The law has therefore had two conflicting impacts on medical ethics: the positive effect of eroding paternalism and replacing it with a patient-centered ethic; and the negative effect of encouraging physicians to be more concerned with avoiding litigation than doing the "right" thing.

RECENT PHILOSOPHICAL ATTENTION TO THE LANGUAGE OF DISEASE HAS FOCUSED PRIMARILY ON THE QUESTION OF ITS VALUE-NEUTRALITY OR NON-NEUTRALITY. PROPONENTS OF THE VALUE-NEUTRALITY THESIS SYMBOLICALLY COMBINE POLITICAL AND OTHER CRITICISMS OF MEDICINE IN AN ATTACK ON WHAT THEY SEE AS VALUE-INFECTED USES OF DISEASE LANGUAGE. THE PRESENT ESSAY ARGUES AGAINST TWO THESES ASSOCIATED WITH THIS VIEW: A METHODOLOGICAL THESIS WHICH TENDS TO DIVORCE THE ANALYSIS OF DISEASE LANGUAGE FROM THE CONTEXT OF THE PRACTICE OF MEDICINE AND A SUBSTANTIVE THESIS WHICH (...) HOLDS THAT DISEASE LANGUAGE IS EVALUATIVELY NEUTRAL. IN PARTICULAR, THE ESSAY CRITICALLY FOCUSES ON THE VALUE NEUTRAL POSITION ADOPTED BY CHRISTOPHER BOORSE, WHICH HE TERMS A FUNCTIONAL THEORY OF DISEASE. THE ARGUMENT CONCERNS WHETHER OR NOT ONE CAN HAVE VALUE NEUTRAL DESCRIPTION OF DISEASE STATES OR WHETHER DISEASE LANGUAGE ESSENTIALLY INVOLVES VALUES. (shrink)

In the Optics, Descartes claims that telescopes and microscopes lead to morally certain knowledge. It is unclear, however, that Descartes’s expressed confidence in these instruments is warranted. In this article, I show how a limited range of telescope and microscope observations could lead to morally certain knowledge for Descartes, and how observations beyond this range admit of enough reasonable doubt to undermine moral certainty. I also explain moral certainty as a form of knowledge in Descartes’s scientific practices, his epistemic commitment (...) to optical instruments, and I offer an explanation for why Descartes never used optical instruments in his scientific endeavours. -/- ---- -/- Dans la Dioptrique, Descartes prétend que les télescopes et les microscopes donnent accès à des connaissances moralement certaines. Cependant, il n’est pas certain que la confiance accordée par Descartes à ces instruments soit justifiée. Dans cet article, je montre comment une gamme limitée d’observations effectuées à l’aide d’instruments d’optique pourraient mener aux connaissances moralement certaines pour Descartes, et comment d’autres observations allant au-delà de cette gamme introduisent suffisamment de doute raisonnable pour saper cette certitude morale. Enfin, j’interprète la certitude morale comme une forme de connaissance dans l’empirisme de Descartes, j’explique son engagement épistémique envers les instruments d’optique, et j’éclaire les raisons pour lesquelles il n’a jamais employé d’instruments d’optique dans ses propres recherches scientifiques. (shrink)

