For many years, some urban architecture has aimed to exclude unwanted groups of people from some locations. This type of architecture is called “defensive” or “hostile” architecture and includes benches that cannot be slept on, spikes in the ground that cannot be stood on, and pieces of metal that hinder one’s ability to skateboard. These defensive measures have sparked public outrage, with many thinking such measures lead to suffering, are disrespectful, and violate people’s rights. In this paper, it is argued (...) that these views are difficult to defend and that much more empirical research on the topic is needed. (shrink)

Can poetry be Diasporic? Can poetry free itself from the shackles of conformism? Can it be independent and divergent, and not seek a home? Is it capable of mustering its inner strengths and living without being enlisted by a collective that accords it power? This article argues that poetry is essentially dialectic. It has little vitality without the presence of the Other, without interaction with him. However, it also contains independent, personal elements and reaches its peak through the individual’s (...) class='Hi'>anti-conformist activity and expression. Poetry, like language, enables us to view ourselves from outside, thereby fulfilling an important role, similar to language itself, and it is created by the individual’s alienation even from himself. Poetry may provide one of the most creative potential tools of Diasporic philosophy, love and creativity being its cornerstones, but it can also be a destructive factor seeking to imprison the creative soul within a home with the solid walls of a rigid community. (shrink)

This paper investigates the political dimension of Fritz Mauthner’s writings in respect to his language critique and his ambivalent relationship to Judaism. Its aim is to oppose the common understanding of Mauthner as a German-nationalist. For doing so, Mauthner’s relation to Judaism is contextualised within his philosophical views on patriotism, mother-tongue, and the formation of social communities. By suggesting an anti-nationalist interpretation of his philosophy, it is argued that participation in a certain linguistic practice can explain what it means (...) to belong to a certain community according to Mauthner. The paper discusses to what extent Mauthner’s writings can be interpreted as anti-nationalist and concludes that he is too contradictory to be understood distinctively as a nationalist or an anti-nationalist. (shrink)

We are often conceived as cognitively at home with conditions that are luminous in roughly the sense that whenever they obtain we know or are in a position to know that they obtain; mental states such as feeling cold or pain are often thought to provide examples of luminous conditions. This chapter argues that there are no non‐trivial luminous conditions, and therefore that we suffer from a kind of cognitive homelessness. The argument involves consideration of gradual processes in which small (...) changes are below our level of discrimination. It is related to, but not the same as, sorites paradoxes, for example about how many grains make a heap. The result provides the basis for an objection to the attempt that Michael Dummett has made to characterize linguistic meaning in terms of assertability rather than truth. (shrink)

