Patients and family members (N = 671) were surveyed in five Mid-Atlantic U.S. hospitals to ascertain the number and kinds of ethical concerns they are presently experiencing or have previously experienced while being sick or receiving medical care. Seventy percent of participants had at least one (range 0–14) type of ethical concern or question. The most commonly experienced concerns pertained to being unsure how to plan ahead or complete an advance directive (29.4%), being unsure whether someone in the family was (...) able to make their own decisions (29.2%), deciding about limiting life-sustaining treatments (28.6%), wondering about disclosing personal medical information to others in the family (26.4%) and not being sure whether to undergo treatment because of cost (26.2%). Most were interested to some degree in getting help from ethics consultants in the future (76.6%). Given this prevalence, common concerns might usefully be addressed systematically, rather than exclusively on a case-by-case basis. (shrink)

Qualitative validation consists in showing that a model is able to mimic available observed data. In population level biological models, the available data frequently represent a group status, such as pool testing, rather than the individual statuses. They are aggregated. Our objective was to explore an approach for qualitative validation of a model with aggregated data and to apply it to validate a stochastic model simulating the bovine viral-diarrhoea virus (BVDV) spread within a dairy cattle herd. Repeated measures of the (...) level of BVDV-specific antibodies in the bulk-tank milk (total milk production of a herd) were used to summarise the BVDV herd status. First, a domain of validation was defined to ensure a comparison restricted to dynamics of pathogen spread well identified among observed aggregated data (new herd infection with a wide BVDV spread). For simulations, scenarios were defined and simulation outputs at the individual animal level were aggregated at the herd level using an aggregation function. Comparison was done only for observed data and simulated aggregated outputs that were in the domain of validation. The validity of our BVDV model was not rejected. Drawbacks and ways of improvement of the approach are discussed. (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

Dr. Henry Beecher, a renowned Harvard Medical School anesthesiologist, sent shock waves through the medical research community and the lay press when he described 22 examples of “unethical or questionably ethical studies” by reputable researchers at major institutions in his now well-known 1966 New England Journal of Medicine article. Beecher concluded this exposé by noting: “The ethical approach to experimentation in man has several components: two are more important than the others, the first being informed consent.... Secondly, there is (...) the more reliable safeguard provided by the presence of an intelligent, informed, conscientious, compassionate, responsible investigator”. Beecher’s... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Belief and Context Determinacy in Interpreting FictionChristine Richards (bio)1Context Determinacy and the Interpretation of FictionThe Pragmatics of ReadingThe basic pragmatic structure of the reading of fiction has been described as a communicative context which has a speaker who performs the speech acts represented by the text and a hearer (addressee) to whom the speech acts are directed [Adams 12]. This model is based on the assumption that the reader (...) and the writer share not only a common language but a common context, which clearly presents problems for readers of fiction, where generic conventions as well as other cultural conventions of writing, such as satire and irony, or the separation of writers and readers by time, have to be contended with. The code model, which assumes that the writer and the reader share a common context, can be represented as shown in figure 1. Click for larger view View full resolutionFigure 1.W = writer, S = speaker, H = hearer, R = reader.However, it has also been argued [Eco, Role of the Reader 40; Eco, Semiotics 69; Richards 262] that no theory of a text is possible without a theory of contexts, since texts are processed and given meaning by a synthesis of propositions in them with those which originate in readers’ supplied contexts; and since the contexts of readers consist, first and foremost, of their background knowledge, beliefs, and culture, which are fundamentally interrelated, interpretation is inevitably determined by extralinguistic as well as linguistic factors. The context model might be represented as shown in figure 2. Click for larger view View full resolutionFigure 2.W = writer, N = narrator, R = reader.[End Page 81]The Extralinguistic ContextA good example of the role played by extralinguistic contexts in the interpretation of a text is to be found in the multiple interpretations of the sentence “The red sun was pasted in the sky like a wafer,” from Stephen Crane’s The Red Badge of Courage [64]. Susan Horton, in her discussion of accounts of this sentence [10–14], shows both how R. W. Stallman interprets Crane’s antiwar fiction as a Christian allegory where the word “wafer” functions as a symbol of the Eucharist [130], and how Marston La France rejects Stallman’s interpretation on the basis that Crane is not a Christian, and certainly not a Catholic [99–100]. La France’s rejection of Stallman’s Christian context for atheism is rooted in his interpretation of the sun as a repeated image in the co-text, which he believes signifies nature’s indifference to death, war and heroism. Here the lexemes “pasted” and “wafer” become images of a seal at the end of a legal document, implying the finality of death in war. Milne Holton interprets the image of the sun as a characteristic of the symbolic imagination of the character Henry Fleming rather than of the writer (Crane) [90–91].Horton documents but does not theorize the determining features of these contexts, but this problem can be tackled by applying Marcello Pagnini’s theory of “the introjection of the referent” [9] to explain how the contextual semes of readers, determined by different cultural systems, are introjected into texts. Following Jurij M. Lotman’s typology of cultural systems [Lotman and Uspenskij], Pagnini cites as relevant systems ethics, ideology, history, philosophy, myth, the law, anthropology, politics, ethnicity, literature, aesthetics, psychology, rhetoric and symbolism [34], which represent fundamentally interrelated complexes of systems that make up societies. If Pagnini’s model is taken with that of Richards [267], which conceives of interpretation as a synthesis of propositional inferences in texts with those drawn from readers’ contexts, these two models provide a methodological basis for explaining how the contexts of Stallman’s and La France’s conflicting interpretations derive from philosophically opposed belief systems within culture—Christianity and atheism. These models also help to explain Holton’s interpretation as one located within a different philosophical context, that of the convention of character analysis in fiction, which during the last few decades has developed into the more theoretically sophisticated field of narratology. It should be stressed, however, that interpretations themselves always take place within historical and interactive frameworks, which are influenced... (shrink)

