Cet entretien réalisé le 30 novembre 1999 à Paris présente l’évolution de la philosophie de Michel Henry, depuis L’essence de la manifestation jusqu’à l’Incarnation. Il s’agit de présenter le projet, la place et la centralité de L’essence de la manifestation dans l’œuvre de M. Henry, puisque c’est dans cet ouvrage qu’il a mis au jour les présuppositions de sa phénoménologie de la vie et de l’intériorité subjective, présuppositions qu’il fera travailler dans tous les ouvrages qui lui succéderont, ceci (...) jusqu’à L’incarnation. Elle s’oppose à une phénoménologie du monde, de l’extériorité et de l’objectivité. Son concept central, celui de chair, pense la matière affective du Soi, c’est-à-dire du corps subjectif. Il est inséparable d’une thèse : à savoir que la corporéité (rapport au corps) est antérieure à l’intentionnalité (rapport au monde). Une phénoménologie du corps subjectif est donc apte à saisir la vie dans son immanence. Elle conduit à une archéologie de la chair dans l’Incarnation, analyse de la matière constituante de la vie qui précède et habite toute intentionnalité. (shrink)

L’essence de la manifestation semblait laisser dans l’ombre le problème du corps pourtant appelé par la critique de la subjectivité purement formelle. La lecture de l’Essai sur l’ontologie biranienne, initialement destiné à constituer un chapitre de la célèbre thèse de Michel Henry, venait éclairer par la..

French end-of-life law aims at protecting patients from unreasonable treatments, but has been used to force caregivers to prolong treatments deemed unreasonable. We describe six cases (five intensi...

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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Daniel Susskind examines how machines will generate more prosperity, but he is convinced that their proliferation will have some alarming consequences, like higher income inequality, dangerous greed for power to control others, and a world in which people lose their sense of meaning in life for lack of work.

Can we sustain the idea, once expressed by Henri Poincaré, that science and values only touch but do not interpenetrate? Isn’t such an idea nothing more than an idealization? Is there no link between science and genuine human flourishing?

Cet ouvrage vise à montrer comment la méthodologie de corpus fait fructifier plusieurs domaines linguistiques. Il importe donc de démontrer les liens entre les outils, les méthodes et les analyses. Comme le titre l’indique clairement, l’approche adoptée se veut inductive (corpus-driven) et écologique. Autrement dit, le corpus y est utilisé comme point de départ pour élaborer une théorie linguistique et les données sont authentiques tant dans leur origine que dans leur traitement. Le volume se...

An attempt is made to give a coherent account of the logical essence of the Copenhagen interpretation of quantum theory. The central point is that quantum theory is fundamentally pragmatic, but nonetheless complete. The principal difficulty in understanding quantum theory lies in the fact that its completeness is incompatible with external existence of the space—time continuum of classical physics.

The original text, written in the language and style of 1909, is almost completely unreadable in 2011. I have taken the liberty of editing it and paraphrasing it for the sake of readability; I have made every effort to preserve the author’s original meaning. Section headings and tables have been added by Prof. Steinhart. Note that Figure 1 is by Adams.

