Richard Rorty and Edmund Husserl would appear to be poles apart, facing each other from opposite corners of the philosophical ring. Husserl is a rationalist searching for an absolute foundation for science which will guarantee its apodeictic truth. Rorty is a post-modernist for whom science is but one discourse among many, none of which corresponds with reality.

Current scientific research on consciousness aims to understand how consciousness arises from the workings of the brain and body, as well as the relations between conscious experience and cognitive processing. Clearly, to make progress in these areas, researchers cannot avoid a range of conceptual issues about the nature and structure of consciousness, such as the following: What is the relation between intentionality and consciousness? What is the relation between self-awareness and consciousness? What is the temporal structure of conscious experience? What (...) is it like to imagine or visualize something, and how is this type of experience different from perception? How is bodily experience related to self-consciousness? Such issues have been addressed in detail in the philosophical tradition of phenomenology, inaugurated by Edmund Husserl (1859-1938) and developed by numerous other philosophers throughout the 20th century. This chapter provides an introduction to this tradition and its way of approaching issues about consciousness. We first discuss some features of phenomenological methodology and then present some of the most important, influential, and enduring phenomenological proposals about various aspects of consciousness. These aspects include intentionality, self-awareness and the first-person perspective, time-consciousness, embodiment, and intersubjectivity. We also highlight a few ways of linking phenomenology and cognitive. (shrink)

Current scientific research on consciousness aims to understand how consciousness arises from the workings of the brain and body, as well as the relations between conscious experience and cognitive processing. Clearly, to make progress in these areas, researchers cannot avoid a range of conceptual issues about the nature and structure of consciousness, such as the following: What is the relation between intentionality and consciousness? What is the relation between self-awareness and consciousness? What is the temporal structure of conscious experience? What (...) is it like to imagine or visualize something, and how is this type of experience different from perception? How is bodily experience related to self-consciousness? Such issues have been addressed in detail in the philosophical tradition of phenomenology, inaugurated by Edmund Husserl (1859-1938) and developed by numerous other philosophers throughout the 20^th century. This chapter provides an introduction to this tradition and its way of approaching issues about consciousness. We first discuss some features of phenomenological methodology and then present some of the most important, influential, and enduring phenomenological proposals about various aspects of consciousness. These aspects include intentionality, self-awareness and the first-person perspective, time-consciousness, embodiment, and intersubjectivity. We also highlight a few ways of linking phenomenology and cognitive. (shrink)

One of the most difficult decisions a clinician may face is when, if ever, to decline what a patient wants, based on the clinician’s own moral conscience. Regardless of what the clinician decides, the outcome may be deeply emotionally painful for both parties, and the pain may last. I will discuss this pain, how it occurs, and what we can do to try to reduce it before, during, and after a conflict arises. Approaches include explaining how we are like the (...) patient or doctor, that no one is perfect, and that what we do is not who we are. (shrink)

To what extent is the external world the way that it appears to us in perceptual experience? This perennial question in philosophy is no doubt ambiguous in many ways. For example, it might be taken as equivalent to the question of whether or not the external world is the way that it appears to be? This is a question about the epistemology of perception: Are our perceptual experiences by and large veridical representations of the external world? Alternatively, the question might (...) be taken as asking whether or not the external world is like its ways of appearing to us, where the expression “ways of appearing” is intended to pick out aspects of our perceptual experiences themselves. This is a metaphysical version of the question of the relationship between appearance and reality: What is the relationship between the phenomenal features that characterize perceptual experience, on the one hand, and the mind-independent features of the external objects of perception, on the other? There are some philosophers who might resist distinguishing between these two questions. For them, “ways of appearing” in the phenomenal sense just are the ways that things appear to be (let’s call the latter the “intentional sense” of “ways of appearing”).1 That is, the phenomenal character of an experience is nothing over and above its representational content. Phenomenal properties are represented properties—the properties that an experience attributes to the external objects of perception. The question of whether or not phenomenal properties can be identified with the represented properties of an experience mirrors traditional questions in the philosophy of perception. If they can be identified with each other, then in veridical perception we might be said to “directly grasp” features of the external world through perception. The properties that are present to the mind are the very same properties that belong to the external objects of perception. Such a view affords.... (shrink)

The variety of general issues and particular controversies in biomedical ethics can be understood as reflecting a deeper unity than normally supposed. The principle of plenitude and the paradigm of the "chain of Being" form the tie among the phenomena. They are defined, and their presence is tracked especially through some of the ideas and language in the debate about the ethics of abortion. Keywords: plenitude, great chain of Being, abortion, explanation CiteULike Connotea Del.icio.us What's this?