Alexis de Tocqueville asserted that America had no truly great literature, and that American writers merely mimicked the British and European traditions of the eighteenth and nineteenth centuries. This new edited collection masterfully refutes Tocqueville's monocultural myopia and reveals the distinctive role American poetry and prose have played in reflecting and passing judgment upon the core values of American democracy. The essays, profiling the work of Mark Twain, F. Scott Fitzgerald, John Updike, Edith Wharton, Walt Whitman, Henry James, Willa (...) Cather, Walker Percy, and Tom Wolfe, reveal how America's greatest writers have acted as society's most ardent cheerleaders and its most penetrating critics. Christine Dunn Henderson's exciting new work offers literature as a portal through which to view the philosophical principles that animate America's political order and the mores which either reinforce or undermine them. (shrink)

Some have characterized the twentieth century as a Nietzschean century, while others, such as Bernard-Henri Lévy, call this Le siècle de Sartre. Those who are interested in the works of Sartre and Nietzsche wish to know what these two authors, who have left a deep impression on the twentieth century, share in common. Others, myself included, dare to ask: "Was Sartre a Nietzschean?" Studies on this connection are few and, besides Jean-François Louette's book, Sartre contra Nietzsche, no major study exists. (...) What is the particular nature of the relations between their thoughts? Is there an influence of Nietzsche upon Sartre? Is there a philosophical kinship? I will begin by clarifying the question of Sartre's interest in Nietzsche. Then, I will demonstrate that they had the same philosophical starting point: nihilism. Finally, I will show that both give a similar answer to the problem opened by nihilism, the question of meaning. (shrink)

The Routledge Handbook of Critical Pedagogies for Social Work traverses new territory by providing a cutting-edge overview of the work of classic and contemporary theorists, in a way that expands their application and utility in social work education and practice; thus, providing a bridge between critical theory, philosophy, and social work. Each chapter showcases the work of a specific critical educational, philosophical and/or social theorist including: Henry Giroux, Michel Foucault, Cornelius Castoriadis, Herbert Marcuse, Paulo Freire, bell hooks, Joan Tronto, (...) Iris Marion Young, Karl Marx, Antonio Gramsci and many others to elucidate the ways in which their key pedagogic concepts can be applied to specific aspects of social work education and practice. The text exhibits a range of research-based approaches to educating social work practitioners as agents of social change. It provides a robust and much needed, alternative paradigm to the technique-driven ‘conservative revolution’ currently being fostered by neoliberalism in both social work education and practice. The volume will be instructive for social work educators who aim to teach for social change, by assisting students to develop counter-hegemonic practices of resistance and agency, and reflecting on the pedagogic role of social work practice more widely. The volume holds relevance for both postgraduate and undergraduate/qualifying social work and human services courses around the world. (shrink)

This landmark book is now reissued in a new edition that has been vastly rewritten and updated to respond to recent Kantian literature.

