This essay describes how longstanding conceptions of professionalism in American medical care came under attack in the decades since the enactment of Medicare in 1965 and how the reform strategy and core provisions of the 2010 Affordable Care Act illustrate the weakening of those ideas and the institutional practices embodying them.The opening identifies the dominant role of physicians in American medical care in the two decades after World War II. By the time Medicare was enacted in 1965, associations of American (...) physicians were almost completely in charge of medical education, specialist certification, and the enforcement of professional norms on their members. Who could be a doctor, what education and training would be required, and what collegial oversight was operative was first a professional matter and only secondly implicated the state through malpractice or major corporations via the employment of physicians. (shrink)

This article offers an historical-materialist account of the coup in Honduras on 28 June 2009, which ousted democratically elected President Manuel Zelaya. It draws on over two dozen interviews with members of theFrente Nacional de la Resistencia Popular[National Front of Popular Resistance, FNRP], and participation in numerous marches and assemblies over two periods of fieldwork – January 2010, and June–July 2011. The paper steps back in time to provide an historical cartography of the basic material structures of the Honduran economy (...) and its integration into the world market, as well as the geopolitical role it played as a launching pad for Ronald Reagan’s counter-insurgency campaigns against guerrilla forces elsewhere in the region during the 1980s. We show how the defeat of mass guerrilla insurgencies in Guatemala and El Salvador, as well as the triumph over the Sandinista government in Nicaragua by 1990, allowed for the neoliberal pacification of Central America as a whole, including Honduras. We further demonstrate how the centre-leftist Manuel Zelaya, elected to the Honduran presidency in 2006, modestly encroached upon neoliberal orthodoxy and forged geopolitical alliances with left and centre-left governments elsewhere in the region, laying the bases for his violent overthrow. Finally, the paper traces the origins, trajectory, and heterogeneity of the resistance that emerged almost immediately after the coup had been carried out. (shrink)

Many business and government institutions appear to have failed in meeting society’s expectations of them. Continuing scandals and failures, as well as an increasingly obvious lack of responsibility to customers, have caused communities to question the probity and operation of these organisations. Consequently, “social licence to operate” is becoming an increasingly common process and one which demands a change in management philosophy and behaviour in our institutions. Improving the quality of responsible management practice is a critical element in this new (...) management philosophy, and which demands an intense focus on including ethical considerations in the core management competence of decision-making. We draw on a combined 100-plus years of international consulting experience, “C“ and senior executive work experience, and academic research to present a practical framework for responsible management practice which, we believe, can also form the foundation for the required organisational cultural transformation required of many existing organisations. (shrink)

Robust stakeholder engagement in health research requires broad communicative integration, not only of patients but also other stakeholders such as health system leaders, clinicians, and researcher...

The eminent scholar Lewis R. Gordon offers a probing meditation on freedom, justice, and decolonization. What is there to be understood and done when it is evident that the search for justice, which dominates social and political philosophy of the North, is an insufficient approach for the achievements of dignity, freedom, liberation, and revolution? Gordon takes the reader on a journey as he interrogates a trail from colonized philosophy to re-imagining liberation and revolution to critical challenges raised by (...) Afropessimism, theodicy, and looming catastrophe. He offers not forecast and foreclosure but instead an urgent call for dignifying and urgent acts of political commitment. Such movements take the form of examining what philosophy means in Africana philosophy, liberation in decolonial thought, the unshackling of political philosophy from the liberal moral theory setting the stage for the decolonization of justice and normative life, unleashing the obstacles to cultivating emancipatory politics, challenging reductionist forms of thought that proffer harm and suffering as conditions of political appearance and the valorization of nonhuman being. He asserts instead emancipatory considerations for occluded forms of life and the irreplaceability of existence in the face of catastrophe and ruin, and he concludes, through a discussion with the Circassian philosopher and decolonial theorist, Madina Tlostanova, with the project of shifting the geography of reason. (shrink)