In 1988, the California state legislature passed the California Street Terrorism Enforcement and Prevention Act, which allowed courts to “enhance” the sentences of offenders who have been proven to "promote, further, or assist in any criminal conduct by gang members." It bundled together criminality, policing, and incarceration in ways that drew upon the fears of the black/latino Others that were imminent in panics surrounding the “crack epidemic” and inner-city crime. Jumping to April 2016, the Salvadoran government has passed strikingly similar (...) legislation, which centers on reclassifying gang-associated crimes as terroristic; in essence under their new laws gang affiliation is a terrorist. This, too, has been enacted in the midst of panic about gang violence and low-level warfare between gangs and the Salvadoran state. The adoption of US-style anti-gang approaches by the Salvadoran government is not new. In 2003, the right-wing government passed mano dura [“iron fist”] policies that sought to address increases in gang associate crime with zero-tolerance, tough-on-crime measures. Law enforcement received expanded leeway to target and arrest gang members, especially those from Mara Salvatrucha 13 and Barrio 18. Despite the lack of sustained reductions in violent crime, the mano dura policies have remained and will only be exacerbated by the new legislation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:World Alienation in Feminist ThoughtThe Sublime Epistemology of Emphatic Anti-EssentialismBonnie Mann (bio)The earth is the very quintessence of the human condition.Hannah ArendtWe are tied to place undetachably and without reprieve.Edward CaseyThe alliance between feminism and postmodernism1 in the American academy has brought about a revolution in feminist epistemology. The early feminist epistemology of unmasking, of sorting through appearances to get to the real underneath, has been discredited as (...) "essentialist."2 Feminist standpoint epistemology was an attempt to respond to this accusation by using social location as a "standpoint" from which at least local and situated knowledge could be articulated.3 More recently, many feminists have taken on the epistemology of the simulacrum. Here "the real" plays a part only as that which dissolves into the appearances themselves. Behind the appearances, if there were such a place, would be only an abyss of absence.With this revolution in feminist epistemology comes a wholesale displacement [End Page 45] of the feminist project. Others have argued that the feminist political project is displaced in the alliance with postmodernism.4 On my view, the epistemological and political displacements accompany and instantiate an even deeper level of dispossession. The ultimate price we pay for the feminist alliance with postmodernism may well be a material displacement, in which we are dispossessed of our ability to inquire into and articulate our relationship to the earth itself. We find this planet we inhabit, this physical place that sustains us moment by moment, to be effectively shut out of what now passes as "good" feminist inquiry.In 1958, Hannah Arendt wrote already of "the advent of a new and yet unknown age," marked by world-alienation, a "twofold flight from the earth into the universe and from the world into the self" (1958, 6). The "unknown age" has now been named. Postmodernity takes this flight one step further than Arendt foresaw, however, and even folds the universe and the self into discourse. World-alienation has taken the form of the self-enclosed universe of the text. Our sojourn in the world of signs is so paradigmatic of "the postmodern condition," that asking the question of our relationship to the physical planet we inhabit seems naive and nostalgic. Anything we might say about the earth, after all, is already in language, already bound up in discourse. To speak of an "earth" or "nature" that exceeds discourse is to find oneself locked, even so, within discourse. Having lost our belief in the referentiality of language, in the relation between words and things, we are stuck with signs that refer only to other signs.A capitulation to our very real physical and phenomenological experience of world-alienation finds here its theoretical form. We give in to placelessness. As Edward S. Casey writes, "To say 'I have no place to go' is to admit to a desperate circumstance. Yet we witness daily the disturbing spectacle of people with no place to go: refugees from natural catastrophes or strife-torn countries, the homeless on the streets of modern cities, not to mention 'stray' animals. In fearing that 'the earth is becoming uninhabitable'—a virtual universal lament—we are fearing that the earth will no longer provide adequate places in which to live. The incessant motion of postmodern life in late-capitalist societies at once echoes and exacerbates this fear" (Casey 1993, xiii). Intellectually, we find ourselves in equally desperate circumstances, trapped as we are inside a language that can refer only to itself. This self-enclosure becomes a kind [End Page 46] of no place, a world-alienated space without place,5 and feminist thinking is set adrift from the physical places that give feminist thinkers our moment by moment sustenance. In its alliance with postmodernism, feminism has capitulated to the placelessness that so marks our phenomenological experience at the turn of the millennium.6Yet we inhabit this planet. Faced with its destruction we are compelled to make sense of our relationship to it and to act to save it. A feminist philosophy that turns its back on the earth embraces, rather than contests, the world-alienation of which Arendt spoke. Yet our alienation... (shrink)

Niels Kaj Jerne has proposed the “immune network theory” of interactions among anti‐idiotypic antibodies, able to interfere with humoral responses to certain antigens. After the occurrence of the primary generation of antibodies, against an antigenic epitope, idiotypes of these antibodies induce anti‐idiotypic antibodies that modulate the intensity of the first response, and so on. Adverse effects following SARS‐COV‐2 COVID‐19 vaccines are occasionally similar to the symptoms of COVID‐19 infection. Rare events linked to SARS‐CoV‐2 vaccines also resemble some rarely (...) reported COVID‐19 complications. Safety data from product information by European Medicines Agency suggest that spectra do overlap for four main vaccines. The proposition is that vaccine events and COVID‐19 complications are related to anti‐idiotypic antibodies whose spatial shape can lead to interactions with ACE2 molecules, in individuals with a prolonged Spike protein synthesis. The vaccines target cells by their affinity to the vaccine vector, or to engulf lipid nanoparticles. Anti‐idiotypic antibodies shaped similarly to the Spike protein possibly interact with ACE2 molecules and cause diverse signs and symptoms. (shrink)

How should we understand postphenomenological methodology? Postphenomenology is a research perspective which builds on phenomenological and pragmatist philosophy to explore human–technology relations, but one with open methodological questions. Here, I offer some thoughts on the epistemological processes that should be (and often implicitly may be) at work in this research. In particular, I am concerned with postphenomenological research on technological “multistability,” i.e., a device’s ever-present capacity to be used for a variety of purposes, and to always be meaningful in multiple (...) ways. I develop a methodology called “variational cross-examination,” which entails the critical contrast of a device’s various stabilities. As a set of instructive examples, I draw on my own line of research on the politics of public spaces, and especially the critique of anti-homeless design. (shrink)

