This book outlines and evaluates the principal strands of critical legal studies, and achieves much more as well.

Both communitarianism and casuistry have sought to restore ethics as a practical science—the former by incorporating various traditions into a shared definition of the common good, the latter by considering the circumstances of each situation through critical reasoning. Mark G. Kuczewski analyzes the origins and methods of these two approaches and forges from them a new unified approach. This approach takes the communitarian notion of the person as its starting point but also relies upon the narrative and analogical tools (...) of case-based reasoning. He separates out the rhetoric that is incongruent with the Aristotelian aspirations of each method to show that the two are complementary, and that consensus can emerge from fragmentation. He then applies his resulting method to three major problems in bioethics: the difficulties that the issue of personal identity poses for advance directives, the role of the family in medical decision making, and the refusal of treatment because of religious beliefs. He analyzes the need to assume a communitarian notion of the person as a starting point for the application of casuistic insights. Combining theoretical, practical, and scholarly insights, this book will be of interest to philosophers, political and social scientists, and bioethicists. (shrink)

A step-by-step guide to Foucault's History of Sexuality Volume I, The Will to KnowledgeIn the first volume of his History of Sexuality, The Will to Knowledge, Foucault weaves together the most influential theoretical account of sexuality since Freud. Mark Kelly systematically unpacks the intricacies of Foucault's dense and sometimes confusing exposition, in a straightforward way, putting it in its historical and theoretical context.This is both a guide for the reader new to the text and one that offers new insights (...) to those already familiar with Foucault's work. (shrink)

Contemporary bioethics has been somewhat skewed by its focus on high-tech medicine and the resulting development of ethical frameworks based on an acute-care model of healthcare. Research and scholarship in bioethics have payed only cursory attention to ethical issues related to disability. I argue that bioethics should concern itself with the full range of theoretical and practical issues related to disability. This encounter with the disability community will enrich bioethics and, potentially, society as well. I suggest a number of items (...) that the bioethics agenda should include, such as the development of a casuistry of the right to healthcare and to community integration and an advocacy role in fostering an understanding among the public and policy makers of the need to reform research and treatment related to disability. (shrink)

I analyze the insights present in Elisabeth Kübler-Ross’s seminal work, On Death and Dying that have laid the foundation for contemporary clinical bioethics as it is practiced by clinical ethics co...

Immigrants lacking health insurance access the health care system through the emergency departments of non-profit hospitals. Because these persons lack health insurance, continued care can pose challenges to those institutions. I analyze the values of our health care institutions, utilizing a Walzerian approach that describes its appropriate sphere of justice. This particular sphere is dominated by a caring response to need. I suggest that the logic of this sphere would be best preserved by providing increased access to health insurance to (...) this population. This access would marry the rights of these members of our community to access care to our responsibility to contribute to financing of the system. I close with some considerations on what it means to be a member of the community. (shrink)

This dissertation examines the two most popular contemporary revivals of Aristotelian ethics, communitarianism and casuistry. I consider how these two schools of thought which take Aristotle's ethics as their starting point, can seem to be so diametrically opposed. The communitarian approach to ethics, personified by Alasdair MacIntyre, Michael Sandel, and Ezekiel J. Emanuel argues that a shared notion of the self or the good life must be sought prior to resolving ethical problems. Conversely, the new casuistic movement, exemplified by the (...) recent work of Albert Jonsen, Stephen Toulmin, and Carson Strong eschews such theoretical baggage in favor of a case-based ethics. By examining each school of thought in the light of their Aristotelian aspirations, namely, their desire to re-establish an ethics based upon prudence that overcomes the fact/value distinction, spurious elements of their rhetoric are rejected. This allows us to see the compatible strains in communitarianism and casuistry and to demonstrate the elements they must borrow from each other in order to be viable approaches to ethical and political philosophy. (shrink)

