Stosunek do Innego rzutuje i będzie rzutował na konkretne wybory i losy polskiego społeczeństwa.Podejmując dyskusję znanej uwagi J.T. Grossa, łączącej podejście do imigrantówz nieprzepracowanym problemem polskich „marginesów Zagłady”, autor próbuje umieścićją w kontekście kwestii upodmiotowienia Polaków jako zbiorowości. Stawia tezę, że historycznieuwarunkowana, słaba umiejętność zbiorowego podejmowania odpowiedzialności zatrudne sprawy w podobny sposób określa oba zagadnienia. Tak wzięcie odpowiedzialnościza przeszłość, jak podjęcie jej za teraźniejsze wybory, wymaga bowiem takiej zbiorowejumiejętności. Słabość w tej sferze ogranicza samą możliwość praktykowania zalecanej przezJacques’a Derridę „gość-inności”.

Taking as its point of departure Leder's phenomenological discussion of the `absent' body, this article explores the nature of human corporeality as a site of transgression. The body, I argue, using a process metaphysic, is first and foremost excessive, driven by human desire rather than animal need: a sensual mode of existence organized around the pleasure/pain axis. To be excessive/transgressive, however, implies the crossing of boundaries or limits which vary according to history and culture, time and place. These issues are (...) illustrated through a range of thinkers from Bakhtin to Kristeva, Irigaray to Deleuze and Guattari. A full-scale endorsement of the poststructuralist position is, however, rejected in favour of an approach which steers a middle ground between these transgressive, more fluid arguments and a foundationalist ontology of the emotional body as an ongoing structure of lived experience. The article concludes with some reflections on the complex pattern of corporeal `appearances', some more pleasant than others, which characterize our bodily-being-in-the-world. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Human Genome ProjectSharon J. Durfy (bio) and Amy E. Grotevant (bio)In recent years, scientists throughout the world have embarked upon a long-term biological investigation that promises to revolutionize the decisions people make about their lives and lifestyles, the way doctors practice medicine, how scientists study biology, and the way we think of ourselves as individuals and as a species. It is called the Human Genome Project, and its (...) ultimate goal is to map and determine the chemical sequence of the three billion nucleotide base pairs that comprise the human genome. The feat is expected to take about fifteen years (see General Surveys).These three billion base pairs include an estimated 50,000 to 100,000 genes. The rest of the genome—perhaps 95 percent of it—is nongenic sequences with unknown function, sometimes called "junk." Determining the order and organization of all this material has been likened to tearing six volumes of the Encyclopaedia Brittanica into pieces, then trying to put it all back together to read the information (Surveys: Hall 1990). The effort could be well worth it, many scientists say, because it is expected to yield major insights into many common and complex diseases, including cancer, cardiovascular disease, and Alzheimer's disease (Debate: Dulbecco 1986; Koshland 1989).The Human Genome Project is not without controversy, however (Debate: Davis 1990; Leder 1990; Rechsteiner 1990). Many scientists fear that funding for it will be diverted from other areas of research, rather than obtained from new funding sources. This has enlivened the debate about the relative value of "big" versus "small" science. Also, the value of undertaking a complete sequencing of the genome has been questioned, especially given the high proportion of non-genic sequences.Advocates of the effort converted many critics by making two alterations in the original plan. Plans were included to simultaneously determine the nucleotide sequence of the genomes of other organisms; this provides comparisons and points of reference for the human sequence (U.S.: NIH/DOE 1990). Second, in response to concerns about the high cost of developing technology to sequence the whole [End Page 347] genome, the focus moved from large-scale sequencing to mapping the genome, which would hasten the search for disease genes (U.S.: NIH/DOE 1990).The ideal map would be both genetic, locating DNA markers, or signposts, at closely spaced intervals along the chromosomes, and physical, indicating the exact distance between these markers (Map: McKusick 1991). Since 1973, Human Gene Mapping workshops (HGM) have been held at least every two years to locate, compare, and compile genetic markers. This information is published and is accessible through Genome Database at Johns Hopkins University (McKusick 1991). The most recent Human Genome Mapping workshop was held in August 1991, at which the Human Genome Organization (HUGO) began to assume increased responsibility for coordination of the international mapping effort (Surveys: Maddox 1991).Historical Background of the United States EffortThe first serious discussions about sequencing the entire human genome occurred at a workshop at the University of California at Santa Cruz in 1985 (U.S.: Sinsheimer 1989). A second workshop, organized by the U.S. Department of Energy (DOE) and held in March 1986, addressed the feasibility of an organized program (U.S.: DOE 1986). Shortly thereafter, DOE instituted its own genome project (U.S.: DOE 1987). Reports in early 1988 from both the National Research Council (NRC) of the National Academy of Sciences (NAS) and Congress' Office of Technology Assessment (OTA) (U.S.: NRC 1988; OTA 1988) served as catalysts, and in fiscal year 1988, the U.S. Congress officially launched the Human Genome Project by appropriating funds to both the Department of Energy and the National Institutes of Health (NIH).To avoid potential congressional "meddling" (U.S.: Roberts 1988), NIH and DOE drafted a memorandum of understanding for interagency coordination in October 1988 (U.S.: NIH/DOE 1990). The agencies then created both separate and joint committees, and working groups to administer the project. NIH established the Office of Human Genome Research in 1988 (directed by James D. Watson) to plan and coordinate NIH genome activities. That office has evolved into the National Center for Human Genome Research (NCHGR... (shrink)

