Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/UWS more respondents agreed with treatment withdrawal when they considered that VS/UWS patients did not feel pain (77%) as compared to those who thought VS/UWS did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

When someone steps on your toe on purpose, it seems to hurt more than when the person does the same thing unintentionally. The physical parameters of the harm may not differ—your toe is flattened in both cases—but the psychological experience of pain is changed nonetheless. Intentional harms are premeditated by another person and have the specific purpose of causing pain. In a sense, intended harms are events initiated by one mind to communicate meaning (malice) to another, and this could shape (...) the recipient’s experience. This study examined whether self-reported pain is indeed higher when the events producing the pain are understood as intentionally (as opposed to unintentionally) caused by another person. Although pain was traditionally conceived to be solely physical in nature (Aydede, 2005), its experience varies substantially with psychological context. The placebo analgesia effect, for example, is the reduction of pain without a change in physical stimulation when context, expectations, or sugar pills challenge the interpretation of a sensation as painful (e.g., Fields, 2008). The nocebo effect, in turn, is the experience of pain without any physical stimulation—as when participants report headaches when told that a (nonexistent) electric current is passing through their heads (Schweiger & Parducci, 1981). These variations in pain experience seem to depend on the meaning of the stimulus: A sugar pill is meant to decrease pain, whereas electric current is meant to increase pain. In an interpersonal context, the meaning of an action is derived from the would complete. perceiver’s perceptions of the actor’s intention (Clark, 1996). (shrink)

One barrier to optimal pain management in the neonatal intensive care unit (NICU) is how the healthcare community perceives, and therefore manages, neonatal pain. In this paper, we emphasise that healthcare professionals not only have a professional obligation to care for neonates in the NICU, but that these patients are intrinsically worthy of care. We discuss the conditions that make neonates worthy recipients of pain management by highlighting how neonates are (1) vulnerable to pain and harm, and (2) completely dependent (...) on others for pain management. We argue for a relational account of ethical decision-making in the NICU by demonstrating how an increase in vulnerability and dependence may be experienced by the healthcare community and the neonate’s family. Finally, an ethical framework for decisions around neonatal pain management is proposed, focussing on surrogate decision-making and the importance of compassionate action through both a reflective and an affective empathy. As empathy can be highly motivating against pain, we propose that, in addition to educational programs that raise awareness and knowledge of neonatal pain and pain management, healthcare professionals must cultivate empathy in a collective manner, where all members of the NICU team, including parents, are compassionate decision-makers. (shrink)

made with any ambitions for ontological reduction (e.g. denying that there are pains but only states of having pain). So I'm afraid that Tye's objections deriving from attributing to me such a view and pointing out that Representationalism is needed to capture, amongst other things, the fact that we experience pains in phantom limbs are all beside the point. Instead, the question is entirely a matter of whether the inferences mentioned in my original paper and Tye's reply fail because, although (...) the 'in'. (shrink)

OBJECTIVE: We studied and compared the attitudes of pregnant women v new mothers in an attempt to confirm changing patterns of maternal response towards medical ethical decision making in critically ill or malformed neonates. DESIGN: Data were obtained by questionnaires divided into three sections: 1. sociodemographic; 2. Theoretical principles which might be utilised in the decision-making process; 3. Hypothetical case scenarios, each followed by possible treatment options. RESULTS: Pregnant women (n = 545) consistently requested less aggressive medical intervention for the (...) hypothetical cases than did new mothers (n = 250) [Trisomy 18: 57% v 42%; p = 0.0004; Asphyxia: 75% v 63%; p = 0.0017; Down's syndrome 81% v 62%; p = 0.0001; LBW 85% v 75%; p = 0.004]. Significant differences were also observed in the responses to the theoretical principles, with pregnant women attributing less importance to preserving life at all cost, while being more concerned with physical and emotional pain and suffering, with financial cost, and with the infant's potential for future productivity. (shrink)

Apresentam-se os resultados clínicos principais de uma primeira investigação efectuada a familiares de doentes sob tratamento paliativo no domicílio da área de Lisboa, com o instrumento de medida da satisfação SERVQUAL Modificado. Dos 58 familiares/doentes que responderam ao questionário apenas uma minona estava insatisfeita (uma classe de 5 indivíduos mostra-se francamente insatisfeita), uma classe de 15 estava moderadamente satisfeita, havendo 38 individuos fortemente satisfeitos com a qualidade e prontidäo dos serviços prestados. Porém urna percentagem elevada de doentes, segundo a opinião (...) retrospectiva dos cuidadores, faleceu com sintomatologia agravada, nomeadamente dores (60%), obstipação (67%) e depressão/ansiedade (43%). Discute-se a consistência e validade do questionáno SERVQUAL Modificado, contextualizam-se os resultados no que é o standard da prática da MCP e integram-se na promoção da dignidade humana no fim da vida. We present the main clinical findings of research on palliative home care, carried out among relatives of patients in the Lisbon area. An adapted version of SERVQUAL was used. Of a total of 58 carers surveyed only a small number (5) was unsatisfied 15 were only moderately satisfied. 38 family carers were strongly satisfied with the services. Yet, a high percentage of patients, as viewed in retrospect by their relatives died with some aggravated symptoms: 60% with more pain, 67% constipation, and 43% anxiety/depression. We discuss the consistency and validity of this adapted SERVQUAL tool and the main results are contextualized beanng in mind the standard practice of palliative medicine and the pursuit of human dignity in death. (shrink)

