In this book, Jeremy Kirby analyzes Book Gamma of Aristotle's Metaphysics and introduces the debates such as relativism versus the idea of a ready-made world, the possibility of true contradictions, the nature and possibility of metaphysics, the limits of thought, and logic.

Critical-care decision making is highly complex, given the need for health care providers and organizations to consider, and constructively respond to, the diverse interests and perspectives of a variety of legitimate stakeholders. Insights derived from an identified set of ethics-related considerations have the potential to meaningfully inform inclusive and deliberative policy development that aims to optimally balance the competing obligations that arise in this challenging, clinical decision-making domain. A potential, constructive outcome of such policy engagement is the collaborative development of (...) an as-fair-as-possible dispute resolution process that incorporates an appropriated-justified, defensible critical-care obligation threshold. (shrink)

It has become somewhat a commonplace in recent political philosophy to remark that all plausible political theories must share at least one fundamental premise, ‘that all humans are one another's equals’. One single concept of ‘basic equality’, therefore, is cast as the common touchstone of all contemporary political thought. This paper argues that this claim is false. Virtually all do indeed say that all humans are ‘equals’ in some basic sense. However, this is not the same sense. There are not (...) one but two concepts of basic equality, and they reflect not a grand unity within political philosophy but a deep and striking division. I call these concepts ‘Equal Worth’ and ‘Equal Authority’. The former means that each individual’s good is of equal moral worth. The latter means that no individual is under the natural authority of anyone else. Whilst these two predicates are not in themselves logically inconsistent, I demonstrate that they are inconsistent foundation stones for political theory. A theory that starts from Equal Worth will find it near impossible to justify Equal Authority. And a theory that starts from Equal Authority will find any fact about the true worth of things, including ourselves, irrelevant to justifying legitimate action. This helps us identify the origin of many of our deepest and seemingly intractable disagreements within political philosophy, and directs our attention to the need for a clear debate about the truth and/or relationship between the two concepts. In short, my call to arms can be summed up in the demand that political philosophers never again be allowed to claim ‘that all human beings are equals’ full stop. They must be clear in what dimension they claim that we are equals—Worth or Authority. (shrink)

Historically, the triage of temporarily scarce health resources has served narrow utilitarian ends. The recent H1N1 pandemic experience provided an opportunity for expanding the theoretical foundations/understandings of critical care triage in the context of declared infectious pandemics. This paper briefly explores the ethics-related challenges associated with the development of modern critical care triage protocols and provides descriptions of some ‘enhanced fairness’ features which were developed through the use of an inclusive deliberative engagement process by a Canadian provincial Department of Health.

