Rationing in healthcare remains very much a taboo topic. Before COVID-19, it rarely received public attention, even when it occurred in everyday practices, mainly in the form of implicit rationing, as it continues to do today. There are different definitions, types and levels of healthcare rationing, according to different perspectives. With the aim of contributing to a more coherent debate on such a highly emotional healthcare issue as rationing, here are provided a number of reflections from a patient advocate perspective (...) which are specifically focused on bedside rationing, the most troublesome level, both for patients and clinicians, particularly in regard to cancer care. Oncology, with its numerous expensive therapies and increasing number of patients, is undeniably one of the main areas contributing to the increase in healthcare costs. However, the fixed budgets of today's publicly financed health systems cannot allow unlimited access to the potentially beneficial treatments to all patients. Bedside rationing constitutes the last phase of many decision-making processes occurring at different interrelated levels (macro-levels), both inside and outside healthcare systems, which implicitly and inevitably result in a bottleneck determined by the upstream decisions themselves. Shifting from implicit to explicit bedside rationing essentially means moving from a paternalistic to a citizen-before-patient approach; this implies, first of all, a cultural change. Practical bedside rationing is an ethically complex topic, but one that needs to be urgently addressed in a transparent and open debate. In this scenario, the oncological community – patients, patient advocates and clinicians – can and should play an important role. (shrink)

By the end of the seventeenth century, high culture had banished astrology as a mixture of superstition and imposture. The great astrological treatises of the past - in particular the Ptolemaic Tetrabiblos (whose very authenticity was cast into doubt) - stopped being published; a hodgepodge of minor writings, mostly preserved in manuscript form, lay mouldering in oblivion in the far recesses of libraries. It was only in the latter decades of the eighteenth century that the learned world began once again (...) to pay attention to the ancient art, when historians of ancient religions and science began to realize the impossibility of exploring their subjects without taking into account a presence that could be neither denied nor underestimated. The history of astrology then began to take shape as a specific field of study, and historicophilological research was able to employ it as a tool for penetrating the tie between mythos and logos, at the origin of western civilization. Along with the image of the Greek miracle, an overly simplistic and schematic definition of reason and science began to decline. It was necessary to isolate, as Hermann Usener sought to do, the “wild germ of science” and to acknowledge the fact that logic and magic bloom on the same stem, as Aby Warburg has often reminded us, with reference to Jean Paul. (shrink)

The field of consciousness studies has long benefitted from the investigation of non- ordinary states of consciousness, both spontaneous and facilitated by mind-altering agents. In the present study, I look at the implications of spontaneous near-death experiences and experiences facilitated by the dissociative anaesthetic ketamine. These experiences reputedly have similar phenomenologies, such as a feeling of dying, motion through darkness, entering another realm, visions of light, and a sense of separation from the physical body. To assess whether ketamine and near-death (...) experiences really are similar, I undertake a systematic comparison of 36 accounts of NDE-like experiences under ketamine with 36 accounts of NDE that resulted from cardiac arrest or other life-threatening circumstances in which wakefulness was maintained . The results suggest that ketamine and near- death experiences are indeed similar, which might be taken to imply that NDEs have a purely chemical or psychophysiological basis. However, this conclusion is not inevitable, and I draw upon the intriguing 'spatial' or 'situated' characteristic of ketamine and near-death experiences to suggest an alternative to both neuropsychological reductionism and a straightforward post-mortem survival theory. To develop the idea of a dynamic interrelation of consciousness and 'place', I draw on contemporary Japanese philosophies of body-mind. (shrink)

The paper aims to investigate the meaning of historicity in the light of Ágnes Heller’s interpretation of history as ‘being-in-common’. By touching on the problem of the modern world’s axiological pluralism, the issue of the legitimation of moral theories and the dilemma of morals, the paper analyses Heller’s conception of human goodness as an incontrovertible, inexplicable and mysterious ‘fact’ that is able to illuminate the path of human life and determine the opening of the individual onto the world with the (...) same wonder that marks the beginning of any philosophical attitude. (shrink)

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This study assessed self-reported health-related quality of life and psychological adjustment in 43 adolescents and young adults with congenital melanocytic nevi and examined associations with sociodemographic variables, characteristics of the CMN, perceived social reactions, and cognitive emotion regulation strategies. Outcome measures included the Pediatric Quality of Life Inventory™ 4.0 and the Strengths and Difficulties Questionnaire. Findings suggest impaired psychosocial health and psychological adjustment in youth with CMN compared to community norms. Impairments were associated with higher age of participants, lower socioeconomic (...) status, visibility of the skin lesion, perceived stigmatization, poorer perceived social support, and maladaptive cognitive emotion regulation strategies, but not with sex of participants, extent of the skin lesion, and surgical removal of the nevus. Implications for clinical practice and future research are discussed. (shrink)

