As empathy gains importance within academia, we propose this review as an attempt to bring clarity upon the diverse and widely debated definitions and conceptions of empathy within the medical field. In this paper, we first evaluate the limits of the Western mainstream medical culture and discuss the origins of phenomena such asdehumanizationanddetached concernas well as their impacts on patient care. We then pass on to a structured overview of the debate surrounding the notion of clinical empathy and its taxonomy (...) in the medical setting. In particular, we present the dichotomous conception of clinical empathy that is articulated in the debate aroundcognitive empathyandaffective empathy. We thus consider the negative impacts that this categorization brings about. Finally, we advocate for a more encompassing, holistic conception of clinical empathy; one that gives value to a genuine interest in welcoming, acknowledging and responding to the emotions of those suffering. Following this line of reasoning, we advance the notion of ‘empathic concern’, a re-conceptualization of clinical empathy that finds its source in Halpern in Med Health Care Philos (2014) 17:301–311engaged curiosity. We ultimately advance Narrative Medicine as an approach to introduce, teach and promote such an attitude among medical trainees and practitioners. (shrink)

Drawing on philosophy, law and political science, and on a wealth of practical experience delivering emergency medical services in conflict-ridden settings, Lepora and Goodin untangle the complexities surrounding compromise and complicity.

Boredom, in cinema as well as in our everyday experience, is usually associated with a generalised loss of meaning or interest. Accordingly, boredom is often perceived as that which ought to be avo...

Compromise arises in contexts where irreconcilable claims must nonetheless somehow be resolved. Ordinary people in everyday life, politicians and artists, doctors engaging in research, humanitarian workers providing aid in the midst of war – all of them will have faced situations where compromise appeared to be the only reasonable option, and yet will have felt that there was nevertheless something deeply wrong with it. The aim of this paper is to help make sense of that sentiment. The focus of this (...) paper will be on some aspects of the morality of compromise. Its lynchpin will be to construe compromise as a joint action, in particular, a joint wrongdoing – taking part in, and sharing responsibility for, the doing of things that are wrong from the point of view of those who are the parties to the compromise. The question of ‘what is wrong with compromise?’ is thus recast as a question of ‘what is my part in the wrongs being done as part of the compromise?’ It is tempting to suppose that a compromise serves to dilute personal responsibility, parsing it out among parties to the compromise. Viewing a compromise as a joint action, in contrast, will help us to see how a compromise actually increases responsibility among parties to it. They are now jointly collaborating in some action that each of them sees as wrong, at least in part (albeit in differing parts). Discussions of compromise traditionally prioritize the inter-personal aspect – compromise, in the transitive form of ‘compromising with’ someone. But I argue that the intransitive form – ‘compromise of’ – deserves pride of place. The reason for prioritizing the intransitive ‘compromise of’ is simple: that is what is involved in the intra-personal calculation that must, of necessity, go on inside one's own head in the process of deciding whether or not to agree to a 'compromise with' someone else. In this paper I shall concentrate specifically on compromises of principles, or (more precisely) on ‘matters of principled concern to the compromising parties’. Not only is that the most troubling and morally problematic sort of compromise, it is also logically the most central case. I demonstrate that that is so by shifting the focus from inter-personal compromise to the more fundamental intra-personal process underlying it – the compromise we are involved in when adjudicating among our own conflicting values, to decide whether or not to agree to a compromise of the inter-personal sort. This is the subject of the first section of the paper below. Compromise involves resolving conflicts of principles through mutual concessions that are accepted and undertaken by all parties. Doing so may be on-balance desirable, not only from some larger perspective (of social peace, or whatever) but also from each party's own perspective. Nevertheless, from each party's perspective, compromise necessarily involves interacting with, and sometimes contributing to, wrongdoing. Morally, something is lost, even if more is gained on balance. (shrink)

After initially emerging in China, the coronavirus (COVID-19) outbreak has advanced rapidly. The World Health Organization (WHO) has recently declared it a pandemic, with Europe becoming its new epicentre. Italy has so far been the most severely hit European country and demand for critical care in the northern region currently exceeds its supply. This raises significant ethical concerns, among which is the allocation of scarce resources. Professionals are considering the prioritisation of patients most likely to survive over those with remote (...) chances, and this news has triggered an intense debate about the right of every individual to access healthcare. The proposed analysis suggests that the national emergency framework in which prioritisation criteria are currently enforced should not lead us to perceive scarce resources allocation as something new. From an ethical perspective, the novelty of the current emergency is not grounded in the devastating effects of scarce resources allocation, which is rife in recent and present clinical practice. Rather, it has to do with the extraordinarily high number of people who find themselves personally affected by the implications of scarce resources allocation and who suddenly realise that the principle of ‘equals should be treated equally’ may no longer be applicable. Along with the need to allocate appropriate additional financial resources to support the healthcare system, and thus to mitigate the scarcity of resources, the analysis insists on the relevance of a medical ethics perspective that does not place the burden of care and choice solely on physicians. (shrink)

