_Intersubjective Processes and the Unconscious _looks at how the minds of the therapist and the patient interact with each other in a profound and unconscious way: a concept first described by Freud. This book expands Freud’s ideas further and examines how these have been greatly elaborated by contributions from the Kleinian School as well as from the work of Bion. It explores how, together, patient and therapist co-create a narrative through these unconscious intersubjective processes. Topics of discussion include: the unconscious (...) dimensions of intersubjective processes an historical overview of Freudian, Kleinian and Bionian contributions an integrated theory of the nature of unconscious intersubjective processes the central importance of dreaming in intersubjective processes the clinical implications of this intersubjective model The author offers in-depth clinical examples and case vignettes to illustrate the application of these principles when working with trauma, countertransference dreams and supervision. As such, this book will be invaluable to all psychoanalysts and psychotherapists interested in the topic of intersubjectivity as well as those who want to learn more about the interactional dimensions of Freud, Klein and Bion. (shrink)

Examines the role of indeterminacy in 19th-century British art. Chronicles the irreconcilable tension between the visual and the verbal, beginning in 1806 with Wordsworth's questioning of the essential ground and companionableness of things, and concluding with Hardy's dramatization of the treacherous relationship between the word and the image. Writers revealed here, including Tennyson and Browning, rely in varying degrees on the pictorial to forge analogs as evidence of the kindredness of things. Annotation copyrighted by Book News, Inc., Portland, OR.

Howard Brody expresses concern that citing the “two cases that put futility on the map,” namely Helga Wanglie and Baby K, may be providing ammunition to the opponents of the concept of medical futility. He in fact joins well-known opponents of the concept of medical futility in arguing that it is one thing for the physician to say whether a particular intervention will promote an identified goal, quite another to say whether a goal is worth pursuing. In the latter instance, (...) physicians are laying themselves open “to the criticism of taking on basic value judgments that are more appropriately left to patients and their surrogates.” Brody states that in both the Wanglie and Baby K cases, the “basic value judgments” had to do with the worthiness of maintaining unconscious life via medical technology. He classifies this as “a question of professional integrity—but not a question of futility,” adding that “more than semantics hinges on this distinction.” The “more than semantics” factor is a pragmatic, even political one. Failure to make this distinction renders physicians “that much more suspect and less trustworthy in the public debate.”. (shrink)

Jnanasrimitra (975-1025) was regarded by both Buddhists and non-Buddhists as the most important Indian philosopher of his generation. His theory of exclusion combined a philosophy of language with a theory of conceptual content to explore the nature of words and thought. Jnanasrimitra's theory informed much of the work accomplished at Vikramasila, a monastic and educational complex instrumental to the growth of Buddhism. His ideas were also passionately debated among successive Hindu and Jain philosophers. This volume marks the first English translation (...) of Jnanasrimitra's Monograph on Exclusion, a careful, critical investigation into language, perception, and conceptual awareness. Featuring the rival arguments of Buddhist and Hindu intellectuals, among other thinkers, the Monograph reflects more than half a millennium of competing claims while providing an invaluable introduction to a crucial philosopher. Lawrence J. McCrea and Parimal G. Patil familiarize the reader with the author, themes, and topics of the text and situate Jnanasrimitra's findings within his larger intellectual milieu. Their clear, accessible, and accurate translation proves the influence of Jnanasrimitra on the foundations of Buddhist and Indian philosophy. (shrink)

A referral was made to our Cardiac Transplant Program for a patient who was in the New Jersey Prison System. The Medical Director of the New Jersey Department of Corrections called regarding a 39-year-old inmate who was being treated in a New Jersey hospital that has a unit for prisoners from a nearby cor- rectional facility. The referring physician described the patient to our Medical Director of heart transplantation as a “murderer” who had been incarcerated since 1987 and sentenced to (...) prison for 30 years without eligibility for parole before completion of his 30-year sentence. The patient was being treated in the CCU of the facility and according to preliminary studies, was suffering from a possible dilated cardiomyopathy. There was evidence of a prior cerebrovascular accident (etiology unknown) with a dense hemiplegia of the left side. The patient was alert but unable to care for himself. There were a number of specific tests necessary to evaluate the patient's candidacy for heart transplantation before actually placing him-on a waiting list. However, the transplant director was uncertain about having the patient brought to our facility for further testing and called some members of the Transplant Selection Committee team to discuss the case. (shrink)

