childhood innocence are often entangled with values judgements. Inherent in innocence is the notion that that which we are innocent of is undesirable. Further, attributing innocence to some implies the tolerability of blame for others. This has unique implications in a (...) medical setting. This essay explores the implications of espousing the innocence of paediatric patients. Ultimately, because attribution of innocence is both prone to bias and rooted in the same framework as blame, it degrades patient-centred care and compromises the patient–provider relationship. I argue that avoiding such characterisations may allow providers to more effectively promote paediatric health. (shrink)

Ideological indoctrination is explicit and pervasive in China, with the school curriculum used to mould the spirit and character of adolescents, fulfilling ideological and political purposes. But the exact content varies over time. Comparing two versions of textbooks published in 1997 and 2005, this paper depicts the continuities and change in the curricular discourses centred on the notion of ‘good citizen’. While keeping the official status of socialism and the Party leadership untouched, the new textbooks soften the presentation and packaging (...) of the ideological content, very much in tandem with the soft authoritarianism practised since the post‐Deng era when China has been deeply involved in the processes of marketisation, liberalisation and globalisation. The new textbooks also adopt a stance of greater reconciliation with human rights and global citizenship. While being granted more autonomy and rights, young citizens are still expected to shoulder the mission of national revival and socialist modernisation—very much derived from official policies. (shrink)

Thomas Kuhn's thesis concerning the structure of scientific change was critically examined in relation to the historical problems of social science. The use and interpretation of Kuhn's ideas by psychologists was reviewed and found to center around the proliferation of theoretical views as paradigms, the viewing of theoretical differences as paradigm clashes, and efforts to affirm particular conceptions of psychology's past or future. Such use was seen as curbing discussion of fundamental issues, and to reflect a continuing neglect of (...) the foundational problems peculiar to social science. The relevance of Kuhn's work was seen to rest on a more critical view of his idea of “mature” science, better understanding of the type of social psychology upon which his thesis rests, and greater appreciation of his hermeneutic approach to social-historical analysis. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:LIGHT AND METAPHOR IN PLOTINUS AND ST. THOMAS AQUINAS KEVIN CORRIGAN St. Thomas More College University of Saskatchewan Saskatoon, Saskatchewan I HAVE TWO CONCERNS in this paper. The first is a broad concern, related to the nature of metaphor, which stems from the destructionist or deconstructionist tendencies in some contemporary phenomenology or phenomenological existentialism. According to these views, the logocentric emphasis of the Western tradition must (...) be shown for what it really is : an attempt to erect a cover upon a fundamental absence. In Nietzsche's well known view, "truths are illusions of which one has forgotten that they are illusions; worn-out metaphors which have become powerless to affect the senses, coins which have their obverse effaced and now are no longer of account as coins but merely as metal." 1 For Jacques Derrida all metaphoricity is caught up in an endless circle, which precludes any privileged vantage-point from which one might determine order, hierarchy and center-point. In particular, the unique heliotropic metaphor which, in Derrida's polemic, determines the whole course of Western philosophy " from the Platonic eidos to the Hegelian idea" 2 rests only upon the infinite absence of circularity, for the movement of transference " which turns the sun into metaphor " also inevitably "turns philosophical metaphor towards the sun." 3 1 Nietzsche, "On Truth and Falsity in their Ultramoral Sense (1873)," Works 2 (New York: Russell and Russell, 1964), p. 180. 2 J. Derrida, "White Mythology", trans. F. C. T. Moore, New Literary History 6 (1974), 1: 5-74 ["La mythologie blanche" in Rhetorique et philosophie, Poetique 5 (Paris: Editions du Seliu, 1971)], p. 55. a Ibid., p. 51. 187 188 KEVIN CORRIGAN In this paper I shall examine the thought of Plotinus and Aquinas, broadly described as idealist and realist respectively, with a view to determining whether or not this transference from the physical to the metaphysical is only an illicit, covert erasure of the material sense and a forgetting that all metaphor is self-implicating, that there is no non-metaphorical standpoint from which to grasp the order and structure of the metaphorical. My second concern is much more specific. It is, first, to compare Plotinus and Aquinas on light and metaphor-two thinkers who might be considered to be poles apart on these questions: on the one hand, Plotinus, the father of Neoplatonic emanationism with its insistence upon the primacy of divine light and the father, surely too, of the tradition of light-metaphysics in the later, mediaeval period; on the other hand, St. Thomas, staunchly realist in the Aristotelian tradition. Second, I will seek to show that this first impression of the gulf between the two thinkers is not borne out by a close textual analysis, and that their respective theories, despite the admitted significant difference in viewpoint, are in some respects very close indeed. Let us look briefly at the light-metaphysics tradition first. For Robert Grosseteste light is the source of all activity and its diffusion is not a material change or a change in place, but rather an instantaneous and substantial multiplication of itself in three dimensions.4 Thus, for the author of the De Intelligentiis light is the fundamental principle of motion and life: " Est autem prima lucis operatio in sensibilibus quad motum et vitam operatur in viventibus." 5 Since light is the noblest of corporeal things, it therefore has an intermediate place between pure form and matter, and for Grosseteste and also Bonaventure it is consequently named the forma corporeitatis, the fundamental form of body as 4 De philosophischen W erke des Robert Grosseteste, ed. Ludwig Baur, in Clemens Baeumker, Beitriige zur Geschichte der Philosophic des Mittelalters, vol. IX (Munster, 1912), De Luce, p. 51. 5 Clemens Baeumker, Witelo: Ein Philosoph und Naturforscher des XIII Jahrhunderts, Band III, Heft 2 of Beitriige zur Geschichte der Philosophie des Mittelalters (Munster, 1908), Liber de intelligentiis IX, p. 11. PLOTINUS AND ST. THOMAS AQUINAS 189 such, since light introduces dimension into matter. Light then is the substantial form of the physical universe.6 But how is physical light related to spiritual light? For the light-metaphysics tradition, spiritual light (whether the Uncreated Light which is God himself or the... (shrink)

