Research teams have made considerable progress in treating absolute uterine factor infertility through uterus transplantation, though studies have differed on the choice of either deceased or living donors. While researchers continue to analyze the medical feasibility of both approaches, little attention has been paid to the ethics of using deceased versus living donors as well as the protections that must be in place for each. Both types of uterus donation also pose unique regulatory challenges, including how to allocate donated organs; (...) whether the donor / donor's family has any rights to the uterus and resulting child; how to manage contact between the donor / donor's family, recipient, and resulting child; and how to track outcomes moving forward. (shrink)

Environmental problems often outstrip the abilities of any single scientist to understand, much less address them. As a result, collaborations within, across, and beyond the environmental sciences are an increasingly important part of the environmental science landscape. Here, we explore an insufficiently recognized and particularly challenging barrier to collaborative environmental science: value pluralism, the presence of non-trivial differences in the values that collaborators bring to bear on project decisions. We argue that resolving the obstacles posed by value pluralism to collaborative (...) environmental science requires detecting and coordinating the underlying problematic value differences. We identify five ways that a team might coordinate their problematic value differences and argue that, whichever mode is adopted, it ought to be governed by participatory virtues, pragmatic resolve, and moral concern. Relying on our experiences with the Toolbox Dialogue Initiative, as well as with other dialogical approaches that support team inquiry, we defend the claim that philosophical dialogue among collaborators can go a long way towards helping teams of environmental scientists and fellow travelers detect their problematic value differences. Where dialogical approaches fare less well is in helping teams coordinate these differences. We close by describing several principles for augmenting philosophical dialogue with other methods, and we list several of these methods in an appendix with brief descriptions and links for further learning. Overall, the article makes three main contributions to the research collaboration and values in science literatures: It deepens our understanding of problematic value pluralism in team science; It provides actionable guidance and methods for improving values-oriented philosophical dialogue interventions; and It demonstrates one way of doing engaged philosophy. (shrink)

Bethany Henning argues that within the naturalistic strains of American philosophy, there is an implicit theory of the unconscious that finds its fullest expression within the work of John Dewey. Although the unconscious contributes to all experience, it plays a principal role in experiences that are emphatically aesthetic.

Treatment of military-related posttraumatic stress disorder is a major public health care concern. Since 2001 over 2.5 million troops have been deployed to Iraq or Afghanistan, many of whom have experienced direct combat and sustained threat. Estimates of PTSD rates related to these wars range from 8% to over 20%, or 192,000 to 480,000 individuals. Already, nearly 250,000 service members of Operations Enduring Freedom, Iraqi Freedom, and New Dawn have sought VA health care services for PTSD. This recent increased need (...) for mental health services comes in addition to the ongoing needs of Vietnam-era and other veterans who continue to suffer from PTSD. PTSD is related to high co-morbidities of other mental health difficulties, poorer physical health status, and increased medical care utilization. Such high demand for services is an important contributor to the large cost associated with combat-related PTSD. Accordingly, promoting successful, cost-effective treatment strategies for PTSD is a chief public health care priority. (shrink)

In response to the Covid‐19 pandemic, health care systems worldwide canceled or delayed elective surgeries, outpatient procedures, and clinic appointments. Although such measures may have been necessary to preserve medical resources and to prevent potential exposures early in the pandemic, moving forward, the indirect effects of such an extensive medical shutdown must not outweigh the direct harms of Covid‐19. In this essay, we argue for the reopening of evidence‐based health care with assurance provided to patients about the safety and necessity (...) of high‐value vaccinations, screenings, therapeutics, and procedures. To ensure that virtually all non‐Covid‐related services do not come to a halt again, health care systems and physician practices must preemptively increase their capacity, secure adequate personal protective equipment to safeguard health care personnel, and develop a measured approach to reclosing such routine health care, should it become necessary in the future. (shrink)