How is it that sounds from the mouth or marks on a page—which by themselves are nothing like things or events in the world—can be world-disclosive in an automatic manner? In this fascinating and important book, Lawrence J. Hatab presents a new vocabulary for Heidegger’s early phenomenology of being-in-the-world and applies it to the question of language. He takes language to be a mode of dwelling, in which there is an immediate, direct disclosure of meanings, and sketches an extensive (...) picture of proto-phenomenology, how it revises the posture of philosophy, and how this posture applies to the nature of language. Representational theories are not rejected but subordinated to a presentational account of immediate disclosure in concrete embodied life. The book critically addresses standard theories of language, such that typical questions in the philosophy of language are revised in a manner that avoids binary separations of language and world, speech and cognition, theory and practise, realism and idealism, internalism and externalism. (shrink)

This book explores what anyone interested in ethics can draw from Heidegger's thinking. Heidegger argues for the radical finitude of being. But finitude is not only an ontological matter; it is also located in ethical life. Moral matters are responses to finite limit-conditions, and ethics itself is finite in its modes of disclosure, appropriation, and performance. With Heidegger's help, Lawrence Hatab argues that ethics should be understood as the contingent engagement of basic practical questions, such as how should human (...) beings live? (shrink)

The report of the President's Council on Bioethics, Human Cloning and Human Dignity, addresses the central ethical, political, and policy issue in human embryonic stem cell research: the moral status of extracorporeal human embryos. The Council members were in sharp disagreement on this issue and essentially failed to adequately engage and respectfully acknowledge each others' deepest moral concerns, despite their stated commitment to do so. This essay provides a detailed critique of the two extreme views on the Council (i.e., embryos (...) have full moral status or they have none at all) and then gives theoretical grounding for our judgment about the intermediate moral status of embryos. It also supplies an account of how to address profound moral disagreements in the public arena, especially by way of constructing a middle ground that deliberately pays sincere respect to the views of those with whom it has deep disagreements. (shrink)

In this book, Lawrence Hatab provides an accessible and provocative exploration of one of the best-known and still most puzzling aspects of Nietzsche's thought: eternal recurrence, the claim that life endlessly repeats itself identically in every detail. Hatab argues that eternal recurrence can and should be read literally, in just the way Nietzsche described it in the texts. The book offers a readable treatment of most of the core topics in Nietzsche's philosophy, all discussed in the light of the (...) consummating effect of eternal recurrence. Although Nietzsche called eternal recurrence his most fundamental idea, most interpreters have found it problematic or needful of redescription in other terms. For this reason, Hatab's book is an important and challenging contribution to Nietzsche scholarship. (shrink)

This teaching of Vatican II raises the problem of how to know when the ordinary universal magisterium has proposed some doctrine as definitive. Fr. Francis A. Sullivan has put forth some principles that he claims are important for establishing that a doctrine has been definitively taught. Key to Sullivan’s principles is the claim that the constant consensus of theologians is a sign and a necessary condition for establishing whether the ordinary universal magisterium has taught a particular doctrine as definitive. This (...) essay argues against this claim. It maintains that while the consensus of theologians may be sign of definitive teachings, it is not a necessary condition for those teachings. Lastly, the essay suggests that the current discussion about the definitive, infallible teachings of the ordinary universal magisterium would be greatly aided if it took place in the context of the quest for catholicity in time and if it firmly kept in mind the nature of church as a communion. (shrink)

ABSTRACT By means of the high ratings that they awarded to subprime mortgage‐backed bonds, the three major rating agencies—Moody's, Standard & Poor's, and Fitch—played a central role in the current financial crisis. Without these ratings, it is doubtful that subprime mortgages would have been issued in such huge amounts, since a major reason for the subprime lending boom was investor demand for high‐rated bonds—much of it generated by regulations that made such bonds mandatory for large institutional investors. And it is (...) even less likely that such bonds would have become concentrated on the balance sheets of the banks, for which they were rewarded by capital regulations that tilted toward high‐rated securities. Why, then, were the agencies excessively optimistic in their ratings of subprime mortgage‐backed securities? A combination of their fee structure, the complexity of the bonds that they were rating, insufficient historical data, some carelessness, and market pressures proved to be a potent brew. This combination was enabled, however, by seven decades of financial regulation that, beginning in the 1930s, had conferred the force of law upon these agencies' judgments about the creditworthiness of bonds and that, since 1975, had protected the three agencies from competition. (shrink)

