This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable (...) of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health. (shrink)

The mentalist mind-brain model is defended against alleged weaknesses. I argue that the perceived failings are based mostly on misinterpretation of mentalism and emergent interaction. Considering the paradigmatic concepts at issue and broad implications, I try to better clarify the misread mentalist view, adding more inclusive detail, relevant background, further analysis, and comparing its foundational concepts with those of the new cognitive paradigm in psychology. A changed "emergent interactionist" form of causation is posited that combines traditional microdeterminism with emergent "top-down" (...) control. This emergent form of causation has wide application to causal explanation in general and is hypothesized to be the key common precursor for the consciousness revolution and subsequent boom in new worldviews, "systems thinking," emerging new paradigms, and other transformative developments of the 1970s and 1980s. (shrink)

In this paper I argue that it is morally important for doctors to trust patients. Doctors' trust of patients lays the foundation for medical relationships which support the exercise of patient autonomy, and which lead to an enriched understanding of patients' interests. Despite the moral and practical desirability of trust, distrust may occur for reasons relating to the nature of medicine, and the social and cultural context within which medical care is provided. Whilst it may not be possible to trust (...) at will, the conscious adoption of a trusting stance is both possible and warranted as the burdens of misplaced trust fall more heavily upon patients than doctors. (shrink)

This article examines the implicit promises of fairness in evidence based medicine , namely to avoid discrimination through objective processes, and to distribute effective treatments fairly. The relationship between EBM and vulnerable groups is examined. Several aspects of EBM are explored: the way evidence is created , and the way evidence is applied in clinical care and health policy. This analysis suggests that EBM turns our attention away from social and cultural factors that influence health and focuses on a narrow (...) biomedical and individualistic model of health. Those with the greatest burden of ill health are left disenfranchised, as there is little research that is relevant to them, there is poor access to treatments, and attention is diverted away from activities that might have a much greater impact on their health. (shrink)

THE MARKET AS AN ECONOMIC PROCESS by Ludwig M. Lachmann New York: Basil Blackwell, 1986. 173 pp., $29?95.

Conceptual foundations for the changeover from behaviorism to mentalism are reviewed in an effort to better clarify frequently contested and misinterpreted features. The new mentalist tenets which I continue to support have been differently conceived to be a form of dualism, mind-brain identity theory, functionalism, nonreductive physical monism, dualist interactionism, emergent interactionism, and various other things. This diversity and contradiction are attributed to the fact that the new mentalist paradigm is a distinctly new position that fails to fit traditional philosophic (...) dichotomies. Formerly opposed features from previous polar alternatives become merged into a novel unifying synthesis, an unambiguous description of which demands redefinition of old terms or/and the invention of new terminology. The present analysis and interpretation are backed by statements from the early papers. (shrink)

In this paper we consider the use of cases in medical ethics research and teaching. To date, there has been little discussion about the consent or confidentiality requirements that ought to govern the use of cases in these areas. This is in marked contrast to the requirements for consent to publish cases in clinical journals, or to use personal information in research. There are a number of reasons why it might be difficult to obtain consent to use cases in ethics. (...) Many cases concern people who are incompetent, and thus unable to give consent. Often the material is of a sensitive nature, it is not clear who should give consent, or the ethicist has no access to those involved. We argue that the use of cases in ethics research and teaching can be justified by appeal to the public interest argument, and suggest a number of areas for discussion and clarification. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Father’s Will: Christ’s Crucifixion and the Goodness of God by Nicholas E. Lombardo, O.P.Roger W. NuttThe Father’s Will: Christ’s Crucifixion and the Goodness of God. By Nicholas E. Lombardo, O.P. Oxford: Oxford University Press, 2013. Pp. ix + 270. $99.00 (cloth). ISBN: 978-0-19-968858-6.The centrality that Christ’s death by crucifixion has in Christian life, doctrine, and culture is scarcely in need of elaboration. Nevertheless, the relation between (...) the will of the Father and the violent and humiliating manner of Christ’s death raises substantive questions concerning the internal coherence of Christian claims about the love, goodness, and justice of God. In The Father’s Will: Christ’s Crucifixion and the Goodness of God, Nicholas E. Lombardo, O.P., confronts these questions, openly acknowledging their difficulty and seriousness, and provides a philosophically precise and theologically fresh response to the challenges they pose to the credibility of the Christian message.The ten chapters of The Father’s Will are divided into tripartite units that progress in logical sequence from “philosophical prolegomena” (part 1) to “New Testament evidence” (part 2), culminating with a “theological [End Page 317] evaluation” (part 3). The question at the heart of the book is how to reconcile the Christian doctrine that God and evil are incompatible with the theology of the Cross, which seems to require that God’s will is implicated in the evil actions that bring about Christ’s death.The first five chapters (part 1) provide a philosophical analysis of intention (chap. 1), value and obligation (chap. 2), double-effect reasoning (chap. 3), the ethical problems associated with self-sacrifice (chap. 4), and God’s will in relation to the crucifixion (chap. 5). Drawing on his analysis of intention and employing the principle of double effect, Lombardo establishes that it is not necessary to conclude that God wills the evils that are attendant on Christ’s death. “Actions performed by rational intentions,” Lombardo explains, “are not only intended; they are also willed. Rational intending implies rational choice, and rational choice is an act of the will” (32). This understanding of intention and willing, as distinguishable from intentional action, provides a foundation upon which the moral goodness of actions can be determined. “For an action to be good,” Lombardo argues, “it must do more than simply advance our natural inclinations: it must also avoid frustrating them. Only actions that both advance our natural inclinations and avoid frustrating them are morally good” (49). When moral actions have good effects and nonintended bad effects that do not outweigh the good effects—as in cases of self-defense or the use of medicine and medical procedures—these complex actions retain their moral goodness, notwithstanding the bad effects. The reason for this is that the bad effects are not included in the agent’s intention. Lombardo presents the crucifixion of Christ as one of these complex cases in which the bad effects can be separated from the agent’s intention. Chapter 3 explores the reasoning associated with the principle of double effect to clarify how actions implicated in bad or evil effects can be judged to be morally good. Lombardo is hesitant to identify double effect as an isolated principle that is applicable within unique circumstantial cases. Rather, he presents double effect as “merely an algorithm for applying basic concepts to morally ambiguous actions” (72). For example, in addition to affirming that the intended effects of the action are consistent with our natural inclinations, in cases of double-effect reasoning “the action’s positive, intended effects [must] outweigh the action’s negative, nonintended effects” (73). This material, in turn, connects logically with the conclusion of chapter 4 on the ethics of self-sacrifice: “double effect reasoning shows that it can be acceptable, and even heroic, to cause our own death non-intentionally for the sake of some greater good” (79). The last chapter in part 1 applies these distinctions to the problem of God’s will and the moral evil involved in Christ’s crucifixion. Here, the basic dilemma that the book addresses is succinctly restated: “Being all good, God never wants... (shrink)