Environmental changes can bear upon the environmental virtues, having effects not only on the conditions of their application but also altering the concepts themselves. I argue that impending radical changes in global climate will likely precipitate significant changes in the dominate world culture of consumerism and then consider how these changes could alter the moral landscape, particularly culturally thick conceptions of the environmental virtues. According to Jonathan Lear, as the last principal chief of the Crow Nation, Plenty Coups exhibited the (...) virtue of “radical hope,” a novel form of courage appropriate to a culture in crisis. I explore what radical hope may look like today, arguing how it should broadly affect our environmental character and that a framework for future environmental virtues will involve a diminished place for valuing naturalness as autonomy from human interference. (shrink)

As Montaigne put it, on the highest throne in the world man sits on his arse. Usually this epigram makes people laugh because it seems to reclaim the world from artificial pride and snobbery and to bring things back to egalitarian values. But if we push the observation even further and say men sit not only on their arse, but over a warm and fuming pile of their own excrement—the joke is no longer funny. The tragedy of man's dualism, his (...) ludicrous situation, becomes too real. The anus and its incomprehensible, repulsive product represents not only physical determinism and boundness, but the fate as well of all that is physical: decay and death. [Becker, 1973, p. 31]. (shrink)

Traditionally, analytic philosophers writing on aesthetics have given short shrift to nature. The last thirty years, however, have seen a steady growth of interest in this area. The essays and books now available cover central philosophical issues concerning the nature of the aesthetic and the existence of norms for aesthetic judgement. They also intersect with important issues in environmental philosophy. More recent contributions have opened up new topics, such as the relationship between natural sound and music, the beauty of animals, (...) and the aesthetics of gardens. Using these materials, it is now easy to include a module on the aesthetics of nature as one part of an introductory course on aesthetics, or even to design an entire upper-level undergraduate or graduate seminar around the topic. Author Recommends: Don Mannison, 'Comments Stimulated by Reinhardt's Remarks: A Prolegomenon to a Human Chauvinistic Aesthetic'. Environmental Philosophy. Eds. Don Mannison, Michael McRobbie, and Richard Routley (Canberra: Australian National University, 1980), 212–16. Readers coming fresh to contemporary debates may find the lack of attention to natural beauty in twentieth-century philosophy somewhat puzzling. This paper, which defends the view that nature cannot be aesthetically appreciated as such, presents this attitude in a particularly pure form. Ronald Hepburn, 'Contemporary Aesthetics and the Neglect of Natural Beauty'. British Analytical Philosophy. Eds. Bernard Williams and Alan Montefiore (London: Routledge and Kegan Paul, 1966), 285–310. Reprinted in The Aesthetics of Natural Environments. Eds. Allen Carlson and Arnold Berleant (Peterborough, Ontario: Broadview Press, 2004). This seminal essay marks the beginning of contemporary discussion of the aesthetics of nature. Many of its ideas and themes continue to reverberate in contemporary debates. Allen Carlson, Aesthetics and the Environment: The Appreciation of Nature, Art and Architecture (London: Routledge, 2000). This volume is a collection of Carlson's influential essays on environmental aesthetics. Chapters 4 and 5, 'Appreciation and the Natural Environment' and 'Nature, Aesthetic Judgment, and Objectivity', set the agenda for much subsequent discussion in the aesthetics of nature. Chapter 6, 'Nature and Positive Aesthetics', develops and defends the controversial idea that nature, unlike art, is always aesthetically good. Arnold Berleant, 'The Aesthetics of Art and Nature'. Landscape, Natural Beauty and the Arts. Eds. Salim Kemal and Ivan Gaskell (Cambridge: Cambridge University Press, 1993), 228–43. Reprinted in The Aesthetics of Natural Environments. Eds. Allen Carlson and Arnold Berleant (Peterborough, Ontario: Broadview Press, 2004). In this