Transplantation continues to push the frontiers of medicine into domains that summon forth troublesome ethical questions. Looming on the frontier today is human facial transplantation. We develop criteria that, we maintain, must be satisfied in order to ethically undertake this as-yet-untried transplant procedure. We draw on the criteria advanced by Dr. Francis Moore in the late 1980s for introducing innovative procedures in transplant surgery. In addition to these we also insist that human face transplantation must meet all the ethical requirements (...) usually applied to health care research. We summarize the achievements of transplant surgery to date, focusing in particular on the safety and efficacy of immunosuppressive medications. We also emphasize the importance of risk/benefit assessments that take into account the physical, aesthetic, psychological, and social dimensions of facial disfiguration, reconstruction, and transplantation. Finally, we maintain that the time has come to move facial transplantation research into the clinical phase. (shrink)

Main Response Topics ? Introduction ? Open display and public evaluation ? Publicity versus patient privacy ? Facial tissue donation ? Validity of Louisville Instrument for Risk Acceptance ? Patients' understanding of risk ? Face versus hand transplantation ? Rejection rates/risks ? Patient compliance ? Exit strategy ? Functional recovery ? Societietal implications ? Psychological implications ? Conclusion: Uncertainty likely to persist.

The Mesillas Yesharim / Path of the Just was the masterpiece of Rabbi Moshe Chaim Luzzatto, the great mystic, philosopher, sage, and saint. For centuries, this classic text for better living has been every man's primer for ideal life. Wherever there were Jews there was a well-thumbed Mesillas Yesharim. In this book, Rabbi Twerski applies the text and themes of Mesillas Yesharim to the everyday challenges of the 90s. He shows us how we can succeed in the quest for (...) a better life and in bettering ourselves. (shrink)

I build on Adam Smith’s account of the impartial spectator in The Theory of Moral Sentiments in order to offer a modest ideal observer theory of moral judgment that is adequate in the following sense: the account specifies the hypothetical conditions that guarantee the authoritativeness of an agent’s (or agents’) responses in constituting the standard in question, and, if an actual agent or an actual community of agents are not under those conditions, their responses are not authoritative in setting this (...) standard. However, in the account that I provide, the hypothetical conditions can themselves be constructed from the psychology and interactions of actual human beings. In other words, facts about the morally appropriate and inappropriate are determined from hypothetical conditions that––while agents in a given society might have yet to attain them––can be constructed from those agents’ shared experiences. Thus, the account offers both an attainable standard of moral judgment and a standard that can transcend the biases of the society which gave rise to it. I also defend the account against three challenges: (a) ideal observer theories do not offer the right kind of motivation to act on the verdicts of the ideal observer; (b) ideal observer theories cannot explain why the idealization in question is well-motivated and not objectionably ad hoc; (c) the standard used in ideal observer theories cannot be defended upon further reflection, because we would need a non-arbitrary, second-order standard to govern our reflection on the first-order standard of moral judgment. (shrink)

I offer a novel two-stage reconstruction of Hume’s general-point-of-view account, modeled in part on his qualified-judges account in ‘Of the Standard of Taste.’ In particular, I argue that the general point of view needs to be jointly constructed by spectators who have sympathized with (at least some of) the agents in (at least some of) the actor’s circles of influence. The upshot of the account is two-fold. First, Hume’s later thought developed in such a way that it can rectify the (...) problems inherent in his Treatise account of the general point of view. Second, the proposed account provides the grounds for an adequate and well-motivated modest ideal observer theory of the standard of virtue. (shrink)

Physicians frequently ask whether they should give patients what they want, usually when there are considerations pointing against doing so, such as medicine’s values and physicians’ obligations. It has been argued that the source of medicine’s values and physicians’ obligations lies in what has been dubbed “the internal morality of medicine”: medicine is a practice with an end and norms that are definitive of this practice and that determine what physicians ought to do qua physicians. In this paper, I defend (...) the claim that medicine requires a morality that is internal to its practice, while rejecting the prevalent characterization of this morality and offering an alternative one. My approach to the internal morality of medicine is constructivist in nature: the norms of medicine are constructed by medical professionals, other professionals, and patients, given medicine’s end of “benefitting patients in need of prima facie medical treatment and care.” I make the case that patients should be involved in the construction of medicine’s morality not only because they have knowledge that is relevant to the internal morality of medicine—namely, their own values and preferences—but also because medicine is an inherently relational enterprise: in medicine the relationship between physician and patient is a constitutive component of the craft itself. The framework I propose provides an authoritative morality for medicine, while allowing for the incorporation, into that very morality, of qualified deference to patient values. (shrink)

