Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

The aim of this study was to assess nurses’ and physicians’ ethical dilemmas in clinical practice. Nurses and physicians of the Clinical Hospital Centre Rijeka were surveyed (N = 364). A questionnaire was used to identify recent ethical dilemma, primary ethical issue in the situation, satisfaction with the resolution, perceived usefulness of help, and usage of clinical ethics consultations in practice. Recent ethical dilemmas include professional conduct for nurses (8%), and near-the-end-of-life decisions for physicians (27%). The main ethical issue is (...) limiting life-sustaining therapy (nurses 15%, physicians 24%) and euthanasia and physician-assisted suicide (nurses 16%, physicians 9%). The types of help available are similar for nurses and physicians: obtaining complete information about the patient (37% vs. 50%) and clarifying ethical issues (31% vs. 39%). Nurses and physicians experience similar ethical dilemmas in clinical practice. The usage of clinical ethics consultations is low. It is recommended that the individual and team consultations should be introduced in Croatian clinical ethics consultations services. (shrink)

Several non-naturalist philosophers look for ways to maintain the objectivity of morals without making any ontological commitments. Recently Derek Parfit proposed an account of non-ontologically existing irreducible moral properties. My first aim in this paper is to outline that such an account is doomed to fail. My second aim in this paper is to argue that irreducible moral properties can be integrated with adaptions into an ontological framework such as E.J. Lowe’s four-category ontology. If it can be shown that irreducible (...) moral properties have a proper place in such an ontology, then there is no need to distinguish between an ontological and non-ontological mode of existence, which, in turn helps to eschew the obscurities that this distinction brings in its wake. (shrink)

