The heme‐containing cytochromes P‐450 are a ubiquitous family of monooxygenase isozymes responsible for the oxidative metabolism of a wide variety of endogenous as well as exogenous compounds. Many of the compounds metabolized by this enzyme system are effectively detoxified and converted to derivatives more easily eliminated from the organism. However, some compounds can be activated to reactive species capable of eliciting a cascade of toxic lesions, including cancer. Since its discovery nearly 30 years ago, the cytochrome P‐450 enzyme system has (...) received a great deal of attention, particularly in the areas of their mechanisms of metabolism, range of substrate specificity, the purification and characterization of the multiple isozymes and, more recently, the regulation of expression of specific forms. This review will discuss current notions concerning the expression of at least one cytochrome P‐450 isozyme and future directions that should lead to a more complete understanding of cytochrome P‐450 gene expression in general, particularly as it impacts upon biochemical pharmacology. (shrink)

Mettre à la question l’éthique de Heidegger, c’est répondre à l’impossibilité d’en dire le fondement dans les termes de ses propres préoccupations thématiques. Car si l’éthique évoque une « patrie » du Dasein, celui-ci demeure tragiquement étranger à son appel. Étrangeté entretenue par un inextricable conflit du langage et de l’Être, ainsi que due au privilège de la « mortalité » sur la puissance créatrice de la « natalité ». D’où une lecture de cette « analytique des ultimes » dont (...) est porteur le texte Des Hégémonies brisées. Lecture qui ne gage du reste pas du succès d’une éthique « heideggérienne », mais ouvre la voie vers une reprise fondationnelle du rapport du Dasein à son éthique. (shrink)

Promythion.--Antipodes.--Le fanatisme des formules.--La morale au service de l'état.--De l'asynaptisme.--Une société super-étatiste il y a trente siècles.--Le monde périodique.--L'état et le problème social.--Epimythion.

Quand, en 1747, Diderot et d’Alembert reprennent la direction de l’Encyclopédie, ils héritent d’un projet conçu au départ comme une traduction de la Cyclopaedia d’Ephraïm Chambers. Celle-ci ayant laissé son empreinte sur ce qui sera présenté par la suite comme un ouvrage original, les éditeurs seront souvent amenés à revenir sur leur relation au modèle anglais. Dans les polémiques autour de la publication des premiers volumes, les emprunts à Chambers, entre autres, ont été relevés par les défenseurs de la religion, (...) qui accusaient les encyclopédistes à la fois de plagiat et d’impiété. À partir de ces remarques, cet article propose de considérer la contribution de l’abbé Mallet, l’un des premiers collaborateurs recrutés par Diderot et d’Alembert, et auteur de plusieurs centaines d’articles de l’Encyclopédie. Définir ce qui y relève de l’emprunt ou de l’invention révèle des erreurs majeures dans l’histoire de la réception de cet ouvrage, ce qui nécessite une réévaluation de son théologien principal. (shrink)

This is an excerpt from the contentGender equality as a badge of modernity is one of the primary features of the homogenizing process known as globalization. Just as all but a handful of states now claim to be “republics”, regardless of the degree of substantive public rule, an affirmation of equal rights for men and women uniformly appears in modern constitutions and international conventions. Even more striking than the gap between formal and substantive democracy is the chasm that separates these (...) claims of gender equality from the reality of the lives of the world’s women and girls, a breach that is visible in multiple contexts, from the stubbornly low percentages of women in positions of political and economic power, to the cultural transmission of sexual subordination in mass media, to the growing number of impoverished, enslaved, and stateless women worldwide. Using the lens of citizenship to assess, understand and address this gap between formal and substantive equality is the principle project of Gender Equality. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS ~49 actual politics as President of the Italian Liberal Party from 1944 to i947, but demonstrates through a study of Piero Gobetti that neither Croce's own conservatism nor his doctrinal rigidity was a necessary corollary of "absolute historicism" in politics. As the main intellectual beacon of opposition to Fascism during its twenty years of power, Croce enjoyed enormous prestige in 1944; but as Don Benedetto, with his (...) great family estates in the South, he could not bring himself to admit that, if Fascism was only an "interlude," it was precisely an interlude in the resolution of a social crisis. As Roberts says (233) Croce's philosophical liberalism validated his right to hold conservative views; but if he wanted to speak for a "pre-partisan" view, he should have avoided party involvements altogether. He undermined his own philosophical authority in a matter of months, and so lost his greatest cultural opportunity. When he died in 195~ he was already a back number, and it was no one's fault but his own. Roberts does a good job on Croce's historical works in the next chapter. Croce's conservatism, his ingrained personal prejudice against serious social change, explains the evident presence of an element of special pleading in the Historyofltaly x87I-I915, and the History of Europe in the Nineteenth Century. All of Croce's formal histories were written as part of his defence of the liberal spirit against Fascism. But in these two works, which dealt with the world in which Fascism was actually born, we can readily detect his anxiety to prove that Fascism was indeed an interlude--and that when it was over nothing important would be changed. His other works are more respectable examples of "ethico-political history," but that is only because they are more "ethical" and less "political," so to speak. Croce was in many ways fortunate to live and work in the great "interlude" between 1914 and i945. For the fact is that he was not himself very good at the sympathetic and humanely humble dialogue that his theory called for, and the worst of his many heritages from Hegel was precisely that identification of philosophy with the "logic of the pure concepts" which enabled him to defend himself against philosophical dialogue with such righteous certitude. Roberts has none of this righteous spirit, and I hope most earnestly that his book will help many readers to see past it in Croce. H. S. HARRIS York University Michel Haar. Le chant de la terre. Paris: Editions de l'Herne, 1987. Pp. 3oL FF 13o. In Le chant de la terre Michel Haar finds himself swimming upstream. Whereas many Parisian thinkers conclude that every possiblefundamentum inconcussumhas finally met its end, Haar holds "that the thought of Ereignisdoes not give way.., to a liberation of multiple and decentered forces. On the contrary, the turn from the oblivion of Being marks a reentry into the Simple and a concentration in the Same [l'Unique]" (a7)" Thus Haar's general concern is with foundations and origins. However, Haar's project is not a resumption of Cartesian philosophy, for he resumes Heidegger's analysis of Dasein in Being and Time, which undercuts Cartesian dualism and shows that man, as Being-in-the-world, is essentially finite, historical, and 150 JOURNAL OF THE HISTORY OF PHILOSOPHY 28:1 JANUARY 1990 linguistic. Haar then undertakes the sisyphean task of showing that something called 'earth,' while itself ahistorical and "pre-linguistic," is at the basis of man's historical and thoroughly linguistic existence. Therefore it behooves Haar, given the abysmal difference between the historical/linguistic domain and the ahistorical/pre-linguistic domain, to show that the latter can have a foundation in the former--that is, how the ahistorical, prelinguistic earth makes a difference for man even though one can never "escape" the historical/linguistic realm in any practical or theoretical sense. To do this Haar initially appeals to two Heideggerian notions: Stimmung (roughly translated as 'disposition') and phusis. Following Heidegger, Haar argues that disposition, while rooted in Dasein's facticity, by nature is attuned to something beyond this facticity. Since "every Grundstimraung reveals the Grund [ground], the abysmal foundation... (shrink)

