Better health requires sectors like housing and education, and healthcare, to collaborate. That needs three strategies. Make full use of waivers to foster experimentation. Use techniques to encourage agencies at all levels to work together. And use new incentives to foster local partnerships.

In this paper I present both a critical appraisal of Humphreys' probabilistic theory of causality and a sketch of an alternative view of the relationship between the notions of probability and of cause. Though I do not doubt that determinism is false, I claim that the examples used to motivate Humphreys' theory typically refer to subjective rather than objective chance. Additionally, I argue on a number of grounds that Humphreys' suggestion that linear regression models be used as a canonical form (...) for the description of causal relations is untenable. I conclude by exploring the variety of ways in which probabilistic elements can be embedded into the structure of causal mechanisms. This investigation suggests both that deterministic mechanisms can produce stochastic behavior and stochastic mechanisms can produce deterministic behavior. Note: Link is to the article in a subscription database available to users affiliated with Butler University. Appropriate login information will be required for access. Users not affiliated with Butler University should contact their local librarian for assistance in locating a copy of this article. (shrink)

Individual choice and freedom are repeatedly invoked in contemporary policy debates, including those with a focus on risk behaviors such as smoking and health insurance coverage. The idea of making the right choice with regard to health and well-being has been fortified by the neoliberal discourse of self-reliance, personal autonomy, and responsibility. This neoliberal view, stemming from the conceptualization of freedom of philosopher John Stuart Mill justifying the freedom of the individual in opposition to unlimited state control, holds that (...) success, good health, and favorable educational outcomes are largely due to individual effort. Correspondingly, so too is failure, including failure of.. (shrink)

This is the first dictionary dedicated to the work of Jean Baudrillard. It explains and contextualises more than a hundred key concepts, terms, influences and topics within his thought. An essential reference for students and scholars of Baudrillard, it also serves as an authoritative overview of how his ideas have shaped a broad range of disciplines, from art, architecture, film and photography to sociology, philosophy, human geography, media studies and cultural studies. The entries are written by 35 leading Baudrillard specialists (...) from around the world, including Rex Butler, Mike Gane, Gary Genosko, Victoria Grace, Diane Rubenstein and Andrew Wernick. (shrink)

Este artículo revisita el concepto de exterior constitutivo, inspirado por el pensamiento de Jacques Derrida y consolidado por Henry Staten. Para ello, se recuperan ideas de ambos autores, además de analizar aportaciones de otros como Ernesto Laclau, Chantal Mouffe, Judith Butler y Stuart Hall, quienes se valen del concepto para producir un viraje al esencialismo y constructivismo que ha cercado el estudio de las identidades colectivas. Laclau y Mouffe muestran cómo el exterior disloca lo que es materia de (...) afirmación y mantiene en desequilibrio las fronteras simbólicas que prefiguran las identidades. Butler involucra procesos de abyección y repudios fundacionales que contornean las ideas de “yo” que se fabrican por vías de la interdicción. Hall muestra la codependencia del Otro, quien actúa como correlato de cualquier idea de identidad. Se concluye que las identidades trabajan por exclusión y que, en el plano de formación docente, se censuran ciertos sujetos y posiciones. (shrink)

E-patients are increasingly using the Internet to gain knowledge about medical conditions, thereby problematizing the biomedical assumption that patients are ‘lay’. The present paper addresses this development by investigating the epistemic identities of patients participating on an online health forum. Using poststructuralist discourse analysis to analyze a corpus of cardiology-related threads on an ‘Ask a Doctor’ forum, we compare how patients are discursively constructed by online professionals as ‘knowing’ or ‘not knowing’ with the online knowledge identities patients choose for themselves. (...) Analysis reveals a complex picture, with patients positioning themselves and being constructed as biomedical novices, as well as claiming the subject positions of experts challenging medical expertise. This paper provides a snapshot of an important social identity in transition, illustrates a procedure for comparing language use around imposed and self-appropriated identities, and considers discursive choice in relation to the metapragmatic matter of “sayability”. (shrink)

This paper addresses the question of whether mental representations are compositional. Several researchers have claimed recently that there are empirical data that show mental representations to be context-sensitive in a way that threatens compositionality. Some have then gone on to claim that connectionist encoding schemes are well suited to accommodate such noncom-positionality. I argue here that the data do not show that mental representations are noncompositional, and that there are significant problems with the suggested interpretations of connectionist encoding schemes.

