This chapter contains sections titled: Abstract Introduction The Inscrutability of Objectual Reference Empiricism, Naturalism, and Provincialism References.

BackgroundRegulations on forgoing life-sustaining treatment (LST) have developed in Asian countries including Japan, Korea and Taiwan. However, other countries are relatively unaware of these due to the language barrier. This article aims to describe and compare the relevant regulatory frameworks, using the (more familiar) situation in England as a point of reference. We undertook literature reviews to ascertain the legal and regulatory positions on forgoing LST in Japan, Korea, Taiwan, and England.Main textFindings from a literature review are first presented to (...) describe the development of the regulatory frameworks surrounding the option of forgoing LST in each country. Based on the findings from the four countries, we suggest five ethically important points, reflection on which should help to inform the further development of regulatory frameworks concerning end-of-life care in these countries and beyond. There should be reflection on: (1) the definition of – and reasons for defining – the ‘terminal stage’ and associated criteria for making such judgements; Korea and Taiwan limit forgoing LST to patients in this stage, but there are risks associated with defining this too narrowly or broadly; (2) foregoing LST for patients who arenotin this stage, as is allowed in Japan and England, because here too there are areas of controversy, including (in England) whether the law in this area does enough to respect the autonomy of (now) incapacitated patients; (3) whether ‘foregoing’ LST should encompass withholdingandwithdrawing treatment; this is also an ethically disputed area, particularly in the Asian countries we examine; (4) the family’s role in end-of-life decision-making, particularly as, compared with England, the three Asian countries traditionally place a greater emphasis on families and communities than on individuals; and (5) decision-making with and for those incapacitated patients who lack families, surrogate decision-makers or ADs.ConclusionComparison of, and reflection on, the different legal positions that obtain in Japan, Korea, Taiwan, and England should prove informative and we particularly invite reflection on five areas, in the hope the ensuing discussions will help to establish better end-of-life regulatory frameworks in these countries and elsewhere. (shrink)

Forms of Artificial Intelligence (AI) are already being deployed into clinical settings and research into its future healthcare uses is accelerating. Despite this trajectory, more research is needed regarding the impacts on patients of increasing AI decision making. In particular, the impersonal nature of AI means that its deployment in highly sensitive contexts-of-use, such as in healthcare, raises issues associated with patients’ perceptions of (un) dignified treatment. We explore this issue through an experimental vignette study comparing individuals’ perceptions of (...) being treated in a dignified and respectful way in various healthcare decision contexts. Participants were subject to a 2 (human or AI decision maker) x 2 (positive or negative decision outcome) x 2 (diagnostic or resource allocation healthcare scenario) factorial design. We found evidence of a “human bias” (i.e., a preference for human over AI decision makers) and an “outcome bias” (i.e., a preference for positive over negative outcomes). However, we found that for perceptions of respectful and dignified interpersonal treatment, it matters more who makes the decisions in diagnostic cases and it matters more what the outcomes are for resource allocation cases. We also found that humans were consistently viewed as appropriate decision makers and AI was viewed as dehumanizing, and that participants perceived they were treated better when subject to diagnostic as opposed to resource allocation decisions. Thematic coding of open-ended text responses supported these results. We also outline the theoretical and practical implications of these findings. (shrink)

continent. 1.2 (2011): 78-91. This article consists of three parts. First, I will review the major themes of Quentin Meillassoux’s After Finitude . Since some of my readers will have read this book and others not, I will try to strike a balance between clear summary and fresh critique. Second, I discuss an unpublished book by Meillassoux unfamiliar to all readers of this article, except those scant few that may have gone digging in the microfilm archives of the École (...) normale supérieure. The book in question is Meillassoux’s revised doctoral dissertation L’Inexistence divine (or The Divine Inexistence ), with its seemingly bizarre vision of a God who does not yet exist but might exist in the future. Without literally accepting this view, I will claim that it is philosophically interesting in ways that even a hardened sceptic might be able to appreciate. Third and finally, I will speculate on the possible future of Meillassoux’s speculative materialism itself. And here I mean its future development not by Meillassoux, but by those readers who might be inspired by his book. Plato could never have predicted the emergence of Aristotle’s philosophy, despite the obvious debt of the latter to the former. Nor could Descartes have predicted Spinoza and Leibniz, nor Kant the German Idealists, and neither could Husserl in 1901 have foreseen the later emergence of Heidegger. How are the works of interesting philosophers transformed by later thinkers of comparable importance? While it may seem that there are countless ways to do this, I think there are only two basic ways in which this happens: you can radicalize your predecessors, or you can reverse them. I will close this article with a few words about these two methods, and try to imagine how Meillassoux might be radicalized or reversed by some future admirer. My view is that the more important thinkers are, the easier they are to radicalize or reverse. This helps explain why the great philosophers of the West have so often appeared in clusters, succeeding one another at relatively brief intervals during periods of especial ferment. 1. After Finitude After Finitude is unusually short for such an influential book of philosophy: running to just 178 pages in the original French, and an even more compact 128 pages in the English version, despite the introduction of roughly eight pages of new material for the English edition. Rather than summarizing Meillassoux’s book in the order he intended, I will focus on six points that strike me as the pillars of his debut book. Along the way, I will offer a few criticisms as well. The first pillar of the book is Meillassoux’s own term “correlationism.”1 Although he introduces this term as the name for an enemy, it is striking that Meillassoux remains impressed by correlationism much more than his fellow speculative realists are. This continued appreciation for his great enemy influences the shape of his own ontology. Is there a world outside our thinking of it, or does the world consist entirely in being thought? Traditionally, this dispute between realism and idealism has been dismissed in continental philosophy as a “pseudo-problem,” in a strategy pioneered by Husserl and extended by Heidegger. We cannot be realists, since following Kant we have no direct access to things-in-themselves. But neither are we idealists, since the human being is always already outside itself, aiming at objects in intentional experience, deeply engaged with practical implements, or stationed in some particular world-disclosing mood. The centuries-old dispute between realism and idealism is dissolved by saying that we cannot think either real or ideal in isolation from the other. There is neither human without world nor world without human, but only a primordial correlation or rapport between the two. This is what “correlationism” means: philosophy trapped in a permanent meditation on the human-world correlate, trying to find the best model of the correlate: is it language, intentionality, embodiment, or some other form of correlation between human and world? Among other problems, this generates some friction between philosophy and the literal meaning of science. When cosmologists say that the universe originated 13.5 billion years ago, they do not mean “13.5 billion years ago for us ,” but literally 13.5 billion years ago, well before conscious life existed, and thus at a time when there was no such thing as a correlate. Meillassoux also coins the term “ancestrality” (10) for the reality that predated the correlate, and later expands this term to “dia-chronicity,” (112) to refer to events occurring after the extinction of human beings no less than to those occurring before we existed. Up to this point, Meillassoux’s focus on ancestral entities existing prior to consciousness might seem like a straightforward realist who wants to unmask correlationism as just another form of idealism. Yet Meillassoux also admires the correlationist maneuver, which can obviously be traced back to Kant. Unlike a thinker such as Whitehead, Meillassoux feels no nostalgia for the pre-critical realism that came before Kant: “we cannot but be heirs of Kantianism,” he says (29). What impresses Meillassoux about correlationism is something both simple and familiar. If we attempt to think a tree outside thought, this is itself a thought . Any form of realism which thinks it can simply and directly address the world the way it is fails to escape the correlational circle, since the attempt to think something outside of thought is itself nothing other than a thought, and thereby collapses back into the very human-world correlate that it pretends to escape. For Meillassoux this step, suggested by Kant but first refined by the ensuing figures of German Idealism, marks decisive forward progress in the history of philosophy that must not be abolished. Any attempt to break free from the correlate must first acknowledge its mighty intellectual power. Realist though he may seem, Meillassoux’s works are filled with praise of such figures as Fichte and Hegel, not of so-called “naïve realists.” It is also the case that for Meillassoux, not all correlationisms are the same. The second pillar of his book is a distinction between various positions that I have termed “Meillassoux’s Spectrum,” though of course he is never so immodest as to name it after himself. He distinguishes between at least six different possible positions, and perhaps we could add even subtler variations if we wished. But in its simplest form, Meillassoux’s Spectrum allows for just four basic outlooks on the question of realism vs. anti-realism. Three of these are easy to understand, since we have already been discussing them. At one extreme is so-called “naïve realism,” which holds that a world exists outside the mind, and that we can know this world. Meillassoux rejects this naïve realism as having been overthrown by Kant’s critical philosophy. At the other extreme is subjective idealism, in which nothing exists outside the mind. For to think a dog outside thought immediately turns it into a thought, and therefore there cannot be anything outside; the very notion is meaningless. In between these two is what we have called correlationism. And here comes a crucial moment for Meillassoux, since he distinguishes between the two forms of “weak” and “strong” correlationism, and chooses the strong form as the launching pad for his own philosophy. Weak correlationism is easy to explain, since we all know it from the philosophy of Kant. The things-in-themselves can be thought but not known. They certainly must exist, since there cannot be appearances without something that appears. And we can think about them, which idealism holds to be impossible. They are simply unknowable due to the finitude of human thought. Strong correlationism is the new position introduced by Meillassoux (though he sees it at work in numerous twentieth century thinkers), midway between weak correlationism and subjective idealism. The major difference between the three positions is as follows. Weak correlationism says: “The things-in-themselves exist, but we cannot know them.” The subjective idealist says: “This is a contradiction in terms, since when we think the things-in-themselves, we already turn them into thoughts.” But the strong correlationist says: “Just because ‘things-in-themselves’ is a meaningless notion does not mean that they cannot exist. No one has ever traveled to the world-in-itself and come back to make a report on it. Thus, the fact that we cannot think things-in-themselves without contradiction does not prove that they do not exist anyway. There may be things-in-themselves, we simply are not capable of thinking them without contradiction form within the correlational circle.” This step is crucial for Meillassoux, since strong correlationism is the position he attempts to radicalize into his own new standpoint: speculative materialism. As I see it, this step of the argument fails. Strong correlationism cannot avoid collapsing into subjective idealism, since the statements of the strong correlationist are rendered meaningless from within. All three of the other positions in the Spectrum make perfectly good sense even for those who disagree with them. The naïve realist says that things-in-themselves exist and we can know them; the meaning of this statement is clear. The weak correlationist can say that things-in-themselves exist but lie forever beyond our grasp; this too makes perfect sense, even though the German Idealists try to show a contradiction at work here. We can also understand the claim of the subjective idealist that to think anything outside thought turns it into a thought, and that for this reason we cannot think the unthought. The strong correlationist, alone among the four, speaks nonsense . This person says “I cannot think the unthought without turning it into a thought, and yet the unthought might exist anyway.” But notice that the final phrase “the unthought might exist anyway” is fruitless for this purpose. For we have already heard that to think any unthought turns it into a thought. But now the strong correlationist wants to do two incompatible things simultaneously with this unthought. On the one hand, he neutralizes the unthought by showing that it instantly changes into just another thought. But on the other hand, he wants to appeal to the unthought as a haunting residue that might exist outside thought, thereby undercutting the absolute status of the human-world correlate found in idealism. But this is impossible. If you accept the argument that thinking the unthought turns it into a thought, you cannot also add “but maybe there is something outside that prevents this conversion from being absolutely true,” because this “something outside” is immediately converted into nothing but a thought for us. In short, Meillassoux here seems to be offering a kind of Zen koan: his “strong correlationism” is reminiscent of the gateless gate, or the sound of one hand clapping, or the command to punch Hegel in the jaw when meeting him on the road. We cannot at the same time both destroy the realist challenge of the things-in-themselves in order to undercut realism and reintroduce that very realist sense in order to undercut idealism. In a world where everything is instantly converted into thought, we cannot claim that there might be something extra-mental anyway, because this “might be something” is itself converted into a thought by the same rules that condemned dogs, trees, and houses to the idealist prison. This brings us to the third pillar of Meillassoux’s argument, which is the key to all the rest: the necessity of contingency. His strategy is to transform our supposed ignorance of things-in-themselves into an absolute knowledge that they exist without reason, and that the laws of nature can change at any time for no reason at all. In this way the cautious agnosticism of Kantian philosophies is avoided, but so is the collapse of reality into thought as found in German Idealism. Meillassoux does try to prove the existence of things-in-themselves existing outside thought; he simply holds that they must be proven after passing through the rigors of the correlationist challenge, not just arbitrarily decreed to exist in the manner of naïve realism. As he puts it, “Everything could actually collapse: from trees to stars, from stars to laws, from physical laws to logical laws; and this not by virtue of some superior law whereby everything is destined to perish, but by virtue of the absence of any superior law capable of preserving anything, no matter what, from perishing” (53). If idealism thinks that the human-world correlate is absolute, for Meillassoux it is the facticity of the correlate that is absolute. He tries to show this with a nice brief dialogue between five separate characters (55-59) which is covered in detail in my forthcoming book,2 but which I will simplify here for reasons of time. In this simplified version, we first imagine a dogmatic realist arguing with a dogmatic idealist. The realist says that we can know the truth about the things-in-themselves; the idealist counters that we can only the truth about thought, since all statements about reality must be turned into statements concerning our thoughts about reality. Here the correlationist enters and proclaims that both of these positions are equally dogmatic. For although we have access to nothing but thoughts, we cannot be sure that these thoughts are all that exist; there could be a reality outside thought, there is simply no way to know for sure. And this latter position is the one that Meillassoux attempts to transform from an agnostic, skeptical point into an ontological claim about the contingency of everything. Consider it this way. How does the correlationist defeat the idealist? The idealist holds that the existence of anything outside thought is impossible. The correlationist, by contrast, holds that something might exist outside the human-world correlate. But this “something might” has to be an absolute possibility. It cannot mean that “something outside thought might exist for thought ,” because that is what the idealist already says. No, the correlationist must mean that something might exist outside thought quite independently of thought. In other words, the correlationist says that idealism might be wrong, and this means it is absolutely true that idealism might be wrong. Thus, correlationism is no longer just a skeptical position. It holds that all the possibilities of the world are absolute possibilities. We have absolute knowledge that any of the possibilities about the existence or non-existence of things-in-themselves might be true, and this means that correlationism flips into Meillassoux’s own position: speculative materialism. As Meillassoux sees it, there are only two options here. Option A is to absolutize the human-world correlate, which is what the idealist does: there absolutely cannot be anything outside thought. Option B, by contrast, is to absolutize the facticity of the correlate: its character of simply being given to us, without any inherent necessity. The correlationist cannot have it both ways by saying: “there absolutely might be something outside thought, yet maybe this is absolutely impossible.” In other words, once we escape dogmatism we can only be idealists or speculative materialists, not correlationists. The human-world correlate is merely a fact, not an absolute necessity. But this facticity itself cannot be merely factical: it must be absolute. Here Meillassoux coins the French neologism factualité , which has been suitably translated into the English neologism “factiality.” (7, 122-3) Factialty means that for everything that exists, it is absolutely possible that it might be otherwise, not just that we cannot know whether or not it might be otherwise. Just as Kant transformed philosophy into a meditation on the categories governing human finitude, Meillassoux wishes to turn philosophy into a meditation on the necessary conditions of factiality, which he calls “figures”—a new technical term for him. (80) One such figure is that the law of non-contradiction must be true, and for an unusual reason. Since everything is proven to be contingent, nothing that exists can be contradictory, for whatever is contradictory has no opposite into which it might be transformed, and thus contingency would be impossible.3 Another such figure is that there must be something rather than nothing: for since contingency exists, something must exist in order to be contingent. It is a daring high-wire act, one that sacrifices realism to the correlational circle in order to rebuild it from out of its own ashes. Some might conclude that the lack of reason in things is a byproduct of the ignorance of finite humans, Meillassoux is making precisely the opposite point. For in fact, the doctrine of finitude usually leads directly to belief in a hidden reason. The fact that it lies beyond human comprehension merely increases our belief in this arbitrarily chosen concealed ground. By defending anew the concept of absolute knowledge Meillassoux evacuates the world of everything hidden. The reason for things having no reason is not that the reason is hidden, but that no reason exists. Thus, even while insisting on the necessity of non-contradiction, he rejects the other Leibnizian principle: sufficient reason. Everything simply is what it is, in purely immanent form, without deeply hidden causes. Or as Meillassoux puts it: “There is nothing beneath or beyond the manifest gratuitousness of the given—nothing but the limitless and lawless power of its destruction, emergence, or persistence” (63).The world is a “hyper-chaos”(64). But this is not the same thing as flux. For the chaos of the world is such that stability might occur just as easily as constant, turbulent change. Let’s now digress a bit, and return to the question of ancestrality, which Meillassoux transforms later in the book into “dia-chronicity.” Correlationism holds that all talk of a world outside the correlate is immediately recuperated by the correlate. The phrase “13.5 billion years ago” becomes “13.5 billion years ago for us ,” and the phrase “the universe following the extinction of humans” becomes “the universe following the extinction of humans for humans .” But notice that whether we talk about the world before or after humans, in both cases it is time that is used to challenge the correlate. Meillassoux has no interest in challenges that might be posed by space. For example, what about a vase in a lonely country house that topples to the floor and smashes when no one is there to watch it? Isn’t this also a challenge to correlationism, no less than the Big Bang or the heat death of the universe long after humans have vanished? In an eight-page supplement to the English translation of After Finitude ,4 possibly in response to my own 2007 review of the French original,5 Meillassoux bluntly denies that space is of any relevance to the question. Spatial distance is a merely harmless challenge to the human-world correlate. After all, even though no one is there in the lonely country house to witness the shattering of the vase, we can say that had there been an observer , that observer would have witnessed the toppling and destruction of the vase. For this event still occurs in a world in which the human-world correlate already exists, whereas the diachronicity of events both before and after the existence of humans makes it impossible to say that had there been an observer they would have witnessed the Big Bang occurring in such and such a fashion. However, it seems to me that Meillassoux merely asserts that the temporal simultaneity of our existence with that of the vase in the lonely country house is enough to render it harmless. It is true that the house does not exist prior to the correlate, but nonetheless it exists outside the correlate, and that is enough to make the same challenge. It is difficult to see why the “had there been an observer” maneuver succeeds in the case of a vase in the countryside in April 2011 but fails in the case of the Big Bang. This is not just a matter of nitpicking Meillassoux’s argumentative style: the fact that he bases his argument on time has at least two important consequences for his position. For in the first place, even though Meillassoux insists that the laws of nature are absolutely contingent, this turns out to be true only in a temporal sense. That is to say, it is a paradoxical feature of Meillassoux’s philosophy that he does allow for the existence of laws of nature, and simply believes that they can change at any moment without reason. Within any given moment, laws of nature do exist. He never suggests that different parts of the universe can have different laws at the same time, nor does he have any interest in the laws of part/whole composition that take place within any given instant. Could it be the case that rather than being made of gold atoms, a small chunk of gold could be made of silver atoms, cotton, horses, or that this same small piece of gold could be made of gigantic vaults filled with even more gold? These are not topics that draw Meillassoux’s attention, since he is focused solely on how the laws of nature might change or endure from one moment to the next . Another implication for Meillassoux’s system is that his concept of things-in-themselves turns out to be to be inadequate. For when he proves that things-in-themselves can exist without humans, this turns out to be true only in a temporal sense as well. Namely, things-in-themselves existed ten billion years ago, and they will continue to exist after all humans have succeeded in exterminating themselves. However, being able to exist before our births and after our deaths is just one small part of what it means to be a thing-in-itself. The more important part is that even if a thing is sitting on a table right now, in front of me, even if I stroke it lovingly or press my face up against it directly, I am still dealing only with a phenomenal version of the thing; the thing-in-itself continues to withdraw from all access. Yet no such thing is acknowledged by Meillassoux. For him finitude is a disaster, and absolute knowledge is in fact possible. Meillassoux’s thing-in-itself exists in independence only of the human lifespan , not of human knowledge. The fifth pillar of Meillassoux’s argument is his use of Cantor’s transfinite mathematics to show that even if the laws of nature are contingent, they need not be unstable, and thus we cannot use the apparent stability of nature to disprove his metaphysics of absolute contingency. What Cantor showed is that there are different sizes of infinity, and that all these infinities cannot be totalized in a single infinite number of infinities. Meillassoux sees this as crucial, since it allows him to discredit any “probabilistic” argument against his theory. The probabilistic argument (as defended quite clearly by Jean-René Vernes)6 would say this: given that the laws of nature seem so stable, it it is extremely improbable that there is no hidden reason for their remaining so stable. As Meillassoux sees it, probability is of value only when we can index an accessible total of cases. These can even be infinite: for example, there are an infinite number of points where a rope can break when stretched tight, but this does not stop us from calculating probabilities for various sections of the rope to break. By contrast, there is no way to sum up the number of possible laws of nature. For here there is no way to totalize; we cannot stand outside of nature and calculate the possible number of laws so as to determine the probabilities that any one of them might change. Therefore, although we can speak of probability when dealing with intraworldly events such as elections, horse races, and coin-flips, we cannot use the words “probable” or “improbable” when describing alterations at the level of nature as a whole. Rather than commenting on the validity of this argument and its use of Cantor, let me simply note that it once again creates a dualistic ontology. We already saw that Meillassoux treats time differently from space. In analogous fashion, he now treats the level of world differently from that of intraworldly events. The emergence of worlds is purely contingent and virtual and governed by no probability at all, while events within the world necessarily follow laws (even if these laws can change at any moment without reason), and thus their probabilities can be calculated. It is a strategy deeply reminiscent of Badiou’s (2005) own dualism between the normal “state of the situation” and the rare and intermittent “event.” The sixth and final pillar of Meillassoux’s book can be dealt with briefly, since we have already touched on it elsewhere. It comes at the very beginning of the book, when Meillassoux says that we must revive the distinction between primary and secondary qualities, and that the primary qualities are the ones that can be mathematized. He admits that he has not yet published a proof of this idea, though in fact it is already known as one of his primary doctrines. And here we encounter the familiar problem with Meillassoux’s inadequate conception of things-in-themselves. “Primary qualities” refers to those qualities that a thing has independently of its relations with us or anything else. But if the primary qualities can be mathematized, this means that they are not entirely independent of us, since our knowledge can get right to the bottom of them. The mathematized qualities of things are independent of us only in Meillassoux’s sense that they will still have those qualities even when all humans are dead. But to repeat, autonomy from the human lifespan is not the same as autonomy from human access. Here once more Meillassoux is concerned only with independence from the human-world correlate across time, not in any given instant. 2. L’Inexistence divine In 1997, the same year in which he turned thirty years old, Meillassoux earned his doctorate at the École normale supériuere with a brazen dissertation entitled L’Inexistence divine ( The Divine Inexistence ). The work was substantially revised in 2003. But even then, with typical fastidiousness, Meillassoux decided that the work was not yet ready for press. It has now been scrapped in favor of some future, multi-volume work bearing the same title. While writing my book on Meillassoux for Edinburgh University Press, I was permitted to translate excerpts from this unpublished work for use as an appendix in my own book; in total, the appendix contains approximately twenty percent of Meillassoux’s 2003 manuscript, the first time any of it will be published in any language. Nonetheless, a portion of the argument was already tested in the article “Spectral Dilemma,” published in English in the journal Collapse (2008: 261-75). There the philosophical motives for the virtual God are already made clear. What troubles us most are early deaths, brutal deaths, deaths of especial injustice– the sorts of deaths in which the brutal twentieth century was so abundant. And here, neither the atheist nor the believer can help us. The atheist can offer nothing but a sad and cynical resignation when reflecting on the victims of these terrible crimes. The believer does little better, being unable to explain how God could have allowed such things to happen, due to the famous intractability of the problem of evil. The solution offered to this dilemma by Meillassoux is bold, and all the more so given that he emerges from such a deeply Leftist, materialist, and unreligious background. His solution is that God does not yet exist, and therefore is not blameworthy for these catastrophes. Given that everything is contingent in Meillassoux’s philosophy, this God and divine justice might never exist, but they can at least exist as an object of hope. Let’s begin by jumping to the end of L’Inexistence divine , where the alternatives are laid out so nicely. There are four basic attitudes that humans can have towards God, Meillassoux says. First, we can believe in God because he exists. This is the classical theist attitude, rejected for the simple reason that it would be amoral and blasphemous to believe in a God who allows children to be eaten by dogs, to use Dostoevsky’s example. Second, we can disbelieve in God because he does not exist: the classical atheist attitude. But this leads to sadness, cynicism, and a sneering contempt for the greatness of human capacity. The third option, rather more complex, is to disbelieve in God because he does exist: in other words, to exist in rebellion against God as the one who must be blamed for the evils of the earth. The examples here might range from Lucifer himself, to the more human figure of Captain Ahab in Melville’s Moby-Dick , to Werner Herzog’s even more recent catchphrase, “Every man for himself, and God against all.” That leaves only the fourth option: believing in God because he does not exist. Meillassoux closes his book by saying that the fourth option has now been tried (namely, in the course of his own book), and that now that all four have been specified, we must choose. The first reaction to this theory of the inexistent God will be laughter. Few readers will ever be literally convinced by it, and probably none will immediately be convinced by it. But if we ask ourselves why we laugh, the answer is because it sounds so improbable that an inexistent God might suddenly emerge and resurrect the dead. It obviously sounds more like a gullible theology than a rigorous piece of philosophical work. Yet two things need to be kept in mind. First, Meillassoux’s theories are hardly more unlikely than those of great philosophers of the past such as Plato, Plotinus, Avicenna, Malebranche, Spinoza, Leibniz, Nietzsche, or Whitehead. We read the great philosophers not because their systems are plausible in commonsense terms that can be measured by the laws of probability. Instead, we read them precisely because they shatter the existing framework of common sense and open up new window on the universe. Second, and even more importantly, Meillassoux has already rejected probability as a valid measuring stick in philosophy. Or rather, he accepts probability in the intra-worldly realm (where it is linked with potentiality), and rejects it at the level of the world itself (where potentiality is replaced with what he calls virtuality). The virtual God can appear at any moment for no reason at all, just as any other new configuration of laws of nature can appear: in a manner that the laws of probability cannot calculate. Responding to those who might ridicule the idea of a sudden emergence of God and a resurrection of the dead, Meillassoux cites Pascal, who asserts that the resurrection of the dead would be far less incredible than the fact that we were born in the first place. This shifts philosophy onto new ground. Rather than concerning ourselves with what is likely to happen in the world as we know it, we focus instead on the most important things that could happen. For this reason, the expected objection that a virtual God is no more likely to appear than a virtual unicorn or a virtual flying spaghetti monster misses the point. Unicorns and spaghetti monsters could also appear, just like any other non-contradictory thing. But these would just be novel bizarre entities among others, not the heralds of completely new worlds. For Meillassoux, the emergence of matter, life, and thought have been the three truly amazing advents of the world so far, each of them dependent on the advent(s) preceding them. As he sees it, there can be no greater intraworldly entity than the human beings who already exist, since nothing in the world is better than the absolute knowledge of which humans alone are capable. This means that the next great advent must be something that perfects human beings rather than superseding them. And this can only be the world of justice, in which the dead are resurrected and their horrible deaths partially cancelled (Meillassoux never considers the possibility of a God who would literally erase the pre-divine past so that it never happened at all). The only immortality worth having is an immortality of this life, not an existence in some ill-defined afterworld. Human existence, he holds, must always be governed by a “symbol” that gives us the “immanent and comprehensible inscription of values in a world.” And just as cosmic history made the three great contingent leaps of matter, life, and thought, with a leap to justice as the only one still to come, a similar structure occurs within human culture and its symbols, which consist so far of the cosmological, naturalistic, and historical symbols, with a “factial” symbol still to come. We can review each of these symbols briefly. The cosmological symbol refers to the ancient dualism between the terrestrial and celestial spheres. Here below everything is conflict, corruption, and decay; but in the heavens nothing is perishable, all movement is circular, and everything is arranged in mutual harmony. This symbol is ended by modern physics when Galileo discovers such blemishes as sunspots and craters on the moon, and when Newton integrates both celestial and terrestrial movement into a single gravitational law. Next comes the naturalistic or romantic symbol, in which perfection comes not from the sky but from nature itself. The world is filled with pretty flowers (Meillassoux claims that the ancients never discussed the beauty of flowers until Plotinus in the third century) and with living creatures naturally moved by pity, at least until society corrupts them. This symbol collapses in the face of reality as we know it, since pity is no more common than war, corruption, and violence. This brings us to the historical symbol, which only now is passing away. Bad things may happen, but history has an inner logic of its own, such that everything works out in the end. The ultimate form of the historical symbol is the economic symbol, whether in a Marxist or neo-liberal form. Just as the Marxist holds that the inner economic logic of the capitalists will inexorably lead them to self-destruction, the neo-liberal assumes that the sum total of individual selfish actions will lead, in the long run, to the greatest possible good. We worship the economy and let it guide history for us, just as the ancients worshipped celestial bodies and held them to be free from blemish. The final remaining symbol is the factial symbol, which Meillassoux hopes will now emerge. Factiality, we recall, is his term for the absolute contingency of everything that exists. Once we have grasped this absolute contingency, we are free to expect the dramatic advent of the coming fourth World: the world of justice, inaugurated by a virtual God and even mediated by a messianic human figure. There is the added feature, however, that this messiah must abandon all claims to special status once the messianic realm of justice is achieved. The messianic figure will then be no more special than any person on the street, since a reign of human equality will have arisen. Although this focus on human being might seem like a return to standard humanism, Meillassoux holds that human pre-eminence has never truly been maintained. Previously, humans have been treated as special only because they contemplate the Good, because they resemble their omnipotent creator, or because they happen to be the temporary victors in a cruel Darwinian death-match between millions of living species. For Meillassoux, by contrast, humans have value because they know the eternal. But it is not the eternal that is important, since this merely represents the blind, anonymous contingency of each thing. What is important is not knowledge of the eternal , but knowledge of the eternal. We should not admire Prometheus for stealing fire from the gods; Prometheus is simply as bad as all the gods, no matter how much he increased our power. Feuerbach and Marx were wrong to say that God is a projection of the human essence, since for Meillassoux the usual concept of God represents the degradation of the human essence. If the traditional God was allowed to inflict plagues and tsunamis on the human race, the Promethean human of the twentieth century simply assumes the right to inflict death camps and atomic fireballs instead. In this respect, we have simply begun to imitate the degradation of humanity that was formerly invested in an omnipotent and arbitrary God. In response to charges that absolute contingency might lead to political quietism, Meillassoux counters that the World of justice would mean nothing unless we had already hoped for it beforehand. A World of justice that came along at random would merely be an improved third World of thought: indeed, a perfect one. But it would have satisfied no craving, and would therefore have no redemptive power. For this reason, we must actively hope for the fourth World of justice for such a fourth World ever to arise. Not only justice, but beauty is dependent on such hope: for Meillassoux, who is here somewhat dependent on Kant, beauty means an accord between our human symbolization and the actual world, which could never be present in a World of the blessed any more than justice could. And just as a messianic figure is needed to incarnate our hope and then abandon power once the World of justice is realized, it is the figure of the child whose fragile contingency shows us a dignity and a demand for justice beyond all power. 3. Meillassoux Radicalized or Reversed Given the promising reception of Meillassoux’s first book, it would not be groundless to engage in early speculation about what it might take to earn him a place in the history of philosophy. Maybe this will never happen—who knows?—but quite possibly it will: his lucid argumentative methods and sheer philosophical imagination at least make him a good candidate to be read well into the future, especially following further elaboration in print of his mature system. Philosophy is often practiced as thought it were nothing more than the amassing of “knockdown arguments.” But this is no more insightful than saying that good architecture is the amassing of steal beams. It is true that poorly constructed building cannot stand for long, but sound construction is merely the first, indispensable step in building. In fact, I am inclined to say that what really makes a philosopher important is not being right, but being wrong . I mean this in a very specific sense. I once heard the interesting remark about twentieth century culture that “you have to remember that the sixties really happened in the seventies.” That is to say, it was in the 1970’s rather than the more honored 1960’s that civil rights, free love, long hair, and the rock and roll drug culture really took root. With respect to the history of philosophy, we might just as easily say: “you have to remember that Plato really happened in Aristotle,” that “Kant really happened in Hegel” or “Hume really happened in Kant,” or that “Husserl’s phenomenology first achieved its truth in Heidegger.” One becomes an important philosopher not by being right, but by attracting rebellious admirers who tell you that you are wrong , even as their own careers silently orbit around your own. To recruit faithful disciples may be comforting and flattering, but the greatest thinkers have generally had to experience refutation at the hands of their most talented heirs. For this reason, I would propose that we size up the magnitude of living thinkers not by deciding how many times they are right and wrong, but by asking instead: who would take the trouble to refute this author? For this reason I do not ask: “Is Meillassoux right?”, since I do not believe in the virtual God myself, nor am I convinced by any important aspect of Meillassoux’s philosophy. Instead, I ask if there are interesting ways to overturn him. Only by being overturned, by no longer remaining a contemporary, does one become a classic. Let’s begin with a simple model of refutation, which can be refined further at a later date once the basic point is established. One kind of refutation simply consists in saying: “This author is a complete idiot.” The refuter now walks away in celebration, and no link between the present and the future is built; all is reduced to rubble. But this sort of mediocre triumphalism is generally practiced by those who achieve little of their own, and is not especially interesting. Much more interesting is the sort of refutation that does not take its target to be a complete idiot. I would like to suggest that there are just two basic ways in which this can be done: radicalization and reversal . It has not escaped my notice that this is a fairly good match for the Deleuzian distinction between irony and humor. Whereas irony critiques and adopts the opposite principle of what it attacks, humor accepts what it confronts but pushes it into highly exaggerated form. The ironist is like the worker who sows chaos by rebeling and contradicting the boss, while the humorist is like the worker who follows orders to an absurdly literal degree, with equally chaotic results. Let’s start with a few examples. In Aristotle’s treatment of Plato, and Heidegger’s of Husserl, we find reversal. Plato’s eidei are transformed by Aristotle into mere secondary substances, and the individual worldly things despised by Plato become what is primary. For Husserl what is primary is whatever is present to consciousness, while for Heidegger this is precisely what is secondary, since the primary stuff of the world withdraws from any form of presence at all. As for radicalization, it is most easily found in the transformation of Kant by German Idealism: “Kant was right to wall off the things-in-themselves from human access, and simply should have realized that the thought of the Ding an sich is also a thought, and thereby the noumena are just special cases of the phenomena,” with much following from this discovery. It would also be easy to read Spinoza as a radicalizer of Descartes, and Berkeley and Hume as radicalized versions of Locke. Perhaps the distinction is now sufficiently clear. Admiring refutations are not those that say “Professor X is an idiot,” which is merely the flip side of the eager disciple’s fruitless “Professor X got everything right.” Instead, it will be some variant of one of the following two options: “Professor X is important, but got it backwards,” or “Professor X is important, but didn’t push things far enough.” In the history of philosophy these two latter cases have often been painful in purely human terms: Aristotle expresses sadness at refuting Plato, Kant is openly annoyed at Fichte, and Husserl feels betrayed and used by Heidegger. Rude handling from later figures almost seems to be the sine qua non of being a great philosopher. Now, it has already been claimed that Meillassoux is an emerging philosopher of the first importance, and by no less a figure than Alain Badiou: “It would be no exaggeration to say that Quentin Meillassoux has opened up a new path in the history of philosophy…” (Preface, vii). But rather than taking Badiou’s word for it, or rejecting his word, we might experiment by asking how Meillassoux could be radicalized or reversed. Are there interesting ways of doing this that might launch whole new schools of philosophy, unexpected or even condemned by Meillassoux himself? While no one can see the future, the present is poor when it is not riddled with virtual futures. The relation between philosophers and their predecessors and successors is always somewhat complicated, of course. But generally there is one central divergence at stake, which might be taken as the key to all the others. On this basis we could say that new thinkers primarily radicalize or primarily reverse the main ideas of their chief philosophical forerunner. There may be specific historical conditions and perhaps even personality traits connected with these two types, but this question can be left aside for now. More important for us is that radicalizers will generally be followed by reversers, and vice versa. Consider the textbook example of a reversal in the history of philosophy: Kant’s Copernican Revolution, which inverts the so-called dogmatic tradition that addresses the world itself, and makes the world revolve instead around the conditions by which it is known. While it is not completely impossible that Kant’s successors might have re-reversed this principle back into a new and stronger dogmatic realism, conditions were premature for such a move. Anyone doing this too early would likely have been an angry anti-Kantian reactionary rather than an original thinker in command of a genuinely new realist principle. The far more likely outcome is the one that actually happened: Kant’s reversal of his predecessors was viewed as incomplete, or as retaining lamentable bits of the traditional view, which despite his admirable breakthrough he was unable to shake off. This was the view of German Idealism, anyway. In similar fashion, Spinoza could also be viewed as a radicalizer of Descartes, who is equally accused of preserving various Scholastic dogmas in an otherwise radical project of philosophical reversal. The point is this: reversals in the history of thought tend to be followed soon thereafter by radicalizations of those reversals. The same may hold true in reverse: radicalizations might generally be followed by reversals, given that it is not always possible to be more radical than the radicals have already been. Consider the case of Husserl, who radicalizes Brentano’s early vagueness about what lies beyond immanent objectivity, and Twardowski’s assertion that there must be an external object lying outside the intentional content, by collapsing everything into the intentional sphere: there is no difference between the Berlin in my consciousness and the actual Berlin that is home to millions of people. It is difficult to see how one could be even more radical than Husserl’s idealist turn here. And thus the road is paved to Heidegger’s reversal of classical phenomenology, in which the key point is what lies deeper than any presence to consciousness: the Sein whose power and obscurity cannot be made exhaustively present, but only sends itself in historical epochs. In similar fashion we might also read Leibniz as a reverser of Spinoza’s radicalization, retrieving a strong sense of individual substance and a certain validity of what the Scholastics had said. Returning to Meillassoux, we might ask which kind of philosopher he is: a radicalizer or a reverser? At present, Meillassoux looks to me like a radicalizer (though for now his future remains shrouded in mist). He takes the correlationist tradition, which allows us to speak only of the relation between human and world, and tries to raise it into an even more extreme claim about the absolute contingency of everything. But whereas German Idealism did this by trying to collapse the distinction between thought and world entirely into the “thought” side, Meillassoux does it by trying to shift the non-absolute contingency of the thought-world correlate from epistemology to ontology. It is no longer a question of the inability of human knowledge to know what lies outside the correlate, but the inability of reality itself to be rooted in any definite laws. Furthermore, if we look at the various features of Meillassoux’s philosophy identified earlier tonight, all but one are already so radical that there is no obvious way to push them further. The one exception would be his claim that the world as a whole can change for no reason at any moment, coupled with the inconsistent claim that within a given world there are laws of nature that everything must follow. If gravitational attraction between all masses is a current law in our world, then for Meillassoux there can be no exceptions to this law for as long as it remains in force. A toppled vase will fall to the floor every time for sure,unless there is a cosmic change by which the laws of nature as a whole have altered. (This is reminiscent of the late medieval distinction between the absolute and ordained power of God, according to which God has the power to set or change the laws of nature, but not to contravene those laws locally once they are set.) On this point, to radicalize Meillassoux would simply be to say: there are no laws of nature even in the local sense. Everything that happens, even in the world here and now, is purely contingent and not governed by even a trace of law. And while this would be a more consistent development of Meillassoux’s thoughts on contingency, it is difficult to see how it could lead to a new philosophy. Instead, the admiring successors of Meillassoux are more likely to reverse one of his already sufficiently radical points. At least four candidates come to mind: *First, we have seen that Meillassoux thinks correlationism is challenged by a time before or after consciousness, but not by a space lying outside it. Perhaps this could be reversed into saying that spatial exteriority is the really crucial point. The arguments on this point are perhaps the least convincing in After Finitude (and do not even occur in the original French edition), and therefore it might be a candidate for the “blind spot” of which no philosopher is ever free. *Second, Meillassoux uses Cantor to claim that the contingency of laws of nature would not entail that they are unstable. A successor of Meillassoux might claim that it does make them unstable, and celebrate this fact. This person would then have to explain why common sense seems to encounter a relatively stable world despite its truly rampant instability. Whereas Meillassoux’s problem is to show how stability might exist despite contingency, this successor’s problem would be slightly different: to show why actual, full-blown instability might have the appearance of stability. *Third, Meillassoux claims that the primary qualities of things are those that can be mathematized. He might be reversed by a successor who says the opposite: the mathematizable qualities are the secondary ones, and the primary ones are those that elude symbolic formulation. While this is a perfectly valid possible objection to Meillassoux, it is one that is made in advance by some of his predecessors and is still made by some of his peers, making it less interesting for futurology than some of his other points. *Fourth and finally, whereas Meillassoux claims that God does not exist but might exist in the future, a successor might argue even more bizarrely that God has always existed but might vanish in the future. Let’s arbitrarily select the first of these possibilities, and imagine briefly where it might lead, if pursued in the future by admiring detractors. Meillassoux comes from the circle of Badiou, and some of Badiou’s most ardent admirers are found in Latin America. So, let’s imagine that towards mid-century some ingenious reversers of Meillassoux emerge in that portion of the Spanish-speaking world. Just for fun, let’s call them Castro and Chávez. And in order to avoid any confusion with the present-day politicians of those names, we will stipulate that Meillassoux’s great successors are both women. The philosopher Castro (we will suppose she comes from Peru) reverses Meillassoux’s argument that the ancestral or diachronic are what most threaten the human-world correlate. Instead, she claims that the diachronic does not threaten the correlate at all, and that we must instead look at space as what ruins the correlate and demands a strange new realism. What would such a philosophy look like? In order to determine this, we might ask what price Meillassoux pays for doing it the opposite way. As I see it, he pays in two separate ways. One is that laws of nature for him are contingent over time . The laws of nature apply to the universe as a whole at any given moment, and would be changed globally if they are ever changed at all. The second price he pays is that Meillassoux has no mereology , or theory of parts and wholes. Everything for him is on the level of the given, or immanent in experience, with the sole proviso that the laws governing this immanence might change without notice at any given moment. In reversing Meillassoux, Castro makes the following claims in the preface to her stunning debut book of 2045, The Cosmos and its Neighborhoods , rapidly translated from Spanish into all the languages of the world: Despite his brilliant analysis of the contingency of laws of nature over time, Meillassoux gets two important assumptions wrong. First, he allows for only one set of contingent laws to govern nature as a whole. Second, he allows laws to govern only the world that is immanent in experience, and thereby fails to explore the contingency among part-whole relations. In this book I will argue, first, that the laws of nature vary in any given instant between one region of the universe and the next; and second, that the world is made up of layers of parts and wholes that are also contingent with respect to one another. Those are the words of Castro. This may sound like a hopeless free-for-all of chaos, yet the book somehow succeeds in drawing some compelling deductions about how laws must vary from one place or level in the world to the next. Trapped in the limited horizon of 2011, and not yet inspired by the heavily balkanized political and technological situation of 2050 that somehow lends additional credence to Castro’s vision, we can only vaguely grasp what such a philosophy might look like. After this reversal of Meillassoux by Castro, the usual pattern leads us to expect a radicalization by Chávez, a young Argentine student of Castro. How could the already strange theories of Castro be radicalized? Perhaps as follows, in a disturbing new book entitled The Implosion of the Neighborhoods , which argues as follows: Castro was right to shift the Meillassouxian framework of contingency from time to space. However, in this respect she retained a surprisingly traditional opposition between the two. In this book I will show that time and space collapse into one another. This may sound too much like the discredited four-dimensional block universe of twentieth century physics and philosophy. However, the four-dimensional universe is a model biased in favor of space, merely adding an extra dimension to the commonsense spatial continuum while stipulating that the serial passage of time is an illusion. In this book I will argue instead for a one-dimensional space-time modeled after our experience of time, in which there is no simultaneous co-existence at all between different parts of the universe, or ‘neighborhoods’ as my esteemed teacher Castro has called them. Instead, the various portions of the universe link to one another by succession rather than by coexistence. Buenos Aires, New York, and Amsterdam do not exist simultaneously in the same landscape, but one after the other in the mind of some observer, and this observer can only be an observer much larger than any human. Against Meillassoux’s notion of a virtual God that does not exist now but might exist in the future, I will argue for an actual God that surveys the universe in sequence, thereby generating the illusion of spatial diversity and even the illusion of individual minds located within that diversity. Once this divine observer dies, the universe as a whole must perish. Again, these ideas are so bizarre that we of 2011 can barely comprehend them, just as Aristotle would have had a difficult time grasping the theories of Descartes. We could then perhaps imagine a further reversal of this theory, emanating from the intellectually resurgent Philippines of the twenty-second century. The Filipino School might argue that the universe is already dead, given the collapse of its spatial richness into the serial observations of a flimsy and mortal God. The virtual universe does not yet exist, but might exist in fully spatial form in the future, and this would require the death of God and the resulting liberation of God’s succession of images as independent, spatially situated realities. With a bit of sharpening, we might be able to make all of these imaginary thinkers more intuitively clear. Along with the history of philosophy, there might arise a new discipline generating imaginary futures for philosophy. The richness of Meillassoux’s system comes not from the fact that he is plausibly right about so many things, but because his philosophy offers such a treasury of bold statements ripe for being radicalized or reversed. He is a rich target for many still-unborn intellectual heirs, and this is what gives him the chance to be an important figure. NOTES 1. Quentin Meillassoux, After Finitude . Trans. R Brassier. (London: Continuum, 2008.) Page 5. The word “correlationism” does not appear in his doctoral thesis. As Meillassoux informed me in an email of February 8, 2011, he first coined this term in 2003 or 2004, while editing for publication a lecture he had given at the École normale supérieure on a day devoted to the theme of “Philosophy and Mathematics,” an event including Alain Badiou as one of the participants. 2. Graham Harman, Quentin Meillassoux: Philosophy in the Making . (Edinburgh: Edinburgh University Press, forthcoming 2011). 3. In an email of December 6, 2010, Meillassoux clarifies that in After Finitude he only deduces the impossibility of a “universal contradiction,” not of a determinate contradiction. In the same email he suggests that he can also prove the latter, though the proof is somewhat lengthier than the one found in After Finitude . 4. After Finitude (18-26), in the passage falling between the two sets of triple asterisks. These pages were sent by Meillassoux to translator Ray Brassier (in French) during the translation process, and do not appear in the original French version of the book. 5. Graham Harman, “Quentin Meillassoux: A New French Philosopher.” Philosophy Today 51.1 (2007): Pages 104-117. The passage where I raise the question of space can be found in the first column of page 107. 6. Vernes is first cited on p. 95 of After Finitude . See Jean-René Vernes, Critique de la raison aléatoire, ou Descartes contra Kant . (Paris: Aubier, 1982).  . (shrink)