OBJECTIVES: To study and report the attitudes of patients and general practitioners (GPs) concerning the obligation of doctors to act for the good of their patients, and to provide a practical account of beneficence in general practice. DESIGN: Semi-structured interviews administered to GPs and patients. SETTING AND SAMPLE: Participants randomly recruited from an age and gender stratified list of GPs in a geographically defined region of South Australia. The sample comprised twenty-one general practitioners and seventeen patients recruited by participating GPs. (...) RESULTS: In practice, acting for the good of the patient not only accommodates the views of patients and GPs on expertise and knowing best, but also responds to the particular details of the clinical situation. Patients had a complex understanding of the expertise necessary for medical practice, describing a contextual domain in which they were expert, and which complemented the scientific expertise of their GPs. General practitioners identified multiple sources for their expertise, of which experience was the most significant. The role of the GP included responding to individual patients and particular clinical problems and ranged from the assumption of responsibility through to the proffering of medical advice. CONCLUSION: This study found that GPs acting for the good of their patients covered a variety of GP actions and patient preferences. Beneficence was not justified by presumed patient vulnerability or the inability of patients to understand medical problems, but furthered through a recognition of the different areas of expertise contributed by both parties to the consultation. (shrink)

Aesthetics, hermeneutics, criticism -- Social Werktreue and the subjectivization of aesthetics -- From musike to metaphysics -- Formalist aesthetics and musical hermeneutics -- Deconstructing the disciplinary divide -- The question of metaphor -- Mimesis and the hermeneutics of music -- Political critique and the politics of music criticism -- Toward a hermeneutics of music criticism.

Paul Ricoeur and the Lived Body’s explorations into the ethical, social, cultural, and affective dimensions of our corporeal existence draw on Paul Ricoeur’s reflection on the lived body. Starting with the fact that one’s own body is irreducible to an object, these essays critically contribute to discourses on the body.

This volume brings together eleven essays that address a range of issues extending from broader questions of social justice to the sexual intimacy that bears the mark of our fleshly existence. Collectively, these essays extend the reach of Paul Ricoeur’s early to late works by taking up some of the major social, political and religious challenges facing us in a postmodern, ultrapluralistic world.

