In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

Improving the health and life of individuals living in poverty requires new models and new approaches, moving healthcare away from today's medical mindset of acute care toward a conception of healthcare as value-based, which necessarily means connecting disparate impacts with the healthcare services that are delivered.

Essays in Memory of Richard Helgerson: Laureations brings together new essays by leading literary scholars of the British and European middle ages and early modern period who have been influenced by the groundbreaking scholarship of Richard Helgerson. The contributors evince the ongoing impact of Helgerson's work in critical debates including those of nationalism, formal analysis, and literary careerism.

"Cluster randomized trials," in which groups of patients are randomly assigned to different therapeutic interventions, provide a powerful way of evaluating drugs. CRTs have not been widely used, in good part because of concerns about whether patients must give informed consent to participate in them. A better understanding of how CRTs fit into clinical practice resolves the concerns.

Secondary education around the world has been significantly disrupted by covid-19. Students have been forced into new ways of independent learning, often using remote technologies, but without the social nuances and direct teacher interactions of a normal classroom environment. Using data from the School Attitudes Survey—which surveys students regarding the perceived level of difficulty, anxiety level, self-efficacy, enjoyability, subject relevance, and opportunities for creativity with regards to each of their school subjects—this study examines students' responses to this disruption from two (...) very different schools with two very different experiences of the pandemic. This paper reports on the composite attitudinal profiles of students in the senior secondary levels at each school. The findings challenged our expectation that the increased difficulty and anxiety caused by the disruption would reduce perceived opportunities for creativity. Indeed, our analyses showed that the students at both schools demonstrated generally positive attitudes toward their learning and strongly associated opportunities for creativity with other attitudinal constructs including enjoyability, subject relevance, and self-efficacy. These complex associations made by the students appear to have buffered the impacts of the disruption, and they may even have supported creative resilience. (shrink)

The contributors to The Moral of the Story, all preeminent political theorists, are unified by their concern with the instructive power of great literature. This thought-provoking combination of essays explores the polyvalent moral and political impact of classic world literatures on public ethics through the study of some of its major figures-including Shakespeare, Dante, Cervantes, Jane Austen, Henry James, Joseph Conrad, Robert Penn Warren, and Dostoevsky. Positing the uniqueness of literature's ability to promote dialogue on salient moral and intellectual (...) virtues, editor Henry T. Edmonson III has culled together a wide-ranging exploration of such fundamental concerns as the abuse of authority, the nature of good leadership, the significance of "middle class virtues" and the needs of adolescents. This collection reinvigorates the study of classic literature as an endeavor that is not only personally intellectually satisfying, but also an inimitable and unique way to enrich public discourse. (shrink)

Politics, Monasticism, and Miracles in Sixth Century Upper Egypt. By James E. Goehring. Studien und Texte zu Antike und Christentum, vol. 69. Tübingen: mohR SiEBEck, 2012. Pp. xiv + 116. €49.

In an attempt to control the 'ballooning' of (discourse about) human rights James Griffin proposes a theory of them grounded in their presumed aim of protecting what he calls 'normative agency'. This paper criticizes the resulting theory's restriction of those thereby deemed to possess human rights only to functioning human agents, and does so in part through special attention to cases of human beings trapped in non-functioning bodies. The need for a less stringent account of the conditions necessary for (...) possession of human rights is suggested, and is defended against the claim that adoption of such an account would continue to favour debasement of the language of human rights. (shrink)

