Making a Difference presents fifteen original essays on causation and counterfactuals by an international team of experts. Collectively, they represent the state of the art on these topics. The essays in this volume are inspired by the life and work of Peter Menzies, who made a difference in the lives of students, colleagues, and friends. Topics covered include: the semantics of counterfactuals, agency theories of causation, the context-sensitivity of causal claims, structural equation models, mechanisms, mental causation, causal (...) exclusion argument, free will, and the consequence argument. (shrink)

Infrastructure management has traditionally been based on a logic of predict and provide in which rising demand was met with an increase in infrastructure capacity. However, recent changes in political, economic, and environmental priorities mean that projects such as new roads, which simply expand supply, have become more controversial, and that reducing demand is now a key challenge. This article is about the different ways in which infrastructure managers have tried to achieve reductions in demand, as well as the range (...) of plans that blend various proportions of technological and institutional innovation. For the sociology of science, the controversies over these urban environment plans are interesting not just because they are scientific controversies but because they are controversies over the relationships between science, expertise, technology, and society. As a result, the authors argue that sociologists of science have a contribution to make as experts in their own right. This article argues that the sociology of scientific knowledge needs to move beyond symmetry and neutrality and outlines some of the ways in which SSK can make a difference by repositioning itself at the center of contemporary policy debates. (shrink)

Making a Difference: Essays on the Philosophy of Causation Edited by BeebeeHelen, HitchcockChristopher and PriceHuwOxford University Press, 2017. xii + 336 pp.

Open peer commentary on the target article “From Objects to Processes: A Proposal to Rewrite Radical Constructivism” by Siegfried J. Schmidt. Upshot: The critique of Western metaphysics, the definition of the sign as an inseparable unity of signified and signifier, the insight that language is a form of life, the deconstruction of the subject, the banning of human beings from the social system, and the appearance of non-human actors have made the traditional distinctions between real/unreal, subject /object, society/nature, and thought/action (...) obsolete. The global map of meaning has to be redrawn. Siegfried J. Schmidt takes on this task in the name of a rewriting of radical constructivism. But is rewriting enough? Do the new differences introduced in place of the old ones “really” make a difference? (shrink)

While the literature in business ethics abounds with philosophical analyses, perspectives from religious thinkers are curiously underrepresented. What religious analysis has occured has often been moralistic in tone, more fit to the pulpit than the classroom or the boardroom. In the three essays that follow, presented originally at a panel at the Annual Meeting of the American Academy of Religion in 1989, ethicists from the Protestant, Roman Catholic, and Jewish traditions analyze a case study familiar to many who teach and (...) research in business ethics — the Consolidated Foods Case. Each author shows how a particular religious tradition might react to the case. The authors show how insights from their traditions would affect corporation's moral deliberations about policy. Specific policy recommendations are offered to CEO John Bryan. (shrink)

One of the major problems for Critical Discourse Analysts is how to move on from their insightful critical analyses to successfully ‘acting on the world in order to transform it’. This paper discusses, with detailed exemplification, some of the areas where linguists have moved beyond description to acting on and changing the world. Examples from three murder trials show how essential it is, in order to protect the rights of witnesses and defendants, to have audio records of significant interviews with (...) police officers. The article moves on to discuss the potentially serious consequences of the many communicative problems inherent in legal/lay interaction and illustrates a few of the linguist-led improvements to important texts. Finally, the article turns to the problems of using linguistic data to try to determine the geographical origin of asylum seekers. The intention of the article is to act as a call to arms to linguists; it concludes with the observation that ‘innumerable mountains remain for those with a critical linguistic perspective who would like to try to move one’. (shrink)