In this article my aim is to see Karl Llewellyn as a member of the central pragmatist canon. Further, I see Llewellyn not only as a “Legal Pragmatist,” but also as developing a full pragmatist philosophy of law. Reading Llewellyn as a pragmatist would greatly add to an extended understanding of early pragmatism. This would show a strong influence of pragmatic thought within the legal academy.. Second, adding Llewellyn to the pragmatist canon would help show pragmatism in action in the (...) world. Llewellyn might be the central theoretical pragmatist of modern US Law. If, as I believe, pragmatism is a philosophy that depends upon an underlying experimentalist attitude towards philosophizing, given his great influence on US law adding Llewellyn brings a large amount of experimentalist data to the tradition. (shrink)

Furthermore, adults with decision-making capacity, including pregnant women, can currently accept interventions with moderate net risks for themselves in other settings (e.g., open f...

Against the background assumptions that knowing what clinical ethics consultation represents to those with whom ethics consultants work most closely is a necessary component for being responsible in the practice of ethics consultation, and the complexities of soliciting and understanding colleague evaluations require another inherent responsibility for the methods by which ethics consultations are evaluated, in this article we report our experience soliciting, analyzing, and trying to understand retrospective evaluations of our Clinical Ethics Consultation Service. These evaluations were collected through (...) a quality assessment effort at our institution. Drawing from the qualitative elements of our survey instrument, we describe unexpected variations among the requests for ethics consultation and the retrospective reports from those colleagues making the requests. Focusing on just one aspect – the reason for request – raised several core questions about how we should evaluate those retrospective reports, what could be learned from the differences that we were now encountering, and what we could learn about the process of evaluating our practices. Working through these questions, we suggest several issues to consider in ongoing efforts to describe and evaluate clinical ethics consultation: the role of time and memory in evaluating retrospective evaluations, the importance of attending to the language of moral shift or disruption with which our colleagues describe their experiences, and how to understand the role of ethics consultation in creating ‘moral space’ for colleagues to process their moral experiences. (shrink)

Foucault only refers to Shakespeare in a few places in his work. He is intrigued by the figures of madness that appear in King Lear, Hamlet, and Macbeth. He occasionally notes the overthrow of one monarch by another, such as in Richard II or Richard III, arguing that “a part of Shakespeare's historical drama really is the drama of the coup d’État.” For Foucault, the first are illustrations of the conflict between the individual and the mechanisms of discipline. The second (...) are, however, less interesting than moments when the sovereign is replaced, not with another sovereign, but with a different, more anonymous, form of power. Yet, in his 1976 Collège de France course, Society Must Be Defended, where he treats the theme at most length, he intriguingly suggests that Shakespearean historical tragedy is “at least in terms of one of its axes, a sort of ceremony, or a rememorialization of the problems of public right.” Foucault was long fascinated by the theatre, and especially its relation to political ceremony. Drawing especially on his 1972 lectures in Paris and a related presentation in Minnesota, this paper asks how we might understand the relation between ceremony, theatre, and politics in Foucault and Shakespeare. Many of Shakespeare's plays, both histories and tragedies, thus demonstrate the importance of ritual and ceremony, a political theatre. Examining the disrupted ceremony of King Lear, the repeated ceremony of King John, the denial of ritual in Coriolanus, and the parody of the ceremonial in Henry IV, Part One opens up a range of historical, theoretical, and political questions. (shrink)

The use of targets to direct public health programmes, particularly in global initiatives, has become widely accepted and commonplace. This paper is an ethical analysis of the utilisation of targets in global public health using our fieldwork on and experiences with voluntary medical male circumcision initiatives in Kenya. Among the many countries involved in VMMC for HIV prevention, Kenya is considered a success story, its programmes having medically circumcised nearly 2 million men since 2007. We describe ethically problematic practices in (...) Kenyan VMMC programmes revealed by our fieldwork, how the problems are related to the pursuit of targets and discuss possible approaches to their management. Although the establishment and pursuit of targets in public health can have many benefits, assessments of target-driven programmes tend to focus on quantifiable outcomes rather than the processes by which the outcomes are obtained. However, in order to speak more robustly about programmatic ‘success’, and to maintain community trust, it is vital to ethically evaluate how a public health initiative is actually implemented in the pursuit of its targets. (shrink)

Categories We Live By makes several claims about Judith Butler's Gender Trouble which Butler seeks to contest, while remaining in fundamental agreement with most of the conclusions in Asta Sveinsdottir's book. At issue is whether or not performativity can rightly be restricted to what is called an exercitive in J. L. Austin's sense, whether Butler is a radical constructivist or a qualified one, and whether unauthorized speech acts have a power to bring a reality into being that (...) is different from those authorized by legal regimes. Along the way, Butler suggest that establishing facts takes place within variable historical schemes and that this argument is neither a denial or facts nor of materiality. Finally, an individualist idea of freedom is subject to criticism in order to make way for an historically constrained freedom, collective in nature. (shrink)