Machine learning algorithms have begun to enter clinical settings traditionally resistant to digitalisation, such as psychiatry. This raises questions around how algorithms will be incorporated in professionals’ practices, and with what implications for care provision. This paper addresses such questions by examining the pilot of an algorithm for the prediction of inpatient violence in two acute psychiatric clinics in the Netherlands. Violence is a prominent risk in acute psychiatry, and professional sensemaking, corrective measures (such as patient isolation and sedation), and (...) quantification instruments (such as the Brøset Violence Checklist, henceforth BVC) have previously been developed to deal with it. We juxtapose the different ways in which psychiatric nurses, the BVC, and algorithmic scores navigate assessments of the potential of future inpatient violence. We find that nurses approach violence assessment with an attitude of doubt and precaution: they aim to understand warning signs and probe alternative explanations to them, so as not to punish patients when not necessary. Being in charge of quantitative capture, they incorporate this attitude of doubt in the BVC scores. Conversely, the algorithmic risk scores import a logic of pre-emption into the clinic: they attempt to flag targets before warning signs manifests and are noticed by nurses. Pre-emption translates into punitive attitudes towards patients, to which nurses refuse to subscribe. During the pilots, nurses solely engage with algorithmic scores by attempting to reinstate doubt in them. We argue that pre-emption can hardly be incorporated into professional decision-making without importing punitive attitudes. As such, algorithmic outputs targeting ethically laden instances of decision-making are a cause for academic and political concern. (shrink)

Medical complicity in torture is prohibited by international law and codes of professional ethics. But in the many countries in which torture is common, doctors frequently are expected to assist unethical acts that they are unable to prevent. Sometimes these doctors face a dilemma: they are asked to provide diagnoses or treatments that respond to genuine health needs but that also make further torture more likely or more effective. The duty to avoid complicity in torture then comes into conflict with (...) the doctor’s duty to care for patients. Sometimes the right thing for a doctor to do requires complicity in torture. Whether this is the case depends on: the expected consequences of the doctor’s actions; the wishes of the patient; and the extent of the doctor’s complicity with wrongdoing. Medical associations can support physicians who face this dilemma while maintaining a commitment to clear principles denouncing torture. (shrink)

Between the radical, creative capacity of our imagination and the social imaginary we are immersed in is an intermediate space philosophers have termed the imaginal, populated by images or (re)presentations that are presences in themselves. Offering a new, systematic understanding of the imaginal and its nexus with the political, Chiara Bottici brings fresh perspective to the formation of political and power relationships and the paradox of a world rich in imagery yet seemingly devoid of imagination. Bottici begins by defining (...) the difference between the imaginal and the imaginary, locating the imaginal's root meaning in the image and its ability to both characterize a public and establish a set of activities within that public. She identifies the imaginal's critical role in powering representative democracies and its amplification through globalization. She then addresses the troublesome increase in images now mediating politics and the transformation of politics into empty spectacle. The spectacularization of politics has led to its virtualization, Bottici observes, transforming images into processes with an uncertain relationship to reality, and, while new media has democratized the image in a global society of the spectacle, the cloned image no longer mediates politics but does the act for us. Bottici concludes with politics' current search for legitimacy through an invented ideal of tradition, a turn to religion, and the incorporation of human rights language. (shrink)

I develop an account of scientific representations building on Charles S. Peirce's rich, and still underexplored, notion of iconicity. Iconic representations occupy a central place in Peirce's philosophy, in his innovative approach to logic and in his practice as a scientist. Starting from a discussion of Peirce's approach to diagrams, I claim that Peirce's own representations are in line with his formulation of iconicity, and that they are more broadly connected to the pragmatist philosophy he developed in parallel with his (...) scientific work. I then defend the contemporary relevance of Peirce's approach to iconic representations, and specifically argue that Peirce offers a useful ‘third way’ between what Mauricio Suárez has recently described as the ‘analytical’ and ‘practical’ inquiries into the concept of representation. As a philosophically minded scientist and an experimentally inclined philosopher, Peirce never divorced the practice of representing from questions about what counts as a representation... (shrink)