In lieu of an abstract, here is a brief excerpt of the content:Kant's Critique of Berkeley HENRY E. ALLISON THE CLAIMTHAT KANT'S IDEALISM,or at least certain strands of it, is essentially identical to that of Berkeley has a long and distinguished history. It was first voiced by several of Kant's contemporaries such as Mendelssohn, Herder, Hamann, Pistorius and Eberhard who attacked the alleged subjectivism of the Critique of Pure Reason. 1 This viewpoint found its sharpest contemporary expression in the (...) notorious Garve-Feder review to which Kant responded at length in the Prolegomena. In subsequent times it has been championed by Schopenhauer, and most nineteenth century German commentators on the relation between the two philosophers. 2 In addition, it has been, and continues to be, the prevailing view of the vast majority of British writers on Kant, including, with significant qualifications, Norman Kemp Smith. 3 This tradition continues despite the fact that Kant specifically, and in no uncertain terms, repudiated this identification in the Prolegomena and the second edition of the Critique. In both works he responds to the charges of subjectivism, and in so doing distinguishes his position from that of Berkeley, who in the eighteenth century was commonly regarded as a solipsist and denier of the "external world." 4 In contra-distinction to Kant's own critical or transcendental idealism, which explains the possibility of synthetic a priori knowledge within the realm of possible experience, Berkeley is characterized as a "dogmatic" or "visionary idealist." He is judged guilty of "degrading bodies to mere illusion" (B69), of regarding things in space as "merely imaginary entities" (B274), and of holding with all "genuine idealists" that: "all knowledge through the senses and experience is i Cf. Hans Vaihinger, Commentar zu Kant's Kritik der Reinen Vernunft (Stuttgart, Berlin, Leipzig, 1892), II, 494-505. Cf. Friederich Fredericks, Der Phainomenale Idealisraus Berkeley's und Kant's (Berlin, 1871); Robert Zimmerman, "Ober Kant's Widerlegung des Idealismus yon Berkeley" (Sitzungsberichte der Akademie der Wissenschaften, Vienna, Philox.-hist. Kl.), LXVIII (1871); Gustav Dieckert, tiber dos Verhiiltnis des Berkeleyschen ldealismus zu Kantischen Vernun]tkritik (Konitz, 1888). Tiffs is a consequence of the general British tendency to view Kant in phenomenalist terms. A typical recent example is found in P. F. Strawson, The Bounds of Sense (London, 1966). Kemp Smith in his Commentary to Kant's Critique o[ Pure Reason (2nd ed., rev., 1923) takes greaZ pains to distinguish between the subjectivist strand in Kant's thought, which is essentially identical to Berkeley's position, and the genuine critical doctrine which stands side by side with it in the text. 9 Cf. I-I.M. Bracken, The Early Reception of Berkeley's Materialism 1710-1733, rev. ed. (The Hague: Martinus Nijhoff, 1965). [43] 44 HISTORY OF PHILOSOPHY nothing but sheer illusion, and only in the ideas of pure understanding is there truth" (374). 5 One of the chief reasons for the continuation of the Kant-Berkeley tradition is that these, and similar statements about Berkeley, which we find in these works and in Kant's correspondenc e with Beck, have not been taken very seriously by Kant's critics. They are usually dismissed as obvious misinterpretations, due to Kant's ignorance of Berkeley's actual writings, and of his reliance upon distorted second and third hand accounts of Berkeley's thought such as is to be found in Beattie. Furthermore, this view is often supported by the philological reflection that Kant did not read English, and that Berkeley's writings were not yet available in German translation. 6 The philological argument, however, loses much of its force when we consider that there was indeed a German translation of Berkeley's Dialogues, which although apparently unknown to nineteenth century scholars, was readily accessible to Kant. This is to be found, together with a translation of Collier's Clavis Universalis and critical analyses, in a work by the professor of philosophy at Rostock, Johann Christian Eschenbach, entitled: Samlung der vornehmsten Schri[tsteller die die tFirklichkeit ihres eignen K~rpers und der ganzen Ki~rperwelt leugnen (Rostock, 1756). Furthermore, in addition to this work, which was probably known to Kant, there is Berkeley's important Latin work, De Motu (1721), as well as French translations of many of... (shrink)

achieved by the actions of a single animal. The concerted activity is coordinated by a multiplicity of cues and signals diffused between groups of ...

