Howard Brody expresses concern that citing the “two cases that put futility on the map,” namely Helga Wanglie and Baby K, may be providing ammunition to the opponents of the concept of medical futility. He in fact joins well-known opponents of the concept of medical futility in arguing that it is one thing for the physician to say whether a particular intervention will promote an identified goal, quite another to say whether a goal is worth pursuing. In the latter instance, (...) physicians are laying themselves open “to the criticism of taking on basic value judgments that are more appropriately left to patients and their surrogates.” Brody states that in both the Wanglie and Baby K cases, the “basic value judgments” had to do with the worthiness of maintaining unconscious life via medical technology. He classifies this as “a question of professional integrity—but not a question of futility,” adding that “more than semantics hinges on this distinction.” The “more than semantics” factor is a pragmatic, even political one. Failure to make this distinction renders physicians “that much more suspect and less trustworthy in the public debate.”. (shrink)

The report of the President's Council on Bioethics, Human Cloning and Human Dignity, addresses the central ethical, political, and policy issue in human embryonic stem cell research: the moral status of extracorporeal human embryos. The Council members were in sharp disagreement on this issue and essentially failed to adequately engage and respectfully acknowledge each others' deepest moral concerns, despite their stated commitment to do so. This essay provides a detailed critique of the two extreme views on the Council (i.e., embryos (...) have full moral status or they have none at all) and then gives theoretical grounding for our judgment about the intermediate moral status of embryos. It also supplies an account of how to address profound moral disagreements in the public arena, especially by way of constructing a middle ground that deliberately pays sincere respect to the views of those with whom it has deep disagreements. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Call for New Theological Reflection on the Sacramental Character of Marriage and the Thought of St. ThomasLawrence J. WelchTheologians across the theological spectrum have called attention to the urgent need for a new reflection on the theological and sacramental character of marriage. Peter Hünermann, known for his strong criticism of magisterial teachings on marriage, and the late Cardinal Carlo Caffarra, known for his equally strong defense of them, (...) have both drawn attention to this need. At an international symposium in September 2015, held in Rome prior to the Ordinary Synod of Bishops on Marriage and the Family, Hünermann gave a presentation entitled "On the Specific Theological Character of the Sacrament of Matrimony."1 The symposium aimed at providing a critical and scholarly discussion of new and constructive perspectives for the Church doctrine on marriage and family life in time for the 2015 synod on the family.2 Some of Hünermann's work from this paper also came to be known from an interview in Commonweal magazine where he summarized some of the main points of his symposium presentation.3 In the interview, he also revealed that before the 2015 synod he [End Page 845] was invited to speak with Pope Francis about the theology of marriage. Understandably, this meeting heightened interest in the German theologian's thought.Hünermann argues that "the specific character of the sacrament of marriage, which is very closely connected to the dying of the marriage bond,... has scarcely been the object of theological reflection, [and] is almost unknown in the consciousness of the bishops." 4 Hünermann appeals to St. Thomas as a way forward for understanding the theological character of marriage. This appeal is situated within a wider examination5 that offers an elaboration and new interpretation of "the specific dogmatic characteristics of the sacrament of matrimony that emerge in today's situation from a critical comparison of the encyclical Casti connubii and the Catholic theological tradition, especially the theology of St. Thomas."6 Sharply critical of the encyclical, Hünermann sees it as having saddled the Church with a legalistic concept of marriage elevated above history that is too far removed from the Catholic theological tradition and St. Thomas's theology of marriage.The year before his death, Cardinal Caffarra gave the 2016 graduation address at the John Paul II Institute for Marriage and Family in Washington, DC.7 Among the challenges he identified for the institute to address was the [End Page 846] need for theological reflection on the sacramental character of marriage. Referring to his earlier work, he pointed out that theology after the Council of Trent "lost the awareness of sacramental ontology, of the real transformation produced by the sacrament in the persons of the spouses [res et sacramentum]."8 Furthermore, according to Caffarra, the "theology of the conjugal covenant was supplanted by the notion of a contract, as a human act by which two persons commit to one another." The sacramental character was thought of as consisting of the assurance of divine graces given to fulfill the contract. Caffarra claimed that, "consequently, the words of Jesus 'What God has joined together, let not man put asunder,' lost all their realistic force. Absolute indissolubility, once the sacrament was perfected [=a ratified, consummated marriage], became essentially indefensible."9The primary interest of this paper is to respond to the call for a renewed theological reflection on the specific character of the sacrament of marriage. I wish to take up Caffarra's suggestion to focus on the sacramental character (res et sacramentum) on the one hand, and on the other hand, Hünermann's suggestion that a kind of ressourcement from St. Thomas Aquinas's theology of marriage can be of great help for a fresh theological reflection on the specific character of the sacrament of marriage. Although I agree with Hünermann that a renewed consideration of the thought of St. Thomas can be a way forward, I differ from him on how it can be. Hünermann notices that St. Thomas speaks of the grace of the sacrament of marriage as a helping grace.10 St. Thomas does indeed speak this way of the... (shrink)

