This paper discusses three cultural narratives that threaten the health of people with intellectual/developmental disabilities (IDD) and which have become more evident during the COVID-19 pandemic. These meta-narratives are the medical model of health/disability; the population health approach to health inequalities; and policies premised on the assumption of the importance of national economic growth as an incentive for reducing health inequalities. Evidence exists that health research is more likely to become policy if it fits within a medical model and addresses (...) national economic growth. These two criteria are particularly problematic for people who have IDD. The paper also proposes a research model to facilitate the inclusion of IDD related issues in future policy regarding health inequalities. (shrink)

This book is of interest to those working at the intersection of contemporary debates in philosophy, ethics, politics and cultural studies.

We generally accept that medicine’s conceptual and ethical foundations are grounded in recognition of personhood. With patients in vegetative state, however, we’ve understood that the ethical implications of phenomenal consciousness are distinct from those of personhood. This suggests a need to reconsider medicine’s foundations. What is the role for recognition of consciousness (rather than personhood) in grounding the moral value of medicine and the specific demands of clinical ethics? I suggest that, according to holism, the moral value of medicine is (...) secured when conscious states are recognized in everyday medical science. Moreover, consciousness fully motivates traditional principles of clinical ethics if we understand respect for autonomy as respect for the dominion of an experiencer in the private, inescapable realm of bodily experience. When medicine’s foundations are grounded in recognition of consciousness, we understand how patients fully command respect even when they lack capacity to exercise their bodily dominion through decision-making. (shrink)

Apocalyptic expectations of Armageddon and a New Age have been a fixture of the American cultural landscape for centuries. With the approach of the year 2000, such millennial visions seem once again to be increasing in popularity. Stephen O'Leary sheds new light on the age-old phenomenon of the End of the Age by proposing a rhetorical explanation for the appeal of millennialism. Using examples of apocalyptic argument from ancient to modern times, O'Leary identifies the recurring patterns in apocalyptic (...) texts and movements and shows how and why the Christian Apocalypse has been used to support a variety of political stances and programs. The book concludes with a critical review of the recent appearances of doomsday scenarios in our politics and culture, and a meditation on the significance of the Apocalypse in the nuclear age. Arguing the Apocalypse is the most thorough examination of its subject to date: a study of a neglected chapter of our religious and cultural history, a guide to the politics of Armageddon, and a map of millennial consciousness. (shrink)

My review of Cordelia Fine's new book, Delusions of Gender: How Our Minds, Society, and Neurosexism Create Difference: The gender wars take no prisoners. In 2005, suggesting that there might indeed be innate differences between men and women derailed the career of Harvard president Larry Summers. He reemerged, years later, as President Obama’s sometime finance guru). Meanwhile, a host of neuroscientists report differences between the brains of men and women that, they say, account for different abilities and career choices. Psychologist (...) and author Cordelia Fine disagrees with the neuroscientists. In Delusions of Gender: How Our Minds, Society, and Neurosexism Create Difference, she has no time for the "special powers" that pop brain science currently imputes to the female brain, reminding us that such claims were made long before the magnetic resonance imaging machine was invented. (shrink)

The strongest version of the principle of the Identity of Indiscernibles states that of necessity, there are no distinct things with all their universals in common (where such putative haecceities as being Aristotle do not count as universals: I use 'universal' rather than 'property' here and in what follows for the simple reason that 'universal' is the term of art that most safely excludes haecceities from its instances). It is commonly supposed that Max Black's famous paper 'The identity of indiscernibles' (...) (2) refutes this thesis. (Armstong's [1], chapter 9 is representative here.) Black argues ([2], p. 156) that it is perfectly possible that there be a world consisting solely of two indiscernible spheres at some distance to each other and that this world constitutes a counterexample to the principle above. The strongest version of the bundle theory of substance claims that of necessity, the substances that make up the world are bundles of universals.1 It is commonly supposed that a consequence of Black's defeat of the principle of the Identity of Indiscernibles is that this bundle theory of substance is mistaken. (Again, Armstong's [1] is representative.) I shall argue that Black's thought experiment does not defeat the bundle theory and that, as a result, the bundle theory can be used to salvage the principle of the Identity of Indiscernibles. (shrink)