Competent patients’ refusals of nursing care do not yet have the legal or ethical standing of refusals of life-sustaining medical therapies such as mechanical ventilation or blood products. The case of a woman who refused turning and incontinence management owing to pain prompted us to examine these situations. We noted several special features: lack of paradigm cases, social taboo around unmanaged incontinence, the distinction between ordinary versus extraordinary care, and the moral distress experienced by nurses. We examined this case on (...) the merits and limitations of five well-known ethical positions: pure autonomy, conscientious objection, paternalism, communitarianism, and feminism. We found each lacking and argue for a ‘negotiated reliance’ response where nurses and others tread as lightly as possible on the patient’s autonomy while negotiating a compromise, but are obligated to match the patient’s sacrifice by extending themselves beyond their usual professional practice. (shrink)

In his response, Michael Tye writes as if I reject Representationalism about pain. But in my original paper (Noordhof 2001) I hoped to make clear that I did not. For instance, I remarked that I had sympathy with the position (95) and, on the subsequent page, outlined what I thought the Represen- tationalist should say. My proposal was that when we experience a pain in the finger, the experience is veridical only if the cause of this experience is a disordered (...) state of the finger. My appeal to the notion of a state was not made with any ambitions for ontological reduction (e.g. denying that there are pains but only states of having pain). So I’m afraid that Tye’s objections deriving from attributing to me such a view and pointing out that Repre- sentationalism is needed to capture, amongst other things, the fact that we experience pains in phantom limbs are all beside the point. (shrink)

Evidence that placebo acupuncture is an effective treatment for chronic pain presents a puzzle: how do placebo needles appearing to patients to penetrate the body, but instead sitting on the skin’s surface in the manner of a tactile stimulus, evoke a healing response? Previous accounts of ritual touch healing in which patients often described enhanced touch sensations suggest an embodied healing mechanism. In this qualitative study, we asked a subset of patients in a singleblind randomized trial in irritable bowel syndrome (...) to describe their treatment experiences while undergoing placebo treament. Analysis focused on patients’ unprompted descriptions of any enhanced touch sensations and any significance patients assigned to the sensations. We found in 5/6 cases, patients associated sensations including “warmth” and “tingling” with treatment efficacy. The conclusion offers a “neurophenomenological” account of the placebo effect by considering dynamic effects of attentional filtering on early sensory cortices, possibly underlying the phenomenology of placebo acupuncture. (shrink)

End-of-life decision making is fraught with ethical challenges. Withholding or withdrawing life support therapy is widely considered ethical in patients with high treatment burden, poor premorbid status, or significant projected disability even when such treatment is not ?futile.? Whether such withdrawal of therapy in the aftermath of attempted suicide is ethical is not well established in the literature. We provide a clinical vignette and propose criteria under which such withdrawal would be ethical. We suggest that it is appropriate to withdraw (...) life support, regardless of the cause of the critical illness or disability, when the following criteria are met: (1) Surrogates request withdrawal of care and the adequacy of surrogates is confirmed, (2) an external reasonability standard is met, (3) passage of time, perhaps 72 hours, to allow certainty regarding the patient's wishes, and (4) psychiatric morbidity should be considered as grounds for withdrawal only in truly treatment-refractory cases. Fundamentally, we believe the question to ask is, ?If this were not an attempted suicide, would a request to withdraw care be reasonable?? We believe that under these circumstances, such withdrawal of life support, even in an individual who has attempted suicide, does not constitute physician assistance with suicide and is distinct from physician aid-in-dying in several important respects. (shrink)

The amygdala is a key brain area regulating responses to stress and emotional stimuli, so improving our understanding of how it is regulated could offer novel strategies for treating disturbances in emotion regulation. As we review here, a growing body of evidence indicates that the gut microbiota may contribute to a range of amygdala-dependent brain functions from pain sensitivity to social behavior, emotion regulation, and therefore, psychiatric health. In addition, it appears that the microbiota is necessary for normal development of (...) the amygdala at both the structural and functional levels. While further investigations are needed to elucidate the exact mechanisms of microbiota-to-amygdala communication, ultimately, this work raises the intriguing possibility that the gut microbiota may become a viable treatment target in disorders associated with amygdala dysregulation, including visceral pain, post-traumatic stress disorder, and beyond. Also see the video abstract here: https://youtu.be/O5gvxVJjX18 The amygdala plays a central role in regulating many aspects of behavior in rodents and humans, from pain responding to social interaction and psychiatric function. Accumulating evidence suggests microbiota-to-amygdala communication along the gut-brain axis is a key modulator of these amygdala-dependent behaviors, with critical implications for health and disease. (shrink)

Over the past few years, over a dozen states have proposed, and almost as many have passed, something referred to as the Pain-Capable Unborn Child Protection Act, a piece of legislation that makes abortion impermissible once fetal pain is possible and that further stipulates the fetus can feel pain at or before 20 weeks of gestation. Some very important questions immediately relevant to the abortion debate, perhaps even to the more complex issue of fetal rights, are raised by this legislation, (...) especially because it would impinge on the second-trimester abortion rights guaranteed by Roe. We first inquire whether the claim of fetal pain perception at or before 20 weeks is true and how such a claim should be substantiated. Next, we inquire whether the fetal capacity to experience pain, at whatever stage of development, reflects on the morality of abortion and whether it should be at all relevant to determining its legality. Finally, we would like to explore the implications that a commitment to a pain-related or sentience criterion of rights might have for a pro-life agenda. (shrink)