In this book, Lawrence Hatab provides an accessible and provocative exploration of one of the best-known and still most puzzling aspects of Nietzsche's thought: eternal recurrence, the claim that life endlessly repeats itself identically in every detail. Hatab argues that eternal recurrence can and should be read literally, in just the way Nietzsche described it in the texts. The book offers a readable treatment of most of the core topics in Nietzsche's philosophy, all discussed in the light of the (...) consummating effect of eternal recurrence. Although Nietzsche called eternal recurrence his most fundamental idea, most interpreters have found it problematic or needful of redescription in other terms. For this reason, Hatab's book is an important and challenging contribution to Nietzsche scholarship. (shrink)

Vedānta Deśika produced his monumental poetic biography of Kṛṣṇa in a time when Kṛṣṇa-centered devotionalism was expanding to become perhaps the dominant mode of bhakti across South Asia. Central to this phenomenon is the growing popularity of the Bhāgavatapurāṇa, and especially of its exploration of Kṛṣṇa’s erotic play with the gopīs in his youth. Troubled by the unrestrained and seemingly adharmic sexuality of Kṛṣṇa, Deśika used the literary techniques and narrative paradigms of the mahākāvya to assimilate but also domesticate this (...) increasingly important Bhāgavata episode: Kṛṣṇa’s eroticism remains central but confined within more conventional marital norms and is thus made dharmically and theologically acceptable. Once he has resolved these dharmic problems, however, Deśika is happy to explore the soteriological, devotional, and paradoxical dimensions of erotic love with Kṛṣṇa. (shrink)

Through his innovative study of language, noted Heidegger scholar Lawrence Hatab offers a proto-phenomenological account of the lived world, the “first” world of factical life, where pre-reflective, immediate disclosiveness precedes and makes possible representational models of language. Common distinctions between mind and world, fact and value, cognition and affect miss the meaning-laden dimension of embodied, practical existence, where language and life are a matter of “dwelling in speech.” In this second volume, Hatab supplements and fortifies his initial analysis by (...) offering a detailed treatment of child development and language acquisition, which exhibit a proto-phenomenological world in the making. He then takes up an in-depth study of the differences between oral and written language (particularly in the ancient Greek world) and how the history of alphabetic literacy shows why Western philosophy came to emphasize objective, representational models of cognition and language, which conceal and pass over the presentational domain of dwelling in speech. Such a study offers significant new angles on the nature of philosophy and language. (shrink)

I critically explore various forms of the language of thought (LOT) hypothesis. Many considerations, including the complexity of representational content and the systematicity of language understanding, support the view that some, but not all, of our mental representations occur in a language. I examine several arguments concerning sententialism and the propositional attitudes, Fodor's arguments concerning infant and animal thought, and Fodor's argument for radical concept nativism and show that none of these considerations require us to postulate a LOT that is (...) innate or otherwise distinct from spoken languages. Instead, I suggest that we maintain the more conservative hypothesis, supported by introspection, that some of our thoughts occur in the languages that we speak. (shrink)