This paper offers an exposition of what the question of method in ethics consultation involves under two conditions: when ethics consultation is regarded as a practice and when the question of method is treated systematically. It discusses the concept of the practice and the importance of rules in constituting the actions, cognition, and perceptions of practitioners. The main body of the paper focuses on three elements of the question of method: canon, discipline, and history, which are treated heuristically to outline (...) what the question of method in ethics consultation fully involves. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:George J. Leonard EMERSON, WHITMAN, AND CONCEPTUAL ART The widespread abandoning of the art object at the end of the 1960s was taken as something radically, even frighteningly, new, by critics and artists alike. Objects, concept artist Joseph Kosuth was asserting by 1969, are "irrelevant" to art. Though an artist might choose, as in the past, to "employ" objects, "all art is finally conceptual." In fact it was now (...) time that the object, nothing more than the "physical residue" of the artist's mental activity, was dispensed with.1 "We / open our eyes and ears seeing life / each day excellent as it is," John Cage chanted: "This / realization no longer needs art...."2 Aestheticians as disparate as Murray Krieger and Harold Rosenberg reacted to this "transfiguration of the commonplace," as Arthur Danto has called it. Danto has gained a wide scholarly audience for his ideas about the 1960s as "the end of art," or at least as the beginning of "post-historical art."3 We know from such works as Renato Poggioli's TL· T^ry oftL· Avant-Garde that, in this century, particular movements have routinely declared themselves to be art's climax.4 Critics like Jacques Barzun and artists like Amedee Ozenfant had been saying for years that art was exhausted. Yet conceptualism's attack on the object struck most critics as something both alarming and new: Irving Sandler wrote in a special edition of the College Art Association's Art Journal devoted to the problem that it demolished "every notion of what art should be,"5 and Murray Krieger feared that this "leap beyond Pop Art" would "complete the obliteration of the realm of art, its objects, its museums...."6 But the conceptualist attacks on the art object were, in fact, not new. One can find attacks as scathing in Emerson and Whitman; so scathing, that criticism has rarely taken them seriously. The attacks the concep297 298Philosophy and Literature tualists mounted in the 1960s were only the culmination ofan intellectual tendency which appeared throughout the West one hundred and sixty years before. It has long been a scholarly commonplace that after 1800 an "intellectual tendency"—as M. H. Abrams finallytermed it—extolling the possibilities of this world emerged in all parts of Western culture. When itappears in literature we nowusually call it, withAbrams, Natural Supernaturalism; or, with Harold Bloom, the "visionary company." Man, Wordsworth decreed, can and must learn to find "Paradise" in "the common day."7 Surprisingly litde work has been done on what happened when this intellectual tendency, Natural Supernaturalism, confronted the art object. Emerson and Whitman can stand for many who were necessarily ill at ease with the idea of art objects as elite objects superior to the common things it was their mission to extol. Wordsworth works before these two; Ruskin develops similar ideas into greater complexity; but since Emerson writes clear expository prose and avoids fanciful terminology, he makes a good place to enter this dark wood. Let us begin with some straightfor-ward, overdue interdisciplinary history, reading Emerson on the art object, noticing similar passages in Whitman, and noting where Emerson has reworked Hegel for his own ends. For Emerson objects are but thought's "inert effect," as for the concept artist Kosuth they would be but the "physical residue" of the artist's activity. Emerson and Kosuth, opposite Shakespeare, do not applaud the art process as the giving to an airy nothing a local habitation and a name; rather they disdain the stuff as petrifactions, as dead mud footprints left by living thoughts diat have raced away.8 In his essay "Circles," Emerson derides our admiration for a work of architecture, directing us to the "litde waving hand" that built it, for "that which builds is better than that which is built." By the same logic, the invisible thoughts which truly wrought the object were even better than the hand and "nimbler."9 When such passages are discussed at all, they are usually considered Platonic,10 but, in his essay "Art," Emerson envisions a use for art objects Plato would have blinked at. For the time being, art objects have a particular "office" to fill. That office, Emerson wrote in... (shrink)

How closely involved with hospital ethics committees should patients and their families become? Should they routinely have access to committees, or be empowered to initiate consultations? To what extent should they be informed of the content or outcome of committee deliberations? Seeing ethics committees as the locus of competing responsibilities allows us to respond to the questions posed by a patient rights model and to acknowledge more fully the complex moral dynamics of clinical medicine.

The realities of long‐term care call for a refurbished, concrete concept of autonomy that systematically attends to the history and development of persons and takes account of the experiences of daily living.

This two-volume work bridges the gap between introductory expositions of logic or set theory on one hand, and the research literature on the other. It can be used as a text in an advanced undergraduate or beginning graduate course in mathematics, computer science, or philosophy. The volumes are written in a user-friendly conversational lecture style that makes them equally effective for self-study or class use. Volume II, on formal (ZFC) set theory, incorporates a self-contained 'chapter 0' on proof techniques so (...) that it is based on formal logic, in the style of Bourbaki. The emphasis on basic techniques will provide the reader with a solid foundation in set theory and provides a context for the presentation of advanced topics such as absoluteness, relative consistency results, two expositions of Godel's constructible universe, numerous ways of viewing recursion, and a chapter on Cohen forcing. (shrink)

Taking the phenomena of “workplace spirituality” as its case, Shape-Shifting Capital argues that “spirituality” is constitutive of contemporary capitalism and outlines a methodology for tracking broad sociological shifts in the nature of Western religion and economy at the level of lived experience.

The prelims comprise: Introduction Monster Mythology The Legal and Ethical Issues Raised by the Human Genome Project Strategies to Regulate Genetic Technology Where do we go from here? Acknowledgments.