continent. 2.2 (2012): 76–81 Comments on Eugene Thacker’s “Cosmic Pessimism” Nicola Masciandaro Anything you look forward to will destroy you, as it already has. —Vernon Howard In pessimism, the first axiom is a long, low, funereal sigh. The cosmicity of the sigh resides in its profound negative singularity. Moving via endless auto-releasement, it achieves the remote. “ Oltre la spera che piú larga gira / passa ’l sospiro ch’esce del mio core ” [Beyond the sphere that circles widest / penetrates (...) the sigh that issues from my heart]. 1 The axiomatic sigh of the pessimist is in a way the pure word of philosophy, a thought that thinks without you, speaks where you are not. The live pneumatic form of the soul’s eventual exit from the dead body’s mouth, the sigh restores consciousness to the funeral of being, to the passing away that is existence. Pessimism speaks in piercing aphorisms because first it sighs. “Beyond the sphere passeth the arrow of our sigh. Hafiz! Silence.” 2 … pessimism is guilty of that most inexcusable of Occidental crimes—the crime of not pretending it’s for real. To the pessimist, the ‘real’ world—the world on whose behalf we are expected to wake up in the morning—is a ceaseless index of its own unreality. The pessimist’s day is not an illumined space for the advancement of experience and action, but a permanently and inescapably reflective zone, the vast interior of a mirror where each thing is only insofar as it is, at best, a false image of itself. Within this speculative situation, inside the doubleness of the mirror, pessimism splits into two paths, false and true, one that tries to fix pessimism (establish a relation with the mirror) and decides in favor of the apparent real, and another that totally falls for pessimism (enters the mirror) and communes with the greater reality of the unreal. These two paths are distinguished by their relation to pessimism’s guilt vis-à-vis the world’s reality-project. The first form, that which remains pessimism for the world and puts on a smiling face, stays guilty to itself (i.e. unconscious) and thus turns hypocritical, becoming at once the pessimism of the commoner who really just wants things to be better for himself and the pessimism of the elite who wants to critically refashion reality in his own image. The general form of this worldly, hypocritical pessimism is the impulse to ‘make the world a better place’, which is the global mask under which the world is diurnally made worse. The second form, that which follows pessimism away from the world and ceases to put on a smiling face, refuses guiltiness as itself theessential Occidental mode of pretense and turns honest, becoming at once the intelligent pessimism required of all ordinary action and the radical pessimism necessary for self-knowledge: seeing that no one is capable of doing good. The general form of this universal, honest pessimism is the impulse not to worry, to give up and embrace dereliction, which is the only real way the world is actually improved. Where worldly pessimism is the engine productive of interminably warring secular and sacred religions (good-projects), universal pessimism strives hopelessly for the paradise of a supremely instantiated pessimus: things are getting so bad that there is no longer any time for them to get worse; things are so constantly-instantly worst that this is BEST. Cosmic pessimism is the mode of universal pessimism which can yet discourse with the world, which has not chosen silence and can spread the inconceivably BAD NEWS in an orderly form ( kosmos ) that the world can understand (if it wanted to). … the result of a confusion between the world and a statement about the world. That is what the world is (the result of a confusion between the world and a statement about the world). … a generalized misanthropy without the anthropos. Pessimism crystallizes around this futility—it is its amor fati , rendered as musical form. Pessimism’s love of fate is a blind love, a love of the blindness of being human in a cosmos conceived around the human’s eclipse, a heavy levitation in the contradictory space between the inescapability of its having been and the impossibility of its will-be. Pessimism’s song of futility is a sensible way of loving fate, with a minimum of eros, by means of a kind of matrimonial love of the fatal. As music, pessimism stays open to the irreparable and the inexorable without the binding of affirmation, in the apparent absence of the radical, infinitely surplus will that absolute amor fati seems to require. Crying, laughing, sleeping—what other responses are adequate to a life that is so indifferent? “Unless a man aspires to the impossible, the possible that he achieves will scarcely be worth the trouble of his achieving it. We should aspire to the impossible, to absolute and infinite perfection [….] The apocatastasis is more than a mystical dream: it is a norm of action, it is a beacon for high deeds [….] For true charity is a species of invasion [….] It is not charity to rock and lull our fellow men to sleep in the inertia and heaviness of matter, but rather to arouse them to anguish and torment of spirit.” 3 … the impossibility of ever adequately accounting for one’s relationship to thought. “The paroxysm of interior experience leads you to regions where danger is absolute, because life which self-consciously actualizes its roots in experience can only negate itself [….] There are no arguments [….] On the heights of despair, the passion for the absurd is the only thing that can still throw a demonic light on chaos [….] I live because the mountains do not laugh and the worms do not sing .” 4 It took three attempts before she was fully decapitated, all the while she continued, perhaps miraculously, to sing. According to the earliest account of Cecilia’s martyrdom, the beheading turns out worse. After not severing her head in three strokes, “the cruel executioner left her half dead” (seminecem eam cruentus carnifex dereliquit). 5 Cecilia’s effortlessly powerful endurance of the three strokes—a fitting icon for pessimism as an art of dereliction—demonstrates the “passivity and absence of effort [….] in which divine transcendence is dissolved.” 6 There’s a ghost that grows inside of me, damaged in the making, and there’s a hunt sprung from necessity, elliptical and drowned. Where the moving quiet of our insomnia offers up each thought, there’s a luminous field of grey inertia, and obsidian dreams burnt all the way down. Like words from a pre-waking dream. There is no reason to think that they are not. NOTES 1. Dante Alighieri. Vita Nuova . ed. and trans. Dino S. Cervigni and Edward Vasta. Notre Dame: University of Notre Dame Press. 1995. 41:10. 2. Hafiz of Shiraz. The Divan . trans. H. Wilberforce Clarke. London: Octagon Press. 1974. 10.9. 3. Miguel de Unamuno. The Tragic Sense of Life in Men and Nations . trans. Anthony Kerrigan. Princeton: Princeton University Press. 1972. 305-6. 4. E.M. Cioran. On the Heights of Despair . trans. Ilinca Zarifopol-Johnston. Chicago: University of Chicago Press. 1992. 9-10. 5. Giacomo Laderchi. S. Caeciliae Virg[inis] et Mart[yris] Acta. . . Rome. 1723. 38. 6. Georges Bataille. On Nietzsche . trans. Bruce Boone. London: Continuum. 2004. 135. See Nicola Masciandaro. “ Half Dead: Parsing Cecilia .” A Commentary on Eugene Thacker’s "Cosmic Pessimism" Gary J. Shipley Pessimism is the refusal to seek distraction, the refusal to remodel failure into a platform for further (doomed) possibilities, the refusal of comfort, the acceptance of the sickness of healthy bodies, the cup of life overflowing with cold vomit. If, as Ligotti suggests when discussing Invasion of the Body Snatchers , 1 humans prefer the anxieties of their familiar human lives to the contentment of an alien one, then the pessimist, we could argue, represents some perverted combination of the two, preferring (presuming he has a choice) the defamiliarization of human life to the contentment of its unquestioned mundanity. The quasi-religious state of mind that Wittgenstein would mention on occasion, that of “feeling absolutely safe,” 2 is a state the pessimist could only imagine being approximated by death, or perhaps some annihilative opiate-induced stupor. This Wittgensteinian commingling of certainty and faith looks every bit the futile gesture, a mere rephrasing of collapse or partial collapse. The only certainty open to the pessimist is that of the toxic formula of life itself—a formula known and lacuna-free. Certainty, far from being the gateway to deliverance, becomes the definitive impediment; and the possibility of salvation, as long as it remains, becomes crucially reliant on postulations of ignorance, epistemic gaps, a perennial incompleteness: “the perfect safety of wooed death […] the warm bath of physical dissolution, the universal unknown engulfing the miniscule unknown.” 