Commentators are divided on the interpretation of Metaphysics Z4 1029b13–22. For one thing, it is unclear whether the passage rejects a claim about the essence of surface, or about the essence of pale. It is usually thought that the claim is disavowed because it involves a circular definition. However, this is conjectural, since Aristotle does not explicitly say anything about circularity in the lines in question. I argue here for an alternative account, which reads the disputed lines as an extension (...) of the immediately preceding remarks. If correct, this also solves the problem as to just what Aristotle is denying. As will emerge, my story is helped by St. Thomas’ reading of lines 21–22, an account that has been curiously ignored in the recent literature. (shrink)

It has been claimed that the earliest expression of a robust scepticism is in the Catalogue of Ships in the Iliad, and even commentators who would not go that far have thought the passage an important guide to epistemological attitudes in Homeric antiquity. It will be argued here that a close examination of the text does not support such conclusions. On the other hand, there are respectable reasons for an interpretation in which religious factors are operative, rather than epistemic ones. (...) The conclusion to be drawn is that the epistemic reading is groundless. (shrink)

In the long 20th century, modern China experienced perhaps the world’s most radical and systematic secularization process and the decimation of traditional religious and ritual cultures. This article seeks to account for this experience by engaging with postcolonial theory, a body of discourse seldom found relevant to China Studies. The article attempts a two-pronged critique of both state secularization and some aspects of existing Postcolonial Studies/theory. It shows the many ways in which nationalist elites in modern China unwittingly absorbed Western (...) Orientalist discourse even as their words and actions were ostensibly anti-colonial, and much of the article examines the consequences of this native Orientalism upon Chinese religiosities. Finally, the article suggests that one cannot discuss governmentality in modern China without understanding how it is intertwined with a sovereign power that is both archaic and, at the same time, has experienced renewal and expansion in modernity. (shrink)

In terms of intervening in embodied experience, medical treatment is wonder-full in its ambition and its metaphysical presumption; yet, wonder’s role in clinical medicine has received little philosophical attention. In this paper, I propose, to doctors and others in routine clinical life, the value of an openness to wonder and to the sense of wonder. Key to this is the identity of the central ethical challenges facing most clinicians, which is not the high-tech drama of the popular conceptions of medical (...) ethics but, rather, the routine of patients’ undramatic but unremitting demands for the clinician’s time and respectful attention. Wonder (conceived as an intense and transfiguring attentiveness) is a ubiquitous ethical source, an alternative to the more familiar respect for rational autonomy, a source of renewal galvanizing diagnostic imagination, and a timely recalling of the embodied agency of both patient and clinician. (shrink)

How should we shape the practice of pastoral care, especially in the context of bioethical counseling? Martin Luther grounded it in a mutual dialogue of brethren. Friedrich Schleiermacher transformed this Protestant understanding according to the modern ideals of freedom and responsibility for oneself. In response to the other basic question of pastoral care: What is the human soul?, Sigmund Freud overcame the Platonic model undergirding Schleiermacher's account. Whoever seeks to care for his own soul and the soul of the other (...) should learn from Freud. One of the most fruitful consequences of such study lies in the formation of a mature religiosity. Another such consequence concerns the pastor's aspiring to an attitude of self-control in counseling. Building one's own competence on the experience and the knowledge of Freud can help one counteract the temptation to transfer one's own (unconscious) wishes onto the conversation partner and conversely to ward off transference from the other onto oneself. On the level of ideals and ultimate principles, however, Christian pastors, unlike Freud, will not see fate and the anonymous forces of Eros and Thanatos, as the ultimate last horizons of human self-understanding. Instead, the good news of sinful man's justification by God transcends even the limits of human existence imposed by fate. (shrink)

The International Classification of Functioning, Disability and Health (ICF), designed by the WHO, attempts to provide a holistic model of functioning and disability by integrating a medical model with a social one. The aim of this article is to analyze the ICF’s claim to holism. The following components of the ICF’s complexity are analyzed: (1) health condition, (2) body functions and structures, (3) activity, (4) participation, (5) environmental factors, (6) personal factors, and (7) health. Although the ICF claims to be (...) holistic, it presupposes a monistic materialistic ontology. We indicate some limitations of this ontology, proposing instead: (a) a pluralistic–holistic ontology (PHO) and (b) a multidimensional view of the human being, with individual and environmental aspects, in relation to three levels of reality implied by the PHO. For the ICF to attain its holistic claim, the interactions between its components should be based on (a) and (b). (shrink)

