Human clinical research has become a huge economic enterprise (Morin et al. 2002; Noah 2002). Because the human subject at the center can be so easily marginalized, many commentators recommend spec...

Based on the existence of polysemy (e.g., lunch can refer to both food and events), it is argued that central tenets of externalist semantics and Fodorian concept atomism, an externalist theory on which words lack semantic structure, are unsound. We evaluate the premise that these arguments rely on—that polysemous words have separate, finer‐grained senses. We survey the evidence across psychology and linguistics and argue that it shows that polysemy does not exist, at least not in this “sense”. The upshot is (...) that if polysemy does not exist, it cannot pose a problem for atomism or externalism. (shrink)

This book examines influential conceptions of sport and then analyses the interplay of challenging borderline cases with the standard definitions of sport. It is meant to inspire more thought and debate on just what sport is, how it relates to other activities and human endeavors, and what we can learn about ourselves by studying sport.

In 1945–46, representatives of the U.S. government made similar discoveries in both Germany and Japan, unearthing evidence of unethical experiments on human beings that could be viewed as war crimes. The outcomes in the two defeated nations, however, were strikingly different. In Germany, the United States, influenced by the Canadian physician John Thompson, played a key role in bringing Nazi physicians to trial and publicizing their misdeeds. In Japan, the United States played an equally key role in concealing information about (...) the biological warfare experiments and in securing immunity from prosecution for the perpetrators. The greater force of appeals to national security and wartime exigency help to explain these different outcomes. (shrink)

With breathtalung speed, traditional criminal prohibitions against assisted suicide have been declared unconstitutional in twelve states, including California and New York. This poses great promise and great peril. The promise is that competent terminally ill patients, as a compassionate measure of last resort, will have the option of putting an end to their suffering by physician-assisted suicide. More sigmficant, legally permitting this controversial option may be a catalyst for doctors, health care institutions, and society to improve the care of the (...) dying. PAS should be limited only to those relatively few competent patients who continue to suffer intolerably despite unrestrained efforts to palliate and who face a continued existence that they regard as worse than death. When dying patients know they will not be abandoned to miserable and pointless suffering if palliative care fails, they will be fortified to cope better with the process of dying.The immediate peril is that PAS will become a quick fix, available on demand to any patient diagnosed as terminally ill, thus bypassing palliative care and producing premature deaths. (shrink)

: Pharmacogenetics offers the prospect of an era of safer and more effective drugs, as well as more individualized use of drug therapies. Before the benefits of pharmacogenetics can be realized, the ethical issues that arise in research and clinical application of pharmacogenetic technologies must be addressed. The ethical issues raised by pharmacogenetics can be addressed under six headings: regulatory oversight, confidentiality and privacy, informed consent, availability of drugs, access, and clinicians' changing responsibilities in the era of pharmacogenetic medicine. We (...) analyze each of these categories of ethical issues and provide policy approaches for addressing them. (shrink)

We surveyed selected physician members of the Society for Health and Human Values (SHHV) to study the benefits and problems of combining a medical career with a strong scholarly interest in the humanities. The 19 usable narrative responses characterized major benefits as experiential base and teaching opportunities. Barriers were numerous and fell under the general headings of: lack of time; lack of institutional rewards; lack of money for research and scholarship; lack of support from humanities peers; lack of suport from (...) medical colleagues; personal financial sacrifice; and lack of training. Some respondents offered creative solutions to these problems, including assertive negotiation of a job description, identification of helpful mentors, and various networking and administrative strategies. The survey results, while preliminary, suggest ways in which SHHV can assist clinicians who wish to develop a serious commitment to humanities study and teaching. (shrink)

Some recent discussions of narrative structure consider the narrative as a sequence of events, and assume that the structure is what is manifested by the relation between any given event and the event 1, or perhaps the whole sequence from the first event up to the th event in the book. In the present discussion this approach will be modified in two ways. It will be modified, later on, by considering what would be happening if the writer were revising his (...) work into the final version, out of a penultimate version which was, as it were, a next-most complex version: one to which some final "complexifying" process had not yet been applied. The other way in which the present discussion will modify that approach is that it will consider narrative not as one sequence of events but as an interrelated set of sequences. · 1. E.g., R. Barthes, "Introduction à l'analyse structurale du récit," Communications, no. 8 , pp.1-27. John Holloway, professor of Modern English at the University of Cambridge, has written The Victorian Sage, The Charted Mirror, The Story of the Night, Blake: The Lyric Poetry, and five volumes of verse, such as New Poems. He is presently completing a book on poetic modes from Milton to Hardy and coediting a four-volume series on English and Irish street ballads. His other contribution to Critical Inquiry," Supposition and Supersession: A Model of Analysis for Narrative Structure" appeared in the Autumn 1976 issue. (shrink)

