The theory and practice of history and its relevance to the modern world, by Britains greatest radical historian.

Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for the review; (3) (...) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL—as a condition, as an experience, and as a process of inner growth—leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions—everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity—further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life. (shrink)

" Dr. Cassell discusses the world of the sick, the healing connection and healer's battle, the role of omnipotence in the healer's art, illness and disease, and ...

The legal and ethical asymmetry between honoring positive claims of conscience versus negative claims of conscience was recently analyzed by several articles in this journal. The first author of this article (ALB) identified unique but defeasible reasons against honoring positive claims of conscience, such as the greater threat they post to institutional values and institutional resources than negative claims of conscience. However, ALB wrote, when these reasons can be overcome, positive claims of conscience should enjoy the same ethical and legal (...) respect as negative claims of conscience. This article argues that the prescription of birth control by non-Roman Catholic physicians in Roman Catholic institutions is an example of a positive claim of conscience that can overcome concerns of institutional values and resources, and therefore ought to receive the same ethical respect and legal protection as negative claims of conscience. In making this argument, this article also responds to several of the thoughtful comments raised by Alberto Giubilini and Dominic Wilkinson. (shrink)

During his career, Ronald Dworkin wrote extensively on an impressive range of issues in moral, political, and legal philosophy, but, like many of his contemporaries, international law remained a topic of relative neglect. His most sustained work on international law is a posthumously published article, “A New Philosophy for International Law” (2013), which displays some familiar aspects of his views in general jurisprudence, in addition to some novel (though perhaps surprising) arguments as well. This paper argues that the moralized account (...) of international law we might have expected is conspicuously missing from this posthumous article; with Dworkin advancing an argument based on a form of political realism instead. (shrink)

Like the broom in “The Sorcerer's Apprentice,” technologies take on a life of their own. To bring them under control, doctors must learn to tolerate ambiguity, resist the lure of the immediate, cease fearing uncertainty, and rechannel their response to wonder.

Extracorporeal membrane oxygenation (ECMO) is currently reserved predominantly for bridging patients to a different destination therapy, but the use of ECMO as a destination therapy itself (ECMO-DT...

Originalism as Faith presents a comprehensive history of the originalism debates. It shows how the doctrine is rarely used by the Supreme Court, but is employed by academics, pundits and judges to maintain the mistaken faith that the Court decides cases under the law instead of the Justices' personal values. Tracing the development of the doctrine from the founding to present day, Eric J. Segall shows how originalism is used by judges as a pretext for reaching politically desirable results. (...) The book also presents an accurate description and evaluation of the late Justice Scalia's jurisprudence and shows how he failed to practice the originalism method that he preached. This illuminating work will be of interest to lawyers, law students, undergraduates studying the Court, law professors and anyone else interested in an honest discussion and evaluation of originalism as a theory of constitutional interpretation, a political weapon, and an article of faith. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.3 (2003) 225-226 [Access article in PDF] Travelers in the Land of Sickness Eric J. Cassell THE PROBLEM OF knowing another person and the world in which that person lives, particularly someone with major mental illness, is addressed in this interesting and rich essay. The number of different metaphors and concepts Potter employs to describe the task of crossing into and then understanding the (...) thoughts, emotions, symptoms, constraints, context, and perspectives of another testifies to the difficulties involved.Yet, as I read the essay, it was not clear what the clinician world traveler, moral tourist, empathizer (and other categories) is supposed to do on the journey to another person. Why do we reach out to the sick person? What is it that we want to know or do that makes this trip necessary? Potter is primarily concerned with mental illness—the examples she cites are patients with schizophrenia—while my experience has in the main been with persons with physical illness, but for the moment, the differences are less important than the central lesson. The illness that the patient presents—the experience of the symptoms, the impairments, disability, and disruptions of the emotional and social existence that happen because of the disease result from an amalgam of the disease process with the specific nature of the sick person. There is no disease in pure form; there is no disease in abstract for clinicians. There is only this sick person. She correctly quotes me, because of all this, as pointing out the importance of integrating knowledge of this particular patient with the abstract knowledge of disease to understand the illness as it is expressed in this person. All to form a basis for the treatment of the patient and especially to help relieve suffering because suffering is always personal, particular, and individual. (It is important in thinking about this topic to remember that most serious diseases, psychiatric and otherwise, are chronic and take place over significant lived time. The acute schizophrenic symptoms or the acute infectious diseases, as dramatic as they are, distract attention from the importance of the place of the sick person.)In physical disease, our long (and continuing) history of separating human beings from nature and the body, and the importance medicine places on objectivity and the objective, have made the inevitable personalization of the disease and symptoms virtually invisible. After ages of explaining psychiatric diseases as the alienation of the person, and a long psychoanalytic period of finding their origins in the person, in the last 30 years these diseases have become increasingly objectified. The place of the person has been diminished as psychiatry has entered the DSM, neurotransmitter, and effective psychotropic drug era. For both physical and mental disease, however, and whatever the current ideology, the nature of person is crucial in determining the onset, diagnosis, course, treatment, and outcome of each illness. It is in order to have an impact on these crucial aspects of sickness that clinicians must come to know their patients to the degree possible. [End Page 225]But there is something more. Nancy Potter quotes a woman with schizophrenia as saying, "All that was my former self has crumbled and fallen together and a creature has emerged of whom I know nothing. She is a stranger to me... She is not real—she is not I... She is I—and because I still have myself on my hands, even if I am a maniac, I must deal with me somehow." (Potter, 2003, p. 215)Must she deal with this crazy self alone? Is that not what her doctors and caregivers are for? But how can they take care of her, protect her, keep what is left intact, and sustain her until she is (hopefully) better without knowing who she is? She makes clear in those few phrases that inside her there is a person with a past, a family, a world, a culture, a role(s) in life, relationships, a body, dreams for the future, things she does, and all the other things that make up a person. It is in... (shrink)