What position on dualism does medicine require? Our understanding of that ques- tion has been dictated by holism, as defined by the biopsychosocial model, since the late twentieth century. Unfortunately, holism was characterized at the start with con- fused definitions of ‘dualism’ and ‘reductionism’, and that problem has led to a deep, unrecognized conceptual split in the medical professions. Some insist that holism is a nonreductionist approach that aligns with some form of dualism, while others insist it’s a reductionist view (...) that sets out to eradicate dualism. It’s important to consider each version. Nonreductive holism is philosophically consistent and clinically unprob- lematic. Reductive holism, however, is conceptually incoherent—yet it is the basis for the common idea that the boundary between medical and mental health disorders must be vague. When we trace that idea through to its implementation in medical practice, we find evidence that it compromises the safety of patient care in the large portion of cases where clinicians grapple with diagnosis at the boundary between psychiatry and medicine. Having established that medicine must embrace some form of nonreduc- tionism, I argue that Chalmers’ naturalistic dualism is a stronger prima facie candidate than the nonreductive alternatives. Regardless of which form of nonreductionism we prefer, some philosophical corrections are needed to give medicine a safe and coherent foundation. (shrink)

Tout s’est passé très vite, prenant l’Église au dépourvu. Le mouvement pour la reconnaissance des mariages et des unions civiles entre personnes du même sexe a connu un succès extraordinaire. La hiérarchie de l’Église catholique oppose une fin de non-recevoir à toute reconnaissance positive des couples homosexuels, en invoquant une morale sexuelle qu’on dit ancienne et invariable,..

After nearly fifty years of mea culpas and explanatory additions, the biopsychosocial model is no closer to a life of its own. Bolton and Gillett give it a strong philosophical boost in The Biopsychosocial Model of Health and Disease, but they overlook the model’s deeply inconsistent position on dualism. Moreover, because metaphysical confusion has clinical ramifications in medicine, their solution sidesteps the model’s most pressing clinical faults. But the news is not all bad. We can maintain the merits of holism (...) as we let go of the inchoate bag of platitudes that is the biopsychosocial model. We can accept holism as the metaphysical open door that it is, just a willingness to recognize the reality of human experience, and the sense in which that reality forces medicine to address biological, psychological, and social aspects of health. This allows us to finally characterize Engel’s driving idea in accurate philosophical terms, as acceptance of consciousness in the context of medical science. This will not entirely pin down medicine’s stance on dualism, but it will position it clearly enough to readily improve patient care. (shrink)

