Adults who are incapacitated and alone, having no surrogates, may be known as “unbefriended.” Decision-making for these particularly vulnerable patients is a common and vexing concern for healthcare providers and hospital ethics committees. When all other avenues for resolving the need for surrogate decision-making fail, patients who are incapacitated and alone may be referred for “public guardianship” or guardianship of last resort. While an appropriate mechanism in theory, these programs are often under-staffed and under-funded, laying the consequences of inadequacies on (...) the healthcare system and the patient him or herself. We describe a qualitative study of professionals spanning clinical, court, and agency settings about the mechanisms for resolving surrogate consent for these patients and problems therein within the state of Massachusetts. Interviews found that all participants encountered adults who are incapacitated and without surrogates. Four approaches for addressing surrogate needs were: work to restore capacity; find previously unknown surrogates; work with agencies to obtain surrogates; and access the guardianship system. The use of guardianship was associated with procedural challenges and ethical concerns including delays in care, short term gains for long term costs, inabilities to meet a patient’s values and preferences, conflicts of interest, and ethical discomfort among interviewees. Findings are discussed in the context of resources to restore capacity, identify previously unknown surrogates, and establish improved surrogate mechanisms for this vulnerable population. (shrink)

In evolutionary psychology predictions, women’s mate preferences shift between fertile and nonfertile times of the month to reflect ancestral fitness benefits. Our meta-analytic test involving 58 independent reports (13 unpublished, 45 published) was largely nonsupportive. Specifically, fertile women did not especially desire sex in short-term relationships with men purported to be of high genetic quality (i.e., high testosterone, masculinity, dominance, symmetry). The few significant preference shifts appeared to be research artifacts. The effects declined over time in published work, were limited (...) to studies that used broader, less precise definitions of the fertile phase, and were found only in published research. (shrink)

This is a review essay in English of Dietrich von Engelhardt’s new 2,000-page, four-volume project: 'Medizin in Romantik und Idealismus: Gesundheit und Krankheit in Leib und Seele, Natur und Kultur' (Medicine in Romanticism and Idealism: Health and Illness in Body and Soul, Nature and Culture). (Stuttgart-Bad Cannstatt: frommann-holzboog, 2023), 4 Vols., LII + 1964 pp.

Business and society academics face an ongoing dilemma between the rigorous demands of good scholarship and the personal and pragmatic demands of constituencies and themselves. This dilemma is, above all, an ethical one, but it is partially solvable by paying closer attention to theory and methodology while acknowledging individual biases and desires and helping others in the field to do the same.

Memory perspectives on past events allegedly take one of two shapes. In field memories, we recall episodes from a first-person point of view, while in observer memories, we look at a past scene from a third-person perspective. But this mere visuospatial dichotomy faces several practical and conceptual challenges. First, this binary distinction is not exhaustive. Second, this characterization insufficiently accounts for the phenomenology of observer memories. Third, the focus on the visual aspect of memory perspective neglects emotional, agential, and self-related (...) social aspects. Fourth, the focus on the time of recall neglects the fact that visual, emotional, agential, and social aspects of perspective can also be dissociated in the original experience. In this chapter, we move away from the standard visual dichotomy. Instead, we propose that memory perspective is better understood along four lines: visual, agential, emotional, and social. Drawing on empirical research, we argue that these dimensions predict a disposition to recall a past event based on the present situation of the memorizer. This account supports seeing episodic memory as a natural kind, supported by scenario construction mechanisms and minimal memory traces. By remapping the classic distinction between field and observer perspectives along four dimensions, our proposal provides explanatory advantages and secures practical gains by enabling testable hypotheses. (shrink)

Some philosophers argue that Hume, given his theory of causation, is committed to an implausibly thin account of what it is like to act voluntarily. Others suggest, on the basis of his argument against free will, that Hume takes no more than an illusory feature of action to distinguish the experience of performing an act from the experience of merely observing an act. In this paper, I argue that Hume is committed to neither an unduly parsimonious nor a sceptical account (...) of the phenomenology of agency. (shrink)

