This collaborative essay experimentally applies the insights of Mary Shelley's 1818 gothic fantasy Frankenstein to clinical interactions between present-day physicians and the patients they, akin to Shelley's human protagonist, so often seem to bring (back) to life. Because that process is frequently fraught with unspoken elements of ambivalence, disappointment, frustration, and failure, we find in Shelley's speculative fiction less a cautionary tale of overreach than a dynamic parable of the role that the unspoken, the invisible, and the unknown might play (...) in contemporary physician/patient relationships. Playing with that parable, we consider its relevance to four often unacknowledged dynamics that shape physician/patient interaction: commitment to a false binary of life and death; the tyranny of normative aesthetics; shared negative affect; and the ethics of care and care-denial. To "speak with Frankenstein" is, we show, to make space for the otherwise unspeakable. The result is a more complete model of narrative medicine that accommodates to its ideal of open communication and full attention the persistence of what cannot be said, seen, or known--only imagined and approximated. (shrink)

Moral philosophers typically have confronted two distinct kinds of problems. First, they have attempted to discover the supreme principle of morality and show how it should influence our conduct by indicating what specific virtues, obligations, laws, and way of life it would require. Second, they have tried to demonstrate that we ought to live according to its demands and do what is morally right even when our immediate desires pull us in the opposite direction.

This multidisciplinary volume documents the resurrection of the importance of narrative to the study of individuals and groups and argues that narrative may become a lingua franca of future debates in the human sciences.

A relative value of life dependent on age has been produced from a survey of 721 randomly selected individuals together with other observations of professional practice. The results are presented in diagrammatic form. If two identical people, except for age, present for medical treatment for a life-threatening condition and only one can be treated then the diagram indicates what the choice should be.

In those twenty or so pages of section xi of Part Two of the Philosophical Investigations in which Wittgenstein discusses the concept of noticing an aspect and its place among the concepts of experience, there are three passages which are explicitly concerned with the relations between seeing and interpreting in the experience of noticing an aspect.

More than three decades after its advent in political science, rational choice theory has yet to add appreciably to the stock of knowledge about politics. In Pathologies of Rational Choice Theory we traced this failure to methodological defects rooted in the aspiration to come up with universal theories of politics. After responding to criticisms of our argument, we elaborate on our earlier recommendations about how to improve the quality of rational choice applications. Building on suggestions of contributors to this volume, (...) we lay out an empirically based research program designed to delineate the conditions under which rational choice explanations are likely to be useful. (shrink)

Scientia nova veröffentlicht Originalarbeiten bahnbrechender Forscher oder allgemeinverständliche Einführungen in schwierige Spezialgebiete, die für die Philosophie, Logik und Mathematik von ebenso großer Bedeutung sind, wie für die Natur- und Sozialwissenschaften. Scientia nova ist eine Bibliothek des modernen wissenschaftlichen Denkens, die dazu beiträgt, die Zersplitterung der Forschung in Spezialgebiete zu überwinden und einem neuen Denkstil zum Durchbruch zu verhelfen.

Romanticism is recognized as a wellspring of modern-day environmental thought and enthusiasm for nature-preservation, but the character of the affinities between the two is less well understood. Essentially, the Romantics realised that nature only becomes a matter for ethical concern, inspiration and love when the mind and sensibility of the human observer/agent are properly attuned and receptive to its meaning. That attunement involves several factors: a more appropriate scientific paradigm, a subtler appreciation of the impact that the setting of human (...) dwelling, especially landscape, may have on character; the discovery of 'life' and spontaneity as a motif in science and art; a deeper and more complex sense of time; and a feel for place drawn from the life-world rather than physics or economics. Romanticism invented a new language and set of descriptions to illuminate all of these things, one we neglect or forget at our peril. (shrink)

Environmental theorists, seeking the origin of Western exploitative attitudes toward nature, have directed their attacks against 'humanism'. This essay argues that such criticisms are misplaced. Humanism has much closer affinities to environmentalism than the latter' s advocates believe. As early as the Renaissance, and certainly by the late eighteenth century, humanists were developing historically-conscious, hermeneutically-grounded modes of understanding, rather than the abstract, mathematical models of nature often associated with them. In its twentieth-century versions humanism also shares much of the mistrust (...) of consumerism, instrumental reason, and 'worldlessness' that marks environmentalist literature. Nevertheless, humanism is indeed committed to the principle that human beings are and ought to be free, and opposes theoretical approaches that suppress freedom. Reconciling humanism and environmentalism thus involves two steps: resisting the former's tendency to treat nature and freedom as metaphysical polarities, and drawing environmental theory away from flirtation with deterministic, biologistic worldviews. The essay concludes by suggesting Aldo Leopold's A Sand County Almanac as the paradigm case of environmental thought with roots in humanist approaches. (shrink)

Recent developments in themethodology of economics have drawn uponpragmatist and realist philosophies of socialscience. These recent developments areoutlined. It is argued that a specific variantof realist philosophy known as critical realismcan provide the basis for a prescriptiveeconomic methodology that is not susceptible topragmatist criticisms.