The paper explores the possibilities of using applied qualitative research to help to achieve changes in the context of education. It presents three case studies: an evaluation of an educational software package which may be implemented nationally; an assessment of the impact of a 1:1 Technology Rich Learning Environment experimental project conducted in two Slovak elementary schools; and international comparative research on the curricula of psychology courses in secondary schools. The authors ask three questions: 1. does qualitative research have the (...) potential/resources/capacity to guide us in the process of making policy related decisions? 2. Does it have enough credibility in the eyes of the consumers—whether these are decision-makers themselves or a wider community that often plays a role in public decisions? 3. Could this type of work still count as academic inquiry? The discussion evolves around the reflection of the position of researchers in this type of research design, and the authors conclude that applied qualitative research could be the source of solid evidence for making decisions related to education—although this evidence is different to that provided by quantitative research. (shrink)

This edited collection focuses on the contextual presence of theory, the practices of doing theory, and refractions on and agendas for theory respectively. The contributors to the first volume from around the world reflect a range of perspectives and positions in the debate about the purpose and value of educational theory.

Codes of conduct are a conspicuous feature of modern business organization, but doubts have been raised regarding their efficacy in ensuring high standards of behavior. Although some of the issues involved have been discussed at some length in the business ethics literature, the amount of systematic empirical evidence on the impact of codes is very limited. This paper seeks to make a contribution to that body of knowledge by studying the policies and procedures of a sample of banks which have (...) signed a statement on banking and the environment promulgated by the United Nations Development Programme. Although some differences are found when compared with a sample of banks which did not sign the Statement, they are not extensive. The implications of the findings, for codes of conduct and for future empirical studies, are then discussed. (shrink)

The identity of indiscernibles states that indiscernible objects must be identical. Many philosophers have held that the PII turns out to be either true but trivial, or non-trivial but false, depending on how the notion of discernibility is spelled out. In this paper, I propose and defend an account of this notion which aims to yield a minimally non-trivial and yet plausible version of the PII. I argue moreover that this version of the principle is immune to a number of (...) well-known and recent objections to the PII. (shrink)

A significant body of research concludes that stable beliefs of perceived consumer effectiveness lead to sustainable consumption choices. Consumers who believe that their decisions can significantly affect environmental and social issues are more likely to behave sustainably. Little is known, however, about how perceived consumer effectiveness can be increased. We find that feelings of guilt and pride, activated by a single consumption episode, can regulate sustainable consumption by affecting consumers’ general perception of effectiveness. This paper demonstrates the impact that guilt (...) and pride have on perceived consumer effectiveness and shows how this effect rests on the ability of these emotions to influence perceptions of agency. After experiencing guilt or pride, consumers see themselves as the cause of relevant sustainability outcomes. The process of causal attribution associated with these emotions influences consumers’ use of neutralization techniques. Through the reduction in consumers’ ability to neutralize their sense of personal responsibility, guilt and pride positively influence perceived consumer effectiveness. The inability to rationalize-away their personal responsibility, persuades consumers that they affect sustainability outcomes through their decisions. The research advances our understanding of sustainable consumption and identifies a new avenue for the regulation of individual consumer behavior that has significant implications for the development of sustainable marketing initiatives. (shrink)

Some philosophers have claimed that causally determined agents are not morally responsible because they cannot make a difference in the world. A recent response by philosophers who defend the compatibility of determinism and responsibility has been to concede that causally determined agents are incapable of making a difference, but to argue that responsibility is not grounded in difference making. These compatibilists have rested such a claim on Frankfurt cases—cases where agents are intuitively responsible for acts (...) that they couldn’t have failed to perform. This essay argues, first, that the intuitive plausibility of the idea that responsibility is grounded in difference making is not completely put to rest by Frankfurt cases, even if those cases successfully show that responsibility is not grounded in difference making in the sense of access to alternative possibilities of action. It then goes on to develop a different compatibilist strategy, one according to which responsibility is grounded in difference making, but the type of difference making it is grounded in does not require access to alternative possibilities. Indeed, it is a form of difference making that is clearly compatible with determinism. (shrink)

