Background Defensive medicine is physicians’ deviation from standard medical care which is primarily intended either to reduce or avoid medico legal litigation. Although the Federal Ethics Committee review in Ethiopia has shown that applications for medical/surgical error investigation claims are increasing at an alarming rate, there is no study to date done to estimate the degree of defensive practice done by the physicians with an intention of avoiding this increasing legal claim. This study assessed the practice of defensive medicine among (...) highly litigious disciplines (surgery) and described factors associated with its practice. Methods Cross sectional quantitative study using online survey questionnaires was conducted to assess the degree of defensive practice and six factors (age, years of experience, specialty, monthly income, place of practice and previous medico legal history) associated with its practice were assessed among surgeons working in Ethiopia. Results A total of 430 surgeons directly received an online survey questionnaire and 236 of them successfully completed the questionnaire making the response rate 51.2%. Nearly half of the study participants (51.7%) were aware of the concept of defensive medicine and 174 (74%) reported performing one form of defensive practice. Twenty-nine (12.3%) of the participants have legal dispute history, though only 1.3% of them ended up in penalty. Avoiding high risk procedures was the commonest defensive act performed by 60% of the participants, followed by ordering tests unnecessarily (52.1%). Multinomial logistic regression model showed that there was no association between age of the participant, place of practice, year of experience and defensive practice. This model also showed that cardiothoracic and vascular surgeons perform less defensively than surgeons with other specialty with P value of 0.02. Conclusion The practice of defensive medicine is widespread among surveyed Ethiopian surgeons and further studies are required to objectively estimate the effect of defensive practice on the health care system of the country. Policy makers need to develop strategy towards decreasing this high rate of defensive practice. (shrink)

Shared activity is often simply willed into existence by individuals. This poses a problem. Philosophical reflection suggests that shared activity involves a distinctive, interlocking structure of intentions. But it is not obvious how one can form the intention necessary for shared activity without settling what fellow participants will do and thereby compromising their agency and autonomy. One response to this problem suggests that an individual can have the requisite intention if she makes the appropriate predictions about fellow participants. I argue (...) that implementing this predictive strategy risks derailing practical reasoning and preventing one from forming the intention. My alternative proposal for reconciling shared activity with autonomy appeals to the idea of acting directly on another's intention. In particular, I appeal to the entitlement one sometimes has to another's practical judgment, and the corresponding authority the other sometimes has to settle what one is to do. (shrink)

What is it for a duty or obligation to be directed? Thinking about paradigmatic cases such as the obligations generated by promises will take us only so far in answering this question. This paper starts by surveying several approaches for understanding directed duties, as well as the challenges they face. It turns out that shared agency features something similar to the directedness of duties. This suggests an account of directedness in terms of shared agency – specifically, in terms of the (...) so-called practical intimacy that holds between individuals when they act together. The final section addresses a challenge to the shared agency approach posed by legal wronging in tort law. (shrink)

Immediately before the release of DSM-5, a group of psychiatric thought leaders published the results of field tests of DSM-5 diagnostic criteria. They characterized the interrater reliability for diagnosing major depressive disorder by two trained mental health practitioners as of “questionable agreement.” These field tests confirmed an open secret among psychiatrists that our current diagnostic criteria for diagnosing major depressive disorder are unreliable and neglect essential experiences of persons in depressive episodes. Alternative diagnostic criteria exist, but psychiatrists rarely encounter them, (...) forestalling the discipline’s epistemological crisis. In Alsadair MacIntyre’s classic essay, such crises occur in science when a person encounters a rival schemata that is incompatible with their current schemata and subsequently constructs a narrative that allows them to reconstruct their own tradition. In search of rival schemata that are in conversation with their own tradition, psychiatric practitioners can utilize alternative diagnostic criteria like the Cultural Formulation Interview, embrace an epistemologically humble psychiatry, and attend to the narrative experience of a person experiencing a depressive episode. (shrink)