ABSTRACTI consider objections to the use of living wills based upon the discontinuity of personal identity between the time of the execution of the directive anbd the time the person becomes incompetent. Recent authors, following Derek Parfit's “Complex View” of personal identity, have argued that there is often not sufficient identity interests between the competent person who executes the living will and the incompetent patient to warrant the use of the advance directive. I argue that such critics err by seeking (...) personal identity in a purely descriptive manner. By exploring Buchanan and Brock's concept of “surviving interests”, an argument is developed that certain future‐oriented acts have a normative force that contributes to the narrative unity which is constitutive of personal ideality. This narrative concept of the self is entailed by many of the our ordinary practices and challenges the philosophical consensus to view the self in a more dynamic and communitarian manner. (shrink)

I explore the possible meanings that the notion of the common morality can have in a contemporary communitarian approach to ethics and public policy. The common morality can be defined as the conditions for shared pursuit of the good or as the values, deliberations, traditions, and common construction of the narrative of a people. The former sense sees the common morality as the universal and invariant structures of morality while the second sense is much more contingent in nature. Nevertheless, the (...) communitarian sees both aspects as integral in devising solutions to public policy problems. I outline how both meanings follow from communitarian philosophical anthropology and illustrate how they work together when addressing a question such as that of providing universal health insurance in the United States. The common morality forms the basis of building an implicit consensus that is available to and reaffirmed by the shared reflections of the citizenry. (shrink)

Contemporary bioethicists and scholars of ancient philosophy explore the import of classical ethics on pressing bioethical concerns.

Bioethicists think about families in terms of conflicting interests. This mistake results from an impoverished notion of informed consent. Only by adequately characterizing the process of informed consent can we capture the phenomenon of shared decisionmaking.

A 24-year-old Hispanic male came into the emergency room of a large public teaching hospital with acute cardiac failure and chest pain. He was admitted and diagnosed with rheumatic heart disease and regurgitation and stenosis of both mitral and aortic valves. Medical judgment concluded that the patient needed to be medically stabilized and then undergo cardiac surgery to repair heart valves. The patient spoke only Spanish. Investigation through an interpreter revealed that he was an illegal alien from a Central American (...) country who has lived in this country for five to seven years. He came to the United States so that he could receive treatment for his heart condition, evidently fearing that he would not receive treatment in his home country. The patient entered this country through the assistance of some distant relatives. He did not have a strong support system. (shrink)

This special section deals with the new professionalism movement. The interest in the term “professionalism” has been growing steadily in medicine, and the word now seems to be everywhere. However, bioethicists have lagged behind our colleagues in medicine and nursing in explicitly contributing to this movement. This special section adds to the effort to catch up.

McCullough et al. propose adaptations that motivate forgiveness when the potential benefits of continuing the relationship outweigh the costs incurred by the transgression. The costs incurred are definite, whereas future benefits of forgiveness are only probabilistic. This situation exposes the forgiver to cheating in the form of repeat transgression. Adaptations motivating genuine forgiveness are therefore unlikely to evolve.