In a letter to Lorenzo di Pierfrancesco dei Medici, dating from 1477 to 1478, the Platonist philosopher Marsilio Ficino develops the classical theme of the correspondence between man and cosmos on the basis of the astrological techniques. The inner heaven, a term of the relationship between macrocosm and microcosm, takes the form of what astrologers call the birth theme: the series of astral positions at the moment of birth and related to its place. Taking up Origen’s theme of the inner (...) heavens, he systematically applies the theory of planet-signs to deciphering underlying themes of individual personality. (shrink)

O artigo apresenta o livro O fogo e o relato. Ensaios sobre criação, escrita, arte e livros, do filósofo italiano Giorgio Agamben, discutindo alguns dos limiares poéticos do seu pensamento político. Parte-se de alguns dos debates subentendidos de Agamben com Jacques Derrida sobre linguagem e literatura, passa-se pelo ato poético como ato de resistência, define-se a potência inoperante presente em gestos de interrupção discursiva e chega-se à discussão sobre vida e obra em contexto biopolítico. Seguindo a ordem dos capítulos, mas (...) sem pretender esgotá-los, o pressuposto do artigo é de que o italiano, que tem a poesia e a literatura geralmente vinculada a uma espécie de “primeira fase” de sua obra, também na série biopolítica nomeada Homo Sacer lançou mão da poesia e da literatura como forte estratégia de resistência e abertura de limiares ante a lógica que se desenha do poder soberano. Se, por um lado, o livro pode ser lido como formando um círculo hermenêutico, os capítulos, por outro lado, permitem ao leitor perceber as principais linhas em que filosofia, literatura, poesia e política se entrecruzam para o pensador italiano. Por isso, também, recorreu-se à relação direta de alguns argumentos expostos em O fogo e o relato tanto com noções e argumentos presentes em outros livros de Agamben, quanto pontualmente com outros interlocutores. (shrink)

Ce texte a déjà paru dans Tradurre. Pratiche, teorie, strumenti, n° 10, Primavera 2016. F. Scotto, Il senso del suono. Traduzione poetica e ritmo, Roma, Donzelli, 2013, 224 p. Ce mot « rythme » ne m'est pas clair. Je ne l'emploie jamais. Paul Valéry Nel suo vastissimo trattato Critique du rythme. Anthropologie historique du langage, Henri Meschonnic si sofferma sulla scorretta etimologia che fonda il mito del ritmo, ossia quella che ricollega il ῥυθμός al movimento del mare : seguendo - (...) Recensions. (shrink)

ObjectiveProcessing Speed, the ability to perceive and react fast to stimuli in the environment, has been shown to be impaired in children with attention deficit hyperactivity disorder. However, it is unclear whether PS can be improved following targeted treatments for ADHD. Here we examined potential changes in PS following application of transcranial electric stimulation combined with cognitive training in children with ADHD. Specifically, we examined changes in PS in the presence of different conditions of mental fatigue.MethodsWe used a randomized double-blind (...) active-controlled crossover study of 19 unmedicated children with ADHD. Participants received either anodal transcranial direct current stimulation over the left dorsolateral prefrontal cortex or transcranial random noise stimulation, while completing CT, and the administration order was counterbalanced. PS was assessed before and after treatment using the MOXO-CPT, which measures PS in the presence of various conditions of mental fatigue and cognitive load.ResultstRNS combined with CT yielded larger improvements in PS compared to tDCS combined with CT, mainly under condition of increased mental fatigue. Further improvements in PS were also seen in a 1-week follow up testing.ConclusionThis study provides initial support for the efficacy of tRNS combined with CT in improving PS in the presence of mental fatigue in pediatric ADHD. (shrink)

This paper provides a critical overview of the realist current in contemporary political philosophy. We define political realism on the basis of its attempt to give varying degrees of autonomy to politics as a sphere of human activity, in large part through its exploration of the sources of normativity appropriate for the political and so distinguish sharply between political realism and non-ideal theory. We then identify and discuss four key arguments advanced by political realists: from ideology, from the relationship of (...) ethics to politics, from the priority of legitimacy over justice and from the nature of political judgement. Next, we ask to what extent realism is a methodological approach as opposed to a substantive political position and so discuss the relationship between realism and a few such positions. We close by pointing out the links between contemporary realism and the realist strand that runs through much of the history of Western political thought. (shrink)

