Clinical ethics consultation is largely outside the scope of regulation and oversight, despite its importance. For decades, the bioethics community has been unable to reach a consensus on whether there should be accountability in this work, as there is for other clinical activities that influence the care of patients. The American Society for Bioethics and Humanities, the primary society of bioethicists and scholars in the medical humanities and the organizational home for individuals who perform CEC in the United States, has (...) initiated a two‐step quality attestation process as a means to assess clinical ethics consultants and help identify individuals who are qualified to perform this role. This article describes the process. (shrink)

Ricoeur’s hermeneutics provides us with an important and original account of the meaning and the implications of the “ontological turn” that has taken place in hermeneutics since Heidegger’s work. By means of the pair ontologisation and hermeneutisation, which is borrowed from Jean Grondin, this paper examineshow Ricoeur rethinks the relation between being and language. Distancing itself from Nancy’s critique of Ricoeur’s hermeneutics, this paper first shows thatRicoeur’s hermeneutic ontology should not be understood as a “secondary” form of hermeneutics. Rather, it (...) provides us with a critical revision of Heidegger’s “primordial” hermeneutics that is centered on the notion of announcement. Secondly, it shows how, by this revision, Ricoeur does not only develop an alternative to Heidegger’s accounts of announcement and attestation, but also to Derrida’s account of equivocity. (shrink)

In this article, I will explore the archeology of the concept of attestation in Ricoeur’s work. In a brief discussion of his early reflections on Husserl’s concept of the ego (as an example of reflexive philosophy), I show how the dialectic of trust and suspicion enters Ricoeur’s hermeneutic concerns. I argue that this dialectics remains present in his account of attestation. By a brief confrontation with Heidegger’s notion of attestation as developed in Being and Time, I show (...) that the uniqueness of Ricoeur’s account of attestation is to be found in this dialectic of trust and suspicion that he reinterprets in his later work in light of the concept of attestation. (shrink)

A travers une analyse des concepts d’affirmation originaire, d’attestation et de reconnaissance, cet article tente de reconstituer le sens et les motivations du cheminement réflexif qui conduit Ricœur de L’Homme faillible à Soi-même comme un autre et à Parcours de la reconnaissance . Pour ce faire, il s’efforce d’abord de montrer ce qui fait la continuité profonde, de problématique et de méthode, du projet anthropologique ricœurien; afin de dégager ensuite les difficultés centrales liées à l’idée d’une constitution poétique du (...) soi, qui conduisent Ricœur à réélaborer les concepts directeurs de son herméneutique du soi. A la lumière du dialogue constant de Ricœur avec la philosophie de Nabert, il tente enfin de montrer comment les concepts d’attestation et de reconnaissance trouvent, pour l’essentiel, leur genèse dans un approfondissement de la notion d’affirmation originaire, lui-même prolongé par une réflexion sur le témoignage.  . (shrink)

The Quality Attestation Presidential Task Force's recent proposal for “quality attestation” (QA) of clinical ethics consultants was advanced on the premise that, “[g]iven the importance of clinical ethics consultation, the people doing it should be asked to show that they do it well.” To this end, the task force attempted to develop “a standardized system for proactively assessing the knowledge, skills, and practice of clinical ethicists.” But can this proposed method deliver? If the proposed QA process is flawed, (...) it will label clinical ethicists as qualified to do clinical ethics consultations (CECs) when they are not. The result will be the creation of a new, likely intractable, problem of CEC “false positives:” consultants who have passed QA without actually possessing the requisite knowledge and skills to perform CECs.To avoid the risk of false positives, the QAPTF needs to conduct a rigorous analysis of the skills that the QA process will be positioned to judge and those that are simply beyond the scope of its current metrics. Rather than “attesting” to overall CEC “quality,” QA needs to be precise about the skill inventory it can confirm yet honest about the skills it has no basis to assess. I will argue here that QA has strong prospects for accurately assessing consultants’ competence in ethical analysis but very weak prospects for determining competence in two other skills listed as essential by the QAPTF: value‐neutrality and conflict resolution. (shrink)

Aristotelian relativism about the future (as recently defended by MacFarlane ( 2003 )) claims that a prediction made on Monday, such as ‘It will rain’, can be indeterminate on Monday but determinate on Tuesday. A serious objection to this intuitively appealing view is that it cannot coherently be attested: for if it is attested on Monday, then our blindness to what the future holds precludes attesting that the prediction is determinate on Tuesday, and if it is attested on Tuesday (when, (...) suppose, it rains), then the fact that it rains precludes attesting that the prediction is indeterminate on Monday. In this paper, I focus on Moruzzi and Wright ( 2009 )’s recent development of this objection and argue that it fails. This result removes a major obstacle to defending the Aristotelian view. (shrink)