In lieu of an abstract, here is a brief excerpt of the content:Aristotle On MetaphorJohn T. KirbyMuch Madness is divinest Sense—To a discerning Eye——Emily DickinsonOurs is an age of metaphor. Wayne Booth, in his inimitable fashion, remarks,There were no conferences on metaphor, ever, in any culture, until our own century was already middle–aged. As late as 1927, John Middleton Murry, complaining about the superficiality of most discussions of metaphor, could say, "There are not many of them."... Explicit discussions of something (...) called metaphor have multiplied astronomically in the past fifty years.... students of metaphor have positively pullulated.1In the postmodern era philosophers of language, particularly those outside the analytic tradition, tend to think more and more in terms of all language as being metaphorical. This trend, however, is not a new one; it seems to have its roots back as far as Heraclitus, and, in the modern world, was certainly espoused by Giambattista Vico in his Nuova Scienza (1725). What we may call the Viconian tradition was embraced on the continent by Nietzsche, and, in the Anglo–American world, by Ivor Richards.2 Nietzsche's thought had far–reaching consequences in terms of its influence on the work of Paul de Man and Jacques Derrida, who in the late 1960s and the 1970s found themselves in the center of a vortex of controversy over the notion of "deconstruction," and its interrogation not only of Western metaphysics but also of human language and thought generally. Now, it seemed, such simple formulae as "This X is Y" called into question the whole process of naming and predication. But even among those for whom this is an unconvincing position, the problem of metaphor continues to be a fascinating one. How to define [End Page 517] it? What are its uses? What is its relation to literal, or nonfigured, language? And what its relation to human cognition?3Booth goes on to say, "there have been many more discussions of what people from the Greek philosophers on called metaphor than any bibliography could show."4 That being so, a sustained study of Aristotle's concept of metaphor needs no further justification, since it is to him that we owe the terms in which the debate was framed for many hundreds of years. Indeed, here as often, even those who wish to propose new or different parameters for the analysis of metaphor must do so against the grain of the Aristotelian tradition.5 This, if nothing else, is a measure of the tremendous influence Aristotle has had on the history of Western rhetoric and poetics.As on many other topics, it is now fashionable to condescend to Aristotle for the limitations of his study of metaphor, or—more aggressively still—to find fault with its parameters. Certainly he did not preempt any further discussion on the issue; nor, I imagine, would he have wanted to. But I surmise that there is more to be learned from an appreciative study of his methods here than one might initially suppose. In this study, then, after a few remarks on recent studies of metaphor, I propose to examine the state of the question before Aristotle, and then [End Page 518] to look at what he has to say about metaphor in the Poetics and Rhetoric.In their attempts to cope with the notion of language generally, and specifically with the questions of literal versus figurative language, scholars over the last hundred years or so have themselves appropriated a number of metaphors purporting to describe the phenomenon. These include (above all) models based on comparison and interaction. The comparison model, it is typically said, conforms more to the classical approach to metaphor, whereas those based on interaction stem primarily from the work of Richards and Black.6 Indeed it is from this notion of interaction that the terms "tenor" and "vehicle" were born, the former referring to the underlying idea that is illustrated or illuminated by the latter, which is "applied" to it; and Richards is right both to point out [1] that the word "metaphor" is sometimes used to signify what he means by "vehicle," and sometimes to mean the symbiosis resulting from the conjunction of tenor and vehicle, and [2] that... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume 29, Number 2, November 2003, pp. 305-325 Hume, Sympathy, and the Theater BRIAN KIRBY Every movement of the theater, by a skillful poet, is communicated, as it were by magic, to the spectators; who weep, tremble, resent, rejoice, and are inflamed with all the variety of passions, which actuate the several personages of the drama. (EPM 5.2.26; SBN 221-2) Much has been written recently about (...) the role of sympathy in Hume's moral theory. That may indeed be its most important use. But it seems from a number of illustrations he uses that it has broader applications, in particular, application to a spectator's appreciation of drama. The problem some see with this broader application is that it conflicts with the basic definition of sympathy as a process by means of which impressions are shared. The actors on the stage would not seem to have the same passions which "inflame" the spectators. Worse, the spectators do not believe in their hearts that the passions which inflame them have real correlates. At first blush, "sympathy" might mean any one of several things. In "The Conscience of Huckleberry Finn," for example, Jonathan Bennett says, "As for 'sympathy': I use this term to cover every sort of fellow-feeling, as when one feels pity over someone's loneliness, or horrified compassion over his pain, and when one feels a shrinking reluctance to act in a way which will bring misfortune to someone else."1 However, fellow-feeling is not a sharing of feelings in Hume's sense. Alvin I. Goldman comes closer to Hume's meaning in a narrow description of empathy: "To empathize with someone, in its Brian Kirby, Associate Professor of Philosophy Emeritus at St. Lawrence University, is at 172 Miner Street Road, Canton, NY 13617, USA. e-mail: [email protected] 306 Brian Kirby most frequent sense, is to sympathize or commiserate, which involves shared attitudes, sentiments, or emotions."2 Still, Hume's sympathy is not the commiseration but rather what is involved in the commiseration, the shared attitudes, sentiments, and emotions. "No quality of human nature," says Hume, "is more remarkable, both in itself and in its consequences, than that propensity we have to sympathize with others, and to receive by communication their inclinations and sentiments, however different from, or even contrary to our own" (T 2.1.11.2; SBN 316). The principle of sympathy as he describes it in his technical sense is as follows: When any affection is infus'd by sympathy, it is at first known only by its effects, and by those external signs in the countenance and conversation, which convey an idea of it. This idea is presently converted into an impression, and acquires such a degree of force and vivacity, as to become the very passion itself, and produce an equal emotion, as any original affection. However instantaneous this change of the idea into an impression may be, it proceeds from certain views and reflections, which will not escape the strict scrutiny of a philosopher, tho' they may the person himself, who makes them. (T 2.1.11.3; SBN 317) If sympathy has to do with the sharing of impressions, what can one say about possible broader applications in which the correlate impression is absent? One tack to take is to dismiss the illustrative examples as aberrations or at least minor inconsistencies on Hume's part. A second is to argue that the broader applications follow reasonably, given Hume's description of the mechanism of sympathy. I propose, in this paper, to take the second tack. The above description characterizes what one might call sympathy in its normal social context in which the feelings of another are identifiable from his verbal and bodily behavior. Of course, the identification is not infallible. The other person may intend to deceive by lying or mimicking the behavior associated with a feeling. But such occasions are parasitic on normal contexts. But beyond the normal social context, there are other occasions which elicit sympathy, situations in which passions are aroused in the sympathizers for good cause, but which have no correspondent in the objects of sympathy. The case... (shrink)