In this undergraduate textbook Lewis R. Gordon offers the first comprehensive treatment of Africana philosophy, beginning with the emergence of an Africana consciousness in the Afro-Arabic world of the Middle Ages. He argues that much of modern thought emerged out of early conflicts between Islam and Christianity that culminated in the expulsion of the Moors from the Iberian Peninsula, and from the subsequent expansion of racism, enslavement, and colonialism which in their turn stimulated reflections on reason, liberation, and the (...) meaning of being human. His book takes the student reader on a journey from Africa through Europe, North and South America, the Caribbean, and back to Africa, as he explores the challenges posed to our understanding of knowledge and freedom today, and the response to them which can be found within Africana philosophy. (shrink)

Biological kin share up to half of their genetic material, including predisposition to disease. Thus, variants of clinical significance identified in each individual’s genome can implicate an exponential number of relatives at potential risk. This has renewed the dilemma over family access to research participant’s genetic results, since prevailing US practices treat these as private, controlled by the individual. These individual-based ethics contrast with the family-based ethics – in which genetic information, privacy, and autonomy are considered to be familial – (...) endorsed in UK genomic medicine and by participants in a multi-method study of US research participants presented here. The dilemma reflects a conflict between US legal and ethical frameworks that privilege “the individual” and exclude “the family” versus actual human genetics that are simultaneously individual and familial. Can human genetics succeed in challenging bioethics’ hegemonic individualism to recognize and place the family at the center of the room where bioethics happens? (shrink)

This paper examines phenomenology as a living form of thought with significance for decolonial epistemic practice. After discussing how phenomenology addresses concerns of living thought, the author outlines disciplinary decadence as a form of colonial epistemic practice and offers his theory of teleological suspensions of disciplinarity among the decolonial epistemic practices that could be devoted not only to the decolonization of thought but also ideas pertaining to normative life.

Business Ethics, the Environment & Responsibility, EarlyView.

This article is a reflective essay, drawing upon insights on racism and related forms of oppression as expressions of bad faith, on several influential movements in contemporary philosophy of race and racism. The author pays particular attention to theories from the global south addressing contemporary debates ranging from Euromodernity, philosophical anthropology, and the racialization of First Nations or Amerindians to intersectionality theory, discourses on privilege, decolonization, and creolization.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 36.1 (2003) 1-21 [Access article in PDF] Did Habermas Cede Nature to the Positivists? Gordon R. Mitchell Jürgen Habermas's "colonization of the lifeworld" thesis (1987, 332-73) posits that many of society's pathologies are due to the tendency of institutions to convert social issues that ought to be sorted out by a debating citizenry into technical problems ripe for resolution by expert bureaucracies, thus pre-empting important (...) public discussion. Habermas has attempted to lay bare the pernicious effects of this colonization process in his analysis of public opinion polling, welfare policy, education, German reunification, immigration, and other social issues (see Habermas 1997, 1994, and 1970; Holub 1992). In each of these contexts, Habermas has publicly challenged the encroachment of scientistic modes of decision-making into spheres where joint communicative action by deliberating citizens would yield more appropriate and legitimate judgments. This critical impulse is also evident in Habermas's methodological reflections on the proper role of academic scholarship, where he has argued vigorously against attempts to graft "objectivating" methods of natural scientific inquiry onto research projects in the social sciences (1971, 304-17).From all of this, one might gather that Habermas's commitment to rolling back the influence of technical forms of reasoning is connected to some intrinsic quarrel he has with the natural sciences. Yet such a sweeping generalization is hard to sustain in light of the fact that Habermas does not oppose technical reasoning per se; he recognizes that the daunting complexity of social life in late capitalism requiresthat certain "steering" tasks be delegated to systems that utilize largely instrumental logics to co-ordinate action. Likewise, he acknowledges that the disciplines of the natural sciences necessarily play important supporting roles in such steering projects.One normative presupposition of Habermas's colonization thesis is that there exists some proper boundary demarcating where the sphere of technical reasoning ends and the realm of communicative rationality begins. [End Page 1] On one side of this boundary, Habermas has provided many details on what he sees as the essential qualities of a properly functioning "public sphere," where "new social movements" continuously reweave the threads of communicative fabric holding society together (1996, 359-87), and where "historico-hermeneutic" academic study reflects on public life, sluicing insight back into the capillaries of democratic deliberations (1987, 374-403).What lies on the other side of the boundary is murkier. The proper role of natural scientific investigation has received relatively scant attention in Habermas's critical theory of society, and this has led to some confusion regarding his account of the natural sciences, as well as debate over whether this account has political purchase. One would think that sympathetic commentators, such as Helen Longino (who bases much of her own coherence theory of scientific truth on Habermas), would have reassuring things to say on this point. Yet her lukewarm assessment that, "in trying to clear a space for an autonomous social and critical theory, [Habermas] has ceded nature to the positivists" (1990, 202), raises questions about the flexibility and scope of Habermas's theory of communicative action as a basis for critique of scientific practice.One way to test Habermas's account of the natural sciences on this count is to put his views in conversation with science studies commentators who share a similar commitment to the idea that dialogue and argumentation are constitutive elements of scientific practice. Such an approach recasts the "ceding to positivism" question into a moment of controversy over the role of dialogue, not only as an essential motor driving the scientific enterprise, but also as a vehicle for democratic decision-making on issues related to the purpose and direction of scientific inquiry in society.Part one of this essay locates discursive norms embedded pragmatically in the notion of scientific objectivity. By bringing a modified version of Habermas's theory of communicative action into conversation with other approaches to science studies that foreground intersubjective dialogue as the key motor driving the scientific enterprise, I develop a foundation for robust criticism of systematically distorted scientific communication. Specific strategies of... (shrink)