This Neurocomputing special issue is based on selected, expanded and significantly revised versions of papers presented at the Second International Conference on Brain Inspired Cognitive Systems (BICS 2006) held at Lesvos, Greece, from 10 to 14 October 2006. The aim of BICS 2006, which followed the very successful first BICS 2004 held at Stirling, Scotland, was to bring together leading scientists and engineers who use analytic, syntactic and computational methods both to understand the prodigious processing properties of biological systems and, (...) specifically, of the brain, and to exploit such knowledge to advance computational methods towards ever higher levels of cognitive competence. The biennial BICS Conference Series (with BICS 2008 recently held in Sao Luis, Brazil, 24–27 June, and BICS 2010 due to be held in Madrid, Spain) aims to become a major point of contact for research scientists, engineers and practitioners throughout the world in the fields of cognitive and computational systems inspired by the brain and biology. The first paper in this special issue is by Carnell who presents an analysis of the use of Hebbian and Anti-Hebbian spike timedependent plasticity (STDP) learning functions within the context of recurrent spiking neural networks. He shows that under specific conditions Hebbian and Anti-Hebbian learning can be considered approximately equivalent. Finally, the author demonstrates that such a network habituates to a given stimulus and is capable of detecting subtle variations in the structure of the stimuli itself. Hodge, O’Keefe and Austin present a binary neural shape matcher using Johnson counters and chain codes. They show that images may be matched as whole images or using shape matching. Finally, they demonstrate shape matching using a binary associative-memory neural network to index and match chain codes where the chain code elements are represented by Johnson codes. (shrink)

In the introduction to Geography and Ethics: Journeys in a Moral Terrain, Proctor claims that 'there is a strong resonance among all the essays [in the edited volume] as to the geographical embeddedness of ethics, an argument made implicitly or explicitly that geography matters in finding clarifications of, or solutions to, ethical questions'. There is no doubt that geography, broadly enough construed, can function so as to clarify not only ethical questions but political, social and legal ones as well. While (...) not denying that geographical considerations of various kinds have contributed to discussions about vagrancy, the meaning and use of public space, public welfare in relation to urban development, race and class relations and the like, I shall argue that geographical considerations by themselves have little relevance to the question of the morality of the growing legislation of what has come to be known as anti-vagrant or anti-homelessness laws. Discussions on the relationship between facts and values have advanced considerably since Hume's infamous is-ought distinction, and the interplay of facts and values has been increasingly asserted in contexts far removed from that invoked by Hume. While considerations of fact and value cannot be neatly separated in many cases, I discuss two essays in which geographers make little, if any, case for a connection and show little awareness that a case does have to be made—that facts, even when nicely described, do not by themselves speak value. Geography is then contrasted with architecture with regard to the issue of the embeddedness of ethics in these fields. It has recently been argued that in architecture there is no clear separation between ethical issues and architectural or design problems. Ethics, it is claimed, is intrinsic to the practice of architecture, but extrinsic to most other disciplines—including geography. (shrink)

Williamson's influential anti-luminosity argument aims to show that our own mental states are not “luminous,” and that we are thus “cognitively homeless.” Among other things, this argument represents a significant challenge to the idea that we enjoy basic self-knowledge of our own occurrent mental states. In this paper, I summarize Williamson's anti-luminosity argument, and discuss the role that the notion of “epistemic basis” plays in it. I argue that the anti-luminosity argument relies upon a particular version (...) of the basis-relative safety condition on knowledge. This commitment is significant because basic self-knowledge seemingly lacks any kind of distinct epistemic basis, such as inference, observation, testimony, etc., despite representing a genuine kind of knowledge of contingent matters of fact. I consider a disjunctivist account, according to which true basic self-beliefs indeed lack an epistemic basis in any kind of epistemic method, yet are still epistemically grounded in the mental states they concern. I argue that this account of self-knowledge is compatible with standard understandings of the basis relative safety condition on knowledge, but rejects the particular version required by the anti-luminosity argument. (shrink)

Foreigners go home! This is a reverberating chorus at the heart of the migration crisis everywhere in the world. This call manifests itself in the recurring xenophobic or Afrophobic attacks directed at foreign nationals in South Africa. This article reflects on the most recent xenophobic attacks directed at foreign nationals during the anti-immigration march, held on 24 February 2017, in the City of Tshwane. This article states that calls for foreigners to go home and the xenophobic or Afrophobic violent (...) attacks that accompanied them were a direct attack on ubuntu. It was an attack that rendered ubuntu ‘homeless’ and reflected the direct opposite of what an African community generally stands for. It was also an attack directed towards the migrant God; hence, the article proposes a re-imagination of the theology of ubuntu and the agency of faith communities as an antidote to the recurring calls for foreigners to go home. (shrink)