Multimodal neuroimaging provides a rich source of data for identifying brain regions associated with disease progression and aging. However, present studies still typically analyze modalities separately or aggregate voxel-wise measurements and analyses to the structural level, thus reducing statistical power. As a central example, previous works have used two quantitative MRI parameters—R2* and quantitative susceptibility —to study changes in iron associated with aging in healthy and multiple sclerosis subjects, but failed to simultaneously account for both. In this article, we propose (...) a unified framework that combines information from multiple imaging modalities and regularizes estimates for increased interpretability, generalizability, and stability. Our work focuses on joint region detection problems where overlap between effect supports across modalities is encouraged but not strictly enforced. To achieve this, we combine L1, total variation, and L2 group lasso penalties. While the TV penalty encourages geometric regularization by controlling estimate variability and support boundary geometry, the group lasso penalty accounts for similarities in the support between imaging modalities. We address the computational difficulty in this regularization scheme with an alternating direction method of multipliers optimizer. In a neuroimaging application, we compare our method against independent sparse and joint sparse models using a dataset of R2* and QS maps derived from MRI scans of 113 healthy controls: our method produces clinically-interpretable regions where specific iron changes are associated with healthy aging. Together with results across multiple simulation studies, we conclude that our approach identifies regions that are more strongly associated with the variable of interest, more accurate, and more stable with respect to training data variability. This work makes progress toward a stable and interpretable multimodal imaging analysis framework for studying disease-related changes in brain structure and can be extended for classification and disease prediction tasks. (shrink)

This research examined whether induced joy influences fifth graders’ performance in literacy tasks. Children were asked to recall a joyful experience, used as a joy induction, before completing either a grammar (Study 1) or textual comprehension task (Study 2). The grammar task involved understanding at the surface level and retrieval of appropriate declarative and procedural knowledge, but limited elaboration unlike the textual comprehension task, which tackled inference generation. By differentiating tasks based on depth of processing required for completion we aimed (...) at testing the validity of two concurrent hypotheses: that of a facilitating effect and that of a detrimental effect of induced joy. Compared to controls, joy induced children showed better performance on the grammar task – specifically children with lower language ability. No differences across groups emerged as a function of joy induction on the text comprehension task. Results are discussed with respect to emotion effects on cognition. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might (...) be causing them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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1 Introduction1 In the 1980s, hermeneutics was often incorporated into deconstructionism and literary theory. Rather than focus on authorial intentions, the nature of writing itself including codes used to construct meaning, socio-economic contexts and inequalities of power,2 Gadamer introduced a different perspective; the interplay between effects of history on a reader’s understanding and the tradition(s) handed down in writing. This interplay in which a reader’s prejudices are called into question and modified by the text in a fusion of understanding and (...) topic revitalized the study of the printed word. Gadamer’s turn to language for understanding the meaning of Being also appealed to the post-modern antipathy toward modernity and metaphysics.3 If the truth and validity of interpretations are limited to communities of language, then our mode of being in history cannot but be historical. This point of view rendered Gadamer’s phenomenological hermeneutics vulnerable to the critique of moral and epistemological relativism. However, Gadamer’s theory of interpretation also stems from re-examination of the beginning of knowledge in the Pre-Socratics and Plato, and on this basis, is receptive to another dimension of inquiry than that which was trending in North America. -/- At the East-West Center, University of Hawai’i at Manoa in 1982, Chung-ying Cheng for the first time introduced onto-hermeneutics to an audience of esteemed philosophers including Li Zehou, Ren Jiyu, Feng Youlan, and Zhang Liwen.4 In contrast to schools of deconstruction and literary theory that had disengaged the interpreter from trans-historical sources of meaning and truth, Cheng explained that interpreters exist within a cosmological order inextricable from responsibility to harmonize Heaven and Earth in creative acts of interpretation. By integrating Chinese cosmology into hermeneutics through ontology, he tacitly challenged philosophers in the West to re-examine assumptions about humanity’s place in nature and by implication, Gadamer’s recovery of the beginnings of knowledge in Western philosophy. -/- Cheng’s Neo-Confucianism is inspired by the method and goals of Thomé H. Fang. The following words by Fang seem to prefigure, although in an indistinct and bundled way, aspects of Cheng’s philosophy including a Mencian theory of human nature, comprehensive observation, and creativity: “In the very process of living in concord with creative Nature, Man is charged with an ideal to be fully realized in the light of the principle of comprehensive harmony.”5 Like Fang, Cheng reinvigorates Chinese culture and language, but not solely in order to vindicate the insights of Neo-Confucianism. He has studied Western thought, from pragmatism and the analytic school to German idealism and phenomenology, to unlock and clarify philosophical concepts within the Yijing tradition and thereby render them intelligible to Anglophones. The result has been an awakening of Western scholars to the moral and cultural consequences of decoupling their thought from metaphysical foundations that are neither dogmatic nor doctrinal. -/- Not unlike the dialectic of Gadamer’s dialogue form, onto-generative hermeneutics integrates contrary positions on the same topic in order to blend both sides into a world philosophy, or as Cheng says, a “totalizing or integrative theory,”6 not to be confused with a theoretical rewording of a theory. On the contrary, the universal scope and relevance of hermeneutics stems from personal experience. Just as Gadamer, in response to faction and strife, immersed himself in Plato during the war years, and developed a method with which to harmonize opposites, so too, according to On-cho Ng, was Cheng moved by faction, strife and political persecution to develop a path toward unity.7 Gadamer taught at McMaster University in Hamilton, Ontario, and Cheng at the University of Hawai’i at Manoa among other institutions in North America. They facilitated trans-continental educational and cultural ties. Similar experiences yield similar insights irrespective of differences of time and place. Hence, authors in this issue who reside in Europe, China and North America, delineate the differences between Gadamer and Cheng, yet also, in light of Cheng’s onto-generative method and cosmology, develop integrative theories. Due to the page-budget restriction of the publisher, certain articles of this special theme will be subsequently published in the next issue. -/- 2 Integrative Theory This special issue of The Journal of Chinese Philosophy confirms a dimension of hermeneutics that Cheng has both motivated and inspired. The contributors do not abide by the conviction that since thought is mediated by language, interpretations cannot transcend culture. On the contrary, their research exemplifies the fruits of trans-historical onto-dialogical hermeneutics within limits defined by their field inquiry, organized into Parts I and II, around three themes: language, the philosophy of history and ethics. -/- Andrew Fuyarchuk introduces the theme of ontology in relation to Gadamer’s turn to language. Fuyarchuk argues that Chung-ying Cheng’s criticism of Gadamer’s hermeneutics is informed by Heidegger’s concept of Dasein and thereby overlooks how Gadamer’s Platonic-Pythagorean problem of the division between the One and Many is harmonized in the event of language, which in turn positions Gadamer in proximity to the presupposed grounds of receptivity in Cheng’s onto-generative hermeneutics. Lauren Pfister’s contributing article addresses the year 2000 meeting between Cheng and Gadamer in Heidelberg and expands the transhistorical grounds of meaning in Gadamer to matters of theology. Pfister’s summary of the written Chinese record of their conversation indicates that Cheng does not address the role of Christian philosophy and hence, the role of the inner word in Gadamer’s hermeneutics. This is important not only for detecting changes in Cheng’s philosophical development, but also for modifying his hermeneutics along the lines of a living conversation, possibilities explored by Pfister in a sequel to the article submitted to this issue. Nevertheless, by raising the issue of how Gadamer’s turn to language for understanding the meaning of Being extends possibilities in Cheng’s thought, Pfister anticipates the article by Katarina Gajdosova. She returns to the roots of Chinese thought during the Warring States period and broadens the meaning of names in recently excavated texts. Contrary to the conventions about how to understand terms, she appeals to both Heidegger’s ontology and Cheng’s notion of receptivity and creativity to reinterpret naming in relation to cosmology. Along the same lines, insofar as the event of Being is lingual, Jay Goulding captures its emergent structure in an evolving community of scholars and scholarship. He recalls his philosophical journey toward Cheng’s philosophy that begins in conversations with Gadamer at McMaster University in Hamilton, leads to Heidegger and Asian thought, expands into turning points with teachers and colleagues from various backgrounds that by increments contributed to Goulding’s formulation of “Daoist phenomenology.” -/- Although differing traditions guide their inquiries and research, Cheng and Gadamer recall the wisdom of the past to ameliorate the fragmentation in contemporary life. This leads them to re-examine the origins of philosophy; historical roots and thus sources of creative re-interpretations East and West whose affinities are developed in contributions by Hyun Höchsmann and Friederike Assandri. Höchsmann assesses convergences and divergences in the origins of Chinese and Western philosophy (Confucius and Socrates, the Yijing and Pre-Socratics) that culminates in pairing Gadamer’s understanding of paideia in the context of Plato’s political cosmology in the Timaeus with moral and social cultivation in The Western Inscription. She delineates the limits of this comparison which in turn justifies introducing Vattimo’s notion of locality. Assandri’s comparative analysis moves between India and China, Buddhism and Tang Daoism. Based on Gadamer’s argument that writing detaches concepts from their cultural moorings, she defines and applies three levels of understanding in onto-generative hermeneutics to Buddhist terms that were assimilated into the Benji Jing and in so doing clarifies essential dimensions of Daoism. -/- Contributions by Stephen Palmquist and Nicholas Brasovan position Cheng in relation to Kant and Gadamer by way of Aristotle’s ethics respectively. On the one hand, Palmquist plots Cheng’s evolving criticism of Kant’s moral philosophy and draws on crucial dimensions of Gadamer’s hermeneutics to reposition that criticism in a constructive relation to Kant’s emphasis on the philosophical conditions of morality while also indicating how religious dimensions of his thought answer Cheng’s concerns for lived moral action. For Palmquist, Gadamer enables a constructive criticism of Cheng. On the other hand, Brasovan compares Cheng’s Yijing-based account of moral deliberation with Gadamer’s Aristotelian-based ethics and reasons that in contrast to Cheng, Gadamer’s hermeneutical consciousness is disengaged from practical knowledge. For Brasovan, Cheng is a constructive critic of Gadamer. Palmquist and Brasovan’s divergent angles on Gadamer and Cheng map onto a dialectic of contrast and complementarity that constitutes the inner logic of Cheng’s philosophy. In other words, Gadamer and Cheng ought to be read alongside one another for the sake of removing discrepancies and contradictions, which constitutes the organic structure of their thinking. -/- 3 Our Mode of Being in History Is Not Historical The conversations between Cheng and Gadamer in this issue of The Journal of Chinese Philosophy pivot on language, philosophy of history and ethics within a comparative framework of analysis, but also explore the grounds that make the comparisons possible. Those grounds are informed by Chinese cosmology, and function to wrest Gadamer from the shadow of Heideggerian facticity and reposition him within the range of Cheng’s ideas about our place in nature that is embedded in his question about how mind emerges from inorganic matter.8 -/- For Gadamer scholars of Heidegger, human finitude, our ownmost individuating death ensures that hermeneutics is always open to the other as other, always on the way toward understanding the meaning of Being. To arrest the process in a concept of “the Absolute” cannot but represent someone’s point of view, and thereby render hermeneutics indistinguishable from ideology. However, insofar as finitude is defined by them in terms of an onto-theological concept of immorality, finitude is a metaphysical concept consistent with epistemologies and confuse beings with the meaning of Being. As a result, the celebrated political value of hermeneutics to always be on the way toward an understanding of the meaning of Being admits subtle variations on the same worldview that are insufficiently self-critical. -/- Gadamer scholars of Heidegger are right. A transformation in ethos and opening to the meaning of Being depends on awareness of finitude. Yet this awareness does not yield openness to more of the same, i.e., discourse structurally incapable of coming to unity but instead, for both Gadamer and Cheng, openness to a distinctly different ontological dimension of reality. As Sandra Wawrytko and So-Seong Park indicate,9 this ontological dimension is prefigured in the experience of being-as-a-whole or the totality of all possible relations in both Chinese totemic shamanistic rituals,10 and Greek Dionysian festivals.11 Through these religious experiences human ethos and therefore consciousness is expanded and elevated from being centered on one’s ownmost concerns toward an affinity with all sentient beings from insects and plants to animals. The channel for this affinity is an auditory disposition and hence, the emotions, compassion, and feeling response. -/- The capacity for an auditory disposition, or as Gadamer calls it, listening consciousness to respond to the inter-relationality and therefore inherent balance of nature is developed through music, song and dance of the religious rituals and festivals. They facilitate the unity of mind with nature. This use of music, that transforms ordinary consciousness, explains Cheng’s emphasis on the receptivity of feeling response in comprehensive observation, and Gadamer’s emphasis on openness to the other in attunement. However, an auditory disposition characteristic of pre-literate oral cultures that reveals the “All” need not rely on religion. As theorists about the evolution of language have explained,12 modern languages preserve their pre-historical past in music or prosody. That is to say, the song and dance that revealed the totality of inter-related beings to an ethos of comprehensive observation and attunement toward beings in classical civilizations is retained in the back-and-forth movement or rhythm of the dialogue form. Our mode of being in history is a mode of being in nature – through the music of language. -/- While alerting the reader to the limits of a nominalist interpretation, Gadamer expresses the inner law of the nature as follows: “in perishing there is always becoming, and in becoming there is always perishing.”13 Considered in process, opposites generate and blend into each other. This law of nature applies to everything.14 Hence, in a manner comparable to Pfister’s concluding insights, onto-dialogical hermeneutics is not only open to discrete events of otherness but moreover, to the moving structure of reality expressed, as Gajdosova suggests, in the existential moment of naming. Considered as interplay of tension and resolution with a life of its own, the dialectic of a dialogue is self-similar to the way in which an organism grows (by instinct). There is, therefore, a sense in which the art of interpretation extends the human mind into the eternal cycles of nature such that we participate in the articulation of the inner telos/homeostasis toward which all beings strive and importantly for Gadamer scholars of Heidegger, within the material limits of energy to which our embodied minds are self-evidently subject. In mortality there is always immortality. (shrink)