Thomas Paine often declared himself a citizen of the world. This Norton Critical Edition presents Paine and his writing within the transatlantic and global context of the revolutionary ideas and actions of his time. Thomas Paine's loyalties were with universal and self-evident principles rather than with a particular group or nation, and it is this dimension that informed his most important works. This Norton Critical Edition shows how Paine's fury at the British Empire, including its injustices (...) to South Asians and Africans, shaped his first best seller, Common Sense, and how his direct involvement with the French Revolution pushed his ideas toward a unique form of democratic radicalism. Together with his rejection of organized religion, Paine's radicalism resulted in his being one of the most hated men in both monarchial Britain and republican America. This volume includes J. M. Opal's introduction, "Thomas Paine and the Revolutionary Enlightenment, 1770s-90s," which provides essential biographical and historical details across three tumultuous decades. Paine's most important works-from Common Sense (1776) through Agrarian Justice (1796)-are reprinted and are accompanied by explanatory annotations. Supporting materials include a wide range of documents from the turbulent years following the publication of both Common Sense and the Declaration of Independence. These include Pennsylvania's gradual emancipation statute of the 1780s, an ex-slave's impassioned call for revolutionary violence against European imperialists and masters, and a British conservative's witty rejoinder to Paine's vision of a brave new world. Four major interpretations of Paine's work are provided by Nathan R. Perl-Rosenthal, Robert A. Ferguson, Gary Kates, and Gregory Claeys. A Selected Bibliography is also included. (shrink)

Vivre avec la douleur neuropathique chronique lorsqu’elle est prise en charge par la stimulation de la moelle épinière (SME), laquelle est un type de technologie de neuromodulation, est une expérience dans laquelle différents vécus s’enchevêtrent. En m’appuyant sur le travail de terrain de type ethnographique que j’ai mené dans un hôpital néerlandais en 2012, je mobilise un cadre phénoménologique pour m’intéresser aux trois dimensions entrelacées qui constituent un tel vécu. Rendre compte de ce que signifie vivre avec la SME ne (...) peut se faire sans prendre en considération les expériences antérieures avec la douleur neuropathique chronique et avec la douleur neuropathique chronique prise en charge par des médicaments analgésiques. Si elles appartiennent a priori au passé, ces expériences sous-tendent ce qui peut être envisagé, et ce qui est craint, dans le présent et le futur. Alors que la douleur neuropathique chronique et la douleur neuropathique chronique prise en charge par des antalgiques perturbent l’intentionnalité corporelle de celles et ceux qui en font l’expérience (“je ne peux pas”), la SME est vécue comme une “reconstruction du monde,” lequel est, cette fois, défini par “je peux.” Un tel accomplissement n’est cependant ni aisé ni absolu. Au contraire, il exige qu’une attention soutenue soit portée au corps et à ses sensations. De même, bien vivre avec la douleur neuropathique chronique prise en charge par la SME demande un “travail de désenchevêtrement” (Oudshoorn, 2020) vis-à-vis d’autres objets technologiques potentiellement dangereux et vis-à-vis du regard des autres. “Je peux / je ne peux pas” n’est pas un trait du corps douloureux uniquement; il est aussi lié aux effets invalidants de l’environnement sociomatériel, lesquels font émerger des “inadaptations / inadapté.e.s” (Garland-Thomson, 2011). (shrink)

This paper focuses on the possibility of conceiving a form of ontological nihilism, starting from D. M. Armstrong’s combinatorialism. This possibility has been suggested by Efird and Stoneham, by means of proposing an alternative strategy to the ‘subtraction argument’. They claim that it is possible to sustain such nihilism trough the concepts of construction and totality state of affairs. However, this hypothesis will require the acceptance of non-instanciated universals, that is, platonic universals. Yet this is opposite to requirements that are (...) basic for a combinatorial theory, which should uphold that universals exist only in their instantiations. Then, the assumption of platonic universals results in high costs for a combinatorial naturalism, according to which only exists what is located in space and time. (shrink)

This paper focuses on the possibility of conceiving a form of ontological nihilism, starting from D. M. Armstrong’s combinatorialism. This possibility has been suggested by Efird and Stoneham, by means of proposing an alternative strategy to the ‘subtraction argument’. They claim that it is possible to sustain such nihilism trough the concepts of construction and totality state of affairs. However, this hypothesis will require the acceptance of non-instanciated universals, that is, platonic universals. Yet this is opposite to requirements that are (...) basic for a combinatorial theory, which should uphold that universals exist only in their instantiations. Then, the assumption of platonic universals results in high costs for a combinatorial naturalism, according to which only exists what is located in space and time. (shrink)

This book's importance is derived from three sources: careful conceptualization of teacher induction from historical, methodological, and international perspectives; systematic reviews of research literature relevant to various aspects of teacher induction including its social, cultural, and political contexts, program components and forms, and the range of its effects; substantial empirical studies on the important issues of teacher induction with different kinds of methodologies that exemplify future directions and approaches to the research in teacher induction.