Henry Allison is one of the foremost interpreters of the philosophy of Kant. This new volume collects all his recent essays on Kant's theoretical and practical philosophy. All the essays postdate Allison's two major books on Kant, and together they constitute an attempt to respond to critics and to clarify, develop and apply some of the central theses of those books. Two are published here for the first time. Special features of the collection are: a detailed defence of the (...) author's interpretation of transcendental idealism; a consideration of the Transcendental Deduction and some other recent interpretations thereof; further elaborations of the tensions between various aspects of Kant's conception of freedom and of the complex role of this conception within Kant's moral philosophy. (shrink)

Although a good deal has been written about Kant's conception of free will in recent years, there has been no serious attempt to examine in detail the development of his views on the topic. This book endeavours to remedy the situation by tracing Kant's thoughts on free will from his earliest discussions of it in the 1750s through to his last accounts in the 1790s. This developmental approach is of interest for at least two reasons. First, it shows that the (...) path that led Kant to view freedom as a transcendental power that is both radically distinct from and compatible with the causality of nature was a winding one. Second, it indicates that, despite the variety of views of free will that Kant held at various times, the concept occupied a central place in his thought, because it was the point of union between his theoretical and practical philosophy. (shrink)

Research has shown that a majority of employed women experience sexual harassment and suffer negative repercussions because of it; yet only a minority of these women label their experiences “sexual harassment.” To investigate how people identify sexual harassment, in-depth interviews were conducted with 18 waitpeople in restaurants in Austin, Texas. Most respondents worked in highly sexualized work environments. Respondents labeled sexual advances as sexual harassment only in four specific contexts: when perpetrated by someone who exploited their powerful position for personal (...) sexual gain; when the perpetrator was of a different race/ethnicity than the victim—typically a minority man harassing a white woman; when the perpetrator was of a different sexual orientation than the victim—typically a gay man harassing a straight man; or when violence or the threat of violence was used. The authors argue that the hegemonic norms of acceptable sexual activity privilege heterosexual relationships, legitimize institutionalized forms of sexual exploitation in the workplace, and may protect assailants of the same race and sexual orientation as their victims from charges of sexual harassment. (shrink)

Plato is a much more experimental philosopher, this book argues, than most commentators acknowledge. Supporting this position, Henry Teloh combines exegesis of particular passages with a synoptic view of Plato's philosophical development through his early, middle, and late dialogues. The result is a study of Plato's ideas with a more ambitious scope than any since W. D. Ross's in 1951,The book chronicles Plato's changing interests through a focus on his ontological commitments—that is, on the types of entities he addresses. (...) It also traces many of the assumptions in Plato's thought back to their sources in pre-Socratic philosophy. By depicting the changes in Plato's thought from one period of dialogue composition to another, and by seeking to explain these changes from textual evidence, this book offers an appealing introduction to Plato for all humanists. (shrink)

Disabled people face obstacles to participation in epistemic communities that would be beneficial for making sense of our experiences and are susceptible to epistemic oppression. Knowledge and skills grounded in disabled people's experiences are treated as unintelligible within an ableist hermeneutic, specifically, the dominant conception of disability as lack. My discussion will focus on a few types of epistemic oppression—willful hermeneutical ignorance, epistemic exploitation, and epistemic imperialism—as they manifest in some bioethicists’ claims about and interactions with disabled people. One of (...) the problems with the epistemic phenomena with which I am concerned is that they direct our skepticism regarding claims and justifications in the wrong direction. When we ought to be asking dominantly situated epistemic agents to justify their knowledge claims, our attention is instead directed toward skepticism regarding the accounts of marginally situated agents who are actually in a better position to know. I conclude by discussing disabled knowers’ responses to epistemic oppression, including articulating the epistemic harm they have undergone as well as ways of creating resistant ways of knowing. (shrink)

Journal of Social Philosophy, EarlyView.

This is the first comprehensive study of the sublime in Lucan. Drawing upon renewed literary-critical interest in the tradition of philosophical aesthetics, Henry Day argues that the category of the sublime offers a means of moving beyond readings of Lucan's Bellum Civile in terms of the poem's political commitment or, alternatively, nihilism. Demonstrating in dialogue with theorists from Burke and Kant to Freud, Lyotard and Ankersmit the continuing vitality of Longinus' foundational treatise On the Sublime, Day charts Lucan's complex (...) and instructive exploration of the relationship between sublimity and ethical discourses of freedom and oppression. Through the Bellum Civile's cataclysmic vision of civil war and metapoetic accounts of its own genesis, through its heated linguistic texture and proclaimed effects upon future readers and, most powerfully of all, through its representation of its twin protagonists Caesar and Pompey, Lucan's great epic emerges as a central text in the history of the sublime. (shrink)

This book, which takes account of everything that survives from the manuscripts Hegel produced during his first academic career at the University of Jena, is the first comprehensive survey of the development of Hegel's mature system.

