An important thinker who contributed to eighteenth-century debates in epistemology, metaphysics, and ethics, Catharine Trotter Cockburn pursued the life of a dramatist and essayist, despite the prevailing social, cultural, and moral prescriptions of her day. Cockburn’s philosophical writings were polemical pieces in defence of such philosophers as John Locke and Samuel Clarke, in which she grappled with the moral and theological questions that concerned them and produced her own unique answers to those questions. Her works are interesting both for (...) their approach to philosophical issues that continue to be debated today and for the way that they inform our understanding of the early-modern period. (shrink)

In Psychoanalysis as a Subversive Phenomenon, Amber M. Trotter explores processes of social change, highlights the role of ethics, and illuminates ways in which analytic theory and practice can disrupt contemporary American culture.

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Contemporary bioethics begins with the perception that medical values are a matter of public, rather than merely professional, interest. Such was the message of delegates in Helsinki and of the New Jersey court that decided for Quinlan. It is a theme that lurks within almost every major bioethical treatise since the first edition of PrinciplesofBioethics. This perception also undergirds the increasingly popular suggestion that moral authority in the patient-physician relationship resides neither in the medical profession, nor in the singular will (...) of the patient, but in moral communities that link both parties with higher social orders. (shrink)

According to Native American myths, there once roamed an Eye Juggler—a humanoid deity who could detach his eyes and juggle them. His talents were of no special appeal to members of the various tribes, given that it is quite possible to hunt buffalo, prepare meals, or play stickball without tossing around your eyes. However, there was a white man who grew interested in the Eye Juggler. Sensing great utility in detachable eyes—for spying, or looking two ways at once—the white man (...) formulated a deal. He would trade away his wealth in return for the Eye Juggler's gift. To this proposition the Juggler agreed, but also issued a warning. If the eyes stay detached for very long, they rot and cannot be used. (shrink)

In fall 2002, Paul Ellwood's Jackson Hole Group proposed “Heroic Pathways”—a healthcare reform concept that includes a voluntary system of portable, personal electronic medical records owned by patients and a health information pathway that is managed by patients and clinicians. This proposal, like so much of the innovative thinking in healthcare policy, is premised on the conviction that informed patients will drive healthcare changes in the near future.

In “Ethics and the Underpinnings of Policy in Biodefense and Emergency Preparedness,” Lisa Eckenwiler advances discussion about emergency preparedness by exploring ethical commitments that shape healthcare and defense policy in an age of terrorism. Eckenwiler rightly discerns that policymakers' assumptions about controlling and containing hostile malefactors and the need for public consent regarding security measures are part of an epistemic framework that orders the current response to terrorism. Again rightly, she suggests that citizens ought to have a say in shaping (...) and interpreting such fundamental assumptions, a reductive medical model that focuses on mitigation and the management of casualties is insufficient for understanding and responding to the complex social, political, and economic factors that precipitate terrorist attacks, and there is in emergency preparedness an ethically problematic disproportion between the demands society places on public health/medical professionals and the resources society provides for them to meet these demands. She is also probably correct in claiming that, properly understood, the ethical underpinnings of public health policy are teleological in nature. (shrink)

This issue of CQ was conceived in Salt Lake City, at the third annual meeting of the American Society of Bioethics and Humanities (ASBH). There, President-elect Laurie Zoloth delivered a stirring address, emphasizing the role of bioethics in responding to social deprivations and suggesting that ASBH on important issues where members share consensus. Not all the stirrings were pleasant. Debate erupted about the propriety of consensus statements, especially regarding possible deleterious effects on academic discourse, misappropriation of dues, and the proliferation (...) of quasi-political factions. The roots of this controversy extend deeply into the collective psyche of contemporary bioethics. (shrink)

Old habits die slowly. Hence there is little surprise that attorneys fashioning the Model State Emergency Health Powers Act preserved much of their own standard operating procedure. This model statute was designed for the worst of times—for horrific scenarios in which terrorism, infectious disease, or natural calamity threaten to derail the machinery of civilization while snuffing out thousands or even millions of human lives. Such grave threats seem to justify grave measures aimed at restoring order and maximizing survival. So, the (...) model statute bestows sweeping power on state governors and public health officials, allowing them to seize private property, obtain clinical services through impressment, and enact quarantine and isolation measures without the usual due process. Yet amid all these drastic measures, certain standards persist. (shrink)

As medical students we were not discouraged from introducing ourselves by saying, “Hello, I'm Dr. So-and-so,” as opposed to identifying ourselves as students. If we happened to be doing rounds with an intern or resident, the physician would introduce himself or herself as “Dr. X and over here is Dr. Y”—indicating a student. When I introduced myself as a medical student, I got the feeling that people thought it was silly or unnecessary.

