Incisively and stylishly written, this book constitutes an open challenge to reconsider the fundamental question of the relationship of law to society.

What role should the physician's conscience play in the practice of medicine? Much controversy has surrounded the question, yet little attention has been paid to the possibility that disputants are operating with contrasting definitions of the conscience. To illustrate this divergence, we contrast definitions stemming from Abrahamic religions and those stemming from secular moral tradition. Clear differences emerge regarding what the term conscience conveys, how the conscience should be informed, and what the consequences are for violating one's conscience. Importantly, these (...) basic disagreements underlie current controversies regarding the role of the clinician's conscience in the practice of medicine. Consequently participants in ongoing debates would do well to specify their definitions of the conscience and the reasons for and implications of those definitions. This specification would allow participants to advance a more philosophically and theologically robust conversation about the means and ends of medicine. (shrink)

Habermas's paradigm of communicative action is usually taken to be pretty much dominated by consensus, "Yes-saying." What if this were a radically one-sided perception? We take up this unorthodox position by arguing that "no-saying" in this paradigm is typically overlooked and underemphasized. To demonstrate this, we consider how negativity is figured at the most basic onto-ethical level in communicative action, as well as expressed in civil disobedience, a phenomenon to which Habermas assigns the remarkable role of "touchstone" (Prufstein) of constitutional (...) democracy. Once the importance of no-saying is drawn out, the paradigm looks distinctly less hostile to dissensus and agonism in democratic life. (shrink)

Categories We Live By makes several claims about Judith Butler's Gender Trouble which Butler seeks to contest, while remaining in fundamental agreement with most of the conclusions in Asta Sveinsdottir's book. At issue is whether or not performativity can rightly be restricted to what is called an exercitive in J. L. Austin's sense, whether Butler is a radical constructivist or a qualified one, and whether unauthorized speech acts have a power to bring a reality into being that is different (...) from those authorized by legal regimes. Along the way, Butler suggest that establishing facts takes place within variable historical schemes and that this argument is neither a denial or facts nor of materiality. Finally, an individualist idea of freedom is subject to criticism in order to make way for an historically constrained freedom, collective in nature. (shrink)

Surgeons have an ethical obligation to ensure all patients, regardless of their personal characteristics, receive the same quality of care. Established surgeons also have an obligation to ensure equal treatment for their peers and for those who would like to join the field. The commitment to ethical hiring and working standards entails making certain all individuals have the same opportunities free from discriminatory practices. The world of business has long realized the positive implications of having a diverse and inclusive workforce. (...) Studies have shown a positive correlation between increased racial and gender diversity and company performance. Diversity can lead to an increase in knowledge by sharing ideas with individuals who come from different life experiences and breakdown cultural barriers. We have already begun to see the impact of ignoring the importance of diversity within healthcare, including surgery. Healthcare disparities are defined by the NIH as “differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups.” Healthcare disparities persist despite decades acknowledging their existence, and they are pernicious and prevalent in surgery. One proposed method to help reduce or eliminate healthcare disparities is to increase the diversity of the workforce treating the patients, which would in turn reduce potential bias the patients face in the healthcare setting. Implicit bias can play a key role in interactions with patients and colleagues and needs to be explored on an individual basis. Cultural competence training can also provide surgeons the ability to effectively communicate with not only a diverse population of patients but also a diverse surgical workforce. All surgeons regardless of their role can have a positive impact on diversity as it relates to patient care and the surgical workforce. (shrink)

The question of what makes a life livable is linked with the question, what makes for an inhabitable world. This last was not Scheler’s question, but it follows from the world that he describes, the world that he claims is exhibited through the tragic. When the world is an object immersed in sorrow, how is it possible to inhabit such a world? What about the persistence of uninhabitable sorrow? The answer lies less in individual conduct or practice than in the (...) forms of solidarity that emerge, across whatever distance, to produce the conditions for inhabiting the world. (shrink)

Two visual world experiments investigated the processing of the implicature associated with some using a “gumball paradigm.” On each trial, participants saw an image of a gumball machine with an upper chamber with orange and blue gumballs and an empty lower chamber. Gumballs dropped to the lower chamber, creating a contrast between a partitioned set of gumballs of one color and an unpartitioned set of the other. Participants then evaluated spoken statements, such as “You got some of the blue gumballs.” (...) Experiment 1 investigated the time course of the pragmatic enrichment from some to not all when the only utterance alternatives available to refer to the different sets were some and all. In Experiment 2, the number terms two, three, four, and five were also included in the set of alternatives. Scalar implicatures were delayed relative to the interpretation of literal statements with all only when number terms were available. The results are interpreted as evidence for a constraint-based account of scalar implicature processing. (shrink)