The goals of medicine -- A story about a patient with aortic stenosis -- What are facts in medicine? -- Clarify the chain of events that led to the present state : the case as a narrative -- The case of Myra Manner -- Examine your presuppositions and preconceptions -- Separate and examine the values at issue -- A question of judgment -- The patient, the doctor, and the relationship -- Observation, prognosis, and prognosticating -- Thinking in medicine -- Accepting (...) the challenge. (shrink)

My conclusions are threefold: The subject of cosmic evolution is my religion. The process of change itself (especially developmental change) is my God. And global ethics and a planetary culture, which cosmic evolution mandates, are the key to the survival of technologically competent life forms, both here on Earth and perhaps elsewhere in the Universe.

This collection furthers English-language scholarship on the philosophy of Max Scheler, with a focus on areas that are potentially integral to Scheler's continuing legacy. The chapters are divided according to Scheler's early work in phenomenology and value theory and his later work in metaphysics and anthropology.

Various, albeit largely incongruent, attempts have been made at demonstrating the critical force of phenomenology. Mohr seeks to rekindle the project by accentuating the critical potential hidden within a core phenomenological presupposition: the discrepancy between conceptual and intuitive meaning (logos and phenomenon). Phenomenological attention on the discrepancy itself as an experienced phenomenon constitutes the starting point of critical phenomenology. While Adorno famously rejects intuition as a viable candidate for grounding critique, Mohr argues that reflection on lived experiences and the nonformal (...) meanings they yield provide a robust source for critical self-reflection. As such, ideology may be most effectively unmasked by means of a proper attitudinal orientation to the intuitive meanings within one’s lived social experiences. (shrink)

Let M be a model of ZFAC (ZFC modified to allow a set of atoms), and let N be an inner model with the same set of atoms and the same pure sets (sets with no atoms in their transitive closure) as M. We show that N is a permutation submodel of M if and only if N satisfies the principle SVC (Small Violations of Choice), a weak form of the axiom of choice which says that in some sense, all (...) violations of choice are localized in a set. A special case is considered in which there exists an SVC witness which satisfies a certain homogeneity condition. (shrink)