The embryonic vertebrate face is composed of similarly sized buds of neural crest‐derived mesenchyme encased in epithelium. These buds or facial prominences grow and fuse together to give the postnatal morphology characteristic of each species. Here we review the role of neural crest cells and foregut endoderm in differentiating facial features. We relate the developing facial prominences to the skeletal structure of the face and review the signals and genes that have been shown to play an important role in facial (...) morphogenesis. We also examine two experiments one at the genetic level and one at the signal level in which transformation of facial prominences and subsequent change of jaw identity was induced. We propose that signals such as retinoids and BMPs and downstream transcription factors such as Distal‐less related genes specify jaw identity. BioEssays 25:554–568, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

Studies of AGL have frequently used training and test stimuli that might provide multiple cues for learning, raising the question what subjects have actually learned. Using a selected subset of studies on humans and non‐human animals, Trotter et al. demonstrate how a meta‐analysis can be used to identify relevant experimental variables, providing a first step in asssessing the relative contribution of design features of grammars as well as of species‐specific effects on AGL.

In the third and subsequent editions of Principles of Biomedical Ethics, Tom Beauchamp and James Childress articulate a series of ethical norms that they regard as “derived” from, and hence carrying, the “authority” of the common morality. Although Beauchamp and Childress do not claim that biomedical norms they derive from the common morality automatically become constituents of the common morality, or that every detail of their account carries the authority of the common morality, they regard these derived norms as provisionally (...) binding in a way that does not apply to the norms of mere “particular” moralities. Whereas particular moralities “do not bind other persons or communities,” Beauchamp and Childress have designed the norms of Principles of Biomedical Ethics to be “extensions” of the common morality that universally binds other persons and communities. Beauchamp and Childress seem to hold that (1) the norms they articulate in Principles of Biomedical Ethics are derived in an objective way from the common morality, and also that by virtue of being so derived (2) they carry a moral authority that objectively exceeds the authority of norms constituting particular moralities. My thesis in this essay is that both of these claims are false. (shrink)

Civics and Moral Educationwas implemented as a new moral education programme in Singapore schools in 1992. This paper argues that the underlying theme is that of citizenship training and that new measures are under way to strengthen the capacity of the school system to transmit national values for economic and political socialisation. The motives and motivation for retaining a formal moral education programme have remained strong. A discussion of the structure and content of key modules in Civics and Moral Education (...) shows how curriculum writers have attempted to integrate separate strands of civics and moral education from earlier programmes and present them in a less divisive manner. The paper also assesses the impact of the written civics and moral education programme on teachers and pupils, and the way in which strategies have been used by curriculum agencies to overcome possible obstacles at the curriculum implementation phase. (shrink)

Asset freezes are sometimes viewed as the quintessential form of targeted sanctions—relatively effective in achieving their goals, while affecting only the individuals and companies that are “bad actors.” However, as part of the roundtable “Economic Sanctions and Their Consequences,” this essay argues that there are significant ethical problems raised by asset freezes and other forms of targeted financial sanctions. Sanctioners have long been criticized for targeting individuals and companies for arbitrary reasons or without adequate due process. However, there is a (...) second concern that is less well known. Asset freezes and other targeted financial sanctions may be imposed on government officials, government agencies, or private companies that hold a critical role in the target country's economy. A country's central bank, national oil company, or national shipping line, for example, may be severely compromised as a result of its inclusion on a financial blacklist. In addition to the explicit prohibitions imposed by targeted financial sanctions, there is a chilling effect as well. This can be seen when international banks and corporations withdraw from the target country altogether because the burden of compliance with these measures is so great, and the potential penalties so high. (shrink)

This dissertation reassesses the complex philosophical relationship between Sartre and psychoanalysis. Most scholarship on this topic focuses on Sartre’s criticisms of the unconscious as anathema both to his conception of the human psyche as devoid of any hidden depths or mental compartments and, correlatively, his account of human freedom. Many philosophers conclude that there is little common ground between Sartrean existentialism and psychoanalytic theory. I argue, on the contrary, that by shifting the emphasis from concerns about the nature of the (...) unconscious to questions about the role of imagination in psychical life, we can see that Sartre and Freudian-Lacanian psychoanalytic theory develop strikingly similar accounts of human subjectivity. After establishing the historical background of Sartre’s career-long engagement with psychoanalysis, I demonstrate the proximity of Sartre and Lacan on the nature of unconscious thought. I proceed to develop the claim that there is a homology between the concept of unconscious fantasy in psychoanalysis and the concept of the imaginary in Sartre’s philosophical corpus. Despite the concept of fantasy being one of the more structuralist-inspired aspects of Lacan’s metapsychology, I show that Sartre’s concept of the imaginary is likewise a structural feature of the psyche, one which establishes the coordinates within which the subject engages with the world. For Sartre, Freud, and Lacan fantasies form the core of subjectivity, giving form to the basic patterns of one’s character. Taken together, these three thinkers furnish a nuanced view of fantasy/the imaginary. On the one hand it is determining insofar as it is responsible for many of the psychopathologies met with in psychoanalysis. On the other hand, it is liberating insofar as the agency of the subject is implicated in the formation of fantasy. I thereby show that Sartre does not fit the caricatured picture of a radical voluntarist that is often attributed to him and that psychoanalysis can accommodate a conception of human freedom. (shrink)