El siguiente ensayo busca explorar la tesis según la cual en la atestación o reconocimientode sí, el sí-mismo que está en juego está atestiguado primeramente de modo prospectivo. Atestiguarse esreconocerse no en sí, sino en un envío, en una conminación que resulta del encuentro con lo otro; de estemodo, se puede afirmar que la identidad personal es ante todo una identidad de éxodo, es decir enviada.Para el análisis de estas tesis quisiéramos centrarnos en la fenomenología hermenéutica del hombre capazque desarrolla (...) Ricoeur de modo explícito en Soi-même comme un autre, y que ya ha bosquejado desdeLe volontaire et l'involontaire. Con ello interrogaremos en qué sentido las capacidades son un modo deser respondiente del sí-mismo ante lo otro que lo envía, y luego interrogaremos, en los márgenes de lahermenéutica bíblica del autor, el alcance de lo que significa responder para el sí-mismo. (shrink)

The American Society for Bioethics and Humanities is now proposing a process whereby the role and authority of clinical ethics consultants can be legitimated. Without regulation and oversight, the field lacks validity and accountability. ASBH has sought to remedy the lack of uniform standards and accreditation by publishing Core Competencies in Health Care Ethics Consultation and an education guide, and now by proposing a “quality attestation process,” situated between national certification processes and local credentialing practices, to “attest to the (...) skills and ability of properly trained and competent clinical ethicists.” If the process is successful, a cadre of certified clinical ethics consultants will emerge. Before the dawn of this new era, it is worth pausing to consider the adequacy of the quality attestation process itself and how it will affect the current world of clinical ethics consultants. Ethics consultations are often done by a multidisciplinary team, and the consult note is a compilation or synthesis of the work of the team. If the evidence required to attest to one's quality as an ethics consultant is to bear on one's ability to work with a team and present an integrated consult note, then these notes are relevant. If, however, the evidence is to bear on the quality of one's own work, then the evidence is inconclusive at best, fraudulent at worst. The quality attestation process seems to be predicated on the individual ethics consultant model, which may not jibe with the realities of ethics consultation. There may be more than one way to demonstrate one's competence, and there may be more than one competency to demonstrate. (shrink)

The aim of this article is to discuss and illustrate the grammaticalization process and the polysemic and polyfunctional nature of the Spanish and Catalan markers la verdad and la veritat, from an original objectified referential meaning of the forms to a highly subjectified procedural meaning of the markers. The pragmatic meaning of these markers stems from the loss of semantic features and the different uses that they can adopt in a variety of syntactic and pragmatic contexts, where their subjective, evaluative, (...) and intensifying modal dimensions are fully manifested. In lexical terms, they are noun phrases that can take variable and invariable forms. In morphological terms, the variable form is inflected in number and has a referential value, whereas the invariable form, prosodically extraposed, or followed by a verbal predicate when working as pragmatic marker, is always uninflected and is polyfunctional, with a procedural value. When followed by a verbal predicate, la verdad and la veritat acquire a structural dimension, besides their modal illocutionary one, being used as boundary markers that separate description of facts from first person evaluation, in a monologued stretch of discourse. In an interactional context, the marker frequently prefaces counter expectations. In order to show its grammaticalization process, I will discuss and exemplify their role as evidential marker with a truth-attesting value, epistemic modality markers used to introduce the speaker’s attitude to the content of the proposition or to the addressee in the context of an utterance, intensifiers or boosters used to modify the illocutionary force of a speech act, and discourse boundary markers used to delimit real-world facts from personal opinion. In order to account for their polysemic and polyfunctional dimensions, I will propose salient meanings and prototypical functions. (shrink)

A proposal by the American Society for Bioethics and Humanities (ASBH) to identify individuals who are qualified to perform ethics consultations neglects case complexity in candidates’ portfolios. To protect patients and healthcare organizations, and to be fair to candidates, a minimum case complexity level must be clearly and publicly articulated. This proof-of-concept study supports the feasibility of assessing case complexity. Using text analytics, we developed a complexity scoring system, and retrospectively analyzed more than 500 ethics summaries of consults performed at (...) an academic medical center during 2013. We demonstrate its use with seven case summaries that range in complexity from uncomplicated to very complicated. We encourage the ASBH to require a minimum level of case complexity, and recommend that attestation portfolios include several cases of moderate complexity and at least one very complex case. (shrink)