What does socially responsible investing (SRI) accomplish for investors and for society? Proponents of SRI claim that the practiceyields competitive portfolio returns for investors, while at the same time achieving better outcomes for society at large. Skepticsview SRI as ineffective at best and ill-conceived marketing hype at worst. My objective in this paper is to apply mainstream finance research findings to the question of whether SRI may be expected to lead to superior social outcomes. I conclude that under the perfectmarkets (...) assumptions underlying most finance theory, SRI will not affect social outcomes. However, given well documented imperfections in equity markets, the claim that SRI “makes a difference” to society is a reasonable one that is consistent with current theoretical and empirical research in finance. (shrink)

Today, more people want to know how to make a meaningful difference to what they care about. But for that, traditional approaches to learning often fall short. In this book, we offer a theoretical and practical way forward. We introduce the concept of social learning spaces for developing both new capabilities and a sense of agency. We provide a rich framework for focusing on the value of social learning spaces: how to generate this value, monitor it, and learn iteratively (...) through the process. The book is a useful extension and refinement of 'communities of practice' for those familiar with the theory. For those who are not, the chapters will lay out a new way to approach learning. This volume is written to serve the needs of readers across fields, including researchers, educators, and leaders in business, government, healthcare, and international development. (shrink)

Too many activists mix only with other activists and imagine that everyone else thinks as they do. They start to believe in their own propaganda and lose their feel for what the average person in the street might think. They no longer know what is achievable and what is a fantasy that has grown out of their own intense conviction of the need for change. Henry saw this in the Socialist Workers Party, where members were so used to the Marxist- (...) Trotskyist framework that they all accepted that they lost contact with the real world in which they were trying to make a revolution. As Henry put it: "You need to have a crap detector rotating all the time.". (shrink)

In 2008 UK legislation was amended to enable the use of deferred consent for paediatric emergency care (EC) trials in recognition of the practical and ethical difficulties of obtaining prospective consent in an emergency situation. However, ambiguity about how to make deferred consent acceptable to parents, children and practitioners remains. In particular, little is known about practitioners’ views and experiences of seeking deferred consent in this setting.

How are beliefs efficacious? One answer is: via rational intentional action. But there are other ways that beliefs are efficacious. This dissertation examines these other ways, and sketches an answer to the question of how beliefs are efficacious that takes into account how beliefs are involved in the full range of behavioral disciplines, from psychophysiology and cognition to social and economic phenomena. The account of how beliefs are efficacious I propose draws on work on active accounts of perception. I develop (...) an account based on a proposal sketched by the cognitive scientist Ulrich Neisser. Neisser sketched an active account of perception, on which dynamic anticipatory schemata direct an organism's exploration and action, and are in turn revised as a result of exploration and action. This notion of schema has roots in nineteenth century neurophysiology and in Frederick Bartlett's subsequent work on memory. Neisser appealed to it to unite what he thought was right about information-processing accounts of perception with what he thought was right about ecological accounts of perception. The point that we must anticipate in order to perceive has been recognized by philosophers in the form of the "theory-ladenness of observation." I extend the concept of anticipatory schema to include its role in social perception and social interaction; the concept of anticipatory schema provides a more interactive account of the role of expectations in the maintenance and existence of social institutions, and can be used to enrich the account of convention David Lewis provided. I also show that the concept of rational expectations, which explains the neutrality of money in terms of the efficacy of anticipatory expectations, is compatible with the proposed account of how beliefs are efficacious. I discuss how the proposal accounts for the three main modes by which beliefs can be efficacious: via their role in causing intentional action, via their role in causing economic phenomena and the existence and maintenance of social institutions, and via their role in causing unintentional physiological responses, including anticipatory physiological responses that can enable perception, cause involuntary actions and give rise to the placebo effect. (shrink)

Standard approaches to counterfactuals in the philosophy of explanation are geared toward causal explanation. We show how to extend the counterfactual theory of explanation to non-causal cases, involving extra-mathematical explanation: the explanation of physical facts by mathematical facts. Using a structural equation framework, we model impossible perturbations to mathematics and the resulting differences made to physical explananda in two important cases of extra-mathematical explanation. We address some objections to our approach.