3 The height of Leibniz’s Panglossian insanity nurtured the idea that our knowing everything—via the universal calculus—could be accurately described a triumph, as opposed to a nightmare in which our every futility is laid bare. Stagnancy and boredom are perhaps two of the greatest ills of Western civilisation, and the most potent pessimism tells you that you’re stuck with both. The most we can hope for, by way of salvation, is to throw open our despair to the unknown. The fact that Schopenhauer’s pessimism stopped short of morality and allowed him to play the flute, as Nietzsche complained, highlights the predicament of a man who despite having adorned nothingness with a smiling face still found himself alive. The demand here is that it be felt: a cross-contamination of intellect and emotion. The safety net of numerous parentheses makes for a failed philosophy, rather than a philosophy of failure. Depressives make bad pessimists, because, unless they choose to die, living will always infect them with necessities of hope, forcing them to find something, anything (all the various “as ifs”) to make existence tolerable. For as Cioran observed, while “[d]epressions pay attention to life, they are the eyes of the devil, poisoned arrows which wound mortally any zest and love of life. Without them we know little, but with them, we cannot live.” 4 And even when cured of our depressions we’ll find ourselves consumed, eaten alive by the hyper-clinical (borderline autistic) mania that replaces them: a predicament captured all too clearly in the microscriptual fictions of Robert Walser, where spectral men and women stifle their depressive madness with protective comas of detail, their failed assimilations buried beneath thick crusts of remote data. Like Beckett’s Malone their stories may have ended, but cruelly their lives have not. Pessimism is an extraneous burden (a purposeless weight) that makes everything else harder to carry, while at the same time scooping it out and making it lighter. If pessimism had a sound it would be the harsh non-noise of tinnitus—the way that every person would hear themselves if they refused their distractions long enough to listen: a lungless scream from the extrasolar nothing of the self. The music of pessimism—if indeed we can imagine such a thing—is the reverberating echo of the world’s last sound, conjectured but never heard, audible only in its being listened for. The one consolation of this hollow paradox of audibility being, that “he will be least afraid of becoming nothing in death who has recognized that he is already nothing now.” 5 The pessimist suffers a derangement of the real, a labyrinthitis at the nucleus of his being: he’s the stumbling ghost relentlessly surprised that others can see him. If Cioran’s refusal is manifested in sleep (when even saying ‘no’ is too much of a commitment), then Pessoa’s resides in the dreams inside that sleep. Pessoa chooses to exploit the fact that he’s being “lived by some murmuring non-entity both shadowy and muddied” 6 by growing more voids to live him. His is a Gnostic breed of sleep, “sleeping as if the universe were a mistake,” 7 a sleep that dreams through Thacker’s cosmic pessimism (“a pessimism of the world-without-us.”, “the unhuman orientation of deep space and deep time” 8 ), through the critical error of there being anything at all when there could be nothing. The metaphysical pessimist is someone who, however well life treats them, still desires to wake from it, as from the poisonous air of a bad dream. Pessimism is a paradox of age, being simultaneously young and old; its youth residing in a refusal to accept the authority of existence (its rich history, its inherent beneficence), a refusal to “get over” the horror of what it sees with its perpetually fresh eyes, and its maturity in the unceremonious disposal of the philosophical playthings (those futile architectures) of adolescence. As Thacker remarks: “Pessimism abjures all pretenses towards system—towards the purity of analysis and the dignity of critique.” 9 A sentiment shared with Pessoa, who duly categorizes those that choose to enact this futile struggle: “The creators of metaphysical systems and of psychological explanations are still in the primary stage of suffering.” 10 If the pessimist has shared a womb with anyone, it’s with the mystic and not the philosopher. As Schopenhauer tells us: “The mystic is opposed to the philosopher by the fact that he begins from within, whereas the philosopher begins from without. […] But nothing of this is communicable except the assertions that we have to accept on his word; consequently he is unable to convince.” 11 The crucial difference between the mystic and the pessimist is not the latter’s impassivity and defeatism, but his unwillingness/inability to contain in any way the spread of his voracious analyticity, his denial of incompleteness, his exhaustive devotion to failure. The truth of our predicament, though heard, is destined to remain unprocessed. Like the revelations of B.S. Johnson’s Haakon (“We rot and there’s nothing that can stop it / Can’t you feel the shaking horror of that?” 12 ) the pessimist’s truths are somehow too obvious to listen to, as if something inside us were saying, “Of course, but haven’t we gotten over that?” Pessimism is simple and ugly, and has no desire to make itself more complex or more attractive. The true moral pessimist knows that the Utilitarian’s accounts will always be in the red. He can see that for all his computational containments, his only honest path is a negative one, and that such a path has but one logical destination: that of wholesale human oblivion. Thacker notes how at the core of pessimism lies the notion of “the worst,” through which death is demoted by the all-pervasive suffering of a life that easily eclipses its threat. And so with doom made preferable to gloom, death begins to glint with promise, “like beauty passing through a nightmare.” 13 But even among pessimists suicide is, for the most part, thought to be an error. Schopenhauer, for instance, regarded suicide a mistake grounded in some fundamentally naïve disappointment or other. Pessoa too thought suicide an onerous escape tactic: “To die is to become completely other. That’s why suicide is a cowardice: it’s to surrender ourselves completely to life.” 14 There is a call here to be accepting of and creative with the puppetry of your being, an insistence that it’s somehow a blunder to attempt to hide in death from the horrors you find inlife. 15 Tied up with this perseverance is the slippery notion of the good death, for maybe, as Blanchot warns, suicide is rarely something we can hope to get right, for the simple reason that “you cannot make of death an object of the will.” 16 “Even in cases where the entire corpus of an author is pessimistic, the project always seems incomplete,” 17 and this is not simply because the project itself belies something yet to be disclosed, but because the project itself is a thing waiting. It waits on a cure it knows will not come, but for which it cannot do anything (as long as it continues to do anything) but wait. NOTES 1. See Thomas Ligotti. The Conspiracy Against the Human Race . New York: Hippocampus Press. 2010. 91. 2. Ludwig Wittgenstein. “A Lecture on Ethics.” Philosophical Review . (74) 1. 1965. 8. 3. Vladimir Nabokov. Pale Fire . New York: Vintage. 1989. 221. 4. E. M. Cioran. The Book of Delusions . trans. Camelia Elias. Hyperion. 5.1. (2010): 75. 5. Arthur Schopenhauer. The World as Will and Representation. vol. 2 . trans. E .F J. Payne. New York: Dover. 1966. 609. 6. Eugene Thacker. “Cosmic Pessimism.” continent. . 2.2 (2012): 67. 7. Fernando Pessoa. The Book of Disquiet . trans. Richard Zenith. London: Penguin. 2002. 35. 8. Eugene Thacker. “Cosmic Pessimism.” continent. . 2.2 (2012): 68. 9. Ibid. 73. 10. Fernando Pessoa. The Book of Disquiet . trans. Richard Zenith. London: Penguin. 2002. 341. 11. Arthur Schopenhauer. The World as Will and Representation. vol. 2 . trans. E .F J. Payne. New York: Dover. 1966. 610-11. 12. B.S Johnson. “You’re Human Like the Rest of Them.” in Jonathan Coe. Like a Fiery Elephant: The Story of B.S. Johnson . London: Picador. 2004. 177. 13. Fernando Pessoa. The Book of Disquiet . trans. Richard Zenith. London: Penguin. 2002. 415. 14. Ibid. 199. 15. “Suicide is, after all, the opposite of the poem.” Anne Sexton. No Evil Star: Selected Essays, Interviews and Prose . ed. Steven Gould Axelrod. Ann Arbor: University of Michigan Press. 1985. 92. 16. Maurice Blanchot. The Space of Literature . trans. Ann Smock. Lincoln: University of Nebraska Press. 1989. 105. 17. Eugene Thacker. “Cosmic Pessimism.” continent. . 2.2 (2012): 75. (shrink)