U.S. politicians and policymakers have been preoccupied with how to pay for health care. Hardly any thought has been given to what should be paid for—as though health care is a commodity that needs no examination—or what health outcomes should receive priority in a just society, i.e., rationing. I present a rationing proposal, consistent with U.S. culture and traditions, that deals not with “health care,” the terminology used in the current debate, but with the more modest and limited topic of (...) medical care. Integral to this rationing proposal—which allows scope to individual choice and at the same time recognizes the interdependence of the individual and society—is a definition of a “decent minimum,” the basic package of medical treatments everyone should have access to in a just society. I apply it to a specific example, diabetes mellitus, and track it through a person's life span. (shrink)

It probably should not be surprising, in this time of soaring medical costs and proliferating technology, that an intense debate has arisen over the concept of medical futility. Should doctors be doing all the things they are doing? In particular, should they be attempting treatments that have little likelihood of achieving the goals of medicine? What are the goals of medicine? Can we agree when medical treatment fails to achieve such goals? What should the physician do and not do under (...) such circumstances? Exploring these issues has forced us to revisit the doctor-patient relationship and the relationship of the medical profession to society in a most fundamental way. Medical futility has both a quantitative and qualitative component. I maintain that medical futility is the unacceptable likelihood of achieving an effect that the patient has the capacity to appreciate as a benefit. Both emphasized terms are important. A patient is neither a collection of organs nor merely an individual with desires. Rather, a patient (from the word to suffer ) is a person who seeks the healing (meaning to make whole ) powers of the physician. The relationship between the two is central to the healing process and the goals of medicine. Medicine today has the capacity to achieve a multitude of effects, raising and lowering blood pressure, speeding, slowing, and even removing and replacing the heart, to name but a minuscule few. But none of these effects is a benefit unless the patient has at the very least the capacity to appreciate it. Sadly, in the futility debate wherein some critics have failed or refused to define medical futility an important area of medicine has in large part been neglected, not only in treatment decisions at the bedside, but in public discussions—comfort care—the physician’s obligation to alleviate suffering, enhance well being and support the dignity of the patient in the last few days of life. (shrink)

Regina R. is a 12-year-old girl with recently diagnosed insulin-dependent diabetes. Before discharging her from the hospital, her family physician and consulting diabetes specialist try to instruct the girl and her parents in the appropriate program of treatment, including diet, insulin, and regular self-monitoring. However, the parents become upset when they learn what is involved in insulin treatment and inform the family physician they plan to employ the services of an alternative healing clinic that promises to cure their daughter with (...) a combination of herbal potions, macrobiotics, aroma therapy, therapeutic touch, Ayurveda, homeopathy, and guided imagery. (shrink)

Book reviewed in this article: The Physician's Covenant: Images of the Healer in Medical Ethics. By William F. May.

The principle of double effect has a long history, from scholastic disputations about self-defense and scandal to current debates about terrorism, torture, euthanasia, and abortion. Despite being widely debated, the principle remains poorly understood. In Intention, Character, and Double Effect, Lawrence Masek combines theoretical and applied questions into a systematic defense of the principle that does not depend on appeals to authority or intuitions about cases. Masek argues that actions can be wrong because they corrupt the agent's character and (...) that one must consider the agent's perspective to determine which effects the agent intends. This defense of the principle clears up common confusions and overcomes critics' objections, including confusions about trolley and transplant cases and objections from neuroscience and moral psychology. This book will interest scholars and students in different fields of study, including moral philosophy, action theory, moral theology, and moral psychology. Its discussion of contemporary ethical issues and sparse use of technical jargon make it suitable for undergraduate and graduate courses in applied ethics. The appendix summarizes the main cases that have been used to illustrate or to criticize the principle of double effect. (shrink)