In 2000, US Secretary of Health and Human Services Secretary Tommy Thompson mobilized the US public health infrastructure to deal with escalating trends of excess body weight. A cornerstone of this effort was a report entitled The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. The report stimulated a great deal of public discussion by utilizing the distinctive public health terminology of an epidemic to describe the growing prevalence of obesity in the US population. We suggest (...) that the ensuing controversy was fueled in part by the report's ambiguous usage of the evocative term “epidemic.” In some passages, the report seems to use “epidemic” in a literal sense, suggesting that rising prevalence of excess body weight should be defined technically as a disease outbreak. Other passages of the report present the same key term metaphorically, leaving readers with the impression that the epidemic language is invoked primarily for rhetorical effect. Here, we explore dynamics and implications of both interpretations. This analysis sheds light on the ongoing public argument about the appropriate societal response to steadily increasing body sizes in the US population; likewise, it capitalizes on the accumulated knowledge that the field of public health has garnered from combating diverse historic epidemics. Our interdisciplinary approach deploys critical tools from the fields of rhetoric, sociology and epidemiology. In particular, we draw from metaphor theory and public address scholarship to elucidate how the Call to Action frames public deliberation on obesity. We turn to the applied public health literature to develop a reading of the report that suggests a novel approach to the problem—application of the Epidemic Investigation protocol to streamline the public health response and reframe the public argument about obesity. (shrink)

Apparent design breakthroughs in short-range missile defense systems such as Theater High-Altitude Air Defense have prompted questions about the legality of such systems under the 1972 Antiballistic Missile Treaty. Prominent physicists have used computer “footprint” methodology to prove that if engineered to specifications, THAAD might exceed ABM Treaty performance limits banning highly effective missile defense systems. In response, missile defense officials commissioned Sparta, Inc. to conduct secret research casting doubt on the validity of such findings. The substantial diplomatic issues at (...) stake and the interesting rhetorical dynamics involved in this dispute warrant close scholarly analysis. Attention to the iterative relationship between the interpenetrating spheres of public argument and scientific practice in this case yields novel insight about the processes in which technical knowledge of defense systems is forged and raises fresh issues for the “closure project” in science and technology controversy studies. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