O'Donnell, J. R. Anton Charles Pegis on the occasion of his retirement.--Conlan, W. J. The definition of faith according to a question of MS. Assisi 138: study and edition of text.--Spade, P. V. Five logical tracts by Richard Lavenham.--Maurer, A. Henry of Harclay's disputed question on the plurality of forms.--Brown, V. Giovanni Argiropulo on the agent intellect: an edition of Ms. Magliabecchi V 42.--Synan, E. A. The Exortacio against Peter Abelard's Dialogus inter philosophum, Iudaeum et Christianum.--Fitzgerald, W. Nugae Hyginianae.--Sheehan, M. (...) M. Marriage and family in English conciliar and synodal legislation.--Shook, L. K. Riddles relating to the Anglo-Saxon scriptorium.--Boyle, L. E. The De regno and the two powers.--Colledge, E. A Middle English Christological poem.--Gough, M. R. E. Three forgotten martyrs of Anazarbus in Cilicia.--Häring, N. Chartres and Paris revisited.--Hayes, W. Greek recentiores, (Ps.) Basil, Adversus eunomium, IV-V.--Owens, J. The physical world of Parmenides. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Dieu comme soi-même: connaissance de soi et connaissance de Dieu selon Thomas d’Aquin: l’herméneutique d’Ambroise Gardeil by Camille de BelloyThomas M. Osborne Jr.Dieu comme soi-même: connaissance de soi et connaissance de Dieu selon Thomas d’Aquin: l’herméneutique d’Ambroise Gardeil. By Camille de Belloy, O.P. Paris: Vrin, 2014. Pp. 297. €32.00 (paper). ISBN: 978-2-7116-2605-2.This book is a discussion of La Structure de l’âme et l’expérience mystique (1927) by Ambroise Gardeil (...) (1859–1931). In this two-volume work of mystical theology, Gardeil explains the material cause of the experiential knowledge that comes from the gift of wisdom, which is one of the seven gifts of the Holy Spirit. La Structure is the third book in a trilogy that focuses on the supernatural knowledge of God, beginning with apologetics in La Crédibilité et l’apologétique (1st ed. 1908), and continuing with the nature of revelation in Le Donné révélé et la théologie (1st ed. 1910). In La Structure, Gardeil develops the thesis that there is an analogy between experiential self-knowledge and the mystical experiential knowledge of God. In the course of his inquiry, Gardeil touches upon philosophical and theological problems concerning self-knowledge, intentionality, the structure of the mind (mens), God’s indwelling in the souls of the just, and the relationship between faith and the gift of wisdom. De Belloy’s new volume is on Gardeil’s presentation of this analogy and its reception by his contemporaries.De Belloy considers largely the issues that surround self-knowledge, the structure of the soul, and mystical experience. He draws together material from Gardeil’s own sources, Gardeil’s contemporaries, and subsequent Thomistic scholarship. He sheds light on the issues themselves, the historical context, and different hermeneutical strategies in Thomism. According to De Belloy, this twentieth-century Thomistic and largely Dominican discussion is important for contemporary philosophers and theologians. To shed light on the context, De Belloy considers a lengthy three-part “Examen de conscience” in Revue Thomiste (1928–29), in which Gardeil responded to published and unpublished comments by his fellow Dominicans Réginald Garrigou-Lagrange (a former student), Marie-Dominique Roland-Gosselin (Le Saulchoir), and Albino González Menéndez-Reigada, as well as a young student, Jean Daujat. De Belloy remarks that Maritain’s discussion of Gardeil in The Degrees of Knowledge to some extent attempts to harmonize the substance of Gardeil’s work with