One of the central issues in political philosophy is the problem of perspective: if there is a dispute as to how justice is to be defined, or a dispute as to whether a particular situation is unjust, how do we determine who is right? I reject the claim that an idealized speech situation or a transcendental perspective can legitimately be invoked to resolve such disputes. In their place, I discuss critical theory's commitment to the position that all perspectives are ideo (...) logical, partial, and rooted in interests. I then discuss Lukács's notion that, given that ideology and interests are ineluctable, certain per spectives are epistemologically privileged (though not transcenden tal). I discuss the notion of the preferential option for the poor in liberation theology, as an instance of such a claim of epistemological privilege. I argue that this has implications for the concept of alterity, and specifically for the role of the Other in a community of discourse. Finally, I discuss Lyotard's notion of incommensurable phrase regi mens, and the particular kind of harm which is done by exclusion from a discursive community. Key Words: critical theory • epistemological privilege • liberation theology • Lukács • Lyotard. (shrink)

Inspired by Max Weber's thesis on the Protestant ethic, this volume sets out to understand the role and influence of Christianity on overseas Chinese entrepreneurs working in China during its transition from a centrally-planned economy ...

In Holding Health Care Accountable , E. Haavi Morreim differentiates between duties of expertise and resource duties, arguing for tort liability respecting the former and contract liability respecting the latter. Though Morreim's book addresses ordinary clinical medicine, her liability scheme may also be relevant elsewhere. Focusing on disaster medicine, and especially the medical management of violent mass disasters (e.g., where terrorists have deployed weapons of mass destruction), I argue in this essay that Morreim's classification of duties still fits, but that (...) it is difficult to hold government powers accountable for their many resource and expertise duties. This difficulty is compounded by political arrangements that foist under-funded mandates for disaster services on healthcare providers. As a result of such arrangements, hospitals and clinicians are prone to liability for expenditures and clinical interventions that are beyond their scope. This problem can be mitigated, I argue, by examining and clarifying the apparent social compact between society and healthcare. (shrink)

Workers with involuntary clients influence the behaviour of their clients. One of the methods by which workers influence their clients relates to the way they model, encourage or reinforce their comments and behaviours. Practitioners may be aware or unaware of this process and of the extent to which it can impact on clients. This paper describes the process of modelling and reinforcement and discusses some of the ethical issues it raises. It suggests some guidelines by which the process may be (...) undertaken in an ethical manner and recommends the use of the ethics of care and concept of human dignity as additional theoretical resources to assist in working with this client group. (shrink)

Were terrorists ever to effectively deploy weapons of mass destruction, medical practice would be quickly transformed. Many ordinary clinicians would be asked or required to treat unfamiliar yet serious medical conditions in a setting of overwhelming urgency and impossible odds. Clinical focus would shift from doing good things for a succession of individual patients to considering many patients at once, a change that could beget loss of trust and rapport with patients. Clinicians might also experience restrictions in personal liberties and (...) appropriation of their property. The purpose of this essay is to develop a teleological framework for undertaking this transformation. In ordinary clinical medicine, the elusiveness of the individual telos (i.e., the good for the individual) is acknowledged in procedures (such as social history taking, informed consent and outpatient scheduling) designed to protect patients' (and clinicians') prerogatives to interpret the telos for themselves. In mass casualty scenarios, on the other hand, the telos is standardized and regarded as an Immediate Object (usually as a state of affairs in which survival is maximized and permanent disability is minimized). Clinicians who provide mass casualty care will face a number of ethical challenges that can be negotiated by appealing to the political and ethical rationale, and limits, pertaining to the pursuit of aggregate survival as an Immediate Object. (shrink)

Paul Ricœur’s hermeneutic approach to psychoanalysis stresses the interpretation of meanings revealed via the narratives woven through the discursive exchanges between analyst and analysand. Despite the tremendous influence Ricœur’s interpretation enjoyed both in philosophy and in psychoanalysis, his approach has been subject to severe criticism by Adolf Grünbaum who argues that Freud modeled psychoanalysis on the natural sciences, and therefore it should be judged according to natural scientific standards. I argue that Grünbaum incorrectly downplays the importance of speech and language (...) in psychoanalytic theory and practice, and moreover, that Ricœur’s approach offers important insights that deserve to be redeployed today. (shrink)

In a recent issue of CambridgeQuarterlyofHealthcareEthics, Howard Brody and Lawrence Schneiderman offer contrasting opinions about how to apply the concept of in medicine. Brody holds that are those in which it is reasonably certain that a given intervention when applied for the purpose of attaining a specific clinical goal. To determine which actions are futile, Brody prescribes a division of labor. Patients are charged with choosing the goals of treatment while physicians are charged with determining whether specific treatments will be (...) effective in achieving these goals. Though physicians do not choose specific goals, Brody thinks they have a prerogative to decide whether they can, in good conscience, aid in the achievement of specific patient goals. Let us use to denote choosing between alternative goals and to denote choices about whether one will assist in the pursuit of particular goals. Brody's position is essentially that patients are positive validators and that physicians are negative validators. Brody concludes that treatments that are effective in achieving patients' goals are not futileFutilitypromote a goal that both agree is desirable.”. (shrink)