Is it ethical to perform a surgery whose purpose is to make a male look like a female or a female to appear male? Is it medically appropriate? Sexual reassignment surgery (SRS) violates basic medical and ethical principles and is therefore not ethically or medically appropriate. (1) SRS mutilates a healthy, non-diseased body. To perform surgery on a healthy body involves unnecessary risks; therefore, SRS violates the principle primum non nocere, “first, do no harm.” (2) Candidates for SRS may believe (...) that they are trapped in the bodies of the wrong sex and therefore desire or, more accurately, demand SRS; however, this belief is generated by a disordered perception of self. Such a fixed, irrational belief is appropriately described as a delusion. SRS, therefore, is a “category mistake”—it offers a surgical solution for psychological problems such as a failure to accept the goodness of one’s masculinity or femininity, lack of secure attachment relationships in childhood with same-sex peers or a parent, self-rejection, untreated gender identity disorder, addiction to masturbation and fantasy, poor body image, excessive anger, and severe psychopathology in a parent. (3) SRS does not accomplish what it claims to accomplish. It does not change a person’s sex; therefore, it provides no true benefit. (4) SRS is a “permanent,” effectively unchangeable, and often unsatisfying surgical attempt to change what may be only a temporary (i.e., psychotherapeutically changeable) psychological/psychiatric condition. National Catholic Bioethics Quarterly 9.1 (Spring2009): 97–125. (shrink)

Paul Ricoeur’s narrative and critical hermeneutics provides the conceptual resources to accommodate Barthes’ and similar critiques of subjectivity whilepositing a revised form of authorial intention similar to the “postulated author” of Alexander Nehamas and the “creative process” of Richard Wollheim. Though influenced by Barthian critiques, all three thinkers retain a notion of authorial intent*one distinct from the intentions of the historical author*necessary for the understanding of meaning in the philosophy of literature. Yet, the implications of this allow us to (...) reverse the Ricoeurian insight of understanding human action as a text, and show how human action provides clarification on authorial intention. Using Ricoeur and Nehamas, I would like to revisit the issue of authorialintention in order to show the insights this offers for hermeneutics and philosophy of literature. If authorial intention is properly reestablished as distinct from theintentions of the historical writer, we can turn to a minimalistic version of the analytic philosophy of action based on Ricoeur and Carlos Moya to provide auseful heuristic conceptual framework to look at both authorial and ‘readerly’ intention.In employing the philosophy of action, this conceptual framework will be used instrumentally in aid of interpreting the text and providing further analysisand conceptual clarity to the notion of authorial intention. Further, analyzing ‘writerly’ and ‘readerly’ intention as action*communicative action*sidesteps thephilosophical issue of the ‘artistic process’ which had absorbed the attention of aesthetics since Plato, without sidestepping the issues of authorial intention andreaderly intention.1 I will argue that in using variants of the philosophy of action, we can ignore psychological issues and instead focus on the broader issues ofmeaning-expression at the heart of both readerly and writerly intention. I will then demonstrate this heuristic framework using Hölderlin’s epic poetry and Blanchot’s The Writing of the Disaster. (shrink)

This short piece by Richard Kearney updates for the contemporary conversation the original forward he co-authored with his fellow conference organizer Joseph S. O’Leary. It lays out the themes of the publication of their 1979 Colloquium Heidegger et la question de Dieu. If Heidegger seems to suggest a discussion of theology by engaging Being, which religious tradition pairs with God, he himself was not interested in this correlation. He nevertheless served to open a path for others to follow. Facing (...) up to the crisis of technological alienation, and firmly grounded in the Western tradition’s double belonging to the Hebraic and Hellenic traditions, the contributors of contributors of this original conference take up precisely this task to rethink the question of God. (shrink)

Gideon Rosen’s [1990 Modal fictionalism. Mind, 99, 327–354] Modal Fictionalist aims to secure the benefits of realism about possible-worlds, whilst avoiding commitment to the existence of any world other than our own. Rosen [1993 A problem for fictionalism about possible worlds. Analysis, 53, 71–81] and Stuart Brock [1993 Modal fictionalism: A response to Rosen. Mind, 102, 147–150] both argue that fictionalism is self-defeating since the fictionalist is tacitly committed to the existence of a plurality of worlds. In this paper, I (...) develop a new strategy for the fictionalist to pursue in response to the Brock–Rosen objection. I begin by arguing that modal fictionalism is best understood as a paraphrase strategy that concerns the propositions that are expressed, in a given context, by modal sentences. I go on to argue that what is interesting about paraphrastic fictionalism is that it allows the fictionalist to accept that the sentence ‘there is a plurality of worlds’ is true without thereby committing her to the existence of a plurality of worlds. I then argue that the paraphrastic fictionalist can appeal to a form of semantic contextualism in order to communicate her status as an anti-realist. Finally, I generalise my conception of fictionalism and argue that Daniel Nolan and John O’Leary-Hawthorne [1996 Reflexive fictionalisms. Analysis, 56, 26–32] are wrong to suggest that the Brock-Rosen objection reveals a structural flaw with all species of fictionalism. (shrink)