This paper offers a targeted five-point critique of the current debate about the problem of basic equality. First, it argues that the debate should be refocussed away from any particular concept(ion) of basic equality to a more agnostic proposition about the possibility of establishing equality in any basic moral property. Second, it re-articulates the problem in terms of grounding relations rather than supervenience. Third, it argues that proponents of predominant approach to solving this problem have failed to properly distinguish between (...) two different non-scalar properties defined in terms of scalar properties: ‘range properties’ and ‘bare properties’. Once disambiguated it is clear as to why such an approach must fail. However, this critique does direct our attention to a possible alternative strategy, that is, grounding our equality upon a ‘relative property’. (shrink)

Philosophy &Public Affairs, Volume 52, Issue 4, Page 500-531, Fall 2024.

This article explores the controversial practice of transnational gestational surrogacy and poses a provocative question: Does it have to be exploitative? Various existing models of exploitation are considered and a novel exploitation-evaluation heuristic is introduced to assist in the analysis of the potentially exploitative dimensions/elements of complex health-related practices. On the basis of application of the heuristic, I conclude that transnational gestational surrogacy, as currently practiced in low-income country settings , is exploitative of surrogate women. Arising out of consideration of (...) the heuristic's exploitation conditions, a set of public education and enabled choice, enhanced protections, and empowerment reforms to transnational gestational surrogacy practice is proposed that, if incorporated into a national regulatory framework and actualized within a low income country, could possibly render such practice nonexploitative. (shrink)

Practical approaches to the notions of subsets and extension sets are compared, coming from broadly set-theoretic and category-theoretic traditions of mathematics. I argue that the set-theoretic approach is the most practical for ‘looking down’ or ‘in’ at subsets and the category-theoretic approach is the most practical for ‘looking up’ or ‘out’ at extensions, and suggest some guiding principles for using these approaches without recourse to either category theory or axiomatic set theory.

It is often challenging for mental health‐care providers and health organizations to perform their various roles and to meet their varied obligations. In complex mental health‐care circumstances the concurrent application of relevant ethical principles and values often leads to the emergence of completing obligations that need to be carefully weighed and balanced in the making of care‐related decisions. Although some clinical circumstances, such as those potentially triggering the duty to warn, are adequately guided by existing rules based on legal precedents, (...) there is a gap in decision‐making support in other mental health‐care domains. This article proposes that a set of targeted, decision‐making approaches be developed to assist in the handling of specific, challenging circumstances. By way of illustration, two novel approaches are introduced; that is, choosing to work within a moral relational space of optimal therapeutic engagement (at the micro level of clinical practice), and the use of a health policy development approach that instantiates deliberative engagement (at the meso and macro levels of health organization). (shrink)

New materialisms argue for a more science-friendly humanities, ventilating questions about methodology and subject matter and the importance of the non-human. However, these new sites of attention - climate, biology, affect, geology, animals and objects - tend to leverage their difference against language and the discursive. Similarly, questions about ontology have come to eclipse, and even eschew, those of epistemology. While this collection of essays is in kinship with this radical shake-up of how and what we study, the aim is (...) to re-navigate what constitutes materiality. These efforts are encapsulated by a rewriting of the Derridean axiom, 'there is no outside text' as 'there is no outside nature.' What if nature has always been literate, numerate, social? And what happens to 'the human' if its exceptional identity and status is conceded quantum, non-local and ecological implication? (shrink)