Garrigou-Lagrange’s critical comments. De Belloy emphasizes the interaction between Gardeil and Roland-Gosselin, and at the end of his volume, includes their previously unpublished correspondence.Although De Belloy often notes the difficulty of reading Gardeil’s neo-Scholastic prose, it seems to me that the non-native French reader will find Gardeil more accessible than De Belloy, especially when the latter draws on writers such as Henri Bergson and Hans-Georg Gadamer. Moreover, De Belloy’s discussion is easier to follow if one has already read and is familiar with the four parts of Gardeil’s La Structure. In part 1, Gardeil addresses the structure of mind or spirit (mens), and in particular considers Augustine’s [End Page 472] three main, threefold divisions of the soul in De Trinitate (mens, notitia, amor; memoria [sui], intelligentia, voluntas; memoria [Dei], intelligentia, amor) and Aquinas’s own interpretation and appropriation of these divisions. In part 2, Gardeil describes the way in which sanctifying grace, a created quality that is distinct from the infused virtues, causes the soul’s conformity to God’s essence. In part 3, he discusses God’s presence within the souls of the just and agrees with previous Thomists that God is especially present to the just as an object of faith and love. In part 4, he applies the previous discussion to the structure of mystical knowledge. This last part is the culmination of the entire work, as it addresses the analogy between self-knowledge and the knowledge of God that was defended by earlier Dominican Thomists such as John of St. Thomas (1589–1644) and Thomas de Vallgornera (c. 1595–1665).Part... (shrink)

Publié de 1899 à 1950, le Dictionnaire de théologie catholique a longtemps été considéré comme l’incarnation de positions doctrinales conservatrices. À parcourir les articles qui traitent en son sein des domaines et des méthodes de la théologie, comme les articles Fondamentale ou générale (théologie) du chanoine Albert Michel, Lieux théologiques d’Ambroise Gardeil, Salamanque (théologiens de) de Thomas Deman, Thomisme de Réginald Garrigou-Lagrange ou encore Théologie d’Yves Congar, force est de constater que le Dictionnaire de théologie catholique a en réalité activement (...) participé aux grands débats épistémologiques qui ont contribué à renouveler profondément le champ de la théologie catholique contemporaine. (shrink)

Désormais accessible du fait de l’ouverture des archives vaticanes pour le pontificat de Pie XII, le dossier de la Congrégation du Saint-Office sur le Père Congar fait toute la lumière sur les trois passages du théologien devant elle. Le premier, en janvier 1939, concerne Chrétiens désunis qui s’en tire avec un avertissement bénin, mais suffisant pour que la seconde version du livre ne soit jamais publiée. Le second, en 1951-1952, concerne Vraie et fausse réforme dans l’Église qui est interdit de (...) réédition et de traduction. Alors que les deux premiers se sont déroulés en l’absence du Père Congar et à son insu, le troisième voit sa comparution au Saint-Office, en décembre 1954, pour un interrogatoire sur l’ensemble de son œuvre. Deux dominicains français, les Pères Garrigou-Lagrange et Gagnebet ont été mêlés de près à ces différentes procédures. En octobre 1955, le théologien est assigné à Cambridge par le maître général des dominicains, avec soumission à la censure romaine du moindre de ses écrits. Son exil ne finira qu’en décembre 1956 avec son assignation au couvent de Strasbourg. (shrink)

Récompensé par trois prix en 2014 (Prix Darlene Clark Hine de l’Organization of American Historians, Prix Frances Richardson Keller-Sierra de la Western Association of Women Historians, et Prix Emily Toth venant des Popular Culture and American Associations), l’ouvrage d’Estelle B. Freedman, professeur d’histoire des États-Unis à l’université de Stanford et spécialiste de l’histoire des femmes et de la sexualité en Amérique du Nord, Redefining Rape : sexual violence in the era of suffrage and...