Ran is one of the most abundant and best conserved of the small GTP binding and hydrolyzing proteins of eukaryotes. It is located predominantly in cell nuclei. Ran is a member of the Ras family of GTPases, which includes the Ras and Ras‐like proteins that regulate cell growth and division, the Rho and Rac proteins that regulate cytoskeletal organization and the Rab proteins that regulate vesicular sorting. Ran differs most obviously from other members of the Ras family in both its (...) nuclear localization, and its lack of sites required for post‐translational lipid modification. Ran is, however, similar to other Ras family members in requiring a specific guanine nucleotide exchange factor (GEF) and a specific GTPase activating protein (GAP) as stimulators of overall GTPase activity. In this review, the multiple cellular functions of Ran are evaluated with respect to its known biochemistry and molecular interactions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume 29, Number 1, April 2003, pp. 89-98 Another "Curious Legend" about Hume's An Abstract of a Treatise of Human Nature MARK G. SPENCER I In 1938, J. M. Keynes and P. Sraffa edited and introduced for Cambridge University Press a reprinting of An Abstract of A Treatise of Human Nature.1 The Abstract they claimed in their subtitle was "A Pamphlet hitherto unknown by DAVID HUME." (...) Arguing against a number of nineteenth and early-twentieth -century scholars who attributed authorship of an abstract of the Treatise to Adam Smith, Keynes and Sraffa convincingly documented in their introductory essay many solid reasons for thinking that the pamphlet being reprinted was Hume's.2 Sixty years on, their account dispelling this "curious legend" of Smith's authorship has now become the received opinion. T.E. Jessop accepted Keynes and Sraffa's argument (having seen it in proof before the edition was published) in his bibliography of 1938, and Norman Kemp Smith gave their version an early supportive review.3 E.C. Mossner, in his well-known biography of Hume, accepted wholeheartedly Keynes and Sraffa's findings.4 When in 1978 the Selby-Bigge's edition of Hume's Treatise saw its second edition the text of the Abstract was appended and a note gave P.H. Nidditch's opinion that "Hume's authorship is overwhelmingly likely."5 More recently Mark G. Spencer is Social Sciences and Humanities Research Council of Canada Postdoctoral Research Fellow, Department of History, University of Toronto. Sidney Smith Hall, 100 St. George St., Toronto, Ontario MSS 3GS, Canada. [email protected] 90 Mark G. Spencer in the pages of this journal, Jeff Broome, David Raynor, and David Fate Norton have all helped buttress the case for Hume's authorship, as did R. W. Connon and M. Pollard elsewhere.6 Despite an occasional dissenting voice,7 the Abstract is now widely, and rightly (or so it seems to this author), thought to have been Hume's. But with all of this scholarly attention focused on confirming Hume's authorship, another much more contentious aspect of Keynes and Sraffa's interpretation has gone largely unnoticed. Keynes and Sraffa's billing of the Abstract as "A Pamphlet hitherto unknown by DAVID HUME," suggested that before 1938 the Abstract had not been attributed publicly to Hume and that the contents of the pamphlet also had been completely unknown. "Students of Hume have known that an abstract of the Treatise was made and intended for publication," wrote a reviewer of Keynes and Sraffa, "[b]ut no copy of this abstract was known to exist: indeed it was usually supposed that the abstract had never been printed at all."8 Relying on Keynes and Sraffa it would be easy to suppose that the Abstract was never publicly ascribed to Hume and even that the contents of the pamphlet had been overlooked entirely until Keynes and Sraffa came along. One of the purposes of the present short essay is to dispel, once and for all, that misunderstanding about the Abstract. Norman Kemp Smith went part of the way toward that end in 1938 when he reviewed Keynes and Sraffa's edition. But in the process Kemp Smith introduced another "curious legend" that has slipped into scholarly acceptance with little comment and no debate. We will see that it is a mistake to argue, as Kemp Smith did, that Hume's authorship of a sixpenny pamphlet was known to readers of An universal biographical and historical dictionary, published in 1800. There is no discussion of Hume's Abstract in that book. However, the Abstract was discussed in print in at least three different publications between 1818 and 1827, long after its initial publication in 1740 and long before Keynes and Sraffa brought it to the attention of their audience in 1938. While pre-1938 Hume scholars had overlooked the Abstract, at least one of Hume's early nineteenth-century critics knew of the Abstract's existence, attributed the work to Hume, and even quoted extensively from Hume's "Preface." Most interesting of all, Hume's authorship of the Abstract was interpreted in ways that are telling of the historical reception of... (shrink)

Epistemology -- Power I -- Power II -- Subjectivity -- Resistance -- Critique -- Ethics.