Originally delivered to mark the fiftieth anniversary of both Frantz Fanon’s death and the publication of his seminal discourse on decolonization, The Wretched of the Earth, these remarks seek to offer a preliminary outline of Fanon’s continuing relevance to the present. Conceptually spanning such touchstone elements of Fanon’s thought as sociogeny, race, violence, the human, and the relation between decolonial ethics and decolonial politics, the authors turn our attention to diagnosing the neoliberal face of contemporary coloniality/modernity and contributing to movements (...) from the Arab (or North African) Spring to the Occupy movement, from Philadelphia’s “flash mobs” to the new Latin American Left. (shrink)

This book explores the richness of contemporary philosophical reflection in Eastern and Central Europe. Philosophers from Poland, Russia, the Czech Republic, and the United States discuss the status of democracy, nationalism, language, economics, education, women, and philosophy itself in the aftermath of communism. Fresh ideas are combined with renewed traditions as poignant problems are confronted.

What does it mean for philosophy to be ‘colonised’ and what are some of the challenges involved in ‘decolonising’ it in philosophical and political terms? After distinguishing between philosophy and its practice as a professional enterprise, I explore six ways in which philosophy, at least as understood in its Euromodern form, could be interpreted as colonised: (1) Eurocentrism and its asserted racial and ethnic origins/misrepresentations of philosophy's history, (2) coloniality of its norms, (3) market commodification of the discipline, (4) disciplinary (...) decadence, (5) solipsism, and (6) appeals to redemptive narratives of colonial practice. The remainder of the article examines conditions for decolonising philosophy, which include unlocking its potential as a liberatory practice, identifying its humanistic dimensions, rethinking metaphysical assumptions, and embracing political responsibility wrought from the production of knowledge. (shrink)

De nombreux philosophes noirs donneraient cher pour avoir pris un café avec Jean-Paul Sartre. Si nous en avions la possibilité, beaucoup d’entre nous commenceraient par le remercier de son courage. Il a lutté non seulement contre les forces anti-humaines de la société française et de la société américaine, mais aussi contre ces forces en lui qui proposaient toujours la séduction d’une..

First published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.

While many "benchtop-to-bedside" research pathways have been developed in "Type I" translational medicine, vehicles to facilitate "Type II" and "Type III" translation that convert scientific data into clinical and community interventions designed to improve the health of human populations remain elusive. Further, while a high percentage of physicians endorse the principle of citizen leadership, many have difficulty practicing it. This discrepancy has been attributed, in part, to lack of training and preparation for public advocacy, time limitation, and institutional resistance. As (...) translational medicine and physician-citizenship implicate social, political, economic and cultural factors, both enterprises require "integrative" research strategies that blend insights from multiple fields of study, as well as rhetorical acumen in adapting messages to reach multiple audiences. This article considers how argumentation theory's epistemological flexibility, audience attentiveness, and heuristic qualities, combined with concepts from classical rhetoric, such as rhetorical invention, the synecdoche, and ethos, yield tools to facilitate translational medicine and enable physician-citizenship. (shrink)

The emergence of a conception of the marketing firm (Foxall, 1999a) conceived within behavioral psychology and based on a corresponding model of consumer choice, (Foxall, 1990/2004) permits an assessment of the levels of behavioral and organizational analysis amenable to neuroscientific examination. This paper explores the ways in which the bilateral contingencies that link the marketing firm with its consumerate allow appropriate levels of organizational neuroscientific analysis to be specified. Having described the concept of the marketing firm and the model of (...) consumer behavior on which it is based, the paper analyzes bilateral contingencies at the levels of (i) market exchange, (ii) emotional reward, and (iii) neuroeconomics. Market exchange emerges as a level of analysis that lends itself predominantly to the explanation of firm—consumerate interactions in terms of the super-personal level of reinforcing and punishing contingencies: the marketing firm can be treated as a contextual or operant system in its own right. However, the emotional reward and neuroeconomic levels of analysis should be confined to the personal level of analysis represented by individual managers on the one hand and individual consumers on the other. This also entails a level of abstraction but it is one that can be satisfactorily handled in terms of the concept of bilateral contingency. (shrink)