Fredrik Svenaeus' book is a delight to read. Not only does he exhibit keen understanding of a wide range of topics and figures in both medicine and philosophy, but he manages to bring them together in an innovative manner that convincingly demonstrates how deeply these two significant fields can be and, in the end, must be mutually enlightening. Medicine, Svenaeus suggests, reveals deep but rarely explicit themes whose proper comprehension invites a careful phenomenological and hermeneutical explication. Certain philosophical approaches, (...) on the other hand - specifically, Heidegger's phenomenology and Gadamer's hermeneutics - are shown to have a hitherto unrealized potential for making sense of those themes long buried within Western medicine. Richard M. Zaner, Ann Geddes Stahlman Professor of Medical Ethics, Vanderbilt University. (shrink)

A large slice of contemporary phenomenology of medicine has been devoted to developing an account of health and illness that proceeds from the first-person perspective when attempting to understand the ill person in contrast and connection to the third-person perspective on his/her diseased body. A proof that this phenomenological account of health and illness, represented by philosophers, such as Drew Leder, Kay Toombs, Havi Carel, Hans-Georg Gadamer, Kevin Aho, and Fredrik Svenaeus, is becoming increasingly influential in philosophy of medicine (...) and medical ethics is the criticism of it that has been voiced in some recent studies. In this article, two such critical contributions, proceeding from radically different premises and backgrounds, are discussed: Jonathan Sholl’s naturalistic critique and Talia Welsh’s Nietzschean critique. The aim is to defend the phenomenological account and clear up misunderstandings about what it amounts to and what we should be able to expect from it. (shrink)

In this article I aim at developing a phenomenology ofillness through a critical interpretation of the worksof Sigmund Freud and Martin Heidegger. The phenomenonof ``Unheimlichkeit'' – uncanniness and unhomelikeness– is demonstrated not only to play a key role in thetheories of Freud and Heidegger, but also toconstitute the essence of the experience of illness.Two different modes of unhomelikeness – ``The minduncanny'' and ``The world uncanny'' – are in thisconnection explored as constitutive parts of thephenomenon of illness. The consequence I draw (...) fromthis analysis is that the mission of health careprofessionals must be not only to cure diseases, butactually, through devoting attention to thebeing-in-the-world of the patient, also to open uppossible paths back to homelikeness. This mission canonly be carried out if medicine acknowledges the basicimportance of the meaning-realm of the patient's life– his or her life-world characteristics. (shrink)

I want to thank the commentators for bringing the phenomenological analysis of anorexia that I attempted in my article yet some steps further. Phenomenology of illness is a young field and in the case of anorexia there remains much to be said and done. ‘Capturing the “double experience,” the paradoxicality embodied in anorexia,’ was exactly my aim and I am grateful to Drew Leder for bringing home many of my points in such an explicit and systematic manner (Leder 2013, 94). (...) Dr. Leder’s study The Absent Body, published already in 1990, is one of the earliest and most important attempts to understand the ways of the body in illness from a phenomenological perspective, an attempt that has been central to my own .. (shrink)

Reviews work on moral judgment motivational internalism from the last two decades.

According to linguistic conventionalism, necessities are to be explained in terms of the conventionally adopted rules that govern the use of linguistic expressions. A number of influential arguments against this view concerns the ‘Truth-Contrast Thesis’. This is the claim that necessary truths are fundamentally different from contingent ones since they are not made true by ‘the facts’. Instead, they are supposed to be something like ‘true in virtue of meaning’. This thesis is widely held to be a core commitment of (...) the conventionalist position, and the view is frequently rejected on the grounds that this thesis is untenable. I argue that this line of reasoning is mistaken. While the thesis should be rejected, it is not, I argue, entailed by linguistic conventionalism – nor was it invariably accepted by the paradigmatic conventionalists. (shrink)

We introduce generalized quantifiers, as defined in Tarskian semantics by Mostowski and Lindström, in logics whose semantics is based on teams instead of assignments, e.g., IF-logic and Dependence logic. Both the monotone and the non-monotone case is considered. It is argued that to handle quantifier scope dependencies of generalized quantifiers in a satisfying way the dependence atom in Dependence logic is not well suited and that the multivalued dependence atom is a better choice. This atom is in fact definably equivalent (...) to the independence atom recently introduced by Väänänen and Grädel. (shrink)