The realities and myths of long-term care and the challenges it poses for the ethics of autonomy are analyzed in this perceptive work. The book defends the concept of autonomy, but argues that the standard view of autonomy as non-interference and independence has only a limited applicability for long term care. The treatment of actual autonomy stresses the developmental and social nature of human persons and the priority of identification over autonomous choice. The work balances analysis of the ethical concepts (...) associated with autonomy with discussion of the implications of the ethical analysis for long term care. A central chapter involves a phenomenological analysis of four general features of everyday experience (space, time, communication, and affectivity) and explores their practical implications for long term care. This work concludes with a discussion of the advantages associated with a phenomenologically-inspired treatment of actual autonomy for the ethics of long-term care. (shrink)

Copyrighted originally by George Allen and Unwin Ltd. in 1962 this paper edition makes Conze's review of Indian Buddhism available at a relatively low price. The book is divided into three parts: Archaic Buddhism which deals with facets common to all of Indian Buddhism, the Sthaviras which deals with the Hinayäna, and the Mahäyäna. Often a commentator will present a traditional view of Indian Buddhism through a translation of some Buddhist's compendium on Buddhism. This work, however, is the result (...) of the author's own long research into Buddhism, and thus at times it reflects his own reactions to aspects of Buddhism rather than those of a more Catholic Buddhist. Specifically his remarks on tantra and logic, though representative of some Buddhist opinion at some time, do not reflect the views of more Catholic Buddhist historians and scholars. However, in his introduction the author describes the scope of his work with the full realization that he cannot fulfill the rather awesome demands which a review of the whole of Indian Buddhism asks.--P. J. H. (shrink)