There seems to be something self-evident—irresistibly so, to judge from its gleeful propagation—about the use of the phrase, “Jane Austen and the Masturbating Girl,” as the Q.E.D. of phobic narratives about the degeneracy of academic discourse in the humanities. But what? The narrative link between masturbation itself and degeneracy, though a staple of pre-1920s medical and racial science, no longer has any respectable currency. To the contrary: modern views of masturbation tend to place it firmly in the framework of optimistic, (...) hygienic narratives of all-too-normative individual development. When Jane E. Brody, in a recent “Personal Health” column in the NewYork Times, reassures her readers that, according to experts, it is actually entirely possible for people to be healthy without masturbating; “that the practice is not essential to normal development and that no one who thinks it is wrong or sinful should feel he or she must try it”; and that even “’those who have not masturbated … can have perfectly normal sex lives as adults,’” the all but perfectly normal Victorianist may be forgiven for feeling just a little—out of breath.3 In this altered context, the self-evidence of a polemical link between autoeroticism and narratives of wholesale degeneracy 4 draws on a very widely discredited body of psychiatric and eugenic expertise whose only direct historical continuity with late twentieth-century thought has been routed straight through the rhetoric and practice of fascism. But it now draws on this body of expertise under the more acceptable gloss of the modern, trivializing, hygienic-developmental discourse, according to which autoeroticism not only is funny—any sexuality of any power is likely to hover near the threshold of hilarity—but also must be relegated to the inarticulable space of infantility. 3. Jane E. Brody, “Personal Health,” New York Times, 4 Nov. 1987.4. Rosenblatt, “The Universities,” p. 3. Eve Kosofsky Sedgwick is professor of English at Duke University and the author of Between Men: English Literature and Male Homosocial Desire and Epistemology of the Closet. (shrink)

A broad critical review of national policies on biomedical research - human, epidemiologic, clinical trials, genetic, reproductive, etc.

"When it comes to morality as it is practiced in medicine, Brody makes clear that the ethical issues are never as simple as black and white - that there are myriad factors and fine nuances that can and should challenge decision making as it is commonly practiced in difficult medical cases. In this collection, delving thoughtfully and systematically into methodology, research ethics, clinical ethics, and Jewish medical ethics, he tackles thorny life-and-death questions head-on and fearlessly. He casts a light into (...) all the corners of end-of-life decisions - a field in which he has exemplary credentials - while illuminating a new understanding of morality and ethics." "The introduction outlines much of Brody's approach, defines the terminology used, and contrasts his ethical positions with much of the competing literature, Taking Issue will be invaluable to students and scholars in medical ethics, bioethics, and the philosophy of medicine." "Baruch A. Brody is the Leon Jaworski Professor Biomedical Ethics and director of the Center for Medical Ethics and Health Policy at Baylor College of Medicine. He is also a professor of philosophy at Rice University and director of the Ethics program at the Methodist Hospital."--BOOK JACKET. (shrink)

: The "difference position" holds that clinical research and therapeutic medical practice are sufficiently distinct activities to require different ethical rules and principles. The "similarity position" holds instead that clinical investigators ought to be bound by the same fundamental principles that govern therapeutic medicine—specifically, a duty to provide the optimal therapeutic benefit to each patient or subject. Some defenders of the similarity position defend it because of the overlap between the role of attending physician and the role of investigator in (...) a research trial. This overlap is maximal when the same physician occupies both roles with respect to a particular patient-subject. We address the ethical tensions inherent in that role conflict and argue that the tensions are real but manageable. The difference position provides a sound ethical framework within which to manage those tensions, while the similarity position is unsatisfactory because it seeks to deny the existence of the tensions. (shrink)