One fundamental assumption seems to underlie – explicitly or implicitly – every critique of Brenner I have seen: that there can be no such thing as a Marxist theory of competition, the ‘horizontal’ relation among many capitals, that does not presuppose the ‘vertical’ class relation between capital and living labour. To start with the relation between capital and living labour is the only way to establish one's Marxist credentials. In support of that assumption, more than one critic has invoked Marx's (...) comment that competition does not produce or explain capitalist laws of motion but merely executes them, as their visible manifestation in the external movements of individual capitals. Predictably, too, some critics have gleefully turned against Brenner the charge he has famously levelled against other Marxists: that his focus on competition and the market makes him a ‘neo-Smithian’. (shrink)

Objective The UK Human Papillomavirus (HPV) vaccine programme commenced in the autumn of 2008 for year 8 (age 12–13 years) schoolgirls. We examine whether the vaccine should be given when there is a difference of opinion between daughters and parents or guardians. Design Qualitative study using semi-structured interviews. Participants A sample of 25 stakeholders: 14 professionals involved in the development of the HPV vaccination programme and 11 professionals involved in its implementation. Results Overriding the parents' wishes was perceived as problematic (...) and could damage the relationship between school and parents. A number of practical problems were raised in relation to establishing whether parents were genuinely against their daughter receiving the vaccine. Although many respondents recognised that the Gillick guidelines were relevant in establishing whether a girl could provide consent herself, they still felt that there were significant problems in establishing whether girls could be assessed as Gillick competent. In some areas school nurses had been advised not to give the vaccine in the absence of parental consent. None of the respondents suggested that a girl should be vaccinated against her consent even if her parents wanted her to have the vaccine. Conclusions While the Gillick guidelines provide a legal framework to help professionals make judgements about adolescents consenting to medical treatment, in practice there appears to be variable and confused interpretation of this guidance. Improved legal structures, management procedures and professional advice are needed to support those who are assessing competence and establishing consent to vaccinate adolescents in a school setting. (shrink)

This paper takes as its starting point the conjoining of the perceived and conceived spaces of what Soja (1996) calls Thirdspace and what Lefebvre calls ‘lived space’ to launch a discussion about ideas surrounding contemporary concepts of community. The sites under discussion are the ubiquitous shopping malls and the enclave estates or master planned communities (mpcs) which, it is argued, by their design offer only ‘illusions of community.’ The claim in this paper is that within these spaces of control are (...) spatialities of resistance–vagrant spaces-that can, under certain circumstances, point to the—poverty of participation—in the community experience. (shrink)

Explores the ethical and political possibilities of philosophy after deconstruction.