This article maintains that it is the constitutional responsibility of the courts, here the courts of the State of Michigan, to engage in judicial policymaking in the process of formulating common law rules. The article is written in response to the views expressed by some Justices of the Michigan Supreme Court that separation of powers concerns should impose significant limits on the power of the courts to establish and develop the common law of Michigan. Specifically, the contention is (...) that policymaking is exclusively the province of the legislature, so that the courts cannot properly formulate common law rules that may have significant social and economic effects. The article strongly disagrees with the proposition that there is any kind of constitutional constraint, either prudential or structural, on the power, and indeed, the constitutional responsibility of the Michigan courts (or the courts of any state) to engage in judicial policymaking in the process of formulating common law rules.The judicial power given to the Michigan courts by the Michigan Constitution includes the power to do what courts have always done in the Anglo-American legal system. The judicial power gives the courts the responsibility to adjudicate controversies between private persons and in the process to develop a common law through the workings of binding precedent and stare decisis. In so doing, the courts may properly take into account considerations of social and economic policy just as the legislature does when it engages in the process of enacting legislation. The difference between what the courts do and what the legislature does is a difference in process, not a difference in substance. Judicial policymaking takes place within the judicial process, that is, in the adjudication of controversies between persons in which the courts promulgate common law rules. The common law develops in a line of growth through the workings of binding precedent and stare decisis, and to the extent that there are limitations on the development of the common law, these are limitations that inhere in the judicial process itself. When the courts, for example, consider whether a new claim or a new defense should be recognized by the common law, they must consider whether that new claim or defense properly follows in the line of growth from existing doctrine and precedent. But if the courts conclude that it does, that is, if the claim or defense is consistent with the line of growth of existing doctrine and precedent, the courts are not constrained from recognizing the claim or defense on the ground that the substance of the claim or defense is a matter for the legislature rather than for the courts or that the resulting common law rule may have significant social and economic effects. The legislature, in contrast, enacts legislation through the legislative process. That process is a freewheeling one, often dependent on political compromise and completely unrestrained by the kind of limitations that inhere the judicial process. There is no legislative concept of line of growth, and the legislature can and often does enact legislation that brings about fundamental societal change or reverses the course of public policy. In our constitutional system, the most important questions of public policy are, of course, determined by the Legislature. Where the legislature disagrees with the policy choices reflected in a common law rule, the legislature has the power to enact legislation changing the common law rule. But there are many areas of private law where the legislature has not acted. In our constitutional system, where the matter in issue is not covered or preempted by legislation, the courts may formulate a common law rule to cover that matter, and in so doing may engage in judicial policymaking. Judicial policymaking is a part of the development of the common law, and the courts cannot avoid their responsibility to engage in judicial policymaking to the extent that it is necessary in the process of formulating the common law. As a constitutional matter, there are no separation of powers considerations that prohibit the courts from engaging in judicial policymaking. This part of the article traces judicial policymaking and the common law back to the seminal writings of Oliver Wendell Holmes, Roscoe Pound and Benjamin Cardozo.The article then discusses at length judicial policymaking and the development of the common law in Michigan. It shows that the clearest history of judicial policymaking in development of the common law is the liability-limiting rules of the late nineteenth century that were promulgated in the wake of the Industrial Revolution to protect the newly-emerging industries. During that time the courts in Michigan and elsewhere grafted on to the general principles of negligence law liability rules such as assumption of risk, contributory negligence, and the fellow servant doctrine, all of which had the effect of denying recovery to workers and other victims of industrial accidents. Beginning in the middle of the twentieth century, however, the Michigan Supreme Court began excising its constitutional power to make changes in the common law, expanding significantly the scope of tort liability in Michigan. Emphasizing that "rules created by the court could be altered by the court," and that the court had a "corrective responsibility when dealing with judge-made law," the Court, in approximately a 30 year period: eliminated the imputed negligence doctrine, under which the driver's negligence was imputed to the passenger in the passenger's suit against a third party; eliminated charitable immunity as a defense to a tort action; held that a wife could maintain at tort action for loss of her husband's consortium; abrogated the defense of assumption of risk, which had been applied outside of the employment area, held that there could be recovery for pre-natal injuries and finally abolished contributory negligence as a complete bar to recovery in favor of a comparative negligence approach. In these cases the Court discussed the relevant policy considerations influencing their decisions with respect to the common law rule at issue. In the last quarter century, the Court continued to take into account policy considerations in developing the common law, but not infrequently there was disagreement on the Court as to where policy considerations should lead, with some Justices arguing that policy considerations supported the imposition of tort liability, while other Justices argued that they did not.The article concludes that it has been demonstrated that in the development of the common law of Michigan, the Michigan Supreme Court has at all times engaged in judicial policymaking. From the liability-limiting rules of the late nineteenth century designed to protect the newly-emerging industries in this state, to the Court's exercise of its power to change the common law in Michigan over a 30 year period by expanding significantly the scope of tort liability in Michigan, to its recognition of new claims, such as a child's right to recover for loss of a parent's consortium caused by a negligent injury, to its imposition of limits on tort recovery, such as the open and obvious doctrine, the Court has invoked considerations of policy in support of its decisions. In these cases, the Court's invocation of policy considerations was sometimes accompanied by substantial disagreement among members of the Court over where policy should lead, but at no time did the Court ever suggest that separation of powers considerations should somehow operate as a kind of restraint on the Court's use of policy in the development of the common law. It is the power and responsibility of the Michigan Courts under the Michigan Constitution to make policy choices in formulating the common law. (shrink)

Background: Recent research demonstrates that people sometimes make different medical decisions for others than they would make for themselves. This finding is particularly relevant to end-of-life decisions, which are often made by surrogates and require a trade-off between prolonging life and maintaining quality of life. We examine the impact of decision role, patient age, decision maker age and multiple individual differences on these treatment decisions. Methods: Participants read a scenario about a terminally ill cancer patient faced with (...) a choice between an aggressive chemotherapy regimen that will extend life by two years and palliative treatments to control discomfort for one remaining month. Participants were randomly assigned to one of three decision roles (patient, physician, or an abstract other) and the scenario randomly varied whether the patient was described as 25 or 65-years old. Results: When deciding for a 65-year old patient, approximately 60% of participants selected aggressive chemotherapy regardless of decision role. When deciding for a 25-year old patient, however, participants were more likely to select chemotherapy for a patient (physician role) or another person (abstract other) than for themselves (70%, 67%, and 59%, respectively). In addition, confidence that powerful others (eg, physicians) control one’s health, as well as respondents’ age and race, consistently predicted treatment choices. Conclusions: Patient age appears to influence medical decisions made for others but not those that we make for ourselves. These findings may help to explain the discord that often occurs when younger cancer patients refuse life-extending treatments. (shrink)

Ex interiore ipso exeas. Preface. This book reconstructs the history of a still open dialectics between several ethoi, that is, shared codes of unwritten rules, moral traditions, or self-aware attempts at reforming such codes, and ethical theories discussing the nature and justification of such codes and doctrines. Its main claim is that this history neither amounts to a triumphal march of reason dispelling the mist of myth and bigotry nor to some other one-way process heading to some pre-established (...) goal, but instead to a chain of controversies where the partners’ will to win unintentionally yields a wealth of insights on human existence that has still something to teach us. -/- 1. The Hellenic moral tradition. -/- Two different traditions of morality in vi-v century Greece are described. The birth of philosophical questioning of traditional morality and temporal and spatial variation of custom is described within the context of the v century crisis, the demise of traditional aristocratic and tyrannical rule and the birth of democracy. Two conflicting answers to the challenge are reconstructed, namely conventionalist or immoralist theories formulated by the Sophists and the eudemonist and intellectualist Socratic theory. -/- 2. Plato and the Good. -/- Plato’s own reformulation of Socrates rejoinder to the Sophists is reconstructed. His psychological views, his classification of the four cardinal virtues and his political theory are described as parts of a unitary system, culminating in an extremely realist moral ontology identifying the idea of the good with the essence of the (moral and extra-moral) world itself. -/- 3. Aristotle and practical philosophy. -/- Aristotle’s invention of practical philosophy as a field separated from first philosophy is shown to be an implication of his break with Plato moral ultra-realism. Aristotle’s agenda in his moral works is arguably dependent on a polemical intention, namely dismantling Socratic intellectualism. The semi-inductive or virtuously circular method of practical philosophy is illustrated, starting with the received opinions of the better and wiser individuals and trying dialectically to sift what is left of mistake and inconsistency in such opinions, finally trying to correct mistakes and make the overall practical science more consistent. The relationship of individual ethics, or ‘monastics’, with the art and the science of the pater families, or ‘economics’, and the science of the ruler and citizen, or politics, is illustrated. The nature of virtues, or better, excellences of character, is discussed, highlighting the basic role of hexes, or ‘dispositions’. Prudence, or better, practical wisdom, is the focus of the chapter. Its relationship with boùleusis or deliberation is discussed, and its autonomous status vis-à-vis theoretical knowledge is stressed. -/- 4. Cynics and Stoics: ethics as therapy. -/- The chapter provides an overview of Hellenistic ethics, which almost amounts to Hellenistic schools of philosophy, in so far as ‘philosophy’ became in these centuries primarily the name for a way of life. The typical character of the Cynical movement is highlighted, that of a school of life, not a school aimed at providing any kind of intellectual training was to be provided. The various phases of Stoicism are described, and the shifting place that was given to ethics in the Stoic system of idea, culminating in the paradoxical view of ethics, its impossibility in principle notwithstanding, as the only truly significant and necessary part of philosophy. The peculiar character of the Epicurean school is described, a combination of the science of well-being aiming, more than pleasure understood as in the popular view, the reduction of useless suffering, of unnecessary needs, and at a balanced selection of pleasures of the best and most durable kind. -/- 5. Roman and Imperial Moralists. -/- The chapter is dedicated to the reconstruction of a particular kind of literature, whose specific features have long been under-stressed, namely the Roman and Imperial moral literature. Cicero is treated at some length, showing how his own synthesis of various Hellenistic trends is as a truly philosophical enterprise, deserving serious consideration after one or two centuries when he was confined to the role of literate. Epictetus is given pride of place, stressing the novelty of his approach to ethics as cognitive therapy, in this case just following an already existing new wave of interest after nineteenth-century oblivion justified by alleged lack of authentic ‘philosophical’ character. -/- 6. The Hebrew moral tradition. -/- A reconstruction of basic ideas from a few books of the Hebrew Bible is provided, starting with the Prophetic tradition and the focus on God’s mercy as the source of motivation and standard for human behaviour. Then a comparative analysis is undertaken of a parallel tradition, namely the three codifications of the Torah (Law or, better, Instruction), highlighting how a core of moral ideas may be recognized as a basis and preamble of codification of civil law, cultural practice, and regulation of ritual purity. The importance of Levitic is stressed as the turning point when the stress on mercy, typical of the Prophetic tradition, starts being combined with legal tradition yielding the change in the sensibility of the Second Temple time. -/- 7. Second Temple Judaism. -/- This chapter describes the Long March leading from the post-exile Zadokite restoration to the first-century aevi vulgaris. The first topic reconstructed is the Zadokite theology of the double retribution. The second is the alternative Enochic tradition consistently rejecting the central role of the Temple, the Priesthood and worship as atonement for sins and offering as an alternative God’s unlimited mercy and preaching mercy, not sacrifice as the way of behaving requested by God. Wisdom literature, the third subject discusses, is a kind of third way, on the one hand increasingly critical towards the double retribution and ruling theology’s optimism facing the world as it is and on the other mocking at the Enochic current as a band of dreamers and visionaries. The third way consists in disenchantment facing the word as it is combined with a refusal of vain and childish hope of prizes for the righteous, suggesting instead the leading idea of right deeds for righteousness’s sake. Rabbi Hillel, Rabbi Yeshua and Philo of Alexandria are described as the three leading figures at the culminating point of such process of emergence of a new sensibility, gradually including mercy as an essential part of justice and establishing the starting point of both the Rabbinic and the Christian tradition. This starting point consists precisely in the precept of one’s neighbour’s love or of the golden rule, whose meaning is, arguably, more consistent than a long-lasting Christian tradition deriving from John and Augustine made us believe. And Christian morality, vis-à-vis allegedly legalist ‘Ancient Testament’ teachings, is less of a novelty than most early Christian writers announced. -/- 8. Talmudic moral doctrines and proto-Christian paraenesis. -/- The first three sections examine the moral doctrines of so-called 'ethical Treaties' from the Talmud, a group of treaties, among which the best known is Pirke Avot, that were left out of the six "orders" of the canon as they did not fit in any of the six groups of issues ritual or legal on which the division was based. According to Maimonides, their peculiar theme is provided by the Deot, 'opinions', i.e., mental dispositions, that is, the translation of the Greek term hexes and Arab akhlak (in turn providing in this language the name for ethics as such). The three topics I reconstruct are: i) the notion of Torah: The Torah is understood as the world order itself, or as the ‘Wisdom’ that existed even before creation and was "the tool by which the world was built"; however, the Torah is an earthly and human entity, as it was "received" by humans, and from that very moment belongs to them; ii) the relationship between love of God and love of neighbour; the treaties require us to study and practice the Torah ‘for its own sake’, that is, require us to act out of love, not out of fear or hope of reward; iii) the idea of sanctification of daily life: having disappeared with the destruction of the Temple the possibility of any conflict between liturgical service and everyday life, the latter is assumed to be in itself divine service: to give food to the poor has the same value as sacrifices in the Temple, and as an implication, the insistence become recurrent on the goodness of created things in themselves along with a polemic against ascetic currents. The conclusions drawn are: i) the moral teachings of the Talmud and those of Yeshua are, rather than similar, virtually identical; one may safely say that the precept of love and the golden rule are central ones for all Talmudic rabbis, that mercy plays an indispensable role alongside with justice, and the latter is not a different thing from one’s neighbour’s love; ii) a peculiarity of Talmud rabbis facing Yeshua is the idea of study as worship, and knowledge as a source of justice; but this is an idea of Judaism after the Temple's destruction that cannot be attributed to the Pharisees of Yeshua’s time; iii) the relation of study and practice in the Talmud parallels that between faith and deeds in Paul's epistles, that is, respectively faith or learning are a necessary and sufficient condition to be recognized as righteous, but deeds are the inevitable effect of either faith or learning. The last two sections examine first the various Christian currents and then Gnostic para-Christian or non-Christian currents as well as Manicheism. The sayings ascribed to Yeshua are examined first, yielding the conclusion that a close equivalent may be found for every saying in Talmudic literature and yet the whole is ascribed to one rabbi, with rather consistent stress on God’s mercy and unconditional forgiving as the mark of true imitation of God. Thus, Yeshua’s teaching is pure, purest Judaism. The last section describes briefly the galaxy of Gnostic currents and Manicheism, trying to sketch the profile of moral teachings resulting from an encounter of Asian spiritual traditions, Hellenistic lore and sparks of teachings from apocalyptic Jewish currents. -/- 9. Christianity as “philosophy”. -/- The chapter reconstructs the stormy story of several encounters between Christian currents and Hellenistic philosophical schools. The first one was with late Cynicism. Recent, rather controversial, literature discovered the jargon and several rhetorical topics from the Stoic and Cynical popular philosophy in a few books from the New Testament itself. This, far from proving that Rabbi Yeshua himself had been influenced by cynical preachers, is a proof of the necessity to translate the original Christian message in a Greek lexicon deeply impregnated with cynic terminology. The second was with Platonism, yielding the mild and temperate moral teaching of Clemens of Alexandria, teaching the sanctity of nature and the human body, the joy of moderate fruition of ‘natural’ kinds of pleasures, and the beauty of the marital life – in short, the opposite of the standard picture of Medieval Christianity. Ambrose of Milan brings about a different kind of synthesis, namely with Middle Platonism, where Stoic themes prevail. The most shocking case is Augustine, where early Manichean education is overcome in a former phase by a synthesis of Plotinian Neo-Platonism and Christian preaching, yielding a sustained polemic with the Manicheans and rather optimistic views on life and Creation, the body and sexuality, and Hebrew-Judaic tradition not far from Clemens of Alexandria. In a later phase, occasioned by controversy on the opposite front, with such Christian currents as the Pelagians and Donatists, Augustine comes back to heavily anti-Judaic and world-denying ascetic attitudes where is earlier Manichean upbringing seems to emerge again. The tragedy of medieval Christianity will be the later Augustine’s overwhelming influence. A final section is dedicated to the monastic tradition where a curious mixture of world-denying asceticism with an astonishingly penetrating ‘science’ of introspection emerges. -/- 10. Ethics in the Arabic-Islamic Philosophy. -/- The Qurān and the qadit, that is, collections of sayings ascribed to the prophet Muhammad contain a wealth of precepts and catalogues of virtues mirroring moral contents from the Jewish and the Christian traditions, among them the basic notion of imitation of the Deity, where mercy is assumed to be its basic trait. An important tradition within Islam, namely Sufism, stressed to the utmost degree the role of mercy, turning Islam into a mystic doctrine centred on the retreat from the world, abandonment to God’s will, and a peaceful and fraternal attitude to our fellow-beings. A secular literary tradition originating in the Sassanid Empire, the literature of advice to the Prince, had for a time a widespread influence in the newly constituted Arabic-Islamic commonwealth. In a later phase, the legacy of Hellenic philosophy made its way into the intellectual elite of the Islamic world. The first important legacy was Platonic, and the Republic became the main text for Islamic Platonism. In a second phase also Aristotelian and Stoic influence were assimilated. Miskawayh’s treatise was the masterwork at the time Arabic philosophy reached its Zenith. It is a treatment of the soul’s diseases and their remedies, combining the Aristotelian doctrine of the golden mean with the Stoic doctrine of the passions and elements of Galenic medicine. Towards the eleventh-twelve centuries, a war raged among theologians and philosophers, finally won by the former with the disappearance of philosophy as such. The newly established mainstream, yet, was no kind of intolerant fanaticism. It drew from the work of mystic theologian Al-Ghazālī, the best heir of Sufism, teaching a tolerant and peaceful attitude to our fellow-beings and a passive attitude to destiny as an expression of the Divine will. -/- 11. Ethics in the Jewish philosophy. -/- The encounter between the Talmudic tradition and Hellenic philosophy had taken place for the first time in Alexandria at the time of Philo but the two traditions had parted way again. In fact, the kind of Platonic Judaism founded by Philo survived only within Christianity, in the fourth Gospel and then in writings by Clemens of Alexandria. The Talmudic literature had absorbed too a few traits from the Hellenic Philosophy, namely an idea of ethics as care of the self and a role for the education of character as propaedeutic to theoretical knowledge. In the Arabic-Islamic world, a second round started when Jewish authors writing in Arabic undertook the task to prove the full compatibility of the tradition deriving from Tora and Platonic philosophy. The culmination of this attempt is provided by Moshe ben Maimon who tried to use Aristotelian ethics as a language into which the teaching from the Pirke Avot could be translated. -/- 12. The practical philosophy revival in Latin Europe. -/- A reconstruction is carried out of a fresh start of philosophical ethics in Latin Europe at the turn of the Millennium rescuing a Platonic and Augustinian legacy, with Anselm and Peter Abelard. In this phase remarkable innovations are introduced, including Abelard’s claim of the obliging character of erring consciousness. In a second phase, the rediscovery of Nicomachean Ethics thanks to Latin translation of Arabic versions, gives birth to a new wave of ethical studies, recovering the very idea of Aristotelian practical philosophy, with the potential implication of a full legitimization of natural morality, i.e. ethics without Revelation. -/- 13. Scholastic practical philosophy: Thomas Aquinas. -/- Aquinas’s ethics is theological ethics out of which it would be vain to try to extract self-contained philosophical ethics. His treatment of topics in philosophical ethics, yet, does not boil down to the repetition of Aristotelian arguments but is rather a creative reshaping of such arguments. For example, he introduces also in the practical philosophy a first principle parallel to the principle of non-contradiction; and he also carries out a synthesis of Aristotelianism, Stoicism, neo-Platonism. Even though it is essentially moral theology, Aquinas’s doctrine - unlike Augustine – grants full citizenship to "natural" morality, firstly by rejecting the claim that the corruption of human nature due to the original sin is so radical as to leave pure nature incapable of moral goodness. The doctrine is presented in a more sophisticated formulation in a few of the Quaestiones such as De Malo and De Veritate, in the Summa contra Gentes and in the commentaries to Aristotle than in the famous Summa Theologica, but the latter work includes the only or the largest exposition of some decisive part of the theory. Thus, the Summa Theologica should be read for what it is more than criticized for not being what it was not meant to be. It was not meant to be the brilliant synthesis of all that Reason he had been able to produce with what Revelation had added about which the Neo-Thomists used to dream, but rather a manual for the training of preachers and confessors, where theoretical claims are not too ambitious, and a few serious tensions are left. Besides a jump between the Prima Secundae and the Secunda Secundae, being the former an essay in virtue theory and the latter a handbook for confessors, the most serious tension is perhaps the one between the ethics of right reason presented in most of Prima Secundae and the eudemonistic ethics developed in quaestiones 1-5 of the same part; the alternative ethical theory which also may be found in Augustine, the Stoic view of a cosmic reason eventually coincident with the moral law, was believed by Anselm (followed by John Duns Scotus and William of Ockham) to be incompatible with eudemonism. It is questionable whether Thomas was able to solve the tension proving that it is just an apparent tension, in so far as the right reason and bliss derived from the knowledge of God tend to coincide, but this is just a conjecture. Thomas’s ethics is a virtue ethics, not a law-based one, and moral judgment focuses on the virtues, particularly charity, not on the commandments and even less on absolute prohibitions; Thomas, however, would not have considered a drastic alternative between law and the virtues such as the one which has been advanced in late twentieth-century philosophy to be justified. Nonetheless, when it discusses ‘special’ virtues, it ceases to be an ethics of virtue and becomes a disappointing and often contradictory discussion of legal and illegal acts. Such a discussion takes most of the time ‘reasonable’ middle positions on controversial issues but not the alternative approach that Aristotelianism would have made possible; even when some occasional Aristotelian claim shows up, such as money’s barrenness as a reason against usury, this seems to be made by an author who apparently ignores the Aristotelian Thomas of the Prima Secundae. It is an ethic of human autonomy which recognizes the binding character of the individual conscience and, potentially, even a duty to disobey unjust laws. It is true that what Thomas writes in his discussion of the death penalty and persecution of heretics is simply disgusting, and yet we should blame Thomas the man, not the Thomist ethical theory. Finally, Thomas’s ethics is no way an ethical ‘absolutism’, as both the traditionalist Catholic theologians and secularists tend to believe, but rather an ethic of prudential judgment on the individual case. Exceptions to this approach – or better the result of logical fallacies – are provided by the thesis of the absolute character of negative precepts and of the existence of so-called intrinsically evil acts, a thesis that would simply cease to make sense in the light of Thomas’s own distinction between human act and natural act, carrying consequences that Thomas did not live long enough to draw. -/- 14. Scholastic practical philosophy: John Duns Scotus and William of Ockham. A reconstruction is carried out of the ethical doctrines by both most authoritative Franciscan doctors. Their continuity with Aquinas is vindicated against prejudice carried by centuries of polemics within the Catholic Church and tendentious disparaging of both as forerunners of execrable Reformation. Besides aspects of continuity, also the important novelties are illustrated, first John’s abandonment of Aquinas’s and Augustine’s eudemonism, asserting righteousness for righteousness’s sake, and then William’s explicit defence of the philosopher’s virtues, that is, natural morality, and his solution to the dilemma of God’s omnipotence and the universal validity of natural law extending to God himself. -/- 15. Aristotelianism interpreted by the Magistri Artium. -/- A reconstruction of the until recently forgotten ethical doctrines by the Parisian Magistri Artium, falsely depicted as ‘Averroists’ and either deprecated as heretics or mistaken for predecessors of modern secularism. In fact, they illustrate a view of ‘natural’ virtue as may be understood by human reason without the assistance by Revelation. -/- Etiamsi daremus Deum non esse. Intermediate considerations. Three considerations may be suggested by the story told in the book. The first one is that intellectual histories have been mounted in the past with the same state of mind as one may mount a war chariot. Such constructions are not very helpful as tools for understanding the past. Wars waged in the past have left the field obstructed by ruins not easy to remove even by those historians who have animated by an impartial academic motivation. They have been influenced too by consequences of past emphasis on some authors and damnatio capitis suffered by others, by stratifications left on sources by secondary literature and translations, by allotment of originally close sources to different literary genres, by the monopolization of religious texts by churches with full cooperation by secular scholars who still fear contamination. The second one is that aware or unaware ethnocentrism has carried various calamities to our comprehension of the past. Their last vestiges have surfaced again in the semi-scholarly discussion on the idea of Europe occasioned by the debate on a project of a European Constitution. Mention of Europe’s Christian roots has been the clumsiest move. Proclamations of such roots were so obvious in what they affirmed as they were totally off-path concerning what they omitted, namely that he modern European moral tradition included legacies from Middle-Eastern wisdom, Hellenic philosophy, Roman Imperial legal literature, and, besides, a Jewish legacy in turn incorporating other more ancient Middle-Eastern legacies and which has been partly conveyed by Christianity. And the Islamic-Arabic philosophy too, in so far it made the Nicomachean Ethics available to Latin Christian scholars, is one more of Europe’s roots. The third is that religious traditionalists and secularist fundamentalists have gone hand in hand for a couple of centuries in either extolling or deprecating the allegedly Modern idea of Ethics without God, first formulated by Hugo Grotius with the claim that natural law would still be valid ‘etiamsi daremus – quod sine summo scelere dari potest – Deum non esse’. The facts are, firstly, that this is not an irreligious claim and Grotius was just a pious and meek Christian and, secondly, that it is not a ‘modern’ claim but rather one more formulation of the claim that there is a natural morality, independent of divine revelation, a claim shared by Moshe ben Maimon, Aquinas and William of Ockham. -/- . (shrink)