This is a clear and critical account of Foucault's political thought: what he said, how it's been used and its influence today. Michel Foucault, French philosopher, social theorist, historian of ideas and literary critic, is primarily known as a radical thinker who disturbs our understanding of society, yet little attention has been paid to his politics. Now, Mark Kelly details and criticises all of Foucault's major political ideas: the historical relativity of knowledge; exclusion and abnormality; his radical reconception of (...) power; his historical analysis of biopolitics in terms of discipline and biopower; his concept of governmentality; and his late work around ethics and subjectivity. Kelly shows how Foucault's positions changed over time, how his thought has been used in the political sphere and examines the importance of his work for politics today. It engages with Foucault's entire corpus, from his first works right up to his posthumously published College de France lectures and the unabridged version of the History of Madness. It looks at the theoretical reception of Foucault's thought and how it has been applied to real-world problems. (shrink)

In this article, I consider the interoperation of twin contemporary governmental imperatives, fostering economic growth and ensuring biopolitical security, in the face of the COVID-19 pandemic. At a theoretical level, I thereby consider the question of the applicability of a Marxist analysis vis-à-vis a Foucauldian one in understanding state responses to the pandemic. Despite the apparent prioritization of preserving life over economic activity by governments around the world in this context, I will argue that the basic problem that COVID-19 posed (...) for the state was one of sheer unknowability and that the fundamental motive for the governmental response was a concern for security in Foucault’s sense, that is, ensuring a baseline predictability in the social field, upon which economic activity, like myriad other social activity, is premised. I argue that this drive for security motivated states to appeal to medical experts to determine the direction of their response, who in turn applied a default model of quarantine. While we cannot be certain that the medically-guided response was optimal in terms either of health outcomes or economically, I argue it served its essential purpose by providing a structured framework for social action in the face of the unknown. While this is vital for the maintenance of the basic coordinates of capitalist society, I argue it nonetheless cannot entirely be explained simply by an appeal to Marxist categories and instead requires Foucault’s insights into the medicalization of society. (shrink)

Communitarian critics have derided case-based reasoning for ignoring the need to arrive at a shared hierarchy of goods prior to case.

Spirituality or religion often presents as a foreign element to the clinical environment, and its language and reasoning can be a source of conflict there. As a result, the use of spirituality or religion by patients and families seems to be a solicitation that is destined to be unanswered and seems to open a distance between those who speak this language and those who do not. I argue that there are two promising approaches for engaging such language and helping patients (...) and their families to productively engage in the decision-making process. First, patient-centered interviewing techniques can be employed to explore the patient's religious or spiritual beliefs and successfully translate them into choices. Second, and more radically, I suggest that in some more recalcitrant conflicts regarding treatment plans, resolution may require that clinicians become more involved, personally engaging in discussion and disclosure of religious and spiritual worldviews. I believe that both these approaches are supported by rich models of informed consent such as the transparency model and identify considerations and circumstances that can justify such personal disclosures. I conclude by offering some considerations for curbing potential unprofessional excesses or abuses in discussing spirituality and religion with patients. (shrink)

This collection of thirty-one cases and commentaries addresses ethical problems commonly encountered by the average health care professional, not just those working on such high-tech specialties as organ transplants or genetic engineering. It deals with familiar issues that are rarely considered in ethics casebooks, including such fundamental matters as informed consent, patient decision-making capacity, the role of the family, and end-of-life decisions. It also provides resources for basic but neglected ethical issues involving placement decisions for elderly or technologically dependent patients, (...) rehabilitation care, confidentiality regarding AIDS, professional responsibility, and organizational and institutional ethics. The authors describe in detail the perspectives of each party to the case, the kind of language that ethicists use to discuss the issues, and the outcome of the case. A short bibliography suggests useful articles for further reading or curriculum development. Easily understood by readers with no prior training in ethics, this book offers guidance on everyday problems from across the broad continuum of care. It will be valuable for health-care professionals, hospital ethics committees, and for students preparing for careers in health-care professions. (shrink)