The present paper is a commentary on an article by Drew Leder [1]. Leder identifies a series of texts in the clinical encounter, emphasizes the central role of interpretation in making sense of each of these texts, and articulates ordering principles to guide the interpretive work.The metaphor of clinical work as textual explication, however, creates the expectation that there is a text somewhere to be found. Such an expectation invites doctors and patients to search for the text and runs the (...) risk of conceptualizing patients as more static than they are. If one is to use the textual metaphor, one must appreciate the radical extent to which the clinical encounter is a mutually produced and shifting entity. The qualities of mutuality and indeterminacy are not those one usually associates with texts. One might ultimately be better served by a different metaphor based more directly on uncertainty. (shrink)

Remember that childhood game “Odds or Evens” you used to play in order to settle important disputes such as who gets the last slice of pizza? There was only one element of skill to that game: trying to figure out what the other person would throw. But that wasn’t easy. If your opponent was savvy, that meant trying to figure out what he thought you were going to throw. And that sometimes meant figuring out what he thought you thought he (...) was going to throw. -/- Philosophers call this “thought attribution,” and top poker players are remarkably good at it. The ability to attribute thoughts to other people is especially important in the No-Limit Texas Hold’em tournaments that have, through television and the Internet, swept the globe in recent years. What is required to succeed in this game is not merely attributing “first-order” thoughts to other players, but attributing to them thoughts about your thoughts about their thoughts. In fact, that’s the minimum. The kind of thinking done by the very best players (T. J. Cloutier, Howard Lederer, and Daniel Negreanu are especially good at it) is much more complex than that. -/- In this paper, I explore the light that recent philosophical work on thought attribution sheds on the kind of thinking that goes on at the expert poker table. The paper should be revealing to poker experts and novices alike. And it should be of interest to philosophers interested in poker or thought attribution. -/- The essay is published in Poker and Philosophy, a volume of Open Court's Popular Culture and Philosophy Series. The goal of the series is to introduce philosophical themes to non-philosophers by way of particular topics of interest (in this case poker). (shrink)

The American Medical Association enacted its Code of Ethics in 1847, the first such national codification. In this volume, a distinguished group of experts from the fields of medicine, bioethics, and history of medicine reflect on the development of medical ethics in the United States, using historical analyses as a springboard for discussions of the problems of the present, including what the editors call "a sense of moral crisis precipitated by the shift from a system of fee-for-service medicine to a (...) system of fee-for-system medicine, better known as 'managed care.'" The authors begin with a look at how the medical profession began to consider ethical issues in the 1800s and subsequent developments in the 1900s. They then address the sociological, historical, ethical, and legal aspects of the practice of medicine. Later chapters discuss current and future challenges to medical ethics and professional values. Appendixes display various versions of the AMA's Code of Ethics as it has evolved over time. Contributors: George J. Annas, J.D., M.P.H., Arthur Isak Applbaum, Ph.D., Robert B. Baker, Ph.D., Chester R. Burns, M.D., Ph.D., Arthur L. Caplan, Ph.D., Alexander Morgan Capron, J.D., Christine K. Cassel, M.D., Linda L. Emanuel, M.D., Ph.D., Eliot L. Freidson, Ph.D., Albert R. Jonsen, Ph.D., Stephen R. Latham, J.D., Ph.D., Susan E. Lederer, Ph.D., Florencia Luna, Ph.D., Edmund D. Pellegrino, M.D., Charles E. Rosenberg, Ph.D., Mark Siegler, M.D., Rosemary A. Stevens, Ph.D., Robert M. Tenery, Jr., M.D., Robert M. Veatch, Ph.D., John Harley Warner, Ph.D., Paul Root Wolpe, Ph.D. (shrink)