To the uninitiated, academic philosophy can be intimidating. Its extensive history (over two millennia) and seemingly all-encompassing breadth and depth of study makes knowing everything about philosophy impossible. Philosophers are fortunate because they are expected to specialize in specific areas, but librarians are not as fortunate. Librarians often have collection development responsibilities for a variety of academic disciplines. Collection development in philosophy can seem like a world unto itself in part because philosophical inquiry reaches into other academic disciplines. Amongst academic (...) philosophers, there are different approaches or methodologies for doing philosophy, including eastern and western philosophy, as well as a divide between analytic and continental philosophers. In addition to growing the collection, the philosophy subject librarian may be called upon by philosophers and aspiring philosophers (i.e., students) for research assistance. To make matters more intimidating, philosophers seem to think and speak differently than others. The complex ideas and esoteric terminology that rarely finds its way outside of the philosophy classroom can make collection development, research services, and even simple faculty-to-librarian communication difficult. To succeed as a librarian subject specialist, you should work hard to develop an adequate understanding of the types of materials that are most valuable to your community. Cultivating this knowledge is critical because budgets are limited. This volume will help librarians thrust into the position of philosophy subject specialist to get up to speed and begin excelling in their new roles. The goal of this guide is to simplify collection development and research assistance for philosophy. To accomplish this, I will provide a brief overview of philosophy as a field and share the information you need to succeed in your role as the new philosophy selector. This volume will help to alleviate some of the communication barriers between philosophers and librarians and will provide practical advice, recommendations, and resources for building a strong philosophy collection. (shrink)

The National Commission for the Protection of Human Subjects of Bio-medical and Behavioral Research ended its work by substantially endorsing the status quo which places primary reliance on local Institutional Review Boards for subject protection. This was predictable because of the commission's researcher-dominated composition which permitted it to assume that research is good; experimentation is almost never harmful to subjects; and researcher-dominated IRBs can adequately protect the interests of human subjects. The successor Presidential Commission can learn much by reexamining these (...) premises. (shrink)

While there is no denying the relevance of ethical knowledge and analytical and cognitive skills in ethics consultation, such knowledge and skills can be overemphasized. They can be effectively put into practice only by an ethics consultant, who has a broad range of other skills, including interpretive and communicative capacities as well as the capacity effectively to address the psychosocial needs of patients, family members, and healthcare professionals in the context of an ethics consultation case. In this paper, I discuss (...) how emotion can play an important interpretive role in clinical ethics consultation and why attention to the role of defense mechanisms can be helpful. I concentrate on defense mechanisms, arguing first, that the presence of these mechanisms is understandable given the emotional stresses and communicative occlusions that occur between the families of patients and critical care professionals in the circumstances of critical care; second, that identifying these mechanisms is essential for interpreting and managing how these factors influence the way that the “facts” of the case are understood by family members; and, third, that effectively addressing these mechanisms is an important component for effectively doing ethics consultation. Recognizing defense mechanisms, understanding how and why they operate, and knowing how to deal with these defense mechanisms when they pose problems for communication or decision making are thus essential prerequisites for effective ethics consultation, especially in critical care. (shrink)

American healthcare -- Bioterror and bioart -- State of emergency -- Licensed to torture -- Hunger strikes -- War -- Cancer -- Drug dealing -- Toxic tinkering -- Abortion -- Culture of death -- Patient safety -- Global health -- Statue of security -- Pandemic fear -- Bioidentifiers -- Genetic genocide.

Georges J. D. Moyal - Deux notes sur l' «imparfaite science» du geometre athee - Journal of the History of Philosophy 43:3 Journal of the History of Philosophy 43.3 277-300 Deux notes sur l'« imparfaite science » du géomètre athée Georges J. D. Moyal Deux questions. La Ve Méditation de Descartes vise à démontrer que l'existence d'un Dieu vérace est la condition nécessaire de toute science. En effet, Descartes y écrit ceci : « . . . je remarque que la (...) certitude de toutes les autres choses en dépend si absolument [sc. de l'existence de Dieu], que sans cette connaissance il est impossible de pouvoir jamais rien savoir parfaitement. » Ce qui le mène, bien entendu, d'abord à reconnaître que « . . . si j'ignorais qu'il y eût un Dieu [ . . . ] je n'aurais jamais une vraie et certaine science d'aucune chose que ce soit, mais seulement de vagues et inconstantes opinions » et par là même, à refuser ensuite cette parfaite science au géomètre athée : « Or, qu'un athée puisse connaître clairement que les trois angles d'un triangle sont égaux à deux droits, je ne le nie pas ; mais je maintiens seulement qu'il ne le connaît pas par une vraie et certaine science, parce que toute connaissance qui peut être rendue douteuse ne doit pas être appelée science . . . » Il faut reconnaître qu'il y a à nos yeux, aujourd'hui, quelque chose de surprenant à ce que le géomètre athée se voie ainsi refuser cette parfaite science.. (shrink)