Ethical instruction is critical for trainee accountants. Various teaching methods, both active and passive, are normally utilised when teaching accounting ethics. However, students’ learning styles are rarely assessed. This study evaluates the learning styles of accounting students and assesses the interaction of teaching methods and learning styles in an ethics instruction environment. The ethical attitudes and preferred learning styles of a cohort (137) of final year accounting students were evaluated pre-instruction. They were then subject to three different teaching methods while (...) studying ethics during an auditing course. When ethical attitudes and preferred learning styles were re-assessed post-instruction, the teaching methods were found to have influenced active learners more than passive ones. Furthermore, when learning styles matched teaching methods used, usefulness was assessed as high but when learning styles and teaching methods differed, usefulness deteriorated significantly. Students displayed a preference for passive learning styles, despite being so advanced in their education. The implications are that instructors should consider learning styles before deciding on appropriate teaching methods, in accounting ethics environments. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Day in the Life of a Spanish InterpreterGianna O'LearyThe good thing about Mondays is they almost guarantee I'll be able to sleep at least until 8 am. If I have a double shift, my supervisor will try to "un-zombie me" for the night as much as possible.I get out of my car and head to the three small offices that are the interpreter's dominion. It takes me about (...) ten minutes because the hospital is huge, and our offices are located on the other side of the building. One office is my supervisor's, the other is the sign language supervisor's, and the third is for all of us Spanish interpreters working today.My first hour is all about phones. I sit at the desk and open EPIC, the hospital software where doctors, nurses, therapists, and yes, interpreters, work with the rest of the staff. I listen to the first voicemail; it's nothing unusual. It's from a mom who needs a follow-up appointment with Neurology. I call Mom back (at Children's, all our clients' parents are "Mom" and "Dad," they seem to like it, and I never heard a complaint about it). Her daughter has a seizure disorder, and she's due for a followup. They need to do it because the girl is growing, and she is outgrowing her Keppra medication; the doctor will probably increase the dose. They will also do an EEG to make sure her seizure activity is under control.I continue picking up the phone, listening to messages, calling people back, and documenting the messages that were not answered. Other interpreters will take them later and try to call them again. In the meantime, when nobody answers, I translate a few of the forms for the Autism clinic. Their patients are usually two to three years old, and moms are usually worried they have not talked yet. Usually, when asked what they want for their child, their answer is for them to talk and act like normal children. If you work at a children's hospital, it's a very common goal.My first appointment of the day is with the ENT (ears, nose, and throat) clinic. I go to the clinic's virtual space and see the patient has not arrived. Five minutes later, there is no sign of him, so I call them. Mom forgot about the appointment, and she is very apologetic. We reschedule it and I let ENT know. Then, I send a message to the hospital interpreter to ask if they need help. "Yes, please!" Someone just asked them to go help with rounds. Can I go?"Sure! Send me the name and number of the room."I am glad to have this little app on my phone, and that we text more than anything when we need help. It helps me keep everything on track. I have an anxiety disorder so severe that when I get anxious (and work always makes me anxious), my brain imitates symptoms of ADHD. I do not have ADHD per se, but if I think I am making a mistake, that I am not learning fast enough, or, that lives could be in danger (like, for example, in a hospital), my thoughts race, and it is very hard for me to focus on anything. For functionality purposes, I suffer from ADHD about 70% of the time I'm at work.This little app can be my personal hell. If I am interpreting for a doctor and the pager goes off, my mind will not rest. My anxiety takes over. What if it's urgent? What if someone—not only someone—but a child, is dying? If I haven't checked my messages and the pager is going off, my mind is, too. It has been almost two years since I started this job, and so far, nobody has died during my service, so my brain understands it may be ok to relax a little. In the end, anxiety is anxiety, and it will get you. It will find something to worry about. Anxiety shines with creativity and thrives in a high-paced... (shrink)

Biomedical diagnostic science is a great deal less successful than we've been willing to acknowledge in bioethics, and this fact has far-reaching ethical implications. In this article I consider the surprising prevalence of medically unexplained symptoms, and the term's ambiguous meaning. Then I frame central questions that remain answered in this context with respect to informed consent, autonomy, and truth-telling. Finally, I show that while considerable attention in this area is given to making sure not to provide biological care to (...) patients without a need, comparatively little is given to the competing, ethically central task of making sure never to obstruct access to biological care for those with diagnostically confusing biological conditions. I suggest this problem arises from confusion about the philosophical value of vagueness when it comes to the line between biological and psychosocial needs. (shrink)

Recent accounting scandals involving the collapse of large corporate firms have brought into question the adequacy of ethics education within accounting programs. This paper investigates the ethical decisions of accountancy students and in particular analyses the effect of group (as opposed to individual) decision-making on ethical decisions. Final year accountancy students (sample size of 165) were randomly allocated into two experimental conditions. The participants were then presented with five (5) ethical vignettes. One experimental condition involved completing the ethical decisions as (...) individuals (60). The other involved completing the ethical decision-making as a group of 3–4 participants (34). A consistent pattern of behaviour was observed in the analysis of individual versus group responses. Individuals displayed stronger tendencies than groups to take the extreme actions of acting either unethically or ethically (whistleblowing), whereas groups displayed stronger tendencies to take the safer (neutral) options. It was concluded that groups reached consensus decisions, in an ethical context, probably as a result of peer pressure. The significant implication of this finding is in relation to the emphasis accounting programs place on group work. Group work may enhance students’ abilities to work as a team. However, as revealed in this study’s results, group work may not be an effective means of producing the optimal decision in all subject matter areas, especially complex areas such as ethical decision-making. (shrink)

The final book of O'Leary's trilogy, Conventional and Ultimate Truth deals with the nature of theological rationality today, drawing on Buddhist ideology.