The first argument that Hume offers against believing in miracle stories in Part 2 of his essay on miracles relies on social context in a way that makes it difficult to follow. Hume says that there’s never been a miracle story that’s well enough attested with respect to certain criteria of testimonial strength. A little later in the essay, he cites recent miracle stories coming from that Saint Médard cemetery as meeting the criteria to an exceptionally high degree, but even (...) so, he claims that we can dismiss the stories out of hand. The hidden background assumption is that his Protestant readers wouldn’t have been tempted to believe in miracle stories coming from an oppressed Catholic sect. Other examples in Part 2 of the essay work in the same way. Hume praises to the skies the quality of the evidence for an earlier Jansenist miracle, for a miracle involving the restoration of a leg through holy water at a Catholic cathedral, and a miracle at a temple of Serapis knowing that his readers won’t be inclined to believe in any of them. The point is that these miracles are better attested than the miracle stories in the Bible, and if we shouldn’t believe in the better attested stories, then we shouldn’t believe in the worse. This can seem like an appeal to prejudice, but really Hume is doing something subtler. He knows that it’s easier to criticize the irrational beliefs of others, but sees that once we turn the same standards that we use on others on our own beliefs, epistemic progress is possible. (shrink)

The aim of this article is to show that the “attestation of evil and testimony of hope” are characterized by the genitive that accompanies them. This places them both, each no less than the other, in two different horizons: while the horizon of attestation is Heideggerian, the horizon of testimony is a legacy of Jean Nabert. Both of these horizons are present in the thought of Ricœur, and characterize the entire spectrum of his work. However, we are not (...) dealing here with a syncretism resulting from the co-presence of a hermeneutic source and of the philosophy of reflection. On the contrary, I attempt to show that the co-presence of attestation and testimony results from the fact that Ricœur never stopped “walking on two legs,” given what he writes in a conversation published in the Critique and Conviction, and that this presence is rooted in Ricœur’s formation, which is at the same time philosophical, literary and biblical, as he never renounced either the former one, or the latter ones. (shrink)

This article presents the edition of three unpublished 16th-century scrolls preserved in the Palau Ribes Collection (Barcelona) that contain diagrammatic representations of the holy places of Mecca and Medina. One of them certifies the fulfillment of the major (ḥajj) and minor (ʿumra) pilgrimage to the holy city of Mecca on behalf of a little girl, in what appears to be a certificate reused by removing the names of the original parties. The other two documents extoll the city of Medina and (...) the Prophet Muḥammad, as part of the pious visit to his tomb (ziyāra) carried out by individuals who are not mentioned by name. In addition, the three documents share the same material characteristics, and present textual structures that suggest they were mass-produced models. They therefore constitute three case studies evidencing a significant shift in the production of Islamic certificates of pilgrimage, and can thus help expand our knowledge of the ritual itself. (shrink)

The subject of this article is the istishhād method used by Abû Ishâq al-Zajjāj (d. 311/923) in his work calledMa‘ānī al-Qur’ān wa i‘rābuh. Zajjāj, who lived in the third and fourth centuries of the Islamic calendar, is one ofthe leading scholars of the Arabic language. Zajjāj, who wrote various works in the field of Arabic language,wrote his most important work in the field of tafsir named Ma‘ānī al-Qur’ān wa i‘rābuh, in a long period ofabout sixteen years. In this work, Zajjāj (...) examined the verses in terms of language and rhetoric, and also includedexplanations about word structure and syntax rules. In his analyzes and evaluations, it is seen that Zajjāj madeistishhād from verses of the Qur'an, Qur’anic recitation, hadiths, poems and Arabic dialects. The verses of theQur'an are at the forefront of the istishhāds used by Zajjāj in his mentioned work. Zajjāj, who applied to poemsin the second place, made istishhād with nearly five hundred poems in his work. In the present study, Zajjāj’s lifestory, his tafsir named Ma‘ānī al-Qur’ān and the characteristics of the work are briefly mentioned. Followingthis, the concept of istishhād, the place and importance of istishhād in Arabic language are examined. Finally, theistishhād method used by Zajjāj in his work named Ma‘ānī al-Qur’ān has been tried to be explained with someexamples. (shrink)