The way information and communication technology (ICT) develops can promote or hinder the democratic potential of this critical societal infrastructure. Concerns about the role standards development organizations (SDOs) play in this context predate the “digital age” but are reemerging amid substantial changes in the institutional landscape of standardization. This article explores the increasingly critical link between the institutional design of SDOs and the democratic design of ICT. We review some principles of democracy in terms of the design of technology, apply (...) these to standardization, and discuss the role public policy may play here, while distinguishing between input and output legitimacy. (shrink)

At the conclusion of his De lege naturae apodictica methodus, a treatise on the law of nature, how it is grasped by the human mind, and how it coheres with the Decalogue, Niels Hemmingsen claims to have eschewed the use of theological sources in his argument, claiming instead to have demonstrated ‘how far reason is able to progress without the prophetic and apostolic word’. Yet the reader of the treatise will notice several citations of theologians alongside those of pagan poets (...) and philosophers. This essay demonstrates that there is less here than meets the eye, that is, that Hemmingsen quotes theologians only to buttress what one can know from natural reason or the classical tradition, even when he is discussing God, and thus he does not violate his own stated principle. (shrink)

The most up-to-date philosophical discussion of the quasi-historical fantasy television show Game of ThronesThe Ultimate Game of Thrones and Philosophy treats fans to dozens of new essays by experts who examine philosophical questions raised by the Game of Thrones story.

Debates concerning the relationship between Tridentine Catholicism and Catholicism after Vatican II dominate theological conversation today, particularly with regard to understandings of the Church and its engagement with the world. Current historical narratives paint ecclesiology after the Council of Trent as dominated by juridical concerns, uniformity, and institutionalism. Purportedly neglected are the spiritual, diverse, and missional aspects of the Church. This book challenges such narratives by investigating the Spanish Jesuit Francisco Suárez's theology of ecclesial unity and catholicity. Analyzing standard as (...) well as overlooked sources of Suárez's ecclesiology, the author shows how Suárez wrestles with the new demands of his time and anticipates later ecumenical developments in twentieth-century Catholic ecclesiology. Early modern expansion prompted theologians after Trent to reckon with the ecclesial status of baptized Protestants, the Greek Orthodox, and non-believers in the New World. It further prompted reflection on the universality, or catholicity, of the Church, and how the Church's mission to the nations serves her greater unity in Christ. Throughout this exposition, the author reveals Suárez's vision of the Church to be deeply spiritual, diverse, and missional-not at the expense of the institutional, but as it's necessary and life-giving source. The Church, for Suárez, is primarily a way of life. This book explores not only Suárez's speculative ecclesiology, but how the unity and catholicity of the body of Christ is lived out in practice, that is, in the worship and works of the faithful, and, most notably, in the charism of his own religious order, the Society of Jesus. Suárez thus shows his readers what the spiritual dynamic between Christic unity and missional catholicity should look like in the Church. (shrink)

This chapter contains section titled: “You're Right. There's No Earth. It's All a Legend” “I'm Not a Cylon!…Maybe, But We Just Can't Take That Chance” “You Have to Have Something to Live For. Let it be Earth” Notes.

Within the epistemology of the sciences, conventionalism has been the subject of regular criticism for over six decades. Critics such as W. V. Quine and Morton White, and more recently Nathan Salmon (1992), and Paul Boghossian (1996), have attacked even the most basic tenet of conventionalism, namely its claim that the truth of certain statements is fixed not by stipulation-independent facts, but by the conventions governing the meaning of those statements and their constituents.

Alexander George has put forward a novel interpretation of the Quine-Carnap debate over analyticity. George argues that Carnap's claim that there exists an analytic-synthetic distinction was held by Carnap to be empty of empirical consequences. As a result, Carnap understood his position to be empirically indistinguishable from Quine's. Although George defends his interpretation only briefly, I show that it withstands further examination and ought to be accepted. The consequences of accepting it undermine a common understanding of Quine's criticism of Carnap, (...) and I argue that it is difficult to find a perspective from which Quine can criticize Carnap in a non-question-begging way. (shrink)