The realities of long‐term care call for a refurbished, concrete concept of autonomy that systematically attends to the history and development of persons and takes account of the experiences of daily living.

Jonathan Lowe argues that metaphysics should be restored to a central position in philosophy, as the most fundamental form of rational inquiry, whose findings underpin those of all other disciplines. He portrays metaphysics as charting the possibilities of existence, by idetifying the categories of being and the relations of ontological dependency between entities of different categories. He proceeds to set out a unified and original metaphysical system: he defends a substance ontology, according to which the existence of the world s (...) one world in time depends upon the existence of persisting things which retain their identity over time and through processes of qualitative change. And he contends that even necessary beings, such as the abstract objects of mathematics, depend ultimately for their existence upon there being a concrete world of enduring substances. Within his system of metaphysics Lowe seeks to answer many of the deepest and most challenging questions in philosophy. (shrink)

RECENT PHILOSOPHICAL ATTENTION TO THE LANGUAGE OF DISEASE HAS FOCUSED PRIMARILY ON THE QUESTION OF ITS VALUE-NEUTRALITY OR NON-NEUTRALITY. PROPONENTS OF THE VALUE-NEUTRALITY THESIS SYMBOLICALLY COMBINE POLITICAL AND OTHER CRITICISMS OF MEDICINE IN AN ATTACK ON WHAT THEY SEE AS VALUE-INFECTED USES OF DISEASE LANGUAGE. THE PRESENT ESSAY ARGUES AGAINST TWO THESES ASSOCIATED WITH THIS VIEW: A METHODOLOGICAL THESIS WHICH TENDS TO DIVORCE THE ANALYSIS OF DISEASE LANGUAGE FROM THE CONTEXT OF THE PRACTICE OF MEDICINE AND A SUBSTANTIVE THESIS WHICH (...) HOLDS THAT DISEASE LANGUAGE IS EVALUATIVELY NEUTRAL. IN PARTICULAR, THE ESSAY CRITICALLY FOCUSES ON THE VALUE NEUTRAL POSITION ADOPTED BY CHRISTOPHER BOORSE, WHICH HE TERMS A FUNCTIONAL THEORY OF DISEASE. THE ARGUMENT CONCERNS WHETHER OR NOT ONE CAN HAVE VALUE NEUTRAL DESCRIPTION OF DISEASE STATES OR WHETHER DISEASE LANGUAGE ESSENTIALLY INVOLVES VALUES. (shrink)

This article accepts the proposition that old people want to be treated with dignity and that statements about dignity point to ethical duties that, if not independent of rights, at least enhance rights in ethically important ways. In contexts of policy and law, dignity can certainly have a substantive as well as rhetorical function. However, the article questions whether the concept of dignity can provide practical guidance for choosing among alternative approaches to the care of old people. The article explores (...) the paradoxical relationship between the apparent lack of specific content in many conceptions of dignity and the broad utility that dignity appears to have as a concept expressive of shared social understandings about the status of old people. (shrink)