The articles brought together in this double-length section of the Annual Review of Theory, Culture & Society focus on two intertwined strands of the thought of Georg Simmel, both of them neglected until recent years. A first bears on what might be called Simmel’s metaphysics of the social, or what he himself once called ‘sociological metaphysics’. A second strand centres on the renewed contemporary relevance of Simmel’s ideas about money economies and their relation to precarious individual life-situations in an age (...) of global economic turbulence. Current sensibilities in the wake of global economic crisis and the demise of some of the more euphoric sociologies of globalization of the last two decades provide a timely setting for a reappraisal of Simmel’s thinking. With the completion in 2012 of the Suhrkamp edition of Simmel’s collected works, Simmel’s themes need to be explored more deeply, including particularly his thinking about lived experience, transcendence, death, fragmentary worlds of value, and allegorical representation. This issue of the journal showcases some of the latest scholarly work and foregrounds several pivotal primary pieces unavailable in English until now. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:166 BOOK REVIEWS Those who read this handsome book and study the paintings and sculptures of Zarlenga in excellent color will be able to follow the phases of his artistic development and find many subjects for medita· tion and enjoyment. Aquinas Institute of Theology St. Louis, Missouri BENEDICT M. ASHLEY, O.P. The Thought of Thomas Aquinas. By BRIAN DAVIES, O.P. Oxford: Oxford University Press, 1992 (cloth); Oxford: Clarendon (...) Press, 1993 (paper). Pp. xv + 391. An establishing circumstance of the ' restoration ' of Christian philosophy at the end of the last century, and the turn of this century, was that the medieval authors whom Christian philosophers turned to were, by profession, theologians whose appropriation of philosophy was for explicitly theological ends. By and large, however, the modern authors who set about retrieving medieval thought had an agenda quite different from that of their medieval luminaries. Still reeling from the philosophical fall-out of the Enlightenment, and encountering rationalism, idealism, and empiricism on all sides, committed Christian thinkers sought a source of philosophical reflection and, perhaps more importantly, justification, that could buttress the claims made by Christianity for those who were within the believing community, and defend the faith from the intellectual attacks of those who were not. The enduring philosophical inheritance of the Middle Ages, and particularly the philosophia perennis of St. Thomas Aquinas, was that source, wrote Leo XIII in his Aeterni patris, and Catholic philosophers soon collected. But the inheritance was not fully collected. With distinctive philosophical goals in mind, Christian philosophers focused upon the putative philosophy of medieval writers, particularly Aquinas, and largely left theological reflection alone. And, when theological contentions on the part of medieval authors did make their way into the discussion, they were almost inevitably appropriated as a legitimate incorporation of revealed teaching into what somehow remained the philosophical project. The result was 'Christian Philosophy.' Although this resulted in the flurry of Catholic philosophical study during the first half of this century, the picture that emerged of the medieval authors, and of Thomas in particular, was inevitably one-sided, and incomplete. An overly pessimistic assessment of the situation would be to say that, for all the hard work of the Gilsons and Maritains, Van Steenberghens and DeKonincks, we are no nearer to Thomas today than we were in the 1870s. BOOK REVIEWS 167 Brian Davies's endeavor seeks to change that, because it attempts to provide the modern reader with a comprehensive introduction to the great expanse of Thomas's thought according to the manner in which Thomas himself presented it in his mature theological masterpiece, the Summa theologiae. Fr. Davies has succeeded magnificently, and his book will become, as it should, a mainstay on the bookshelves of university libraries, students, and teachers alike. Professional philosophers whose work never leads them to Thomas's discussion on Christ, say, can readily get a good working knowledge of how Thomas approaches this center of Christian faith and practice. And the student who is altogether new to Aquinas can grasp something of the ' movement ' of Thomas's thought by reading, and re-reading, Davies judicious renderings of Thomas's doctrine on human acts. This is a book of many uses, all of them instructive and helpful. Considering this book to be an introduction, as Fr. Davies does (p. viii), does not do justice to the quantity of his achievement in writing it, or of the student's investment in reading it. The work occupies some 391 pages, reading made difficult by the tightly-knit character of Thomas's thought, though Davies' easy writing helps to allay the burden. The physical constitution of the book, in slightly off-white octavo paper and an 11-point base font, makes for comfortable reading. Davies has avoided excessive footnoting, giving references to Thomas's text judiciously, and he also provides a well-tailored and impressively diverse bibliography at the end.of the volume which can be effectively consulted by his reader. The author himself is a foundational theologian at Blackfriars in Oxford, so one might expect him instinctively to address the particular audience he encounters in his work. But, save on a very few occasions, Fr. Davies is mindful that in... (shrink)