ArgumentA number of issues related to vaccines and vaccinations in society are discussed in this paper. Our purpose is to merge an analysis of some recent changes in the vaccine market with social science research on the relationship between citizens and authorities. The article has two empirical parts. The first shows how the vaccine market, which for many years has had immense financial problems, nowadays seems to becoming economically vitalized, mostly due to the production of new and profitable vaccines. However (...) prosperous the future may appear, certain reactions from the public regarding vaccination initiatives offer insight into inherent problems of vaccine policies in many Western countries. In the second part of the article, these problems are exemplified with the recent controversy over the MMR (measles, mumps, and rubella) vaccine. We conclude that in spite of the improving profit-margins, the vaccine market remains vulnerable and insecure. Vaccines are permeated bysociety, even more so than pharmaceutics that are used to cure or alleviate illnesses. Radical changes in financial conditions with promises of a more profitable market will not, we argue, solve other even more fundamental problems. (shrink)

By rejecting the old divide between prehistory and history, the group of scholars behind Deep History opens a new window on the problem of the unity and diversity of human experience over the very long run. Their use of kinship metaphors suggests not only a link between modern society and the deep past, but also perhaps a way to imagine the common legacy of the human species. But what emerges from Deep History is hardly a sunny story about the distant (...) origins of social justice and ecological harmony. The other central metaphor of the book—the fractal—uncovers the slow prelude to the Anthropocene. Rather than seeing a sharp break in the Industrial Revolution from an “organic” to a fossil fuel-burning economy, these scholars stress the history of environmental destruction that has accompanied human expansion. My critical reading presents an alternative understanding of deep history as an arena for a new politics of species. Here a cornucopian understanding of human adaptation clashes with a new pessimism about the climatic fragility of Neolithic civilization. (shrink)

According to Paul Boghossian, some truths are knowable a priori because they are expressed by epistemically analytic sentences. In such cases, understanding the sentence is meant to suffice for justified belief in the proposition it expresses. One alleged route from understanding to justification goes via what Boghossian calls ‘the synonymy model’. This article presents a dilemma for this model and argues that although a strategy for avoiding the dilemma is available, this does not vindicate Boghossian's model.

This article interrogates twelve step practice within Alcoholics Anonymous from the perspective of Foucault’s later work on governance, truth-telling and subjectivity. Recent critical studies of addiction tend to view self-help cultures like that of AA and related twelve step programs as integral parts of contemporary power/knowledge complexes, and thus as agents of the modern “will to knowledge” that Foucault often engages with. In line with the widespread Foucauldian critique of governmentality, addiction self-help culture is thus conceived as one that primarily (...) reproduces abstract, neoliberal norms on health and subjectivity. The argument put forward in this article aims to upset this framework attending to a number of features of twelve step practice that, arguably, bear striking resemblances to Foucault’s later discussions of ethics, care of self and truth-telling. In this, it is suggested that a close study of AA practices, might interrupt assumptions about contemporary addiction discourse and its relationship to issues of truth and power often reproduced in Foucauldian critiques. (shrink)

This article puts forth a theory and history of the experiential moment of romance, traced from Homer’s Odyssey to Jean-Jacques Rousseau. Differing from other forms of the moment that have been bequeathed by Western tradition—such as kairos, conversio, the Aristotelian pair peripeteia and anagnorisis, or the Romantic Augenblick—the experiential moment foregrounds experientiality within a self-enclosed and atelic temporality: a time that goes nowhere. Building on previous theories of epic and romance that see them as conflicting temporal forms, the first part (...) of the article demonstrates how the experiential moment in traditional romance always exists in tension with the temporality of the epic project of the collective. The second part proposes a new reading of Rousseau by showing how his three works, Julie, ou La Nouvelle Héloïse, Les Confessions, and Les Rêveries du promeneur solitaire not only continue this conflict into the modern period but also begin to reverse the old hierarchical relationship between epic and romance or the temporality of the collective and that of the experiencing individual in her individual consciousness. It is argued that Rousseau in his final work the Rêveries strives to liberate the experiential moment from epic temporality altogether and thereby lays the foundation for a wholly new way of approaching the moment in literary modernity. (shrink)