The repeal of the Eighth Amendment was a turning point in Irish social history, especially in relation to the Catholic Church. But abortion is not a settled matter and it will continue to generate controversy. Likewise, issues such as surrogacy and assisted dying will give rise to sharp differences of opinion. Legislation that seeks to address bioethical issues such as these will inevitably provoke demands for amendments or repeal. By examining developments in biomedical science, Irish law and some central aspects (...) of Catholic moral teaching, Don O'Leary builds a thorough analysis of the controversies relating to: contraception, abortion, IVF, surrogacy, human embryonic stem cell research, assisted suicide, church control of healthcare services. Biomedical Controversies in Catholic Ireland is essential reading for anyone who wishes to understand the historical background, ethical arguments and scientific advances that will inform debates about morality and social policy in the coming years. -- (from amazon.com). (shrink)

If I have understood Pearson's use of “a practice” correctly my main objection to his project is that it gives the current practices of teaching far too much normative force over the educational beliefs of teachers. While the principles of practical reasoning advocated by Pearson may serve to test the coherence of the various beliefs which are part of current practice, they do not suffice to test the reasonableness of such beliefs. To do this we need, at least for some (...) of these beliefs, to draw upon the resources made available to us by such theoretical practices as psychology, philosophy, history, etc. None of these, of course, nullifies the significance of regarding teaching as a practice. Indeed, such a conception is a forceful reminder that the theoretical practices which are concerned with education need to focus on current teaching practices if they are to guard against the sort of empty rationalism despised by Oakeshott, while saying something to the teaching profession. This will not give us an educational theory, but rather theoretical perspectives on teaching as a practice. (shrink)