In contrast to Bernstein's emphasis on the common ground shared by Rorty and Habermas, this paper stresses the basic differences between them, particularly their diverse assessments of rationalism, universalism, foundationalism and developmentalism, as well as their opposed evaluations of systematic thought and critical social theory. Several difficulties with Rorty's views on reason, truth and objectivity, as with his historicism and physicalism are suggested. It is concluded that Bernstein's emphasis on the common elements in their "moral-political vision", in the face of (...) these striking theoretical differences, overestimates the extent to which normative ideals can survive being cut off from larger contexts of ideas. (shrink)

Four years ago The Hastings Center initiated a That project gave the Center staff a chance to explore one swath of the theoretical literature concerning how members of democratic regimes ought to think about and respond to the differences among themselves. Much of that literature, produced by philosophers like Charles Taylor, Martha Nussbaum, and John Kekes, is wonderfully articulate about difference in general. But it is nearly silent about how particular categories of difference actually make a difference (...) in the lives of particular individuals negotiating particular institutions. (shrink)

Christianity changed the world for the better through the development of education, charity organisations, art, music, law and medical care among others. However, not all changes initiated by Christianity were positive. The Christian religion was also responsible for division, death, destruction and war. Focusing on the positive changes, nearly 500 years after the reformation though, it seems as if Christianity has lost its renewing and transformative powers. It seems as if society, politics and the economy are pressurising Christianity to conform (...) to the world and not the other way round. Therefore, the research focuses on the question whether Christians can bring about positive change and transformation to the current problems in society. What can Christians do to provide a religious response to current persistent societal problems? Change agents - people who drive positive change - are capable and competent, make use of networks, are visible and contactable and are often also outsiders in the communities they serve. Examples of the work done by change agents - Christians within their local communities - through small-scale community projects are showcased here to suggest possible ways forward for dealing with persistent problems from a Christian point of view. (shrink)

Biologists studying complex causal systems typically identify some factors as causes and treat other factors as background conditions. For example, when geneticists explain biological phenomena, they often foreground genes and relegate the cellular milieu to the background. But factors in the milieu are as causally necessary as genes for the production of phenotypic traits, even traits at the molecular level such as amino acid sequences. Gene-centered biology has been criticized on the grounds that because there is parity among causes, the (...) “privileging” of genes reflects a reductionist bias, not an ontological difference. The idea that there is an ontological parity among causes is related to a philosophical puzzle identified by John Stuart Mill: what, other than our interests or biases, could possibly justify identifying some causes as the actual or operative ones, and other causes as mere background? The aim of this paper is to solve this conceptual puzzle and to explain why there is not an ontological parity among genes and the other factors. It turns out that solving this puzzle helps answer a seemingly unrelated philosophical question: what kind of causal generality matters in biology? (shrink)

I suggest that Fischer concedes too much to the consequence argument when he grants that we may not make a difference. I provide a broad sketch of (my take on) the dispute between compatibilists and incompatibilists, while suggesting that some of the discussion may have confused the freedom required for moral responsibility with a very different notion of autonomy. I introduce that less usual notion of autonomy and suggest that those who are autonomous, in this sense, do make a (...) difference. (shrink)

If self-interested behavior conflicts with the collective welfare, rules of cooperation are often installed to prevent egoistic behavior. We hypothesized that installing such rules may instigate personal moral norms of cooperation, but that they fail in doing so when installed by a leader who is self-interested rather than self-sacrificing. Three studies confirmed this and also showed that, consequently, only self-sacrificing leaders were able to install rules that increase cooperation without the need for a perfectly operating monitoring system.

An unlearned carpenter of my acquaintance once said in my hearing: “There is very little difference between one man and another; but what little there is, is very important.” – William James (1890) On the question of “the individual and the community in pragmatism,” most people would probably think first of Dewey’s influential ideas about the individual and society: his conception of education as preparation for responsible citizenship, perhaps, or his critique of the “ragged individualism” o...