This text proposes an interpretation of the work of Franklin Leopoldo e Silva based on the reading of some of his numerous published articles and books, without neglecting the classes and guidance received from the stage of Scientific Initiation to Postdoctoral studies. Precisely, by highlighting the importance of three thinkers widely studied by Professor Franklin – Berkeley, Bergson and William James –, we suggest that at the heart of this philosophical experience there would be a constant: empiricism. Whether in the (...) classical or radical version, the line we draw in this multiplicity reveals an openness to concrete empiricism. (shrink)

This paper examines the deontic logic of the Talmud. We shall find, by looking at examples, that at first approximation we need deontic logic with several connectives: O T A Talmudic obligation F T A Talmudic prohibition F D A Standard deontic prohibition O D A Standard deontic obligation. In classical logic one would have expected that deontic obligation O D is definable by $O_DA \equiv F_D\neg A$ and that O T and F T are connected by $O_TA \equiv F_T\neg (...) A$ This is not the case in the Talmud for the T (Talmudic) operators, though it does hold for the D operators. We must change our underlying logic. We have to regard {O T , F T } and {O D , F D } as two sets of operators, where O T and F T are independent of one another and where we have some connections between the two sets. We shall list the types of obligation patterns appearing in the Talmud and develop an intuitionistic deontic logic to accommodate them. We shall compare Talmudic deontic logic with modern deontic logic. (shrink)

The book that the French reader holds in his hands is one of the century’s most fascinating and liberating. It does nothing less than instigate the psychoanalytic approach as a universal method of...

As a site of colonial conquest, sub-Saharan Africa has experienced colonialism’s historic and continuing harms. One of the aspects of this harm is epistemic. In the analytic philosophical tradition, this harm can partly be theorised in line with the literature on epistemic injustice, although it does not fit squarely. I show this by arguing for what can be understood as a colonial state’s specific manifestation of epistemic injustice. This manifestation takes into account the historical context of colonisation and the continuing (...) coloniality of sub-Saharan African countries. From this, I argue for an approach to remediating this epistemic injustice that relies on the fair-minded pursuit of knowledge. This approach, I briefly argue, gains valuable insights from African epistemological traditions and can be beneficial to other epistemic injustice instances that result specifically from historical cases of oppression. (shrink)

You and I are going to die. We are aware that it is going to happen, but not exactly when—in which there is relief, but also anxiety. What happens to us when we know with some precision what our last day will be? In this text, we discern the process of our own death, once we have reliable information about the approximate moment of the cessation of our life. Tú y yo vamos a morir. Estamos al tanto de que va (...) a ocurrir, pero no exactamente cuándo —en lo cual hay alivio, pero también angustia—. ¿Qué nos ocurre al saber con cierta precisión cuál será nuestro último día? En este texto, discernimos el proceso de nuestra propia muerte, una vez que tenemos información confiable sobre el momento aproximado del cese de nuestra vida. (shrink)

This volume includes all Dewey's writings for 1938 except for Logic: The Theory of Inquiry, as well as his 1939 Freedom and Culture, Theory of Valuation, and two items from Intelligence in the Modern World. Freedom and Culture presents, as Steven M. Cahn points out, the essence of his philosophical position: a commitment to a free society, critical intelligence, and the education required for their advance.

RESUMENEl concepto de acontecimiento tiene en la obra de Žižek una función predominantemente política, pese a que su realización es deudora de la ontología que el esloveno desarrolla. Una de sus finalidades fundamentales será dilucidar si se puede distinguir entre un acontecimiento y un acto. En caso afirmativo, este último pasaría aconsiderarse com o el modo mediante el cual una subjetividad se relaciona con el acontecimiento. El objetivo que persigue el pensador esloveno es ayudar con esta concepción al desarrollo de (...) una alternativa al capitalismo.PALABRAS CLAVEACTO, ACONTECIMIENTO, CAPITALISMO, FANTASMAABSTRACTThe concept of event has an ultimately political role in Žižek’s work despite its realization is indebted to the development of Žižek’s ontology. One of his main purposes will be to clarify whether it’s possible to differentiate event from act. If so, actwould become the means by which subjectivity relates to event. Žižek’s target is to use this concept to help develop an alternative to capitalism.KEYWORDSACT, EVENT, CAPITALISM, GHOST. (shrink)