Here I present the first version of the transcription of the Commentarius in Metaphysicam by Konrad Graf from Cod. Pp 183 4°, Teil 2, Zentral- und Hochschulbibliothek Luzern [ZHB], Sondersammlung (ff. 1r-56v), which collects Graf's lectures in metaphysics, held at the Lucerne Gymnasium in 1635-36. The transcription of the text was carried out at the Lucerne Faculty of Theology within the SNSF project "Zwischen monastischer und reformierter Metaphysik. Die schweizerische 'Wiege' der Ontologie im Zeitalter der Reformation" (SNSF project 100012_192559 - (...) applicant: Prof. Dr. Giovanni Ventimiglia (TF- University of Lucerne), Employees: Marco Lamanna, Chiara Paladini. The project aimed to redefine the "cartography" of the Reformation in Switzerland on the traces of metaphysics teaching (Reportationes) in Swiss educational institutions and monastic poles, and thereby to gain a precise place for Swiss studies in the panorama of research on metaphysics and ontology in the early modern period. The project was based on a preliminary investigation that made it possible to recover new texts transmitting lessons on metaphysics held in Lucerne and Engelberg. The method was 1. to produce a systematic and comprehensive documentation based on an index of manuscripts and printed texts, most of them already identified, which testify to the existence of a cultural flourishing in Switzerland that has so far remained unexplored. 2. this documentation should be placed on a solid textual basis by transcribing and eventually critically editing those texts judged to be of interest in terms of their content and influence, in order to make them accessible to the scholarly community and to readers. 3. finally, we will examine the specific aspects of the teachings transmitted in these manuscripts. (shrink)

Disagreement among philosophers over the proper justification for political institutions is far from a new phenomenon. Thus, it should not come as a surprise that there is substantial room for dissent on this matter within democratic theory. As is well known, instrumentalism and proceduralism represent the two primary viewpoints that democrats can adopt to vindicate democratic legitimacy. While the former notoriously derives the value of democracy from its outcomes, the latter claims that a democratic decision-making process is inherently valuable. This (...) article has two aims. First, it introduces three variables with which we can thoroughly categorise the aforementioned approaches. Second, it argues that the more promising version of proceduralism is extrinsic, rather than intrinsic, and that extrinsically procedural accounts can appeal to other values in the justification of democracy without translating into instrumentalism. This article is organised as follows. I present what I consider to be the ‘implicit view’ in the justification of democracy. Then, I analyse each of the three variables in a different section. Finally, I raise an objection against procedural views grounded in relational equality, which cannot account for the idea that democracy is a necessary condition for political legitimacy. (shrink)

The current situation around COVID-19 portrays a threat to us in several ways: It imposes uncertainty, a lack of control and reminds us of our own mortality. People around the world have reacted to these threats in seemingly unrelated ways: From stockpiling yeast and toilet paper to favoring nationalist ideas or endorsing conspiratorial beliefs. According to the General Process Model of Threat and Defense the confrontation with a threat - a discrepant experience - makes humans react with both proximal and (...) distal threat responses. While the proximal response manifests in behavioral inhibition that leads to heightened anxious arousal and vigilance, distal responses seek to lower behavioral inhibition and the associated state of anxiety and vigilance through engaging in distal defenses. In the present research, we propose that the reactions to COVID-19 may represent distal defense strategies to the pandemic (in the form of environmental or group related worldview defenses) and therefore can be explained and forecasted by the model. Thus we hypothesized increased perceived COVID-19 threat perception to lead to a proximal threat response in the form of heightened behavioral inhibition. This, in return, should enhance the use of distal defenses (i.e.: several ingroup biases, system justification and conspiratorial beliefs) overlapping with the reactions observed as a response to COVID-19. This hypothesized mediated effect of increased perceived COVID-19 threat on distal defenses was tested in two pre-registered studies: In Study 1 (N = 358) results showed perceived COVID-19 threat to be related to behavioral inhibition and in turn to be associated with increased distal defenses (i.e., higher entitativity, control restoration motivation, passive party support). In Study 2 (N = 348) we manipulated COVID-19 threat salience and found results suggesting the distal defenses of system justification and conspiratorial beliefs to be mediated by the proximal threat response. The results of the present research hint towards a common mechanism through which the seemingly unrelated reactions to COVID-19 can be explained. The results might help to predict future behavior during the COVID-19 pandemic and design measures to counteract detrimental effects of the pandemic. (shrink)

Friedrich Albert Lange is usually regarded as a representative of physiological neo-Kantianism or as a forerunner of the Marburg school of neo-Kantianism. In this paper I try to reconstruct Lange’s theory of values to argue that his philosophy is better framed as an intermediate point in the development of the two-world theory (facts/values) between Hermann Lotze and Southwestern neo-Kantianism.