Chapter 1 First Person Access to Mental States. Mind Science and Subjective Qualities -/- Abstract. The philosophy of mind as we know it today starts with Ryle. What defines and at the same time differentiates it from the previous tradition of study on mind is the persuasion that any rigorous approach to mental phenomena must conform to the criteria of scientificity applied by the natural sciences, i.e. its investigations and results must be intersubjectively and publicly controllable. In Ryle’s view, (...) philosophy of mind needs to adopt an antimentalist stance to achieve this aim. Antimentalism not only definitively rejects the idea that mind is a substance separated from the body, it also denies that mental phenomena radically differ from physical phenomena by virtue of several unique features. Most problematically, mental phenomena have a conscious character (mental states are related to specific qualitative feelings) and are accessible only to the first-person (only the subject knows directly what s/he is experiencing inside his/her mind). Ryle takes a strong stance on antimentalism going so far as to maintain that an approach to mind which aims to meet the criteria of scientificity set by the natural sciences must avoid any reference to internal, unobservable mental states. In his view (which is considered a specifically philosophical version of psychological behaviorism and also addresses questions put forward in psychological research), mental states can be redescribed in terms of behavioral dispositions. In this chapter, we address the historical roots of the antimentalist view and analyze its relation to the later tradition of research on mind. We show that, compared to the antimentalist stance, functionalism and cognitivism take a step back when they maintain that direct reference to mental states is necessary since mental states cause and therefore explain human behavior. This step backwards is often interpreted as a return to mentalism. However, this is only partially true. Indeed, we suggest that these later traditions retain one important element of Ryle’s antimentalism, i.e. the idea that mental states must be uniquely identified using external and publicly observable criteria, while excluding any reference to introspection and those qualitative dimensions of a mental state, which are accessible only to the first-person. According to the perspective we put forward, this epistemological stance has continued to influence contemporary research on mind and current philosophical and psychological theories which both tend to exclude the subjective qualities of human experience from their accounts of how the mind works. The issue we raise here is whether this is legitimate or whether subjective qualities do play a role with respect to the way our mind works. The conclusion of this chapter anticipates the argument the book makes in in favor of this latter position, starting from a particular angle, i.e. the problem of how we categorize concepts related to our internal states. -/- Chapter 2 The Misleading Aspects of the Mind/Computer Analogy. The Grounding Problem and the Thorny Issue of Propriosensitive Information -/- Abstract. After the crisis of behaviorism, cognitivism and functionalism became the predominant models in the field of psychology and of philosophy, respectively. Their success is mainly due to the new key they use for interpreting mental processes: the mind/computer analogy. On the basis of this analogy, mental operations are seen as cognitive processes based on computations, i.e. on manipulations of abstract symbols which are in turn understood as informational unities (representations). This chapter identifies two main problems with this model. The first is how these symbols can relate to and communicate with perception and thus allow us to identify and classify what we perceive through the senses. Here we limit ourselves to presenting this issue in relation to the classical symbol grounding problem originally put forward by Harnad on the basis of Searle’s Chinese room argument. An attempt to address the problem raised here will be made in chap. 3. The second point we discuss in relation to the mind/computer analogy concerns the idea of information it fosters. Indeed, following this analogy, information is something available in the external world which can be captured by the senses and transmitted to the central system without being influenced or modified by the procedures of transmission. This perspective does not take into account that – unlike computers – in living beings information is acquired by means of the body. As Ulric Neisser has already pointed out, the body is itself an informational source that provides us with additional sensory experience that influences (modifies or complements) the information extracted from the external world by the senses. To develop this line of analysis and to determine exactly what information is provided by the body and how this might influence cognition, we examine Sherrington’s and Gibson’s positions. Moving on from their views, we qualify bodily information in terms of ‘proprioception’. We use ‘proprioception’ in a broad sense to describe any kind of experience we have of our internal states (including postural information as well as sensations related to the general state of the body and its parts). Following Damasio’s and Craig’s studies, we further elaborate this position, arguing that living beings are equipped with an internal propriosensitive monitoring system which maps all the changes that constantly occur in our body and that give us perceptual (‘proprioceptive’ or propriosensitive) information about what happens inside us. Moreover, relying on Goldie’s and Ratcliffe’s view, we show that emotional information can also be considered as a form of ‘proprioception’ which contributes to determining everything we perceive. This analysis leads us to the second main thesis of this book: ‘proprioception’ is a form of internal perception and it is an essential component of the sensory information we can access and use for all cognitive purposes. -/- Chapter 3 Semantic Competence from the Inside: Conceptual Architecture and Composition -/- Abstract. Concepts are essential constituents of thought: they are the instruments we use to categorize our experience, i.e. to classify things and group them together in homogeneous sets. Here we define concepts as the internal mental information (representations) that allows us, among other things, to master words in natural language. By analyzing the way in which individuals master word meanings we explore a number of hypotheses regarding the nature of concepts. Following Diego Marconi’s research, we differentiate between two kind of abilities that underpin lexical competence – so-called ‘referential’ and ‘inferential competence’ – and we suggest that, in order to support these abilities, concepts must also include two corresponding kinds of information, i.e. inferential and referential information. We point out that the most widely used and acknowledged theories of concepts do not make this distinction, instead broadly characterizing the information used for categorization in terms of propositionally described feature lists. However, we show that while feature lists can explain inferential competence, they do not account for referential competence. To address the issue of referential competence we examine Ray Jackendoff’s hypothesis that to account for the possibility of linking perceptual and conceptual information we need to assume the existence of a (visual) representation that encodes the geometric and topological properties of objects and bridges the gap between the percept and the concept. Furthermore, we analyze the extension of this work by Jesse Prinz who introduced the notion of a proxytype, a perceptual representation of a class of objects that incorporates structural and parametric information related to their appearance. However, as we point out, proxytypes can only explain the relationship between perception and concepts with respect to instances that can be perceived through the senses and that belong to the same class by virtue of their physical similarity. We suggest that this notion be extended to include larger conceptual classes. To accomplish this, we further develop Mark Johnson, George Lakoff and Jean Mandler’s idea of a schematic image and argue that conceptual representations include a perceptual schema. Perceptual schemata are non-linguistic, structured experiential gestalts (patterns or maps) that make use of information taken from all sensory modalities, including body perception. They accomplish a quasi-conceptual function: they allow us to recognize and to classify different instances. In this work, we hypothesize that perceptual schemata are an essential component of concepts, but not identical to them. Instead, we suggest that concepts include both perceptual and propositional information with perceptual schemata providing the ‘perceptual core concept’ that grounds related propositional information. -/- Chapter 4 In the Beginning There Were Categories. The Bodily Origin of Prelinguistic Categorical Organization: The Example of Folkbiological Taxonomies -/- Abstract. Studies of categorization in psychology and the cognitive sciences have made use of the notions of ‘category’ and ‘concept’ without precisely defining what is meant by either; in fact, often these terms have been used as synonyms, making it difficult to address specific issues related to conceptual development. This chapter begins by discussing the definitions of, as well as the distinctions between, ‘categories’ and ‘concepts’ in the classical philosophical tradition (Aristotle, Kant and Husserl). We introduce our view of categories with reference to Husserl. Categorization is defined as the way in which our experience is originally (pre-linguistically) organized in a passive and fully unconscious manner on the basis of universal structuring principles. Conceptualization is explained as a later process in which the earlier categorical macro-classes are further subdivided into more specific and detailed sets; this later process also relies on linguistic learning and exposure to culture. On the basis of Ray Jackendoff, Jean Mandler, George Lakoff and Mark Johnson’s work, we hypothesize that categorization is a two-step process that begins with the formation of homogeneous sets of entities partitioned into regions that describe the ontological boundaries of the objects that humans perceive (categories) and continues at a later stage with the development of more specific classifications (concepts). In this chapter, we mainly address three related issues: Why should we assume that there is categorical organization which precedes the development of a conceptual system? How do categories and concepts relate to each other? Shall we hypothesize that categories are innate or that they are formed before concepts on the basis of information and organizational structure available at a very early developmental stage? We show that categorical partitions are necessary for categorization and, following Mandler, that the general categories we form at an early age do not match our adult superordinate concepts. As for the third issue, we argue that there might be no need to assume that categories are innately present in the human mind, since their formation can be explained – at least in certain cases – by basic mechanisms that work on body (propriosensitive) information. This hypothesis will not be discussed in general, but in relation to a particularly relevant example of categorical partition, i.e. the folk-biological dichotomy between ANIMATE/INANIMATE. This is compared with other dichotomies that derive from it, but are not directly categorical such as LIVING/NON-LIVING and BIOLOGICAL/NON-BIOLOGICAL. -/- Chapter 5 Internal States: From Headache to Anger. Conceptualization and Semantic Mastery -/- Abstract. Here we ask if we can also apply the distinction between referential and inferential competence we introduced in Chapter 3 to words that do not refer to things that are perceived using the external senses, especially to words/concepts that denote bodily experiences (such as pain, thirst, hunger, etc.) or emotions. We introduce and discuss the hypothesis that – even though such words/concepts do not refer to intersubjectively identifiable entities in the external world – they do have a kind of referent that can be accessed via direct perception, more specifically ‘proprioception’, as we have defined it in terms of all propriosensitive information we can consciously access. In the first part of the chapter, we specifically consider terms denoting bodily experiences such as ‘pain’ or ‘hunger’ and argue that their referents are identified and classified from a first-personal point of view on the basis of four main characteristics: their specific intensity, their localization in the body, their co-occurrence with other signals and above all their specific qualitative sensations. Emotions are addressed in the second part of the chapter. We suggest that there is a continuity between bodily experiences and emotions. In particular, we argue for a perceptual theory of emotions in line with that proposed by James and Lange at the end of the 19th century and developed more recently by authors such as Damasio (see also chap. 2§5, §6). The hypothesis we put forward is that the referential information that supports the categorization of emotions and therefore also our mastery of terms referring to emotions consists in the perception (i.e. the ‘proprioception’) of those bodily states and changes in bodily states which constitute our emotional experience. In the context of this discussion we examine some objections to this line of reasoning that arise from a cognitivist perspective and following authors such as Oatley, Johnson-Laird and Frijda, we distinguish between basic emotions that can be identified and classified solely on the basis on how they feel and complex emotions whose identification and classification additionally depends on cognitive factors. To describe how emotions are identified and classified on the basis of how they feel, we rely on Marcel and Lambie’s distinction between an ‘emotion state’ and an ‘emotion experience’. Both notions indicate kinds of feelings that we consciously experience. However, they describe first-order and second order emotion awareness respectively. The emotion state is the feeling we have of the bodily states and changes that occur when we are experiencing an emotion, while the emotion experience is the fully developed and integrated emotion we both experience and are, with reflection, aware of experiencing. On the basis of this differentiation, we also show that the same characteristics that aid in the identification and classification of bodily experiences (specific qualitative sensations; somatic localization; specific intensity; presence/absence of specific concomitant sensations) can also be used for the identification and classification of emotions – at least basic emotions. In the last two sections of the chapter we present some clinical evidence on the semantic competence of people who suffer from Alexithymia and Autism Spectrum Disorder which supports the conclusions of our preceding analyses. -/- Chapter 6 The ‘Proprioceptive’ Component of Abstract Concepts -/- Abstract. In this chapter, we address the issue of whether the mastery of abstract words requires only inferential knowledge and thus, if the concepts that support the mastery of abstract words include only linguistic information. We start by differentiating the notions of ‘abstract’ and ‘general’ which are often erroneously confused. We then identify a strict definition of abstract, as contrasted with ‘concrete’, that applies to words or concepts whose referent cannot be experienced by the senses. We argue that abstract words/concepts would be better described as theoretical, because they are usually conceived as structured sets of inferential knowledge expressed linguistically; that is, as small theories. Pointing out parallels with Carnap’s analysis of this issue in philosophy of science, we hypothesize that words/concepts denoting non-observable entities are not all ‘equally theoretical’, because their link to sensory experience can be stronger or weaker. We revive the distinction, inspired by Quine, between theoretical and intertheoretical concepts/words. This distinction relies on the fact that the former – unlike the latter – retains a strong, although indirect, connection with perception. In Quine’s discussion, perception is understood uniquely in terms of observability, i.e. of external sensory experience. Here we argue, however, that bodily, ‘proprioceptive’ (i.e. propriosensitive) experience can also serve to referentially ground theoretical (i.e. abstract) concepts/words. We frame this issue using the example of the theoretical concept ‘freedom’ and Lakoff’s hypothesis that this concept is developed on the basis of bodily information. We contrast this with the example of ‘democracy’ which more closely resembles an intertheoretical concept/word. Furthermore, we show that one of the classical views put forward in psycholinguistic research to explain how abstract concepts are mentally represented – i.e. Paivio’s Dual Coding Theory – points in the same direction as our analysis. The same is true of Barsalou’s work suggesting that we use internal information to understand at least some abstract words. To sustain this position, we put forward two lines of evidence: the first comes from psycholinguistic studies while the second examines deficits of semantic competence exhibited by people with Autism Spectrum Disorder. On the basis of our analysis, we put forward a classification that distinguishes between different kinds of concreteness and different degrees of abstraction: concepts/words referring to body experiences and basic emotions are described as analogous to concrete concepts/words because they are grounded in perceptual (i.e. propriosensitive) experience, while abstract concepts/words are considered more or less abstract depending on whether they are intratheoretical (and rely entirely on inferential information) or theoretical (and are partially grounded in perceptual – or more often in propriosensitive perceptual – information). In the last section of the chapter we consider two scales that have been used in psycholinguistic research to measure the degree of concreteness vs. abstractness of words and we show that – used conjointly – they can provide a measure of the internal vs. external grounding of specific words. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Prolegomena to a Comparative Reading of The Major Life of St. Francis and The Life of MilarepaMassimo A. RondolinoDifferent religious traditions in different cultures have recorded and transmitted the lives of individuals recognized as “perfected.” The particular doctrinal framework within which each of such figures is identified as “perfected” is certainly specific to the religious tradition that tells their life stories. Similarly, the social processes by which these (...) religious life writings are written, received, and circulated are appropriate to the historical and geographical contexts of their composition. Yet, narrative parallels can be detected across traditions, and the question arises whether these apparent similarities in the creation of such religious life stories across cultures, space, and time reflect actually similar doctrinal and political agendas. Could there be an underlying hagiographic process common to all these literary traditions, regardless of their compositional contexts? In other words, is the writing of spiritual lives a phenomenon that is contextual to a specific religious tradition, or is it rather a particular human response to given social and historical circumstances?I want to offer here a preliminary assessment of a study in comparative hagiology. To this end, I focus on two specific narrative traditions that pertain to two distinct religious, historical, and geographical contexts: the hagiographic writings on the medieval Christian St. Francis of Assisi (1182–1226) and the namthars on the Tibetan Buddhist Milarepa (Mi la ras pa; ca. 1052–1135). In particular, here I make some considerations on a comparative reading of the “standard versions” of their life stories: The Major Life of St. Francis (Legenda Maior Sancti Francisci) by Bonaventure of Bagnoregio (1221–1274), and The Life of Milarepa (Mi la ras pa’i rnam thar) by Tsangnyön Heruka, the “madman” of Tsang (gTsang smyon Heruka; 1452–1507).1The composition and reception of religious life writings is famously characteristic of early and medieval Christianity, with its complex and extensively studied production of hagiographic texts. Similarly, the compilation and distribution of life narratives in a religious context also plays a crucial role in the historical and cultural development of Tibetan Buddhism, with its extensive production of namthars (rnam thar, literally “great liberation” and, therefore, “stories of great liberation”). Within these large narrative traditions, St. Francis of Assisi and Milarepa eminently stand [End Page 163] out, both within and outside their respective cultural contexts, as two among the most renowned spiritual figures in Christianity and Tibetan Buddhism, respectively.2 Furthermore, both figures and their related narrative traditions have been the object of scholarly studies for nearly a century.3Indeed, the spirituality embodied by St. Francis and Milarepa has been already the focus of attempted comparisons that have essentially and consistently focused on a direct assimilation of their respective extreme asceticism and teachings of poverty and renunciation, by drawing extensively on the literary accounts of their lives.4 Yet, it is important to note that the lives of these two exceptional individuals are also almost exclusively known through the dominating perspective of a single author’s works. In fact, although one of the best-known texts on St. Francis is the anonymous Little Flowers of St. Francis (Fioretti di San Francesco, late fourteenth century), the saint’s life and deeds are primarily known through their rendering by Bonaventure of Bagnoregio, general minister of the Franciscan order. Similarly, the acts and teachings of Milarepa as they are familiar to Tibetan (and Western) audiences result primarily from the work of the wandering yogin Tsangnyön Heruka.Reflecting on the apparent parallelisms between the lives and teachings of St. Francis and Milarepa, though, I wonder whether such similarities may not extend beyond the spirituality that the saint and the repa embody. In particular, I am curious as to whether the analogies between the two figures that have been already outlined by several scholars may not actually arise from similarities in the sources’ underlying compositional dynamics and, in particular, in the authors’ approaches to the interpretation and retelling of these individuals’ lives as embodiments of a particular form of spirituality. In fact, if religious life writings are a form of communication that can be found in communities that belong to different traditions, times... (shrink)

In the present super-aging society, issues concerning what treatment should be given for incapacitated patients have become more important than ever before. This paper discusses whether or not an incapacitated patient’s refusal of treatment should be respected. The authors present a complete hypothetical scenario involving a 75-year-old moderately demented man suffering from malignant lymphoma. Of primary importance are the respect for patient dignity and the protection of human rights. Acts such as coercion, disregard, restriction, and surveillance can be unethical in (...) many situations. The effectiveness of chemotherapy for malignant lymphoma and its adverse outcomes could offset each other, leaving no net benefits for the patient. The patient is vulnerable and this very vulnerability requires the utmost protection and care. However, protection must be sensitive and comprehensive and the protection of his life at the expense of many other valuable factors is not justifiable. Coercing unwanted treatment would be intrusion, not protection, because of the physical and psychological suffering. When the refusal is explicit, consistent, and stable enough, it should to be viewed as true and current desire. Due to moderate dementia, the patient has lost his rational capacity, but his emotional capacity remains. If the remaining portion of his personality is rooted in his feelings, these feelings should be respected as much as possible. Those involved in the care of the patients who refuse treatment should not force them to undergo it simply on the grounds that it may be an established standard in their own country. What must be asked first is whether or not forced treatment would promote the patient’s subjective well-being. Additionally, treatment decisions should not be distorted due to the selfishness or discriminatory feelings of those involved in his care. In situations in which patients lack decisionmaking capacities, overriding the patients’ refusals of treatment should be regarded as an exception, rather than a standard course of action. Even in patients who are incapacitated, treatment refusal could stem from the feelings of the individual. Their subjective wellbeing would not be improved through close observation, restraint, denial, and coercion, the purpose of which they does not understand. (shrink)

Background The principle of respect for autonomy (PRA) is a central tenet of bioethics. In the quest for a global bioethics, it is pertinent to ask whether this principle can be applied as it is to cultures and societies that are devoid of the Western sociopolitical historical pressures that led to its emergence. Relational autonomists have argued for a more inclusive approach to patient autonomy which takes into account factors such as interdependency and social relations. However, at the (...) outset of any relational approach, it is necessary to identify underlying factors that influence patient autonomy in non-Western cultures. Objective To conduct a review of the literature to uncover the mechanisms through which social, cultural, and religious factors influence and impact the application of the PRA in healthcare decision-making in non-Western cultures and societies. Methods We conducted a systematic review through a comprehensive search of three major electronic databases of biomedical sciences. Returned citations were imported to Covidence, full texts were assessed for eligibility, included articles were thoroughly reviewed and data was synthesized. PRISMA guidelines were followed. Results Our search retrieved 590 non-duplicate results, 50 of which were included after screening and full-text eligibility checks. The included studies were predominantly qualitative in nature, with few quantitative, mixed-methods, and review studies included. Our synthesis of data identified nine key factors that influenced patients’ autonomous decision-making through cultural, social, religious, or intersectional pathways. Conclusion Two main conclusions emerge from this review. Firstly, there is a notable dearth of bioethical research examining the influence of diverse factors on patients’ inclination towards different conceptions of autonomy. Secondly, the analysis of prevalent collectivist cultures and deference of autonomy adds value to the solution-oriented relational autonomy debate. This raises questions regarding how decision-making can be truly autonomous in the presence of such large-scale factors, warranting further attention. (shrink)

In 1992, the United States Supreme Court, in Planned Parenthood of Southeastern Pennsylvania v. Casey, upheld the ruling in Roe v. Wade, namely that women have a right “to choose to have an abortion before viability and to obtain it without undue interference from the State.”1 However, since this ruling, some states have imposed regulations that greatly limit this right by restricting access. Texas is a recent example of this. Two proposed restrictions in House Bill 2, which will (...) be discussed in detail below, will force all but eight clinics that are located in metropolitan areas to shut down. The U.S. Supreme Court put the proposed restrictions on hold in October 2014, allowing several clinics to remain open while the restrictions are being appealed in the U.S. Court of Appeals for the Fifth Circuit. If the restrictions are passed, however, those clinics will be forced to shut down and, as a result, many women in Texas will be required to travel more than 100 miles in order to access a safe and legal abortion. Much of the focus of these restrictions has been on women and rightly so. However, I want to turn the attention to physicians. The requirements exacerbate unfair treatment of abortion providers compared with other physicians. Abortion providers face threats from the public—some of which turn into violent attacks—and they are often ostracized by their fellow medical practitioners. There are so few abortion providers to begin with and the proposed requirements limit these physicians’ opportunities to practice the branch of medicine of their choosing. Although the HB 2 requirements may not result in an unconstitutional undue burden on physicians, the challenges created by the bill limit physicians’ abilities to provide abortions. As a result of these limits, HB 2 creates an unconstitutional undue burden for women seeking abortions by creating barriers directed at abortion providers and clinic staff who are willing and able to provide abortions. The first of the two controversial HB 2 requirements is the admitting privileges requirement: “A physician performing or inducing an abortion must, on the date the abortion is performed or induced, have active admitting privileges at a hospital that is located not further than 30 miles from the location at which the abortion is performed or induced.”2 The second requirement is the ambulatory surgical center requirement: “The minimum standards for an abortion facility must be equivalent to the minimum standards adopted under [Texas Health & Safety Code] [...] for ambulatory surgical centres.”3 In order to meet these state-mandated obligations, some abortion clinics would have to spend more than $1 million in upgrades if they wish to remain open. The District Court decided that the ambulatory surgical center requirement places an unconstitutional undue burden on women, and that the two requirements together place an undue burden on women in Texas and especially in the Rio Grande Valley where the nearest clinic is a couple hundred miles away.4 Later, the U.S. Court of Appeals for the Fifth Circuit reversed the District Court’s decision and argued, “the admitting privileges requirement is constitutional on its face.”5 While the regulations are being appealed, the Supreme Court granted a stay of injunction, allowing about twelve abortion clinics to reopen until a final decision regarding the regulations is made. The District Court ruled that the purpose of the two regulations was to create a substantial obstacle for women seeking abortions in Texas. While the defendants argued that the regulations were designed to make abortions safer and reduce risk, the Court decided that this was not the case. An abortion, especially a first-term abortion, is a very safe procedure and is safer than many other routine surgical procedures. As stated in Planned Parenthood v. Casey, “Unnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on the right.”6 The undue burden in this case is imposed, not through restricting women’s access directly, but by restricting physicians’ freedom to perform abortions. The admitting privileges requirement has reduced the number of physicians who can perform abortions and the ambulatory surgical center requirement has reduced the number of clinics where abortions can be performed. The American Medical Association states, “[t]he Principles of Medical Ethics of the AMA do not prohibit a physician from performing an abortion in accordance with good medical practice and under circumstances that do not violate the law.”7 This means that physicians are not required to perform abortions, except in emergency situations, but can as long as the procedure is done safely and does not violate the law. The new Texas regulations, however, are so restrictive that few abortion providers, limited to only four urban areas, can legally perform abortions. Physicians do not have an absolute right to perform abortions as opposed to women who have an absolute right to have access to an abortion. Physicians do face many challenges that other professionals face in terms of obtaining qualifications and finding work. Abortion providers, however, face challenges that most other physicians do not. The restrictions imposed by these regulations exacerbate unfair treatment toward abortion providers and place further obstacles in their path in terms of providing the service they want and are qualified to provide. Both abortion clinics and abortion providers are being treated differently from other medical clinics and physicians. For instance, “grandfathering of existing facilities and the granting of waivers from specific requirements is prohibited for abortion providers, although other types of ambulatory surgical facilities are frequently granted waivers or are grandfathered.”8 Many abortion clinics cannot afford the necessary upgrades. Furthermore, it is extremely expensive to open a brand new clinic that complies with the ambulatory surgical center requirements. Being grandfathered in would be the only option available to abortion clinics that cannot afford the upgrade. However, unfair treatment of abortion clinics and providers is preventing those clinics from being grandfathered into the new system. As a result, many abortion clinics may be forced to close. Admitting privileges are proving difficult or impossible for physicians both to obtain and, for those who have already been granted privileges, to keep. Dr. Sherwood Lynn, an obstetrician-gynecologist who has performed abortions for decades, describes the process of obtaining admitting privileges and the difficulties abortion providers face. After sending in an application a physician must wait for the hospital to send them the required materials, “but if the address of the practice on the application is of an abortion provider or clinic, [the hospital] won’t send [them] the package of materials required. [They] simply can’t apply.”9 Dr. Lynn and several other physicians have surmised that hospitals are only withholding privileges from qualified physicians who perform abortions and that other physicians do not face this discriminatory treatment. Hospitals have also revoked privileges granted to physicians after learning that the physicians perform abortions. For instance, in Texas two doctors, “received notices [...] informing them that their admitting privileges to the University General Hospital of Dallas have been revoked, with the hospital’s CEO claiming the hospital was unaware they were providing abortion care and that the hospital believed such care would damage its reputation.”10 What is curious about this revocation is that, “federal and state laws [...] forbid hospitals from discriminating against doctors who perform abortions,” and yet hospitals are clearly doing just that.11 Dr. Pamela Richter, another abortion provider in Texas, had her temporary admitting privileges revoked with no explanation and because of this, the clinic where she performed abortions, Reproductive Services, can no longer provide abortions at all.12 As the hospital gave no reason for the revocation, it not clear Dr. Richter’s privileges were revoked because she performs abortions. Dr. Richter, however, has performed over 17,000 abortions and her privileges were revoked soon after HB 2 was introduced.13 According to the Texas Hospital Association, giving admitting privileges to doctors who do not work for the hospital is expensive and time-consuming but this does not account for the fact that hospitals are revoking previously granted privileges from physicians whom they learn are providing abortion services.14 As mentioned previously, the District Court found that the admitting privileges requirement and the ambulatory surgical center requirement do not further ensure the health and safety of women undergoing an abortion. Several physicians have testified to this fact. Dr. Lynn stated in an interview: The admitting privileges requirements are [...] absolutely unnecessary. If you have a number of patients waiting for procedures, and something happens and a patient needs to be transferred to a hospital, you’re not going to leave everyone else and go to the hospital. That makes no sense. You’re going to refer that person to a gynecologist at the hospital. There is no safety issue involved here. If a patient shows up with an emergency, every hospital is required to admit that patient. They have to by law.15 It is rare that complications will arise from an abortion performed in a clinic. Dr. Richter, for example, has performed more than 17,000 abortions and not once had to send a patient to a hospital because of complications resulting from the procedure. According to Dr. Lynn even if abortion providers were granted privileges to hospitals, it is unlikely that they will exercise them. In essence, having admitting privileges at a hospital does nothing to further ensure the safety of an already safe procedure. The only result of the admitting privileges requirement is to limit certain physicians’ ability to perform legal abortions. Not only do the HB 2 requirements fail to further ensure the health and safety of women, the HB 2 requirements may actually create more health risks to women who cannot access the eight remaining clinics. The first risk is that the remaining clinics would have an influx of patients that they may not be able to handle, forcing women to wait longer for an appointment. As stated by the District Court, “[e]ven assuming every woman in Texas who wants an abortion [...] could travel to one of the four metropolitan areas where abortions will still be available, the cumulative results of HB 2 are that, at most, eight providers would have to handle the abortion demand of the entire state.”16 Furthermore, “[t]hat the State suggests that these seven or eight providers could meet the demand of the entire state stretches credulity.”17 Abortion is a time sensitive procedure. It is safest when performed early in a pregnancy. The increase in patients to these remaining clinics, assuming all women in Texas can access them, will increase wait times and may force women to have abortions later in pregnancy. In the worst-case scenario, a woman would not see an abortion provider at all before viability. Such instances may be rare, but they are possible. In such cases, women’s access to legal abortions becomes impossible and thereby violate the ruling in Roe. Clinics may be able to avoid the aforementioned problems if they hire more physicians. However, there are two barriers to hiring more physicians. First, as mentioned previously, admitting privileges to Texas hospitals are difficult, if not impossible, for abortion providers to obtain. Second, given the negative treatment of abortion providers by anti-abortion groups, many physicians are not willing to perform abortions. The harassment abortion providers face is unique to those physicians and many physicians will not perform abortions for that reason. In an article published in the Austin Chronicle, anti- abortion activist Abby Johnson, “discusses how her group investigated appraisal district records to find the new location of where an Austin abortion physician plans to work.”18 Johnson states, “These abortionists are feeling the pressure from the pro-life movement in Texas. I think they feel like they’re on the run. And that’s how we want to keep it.”19 If the HB 2 requirements are passed and there remain at most eight abortion providers in Texas, these activists will concentrate on those clinics and, “the dangerous impact of their intimidation tactics will be exacerbated.”20 Even if the number of physicians needed to meet the demand in Texas can obtain admitting privileges and work at one of the remaining clinics, they may choose not to do such work because they are putting themselves at risk. The harm abortion providers face from such anti-abortion groups is not unique to Texas. There are stories from all over the country and from other countries where abortion is legal of physicians receiving death threats. Dr. George Tiller, an abortion provider in Kansas, was killed outside his church and had received numerous death threats prior to this. The HB 2 requirements are making it so that abortion providers either cannot provide their services any longer or will face increased threats and increased danger to themselves. Physicians are allowed to conscientiously object to providing medical interventions in certain circumstances for moral and religious reasons. However, there are limits on this right. According to the American Congress of Obstetricians and Gynecologists, “[w]hen conscientious refusals conflict with moral obligations that are central to the ethical practice of medicine, ethical care requires that the physician provide care despite reservations or that there be resources in place to allow the patient to gain access to care in the presence of conscientious refusal.”21 I would argue fear for one’s safety in the face of immediate threats is perhaps a stronger ground on which to refuse to provide care than a personal belief that abortion is immoral or against one’s religion. ACOG also states, “[p]roviders with moral or religious objections should either practice in proximity to individuals who do not share their views or ensure that referral processes are in place so that patients have access to the service that the physician does not wish to provide.”22 This responsibility has been largely disputed by the medical community but in cases of rape, incest, and health risks to women, referrals must be made without exception. However, under the requirements of HB 2, working in proximity to an abortion provider may not be possible because they are so geographically limited. Referrals are supposed to be made within reason. Some areas of Texas, such as the Rio Grande Valley, are up to 200 miles away from the nearest clinic that would remain open if HB 2 is passed. Referrals may simply not be feasible given the geographical distances and the decreasing number of available physicians. As mentioned above, there are two risks to the health and safety of women as a result of HB 2. The second of these is that if a woman cannot access one of the remaining clinics, she may seek out a more convenient but illegal and unsafe abortion, which is far more likely to result in a dangerous complication. Dr. Lynn states, “[b]ecause of the restrictions lawmakers impose, women will seek abortions illegally, and we’re going to see a rise in septic abortions.”23 Some areas of Texas might effectively revert back to a pre-Roe era where abortions were performed in unsanitary conditions by unqualified people resulting in dangerous medical complications far more often than legal abortion procedures do now. Physicians like Dr. Lynn who want to prevent this from happening generally cannot do so without facing legal sanction. Physicians have a duty to provide safe medical care and if they cannot obtain admitting privileges, they cannot exercise this duty. ACOG released a statement expressing their objections to the new requirements. They state that HB 2 is, “plainly intended to restrict the reproductive rights of women in Texas through a series of requirements that improperly regulate medical practice and interfere with the patient-physician relationship.”24 Executive Vice-President of ACOG, Hal C. Lawrence III stated: The Texas bills set a dangerous precedent of a legislature telling doctors how to practice medicine and how to care for individual patients. ACOG opposes legislative interference, and strongly believes that decisions about medical care must be based on scientific evidence and made by licensed medical professionals, not the state or federal government.25 Abortion is one of only a few areas of medicine where the legislature imposes so many regulations restricting particular physicians’ ability to practice medicine. Not only are abortions providers being regulated by the state, they are also facing clear discrimination from others within the medical community. The state is closing down clinics that do not meet the ambulatory surgical center requirements and hospitals are denying physicians admitting privileges because they perform abortions. In summary, abortion providers are being discriminated against both by the legislature and other members of the medical community. Other physicians who do not perform abortions are not denied admitting privileges on discriminatory grounds. Clinics that cannot afford upgrades to become an ambulatory surgical center are being grandfathered in, while abortion clinics are being forced to close down. Ob-Gyns who conscientiously object to performing abortions and who are not located in close proximity to at least one abortion provider cannot effectively fulfill their duty to refer patients. Lastly, given the barriers these regulations will create, there will likely be a rise in complications resulting from abortions provided under grossly unsafe conditions. Physicians, whose duty it is to provide safe and effective medical care, are being denied the right to exercise this duty. While this denial may not be unconstitutional, it is certainly unjust and discriminatory and creates obstacles that other physicians do not face. Most importantly, these obstacles are creating an undue burden for women. The HB 2 requirements do not increase the health and safety of abortions; all they do is create substantial obstacles for women. In light of these observations, the requirements seem to me to be in clear violation of Casey, in which it was decided that, “[u]nnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on that right.”26 These regulations do just what Casey was meant to prohibit and this is accomplished through limiting physicians’ ability to practice safe abortions across the state of Texas. Therefore, the HB 2 requirements may not impose an undue burden on doctors but they do impose an undue burden on women. PDF available: Rachel Hill, "Texas HB 2," Voices in Bioethics. References: 1 Planned Parenthood of Southeastern Pennsylvania v. Casey, pg. 2. 2 Whole Women’s Health v. Lakey, pg. 2. 3 Ibid. 4 Ibid., 4. 5 Ibid., 2. 6 Planned Parenthood v. Casey, pg. 16 7 AMA Code of Medical Ethics, “Opinion 2.01 – Abortion,” American Medical Association. 8 Whole Women’s Health v. Lakey, pg. 10. 9 Dr. Sherwood Lynn, “A Texas Ob-Gyn Details the Horrific Consequences of Abortion Restrictions,” Cosmopolitan. 10 Feminist Newswire, “Texas Hospitals Revoke Admitting Privileges to Abortion Providers,” Feminist Majority Foundation Blog. 11 Ibid. 12 Ibid. 13 Ibid. 14 Glenn Hegar, “Texas Hospital Association’s Statement of Opposition to Section 2 of the Committee Substitute for Senate Bill 5,” Texas Hospital Association. 15 Dr. Lynn, “A Texas Ob-Gyn.” 16 Whole Women’s Health v. Lakey, pg. 10. 17 Ibid. 18 Mary Tuma, “Undercover Audio Reveals Anti-Abortion Tactics: Anti-abortion activists monitor and track providers, patients,” Austin Chronicle. 19 Ibid. 20 Ibid. 21 Committee on Ethics, “The Limits of Conscientious Refusal in Reproductive Medicine,” The American Congress of Obstetricians and Gynecologists. 22 Ibid. 23 Dr. Lynn, “A Texas Ob-Gyn.” 24 “Ob-Gyns Denounce Texas Abortion Legislation: Senate Bill 1 and House Bill 2 Set Dangerous Precedent,” The American Congress of Obstetricians and Gynecologists. 25 Ibid. 26 Planned Parenthood v. Casey, pg. 16. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Human Genome Research in an Interdependent WorldAlexander Morgan Capron (bio)This has been the year of agenda-setting conferences for the ambitious ELSI (ethical, legal and social issues) program of the Human Genome Project (HGP). But of the dozen or more major meetings of this sort held across the country, the one held at the National Institutes of Heakh (NIH) in Bethesda, MD, June 2-4, 1991, was distinctive in several (...) class='Hi'>respects.1As its name implies, "Human Genome Research in an Interdependent World" was a global look at the issues raised by gene mapping and sequencing. Unlike previous conferences, however, this meeting looked beyond a comparative analysis of clinical and domestic legal issues, and concentrated on topics that may require responses on a truly international level if they are to be successfully resolved.The meeting's organizers gathered an impressive group of more than seventy participants from fifteen countries, including the first significant contingent of Soviet and Japanese scientists, physicians, and philosophers at an ELSI meeting. In addition to talks by the heads of the genome projects in the Soviet Union, Japan, and the United States, the meeting was keynoted by Dr. James Wyngaarden, director general of the Human Genome Organization (HUGO), and I had the honor of serving as its general chairman.The goal of the meeting was to consider an array of issues that scientists, philosophers, and lawyers from around the world suggested might have international significance, with an eye to deciding three things: (1) Does the issue deserve further attention? (2) Is the issue best addressed in an international or domestic context? and (3) Do structures exist to which the issue can be referred for resolution? In the final sessions, the entire group debated proposed resolutions on the various topics and narrowed the list needing further, intensive exploration.To provide an international framework for this process, the conference [End Page 247] established a Global Steering Committee on Ethical and Social Issues in Genome Research, which will coordinate the efforts of several task forces charged with refining the tentative resolutions adopted by the conference participants on June 4. The task forces are expected to be able to complete work on some topics by the time of the steering committee's first meeting, which was described by one participant as a "check point," probably within the coming year; on other topics, the task forces will provide interim reports and arrange to continue their analysis. Several topics—less complex or more embryonic—were referred directly to the steering committee. On all issues, a major objective will be to ascertain what existing or newly created structure or structures are capable of implementing the group's recommendations and then to monitor the issue to ensure that appropriate implementation is occurring.Issues to be Explored by Task ForcesInsurance and EmploymentWhile individuals may derive medically useful information from the expanded range of genetic tests that will flow from the HGP, they could also be harmed if test results become a basis for discrimination. An area of particular concern at the conference in Bethesda was whether genetic information should be used to decide eligibility for employment or the scope and cost of health and life insurance. The complexity of this issue is increased as barriers to worker migration fall (especially in Europe) and as more firms carry on business internationally. Furthermore, questions arise about the limits of required testing and whether individuals may decline to be informed of the results of tests.The task force will not only gather information on practices and legal standards throughout the world—especially in light of the differences among nations with regard to the linkage of employment and various forms of insurance—but will also examine international anti-discrimination laws as a possible means of supplementing domestic statutes and regulations. As a starting point, the Bethesda meeting agreed on a set of principles for the task force to refine.2ForensicsAlthough their legal status is not fully resolved, DNA tests are being used increasingly in judicial proceedings and civil and criminal investigations as a highly probative means to identify people. Most forensic uses of "DNA fingerprints" are domestic, but international cooperation among investigative bodies... (shrink)