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 63.2 (2002) 225-237 [Access article in PDF] Did Bayle Read Saint-Evremond? Thomas M. Lennon Of course Bayle read Saint-Evremond—he quotes him. Moreover, he published one of Saint-Evremond's texts. But there is reading, and then there is reading. There is selective, inattentive perusal of excerpts or even secondary sources, with no attempt to penetrate beyond a superficial understanding; and then there is comprehensive, close (...) scrutiny of the best primary sources, with sensitivity to nuance, and attention to context. In short, there is a difference between skimming and studying. Did Pierre Bayle (1647-1706) skim or study the work of Saint-Evremond (ca.1614-1703)?This article argues that Bayle's first-hand knowledge of Saint-Evremond's work was superficial and dependent on a secondary source that gives that work a less than obvious, and hitherto unappreciated meaning for Bayle. This shift matters because it bears on the question of the status of Bayle's religious faith. With her classic Pierre Bayle (1963-64), Elizabeth Labrousse set aside the traditional view of Bayle as a religious skeptic whose professions of faith cannot be taken at face value. Such had been the view held by many in Bayle's own time, most notably by Pierre Jurieu, and near-universally from the Enlightenment into the twentieth century. Very recently, in a work that is no less impressive than hers on this and other topics in Bayle, Gianluca Mori has defended the traditional view, basing a part of his argument on Bayle's use of Saint-Evremond. 1 Thus the question above. Moreover, the matter of Bayle's religious belief is not a merely biographical one. First, there is the fact of his [End Page 225] influence, especially given his huge readership, although Bayle's influence may well be other than anything he intended. Secondly, in any case, the interpretation of Bayle's work as a whole depends on it, for virtually everything he wrote besides the Dictionnaire has a religious dimension.To appreciate the importance of the question, something must first be said about Charles de Marguetel de St. Denis, sieur de Saint-Evremond. He was known in his time, and still is, as a libertine. It is difficult, however, to define libertinage beyond a combination of hedonistic mores and dubious religious beliefs—Epicureanism in some loose and popular sense. 2 What is more important, in any case, is how Bayle might have thought the term applied to Saint-Evremond; and here it is clear that outright atheism may have been at issue. Bayle reports that it was publicly known that Saint-Evremond "ended his long life, just as he had lived it, en esprit fort." He seems certainly to have died without benefit of religion. When asked on his deathbed whether he wished to be reconciled, says Bayle, he answered yes, "with all my heart. I would like to be reconciled with my appetite. For my stomach is no longer functioning in its usual way." Bayle was often at pains to insist upon the ultimate inaccessibility of others' real beliefs (and of the inappropriateness of attempting to reach them). In this case, however, he was prepared to hold up Saint-Evremond as a counter-example to the widely-held belief that there were no speculative atheists, i.e., people who would sincerely deny the existence of God, but only practical atheists, i.e., people who live as if they did not believe in the existence of God, but who, try as they may, are at least occasionally aware of it. 3This view of Saint-Evremond is important because, when accused of irreligion himself, Bayle cited the libertine's work as indicative of his own beliefs. To understand how Bayle came to be accused, and the significance of this response to it, some of the historical background is first necessary. Bayle's Dictionnaire historique et critique sold better than any text in the eighteenth century, philosophical or otherwise; and it was a best-seller right from the publication of its first edition, in... (shrink)

Recently, the concept of "gender identity" has enjoyed a great deal of attention in gender metaphysics. This seems to be motivated by the goal of creating trans-inclusive theory, by explaining trans people's genders. In this paper, we aim to unmotivate this project. Notions of "gender identity" serve important pragmatic purposes for trans people, such as satisfying the curiosity of non-trans people, and, relatedly, securing our access to important goods like legal rights and medical care. However, we argue that this does (...) not mean that "gender identity" is a metaphysically substantial thing that deserves extensive theoretical attention. There are reasons to be skeptical of such a concept. We trace the history of "gender identity," primarily to identify its roots in trans-antagonistic medical theory and its connections to the problematic "wrong-body" model--a legacy that has pathologized and flattened trans experience. Moreover, we argue that trans people primarily use "gender identity" to explain ourselves to non-trans people, rather than to discuss ourselves among ourselves. Thus, we urge theorists to resist the urge to substantiate gender identity. Instead, we encourage the development of new and better concepts, ones that attend to the lived realities of trans community and the flourishing gender terms and practices that are constructed there. If these lived realities are taken seriously, there is no need to “explain” trans people’s genders; we can simply see them as they are. (shrink)

Viewpoints advocating the thesis that Indic philosophy had encompassed, and continues to encompass and be enriched by, Marxist philosophy; papers presented at a 1992 seminar, organized by the Dept. of Sanskrit, University of Calicut.