ABSTRACT By means of the high ratings that they awarded to subprime mortgage‐backed bonds, the three major rating agencies—Moody's, Standard & Poor's, and Fitch—played a central role in the current financial crisis. Without these ratings, it is doubtful that subprime mortgages would have been issued in such huge amounts, since a major reason for the subprime lending boom was investor demand for high‐rated bonds—much of it generated by regulations that made such bonds mandatory for large institutional investors. And it is (...) even less likely that such bonds would have become concentrated on the balance sheets of the banks, for which they were rewarded by capital regulations that tilted toward high‐rated securities. Why, then, were the agencies excessively optimistic in their ratings of subprime mortgage‐backed securities? A combination of their fee structure, the complexity of the bonds that they were rating, insufficient historical data, some carelessness, and market pressures proved to be a potent brew. This combination was enabled, however, by seven decades of financial regulation that, beginning in the 1930s, had conferred the force of law upon these agencies' judgments about the creditworthiness of bonds and that, since 1975, had protected the three agencies from competition. (shrink)

This book explores what anyone interested in ethics can draw from Heidegger's thinking. Heidegger argues for the radical finitude of being. But finitude is not only an ontological matter; it is also located in ethical life. Moral matters are responses to finite limit-conditions, and ethics itself is finite in its modes of disclosure, appropriation, and performance. With Heidegger's help, Lawrence Hatab argues that ethics should be understood as the contingent engagement of basic practical questions, such as how should human (...) beings live? (shrink)

Jnanasrimitra (975-1025) was regarded by both Buddhists and non-Buddhists as the most important Indian philosopher of his generation. His theory of exclusion combined a philosophy of language with a theory of conceptual content to explore the nature of words and thought. Jnanasrimitra's theory informed much of the work accomplished at Vikramasila, a monastic and educational complex instrumental to the growth of Buddhism. His ideas were also passionately debated among successive Hindu and Jain philosophers. This volume marks the first English translation (...) of Jnanasrimitra's Monograph on Exclusion, a careful, critical investigation into language, perception, and conceptual awareness. Featuring the rival arguments of Buddhist and Hindu intellectuals, among other thinkers, the Monograph reflects more than half a millennium of competing claims while providing an invaluable introduction to a crucial philosopher. Lawrence J. McCrea and Parimal G. Patil familiarize the reader with the author, themes, and topics of the text and situate Jnanasrimitra's findings within his larger intellectual milieu. Their clear, accessible, and accurate translation proves the influence of Jnanasrimitra on the foundations of Buddhist and Indian philosophy. (shrink)

Fodor and others who think that scientific, computational psychology will vindicate commonsense belief-desire psychology have maintained that belief can be identified with the explicit storage of a token with appropriate content. I review and develop problems for the explicit storage view and show that a more plausible account identifies belief with the disposition to use a token with appropriate content in explicit reasoning and planning processes and as a basis for action. I argue that this type of inner disposition account (...) will also apply to most other common sense attitudes. The result is a realism about commonsense belief-desire psychology that is more modest than Fodor's: While such inner dispositions probably do exist, these states will probably not be the main focus of scientific psychological theories. (shrink)

Regina R. is a 12-year-old girl with recently diagnosed insulin-dependent diabetes. Before discharging her from the hospital, her family physician and consulting diabetes specialist try to instruct the girl and her parents in the appropriate program of treatment, including diet, insulin, and regular self-monitoring. However, the parents become upset when they learn what is involved in insulin treatment and inform the family physician they plan to employ the services of an alternative healing clinic that promises to cure their daughter with (...) a combination of herbal potions, macrobiotics, aroma therapy, therapeutic touch, Ayurveda, homeopathy, and guided imagery. (shrink)

Kaitlyn Creasy has written a very fine book, in which she sets out an important question—how affect and nihilism correlate in Nietzsche’s philosophy—and provides a multifaceted and well-organized answer that pays due attention to the complexities in Nietzsche’s texts as well as to current scholarship relevant to the matters at hand. The term “affective nihilism” is not deployed by Nietzsche per se, but it turns out to be a very useful concept for focusing and coordinating central aspects of Nietzsche’s thought. (...) In the Nachlass, Nietzsche defines nihilism as “the radical repudiation of value, meaning, and desirability” in human existence, where “the highest values... (shrink)

How is it that sounds from the mouth or marks on a page—which by themselves are nothing like things or events in the world—can be world-disclosive in an automatic manner? In this fascinating and important book, Lawrence J. Hatab presents a new vocabulary for Heidegger’s early phenomenology of being-in-the-world and applies it to the question of language. He takes language to be a mode of dwelling, in which there is an immediate, direct disclosure of meanings, and sketches an extensive (...) picture of proto-phenomenology, how it revises the posture of philosophy, and how this posture applies to the nature of language. Representational theories are not rejected but subordinated to a presentational account of immediate disclosure in concrete embodied life. The book critically addresses standard theories of language, such that typical questions in the philosophy of language are revised in a manner that avoids binary separations of language and world, speech and cognition, theory and practise, realism and idealism, internalism and externalism. (shrink)