A new era has emerged in research on entheogens largely due to clinical trials conducted at Johns Hopkins University and similar studies sponsored by the Council for Spiritual Practices. In these notes and queries, I reflect on implications of these developments for psychological studies of religion and on what this research may mean for Christian churches in the United States. I conclude that the aims and methods of this research fit well within Jamesian efforts of contemporary psychology of religion to (...) assess religious practices by their fruits for life. Furthermore, some communitarian religious concerns that religious experiences occasioned by entheogens pose risks to the integrity of religious community are shown to be largely unfounded. However, it is suggested that certain risks for religious life posed by all investigations/interventions by knowledge experts—in particular, the colonization of the religious life world and the commodification of its practices—also attend these developments for Christian churches. Additionally, risks of individual harm in the use of entheogens appear to be significant and, therefore, warrant earnest ethical study. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Bergsonism and the History of Analytic Philosophy by Andreas VrahimisLeonard LawlorAndreas Vrahimis. Bergsonism and the History of Analytic Philosophy. History of Analytic Philosophy. Cham: Palgrave Macmillan, 2022. Pp. xix + 395. Hardback, $139.99.Bergsonism and the History of Analytic Philosophy is a great achievement in the history of ideas in general. The wealth of historical details that Andreas Vrahimis musters indicates that he has a profound understanding of twentieth-century (...) philosophy. More importantly, this book overflows with philosophical insights. The wealth of insights indicates that Bergsonism and the History of Analytic Philosophy is also a great achievement in philosophy as such. Andreas Vrahimis has written a remarkable book.Bergsonism and the History of Analytic Philosophy presents the origins of the division between analytic philosophy and continental philosophy. This story is familiar, with analytic philosophy siding with science and continental with poetry; with analytic philosophy being a kind of rationalism and continental a kind of irrationalism; with analytic philosophy using a writing style of dry, logical argumentation and continental using a writing style of images and emotions; and finally, with analytic philosophy writing only of what can be expressed and continental writing of the ineffable. Yet, Bergsonism and the History of Analytic Philosophy tells a story that is unfamiliar and even novel. The genealogy Vrahimis lays out is not of the rift between analytic philosophy and phenomenology (although this rift appears in the book's final chapters) but between analytic philosophy and Bergson. As Vrahimis clearly shows, the popularity of Bergson's thought at the beginning of the twentieth century caused the split, and even the hostility, between analytic and continental [End Page 332] philosophy. Therefore, Vrahimis does not title his book Bergson and the History of Analytic Philosophy, but Bergsonism and the History of Analytic Philosophy (2). Bergsonism is the popular view of Bergson's thought. It turned Bergson's thought into a "fad" (263). But Bergsonism contained many misunderstandings of Bergson. In the early twentieth century, Bergson was, in short, "a misunderstood celebrity." Unfortunately for Bergson's legacy, Bergson himself allowed Bergsonism to flourish as a cultural movement. Until The Creative Mind (published in 1934 in France as La pensée et le mouvant, after "the demise of Bergsonism"), Bergson never attempted to correct the misinterpretations of his thought that Bergsonism presented. Chapter by chapter, Vrahimis shows how the analytic philosophy criticisms leveled against Bergson are based in Bergsonism's distortions of Bergson's thought. The founding members of analytic philosophy aimed their attacks at a strawman Bergson.Bergsonism and the History of Analytic Philosophy's first three chapters set the stage for the analytic philosophers' attacks on Bergson. In fact, chapter 3 contains one of the clearest summaries of Bergson's thought I have ever read. Then, the book is arranged chronologically, starting with William James's 1905 "The Experience of Activity" in chapter 4 and ending with Ryle's 1958 "Phenomenology versus The Concept of Mind" in chapter 12. William James is not one of Bergson's critics. Chapter 4 shows how James praised Bergson's thought because of its similarity with pragmatism. This praise popularized Bergson's thought and thus led to Bergsonism. Chapters 4 through 12 (there is also a chapter 13 that serves as the book's conclusion) concern specific philosophers' criticisms of Bergson and then, in the final chapters, specific philosophers' criticisms of Lebensphilosophie and continental philosophy. There are chapters on Russell, Karin Costelloe-Stephen, L. Susan Stebbing, Neurath and the Vienna Circle (against Lebensphilosophie), Schlick (against Bergson as the originator of Lebensphilosophie), Carnap and Ayer (against Heidegger and Sartre), and Ryle (against Husserl). Most of the chapters concern the criticisms that resulted from Bergson's valorization of intuition as a source of knowledge. Bergson's definitions of intuition contribute to the belief that he is antiscience and an anti-intellectualist. Because intuition is introspection, it even suggests that Bergson's own philosophy is a kind of individualism. Because intuition is inexpressible, it also raises the problem that Bergson's own intuition of time as duration cannot be verified; rather, it can be challenged only by someone else's own intuition. Chapter 11 then shows how Heideggerian Angst challenges... (shrink)