Claims regarding collective or group mental states are fairly commonplace: we speak of things like the belief of the Church, the will of the faculty, and the opinion of the Supreme Court, often without considering what such claims really mean and whether they are true in any interesting sense. In this paper I take a threefold approach: first, I articulate several ways in which a group might be said to have beliefs and other mental states. Second, I explore the implications, (...) positive and negative, of these accounts of collective mental states. Third, I give a brief defense of my own view despite its somewhat disturbing implications for our membership in Church, State, and other groups. (shrink)

Introduction In 2007, a national review committee was instituted in The Netherlands to review cases of active ending of life for newborns. It was expected that 15–20 cases would be reported. To date, however, only one case has been reported to this committee. Reporting is essential to obtain societal control and transparency; the possible explanations for this lack of reporting were therefore explored. Methods Data on end-of-life decision-making were scrutinised from Dutch nation-wide studies (1995, 2001 and 2005), before institution of (...) the committee. Physicians received a questionnaire about their medical decision-making for stratified samples of deceased infants up to 1 year, drawn from the central death registry. Results In 2005, 58% of all deaths were preceded by an end-of-life decision, compared with 68% in 2001 and 62% in 1995. The use of drugs with a possible life-shortening effect tended to be lower. In 2005, all four cases in the study in which an infants' life was actively ended were preceded by a decision to forego life-prolonging treatment. In three cases, the infant's life expectancy was short; one case involved a longer life expectancy. Discussion The expected number of cases is probably an overestimation due to changes in medical practice such as the tendency to attribute less life-shortening effects to opioids. The lack of reports is probably also associated with requirements in the regulation; it may be difficult to fulfil them due either to time constraints or the nature of the suffering that is addressed. If societal control of active ending of life is considered useful, changes in the regulation may be needed. (shrink)

Introduction: The Dutch Euthanasia Act states that euthanasia is not punishable if the attending physician acts in accordance with the statutory due care criteria. These criteria hold that: there should be a voluntary and well-considered request, the patient’s suffering should be unbearable and hopeless, the patient should be informed about their situation, there are no reasonable alternatives, an independent physician should be consulted, and the method should be medically and technically appropriate. This study investigates whether physicians experience problems with these (...) criteria in medical practice.Methods: In 2006, questionnaires were sent to a random, stratified sample of 2100 Dutch physicians . Physicians were asked about problems in their decision-making related to requests for euthanasia or assisted suicide after enforcement of the 2002 Euthanasia Act.Results: Of all physicians who had received a request for euthanasia or assisted suicide , 25% had experienced problems in the decision-making with regard to at least one of the criteria of due care. Physicians who had experienced problems mostly indicated to have had problems related to evaluating whether or not the patient’s suffering was unbearable and hopeless and whether or not the patient’s request was voluntary or well considered .Discussion: Physicians in The Netherlands most frequently reported problems related to aspects in which they have to evaluate the patient’s subjective perspective. However, it can be questioned whether placing emphasis on these subjective aspects is an adequate fulfilment of the duties imposed on physicians, as laid down in the Dutch Euthanasia Act. (shrink)

The notion of patients’ duties has received periodic scholarly attention but remains overwhelmed by attention to the duties of healthcare professionals. In a previous paper the author argued that patients in publicly funded healthcare systems have a duty to participate in clinical research, arising from their debt to previous patients. Here the author proposes a greatly extended range of patients’ duties grounding their moral force distinctively in the interests of contemporary and future patients, since medical treatment offered to one patient (...) is always liable to be an opportunity cost in terms of medical treatment needed by other patients. This generates both negative and positive duties. Ten duties—enjoining obligations ranging from participation in healthcare schemes to promoting one’s own earliest recovery from illness—are proposed. The characteristics of these duties, including their basis, moral force, extent and enforceability, are considered. They are tested against a range of objections—principled, societal, epistemological and practical—and found to survive. Finally, the paper suggests that these duties could be thought to reinforce a regrettably adversarial characteristic, shared with rights-based approaches, and that a preferable alternative might be sought through the notion of a “virtuous patient” contributing to a problem-solving partnership with the clinician. However, in defining and giving content to that partnership, there is a clear role for most, if not all, of the proposed duties; their value thus extends beyond the adversarial context in which they might first be thought to arise. (shrink)