God, Revelation and Authority by Carl Henry is one of the most important evangelical theological works of the twentieth century. Published between 1976 and 1983, it shaped the evangelical movement in countless ways and is still widely read, studied, and appreciated as a clear statement of evangelical beliefs contra liberalism and neo-orthodoxy. What you need to know is that God, Revelation and Authority is a key resource for understanding, teaching and defending many doctrines central to evangelicalism, including biblical inerrancy. (...) It's no accident that the list of endorsers for these books reads like a Who's Who of evangelical Christianity. If you want to have a better grasp of evangelical theology and its formation, there's no better place to begin than God, Revelation and Authority. Carl F. H. Henry was a central religious figure of the 20th century. In a 2004 article, Christianity Today stated that Carl Henry, along with Billy Graham and Boston pastor Harold John Ockenga, "practically invented what later became known as evangelicalism." He also helped found and served as the first editor for Christianity Today. God, Revelation and Authority is Henry's magnum opus. It contains the developed ideas of this prominent thinker on topics that include infallibility and inerrancy, divine revelation in nature, historical criticism, the Holy Spirit, the Church, and biblical history. It also includes the "Chicago Statement on Biblical Inerrancy" which for many years within evangelical circles has been an authoritative declaration regarding inerrancy. Later in life, Carl Henry spent a great deal of time considering the related concepts of religious knowledge and the doctrine of God. He concluded that, "if we humans say anything authentic about God, we can do so only on the basis of divine self-revelation; all other God-talk is conjectural." This basic premise underlies the entirety of God, Revelation and Authority. As you read God, Revelation and Authority you will see how many of the ideas in these six volumes have been enormously influential in shaping the beliefs and "distinctives" shared by evangelicals all over the world. - Publisher. (shrink)

John Stuart Mill was the leading British philosopher of the nineteenth century and his famous essay Utilitarianism is the most influential statement of the philosophy of utilitarianism: that actions, laws, policies and institutions are to be evaluated by their utility or contribution to good or bad consequences. Henry West has written the most up-to-date and user-friendly introduction to utilitarianism available. The book serves as both a commentary to and interpretation of the text. It also defends Mill against his critics. (...) An appendix reviews in detail the structure and arguments of Utilitarianism. This book is primarily intended as a textbook for students in philosophy assigned to read Utilitarianism but it should also prove helpful to students and professionals in other fields such as political science, history and economics. (shrink)

This study seeks to understand women's use of makeup in the workplace. The authors analyze 20 in-depth interviews with a diverse group of women who work in a variety of settings to examine the appearance rules that women confront at work and how these rules reproduce assumptions about sexuality and gender. The authors found that appropriate makeup use is strongly associated with assumptions about health, heterosexuality, and credibility in the workplace. They describe how these norms shape women's personal choices to (...) wear makeup. Next, they examine how some women transform the meanings of wearing makeup and, in rare instances, attempt to subvert the institutionalized norms. Although many women find pleasure in wearing makeup, the authors conclude that the institutional constraints imposed by the workplace effectively limit the possibilities for resistance. (shrink)

This paper focuses on epistemic practices within biomedical ethics that are related to disability. These practices are one of the reasons that there is tension between biomedical ethicists and disability advocates. I argue that appeals to conceptual neutrality regarding disability, which Anita Silvers recommends, are counterproductive. Objectivity as neutrality serves to obscure the social values and interests that inform epistemic practices. Drawing on feminist standpoint theory and epistemologies of ignorance, I examine ways that appeals to objectivity as neutrality serve to (...) maintain the status quo and ignorance regarding disability. I adapt Charles Mills’s notion of “white ignorance” in order to consider the systematic social ignorance regarding disability that is treated as knowledge. Bioethicists commonly dismiss the reports of disabled people regarding their quality of life as biased, while claiming that their own judgments are objective. Sandra Harding’s notion of strong objectivity is useful for thinking about ways that examination of values and interests informing epistemic practices related to disability in biomedical ethics could create better knowledge practices by taking the standpoint of disabled people seriously. (shrink)