paper, Berleant presents his influential idea of an 'engaged aesthetics' for nature. Yuriko Saito, 'The Aesthetics of Unscenic Nature'. Journal of Aesthetics and Art Criticism 56 (1998): 101–11. This article develops Saito's idea that ethical considerations play a critical role in the aesthetics of nature, and presents a novel argument for Positive Aesthetics for nature. Malcolm Budd, The Aesthetic Appreciation of Nature: Essays on the Aesthetics of Nature (Oxford: Oxford University Press, 2002). This book collects Budd's papers on the aesthetics of nature, which contain important criticisms of Carlson's natural environmental model and the notion of Positive Aesthetics for nature. Noël Carroll, 'On Being Moved by Nature: Between Religion and Natural History'. Landscape, Natural Beauty and the Arts. Eds. Salim Kemal and Ivan Gaskell (Cambridge: Cambridge University Press, 1993), 244–66. Reprinted in The Aesthetics of Natural Environments. Eds. Allen Carlson and Arnold Berleant (Peterborough, Ontario: Broadview Press, 2004). This paper argues for the importance of aesthetic appreciation that emphasizes emotional responses to nature. A philosophically sophisticated and influential treatment by a leading aesthetician. Ned Hettinger, 'Allen Carlson's Environmental Aesthetics and Protection of the Environment'. Environmental Ethics 27 (2005): 57–76. In this essay, an environmental philosopher gives careful and thorough consideration to the place of aesthetic considerations in environmental protection, focusing on Carlson's work. John Andrew Fisher, 'What the Hills are Alive With: In Defense of the Sounds of Nature'. Journal of Aesthetics and Art Criticism 56 (1998): 167–79. Reprinted in The Aesthetics of Natural Environments. Eds. Allen Carlson and Arnold Berleant (Peterborough, Ontario: Broadview Press, 2004). Most discussions of nature aesthetics focus on visual experiences; this essay is the first philosophical study of the aesthetics of natural sounds. A nuanced and original paper. Allen Carlson and Arnold Berleant. 'Introduction: The Aesthetics of Nature'. The Aesthetics of Natural Environments. Eds. Allen Carlson and Arnold Berleant (Peterborough, Ontario: Broadview Press, 2004), 11–42. A comprehensive review of the literature, this essay contains the best available bibliography on the subject. Online Materials: http://plato.stanford.edu/entries/environmental-aesthetics/ Environmental Aesthetics: Allen Carlson's entry in the Stanford Encyclopedia of Philosophy. http://www.aesthetics-online.org/articles/index.php?articles_id=17 Teaching Environmental Aesthetics: Allen Carlson's article on the American Society for Aesthetics Web site. http://www.uqtr.uquebec.ca/AE/Vol_6/ Volume 6 of AE: Canadian Aesthetics Journal /Revue canadienne d'esthetique: Papers by Thomas Heyd and Ira Newman on Allen Carlson's book Aesthetics and the Environment, along with a response from Carlson. http://www.contempaesthetics.org/newvolume/pages/article.php?articleID=400 Paradoxes and Puzzles: Appreciating Gardens and Urban Nature: An essay by Stephanie Ross in the online journal Contemporary Aesthetics. Sample Syllabus for a three-week module in an undergraduate aesthetics course: This three week module can easily be adapted to fit shorter available class time or reduced reading expectations for students. A lighter two-week module, for instance, would drop the Hepburn reading and do either the Carroll essay or the Saito essay, but not both. Note that all readings for this module are reprinted in Allen Carlson and Arnold Berleant (eds.), The Aesthetics of Natural Environments (Peterborough, Ontario: Broadview Press, 2004). Week 1: Introduction Reading: Ronald Hepburn, 'Contemporary Aesthetics and the Neglect of Natural Beauty'. British Analytical Philosophy. Eds. Bernard Williams and Alan Montefiore (London: Routledge and Kegan Paul, 1966), 285–310. Discussion of Hepburn's essay will allow the instructor to bring out the distinctive issues and themes of the aesthetics of nature. Week 2: Objectivity or Subjectivity? Readings: Allen Carlson, 'Appreciation and the Natural Environment'. Journal of Aesthetics and Art Criticism 37 (1979): 267–76. Arnold Berleant, 'The Aesthetics of Art and Nature'. Landscape, Natural Beauty and the Arts. Eds. Salim Kemal and Ivan Gaskell (Cambridge: Cambridge University Press, 1993), 228–43. This