Phenomenology is an emerging field within the broader domain of African and Africana philosophy. The phenomenological method, with its various approaches to studying the meaning of lived experience, is at the core of the thought of African philosophers such as Paulin Hountondji, Dismas A. Masolo, Achille Mbembe, Mabogo More, Tsenay Serequeberhan, Noel Chabani Manganyi, and proponents of Africana Philosophy such as WEB Du Bois, Frantz Fanon, Lucius Outlaw, Lewis Gordon, George Yancy, and Linda Martin Alcoff. Technically, the term “African phenomenology” (...) is not used as widely, or introduced as systematically, as Africana phenomenology. The aim of this chapter is to introduce some of the central issues and theorists of the field of African phenomenology. As the subtitle of this chapter indicates, its scope is limited to what one may call introductory perspectives in African phenomenology. The idea is to outline for further investigation some thematically related contributions to African phenomenology with specific reference to the grounding work of Paulin Hountondji as related to works of Kwasi Wiredu and Dismas A. Masolo. Hountondji’s critical adoption of Husserl’s classic phenomenological approach offers a broad, foundational scope, which makes it particularly suitable for a basic introduction to African phenomenology. (shrink)

ABSTRACT:Biomedical and philosophical traditions postulate the experience of pain either as quantifiable or as sociocultural phenomena. This critical assessment offers a close reading of Lara Parker’s Vagina Problems: Endometriosis, Painful Sex, and Other Taboo Topics (2020) and Abby Norman’s Ask Me About My Uterus: A Quest to Make Doctors Believe in Women’s Pain (2018), analyzing the authors’ use of language as a tool to comprehend and communicate pain. Norman’s and Parker’s memoirs narrate the lived experience of endometriosis, a condition diagnosed (...) almost exclusively in women and characterized by chronic pain. The essay looks at how metaphors are employed in living and narrating endometriosis in medical, social, and cultural settings that are highly skeptical of women’s pain and trace a shift in the use of pain metaphors towards an acceptance of the pain experience, which is conceptualized as empowering by the climax of the narrative. (shrink)

We consider conditionals of the form A ⇒ B where A depends on the future and B on the present and past. We examine models for such conditional arising in Talmudic legal cases. We call such conditionals contrary to time conditionals.Three main aspects will be investigated: Inverse causality from future to past, where a future condition can influence a legal event in the past (this is a man made causality).Comparison with similar features in modern law.New types of temporal logics arising (...) from modelling the Talmudic examples. We shall see that we need a new temporal logic,which we call Talmudic temporal logic with linear open advancing future and parallel changing past, based on two parameters for time. (shrink)

Nul n'était mieux qualifié que l'autour de ce livre - docteur en philosophie et rabbin de la synagogue de Birmingham - pour entreprendre le véritable tour de force qu'il a réussi en réalisant la synthèse de l'enseignement contenu dans le Talmud. La richesse de son information n'a d'égale que la maîtrise avec laquelle il répartit son savoir en une suite de chapitres aussi clairs que précis. Cet ouvrage, pendant longtemps encore, rendra d'inestimables services à ses lecteurs.

In the early twentieth century Walter Benjamin introduced the idea of epochal and ongoing progression in interaction between mind and the built environment. Since early antiquity, the present study suggests, Benjamin’s notion has been manifest in metaphors of gender in city-form, whereby edifices and urban voids have represented masculinity and femininity, respectively. At the onset of interaction between mind and the built environment are prehistoric myths related to the human body and to the sky. During antiquity gender projection can be (...) detected in western perceptions linking natural and built environments, commencing with Plato’s Atlantis and his Myth of Er, and later as a likely import of the Chinese yin-yang mythology. Culminating with the Age of Discovery, alongside advances in experiential awareness of the Earth’s sphericity, respective feminine and masculine earmarks can be detected in early modern perspicacity of the Earth’s southern and northern hemispheres. Our conceptions of natural and built environments inherently continue to contain gender traits. Yet urban voids, as the feminine face of city-form, have been severely understated in the built environment. Through design and configuration of urban voids, allegories of femininity in city-form ought to be celebrated, not discarded. (shrink)