A comunicação busca encontrar o que seria o salão literário de Dona Leonor de Almeida, Marquesa de Alorna. Nesta revisitação, constatamos a emergência de uma sociabilidade heterossexual onde a conversação se eleva a arte.Elegemos o Palácio Fronteira como o salão em português. Propomos que o emblemático Palácio Fronteira, em São Domingos de Benfica, subsuma todos os outros salões que sabemos terem existido – sem esquecermos nunca da iniciática função dos outeiros de Chelas.Conhecemos Alcipe romanticamente “épica” cuja vida mergulhada na caótica (...) época de transição histórica é evocada pelos mais diversos testemunhos da elite que a frequenta. Contactamo-la sobretudo no discurso directo em que a sua palavra poética fala. No salão de Benfica também se assiste ao declínio do discurso normativo-eclesiástico e se constata a emergência da afirmação da mulher enquanto ser de beleza, pensamento, vontade e poder. Alcipe não se afirma apenas enquanto uma culta aglutinadora de gente de espírito da sua geração, mas como alguém que, além de ter sabido impor a opinião poética vanguardista do seu tempo, possui igualmente ideias políticas próprias e, pese embora os mal-entendidos do seu tempo, pretende partilhar da solução dos problemas. (shrink)

Political realism is characterised by fidelity to the facts of politics and a refusal to derive political judgments from pre- political moral commitments. Even when they are not taken to make normative theorising impossible or futile, those characteristics are often thought to engender a conservative slant, or at least a tendency to prefer incremental reformism to radicalism. I resist those claims by distinguishing between three variants of realism—ordorealism, contextual realism, and radical realism—and contrasting them with both non-ideal theory and utopianism. (...) I then develop a version of radical realism as a form of debunking and vindicatory genealogy. Even though this new approach eschews both feasibility constraints (unlike non-ideal theory) and prescriptions about the ideal society (unlike utopianism), I show how it has more radical potential than morality-driven (and hence often ideological) political theory, and how it supports both open-ended, radical social critique and concrete forms of prefigurative political action. (shrink)

This paper examines how radical realism, a form of ideology critique grounded in epistemic rather than moral normativity, can illuminate the relationship between ideology and political power. The paper argues that radical realism can has both an evaluative and a diagnostic function. Drawing on reliabilist epistemology, the evaluative function shows how beliefs shaped by power differentials are often epistemically unwarranted, e.g. due to the influence of motivated reasoning and the suppression of critical scrutiny. The paper clarifies those mechanisms in order (...) to address some recent critiques of radical realism. The paper then builds on those clarifications to explore the how tracing the genealogy of legitimation stories can diagnose the distribution of power in society, even if ideology does not play a direct stabilising role. This diagnostic function creates a third position in the debate on ideology between culturalists and classical Marxists, and it can help reconciling aspects of structural and relational theories of power. (shrink)

Hypocrisy is widely thought to be morally objectionable in a way that undermines the hypocrite’s moral standing to blame others. To wit, we seem to intuitively accept the “Nonhypocrisy Condition:” R has the standing to blame S for some violation of a moral norm N only if R’s blaming S is not hypocritical. This claim has been the subject of intensifying philosophical investigation in recent years. However, we can only understand why hypocrisy is morally objectionable and has an effect on (...) standing to blame if we can correctly characterize hypocrisy itself. Unfortunately, some recent discussions fail to do this, which fatally undermines subsequent arguments concerning the effect of hypocrisy on the standing to blame. This paper’s central aim is to develop and defend a better account of hypocrisy. The hope is that with such an account in hand, we can explain and perhaps justify our moral aversion to hypocrisy in general as well as the Nonhypocrisy Condition in particular. (shrink)

This essay outlines an empirically grounded account of normative political legitimacy. The main idea is to give a normative edge to empirical measures of sociological legitimacy through a nonmoralized form of ideology critique. A power structure’s responsiveness to the values of those subjected to its authority can be measured empirically and may be explanatory or predictive insofar as it tracks belief in legitimacy, but by itself it lacks normative purchase. It merely describes a preference alignment, and so tells us nothing (...) about whether the ruled have reason to support the rulers. I argue that we can close this gap by filtering the preferences of the ruled through a form of nonmoralized epistemic ideology critique, itself grounded in an empirical account of how belief in legitimacy is formed. (shrink)