Do cultural models facilitate particular ways of perceiving interactions in nature? We explore variability in folkecological principles of reasoning about interspecies interactions. In two studies, Indigenous Panamanian Ngöbe and U.S. participants interpreted an illustrated, wordless nonfiction book about the hunting relationship between a coyote and badger. Across both studies, the majority of Ngöbe interpreted the hunting relationship as cooperative and the majority of U.S. participants as competitive. Study 2 showed that this pattern may reflect different beliefs about, and perhaps different (...) awareness of, plausible interspecies interactions. Further probes suggest that these models of ecological interaction correlate with recognition of social agency in nonhuman animals. We interpret our results in terms of cultural models of nature and nonhuman agency. (shrink)

Human connection is universally important, particularly in the context of serious illness and at the end of life. The presence of close family and friends has many benefits when death is close. Hospital visitation restrictions during the Coronavirus pandemic therefore warrant careful consideration to ensure equity, proportionality, and the minimization of harm. The Australian and New Zealand Society for Palliative Medicine COVID-19 Special Interest Group utilized the relevant ethical and public health principles, together with the existing disease outbreak literature and (...) evolving COVID-19 knowledge, to generate a practical framework of visiting restrictions for inpatients receiving palliative and end-of-life care. Expert advice from an Infectious Diseases physician ensured relevance to community transmission dynamics. Three graded levels of visitor restrictions for inpatient settings are proposed, defining an appropriate level of minimum access. These depend upon the level of community transmission of COVID-19, the demand on health services, the potential COVID-19 status of the patient and visitors, and the imminence of the patient’s death. This framework represents a cohesive, considered, proportionate, and ethically robust approach to improve equity and consistency for inpatients receiving palliative care during the COVID-19 pandemic and may serve as a template for future disease outbreaks. (shrink)

A request that an ethics committee or consultant analyze the ethical issues in a case, delineate ethical options, or make a recommendation need not automatically but often does elicit legal information. In a recent book in which ethics consultants described cases on which they had worked, almost all cited a legal case or statute that had shaped the consultation process. During a period of just a few months, case consultation done under the auspices of one university hospital ethics committee involved (...) interpretation of statutes on living wills, durable powers of attorney, competency, confidentiality, guardianship, AIDS testing, and disability. At another hospital, 30% of ethics consultations were thought to involve legal issues. Attorneys at a third hospital estimated that virtually every case involves legal issues. The notion that ethics consultation is an “amalgam” of medicine, ethics, interpersonal skills, and law is gaining currency. Ethics consultation has become a channel through which law enters the clinical setting. (shrink)

The first half of this article offers two possibilities of how the argument Kojonen makes might be vulnerable to other new developments in evolutionary science and psychology—potential broadsides that might threaten to sink the salvaged ship of design once again. Work on the development of life suggests that life is a simplification of surrounding environmental information, and therefore life does not generate new information. Second, the psychology of pareidolia suggests we find design as a bias of our information processing, rather (...) than observing something that exists. The second half of the article offers a critique of how the metaphors we use to describe God and the world shape our approaches to solving theological and philosophical questions (particularly theodicy). I offer some organic metaphors in place of the usual mechanistic metaphors to think about how the design argument could be reformulated. (shrink)

Volume 19, Issue 11, November 2019, Page 37-39.