There has been much first-rate work done in recent years both by way of criticizing Humean assumptions and explicating alter native concepts of causal explanation and non-logical necessity. Roderick Chisholm early showed the inadequacies of neo-Humean views of explanation in his articles on counterfactual inference, and C. J. Ducasse, Sterling Lamprecht, William Kneale, Nicholas Maxwell, Richard Taylor, G. E. M. Anscombe, P. T. Geach, Milton Fisk, Baruch Brody, Peter Alexander, R. Harré, and William Wallace, among others, have articulated interesting alternative (...) views to the Humean ones they have so trenchantly criticized. We will be concerned with the recent work of Harré and Wallace in this study. Harré has not only launched a fresh attack but has also presented what is probably the most fully developed neorealistic [[sic]] alternative. Wallace’s work is basically historical but has an intentional systematic import also. The books of the two authors are mutually supportive. (shrink)

In seeking to clarify the concept of conflict of interest (COI) in debates about physician–industry relationships, Howard Brody (2011) highlights the extent to which the prob- lem turns on a common pejorative understanding of COI. Whether it is the academic or public policy “pharmapologists” or “pharmascolds” talking about COI, there is often a straightforward and overly simplistic correlation made: that is, a conflict of interest—by definition—leads to fraudulent or corrupt behavior. The same type of reasoning is com- monly found in (...) discussions about COI outside the health sciences, most notably in news stories about the awarding of government contracts or the behaviour of corporate executives. The problem is that in focusing on dramatic failures to manage COI (e.g., around Vioxx), there is a tendency to strongly associate COI with extreme forms of financial and even criminal misconduct, leaving the public, policymakers, academics, and professionals with a skewed and limited understanding of the concept. (shrink)

Bioethics' interdisciplinary base -- Patient-centered care -- Evidence-based medicine and pay-for-performance -- Community dialogue -- Overview : bioethics, power, and learning to see -- Cross-cultural concerns -- Race and health disparities -- Disabilities -- Environmental and global issues -- New technologies -- Conclusion.

How did one of the greatest Jewish thinkers of the 20th century grapple with the founding of Israel and the Israeli-Palestinian conflict—one of the most significant political conflicts of his time? Samuel Hayim Brody traces the development of Martin Buber's thinking and its implications for the Jewish religion, for the problems posed by Zionism, and for the Zionist-Arab conflict. Beginning in turbulent Weimar Germany, Brody shows how Buber's debates about Biblical meanings had concrete political consequences for anarchists, socialists, Zionists, Nazis, (...) British, and Palestinians alike. Brody further reveals how Buber's passionate commitment to the rule of God absent an intermediary came into conflict in the face of a Zionist movement in danger of repeating ancient mistakes. Brody argues that Buber's support for Israel stemmed from a radically rich and complex understanding of the nature of the Jewish mission on earth that arose from an anarchist reading of the Bible. (shrink)

It seems to me that those who place great value on the right to human freedom can be badly divided on the question of the use of force by states to defend the liberties of those who are not citizens of that particular state. Concerned about the liberties to be defended, they might be enthusiastic supporters of the use of such force by liberty-loving countries throughout the world. Concerned about the liberties that might be violated when the state marshals its (...) forces for use internationally, they might adopt a more isolationist approach to this issue. This paper is an attempt to help clarify this conflict by looking at some of the philosophical issues it raises. Because I wish to avoid factual debates about current conflicts, I will give no real-life examples. However, they are on my mind, and I hope the reader will keep them in mind as well. (shrink)

This book explores the controversial relationship between physicians and the pharmaceutical industry, identifies the ethical tensions and controversies, and proposes numerous reforms both for medicine's own professional integrity and for effective public regulation of the industry.

Although the physician’s use and misuse of power have been discussed in the social sciences and in literature, they have never been explored in medical ethics until now. In this book, Dr. Howard Brody argues that the central task is not to reduce the physician’s power, as others have suggested, but to develop guidelines for its use, so that the doctor shares with the patient both information and the responsibility for deciding on appropriate treatment. Dr. Brody first reviews literary works (...) dealing with medical power, from Dostoevsky’s “The Grand Inquisitor” to stories by William Carlos Williams, Vonda McIntyre, and Richard Selzer. These works, he shows, reveal the healers’ ambivalence over their own powers and patients’ fears of the abuse of power. Dr. Brody then points out important but neglected ethical issues that emerge from an analysis of power, such as the tension between care of individual patients and the pressures of the doctor’s workload; the rescue fantasy that impels some physicians to extraordinary lengths to save a life; and the economic system, which rewards surgeons and other specialists more than it does physicians who spend time talking with patients about their problems. He also shows how the perspective of shared power can shed new light on standard topics in medical ethics—from informed consent and confidentiality to resource allocation and cost containment. (shrink)