Abstract:Social contracting has a long and important place in the history of political philosophy (Hardin, 1991; Waldron, 1989) and as a theory of justice (Baynes, 1989; Rawls, 1971). More recently, it has been developed into an individual rights-based theory of organizations (Keeley, 1980, 1988), and as a way to integrate ethics and moral legitimacy into corporate strategy and action (Donaldson, 1982; Freeman&Gilbert, 1988). Currently, it is being proposed as an integrative theory of economic ethics (Donaldson&Dunfee, forthcoming). This paper will extend (...) the Donaldson and Dunfee approach by arguing thatsocial contracting can best be understood and applied in organizational settings if it is perceived and treated as a network governance process. This insight can benefit management scholars and practitioners alike, since it calls attention to the processes by which trust is created and sustained in on-going contractual relationships. It also strongly suggests that a new approach to applying managerial discretion, asmoral agency, is needed to realize the full competitive and ethical potential of emerging network forms. (shrink)

The placement of hydrogen in the periodic table has unique implications for fundamental questions of chemical behavior. Recent arguments in favor of placing hydrogen either separately at the top of the table or as a member of the carbon family are shown to have serious defects. A Coulombic model, in which all compounds of hydrogen are treated as hydrides, places hydrogen exclusively as the first member of the halogen family and forms the basis for reconsideration of fundamental concepts in bonding (...) and structures. The model provides excellent descriptive and predictive ability for structures and reactivities of a wide range of substances. (shrink)

A few years ago a battered infant was admitted to a California hospital. After a period of observation and testing, the physicians concluded that the infant had been beaten so badly that his brain was almost completely destroyed, leaving him permanently unconscious. The hospital had just adopted a policy specifying that life-sustaining treatment for permanent unconsciousness was futile and, therefore, not indicated. According to this policy, after suitable subspecialty consultations and deliberations, including efforts to gain parental agreement and documentation of (...) unanimous ethics committee support, the patient's physician had the authority to discontinue life-sustaining treatment. The infant's physician wished to do this. The mother, however, who was the prime battery suspect, insisted that the baby be kept alive. (shrink)

U.S. politicians and policymakers have been preoccupied with how to pay for health care. Hardly any thought has been given to what should be paid for—as though health care is a commodity that needs no examination—or what health outcomes should receive priority in a just society, i.e., rationing. I present a rationing proposal, consistent with U.S. culture and traditions, that deals not with “health care,” the terminology used in the current debate, but with the more modest and limited topic of (...) medical care. Integral to this rationing proposal—which allows scope to individual choice and at the same time recognizes the interdependence of the individual and society—is a definition of a “decent minimum,” the basic package of medical treatments everyone should have access to in a just society. I apply it to a specific example, diabetes mellitus, and track it through a person's life span. (shrink)

Book reviewed in this article: The Physician's Covenant: Images of the Healer in Medical Ethics. By William F. May.

This book is a comprehensive exposition of the Transcendental Deduction of the Categories in both editions of Kant’s Critique of Pure Reason.

The success or failure of an ineffective assistance of counsel claim turns largely on the testimony of trial counsel. It is therefore common for the government to communicate ex parte with trial co...