We are even less aware of our internal organs and the physiological processes that keep us alive. In this fascinating work, Drew Leder examines all the ways in which the body is absent—forgotten, alien, uncontrollable, obscured.

Bodily pain and distress come in many forms. They can well up from within at times of serious illness, but the body can also be subjected to harsh treatment from outside. The medical system is often cold and depersonalized, and much worse are conditions experienced by prisoners in our age of mass incarceration, and by animals trapped in our factory farms. In this pioneering book, Drew Leder offers bold new ways to rethink how we create and treat distress, clearing the (...) way for more humane social practices. Leder draws on literary examples, clinical and philosophical sources, his medical training, and his own struggle with chronic pain. He levies a challenge to the capitalist and Cartesian models that rule modern medicine. Similarly, he looks at the root paradigms of our penitentiary and factory farm systems and the way these produce distressed bodies, asking how such institutions can be reformed. Writing with coauthors ranging from a prominent cardiologist to long-term inmates, he explores alternative environments that can better humanize—even spiritualize—the way we treat one another, offering a very different vision of medical, criminal justice, and food systems. Ultimately Leder proposes not just new answers to important bioethical questions but new ways of questioning accepted concepts and practices. (shrink)

Veterinarians serve on the front lines working to prevent animal suffering and abuse. For centuries, their compassion and expertise have improved the quality of life and death for animals in their care. However, modern interest in animal rights has led more and more people to ask questions about the ethical considerations that lie behind common veterinary practices. This Common Threads volume, drawn from articles originally published in the Journal of Animal Ethics (JAE), offers veterinarians and other interested readers a primer (...) on key issues in the field. Essays in the first section discuss aspects of veterinary oaths, how advances in animal cognition science factor into current ethical debates, and the rise of complementary and alternative veterinary medicine and its relationship to traditional veterinary medicine. The second section continues with an essay that addresses why veterinarians have an obligation to educate animal caregivers to look past "cuteness" in order to treat all animals with dignity. The collection closes with three short sections focusing on animals in farming, trade, and research ”areas where veterinarians encounter conflicts between their job and their duty to advocate and care for animals. Contributors: Judith Benz-Schwarzburg, Vanessa Carli Bones, Grace Clement, Simon Coghlan, Priscilla N. Cohn, Mark J. Estren, Elisa Galgut, Eleonora Gullone, Matthew C. Halteman, Andrew Knight, Drew Leder, Andrew Linzey, Clair Linzey, Kay Peggs, Megan Schommer, Clifford Warwick, and James W. Yeates. (shrink)

I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts. The literary critic reading a novel, the judge asked to apply a law, must arrive at a coherent reading of their respective texts. Similarly, the physician interprets the text of the ill person: clinical signs and symptoms are read to ferret out their meaning, the underlying disease. However, I suggest that the hermeneutics (...) of medicine is rendered uniquely complex by its wide variety of textual forms. I discuss four in turn: the experiential text of illness as lived out by the patient; the narrative text constituted during history-taking; the physical text of the patient's body as objectively examined; the instrumental text constructed by diagnostic technologies. I further suggest that certain flaws in modern medicine arise from its refusal of a hermeneutic self-understanding. In seeking to escape all interpretive subjectivity, medicine has threatened to expunge its primary subject — the living, experiencing patient. (shrink)

Pain is far more than an aversive sensation. Chronic pain, in particular, involves the sufferer in a complex experience filled with ambiguity and paradox. The tensions thereby established, the unknowns, pressures, and oscillations, form a significant part of the painfulness of pain. This paper uses a phenomenological method to examine nine such paradoxes. For example, pain can be both immediate sensation and mediated by complex interpretations. It is a certainty for the experiencer, yet highly uncertain in character. It pulls one (...) to the present but also projects one outward to a feared or desired future. Chronic pain can seem located in the body and/or mind; interior to the self, or an alien other; confined to a particular point and/or radiating everywhere. Such fundamental paradoxes, existential and epistemological, can challenge those living with long-term pain. (shrink)

Philosopher and physician Drew Leder shows how a phenomenology of lived embodiment reveals a series of healing strategies available in the face of the bodily breakdowns and challenges that are a part of the human condition.