This work is an initial step toward developing a cognitive theory of cyber deception. While widely studied, the psychology of deception has largely focused on physical cues of deception. Given that present‐day communication among humans is largely electronic, we focus on the cyber domain where physical cues are unavailable and for which there is less psychological research. To improve cyber defense, researchers have used signaling theory to extended algorithms developed for the optimal allocation of limited defense resources by using (...) deceptive signals to trick the human mind. However, the algorithms are designed to protect against adversaries that make perfectly rational decisions. In behavioral experiments using an abstract cybersecurity game (i.e., Insider Attack Game), we examined human decision‐making when paired against the defense algorithm. We developed an instance‐based learning (IBL) model of an attacker using the Adaptive Control of Thought‐Rational (ACT‐R) cognitive architecture to investigate how humans make decisions under deception in cyber‐attack scenarios. Our results show that the defense algorithm is more effective at reducing the probability of attack and protecting assets when using deceptive signaling, compared to no signaling, but is less effective than predicted against a perfectly rational adversary. Also, the IBL model replicates human attack decisions accurately. The IBL model shows how human decisions arise from experience, and how memory retrieval dynamics can give rise to cognitive biases, such as confirmation bias. The implications of these findings are discussed in the perspective of informing theories of deception and designing more effective signaling schemes that consider human bounded rationality. (shrink)

The paper contrasts the economic, ethical, and organizational differences in the U.S. and Europe, as well as the differences in governance and leadership between U.S. and European managers, and how these differences impact decision-making and governance of U.S. and European businesses. In addition, the paper explores and contrasts select ethical and cultural issues between managers on both sides of the Atlantic. It is the authors' view that on both sides of the Atlantic we embrace the call for more ethics (...) in our lives and we expect it from our business leaders and our business dealings. However, in the markets we consistently have seen a short-term orientation of corporate outcomes. It is hoped that there will be a silver lining to the current economic crisis that will help move us away from this position which makes things like ethics, long-term virtues, fairness, all nice to talk about but somewhat estranged from the realities that are practiced in businesses. It remains to be seen if U.S. organizations, business schools and business leaders will change this current position more rapidly than in Europe. The authors are confident, however, that businesses and governments on both sides of the Atlantic will make all efforts for a pronounced transition to integrate ethics into the real strategic thrusts of conducting business. (shrink)

In this article, we use the theory of Information Ethics to argue that deceased people have a prima facie moral right to privacy in the context of health data research, and that this should be reflected in regulation and guidelines. After death, people are no longer biological subjects but continue to exist as informational entities which can still be harmed/damaged. We find that while the instrumental value of recognising post-mortem privacy lies in the preservation of the social (...) contract for health research, its intrinsic value is grounded in respect for the dignity of the post-mortem informational entity. However, existing guidance on post-mortem data protection is available only in the context of genetic studies. In comparing the characteristics of genetic data and other health-related data, we identify two features of DNA often given as arguments for this genetic exceptionalism: relationality and embodiment. We use these concepts to show that at the appropriate Level of Abstraction, there is no morally relevant distinction between posthumous genetic and other health data. Thus, genetic data should not automatically receive special moral status after death. Instead we make a plea for ‘contextual exceptionalism’. Our analysis concludes by reflecting on a real-world case and providing suggestions for contextual factors that researchers and oversight bodies should take into account when designing and evaluating research projects with health data from deceased subjects. (shrink)

Unlike Hanafī jurists, most of the jurists maintain that qiyās is permissible (jāʿiz) for the origins (aṣl) in which the qiyās rule is invalid, including ruhsat (permission); kaffarah (expiation) and ḥadd (penalties). Shāfiʿī jurists, Imam al-Shāfiʿī and his followers like al-Juwaynī, argue that Hanafī jurists are contradictory since they apply qiyās in many cases despite their judgment that qiyās is invalid, and on the contrary they defend that these are derived from the literal interpretation techniques out (...) of qiyās format. Nevertheless, Shāfiʿī jurists persist that they rule on the qiyās applications through Islamic jurisprudence inference methods (istinbāt) such as Islamic juristic preference (istiḥsān), even beyond qiyās. In his sense of search effective cause: ʿilla (taʿlil), al-Juwaynī focuses on the proper meaning/suitability (munāsaba). He runs the mechanism of taʿlil even in the presence of the deepest proper meaning. He customizes the formulation of the suitability (munāsaba)/proper meaning for the origins in which the qiyās’ rule is invalid. Kaffarah and ḥadd consequently expand the validity area and minimize the restricted area for qiyās. Al-Juwaynī’s approach agrees to his rational personality as well as the value that he appreciates for qiyās. In this paper, the aim of study is to identify the borders and limitations of qiyās in al-Juwaynī’s thought with discussions about the disagreements between the jurists in the specified areas.Summary: As a general principle, devoting (taʿabbud) is the foundation for jurisprudence for al-Imām al-Shāfiʿī and reasoning (taʿaqqul/taʿlīl) for Abu Hanīfa. Despite this, Abu Hanīfa and Hanafī jurists consider non-qiyās foundations (ma’dul bih ‘anil-qiyās) including the quantified ordinances (muqaddarāt/taqdīrat) and ruhsat (permission) as well as kaffarah (expiation) and ḥadd (penalty) as the banned areas for the analogy (qiyās) and profess that qiyās cannot be applied in these areas. It may be contradictory that they state in one hand that the foundation of rulings is taʿaqqul, and on the other hand, bars the above-mentioned areas for qiyās. On the contrary to their general approach, Shāfiʿī jurists, in particular, argue that it is untrue to absolutely exclude use of analogy in those areas, which are rather open to qiyās. Al-Imām al-Shāfiʿī and one of his followers, al-Juwaynī, describe that Hanafī jurists’ applications do not jibe with their principles so that they do refer the inference methods (istinbāt) (e.g. juristic preference: istiḥsān), furthering qiyās although they take qiyās as illicit in kaffarah and ḥadd. However, Hanafī jurists defend that they are not in a contradiction, and indeed they do not apply qiyās in kaffarah and ḥadd and derive their illations mostly from textual implications (dalālah) that are mostly out of qiyās format such as tanqīh al-maʿnā (isolating ʿilla), istidlāl, and dalālah al-naṣṣ (inferred meaning). As understood from the relevant arguments, applying qiyās in these areas is directly associated with the issue of potentiality for “the analogy in reason.” The type of qiyās that Hanafī jurists consider illicit in kaffarah and ḥadd is the analogical actions made for the reasons. One of the most rationalist representatives of Shāfiʿī uṣūl, al-Juwaynī pronounces that the method to determine ʿilla (cause) is fundamentally the suitability (munāsaba) that can be defined as “rational compatibility.” In his opinion, the ratiocination (taʿlīl) is based on this suitability. According to him, the indications of qiyās will be clear or it becomes practicable even in the presence of low-level, implicit suitability. Al-Juwaynī considers that it is licit to apply the analogy for the kaffarah and ḥadd as well as the non-qiyās foundations, including ruhsat and muqaddarāt or taqdīrat, whether direct or explicit (i.e. the meaning of analogy: qiyās al-maʿnā) or indirect or implicit (i.e. the commonality of analogy: qiyās al-shabah). In this context, one of Juwayni’s concern is “the matter of inherence in textual sources such as naṣṣ or the Qur’ān and the Sunna),” corresponding to the area where the judgment is based on a specific reason by naṣṣ. For him, a number of reasonable meanings can be inferred in these areas when it is critiqued independent of the uttered words. But the inherence mentioned in the texts of naṣṣ, indicates to avoid the use of analogy for making a judgment. Al-Juwaynī asserts that some fractional elaborate or detailed meanings cannot be obtained for physical prayers and only a set of universal meanings can be imagined. He defines that it is permissible to compare the reasons of physical worshipping with each other when any suitable meaning is present. He considers that for the permissibility of qiyās in ruhsat, it is adequate to find a meaning suitable for the judgment, and besides, the commonality of analogy (qiyās al-shabah) is applicable in the area of muqaddarāt or taqdīrat. Nevertheless, a patient’s condition is similar to that of a traveller in terms of ruhsat for not fasting (ṣavm). In al-Juwaynī’s way of thinking, patients should act like travellers for ruhsat to shorten (qaṣr) the prayers (ṣalāh) due to “requiring” as a proper meaning. However, as mentioned by al-Juwaynī, there is a consensus (ʿijmā or ittifāq) on the fact that a patient cannot shorten his or her prayers. Due to this impediment, it is understood that the rule of shortening their prayers (ṣalāh) is permissible for travellers but not for patients (manʿ al-ʿijmā’).In criminal cases, the right of oath before the court is belonging to the defendant, whereas to the claimant in kasāme, an oath method in unidentified murders. Taking an oath from the claimant is merely inherent to the kasāme application. Al-Juwaynī states that this inherence is known by the principle of being inherent to each circumstance (iḥtisās bi-l hāl), and with this aspect, kasāme is a closed area for qiyās. According to al-Juwaynī, contracts are suitable for qiyās because they have conditions such as offers and agreements explicitly stating the quality and quantity, and mutual assent. He describes that these are the reasons unavailable for qiyās with respect to their characteristics. With this, the contracts are among the reasonable sources in one respect and the unreasonable in another respect. Consequently, al-Juwaynī suggests that the analogy loses its functionality or validity in a limited number of the closed areas for qiyās, which are the static devotional judgments (taʿabbud) having no proper meaning, direct or indirect, or explicit or implicit; the areas where the judgment is made inherent to a specific reason by the naṣṣ (ihtisās bi-l-nass) (as in the example that sacrificing a female goat at the age of less than one year is a specific judgment for Burde b. Niyār). The point leads to the judgment is made inherent to a specific reason by the principle of ihtisās bi-hāl; and banned ʿijmā issues (as in the example of ʿijmā that it is agreed on the fact that patients cannot shorten (qaṣr) their prayers (ṣalāh), unlike travellers. Al-Juwaynī sees the application of qiyās as licit based on the availability of suitable meaning in all areas except for the above-mentioned issues. That he minimizes the closed areas for qiyās and widely expands the functionality of analogy is the reflections of the value that he gives to qiyās. (shrink)

This study clearly reveals that the benefits ascribed to strategic planning typically are achieved through a variety of means. A formal process that seeks to plan in a comprehensive, linear fashion is likely to be too complicated, politically divisive, expensive and inflexible, and to ignore how decisions are made in a complex, highly decentralised university. While many approaches to planning are used, universities must ensure they provide periodically opportunities for university staff—freed from daily responsibilities—to consider strategic concerns. Accurate (...) and relevant information must be available to all who make and carry out decisions. Planning should be viewed as a learning process rather than a document producing exercise. Extensive communication among university staff and faculty is needed to ensure informed debate and substantial acceptance of decisions—otherwise they are unlikely to be implemented. Perhaps most important is not the process employed but the decision-maker's breadth of perspective and sophistication. No process will overcome lack of competent leadership. The importance of daily decision-making in various councils and committees on issues such as cost containment and budgetary priorities is underestimated in the literature on planning.Critics have doubted whether universities' structures and processes permit them, or their leaders have the resolve, to confront the emerging issues. However, in many respects, the universities' decentralised, multiple decision-making practices may suit them well. They face the same challenging societal changes as other sectors of society. Their staff include some of the most capable individuals in the United States, and in the past they have been highly adaptable during periods of profound social change.Universities do not appear to be less aware of the need to adapt, nor more constrained in adapting to new conditions, than other sectors of society. In fact, university research and scholarship will be highly important in pointing the way for the whole of society to meet this era's challenges. If pessimistic predictions about current trends turn out to be accurate, universities no doubt will adapt at least as well as other kinds of institutions. The travails of business in this environment are daily news! There will be occasional casualties among the universities, as frequently occurs during major social transitions, but institutions that have grown in importance for over 1,000 years, will doubtless emerge from this period perhaps somewhat changed but still performing their historic social functions. (shrink)

In this thesis I argue that what we tend to see in contemporary accounts of human service practice in the relevant literature is a ‘common-sense’ informed by a complex mix of neoliberal political and policy imperatives and various kinds of technical-rational styles of administration and management. These accounts of practice can inadvertently contribute to the problems they are meant to address and can do more harm than good. Common-sense accounts of practice also align with how human services are typically (...) regulated and they align with prevailing ways the education of human services takes place, including in universities. Consequently, the same types of problems that take place with human service practice also take place with the institutionalisation and reproduction of human services. If we are serious about achieving good practice in human services, then we need to think more clearly about what practice in human services is. <br /><br />There is a good case for articulating a theory of human service practice to inspire new and better ways of achieving good practice. The theory of good practice outlined here draws on the philosophy of Aristotle and neo-Aristotelian accounts of practice. It draws especially on Dunne who argues that a theory of practice should offer a defensible account of how we should conceptualise the stuff that human services deal with, and the sorts of knowing, action and ends that best accord with such conceptualisations. <br /><br />I argue that the beings at the centre of human services should be understood as complex, emergent, unpredictable, and ‘wicked’ in the sense that Rittel and Webber talk about. This highlights the possibility that the people, problems and practices of human services can be revealed in multiple and contrary ways. Accordingly, human services hold both promises and dangers for people and good practice is far from self-evident and is highly contestable in each individual case. <br /><br />I argue that phronesis (practical wisdom) is the way of knowing that best corresponds to and is most suited to deal with the uncertain, messy, contingent and context-dependent beings of human services, which require and deserve ongoing deliberations and good determinations on each occasion that are at the same time always tentative and remain open to other suggestions and modification especially because our knowledge may be erroneous and incomplete. I argue that good practice also requires reflexivity and value rationality to help identify and alleviate the problems associated with neoliberal approaches to practice and as an alternative to technical rationality and value neutrality. <br /><br />I make the case for praxis (good action) along with a range of other human activities including value-rational deliberation as the forms of action that best align with and are most appropriate for dealing with the ever-changing, often inexplicable and always difficult beings of human services. Praxis is in accordance with phronesis and can be understood in part as durable practice and in part as responding to each case in new ways. In particular, it involves figuring out and enacting the most desirable course of action in each instance of practice while at the same time remaining receptive to other possibilities and to doing things differently particularly because we might not always be immediately aware of what we are doing, and our actions could be doing more harm than good. <br /><br />I show that clarity about our telos will help to re-orient human services to pursuing preferred ends and securing goods that are better suited to the entities of human services compared to instrumentally designed relations between widely applicable and transferable techniques and pre-determined outcomes. I argue for the telos of youth work to be enabling young people to live the good life. Following my accounts of phronesis and praxis this orientation of human services towards more desirable and ethical purposes takes the form of a commitment that is always carefully reconsidered at the same time as determinedly pursued. However, unlike outputs that can be wholly predetermined, efficiently sought after and completely achieved, this is an end that is never fully attained. This is especially the case because there is always more that can be known and done and because there are always disagreements on the goods to be secured. <br /><br />This theory of practice should correspond to and supports the education of people for professional practice. In particular, the education of human services needs to reproduce how the beings of human services are to be conceptualised and the ways of knowing, forms of action and ends that cohere. At the same time, university-based human service education should support the development, exercise and experience of good practice-as-praxis guided by phronesis. <br />. (shrink)

This research investigates the importance of trade-off salience in understanding how variations in consumers’ construal levels can influence moral judgments. Across five experiments, trade-offs are implied and explicitly made salient, and construal levels are manipulated by altering temporal distance and perceptual fluency, and by using a well-established cognitive method. Consistent with prior research, we demonstrate that higher construal levels can reduce anticipated unethical behavior, when trade-offs are not salient, by making higher-level moral values more prominent. When trade-offs are salient, (...) however, we reveal that unethical behavior is increased when construal levels are elevated by making desirability-related thoughts relatively more prominent, compared to feasibility-related thoughts. Tests of mediation provide support for the role of desirability- and feasibility-related thoughts. Together, our results provide insight into the opposing predictions made by construal level theory for ethical decision making by revealing how trade-off salience, often inherent in ethical dilemmas, systematically influences the effects of construal level on ethical decision making. (shrink)

Ethical theories normally make room both for global duties to human beings everywhere and special duties to those we are attached to in some way. Such a split-level view requires us to specify the kind of attachment that can ground special duties, and to explain the comparative force of the two kinds of duties in cases of conflict. Special duties are generated within groups that are intrinsically valuable and not inherently unjust, where the duties can be shown (...) to be integral to relationships within the group. Since nations can be shown to meet these conditions, acknowledging special obligations towards compatriots is justified. However for such partiality to be reasonable, it must be balanced against recognition of duties of global justice. These duties include duties to respect human rights and duties of fairness towards non-nationals. Weighing such duties against domestic duties of social justice is not a simple task, and the outcome should depend on the precise specification of the duty at stake. In particular, the duty to respect human rights fragments into four sub-duties whose force when set against local duties is markedly different. (shrink)

Scientific models share one central characteristic with fiction: their relation to the physical world is ambiguous. It is often unclear whether an element in a model represents something in the world or presents an artifact of model building. Fiction, too, can resemble our world to varying degrees. However, we assign a different epistemic function to scientific representations. As artifacts of human activity, how are scientific representations allowing us to make inferences about real phenomena? In reply to this concern, philosophers (...) of science have started analyzing scientific representations in terms of fictionalization strategies. Many arguments center on a dyadic relation between the model and its target system, focusing on structural resemblances and “as if” scenarios. This chapter provides a different approach. It looks more closely at model building to analyze the interpretative strategies dealing with the representational limits of models. How do we interpret ambiguous elements in models? Moreover, how do we determine the validity of model-based inferences to information that is not an explicit part of a representational structure? I argue that the problem of ambiguous inference emerges from two features of representations, namely their hybridity and incompleteness. To distinguish between fictional and non-fictional elements in scientific models my suggestion is to look at the integrative strategies that link a particular model to other methods in an ongoing research context. To exemplify this idea, I examine protein modeling through X-ray crystallography as a pivotal method in biochemistry. (shrink)

This paper takes as a starting point a recent development in privacy-debates: the emphasis on social and institutional environments in the definition and the defence of privacy. Recognizing the merits of this approach I supplement it in two respects. First, an analysis of the relation between privacy and autonomy teaches that in the digital age more than ever individual autonomy is threatened. The striking contrast between on the one hand offline vocabulary, where autonomy and individual decision making prevail, (...) and on the other online practices is a challenge that cannot be met in a social approach. Secondly, I elucidate the background of the social approach. Its importance is not exclusively related to the digital age. In public life we regularly face privacy-moments, when in a small distinguished social domain few people are commonly involved in common experiences. In the digital age the contextual integrity model of Helen Nissenbaum has become very influential. However this model has some problems. Nissenbaum refers to a variety of sources and uses several terms to explain the normativity in her model. The notion ‘context’ is not specific and faces the reproach of conservatism. We elaborate on the most promising suggestion: an elaboration on the notion ‘goods’ as it can be found in the works of Michael Walzer and Alisdair Macintyre. Developing criteria for defining a normative framework requires making explicit the substantive goods that are at stake in a context, and take them as the starting point for decisions about the flow of information. Doing so delivers stronger and more specific orientations that are indispensible in discussions about digital privacy. (shrink)

continent. 2.1 (2012): 6–21. The French philosopher and novelist Tristan Garcia was born in Toulouse in 1981. This makes him rather young to have written such an imaginative work of systematic philosophy as Forme et objet , 1 the latest entry in the MétaphysiqueS series at Presses universitaires de France. But this reference to Garcia’s youthfulness is not a form of condescension: by publishing a complete system of philosophy in the grand style, he has already done what none of us (...) in the older generation of speculative realists has done so far. His book is sophisticated, erudite, rigorous, imaginatively rich, and abundant in worldly wisdom– despite the author’s conclusion that wisdom does not exist. The quality and scope of Forme et objet took few observers by surprise, since Garcia has been treated as an emerging philosopher to watch across half a decade of Parisian oral tradition. But Garcia was not just the subject of rumor, being already well known to the French public as a writer of fiction. His debut novel, La meilleure part des hommes , 2 was awarded the 2008 Prix de Flore 3 and has already appeared in English as Hate: A Romance . 4 His follow-up novel, Mémoires de la jungle , 5 made clever use of a chimpanzee narrator. Nor was Garcia only published as a novelist before last November: his philosophical study L’Image 6 had already appeared when the author was just twenty-six, a year before he was crowned by the muses at the historic Café de Flore. And then in 2011, just months before the appearance of Forme et objet , Garcia published a widely distributed work entitled Nous, animaux et humains , 7 with its focus on Jeremy Bentham’s ideas about animals. Given this prolific and versatile track record, an optimistic scenario might envisage the young Garcia as one of those combined literary/philosophical talents who appear intermittently in France across the centuries: Jean-Paul Sartre is merely the most famous recent case. While more time is needed to see how Garcia will channel his impressive mental energies, Forme et objet displays such breadth of insight that its author has a good chance to emerge as one of the leading philosophers of his generation. If we accept Aristotle’s dictum that the peak mental age is fifty-one, then to read Garcia’s massive book is to gain some idea of what European philosophy might look like in the futuristic-sounding 2030’s. The present article is confined to Forme et objet . At 486 pages, the work is obviously daunting in size. Indeed, it is even longer than it sounds, given that many of its early sections are printed in a smaller typeface to designate them as supplemental commentary to the main flow of the argument. But while the length of the book reportedly led to delays in French publication, and will probably slow the inevitable appearance of an English translation, the length of the book should not deter interested readers– much of it results from Garcia’s teacherly writing style. Whereas Quentin Meillassoux’s prose displays an arctic economy of means, Garcia’s style is reminiscent of the repeated lessons of oral classroom proceedings. Rarely is the reader given fewer than three or four chances to master an idea before the author moves on to the next. In practice, the style feels welcoming rather than long-winded. Otherwise, the structure of Forme et objet is surprisingly simple. There is a useful Introduction of less than twenty pages. Then comes Book I: Formally , running to approximately 135 pages. Here Garcia outlines the most basic features of a thing “no matter what it is,” or n’importe quoi , an everyday phrase that Garcia shapes into a technical term. This part of the book feels at times like a more amiable version of Hegel’s Science of Logic , a parallel emphasized further by the threefold articulation of its theme: 1. Thing; 2. Thing and World; 3. Being and Understanding. This is followed by the much longer Book II: Objectively , totaling more than 300 pages. It contains sixteen essay-like meditations on specific kinds of objects—including time, animals, humans, history, gender, and death. Here each chapter rolls smoothly into the next, making this second part of the book feel more like a different work of Hegel: The Phenomenology of Spirit . But these are merely analogies. Garcia is no Hegelian, even if the book contains a few dialectical flourishes that seem to reflect his early enthusiasm for the Frankfurt School. Forme et objet ends with a six-page Coda, followed by the usual page of acknowledgments. In what follows, I will briefly summarize each of these four parts of the book before ending with some more general remarks. Before doing so, it will be useful to situate Garcia biographically (as much as I am able) and philosophically. Though Toulouse is his native city, his formative years were spent largely in Algeria, where his family has deep roots. During our sole private conversation, Garcia mentioned that his parents are professors of literature. 8 As a student of philosopher Garcia flourished so early that many of his current ideas date to his teenaged years: “There are sentences in Forme et objet that I wrote when I was seventeen,” he said in response to a question on that cold night on the Canal St.-Martin. I recalled that remark when reading his brilliant account, late in the book, of the central role of adolescence in contemporary culture. While many prodigies blow through their formal academic training without serious obstruction, Garcia’s student memories are rich in tales of isolation and struggle, though equally rich in gratitude for a half-dozen or so exceptional teachers who provided the intellectual space he needed: Meillassoux and Alain Badiou are simply two of the most prominent figures on that list. Though there are many points of agreement between Garcia’s philosophical position and my own, he not only reached his position years before reading my work, 9 he arrived along a rather different path: not through phenomenology, but via the Frankfurt School, which may be one of the reasons for his profound fascination with aesthetics. Garcia’s cultural background is as broad as one could wish: he is no less informed about punk rock and European football leagues than about the spiritualist roots of Bergson’s philosophy. Curious about everything and contemptuous towards nothing, Garcia can be expected to write insightfully on dozens of topics in the years to come. Given that his philosophy is so personally tantalizing in its agreements and disagreements with my own, and given the great internal richness of Forme et objet itself, the present review is no better than a first effort at coming to terms with the challenges posed by this minstrel from the rising generation. This is especially intriguing for older Generation X’ers like me, since confrontation with the younger generation is one of the many themes treated insightfully in Garcia’s book. 1. Introduction Garcia begins in defense of a so-called “flat ontology,” in which all things are equally things. While Roy Bhaskar 10 used this term pejoratively to refer to anti-realist philosophies that flatten everything onto an epistemic plane of human access, Manuel DeLanda 11 (an admirer of Bhaskar) reversed it into the positive principle that all realities are equally realities. Similar notions can be found in the “absistence” of Alexius Meinong, 12 the “irreduction” of Bruno Latour, 13 and my own critique 14 of the undermining/overmining pair. Also noteworthy is Levi Bryant’s use of the term “flat ontology” throughout The Democracy of Objects 15 and his earlier essay “The Ontic Principle.” 16 But for Garcia, flatness is only one face of the cosmos, and one that he ultimately declares to be rather impoverished. Even so, he always remains an advocate of a flat ontology. Insofar as everything is equally something, no matter what it is ( n’importe qui ), everything is equally a thing, equally solitary in its relation with world. This is why his book abounds in those long lists of random, ontologically equivalent entities that Ian Bogost has playfully termed “Latour Litanies.” 17 The first litany in Garcia’s book runs as follows: “We live in this world of things, where a cutting of acacia, a gene, a computer-generated image, a transplantable hand, a musical sample, a trademarked name, or a sexual service are comparable things.” (7) Yet Garcia is frankly dualistic; his flat ontology only lasts until page 159 and the end of Book I (entitled “Formally”), which deals entirely with things that are equally things. Thereafter Garcia turns his attention from things to objects, which are not flat in the least, but engage in hierarchical relations with one another. In agreement with both DeLanda and the speculative realists, Garcia proclaims that his book “proposes to put to the test a thought about things rather than a thought about our thought about things .” (8) Just as ducklings are “imprinted” (9) after hatching and treat the first creature they see as their mother, philosophers are imprinted by the idea with which they begin. Hence, philosophies that begin with human access will never truly find their way back to things. This makes Garcia rather suspicious of twentieth century philosophy, since “the twentieth century—to which in some way this work proposes to bid adieu—has been a period of theorizing modes of access to things rather than things...” (9) Among other possible benefits of the philosophy of things that Garcia proposes, it is fully able to account for thought as a special variant of things, while the reverse is not possible.(10) In Book I of Forme et objet , Garcia’s “things” are so flat, so de-determined, that he is forced to renounce some of the most basic features ascribed to things by most realists. As he tells us in his foreboding third footnote: “We will maintain that the solitude [of things] is less than unity, less than identity, and that it does not imply acceptance (any more than refusal) of the principle of non-contradiction.” (11) In a contemporary world cluttered with too many things, Garcia’s flat and formal plane provides us with some breathing room: “The formal plan of thought enables or re-enables us to cut short all accumulation—whether of knowing, experience, or action—by a simplicity, an impoverished surface...” (13) As Garcia says elsewhere in responding to a Deleuzian critic of the book, his starting point in flat ontology is designed to obstruct the claims of both analytic philosophy and Hegelianism: “Hence, this work seeks to protect each thing—real, imaginary, inconsistent, contradictory—both against Ockham’s Razor and against the Aufhebung or dialectical process.” 18 Yet contrary to the equalizing spirit of many flat ontologies, “we will add to our formal ontology of the equal, an objective ontology of the unequal.” (13) But initially, Garcia joins all flat ontologists in holding that everything is irreducible: “this irreducibility, which we will term the ‘chance’ of each thing... also marks the refusal of a positive thought that reduces things exclusively to natural things, or social things, or historical things, etc.” (15) This irreducible “chance” of a thing emerges as an important technical term in the book, always paired with its inverted brother, the “price to pay” ( prix à payer ). On pages 17-19, we find the only diagrams in the book. What they illustrate is that Garcia wishes to avoid two equally dangerous extremes. The first is the philosophy of substance, featuring the thing-in-itself as a mighty river fed by attributes as if by subordinate tributary streams. This model can be found in many of the classic thinkers of West and East alike. In it, “there is obviously a hierarchization between that which is dragged towards something other than itself, and this other which serves it as an ontological support while supporting its proper being.” (16) For Garcia, the second extreme worth avoiding is the philosophy of events: “One thus conceives trajectories of being, identified as events, facts, powers, intensities, or intentionality. These vectors of being come first, bearing and supporting being, displacing it, but without ever finding a stopping point, a buffer, an objective consistency.” (17) The first model gives us a thing too wrapped up in itself, too compact . This word “compact” (the French and the English are the same) is another technical term for Garcia. But if the “compact” model of things leads us to something more than things, the philosophy of events gives us less than things, by dissolving them into a play of vectors. Garcia’s alternative lies midway between these two extremes: Being enters the thing, being comes out of it. And a thing is nothing other than the difference between the enters and the being that comes out. Thus, the circuit of being is never halted. In the thing, there is never the thing-in-itself. And the thing is never in-itself, but outside of itself. Nonetheless, being is not eventally “pollinated” by vectors: it possesses an objecting halting-point... (19) This single idea is the key to Garcia’s book: the thing is neither a self-contained durable lump nor some sort of evental flux. Instead, the thing is the difference between its various components and its relations with its environment. Or stated differently: “the price to pay for this disposition is a circulation of being that systematically distinguishes two senses of things: that which is in the thing , and that in which the thing is , or that which encompasses it and that which it encompasses,” (19) translating comprendre here as “encompass.” 19 In a beautiful description of a piece of black slate, Garcia sums up the various minerals, qualities, and shapes that compose [ comprend ] it, and calls them “that which is in the thing,” (20) noting that this tells us nothing about “that in which [the slate] is”—namely, all the various situations in which the black slate can be found. Instead, the slate is the difference between these two: the most characteristic principle of Garcia’s philosophy. 2. Formally Book One of Forme et objet , “Formally,” is concerned with the formal equality of all things in a flat world. “Two questions mark the boundaries of reflection: of what is everything composed [ composé ], and: what do all things compose?” (27) Looking downward, we wish to know what everything is made of; looking upward, we want to know the ultimate result of the combination of all things. Here we must turn our attention to the thing n’importe quoi— no matter what it is. (30) Anything with finite qualities is obviously too specific to be relevant to global ontological questions. To an equal degree, something possessing all qualities (think of Whitehead’s God) 20 would not be n’importe quoi either, since it would still be too definite, even if incredibly vast. The same holds for contradictions, since these all differ from each other. The square circle, the non-white black white, and the non-city city are all too distinct to count as the thing no matter what it is. The n’importe quoi must be devoid of all specific qualities, including contradictory ones. In one of the more intriguing points in his book, so reminiscent of Meinong, Garcia proclaims that “the ‘no matter what it is’ is neither a reality nor an abstract construction, nor both of these at once; the ‘no matter what it is’ is simply the plane of equality of that which is real, that which is possible, that which is inexistent, that which is past, that which is impossible, that which is true, that which is false, that which is bad.”(39-40) Since everything has two faces, it would be a grievous mistake to focus on just one of them at the expense of the other, as physicalism or materialism do when reducing the world to minuscule physical underpinnings. For scientistic materialism, “it is either atoms, particles, or fields of force... which are the things.” (47-48) Moreover, “these more-than-things are accompanied by less-than-things: for example, ideas or facts of consciousness are determined by the state of matter and are not autonomous things, but manifestations reduced to secondary effects of material processes...” (48) On this point, Garcia’s position is in complete accord with my own critique of undermining and overmining. 21 Where we disagree is that Garcia is more deeply suspicious of the notion of substance, which I view as salvageable with a few needed changes, while Garcia sees this operation as hopeless: “A substance, in the history of philosophy, is the more-than-thing par excellence.” (51) Another agreement between our positions is visible when Garcia claims (correctly, in my opinion) “that it is vain to distinguish between things which are material and those which are not.” (52) Yet we also find an even more important disagreement, since for Garcia withdrawal cannot be the quality of a thing. Instead, the absence of a thing is simultaneous with it, embodied in all that is not it– the absence of the sculpture of a woman is to be found in the mold that appears at the same time as it, and thus withdrawal must be viewed as an “event” rather than as something pertaining to an object. For Garcia, nothing withdraws beyond access. Since we must distinguish between “that which is something” and “that which something is,” and since the former is identified with “no matter what it is is” and the latter with “ not no matter what it is,” we can say that “everything is thus a milieu, a fragile link between ‘no matter what it is’ and ‘ not no matter what it is.’” (62) And here we find Garcia’s critique of the thing-in-itself: “A thing is never defined en bloc . We can affirm that a thing is this or that, but that does not suffice. It is still necessary to state precisely that which is this thing .” (62) Stated differently, “something is not in itself : for that which is in the thing is not the thing, and that in which the thing is is not the thing.” (62) And here Garcia and I, facing the same evidence, draw opposite conclusions. For me, the fact that nothing can be identified with either its components or its concrete location means that the thing must be something in-itself distinct from both of these. Yet for Garcia, to be in-itself would mean to be identified with just one of these two extreme terms, and hence the thing can only be the difference between them. Garcia is equally suspicious of the classical tendency to view “unity” as a property of the thing, since in his eyes unity is too relational a property to belong to things. (65) While specific things are situated determinately with respect to other things, we are still speaking here about the thing no matter what it is, and this can be viewed only in terms of solitude, which all things share: a human being, a hand, or a chair or all equally things insofar as they are on their own , not insofar as they are one . (64) A thing is alone, and relates only to the one thing that is not another thing: world. In a striking parallel to my own argument for a partial revival of occasionalism, Garcia tells us that “the things communicate only by their solitude: it is because everything is equally on its own in the world that things can be together, enmeshed in one another.” (67) Alone in their solitude, things all relate to world, which serves as a mediator allowing them to become mixed up in one another. As we have seen, one reason that nothing can be in itself is because everything is in something else. For Garcia, “to be in something and to be something are equivalent.” (69) Stated more broadly, “being is thus the difference between the two aspects of each thing: that which is it, and that which it is.” (70) And even more vividly: “a thing is almost like a sack: there is that which one puts in the sack and that which remains outside the sack.” (70) But not quite like a sack, “since a thing is not a thin skin or film. Instead, a thing is comparable to a sack that is immaterial and without thickness: it is nothing other than the difference between that which is this thing and that which thing is, between content and container.” (71) Nothing can be in-itself because everything is two selves at once. For example, we cannot say that our self is defined by our consciousness: “Everything has a self because nothing is in itself. The self is not the quality of that which is related to itself (which is conscious, for example) or which thinks itself related to itself. Nonetheless, for an entity called ‘conscious’ to be related to itself, it is necessary that this very relation should be another thing than the self to which it is related.” (71) Consciousness cannot be the self, precisely because it is other than that of which it is conscious. Nothing is able to grasp itself. The self is “the function by which being and composition [ compréhension ] are mutually excluded...” (72) The self is “the point of shadow of everything that projects some light...” (72) The in-itself faces two opposite dangers: “For something to be in-itself is to be a self. Something which is a self flies out through one of its two sides... Stated differently, being in-itself is simply the possibility of a double failure.” (73) The in-itself can be termed compact : “There remains to us a means of thinking that which does not fully enter into the world, though without exiting from it. This means is what we call the compact.” (76) In a sense, the compact is the opposite of the world. For in the case of the world, everything enters it and it enters nothing; as for the compact, it enters the world (since it is something, after all) while nothing enters it. (77) The compact marks the presence of the impossible in the world. (78) It is not impossible, but possible only on the condition that it fails. (78) The time has come to speak of where a thing is located. “The sole condition of a thing is that of being in another thing than itself, and thus in another thing than something.” (78) A condition is “that which determines something, that which forms something, that in which something is.” (78) As for humans, “the condition of someone is his situation; my social condition is that which socially determines me, my place and my function...” (79) More generally, “to be conditioned is to find oneself reduced to that in which one is.” (79) Everything is conditioned, but nothing is reducible to this condition. To determine the condition of something is to determine in what it is. A thing is located in that which contradicts it, just as a statue exists in its mold, which is precisely that which it is not. Since the thing is finite and definite, its condition or form must be infinite and indefinite. That in which all things are is the world, which Garcia also terms “the whole.” (81) “To try to be in-itself is to attempt to remain outside the world. And indeed, to try to be in-itself is only a path of entry into the world.” (83) For Garcia, “the world is not the pre-existent container of the things it contains, a priori , nor the construction by the mind of a fictional ensemble of all things, a posteriori .” (85) Instead, the world is simultaneous with all things; the two always go together. The world cannot be a determinate world, such as the physical universe or mathematical space, since these are already too specific and limited. “Every determinate world, which is in fact a universe , is a ‘big thing’ [ grosse chose ]: it is a set, however vast, of composite things which itself embodies a thing.” (85) Every determinate world is really just a “big thing.” Stated differently, “it is nothing other than a balanced milieu between the things that compose it and the thing that it composes.” (85) We generally picture the world as a physical univer. (shrink)