Characterizing the contemporary world as massively entropic and pointing to the proletarianization of human beings, Bernard Stiegler claims that we need to “bifurcate”. This paper clarifies what he means by bifurcation and examines the conditions necessary for its occurrence. After explaining how Stiegler’s general organology provides a framework for his assessment of our present, the paper focuses on how humans can become capable of producing bifurcations. Emphasizing that bifurcation must occur in relation to technology, the paper identifies it as an (...) inventive dis-closure of a current system that transforms both technology and us through the creation of knowledge. It then shows that although the problem of our time is primarily one of automatization, we must deal with it through internalization rather than disautomatization. Our very humanity is being disrupted because we are not realizing the possibilities offered by the development of technology, and this can only be achieved if we internalize technology. The process of internalizing technology is itself bifurcative and enables us to overcome our proletarianization. (shrink)

On March 28, 2008, the Association for Computer Machinery's Special Interest Group for Computers and Society conferred the 2008 Making a Difference Award on Dr. Jim Thatcher. Dr. Thatcher's work in the area of assistive technologies has spanned four decades, and has enabled many blind and visually impaired individuals throughout the world to expand their use of computers in their daily lives. This summer, I had the opportunity to talk with Dr. Thatcher about his extraordinary career and this (...) acknowledgement he has received from the ACM. --- MN. (shrink)

There has, over the last few decades, been a considerable growth in the development ‘business’ where, largely western, donors have sought to help the poorer nations develop. Much of this growth has been driven by Christian motivation. Increasingly such projects are being held accountable to try to ensure that the money and the effort being spent are being well spent. The question that is being asked of, and by, development workers is ‘how do we know that we are making (...) a difference?’ and a range of practices have been developed to assess, to measure, to evaluate such effects. Terms like impact assessment, objectives, log-frames, objective verifiable indicators, baselines, clients, have become part of the language. In this paper the author raises various fundamental questions about this practice of evaluating development projects, and in so doing challenges the suitability of some of the current practices for development work. (shrink)

Ethical leadership research has primarily relied on social learning and social exchange theories. Although these theories have been generative, additional theoretical perspectives hold the potential to broaden scholars’ understanding of ethical leadership’s effects. In this paper, we examine moral typecasting theory and its unique implications for followers’ leader-directed citizenship behavior. Across two studies employing both survey-based and experimental methods, we offer support for three key predictions consistent with this theory. First, the effect of ethical leadership on leader-directed citizenship behavior is (...) curvilinear, with followers helping highly ethical and highly unethical leaders the least. Second, this effect only emerges in morally intense contexts. Third, this effect is mediated by the follower’s belief in the potential for prosocial impact. Our findings suggest that a follower’s belief that his or her leader is ethical has meaningful, often counterintuitive effects that are not predicted by dominant theories of ethical leadership. These results highlight the potential importance of moral typecasting theory to better understand the dynamics of ethical leadership. (shrink)

An effect is typically explained by citing a cause, but not any cause will do. The oxygen and the spark were both causes of the fire, but normally only the spark explains it. What then distinguishes explanatory from unexplanatory causes? One might attempt to characterise this distinction in terms of intrinsic features of the causes. For example, some causes are changes while others are standing conditions, and one might claim that only the changes explain. Both the spark and the oxygen (...) are causes of the fire, but only the spark is a change, and perhaps this is the reason only the spark explains. On the other hand, one might attempt to characterise the distinction between explanatory and unexplanatory causes in terms of the relation between cause and effect. For example, only some causes are sufficient for their effects, and perhaps only sufficient causes explain. There is, however, an elementary feature of the distinction between explanatory and unexplanatory causes that neither an intrinsic nor a relational approach are well-suited to capture. This is the so-called `interest-relativity' of explanation: the very same cause may be explanatory for one person but not for another. When there is a famine in India, an Indian peasant may explain this by citing the drought, while a member of the World Health Organization may instead cite the failure of the Indian government to stock adequate reserves of food (Hart and Honore, 1985, pp. (shrink)