This study conducted on a sample of 295 Dutch and Italian undergraduate and graduate students aims to investigate how psychopathic personality traits (meanness, boldness and disinhibition) may lead to cheating behavior, and to study whether there are correlations between psychopathic traits, motivation, moral disengagement, the perception of seriousness of academic dishonesty and frequency of academic dishonesty to try to better understand what causes students to cheat and engage in dishonest conduct. Results confirmed the key role of psychopathic traits, particularly the (...) disinhibition aspect in predicting academic dishonesty. In addition, it was shown that students’ perceptions of what constitutes academic dishonesty and what does not are also important in predicting the frequency of dishonest behavior. Furthermore, the role of motivation and moral disengagement in predicting and mediating the relationship between traits of psychopathy and academic dishonesty were analyzed through mediation and regression analysis. (shrink)

This essay explores Werner Hamacher’s suggestion that the realm of “philology” lies epékeina tes ousías. I suggest that for him “philology” is concerned with what, according to Plato, generates meaning without itself being generated, and that in his work this “beyond being” is often mediated in terms of caesura. After a brief engagement with a conversation of sorts between Hamacher and Jacques Derrida, in which the view of his “philology” as mostly derivative of Derrida’s work is rejected, the essay returns (...) to Hamacher’s discussion of caesura as what constitutes the very possibility of language. The final section focuses on Hamacher’s engagement with Walter Benjamin and Paul Celan and his suggestion that Dichtung (poetry) is the first philology. The essay concludes by arguing that Hamacher’s philology opens up new ways of thinking about thinking, as well as about the relationship between literature and philosophy. (shrink)

In contemporary science uncertainty is often represented as an intrinsic feature of natural and of human phenomena. As an example we need only think of two important conceptual revolutions that occurred in physics and logic during the first half of the twentieth century: (1) the discovery of Heisenberg’s uncertainty principle in quantum mechanics; (2) the emergence of many-valued logical reasoning, which gave rise to so-called ‘fuzzy thinking’. I discuss the possibility of applying the notions of uncertainty, developed in the framework (...) of quantum mechanics, quantum information and fuzzy logics, to some problems of political and social sciences. (shrink)

Analyzing navigational abilities and related aspects in individuals with Down syndrome (DS) is of considerable interest because of its relevance to everyday life. This study investigates path learning, the conditions favoring it, and the cognitive abilities involved. A group of 30 adults with DS and 32 typically-developing (TD) children matched on receptive vocabulary were shown a 4 × 4 Floor Matrix and asked to repeat increasingly long sequences of steps by walking on the grid. The sequences were presented under two (...) learning conditions, one called Oral instructions (participants received verbal instructions such as “turn right” or “turn left”), the other Observation (participants watched the experimenter's moves). Participants were also assessed on verbal and visuospatial cognitive measures. The results showed a similarly better performance in both groups when the Floor Matrix task was administered in the Observation as opposed to the Oral instructions condition. As for the relation with cognitive abilities, in the Floor Matrix task in the Oral instructions condition, individuals with DS showed an effect of both verbal and visuospatial abilities, which was only positive for verbal ability. The effect of verbal and visuospatial abilities was negligible in the TD group. In the Observation condition, performance was predicted by sequential working memory in both groups. Overall, these results shed light on path learning in individuals with DS, showing that they benefited from the Observation condition, and that the involvement of their cognitive abilities depended on the learning condition. (shrink)

This article is about the terms used in the works traditionally ascribed to Alexander of Aphrodisias to mean the process of abstraction through which intellect separates form and matter. The passages are studied in order to identify what nouns and verbs are used. Since in two works of dubious authorship aphaireô and aphairesis are found, the usage of these terms in the works that can be ascribed with certainty to Alexander is studied. The results obtained are examined in the light (...) of the hypotheses about the authorship and chronology of the cited works formulated by scholars so far. (shrink)