This article develops a phenomenology of suffering with an emphasis on matters relevant to medical practice and bioethics. An attempt is made to explain how suffering can involve many different things—bodily pains, inability to carry out everyday actions, and failure to realize core life values—and yet be a distinct phenomenon. Proceeding from and expanding upon analyses found in the works of Eric Cassell and Elaine Scarry, suffering is found to be a potentially alienating mood overcoming the person and engaging her (...) in a struggle to remain at home in the face of loss of meaning and purpose in life. Suffering involves painful experiences at different levels that are connected through the suffering-mood but are nevertheless distinguishable by being primarily about my embodiment, my engagements in the world together with others, and my core life values. Suffering is in essence a feeling , but as such, it has implications for and involves the person’s entire life: how she acts in the world, communicates with others, and understands and looks upon her priorities and goals in life. Suffering-moods are typically intense and painful in nature, but they may also display a rather subconscious quality in presenting things in the world and my life as a whole in an alienating way. In such situations, we are not focused directly upon the suffering-mood—as in the cases of pain and other bodily ailments—but rather, upon the things that the mood presents to us: not only our bodies, but also other things in the world that prevent us from having a good life and being the persons we want to be. Such suffering may in many cases be transformed or at least mitigated by a person’s identifying and changing her core life values and in such a manner reinterpreting her life story to become an easier and more rewarding one to live under the present circumstances. (shrink)

This article offers a new account of the moral substance of shame. Through careful reflection on the motives and intentional structure of shame, I defend the claim that shame is an egocentric and morally blind emotion. I argue that shame is rooted in our desire for social affirmation and constituted by our ability to sense how we appear to others. What makes shame egocentric is that in shame we are essentially concerned about our own social worth and pained by the (...) perception of our self as socially worthless. In itself, shame entails no morally pertinent concern about others or understanding of what is morally significant. I contrast shame with the possibility of relating to others—and to oneself—with love and care. Indeed, I propose that love is essential for moral understanding and motivation. The argument of the article unfolds through critical appraisals of the main strategies for defending the moral value of shame. First, against the claim that shame entails respect for others, I argue that shame's sensitivity to the opinions of others is motivated by egocentric self-concern. Second, against the view that shame over failures to live up to moral values is morally valuable, I argue that regardless of whether the values guiding our shame are moral or not, the perspective of shame is oblivious to their moral meaning. Third, against the claim that shame is crucial for self-understanding, I argue that the desire for affirmation that drives shame is a powerful source of self-deception. (shrink)

We review the state of the art in moral psychology to answer 6 questions: 1) Where do moral beliefs and motivations come from? 2) How does moral judgment work? 3) What is the evidence for the social intuitionist model? 4) What exactly are the moral intuitions? 5) How does morality develop? And 6) Why do people vary in their morality? We describe the intuitionist approach to moral psychology. The mind makes rapid affective evaluations of everything it encounters, and these evaluations (...) (intuitions) shape and push subsequent moral reasoning. This approach to moral judgment has a variety of implications for moral philosophy and for the law in that it questions common assumptions about the reliability and causal efficacy of private, conscious reasoning. (shrink)

This article is an attempt to analyse the experience of embodiment in illness. Drawing upon Heidegger' sphenomenology and the suggestion that illness can be understood as unhomelike being-in-the-world, I try to show how the way we live our own bodies in illness is experienced precisely as unhomelike. The body is alien, yet, at the same time, myself. It involves biological processes beyond my control, but these processes still belong to me as lived by me. This a priori otherness of the (...) body presents itself in illness in an uncanny and merciless way. The unhomelike breakdown of our everyday being-in-the-world suffered in illness is explored through Heidegger's notion of the world being a “totality of relevance”, a pattern of meaning played out between different “tools”. The lived body is compared to a broken tool that alters and obstruct sour way of being “thrown” and “projecting” ourselves in the meaning patterns of the world through feelings,thoughts and actions. The similarities and differences between this unhomelikeness of illness and the specific unhomelikeness of authentic understanding,reached according to Heidegger in existential anxiety,are discussed. In order to illustrate how the lived body can present itself as “broken” and “other” to its owner, and in what way this unhomelike experience calls for help from health-care professionals, I make use of a clinical example of a severe and common disease: stroke. (shrink)