With a mass digitisation programme underway and the addition of non-print legal deposit and web archive collections, the National Library of Scotland is now both producing and collecting data at an unprecedented rate, with over 5PB of storage in the Library’s data centres. As well as the opportunities to support large scale analysis of the collections, this also presents new challenges around data management, storage, rights, formats, skills and access. Furthermore, by assuming the role of both creators and collectors, libraries (...) face broader questions about the concepts of ‘collections' and ‘heritage', and the ethical implications of collecting practices. While the ‘collections as data’ movement has encouraged cultural heritage organisations to present collections in machine-readable formats, new services, processes and tools also need to be established to enable these emerging forms of research, and new modes of working need to be established to take into account an increasing need for transparency around the creation and presentation of digital collections. This commentary explores the National Library of Scotland's new digital scholarship service, the implications of this new activity and the obstacles that libraries encounter when navigating a world of Big Data. (shrink)

Bourdieu's academic work and his political interventions have always proved controversial, with reactions varying from passionate advocacy to savage critique. In the last decade of his career, the French sociologist Pierre Bourdieu became involved in a series of high-profile political interventions, defending the cause of striking students and workers, speaking out in the name of illegal immigrants, the homeless, and the unemployed, challenging the incursion of the market into the field of artistic and intellectual production. This new study presents the (...) first sustained critical analysis of the political implications of Bourdieu's sociology. Through a close reading of the political speeches and pronouncements of his later years, Jeremy F. Lane provides a detailed exposition both of Bourdieu's critique of neo-liberalism and of his own political position. Bourdieu's theory of politics is also brought into critical dialogue with the work of a range of other commentators of a broadly Marxist or post-Marxist orientation who have also intervened in such debates - theorists such as Stuart Hall, Ernesto Laclau and Chantal Mouffe, Judith Butler, Slavoj Zizek and Jacques Rancière. The first sustained analysis of Bourdieu's politics - this study will seek to assess the validity of his claims as to the distinctiveness and superiority of his own field theory as a tool of political analysis. It will be of great use to students, and researchers in sociology, social theory; cultural studies, French studies and political science. (shrink)

Over the past few years, a growing number of people have called for reconceptualizing participation in health research as a moral obligation. John Harris argues that seriously debilitating diseases give rise to important needs, and since medical research is necessary to relieve those needs in many circumstances, people are morally obligated to act as research subjects.1 Rosamond Rhodes claims that research participation is a moral obligation for reasons of justice, beneficence, and self-development: because we all benefit significantly from modern medicine, (...) we are all required to do our part in advancing the state of medical knowledge.2 Individuals who reap the benefits of medical knowledge without contributing .. (shrink)

Working within the tradition of continental philosophy, this article argues in favour of a phenomenological understanding of language as a crucial component of bioethical inquiry. The authors challenge the ‘commonsense’ view of language, in which thinking appears as prior to speaking, and speech the straightforward vehicle of pre-existing thoughts. Drawing on Maurice Merleau-Ponty's (1908–1961) phenomenology of language, the authors claim that thinking takes place in and through the spoken word, in and through embodied language. This view resituates bioethics as a (...) matter of bodies that speak. It also refigures the meaning of ethical self-reflexion, and in so doing offers an alternative view on reflexivity and critique. Referring to the Kantian critical tradition and its reception by Hannah Arendt and Michel Foucault, we advance a position we call ‘critical ethical reflexivity’. We contend that Merleau-Ponty's phenomenology of language offers valuable insight into ethical reflexivity and subject formation. Moreover, his understanding of language may foster new qualitative empirical research in bioethics, lead to more nuanced methods for interpreting personal narratives, and promote critical self-reflexion as necessary for bioethical inquiry. (shrink)

The concept of social structure is ill defined in the literature despite the perennial problem and ongoing discussion about the relationship between agency and structure. In this paper I will provide an outline of what the term social structure means, but my main focus will be on emphasizing the value of the concept for nursing research and demonstrate how its erasure in some research negatively effects on our understanding of the nurses' role in clinical practice. For example, qualitative research in (...) nursing has largely focused on agency through such theories as phenomenology, hermeneutics, and symbolic interactionism. The result is that social structure may be erased or seen as epiphenomena of agency. My purpose is to provide a theoretical discussion of social structure and how such a discussion can help us to understand how nurses live and experience clinical practice. While not denying the importance of agency, I will argue that the thinned out approach to social structure places limits on our understanding of the constraints nurses experience in their working lives. The result is that nurses' attitudes and clinical failings are individualized, resulting in ever more calls for improved education, when a more thorough examination of structural issues may elucidate more fundamental problems. (shrink)

(2001). Activities, Not Rules: The Need for Responsive Practice (On the Way Toward Responsibility) The American Journal of Bioethics: Vol. 1, No. 4, pp. 52-54.