Twenty-four years remind the tears of my eyes.In the groin of the natural doorway I crouched like a tailorSewing a shroud for a journeyBy the light of the meat-eating sun.Dressed to die, the sensual strut begun,With my red veins full of money,In the final direction of the elementary townI advance for as long as forever is.1The first problem raised in this poem is the agrammatical status of the word remind, which in normal usage governs either a verbal or phrasal complement. (...) The reader’s question is: “reminds you of what?” And it is a natural expectation, as the poem unfolds, that this lacuna.. (shrink)

ABSTRACT:The bioethics literature has paid little attention to resistance to COVID-19 vaccination, despite the safety and effectiveness of vaccines and the heavy death toll of the virus. A narrative approach to the problem might begin with descriptions of good and bad narratives about vaccination. Bad stories about vaccination tend to be constructed backwards, starting with the desired conclusion (vaccination is dangerous or ineffective) and from that filling in needed "facts" to support the conclusion. Physicians need to act in more trustworthy (...) ways in order to convince at least some patients to consider vaccination. (shrink)

2020 Gradiva Award Nominee, Best Edited Book Psychoanalytic Perspectives on Women and Their Experience of Desire, Ambition and Leadership considers how these factors can be understood, nurtured, or thwarted and the subsequent impact on women's identity, authority and satisfaction. Psychoanalysis has long struggled with its ideas about women, about who they are, how to work with them, and how to respect and encourage what women want. This book argues that psychoanalytic theory and practice must evolve to maintain its relevance in (...) a volatile landscape. Each section of the book begins with a chapter that reviews contemporary ideas regarding women, as well as psychoanalytic history, gender bias, and societal norms and deficits. Three composite clinical stories allow our distinguished contributors to discuss the contexts within which individual experience can be affected, and the role that clinical work may have to mobilize and advance passion and vitality. In their discussions, the interplay of clinical psychoanalysis, sociopolitical context, and understanding of gender, combine to offer a unique perspective, built on decades of scholarship, personal experience, and clinical expertise. Psychoanalytic Perspectives on Women and Their Experience of Desire, Ambition and Leadership will serve as a reference for all psychoanalysts and psychoanalytic psychotherapists as well as gender studies scholars interested in the progress of psychoanalytic theory regarding women in the 21st century. Contributors to this book include: Rosemary Balsam, Brenda Bauer, Andrea Celenza, Diane Elise, Adrienne Harris, Dorothy Holmes, Nancy Kulish, Vivian Pendar, Dionne Powell, and Arlene Richards. (shrink)

As the debate over how to manage or discourage physicians’ financial conflicts of interest with the drug and medical device industries has become more heated, critics have questioned or dismissed the concept of “conflict of interest” itself. A satisfactory definition relates conflict of interest to concerns about maintaining social trust and distinguishes between breaches of ethical duty and temptations to breach duty. Numerous objections to such a definition have been offered, none of which prevails on further analysis. Those concerned about (...) conflicts of interest have contributed to misunderstandings, however, by failing to demonstrate when social arrangements leading to temptations to breach duties are in themselves morally blameworthy. Clarifying “conflict of interest” is important if we are eventually going to develop productive modes of engagement between medicine and for-profit industry that avoid the serious ethical pitfalls now in evidence. (shrink)

Schizophrenia affects more than 1% of the world's population, causing great personal suffering and socioeconomic burden. These costs associated with schizophrenia necessitate inquiry into the causes and treatment of the illness but generate ethical challenges related to the specific nature and deficits of the illness itself. In this article, we present a systematic analysis of narrative data from 63 people living with the illness of schizophrenia collected through semistructured interviews about their attitudes, beliefs, and experiences related to psychiatric research. In (...) the comments of these individuals, half of whom had had prior personal experience in research protocols, we identified factors influencing openness toward research involvement as well as deterrents that appear to lessen interest in participation. Clear response pattern differences emerged between those with prior research experience and those without such experience. In the discussion, we explore these key findings and outline the implications for safeguards in mental illness research. (shrink)

A recent controversy concerning the pricing of drugs and other technological innovations funded by public dollars raised profound moral and social questions, questions the bioethics community has long overlooked.