COVID-19 caused levels of household food insecurity to spike, but the precarity of so many people in wealthy countries is an outgrowth of decades of eroding public provisions and labour protections that once protected people from hunger, setting the stage for the virus’ unevenly-distributed harms. The prominence of corporate-sponsored foodbanking as a containment response to pandemic-aggravated food insecurity follows decades of replacing rights with charity. We review structural drivers of charity’s growth to prominence as a hunger solution in North (...) America, and of its spread to countries including the UK. By highlighting pre-pandemic pressures shaping foodbanking, including charities’ efforts to retool themselves as health providers, we ask whether anti-hunger efforts during the pandemic serve to contain ongoing socioeconomic crises and the unjust living conditions they cause, or contest them through transformative pathways to a just food system. We suggest that pandemic-driven philanthropic and state funding flows have bolstered foodbanking and the food system logics that support it. By contextualising the complex and variegated politics of foodbanking in broader movements, from community food security to food sovereignty, we reframe simplistic narratives of charity and highlight the need for justice-oriented structural changes in wealth redistribution and food system organisation if we are to prevent the kinds of emergency-within-emergency that we witnessed as COVID-19 revealed the proximity of many to hunger. (shrink)

The high prevalence of cardiovascular diseases demands a reliable and sensitive risk assessment technique. In order to develop a fast and label-free immunosensor for C-reactive protein, a risk factor for this condition, anti-CRP antibodies were physically adsorbed to the hydrogen -terminated surface of nanocrystalline diamond. An Enzyme-Linked ImmunoSorbent Assay reference technique showed that this was a suitable substrate for antibody-antigen recognition reactions. Electrochemical Impedance Spectroscopy was used to electronically detect CRP recognition. The specificity of the immunosensor was demonstrated by (...) incubation with CRP and plasminogen as reference molecule. A different impedance behavior was observed in real-time after CRP addition as compared to plasminogen addition: the impedance increased only during CRP incubation. Fitting the data showed that this corresponded with a decrease in capacitance of the molecular layer due to its increased thickness by specific CRP recognition. Sensitivity experiments in real-time showed a clear discrimination between 1 μM, 100 nM, and 10 nM of CRP after 10 min at 100 Hz. Since, 10 nM of CRP was still clearly distinguishable from buffer solution, our CRP-directed immunosensor prototype reaches a sensitivity that is within the physiologically relevant concentration range of this biomarker in healthy controls and CVD patients. Moreover, this prototype displayed real-time discriminating power between spiked and unspiked serum, and thus also shows its applicability in this biological matrix. © 2011 Elsevier B.V. All rights reserved. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:GOD AND THE STATUS OF FACTS JOHN PETERSON University of Rhode Island Kingston, Rhode Island I EVEN BEFORE mid-century, Platonism was in such retreat that Croce could call it "traditional philosophy." By " Platonism " is meant any philosophy which admits transcendent entities, be they individuals or universals. This philosophy, complains Croce,... has its eyes fixed on heaven, and expects supreme truth from that quarter. This division of heaven (...) and earth, this dualist conception of a reality which transcends reality, of metaphysics over physics, this contemplation of the concept without or outside judgment, for ever imprints the same character, whatever the denomination the transcendental reality may bear: God or Matter, Idea or Will; it makes no difference, while beneath or against each of them there is presumed to subsist some inferior or merely phenomenal reality.1 Though few recent philosophers would follow Croce in his identification of philosophy with history, most would applaud the Italian idealist's castigation of Platonism. Between their acts of mutual criticism, idealists, existentialists, logical empiricists, pragmatists, Marxists, philosophers of language, neo-Nietzschians, deconstructionists and most phenomenologists unite against the transcendent. The metaphysics of Plato and Kant are dead, they chant. No timeless Reality lurks behind appearences, eluding eye, ear, language and inner sense. Insisting on the reality of at least relational universals, the early Russell for a time resisted the tide. But his abandonment 1 Benedetto Croce, " History as the Story of Liberty " in Morton White, ed., The Age of Analysis (New York, 1964), pp. 50-51. 635 636 JOHN PETERSON of logical atomism weakened his case for Platonism and a turn to empiricism followed. Moreover, even as he defended universals in his early days, Russell shunned transcendent individuals. In this effort his most celebrated ploy was the Theory of Descriptions, according to which commitment to individuals such as the king of France and the golden mountain is eschewed. Less famous was his move to spike that metaphysical individual known as substance. This he did by attacking the traditional subject-predicate form of the proposition. If all simple propositions are of the subject-predicate form and if true propositions map facts and thirdly if there are no facts which cannot be mirrored by propositions, then, says Russell, either there is only one substance or there are many substances between which there are no relations.2 And under both alternatives-the one Spinozistic and the other Leibnizian-substance is a hidden, transcendent thing which accounts for all phenomena without itself being part of any phenomenon. But