This paper has two aims: to explore the affective dimensions of moral shock and the way it relates to normative marginalization of those furthest from dominant society and also, more specifically, to articulate the trans experience of constantly being under moral attack because the dominant ‘world’ normatively defines trans individuals out of existence. Toward these ends, I build on Katie Stockdale's recent work on moral shock, arguing that moral shock needs to be contextualized to ‘worlds’ of sense to understand how (...) marginalized people affectively experience shocking events. My focus is the trans experience of moral shock due to the way trans people are positioned outside of dominant society, which creates the conditions to experience cyclical, chronic shock. These affective conditions point to a collective responsibility to ease the affective stress that the most marginalized experience. (shrink)

Trans existence has recently been plagued by two different explanations: a natural, “born this way,” necessity and a social, often-thought perverted, choice. These contrasting explanations of necessity and choice create an explanatory false dichotomy and political double-bind. This talk constructs an alternative explanation for why people transition, one that centralizes the role of desire while recognizing the necessity of choice that arises from that desire. Toward this end, I present a moral psychology of desire. An explanation that recognizes the role (...) desire plays, not just in our actions, but in our perception. This desire is made apparent when one perceives the option to transition as a salient possibility. Once this desire is recognized, it functions as what Bernard Williams calls a categorical desire, a desire that partly constitutes one’s ethical identity and thus makes following through on that desire a matter of practical necessity that adds meaning to our lives. I argue that this explanation eschews the explanatory false dichotomy and evades the political double-bind. (shrink)

_Zettel, _ an en face bilingual edition, collects fragments from Wittgenstein's work between 1929 and 1948 on issues of the mind, mathematics, and language.

In 2005 St Andrews Studies published a volume of essays by Anscombe entitled Human Life, Action and Ethics, followed in 2008 by a second with the title Faith in a Hard Ground. Both books were highly praised. This third volume brings essays on the thought of historical philosophers in which Anscombe engages directly with their ideas and arguments. Many are published here for the first time and the collection provides further testimony to Anscombe's insight and intellectual imagination.

Dubbed “Nietzsche without his hammer” by literary critic James Wood, the Romanian philosopher E. M. Cioran is known as much for his profound pessimism and fatalistic approach as for the lyrical, raging prose with which he communicates them. Unlike many of his other works, such as On the Heights of Despair and Tears and Saints, The New Gods eschews his usual aphoristic approach in favor of more extensive and analytic essays. Returning to many of Cioran’s favorite themes, The New Gods (...) explores humanity’s attachment to gods, death, fear, and infirmity, in essays that vary widely in form and approach. In “Paleontology” Cioran describes a visit to a museum, finding the relatively pedestrian destination rife with decay, death, and human weakness. In another chapter, Cioran explores suicide in shorter, impressionistic bursts, while “The Demiurge” is a shambolic exploration of man’s relationship with good, evil, and God. All the while, The New Gods reaffirms Cioran’s belief in “lucid despair,” and his own signature mixture of pessimism and skepticism in language that never fails to be a pleasure. Perhaps his prose itself is an argument against Cioran’s near-nihilism: there is beauty in his books. (shrink)

Born of a terrible insomnia--"a dizzying lucidity which would turn even paradise into hell"--this book presents the youthful Cioran, a self- described "Nietzsche still complete with his Zarathustra, his poses, his mystical clown's tricks, a whole circus of the heights." On the Heights of Despair shows Cioran's first grappling with themes he would return to in his mature works: despair and decay, absurdity and alienation, futility and the irrationality of existence. It also presents Cioran as a connoisseur of apocalypse, a (...) theoretician of despair, for whom writing and philosophy both share the "lyrical virtues" that alone lead to a metaphysical revelation. "No modern writer twists the knife with Cioran's dexterity. . . . His writing . . . is informed with the bitterness of genuine compassion."--Bill Marx, Boston Phoenix "The dark, existential despair of Romanian philosopher Cioran's short meditations is paradoxically bracing and life-affirming. . . . Puts him in the company of Nietzsche and Kierkegaard."-- Publishers Weekly, starred review "This is self-pity as epigram, the sort of dyspeptic pronouncement that gets most people kicked out of bed but that has kept Mr. Cioran going for the rest of his life."--Judith Shulevitz, New York Times Book Review Emil M. Cioran (1911-1995) is the author of numerous works, including The Fall into Time, A Short History of Decay, and Tears and Saints. (shrink)

There are two aims of this paper: (1) to explore the affective dimensions of moral shock and how it relates to normative marginalization of those furthest from dominant society, but also, more specifically; (2) to articulate the trans experience of constantly being under moral attack because the dominant “world” normatively defines you out of existence. Toward these ends, I build on Katie Stockdale’s recent work on moral shock, arguing that moral shock needs to be contextualized to “worlds” of sense to (...) understand how marginalized people affectively experience shocking events. My focus is the trans experience of moral shock due to the way trans people are positioned outside of dominant society, creating the conditions to experience cyclical, chronic shock. These affective conditions point to a collective responsibility to ease the affective stress that the most marginalized experience. (shrink)