I have developed transcendental arguments to refute several versions of Nick Bostrom’s simulation hypothesis. I called some of these arguments the SIM-style argument. In this paper, I have four main aims. First, I employ the SIM-style argument to remedy a defect in Hilary Putnam’s Brain-in-vat argument. Second, I show that the most radical skepticism, which Tim Button called the nightmarish Cartesian skepticism, can be refuted by the SIM-style argument or by another transcendental argument I develop here. Third, I compare my (...) approach to radical skepticisms with Donald Davidson’s, as it is often regarded as an exemplar of transcendental arguments. Fourth, I explain how the prominent objections, mainly developed by Barry Stroud, to transcendental arguments can incur two undesirable results: psychologism and Kantian skepticism. (shrink)

Jakovljevic and Crnčevic review the concept of comorbidity in relation to mental disorders, which is timely. Yet they seem to ignore a longstanding and important notion of comorbidity, highlighted in psychiatry particularly by Sigmund Freud. The ignored notion is that of compensatory comorbidity. Compensatory comorbidity is a special case of compensatory phenomena in relation to disrupted health.

In this Article we explore the evolution of property law and examine the applicability of the prevailing accounts according to which property institutions oscillate between the extreme points of open access and private property. We show that the evolution of property is a much more nuanced process, shaped by the interplay of the following three dimensions: number of owners, extent of dominion and asset configuration. Accordingly, property institutions can assume a myriad of positions along the aforementioned dimensions in response to (...) the constant change in exclusion and management costs. We demonstrate our theory by discussing examples of three dimensional adjustments of real, personal and intellectual property. (shrink)

This volume presents the concept of Ecoscape as spatial interrelations, or spatially patterned processes, that are constitutive of an environment_an ecosystem. Contributors investigate environmental issues concerning the human impact on geohistory, food distribution, genetically modified biota, waste management, scientific mapping, and the rethinking of human identity.

Clinical medicine is an inexact science. In situations of uncertainty, we often ask an experienced colleague for a second opinion. But what if one could effectively call upon the experience of thou...