In lieu of an abstract, here is a brief excerpt of the content:Flesh in Public:Eros and Political TransformationBethany HenningAmerican Sexual CrisisWe live in a time of erotic dysfunction: In 2020, and again in 2023, there was a brief media frenzy in the wake of studies published by UCLA that concluded that Gen Z is having statistically less sex than millennials did in their formative years. The generational angle made for good headlines, but the same surveys indicated that people of all (...) ages are having less sex than they used to (Herbenick et al.; Wellingham). We needn't work hard to identify likely factors that might have led us here. The pandemic undoubtedly shifted our tolerance for closeness and contact, which has only reinforced the proliferation of technological commodities (devices, apps, platforms) that have made isolation ever more convenient. These studies also found an increase in "rough sex" (inclusive of choking) when people do manage to have sex—which is enough to generate a separate paper pondering the relationship between aggressiveness in the American psyche, the apparent anti-feminist backlash to the #MeToo movement, or it has given some a need to fetishize/work through profound feelings of powerlessness that arise in other domains of life (Skinner and Gottfried). But I tend to think that the recent decrease in sexual activity is the symptom of a wider pathology that should be understood as an "erotic depression."In 1998, as Queer Theory was just beginning to achieve a narrow but resolute foothold in academic life, Lauren Berlant and Michael Warner wrote "there is nothing more public than privacy" (Berlant and Warner 548). This aporetic statement develops into their central claim that our negotiation of the commons is structured by a "core national culture" that "can be imagined as a sanitized space of sentimental feeling and immaculate behavior" through the mechanism of "national heterosexuality." National heterosexuality (distinct from though similar to Adrienne Rich's "compulsory heterosexuality") [End Page 51] is the tacit assumption that family life with its reproductive and consumptive activities is the arrangement that authorizes/redeems desire. If this is the tacit assumption that structures public space, we needn't go through the trouble to represent sexual desires and practices in public. We then assume that normal, healthy sexuality occurs in private. The content of intimate life is presupposed, and protection of this private life and its material pleasures is the central concern around which American politics is organized. For Berlant and Warner, differentiating between what is "public" and what is "private" isn't thoroughly explicated. In The Public and Its Problems, Dewey offered a functional distinction between the private as transactions between individuals that are "immediately and directly engaged," and the public as the as-yet-inchoate collection of individuals that are affected by the "indirect consequences" of a private transaction (LW 2:244). The public, in other words, coheres on the basis of a problem that emerges while their attention is engaged elsewhere—presumably by their own private transactions. But, if that public is to cohere and advocate for itself, fellow-sufferers must find a way to recognize one another as such and then organize around their shared interest. The impediments to queer liberation thus indicate a general hurdle in democratic life: The search for the public involves qualitative work in an affective field that is troubled by the repressive mechanisms that split the private and the public into a strict dichotomy—if the dominant customs repress the crucial affective capacities of the inchoate public, would-be political movements are repressed before suffering can be expressed.If sexual life can be thought of as one possible expression of erotic perception, and if the Deweyan can accept an analogue between erotic perception and what Dewey calls "qualitative thought," then our erotic deficits amount to a diminished sensitivity and a failure of sensual attentiveness to a crucial layer of experience as a whole. Democratic life withers when we fail to perceive the connection between what we do and what we suffer. Without these rhythms of reciprocal response, the live creature becomes hopelessly alienated. The work of Dewey and of Merleau-Ponty represent some of the most successful attempts to think ecologically, because they are willing to take... (shrink)

Modern feminist movements run the risk of being appropriated by capitalist agenda and commodified for mass appeal, thus stripping them of their revolutionary potential. I would propose that in order for feminism to challenge this, movements may want to consider the subversion of subjectivity. Deleuze and Guattari's notions of becoming-animal and becoming-woman emphasise a subjectivity not confined by rigid identity, such as man/woman. However, feminists have challenged this theory, suggesting it is difficult to both fight for and dispel the very (...) same notion, that is, woman. I argue that in first considering the feminine subject via the Lacanian understanding of ‘Woman’, it can be argued that feminine subjects can engage with becoming-animal to destabilise the notion of ‘Woman’. Riot Grrls, FEMEN and Pussy Riot all demonstrate tactics which could be said to utilise becoming-animal and have had varying success in avoiding commodification. (shrink)