Lines 380–7 have been much discussed, sometimes in isolation, without due regard for context in speech, scene, and play; and sometimes with regard primarily to the history of ideas, or of Greek moral values. Phaidra states that virtue may be subverted, despite knowledge, by pleasure, of which αὶδώς—dual, harmless and harmful—is an instance. A notorious problem of interpretation centres on the related questions of how αὶδώς, shame can be listed among ήδοναί, pleasures; and of what is meant by dual αὶδώς. (...) The interpretation here advanced is bold, but in essence simple: in this context, αὶδώς is a euphemistic metonymy for ἔρως, which is harmless and pleasurable in its proper place, but potentially troublesome or painful. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:DOES GOD HAVE A QUIDDITY ACCORDING TO AVICENNA* IN THE NEW critical edition of Avicenna's MemphyS'ics by S. Van Riet at Louvain (I, 1977; II, 1980; III, 1983), Gerard Verbeke states that according to Avicenna, "L'Etre necessaire n'a pas une essence qui est distincte de son existence" (II, p. * 42, at note 159), i.e. that the Necessary Being does not have an essence that is distinct from its (...) existence. One looks in vain for a precise reference to an Avicennian text. On the other hand, in a three-part study, Albert G. Judy, O.P., "Avicenna's Me1taphy8'ics in the Summa contra Gentiles," published in Angelicum, part I: 52 (1975) 340-384; part II: 541-586; part Ill: 53 (1976) 183-226, states quite clearly that the "First" does not have a quiddity but only an "anity" (anitas)... (546), and that Avicenna... finds that the absolutely necessary being cannot have what every other reality has, namely, a quiddity, a "whatness " distinct from its" whether-ness" or anitas (547-548). Moreover, the first appendix of Judy's article contains a redaction of the 1495 and the 1508 Venice editions of ltletaphyiscs 8.4, which differs chiefly in punctuation from the excellent Van Riet text based on five Latin MSS. A slightly more nuanced position is. found in Etienne Gilson's Elements of Christian Philosoph;y (Garden City, N. Y.: Doubleday, 1960), p. 127: "... such exactly had been the con- * Delivered before the Society for the Study of Islamic Philosophy and Science meeting in conjunction with The American Catholic Philosophical Association in Milwaukee, Wisconsin, on April 12, 1985. 79 80 E. M. MACIEROWSKI clusion of Avicenna: the first has no quiddity (quidditatem non habet)," a claim that cites (305, note 28) secondary literature which one can trace as far back as Father M.-D. RolandGosselin 's edition of the De ente et essentia. What is at stake in this dispute? What if God does not have a quiddity? It would seem that He should be utterly unknowable, if quiddity or essence is a principle of knowledge as well as of being. Such would be plausible consequences of Gilson's and Judy's position. What, on the other hand, if God does have a quiddity? One possible inference, if we happened to have access or insight into the divine quiddity, is that we could have a sort of mystical union with God, perhaps even in this life; or again, one might draw pantheistic conclusions. Verbeke does not follow such paths. His inference points toward a rawrochement between Avicenna's doctrine and that of St. Thomas Aquinas, who maintained not only that God is His own essence (and therefore that it is reasonable to speak of a divine essence) but also that God's essence is no other than His esse, His being or existence. Accordingly, for scholars to have such opposed views about so important a topic even at the hermeneutical level of Avicenna's position points to a serious difficulty. Since Judy does offer texts in support of his interpretation, let us consider the evidence, using his section numbers and Van Riet's pages and lines: Judy, section 4=Van Riet 398.83-399.84 goes thus in Latin: Redibo igitur et dicam quod primum non habet quidditatem, nisi anitatem, quae sit discreta ab ipsa. This text he renders, "The first does not have a quiddity, except an 'anity,' which is distinct from it" (549). The other text in Latin (Judy, section 13=Van Riet 401.31-32) goes thus: Igitur necesse esse non habet quidditatem nisi quod est necesse esse, et haec est anitas, which he renders, "Therefore necessary being does not have a quiddity, but only the fact of its necessary being, and this is DOES GOD HAVE A QUIDDITY ACCORDING TO AVICENNA 81 'anity'" (559). We wonder, however, why nisi should be translated "except" in section 4 and "hut only" in section 13. One would have expected a sed solum or a sed tantum to justify the rendering "but only." Accordingly, the translation should be corrected to read, " Therefore the necessary being has no quiddity except that it is necessary being, and this... (shrink)

Pain sensation in autism spectrum disorder has been a growing research field in the last two decades. Existing pain research has focused on pain sensitivity, suggesting either hyposensitivity or hypersensitivity to pain in individuals with ASD. However, research about other aspects of pain experience is scarce. Moreover, most pain-related research in ASD focused on quantitative measures, such as neuroimaging or parental reports. Instead, this paper aimed to illuminate the various aspects of pain experience as perceived by adults with ASD. Its (...) descriptive qualitative research design incorporated semi-structured interviews and deductive thematic analysis. This phenomenological approach captured the subjective pain experience through the lens of people with ASD. Four primary themes emerged from the data: physical pain experience, including the sequence of pain sensitivity, pain awareness, pain-related emotional aspects, and pain communication; direct and indirect coping strategies; function and participation outcomes; and suggestions for Healthcare Providers. The findings echo the crucial role of pain awareness and communication in the pain experience of people with ASD. These two factors have been reported as profoundly influencing coping strategies, function, and participation. The results emphasize the need to expand the exploration of pain in this population, calling for greater understanding, and listening to this population’s unique pain profiles and experiences to promote better-suited evaluation, diagnosis, and intervention in pain conditions. (shrink)