Mu'tazila and Shīʿa (Zaydiyya-Imāmiyya) have common views on many theological issues except the imamate. This issue has been generally accepted by other Islamic scholars rather than Shīʿa and by Western researchers. That in this interaction between the Mu‘tazila and the Shīʿa, the Shīʿa is the side mostly affected. However, it is an issue that should not be overlooked that the Shīʿa partially influenced the Mu'tazila in ʿAlī b. Abī Ṭālib, over the other Companions. In this context, some (...) persons from the Baghdad Mu’tazila School such as Bishr b. al-Muʿtamir (d. 210/825), Jaʿfar b. Mubashir (d. 234/848), Jaʿfar b. Harb (d. 236/850) and al-Iskāfī (d. 240/854) argued that the imamate of Abū Bakr, who was less virtuous, was permissible although they considered ʿAlī as the most virtuous person after the Prophet. In addition, al-ʿAllāf (d. 235/849-850), al-Naẓẓām (d. 231/845), Abū Abdullah al-Basrī (d. 369/979-80) and Qāḍī ʿAbd al-Jabbār (d. 415/1025) along with Abū ʿAlī al-Jubbāʾī (d. 303/916), one of the chiefs of the Basra Mu'tazila School, and Abū Hāshim al-Jubbāʾī (d. 321/933) did not accept the order of caliphate as the order of virtue. This study focuses on the issue of whether the aforementioned affinity between Mu'tazila and Shīʿa affected Mu'tazila, especially in the interpretation of the verses associated with ʿAlī. In the study, the aforementioned problem was examined through the tafsīr al-Kashshāf of the Muʿtazilī mufassir al-Zamakhsharī (d. 538/1144). In addition to the importance of tafsīr, the fact that al-Zamakhsharī took lessons from Shīʿīte/Zaydī persons and he wrote the tafsīr with the support of Zaydī leader al-Wahhās (d. 506/1112) is effective in handling this issue through al-Kashshāf's tafsīr. In the first part of the study, first of all, the interaction between Imāmiyya and Zaydism, which are the two most important branches of Mu‘tazila and Shīʿa, is briefly mentioned. Then, Mu'tazila’s and Al-Zamakhsharī’s view on ʿAlī's position among other caliphs is emphasized. Al-Zamakhsharī, who is from the Basra school of the Mu'tazila, does not consider ʿAlī b. Abī Ṭālib superior to Abū Bakr, unlike al-ʿAllāf, Abū ʿAlī al-Jubbāʾī, Abū Hāshim al-Jubbāʾī and Qāḍī ʿAbd al-Jabbār, who are the leading figures of this school. In fact, the fact that he always observed the order of the caliphate while talking about the merits of the four caliphs supports the possibility that, unlike his predecessors, he accepted the order of the caliphate as the order of virtue. In the second part, it is questioned whether the narrations that al-Zamakhsharī included in his tafsīr of the verses associated with ʿAlī are similar to the narrations of the Shīʿīte/Zaydī/Imāmī tradition and whether he interpreted the verses in parallel with these narrations. In this respect, the tafsīr al-Kashshāf has been examined comparatively with the Sunni and Shiite tafsīrs prior to it. Eventually, while interpreting these verses associated with the Ahl al-bayt (members of the Prophet’s household), al-Zamakhsharī highlights the narrations that appreciate the virtues of ʿAlī b. Abī Ṭālib and his child. However, he also refrains from making comments that would be in line with the Shīʿa's belief in imamate. In particular, his tafsīr of the verse al-Aḥzāb 33/33 in the context of the Prophet’s wives is the greatest indicator of this situation. It has been determined that while al-Zamakhsharī includes the narrations highlighting the virtue of ʿAlī b. Abī Ṭālib and his children, he mostly follows the Sunni commentator al-Thaʿlabī. In particular, it has been seen that al-Zamakhsharī transferred the narration material in the interpretation of the relevant verses from al-Thaʿlabī's commentary almost in the same way. However, it is noteworthy that al-Zamakhsharī differs from him in some details such as linguistically supporting these narrations in some verses such as ʾĀli ʿImrān 3/61 and al-Māʾidah 5/55. An indirect influence can be mentioned because al-Thaʿlabī frequently narrates the narrations supporting the Shīʿītes in places where there is a Sunni-Shīʿīte conflict. Therefore, although there is no evidence that al-Zamakhsharī took these narrations from Shīʿīte sources, it is seen that he brought ʿAlī b. Abī Ṭālib-based narrations in Sunni sources into the fore. Even in the commentary of al-Ḥākim al-D̲h̲us̲h̲amī, al-Zamakhsharī's teacher in the line of Zaydi/Mu'tazili, the lack of Ali emphasis in the interpretation of the aforementioned verses supports our view. (shrink)

A pervasive misunderstanding of Confucian philosophy’s concepts considers them to be directives that call for deference and subordination, principally associated with the concept Lǐ 禮 which is understood as rites, rituals, manners, or generally “propriety”. Imposing Lǐ 禮 is considered a path to social and personal harmony. However, an analysis of the conditions and implications of Lǐ 禮 in early Confucian thinking shows that authentic respect, not obedience, is considered the essential condition for good governance and an ordered (...) society. Significantly, authentic respect can only originate from within the self, it cannot be commanded. Based upon self-cultivation, participation in ritual and exemplary conduct establishes a commitment to respect, and the purposeful distinctions expressed through Lǐ 禮 make social order intelligible. Considering the essence of respect in depth, and comparing it to the ethics conceived by Immanuel Kant, neither Confucian nor Kantian ethics are truly deontological in the sense of a “duty that is owed to an external instance”, rather they both rest on the autonomy of the self. A synthesis of both implies that extending authentic respect to an other in an encounter within the context of Lǐ 禮 gives rise to “Existential Reciprocity”: a virtuous cycle which mutually affirms both the self and the other, while rejecting a dichotomous opposition between self-esteem and morality. This is not contingent on external factors, but accessible from a self-determined, autonomous engagement with self-affirming conduct and productive encounters. Benefits are immediate and personal, and this forms the conditions in which harmonious relationships are a natural outcome. (shrink)

Service and personal care robots are starting to cross the threshold into the wilderness of everyday life, where they are supposed to interact with inexperienced lay users in a changing environment. In order to function as intended, robots must become independent entities that monitor themselves and improve their own behaviours based on learning outcomes in practice. This poses a great challenge to robotics, which we are calling the “autonomy-safety-paradox” (ASP). The integration of robot applications into society requires the reconciliation (...) of two conflicting aspects: increasing machine autonomy and ensuring safety in end-use. As the level of robot autonomy grows, the risk of accidents will increase, and it will become more and more difficult to identify who is responsible for any damage incurred. However, emphasizing safety impairs the autonomous functioning of the robot. This problem implies the need for a broadened concept of product safety. Our comparative study shows that the institutional framing of the ASP as well as concrete solutions to this problem differs between Europe and Japan in two respects: (1) the understanding of robot agency and (2) the concept of “appropriate” user–robot interaction. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Aristophanes' Thesmophoriazousai and the Challenges of Comic Translation:The Case of William Arrowsmith's Euripides AgonistesElizabeth ScharffenbergerThesmophoriazousai is conspicuously absent from the well-known and widely used series of Aristophanes translations that, under the editorial supervision of William Arrowsmith, was published originally by the University of Michigan Press and then taken up by New American Library. This is not to say, however, that a translation of the comedy was never (...) composed for this series. Arrowsmith took the task upon himself and began his translation of Thesmophoriazousai some time before 1960 when the Aristophanes series was at the height of its production; in later years, he revised his text at least once, and the evidence points to 1968-1973 as the principal period during which the translation was reworked. The cover page on the manuscript that he sent me in 1991 indicates that an introduction and notes (standard in this series) were to accompany the translation, but the package I received contained only the translated text, and I have no idea whether the notes and commentary were ever composed or finished. The text of the translation has a handful of typographical errors and minor inconsistencies in the directions on costuming and staging, which seem to mark the project as an arrested work in progress.The unpublished creation of a renowned classicist who was also a prolific and respected translator, Arrowsmith's Thesmophoriazousai — titled on the manuscript's cover page, Euripides Agonistes (Thesmophoriazousae)— provides an exciting venue for exploring the challenges involved in translating Aristophanes for contemporary English-speaking audiences. My purposes in this paper are thus twofold. I want to examine selected aspects of Arrowsmith's version of this comedy and also advance some general ideas about the challenges involved in translating the plays of Aristophanes and, for that matter, any comic work. My endeavor on both scores will be both preliminary and cursory; there is no way to do justice to every feature of this translation in a few pages or to [End Page 429] produce a complete theory of comic translation. But I hope that I can suggest a reasonably systematized foundation for analyzing the choices Arrowsmith made in his rendering of Thesmophoriazousai and, at the same time, present a set of criteria that might have broader use to people who rely on all kinds of comic translations.The "Frames" of Comic TranslationThere are very few works that treat, from either practical or theoretical perspectives, the translation of comic works and comic devices such as parodies and puns. These works include an essay on translating Ari-stophanes published in 1960 by Arrowsmith, titled "The Lively Conventions of Translation," as well as Douglass Parker's 1992-93 Arion essay in Arrowsmith's memory and André Lefevere's Translating Literature: Practice and Theory in a Comparative Literature Context. Their consensus is that translating comedy, especially Aristophanic comedy, poses formidable and unique challenges.1The most obvious challenge is the topicality of jokes and comic scenarios. According to Arrowsmith, "It is initially the hard facts of culture that most torment the translator of Greek comedy.... Tragedy... keeps a decent distance from common life, but comedy dumps into the translator's lap an intolerable profusion of things—odd bits of clothing, alien cuisine... unfamiliar currency, etc." (1960, 123). Thesmophoriazousai bears out this observation; it overflows with difficult "things" and "hard facts" to translate, beginning with the many props and elements of costume that come into play in the prologue with the appearance of Agathon and the dressing of the Kinsman, and including such crucial items as Mica's wineskin "baby." The problem of "translating" these objects is compounded by the challenges involved in making intelligible the comedy's preoccupation with Euripides and its many-layered engagement with Euripidean tragedy, which give rise to the parodies of Telephus, Palamedes, Helen, and Andromeda. These parodies go hand in hand with countless theatrical in-jokes and self-conscious references to local Athenian theatrical practices. Then there are the play's festal performance context (the Dionysia) and festal setting (the Thesmophoria), its allusions to local forensic and judicial procedures, and its caricatures of figures such as Agathon and Cleisthenes who, like Euripides, would have... (shrink)

Making public policy choices based on available scientific evidence is an ideal condition for any policy making. However, the mechanisms governing these scenarios are complex, non-linear, and, alongside the medical-health and epidemiological issues, involve socio-economic, political, communicative, informational, ethical and epistemological aspects. In this article we analyze the role of scientific evidence when implementing political decisions that strictly depend on it, as in the case of the COVID-19 pandemic. In carrying out this analysis, we will focus above all (...) on the Italian case. This, on the one hand, precisely because Italy led the way regarding the containment policies of the pandemic. Secondly, the government's action was immediately criticized in various respects. Some were calling into question not only the cumbersome political mechanisms, but also suggesting a scarce ability to take scientific evidence into account. On other fronts, there are those who have criticized Italy for its blind and uncritical faith in science and for the paternalism of its decisions. This debate therefore offers the possibility of dealing with some aspects concerning scientific results and their implementation at the political level from the point of view of a political philosophy of science, roughly in the spirit suggested by John Dupré. (shrink)