section covers two very different approaches to thinking about the aesthetic appreciation of nature. Consideration of these provides an opportunity for students to reflect on nature's relationship to art, and on the character of aesthetic experience itself. Week 3: Pluralistic Approaches Readings: Yuriko Saito, 'Appreciating Nature on its Own Terms'. Environmental Ethics 20 (1998): 135–49. Noël Carroll, 'On Being Moved by Nature: Between Religion and Natural History'. Landscape, Natural Beauty and the Arts. Eds. Salim Kemal and Ivan Gaskell (Cambridge: Cambridge University Press, 1993), 244–66. This section considers approaches that are motivated by perceived limitations of the two approaches mentioned above. In discussing these, students will focus on the significance, for the aesthetics of nature, of emotion and also of broader ethical considerations. Sample Syllabus for an upper-level undergraduate or graduate seminar: Books on Syllabus: Glenn Parsons, Aesthetics and Nature [AN] (London: Continuum Press, forthcoming November 2008). Allen Carlson, Aesthetics and the Environment: The Appreciation of Nature, Art and Architecture [AE] (London: Routledge, 2000). Allen Carlson and Arnold Berleant (eds.), The Aesthetics of Natural Environments [ANE] (Peterborough, Ontario: Broadview Press, 2004). Week 1: Introduction Parsons, AN, ch. 1. Allen Carlson, 'Environmental Aesthetics'. The Routledge Companion to Aesthetics. Eds. Berys Gaut and Dominic Lopes (London: Routledge, 2001), 423–36. Don Mannison, 'Comments Stimulated by Reinhardt's Remarks: A Prolegomenon to a Human Chauvinistic Aesthetic'. Environmental Philosophy. Eds. Don Mannison, Michael McRobbie, and Richard Routley (Canberra: Australian National University, 1980), 212–16. Ronald Hepburn, 'Contemporary Aesthetics and the Neglect of Natural Beauty'. British Analytical Philosophy. Eds. Bernard Williams and Alan Montefiore (London: Routledge and Kegan Paul, 1966), 285–310. Reprinted in ANE. Week 2: Imagination Parsons, AN, ch. 2. Thomas Heyd, 'Aesthetic Appreciation and the Many Stories About Nature'. British Journal of Aesthetics 41 (2001): 125–37. Reprinted in ANE. Emily Brady, 'Imagination and the Aesthetic Appreciation of Nature'. Journal of Aesthetics and Art Criticism 56 (1998): 139–47. Reprinted in ANE. Marcia Eaton, 'Fact and Fiction in the Aesthetic Appreciation of Nature'. Journal of Aesthetics and Art Criticism 56 (1998): 149–56. Reprinted in ANE. Week 3: Formalism Parsons, AN, ch. 3. Carlson, 'Formal Qualities and the Natural Environment', AE, ch. 3. Allen Carlson, 'On the Possibility of Quantifying Scenic Beauty'. Landscape Planning 4 (1977): 131–72. Ira Newman, 'Reflections on Allen Carlson's Aesthetics and the Environment'. AE: Canadian Aesthetics Journal /Revue canadienne d'esthetique 6 (2001) http://www.uqtr.uquebec.ca/AE/Vol_6/Carlson/newman.html>. Nick Zangwill, 'Formal Natural Beauty'. Proceedings of the Aristotelian Society 21 (2001): 209–24. Week 4: Science and Nature Aesthetics Parsons, AN, ch. 4. Aldo Leopold, 'Country'. A Sand County Almanac, with Essays on Conservation from Round River (New York, NY: Ballantine Books, 1966), 177–80. Carlson, 'Appreciation and the Natural Environment', AE, ch. 4. Carlson, 'Nature, Aesthetic Judgment, and Objectivity', AE, ch. 5. Glenn Parsons, 'The Aesthetics of Nature'. Philosophy Compass 2 (2007): 358–72. Week 5: Positive Aesthetics Carlson, 'Nature and Positive Aesthetics', AE, ch. 6. Eugene Hargrove, Foundations of Environmental Ethics (Denton, TX: Environmental Ethics Books, 1996), ch. 6. Yuriko Saito, 'The Aesthetics of Unscenic Nature'. Journal of Aesthetics and Art Criticism 56 (1998): 101–11. Malcolm Budd, 'The Aesthetics of Nature'. Proceedings of the Aristotelian Society 100 (2000): 137–57. Glenn Parsons, 'Nature Appreciation, Science and Positive Aesthetics'. British Journal of Aesthetics 42 (2002): 279–95. Week 6: Animals Edmund Burke, A Philosophical Enquiry into the Origin of our Ideas of the Sublime and Beautiful. Ed. James T. Boulton (Notre Dame, IN: University of Notre Dame Press, 1968 [1757]), Pt. III, sec. VI. Holmes Rolston III, 'Beauty and the Beast: Aesthetic Experience of Wildlife'. Valuing Wildlife: Economic and Social Perspectives. Eds. Daniel J. Decker and Gary R. Goff (Boulder, CO: Westview Press, 1987), 187–96. Glenn Parsons, 'The Aesthetic Value of