The Quality Attestation Presidential Task Force has made a thoughtful and thorough contribution to the establishment of clinical ethics consultation as a professional field. As Eric Kodish, Joseph J. Fins, and colleagues indicate, quality attestation is another step in bringing greater accountability and transparency to CEC. To complete this process, however, the work of the QAPTF must be situated within a larger project. As the field further develops, there will be a move toward restricting CEC to those who (...) have demonstrated, by means of this version of the quality attestation or an eventual iteration of it, that they are capable of conducting an ethics consultation with the skill, knowledge, and rigor necessary. This raises the question of how potential consultants will gain the experience required to produce a portfolio of cases when only those who are qualified are permitted to perform CECs, either by their institution or by some external evaluator, such as The Joint Commission. Now may be the time to begin thinking about further developments in the field that will complement both current academic training programs and the quality attestation process. For this, we might look to the Association for Clinical Pastoral Education for its model for certifying educators of chaplains who wish to become professionals. (shrink)

This essay aims to correct a prevalent misconception about Paul Ricoeur’s hermeneutics, which understands it to support a conception of human understanding as finite as Heidegger did, but in a more “conceptuallyconservative” way. The result is that Ricoeur’s work is viewed as incapable of addressing the most pressingproblems in contemporary Continental metaphysics. In response, it is argued that Ricoeur is in fact the firstto develop an infinite hermeneutics, which departs significantly from Heideggerian finitude. This positionis demonstrated by tracing the itinerary (...) from Heidegger’s account of aletheia to Ricoeur’s account ofattestation. The conclusion, then, not only clears Ricoeur of the stated charges, but also presents a moreviable path for the future of hermeneutics. (shrink)

I examine the problem of what Ricœur calls représentance, which is a stand-in narratives offer of what took place (in the case of historical narratives) or actions (in the case of the re-telling of what people did). Ricœur rejects as insufficient two naive options: first, a simple adequacy between what took place and the historical narrative about it and, second, a simple heterogeneity between them so that historical narratives would be mere “possible versions” of what took place. I explore further (...) why Ricœur brought into consideration the attitude of the one offering the narrative, what he calls a “being-in-debt” or “attestation”. I then offer an assessment of Ricœur’s success in still claiming that what actually happened serves as the ultimate referent of the narratives given of the past event or the action. (shrink)

One element of the American Society for Bioethics and Humanities’ recently-piloted quality attestation portfolio for clinical ethics consultants is a “philosophy of clinical ethics consultation statement” describing the candidate’s approach to clinical ethics consultation. To date, these statements have been under-explored in the literature, in contrast to philosophy statements in other fields such as academic teaching. In this article, I argue there is merit in expanding the content of these statements beyond clinical ethics consultation alone to describe the author’s (...) approach to other important “domains” of healthcare ethics practice. I also claim such statements have at least three additional uses outside quality attestation: as a reflective practice learning tool to increase role clarity among practicing healthcare ethicists and bioethics fellows; assisting practicing healthcare ethicists in clarifying role expectations with those they work with; and helping inform developing professional practice standards. (shrink)

Paul Ricoeur is a philosopher of wide ranging interests whose main concern is hermeneutics. His hermeneutics is self-reflexive, an existential appropriation that eventually gives way to self-understanding. Questions pertaining to self-identity, the problem of the other and intersubjectivity are presented by him in a tensive style, keeping the scope of interpretations wide open. While discussing the question of self-identity, he moves towards intersubjectivity which is centred on self-esteem. It provides a context for self-constancy which gives to a moral identity, an (...) attestation of Here I am. Here arises the basic issue, how the narrative identity which is hermeneutical give rise to an ethical relation. If so, Ricoeur must be ready to see that there is an asymmetric relation between the same and the other which can be termed ethical. Though he says that conscience contains an injunction to attest ourselves to say, Here I am, it is a statement of “said” and not one of “saying”. Only a statement of “saying” can interrupt ontology and enact the movement from the same to the other which is ethical. Hence, Ricoeur stands at the hemeneutical level which cannot abandon ontology. But the polysemic nature of alterity posed by him never closes the possibilities of an ethical interpretation. (shrink)

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...) on the pathway to an eventual certification process for clinical ethics consultants. (shrink)

Both Ricoeur and Foucault, apparently independently of each other, dedicated much effort to provide an account of truth that goes far beyond the truth of sentences, propositions, or judgments. While well aware of the speech act theory and pragmatics, they want to go beyond a formalism of rules of speech or arguments and integrate the attitude of the one who speaks in the very notion of truth. They see truth not merely as a property of statements, but as an existential (...) process in such a way that the truth of statements is linked to the historically situated speaker. Truth as a property of statements is related to truth as an event. However, both reject any form of historicism or relativism. I examine Ricoeur's notion of attestation and Foucault's notion of parrhesia, showing how both notions represent a kind of “poetics of truth”, which combines the existential position of the speaker and the historical circumstances of utterance. I show the extent to which both poetics of truth are political and ethical and how successful each poetics is: Ricoeur believes that he can maintain a claim to universality whereas Foucault abandons such a claim and instead subscribes to a radical singularity of the event of speech in a mode of truth that is, as he says, “polemic”. (shrink)