In lieu of an abstract, here is a brief excerpt of the content:Love of God above SelfJordan OlverIS THERE ANY LOVE that is not ultimately a form of self-love? Anders Nygren famously maintained that for Thomas Aquinas there is not. Nygren was led to this conclusion in large part by Aquinas’s claims that love is an act of the will and that the ultimate end of the will is happiness: if every act of love is on account of happiness as (...) an ultimate end, it seems to follow that all love of others is motivated by, and reducible to, love of self.1 Others have drawn this conclusion for similar reasons. Scott MacDonald, for example, interprets Aquinas as proposing “egoistic rationalism”; he believes that this ethical position follows from Aquinas’s claim that human beings, like all creatures, seek their perfection.2Texts, however, can be produced to show that Aquinas himself believes that nonegoistic love is possible.3 If he is an [End Page 97] egoist, he is not so intentionally; he can only be so in the sense that his principles, despite his wishes, necessitate such a position. While Nygren interpreted Aquinas as an unwilling egoist of this sort,4 most modern scholars of Aquinas’s thought on love have held that his principles do not necessitate egoism, and they have endeavored to explain how nonegoistic love is possible on Thomistic grounds. Modern attempts to solve the “problem of love in Thomas Aquinas” normally look back to Pierre Rousselot’s 1908 work Pour l’histoire du problème de l’amour au moyen âge.5 Rousselot identified the “problem of love” as whether a love that is not egoistic is possible and, if it is, what the relation might be between this love and the love of self which appears to be the foundation of natural tendencies.6 Rousselot believed that in the Middle Ages this problem was primarily dealt with through the consideration of the more particular problem of whether it is possible to love God above self apart from grace. This approach, he thought, offered significant advantages: it was simultaneously concrete and profound, and the object of love was both the last end and the author of all natural appetites.7 If genuine love for another is possible, that possibility would be discoverable in this case and through analysis of love of God above self it would seem that one could [End Page 98] arrive at the principles needed to make sense of other nonegoistic loves.8 Accordingly, when Rousselot presented Aquinas’s solution to the problem of love, he did so exclusively through an explanation of Aquinas’s teaching on love of God above self.9 The most notable feature of this account was its appeal to the part-whole relation: Rousselot proposed that for Aquinas our love for God above self is due to the fact that we relate to God as a part to a whole.Rousselot’s work inspired a scholarly discussion that has persisted now for over a century. This discussion may be roughly divided into three stages: the early twentieth century, the mid-twentieth century, and the late-twentieth century to the present. General agreement with Rousselot characterizes early twentieth-century scholarship. Scholars of this period, such as Charles-Vincent Héris, Reginald Garrigou-Lagrange, and H.-D. Simonin, may claim that Rousselot neglects or overemphasizes something, but they do not assert that he is substantially wrong.10 By contrast, rejection or neglect of the “part-whole” approach to love of God above self characterizes the scholarship of the mid-twentieth century. Étienne Gilson, in his 1932 work L’esprit de la philosophie médiévale, vigorously objects to Rousselot’s account, arguing that the part-whole relationship, as it functions in Aquinas’s arguments for love of God above self, should not be understood in “a distressingly literal way,” but simply as “a metaphor, the first moment in a manuductio.”11 [End Page 99] Louis-Bertrand Geiger also emphatically rejects Rousselot’s account, arguing that the real explanation of disinterested love is to be found in the will’s special, “objective” inclination to the “good in itself” as opposed to the “good for me”; we love God... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:You Mean It’s Not My Fault:Learning about Lipedema, a Fat DisorderCatherine A. Seo“As a surgeon there is nothing more I can do for you. You need to lose 75 pounds before I can even consider repairing the damage done.” Implied and not directly stated, “… Because it’s your fault.” I sat listening, dumbfounded. I was at one of the top teaching hospitals in the country, face to face with (...) a respected Harvard Medical School trained surgeon who came highly recommended.I had seemingly irreversible damage that was leading to permanent immobility. I was experiencing excessive and uncontrollable swelling in my extremities. I was in unrelenting pain that prevented me from sleeping through the night.The surgeon looked down at the floor avoiding my gaze and—after never before mentioning weight as a possible