This article develops a phenomenological exploration of chronic pain from a first-person perspective that can serve to enrich the medical third-person perspective. The experience of chronic pain is found to be a feeling in which we become alienated from the workings of our own bodies. The bodily-based mood of alienation is extended, however, in penetrating the whole world of the chronic pain sufferer, making her entire life unhomelike. Furthermore, the pain mood not only opens up the world as having an (...) alien quality, it also makes the world more lonesome and poor by forcing the sufferer to attend to the workings of her own body. To suffer pain is to find oneself in a situation of passivity in relation to the hurtful experiences one is undergoing. In making the body and the world more unhomelike places to be in, pain also tends to rob a person of her language. Severe pain is hard to describe because it pushes the person towards the borderlines of imaginable experience and because it makes it hard to see any meaning and purpose in the situation one has been forced into. The analysis of chronic pain in the article is guided by the attempts made by Maurice Merleau-Ponty, Jean-Paul Sartre, and Martin Heidegger to understand the nature of human embodiment and existence, and also by descriptions of chronic pain found in the Swedish author Lars Gustafsson’s novel The Death of a Beekeeper. (shrink)

The relevance of the Aristotelian concept ofphronesis – practical wisdom – for medicine and medical ethics has been much debated during the last two decades. This paper attempts to show how Aristotle’s practical philosophy was of central importance toHans-Georg Gadamer and to the development of his philosophical hermeneutics, and how,accordingly, the concept of phronesiswill be central to a Gadamerian hermeneutics of medicine. If medical practice is conceived of as an interpretative meeting between doctor and patient with the aim of restoring (...) the health of the latter, then phronesis is the mark of the good physician, who through interpretation comes to know the best thing todo for this particular patient at this particular time. The potential fruitfulness of this hermeneutical appropriation of phronesis for the field of medical ethics is also discussed. The concept can be (and has been) used in critiques of the conceptualization of bioethics as the application of principle-based theory to clinical situations, since Aristotle’s point is exactly that problems of praxis cannot be approached in this way. It can also point theway for alternative forms of medical ethics, such as virtue ethics or a phenomenological andhermeneutical ethics. The latter alternative would have to address the phenomena of healthand the good life as issues for medical practice. It would also have to map out in detail the terrain of the medical meeting and the acts of interpretation through which phronesis is exercised. (shrink)

This article develops a new phenomenological analysis of the interpersonal motives and structure of shame. I pursue the argument that shame is rooted in our desire for social affirmation and conditioned by our ability to see ourselves as we appear to others. My central thesis is that shame is what we feel when, due to some trait or action of ours, we come to perceive ourselves as fundamentally despicable and non-affirmable. By showing how our urge for affirmation fuels and informs (...) our self-perception in shame, the analysis provides a better understanding of the simultaneously interpersonal and personal character of shame. Furthermore, it sheds new light on some central aspects of shame that have been insufficiently understood: on the emotional charge and quality of shame, on the role played by our values and identity in shame, and on the continuity, differences, and transfers between personal shame, social shame, and embarrassment. (shrink)

Patient participation is one of the most prevalent focus areas in the Danish healthcare debate. Patient participation is generally presented as a fundamental democratic right, and is stated in an objective language with legal requirements for healthcare professionals to ensure that patients systematically participate in their own courses of care and treatment. In the research literature, it is not clear what is meant by ‘patient participation’, and several discourses on patient participation exist side by side. This study explores how discourses (...) of patient participation unfold and are at play in the articulations in official legal and political documents and patient records relating to a Danish psychiatric context. The documents and patient records have been analyzed using a Fairclough‐inspired critical discourse approach which is concerned with how power is exercised through language. The research findings show that patient participation within Danish psychiatric healthcare is governed within a neoliberal discourse where underlying discourses; discourse of biomedicine, paternalism, management, evidence and ethics of care are embedded, and a discourse that seems to ascribe stigmatizing traits to mentally ill patients. (shrink)