Thomasma and Pellegrino''s [3] focus on the healing relationship as the way to give medical ethics a philosophical foundation contains a number of difficulties. Most importantly, their approach focuses philosophical analysis on an idealized view of the healing relationship in which the ideal of health is seen as an uncontroversial norm in the individual case. medical ethics is then characterized as an intrinsic part of the medical act itself. Philosophical inquiry seems limited to a description of the practice of medicine (...) in which ethical norms are embodied. Insufficient attention to methodology leaves unclear how this vision is to be achieved in philosophical reflection. (shrink)

In this paper I analyze the alleged conflict between economic incentives to efficiently utilize health care resources and the obligation to provide patients with the best possible medical care. My analysis is developed in four stages. First, I discuss briefly the nature of prospective payment systems and economic incentives as well as the issue of professional autonomy. Second, I disscuss the notion of an incentive for action both as an economic incentive and as a concept of moral psychology. Third, I (...) analyze several definitions of the physician's professional obligation and discuss four conditions that morally qualify the obligation. And fourth, I explore why the views of economists and physicians differ so strikingly on the question of economic incentives. In the process of this analysis, I argue that criticisms of prospective payment systems which are premised primarily on the conflict between economic incentives to contain cost and the professional obligation of beneficence are probably as much a matter of rhetoric as serious argumentation. Keywords: autonomy, beneficence, cost containment, economic incentives, moral obligation, prospective payment CiteULike Connotea Del.icio.us What's this? (shrink)

The law has therefore had two conflicting impacts on medical ethics: the positive effect of eroding paternalism and replacing it with a patient-centered ethic; and the negative effect of encouraging physicians to be more concerned with avoiding litigation than doing the "right" thing.

This paper offers an exposition of what the question of method in ethics consultation involves under two conditions: when ethics consultation is regarded as a practice and when the question of method is treated systematically. It discusses the concept of the practice and the importance of rules in constituting the actions, cognition, and perceptions of practitioners. The main body of the paper focuses on three elements of the question of method: canon, discipline, and history, which are treated heuristically to outline (...) what the question of method in ethics consultation fully involves. (shrink)

The proliferation of ethics committees and ethics consultation services has engendered a discussion of the issue of the expertise of those who provide clinical ethics consultation services. In this paper, I discuss two aspects of this issue: the cognitive dimension or content knowledge that the clinical ethics consultant should possess and the practical dimension or set of dispositions, skills, and traits that are necessary for effective ethics consultation. I argue that the failure to differentiate and fully explicate these dimensions contributes (...) to the confusion over the issue of expertise and fuels, at least partly, the controversies about expertise (or authority) in ethics and the legitimacy of the use of ethical knowledge in clinical ethics consultation. (shrink)

Central to much medical ethical analysis is the concept of the role of the physician. While this concept plays an important role in medical ethics, its function is largely tacit. The present paper attempts to bring the concept of a social role to prominence by focusing on an historically recent and rather richly contextured role, namely, that of consultation liaison psychiatry. Since my intention is primarily theoretical, I largely ignore the empirical studies which purport to develop the detailed functioning of (...) the role. My limited intent is to draw attention to the theoretical complexity of the consultation liaison role as an example of the general relevance of role concepts to medical ethics. For this reason, consultation liaison psychiatry will function as an illustration of fundamental concepts of medical ethics rather than as a subject of analysis in its own right. Similarly, the concept of the social role will be developed only as is necessary to explore the general relationship between the consultation liaison role and ethical analysis. Keywords: medical ethics, consultation liaison psychiatry, social role, autonomy, institution CiteULike Connotea Del.icio.us What's this? (shrink)

Friedrich Nietzsche has emerged as one of the most important and influential modern philosophers. For several decades, the book series Monographien und Texte zur Nietzsche-Forschung (MTNF) has set the agenda in a rapidly growing and changing field of Nietzsche scholarship. The scope of the series is interdisciplinary and international in orientation reflects the entire spectrum of research on Nietzsche, from philosophy to literary studies and political theory. The series publishes monographs and edited volumes that undergo a strict peer-review process. The (...) book series is led by an international team of editors, whose work represents the full range of current Nietzsche scholarship. (shrink)