The unlivable is the most extreme point of human suffering and injustice. But what is it exactly? How do we define the unlivable? And what can we do to prevent and repair it? These are the intriguing questions Judith Butler and Frédéric Worms discuss in a captivating dialogue situated at the crossroads of contemporary life and politics. Here, Judith Butler criticizes the norms that make life precarious and unlivable, while Frédéric Worms appeals to a "critical vitalism" as a (...) way of allowing the hardship of the unlivable to reveal what is vital for us. For both Butler and Worms, the difference between the livable and the unlivable forms the critical foundation for a contemporary practice of care. Care and support, in all their aspects, make human life livable, that is, "more than living." To understand it, we must draw on the concrete practices of humans who are confronted with the unlivable: the refugees of today and the witnesses and survivors of past violations and genocide. They teach us what is intolerable but also undeniable about the unlivable, and what we can do to resist it. Crafted with critical rigor, mutual respect, and lively humor, the compelling dialogue transcribed and translated in this book took place at the École Normale Supérieure (ENS) on April 11, 2018, at a time when close to two thousand migrants were living in nearby makeshift camps in northern Paris. The Livable and the Unlivable showcases this 2018 dialogue in the context of Butler's and Worms's ongoing work and the evolution of their thought, as presented by Laure Barillas and Arto Charpentier in their equally engaging introduction. It concludes with a new afterword that addresses the crises unfolding in our world and the ways a philosophically rigorous account of life must confront them. While this book will be of keen interest to readers of philosophy and cultural criticism, and those interested in vitalism, new materialism, and critical theory, it is a far from merely academic text. In the conversation between Butler and Worms, we encounter questions we all grapple with in confronting the distress and precarity of our times, marked as it is by types of survival that are unlivable, from concentration camps to prisons to environmental toxicity, to forcible displacement, to the Covid pandemic. The Livable and the Unlivable at once considers longstanding philosophical questions around why and how we live, while working to retrieve a philosophy of life for today's Left. (shrink)

Computationalism, the notion that cognition is computation, is a working hypothesis of many AI researchers and Cognitive Scientists. Although it has not been proved, neither has it been disproved. In this paper, I give some refutations to some well-known alleged refutations of computationalism. My arguments have two themes: people are more limited than is often recognized in these debates; computer systems are more complicated than is often recognized in these debates. To underline the latter point, I sketch the design and (...) abilities of a possible embodied computer system. (shrink)

Bourdieu is an important thinker within the sociological tradition and has a philosophically sophisticated approach to theoretical knowledge and research practice. In this paper, we examine the implication of his work for nursing and the health sciences more broadly. We argue that his work is best described as a reflexive realist who provides a space for a nonpositivist approach to knowledge that does not fall into the trap of idealism or relativism. We emphasize that Bourdieu was not an abstract theorist, (...) but only utilized theories to understand and explain the social world in all its empirical complexity. Theory is emphasized over method without denying the importance of method. We then provide a brief overview of some of his key concepts: habitus, field and capital. His work is a scientifically astute practice that has an emancipatory purpose, with particular resonance to the problems of nursing as a social practice. Some have criticized Bourdieu for undermining agency and we briefly address this issue, but argue that his conceptual framework helps us to understand what endures in social practice and why change is often problematic. In short, this paper argues that Bourdieu's work is a fruitful resource for critiquing existing nursing approaches that are preoccupied with agency over structure. (shrink)

A standard view would suggest that research is a neutral apolitical activity. It neutralizes external pressures by its fidelity to robust scientific methods. However, politics is an inevitable part of human knowledge. Our knowledge of the world is always mediated by human priorities. What matters is therefore a contested and political debate rather a neutral accumulation of factual data. How researchers manage this varies. Research paradigms are one way in which research engages with knowledge. They frame knowledge within epistemological and (...) ontological philosophies. In this paper, I will explore this view in relation to neo‐positivism, qualitative research, Foucault and critical realism. I will argue that if nursing knowledge is to be effective it needs to acknowledge the political, particularly in the context of neoliberalism. Healthcare systems are having to cope with a social world increasingly dominated by market fundamentalism, extreme levels of inequality and a rise in xenophobia. These forces are undermining the provision of ethically sound health care, misdirecting research practice and contributing to a discourse of dehumanization. These forces need to be challenged politically and I will argue that epistemologically diverse approaches, alongside a realist ontology can provide a way forward for nursing research. (shrink)

The author examines concepts of real time and real-time in relation to notions of perception and processes of sonification. He explores these relationships in three case studies and suggests that sonification can offer a form of reconciliation between ontology and phenomenology, and between ourselves and the flux we are part of.