Two problems seem to plague Adam Smith’s account of sympathy and approbation in The Theory of Moral Sentiments (TMS). First, Smith’s account of sympathy at the beginning of TMS appears to be inconsistent with the account of sympathy at the end of TMS. In particular, it seems that Smith did not appreciate the distinction between ‘self-oriented sympathy’ and ‘other-oriented sympathy’, that is, between imagining being oneself in the actor’s situation and imagining being the actor in the actor’s situation. Second, Smith’s (...) account of approbation, according to which a sentiment of approval arises when there is recognition of concordance between the spectator’s sympathetic passion and the actor’s original passion, seems to face the following problem: since the spectator attains both his own sympathetic passion and the actor’s original passion by sympathizing with the actor, the sympathetic passion of the spectator and the original passion of the actor will necessarily be identical. Therefore, Smith’s account of approbation requires that the spectator utilize both self-oriented and other-oriented sympathy (‘the double-sympathy model of approbation’). I offer a novel developmental account of sympathy in TMS that renders Smith’s account of sympathy consistent and allows for the utilization of the double-sympathy model of approbation. (shrink)

My question in the chapter is this: could (and should) the role of the physician be construed as that of a friend to the patient? I begin by briefly discussing the “friendship model” of the physician-patient relationship—according to which physicians and patients could, and perhaps should, be friends—as well as its history and limitations. Given these limitations, I focus on the more one-sided idea that the physician could, and perhaps should, be a friend to the patient (a “physician-qua-friend model” of (...) the physician-patient relationship). I show that given recent developments in our understanding of the physician-patient relationship, this idea is far from asinine. I then make the case that the most plausible conception of the physician-qua-friend model incorporates the following components: (a) a common goal, that is, one that physician and patient share; (b) certain forms of equality between physician and patient; (c) an ideal of a caring physician. Finally, I show how the model can be instantiated in a certain type of physician-patient interaction, namely, in physician-assisted dying. (shrink)

The literature on conscientious objection in medicine presents two key problems that remain unresolved: Which conscientious objections in medicine are justified, if it is not feasible for individual medical practitioners to conclusively demonstrate the genuineness or reasonableness of their objections? How does one respect both medical practitioners’ claims of conscience and patients’ interests, without leaving practitioners complicit in perceived or actual wrongdoing? My aim in this paper is to offer a new framework for conscientious objections in medicine, which, by bringing (...) medical professionals’ conscientious objection into the public realm, solves the justification and complicity problems. In particular, I will argue that: an “Uber Conscientious Objection in Medicine Committee” —which includes representatives from the medical community and from other professions, as well as from various religions and from the patient population—should assess various well-known conscientious objections in medicine in terms of public reason and decide which conscientious objections should be permitted, without hearing out individual conscientious objectors; medical practitioners should advertise their conscientious objections, ahead of time, in an online database that would be easily accessible to the public, without being required, in most cases, to refer patients to non-objecting practitioners. (shrink)

I demonstrate that analogies, both explicit and implicit, between Wittgenstein’s discussion of rituals, aesthetics, and psychoanalysis (and, indeed, his own philosophical methodology) suggest that he entertained the idea that Freud’s psychoanalytic project, when understood correctly—that is, as a descriptive project rather than an explanatory-hypothetical one—provides a “surveyable representation” (übersichtliche Darstellung) of certain psychological facts (as opposed to psychological concepts). The consequences of this account are that it offers an explanation of Wittgenstein’s admiration for and self-perceived affinity to Freud, as well (...) as of his apparent “know-nothing approach” to empirical psychology. (shrink)

_ Source: _Volume 26, Issue 1, pp 34 - 66 During his final years, R. Nahman of Bratslav endeavored to find a solution for the paradox of unrealized messiahs. His solution was outlined in his dream about birds in December 1806, on the Sabbath of _Parashat Va-yeḥi_. This dream was influenced by his reading of a story told in the _Zohar, Parashat Va-yeḥi_, of a “vision of birds” of R. Yehudah, a disciple of R. Shimon bar Yohai, that exemplifies the (...) crisis experienced by the circle of disciples of R. Shimon following his death. The essay elaborates on the connections between the dream and the _Zohar_ story and their influence on R. Nahman’s messianic endeavor. (shrink)

Although Ezekiel's vision of the return and resettlement of Israel in postexilic times had no effect on subsequent events, his prescriptions for those events display his lofty conception of a prophet's responsibility in an age of ruin.