Nietzsche's On the Genealogy of Morality is a forceful, perplexing, important book, radical in its own time and profoundly influential ever since. This introductory textbook offers a comprehensive, close reading of the entire work, with a section-by-section analysis that also aims to show how the Genealogy holds together as an integrated whole. The Genealogy is helpfully situated within Nietzsche's wider philosophy, and occasional interludes examine supplementary topics that further enhance the reader's understanding of the text. Two chapters examine how the (...) Genealogy relates to standard questions in moral and political philosophy. Written in a clear, accessible style, this book will appeal to students at every level coming to read the Genealogy for the first time, and a wider range of readers will also benefit from nuanced interpretations of controversial elements in Nietzsche's work. (shrink)

Through his innovative study of language, noted Heidegger scholar Lawrence Hatab offers a proto-phenomenological account of the lived world, the “first” world of factical life, where pre-reflective, immediate disclosiveness precedes and makes possible representational models of language. Common distinctions between mind and world, fact and value, cognition and affect miss the meaning-laden dimension of embodied, practical existence, where language and life are a matter of “dwelling in speech.” In this second volume, Hatab supplements and fortifies his initial analysis by (...) offering a detailed treatment of child development and language acquisition, which exhibit a proto-phenomenological world in the making. He then takes up an in-depth study of the differences between oral and written language (particularly in the ancient Greek world) and how the history of alphabetic literacy shows why Western philosophy came to emphasize objective, representational models of cognition and language, which conceal and pass over the presentational domain of dwelling in speech. Such a study offers significant new angles on the nature of philosophy and language. (shrink)

Discussion of the ethics of forgoing medically provided nutrition and hydration tends to focus on adults rather than infants and children. Many appellate court decisions address the legal propriety of forgoing medically provided nutritional support of adults, but only a few have ruled on pediatric cases that pose the same issue.The cessation of nutritional support is implemented most commonly for patients in a permanent vegetative state ). An estimated 4,000 to 10,000 American children are in the permanent vegetative state, compared (...) to 10,000 to 25,000 adults. Yet the dearth of literature, case reports, and court decisions suggests that physicians and families of pediatric patients stop medically provided nutrition or seek court orders much less frequently. (shrink)

A few years ago a battered infant was admitted to a California hospital. After a period of observation and testing, the physicians concluded that the infant had been beaten so badly that his brain was almost completely destroyed, leaving him permanently unconscious. The hospital had just adopted a policy specifying that life-sustaining treatment for permanent unconsciousness was futile and, therefore, not indicated. According to this policy, after suitable subspecialty consultations and deliberations, including efforts to gain parental agreement and documentation of (...) unanimous ethics committee support, the patient's physician had the authority to discontinue life-sustaining treatment. The infant's physician wished to do this. The mother, however, who was the prime battery suspect, insisted that the baby be kept alive. (shrink)

For two and a half millennia readers of Aristotle have been struggling to understand just what sort of causation is being attributed to the Prime Unmoved Mover or PM, whether final or efficient, assuming that this supreme being could not be a material cause or even a formal cause of the entire cosmos. Fred Miller entered into this still ongoing debate with a fresh proposal, drawing on an almost incidental remark in GC 1.6.323a25-33 that was later picked up by Philoponus (...) in his commentary on Aristotle’s text. The fundamental question is whether the PM’s causal role is to be restricted to a case of final causation or is there evidence for efficient causation as well? Just how ancient this question of interpretation is can be clearly shown by the following remarks made by Simplicius in the first half of the sixth century in his Neo-Platonist commentary on Phys VIII.6.267b17-26:Simplicius goes on to argue in some detail for this dual picture, primarily because of his harmonizing approach to Plato and Aristotle, but also by referencing some very specific passages in other works—notably Cael, GC, DM—but also Met, albeit only from its first book (1361.11-1363.24). He starts out here by claiming that “[n]o one disputes that Aristotle calls god or the primary mover a final cause” but realizes that showing that the PM is an efficient cause as well needs some textual support, which he dutifully attempts to provide. We will be going over some of the same ground cited here in trying to articulate Aristotle’s conception of divine causation and in particular to decide if Fred Miller’s thoughts about the “untouched toucher” will help us in the overall endeavor to explore Λ.6-10. Since he points out (at p. 278) that the PM could hardly be a material cause or even a formal cause, his framing the issue as to whether the mode of causation here is exclusively efficient or exclusively final, or, on the other hand, both at once, seems very close to how Simplicius set up the problem. Indeed, he cites the same section of Simplicius’s commentary quoted above and finds this ancient perplexity a good jumping off point for his own attempt to shed light on a fundamental issue of interpretation, noting that if we balk at the Neo-Platonic suggestion that Aristotle’s PM “is on a par with Plato’s demiurge,” the question becomes: “in what way is the prime mover supposed to be an efficient cause?” (p. 279). Miller’s novel suggestion is that one way of dealing with this question is the thought that the PM is an “untouched toucher.” It is crucial to his picture that this suggestion is strongly tied to the prospect of finding “a way in which the unmoved mover of the cosmos could be a genuine efficient cause” (p. 287) and not I believe, as W.D. Ross may have held, an efficient cause only by being a final cause. This will become important when we explore what untouched touching would be quite generally, given the emphasis on the psychological dynamics of this sort of affective action as suggested by the everyday examples provided by both Aristotle and Philoponus. (shrink)