The book reconstructs the history of Western ethics. The approach chosen focuses the endless dialectic of moral codes, or different kinds of ethos, moral doctrines that are preached in order to bring about a reform of existing ethos, and ethical theories that have taken shape in the context of controversies about the ethos and moral doctrines as means of justifying or reforming moral doctrines. Such dialectic is what is meant here by the phrase ‘moral traditions’, taken as a (...) name for threads of moral discourse, made in turn of other interwoven threads, including transmission of shared codes, appeals to reform of prevailing custom, rational argument about the justification of some precept on the basis of some shared general teaching or principle, and rational argument about the ultimate basis for principles and justification of authoritative teaching. That is, the approach adopted to the reading of ethical texts depends on a firm belief in the fact that philosophers hardly created any ethical doctrine out of nothing. The main point this book tries to highlight is how different philosophical theories emerged and followed each other as a result of attempts at accounting for what was going on in the world of moral traditions. Changes were propelled by controversies between different schools, and highly abstract arguments were the unintended effects of moves made by controversialists forced to transform (and occasionally to turn upside down) their own doctrines in order to face the challenge posed by other arguments. This is the reason why the book examines not only texts that already enjoy pride of place in the history of philosophy (Aristotle, Kant, Hegel), but also other texts usually treated in the histories of religions (the Bible, the Talmud, the Quran), and others considered to be much less philosophical (Plutarchus, Pufendorf). -/- 1. Plato and a response to ethical scepticism. Two different traditions of morality in VI-V century Greece are described. The birth of philosophical questioning of traditional morality and temporal and spatial variation of custom is described within the context of the v century crisis, the demise of traditional aristocratic and tyrannical rule and the birth of democracy. Two conflicting answers to the challenge are reconstructed, namely conventionalist or immoralist theories formulated by the Sophists and the eudemonist and intellectualist Socratic theory. Plato’s own reformulation of Socrates answer to the Sophists is reconstructed. His psychological views, his classification of the four cardinal virtues and his political theory are described as parts of a unitary system, culminating in an extremely realist moral ontology identifying the idea of the good with the essence of the (moral and extra-moral) world itself. -/- 2. Aristotle and the invention of practical philosophy. Aristotle’s invention of practical philosophy as a field separated from first philosophy is shown to be an implication of his break with Plato moral ultra-realism. Aristotle’s agenda in his moral works is arguably dependent on a polemical intention, namely dismantling Socratic intellectualism. The semi-inductive or virtuously circular method of practical philosophy is illustrated, starting with the received opinions of the better and wiser individuals and trying dialectically to sift what is left of mistake and inconsistence in such opinions, finally trying to correct mistakes and make the overall practical science more consistent. The chapter illustrates then the relationship of individual ethics, or ‘monastics’, with the art and the science of the pater familias, or ‘economics’, and the science of the ruler and citizen, or politics. The nature of virtues, or better, excellences of character, is discussed, highlighting the basic role of hexis, or ‘disposition’. Prudence, or better practical wisdom, is the focus of the chapter. Its relationship with bouleusis or deliberation is examined, and its autonomous status vis-à-vis theoretical knowledge is stressed. -/- 3. Diogenes and philosophy as a way of life. The chapter provides an overview of Hellenistic ethics, which almost amounts to Hellenistic schools of philosophy, in so far as ‘philosophy’ became in these centuries primarily the name for a way of life. The typical character of the Cynical movement is highlighted, that of a school of life, not a school aimed at providing any kind of intellectual training was to be provided. -/- 4. Epicurus and ethics as self-care. The peculiar character of the Epicurean school is described, a combination of a science of well-being aiming, more than at pleasure as in the popular view, at reduction of useless suffering, of unnecessary needs, and at a balanced selection of pleasures of the best and most durable kind. -/- 5. Epictetus and ethics as therapy of the passions. The various phases of Stoicism are described, and the shifting place given to ethics in the Stoic system of idea, culminating in the paradoxical view of ethics, its impossibility in principle notwithstanding, as the only truly significant and necessary part of philosophy. Cicero is treated, showing how his own synthesis of various Hellenistic trends is as a truly philosophical enterprise, deserving serious consideration after one or two centuries when he was confined to the role of literate. Epictetus is chosen as the best example of what the Stoic tradition could yield, an art of living based on sophisticated introspection, in turn aimed at making a kind of cognitive therapy possible, dismantling obnoxious passions at their root by systematically correcting false representations. -/- 6. Philo and the reconciliation of Torah and Platonism. A reconstruction of basic ideas from a few books of the Hebrew Bible is provided, starting with the Prophetic tradition and the focus on God’s mercy as the source of motivation and standard for human behaviour. Then a comparative analysis is undertaken of a parallel tradition, namely the three codifications of the Torā (Law or, better, Instruction), highlighting how a core of moral ideas may be recognized as a basis and preamble of codification of civil law, cultural practice, and regulation of ritual purity. The importance of Leviticus is stressed as the turning point when emphasis mercy, typical of the Prophetic tradition, is combined with the legal tradition, yielding the change in sensibility of the Second Temple time. Philo of Alexandria is described as one of the three leading figures – together with Rabbi Hillel and Rabbi Yeshua – at the apex the emergence of the mentioned new sensibility, gradually including mercy as an essential part of justice and establishing the starting point of both the Rabbinic and the Christian tradition. This consists precisely in the precept of one’s neighbour’s love or of the golden rule, two eventually identical precepts whose meaning is arguably more sober and sensible than the long-lasting Christian tradition deriving from John and Augustine has made us believe and no novelty vis-à-vis so-called Ancient-Testament teachings. -/- 7. Augustine and Christianity as Neo-Platonism. The first section examines the moral doctrines of so-called 'ethical Treaties' from the Talmud, a group of treaties, among which the best known is Pirqé Avot, that were left out of the six "orders" of the canon as they did not fit in any of the six groups of issues ritual or legal on which the division was based. According to Maimonides, their peculiar theme is provided by the Deòt, 'opinions', i.e., mental dispositions, that is, the translation of the Greek term hexeis and Arab akhlak (in turn providing in this language the name for ethics as such). The three topics I reconstruct are: i) the notion of Torah: The Torah is understood as the world order itself, or as the ‘Wisdom’ that existed even before creation and was ‘the tool by which the world was built’; however, the Torah is an earthly and human entity, as it was "received" by humans, and from that very moment belongs to them; ii) the relationship between love of God and love of neighbour; the treaties require us to study and practice the Torah ‘for its own sake’, that is, require us to act out of love, not out of fear or hope of reward; iii) the idea of sanctification of daily life: having disappeared with the destruction of the Temple the possibility of any conflict between liturgical service and everyday life, the latter is assumed to be in itself divine service: to give food to the poor has the same value as sacrifices in the Temple, and as an implication, the insistence become recurrent on the goodness of created things in themselves along with a polemic against ascetic currents. The conclusions drawn are: i) the moral teachings of the Talmud and those of Yeshua are, rather than similar, virtually identical; one may safely say that the precept of love and the golden rule are central ones for all Talmudic rabbis, that mercy plays an indispensable role alongside with justice, and the latter is not a different thing from one’s neighbour’s love; ii) a peculiarity of Talmud rabbis facing Yeshua is the idea of study as worship, and knowledge as a source of justice; but this is an idea of Judaism after the Temple's destruction that cannot be attributed to the Pharisees of Yeshua’s time; iii) the relation of study and practice in the Talmud parallels that between faith and deeds in Paul's epistles, that is, respectively faith or learning are a necessary and sufficient condition to be recognized as righteous , but deeds are the inevitable effect of either faith or learning. The sayings ascribed to Yeshua are examined first, yielding the conclusion that a close equivalent may be found for every saying in Talmudic literature and yet the whole is ascribed to one rabbi, with rather consistent stress on God’s mercy and unconditional forgiving as the mark of true imitation of God. Thus, Yeshua’s teaching is pure Judaism. The third section describes briefly the galaxy of Gnostic currents and Manichaeism, trying to sketch the profile of moral teachings resulting from an encounter of Asian spiritual traditions, Hellenistic lore and sparks of teachings from apocalyptic Jewish currents. The last section summarizes the turbulent history of several encounters between Christian currents and Hellenistic philosophical schools. The first one was with late Cynicism. Recent, rather controversial, literature discovered the jargon and a few topics from the Stoic-Cynical popular philosophy in a few books from the New Testament itself. This, far from proving that Rabbi Yeshua had been influenced by cynic preachers, is a proof of the necessity felt by Christian preachers to translate the original ‘Christian’ teaching into a Greek lexicon deeply impregnated with cynic terminology. The second was with Platonism, yielding the mild and temperate moral teaching of Clemens of Alexandria, teaching the sanctity of nature and the human body, the joy of moderate fruition of ‘natural’ kinds of pleasures, and the beauty of the marital life – in short, the opposite of the standard picture of Medieval Christianity. Ambrose of Milan brings about a different kind of synthesis, namely with Middle Platonism, where Stoic themes prevail. The most shocking case is Augustine, where an early Manichean education is overcome in a former phase by a synthesis of Plotinian Neo-Platonism and Christian preaching, yielding a sustained polemic with the Manicheans and rather optimistic views on life and Creation, the body and sexuality, and Hebrew-Judaic tradition not far from Clemens of Alexandria. In a later phase, occasioned by controversy on the opposite front, with such Christian currents as the Pelagians and Donatists, Augustine comes back to heavily anti-Judaic and world-denying ascetic attitudes where is earlier Manichean upbringing seems to emerge again. The tragedy of medieval Christianity will be the later Augustine’s overwhelming influence. A final section is dedicated to the monastic tradition where a curious mixture of world-denying asceticism with an astonishingly penetrating ‘science’ of introspection emerges. -/- 8. Al Farabi and the reconciliation of Islam and Platonism. The Qurān and the qadit, that is, collections of sayings ascribed to the prophet Muhammad contain a wealth of precepts and catalogues of virtues mirroring moral contents from the Jewish and the Christian traditions, among them the basic notion of imitation of the Deity, where mercy is assumed to be its basic trait. An important tradition within Islam, namely Sufism, stressed to the utmost degree the role of mercy, turning Islam into a mystic doctrine centred on retreat from the world, abandonment to God’s will, and a peaceful and fraternal attitude to our fellow-beings. A secular literary tradition originating in the Sassanid Empire, the literature of advice to the Prince had for a time a widespread influence in the newly constituted Arabic-Islamic commonwealth. In a later phase, the legacy of Hellenic philosophy made its way into the intellectual elite of the Islamic world. The first important legacy was Platonic, and the Republic became the main text for Islamic Platonism. Al-Farabi wrote an enjoyable remake of the Platonic Republic, arguing that the citizen’s virtues were the basis on which the political building needs to rest. The secular lawgiver is enlightened by the light of reason in his everyday practice of governance, but room is made for the Prophet as the voice of revealed truth that confirms and completes the rational truth that philosophy may afford. In a second phase also Aristotelian and Stoic influence were assimilated. Miskawayh’s treatise was the masterwork at the time Arabic philosophy reached its Zenith. It is a treatment of the soul’s diseases and their remedies, combining the Aristotelian doctrine of the golden mean with the Stoic doctrine of the passions and elements of Galenic medicine. Towards the eleventh-twelve centuries a war raged among theologians and philosophers, finally won by the former with disappearance of philosophy as such. The newly established mainstream, yet, was no kind of intolerant fanaticism. It drew from the work of mystic theologian Al-Ghazālī, the best heir of Sufism, teaching a tolerant and peaceful attitude to our fellow-beings and a passive attitude to destiny as an expression of the Divine will. -/- 9. Moshe ben Maimon and the reconciliation of Torah and Aristotelian ethics. The encounter between the Talmudic tradition and Hellenic philosophy had taken place a first time in Alexandria at the time of Philo but the two traditions had parted way again. In fact, the kind of Platonic Judaism founded by Philo survived only within Christianity, in the fourth Gospel and then in writings by Clemens of Alexandria. The Talmudic literature had absorbed just less striking traits from the Hellenic Philosophy, namely an idea of ethics as care of the self and a role for the education of character as propaedeutic to theoretical knowledge. In the Arabic-Islamic world, a second round started when Jewish authors writing in Arabic undertook the task to prove the full compatibility of the tradition deriving from Torah and Platonic philosophy. The culmination of this attempt is provided by Moshe ben Maimon who tried to use Aristotelian ethics as a language into which the teaching from the Pirké Avot could be translated. -/- 10. Thomas Aquinas and the reconciliation of Christian morality and Aristotelian ethics. In the first section the fresh start is described of philosophical ethics in Latin Europe at the turn of the Millennium. In a first phase, Anselm and Peter Abelard built on a Platonic and Augustinian legacy. In this phase. remarkable innovations are introduced, including Abelard’s claim of the obliging character of erring consciousness. In a second phase, the rediscovery of Nicomachean Ethics thanks to Latin translation of Arabic versions gives birth to a new wave of ethical studies, recovering the very idea of Aristotelian practical philosophy, with the potential implication of full legitimization of natural morality, i.e. ethics without Revelation. Aquinas’s ethics is a theological ethics out of which it would be vain to try to extract a self-contained philosophical ethics. His treatment of topics in philosophical ethics, yet, does not boil down to repetition of Aristotelian arguments but is rather a creative reshaping of such arguments. For example, he introduces also in the practical philosophy a first principle parallel to the principle of non-contradiction; and he also carries out a synthesis of Aristotelianism, Stoicism, and neo-Platonism. Even though it is essentially moral theology, Aquinas’s doctrine - unlike Augustine – grants full citizenship to "natural" morality, firstly by rejecting the claim that the corruption of human nature due to the original sin is so radical as to leave "pure nature" incapable of moral goodness. The doctrine is presented in a more sophisticated formulation in a few of the Quaestiones, such as De Malo and De Veritate, in the Summa contra Gentes and in the commentaries to Aristotle than in the famous Summa Theologica, but the latter work includes the only or the largest exposition of some decisive part of the theory. Thus, the Summa Theologica should be read for what it is more than criticized for not being what it was not meant to be. It was not meant to be the brilliant synthesis of all that Reason he had been able to produce with what Revelation had added about which the Neo-Thomists used to dream, but rather a manual for the training of preachers and confessors, where theoretical claims are not too demanding and a few serious tensions are left. Besides a jump between the Prima Secundae and the Secunda Secundae, being the former an essay in virtue theory and the latter a handbook for confessors, the most serious tension is perhaps the one between the ethics of right reason presented in most of Ia-IIae and the eudemonistic ethics developed in quaestiones 1-5 of the same part; the alternative ethical theory which also may be found in Augustine, the Stoic view of a cosmic reason eventually coincident with the moral law, was believed by Anselm (followed by John Duns Scotus and William of Ockham) to be incompatible with eudemonism. It is questionable whether Thomas could reduce the tension proving that it is just an apparent tension, in so far as the right reason and bliss derived from knowledge of God tend to coincide, but this is just a conjecture. Thomas’s ethics is a virtue ethic, not a law-based one, and moral judgment focuses on the virtues, particularly charity, not on the commandments and even less on absolute prohibitions; Thomas, however, would not have considered a drastic alternative between law and the virtues such as the one which has been advanced in late twentieth-century philosophy to be justified. Nonetheless, when it discusses ‘special’ virtues, it ceases to be an ethics of virtue and becomes a disappointing and often contradictory discussion of legal and illegal acts. Such a discussion takes most of the time ‘reasonable’ middle positions on controversial issues but not the alternative approach that Aristotelianism would have made possible; even when some occasional Aristotelian claim shows up, such as money’s barrenness as a reason against usury, this seems to be made by an author who apparently ignores the Aristotelian Thomas of the Prima Secundae. It is an ethic of human autonomy which recognizes the binding character of the individual conscience and, potentially, even a duty to disobey unjust laws. It is true that what Thomas writes in his discussion of death penalty and persecution of heretics is simply disgusting, and yet we should blame Thomas the man, not Thomist ethical theory. Finally, Thomas’s ethics is not ethical ‘absolutism’, as both traditionalist Catholic theologians and secularist enemies of dogmatic morality tend to believe. It is instead an ethic of prudential judgment. Exceptions to this approach – or better results of logical fallacies – are such claims as the absolute character of negative precepts and of the existence of "intrinsically evil acts", claims that simply cease to make sense in the light of Thomas’s own distinction between human act and natural act, carrying consequences Thomas did not live long enough to draw or was not consistent enough to dare to draw. -/- 11. Francisco de Vitoria and casuistry. The first topic illustrated is the discussion about the notion of pura natura, namely the human condition after the original sin and before divine revelation. The core notion was already there in Aquinas but was later developed by Caietanus (Thomas de Vio) with a number of interesting implications: firstly a view of human nature as such much more positive than Augustine’s and his followers’ view, including both Calvinists and Jansenists; secondly, the implication that the philosopher’s morality, as opposed to the Christian’s morality, is a quite respectable kind of morality; thirdly, that theocracy and prosecution of the unfaithful lacked justification, with more far-fetching consequences than Aquinas himself had dared to draw. The second topic is casuistry, a new name for a comparatively older way of thinking, which was already there in late Stoicism and Cicero as well as in the Talmudic literature. This is an approach aimed at yielding probable enough solutions for doubtful cases even in absence of completely safe staring points. The genre developed from medieval reference books for confessors and became by the sixteenth-century a sophisticated tool-box for dealing with various fields of applied ethics. Francisco Vitoria, the main authority of Baroque Scholasticism, was a controversial figure, among the proponents of the new discipline of casuistry and a consistent proponent of more separation between the religious and the civil authority, stricter limits to the legitimacy of war, innate rights of non-Christian nations in the New World based on the notion of pura natura, providing a standard of ‘natural’ goodness, previous to revelation, on which the Indian nations were judged to live in a naturally good condition, provided with the institutions of family, justice, and religion had accordingly a right to full respect by Christian sovereigns. Bartolomé de Las Casas, arguing along similar lines, was the leader of a historical battle in defence of the rights of the Indios. -/- 12. Michel de Montaigne and the art of living. A short description of one of the Renaissance Phyrronism, one of the classical philosophies revived in the fifteenth and sixteenth century. Montaigne combines the sceptical epistemology with an understanding of ethics – indeed of philosophy as a whole – in terms of an art of living inspired by two basic ideas, sagesse, that is, practical wisdom as the only kind of rationality available after theology, science, and tradition have declared bankrupt, and an aesthetic ideal of self-transformation through the art of writing and introspection. -/- 13. Pierre Nicole and neo-Augustinianism. The chapter illustrates first the vicissitudes of Augustinianism newly born after the late medieval triumph of Thomist Aristotelianism in the alternative Protestant and Catholic versions processed by the Calvinists and the Jansenists. Then it illustrates the doctrines of Pierre Nicole, Blaise Pascal’s best disciple, on the impossibility of introspection, on the ubiquity of self-deception, on the incurably evil character of the passion of love, and on the two moralities, the one of the man of the world, the morality of honesty which is indispensable for granting peace and order but devoid of any true value for eternal salvation, since the same external behaviour may be prompted by opposite motivations, and the morality of charity, the only true one but also useless to society. The third topic is Pierre Malebranche’s view of self-deception as a ubiquitous phenomenon accounting for human action and responsibility and his reformulated theory of self-love, no less ubiquitous than for Nicole and yet not as incurably evil, given the distinction between morally indifferent and even necessary amour de soi and vicious amour proper, a distinction on which the whole of Rousseau’s moral and political theory rests. -/- 14. Samuel von Pufendorf and the new science of morality. The chapter is dedicated to the discovery of the idea of a ‘new moral science’. Hugo Grotius is discussed first highlighting the real character of his project, much closer to the Thomist idea of a natural law accessible to non-corrupted human reason when human beings are living in a state of pura natura. Then Hobbes’s combination of scepticism, voluntarism, and conventionalism is described and both the continuity with Grotius’s new science, in the search for non-revealed rational morality, and the break with him, in the adoption of voluntarism and refusal of an intellectualist view of natural law, are illustrated. Pufendorf’s work is illustrated as a synthesis of the two previous attempts and the – up to Schneewind underestimated – paradigmatic example of the new science of morality. -/- 15. Richard Cumberland and consequentialist voluntarism. The chapter gives an overview of eighteenth-century Anglican ethics, noticing how the Cambridge tradition gave special weight to natural theology as opposed to positive or revealed theology – and how two Cambridge fellows, John Gay and Thomas Brown, elaborated on Cumberland’s (and Malebranche’s, as well as Leibniz’s) strategy for finding a third way between intellectualist view and voluntarist view of the laws of nature. The result of their elaboration was a kind of a rational-choice account of the origins of natural laws, where a law-giver God chooses among a number possible sets of laws on a maximizing criterion, and God’s maximandum is happiness for his creatures. The chapter notices also how such a solution aimed at solving at once the problem of evil and that of the foundation of moral obligation by proving how God’s choice was justified as far as it was the one minimising the amount of suffering in the world. 16. Richard Price and intuitionism. The chapter describes first the doctrines of the Cambridge Platonists, an example of hyper-rationalist reaction to Calvinism. Secondly it describes the sophisticated and universally ignored – from Sidgwick to Anscombe –version of what was later labelled ‘ethical intuitionism’ – showing how it escapes familiar objections and misrepresentations of intuitionism – from Mill to Rawls – in grounding its argument on transcendental arguments while carefully avoiding recourse to introspection and psychological evidence, which has been taken as a too easy target by critics of intuitionism. Thirdly, the chapter discusses Whewell’s ‘philosophy of morality’, as opposed to ‘systematic morality’, not unlike Kant’s distinction between a pure and an empirical moral philosophy. Whewell worked out a systematization of traditional normative ethics as a first step before its rational justification; he believed that the point in the philosophy of morality is justifying a few rational truths about the structure of morality such as to rule hedonism, eudemonism, and consequentialism; yet a system of positive morality cannot be derived solely from such rational truths but requires consideration of the ongoing dialectics between idea and fact in historically given moralities. Whewell’s intuitionism turns out closer to Kantian ethics than commentators have made us believe until now, and quite different from what Sidgwick meant by intuitionism. -/- 17. Adam Smith and the morality of role-switch. The chapter describes first, Hutcheson’s attempt at basing the ‘new science’ of natural law on different bedrock than Pufendorf and the English Platonists, namely a moral sense, a faculty whose existence is assumed to be proved on an empirical basis. The second step is a reconstruction of Hume’s rejoinder in terms of a new science of man including morality on an ‘experimental’ basis, that is, a ‘Newtonian’ hypothetical-deductive approach, distinguished from Hutcheson’s allegedly uncritical descriptive approach to human nature. The third step is a reconstruction of Adam Smith theory of morality understood as emerging from a spontaneous interplay of exchanges of situations (the most basic meaning of the word ‘sympathy’ as construed by this author). -/- 18. Jeremy Bentham and utilitarianism. The bulk of the chapter is dedicated to the doctrines of Jeremy Bentham. The Enlightenment spirit that suggested the idea of a new morality, free from religion, is illustrated. The notion of utility is illustrated as well as the subsequent formulations of the principle of utility. The idea of felicific calculus is discussed, showing how its inner difficulties prompted several reformulations of the principle of utility in order to avoid undesirable implications of proposed formulations. The role of the thesis of spontaneous convergence between interest and duty is discussed, showing how it left numberless questions open, and the distinction between the virtues of prudence, justice and beneficence is described as a way out of the deadlocks of classical utilitarianism. After Bentham, Mill’s reformed utilitarianism is reconstructed, showing how it is a kind of mixed system – as closer to common sense as it gives up Bentham’s claims to consistency and simplicity – resulting as unintended consequences from the controversies in which Mill was too keen to engage. The hidden agenda of the controversy between Utilitarianism and Intuitionism, going beyond the image of the battle between Prejudice and Reason, is described, showing how both competing philosophical outlooks turn out to be more research programs than self-contained doctrinal bodies, and such programs appear to be implemented, and indeed radically transformed while in progress thanks to their enemies no less than to their supporters. -/- 19. Immanuel Kant, practical reason and judgment. The chapter argues that Kant took from Moses Mendelssohn the idea of a distinction between geometry of morals and a practical ethic. He was drastically misunderstood by his followers precisely on this point. He had learned from the sceptics and the Jansenists the lesson that men are prompted to act by deceptive ends, and he was aware that human actions are also empirical phenomena, where laws like the laws of Nature may be detected. His practical ethics made room for judgment as a holistic procedure for assessing the saliency of relevant moral qualities in one given situation; this procedure yields the same results as the geometry of morals does for abstract cases but does so immediately and without balancing conflicting duties with each other, since what makes for the salient quality of a situation is perceived from the very beginning. Kant's practical philosophy is richer than the received image, making room for an ‘empirical moral philosophy’ or moral anthropology including treatment of commerce, needs, value and price, happiness and well-being; the overall social theory and philosophy of history is less different from Adam Smith's than the received image makes believe; the paradox of happiness is central to Kant's philosophy; a distinction between happiness and well-being is clearly drawn; the distinction plays a basic role in establishing a link between the economic and the moral life. -/- 20. Georg Wilhelm Friedrich Hegel and the critique of abstract universalism. The chapter describes first the Romantic movement and the implications some of its concerns, rescuing passions, community, tradition, the individual as the bearer of a unique destiny, and the longing for organic unity between the individual, mankind and nature. Hegel’s contribution is discussed then, highlighting how, on the one hand, he shared a number of these concerns and on the other he had more rationalist leanings. The notion of morality is the pivotal point of the reconstruction, highlighting how Hegel construes this notion as a key to his own diagnosis of the malaise of modernity – the separation of individual and Gemeinschaft – and how his attack on Kant turns around this very idea. -/- 21. Friedrich Nietzsche against Christianity and the Enlightenment. The chapter illustrates first the idea of deconstruction of the back-world of values. Nietzsche claims to be legitimate heir of the French moralists, Leibniz, Kant and Hegel, in so far as he allegedly carries out to its deepest implications their discovery of what lies behind traditional naïve belief in the existence of an objective realm of values just waiting for description by the philosopher. The two exemplars form which genealogy draws inspiration are the classical philologist’s historical reconstructions of lost meanings and the chemist’s decomposition of elements. Then the genealogy of the notions of good and evil carried out in the first dissertation of Genealogy of morals is illustrated with its paradoxical conclusion that will to power is in fact the only ‘genuine’ kind of goodness. The third point illustrated is the dialectic of ascetism and self-realization with its ambiguous outcome. The suggested interpretation of such outcome is that Nietzsche’s normative ethics is a kind of virtue ethics taking an aesthetic ideal as a normative standard -/- 22. George Edward Moore and ideal utilitarianism. The chapter discusses the ideas of common sense and common-sense morality in Sidgwick. I argue that, far from aiming at overcoming common-sense morality, Sidgwick aimed purposely at grounding a consist code of morality by methods allegedly taken from the natural sciences to reach, also in ethics, the same kind of “mature” knowledge as in the natural sciences. His whole polemics with intuitionism was vitiated by the a priori assumption that the widespread ethos of the educated part of humankind, not the theories of the intuitionist philosophers, was what was worth considering as the expression of intuitionist ethics. In spite of a naïve positivist starting-point, Sidgwick was encouraged by his own approach in exploring the fruitfulness of coherentist methods for normative ethics. Thus, Sidgwick left an ambivalent legacy to twentieth-century ethics: the dogmatic idea of a “new” morality of a consequentialist kind, and the fruitful idea that we can argue rationally in normative ethics albeit without shared foundations. Then it reconstructs the background of ideas, concerns and intentions out of which Moore’s early essays, the preliminary version, and then the final version of Principia Ethica originated. I stress the role of religious concerns, as well as that of the Idealist legacy. I argue that PE is more a patchwork of rather diverging contributions than a unitary work, not to say the paradigm of a new school in Ethics. I add a comparison with Rashdall’s almost contemporary ethical work, suggesting that the latter defends the same general claims in a different way, one that manages to pave decisive objections in a more plausible way. I end by suggesting that the emergence of Analytic Ethics was a more ambiguous phenomenon than the received view would make us believe, and that the wheat (or some other gluten-free grain) of this tradition, that is, what logic can do for philosophy, should be separated from the chaff, that is, the confused and mutually incompatible legacies of Utilitarianism and Idealism. -/- 23. Edmund Husserl and the a-priori of action. The chapter illustrates first the idea of phenomenology and the Husserl’s project of a phenomenological ethic as illustrated in his 1908-1914 lectures. The key idea is dismissing psychology and trying to ground a new science of the a priori of action, within which a more restricted field of inquiry will be the science of right actions. Then the chapter illustrates the criticism of modern moral philosophy carried out in the 1920 lectures, where the main target is naturalism, understood in the Kantian meaning of primacy of common sense. The third point illustrate is Adolph Reinach’s theory of social acts as a key the grounding of norms, a view that basically sketches the very ideas ‘discovered’ later by Clarence I. Lewis, John Searle, Karl-Otto Apel and Jürgen Habermas. A final section is dedicated to Nicolai Hartman, who always refused to define himself a phenomenologist and yet developed a more articulated and detailed theory of ‘values’ – with surprising affinities with George E. Moore - than philosophers such as Max Scheler who claimed to Husserl’s legitimate heirs. -/- 24. Bertrand Russell and non-cognitivism. The chapter reconstructs first the discussion after Moore. The naturalistic-fallacy argument was widely accepted but twisted to prove instead that the intuitive character of the definition of ‘good’, its non-cognitive meaning, in a first phase identified with ‘emotive’ meaning. Alfred Julius Ayer is indicated as a typical proponent of such non-cognitivist meta-ethics. More detailed discussion is dedicated to Bertrand Russell’s ethics, a more nuanced and sophisticated doctrine, arguing that non-cognitivism does not condemn morality to arbitrariness and that the project of a rational normative ethics is still possible, heading finally to the justification of a kind of non-hedonist utilitarianism. Stevenson’s theory, another moderate version of emotivism is discussed at some length, showing how the author comes close to the discovery of the role of a pragmatic dimension of language as a basis for ethical argument. Last of all, the discussion from the Forties about Hume’s law is described, mentioning Karl Popper’s argument and Richard Hare’s early non-cognitivist but non-emotivist doctrine named prescriptivism. -/- 25. Elizabeth Anscombe and the revival of virtue ethics. The chapter discusses the three theses defended by Anscombe in 'Modern Moral Philosophy'. I argue that: a) her answer to the question "why should I be moral?" requires a solution of the problem of theodicy, and ignores any attempts to save the moral point of view without recourse to divine retribution; b) her notion of divine law is an odd one more neo-Augustinian than Biblical or Scholastic; c) her image of Kantian ethics and intuitionism is the impoverished image manufactured by consequentialist opponents for polemical purposes and that she seems strangely accept it; d) the difficulty of identifying the "relevant descriptions" of acts is not an argument in favour of an ethics of virtue and against consequentialism or Kantian ethics, and indeed the role of judgment in the latter is a response to the difficulties raised by the case of judgment concerning future action. A short look at further developments in the neo-naturalist current is given trough a reconstruction of Philippa Foot’s and Peter Geach’s critiques to the naturalist-fallacy argument and Alasdair MacIntyre’s grand reconstruction of the origins and allegedly unavoidable failure of the Enlightenment project of an autonomous ethic. -/- 26. Richard Hare and neo-Utilitarianism. The chapter addresses the issue of the complex process of self-transformation Utilitarianism underwent after Sidgwick’s and Moore’s fatal criticism and the unexpected Phoenix-like process of rebirth of a doctrine definitely refuted. A glimpse at this uproarious process is given through two examples. The first is Roy Harrod Wittgensteinian transformation of Utilitarianism in pure normative ethics depurated from hedonism as well as from whatsoever theory of the good. This results in preference utilitarianism combined with a ‘Kantian’ version of rule utilitarianism. The second is Richard Hare’s two-level preference utilitarianism where act utilitarianism plays the function of eventual rational justification of moral judgments and rule-utilitarianism that of action-guiding practical device. -/- 27. Hans-Georg Gadamer and rehabilitation of practical philosophy. The post-war rediscovery of ethics by many German thinkers and its culmination in the Sixties in the movement named ‘Rehabilitation of practical philosophy’ is described. Among the actors of such rehabilitation there were a few of Heidegger’s most brilliant disciples, and Hans-Georg Gadamer is chosen as a paradigmatic example. His reading of Aristotle’s lesson I reconstructed, starting with Heidegger’s lesson but then subtly subverting its outcome thanks to the recovery of the central role of the notion of phronesis. -/- 28. Karl-Otto Apel and the revival of Kantian ethics. Parallel to the neo-Aristotelian trend, there was in the Rehabilitation of practical philosophy a Kantian current. This started, instead than the rehabilitation of prudence, with the discovery of the pragmatic dimension of language carried out by Charles Peirce and the Oxford linguistic philosophy. On this basis, Karl-Otto Apel singled out as the decisive proponent of the linguistic and Kantian turn in German-speaking ethics, worked out the performative-contradiction argument while claiming that this was able to provide a new rational and universal basis for normative ethics. An examination of his argument is some detail is offered, followed by a more cursory reconstruction of Jürgen Habermas’s elaboration on Apel’s theory. -/- 29. John Rawls and public ethics as applied ethics. Rawls’s distinction between a “political” and a “metaphysical” approach to one central part of ethical theory, namely the theory of justice, is interpreted as a formulation of the same basic idea at the root of both the principles approach and neo-casuistry, both discussed in the following chapter, namely that it is possible to reach an agreement concerning positive moral judgments even though the discussion is still open – and in Rawls’ view never will be close – on the basic criteria for judgment. -/- 30. Beauchamp and Childress and bioethics as applied ethics. The chapter presents the revolution of applied ethics while stressing its methodological novelty, exemplified primarily by Beauchamp and Childress principles approach and then by Jonsen and Toulmin’s new casuistry. -/- . (shrink)

Epidemiological models have played a central role in the COVID-19 pandemic, particularly when urgent decisions were required and available evidence was sparse. They have been used to predict the evolution of the disease and to inform policy-making. In this paper, we address two kinds of epidemiological models widely used in the pandemic, namely, compartmental models and agent-based models. After describing their essentials—some real examples are invoked—we discuss their main strengths and weaknesses. Then, on the basis of this analysis, we (...) class='Hi'>make a comparison between their respective merits concerning three different goals: prediction, explanation, and intervention. We argue that there are general considerations which could favour any of those sorts of models for obtaining the aforementioned goals. We conclude, however, that preference for particular models must be grounded case-by-case since additional contextual factors, as the peculiarities of the target population and the aims and expectations of policy-makers, cannot be overlooked. (shrink)

Background Non-invasive prenatal testing (NIPT), which can screen for aneuploidies such as trisomy 21, is being implemented in several public healthcare systems across Europe. Comprehensive communication and information have been highlighted in the literature as important elements in supporting women’s reproductive decision-making and addressing relevant ethical concerns such as routinisation. Countries such as England and France are adopting broadly similar implementation models, offering NIPT for pregnancies with high aneuploidy probability. However, we do not have a deeper understanding of how professionals’ (...) counselling values and practices may differ between these contexts. Methods In this paper, we explore how professionals in England and France support patient decision-making in the provision of NIPT and critically compare professional practices and values. We draw on data from semi-structured interviews with healthcare professionals. Results Both English and French professionals emphasised values relating to patient choice and consent. However, understandings and application of these values into the practice of NIPT provision differed. English interviewees placed a stronger emphasis on interpreting and describing the process of counselling patients and clinical care through a “principle” lens. Their focus was on non-directiveness, standardisation, and the healthcare professional as “decision-facilitator” for patients. French interviewees described their approach through a “procedural” lens. Their focus was on formal consent, information, and the healthcare professional as “information-giver”. Both English and French professionals indicated that insufficient resources were a key barrier in effectively translating their values into practice. Conclusion Our findings illustrate that supporting patient choice in the provision of NIPT may be held as an important value in common on a surface level, but can be understood and translated into practice in different ways. Our findings can guide further research and beneficially inform practice and policy around NIPT provision. (shrink)