Animals'. Environmental Ethics 27 (2007): 151–69. Week 7: Pluralism Parsons, AN, ch. 5. Noël Carroll, 'On Being Moved by Nature: Between Religion and Natural History'. Landscape, Natural Beauty and the Arts. Eds. Salim Kemal and Ivan Gaskell (Cambridge: Cambridge University Press, 1993), 244–66. Reprinted in ANE. Yuriko Saito, 'Appreciating Nature on its Own Terms'. Environmental Ethics 20 (1998): 135–49. Reprinted in ANE. Ronald Hepburn, 'Nature Humanized: Nature Respected'. Environmental Values 7 (1998): 267–79. Ronald Hepburn, 'Trivial and Serious in Aesthetic Appreciation of Nature'. Landscape, Natural Beauty and the Arts. Eds. Salim Kemal and Ivan Gaskell (Cambridge: Cambridge University Press, 1993), 65–80. Glenn Parsons and Allen Carlson, 'New Formalism and the Aesthetic Appreciation of Nature'. Journal of Aesthetics and Art Criticism 62 (2004): 363–76. Week 8: Engagement Parsons, AN, ch. 6. Arnold Berleant, 'The Aesthetics of Art and Nature'. Landscape, Natural Beauty and the Arts. Eds. Salim Kemal and Ivan Gaskell (Cambridge: Cambridge University Press, 1993), 228–43. Reprinted in ANE. Cheryl Foster, 'The Narrative and the Ambient in Environmental Aesthetics'. Journal of Aesthetics and Art Criticism 56 (1998): 127–37. Reprinted in ANE. Allen Carlson, 'Aesthetics and Engagement'. British Journal of Aesthetics 33 (1993): 220–27. Week 9: The Sublime Immanuel Kant, Critique of the Power of Judgment. Trans. P. Guyer and E. Matthews (Cambridge University Press, 2000 [1790]). Excerpts from sections 23–9. Edmund Burke, A Philosophical Enquiry into the Origin of our Ideas of the Sublime and Beautiful. Ed. James T. Boulton (Notre Dame, IN: University of Notre Dame Press, 1968 [1757]). Excerpts from Pt. II, sections 1–8. Ronald Hepburn, 'The Concept of the Sublime: Has it any Relevance for Philosophy Today?'. Dialectics and Humanism 15 (1988): 137–55. Stan Godlovitch, 'Icebreakers: Environmentalism and Natural Aesthetics'. Journal of Applied Philosophy 11 (1994): 15–30. Reprinted in ANE. Malcolm Budd, 'Delight in the Natural World: Kant on the Aesthetic Appreciation of Nature. Part I: The Sublime in Nature'. British Journal of Aesthetics 38 (1998): 233–50. Week 10: Aesthetic Preservation Parsons, AN, ch. 7. Janna Thompson, 'Aesthetics and the Value of Nature'. Environmental Ethics 17 (1995): 291–305. Holmes Rolston III, 'From Beauty to Duty: Aesthetics of Nature and Environmental Ethics'. Environment and the Arts: Perspectives on Environmental Aesthetics. Ed. Arnold Berleant (Aldershot, UK: Ashgate, 2002), 127–41. Ned Hettinger, 'Allen Carlson's Environmental Aesthetics and Protection of the Environment'. Environmental Ethics 27 (2005): 57–76. Keekok Lee, 'Beauty for Ever?'. Environmental Values 4 (1995): 213–25. Week 11: Gardens Parsons, AN, ch. 8. Mara Miller, The Garden as an Art (Albany, NY: State University of New York Press, 1993), ch. 1. Mara Miller, 'Gardens as Works of Art: The Problem of Uniqueness'. British Journal of Aesthetics 26 (1986): 252–6. Stephanie Ross, What Gardens Mean (Chicago, IL: University of Chicago Press, 1998), chs. 1, 7. Tom Leddy, 'Gardens in an Expanded Field'. British Journal of Aesthetics 28 (1988): 327–40. David Cooper, 'In Praise of Gardens'. British Journal of Aesthetics 43 (2003): 101–13. Week 12: Art in Nature Parsons, AN, ch. 9. Carlson, 'Is Environmental Art an Aesthetic Affront to Nature?', AE, ch. 10. Sheila Lintott, 'Ethically Evaluating Land Art: Is It Worth It?'. Ethics, Place & Environment 10 (2007): 263–77. Emily Brady, 'Aesthetic Regard for Nature in Environmental and Land Art'. Ethics, Place & Environment 10 (2007): 287–300. Focus Questions1. Are there any important differences between the aesthetic appreciation of art and the aesthetic appreciation of nature? If so, what are they?2. Is preserving nature for its aesthetic value a coherent idea?3. What is the ugliest natural thing or place you can think of? How might proponents of Positive Aesthetics for nature deal with your example?4. Does the concept of the sublime have any significance for our contemporary experience of nature? If it does, what relation does it bear to our aesthetic appreciation of nature?5. Watch Rivers and Tides (2001), the documentary film about the British environmental artist Andy Goldsworthy. Ethically speaking, how do you think we ought to regard his art-making? (shrink)