In lieu of an abstract, here is a brief excerpt of the content:Let’s Start AgainSarah Wood (bio)Nicholas Royle. After Derrida. Manchester: Manchester UP, 1995.Robert Smith. Derrida and Autobiography. Cambridge: Cambridge UP, 1995.start... v. i. to shoot, dart, move suddenly forth, or out: to spring up or forward: to strain forward: to break away: to make a sudden or involuntary movement as of surprise or becoming aware: to spring open, out of place, or loose: to begin to move: of a (...) car, engine, etc. to begin to work, to fire, combust: to set forth on a journey, race, career.—v. t. to begin: to set going: to set on foot: to set up: to drive from lair or hiding place: to cause or undergo displacement or loosening of: to startle (obs.): to pour out or shoot.—n. a sudden movement: a sudden involuntary motion of the body: a startled feeling: a spurt: an outburst or fit: a beginning of movement, esp. of a journey, race, or career: a beginning: a setting in motion: a help in or opportunity of beginning: an advantage in being early or ahead: the extent of such advantage in time or distance: a beginning of building work on a new house-site....—Chambers DictionaryAh, did you once see Shelley plain, And did he stop and speak to you And did you speak to him again? How strange it seems and new!But you were living before that, And also you are living after; And the memory I started at— My starting moves your laughter.—Robert Browning, “Memorabilia”The Shelley whose appearance regularly shocks Browning is, of course, a ghost. The bare fact of talking with a ghost is bound to be curious and impressive—enough to make one start. But at the same time it’s not unusual to converse with ghosts, and this generalization can be taken beyond the sphere of literature, beyond the notion of writers struggling with the mighty dead for imaginative priority, as it is conceived in Harold Bloom’s readings of Browning, for instance. Derrida insists that relationship in general requires the spectral: “[w]hat happens between two, and between all the ‘two’s’ one likes, such as between life and death, can only maintain itself with some ghost, can only talk with or about some ghost [s’entretenir de quelque fantôme]” [Derrida, Specters of Marx xviii]. Perhaps, then, what happens in and between the two books reviewed here needs to be approached in terms of ghosts and the psychoanalysis of ghosts, so powerfully thematized by Nicholas Royle. [End Page 4] Both his After Derrida and Robert Smith’s Derrida and Autobiography seek to make contact with something in writing that gets things going and produces breaks, that displaces and startles. Although each volume could still be called a monograph on Derrida, it responds to something other than a corpus.The sense of shock, wonder, and discontinuity that makes the imagined interlocutor in “Memorabilia” laugh illuminates also something playing itself out across the reception of Derrida’s work. Part of that reception could be conceived in familiar terms—the development of a canon of what could be called Derrida commentaries, the establishment of a set of themes readily associated with Derrida studies (charlatanism, the deconstruction of a metaphysics of presence, and so on). Yet to speak with or about ghosts entails having to start reading, listening, and thinking again, in order to broach familiarity anew without innocent recourse to sheer intuition. These books also, despite their scholarly knowledge of the field, share a sense of responsibility to discuss an aspect of writing—hard to ignore in Derrida—that has begun without commentary, that gets commentary started and that subjects the movement of thought to something like fits. Whether these fits are of phobia, laughter, melancholy, delirium, or anger, their irruption marks interesting gaps in thought’s continuity. More than moods, these strange outbursts might be understood better in terms of the theory of metapsychological “phantoms.” The phantom, according to Nicolas Abraham, is “sustained by secreted words, invisible gnomes whose aim is to wreak havoc, from within the unconscious, in the coherence of logical progression” [“Notes on the Phantom” 175]. The phantom is also “alien to the subject... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Joanne Wood LORDJIM AND THE CONSEQUENCES OF KANTIAN AUTONOMY Autonomy IS the fundamental principle of Kantian ethics. This is so because his moral system is based on the crucial idea that nothing in the world can be called "good without qualification except a good will."1 Thus a good will is good in and of itself, without regard to any possible end. For such a will, morality is categorical, (...) for only with such an imperative can moral laws be said to be laws ofcomplete freedom, and willed without regard to any other interest. Thus autonomy is a necessary condition for a good will, because any heteronomous worth a will could achieve would by definition be conditional, and would therefore violate Kant's notion of the unconditional worth of a good will. However, it is precisely this notion of the absolute worth a good will merits on its own that would seem to bear looking into: there is something intuitively wrong with Kant's assertion that even if"it should happen that, by a particularly unfortunate fate or by the niggardly provision of a stepmotherly nature, this will should be wholly lacking in power to accomplish its purpose," it would still "sparkle like a jewel in its own right, as something that had its full worth in itselP (p. 10). The idea implied in this passage, that a good will could exist somehow apart from the world and any effects achieved therein, is problematic to say the least. How could such a will be known? The metaphor ofa "sparklingjewel" is striking, but flawed: ajewel exists in the world, for all eyes to see if they know where to look, whereas a good will exists in the hearts of men. It is for this reason thatJoseph Conrad's LordJim is a fitting supplement to understanding the implications of a Kantian view of morality, for the central concern of the novel is the moral ambiguity that results from our common obscurity ofvision into ourselves and those around us. Given this 57 58Philosophy and Literature ambiguity, which Kant recognizes when he says, "even the strictest examination can never lead us entirely behind the secret incentives, for, when moral worth is in question, it is not a matter of actions which one sees but ofdieir inner principles which one does not see" (p. 23). It seems then irresponsible still to maintain that the worth ofa good will is independent of the way of the world. Since it is evident that if results or other empirical factors are invalid tojudge intentions, then the only judge capable of assessing in advance what maxim is being acted upon is the moral agent; morality becomes a matter of strictly individual conscience or reason. The moral agent thus becomes romanticized, a lone figure needing no other guidance than that which his or her own reason can provide in order to lead a truly good life. LordJim challenges just such a conception of individualist or self-sufficient morality. Due to the essential ambiguity ofwhatjim himselfis, the novel is an extremely difficult one to read. This is further complicated by the fact that, after the first four chapters, the reader is never given an impersonal view ofJim, but instead Marlow's painstaking efforts to fit together the puzzle ofJim's character: "I don't pretend I understood him. The views he let me have of himself were like those glimpses through the shifting rents in a thick fog— bits of vivid and vanishing detail, giving no connected idea of the general aspect of a country... they were no good for purposes of orientation."2 Given this cloud of uncertainty, Jim remains an enigma from beginning to end. The reader is treated to various judgments ofhim during this time from a wide range of viewpoints which Marlow perhaps pursues in an effort to shed some light on the subject, but which nonetheless leave us in darkness because they all omit one factor or another. There is no Authority in this book. The facts ofJim's case are relatively straightforward: it is the interpretation of what lies behind them, ofJim's "inner principles," which is extraordinarily complex. Jim is working as first mate on... (shrink)