be it from Croce or James or Dewey or Sartre or the Marxists or Quine or whomever, is this anti-platonism really justified? Are these celebrated philosophers right or even consistent in eliminating the transcendent? To see that they are not, one need only consider the case of facts. If facts are timeless and not temporal, then there are transcendent entities after all and the anti-platonists are wrong. Take, for example, the fact that Napoleon was defeated by Wellington at Waterloo on June 18, 1815. Defenders of temporalism as regards facts must either count this as being a past fact or else hold that this fact is no different from the historical event, "fact" being just another name for "event". But both of these options fail. That facts are not events is shown by the difference in how the following questions are answered: (a) " Why did I not hold class this morning in Adams Hall "? and (b) "What is meant by saying that the statement ' I did·not hold class this morning in Adams Hall ' is true "? While (a) may be answered by citing some event which prevented my hold2 Bertrand Russell, The Problems of Philosophy (New York, 1975), pp. 9495. GOD AND THE STATUS OF FACTS 637 ing class in Adams Hall this morning (for example, a fire broke out in Adams Hall just before class), (b) is never answered this way. Though the event of the fire in Adams Hall (or some other event) may be what prevented my holding class this morning in Adams Hall, it is nonsense to cite either that fire or any other event as an answer to (b). Yet, a perfectly sensible answer... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:George Engel’s Legacy for the Philosophy of Medicine and PsychiatryBradley Lewis (bio)KeywordsBiopsychosocial model, George Engel, pragmatism, philosophy of medicine, philosophy of psychiatryEach of the respondents to this paper raises critical and important concerns. I am grateful for the quality of their insights. David Brendel’s response, along with his recent book, Healing Psychiatry: Bridging the Science/Humanism Divide, resembles my efforts in several ways. Like Brendel, I too believe that the (...) American pragmatic philosophy can be helpful in healing the splits and divisions within psychiatry. And, like Brendel, I believe that psychiatry would benefit from what he calls the “four ps” of pragmatism. Where we differ with regard to George Engel and his biopsychosocial model seems to be less about philosophy and more about strategy. Brendel argues that Engel was too scientistic in his manifest reasoning to be considered a pragmatist. I agree with this description of Engel. But, strategically, we can go beyond Engel’s manifest reasoning to draw out the implications of Engel’s writings in a pragmatic fashion. I am not saying that Engel did this himself; I am only saying that it is very possible to reinterpret Engel along these lines.Brendel also argues that the biopsychosocial model itself needs improvement. But, just as it is possible to update Engel’s theoretical scaffold, we can also update Engel’s biopsychosocial model. Along the lines of Brendel’s concerns, we can easily revise the model so that we remember that not all problems need complex analysis and interventions. Some problems are relatively simple and can have a simple solution. We can also revise the model so we include questions of consumer participation and the provisional nature of the clinical encounter. I see nothing in the biopsychosocial model that contradicts either of these concerns. Yes, the biopsychosocial model needs to be updated, refurbished, expanded, and reimagined. That is my point in the paper.The traction of Brendel’s concerns is not can we reinterpret Engel? or can we refresh the biopsychosocial model?—of course we can. The traction of his concern seems to be “should we?” To this strategic question, Brendel’s answer is no and my answer is yes. I argue that it is a good idea to refresh and refurbish Engel and his biopsychosocial model because it helps to create a connection with an important tradition within both medicine and psychiatry: the tradition of balanced, broadminded, nuanced, patient-centered and anti-reductionistic [End Page 327] care. This tradition is important because medicine and psychiatry seem perpetually vulnerable to the temptations of reductionist approaches and to what Engel, and Nassir Ghaemi more recently, call “dogmatism” (Engel 1977, 130; Ghaemi, 2003, 301). Whether reductionism and dogmatism take the form of biopsychiatry, or psychoanalysis, or antipsychiatry, or cognitive-behavioral therapy, the problems of dogmatism are the same.I am sure Brendel would agree with this, which is why he raises pluralism to such a prominent position in his own reasoning. The difference is that Brendel believes we can better get to this kind of balanced clinical care by letting go of the past figures like Engel and moving into the bright light of the twenty-first century. Maybe so. But my thinking when I wrote the paper goes the other way around. For me, if clinical medicine and psychiatry more carefully tended to its history and tradition, it would be less likely to fall sway to the next Johnny-come-lately reductionistic model.Jeffery Spike’s memories of George Engel during the years they worked together at the University of Rochester School of Medicine provide a good sense of why Engel is an important figure to remember and to pay homage. As Spike puts it, Engel was not only a “legendary figure” with an “almost mythical diagnostic ability,” Engel “probably had more influence on the philosophy of medicine in the United States than any other person, physician, or philosopher.” Both of these accomplishments help to explain why Engel is worth remembering.Those of us in medicine and psychiatry all know mythical clinicians and teachers—the ones who seem like Michael Jordan used to seem on the basketball court, able to somehow make even... (shrink)