The contentious, topical debate about whether faith-based health care organizations should be granted accommodation on the basis of institutional conscientious objection to medical assistance is dying (MAiD) is addressed through a comparative analysis of arguments on both sides of the issue that references such relevant considerations as: claimed ‘moral-authority’, competing rights-based claims, obligations arising from patient welfare principles, formal justice, dissimilarity in consequences, and two illustrative arguments from analogy. The analysis leads to the conclusion that nonconditional accommodation on the basis (...) of institutional conscientious objection to MAiD is not ethically acceptable in Canada. A compromise mechanism, consisting of a suggested set of pragmatic conditions, is proposed that could effectively balance the competing moral responsibilities that arise from this conclusion and a core assumption of the paper, i.e., that some dominant faith-based health institutions can legitimately request, and expect, that provincial/territorial governments pay them a measure of respect in their operational, health-care-delivery decision making because of these institutions’ long history of providing high quality, health care in Canada. It is further suggested that provincial/territorial governments only allow large, publicly funded, faith-based health care organizations to enact a conditional version of accommodation on the basis of institutional conscientious objection to MAiD in circumstances where the organization has entered into a formal agreement with the relevant health department to meet the proposed, compromise conditions (or a relevantly-similar set of conditions). (shrink)

Bianchi, Stanley, and Sutander argue in an insightful, cogent manner for the consideration of harm reduction as an ethically-defensible, non-paternal management approach for capable persons...

I argue for the use of the adjunction operator (adding a single new element to an existing set) as a basis for building a finitary set theory. It allows a simplified axiomatization for the first-order theory of hereditarily finite sets based on an induction schema and a rigorous characterization of the primitive recursive set functions. The latter leads to a primitive recursive presentation of arithmetical operations on finite sets.

I remember my immediate fascination with an edited collection, now twenty years old, Who Comes After the Subject? The title seemed to entirely displace the identity of the subject, the “of-courseness” of its uniquely human definition. Indeed, its provocation did more than destabilise the what and where of the subject, as if we might extend this complexity, albeit in attenuated form, to non-human entities. The more radical implication was a destabilisation of human identity itself—its circumscribed location—together with the progress narrative (...) that made the arrival of language, technology and agential smarts synonymous with human achievement. As contemporary concern about planetary health is galvanized around the unique power of human agency to either ruin or redeem an impassive and defenceless Nature, a “before” that lacks what being a subject affords, this article will linger over the logic that continues to sustain this story. By reworking Derrida’s “originary writing” as “originary humanicity,” a different sense of ecological involvement might be possible. (shrink)

The complex health and social circumstances of living-at-risk, frequent users of emergency departments (aREDFUs) in the health jurisdictions of high-income countries, and the related, significant challenges posed for emergency departments and the health care providers working within them, are identified and explored in the paper. Ethical analyses of a set of relevant domains are performed, i.e., individual and relational autonomy considerations, relevant social construction and personal responsibility conceptions, patient welfare principles (beneficence, nonmaleficence, continuity of care), harm reduction methodologies and their (...) applications, health equity, and justice considerations of the distributive, formal and social types. The outcomes of these analyses demonstrate that there are ethically compelling reasons for emergency departments to adopt an ethics-informed, policy-based approach to the longitudinal care and management of living-at-risk, frequent users of emergency departments. From a formal justice perspective, the development and uses of such an approach are justified by a demonstrable relevant difference between living-at-risk, frequent users of emergency departments and other persons and groups of patients who visit emergency departments. We propose an example of such a policy-based approach. Examples of possible, pragmatic applications of this approach, which help ensure that aREDFUs who present to the ED are managed in a fair and optimally consistent manner, are provided for the consideration of an urban emergency department’s policymaking working group. (shrink)

This study investigated women’s lived experience of becoming less obsessed with their bodily appearance. Written narrative accounts were collected from seven women co-participants and a phenomenological analysis of these descriptive protocols was then performed in order to reveal the prereflective structure of the focal phenomenon, seven essential constituents of which emerged. A major goal of this research was to contribute to the undernourished area of phenomenological research regarding the experience of body image.