Lawrence J. Dennis’s intellectual biography of John L. Childs, a leading figure in twentieth-century American educational philosophy between 1930 and 1960, traces Childs’s influence not only on education but also on midcentury politics, economics, and social issues. A disciple of John Dewey and an associate of William Heard Kilpatrick, George S. Counts, Boyd Bode, and other key figures in modern American education, Childs laid the philosophic basis for social reconstruction and became an important contributor to and interpreter of pragmatism (...) as a philosophy of education. Dennis describes how the Christian beliefs so central to Childs as a youth led him as a young man into a decade of YMCA missionary work in China. When he returned to the United States, Childs studied with John Dewey, later coauthoring two chapters of a book with him. Though Childs became a recognized expert on Dewey’s educational theory, he eventually became more of a reconstructionist than his mentor. Dennis carefully recounts Childs’s long association with Dewey as well as his political activities in the American Labor Party, the Liberal Party, and the American Federation of Teachers. He likewise traces the debate about metaphysics, democracy, and indoctrination that ensued among the foremost pragmatists of the day. (shrink)

Should the nation provide expensive care and scarce organs to convicted felons? We distinguish between two fields of justice: Medical Justice and Societal Justice. Although there is general acceptance within the medical profession that physicians may distribute limited treatments based solely on potential medical benefits without regard to nonmedical factors, that does not mean that society cannot impose limits based on societal factors. If a society considers the convicted felon to be a full member, then that person would be entitled (...) to at least a decent minimum level of care — which might include access to scarce life-saving organs. However, if criminals forfeit their entitlement to the same level of medical care afforded to all members of society, they still would be entitled to a kind of rudimentary decent minimum granted to all persons on simple humanitarian grounds. Almost certainly this entitlement would not include access to organ transplants. (shrink)

This paper reports data and scholarly opinion that support the perception of systemic flaws in the management of scientific professions and the research enterprise; explores the responsibility that professional status places on the scientific professions, and elaborates the concept of the responsible conduct of research (RCR). Data are presented on research misconduct, availability of research guidelines, and perceived research quality.

Vedānta Deśika produced his monumental poetic biography of Kṛṣṇa in a time when Kṛṣṇa-centered devotionalism was expanding to become perhaps the dominant mode of bhakti across South Asia. Central to this phenomenon is the growing popularity of the Bhāgavatapurāṇa, and especially of its exploration of Kṛṣṇa’s erotic play with the gopīs in his youth. Troubled by the unrestrained and seemingly adharmic sexuality of Kṛṣṇa, Deśika used the literary techniques and narrative paradigms of the mahākāvya to assimilate but also domesticate this (...) increasingly important Bhāgavata episode: Kṛṣṇa’s eroticism remains central but confined within more conventional marital norms and is thus made dharmically and theologically acceptable. Once he has resolved these dharmic problems, however, Deśika is happy to explore the soteriological, devotional, and paradoxical dimensions of erotic love with Kṛṣṇa. (shrink)