Few could disagree with the starting premise in, “Strangers at the Benchside: Research Ethics Consultation” (Cho et al. 2008). Over the past 40 years, the efforts for addressing the breadth and dep...

BackgroundCentral to ethically justified clinical trial design is the need for an informed consent process responsive to how potential subjects actually comprehend study participation, especially study goals, risks, and potential benefits. This will be particularly challenging when studying deep brain stimulation and whether it impedes symptom progression in Parkinson’s disease, since potential subjects will be Parkinson’s patients for whom deep brain stimulation will likely have therapeutic value in the future as their disease progresses.MethodAs part of an expanded informed consent process (...) for a pilot Phase I study of deep brain stimulation in early stage Parkinson’s disease, an ethics questionnaire composed of 13 open-ended questions was distributed to potential subjects. The questionnaire was designed to guide potential subjects in thinking about their potential participation.ResultsWhile the purpose of the study (safety and tolerability) was extensively presented during the informed consent process, in returned responses 70 percent focused on effectiveness and 91 percent included personal benefit as potential benefit from enrolling. However, 91 percent also indicated helping other Parkinson’s patients as motivation when considering whether or not to enroll.ConclusionsThis combination of responses highlights two issues to which investigators need to pay close attention in future trial designs: (1) how, and in what ways, informed consent processes reinforce potential subjects’ preconceived understandings of benefit, and (2) that potential subjects see themselves as part of a community of Parkinson’s sufferers with responsibilities extending beyond self-interest. More importantly, it invites speculation that a different paradigm for informed consent may be needed. (shrink)

During vertebrate limb development, various genes of the Hox family, the products of which influence skeletal element identity, are expressed in specific spatiotemporal patterns in the limb bud mesenchyme. At the same time, the cells also exhibit ‘self‐organizing’ behavior – interacting with each other via extracellular matrix and cell‐cell adhesive molecules to form the arrays of mesenchymal condensations that lead to the cartilaginous skeletal primordia. A recent study by Yokouchi et al.(1) establishes a connection between these phenomena. They misexpressed the (...) product of the Hoxa‐13 gene in chick limb buds and demonstrated both skeletal pattern perturbations and changes in cell‐cell adhesivity in mesenchyme aberrantly expressing this protein. (shrink)

Are the characteristics and relationships among spatio-temporal entities "real" or are they simply conventional terms that note similarities among things in the world but lack any reality of their own? Or if they are real, what sort of reality do they have? Do we live in a world of causes and effects, or is this relation a useful contrivance for our convenience? What is the nature of this "I" that we invoke when referring to ourselves? Is it body? Mind? Both? (...) Neither? And once its nature is understood, what can be said of the choices it makes? Are they really ours, freely made by an independent will? Or is each choice determined more by the internal makeup of the "I" we happen to be and the social/environmental circumstances in which this "I" finds itself, rather than by any act of will? But if each of us "could not have chosen otherwise" than we have, are we no better than the machines we construct? Then again, maybe some of our more advanced machines should be considered conscious entities? Introduction to Metaphysics: The Fundamental Questions presents these and other intriguing questions, many of which have challenged philosophers from antiquity to the present in their efforts to speculate on the nature of what is real. Often filled with twists and turns, dark corners and hidden recesses, this journey of discovery is an exciting excursion into the depths of human understanding. As guides for this intellectual journey editor Andrew Schoedinger has chosen an impressive array of creative and thought-provoking philosophers: Peter Abelard, Aristotle, Renford Bambrough, George Berkeley, Joseph Butler, Rudolf Carnap, Roderick Chisholm, R.G. Collingwood, Arthur Danto, Donald Davidson, Rene Descartes, C.J. Ducasse, Alvin I. Goldman, Keith Gunderson, David Hume, John Locke, Alasdair MacIntyre, A.I. Melden, John Stuart Mill, D.F. Pears, Hilary Putnam, Anthony Quinton, Bertrand Russell, Michael Scriven, Sydney Shoemaker, P. F. Strawson, Richard Taylor, and others. This volume is a unique invitation to join a distinguished group of theorists as they tackle tough questions concerning the existence of universals, the nature of causation, understanding personal identity, the tangled web of free will, and the challenges posed by the advent of artificial intelligence. (shrink)