The philosophy of science embraces the metaphysical, epistemological and methodological problems which arise in the study of the special sciences and perhaps no branch of the philosophy of science is more deserving of careful investigation than the borderline discipline between philosophy and scientific psychology. The philosophical problems resulting from the impact of psychology upon philosophy include such traditional problems as the existence, nature and origin of consciousness, the relation of the conscious to the unconscious and subconscious mind, the nature and (...) continuity of the self, and the relation of consciousness to its neural conditions. All these problems originate in empirical psychology and are soluble, if at all, only by appeal to psychological evidence and thus through the cooperative efforts of the philosopher and the psychologist. Unfortunately the gulf between philosophers and psychologists is as wide if not wider than that which exists between philosophers and other groups of scientists. The chief obstacle to a philosophical psychology is the alienation of psychology from philosophy which followed the attainment by psychology of its status as an independent science. Psychology as a young and vigorous science, revolting against the parental restraint of philosophy, utterly repudiated philosophy and philosophical modes of thought and, at the same time, philosophy on its side breathed a sigh of relief to be rid of a difficult and recalcitrant offspring. Thus psychological science became more hostile to philosophy than her elder sister sciences, and philosophy went its own speculative way in utter disregard of scientific psychology. Indeed “Psychologismus” has become among philosophers a term of such severe reproach that to refute a philosophical position in certain quarters one need only demonstrate that it is psychological in its origin and foundation. Thus the revolt of psychology against philosophy, natural and inevitable though it was, has been so violent and prolonged as to be detrimental to both psychology and philosophy alike. (shrink)

This is a new release of the original 1927 edition.

IN A PREVIOUS ARTICLE I argued that Plato’s Line of Knowledge in the middle of his Republic taught a “pedagogy of complete reflection.” What I intend to show in this article is that the general lines of that “complete reflection” indicated in the Republic are brought down to the everyday in the Theaetetus where we are invited, among other things, to reflect upon what is involved in the fact that we are reading the dialogue in our lifeworld.

The article reflects on the need for an independent philosophy in relation to faith. After the assimilation of Plato and Aristotle, the official Church tended to attack attempts at independent philosophy as modes of unbelief. But it was precisely independent developments in modern thought that led to the transformation of the ordinary magisterium on certain key questions. Following von Balthasar, the article attempts to make Heidegger’s project our own: to think the ground of metaphysics, and thus of intellect and will, (...) in “the heart” by making use of the seed parables in the Gospels. Taking its point of departure from an analysis of the basic structural features of the field of experience, the text argues for a sympathetic study of the philosophical classics in order to establish a set of critical epicenters in oneself. This furnishes the basis for a dialogical pluralism that will aid in ecumenical dialogue and in the development of the ordinary magisterium. (shrink)