This collection of essays by American philosopher Alain Locke makes readily available for the first time his important writings on cultural pluralism, value relativism, and critical relativism. As a black philosopher early in this century, Locke was a pioneer: having earned both undergraduate and doctoral degrees at Harvard, he was a Rhodes scholar at Oxford, studied at the University of Berlin, and chaired the Philosophy Department at Howard University for almost four decades. He was perhaps best known as a leading (...) figure in the Harlem Renaissance. Locke’s works in philosophy—many previously unpublished—conceptually frame the Harlem Renaissance and New Negro movement and provide an Afro-American critique of pragmatism and value absolutism, and also offer a view of identity, communicative competency, and contextualism. In addition, his major works on the nature of race, race relations, and the role of race-conscious literature are presented to demonstrate the application of his philosophy. Locke’s commentaries on the major philosophers of his day, including James, Royce, Santayana, Perry, and Ehrenfels help tell the story of his relationship to his former teachers and his theoretical affinities. In his substantial Introduction and interpretive concluding chapter, Leonard Harris describes Locke’s life, evaluates his role as an American philosopher and theoretician of the Harlem Renaissance, situates him in the pragmatist tradition, and outlines his affinities with modern deconstructionist ideas. A chronology of the philosopher’s life and bibliography of his works are also provided. Although much has been written about Alain Locke, this is the first book to focus on his philosophical contributions. (shrink)

James Holden manages to convince an alien technology—Abaddon's Gate, created by the protomolecule—that human beings are not a threat. It opens up 1,300 Einstein‐Rosen bridges, providing humanity access to at least as many habitable worlds. Humanity faces a dilemma at the start of the fourth season of The Expanse. The very first words of The Expanse appear on a title card: In the twenty‐third century, humans have colonized the solar system. Of course, The Expanse is a work of science (...) fiction, and its success or failure rests primarily on whether it entertains us, not whether it tells us something significant about our own world. And we certainly do not face the threat of extinction because of accidental exposure to alien technology! However, we would do well to recognize the actual threats to our existence. (shrink)

In this article I consider six definitions of deceiving (that is, other-deceiving, as opposed to self-deceiving) from Lily-Marlene Russow, Sissela Bok, OED/Webster's dictionary, Leonard Linsky, Roderick Chisholm and Thomas Feehan, and Gary Fuller, and reject them all, in favor of a modified version of a rejected definition (Fuller). I also defend this definition from a possible objection from Annette Barnes. According to this new definition, deceiving is necessarily intentional, requires that the deceived person acquires or continues to have a (...) false belief, and must involve the agency of the deceived person; furthermore, the deceiver must know or truly believe that the false belief that the deceived person acquires or continues to have is false. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:INTELLIGO UT CREDAM: ST. AUGUSTINE'S CONFESSIONS* BAPTISM INTO the Catholic Church ended Augustine's Odyssey through the intellectual and spiritual seas of late antiquity. His Confessi.ons tells us how he joined the Manicheans, became attached to astrology, imbibed Aristotle, was attracted to the Academy, learned Epicureanism, discovered the Platonists, and finally came home to Christianity.1 From the first moment he read Cicero, then, Augustine became a seeker of wisdom; few (...) of humanity's questions and concerns failed to move him. His initial conversion to Manicheanism, indeed, was prompted by its alleged ability to give a satisfactory response to the questions raised by human experience. In the same way, his initial aversion to Christianity in part arose from its alleged inability to provide such an account. Still, the nature of Augustine's ultimate conversion to Christianity is not entirely clear. He certainly indicates that a properly tutored biblical faith is the only solution to those questions and concerns which so vexed him: " credo ut intelligam," as Anselm formulated Augustine's understanding. But what is the role of philosophical reflection in this? Does reason work only within the context of faith? Is it merely the scullery maid for explicating the understanding of divine revelation? Or does Augustine say or at least show that unaided human reason has another sphere of operation? Can human reason understand *Earlier versions of this paper were read at the Twentieth International Medieval Congress, Western Michigan University, Kalamazoo, Michigan, May 11, 1985, and at the University of Dallas Augustine Colloquium, November 22, 1985. I am grateful to Dr. Michael Platt for his helpful comments and suggestions. 1 All references to the Confessions are from J. Gibb and W. Montgomery, The Confessions of Augustine (Cambridge, 1927)..JAMES LEHRBERGER, O. CIST. anything about God, human beings, and the universe before the advent of faith? While Augustinian scholarship has tended to stress the way in which philosophical thought. especially Neo-Platonism, operates within Christian faith, I hope to show that Augustine conceives the " faith and reason " relation in broader terms.2 More specifically, in this paper I hope to show that the Confessions presents reason itself, without revelation, as capable of assaying the possibility of any religious claim to 2 The problem of "faith and reason," or " authority and philosophy," in Augustine's thought has a history of critical analysis reaching back to the last century. The early discussions of this question have been traced by Sister Mary Patricia Garvey, in Saint Augustine: Christian or N ea-Platonist (Milwaukee, 1939), pp. 3-40, and more briefly by J. O'Meara, in St. A.ugustine, A.gainst the Academics, "Ancient Christian Writers," XU (Baltimore, 1950), pp. 19-22. The more recent discussions have failed to produce any consensus. H. A. Wolfson, in The Philosophy of the Church Fathers, I (Cambridge, 1956), pp. 127-140, sees Augustine as illustrating the patristic "double faith" against Manichean credulity. R. Cushman, in "Faith and Reason in the Thought of St. Augustine," Church History, 19, 1950), 271-294, awards the primacy to faith on the basis of the perversity of the will. P. Courcelle, in Recherches sur les Confessions de Saint Augustin (Paris, 1950), pp. 251-255, understands Augustine to progress from Neo-Platonism to Christianity without abandoning the former. R. Holte, in Beatitude et Sagesse: Saint Augustin et le probleme de la fin de l'homme dans la philosophie ancienne (Paris, 1962), pp. 373-386, considers the cooperation of reason and authority in Augustine's use of Christianity to confront the philosophic problems of his age. J. O'Meara, in The Young Augustine (New York, 1965), pp. 196197, admits a clarification in Augustine's thought but no basic change in his understanding of the primacy of faith over reason. R. O'Connell, in Saint Augusti.ne's Confessions: the Odyssey of a Soul (Cambridge, 1969), insists on a strong Neo-Platonic influence on Augustine's understanding of the human being as the " fallen soul." A. H. Armstrong, in " St. Augustine and Christian Platonism," Plotinian and Christian Studies (London, 1979), Ch. XI, 1-66, argues that the designation "Christian Platonist" is insufficient to characterize Augustine; the way in which Augustine takes up and transforms... (shrink)