The realities and myths of long-term care and the challenges it poses for the ethics of autonomy are analyzed in this perceptive work. The book defends the concept of autonomy, but argues that the standard view of autonomy as non-interference and independence has only a limited applicability for long term care. The treatment of actual autonomy stresses the developmental and social nature of human persons and the priority of identification over autonomous choice. The work balances analysis of the ethical concepts (...) associated with autonomy with discussion of the implications of the ethical analysis for long term care. A central chapter involves a phenomenological analysis of four general features of everyday experience (space, time, communication, and affectivity) and explores their practical implications for long term care. This work concludes with a discussion of the advantages associated with a phenomenologically-inspired treatment of actual autonomy for the ethics of long-term care. (shrink)

How should one think about innovation in medicine and surgery? Increasingly, the answer to this question has involved reference to what might be called the regulatory ethics paradigm (REP). The regulatory ethics paradigm holds that deviations from standard care involve a degree or kind of experimentation that requires the application of a set of procedures designed to assure the protection of the rights and welfare of the subjects of research. In REP, innovative treatments are regarded as questionable until they are (...) framed in a research protocol with formal mechanisms of informed consent. The protocol must be reviewed and approved by an Institutional Review Board (IRB) or equivalent. The regulatory ethics paradigm in effect imposes the condition that clinical innovations be conducted according to scientific research methodologies. It creates the presumption that without review by an IRB, innovation cannot be conducted in an ethically defensible fashion. The regulatory ethics paradigm also requires the preparation of investigational protocols according to sound evidentiary and methodological standards. In so doing, it creates a presumption that innovations that are not rigorously validated are ethically dubious. These assumptions have deep roots. The Belmont Report, for example, articulated the orienting intuition that “radically new procedures... should... be made the object of formal research at an early stage [emphasis added] in order to determine whether they are safe and effective”.1 The Belmont Report takes the view that formal research to establish safety and efficacy of new interventions is usually feasible at an early stage in the development of a novel intervention. It thus establishes a bias that innovative treatments be conducted and evaluated under a research protocol that has passed muster at an IRB review. Given the …. (shrink)

In “Deception and the Clinical Ethicist,” Christopher Meyers defends that view that deception practiced by clinical ethicists is legitimate if it satisfies a series of justifying conditions (Meyers...

Heidegger revisits German idealism after the “turn” in his thought in the mid-1930’s. There are a couple of reasons for this. One is philosophical, if not “theological” in his sense of that term. The other is personal. This later reason is emphasized by Otto Pöggeler, who suggests that after 1945 Heidegger sought to understand what had gone wrong in the tragic European debacle. Heidegger will lay the blame at the doorstep of what he terms onto-theology and the subjectivism he sees (...) as endemic to the German idealist tradition, above all as exemplified in Hegel’s “onto-theo-ego-logy.” The article explores Heidegger’s reading of this tradi­tion of German philosophy as it begins with Leibniz and culminates in Nietzsche. It is the Event itself that makes possible the overcoming of metaphysics and its onto-theology. As Heidegger says in Contributions to Philosophy (From the Event), the ens realissimum (das Seiendste) “is” no more. It is the Event (Ereignis) that is the “most real,” since it is the Event that shows up and manifests itself as the revelation of the truth of Beinge in Da-sein, the being that is there in the Event. (shrink)

“Why is there something rather than nothing?” This is perhaps one of the most annoying questions posed in recent times by and to philosophers. It has troubled at least two major thinkers in the last and in this century, namely the romantic idealist Friedrich Schelling and the contemporary existentialist Martin Heidegger, since it was first formulated by Leibniz. We can easily get rid of the question as being simplistic; since although it may be true that nothing is simpler than something, (...) we have no notion of what the simplicity of nothing might consist in. Or we can say that the question is related to the theological answer of a benevolent creator, and hence is not able even to be asked within the ambient of the finite human understanding. Or we may say that the question is supremely hypothetical, in that it would presuppose what is not, in fact, the case; and philosophy can be concerned only with what is. Furthermore, to ask the question in any genuine fashion, the nonexistence of the questioner would seem to be required. The question, therefore, appears Zen-like: “What is the answer to a question posed by a nonexistent questioner?”. (shrink)

This paper analyzes one dimension of the frequently alleged contradiction between treating medicine as a business and as a profession, namely the incompatibility between viewing the physician patient relationship in economic and moral terms. The paper explores the utilitarian foundations of economics and the deontological foundations of professional medical ethics as one source for the business/medicine conflict that influences beliefs about the proper understanding of the therapeutic relationship. It, then, focuses on the contrast and distinction between medicine as business and (...) profession by critically analyzing the classic economic view of the moral status of medicine articulated by Kenneth Arrow. The paper concludes with a discussion of some advantages associated with regarding medicine as a business. (shrink)