Who am I, and what am I? These questions are asked through the ages, and answered in various ways in disciplines ranging from philosphy through literature and politics to biology. It is a matter of personal and practical as well as intellectual interest, and perhaps for this reason academic debate on this subject attracts attention and stimulates controversy outside the ranks of the specialists. In Identity six internationally famous contributors, Bernard Williams, Derek Parfit, Henry Harris, Michael Ruse, Terence Cave, (...) and Anthony D. Smith, discuss identity from the viewpoints of their various disciplines. The book offers a comparison and cross-fertilization of insights and theories from outside and within philosophy, shedding light on this concept crucial to the humanities and the social and physical sciences. (shrink)

Henry Home (1696-1782) has been called "perhaps the most complete 'Enlightenment man' among the eighteenth-century Scottish thinkers." Kinsman and friend of David Hume, mentor and patron of Adam Smith, John Millar, and Thomas Reid, he was a key figure in that circle of luminaries. He read law, was called to the bar in 1723, was raised to the Bench of the Court of Session in 1752, with the title Lord Kames (the name of his family estate), and joined the (...) High Court of the Justiciary in 1763. Publishing broadly in law, history, philosophy, and criticism, Kames made significant contributions to the Enlightenment's science of human nature. The Essays is commonly considered Kames's most important philosophical work. In the first part, he sets forth the principles and foundations of morality and justice, attacking Hume's moral skepticism and addressing the controversial issue of the freedom of human will. In the second part, Kames focuses on questions of metaphysics and epistemology to offer a natural theology in which the authority of the external senses is an important basis for belief in the Deity. The text of this volume is based on the third edition of 1779, while the appendix presents substantial variant readings in the first and second editions. (shrink)

The philosophy of quantum mechanics has often been conceived by physicists as a collection of dogmas concerning what can be measured, observed and known. To this branch of dialectics the present paper does not attempt to contribute, chiefly because it is written from the conviction that no part of science, nor any philosophy, can safely predict what may be feasible or knowable. Rather, this brief essay endeavors to expose the epistemology of quantum physics in a way which allows it to (...) be recognized as an extension of the ordinary processes of cognition, as the continuation of a line which starts in sensory perception, leads straight through the methods of classical physics into quantum mechanics and shows no signs of terminating even there. (shrink)

Naguère suspecte, voire rejetée, l'histoire du temps présent a pris aujourd'hui une place sans commune mesure dans l'espace public comme à l'Université - avec l'explosion du nombre d'étudiants en cette matière. A cela, plusieurs raisons : la mémoire et le patrimoine ont envahi l'espace public et scientifique ; le témoignage a pris l'allure d'un impératif social et moral ; la justice temporelle s'est muée en tribunal de l'histoire pour juger de crimes politiques vieux de plusieurs décennies mais dont l'après-coup continue (...) de cheminer dans notre présent. Une évidence, dira-t-on. Mais mesure-t-on pour autant le revirement qui se joue ici? Car le passé n'est plus cet ensemble de traditions à respecter, d'héritages à transmettre, de connaissances à élaborer ni de morts à commémorer ; c'est un constant «travail» de deuil ou de mémoire à entreprendre, tant s'est enracinée l'idée que si le passé doit être arraché des limbes de l'oubli, seuls des dispositifs publics ou privés peuvent l'en exhumer, avec ou sans l'aide de l'historien. Tel est le «présentisme» : devenu un problème à résoudre, et désormais un champ de l'action publique, le passé - et singulièrement le passé proche, celui des dernières catastrophes en date - n'est pas oublié, il est constamment mobilisé et reformulé selon les urgences du jour. L'exigence de vérité propre à la démarche historique s'est muée en exigence sociale de reconnaissance, en politiques de réparation, en discours d'excuses à l'égard des victimes. La question de la contemporanéité n'est pas nouvelle : elle s'est posée à travers les âges, mais Henry Rousso prend la mesure de sa profonde transformation au cours des deux grands après-guerres du XXe siècle et définit ses enjeux fondamentaux : comment écrire une histoire en train de se faire? Comment mettre à distance la proximité apparente? Comment se battre sur deux fronts à la fois - celui de l'histoire et celui de la mémoire, celui d'un présent que l'on ne veut pas voir passer et celui d'un passé qui revient hanter le présent? La nouvelle histoire du contemporain, toute entière inscrite dans cette tension, est plus que jamais marquée par l'incertitude, l'instabilité et l'inachèvement. (shrink)

A biography of Augustine's thought life, as interpreted by the acclaimed church historian, the late Professor Henry Chadwick. Augustine's intellectual development is recounted with clarity and warmth, providing a characteristically rigorous yet sympathetic narrative of this central figure in the history of Christian thought.