Interpretation of the classics in political theory seems to go in waves. For a while we had John Locke, the bourgeois thinker. Now we seem to be in a Locke-as-radical-democrat phase. Locke-the-bourgeois had problems of its own, but a radically democratic Locke -- not just the old Locke as liberal democrat but Locke as quasi-Leveller -- strains the interpretative imagination more than most; yet in recent years, several different kinds of argument have been advanced in support of it, both textual (...) and contextual. The most effective argument has proceeded by situating Locke in the context of radical Whig politics in the 1670s and '80s, the struggles over religious toleration and the royal succession, in particular the �Exclusion Crisis� of 1679-81. This contextual argument has been accompanied by various textual interpretations having to do with Locke's conceptions of property, consent, representation, the right of revolution and natural law. Among other things, these are supposed to show that while Locke had nothing explicit to say about the extent of the franchise, the weight of evidence suggests that he would have supported a fairly wide franchise, perhaps even something like the (almost) manhood suffrage advocated by the Levellers (at least according to some, and probably the most convincing, interpretations of their ideas). Most recently, in these pages, Martin Hughes, building on the work of James Tully and Richard Ashcraft in particular, has pushed the argument as far as it can probably go. His argument on taxation and suffrage has provided a motivation here for a wider exploration of Locke's views on representation, consent and the franchise. (shrink)

There is a curious phenomenon where people from marginalized populations are taken to be arrogant when they show no signs of superiority. In effect, their actions are misconstrued, and their attitudes are rendered unintelligible. Given that arrogance is standardly taken to be a flaw in one’s moral character, understanding such misattributions should give us insight into the affective marginalization many people face. This talk aims to give a thorough exploration of arrogance under oppression. I argue that arrogance is a kind (...) of self-preoccupation that involves projecting one’s values, goals, and concerns onto others as if they were objective values, goals, and concerns. When the affectively marginalized communicate their self-respect through things like protest, people mistake that self-respect as self-preoccupation given how the affectively marginalized are constructed. Furthermore, given how affective marginalization not only inhibits how the marginalized are understood by others, but inhibits their own affective lives, I argue that taking up an arrogant attitude is not always morally vicious, but can be a beautiful form of political resistance but all things considered good. (shrink)

Philosophers of race and other writers in the Black and Latinx intellectual traditions have remarked on what it is like to live under “the racial gaze,” to be shaped and limited by the way whites perceive us. However, little work has been spent developing how the racial gaze functions in whites’, and other racially privileged people’s, moral psychology. I argue in this paper that there is a morally objectionable way of perceiving people of color. This claim builds on an insight (...) from Iris Murdoch that our perception can be morally evaluable and extends it to issues of race. I articulate how racial stereotypes and misvaluing distort one’s perception of people of color and that these distortions are organizing around a dominant conception for race that plays an important role in the oppression of people of color. I believe understanding racist perception lays a foundation for understanding the moral dimensions of interpersonal (as opposed to structural) racism. (shrink)

Watching another person in pain activates brain areas involved in the sensation of our own pain. Importantly, this neural mirroring is not constant; rather, it is modulated by our beliefs about their intentions, circumstances, and group allegiances. We investigated if the neural empathic response is modulated by minimally-differentiating information (e.g., a simple text label indicating another’s religious belief), and if neural activity changes predict ingroups and outgroups across independent paradigms. We found that the empathic response was larger when participants viewed (...) a painful event occurring to a hand labeled with their own religion (ingroup) than to a hand labeled with a different religion (outgroup). Counterintuitively, the magnitude of this bias correlated positively with the magnitude of participants’ self-reported empathy. A multivariate classifier, using mean activity in empathy-related brain regions as features, discriminated ingroup from outgroup with 72% accuracy; the classifier’s confidence correlated with belief certainty. This classifier generalized successfully to validation experiments in which the ingroup condition was based on an arbitrary group assignment. Empathy networks thus allow for the classification of long-held, newly-modified and arbitrarily-formed ingroups and outgroups. This is the first report of a single machine learning model on neural activation that generalizes to multiple representations of ingroup and outgroup. The current findings may prove useful as an objective diagnostic tool to measure the magnitude of one’s group affiliations, and the effectiveness of interventions to reduce ingroup biases. (shrink)

Stephen Davies offers a compelling account of adornment as a form of aesthetic enhancement that aims either to intensify or to contribute to beauty and sublimit.

The orphans of Romania were participants in what is sometimes called “the forbidden experiment”: depriving human infants of intimacy, affection, and human contact is an inhuman practice. It is an experiment which no ethical researcher would set out to do. This paper examines historical data, case histories, and research findings which deal with early deprivation and performs a phenomenological analysis of deprivation phenomena as they impact emotional and physical development. A key element of deprivation is the absence of intimate relationships (...) with other human beings. However, the absence of intimacy impacts not only the social/emotional abilities of infants, but their very ability to perceive the world. Philosophically and from a radically Merleau-Pontean perspective, the intimate face of the other appears to be a world opening event for the child. Its absence has a profound impact on the child’s experience of embodiment, coexistence, spatiality, temporality, and language. When seen through early deprivation, intimacy appears as a necessary foundation for establishing the transcendence of the world beyond perceptual presence, and it provides the possibility for language, culture, and history. (shrink)