The Humean Theory of Reasons, according to which all of our reasons for action are explained by our desires, has been criticized for not being able to account for “moral reasons,” namely, overriding reasons to act on moral demands regardless of one's desires. My aim in this paper is to utilize ideas from Adam Smith's moral philosophy in order to offer a novel and alternative account of moral reasons that is both desire-based and accommodating of an adequate version of the (...) requirement that moral demands have overriding reason-giving force. In particular, I argue that the standpoint of what Smith calls “the impartial spectator” can both determine what is morally appropriate and inappropriate and provide the basis for normative reasons for action—including reasons to act on moral demands—to nearly all reason-responsive agents and, furthermore, that these reasons have the correct weight. The upshot of the proposed account is that it offers an interesting middle road out of a dilemma pertaining to the explanatory and normative dimensions of reasons for informed-desire Humean theorists. (shrink)

A critical assessment of the second chapter of Samuel Fleischacker’s Being Me Being You, where Fleischacker makes use of Smith’s account of empathy to develop a distinctive Smithian conception of ‘humanity’.

This book describes Carmeli's cosmological general and special relativity theory, along with Einstein's general and special relativity. These theories are discussed in the context of Moshe Carmeli's original research, in which velocity is introduced as an additional independent dimension. Four- and five-dimensional spaces are considered, and the five-dimensional braneworld theory is presented. The Tully-Fisher law is obtained directly from the theory, and thus it is found that there is no necessity to assume the existence of dark matter in the (...) halo of galaxies, nor in galaxy clusters.The book gives the derivation of the Lorentz transformation, which is used in both Einstein's special relativity and Carmeli's cosmological special relativity theory. The text also provides the mathematical theory of curved space?time geometry, which is necessary to describe both Einstein's general relativity and Carmeli's cosmological general relativity. A comparison between the dynamical and kinematic aspects of the expansion of the universe is made. Comparison is also made between the Friedmann-Robertson-Walker theory and the Carmeli theory. And neither is it necessary to assume the existence of dark matter to correctly describe the expansion of the cosmos. (shrink)

I demonstrate that analogies, both explicit and implicit, between Wittgenstein’s discussions of rituals, aesthetics, and aspect-perception, have important payoffs in terms of understanding his notion of a “surveyable representation” (übersichtliche Darstellung) as it applies to phenomena that are not exclusively grammatical in nature. In particular, I argue that a surveyable representation of certain anthropological and aesthetic facts allows us to see, qua form of aspect-perception, internal relations and formal connections, so that the inner nature of a ritual or the solution (...) of an aesthetic puzzle is exhibited. This particular form of seeing both explains why Wittgenstein thought that hypothetical explanations about the origins of a ritual are irrelevant to appreciating its meaning and elucidates his understanding of rituals, which involves seeing “internal relations” and “formal connections.” The upshots of the account for work in anthropology are discussed. (shrink)

In this volume, the third in his classic series of texts surveying the history of art theory, Moshe Barasch traces the hidden patterns and interlocking themes in the study of art, from Impressionism to Abstract Art. Barasch details the immense social changes in the creation, presentation, and reception of art which have set the history of art theory on a vertiginous new course: the decreased relevance of workshops and art schools; the replacement of the treatise by the critical review; (...) and the interrelation of new modes of scientific inquiry with artistic theory and praxis. The consequent changes in the ways in which critics as well as artists conceptualized paintings and sculptures were radical, marked by an obsession with intense, immediate sensory experiences, psychological reflection on the effects of art, and a magnetic pull to the exotic and alien, making for the most exciting and fertile period in the history of art criticism. (shrink)

I propose a twofold classification of the main considerations underlying the choice of an election procedure: political criteria on the one hand, and social-choice criteria on the other. I formulate political dichotomies, each combination of which narrows down the choice of procedure to a sub-class of the class of all procedures. I discuss what social-choice theory has to offer in each of these.