BackgroundIn the 1970s, the Federal Trade Commission declared that allowing medical providers to advertise directly to consumers would be “providing the public with truthful information about the price, quality or other aspects of their service.” However, our understanding of the advertising content is highly limited.ObjectiveTo assess whether direct-to-consumer medical service advertisements provide relevant information on access, quality and cost of care, a content analysis was conducted.MethodTelevision and online advertisements for medical services directly targeting consumers were collected in two major urban (...) centres in Nevada, USA, identifying 313 television advertisements and 200 non-duplicate online advertisements.ResultsBoth television and online advertisements reliably conveyed information about the services provided and how to make an appointment. At the same time, less than half of the advertisements featured insurance information and hours of operation and less than a quarter of them contained information regarding the quality and price of care. The claims of quality were substantiated in even fewer advertisements. The scarcity of quality and cost information was more severe in television advertisements.ConclusionThere is little evidence that medical service advertising, in its current form, would contribute to lower prices or improved quality of care by providing valuable information to consumers. (shrink)

Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient’s values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge (...) the information needs of the individual patient. The aim of this paper is to describe ‘core information sets’ which are defined as a minimum set of consensus-derived information about a given procedure to be discussed with all patients. Importantly, they are intended to catalyse discussion of subjective importance to individuals. The model described in this paper applies health services research and Delphi consensus-building methods to an idea orginally proposed 30 years ago. The hypothesis is that, first, large amounts of potentially-important information are distilled down to discrete information domains. These are then, secondly, rated by key stakeholders in multiple iterations, so that core information of agreed importance can be defined. We argue that this scientific approach is key to identifying information important to all stakeholders, which may otherwise be communicated poorly or omitted from discussions entirely. Our methods apply systematic review, qualitative, survey and consensus-building techniques to define this ‘core information’. We propose that such information addresses the ‘reasonable patient’ standard for information disclosure but, more importantly, can serve as a spring board for high-value discussion of importance to the individual patient. The application of established research methods can define information of core importance to informed consent. Further work will establish how best to incorporate this model in routine practice. (shrink)