Normal 0 false false false EN-US JA X-NONE Normal 0 false false false EN-US JA X-NONE The spotlight that Martha Nussbaum turns on the plight of women in developing nations brings the disproportion between human capabilities and the opportunities to exercise them sharply into focus. Social prejudices, economic discrimination, and deep-seated traditions and attitudes all harbor the seeds of systemic injustices within governing policies and institutions. The refusal on the part of a dominant class to recognize the rights and claims (...) of subaltern individuals and groups has both symbolic and material consequences. The power that one group exercises over another brings the refusal to recognize the rights and claims of others to the fore. Thanks to the moral priority that Paul Ricoeur accords to the victim against such refusals, I tie the fragility of identity to the idea of justice’s federating force. This federating force, I therefore argue, accompanies the struggle for recognition among capable human beings. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Criticism, Imagination, and the Subjectivization of AestheticsRoger W. H. SavageThe growing discontent with reductivist practices signals a new current in contemporary criticism's understanding of music, literature and art. George Levine's unease with critics who are unable or unwilling to account for their continuing preoccupation with literary texts they expose as "imperialist, sexist, homophobic and racist" illumines the contradiction fueling the reduction of aesthetics to ideology.1 Cultural studies that deploy (...) literature as evidence of the aesthetics' socio-historical substance mask literature's capacity to break open new perspectives on reality by assuming that literary works are politically complicit with the aesthetics' strategic "mystification of the status quo" (A&I, p. 3). Criticism's indifference to its philosophical presuppositions exacerbates the paradox of denouncing a body of works that constitute criticism's aesthetic and intellectual heritage. According to Mario Valdés, literary studies' coming of age mandates that criticism take account of a tradition nurtured by a succession of philosophers including Hans-Georg Gadamer and Paul Ricoeur.2 For Valdés, the post-structuralist realization that literary texts are indeterminate and inexhaustible prohibits replacing the work of art with critical commentaries on it; criticism's collective and determining role belongs to a shared community of commentary whose history and thought is a record of the changing interpretations and understandings of literary texts' meanings. [End Page 164]Valdés's claim extends to the field of contemporary music criticism, where the fashion of denouncing aesthetics as socially pernicious turns against traditional musicology's institutional authority. By demystifying absolute music (instrumental music devoid of programmatic associations), a self-proclaimed critical musicology revolts against traditional musicology's perceived political and ideological agenda. Critical musicology militates against the aesthetic conceit that absolute music transcends its social construction. Yet, by overlooking the philosophical presuppositions that set music's autonomy against practical affairs, new musicology accedes to the schema it recoils against.The tradition nurtured by Gadamer's philosophical hermeneutics and Ricoeur's hermeneutic phenomenology represents a critical current whose significance has been overshadowed by postmodernist investments in decoding music's social and political content. Gadamer's critique of the subjectivization of aesthetics and Ricoeur's meditations on the imagination's capacity for invention offer an alternativeto contemporary music criticism's reaction against the principle of music's aesthetic autonomy. Gadamer and Ricoeur question art's formal separation from reality, which belongs to the history of Kant's radical subjectivization of aesthetics. Gadamer's critique of art's aesthetic differentiation prepares the ground for revealing how socially informed analyses conform to the schema Kant initiates by divorcing judgments of taste from their surrounding cultural ethos. Gadamer argues that, by discrediting theoretical knowledge that does not rely on the methodology of the natural sciences, the transcendental function Kant ascribes to aesthetic judgment lays the foundation for differentiating between art's aesthetic constitution and a concept of truth that accommodates the standard of the natural sciences. Through reducing the "sensus communis to a subjective principle," Kant legitimates his critique of aesthetic judgments by denying taste any importanceas a mode of knowledge.3Ricoeur's hermeneutical reflections on imagination complement Gadamer's critique of a differentiating consciousness that abstracts art works from their cultural worlds. For Ricoeur, imagination is productive when the fictions that works create affect our understanding of ourselves and our world by re-describing reality. Aesthetics' alignment with ideology encounters a limit in the power works evince by unfolding different ways of seeing or hearing reality. Ricoeur's reflections on imagination stand in stark contrast to the idea that individual works represent a form of cultural capital in the struggle for social position [End Page 165] and power. Contemporary critical practices' failure to account for the philosophical separation of judgments of taste from knowledge of reality precipitates the impasse criticism encounters when it identifies aesthetics with ideology at the expense of a work's capacity to affect reality in productive ways. The dispersal and potential disappearance of music's aesthetic character into the recesses of cultural and political analysis keeps step with the conceptual narrowing imposed by a restrictive sociological critique. Demystifying music's ideological representations of gender, race and identity purges romantic... (shrink)

An animal enters the world with a set of highly specialized and firmly directed instincts which are correlated with pre-typified situations in the environment. Consequently it lives in a surrounding world, structured by its instinctual inheritance, which is specific to its own particular species and admitting only a limited range of variations within which life for it is possible. Man at birth is, compared to the non-human animal, an unfinished being, and his surrounding world partakes of his unfinished character. It (...) is a world that must be fashioned then by man's own activity; he must make a human world for himself. (shrink)

The notion that music’s expressive force is the spring of its affective power calls for a consideration of the language music speaks. Hermann Kretzschmar’s effort to set out a method for explicating music’s affects through discursive means falls short in this regard. Conversely, Hans-Georg Gadamer’s reflections on the language of art opens the way to a hermeneutical consideration of music’s affective significance. Gadamer’s critique of Kant’s subjectivization of aesthetics disabuses us of the romantic conceit that music is a “language beyond (...) language.” Rather, music’s power to speak inheres in the communicability of the experiences occasioned by it. The hermeneutics of music I set out draws on Gadamer’s analysis of the phenomenon of play. Martin Heidegger’s reflections on the origin of the work of art complement Gadamer’s phenomenological account of the work of art’s mode of being. The truth expressed by a work, I accordingly argue, is one that it alone exemplifies. For a phenomenological hermeneutics of music, music’s communicability of feelings and moods to which it gives voice is consequently the spring of its worlding power. (shrink)

If within the borders of human life the truth is, as Vico has said, what is made, then the task of a student of human life can be and should be to find out from what human beings have made what manner of makers they are and what sorts of production their circumstance allows.