This paper presents a naturalist skill-based alternative to traditional function-based naturalist theories of mental health and disorder. According to the novel skill view outlined here, mental health is a skilled action of individuals, rather than a question of the functioning of mental mechanisms. Mental disorder is the failure or breakdown of this skill. This skill view of mental health is motivated by focusing on the process of mental healing. This paper argues that, when we start with a focus on how (...) and why individuals heal from mental disorders, we gain a better understanding of what mental health is: the exercise of self-regulatory metacognitive skill. (shrink)

The lived body has structures of ability built up over time through habit. Serious illness, injury, and incapacity can disrupt these capacities, and thereby, one’s relationship to the body, and to time itself. This paper focuses attention on a series of healing strategies individuals then employ on the “chessboard” of possibilities intrinsic to lived embodiment. This can include restoring past abilities (pointing to the future to recreate the past); and/or transforming one’s bodily structure or use-patterns, or the external environment, to (...) compensate. With many conditions, including progressive aging, no full rehabilitation is possible. Nevertheless, one can also seek consolation, richness, or hope by remembering the past; anticipating the future; or presencing, that is, living fully in the now. Insofar as past, present, and future are interwoven in one’s life experience, many also meet adversity by a life-story revision, constructing a new narrative to render events meaningful. Some also access a sense of transpersonal timelessness, whether through anticipation of an afterlife, or a sense of the eternal present. There is a literature on the adaptive coping mechanism used by the chronically ill, but with its diverse patient populations, methodologies, and categories, it has proved difficult to systematize. This article suggests that the structures of lived embodiment, as explored by phenomenology, provide a way to understand the modes of wholeness individuals access over time, and in relation to time—what is here termed chronic healing. (shrink)

In “Neither Ethical nor Prudent: Why Not to Choose Normothermic Regional Perfusion” Omelianchuk and colleagues offer an exceptionally clear and methodical critique of the ethical and legal permissibility of in situ normothermic regional perfusion (NRP). NRP involves, in part, the reperfusion of organs via extracorporeal membrane oxygenation (ECMO) after a declaration of death and the occlusion of the arteries supplying blood to the brain. The authors’ main conclusion is that NRP invalidates the declaration of death via the standards set by (...) the Uniform Determination of Death Act (which requires either permanent cessation of circulatory and respiratory functions or irreversible cessation of all brain functions for a determination of death) and thereby violates the Dead Donor Rule (DDR) (which, minimally, requires that organ recovery not be the cause of death). Their arguments for these points, however, are flawed. Most notably, this conclusion rests on mistaken assumptions about the role of circulation in both the UDDA and DDR. A close examination of the role of circulation in sustaining life shows that NRP is consistent with both the UDDA and the DDR. (shrink)

Encounters with illness, impairment, and aging can disrupt one’s experiential relationship with self, body, others, and world. “Healing” takes place when the individual is able to re-integrate his or her world, even if the condition is not medically curable. Drawing on work in the phenomenology of the body, this article examines a series of eight “healing strategies” individuals employ, each representing a different way of orienting toward the painful or impaired body. One may lean into freeing oneself from the body, (...) through strategies of “refusing,” “ignoring,” “objectifying,” or “transcending” its problems. Conversely, one may choose to embrace the body, through strategies such as “accepting,” “listening,” “befriending,” or “witnessing.” It can be beneficial to have a good number of such coping strategies at one’s disposal, enhancing flexible response to chronic challenges. They also are often used in synergistic or complementary combinations. (shrink)

