Fifty years ago, in 1961, Feinstein published his first path-breaking articles leading to his seminal work Clinical Judgement and to the establishment of clinical epidemiology. Feinstein had an Aristotelian approach to scientific method: methods must be adapted to the material examined. Feinstein died 10 years ago and few years before his death he concluded that efforts to promote a person-oriented medicine had failed. He criticised medicine for not having recognized that only persons can suitably observe, evaluate and rate their own (...) health status. Feinstein’s position was—as in Clinical Judgement—methodological. He didn’t espouse ethical principles. He pointed to methodological deficiencies in clinical epidemiology and evidence-based medicine. In this article we’ll provide a framework for understanding and justifying Feinstein’s call for a person-oriented medicine which recognizes patients as co-actors in clinical reasoning. It’s argued that craftsmanship and practical wisdom are integrated in clinical judgement and reasoning and that clinical reasoning is not only about means to achieve the end, health. We do also reason and deliberate about ends. The ‘defining end’ of medicine (health) has continuously been negotiated and so been the object of deliberation. For centuries among professionals, in recent years among professionals and patients. These negotiations and deliberations lead to ongoing specifications of health as a ‘guiding end’, i.e. an end guiding clinical reasoning about what to do in particular situations. Feinstein’s self-critical account to clinical epidemiology at the end of his professional career reflects the fact that patients during the last 30–40 years (i.e. in the period after the publication of Clinical Judgement) widely have been recognized as persons with rights to autonomy. Feinstein’s lesson is, however, that espousing and recognizing ethical ideals is not enough. A change of clinical practice and its methods is necessary. His critique also implies that clinical epidemiology and evidence-based medicine as practiced haven’t provided such a turn. (shrink)

Requirement‐sensitive legal moralism is a species of legal moralism in which the legitimacy of turning moral into legal demands depends on the existence of a legitimate moral requirement, producing a legitimate social requirement, which can then ground a legitimate legal requirement. Crucially, each step is defeasible by contingent or instrumental, but not intrinsic moral factors. There is no genuinely moral sphere (e.g., a private sphere) in which the law is not to interfere; only contingent, non‐moral factors can defeat this. Using (...) William A. Edmundson's Three Anarchical Fallacies as a foil, this idea is spelled out; it is shown why considerations based on the harm principle, consent, and the fact of pluralism do not immediately defeat it, but several problems with Edmundson's account are examined to point out where the idea could be further developed. (shrink)

In recent literature, there has been much debate about whether and how luck egalitarianism, given its focus on personal responsibility, can justify universal health care. In this paper we argue that, whether or not this is so, and in fact whether or not egalitarianism should be sensitive to responsibility at all, the question of personal responsibilization for health is not settled. This is the case because whether or not individuals are responsible for their own health condition is not all that (...) is relevant when considering whether we should somehow hold them responsible for their own health condition, e.g. cost-wise. There may also be efficiency-based reasons to hold them responsible, and there may even be egalitarian reasons. Defining universal health care as an insurance system where everyone’s deductible and premium is 0, we will argue that efficiency-based reasons for cost-responsibilization are not convincing, but that there are egalitarian reasons for cost-responsibilization. Luck egalitarianism, therefore, cannot, at least not on its own term, justify universal health care. (shrink)

BackgroundDementia care is essential to promote the well-being of patients but remains a difficult task prone to ethical issues. These issues include questions like whether manipulating a person with dementia is ethically permissible if it promotes her best interest or how to engage with a person who is unwilling to recognize that she has dementia. To help people living with dementia and their carers manage ethical issues in dementia care, we developed the CARE intervention. This is an intervention focused on (...) promoting the ethical self-efficacy of people living with dementia and carers, i.e., their confidence that they can manage ethical issues when they occur. The purpose of this paper is to explain and discuss how we have developed the CARE intervention to promote the ethical self-efficacy of people living with dementia, their family, and professional carers through a specific and, we believe, new use of literary texts.MethodsThe CARE intervention has been developed in two phases: First, we conducted a needs assessment of the occurrence of ethical issues in dementia care and the need for an intervention to support people living with dementia and their carers in managing such issues. Second, in a design phase, we developed the CARE intervention to meet identified needs.ResultsTo address identified ethical issues in dementia care we designed the CARE intervention as a workshop format where people living with dementia and carers can meet, discuss literary texts, and deliberate on how to solve such issues. The workshop is structured by the following elements: An agenda of ethical issues, a collection of literary cases exemplifying ethical issues, a moderator with an understanding of dementia care, and an overview of the ethical principles relevant to the discussion of ethical issues. >This workshop concept is operationalized in three applications tailored to meet the specific ethical issues of each of the study´s three target groups: people living with dementia and family carers, professional and family carers, and professional carers.ConclusionWe conclude the paper by stating that it is possible to develop an intervention that promotes the ethical self-efficacy of people living with dementia and family and professional carers. (shrink)

On history of Buddhist philosophy; contributed articles.

1.1. Universitet. Chto on myslit? -- 1.2. Universitet. Chto on mozhet? -- 1.3. ... i chego ne mozhet? -- 2.1. Nauka. Zachem ėto nuzhno? -- 2.2. Obrazovanie. Kakoe obrazovanie? -- 2.3. Akademicheskie vobody. Dli︠a︡ chego? -- Zakli︠u︡chenie -- Chto pochitatʹ ob Universitete?

Scholarly papers by Gėlėgzhamt︠s︡yn Luvsant︠s︡ėrėn on Mādhyamika, Buddhist philosophy, Mongolian philosophy and Buddhist studies in Mongolia.

The topic of biopolitics is a timely one, and it has become increasingly important for scholars to reconsider how life is objectified, mobilized, and otherwise bound up in politics. This cutting-edge volume discusses the philosophical, social, and political notions of biopolitics, as well as the ways in which biopower affects all aspects of our lives, including the relationships between the human and nonhuman, the concept of political subjectivity, and the connection between art, science, philosophy, and politics. In addition to tracing (...) the evolving philosophical discourse around biopolitics, this collection researches and explores certain modes of resistance against biopolitical control. Written by leading experts in the field, the book’s chapters explore resistance across a wide range of areas: politics and biophilosophy, technology and vitalism, creativity and bioethics, and performance. Resisting Biopolitics is an important intervention in contemporary biopolitical theory, looking towards the future of this interdisciplinary field. (shrink)

The Casimir force between two neutral metallic plates is often considered conclusive evidence for the reality of electromagnetic zero-point fluctuations in ‘empty space’. However, it is not well known that the Casimir force can be derived from many different points of view. The purpose of this note is to supply a conceptually oriented introduction to a representative set of these different interpretations. The different accounts suggest that the Casimir effect reveals nothing conclusive about the nature of the vacuum.

The Casimir force between two neutral metallic plates is often considered conclusive evidence for the reality of electromagnetic zero-point fluctuations in 'empty space' (i.e. in absence of any boundaries). However, it is not well known that the Casimir force can be derived from many different points of view. The purpose of this note is to supply a conceptually oriented introduction to a representative set of these different interpretations. The different accounts suggest that the Casimir effect reveals nothing conclusive about the (...) nature of the vacuum. (shrink)

Ayn Rand's first novel, We the Living, offers an early form of the author's nascent philosophy—the philosophy Rand later called Objectivism. Robert Mayhew's collection of entirely new essays brings together pre-eminent scholars of Rand's writing. In part a history of We the Living, from its earliest drafts to the Italian film later based upon it, Mayhew's collection goes on to explore the enduring significance of Rand's first novel as a work both of philosophy and of literature.