Hume considers the extent to which the Deity might be held responsible for resultant sin, given that he is responsible for the necessary chain of events leading thereto. Were we to place the responsibility with God, it would not, seemingly, be placed upon ourselves. If we countenance a necessary chain of events, and a perfect Deity, so the argument goes, we lack culpability. Hume rejects this line of reasoning, maintaining that the mind of man is by nature formed to attribute (...) praise and blame to action. Surprisingly, Hume accepts what appears to be the contraposition of the claim he has just rejected. He seems to think that the presence of criminality presents a problem for those who would attribute perfection to the Deity. I argue that the conditionals in questions are subjunctive, thus Hume is not committed to the rejection of a claim and the acceptance of its contraposition. (shrink)

This article explores Derrida's suggestion in Of Grammatology that deconstruction might be considered a positive science. The implication here is that ‘no outside of text’ does not evoke an enclosure whose limits can't be breached, an enclosure that discovers human exceptionalism in linguistic and technological capacities. Instead, this sense of a system and its involvements (différance) is already entangled in any ‘atom’ of its expression, whereby ‘no outside of text’ can be read as ‘no outside of Nature’. The logic that (...) informs and justifies the conventional separations between nature and culture, ideation and matter, and human and non-human, are thereby confounded; the dimensions of efficacy, as well as the vexed question of intention appear as non-local (systemic); and the very notion of language – what it is and how it works – is distributed in ways that give rise to the same quandaries that surround the quantum problematic. Indeed, at the end of this meditation the difference between the humanities and the sciences, especially in its current configuration as the impasse of ‘the two cultures’, can no longer be sustained. (shrink)

Interest in the future, clinical implementation of uterus transplantation for uterine factor infertility was recently boosted by the demonstration of proof-of-concept for deceased uterus donation/transplantation. The ethical dimensions of living and deceased uterus transplantation are explored and addressed in the paper through their comparison to the ethical elements of an existing, legal, assisted reproduction practice in some high-income countries, i.e., gestational surrogacy. A set of six ethics lenses is used in the comparative analysis: reproductive autonomy and rights, informed choice/consent, relevant (...) critical relational theories, health equity, theoretical application of the accepted living donation standard, and comparative benefits and burdens considerations. Gestational surrogacy, as currently practiced in some high-income countries, is the assumed, theoretical base-threshold for determination of ethical acceptability in assisted reproduction practices. The analysis demonstrates that : 1) the ethical acceptability of living uterus donation/transplantation is less than that of gestational surrogacy in high-income countries, and 2) the ethical acceptability of deceased uterus donation/transplantation is roughly equivalent to that of gestational surrogacy. This leads to the conclusion that, at the present time, only one version of uterus transplantation practice, i.e., deceased uterus transplantation, should be considered ethically acceptable for possible clinical implementation in high-income countries. (shrink)

Since the global financial crisis in 2008, corporations have faced a crisis of trust, with growing sentiment against ‘elites and ‘big business’ and a feeling that ‘something ought to be done’ to re-establish public regard for corporations. Trust and trustworthiness are deeply moral significant. They provide the ‘glue or lubricant’ that begets reciprocity, decreases risk, secures dignity and respect, and safeguards against the subordination of the powerless to the powerful. However, in deciding how to restore trust, it is difficult to (...) determine precisely what should be done, by whom, and who will bear the cost, especially if any action involves a risk to overall market efficiency and corporate profitability. The paper explores whether corporations have a moral duty to be trustworthy, to bear the cost of being so and thus contribute to resolving the current crisis of trust. It also considers where the state and other social actors have strong reason to protect and enforce such moral rights, while acknowledging that other actors have similar obligations to be trustworthy. It outlines five ‘salient factors’ that trigger specific rights to trustworthiness and a concomitant duty on corporations to be trustworthy: market power, subordination (threat and intimidation), the absence of choice, the need to preserve systemic trust, and corporate political power which might undermine a state’s legitimacy. Absent these factors and corporations do not have a general duty to be trustworthy, since a responsible actor in fair market conditions should be able to choose between the costs and benefits of dealing with generally trustworthy corporations. (shrink)