Hume's Reception in Early America: Expanded Edition brings together the original American responses to one of Britain's greatest men of letters, David Hume. Now available as a single volume paperback, this new edition includes updated further readings suggestions and dozens of additional primary sources gathered together in a completely new concluding section. From complete pamphlets and booklets, to poems, reviews, and letters, to extracts from newspapers, religious magazines and literary and political journals, this book's contents come from a wide variety (...) of sources published in colonial America and the early United States between 1758 and 1850. As well as classics by Thomas Jefferson, John Adams and Alexander Hamilton, it contains scores of unknown and hard-to-locate items, many of which have not been reprinted since their original publication. These responses are divided into four parts covering Hume's Essays; his Philosophical Writings; his History of England; and his Character and Death. Each of those parts has a separate introductory essay, and every selection is introduced by a short headnote that sets the piece in its historical context and provides bibliographical references. Packed with new insights into Hume and American thought and culture, Hume's Reception in Early America reveals the relevance and impact of Hume on American political, philosophical, historical, religious, and aesthetic debates. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 10.4 (2000) 283-286 [Access article in PDF] Introduction This Issue of the Kennedy Institute of Ethics Journal focuses on "Aristotelianism in Contemporary Bioethics." It is an unusual topic for this journal as it is seemingly very theoretical. But, I assure the reader that the theoretical topics explored are of the most practical and pressing kind. The questions addressed concern what kind of knowledge and (...) skill there can be in deliberating about particular cases and issues, whether this knowledge is culturally relative, and how bioethics can balance the rights of the individual in making health care decisions with responsibilities to the community.Authors in bioethics, especially those working in clinical ethics, have long sought to address particular problems with the fewest theoretical commitments possible so as to make broad consensus more plausible. Since theoretical foundations are often disputed, keeping the discussion pragmatic has seemed the more likely road to agreement. Similarly, our American heritage has lent the rhetoric of the rights of the individual to the scholarly dialogue in bioethics. Although no one wishes to do away with such language completely, it sometimes has seemed inadequate to the moral phenomena. To address these concerns, the philosophy of Aristotle has been recruited. Aristotelianism in contemporary bioethics has become identified with two claims: (1) there is such a thing as the ability to reason wisely about particular problems and cases, and (2) there is a need to supplement the American emphasis on the individual with a richer notion of the person or a concept of the common good. Both of these claims address concerns arising from the doctrine of informed consent, the fundamental framework of medical decision making.Contemporary American biomedical ethics is now more than 25 years old. It has been marked by some important successes. For instance, it has evolved an ethical and legal consensus that the doctrine of informed consent is the primary way to make operational the value of respect for the patient. And this doctrine extends to all areas of medical treatment and biomedical research. The doctrine is minimalist in that it relies simply on [End Page 283] the right of a competent patient to refuse unwanted interventions. This approach naturally raises questions concerning whether it can adequately settle the more difficult moral questions society faces without recourse to a grander philosophical theory. Similarly, the doctrine of informed consent places the rights of the individual front and center, and this causes us to ask whether bioethics is intrinsically individualistic. Although some might find individualism unobjectionable, many claim that such individualism does not capture the moral phenomenon of the family's role in ethical medical decision making (Nelson and Nelson 1995) or the need to see particular choices in light of the health care schema we wish for society (Callahan 1990).Aristotelianism has not presented itself as just another competing theory among other approaches to bioethics. Through the notions of practical wisdom and the common good, Aristotelianism can be seen as a metaethical way of tying together the methodological progress in bioethics that has resulted from a rich debate among various methods. For instance, bioethics has seen the flourishing of two important methods: the principles approach and casuistry. Virtue theory has also received much attention. The representatives of each have often argued that the philosophical concepts and principles behind ethical decision making in medicine are minimal.Whether one is talking about the four principles approach of Beauchamp and Childress (1994), the case-based approach (casuistry) of Jonsen and Toulmin (1988), or the virtue theory of Pellegrino and Thomasma (1993), one immediately notices that each method is fairly dependent on the judgment or practical wisdom of a competent practitioner of the method in order to be effective. The four principles approach depends upon someone being able to balance or to specify its mid-level principles in difficult cases; casuistry requires the discrimination of a person of practical wisdom to identify relevant features of cases and reason analogically between paradigm cases and their less clear particular instances, and virtue theory places the competent practitioner of the clinical art at the center of its method and makes... (shrink)