In this paper I examine a strategy which aims to bypass the technicalities of the indispensability debate and to offer a direct route to nominalism. The starting-point for this alternative nominalist strategy is the claim that--according to the platonist picture--the existence of mathematical objects makes no difference to the concrete, physical world. My principal goal is to show that the 'Makes No Difference' (MND) Argument does not succeed in undermining platonism. The basic reason why not is that the (...) makes-no-difference claim which the argument is based on is problematic. Arguments both for and against this claim can be found in the literature; I examine three such arguments, uncovering flaws in each one. In the second half of the paper, I take a more direct approach and present an analysis of the counterfactual which underpins the makes-no-difference claim. What this analysis reveals is that indispensability considerations are in fact crucial to the proper evaluation of the MND Argument, contrary to the claims of its supporters. (shrink)

Calls for the expansion of ethics education in the business and accounting curricula have resulted in a variety of interventions including additional material on ethical cases, the code of conduct, and the development of new courses devoted to ethical development [Lampe, J.: 1996]. The issue of whether ethics should be taught has been addressed by many authors [see for example: Hanson, K. O.: 1987; Huss, H. F. and D. M. Patterson: 1993; Jones, T. M.: 1988–1989; Kerr, D. S. and L. (...) M. Smith : 1995; Loeb, S. E.: 1988; McDonald, G. M. and G. D. Donleavy: 1995]. The question addressed in this paper is not whether ethics should be taught but whether accounting students can reason more ethically after an intervention based on a discrete and dedicated course on accounting ethics. The findings in this paper indicate that a discrete intervention emphasising dilemma discussion has a positive and significant effect on students’ moral reasoning and development. The data collected from interviews suggest that the salient influences on moral judgement development include: learning theories of ethics particularly Kohlberg’s theory of cognitive moral reasoning and development; peer learning; and moral discourse. The implications from the findings in this study suggest that moral reasoning is responsive to particular types of ethics intervention and educators should carefully plan their attempts to foster moral judgement development. (shrink)

The human person makes great demands on the physician and calls for unique attention. Hence the doctor-patient relationship calls for the highest ideals of kindness, patience, trustworthiness, generosity and skill. The Catholic physician brings to these demands a specific meaning: ministering to the sick is to see Christ in them and to show Him to them.

The paper outlines and explores a possible strategy for defending both the action/omission distinction (AOD) and the principle of double effect (PDE). The strategy is to argue that there are degrees of actionhood, and that we are in general less responsible for what has a lower degree of actionhood, because of that lower degree. Moreover, what we omit generally has a lower degree of actionhood than what we actively do, and what we do under known-but-not-intended descriptions generally has a lower (...) degree of actionhood than what we do under known-and-intended descriptions. Therefore, we are in general less responsible for what we omit than for what we do—which is just what AOD says. And we are in general less responsible for what we do under known-but-not-intended descriptions than for what we do under known-and-intended descriptions—which is just what PDE says. (shrink)