Some ethical issues facing contemporary medicine cannot be fully understood without addressing medicine's internal morality. Medicine as a profession is characterized by certain moral goals and morally acceptable means for achieving those goals. The list of appropriate goals and means allows some medical actions to be classified as clear violations of the internal morality, and others as borderline or controversial cases. Replies are available for common objections, including the superfluity of internal morality for ethical analysis, the argument that internal morality (...) is merely an apology for medicine's traditional power and authority, and the claim that there is no single, "core" internal morality. The value of addressing the internal morality of medicine may be illustrated by a detailed investigation of ethical issues posed by managed care. Managed care poses some fundamental challenges for medicine's internal morality, but also calls for thoughtful reflection and reconsideration of some traditionally held moral views on patient fidelity in particular. (shrink)

Originally published in 1948, this book contains an edited version of The Tree of Commonwealth, which was written by Edmund Dudley while imprisoned in the Tower of London in 1509 prior to his execution for treason the following year. Brodie notes any variations between manuscripts and provides a brief biography of Dudley and the impact of his famous text on later monarchs. This book will be of value to anyone with an interest in Tudor history or the history of (...) English statesmanship. (shrink)

The European patent system allows for the introduction of moral issues into decisions about the granting of patents. This feature has.

Current legal standards of informed consent send the wrong message to physicians about their moral and legal expectations. A “transparency” model that sees consent as a conversation process can enhance good medical practice and patient autonomy without foreclosing appropriate judicial review.

The human labor and animal inputs required to manufacture meat products are kept physically and symbolically distanced from the consumer. Recently however, meatpacking plants received significant news media attention when they emerged as hotpots for COVID-19 — threatening workers’ health, requiring plants to slow production, and forcing farmers to euthanize livestock. In light of these disruptions, this research asks: how did news media frame the impact of COVID-19 on the meat industry, and to what extent is a process of _defetishization_ (...) observed? Examining a sample of 230 news articles from coverage of US meatpacking plants and COVID-19 in 2020, I find that news media largely attributes the cause for the spread of COVID-19 in meatpacking plants to the history of exploitative working conditions and business practices of the meat industry. By contrast, the solutions offered to address these problems aim at alleviating the immediate obstacles posed by the pandemic and returning to, rather than challenging, the status quo. These short-run solutions for complex issues demonstrate the constraints in imagining alternatives to a problem rooted in capitalism. Furthermore, my analysis shows that animals are only made visible in the production process when their bodies become a waste product. (shrink)

Minogue's criticism of MacIntyre and Gorovitz's concept of medicine as a science of individuals is flawed by an assumption of the perfectibility of science that is not well supported by experience to date. More significantly, both Minogue and MacIntyre and Gorovitz have been led astray by choosing to use the malpractice issue as a philosophical point of departure for an inquiry into medical error. The problem of error in medicine, and moral culpability for error, is of great philosophical interest but (...) requires a more detailed contextual approach than these two studies provide. CiteULike Connotea Del.icio.us What's this? (shrink)

One of the founding principles of research ethics is that subjects should be treated equally. In the words of the Belmont Report, “equals ought to be treated equally.” This principle does not imply that all subjects should be treated exactly the same. Rather, subjects who are similar in relevant respects should receive similar treatment. Clinical status is clearly relevant to determining how subjects should be treated. Greater resources should be devoted to subjects who have worse diseases. In contrast, fame is (...) irrelevant. Subjects should not receive greater resources simply because they are famous. A more challenging question, one that pervades clinical research yet has received almost no attention in the literature, is whether subjects' level of scientific importance is relevant to determining how much support they should receive. (shrink)

ABSTRACT Stand-up so closely resembles-and is meant to resemble-the styles and expectations of everyday speech that the idea of technique and technical mastery we typically associate with art is almost rendered invisible. Technique and technical mastery is as much about the understanding and development of audiences as collaborators as it is the generation of material. Doing so requires encountering audiences in places that by custom or design encourage ludic and vernacular talk-social spaces and third spaces such as bars, coffee houses, (...) and clubs. Cultivating uncultivated speech and cultivating real audiences in found settings form the background of developing the stand-up comedian, neither of which lend themselves to the conservatory tradition we think of when we think of the development of artists. This article addresses two areas of the overall question of stand-up as art, starting with the ontological question of stand-up comedy: if it is an art where is it located, and what we may mean by “artworks” and “artworld” in stand-up comedy? Then I consider whether stand-up comedy as practiced can be reconciled with several recent definitions for art and note some of the special conditions and contexts for stand-up. (shrink)