In October 2012, the Loyola University Chicago Stritch School of Medicine amended its eligibility requirements for admission. In addition to U.S. citizens and permanent residents, persons who qualify for the Deferred Action for Childhood Arrivals program of the United States Citizenship and Immigration Service are now eligible for admission. Simply put, we extended the educational opportunity of medical school to people who are in a particular category of undocumented immigrants. We became the first medical school in the United States to (...) have an intentional, transparent policy of eligibility for persons eligible for the DACA program. This expanded admissions policy has gained some attention in the popular press and brought us many expressions of support. It has also dismayed a few members of our school's circle of faculty and alumni.We wish to walk you through the history of our policy's development. We believe that viewing it as it developed will make clear three pertinent ideas: this policy flows directly from the mission of medical schools, it suits a positive notion of social justice and is also compelled by a duty not to discriminate on arbitrary grounds, and educators who steward educational institutions must have the moral courage to place considerations of institutional mission and social justice above the political views and negative responses of some alumni and donors. (shrink)

The economic theory of the consumer, which assumes individual satisfaction as its goal and individual freedom to pursue satisfaction as its sine qua non, has become an important ideological element in political economy. Some have argued that the political dimension of economics has evolved into a kind of “secular theology” that legitimates free market capitalism, which has become a kind of “religion” in the United States [Nelson: 1991, Reaching for Heaven on Earth: The Theological Meaning of Economics. (Rowman & Littlefield (...) Publishers, Inc, Savage, Maryland); 2001, Economics as Religion: From Samuelson to Chicago and Beyond (The Pennsylvania State University Press, University Park, Pennsylvania); Thurow: 1983, Dangerous Currents: The State of Economics (Random House, New York); Milbank: 1990, Theology and Social Theory, Beyond Secular Reason (Basil Blackwell, Cambridge, Massachusetts)]. Consumer theory in its ideological form provides an important base for this religion and is no longer merely a positive framework for understanding consumer choice or estimating market demand. The paper explores the view of the human being, the “anthropology,” that is implicit in the economic theory of the consumer and compares its “theological” implications with the corresponding theological anthropologies in the Judaeo-Christian tradition. The paper outlines the assumptions of consumer theory and then focuses on three aspects of the theory from a critical theological perspective: the individual in community, property ownership, and human destiny (or “eschatology” in theological terminology). The principal conclusion is that consumer theory, viewed from this perspective, leads to a reductionist and existentially harmful view of human beings. The maximization of individual satisfaction raises genuine ethical issues when viewed as a political and religious value. The paper argues that the issues could be ameliorated if economists would include more explicit treatment of a social dimension and ethical alternatives in consumer theory and if theologians would give greater attention to economic theory. (shrink)

Fire over Luoyang: A History of the Later Han Dynasty 23–220 AD. Rafe de Crespigny. Sinica Leidensia, vol. 134. Leiden: Brill, 2016. Pp. xii + 580. €167, $200.

The patient was born at 29 weeks gestation. There was a prenatal diagnosis that the child's small intestine had developed outside of the abdominal cavity. The length of gestation had made the initial prognosis good. But after birth, surgery to place the intestine back into the abdominal cavity found that the baby actually had very little small intestine and a diagnosis of was made. The amount of small intestine was not compatible with survival. The transplant service saw the baby twice (...) and each time said the baby's profile did not meet the transplant protocol. (shrink)

The debate regarding physician-assisted suicide continues in our society. Despite the recent opinions of the United States Supreme Court, this issue is unlikely to go away anytime soon. For a variety of reasons, this debate is now conducted in the legalistic terms of individual rights and liberties. As a result, perhaps we philosophers have been left behind. This is now a matter for the legal arena and philosophy is likely to be irrelevant. I would like to suggest otherwise for two (...) reasons. (shrink)

A complete critical edition of the later work of the medieval philosopher and theologian Henry of Harclay is here published for the first time, together with an English translation prepared in collaboration with Raymond Edwards. The Quaestiones Ordinariae introduce students to the key problems of medieval philosophy, as well as enabling scholars to deepen their knowledge of the debates of this period. A further volume will publish Questions 15-29.