The goal is to present how shared decision-making in paediatric oncology occurs from the viewpoints of parents and physicians. Eight Swiss Pediatric Oncology Group centres participated in this prospective study. The sample comprised a parent and physician of the minor patient. Surveys were statistically analysed by comparing physicians’ and parents’ perspectives and by evaluating factors associated with children’s actual involvement. Perspectives of ninety-one parents and twenty physicians were obtained for 151 children. Results indicate that for six aspects of information provision (...) examined, parents’ and physicians’ perceptions differed. Moreover, parents felt that the children were more competent to understand diagnosis and prognosis, assessed the disease of the children as worse, and reported higher satisfaction with decision-making on the part of the children. A patient’s age and gender predicted involvement. Older children and girls were more likely to be involved. In the decision-making process, parents held a less active role than they actually wanted. Physicians should take measures to ensure that provided information is understood correctly. Furthermore, they should work towards creating awareness for systematic differences between parents and physicians with respect to the perception of the child, the disease, and shared decision-making. (shrink)

Thomas Kuhn was not only the greatest historian of science but also one of the most influential philosophers of the twentieth century. Faced with such a significant character, Giuseppe Giordano has decided to focus on Kuhn “the philosopher,” touching on the historian only indirectly. The book is roughly divided into two parts. The first one is devoted to a reconstruction of the genesis of Kuhn's most important ideas, focusing in particular on the essay “The Essential Tension” and on The (...) Structure of Scientific Revolutions. In the second part Giordano considers the reception of Kuhn's work within the philosophy of science community. Since the philosophical debate is almost entirely a post‐Structure phenomenon, the narrative proceeds more or less in chronological order, covering Kuhn's career from the beginning to the end. The story unfolds almost entirely in the realm of ideas, ignoring institutional matters such as Kuhn's role in the creation of a community of professional historians of science or his time as president of the Philosophy of Science Association.The better part of the book is the first. Here Giordano tells us how Kuhn turned from physics to the history of science and, most important, how the concept of “paradigm” evolved from a pedagogic device to a pathbreaking philosophical idea. He also sketches the intellectual background to Kuhn's work, especially the received views on science and on the role of history embodied in the logical positivism of the 1950s. Unfortunately, the author does not make use of recent work on Kuhn, Carnap, and the neopositivists by Peter Galison, Michael Friedman, and others. As a result, the contraposition between the “old” and the “new” philosophy of science is a fairly conventional and dated one. Developments in the historiography of science in the last two decades are also ignored: one would have liked to read something on Kuhn's influence on the new sociology of science, the birth of the micro history of science as a reaction to Kuhn's macro approach, and so forth.But of course no author can discuss everything, and Giordano has explicitly decided to focus on the relationship between Kuhn and the philosophers of his time. Chapter 3 deals with the controversy between Kuhn and Karl Popper. Giordano argues that whereas Popper never really questioned his own theses, Kuhn benefited from the debate, which prompted some significant changes in his position. In this chapter and the following one , Kuhn's thought is presented in its dynamic evolution, as he adjusted and reacted to criticism. In both chapters Kuhn is set at center stage, with the other characters playing supporting roles.The last chapter discusses Kuhn's “mature” views on theory change and scientific progress. It is a pity that nowhere in the book are we provided with a rigorous formulation of crucial concepts such as “progress” and “scientific rationality.” This is the main defect of the book, the philosophical depth and rigor of which is sometimes less than satisfactory. Other examples are a confusion between scientific realism and the correspondence theory of truth , a sloppy formulation of the problem of induction , and the lack of a serious discussion of the Duhem‐Quine problem . Because of these problems, Giordano's book is valuable chiefly as a concise summary and discussion of the overall significance of Kuhn's philosophical work. The commentary is frequently interrupted by long quotations from Kuhn's texts, and the footnotes also quote widely from the secondary literature . This makes Giordano's book a peculiar piece of work, rather like a conflation of a textbook and a Kuhnian anthology.It must be recognized that to write yet another book on Kuhn is a challenging task. Kuhn's work has been dissected, criticized, and interpreted a number of times, and a truly novel analysis would require a truly novel approach. Other scholars have stretched the interpretation of known texts and facts until they have become “new” texts and facts. Giordano does not aim to be controversial and admirably abstains from such flamboyant exercises. However, he does not pursue the other route either: that of digging deeper into the past in order to discover something genuinely novel. A new book on Kuhn should be based, at the very least, on serious archival research in Kuhn's papers at MIT, and Giordano has not done that. Furthermore, he relies on a relatively small fraction of Kuhn's published writings, invariably the most widely known and celebrated ones. It is not surprising, then, that he ends up with a very familiar picture of Thomas Kuhn and his place in twentieth‐century philosophy of science. (shrink)