Let A 1 , A 2 , A 3 A 4 be four observables, the compatible observables among them being (A 1 , A 3 ), (A 1 , A 4 ), (A 2 , A 3 ), (A 2 , A 4 ). In order that the empirical data be reproducible by a quantum or a classical theory, the two-point correlation functions $$\{ C_{ij} = \left\langle {A_i A_j } \right\rangle :i,j a compatible pair\} $$ must necessarily satisfy $$|X_{13} X_{14} (...) - X_{23} X_{24} | \leqslant \left( {1 - X_{13} ^2 } \right)^{{1 \mathord{\left/ {\vphantom {1 2}} \right. \kern-\nulldelimiterspace} 2}} \left( {1 - X_{14} ^2 } \right)^{{1 \mathord{\left/ {\vphantom {1 2}} \right. \kern-\nulldelimiterspace} 2}} + \left( {1 - X_{23} ^2 } \right)^{{1 \mathord{\left/ {\vphantom {1 2}} \right. \kern-\nulldelimiterspace} 2}} \left( {1 - X_{24} ^2 } \right)^{{1 \mathord{\left/ {\vphantom {1 2}} \right. \kern-\nulldelimiterspace} 2}} (*)$$ where Xij=CijC ii −1/2 C jj −1/2 . In the case ofGaussian data, this inequality is alsosufficient; If (*) holds, there is a Gaussian joint distribution for A 1 , A 2 , A 3 , A 4 which reproduces the Gaussian data for compatible pairs. It follows that Bell's inequality is satisfied by all true-false propositions about the Gaussian data. A further consequence of the analysis is thatquantum Gaussian fields satisfy Bell's inequality for all true-false propositions aboutfield measurements.The maximum violation of (*) corresponds to Rastall's example in the case of two-valued observables. (shrink)

It probably should not be surprising, in this time of soaring medical costs and proliferating technology, that an intense debate has arisen over the concept of medical futility. Should doctors be doing all the things they are doing? In particular, should they be attempting treatments that have little likelihood of achieving the goals of medicine? What are the goals of medicine? Can we agree when medical treatment fails to achieve such goals? What should the physician do and not do under (...) such circumstances? Exploring these issues has forced us to revisit the doctor-patient relationship and the relationship of the medical profession to society in a most fundamental way. Medical futility has both a quantitative and qualitative component. I maintain that medical futility is the unacceptable likelihood of achieving an effect that the patient has the capacity to appreciate as a benefit. Both emphasized terms are important. A patient is neither a collection of organs nor merely an individual with desires. Rather, a patient (from the word to suffer ) is a person who seeks the healing (meaning to make whole ) powers of the physician. The relationship between the two is central to the healing process and the goals of medicine. Medicine today has the capacity to achieve a multitude of effects, raising and lowering blood pressure, speeding, slowing, and even removing and replacing the heart, to name but a minuscule few. But none of these effects is a benefit unless the patient has at the very least the capacity to appreciate it. Sadly, in the futility debate wherein some critics have failed or refused to define medical futility an important area of medicine has in large part been neglected, not only in treatment decisions at the bedside, but in public discussions—comfort care—the physician’s obligation to alleviate suffering, enhance well being and support the dignity of the patient in the last few days of life. (shrink)

Two recent policy statements by providers of critical care representing the United States and Europe have rejected the concept and language of “medical futility,” on the ground that there is no universal consensus on a definition. They recommend using “potentially inappropriate” or “inappropriate” instead. As Bosslet and colleagues state: The term “potentially inappropriate” should be used, rather than futile, to describe treatments that have at least some chance of accomplishing the effect sought by the patient, but clinicians believe that competing (...) ethical considerations justify not providing them. Clinicians should explain and advocate for the treatment plan... (shrink)

In Nietzsche's Thus Spoke Zarathustra, a central teaching calls on humanity to be "true to the earth," to affirm "the meaning [Sinn] of the earth." Scholars commonly read this as a call to embrace natural life, countering any transcendent or life-denying doctrine in the tradition. While certainly an apt reading, Gary Shapiro's remarkable new book draws attention to and articulates the many ways in which Nietzsche celebrates the actual earthen characteristics of human habitats: the concrete places, locales, climates, and environments (...) that sustain our dwelling on earth. Here, geology and geography are brought to bear and expanded into an enriched, meaning-laden "geo-philosophy." Shapiro interprets Nietzsche's... (shrink)

Nietzsche's On the Genealogy of Morality is a forceful, perplexing, important book, radical in its own time and profoundly influential ever since. This introductory textbook offers a comprehensive, close reading of the entire work, with a section-by-section analysis that also aims to show how the Genealogy holds together as an integrated whole. The Genealogy is helpfully situated within Nietzsche's wider philosophy, and occasional interludes examine supplementary topics that further enhance the reader's understanding of the text. Two chapters examine how the (...) Genealogy relates to standard questions in moral and political philosophy. Written in a clear, accessible style, this book will appeal to students at every level coming to read the Genealogy for the first time, and a wider range of readers will also benefit from nuanced interpretations of controversial elements in Nietzsche's work. (shrink)