True benevolence is, most fundamentally, a desire that the world be better. It is natural and common, however, to frame thinking about benevolence indirectly, in terms of a desire to make a difference to how good the world is. This would be an innocuous shift if desires to make a difference were extensionally equivalent to desires that the world be better. This paper shows that at least on some common ways of making a “desire to make a (...) difference” precise, this extensional equivalence fails. Where it fails, “difference-making preferences” run counter to the ideals of benevolence. In particular, in the context of decision making under uncertainty, coupling a “difference-making” framing in a natural way with risk aversion leads to preferences that violate stochastic dominance, and that lead to a strong form of collective defeat, from the point of view of betterness. Difference-making framings and true benevolence are not strictly mutually inconsistent, but agents seeking to implement true benevolence must take care to avoid the various pitfalls that we outline. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"To make a difference...":Narrative Desire in Global MedicineByron J. Good and Mary-Jo DelVecchio GoodIf, as Arthur Frank (2002) writes, "moral life, for better and worse, takes place in storytelling," this collection of narratives written by physicians working in field settings in global medicine gives us a glimpse of some aspects of moral experience, practice, and dilemmas in settings of poverty and low health care resources. These essays are (...) written from the midst of practice, in diverse settings in Africa, South Asia, Latin America, the Caribbean, and the United States. The majority of the writers are practitioners of contemporary 'global medicine'—physicians from North America or Europe who spend part of their lives flying into settings of poverty or special need to practice medicine and work with on-going collaborative clinical and public health systems—while a smaller number are working in the societies in which they were born. Although a few work for classic humanitarian organizations or have developed their own local NGO's, the great majority are engaged in the 'hybrid life' described by Robert Riviello and noted by Renée Fox, moving between academic medical centers and distant health care systems that are supported by local governments, major international organizations and funding agencies, and international NGO's like Partners in Health. These diverse forms of practice have become a common model for contemporary clinicians engaged in what has emerged as a new discipline of global health or global medicine, and these narratives give us a glimpse of some of the enduring, as well as newly emerging, forms of moral practice and ethical dilemmas characteristic of today's global medicine.Many of these stories are filled with the tension and pathos that makes clinical narratives powerful to read. Physicians are forced to make unfathomable decisions about whether to resuscitate and keep a baby alive, using all means available, or to let the infant die, whether to carry out a procedure that will save an infant in birth but would put the mother at risk, about how to deal with a cancer found in a very advanced state. However, virtually all of the stories transcend these classical stories of the decisions physicians are forced to make by being placed in settings of great scarcity of resources, which stand in particular contrast to the academic medical settings in North America or Europe where many of these global medicine specialists have trained and many continue to practice. The unspeakable inequality of resources emerges throughout these narratives as a kind of master theme, as the underlying moral, as opposed to plot, which gives meaning and sense to the stories. For those who practice medicine in such settings, global inequalities and scarcity of medical resources are deeply felt. They produce the rage that Jeffrey Deal describes. ("I learned to despise American churches during that time, a time when my world encompassed a dying newborn in Sudan, as well as the air conditioned padded seats [End Page 121] of our affluent suburban church.") They produce the distinctive experiences of helplessness and pain felt by clinicians who cannot separate how they would be able to treat such a patient at home from how they have to practice in these settings. For those clinicians working in their own societies, scarcity of resources often produces deep anger at the corrupt governments that fail to support basic human services for the great majority of their population. ("We were temporary actors performing in the cynical play of scarcity on permanent display in Port-au-Prince," writes Haitian physician Paul Pierre about his experience prior to joining Partners in Health.)But for those who regularly travel back and forth across the divide between rich and poor, whether across national boundaries or within their own society, the challenge to live a moral life is unendingly complicated. While becoming a part of a struggle for global justice with colleagues and advocates from both sides of the divide, few of the narrators can avoid personal feelings of ambivalence and guilt at being able to easily move from one side of that divide to the other back home. Many fantasize about giving up their lives in the north to devote themselves... (shrink)

Michel Foucault and Gilles Deleuze are regarded as French “Nietzscheans” par excellence. By drawing attention to the articulation of “difference” in contemporary thought, this paper attempts to go beyond the label ‘Nietzschean’ in an effort to discern two distinct philosophical trajectories inspired by Nietzsche. I suggest that Deleuze reads Nietzsche as an empiricist whose philosophy of nature critically undermines representational modes of thought from Plato to Hegel and beyond. Difference is therefore given in itself. Foucault, on the other (...) hand, reads Nietzsche primarily as a historian of culture, whose radical reflection on language pushes philosophy into new interpretative forms of analysis that seriously confronts the role of political power in the production of truth. Difference is thus invented and only known within the contours of these fabrications. While no judgement is made about the accuracy or otherwise of their respective interpretations of Nietzsche, this paper implicitly asks whether a Nietzschean genealogical ethos can inform those political struggles today for which the meaning of difference is contested. (shrink)