contraindication to surgery during any of our interactions associated with five surgeries, in over two years, including at least 25 consultations, pre-op, post-op, or follow-up visits stated—in essence, “I can’t help you. You are too fat. It’s your fault.” Not until now, this moment, a couple of months after “the-surgery-gone-wrong-that-ended-in-terrible-complications,” I was being told that it was my fault.He then looked down at his pager that had conveniently buzzed within minutes after he delivered this news, and then walked out of the examining room leaving me to fend for myself in dealing with serious and life-changing complications. Susan1*, his Nurse Practitioner, printed out and handed me a standard listing of BMI calculations, marched me into the common hallway to weigh me, pointed out my BMI >30, reinforced the message that he would do nothing to remedy this horrific situation unless I lost 75 pounds, and then sent me on my way.I stood outside the hospital in shock. This just wasn’t happening, and it couldn’t be happening to me. I had grown to trust this surgeon, and I was struggling to comprehend what had just happened. As the shock wore off, I reengaged in several failed attempts to get help from him. He seemed to have convinced himself that the reason the surgery had gone awry was because of my excess weight, and not because, as I later learned, I had been misdiagnosed and the procedure, as it was performed, was far too aggressive. My health condition was deteriorating and it appeared as if weight was being scapegoated for the complications.If a solution was to be found, I was going to have to find it. After many months of research, I discovered that I have lipedema, an unrecognized [End Page E6] and generally misdiagnosed hereditary, genetically-based fat disorder. I had always had lipedema, which in my case seems to have been triggered at least since puberty. There are an estimated 17 million women in the USA alone who have lipedema, unrecognized or misdiagnosed.I, like most other women in America, knew that weight was a personal choice, and fat is a result of eating too much. Or was it? This ingrained and culturally accepted structure of knowledge began to disintegrate. I then asked the question, if this disease of lipedema is a fat disorder—and I had been to many, many doctors in my 63 years—why was it never identified? Why was I left to struggle in a constant battle trying to accomplish the impossible? I then learned about and named “anti-fat bias” and began to unravel the answers.About LipedemaAccording to Karen L. Herbst, Ph.D., M.D., endocrinologist and expert on fat disorders, lipedema (lipoedema in Europe) is an inherited genetic disease, affecting at least 11% of women of all sizes, from the extremely thin to the morbidly obese, resulting in localized fat that is bilateral, symmetrical and usually from the waist to just above the ankles. It can also affect the upper arms. Unlike the “normal” fat of obesity, lipedemic fat cannot be lost through diet and exercise. It is not uncommon for the comorbidity of overweight or obesity to accompany lipedema. Allen and Hines, physicians at the Mayo Clinic, first named Lipedema in 1940.Believed... (shrink)

Suppose libertarians could prove that durable, unqualified private property rights could be created through 'original acquisition' of unowned resources in a state of nature. Such a proof would cast serious doubt on the legitimacy of the modern state. It could also render the approach to property rights that I favour irrelevant. I argue here that none of the familiar Lockean-libertarian arguments for a strong natural right to acquisition succeed, and that any successful argument for grounding a right to acquire would (...) have to use my favoured approach to property rights - the 'vector-sum' approach. I conclude with some doubts about original acquisition theory and natural property rights. (shrink)

This study considers freedom of speech and the rules of engagement in the public sphere; good government, civic responsibility, and public education; and the foundations of religion and society, as seen through the eyes of seventeenth-century Dutch philosopher, Spinoza.

In lieu of an abstract, here is a brief excerpt of the content:MARITAIN AS AN INTERPRETER OF AQUINAS ON THE PROBLEM OF INDIVIDUATION }UDE P. DOUGHERTY The Catholic University ofAmerica Washington, D.C. I T HE MEDIEVAL problem of individuation is not the contemporary problem of "individuals" or "particulars" discussed by P. F. Strawson, J. W. Meiland, and others.1 In a certain sense the problem of individuation originates with Parmenides, but it is Plato's philosophy of science that bequeaths the problem to (...) Aristotle and to his medieval commentators. Its solution in Aquinas is not that of Aristotle, nor is it that of Scotus or Suarez. Aquinas will distinguish between the problem of individuation and what we may call the problem of "individuality" or the problem of "subsistence." The solution to both will draw upon many Aristotelian distinctions but will incorporate key elements of St. Thomas's own metaphysics, including the real distinction between essence and existence and his doctrine of participation. It is Maritain's appropriation of St. Thomas's metaphysics that enables him to produce a realistic philosophy of science, one that he offers as compatible with contemporary scientific enquiry. It also enables him to develop a theory of person and personality. But the story begins with Plato. Although Plato's theory of knowledge may appear fanciful to the modern reader, his analysis of scientific knowledge contains a basic set of observations whose truth remains uncontested even 1 Cf. P.F. Strawson, Individuals: An Essay in Descriptive Metaphysics (London: Methuen and Co., 1959); J.W. Meiland, Talking About Particulars (New York: Humanities Press, 1970); P. Butchvarov, Resemblance and Identity (Bloomington: Indiana University Press, 1966). 19 20 JUDE P. DOUGHERTY though his explanation be faulty. Plato saw clearly that science is of the universal. Things may be particular, but when we consider them as objects of enquiry, the intellect focuses upon the form taken as an exemplar. In Plato's explanation things belong to their various kinds by participating in incorporeal, eternal, and unchangeable archetypes. From a realist's vantage point the problem may be stated simply: Since things are singular, how is it that we intellectually apprehend them as universal? Aristotle's solution is well known and it is one adopted and amplified by St. Thomas. Universals are abstracted from singular things. No one would present Maritain as a medievalist, but, as an interpreter of Aquinas, he has wielded considerable influence in the United States and in Latin America. Many have come to St. Thomas under his tutelage. His knowledge of Aquinas is extensive and is drawn upon throughout his lifelong work, but perhaps nowhere more than in his philosophy of science and in his discussions of the person. The primary text for Thomas's doctrine of individuation is his commentary on Boethius's De Trinitate, where he discusses the division and methods of the sciences. Maritain's philosophy is indebted mainly to his reading of Thomistic texts, but he draws heavily, as well, on the works of his contemporaries, Reginald Garrigou-Lagrange and Louis Geiger, and on those of the classic commentators on Thomas, Cajetan, Sylvester of Ferrara, and John of St. Thomas. Though employing St. Thomas, Maritain is always a man of the twentieth century. In books such as the Degrees of Knowledge, Science and Wisdom, Existence and the Existent, and A Preface to Metaphysics, his foe is always some contemporary exponent of a nominalist position.2 "Nominalists,'' he will say, "have a taste for the real, but no sense of being."3 Timeless 2 Degrees ofKnowledge [Les Degres du Savoir(l 932)], trans. G.B. Phelan, 4th ed. (New York: Charles Scribner's Sons, 1959); Science and Wisdom [Science et Sagesse (1935)], trans. B. Wall (New York: Charles Scribner's Sons, 1940); Existence and the Existent [Court Traite de L:Existence et de L:Existant (1947)], trans. L. Galantiere and G.B. Phelan (New York: Pantheon Books, 1948); A Preface to Metaphysics [Sept Le~ons sur L'Etre et les Premieres Principes de la Raison Speculative (1934)], trans. B. Wall (New York: Sheed and Ward, 1939). 3 Degrees of Knowledge, 3. AN INTERPRETER OF AQUINAS 21 metaphysics, he will lament, no longer suits the modern intellect. "Three centuries of empirico-mathematics have so warped the intellect... (shrink)

Disorders of Consciousness (DoCs) raise difficult and complex questions about the value of life for persons with impaired consciousness, the rights of persons unable to make medical decisions, and our social, medical, and ethical obligations to patients whose personhood has frequently been challenged and neglected. Recent neuroscientific discoveries have led to enhanced understanding of the heterogeneity of these disorders, and focused renewed attention on the medical and ethical problem of misdiagnosis. -/- This book examines the entanglement of epistemic and ethical (...) uncertainty in DoCs and other medical contexts, and how they interact to create both epistemic and ethical risks. Philosopher and bioethicist L. Syd M Johnson pulls together multiple threads in this work: the ontological mysteries of consciousness, medical uncertainty about unconsciousness, ableist bias, withdrawal of treatment in neurointensive care, and the rarely questioned view that consciousness is essential to personhood and moral status. Johnson challenges longstanding bioethical dogmas about DoC patients, and argues for an ethics of uncertainty for contexts where there is a need for decisive action in the presence of unavoidable uncertainty. The ethics of uncertainty refocuses ethical inquiry concerning persons with DoCs, placing less emphasis on their contested personhood, and more on inductive risk and uncertainty, on respect for autonomy, and especially on epistemic justice. With applications to various decisional contexts where uncertainty and ethical risk interact, this ethical approach enables surrogate decision makers facing fraught and risky choices to fulfill their obligations as moral and epistemic agents. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