This paper explores the process of aging from a phenomenological perspective. Supplementing the model of becoming old found in Simone de Beauvoir’s work with a phenomenology of human suffering and flourishing, it asks whether it is possible to lead a good life in the process of becoming old. Is it possible to flourish while experiencing bodily waning? Is it possible to flourish while experiencing the shrinking of one’s everyday world and the passing away of close others? Aging, at least in (...) its protracted phases, appears to become full of suffering rather than flourishing. What are the prospects of finding meaningful life projects despite old age? By making use of insight found in Heidegger and other phenomenologists the paper tries to develop a slightly different view on aging than the one found in Beauvoir, stressing the importance of embodied experiences and life choices, which not only depend upon societal oppression and being objectified by others, but also upon processes of nature and the possibilities of an intergenerational intersubjectivity. Resources for this project is found in the philosophy of affectivity developed by Heidegger and other phenomenologists of facticity, such as Maurice Merleau-Ponty, Charles Taylor, Helmuth Plessner and Hannah Arendt. (shrink)

In Every Thing Must Go James Ladyman and Don Ross argue for a radical version of naturalistic metaphysics and propose that contemporary analytic metaphysics is detached from science and should be discontinued. The present article addresses the issues of whether science and metaphysics are separable, intuitions and understanding should be excluded from scientific theory, and Ontic Structural Realism satisfies the criteria of the radical version of naturalism advanced by Ladyman and Ross. The point underlying those topics is that successful scientific (...) research presupposes metaphysics, and that basic epistemic virtues common to metaphysics and science may allow us—as opposed to what Ladyman and Ross suggest—to increase our understanding of the world and to put constraints on allowable metaphysical theories. (shrink)

Safety assessment of technologies and interventions is often underdetermined by evidence. For example, scientists have collected evidence concerning genetically modified plants for decades. This evidence was used to ground opposing safety protocols for “stacked genetically modified” plants, in which two or more genetically modified plants are combined. Evidence based policy would thus be rendered more effective by an approach that accounts for underdetermination. Douglas (2012) proposes an explanatory approach, based on the criteria of transparency, empirical competence, internal consistency of explanations, (...) and predictive potency. However, sometimes multiple explanations can satisfy these criteria. We propose an additional criterion based on converse abduction, where explanations are selected on the basis of ontological background assumptions as well as by evidence. We then apply our proposed scheme to the case of the regulation of stacked genetically modified plants. We discuss the implications and suggest follow-up work concerning the generalizability of the approach. (shrink)

In discussions of Fitch’s paradox, it is usually assumed without further argument that knowledge is factive, that if a subject knows that p, then p is true. It is argued that this common assumption is not as well-founded as it should be, and that there in fact are certain reasons to be suspicious of the unrestricted version of the factiveness claim. There are two kinds of reason for this suspicion. One is that unrestricted factiveness leads to paradoxes and unexpected results, (...) the other is that the usual arguments for factiveness are not as compelling as is commonly thought. There may in fact be some kinds of contexts, where factiveness doesn’t hold for knowledge—the usual arguments for factiveness don’t suffice to support the claim that knowledge is unrestrictedly factive. Perhaps all that can be shown is that knowledge is at times factive, or that it is default factive, as it were: this doesn’t show that there can’t be counterexamples, however. Certain aspects of knowledge without unrestricted factiveness are examined briefly. (shrink)

La teoría depredador-presa sugiere que los depredadores generalistas están vinculados a la estabilidad demográfica de las presas, mientras que los especialistas son desestabilizadores. En este artículo hemos hecho una revisión general de las consecuencias demográficas de diferentes estrategias de depredación y hemos intentado testar la hipótesis de que la caza de subsistencia se produce de forma oportunista, la caza de persecución sería la realizada por depredadores especializados y la caza recreativa por depredadores generalistas. Desde esta hipótesis, la caza de persecución (...) tendría efectos desestabilizadores, mientras que los efectos de la caza de subsistencia y recreativa serían neutrales o estabilizadores. Hemos encontrado poco apoyo empírico para esta hipótesis, pero también es cierto que contamos con escasa información de campo. Los cazadores de recreo principalmente cazan de forma oportunista y la caza de persecución muestra una respuesta funcional de tipo III, es decir, disminuye la intensidad de presas cuando lo hace la abundancia de presas y aumenta dicha intensidad ante cierto nivel de abundancia de presas. Sugerimos que los cazadores de recreo limitan los efectos desestabilizadores sobre las poblaciones de caza y que la caza no es un método eficaz de eliminación completa de especies invasoras. Instamos a la realización de nuevos estudios que cuantifiquen las respuestas de los cazadores a la abundancia de presas, en particular estudios que evalúen las respuestas de los cazadores de subsistencia y la persecución ilegal. (shrink)