One of the main challenges faced by realists in political philosophy is that of offering an account of authority that is genuinely normative and yet does not consist of a moralistic application of general, abstract ethical principles to the practice of politics. Political moralists typically start by devising a conception of justice based on their pre-political moral commitments; authority would then be legitimate only if political power is exercised in accordance with justice. As an alternative to that dominant approach I (...) put forward the idea that upturning the relationship between justice and legitimacy affords a normative notion of authority that does not depend on a pre-political account of morality, and thus avoids some serious problems faced by mainstream theories of justice. I then argue that the appropriate purpose of justice is simply to specify the implementation of an independently grounded conception of legitimacy, which in turn rests on a context- and practice-sensitive understanding of the purpose of political power. (shrink)

Drawing on empirical evidence from history and anthropology, we aim to demonstrate that there is room for genealogical ideology critique within normative political theory. The test case is some libertarians’ use of folk notions of private property rights in defence of the legitimacy of capitalist states. Our genealogy of the notion of private property shows that asking whether a capitalist state can emerge without violations of self-ownership cannot help settling the question of its legitimacy, because the notion of private property (...) presupposed by that question is a product of the entity it is supposed to help legitimise: the state. We anchor our genealogical critique in recent work on ideology in epistemology and philosophy of language, and in current debates on the methodology of political theory. But, unlike more traditional approaches that aim to debunk whole concepts or even belief systems, we propose a more targeted, argument-specific form of ideology critique. (shrink)

Hypocrisy is a ubiquitous feature of moral and political life, and accusations of hypocrisy a ubiquitous feature of moral and political discourse. Yet it has been curiously under-theorized in analytic philosophy. Fortunately, the last decade has seen a boomlet of articles that address hypocrisy in order to explain and justify conditions on the so-called “standing” to blame (Wallace 2010; Friedman 2013; Bell 2013; Todd 2017; Herstein 2017; Roadevin 2018; Fritz and Miller 2018). Nevertheless, much of this more recent literature does (...) not adequately address the question, “what is hypocrisy?” In this paper, I develop and defend an account of hypocrisy as vicious, value-expressing inconsistency. I show how this account solves some traditional and some novel philosophical puzzles concerning hypocrisy and affords a deeper understanding of the features of hypocrisy emphasized by other prominent accounts. (shrink)

This paper argues that Deonna and Teroni's attitudinal theory of emotions faces two serious problems. The first is that their master argument fails to establish the central tenet of the theory, namely, that the formal objects of emotions do not feature in the content of emotions. The second is that the attitudinal theory itself is vulnerable to a dilemma. By pointing out these problems, our paper provides indirect support to the main competitor of the attitudinal theory, namely, the perceptual theory (...) of emotions. (shrink)

Should our factual understanding of the world influence our normative theorising about it? G.A. Cohen has argued that our ultimate normative principles should not be constrained by facts. Many others have defended or are committed to various versions or subsets of that claim. In this paper I dispute those positions by arguing that, in order to resist the conclusion that ultimate normative principles rest on facts about possibility or conceivability, one has to embrace an unsatisfactory account of how principles generate (...) normative political judgments. So political theorists have to choose between principles ostensibly unbiased by our current understanding of human motivation and political reality, or principles capable of reliably generating political judgments. I conclude with wider methodological observations in defence of the latter option, and so of a return to political philosophy’s traditional blend of normative and descriptive elements. (shrink)

In recent years, a new generation of activists has reinvigorated debate over the public commemorative landscape. While this debate is in no way limited to statues, it frequently crystallizes around public representations of historical figures who expressed support for the oppression of certain groups or contributed to their past or present oppression. In this paper, I consider what should be done about such representations. A number of philosophers have articulated arguments for modifying or removing public monuments. Joanna Burch-Brown (2017) grounds (...) her argument for removal in what I call the “honorific” function of such representations—the ways in which they express and tend to cultivate admiration for their subjects. In the first two sections of the paper, I develop a novel argument for modifying these representations based on this insight. I argue that leaving such representations unmodified in the public space tends to undermine the dignity of members of oppressed groups as well as their assurance that society and government are committed to their rights and constitutional entitlements. In the paper’s third section, I develop a “balancing test” for determining whether the relevant moral and pragmatic considerations favor making a particular representation inaccessible to the public, or recontextualizing it for public consumption. Unlike some of the existing philosophical treatments of honorific representations that focus on particular monuments, this balancing test is designed for general application to any honorific representation that satisfies the presumptive case for modification. To conclude, I offer some reasons why weak forms of recontextualization that do not involve altering institutional context may often be an insufficient remedy for the problems I describe. (shrink)