The second volume in the Vancouver Studies in Cognitive Science series, this collection presents recent work in the fields of phonology, morphology, semantics, and neurolinguistics. Its overall theme is the relationship between the contents of grammatical formalisms and their real-time realizations in machine or biological systems. Individual essays address such topics as learnability, implementability, computational issues, parameter setting, and neurolinguistic issues. Contributors include Janet Dean Fodor, Richard T. Oehrle, Bob Carpenter, Edward P. Stabler, Elan Dresher, Arnold Zwicky, Mary-Louis Kean, and (...) Lewis P. Shapiro. (shrink)

Although death by neurologic criteria is legally recognized throughout the United States, state laws and clinical practice vary concerning three key issues: the medical standards used to determine death by neurologic criteria, management of family objections before determination of death by neurologic criteria, and management of religious objections to declaration of death by neurologic criteria. The American Academy of Neurology and other medical stakeholder organizations involved in the determination of death by neurologic criteria have undertaken concerted action to address variation (...) in clinical practice in order to ensure the integrity of brain death determination. To complement this effort, state policymakers must revise legislation on the use of neurologic criteria to declare death. We review the legal history and current laws regarding neurologic criteria to declare death and offer proposed revisions to the Uniform Determination of Death Act and the rationale for these recommendations. (shrink)

At the heart of Levinas’s work is the apparently simple idea that through the encounter with another person, we are forced to give up our self-concern and take heed of the ethical relation between us. But, while simple on the surface, when one tries to characterize it in more detail, it can be hard to fit together the various ways in which Levinas talks about this relation and to identify precisely what he took its normative structure to be, as this (...) is described in a number of apparently different ways, that are not obviously compatible or equivalent, such as “command,” “call,” “summons,” “demand,” and so on. In this chapter, we intend to focus on these different characterizations and show what makes them different while also endeavoring to find a way in which Levinas’s conception may nonetheless be fitted together into a coherent account of the face-to-face encounter that is at the heart of his ethics. We will begin by considering the different normative terms used to characterize the encounter in that text and show how they are conceptually distinct from one another; we will then offer a way to read Levinas’s position to nonetheless show how these different normative relations can be fitted together into a stable position. (shrink)

Over the past two decades ethics committees have proliferated in healthcare institutions across the country. Catalysts for this growth include the endorsement of ethics committees by the New Jersey Supreme Court in the Quinlan case, by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical Research in its report entitled Deciding to Forgo Life Sustaining Medical Treatment, by the U.S. Department of Health and Human Services in its 1985 “Baby Doe” regulations, by numerous other courts in (...) treatment decisionmaking opinions issued after Quinlan, and more recently by the Joint Commission on Accreditation of Healthcare Organizations. (shrink)

For over a decade, managed care has profoundly altered how healthcare is delivered in the United States. There have been concerns that the patient-physician relationship may be undermined by various aspects of managed care, such as restrictions on physician choice, productivity requirements that limit the time physicians may spend with patients, and the use of compensation formulas that reward physicians for healthcare dollars not spent. We have previously published data on the effects of managed care on the physician-patient relationship from (...) the physician's perspective. In 1999, we collected data on the impact of managed care arrangements on the physician-patient relationship from the patient's perspective. This article discusses our collective findings. (shrink)

This new anthology of early modern philosophy enriches the possibilities for teaching this period by highlighting not only metaphysics and epistemology, but also new themes such as virtue, equality and difference, education, the passions, and love. It contains the works of forty-three philosophers, including traditionally taught figures such as Descartes, Spinoza, Leibniz, Locke, Berkeley, Hume, and Kant, as well as less familiar writers such as Lord Shaftesbury, Anton Amo, Julien Offray de La Mettrie, and Denis Diderot. It also highlights the (...) contributions of women philosophers, including Margaret Cavendish, Anne Conway, Gabrielle Suchon, Sor Juana Inéz de la Cruz, and Emilie Du Châtelet. (shrink)

Being able to ask others to do things, and thereby giving them reasons to do those things, is a prominent feature of our interpersonal lives. In this paper, I discuss the distinctive normative status of requests – what makes them different from commands and demands. I argue for a theory of this normative phenomenon which explains the sense in which the reasons presented in requests are a matter of discretion. This discretionary quality, I argue, is something that other theories cannot (...) accommodate, though it is a significant aspect of the relations that people stand in to one another, and the kinds of practical reasons that flow from those relations. (shrink)

Some reasons are thought to depend on relations between people, such as that of a promiser to a promisee. It has sometimes been assumed that all reasons that are relational in this way are moral obligations. I argue, via a counter example, that there are non-obligatory relational reasons. If true, this has ramifications for relational theories of morality.

A lineage of prominent philosophers who have discussed the second-person relation can be regarded as advancing structural accounts. They posit that the second-person relation effects one transformative change to the structure of practical reasoning. In this paper, I criticise this orthodoxy and offer an alternative, substantive account. That is, I argue that entering into second-personal relations with others does indeed affect one's practical reasoning, but it does this not by altering the structure of one's agential thought, but by changing what (...) reasons can become available. The importance of second-personal thought for action is heterogenous. Second-person relations make possible the emergence of a wide variety of different kinds of practical reasons: creating some, revealing others. Recognising this diminishes the appeal of the traditional, structural accounts of the practical significance of such second-personal relations. Moving away from structural accounts facilitates a more thorough understanding of the intersubjective form of action. (shrink)

Second-person relations are relations between individuals knowingly engaged in interaction with one another. These are the social contexts within which it is appropriate for one to think of and address another as ‘you’. This dissertation explores the practical consequences for agents of relating to others in this fashion. A critical analysis is offered of Stephen Darwall’s theory of moral obligations in terms of demands that can be addressed from the perspective of a second-person. On the basis of the criticisms raised, (...) a broader conception of ‘second-personal reasons’ is advanced according to which there are a variety of species of practical reasons that are essentially grounded in second-person relations between agents, besides moral obligations. A paradigm case of such a species is the reasons that are presented in requests, and one chapter of this work is devoted to explaining this power people often grant to others: to intentionally create new, discretionary reasons for them. Drawing from several historical antecedents – particularly Martin Buber, Simone Weil and Emmanuel Levinas – the analysis of second-personal reasons is extended to include a discussion of the proper object of agapic love, and a discussion of the possible significance that face-to-face encounters may have for moral epistemology. (shrink)