This paper examines the drive for consensus from the perspective of the good government framework for federal advisory commissions in the United States. Specifically, the paper examines the Federal Advisory Committee Act (FACA) – the statute, its regulations, and case law. It shows that the FACA was intended to be an antidote to abuses in consensus‐making processes, including the failure to fully include competing views on commissions. The index of suspicion in the FACA scheme rises when a group work product (...) – including a consensus report – is to be the basis of recommendations to federal officials. Once FACA's requirements regarding committee composition are satisfied, the index of suspicion drops and FACA is indifferent to consensus‐making; but the conditions for informed, meaningful participation apply to members who dissent from, as well as those who participate in, consensus. In negotiated rulemaking, the push for consensus and closure creates unacceptable tension with the good government goals of openness and accountability. Proponents of consensus‐only bioethics commissions can learn from FACA‐related legislative, agency, and judicial insights that consensus‐seeking is not always desired by government officials; is rarely cost free; and that diversity and dissent enhance openness, accountability, and fairness. The burden of proof is therefore on proponents of a consensus‐only standard for bioethics commissions to demonstrate that a drive for consensus furthers sound decision‐making by government officials more than it sets back openness and accountability to a diverse public. (shrink)

Healthcare policies developed during the COVID-19 pandemic to safeguard community health have the potential to disadvantage women in three areas. First, protocols for deferral of elective surgery may assign a lower priority to important reproductive outcomes. Second, policies regarding the prevention and treatment of COVID-19 may not capture the complexity of the considerations related to pregnancy. Third, policies formulated to reduce infectious exposure inadvertently may increase disparities in maternal health outcomes and rates of violence towards women. In this commentary, we (...) outline these challenges unique to women’s healthcare in a pandemic, provide preliminary recommendations and identify areas for further exploration and refinement of policy. (shrink)

Christopher Southgate's work raises questions about God, evolution, and suffering. In this article, I begin by contributing an alternative to Southgate's “only way” argument and by offering a third option in speculations about the nature of nonhuman animals in heaven. The second half of the article starts with Southgate's approach of evolutionary theodicy as “an adventure in theology” and proposes a new path branching off his work. “Compassionate theodicy” is a reworking of the method and audience of traditional theodicy in (...) the hope that it might become something that could offer theological resources to those who suffer. (shrink)

Max Weber, the grandfather of organizational theory, recognized the close association between health care organizations and law. When he introduced the concept of a legallaw-saturated,rational bureaucracies, healthcare organizations have highly formalized rules and procedures. They pay a great deal of attention to legal criteria in decisionmaking, and some have entire departments devoted to legal risk management.

Recent ethics literature suggests that issues involved in non-heart-beating organ procurement are both highly charged and rather urgent. Some fear that NHB is a public relations disaster waiting to happen or that it will create a backlash against organ donation. The purpose of the study described below was to assess ethics committees' current level of involvement in and readiness for addressing the difficult issues that NHB organ retrieval raises—either proactively through policy development or concurrently through ethics consultation.