In The Sources of Normativity, Korsgaard argues for what can be called “The Universality of Humanity Claim” (UHC), according to which valuing humanity in one’s own person entails valuing it in that of others. However, Korsgaard’s reliance on the claim that reasons are essentially public in her attempt to demonstrate the truth of UHC has been repeatedly criticized. I offer a sentimentalist defense, based on Adam Smith’s moral philosophy, of a qualified, albeit adequate, version of UHC. In particular, valuing my (...) humanity, understood as (my awareness of) my perspective and the reasons determined from within it, entails valuing your humanity, understood as (your awareness of) your perspective and the reasons determined from within it. Given Korsgaard’s emphasis on the publicity of reasons in her argument for UHC, I also discuss the role of reasons in my account. I argue that the relative weights of (at least some of) an agent’s reasons are determined from within a shared evaluative point of view, namely, the standpoint of what Smith calls “the impartial spectator.” These reasons have normative authority over and constrain the agent’s private reasons, that is, those that are determined from within her own particular evaluative point of view. (shrink)

The phase space realizations of quantum groups are discussed using *-products. We show that on phase space, quantum groups appear necessarily as two-parameter deformation structures, one parameter (v) being concerned with the quantization in phase space, the other (η) expressing the quantum groups as “deformation” of their Lie counterparts. Introducing a strong invariance condition, we show the uniqueness of the η-deformation. This suggests that the strong invariance condition is a possible origin of the quantum groups.

Linguistic magic can be divided into three major categories: the fiatic, the Orphic and the talismanic. The first category includes the creation of the signified by its signifier, the best example being the creation of the world by divine words. The Orphic category assumes the possibility of enchanting an already existing entity by means of vocal material. Last but not least is the talismanic, based on the drawing of energy by means of language, in order to use this energy for (...) magical purposes. While the fiatic view assumes the complete superiority of the creator over the created object, the Orphic presupposes a certain similarity between the subject-magician and its object, whose role is to understand and follow the instructions of the magician. In these two categories meaning seems to be a crucial part of the magical linguistic activities. In the third category, the talismanic, linguistic powers are used in order summon higher powers which then descend to take possession of it. By talismanic I refer to the inherent ability of an entity, material, a moment in time, or a human act to draw upon these powers. Unlike amulets, which are usually taken to be objects that protect their possessor, the talisman is able to add power. (shrink)

Résumé L'article propose une nouvelle approche dans l'analyse de la sémantique polydimensionnelle du texte littéraire. Notre modèle dynamique synthétise les traits communs propres à la psychomécanique du langage et à la sémantique interprétative. Cette orientation des recherches permet de renforcer l'analyse des isotopes narratifs par la description de leur genèse pré-discursive. Appliqué à l'étude du texte littéraire, ce modèle manifeste des possibilités supplémentaires dans l'examen des mécanismes intrinsèques de la cohésion textuelle.

Answers to the questions of what justifies conscientious objection in medicine in general and which specific objections should be respected have proven to be elusive. In this paper, I develop a new framework for conscientious objection in medicine that is based on the idea that conscience can express true moral claims. I draw on one of the historical roots, found in Adam Smith’s impartial spectator account, of the idea that an agent’s conscience can determine the correct moral norms, even if (...) the agent’s society has endorsed different norms. In particular, I argue that when a medical professional is reasoning from the standpoint of an impartial spectator, his or her claims of conscience are true, or at least approximate moral truth to the greatest degree possible for creatures like us, and should thus be respected. In addition to providing a justification for conscientious objection in medicine by appealing to the potential truth of the objection, the account advances the debate regarding the integrity and toleration justifications for conscientious objection, since the standard of the impartial spectator specifies the boundaries of legitimate appeals to moral integrity and toleration. The impartial spectator also provides a standpoint of shared deliberation and public reasons, from which a conscientious objector can make their case in terms that other people who adopt this standpoint can and should accept, thus offering a standard fitting to liberal democracies. (shrink)