The philosophy of quantum mechanics has often been conceived by physicists as a collection of dogmas concerning what can be measured, observed and known. To this branch of dialectics the present paper does not attempt to contribute, chiefly because it is written from the conviction that no part of science, nor any philosophy, can safely predict what may be feasible or knowable. Rather, this brief essay endeavors to expose the epistemology of quantum physics in a way which allows it to (...) be recognized as an extension of the ordinary processes of cognition, as the continuation of a line which starts in sensory perception, leads straight through the methods of classical physics into quantum mechanics and shows no signs of terminating even there. (shrink)

Henry Shue,Aude Bandini | : Au vu de l’indolence, voire de l’impavidité dont témoignent les approches qu’ont adoptées la plupart des pays du monde à l’égard du changement climatique, il semble n’y avoir guère d’urgence. La question est de savoir en quoi cela pose problème, si problème il y a. À cela, je réponds que tout, là-dedans, pose problème et, plus précisément, qu’on peut y voir autant une violation des droits fondamentaux que le signe qu’une occasion en or de (...) protéger ces droits a été ratée. Il est, au contraire, urgent d’agir sur deux fronts convergents. Tout d’abord, il faut faire baisser les émissions, nettement et résolument. La concentration de carbone dans l’atmosphère ne cessera pas de croître tant que l’on n’aura pas ramené les émissions à zéro. Ensuite, il faut que l’on développe des technologies utilisant des sources d’énergie alternatives aussi rapidement qu’il est humainement possible de le faire. Parvenue à ce point, l’humanité pourrait se sortir d’affaire, si du moins nous n’avons pas émis la billionième tonne d’ici là. | : The desultory, almost leisurely approach of most of the world’s national states to climate change rejects no detectable sense of urgency. My question is what, if anything, is wrong with this persistent lack of urgency. My answer is that everything is wrong with it and, in particular, that it constitutes a violation of basic rights as well as a failure to seize a golden opportunity to protect rights. Instead, action is urgent on two converging fronts. First, carbon emissions need to be cut back sharply and aggressively. The atmospheric concentration of carbon will not stop growing until emissions are zero. Second, alternative energy technologies need to be developed as quickly as humanly possible. At that point, humanity might be out of the woods, provided that we have meanwhile not emitted the trillionth metric ton. (shrink)

Under the guidance of Professor Veatch, Aristotle stands forth again as the philosopher who, above all, speaks simply and directly to the common sense of all ...

John Searle begins his recent article “Dualism Revisited” by stating his belief that the philosophical problem of consciousness has a scientific solution. He then claims to refute dualism. It is therefore appropriate to examine his arguments against dualism from a scientific perspective.

Sidgwick reviews what he regards as a thorough, but ultimately unsuccessful, attempt by Leslie Stephen to establish an ethical doctrine that aligns with the theory of evolution. Stephen engages in discussions that fall under three categories. The first is subjective psychology; Stephen analyses from the individual's perspective the kind of consciousness that precedes and determines volition. The second is sociology; his aim here is to develop a positive morality understood as a property of the social organism. The third kind of (...) discussion falls under ethical theory; Stephen's purpose is to determine systematically the ideal code of morality. Although Stephen's work is to be praised for its abundance of pertinent observations and reflections, Sidgwick finds it lacking in ‘clearness of method and systematic arrangement.’. (shrink)

This paper discusses the relationship between the views of James and Royce on representation and their attempts to explain the "possibility of error," views which are, I argue, closer than many have thought. Appreciating where they do differ will point not only to an unstressed problem with Royces' argument for the Absolute but also to some unappreciated features of how James' account of truth ties in with his account of epistemic justification.

This paper argues that, according to James, we are committed to their being a kind of stable consensus, and we are committed to its being one that we can recognize ourselves in, but by underwriting such regulative ideals through a ‘will to believe’ rather than a transcendental argument, we make our commitment to their being an end of inquiry a practical rather than theoretical one. Objectivity is something we are committed to making, not something that we are committed to their (...) already being out there to find. There is thus no limit we are approaching that is independent of our approach. Pragmatism is thus a position between Realism and Subjectivism because it takes it as unsettled which story will ultimately hold for us. Subjectivism may reign even after we do our best, but we might be able to do better, and if we can, it is incumbent upon us to do so. (shrink)