Two new manuscripts have come to my attention since I made a study of the MS. tradition of Seneca's Natural Questions. The first is Munich, Bayerische Staats-bibliothek, Clm 18961, part ii , which I shall call Y, a late-ninth-century manuscript from Brittany or the lower Loire. It contains a short collection of theological and philosophical excerpts from a variety of authors, a collection emanating from the circle of Alcuin, probably from the generation after Alcuin himself. Included in the collection are (...) three extracts from the preface of Book 1 of Seneca's Natural Questions. Since the earliest surviving manuscripts of the Seneca work hitherto known are from the twelfth century, it is of considerable interest to see how the text of the Natural Questions in these excerpts relates to the later MS. tradition. (shrink)

Patient autonomy is a fundamental principle in end of life decision making. However, its realisation may take a variety of forms. Discourse analysis was conducted in a qualitative interview study of 19 physicians. The physicians made use of three different discourses, each of which contained a specific understanding of patient autonomy and a physician’s proper activities in the context of end of life decision making.

Gareth Evans'' proposal, as amended by Steven Neale –that a definite pronoun with a quantifiedantecedent that does not bind it has the sense ofa definite description – has been challenged inthe singular case by appeal to counter-examplesinvolving failure of the uniqueness condition forthe legitimacy of a singular description. Thischallenge is here extended to the plural.Counter-examples are provided by cases in which aplural description `the Fs'' does not denote,despite the propriety of the use of `they'' or`them'' it is to replace, because (...) of failure ofcumulativeness. A noncumulative predicate isnot distributive, and conditions for thelegitimacy of `the Fs'' designed to accommodatenondistributive `Fs'' are given in the context ofa two sorted theory with generalized quantifiers.Failure of cumulativeness is not to be confusedwith failure of maximality as Neale and othersdefine it. If not all Fs are Gs, `The Fs are Gs''is false; but it does not follow that `the Fs'' isillegitimate; and if `Fs'' is distributive. it isso only if there are no Fs. These differencesgranted, I give a partial defense of theEvans–Neale proposal from deficiencies in analternative based on the views of P. T.Geach. (shrink)

Patients participating in the shared benefits of publicly funded health care enjoy the benefits of treatments tested on previous patients. Future patients similarly depend on treatments tested on present patients. Since properly designed research assumes that the treatments being studied are—so far as is known at the outset—equivalent in therapeutic value, no one is clinically disadvantaged merely by taking part in research, provided the research involves administering active treatments to all participants. This paper argues that, because no other practical or (...) moral considerations count decisively against so doing, we could and should oblige patients to agree to receive indicated treatment within the terms of any concurrent research protocols. This ensures their treatment will benefit not only themselves but also future patients through contributing to new knowledge. By analogy with the paying of income tax, patients should not be allowed to “veto” their social responsibility to take part in clinical research. (shrink)

Medical screening is justified on the strength of the assumption that the earlier disease is detected, the better it is for the patient. On examination, however, the assumption turns out to be severely flawed, and inadequate anyway, since it is not only the patient with whom we should be concerned, but healthy people as well. Instead of making assumptions about the ill, we should prove a test's overall benefit to the individual taking it before we recommend it.

One of the dominant themes of the symposium from which this collection of articles arose was the ontological status of consent. Is consent a particular state of mind? Is it the signification of that state of mind via a conventionally recognized act? Or, is consent a normative concept that evaluates not only the presence of a state of mind or act, but also the appropriateness of that state of mind or act in the particular circumstances?

Geleitwort von Prof. P. Nicki -- Dr. Hermann Freund im Gespräch mit Prof. Dr. Dr. Hinderk M. Emrich -- Die Angst und der existentielle Sprung -- Die neue Zeit -- Der gedachte Gott -- Wie kommt das Ich zum Du? - Hysterie als Lebensform -- Was heisst, sich entscheiden? - Zur Theologie der Freiheit -- Re-formation der Reformation -- Das metaphysische und zugleich dämonische Wesen des Schlosses in Franz Kafkas Schloss-Roman -- Nachwort von Wolfgang Teichert: Epiphanie oder wo sprechende Philosophie (...) und Theologie aufhören müssen -- Literatur -- Verzeichnis der Mitwirkenden -- Abbildungsverzeichnis. (shrink)