Towards the end of Analyze This , during a shoot-out, the psychotherapistplayed by Billy Crystal falls in front of the mobster played by Robert de Niro andtakes a bullet in his shoulder. De Niro thanks him for taking the bullet, but Crystalprotests that he just tripped up. De Niro replies, ‘No Doc, you tripped on yourunconscious!’ In this observation, the mobster not only provides the key to thisfilm, he also opens up a way of understanding something essential about TheGodfather . (...) One of the central and, for me, unexplained problems in TheGodfather is the motivation for Michael Corleone’s transformation from modelcitizen and war-hero into the ruthless Don who takes his father’s place at thehead of one of New York’s mafia families. In this paper, I will use Analyze This –and Freud – to explain this transformation as a form of ‘tripping over theunconscious’. My suggestion is that Analyze This, in its self-consciously popFreudian fashion, actually gives us the basis for a more serious Freudianinterpretation of Michael’s transformation. If we approach Coppola’s film as atragedy in which the ostensible rise to power of Michael is, in effect, hisdownfall, then we are faced with the question of how to understand the natureof the forces that bring him to that end. Against the idea that Michael is simply destined to take over his father’s position, I will give an account of the underlying psychological forces that bring him to that culmination. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesGianna O'Leary, Paul Hostovsky, Yilu Ma, Leo Almazan, Hilda Sanchez-Herrera, Marisa Rueda Will, Elaine Hsieh, Manuel Patiño, Felicity Ratway, Liliana Crane, Laisson DeSouza, Nilsa Ricci, Linda Pollack-Jackson, Kelley Cooper, Mateo Rutherford-Rojas, Rosa C. Moreno, Maja Milkowska-Shibata, Patricia Coronado, and Catalina Meyer• A Day in the Life of a Spanish Interpreter• Deaf Interpreter• "Call me Dr. XXX!"• Translating Care for the Voiceless Patient• Are We (...) There Yet? A Narrative of Firsthand Interpreter Experiences in the Medical Field and Insights to Aid Language Access Compliance• One Interpreter's Journey of Interpreting for Pregnancy Loss• More Than Words: Communicating for the Quality of Care• From Linguistic Bridge Builder to Aspiring Physician• Towards Language Justice: A Call to Identify and Overcome Structural Barriers• Voices in the Shadows: The Hidden Complexities of Being a Medical Interpreter• The Voice of Patients: The Exclusive Work of a Human Who Can Advocate• Don't Mute the Messenger• The Ramp and the Stop Sign• How Policies and Practices in Medical Settings Impact Communication Access with Deaf Patients and Caregivers• And When May I Cry? Juggling Emotions in Healthcare Interpreting• To Engage or Not to Engage: An Interpreter and a Mother's Need for Connection in the Cardiothoracic Unit• Witnessing Trauma: Emotional Challenges in Medical Interpretation• Being an Interpreter—Beyond Linguistics• 1-800-Quit-NowCopyright © 2024 Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 22 (2002) 163-179 [Access article in PDF] Emptiness and Dogma Joseph S. O'Leary Sophia University The controversial Vatican document Dominus Iesus reasserts that non-Christian religions are objectively in a defective situation as regards salvation.Etymologically, salvation (soteria salus) means health. Here I should like to reflect on apparent symptoms of ill health in Christian theology and ask if Buddhist wisdom can help us formulate a diagnosis and (...) bring the issues into perspective in a healing way. I shall take as my guiding thread an idea familiar to readers of this journal, namely, that Christian theology has suffered from a delusive clinging to substance and identity, and that the Buddhist teachings of dependent co-arising, emptiness, and non-self may provide an antidote.Biblical and Christian traditions are rich in resources for a critique of substantialist conceptions of God and self. The God of the Bible is constantly shattering the fixated, idolatrous images his worshippers form of him, and the Johannine language of God as Spirit, light, love, locates God in a dynamic realm of communal contemplation from which it would be difficult to distill a well-defined divine substance suited to metaphysical analysis. As for self, Paul, and later Luther, present the Christian self as an existential and relational event, not a substantial self-contained soul.What of Christian theology as shaped from Greek metaphysics? Is it irredeemably substantialist, prey to naive reification and objectification? The definition of God as ipsum esse subsistens("being itself subsisting") sufficiently eludes objectification to include the Plotinian sense of God as "beyond being." The idea adopted from Aristotle that "the soul [as knower] is in a manner all things" suggests that metaphysical theology also developed a nonobjectifying conception of human being. The Christological debates of the early Christian centuries rely of necessity on substance language, yet in placing that terminology at the service of a revealed mystery beyond the grasp of language or thought, they introduce a ferment of paradox into the play of concepts and make of it a dance of traces, following the contours of a reality that cannot be brought under substantialist rubrics.Some might see the brilliant relational fireworks of Thomist trinitarian speculation as deconstructing logocentric images of divinity. However, the Trinity in itself is probably best seen as an abstract remainder concept, postulated as a dim background of the revealed phenomenon of Father, Jesus Christ, and Spirit, so that to spin stories of theories about it is futile, a form of misplaced concreteness. Robert Magliola finds [End Page 163] Nagarjunian resonances in the trinitarian logic of the Council of Florence, notably in the decree it addressed to the Copts in 1442 (Magliola, 85-89). The Copts were given an extra dose of the logic that had caused profound unease among the Greek delegates three years earlier (see Gill, 227-232; 325). How much of this later logic did the Latins read back into the patristic texts they cited? Though unbeatable in the fifteenth century, how convincing is it today? Theology has to face the hermeneutical task, and an ongoing one, of assessing the status and function of this trinitarian logic and referring it back to the biblical basis.The desubstantializing tendencies just noted can be drawn on in a contemporary "overcoming of metaphysics" in theology. But the mainstream of the tradition invested massively in substance and identity. It was by strong affirmations of substantial identity that Christianity made its way in the world. Dogma determined the identities of Father, Son, and Spirit as consubstantial hypostases of the one God, the identity of Jesus Christ as true God and true man united in one hypostasis, the real presence of Christ in the Eucharist, the unity, sufficiency, infallibility of the Church and its Scriptures, the continuity of the episcopal and papal ministries as transmitted from the apostles. The substantiality of what was proclaimed was matched by the total conviction of the faith that proclaimed it. Theologians might tinker with speculative elaborations, but the core of faith and dogma was untouchable, never subjected to doubt or questioning.It is a kind of metadogma that all... (shrink)

International Journal of Philosophical Studies, Volume 20, Issue 2, Page 308-313, May 2012.

This paper canvasses the various dimensions along which theories of truth may disagree about the extent to which truth is minimal.