In lieu of an abstract, here is a brief excerpt of the content:Reply to CriticsBethany Henningplato knew that philosophy is not something we write; it is something we live. As Deweyans, we know philosophy is an ideal that emerges within experience as the highest possibility for dialogue. Insofar as a book appears as an extended monologue, it obscures the qualitative and transactive dimensions of philosophy as it is practiced. But sessions like these reveal that books are moments in a conversation, (...) "perchings" in a dialogue that is forever in media res. I am deeply grateful to Bill Myers for organizing this panel, and for the generosity of Frank Ryan, Gregory Pappas, and Jim Garrison for having taken the time to read and think about this book. Each of them has served as a model for philosophical scholarship, and I am humbled and honored to have the opportunity to engage with them directly. They have challenged me in three distinct ways and have engaged with what I have written on separate plateaus of thought, at times revealing layers of which I was not fully aware. So I will do my best to respond to their concerns and develop our shared inquiry in their light. I will also own that my reading of Dewey is selective, and it is my attempt to work through a problem that materialized, as all problems do, in the course of ordinary lived experience.At Southern Illinois University Carbondale, where I attended graduate school, we offered a course called "The American Mind." The title was a provocation, so I applied to teach it one semester. It was a fantastic challenge to try to curate a selection of texts that would serve as an encounter with an intellectual tradition that eludes me as much as it informs me—after all, prior to college, I only knew that a "philosopher" is what becomes of the loser in the board game called Life. I did not know that there was something called "American philosophy" until I applied to study at SIUC.If philosophy is the way that a culture reflects upon itself, then in this book, I have tried to invite the American mind to lie down on the couch. [End Page 95] Or, it might be more accurate to say that I have asked John Dewey, as the representative of American philosophy, how he might psychoanalyze such a mind. My hypothesis is that Dewey's theory of aesthetic experience, and the art that communicates and preserves such moments of intensified vitality, touches the deepest, but unspoken meanings that human beings encounter. This is where quality, the character of an event as a singular whole, the immediate aspect of an event that we feel rather than know, can be stabilized and communicated. If an interpretation can be made of the deep conflicts that have left philosophy at the margins of American life, I believe we would be wise to begin with our "dreams," with the creations of our imagination, the artistic products that reveal the felt dimension of our shared world.Many readers of Dewey choose to focus on his theory of inquiry, his recasting of the scientific method, and his instrumentalism as forming the core of his thought. This is an understandable approach; his work here is novel and corrects bad intellectual habits. However, for the purposes of this book, I have emphasized aesthetic experience, the role of the qualitative, and pursuit of meaning over the correction of practice in my interpretation. This is a controversial choice since it courts the irrational and the vague, but I believe that our neglect of these portions of experience prevents philosophy from reconnecting with American life.Response to Frank RyanFrank Ryan is concerned about the extent to which I have cast the organism as porous, and that I have identified aesthetic experience as unconscious. I agree with Dr. Ryan's assessment that defining aesthetic experience as wholly unconscious would be a grievous error—and I hope not to have made it. There is a misleading ambiguity in the title of the book that might predispose the reader to suspect that I am claiming an equivalence, but what I intended to argue was not that aesthetic experience itself is unconscious, but rather... (shrink)

In this study, Bethany Somma argues for a dichotomous interpretation of human desire developed by late ancient Greek and medieval Islamic philosophers in response to an ambiguity in Aristotle’s account of desire.

Anthropology of Consciousness, EarlyView.

Extending literature on health information to entertainment television, we analyze the prostate cancer narrative presented in the police drama, NYPD Blue. We explain how the physician-patient interaction depicted on the show followed (and sometimes did not follow) the medical dialogue model. Findings reveal that the producers of this show advocate a more dialogic model of medical interaction. Portrayals of incompetent, ineffective physicians are contrasted with the superior, effective efforts of other physicians. The audience learns that a non-dialogic approach characterizes “bad (...) doctors,” while the dialogic method typifies “good doctors.” Likewise, medical professionals can use such texts to enhance physician-patient interaction. (shrink)

ABSTRACTThis study aimed to investigate the emotional impact of sarcasm. Previous research in this area has mainly required participants to answer questions based on written materials, and results have been mixed. With the aim of instead examining the emotional impact of sarcasm when used in a more conversational setting, the current study utilized animated video clips as stimuli. In each clip, one individual answered general knowledge questions while the other provided feedback that could be delivered either literally or sarcastically, and (...) either complimented or criticized the question answerer’s performance. Participants rated the feedback based on the anticipated emotional impact on the recipient, how the speaker intended the recipient to feel, and whether the speaker intended to be humorous. Results overall supported the Tinge Hypothesis, showing that sarcastic criticism was rated as less negative than literal criticism, and sarcastic compliments were rated as... (shrink)

We used attractiveness judgements as a proxy to visualize the ideal female and male body for male and female participants and investigated how individual differences in the internalization of cultural ideals influence these representations. In the first of two studies, male and female participants judged the attractiveness of 242 male and female computer-generated bodies which varied independently in muscle and adipose. This allowed us to map changes in attractiveness across the complete body composition space, revealing single peaks for the attractiveness (...) of both men and women. In the second study, we asked our participants to choose the most attractive male and female bodies in a method of adjustment task in which they could independently vary muscle and adipose to create the most attractive body. We asked whether individual differences in internalization of cultural ideals, drive for muscularity, eating disorder symptomatology and depressive symptoms could systematically shift the location of peak attractiveness in body composition space. We found a clear preference by both genders for a male body with high muscle and low adipose, and a toned, low adipose female body. The degree of internalization of cultural ideals predicted large individual differences in the composition of the most attractive bodies. (shrink)