Heidegger’s thoughts on modern technology have received much attention in many disciplines and fields, but, with a few exceptions, the influence has been sparse in biomedical ethics. The reason for this might be that Heidegger’s position has been misinterpreted as being generally hostile towards modern science and technology, and the fact that Heidegger himself never subjected medical technologies to scrutiny but was concerned rather with industrial technology and information technology. In this paper, Heidegger’s philosophy of modern technology is introduced and (...) then brought to bear on medical technology. Its main relevance for biomedical ethics is found to be that the field needs to focus upon epistemological and ontological questions in the philosophy of medicine related to the structure and goal of medical practice. Heidegger’s philosophy can help us to see how the scientific attitude in medicine must always be balanced by and integrated into a phenomenological way of understanding the life-world concerns of patients. The difference between the scientific and the phenomenological method in medicine is articulated by Heidegger as two different ways of studying the human body: as biological organism and as lived body. Medicine needs to acknowledge the priority of the lived body in addressing health as a way of being-in-the-world and not as the absence of disease only. A critical development of Heidegger’s position can provide us with a criterion for distinguishing the uses of medical technologies that are compatible with such an endeavor from the technological projects that are not. (shrink)

This is a highly ambitious book, defending a long unpopular account of logic and mathematics—namely, conventionalism. Warren’s overall aim is to convince us tha.

Debates about the legitimacy of embryonic stem-cell research have largely focused on the type of ethical value that should be accorded to the human embryo in␣vitro. In this paper, I try to show that, to broaden the scope of these debates, one needs to articulate an ontology that does not limit itself to biological accounts, but that instead focuses on the embryo’s place in a totality of relevance surrounding and guiding a human practice. Instead of attempting to substantiate the ethical (...) value of the embryo exclusively by pointing out that it has potentiality for personhood, one should examine the types of practices in which the embryo occurs and focus on the ends inherent to these practices. With this emphasis on context, it becomes apparent that the embryo’s ethical significance can only be understood by elucidating the attitudes that are established towards it in the course of specific activities. The distinction between fertilized embryos and cloned embryos proves to be important in this contextual analysis, since, from the point of view of practice, the two types of embryos appear to belong to different human practices: (assisted) procreation and medical research, respectively. In my arguments, I highlight the concepts of practice, technology, and nature, as they have been analyzed in the phenomenological tradition, particularly by Martin Heidegger. I come to the conclusion that therapeutic cloning should be allowed, provided that it turns out to be a project that benefits medical science in its aim to battle diseases. Important precautions have to be taken, however, in order to safeguard the practice of procreation from becoming perverted by the aims and attitudes of medical science when the two practices intersect. The threat in question needs to be taken seriously, since it concerns the structure and goal of practices which are central to our very self understanding as human beings. (shrink)

Name der Zeitschrift: Jahrgang: 13 Heft: 2 Seiten: 116-127.

In this theoretical and explorative essay, two issues are discussed, which are based on personal experiences of teaching ethics. The first is what educational purpose does it serve to challenge students as ethical subjects while teaching a class? This issue is mainly discussed through an analysis of Gert Biesta’s works. He argues that an essential purpose for teachers is to enable students to appear as subjects. For this to happen, the teacher must “interrupt” the students by presenting that which challenges (...) his or her basic ethical preconceptions, which in turn forces the student to choose as a subject. However, if the teacher gives priority to such interruptions, s/he risks a conflict with his or her students. That gives rise to the second issue raised in the essay, whether the teacher should express his or her ethical perspectives while teaching ethics. The issue is discussed by analyzing Bruno Latour’s political philosophy. He argues that conflict is an essential feature in any democratic society where everyone’s concerns are presented. For that reason, he argues for the need of public “diplomats,” whose function is to enable an endeavor for peace. As diplomats, both their ethical agency and ability to judge what is worth highlighting is recognized. Thus, the essay concludes that a diplomatic teacher is someone who has the judgement to decide whether his or her ethical perspectives should be highlighted while teaching a class, or if it would disrupt an endeavor for peace. (shrink)

This book brings phenomenology, the main player in the continental tradition of philosophy, to bioethics. Medical science and emerging technologies are examined as endeavours that bring enormous possibilities in relieving human suffering but also great risks in transforming our fundamental life views.