The assessment of student learning is widely regarded with suspicion. Philosophers in particular have been reluctant to take this practice seriously. The essay reviews an ongoing effort to assess the development of philosophical dispositions among undergraduate students at a religiously affiliated liberal arts college. The procedure used in this effort as well as the results obtained so far strongly suggest that the deep learning valued most highly by philosophy teachers can be measured without harm to the teaching enterprise. The essay (...) argues that in light of a current cultural climate that fails to recognize the value of our enterprise, philosophers would be well advised to clearly define our particular learning goals, develop our own instruments, and to exercise more initiative in assessing our students learning. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Raimon Panikkar (1918-2010):Life and LegacyJ. Abraham Vélez de CeaThe interreligious theologian, intercultural philosopher, and pluralist mystic Raimon Panikkar died in Tavertet, Barcelona, on 26 August 2010. He was ninety-one. A pioneer of interreligious dialogue and comparative theology, Panikkar claimed to be at the same time yet without contradiction a Christian, a Buddhist, a Hindu, and a secular man.Panikkar's multiple religious belonging was not a matter of choice and (...) shallow eclecticism but rather a matter of personal experience and profound spiritual growth. His distinction between eclecticism and syncretism might be helpful to understand the complex nature of his religious identity. Eclecticism "is an uncritical mixture of religious traditions and an agreement among them obtained by chopping off all possible discrepancies in favor of an amorphous common denominator." On the contrary, syncretism "is allowing for a possible assimilation of elements by virtue of which these elements cease to be foreign bodies so that organic growth within each tradition is possible, and the mutual fecundation of religious traditions becomes a genuine option."1Another point I would like to clarify is that Panikkar's multiple religious belonging was not a question of being primarily Christian and secondarily something else, as if truth could be quantified. Panikkar objected to this "modern" way of thinking. I remember a conversation with him about this issue in which he compared these attempts to quantify religious identity to those who try to understand the Trinity as being either one or three. He said that if you begin counting you miss the point, and then he added in a defiant tone: "I am 100 percent Christian, 100 percent Hindu, 100 percent Buddhist, and 100 percent secular." When I insisted and told him that for many people multiple religious belonging is just not possible, Panikkar replied: "Well, it is my experience; I cannot help it."Panikkar's multiple religious belonging was often misunderstood and cost him the distrust of both Christians and Hindus. For instance, in 1966, Panikkar applied for a chair in Hindu philosophy at the prestigious Banaras Hindu University. Though [End Page 215] everybody agreed he was by far the most competent candidate, he was not offered the position because for many conservative Hindus Panikkar was not Hindu enough.Similarly, many conservative Catholics today would say that Panikkar went too far with his distinction between Christ and the historical Jesus; for them Panikkar was not Christian enough. However, this would be unfair. As I understand Panikkar, he was not trying to undermine any Christian claim. Quite the contrary, he was challenging what he perceived as a tribal Christology and a reduction of Christianity to a two-thousand-year-old sect. Time will tell, like it did with great thinkers such as Nāgārjuna (ca. 150-250), Śaṅ-kara (788-820), Thomas Aquinas (1225-1274), and Meister Eckhart (ca. 1260-1327), who were also criticized at first by their respective traditions. Perhaps Panikkar was simply ahead of his time, and what today seems controversial to some will become the norm in the future; it would not be the first time.Panikkar was an embodiment of interreligious dialogue, and his theology was the result of such dialogue. He was born in Barcelona on 3 November 1918. His mother was a Catholic from Catalonia, and his father was a Hindu from Kerala, India. After studying philosophy and natural sciences in Barcelona, Madrid, and Bonn, he joined the recently created Opus Dei in 1940. It should be clarified that in the aftermath of the Spanish civil war and compared to the pre-Vatican II National Catholicism of Franco's regime, Opus Dei was a progressive Catholic organization for laypeople interested in sanctifying their professional work.Panikkar was ordained a Catholic priest in 1946 and became the chaplain of a student dormitory in Madrid (Colegio Mayor la Moncloa). That very year he earned his first doctorate, in philosophy, with a dissertation titled El concepto de naturaleza: Análisis histórico y metafísico de un concepto (Complutense University of Madrid, 1946, published in 1951). He was offered a position at the Complutense University but decided to continue with his pastoral work in Madrid, Barcelona... (shrink)

Book reviewed in this article: Mama Might Be Better Off Dead: The Failure of Health Care in Urban America. By Laurie Kaye Abraham. Not All of Us Are Saints: A Doctor's Journey with the Poor. By David Hilfiker.

Ancient Peripatetics and Neoplatonists had great difficulty coming up with a consistent, interpretatively reasonable, and empirically adequate Aristotelian theory of complete mixture or complexion. I explain some of the main problems, with special attention to authors with whom Avicenna was familiar. I then show how Avicenna used a new doctrine of the occultness of substantial form to address these problems. The result was in some respects an improvement, but it also gave rise to a new set of problems, which were (...) later to prove fateful in the history of early modern philosophy. (shrink)

Abraham Verghese proposes to renew medicine by training physicians to read the right texts—literary fiction and patients' bodies—with skilled attention. Analyzing Verghese's proposal with reference to Foucault's idea of the "clinical gaze," I find that Verghese conceives of patients as texts that only physicians can read, meaning that physicians become the storytellers of the bodies, lives, and deaths of the people they meet as patients. I conclude that Verghese's project is unsustainable and alternatively propose thinking analogically of physicians as (...) ship captains who maintain therapeutic distance to reopen interpretative spaces for communities outside of medicine. (shrink)