The publication of Art as Experience in 1934 marked a theoretical turning point away from the disinterested spectatorship of Kant towards an aesthetics of everyday life. Dewey’s major claim therein is that “aesthetic experience” is privileged and ought to be taken as paradigmatic for all experience because it is controlled by an affective unity that he calls “pervasive quality” which harmonizes thought and action with its social and environmental context. In 1935 Walter Benjamin argued that pre-industrial works of art have (...) an “aura” that exerts an affective lure on consciousness, and that the remnants of this aura in the post-industrial age may lead to the abandonment of critical thought and seduce the masses into the sway of fascism. This paper considers John Dewey’s aesthetic theory in light of the critical perspective developed by his contemporaries in the Frankfurt School. I will consider whether Dewey’s reliance on the qualitative dimension of experience undermines the critical reflection that, theoretically, prevents the “aestheticization of politics” that leads to the spread of fascism, and propose that pragmatist aesthetics would benefit from greater tolerance for the “negativity” exemplified by the critical theorists. (shrink)

The dubious relation of “subjective” experience to “objective” reality finds its correlate in the opposition we often suppose between culture and nature. Twentieth century theorists, most notably Freud, have claimed various methods for interpreting the illusions of one realm that hide the truths of the other. Ricœur has famously called the psychoanalytic method of dream interpretation a “hermeneutics of suspicion,” which he sees as a threat to the “mytho-poetic core of imagination.” John Dewey regarded the binary opposition between culture/nature as (...) particularly dubious, preferring to see them as reciprocal phases of a continuous process; if cultural life is an interpretation of the biophysical environment, that environment surely has its say. However, in the century since Freud, the tactics of suspicion have proven themselves to be indispensable for developing of critiques that reveal the subtle operations of anti-democratic ideologies, perhaps at the expense of democratic faith. This paper considers if there are less suspicious, more Deweyan possibilities for the interpreting and sharing of dreams, not for the benefit of the psychic health of the individual dreamer, but for the sake of a recovery of democratic life. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hyper-Abjects:Finitude, “Sustainability,” and the Maternal Body in the AnthropoceneBethany DoaneThe concept of the Anthropocene prioritizes a new paradigmatic scale that seems to outweigh that of “the political”: imagining deep time or the death of the human species as a result of climate change tends to negate the (relatively speaking) smaller-scale concerns of race, class, gender, or capitalism. While feminist critique is often circumscribed by this political scale, and thus (...) may seem to be dwarfed or rendered obsolete by the geological, deep-time scale of the Anthropocene, examining issues of feminist concern from this geological perspective has profound implications for thinking not only of gender politics but also of how to construct something like the political at all in this new era. Suggesting a new and normative global politics is, of course, beyond the scope of this article, but perhaps we might begin to conceive of a political schema that would function more appropriately in light of this grander scale. At the very least we may begin to think the borders or limits of the species as it has existed in the modern era in a way that neither environmentalism nor posthumanism has yet been able to sufficiently tackle.The Anthropocene marks the epoch in which human activities have caused global environmental changes that will leave their mark in the geological strata of the earth itself.1 While the specific moments of its onset are contested, its beginnings are generally associated with the industrial age; Crutzen and Stoermer mark its onset at roughly 1800 with the beginnings [End Page 251] of the industrial revolution. (Timothy Morton pinpoints it more specifically with the invention of the steam engine in 1794.) The changes made in this era of geological, technological, and climate convergence have accelerated in the last seventy years or so in what scientists call the Great Acceleration, which began around 1940 and quickened anthropogenic impact with events like the testing/dropping of atomic bombs, the homogenization of biodiversity, mass extinctions as a result of human activity, and various types of drilling and mining.2 In the era broadly conceived as modernity, the steady march of “progress” that has so shaped the paradigm of the period has been made possible only through its own abjections: those phenomena that mark the era as limited, limiting, and unsustainable. In other words, the “birth of the modern world” was made possible only through devastating acts of violence: institutionalized inequalities like slavery, oppression, colonization, and war. These acts of violence translate as cannibalization at the global scale: the exploitation of most members of the species and the consumption of their resources for the benefit and luxury of the few. While these forms of violence have been criticized and confronted by political and theoretical movements since at least the middle of the twentieth century, thinking of them in terms of the Anthropocene and deep time allows us to consider their consequences in a new light. Our present awareness of the Anthropocene makes visible phenomena like climate, global warming, earth, and the “anthropos” that present us with the very real eventuality of species finitude. Species finitude calls into question not just the practices of modernity that have brought about the Anthropocene (the exploitation of the many for the benefit of the few), but the entire paradigm of global thinking that is invested in progress, growth, and even in any environmentalism that calls for stewardship of the earth. The notion of care for an entity like “nature” or “the environment” only reinforces the separation between the human and its milieu, a separation that is impossible to maintain in light of the absolute inextricability that the Anthropocene brings to light.At the heart of this essay are two theoretical concepts: Julia Kristeva’s abjection, and Timothy Morton’s hyperobjects, both of which stand for a sort of insufficiency or impossibility of discourse (politics, the Symbolic, etc.) in managing some Real object or phenomenon. Kristeva’s abject is generally thought of as functioning at two levels or scales: the personal, in which an individual must cast off the abject of the maternal body in order to become a proper subject; and the social or... (shrink)