Le témoignage a retenu de très près l’herméneutique philosophique de Paul Ricœur. De son sens quasi empirique, celui du témoin d’un procès, à sa signification religieuse, celle du témoin de la foi, en passant par sa signification morale, le témoin vit du bien dont il témoigne. Se trouvant donc au croisement du juridique, de l’historique, de l’éthique et du religieux, le témoignage trouve, dans les analyses de Paul Ricœur, son principe unificateur dans le concept d’identité narrative. J.-Ph. Pierron montre que (...) pour le philosophe de Temps et récit, le témoignage dans le témoin est texte. Il donne donc à penser, ce qui implique une herméneutique de la réception, axée sur l’analyse d’un accueil du témoignage. Corrélativement, parler d’identité narrative, c’est donner l’occasion au témoignage de passer insensiblement d’un pôle d’extériorité, celui du narrateur qui n’est pas l’acteur de ce qu’il raconte, à un pôle d’intériorité, qui fait constitution progressive de soi. En quoi doit se définir une éthique du témoignage. Bearing witness is a very important concept in the philosophical hermeneutic of Paul Ricoeur. From its quasi-empirical meaning, that of the testimony of a witness in a trial, to its religious significance, that of a witness to the faith, and its moral significance, the witness lives from the good to which he bears witness. Bearing witness, which lies at the core of legal, historical, ethical, and religious testimony, finds its unifying principle in the analysis of Paul Ricoeur in the concept of narrative identity. J.-P. Pierron shows that, for the philosopher of Time and Narrative, the testimony of the witness becomes text in the one who bears witness. Thus, it leads to thinking, which implies a hermeneutic of receiving, centered on the analysis of how testimony from a witness is received. Correlatively, to speak of narrative identity is to give an opportunity for bearing witness to move imperceptibly from a position of exteriority, that of a narrator who is not the actor of that which he recounts, to a position of interiority, which makes for a progressive constitution of the self. This ought to define an ethic of bearing witness. (shrink)

Adélard de Bath est d’abord connu comme un des premiers traducteurs arabo-latins de textes scientifiques. On lui attribue en particulier la première traduction des Éléments d’Euclide. Étant donné l’importance de ces traductions dans l’histoire de la pensée occidentale, la connaissance de son itinéraire intellectuel est a priori intéressante. Or deux de ses œuvres, le De Eodem et diverso et les Questiones naturales, antérieures à ses traductions, fournissent des éléments qui permettent de reco...

Adélard de Bath est d’abord connu comme un des premiers traducteurs arabo-latins de textes scientifiques. On lui attribue en particulier la première traduction des Éléments d’Euclide. Étant donné l’importance de ces traductions dans l’histoire de la pensée occidentale, la connaissance de son itinéraire intellectuel est a priori intéressante. Or deux de ses œuvres, le De Eodem et diverso et les Questiones naturales, antérieures à ses traductions, fournissent des éléments qui permettent de reco...

« Je suis la vérité ». Dans cette parole du Christ de Jean, la vérité s’avance dans la figure d’une première personne en son auto-attestation. La vérité est le témoin d’elle-même. Face à elle et contre elle, face à son « nouveau commandement », se configure, dans la pensée de Heidegger, la situation étrange d’un Dieu des commandements dans une histoire de l’être où le tournant romain dans l’essence de l’alètheia donne au theos son empreinte impériale-curiale. C’est un tel (...) face-à-face entre deux visages de l’alètheia qui est ici dessiné, ou plutôt seulement préparé, où le « Je suis la vérité » sera étudié, dans l’évangile de Jean, à partir de la structure du témoignage, de l’auto-attestation comme accomplissement de la manifestation. (shrink)

The Romanian-born European writer Vintilă Horia - whose birth centenary is celebrated this year - was a genuine searcher of truth. His entire work pleads for transgressive-integrating knowledge, in opposition to binary logic and scientism; it is the privileged space of articulation between cognition, creation and gnosis, between the apophatism of science, mystic apofatism and artistic apofatism. Although much less known than the trilogy of exile - Dieu est né en exil, Le chevalier de la résignation and ¡Perseguid a Boecio! (...) - the small-sized novel Le voyage à San Marcos acts as an exemplary attestation to this pompous conjunction. The current article focuses especially on the text’s trans-temporal valence. (shrink)