Fraudulent financial reporting, financial statements with errors so material as to require restatement, and biased reporting marred by defects such as managed earnings have plagued financial reporting in many countries in recent years. All of those failures are ethics failures that represent breaches of fiduciary duties by individuals who accepted responsibilities but did not fulfill them. The financial reporting system practiced in America is viewed by the parties involved in it as generally satisfactory. However, according to another view, the interests (...) of those primarily and secondarily responsible for those reports conflict with the interests of the intended beneficiaries, or users, of the corporate financial statements. A more realistic view of the actual operation of that reporting system shows that it is fundamentally flawed. Primary responsibility for failures rests with top management and financial management of the reporting corporation who are so strongly motivated to render favorable reports on their stewardship that they neglect their fiduciary responsibilities to investors. Secondary responsibility falls on independent auditors who are so heavily influenced by enterprise management that they, too, fail in carrying out their responsibilities to users of the audited financial statements. Ethics compromises are also found in the performances of academic accountants and members of accounting standards-setting bodies. The conflict between managements interest in reporting its performance in a favorable light and investors interest in decision-useful financial information will always exist and require regulation. However, changes in those regulations and in the basic governance arrangements involving shareholders, management, and auditors could reduce the opportunities and temptations for failures in carrying out fiduciary responsibilities. Most importantly, the close relationships between auditors and management must be loosened in favor of closer relationships between auditors and investors. (shrink)

Authority is an uneasy, political notion. Heard with modern ears, it calls forth images of oppression and power. In institutional settings, authority is everywhere present, and its use poses problems for the exercise both of individual autonomy and of responsibility. In medical ethics, the exercise of authority has been located on the side of the physician or the health care institution, and it has usually been opposed by appeal to patient autonomy and rights. So, it is not surprising, though still (...) ironic, that ethics consultation, which develops from this patient rights-dominated ethic, should itself bring forth questions of authority. Nonetheless, it does.Insofar as authority has been discussed in ethics consultations, it has been understandably approached from the broad perspective of legitimation and power, which are common themes in social and political treatments of authority. These treatments have dominated twentieth-century discussions of authority, which primarily view authority as legitimate power. (shrink)

Normal propositional modal systems This first chapter has two main aims. One is to give a general account of the propositional modal systems that we shall ...

Modal propositional logic; Modal predicate logic; A survey of modal logic.

This article discusses the approach of the Clinical Ethics Consultation Advisory Committee (CECA) in developing A Case-Based Study Guide for Addressing Patient-Centered Ethical Issues in Health Care. This article addresses the processes used by the CECA, its use of pivot questions intended to encourage critical reflection, and the target audience of this work. It first considers the salience of case studies in general education and their relevance for training ethics consultants. Second, it discusses the enfolding approach used in presenting the (...) case material designed to engage the trainee in the details of the case while stimulating critical reflection. And, third, this article briefly comments on the target audience with the caveat that even superbly developed cases are prone to misuse, although that prospect should not deter their development. (shrink)

This thematic study focuses especially on the role that suffering plays in the practice of philosophy. It identifies and interprets the basic structures and possibilities related to the experience of suffering; and, it examines some of the significant historical contributions that have influenced our thinking about this issue. ;It begins by developing a preliminary definition of suffering. After which, it seeks and examines those same basic structures in the contributions of Plato, Augustine, Spinoza, Nietzsche, and Heidegger---each in their own chapters. (...) ;The study of Plato centers on suffering conceived in terms of eros, with particular attention paid to that suffering at the crucial intersection of the sensible and the intelligible. ;The study of Augustine focuses on suffering conceived in terms of the tension between the human and the divine. The role of suffering in Christianity is summarized, and Augustine's personal example is employed as an illustration. The contrast between the sufferings of Job and those of Jesus are explored briefly with respect to the question of results. ;The studies of Spinoza and Nietzsche are combined in the same chapter because they both naturalize suffering. In Spinoza, the focus is on his analysis of how human beings rise above their passivity through an increase in their active power of understanding. In Nietzsche, the call for an even greater suffering is analyzed. ;The study of Heidegger examines suffering in both his earlier works and later works . Heidegger's insensitivity to the suffering of the Holocaust is also discussed. ;The conclusion examines the contemporary perspective of James R. Watson's Between Auschwitz and Tradition, and then speculates on what is called for today in terms of thinking and suffering. It argues that thought needs to acknowledge its bodily dwelling, confront its limitations, and open itself to that which is 'other.' In the face of all the resistances, thinking today needs to be suffering. (shrink)