Strengthening a theorem of Hjorth this paper gives a new characterization of which Polish groups admit compatible complete left invariant metrics. As a corollary it is proved that any Polish group without a complete left invariant metric has a continuous action on a Polish space whose associated orbit equivalence relation is not essentially countable.

In the Evolution of Culture. The idea of cultural mentalities first arose in European anthropology's confrontation with global primitive cultures. During the early twentieth century's period of confident imperialism, the European nations articulated their confrontation with non-literate cultures in a poetic imagining of the 'primitive' as a Romantic 'Other'. As psychology developed in Europe to explore the unconscious as well as madness, a new ethnology also sought to enter into the mind of the primitive as an exotic place where logic (...) and reason did not rule. (shrink)

Recent publications by Pogge ( Global ethics: seminal essays. St. Paul: Paragon House 2008 ) and by Singer ( The life you can save: acting now to end world poverty. New York: Random House 2009 ) have resuscitated a debate over the justifiability of famine relief between Singer and ecologist Garrett Hardin in the 1970s. Yet that debate concluded with a general recognition that (a) general considerations of development ethics presented more compelling ethical problems than famine relief; and (b) some (...) form of development would be essential to avoiding the problems of growth noted by Hardin. Better than renewing the debate, we should recognize two points. First, food needs do indeed evoke a moral response that is more direct and compelling than the philosophical positions often generated to rationalize a duty to bring aid. As such the argument for feeding hungry people cannot be generalized into a paradigm for development ethics without distortions that undercut the morally valid elements in Singer’s original argument. Second, contrary to prevailing assumptions in present day development ethics, food aid and famine relief continue to be important priorities for international agencies, notably the World Food Program. Emergency food assistance, the nominal topic of Singer’s original article, thus is an important issue for agricultural as well as development ethics, though one that should indeed be seen as distinct from more complex duties to address the conditions of chronic poverty and underdevelopment. (shrink)