This article uses elements of autoethnography to theorize an in/formal support relationship between a friend with a physical disability, who uses attendant services, and me. Through thinking about our particular “frien-tendant” relationship, I find the common scholarly orientations toward “care” are inadequate. Starting from the conversations between feminist and disability perspectives on care, I build on previous work to further develop the theoretical framework of accessible care. Accessible care takes a critical, engaged approach that moves beyond understanding “accessibility” as merely (...) concrete solutions to create more inclusive forms of care. Care, in this context, is positioned as an unstable tension among competing definitions, including that it is a complex form of oppression. Accessible care draws on feminist disability perspectives and the feminist political ethic of care to build bridges in four areas: from daily experiences of disability and support to theoretical discussions; across feminist care research and disability perspectives; across divisions and anxieties within disability communities; and from the local to transnational applications. These bridges do not aim to resolve debates but allow us to travel back and forth between differing perspectives and demonstrate the tenuous possibility of accessible practices and concepts of care. (shrink)

Kant’s views on enlightenment are best known through his essay, “What is Enlightenment?” This is, however, merely the first of a series of reflections on the subject contained in the Kantian corpus. In what follows, I shall attempt to provide an overview of the Kantian conception of enlightenment. My major concern is to show that Kant had a complex and nuanced conception of enlightenment, one which is closely connected to some of his deepest philosophical commitments, and is as distinct from (...) the views of his contemporaries, including Mendelssohn’s, as his critical philosophy is from the rationalism of Leibniz, Wolff, and Baumgarten. (shrink)

Drawing on a wide range of Kant's recorded thought beyond his Groundwork for the Metaphysics of Morals, this essay presents an overview of Kant's account of practical agency as embodied practical agency and argues against the intellectualized interpretations of Kant's account of practical agency presented by Christine Korsgaard and Henry Sidgwick. In both Kant's empirical-psychological and metaphysical descriptions of practical agency, he presents a recognizably human practical agent that is broader and deeper than the faculty of reason alone. (...) This agent chooses action from a reflective distance, but not from the complete affective distance of reason. We choose neither as reason alone, nor even as the sum of all of our ‘higher’ faculties, of cognition (including reason), feeling, and desire, in Kant's view. Instead, we choose as an agent that also has ‘lower’, ‘sensible’ faculties, of cognition (including sense), feeling, and desire, which together comprise our ‘sensibility’. These mental states of sensibility are not merely confused versions of our higher cognitions, feelings, or desires, and so different from them in degree only, but are instead distinct from our higher states in kind also; and these distinct sensible states are not dependent on our higher states and so on a commitment to the value of humanity, for example. For this reason, a choice in favour of sensible states and in opposition to the moral law need in no way undermine its own foundations and thus be incoherent, as Korsgaard and Sidgwick argue, but instead only immoral. Because Kant does not reduce the problem of immoral choice to one of insufficient reflection and ensuing confusion, he does not view moral progress in cognitive terms alone, whether in the form of a clearer understanding of the moral law, improved judgment in applying it, or deeper insight into our own nature as practical agents. Kant instead recognizes the crucial importance of cultivating our feelings and desires over the course of a lifetime both as a way to make ourselves worthy of the humanity within us directly and also as a way to facilitate future moral choices. (shrink)

The negative consequences of physicians' failure to establish and maintain personal relationships with patients are at the heart of the humanistic crisis in medicine. To resolve this crisis, a new model of doctor-patient interaction is proposed, based on the ideas of Martin Buber's philosophy of dialogue. This model shows how the physican may successfully combine the personal (I-Thou) and impersonal (I-It) aspects of medicine in three stages. These Three Stages of Medical Dialogue include:1. An Initial Personal Meeting stage, which initiates (...) the doctor-patient relationship and involves mutual confirmation; 2. An Examination stage, which requires a shift from a personal to an impersonal style of interaction; 3. An Integration Through Dialogue or Healing Through Meeting Stage, which involves the integration of the impersonal medical data into the ongoing dialogue between doctor and patient, as a basis for shared decision-making. The use of the model, as well as common failures of doctor-patient dialogue are discussed. (shrink)