The unlivable is the most extreme point of human suffering and injustice. But what is it exactly? How do we define the unlivable? And what can we do to prevent and repair it? These are the intriguing questions Judith Butler and Frédéric Worms discuss in a captivating dialogue situated at the crossroads of contemporary life and politics. Here, Judith Butler criticizes the norms that make life precarious and unlivable, while Frédéric Worms appeals to a "critical vitalism" as a (...) way of allowing the hardship of the unlivable to reveal what is vital for us. For both Butler and Worms, the difference between the livable and the unlivable forms the critical foundation for a contemporary practice of care. Care and support, in all their aspects, make human life livable, that is, "more than living." To understand it, we must draw on the concrete practices of humans who are confronted with the unlivable: the refugees of today and the witnesses and survivors of past violations and genocide. They teach us what is intolerable but also undeniable about the unlivable, and what we can do to resist it. Crafted with critical rigor, mutual respect, and lively humor, the compelling dialogue transcribed and translated in this book took place at the École Normale Supérieure (ENS) on April 11, 2018, at a time when close to two thousand migrants were living in nearby makeshift camps in northern Paris. The Livable and the Unlivable showcases this 2018 dialogue in the context of Butler's and Worms's ongoing work and the evolution of their thought, as presented by Laure Barillas and Arto Charpentier in their equally engaging introduction. It concludes with a new afterword that addresses the crises unfolding in our world and the ways a philosophically rigorous account of life must confront them. While this book will be of keen interest to readers of philosophy and cultural criticism, and those interested in vitalism, new materialism, and critical theory, it is a far from merely academic text. In the conversation between Butler and Worms, we encounter questions we all grapple with in confronting the distress and precarity of our times, marked as it is by types of survival that are unlivable, from concentration camps to prisons to environmental toxicity, to forcible displacement, to the Covid pandemic. The Livable and the Unlivable at once considers longstanding philosophical questions around why and how we live, while working to retrieve a philosophy of life for today's Left. (shrink)

Market metaphors have come to dominate discourse on medical practice. In this essay, we revisit Peter Berger and colleagues’ analysis of modernization in their book The Homeless Mind and place that analysis in conversation with Max Weber’s 1917 lecture “Science as a Vocation” to argue that the rise of market metaphors betokens the carry-over to medical practice of various features from the institutions of technological production and bureaucratic administration. We refer to this carry-over as the product presumption. The product presumption (...) foregrounds accidental features of medicine while hiding its essential features. It thereby confounds the public understanding of medicine and impedes the professional achievement of the excellences most central to medical practice. In demonstrating this pattern, we focus on a recent article, “Physicians, Not Conscripts—Conscientious Objection in Health Care,” in which Ronit Stahl and Ezekiel Emanuel decry conscientious refusals by medical practitioners. We demonstrate that Stahl and Emanuel’s argument depends on the product presumption, ignoring and undermining central features of good medicine. We conclude by encouraging conscientious resistance to the product presumption and the language it engenders. (shrink)

This paper presents a discussion of some central ideas in anarchist thought, alongside an account of experiments in anarchist education. In the course of the discussion, I try to challenge certain preconceptions about anarchism, especially concerning the anarchist view of human nature. I address the questions of whether or not anarchism is utopian, what this means, and what implications these ideas may have for dominant paradigms in philosophy of education.

Considerable attention has focussed on the potential of indigenous agricultural knowledge for sustainable development. Drawing upon fieldwork on the soil and water management principles of rice farming systems in Senegambia, this paper examines the potential of the traditional system for a sustainable food security strategy. Problems with pumpirrigation are reviewed as well as previous efforts in swamp rice development. It is argued that sustainability depends on more than ecological factors and in particular, requires sensitivity to socio-economic parameters such as the (...) labor demands of the food security strategy, the sexual division of labor, and food pricing policies. (shrink)

It is an unresolved question in quantum mechanics whether quantum states apply to individual quantum systems, or to ensembles of quantum systems. We show by way of a thought experiment that quantum states apply only to ensembles of quantum systems. A further unresolved question is whether quantum systems possess ontic states. If a quantum state is the state of an ensemble, as we claim, the answer to this question is that quantum states are not ontic. However, a notable recent result (...) in quantum foundations shows that if there are any ontic states at all, then the quantum state must be ontic. Collectively, these two results imply that there are no ontic states. We examine the assumptions required for these results, and suggest that the retrospective effect on state preparations by entangling measurements provides good reason for relaxing the assumption of preparation independence at the ontic level. (shrink)

Over 20 unstable microsatellite repeats have been identified as the cause of neurological disease in humans. The repeat nucleotide sequences, their location within the genes, the ranges of normal and disease‐causing repeat length and the clinical outcomes differ. Unstable repeats can be located in the coding or the non‐coding region of a gene. Different pathogenic mechanisms that are hypothesised to underlie the diseases are discussed. Evidence is given both from studies in simple model systems and from studies on human material (...) and in animal models. Since somatic instability might affect the clinical outcome, this is briefly touched on. Available data and theories on the timing and mechanisms of the repeat instability itself are discussed, along with factors that have been observed to affect instability. Finally, the question of why the often harmful unstable repeats have been maintained throughout evolution is addressed. (shrink)