People can have or lack ‘integrity’. But can public institutions? It is common to speak of the ‘integrity’ of such institutions: in popular discourse, legal decisions, law and regulations, and also increasingly, political theory, and proximate disciplines. Such integrity is often said to be at risk of being ‘subverted,’ ‘corroded,’ and ‘corrupted,’ by both forces within and without. Furthermore, the implication is that this is a very worrying thing. The integrity of our institutions, at least, needs to be preserved, supported, (...) and defended; against money, politics, power, and populists. However, despite such common usage, the concept itself has attracted little theoretical reflection. What can it mean, if anything sensible, for an institution itself – instead of a person (or even say, a body, process, territory or a bridge) – to have ‘integrity’? And, why might it be so important? This is the subject of this paper. It puts forward a substantive moral conception of institutional integrity as the robust disposition of an institution to pursue its purpose efficiently, within the constraints of legitimacy, consistent with its commitments. It argues that it is important because it provides the strongest grounding for a ‘duty of support’ owed by citizens to the institution. The strength of such support owed also gives content to a scalar dimension of the institution’s normative legitimacy, that is, the ‘strength’ (or weakness) of such legitimacy. Further, it illustrates how such a conception of institutional integrity will helpfully advance the current debate regarding institutional corruption. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 57-59, June 2011.

Theological ethics provides a framework for at least adequately resolving the dilemma inherent in the issue of employee rights: the tension between individual rights and organizational authority. The central question is what consitutes the human dignity of the worker. The Roman Catholic theological tradition centers on the concept of human dignity and recognizes the causal relationship between how one's social conditions are divided and structured and the realization of one's human dignity. The author discussed why and how this tradition provides (...) a useful methodology for resolving the employee rights debate. (shrink)

The modern practice of organ donation after cardiocirculatory death (DCD) emerged in the 1990s as a response to the alarmingly wide gap between the number of transplantable organs available through organ donation after neurological death and the urgent organ transplantation needs of persons in end-organ failure. Various important ethical dimensions of DCD have been considered and debated by prominent organ donation/transplantation theorists and clinicians.In this article, consideration of some of these ethical elements provides a foundation for a proposed set of (...) ethically informed, pragmatic conditions that could assist in the development of health policies to guide the practice of organ donation after cardiocirculatory death. (shrink)

The editorial in the September 1982 issue of this journal and many articles before and since have addressed the problem of informed consent. Is it possible? Is it a useful concept? Is there anything new to be said about it? In this article the basic rationale of the rule (patient autonomy) is explained and the extent of the rule explored. Various exceptions have been offered by the law and an attempt is made to catalogue the chief of these. A number (...) of specially vulnerable groups are then identified, the most important, and vexed, being children. How can informed consent be secured in the case of young patients? Finally, a few problems are mentioned in an attempt to get this subject back to reality. The appeal to the principle primum non nocere may be medical paternalism in disguise. Informed consent is the competing principle that reminds us of the primacy of human autonomy. A pointer is given to the future: even the use of sound recordings to explain medical procedures and to activate informed consent so that it may become a reality and not just a lawyer's myth, should be considered. (shrink)

In this critical commentary, a set of ethical considerations of relevance to the (currently contested) interpretation of irremediability for medical assistance in dying (MAiD) in circumstances where the sole-underlying medical condition is a mental health disorder is explored and analyzed. Based on the application of an ethics lens, a practical description of irremediability is proposed for intended use as guidance by Canadian mental health care clinicians, MAiD assessors and providers, and provincial/territorial professional regulatory authorities.

There has been contentious debate over the years about whether there are morally relevant similarities and differences between the three practices of continuous deep sedation until death, physician-assisted suicide, and voluntary euthanasia. Surprisingly little academic attention has been paid to a comparison of the uses of these practices in the two types of circumstances in which they are typically performed. A comparative domains of ethics analysis methodological approach is used in the paper to compare 1) the use of the three (...) practices in paradigm circumstances, and 2) the use of the practices in paradigm circumstances to their use in non-paradigm circumstances. The analytical outcomes suggest that a bright moral line cannot be demonstrated between any two of the practices in paradigm circumstances, and that there are significant, morally-relevant distinctions between their use in paradigm and non-paradigm circumstances. A thought experiment is employed to illustrate how these outcomes could possibly inform the decisions of hypothetical deliberators who are engaged in the collaborative development of assisted dying regulatory frameworks. (shrink)