In this article, I argue that mass incarceration belongs to a category of social status interventions by which the modern state either withholds the ordinary protections and benefits of the law from outlawed groups or subjects them to private punishment based on their mere membership in those groups. In the US these groups include immigrants and resident Latinos, the homeless, the poor and poor blacks, sex workers, and ex-convicts. Outlawry is a fundamentally anti-democratic practice that cannot be justified (...) in terms of deterrence and is incompatible with public safety. (shrink)

This article provides background material to help readers appreciate three speeches printed in this issue, given by Stefan Morawski, Dennis Smith and Hans Joas on the occasion of the presentation to Zygmunt Bauman of a Festschrift in March 1996 in Leeds. The article describes: (1) relevant details of Polish history concerning cultural patriotism, anti-state attitudes, the role of Jews in the communist state apparatus and anti-Semitism, focusing on post-1945; (2) the peculiarities of the indigenous British sociology tradition and (...) the part played by exiles in shaping it; (3) a profile of the `successful outsider'; and (4) the implications of Bauman's recent work on the Holocaust for the Sonderweg thesis about German history and the Historikerstreit, which are also sketched. It concludes that far from being a `homeless intellectual', Bauman has two homes, perhaps reflecting the wider integrating process of Eastern and Western Europe, until recently separated by a gulf. (shrink)

The article focuses on the symptomatic interpretation of some modern concepts that ap­peal to a cosmic order. Against the background of well-known “dark”, homeless systems proposed by such Western thinkers as Q. Meillassoux, K. Barad, D. Haraway, E. Thacker et al., trying to present pictures of a world “without us”, the author examines here anti-colonialist approaches that complement the conclusions of European and North American researchers in their own way. The author shows that the ideas of a direct (...) connection be­tween a moral act and a cosmic order or humanity spilled throughout the cosmos, al­though it turns out that they cannot be considered as the basis for universal coexistence, can nevertheless act as an engine of practical communication. With all fluctuations in the terminology that they use, in which the interchangeability of cosmopolitanism, cos­mology and space is not uncommon, combined with attempts to maintain the specificity of the “local”, it seems that these different works obviously tend to construct a new spe­cial type of statement. (shrink)

Within a social justice ethical framework, the use of ‘enforcement’ measures to prevent people from engaging in ‘street activities’, such as begging and street drinking, can only be morally justified if such initiatives can be shown to benefit the welfare of the vulnerable ‘street users’ affected. It may be hypothesized that this is unlikely, and such measures are bound to be regressive in their effects, but in fact evidence from an evaluation conducted in five locations across England suggests otherwise. Drawing (...) on a normative framework which engages with both moral and political philosophy, this paper argues that the motivations and impacts associated with enforcement are more ethically complex, and less punitive, than they may at first appear. It demonstrates that the use of enforcement measures, when accompanied by appropriate support, can in fact lead to beneficial outcomes for some individuals involved in begging or street drinking in some situations. The outcomes for other members of the street population can, however, be very negative, and are highly unpredictable, such that the use of enforcement is always a high-risk strategy, even if ethically justifiable in certain circumstances. (shrink)

Informed consent is the single most important concept for understanding decision-making capacity. There is a steady pull in the clinical world to transform capacity into a technical concept that can be tested objectively, usually by calling for a psychiatric consult. This is a classic example of medicalization. In this article I argue that is a mistake, not just unnecessary but wrong, and explain how to normalize capacity assessment.Returning the locus of capacity assessment to the attending, the primary care doctor, and (...) even to ethics consultation in today's environment will require a substantial effort to undo a strong but illusory impression of capacity assessment. Hospital attorneys as well as clinical ethicists with a sophisticated understanding of health law can be in the vanguard of this reorientation. (shrink)