The "grassroots turn" in bioethical discussions about justice in allocation of health care resources has attracted a great deal of support; in the absence of a convincing theory of justice in rationing, democratic decisionmaking concerning priority setting emerges with a kind of inevitability. Yet there remain suspicions about this approach – most importantly, worries about the socially corrosive impact of explicit, public decisionmaking that in effect sets a price on the lives of persons. These worries have been quieted, particularly by (...) the work of Leonard Fleck, but not altogether stilled. I explore more sympathetically the ideals to which concerns about public rationing somewhat dimly respond, and suggest constraints on priority setting discussions which might accommodate those ideals rather better. Keywords: "grassroots" decisionmaking, publicity principle, pricing life, rationing health care CiteULike Connotea Del.icio.us What's this? (shrink)

Among the distinguished contributors to the series are fellows of the Institute, past and present, Leonard E. Boyle, Jocelyn Hillgarth, Edouard Jeauneau, James K. McConica, M. Michèle Mulchahey, Joseph Owens, Walter H. Principe, James P. ...

Warren Zevon’s musical career, though brilliant throughout, is particularly notable for its ending: diagnosed with a terminal illness, Zevon refused a potentially debilitating medical treatment to put his remaining energy into recording another album. The resulting record –2003’s 'The Wind' – was in many ways the perfect farewell: songs of dirty, dark, uncompromising, country-tinged rock, blistering guitar solos, all mixed with intelligent, black-as-coal gallows humour. But it was also a moving farewell to his fans, a heartfelt, personal reflection on his (...) life and impending death: it begins with the words “sometimes I feel like my shadow’s casting me” and ends with “keep me in your heart for a while”. 'The Wind' ranks among Zevon’s very best and belongs in the same category as albums like David Bowie’s 'Blackstar' and Leonard Cohen’s 'You Want It Darker': works of great artists that knew the end was coming and made that knowledge musical. But though it had a particular force towards the end, death had always featured as a prominent theme in Zevon’s music. In fact, the albums that preceded his terminal diagnosis – especially 2000’s 'Life’ll Kill Ya' – have a marked preoccupation with death and dying, and many of his song’s characters (gunmen, gangsters, boxers, murderers of all stripes) either dealt death out, died, or both. -/- In this chapter, I argue that Zevon’s music and speech in his late public appearances personify an idea in Martin Heidegger’s philosophy called ‘authentic being-towards-death’. In his landmark text 'Being and Time', Heidegger undertakes a painstaking analysis of human existence. One of its conclusions is that to live a fully authentic life, we must reckon with our mortality, come to terms with it and allow this reckoning to have a transformative effect on how we live and how we think about our existence. This results, Heidegger argues, in a distinct way of being that he calls ‘being-towards-death’ and ‘anticipatory resoluteness’ in the face of death. Authentic being, which involves properly taking ownership of our lives and their meaning, cannot be adequately achieved without a serious confrontation with the fact that we will one day die. I claim that Warren Zevon’s music, with its continual engagement with death which culminates in 'The Wind', is one of the great musical manifestations of exactly this type of project. Heidegger’s writing is often notoriously abstract, but it pertains to the most fundamental issues about what it means to be human. Engaging with it alongside Zevon’s music provides a fruitful opportunity to make it concrete, better able to understand its most important aspects while providing an interesting conceptual toolkit to apply to the music of one of the great songwriters of death. (shrink)

Andrea Pitts’ Anzaldúan reading of multiplicitous agency critically weaves together Latinx, Latina feminist, Black, Indigenous, queer and trans, and disability theorizing alongside Anzaldúan scholarship to demonstrate how pluralistic communities come together for positive social transformation. In this process, they provide a powerful scholarly resource to Anzaldúan scholarship. Ultimately, Pitts invites us to break away from modes of being that fall into individualism, insularities, binaries, isolation, and even imperialism to imagine instead “new geographies of selves” (32). This revision involves developing an (...) agential capacity that recognizes ours and other’s (nos y otrxs) multiplicitous and complex identities and their interaction. By being open to this complexity, opacity, ambivalence, and the imperative to new ways of being both intangible and tangible radical transformations emerge in practice. However, though rooted in Leonard Harris’ insurrectionist ethics, Pitts recognizes one must leave room for a coalitional process that may not succeed but is always open to interpretation and challenge considering the fluidity of multiplicitous agency that informs it (166). (shrink)

This essay is my review of the classic TV series, Route 66. It was a classic “buddy movie,” with two young men who tour the country in a gorgeous 1956 Chevy Corvette, staying in various towns and working at various blue-collar jobs. The acting was generally superb, and the scripts were mainly written by the fine script writer Stirling Silliphant, and produced by the famous producer Herbert Leonard. I suggest that this 50-year-old series tells us a lot about cultural (...) change in America during that time. I suggest also that it helps demonstrate that the charge made by a famous cultural critic of the time—Newton Minow, who was Chairman of the Federal Communications Corporation from 1961 to 1963—that this period of commercial TV was a “vast wasteland” was not merely arrogantly elitist, but was in fact patently false. The 1950s and early 1960s saw many amazingly good series in a wide variety of genres. (shrink)

Essays on Philosophy and Economic Methodology By Daniel M. Hausman Cambridge University Press, 1992. Pp. 259. ISBN 0?521?41740?6. £35.00. Le Fondement de la morale: Essai d'éthiquephilosophique By André Léonard Cerf, 1991. Pp. 381. ISBN not available. FF240. The Philosophy of Time Edited By Robin Le Poidevin and Murray MacBeath Oxford University Press, 1993. Pp. 230. ISBN 0?19?823998?X. £27.50. The Ethics and Politics of Human Experimentation By Paul M. McNeill Cambridge University Press, 1993. Pp. 315. ISBN 0?521?41627?2. £35.00. Modern Conditions, Postmodern (...) Controversies By Barry Smart Routledge, 1991. Pp. 241. ISBN 0?415?06952. £10.99. Religion in Relation. Method, Application and Moral Location By Ivan Strenski Macmillan, 1993. Pp. ix + 257. ISBN 0?333?53469?7. £45.00. Robert Nozick: Property, Justice and the Minimal State By Jonathan Wolff Polity Press, 1991. Pp. ix + 168. ISBN 0?7456?0603?2. £8.95 pbk. (shrink)