In the early twentieth century, China was on the brink of change. Different ideologies - those of radicalism, conservatism, liberalism, and social democracy - were much debated in political and intellectual circles. Whereas previous works have analyzed these trends in isolation, Edmund S. K. Fung shows how they related to one another and how intellectuals in China engaged according to their cultural and political persuasions. The author argues that it is this interrelatedness and interplay between different schools of thought (...) that are central to the understanding of Chinese modernity, for many of the debates that began in the Republican era still resonate in China today. The book charts the development of these ideologies and explores the work and influence of the intellectuals who were associated with them. In its challenge to previous scholarship and the breadth of its approach, the book makes a major contribution to the study of Chinese political philosophy and intellectual history. (shrink)

This article discusses a case in this issue of The Journal of Clinical Ethics by McCrary and colleagues, “Elective Delivery Before 39 Weeks’ Gestation Reconciling Maternal, Fetal, and Family Circumstances,” in which parents asked the medical team to deliver their fetus “early.” The author discusses (1) the importance that parents have to a child when they are able to love the child, and how important it is for decision makers to consider this; (2) exceptional approaches that may enable parents to (...) “change their minds”; and (3) substantive and procedural innovations that may help to prevent clinicians’ views from playing too big a role and/or being arbitrary. The author concludes by describing how he felt when reading the case and uses this to illustrate how clinicians may benefit by assessing their feelings. (shrink)

The primary task of ethics consultants is to work with patients—and sometimes also their families—to discern and then meet patients’ and families’ needs and wants to the extent possible. That is primarily a cognitive endeavor. Yet the feelings of patients and ethics consultants may determine what they can work together to accomplish. This article considers their feelings. It looks at sources of distrust and their hopedfor resolution, specific means to enhance patients’ decision making in their relationship with ethics consultants, and (...) a new, highly different approach that may enhance their relationships more than most commonly used ways of relating. (shrink)

It may be difficult to imagine having a severe impairment such as quadriplegia or being dependent on a respirator. There is evidence that when careproviders make treatment decisions for patients who are in these situations, we imagine the patients are worse-off than they report they are—most patients with even very severe impairments report that they greatly value being alive.1 This misperception may cause us to make treatment decisions for patients with impairments that we might not make for other patients. In (...) this article I describe how to provide better care for patients who have impairments. This includes not presupposing that the patients’ quality of life is decreased, considering with patients how outside factors may be limiting their functioning, and seeking to help offset these factors, if we can, when they exist, to avoid allowing patients’ impairments to result in their being truly “disabled.”. (shrink)

A recently enacted law permits patients to see their electronic medical record (EMR) immediately after their careprovider writes in it. In this article I discuss a proposal that authors make in this issue of The Journal of Clinical Ethics, that ethics consultants (ECs) keep their notes in a separate section of the EMR that patients cannot access when their ethics notes may be troubling to patients, to avoid unduly harming them.I discuss this concern and three more widely applicable clinical goals: (...) to help patients feel safe; to gain patients’ trust; and to provide hope to patients, when possible. These goals apply to careproviders and ECs who seek to help patients and families resolve ethical conflicts. I explain why these goals are singularly important and how careproviders may pursue them, using as an example informing patients about temporal framing to help them find hope. (shrink)