Several authors have recently argued that psychotherapy, as it is commonly practiced, is deceptive and undermines patients’ ability to give informed consent to treatment. This ‘deception’ claim is based on the findings that some, and possibly most, of the ameliorative effects in psychotherapeutic interventions are mediated by therapeutic common factors shared by successful treatments, rather than because of theory-specific techniques. These findings have led to claims that psychotherapy is, at least partly, likely a placebo, and that practitioners of psychotherapy have (...) a duty to ‘go open’ to patients about the role of common factors in therapy ; to not ‘go open’ is supposed to unjustly restrict patients’ autonomy. This paper makes two related arguments against the ‘go open’ claim. While therapies ought to provide patients with sufficient information to make informed treatment decisions, informed consent does not require that practitioners ‘go open’ about therapeutic common factors in psychotherapy, and clarity about the mechanisms of change in psychotherapy shows us that the common-factors findings are consistent with, rather than undermining of, the truth of many theory-specific forms of psychotherapy; psychotherapy, as it is commonly practiced, is not deceptive and is not a placebo. The call to ‘go open’ should be resisted and may have serious detrimental effects on patients via the dissemination of a false view about how therapy works. (shrink)

Lucy Osler's piece, "Controlling the noise: A phenomenological account of Anorexia Nervosa and the threatening body," lays out an important new interpretation of anorexia. Anorexia Nervosa is no longer viewed as primarily a perceptual distortion of body-image, an obsession with thinness, or an attempt to dematerialize—to free the subject from its inert thing-like body. Rather, the body itself, and the visceral body in particular, takes on a "voice" which the anorexic experiences as demanding and threatening. Anorexic monitoring and self-starvation beckons (...) as a way to regain power over this renegade viscerality. Unfortunately, this strategy of self-empowerment is doomed to backfire; hunger, illness, and body/food... (shrink)

Cognitive Behavioral Therapy has become the dominant form of psychotherapy in North America. The CBT model is theoretically based on the idea that all external and internal stimuli are filtered through meaning-making, consciously accessible cognitive schemas. The goal of CBT is to identify dysfunctional or maladaptive thoughts and beliefs, and replace them with more adaptive cognitive interpretations. While CBT is clearly effective as a treatment, there is good reason to be skeptical that its efficacy is due to the causal mechanisms (...) posited by the CBT model. This paper will argue that the specific cognitive schemas posited by the CBT model likely do not play a direct role in the development or treatment of psychological illness. Cognitive schemas, as identified in CBT interventions, are likely to be the result of patient confabulation and epistemically under-supported practitioner-based identification. CBT interventions appear to impose coherence on patients’ psychological states, rather than identifying and modifying preexistent causally efficacious core beliefs. (shrink)

In his text, the author develops the notion of trust as a condition for the possibility of any relational anthropology. Referring to the root associated with trust as the foundation of the relationship, he takes a position in the dispute about the primal nature of trust or perfidy; believes that in the abusive practices of credit and debt there is a reversal of the meaning of what is a necessary element of human life, relationships based on trust. Perfidy is possible (...) precisely because there is trust. On the basis of such concepts, he develops an analysis of events in the global economy at the turn of the 20th and 21th century, especially the financialization, based on the ideas of such authors as Arrighi, Bourdieu, Eichegreen, Pobłocki and Stiegler but also Lacan. (shrink)

This is the first volume to systematically explore the range of contemporary thought concerning the body and draw out its crucial implications for medicine.

This paper explores the ability and desire of the embodied self to “shape-shift”—to experience from within the capacities of animals, or natural phenomena like trees and mountains. Shape-shifting is discussed insofar as it manifests in a broad range of cultural domains, including children’s play, mythico-religious iconography, spiritual practice, sports, the performing arts, and so on. This potential for shape-shifting is grounded not simply in our evolutionary history and biological kinships, but in the phenomenology of the lived-body. Our own powers are (...) explored, expanded, and transformed through our communion with the non-human world. (shrink)

This article discusses three important models of concept combination—Smith and colleagues' Selective Modification model, Hampton's Composite Prototype model, and Costello and Keane's C3 model. Smith and colleagues' famous model of concept combination combines a model for producing complex concepts out of simple concepts with a prototype model of concept representation and a metric for computing the typicality of objects with respect to those concepts. The model of concept combination proposed by Smith and colleagues applies only to modifier–head complex concepts. Hampton's (...) model of concept combination includes, along with a qualitative description of the process resulting in complex concepts, a model of concepts, a model of categorization, and a model of typicality judgement. For Hampton, concept combination consists in the inheritance of typical properties from the combined concepts by the complex concept. (shrink)