Marx and Nietzsche are often compared as practitioners of a hermeneutic of suspicion. I pursue this comparison by focusing on an overlooked similarity between the two. In strangely similar passages, Marx (in Capital) and Nietzsche (in the Genealogy of Morals) introduce explicitly theatrical scenarios into the course of their discussions, complete with what Marx calls dramatis personae, where we witness a descent into a workshop (in some sense underground) in order to learn the secrets of production—the production, in both cases, (...) of value. But neither scenario conforms to the structure of the discovery of a concealed truth—in fact, each challenges this structure directly. By looking at the specific nature of these theatrical descents, we can come to a better understanding of the task of the philosopher in both Nietzsche and Marx, as well as the distinctive position of historical knowledge within a hermeneutics of suspicion. (shrink)

Background While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians' attitudes about prenatal surgery for lethal and non-lethal conditions and to elucidate characteristics associated with these attitudes. Methods Survey of 1200 paediatric surgeons, neonatologists and maternal–fetal medicine specialists. Results Of 1176 eligible physicians, 670 responded. In the setting of a lethal condition for which prenatal surgery would likely result in the child (...) surviving with a severe disability, most respondents either disagreed or strongly disagreed that they would recommend the surgery. Male physicians were twice as likely to recommend surgery for the lethal condition, as were physicians who believe that abortion is morally wrong. Older physicians were less likely to recommend surgery. For non-lethal conditions, most respondents agreed that they would recommend prenatal surgery, even if the surgery increases the risk of prematurity or fetal death. Compared with MFMs, surgeons were less likely to recommend such surgery, as were physicians not affiliated with a fetal centre, and physicians who were religious. Conclusion Physician’s attitudes about prenatal surgery relate to physicians’ beliefs about disability as well as demographic, cultural and religious characteristics. Given the variety of views, parents are likely to receive different recommendations from their doctors about the preferable treatment choice. (shrink)

Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called “moral foundations.” The objective of this study was to determine if “harm” and “fairness” intuitions can explain physicians’ judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to “purity”, “authority” and “ingroup” in cost-related judgments.

Mark Gardner's romance with Meg Lowman is actually impeded, not enhanced, by his new book "How To Meet a Gorgeous Girl.".

Twenty-five years ago, drawing on her fieldwork among the Zapotec, the legal anthropologist Laura Nader proposed the term harmony ideology to characterize postcolonial systems of justice. She found outward social harmony to be the result of coercion, as people were denied access to legal means and were forced either into alternative dispute resolution or into autocoercion, in which marginalized people presented unity to outsiders to avoid state interference. This proposition constitutes a relevant advance in relation to previous approaches to conflict (...) and harmony in the social sciences, but it falls short by failing to account for indigenous notions of and demands for harmony. Ethnographic data from rural Kyrgyzstan and the South Omo region of Ethiopia indicate that there are models of harmony active at various social levels and that harmony is a genuine concern of communities. Demands for harmony are performatively integrated into social practices. The authors argue that, rather than searching for a scale of sociality where harmony might be “organic,” it is necessary to critically assess proclamations of and demands for harmony as means of coercion even within small communities. A focus on social practice in such places reveals that the experience of community partly derives from acts of collectively condemning and sanctioning deviance. (shrink)

Based on a theoretical model of the mood-cognition interface, the prediction is derived and tested empirically that positive mood enhances constructive memory biases. After reading an ambiguous personality description, participants received a positive or negative mood treatment employing different films. Within each mood group, half of the participants were then questioned about the applicability of either desirable or undesirable personality traits to the target person. This questioning treatment was predicted to bias subsequent impression judgements in the evaluative direction of the (...) questioned attributes. As earlier research had shown that such a bias is stronger for negative than positive attributes (presumably because of the higher diagnosticity of negative attributes), a non-trivial test of the sup posed mood effect was possible. Positive mood should enhance constructive effects, but this should be most apparent for negative attributes. The empirical findings lend support to these predictions. Positive mood subjects' impression judgements were biased by the prior questioning even when they did not find the questioned attributes to be particularly applicable to the target person. By contrast, negative mood subjects' judgements were more consistent with their responses to the prior questioning and did not exhibit a constructive bias. (shrink)

State Violence, Coalitions, Subjects After a consideration of the reception of her work in France , Judith Butler assesses the political contribution of queer movements and minority struggles. She addresses the need for the left to reappropriate the forthright critique of the State and its violence and to examine the way minorities are produced. To do so, her analysis starts from the question of immigrant persons. She highlights the issues and the difficulties which are involved, if there is to (...) be a productive critique of the State, the aim of which is to contest it. As part of a dynamic political perspective, she proposes the creation of coalitions. She outlines the main lines of such a coalition, its dynamics and singularities, its articulation with the subject, but also its limits. In conclusion, she examines the issue of revolution and her relation to Marxist thought, indicating the outlines of her current thinking. (shrink)

To help professionals in all health care disciplines grapple with ethical issues, Ahronheim (medicine, New York Medical College), Moreno (biomedical ethics, U. of Virginia) and Zuckerman (Center for Ethics in Medicine, Beth Israel Medical Center) review the history and theory of clinical ethics and present 31 case studies analyzed from medical, ethical and legal perspectives. This second edition expands the original discussions of ethical dilemmas caused by advances in medical genetics, organ transplants, HIV medicine and other developments. The appendix includes (...) Internet references, suggested readings and other resources. (shrink)