The central role played by Darwin's analogy between selection under domestication and that under nature has been adequately appreciated, but I have indicated how important the domesticated organisms also were to other elements of Darwin's theory of evolution-his recognition of “the constant principle of change,” for instance, of the imperfection of adaptation, and of the extent of variation in nature. The further development of his theory and its presentation to the public likewise hinged on frequent reference to domesticates.We have seen (...) that Darwin's reliance on the analogy between domesticated varieties and wild species was a bold and original step, in light of contemporary views on the nature of domesticates. However, as Darwin undoubtedly foresaw, his reliance on the analogy created difficulties as well as solving problems, and these began with his Malthusian codiscoverer of the principle of natural selection, Alfred Russel Wallace. Wallace's paper “On the Tendency of Varieties to Depart Indefinitely from the Original Type,” presented to the Linnean Scoiety along with the first public unveiling of Darwin's theory, states: We see, then, that no inferences as to varieties in a state of nature can be deduced from the observation of those occurring among domestic animals. The two are so much opposed to each other in every circumstance of their existence, that what applies to the one is almost sure not to apply to the other. Domestic animals are abnormal, irregular, artificial; they are subject to varieties which never occur and never can occur in a state of nature.62Much has been made of the similarity of views of Darwin and Wallace, but this quotation surely reveals how utterly different their views were on what to Darwin was an important matter. Several critics of the Origin saw Darwin's reliance on the domesticates as his Achilles heel. As Young has pointed out, Samuel Wilberforce included the following passage in his attack on the Origin: Nor must we pass over unnoticed the transference of the argument from the domesticated to the untamed animals. Assuming that man as the selector can do much in a limited time, Mr. Darwin argues that Nature, a more powerful, a more continuous power, working over vastly extended ranges of time, can do more. But why should Nature, so uniform and persistent in all her operations, tend in this instance to change? Why should she become a selector of varieties?63Another critic, Fleeming Jenkin, found the analogy a weakness in Darwin's theory because of the limited extent of variation in any one direction in domestic animals and plants.64 We have already seen that Darwin had confided a similar view to his notebook thirty years earlier, but changed his mind as a result of his profound study of domesticates. De Beer's reference to “an English country gentleman's knowledge of domestic plants and animals and their breeding”65 fails totally to recognize the originality and depth of Darwin's knowledge of domesticates.Why did Darwin, against the currents of his time, rely so heavily on mankind's experience with domesticated organisms to shape his theory about species in nature? On reason is that only with domesticates was an approach that came close to experimental verification possible. Darwin fully realized the inadequacies of the experiment, as is emphasized by his repeated contrasting of selection under nature and selection by man. Yet the extensive experience and data of plant and animal breeders offered the only reliable base against which Darwin could continually challenge his views. As he wrote in the introduction to Variation, with domestication, “man ... may be said to have been trying an experiment on a gigantic scale.”66 Given Darwin's high opinion of the quantitative work of Malthus and Quetelet (as emphasized by Schweber),67 and his unremitting efforts to secure data by which to test his theories, it was inevitable that he should attach high significance to domesticated varieties. John Tyndall, in his Belfast address of 1874, said: “The strength of the doctrine of Evolution consists, not in experimental demonstration (for the subject is hardly accessible to this mode of proof), but in its general harmony with scientific thought.”68 Darwin would have agreed with the latter thought, but I think he would have challenged the preceding one on the grounds that long experience with domesticated varieties did provide an element of experimental demonstration. It gave him confidence in his theory, and he used his vast knowledge of artificial selection boldly and creatively. (shrink)