We first heard about this case from nurses in one of our intensive care units while we were conducting an inservice. When the session was over, we discussed it between ourselves, and decided that it must have been misrepresented. The case had been presented as one of a teenager who was brain dead, had been so for six months, yet had been brought into the ICU for treatment. We have run into this before, we thought: medical professionals confusing brain death (...) with persistent vegetative state. But, of course, we reasoned, no one can be brain dead for six months. To us, as it would to many, the case sounded like a clinical and ethical impossibility.A week later, we were called by an attending physician from another ICU, at the urging of that unit's nursing staff. They had a patient who was brain dead, whose presence was causing distress among the staff. Ronald Chamberlain, a fifteen-year-old boy, had been a patient at a nearby longterm rehabilitation facility that is equipped to care for ventilator-dependent patients. (shrink)

The dearth of philosophical contributions to medicine has recently been discussed in a series of articles in this journal. The present article focuses on physicians' lack of training in philosophy as a part of the explanation of the scarcity of works in philosophy of medicine. In section I I outline two philosophy courses which would be reasonable additions to the medical school curriculum required of all medical students. In section II I suggest two other philosophy courses as electives in a (...) medical education. All four courses are in the fields of epistemology and metaphysics, and so will help others see the relevance to medicine of philosophical fields other than ethics. (shrink)

Experimental work has revealed causal links between physical cleansing and various psychological variables. Empirically, how robust are they? Theoretically, how do they operate? Major prevailing accounts focus on morality or disgust, capturing a subset of cleansing effects, but cannot easily handle cleansing effects in non-moral, non-disgusting contexts. Building on grounded views on cognitive processes and known properties of mental procedures, we proposegrounded proceduresof separation as a proximate mechanism underlying cleansing effects. This account differs from prevailing accounts in terms of explanatory (...) kind, interpretive parsimony, and predictive scope. Its unique and falsifiable predictions have received empirical support: Cleansing attenuates or eliminates otherwise observed influences of prior events (1) across domains and (2) across valences. (3) Cleansing manipulations produce stronger effects the more strongly they engage sensorimotor capacities. (4) Reversing the causal arrow, motivation for cleansing is triggered more readily by negative than positive entities. (5) Conceptually similar effects extend to other physical actions of separation. On the flipside, grounded procedures ofconnectionare also observed. Together, separation and connection organize prior findings relevant to multiple perspectives (e.g., conceptual metaphor, sympathetic magic) and open up new questions. Their predictions are more generalizable than the specific mappings in conceptual metaphors, but more fine-grained than the broad assumptions of grounded cognition. This intermediate level of analysis sheds light on the interplay between mental and physical processes. (shrink)

The year 2013 may someday be seen as the year a new profession was born. Clinical ethics consultation has been practiced in different ways for roughly 30 years, originally initiated by a group of h...