Photo ID 222412412 © US Navy Medicine | Dreamstime.com ABSTRACT In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. INTRODUCTION Medical resources in an austere environment without quick recourse for resupply or casualty (...) evacuation are often limited. The shortage extends not only to supplies like blood products and drugs, but physicians and other medical personnel. In the midst of a mass casualty scenario, such as a battle that includes intense ground fighting, the medical staff will stretch scarce resources and triage casualties according to specific criteria. Typically, they proceed by providing care for the most severely wounded first, referred to here as conventional triage. At times, though, the staff may reverse the triage so that soldiers with minor wounds can return to the fight. In a mass casualty situation, when medical personnel apply conventional triage and treat casualties from opposing forces, a dilemma may arise. We argue that it can be permissible for military physicians to prioritize their own soldiers over enemy combatants in a mass casualty triage, where reverse triage does not apply. The case we will focus on is as follows: Battlefield Triage: During combat operations on a remote island in the Pacific Ocean, a compatriot soldier and an enemy combatant arrive at the compatriot soldier country’s medical treatment facility. Both have similar gunshot wounds to the abdomen, and they arrive with similar conditions. Both have low oxygen saturation and excessive blood loss. The sole physician only has enough time to stabilize one person. The scenario is brief, and we are aware that medical rules of eligibility will most often dictate how the physician proceeds,[1] but this scenario is useful in setting up the question we focus on in this paper: would it be wrong to favor the stabilization of a soldier just because the soldier is the physician’s compatriot? In other words, can nationality serve as an ethically justified tiebreaker in a situation such as Battlefield Triage?[2] In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. The AMA’s Code of Medical Ethics asserts that physicians have “ethical obligations to place patients’ welfare above their self-interest and above obligations to other groups.”[3] The World Medical Association’s Declaration of Tokyo affirms that “no motive, whether personal, collective or political, shall prevail against this higher purpose” of alleviating distress.[4] Physicians are taught early on that triage decisions must be medically indicated and made without consideration of factors such as race, ethnicity, religion, social status, and nationality. They are taught that public trust and obligations of justice grounded in equality demand that only medical indications be considered. But military physicians in a military setting are beholden to obligations, duties, and responsibilities as members of the military, and when these obligations, duties, and responsibilities conflict, as they do in Battlefield Triage, which loyalties win out and why?[5] Critics of partiality on national grounds argue that partiality undermines public trust in medicine and justice because everyone should be treated equally regardless of nationality.[6] Proponents of partiality argue that military obligations supersede equality and that justice requires partiality in such cases.[7] Despite the critics’ disagreement, both agree that there is a morally right, perhaps even blameless, course of action. Drawing on insights from virtue ethics, we argue that Battlefield Triage is a moral tragedy in which justice is unattainable and there is no action without moral cost. The assumption that there is a morally right choice is flawed. We argue that while no decision in this scenario is free from moral blame, there are reasons to favor treating one’s soldiers over enemy combatants. I. The Case Against Partiality There is a common assumption that there is a morally right or just decision in Battlefield Triage. A number of organizations and scholars claim that it is wrong for military physicians to favor their own soldiers on the grounds of nationality or some form of ‘group membership.’ (In a conflict involving service members from multiple nations working as a coalition, a soldier from an allied country may receive the same priority as the US service member due to ‘group membership.’) The World Medical Association’s WMA Declaration of Lisbon on the Rights of the Patient, which was reaffirmed in 2015, posits that, “[i]n circumstances where a choice must be made between potential patients for a particular treatment that is in limited supply, all such patients are entitled to a fair selection procedure for that treatment. That choice must be based on medical criteria and made without discrimination.”[8] This echoes what was set forth in Article 12 of the Geneva Conventions, which states that “[o]nly urgent medical reasons will authorize priority in the order of treatment to be administered.”[9] The argument for impartiality in Battlefield Triage is that every person is morally equal, and equality entails that medical distribution is, “based on a combination of medical need and urgency.”[10] This is in keeping with the bioethical principles that are generally applied.[11] II. The Case for Partiality On the other side, there are arguments that favoritism is the ethically right decision in Battlefield Triage.[12] The argument asserts that members of the military form a morally significant community of friends and participation in these relationships demands partiality. Just as parents have strong ethical duties to their children and not just any children, military personnel have ethical duties to their group, a group that involves an affirmation of mutual aid and support. Some have termed these ‘associative duties. According to Michael Gross, obligations of friendship, care, and solidarity “leave very little room for generally applicable principles of justice that would obligate a medic to treat enemy or non-compatriot wounded ahead of their compatriots.”[13] This is true in Battlefield Triage, but it may also be true even if the enemy’s soldier were more seriously wounded: “the ethics of small group cohesion, largely an ethics of care, mostly replaces the demands of impartial justice.”[14] In a more recent article, Gross explains that preferential treatment is ethically justified based on fighting capability and “the special obligations people owe friends, family, and, no less, comrades-in-arms.”[15] To not show partiality to the US soldier would be morally wrong on the grounds of friendship and mutual care.[16] III. The Moral Tragedy of Battlefield Triage Defenders and critics of Battlefield Triage favoritism based on nationality both frame their position as just or fair. For example, Justin List argues that physicians are “bound to practice medical neutrality,”[17] Marcus Adams denies that physicians “possess special ethical obligations” to enemy combatants because of their profession.[18] These perspectives assume that there is a morally right decision and that justice is attainable. The assumption that there is or can be a morally right Battlefield Triage decision, and we need to put our heads together to figure it out, remains strongly entrenched. However, the facts of the situation should give us pause; there are too many people and too few resources, and this demands a decision-making process that determines who will receive scarce resources. By its very nature, a battlefield triage decision has to be made based on some characteristic or value, a characteristic or value that will inevitably favor some at the expense of others. This is precisely why competing analyses “in the military context struggle to resolve these conflicts satisfactorily.”[19] Drawing on the insights of virtue ethics, we suggest that Battlefield Triage is a moral tragedy. Virtue ethics suggests that morality is about acting virtuously, which is to say that we should do what a virtuous person would do in the situation. Ethics is about figuring out how a just, wise, compassionate, loving, and fair person would act, and then doing that, as one grows in virtue. But life is not always clear cut, and it is possible that virtuous people may find themselves in a moral tragedy, a situation in which, through no fault of one’s own, a person must make a morally objectionable decision. After the action the virtuous person “emerges having done a terrible thing, the very sort of thing that the callous, dishonest, unjust, or in general vicious agent would characteristically do.”[20] Stated differently, a moral tragedy presents a virtuous person with two or more courses of action, all of which have a moral cost.[21] In Battlefield Triage, no matter how the physician goes about deciding, there is going to be defensible concern from those not saved. The fact that there are more people than can be helped fosters competing values in battlefield triage: maximize lives saved, treat people equally, treat the worse off, and support the war effort. Treating people equally may create tension between treating the worse off, maximizing lives saved, and supporting the war effort. Reverse triage is a case in point, as supporting the war effort conflicts with treating the worse off first, as is a fair lottery system since deploying a lottery may not maximize lives saved or support the war effort. There can be reasons why one person is selected over another, to be sure. Yet, there are reasons for making a decision, and that the decision is subject to legitimate moral concern is another. To recognize the moral tragedy of Battlefield Triage is to recognize the impossibility of acting blamelessly in the situation. In this situation, the virtuous military physician is going to have to sacrifice important values such as justice, compassion, and respect for others, even with a defensible criterion in hand. The physician will grieve this sacrifice accordingly. The physician may find her decision difficult or stressful, and rightly so, because of what her circumstances require of her. This kind of moral tragedy results “in actions which betray and violate the rights of persons to whom there may be a strong duty of care. When this happens, it properly triggers an appropriate moral emotion since our moral integrity has been violated and this affects how we think of ourselves and what we have become.”[22] Rather than view her triage decision as the morally superior choice, the virtuous military physician will view her decisions in these circumstances in a different light: it is the least bad option in a terrible situation, and she did something ethically problematic, something that is contrary to her moral character. She deeply regrets the circumstances in which she had to act. IV. Virtue Ethics A virtue ethicist has insight into how one should go about deciding what to do in a moral tragedy, although virtue ethics may not be as helpful as one may hope. The goal of the virtuous military physician in Battlefield Triage is to adopt the best course of action or the action that she feels she ought to do, all things considered. This does not make her choice devoid of serious wrongdoing—a decision must be made, but that does not make it just. The virtuous military physician will approach the situation with courage, responsibility, and insight. She will think about the decision carefully, wisely, and conscientiously; she will weigh the goods and harms of the choices before her, in conjunction with a proper conception of the good life, human worth, and understanding of her obligations to others—including chain of command, fellow soldiers, and the medical community. She is attuned to the value of human life and has a reasonable idea of the various ways her decisions will affect others. She recognizes that she is in this non-ideal situation through no fault of her own: she is not the one fighting in battles; she is serving her country as a physician, whose job it is to save lives, treat everyone justly, and promote military objectives. She regrets the decision she is forced to make in battlefield triage, acting “with immense regret and pain,” Hursthouse explains, “instead of indifferently or gladly.”[23] This is because, no matter what decision is made, the virtuous military physician “does something terrible or horrible,” something she otherwise would not do and is contrary to her values.[24] V. A Resolvable Moral Tragedy Instead of asking whether there is a morally right decision, in which a decision is morally blameless and above reproach, the virtue ethicist asks whether there is a decision with a convincing rationale, knowing that a decision can have a clear rationale but still be morally tragic. It is perfectly reasonable to think that different virtuous persons will arrive at different courses of action: “two virtuous agents, in the same situation,” Hursthouse writes, “may act differently” in irresolvable moral tragedies, in cases in which there is no clear course of action.[25] Because a person must act in a moral tragedy, one goal is to identify reasons for choosing the chosen action. Some decisions are clearly indefensible—treating neither the compatriot soldier nor the enemy combatant in Battlefield Triage would be wrong—and some decisions are more problematic than others. If the military physician selects to treat the soldier because she does not like the enemy combatant’s skin color, such a reason would be deeply problematic. But much of the debate over how to act in a moral tragedy is not over clearly indefensible or problematic criteria. Instead, the literature is largely about different standards or implementations of justice. Some scholars defend nation-impartial triage as right, while others defend nation-aware triage as right, and each argues that the other side is promoting an unjust or otherwise wrong solution to Battlefield Triage. We suggest that Battlefield Triage is a resolvable moral tragedy and that virtue ethics offers convincing reasons to prefer the treatment of the compatriot soldier rather than the enemy combatant on the grounds of national identity. Virtues are integral to living a good life, a flourishing life, but as Aristotle observed long ago, human beings are inherently social, interdependent and interconnected in profound ways.[26] This goes beyond the obvious fact that we need each other to survive day to day (one person makes clothes, another farms, and another makes tools); the claim is that a good or flourishing life depends in large part on one’s social network or community. This is why many of Aristotle’s moral virtues are other facing: justice, friendship, generosity, and magnanimity, to name a few. Courage, a typically self-facing virtue, is understood by Aristotle to be the virtue that regards one’s fear of death in battle, a battle fought on behalf of one’s city.[27] All of this remains true today. Namely, there is an important sense in which our community matters to our lives: it is easier to live a good, flourishing life if one is part of a good, flourishing community. Our community is made up of smaller groups, and it is more accurate to say that we are simultaneous members of different groups within a broader community. A person may be part of a family, friend group, research team, large state university, city, state, and nation. Groups can function well or not, as we all have experienced, and this suggests that there are virtues or excellences that groups can instantiate. Good groups are unified in purpose, with each member doing their duty alongside others for the attainment of that purpose. Good groups manifest solidarity among their members. Although Aristotle does not list solidarity as a virtue, a number of modern-day virtue ethicists have begun examining how group solidarity can be a virtue that contributes to a good or flourishing life.[28] Solidarity is not conceptualized as an individual virtue, a virtue possessed by a person in isolation of others; instead, it is a collective virtue, a virtue that is shared among members of a defined group with particular ends.[29] “A group has solidarity to the extent that its members are disposed to: (1) share values, aims, or goals; (2) care about those values, aims, or goals; (3) act in accordance with those values, aims, or goals; (4) trust the testimony of other group members with respect to those values, aims, and goals; and (5) feel a sense of belonging to the group.”[30] The virtue of collective or group solidarity involves individuals having special concern for each other, shared aims and values, trust, loyalty, and a sense of belonging with these specific others. There is a oneness to the group in the pursuit of a definite goal or purpose, involving mutual support and affirmation of each member. As such, the group has ends and goods above and beyond the good of each individual person. Sometimes solidarity requires personal sacrifice for the collective (for example, a father sacrificing food so his child can eat). The virtue of collective or group solidarity is important to the military and medical community at every level, and for clear reasons. In the military, there is a clear hierarchy of command, unity of purpose and end, mutual trust and support in complex settings, and so on. Soldiers need to know they can count on one another, and solidarity grounds a soldier’s ability to trust others and be assured of mutual aid. In medicine, solidarity maintains self-regulation of the profession, shared values and goals, as well as public support, not to mention that day-to-day operations require physician trust, engagement, and effort toward the ends of clinical care. Physicians need to work together, along with others, in pursuit of health, and disunity is sowed when there is mistrust, selfishness, or disengagement among the healthcare team and organization. Importantly, just as we are all members of various groups and hence may manifest group solidarity in different settings, the virtuous military physician instantiates collective solidarity with both the medical profession and the military. Her dual loyalty contributes to the moral difficulty of acting in Battlefield Triage. The military physician has competing obligations to distinct groups and cannot satisfy all obligations in Battlefield Triage. Solidarity with the military supports the consideration of favoring the soldier for reasons of national identity, whereas solidarity with the medical community does not. Something has to give, which is why it is a moral tragedy. The virtuous military physician, therefore, must weigh the costs of each course of action. To fulfill her obligations to the medical community would require that she does not use nationality and other non-medical considerations in Battlefield Triage. Since the soldier and enemy combatant are equally injured, justice would demand a random process, perhaps a flip of the coin. Although this may satisfy obligations the military physician has to the medical community, this would be costly to the physician’s military group. If word gets out that the physician decides who to treat based on a coin toss, soldiers, families, and citizens may become frustrated and angry. Soldier morale may go down if it becomes known that a coin flip led to the preventable death of a soldier and the saving of an enemy combatant who had killed (or attempted to kill) other soldiers. As Gross highlights, military solidarity involves a mutual aid promise that military personnel promise to help one another.[31] A military physician is part of the military and, as such, is part of the mutual aid promise, which would appear to be violated if the physician flips a coin. Treating a member of one’s own team may be psychologically more beneficial than treating an enemy combatant and may lead to less moral distress.[32] Finally, treating soldiers rather than enemy combatants promotes broader military and social aims, including returning soldiers to health, maintaining unity of purpose, and minimizing community suffering from a soldier’s death. Favoring members of one’s group, that is, triage based on nationality in Battlefield Triage, would fulfill obligations of military group loyalty, which is contrary to the values and duties of medicine. It does not seem as though showing favoritism in this particular situation is very costly to the medical community or general public, but this is because there is recognition that the physician is in the military. Medicine is impartial to non-medical indications partly because of fairness and to promote public trust in medicine. However, Battlefield Triage is unique, as medicine is being practiced in a non-public, wartime setting. In ordinary circumstances, a patient’s identity is irrelevant, and physicians ought not play favorites. Since Battlefield Triage is not an ordinary circumstance, decisions based on patient identity may not undermine public trust in medicine. In addition, it is contestable that fairness in Battlefield Triage requires that no consideration be paid to one’s nationality. Fairness is about giving each person their due, what is owed to them, and the case can be made that soldiers who place themselves in danger for the sake of the common good or a just cause are owed special attention when they suffer harm in the line of duty. In other words, soldiers voluntarily undergo risk to themselves for the greater good, and society owes them for this sacrifice. This plausibly includes preferential treatment in a situation such as Battlefield Triage. So, while the medical community affirms justice demands non-preferential treatment, the military community can affirm the opposite. The demands of fairness are unclear at best or in conflict in this situation: demands of physician justice decry favoritism, while demands of military justice support favoritism. Triage not based on nationality is arguably unfair and triage based on nationality may not undermine public trust, after all. All things considered, there is a clear rationale for favoring nationality-based preferential treatment in Battlefield Triage. Adopting a nationality-based preference in this situation is more defensible than not. This does not make such a decision ethically right or just. Preference based on nationality is the least bad decision, but it is not morally blameless. It involves one in a serious moral wrong, a wrong otherwise avoided and contrary to one’s character. The virtuous military physician is in a situation in which obligations conflict, and we disagree with Gross, who posits that care of fellow soldiers “is important to the near exclusion of all else.”[33] Gross fails to appreciate the collective virtue of solidarity as applied to those in medicine. The military physician has duties to fellow soldiers but also to fellow physicians, to the medical community, and humanity. To favor a soldier on grounds of nationality violates her duties and responsibilities to this latter group. She is involved in a moral tragedy and can only seek the most just action given the circumstances, yet, at least in virtue ethics, the action remains far from blameless. CONCLUSION We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. As such, the virtuous military physician incurs a moral cost to acting as she does—there is a moral residue. However, despite being a moral tragedy, there are clear reasons to act in favor of treating one’s own, considering group solidarity. As such, these kinds of tragedies are resolvable: virtuous military physicians should favor treatment of their own, although they would do so with sorrow. - [1] Militaries set forth medical rules of eligibility or guidelines used to determine whether a person qualifies for specific medical interventions or treatments in certain circumstances, and these guidelines are binding for a military physician. For example, despite opposition from medical organizations, militaries have adopted reverse triage guidelines for military physicians to follow. For ethical discussion, see Falzone, Elisabeth, P. Pasquier, C. Hoffmann, O. Barbier, M. Boutonnet, A. Salvadori, A. Jarrassier, J. Renner, B. Malgras, and S. Mérat. "Triage in military settings." Anaesthesia Critical Care & Pain Medicine 36, no. 1 (2017): 43-51. https://doi.org/10.1016/j.accpm.2016.05.004 [2] There are issues that are related to this, including the triage of civilians and allied soldiers. We set related issues aside for purposes of this paper [3] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [4] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [5] This is termed the “dual loyalty” dilemma in military medicine and has been described at length elsewhere: Institute of Medicine (US) Board on Health Sciences Policy. Military Medical Ethics: Issues regarding Dual Loyalties: Workshop Summary. Washington (DC): National Academies Press (US); 2008. Toward a Framework for Resolving Dual Loyalties. Available from: https://www.ncbi.nlm.nih.gov/books/NBK214853/ [6] See Kenneth G. Swan and K.G. Swan, Jr., “Triage: The Past Revisited,” Military Medicine 161:8 (1996): 448–452. https://doi.org/10.1093/milmed/161.8.448; Jerome A. Singh, “American Physicians and dual loyalty obligations in the ‘war on terror,’” BMC Medical Ethics 4.4 (2003): 1–10. https://doi.org/10.1186/1472-6939-4-4; Beam, Thomas E. "Medical Ethics on the Battlefield." Military Medical Ethics: Sect. IV. Medical ethics in the military. Medical ethics on the battlefield: the crucible of military medical ethics 2 (2003): 369-402; Hereth, Blake. "Health justice for unjust combatants." Journal of Military Ethics 20, no. 1 (2021): 67-81. https://doi.org/10.1080/15027570.2021.1949782. [7] See Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. Gross, Michael L. "Comradery, community, and care in military medical ethics." Theoretical medicine and bioethics 32 (2011): 337-350. https://doi.org/10.1007/s11017-011-9189-6. Gross, Michael L. "The limits of impartial medical treatment during armed conflict." In Military medical ethics for the 21st century, pp. 71-84. Routledge, 2016. [8] World Medical Association, WMA Declaration of Lisbon on the Rights of the Patient. 5 December 2022, https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient/ [9] Geneva Convention for the Amelioration of the Condition of Wounded, Sick in Armed Forces in the Field. 12 August 1949. https://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.30_GC-I-EN.pdf. [10] List, Justin M. "Medical neutrality and political activism: physicians' roles in conflict situations." In Physicians at war: The dual-loyalties challenge, pp. 237-253. Dordrecht: Springer Netherlands, 2008. 240 [11] Beauchamp, T., and J. Childress. 2013. Principles of Biomedical Ethics, 7th ed. Oxford, United Kingdom: Oxford University Press. [12] Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. [13] Gross, "Comradery, community, and care in military medical ethics," 347. [14] Gross, “Comradery, community, and care in military medical ethics,” 349. [15] Gross, Michael L. "When medical ethics and military ethics collide." Narrative inquiry in bioethics 13, no. 3 (2023): 199-204. 202 https://dx.doi.org/10.1353/nib.2023.a924191 [16] Our argument draws on virtue ethics, from which care ethics derives, and it is worth clarifying how our argument relates to Gross’s. We do not think that the virtue of friendship grounds triage decisions, for we think it is unlikely that the physician and wounded soldier are friends. Instead, as explained below, we think the collective virtue of group solidarity better captures the moral significance of group loyalty and that Gross would agree with us. But since military physicians are part of distinct groups, with competing obligations, the military physician will be forced to sacrifice a value in battlefield triage cases. In other words, we think Gross downplays the dual group membership of a military physician. [17] List,”Medical neutrality and political activism,” 250. [18] Adams,”Triage priorities and military physicians,” 235. [19] London, Leslie, Leonard S. Rubenstein, Laurel Baldwin-Ragaven, and Adriaan Van Es. "Dual loyalty among military health professionals: human rights and ethics in times of armed conflict." Cambridge Quarterly of Healthcare Ethics 15, no. 4 (2006): 381-391. 383. [20] Hursthouse, R. On Virtue Ethics. OUP 1999. 74 [21] Nussbaum, Martha C. "The costs of tragedy: Some moral limits of cost-benefit analysis." The Journal of Legal Studies 29, no. S2 (2000): 1005-1036, 1007. [22] De Wijze, S. (2005). Tragic-remorse–the anguish of dirty hands. Ethical theory and moral practice, 7(5), 453-471, 457. https://doi.org/10.1007/s10677-005-6836-x [23] Hursthouse, 73 [24] Hursthouse, 81 [25] Hursthouse, 72 [26] Aristotle, Politics 1253a8. Reeve, C. D. C., Indianapolis: Hackett Publishing Co., 2017 [27] Aristotle, Nicomachean Ethics. III.6.114a, 34-35. 2002, Nicomachean Ethics, Christopher Rowe (trans.), Oxford: Oxford University Press [28] Byerly, T. Ryan, and Meghan Byerly. "Collective virtue." The Journal of Value Inquiry 50, no. 1 (2016): 33-50. https://doi.org/10.1007/s10790-015-9484-y; Federico, Veronica. "Conclusion: solidarity as a public virtue." Solidarity as a Public Virtue (2018): 495-542. https://doi.org/10.5771/9783845290058. Rehg, William. "Solidarity and the common good: An analytic framework." Journal of Social Philosophy 38, no. 1 (2007): 7-21. https://doi.org/10.1111/j.1467-9833.2007.00363.x [29] Byerly and Byerly. "Collective virtue." 43 [30] Battaly, Heather. "Solidarity: Virtue or vice?." In Social virtue epistemology, pp. 303-324. Routledge, 2022. 304 [31] Ibid., 2011: 341 [32] It might be thought that displaying altruism by helping an enemy combatant at the expense of one’s fellow soldier may be psychologically satisfiying. For evidence that military physicians find it difficult to treat enemy combatants, see Lundberg, Kristina, Sofia Kjellström, Anders Jonsson, and Lars Sandman. "Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties." Military medicine 179, no. 8 (2014): 821-826. https://doi.org/10.7205/MILMED-D-14-00038. Lamblin, Antoine, Clément Derkenne, Marion Trousselard, and Marie-Ange Einaudi. "Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study." BMC Medical Ethics 22 (2021): 1-13. https://doi.org/10.1186/s12910-021-00723-2 [33] Ibid., 2011: 344. (shrink)

Recently, many philosophers and psychologists have claimed that the explanation that grounds both passivity phenomena in the cognitive domain and passivity phenomena that occur with respect to overt actions is, along broad lines, the same. Furthermore, they claim that the best account we have of such phenomena in both scenarios is the “comparator” account. However, there are reasons to doubt whether the comparator model can be exported from the realm of overt actions to the cognitive (...) domain in general. There is a lingering worry concerning such explanations of thought insertion: the "What is compared to what?" problem. Here I examine two ways to tackle this problem. First: thought insertion consists of the misattribution of strings of inner speech which are not attenuated (thought insertion is thus another name for auditory verbal hallucinations). Second: thought insertion is misattributed inner speech which exhibits the same phenomenological characteristics as normal inner speech. After explaining the types of problem that each of these potential solutions faces, I conclude with a set of open questions that the comparator theorist has to tackle. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even (...) if such a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

Religion, environment, tradition, needs, and character determine the framework of people's eating habits. In this context, a special area is reserved for nutrition in the Qur'an. One of the prominent words in the relevant field is “rizq,” referring to things that Allah gives to all creatures for their own benefit. Broadly, children, spouse, action, knowledge, and wisdom can also be evaluated in this context. This study aims to reach detailed data on the subject by examining the verses where the (...) word rizq is mentioned in Surah al-Baqara in terms of language and rhetoric. In every language, but especially in the Arabic language, the words that make up the sentences, the forms of the words, the syntax of the sentence, the forms of expression, and the style are important while determining the meaning. First, the comparison method was applied in the determination of the eloquence subtleties that were taken as a basis in the study. By this method, we compared verses, sentences, and words with other related verses and possible/fictional sentences in different linguistic dimensions; determined the differences between them, and tested the results by applying them to the relevant text. Considering every linguistic structure in the Qur'anic style and investigating its meaning is essential for understanding the Qur'an. In such a reading, the presence as well as the absence of language elements should be taken into consideration and used effectively in determining the meaning. The words used in the Qur'an are fundamental because their presence or absence, the structure of words that they are used together, and the whole text constitute an important and different aspect of the conveyed message. In this paper, ten verses where the word rizq is mentioned in Surah al-Baqara are examined within the framework of the study method. Their application provides examples to a certain extent for the understanding of the specified method. Various data has been obtained about the concept of rizq as reflected in general social life. As rizq, the foods must be healthy and tasty as well as halal in terms of their ingredients and acquisition. The desire for foods of human body may vary according to various factors. However, prohibitions on food are based on reasonable, scientific, or religious reasons. The moral and philosophical dimensions of the subject are always present in the background of these justifications. One of the duties assigned to human beings is to obtain rizq within the framework of the possibilities and capabilities given to them in the world and to distribute it, if any, to those they are responsible for, creatures, and other needy people. It is a requirement of faith to utilize the rizq by considering its raison for existence and to ensure that the way of acquisition is legal and ethical. Legitimate acquisition, sharing, and distribution of what is acquired is primarily related to the sense of conscience. Therefore, it is not in the nature of faith to interfere with what is given to animals, plants, and other people as rizq. From this point of view, infaq plays an important role in understanding the concept of rizq. The Qur'an strongly expresses the desire of man to be fair and generous in the sharing of rizq. (shrink)

This is a comparative study on the 20th's century's Western philosophy Hannah Arendt(1906-1975) and the 16th century's Eastern Confucian thinker Wang Yang-ming(1472-1529). Wang-ming was a Neoconfucian thinker of the 16th century China. In his time, Chinese intellectual world was dominated by Neoconfucian Ch’eng-Chu School which laid much stress on scholastic work of learning. Yang-ming saw a huge obstacle of intellectualism in Ch’eng-Chu school’s theoretical scholasticism that emphasized overly book-learning to be required on the way to become a genuine person. (...) He recognized this kind of rigidintellectualism as the true reason for the dichotomy in his time between knowledge and action, between learning and life, and between selfcultivation and social practice. According to his view, the dichotomy brought about serious political corruption and oppressed human creativity up to the point of total institutionalization of “truth”. Hannah Arendtwas sickened under the severe totalitarianism of the 20th century, especially as a Jew under the German Nazism. She undertook an extensive analysis of how Western civilization generated totalitarian imperialism, fascism, and communism, going through the modern times, all of which made human beings’ language and action superfluous, erupted, and destroyed. Through these experiences, she became disgusted with traditional Western hierarchy of thinking and doing, philosophy and politics, theory and practice, in short, vita contemplativa and vita activa. Although they both lived far away from each other in space and time and used completely different languages, they both, in my view, shared many common problems and concerns, not only in the contents of their thoughts but also in the way and form of construction of thoughts. To the similar extent that people were warned and judged by both thinkers respectively in their times of the totalitarianism of making human beings superfluous and puppet-like, we human beings in the 21st century are considered to be threatened by the totalitarian nullification caused by modern utilitarianism, automation, consumerism, etc. These principles are practiced limitlessly and boundlessly, so that our whole lives of politics, culture, and education are now suffering from that threat. It is my conviction that we can acquire some guide and wisdom from the twothinkers of East and West, because they discovered possible solutions of how to restore and revive human beings’ capacities of thinking and judging, and how to bring action and doing. (shrink)

The epistemic stances of both Whitehead and the Book of Changes are founded on the assumption that process is reality; there are important resonances with respect to perception, meaning and significance. Such a process-oriented approach is productive for developing non-representational and non-dualistic theories in the fields of epistemology, philosophy of language and philosophy of mind. An exploration of these resonances will further provide an appropriate foundation for dialogue between the philosophy of the Book of Changes and that of (...) contemporary Euro-American philosophy. The important differences between the Book of Changes and Whiteheadian philosophy will also become apparent. (shrink)

MACDONNELL JA. Nursing Inquiry 2011; 18: 313–324 Gender, sexuality and the participatory dimensions of a comparative life history policy studyIn this paper, I explore how a critical feminist lens was a crucial element in creating a participatory policy study which used a qualitative design and comparative life history methodology. This study focused on Canadian nurses’ political practice related to advocacy for lesbian health. Findings show that the combination of the gender lens and life history approach offers potential to create (...) knowledge in ways aligned with health‐promoting and emancipatory outcomes. However, the nature of participation and interaction by researcher and participants is contexualized and contested given complex dynamics of power that shape all aspects of this doctoral study process. The critical feminist lens with its focus on reflexivity informed the content and process of knowledge production in this study and shaped key turning points: the ways in which this policy study was conceptualized, the choice of comparative life history methodology, ethical considerations, data collection and analysis and representation of findings. Life history is unlikely to be the methodology that first comes to mind when undertaking a policy study. Its historical roots are associated with biographical, oral history and narrative approaches, which typically aim to elicit understanding of lived experience. Yet, it was this very aspect, this focus on lived experience, which rendered life history methodology fitting as I contemplated how to examine the relationship between nurses and policy. I was interested in understanding nurses’ political practice, how policy influenced nurses’ capacity to advocate in their everyday lives, as well as nurses’ impacts on policy processes and their larger social worlds. (shrink)

Modeling dynamic networks has attracted much interest in recent years, which helps understand networks’ behavior. Many works have been dedicated to modeling discrete-time networks, but less work is done for continuous-time networks. Point processes as powerful tools for modeling discrete events in continuous time have been widely used for modeling events over networks and their dynamics. These models have solid mathematical assumptions, making them interpretable but decreasing their generalizability for different datasets. Hence, neural point processes were introduced that don’t (...) have strong assumptions on generative functions. However, these models can be impractical in the case of a large number of event types. This research presents a comparative study of different point process models for continuous-time networks. Furthermore, a previously introduced neural point process model is applied for modeling network interactions. In this work, network clustering is used for specifying interaction types. These methods are compared using different synthetic and real-world datasets, and their efficiency is evaluated on these datasets. The experiments represent that each model is appropriate for a group of datasets. In addition, the effect of clustering on results is discussed, and experiments for different clusters are presented. (shrink)

This article discusses a number of metaphors about the nature of science, in connection with three types of metaphysical realism: minimal, moderate and essentialistic realism. From the beginning, Kuipers accepts the first and rejects the third type of realism, but it is only later on that he endorses the second type. It is argued that this makes his remarks on essentialistic realism somewhat misleading; and his moderate realism is compared with some realist positions taken by other philosophers. It (...) is further argued that the metaphors of the mirror, the net and the map correspond to essentialistic, minimal and moderate realism, respectively. This explains why the map metaphor is by far the most suitable one in the context of Kuipers' theory of science. This does not imply, however, that it is the (only) true one and that the others are false. (shrink)

Consumers can have difficulty expressing their buying intentions on an explicit level. The most common explanation for this intention-action gap is that consumers have many cognitive biases that interfere with decision making. The current resource-rational approach to understanding human cognition, however, suggests that brain environment interactions lead consumers to minimize the expenditure of cognitive energy. This means that the consumer seeks as simple of a solution as possible for a problem requiring decision making. In addition, this (...) resource-rational approach to decision making emphasizes the role of the principle of Occam’s Razor, inductive inference, and Bayesian reasoning by illuminating the human-environment relationship. This paper introduces the Consumer Contextual Decision-Making Model (CCDMM). Based on the CCDMM, two hypothetical strategies of consumer decision making will be presented. First, the SIMilarity-Strategy (SIMS) is one in which most of a consumer’s decisions in a real-life context are based on prior beliefs about the role of a commodities specific to real-life situation being encountered. Because beliefs are based on previous experiences, consumers are already aware of the most likely consequences of their actions. At the same time, they do not waste time on developing contingencies for what, based on previous experience, is unlikely to happen. Second, the What-is-Out-there-in-the-World-Strategy (WOWS) is one in which prior beliefs do not work in a real-life situation, requiring consumers to update their beliefs. The principle argument being made is that most experimental consumer research describes decision making based on the WOWS, when participants cannot apply their previous knowledge and situation-based strategy to problems. The article analyses sensory and cognitive biases described by behavioral economists from a CCDMM perspective, followed by a description and explanation of the typical intention-action gap based on the model. Prior to a section dedicated to discussion, the neuroeconomic approach will be described along with the valuation network of the brain, which has evolved to solve problems that the human has previously encountered in an information-rich environment. The principles of brain functions will also be compared to CCDMM. Finally, different approaches and the future direction of consumer research from a contextual point of view will be presented. (shrink)

The stated purpose of the Diagnostic and Statistical Manual of Mental Disorders is to classify mental disorders. However, no tenable operational definition of mental disorder is offered in the manual. This leaves the possibility open that the behaviors labeled as disordered in the DSM are not members of a valid category. Attempts to define mental illness fall into the category of essentialist or relativist based, respectively, on the acceptance or denial of the existence of a defining biological attribute (...) class='Hi'>that all mental disorders possess. However, the disorders in the DSM cannot be accounted for by either of these approaches making it unlikely that they represent a single valid concept. Simultaneous inclusion of brain illnesses and normal behaviors in the DSM are a likely explanation for the disparate nature of DSM disorders. (shrink)

MetaphysicsZ.ll has in recent years received considerable attention, because of its importance for the exposition of Aristotle's psychology, which for some time now has been an immensely popular topic among Aristotelian scholars. Z.ll has proved contentious, however, especially over its statement of Aristotle's criticism of Socrates the Younger, who was wont to make a certain ‘comparison’ in the case of animals. Virtually nothing is known about this Socrates the Younger, nor is it known exactly what ‘comparison’ he made with (...) animals. But, as most interpreters suppose from the context of Z. 11, his comparison certainly had much in common with that made by ‘some', who argue that natural objects, like man, are comparable to geometrical figures, like the circle, with respect to their relationship to their matter. Just as the physical matter of circles, such as bronze, stone, and the like, are no part of the essence of the circle, so too the physical matter of man—flesh and bones—is no part of the essence of man. This comparison may hold true, even if, unlike circles, man is in fact found only in a single sort of matter, because the case of man may be like the counterfactual case in which all circles happen to be made of bronze. The bronze would still not belong to the essence of the circle; it would just be difficult psychologically to separate circularity from bronze. (shrink)

In order to prepare bioethics and clinical ethics courses for clinicians in Turkey, we needed to know the attitudes of physicians when placed in ethically difficult care situations. We presented four cases to 207 physicians who are members of the Physicians’ Association in Kocaeli, Turkey. Depending on the decisions they made in each case, we determined whether they were aware of the ethical aspects of the cases and the principles they chose as a basis for their decisions. We aimed to (...) gain information about their ethical tendencies and moral sensitivity. A small number of physicians stated that they would ‘show respect for a patient’s living will’ in the first case, but more stated that they would ‘let the patient refuse the treatment’ in the second. In the third case, where medical confidentiality was the significant ethical issue, most of the physicians said that they would act in order to maintain confidentiality. For the last case, more than half the physicians chose to ‘tell the truth’ to the patient. The paternalism shown in the doctors’ decisions on the first two cases was no longer observed in those made for the last two cases. We concluded that the physicians who participated in our study have low sensitivity to living wills (or advance directives) and patients refusing treatment. However, when issues of medical confidentiality and truth-telling are concerned, they take care to protect the autonomy of the individual and are relatively more aware of the ethical aspects of these cases. (shrink)

Background Respect for autonomy is a key principle in bioethics. However, respecting autonomy in practice is complex because most people define themselves and make decisions influenced by a complex network of social relationships. The extent to which individual autonomy operates for each partner within the context of decision-making within marital or similar relationships is largely unexplored. This paper explores issues related to decision-making by couples for health care and the circumstances under which such a practice should be respected as (...) compatible with autonomous decision-making. Discussion We discuss the concept of autonomy as it applies to persons and to actions, human interdependency and gender roles in decision-making, the dynamics and outcomes of couples’ joint decision-making, and the ethics of couples’ joint decision-making. We believe that the extent to which couples’ joint decision-making might be deemed ethically acceptable will vary depending on the context. Given that in many traditional marriages the woman is the less dominant partner, we consider a spectrum of scenarios of couples’ joint decision-making about a woman’s own health care that move from those that are acceptably autonomous to those that are not consistent with respecting the woman’s autonomous decision-making. To the extent that there is evidence that both members of a couple understand a decision, intend it, and that neither completely controls the other, couples’ joint decision-making should be viewed as consistent with the principle of respect for the woman’s autonomy. At the other end of the spectrum are decisions made by the man without the woman’s input, representing domination of one partner by the other. Conclusions We recommend viewing the dynamics of couples’ joint decision-making as existing on a continuum of degrees of autonomy. This continuum-based perspective implies that couples’ joint decision-making should not be taken at face value but should be assessed against the specific cultural, ethnic, and religious backgrounds and personal circumstances of the individuals in question. (shrink)