This paper lays the groundwork for formulating an approach to literature which pushes Foucault’s thought in directions which he perhaps envisaged, but never pursued. However, one of the major obstacles to formulating a Foucauldian philosophy of literature is the fact that Foucault’s thought itself turned away from literature in the late 1960s. Why does literature apparently disappear from Foucault’s writings after 1969? And why does Foucault’s own re-writing of his theoretical biography elide this earlier interest in literature? In order to (...) answer these questions we will have to find out what role literature played in his early thought. What is at stake here, is not just a better understanding of Foucault’s thought, but more importantly, the possibility of reviving one of the potential lines of flight which that thought cut short as a result of its own endless turning. Hence, my ultimate aim will be to address the question of what can be reclaimed today from Foucault’s abandoned engagement with literature. (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)

In accord with the motto of the Passionists—“We preach Christ crucified”—Breton located the essence of Christianity in a faith and love marked by open-ended questioning and dialogue and by an exodic movement of the spirit. Neoplatonism enabled him to raise his love of free inquiry to a high spiritual plane, and to bring into lucid focus the figure of Christ, ridding it of false absolutizations. Seeing the encounter with Buddhism as the next step in this purification of Christian vision, he (...) pored over Nagarjuna in his last days. The totality of Breton’s life and work enacts a lighter, humbler understanding of the Gospel, one fully responsive to modern and postmodern questions. (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)

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)

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)

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

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)

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)

Those who call themselves ‘scientific realists’ have been concerned to defend one or more of the following cluster of theses: The scientific enterprise’s primary goal is to discover a theory that correctly describes a mind-independent reality. Scientists believe that many of the central claims of current scientific theories correctly describe a mind-independent reality. Moreover, in forming such beliefs, they do not take themselves to be going beyond the bounds of science. If scientific activity continues, science will eventually succeed in providing (...) an account of mind-independent reality that is at least approximately true. Many of the central claims of current scientific theories correctly describe reality. Clearly, and are pieces of scientific sociology, in that they express judgements about the attitudes of scientists towards their theories, while and express judgements about the extent to which science is able to discover the way the world is. and the ‘Sociological Theses’ and the ‘Non-Sociological Theses’.) In this paper, I shall discuss what Bas van Fraassen’s work has to tell us about these claims. I shall argue that at best, he has pointed to one important respect in which defenders of scientific realism may have been on the wrong track. Such defenders have, historically, attempted to provide decisive reasons for believing one or more of the above theses. Van Fraassen has given grounds for thinking that no such rationally compelling reasons are to be had. But since that hardly implies that anyone who subscribes to either the Sociological or Non-Sociological Theses is irrational, it follows that van Fraassen’s polemic fails to undermine scientific realism in any serious way. Correspondingly, I shall argue that van Fraassen’s defence of an alternative to scientific realism, his so-called ‘constructive empiricism’, has only limited success. (shrink)

This paper provides a detailed study of fraud in practice through an empirical investigation of B.P.Sayers, a family-owned stockbroking firm that had been in existence for over 100 years and that collapsed due to the fraudulent activities of the firm's junior partner. An interpretive narrative methodology has been employed which has resulted in the development of a detailed understanding of fraud and moral breakdown in organizations, resulting from a failure of responsibility that arises from a dysfunctional work identification and its (...) moral implications. In developing this account of fraud, the conceptual framework utilized is drawn from the moral philosophical work of Emmanuel Levinas who explicated how the breakdown of social relations of responsibility results, in turn, in moral breakdown. (shrink)

(1996). Compatibilist semantics in metaphysics: A case study. Australasian Journal of Philosophy: Vol. 74, No. 1, pp. 117-134. doi: 10.1080/00048409612347101.

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,..

The ArgumentThis paper argues that science and technology studies need to adopt a much wider view of what counts as a laboratory. The factory, it is suggested, is as much a site of invention and intervention as the laboratory. As a site for the government of economic life, the factory is a laboratorypar excellence. One particular factory is studied — the Decatur, Illinois, plant of Caterpillar Inc. — as it is rethought and remade in accordance with ideals of cellular manufacturing, (...) Just-In-Time systems, customer-driven manufacturing, and competitor benchmarking. But it is not just the changes at the factory itself that are studied. The paper analyzes the linkages and relays between the redesign of a particular manufacturing plant and the plethora of calls for a revitalization of North American manufacturing industry and a new form of economic citizenship. The paper examines the remaking of a factory as anassemblage, a historically specific and temporarily stabilized complex of relations among ways of problematizing the factory in a multiplicity of locales. There are four steps to the changes analyzed here: a problematizing of the factory at the level of North American manufacturing as a whole in the 1980s; a problematizing of the notion of competitiveness at Caterpillar Inc, through the calculative practices of competitor benchmarking and related expertises; a diagraming of the ideal factory in systems terms; and the embedding of notions of the product, of competitiveness, and of a new economic citizenship in the “Assembly Highway” at the Decatur plant. Rethinking the factory took place within this assemblage of relations, rether than at any one site. (shrink)