dewey is an optimistic thinker. He fits into a vein of pragmatism known as meliorism, which holds that the condition of the world can be improved through intelligent, imaginative, human action. For this reason, it is tempting to read Dewey as permanently cheerful—particularly when we compare him with philosophers from the continental tradition who work on similar themes. However, it is important to remember that meliorism holds that improvement is possible through intelligent engagement—not that it is guaranteed. Dewey's aesthetics particularly (...) have been mischaracterized as overly sanguine, lacking solid account of the tragic. This is a misreading since Dewey's aesthetic does make ample room for human suffering on... (shrink)

Much of the ethical debate about controlled non-heart-beating cadaver (NHBC) organ recovery has focused on the University of Pittsburgh Medical Center (UPMC) protocol. Some commentators have voiced serious reservations about the ethical acceptability of that protocol; others have argued that the protocol contains sufficiently stringent ethical safeguards to warrant a limited and carefully monitored trial at UPMC. UPMC is not the only organization pursuing controlled NHBC organ procurement, however. The study of organ procurement organizations described in this article suggests that (...) controlled NHBC organ procurement is a practice that, if not yet widespread, is certainly no longer isolated to a few organizations in which it is carefully monitored. Rather, it is being carried out under a variety of circumstances, many of which are less carefully constrained ethically than at the University of Pittsburgh Medical Center. The next stage of the ethical debate should focus on issues that are arising in a variety of settings as the practice spreads. (shrink)

The field of narrative medicine holds that personal narratives about illness have the potential to give illness meaning and to create order out of disparate facets of experience, thereby aiding a patient’s treatment and resisting universalizing medical discourse. Two narratives of bipolar disorder, Kay Redfield Jamison’s prose memoir An Unquiet Mind and Ellen Forney’s graphic memoir Marbles challenge these ideas. These writers demonstrate that one result of bipolar disorder is a rupture to their sense of identity, making straightforward and verbal (...) forms of narrative impossible. During periods of relative mood stability, reliable memories of mania or depression are equally impossible. As a result, these memoirists seek to develop sources of self-knowledge other than memory and introspection, long the foundations of personal narrative. Finally, An Unquiet Mind and Marbles return attention to questions of selfhood at a time when scholarship on memoir rejects interpretations of life stories as clear and reliable expressions of identity. (shrink)