In lieu of an abstract, here is a brief excerpt of the content:The Philosophy of George Engel and the Philosophy of MedicineJeffrey P. Spike (bio)KeywordsGeorge Engel, psychosocial medicine, medical education, medical humanities, interviewing skills, philosophy of medicine, scientific methodDoctor Brad Lewis has encouraged us to consider George Engel’s philosophy with his excellent essay on Engel and Pragmatism. As a philosopher teaching full time in a medical school, it is refreshing to have an opportunity to analyze the work of two (...) physicians at this level of reflection and abstraction. It is even more of a pleasure because I knew Dr. Engel personally while I was teaching at the University of Rochester School of Medicine. I will make some observations of the philosophy behind Dr. Engel’s work, both published and practical, that is, as reflected in his writing but also in his influence in the medical curriculum at the institution that he called home for some thirty years (as seems appropriate when considering someone’s bona fides as a pragmatist).Engel’s Philosophy and Medicine’s PhilosophyGeorge Engel’s primary philosophical concern was to fight the powerful belief (or perhaps delusion) that medicine was evolving into a pure physical science, an extension of biochemistry and cell biology, or as we would now call them, proteomics and genomics. There is little evidence that he espoused any one methodology for basic science, so much as he opposed any one methodology for medicine. So to say he was a pragmatist seems underdetermined by his words, if that is taken to mean he advocated for changing the methodological model for scientific research. Rather the question is whether his preferred medical methodology is best characterized as pragmatic, or by some other description. On that score I agree with Lewis wholeheartedly.Of course, it might be that the claim of pragmatism is not meant to suggest a change in method for basic science, but to advocate for retaining an appreciation for the whole range of approaches to knowledge, from experimental science to epidemiology, and from epidemiology to acculturation. By that definition of pragmatism, Engel was indeed a pragmatist. Interpreted this way, he wanted medicine to stop worshipping the scientific method and appreciate that there are many paths to knowledge besides through the wet lab.It might be said that there are different scientific methods for different sciences, and Engel wanted us to appreciate that the reductionist methods [End Page 315] appropriate to the sciences of the small are not necessarily methods that can be applied to all sizes of objects we study, or all levels of reality (like the psychological and social). This is the truth about the world, although I am not sure that this is what Engel meant. As Lewis notes, Engel’s writing does sometimes sound as if he worshipped at the alter of science, as if all subjects of importance can be studied scientifically. But if he believed that, he was not correct. It might be, if all the subjects of the university that Lewis mentions are important, that some will turn out to be able to be studied in academically rigorous methods that are not scientific in any of the usual meanings of the word. Consider philosophy itself, for example.To the degree that it may stretch the evidence to say that Engel would have advocated for a pragmatic scientific method, it is still the case that pragmatism as outlined by Lewis and Engel’s biopsychosocial model can both be used to help medicine understand itself and overcome the temptation to idolize science. Medicine is not a science, or at least it is not just a science; in fact, I would suggest that it never was a science, and it will never be a science. Medicine is about health and illness, and uses whatever science it can to promote health and to treat (ameliorate or cure) illness.None of this should necessarily lead us to idolize pragmatism either. If each subject has its own ideal methodology for study, then it may be that pragmatism is the preferred method for, say, clinical judgment, whereas the scientific method is the best for the ‘hard’ sciences, and logic for philosophy. Or perhaps pragmatism and inductive logic are competing models for clinical... (shrink)

The author of “How Bioethics and Case Law Diverge in Assessments of Mental Capacity: An Argument for a Narrative Coherence Standard” (2020) arrives at a reasonable conclusion; however, it is far le...

Living organ donation will soon become the source of the majority of organs donations for transplant. Should mentally handicapped people be allowed to donate, or should they be considered a vulnerable group in need of protection? I discuss three cases of possible living organ donors who are developmentally disabled, from three different cultures, the United States, Germany, and India. I offer a brief discussion of three issues raised by the cases: (1) cultural diversity and cultural relativism; (2) autonomy, rationality, and (...) self-interest; and (3) the proper use and role for clinical ethics consults. (shrink)

The American Journal of Bioethics, Volume 12, Issue 8, Page 13-15, August 2012.

The first ethics casebook that integrates clinical ethics (medical, nursing, and dental) and research ethics with public health and informatics. The book opens with five chapters on ethics, the development of interprofessional ethics, and brief instructional materials for students on how to analyze ethical cases and for teachers on how to teach ethics. In today's rapidly evolving healthcare system, the cases in this book are far more realistic than previous efforts that isolate the decision-making process by professions as if each (...) is not embedded in a larger context that involves healthcare teams, hospital policies, and technology. The central claim of this book is that ethics is an important common ground for all of the health professions. Furthermore, when we recognize that our professions converge upon a common goal we will find less conflict and more pleasure in working together. (shrink)

Many ethics faculty in medical schools do not include abortion in their required curriculum. On the face of it, this is a singular failure since abortion is certainly an important ethical issue. Th...

Surgical ethics is a well-recognized field in clinical ethics, distinct from medical ethics. It includes at least a dozen important issues common to surgery that do not exist in internal medicine simply because of the differences in their practices. But until now there has been a tendency to include ethical issues of anesthesiology as a part of surgical ethics. This may mask the importance of ethical issues in anesthesiology, and even help perpetuate an unfortunate view that surgeons are “captain of (...) the ship” in the operating theater (leaving anesthesiologists in a subservient role. We will have a better ethical understanding if we see surgery and anesthesia as two equal partners, ethically as well as in terms of patient care. Informed consent is one such issue, but it is not limited to that. Even on the topic of what type of anesthesia to use, anesthesiologists have often felt subsumed to the surgeon’s preferences. This commentary takes the case study and uses it as a exemplar for this very claim: it is time to give due recognition for a new field in clinical ethics, ethics in anesthesia. (shrink)