Reply to Professor Martinich The editor of this journal has invited me to reply to Professor Martinich's reply to my reply to his reply to my article, on the condition that I should be brief. I shall try to be very brief. Our discussion has probably reached a point at which we can expect dimin- ishing returns. I shall try also to avoid even the slightest hint of irony, though I am not sure I can succeed in that. I am (...) surprised that Prof. Martinich, who sees so little irony in Hobbes, should find so much in "Calvin and Hobbes." I did think his definition of "orthodoxy" was plausible, taking the term "plausible" in the sense of "having an appearance or show of truth, reasonableness or worth" . That's also, of course, perfectly consistent with thinking the criterion of the creeds too weak. The Church of England, from the time of Elizabeth, has made acceptance of the Nicene and Aposdes' Creeds one of the 39 Articles which define membership in that Church. But Martinich exaggerates when he says that that was the criterion of orthodoxy used by the Church. The 39 Articles cover many other issues as well, including God's incorpo- reality. As a somedme member of that Church, I wonder if Martinich has given thor- ough consideration to all that it requires of its adherents. I welcome Martinich's clarification of his use of the term "Calvinist." It was silly of me to think that he intended it to imply.. (shrink)

In [3] F. P. Ramsey proved as a theorem of Zermelo-Fraenkel set theory (ZF) with the Axiom of Choice (AC) the following result:(1) Theorem. Let A be an infinite class. For each integer n and partition {X, Y} of the size n subsets of A, there exists an infinite subclass of A all of whose size n subsets are contained in only one of X or Y.

Zettel is a collection of fragments which Wittgenstein cut from various of his typescripts and preserved for future use. More than half of the fragments were written in the years 1946-1948, after the completion of Part I and before the composition of Part II of the Philosophical Investigations. This collection may therefore be regarded as a companion volume to the Investigations, adding to both the scope and the Unity of Wittgenstein′s chef d′oeuvre. The fragments were kept in a box and (...) were not strictly ordered. Many have marks showing changes and improvements made after they were cut from the typescripts; some have remarks added in handwriting. Editing the collection for publication was thus a task of considerable difficulty. Since Zettel was first published, further research has been carried out on the fragments and minute comparisons have been made with their typescript and manuscript sources, revealing certain inaccuracies and misinterpretations in the first editing of the work. The second edition corrects these shortcomings and includes new explanatory footnotes; a detailed index, compiled by Stephen Amdur, has also been added. (shrink)

Physician concern about regulatory scrutiny as a barrier to appropriate prescribing for pain management has been identified and studied. A 1991 Pain Research Group survey demonstrated a need to provide updated information about opioids and pain management to state medical board members. Indeed, a national survey even showed a need to provide more education about pain management to oncology Physicians. Two approaches for responding to these concerns have been undertaken in several states by the state medical boards and the pain (...) management community: the development and adoption of administrative policies designed to bring disciplinary standards in line with clinical practice; and the creation of education programs for state medical board members and staffs. Each can have a substantial impact on removing real and perceived regulatory barriers to effective pain relief. (shrink)

This essay, as the title suggests, is not just a reply to Richard Ashcraft -- although it is certainly that too. Its intention is to say something about the political theory of Locke, about his historical context and about the methodological question of contexts in general. About his political theory, I want to make two or three main points which, I think, have important consequences for our understanding of Locke: that he both appropriates and, on critical issues, deliberately neutralizes the (...) radical �discourses� of his time -- so that, for example, he adopts Leveller premises to arrive at something more like Cromwell's (or even more conservative) conclusions; and that he deprives these radical discourses of their most democratic implications less by excluding people from membership in the political nation than by restricting the rights of membership itself. This means, among other things, that the relevant debate is not the one that has so preoccupied Locke scholars -- namely, the controversy about who is a �freeman� or who belongs to the �people�. The decisive question is rather what political rights the �people� have. (shrink)

I believe that the world is a totality of things: there are no properties, or relations, or sets, or states of affairs, or facts, or events; there are only particular things. I also believe that all true statements can be expressed in a canonical language which includes names of things and logical terms only: there will be no predicates in this language. For what is a predicate? Some say that predicates are names of universals which individual things exemplify, or names (...) of sets of which individual things are members. If this is so, it is obvious that a nominalist's canonical language cannot have any predicates. Others say that predicates name nothing, but are satisfied by particular things. What, however, is satisfaction, and how is it different from naming? Semantic relations such as satisfaction, we are told, are not ‘in’ the world. But then a nominalist has no use for them. (shrink)

The paper consists of a reflexive exercise in which Herbert Simon 's views concerning science are applied to his own research. It argues that what connected his ventures into so many different disciplinary domains was a search for complex, hierarchical systems. In the process, the paper establishes a close connection between Simon 's insights and his focus on simulation. Instead of simulating Simon on a computer, though, it simulates Simon on paper. This exercise is then contrasted with Simon 's own (...) attempts to simulate science. This comparison leads to a reflexive evaluation of Simon 's simulations. (shrink)

While agreeing with Poteat that the modern Western culture has gone awry in a humanly destructive way, the paper contends tha the culprit was not, as Poteat claims, Enlightenment critical philosophy, but the materialistic values of the bourgeois form of life and the puritanical view of knowledge and the naturalistic worldview that they generated. Accordingly, the solution proposed is not Poteat's unreflected experience and commonsense worldview but a shift to a humanistic culture-generating stance and a critical humanistic philosophy.