Felony disenfranchisement is best understood as a means of vote suppression. Quite apart from its significance as a form of criminal stigma, disenfranchisement is most properly characterized as one of the ways in which the American voting system reserves political participation for a privileged social and intellectual class. Thus understood, felony disenfranchisement reveals the theoretical underpinnings of an exclusionary version of American democracy in which more or less widespread disenfranchisement is an acceptable or necessary political tactic. Felony disenfranchisement should not (...) be characterized as a sanction for criminal conduct: It fits none of the usual justifications for punishment. Most commentators agree that felony disenfranchisement as a collateral sanction for criminal conduct stigmatizes alike a disparate collection of individuals convicted of crimes carrying a penalty of one year or more - everything from drug possession to murder - and extends, in many instances, long after former felons have completed their sentences. Justifications for refusing the vote to felons, and to former felons who are no longer incarcerated, are surprisingly weak and clearly related to larger issues of democratic participation. Accordingly, it is under the framework of democratic participation that the most persuasive justifications of disenfranchisement might be found. Under the framework of democratic participation, the disenfranchisement debate implicates competing theories of democracy, each of which has profound consequences for the constitution of the American polity. I contend that there are currently three models for the right to vote in American society: (1) a membership model premised upon popular participation in the democratic process as an expression of citizenship; (2) a deliberative model in which popular participation is conditioned upon the duty to be an informed and reflective citizen; and (3) an elite model entrenching political office in a political class that competes for votes among the electoral masses. The continuing vitality of these three models at the level of political debate and constitutional doctrine unsettles the dominant history of the franchise as one of progress from an exclusionary to an inclusionary extension of the mandate, and requires us to acknowledge felony disenfranchisement as part of a larger process of voter exclusion and suppression. (shrink)

Healers: Extraordinary Clinicians at Work, by David Schenck and Larry R. Churchill, and What Patients Teach: The Everyday Ethics of Health Care, by Churchill, Joseph B. Fanning, and Schenck are both important and thought‐inspiring books. For the first, Schenck and Churchill recruited fifty practitioners, mostly physicians but some clinicians who practice alternative therapies, “identified by their peers as excellent healers,” and interviewed them to find out what they did to establish a good relationship with their patients. The results of their (...) interviews and how they wrote their book makes this the best and most concrete understanding of a necessary step to healing that I have read. What Patients Teach examines the patients’ perspective about forming relationships with their clinicians. The patients’ clinicians were asked to nominate patients to be interviewed to help answer the question. This volume, while important, is less extraordinary than the first because we hear less what the patients want to say and more what the authors want to tell us. That aside, taken together, these two books are a major advance in the literature of healing. (shrink)

It is well known that Max Scheler framed his ethics in opposition to Kant’s “formalistic” ethical framework. However, it is a lesser-known fact that Scheler offered a critique of the ancient Greek moral vision. Although this critique was less developed than the one of Kant, the critique of the ancients was no less significant. First explicated in 1912 in Ressentiment, its central theme is reprised in nearly all of Scheler’s main texts even up until his death. Scheler’s contention is with (...) what he calls the “love of goodness,” which he also happens to think Aristotle’s ethics represents. This paper will primarily examine the love of goodness, first, as one side of the “categorial form” of "Pharisaism"—that is, as it represents a “moral illusion”—then as the other side—namely, as it corresponds to “epistemological error." Finally, I consider the specific moral context in light of where it naturally leads Scheler: to the principle of solidarity. (shrink)

Individual-level research in behavioral science can have massive impact and create system-level changes, as several recent mandates and other policy actions have shown. Although not every nudge creates long-term behavior change, defaults and other forms of choice architecture can not only change individual behavior but also reduce inequities and lead to changes in public policy and norms.

To the Editor: Daniel Callahan is correct when, in “Rationing: Theory, Politics, and Passions”, he tells us that the combination of ever-rising medical costs and ever-increasing demand for expensive resources by physicians and their patients will—in the absence of any workable, generally acceptable mode of official rationing—lead to covert rationing. Or, more precisely, it will encourage us to extend the covert rationing that already exists, where those with more get more. As things stand now, this is unavoidable. However..