Objective: Quality of Life is an important predictor of patient's recovery and survival in lung cancer patients. The aim of the present study is to identify 1-year trends of lung cancer patients' QoL after robot-assisted or traditional lobectomy and investigate whether clinical and sociodemographic variables may predict these trends.Methods: An Italian sample of 176 lung cancer patients undergoing lobectomy completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire—Core 30 at the pre-hospitalization, 30 days, 4 months, (...) 8 months, and 12 months after surgery. Sociodemographic and clinical characteristics were also collected. The individual change over time of the 15 dimensions of the EORTC QLQ-C30 and the effects of pre-surgery scores of QoL dimensions, type of surgery, perioperative complications, and age on patients' QoL after surgery were studied with the individual growth curve models.Results: Patients had a good recovery after lobectomy: functioning subscales improved over time, while most of the symptoms became less severe over the care process. Perioperative complications, type of surgery, pre-surgery status, and age significantly affected these trends, thus becoming predictors of patients' QoL.Conclusion: This study highlights different 1-year trends of lung cancer patients' QoL. The measurement of pre- and post-surgery QoL and its clinical and sociodemographic covariables would be necessary to better investigate patients' care process and implement personalized medicine in lung cancer hospital divisions. (shrink)

Why government outsourcing of public powers is making us less free Many governmental functions today—from the management of prisons and welfare offices to warfare and financial regulation—are outsourced to private entities. Education and health care are funded in part through private philanthropy rather than taxation. Can a privatized government rule legitimately? The Privatized State argues that it cannot. In this boldly provocative book, Chiara Cordelli argues that privatization constitutes a regression to a precivil condition—what philosophers centuries ago called "a (...) state of nature." Developing a compelling case for the democratic state and its administrative apparatus, she shows how privatization reproduces the very same defects that Enlightenment thinkers attributed to the precivil condition, and which only properly constituted political institutions can overcome—defects such as provisional justice, undue dependence, and unfreedom. Cordelli advocates for constitutional limits on privatization and a more democratic system of public administration, and lays out the central responsibilities of private actors in contexts where governance is already extensively privatized. Charting a way forward, she presents a new conceptual account of political representation and novel philosophical theories of democratic authority and legitimate lawmaking. The Privatized State shows how privatization undermines the very reason political institutions exist in the first place, and advocates for a new way of administering public affairs that is more democratic and just. (shrink)

Environment learning is essential in everyday life. In individuals with Down syndrome (DS), this skill has begun to be examined using virtual exploration. Previous studies showed that individuals with DS can learn and remember paths in terms of sequences of turns and straight stretches, albeit with some difficulty, and this learning is supported by their cognitive abilities. This study further investigates environment learning in the DS population, newly examining their ability to learn a path from actual movements, and to learn (...) increasingly long paths, and how their performance relates to their visuo-spatial abilities and everyday spatial activities. A group of 30 individuals with DS and 30 typically-developing (TD) children matched for receptive vocabulary performed a 4 × 4 Floor Matrix task in a grid comprising 16 squares (total area 2.3 × 2.3 meters). The task involved repeating increasingly long sequences of steps by actually moving in the grid. The sequences were presented in two learning conditions, called Observation (when participants watched the experimenter’s moves), or Map (when they were shown a map reproducing the path). Several visuo-spatial measures were also administered. The results showed a clear difference between the two groups’ performance in the individual visuo-spatial measures. In the Floor Matrix task, after controlling for visuo-spatial reasoning ability, both groups benefited to the same degree from the Observation condition vis-à-vis the Map condition, and no group differences emerged. In the group with DS, visuo-spatial abilities were more predictive of performance in the Floor Matrix task in the Observation condition than in the Map condition. The same was true of the TD group, but this difference was much less clear-cut. The visuo-spatial working memory and visualization tasks were the strongest predictors of Floor Matrix task performance. Finally, the group with DS showed a significant relation between Floor Matrix task performance in the Observation condition and everyday spatial activity. These results enlarge on what we know about path learning in individuals with DS and its relation to their visuo-spatial abilities. These findings are discussed within the frame of spatial cognition and the atypical development domain. (shrink)

Le Quaestiones 2 («Se l’oggetto adeguato della conoscenza divina sia l’essenza di Dio o l’ente universale») e 3 («Se le creature secondo le loro proprie nature e le loro essenze siano vita in Dio e nel Verbo») della Distinctio 35 dello Scriptum di Pietro Aureoli sono importanti per la ricostruzione sia del pensiero del loro autore che della storia della dottrina delle idee divine nel Medioevo. Aureoli rifiuta il modello tradizionale di causalità esemplare, secondo cui Dio avrebbe creato il mondo (...) sulla base di modelli archetipi esistenti dall’eternità nella sua mente. Ricorrendo al concetto di aequivocatio, stabilisce che l’essenza di Dio è in maniera equivoca l’unico esemplare per tutte le creature ed elabora, così, la teoria della causalità esemplare equivoca. (shrink)