Donating, distributing and ultimately transplantingorgans each has distinct ethical problems. In thispaper I suggest that the first ethical question is notwhat should be done but what is a fair way in whicheach of these problems can be addressed. Experts –whether these be transplant surgeons, policy analysts,political scientists or ethicists – can help guidebut cannot by themselves make such decisions. Inmaking these decisions the difference betweenidentified and non-identified lives is crucial. Isuggest that an approach in which reason is temperedby compassion (``compassionate (...) rationality'') whendealing with identified lives and in whichcompassion is controlled by reason (``rationalcompassion'') in dealing with unidentified lives mustserve us well. Ultimately decisions of this sort areprone to sturdy democratic process which is possibleonly when the preconditions of person, economic andeducational democracy are met. (shrink)

In his précis, James Stacey Taylor sets out his full-blooded Epicureanism, which concludes that “death is not a harm to the person who dies and that persons can neither be harmed nor wronged by events that occur after their deaths.”1 He then considers various topics in bioethics in the light of his Epicureanism, one of which I consider here: presumed consent in the procurement of organs for transplantation. Although I do not accept Taylor's Epicureanism and although his examination of (...) presumed consent is flawed in various ways, I think we can learn something important from him.Taylor couches the problem in terms of what we are supposed to presume about people's consent or dissent and he thinks that the USA and UK have a system of ‘presumed refusal’ “whereby it is presumed that a person would refuse to have her transplantable organs removed from her postmortem unless she had explicitly indicated otherwise” . Taylor makes a common mistake. The USA and UK have never had such a presumption. In these countries, people who explicitly refuse may not have their organs taken, whereas people who do not explicitly consent may have their organs taken if, roughly speaking, their families consent. Thus non-consenters are not presumed to be refusers.Leaving aside the mistake about the status quo, …. (shrink)

In this article, I address what kinds of claims are of the right kind to ground conscientious refusals. Specifically, I investigate what conceptions of moral responsibility and moral wrongness can be permissibly presumed by conscientious objectors. I argue that we must permit HCPs to come to their own subjective conclusions about what they take to be morally wrong and what they take themselves to be morally responsible for. However, these subjective assessments of wrongness and responsibility must be constrained in (...) several important ways: they cannot involve empirical falsehoods, objectionably discriminatory attitudes, or unreasonable normative beliefs. I argue that the sources of these constraints are the basic epistemic, relational, and normative competencies needed to function as a minimally decent health-care professional. Finally, I consider practical implications for my framework, and argue that it shows us that the objection raised by the plaintiffs in Zubik v. Burwell is of the wrong sort. (shrink)

This article explores the meaning and moral significance of presumed consent with particular reference to an opt-out policy for postmortem organ donation. It does so under two general categories: circumstances where we believe consent to have been given and those where we have no reason to believe that it has either been given or been refused. In the context of an opt-out policy, the first category would relate to the idea of tacit consent. It is argued both that substituting (...) the term ‘presumed consent’ would be misleading and that it is unlikely that the conditions for tacit consent would be met in practice. Regarding the second category, where the claim would be one regarding counterfactual consent, two main points are made: that claims about consent are unwarranted, and also that they are unnecessary to moral argument, given that the moral work is done by reasons other than any supposedly provided by a presumption of consent. (shrink)

Eric C. Ip has recently argued that seriously anorexic service users ought to be assumed to be legally incapacitous to refuse life‐saving artificial nutrition unless they can demonstrate otherwise, reversing the ordinary legal presumption in place to protect patients’ liberty and values. In this response, I argue against this proposal on two grounds. Firstly, the proposal is wrongfully discriminatory; it would expose service users to serious harm, and wrong them in numerous ways, on the basis of their diagnosis alone, without (...) significantly benefitting them in any way relative to the status quo. Secondly, he is unable to show that a large majority of such service users actually are incapacitous to refuse life‐saving artificial nutrition. This means that his proposal would likely involve declaring a large number of actually capacitous patients to be incapacitous, without even the requirement of a formal assessment, and burdening them with the responsibility of proving their clinical team wrong if they wish to avoid deprivation of liberty and/or compelled treatment. Given this, his proposal is indefensible. (shrink)

Ben Saunders claims that actual consent is not necessary for organ donation due to ‘normative consent’, a concept he borrows from David Estlund. Combining normative consent with Peter Singer's ‘greater moral evil principle’, Saunders argues that it is immoral for an individual to refuse consent to donate his or her organs. If a presumed consent policy were thus adopted, it would be morally legitimate to remove organs from individuals whose wishes concerning donation are not known. This paper disputes Saunders' (...) arguments. First, if death caused by the absence of organ transplant is the operational premise, then, there is nothing of comparable moral precedence under which a person is not obligated to donate. Saunders' use of Singer's principle produces a duty to donate in almost all circumstances. However, this premise is based on a flawed interpretation of cause and effect between organ availability and death. Second, given growing moral and scientific agreement that the organ donors in heart-beating and non-heart-beating procurement protocols are not dead when their organs are surgically removed, it is not at all clear that people have a duty to consent to their lives being taken for their organs. Third, Saunders' claim that there can be good reasons for refusing consent clashes with his claim that there is a moral obligation for everyone to donate their organs. Saunders' argument is more consistent with a conclusion of ‘mandatory consent’. Finally, it is argued that Saunders' policy, if put into place, would be totalitarian in scope and would therefore be inconsistent with the freedom required for a democratic society. (shrink)

Organ procurement policy from the recently deceased recasts families into gatekeepers of a scarce medical resource. To the frustration of organ procurement teams, families do not always authorize organ donation. As a result, efforts to increase the number of organs available for transplantation often seek to limit the authority of families to refuse organ retrieval. For example, in some locales if a deceased family member has satisfied the legal conditions for first-person prior assent, a much looser and easier standard to (...) satisfy than informed consent, organ retrieval may proceed despite the family’s objections. Some countries have replaced voluntary consent to organ donation with forms of organ conscription. Often referred to under the misnomer “presumed consent,” such policies legalize the harvesting of organs at death, unless individuals exercise official options to opt out. As this article explores, however, there are good grounds for affirming the authority of the family to consent to or to deny organ donation on behalf of recently deceased family members, as well as to reject first-person assent and “presumed consent” policies of organ procurement. Insofar as individuals have failed clearly and competently to provide informed consent to organ donation, moral authorization for the use of the person and his body ought to be grounded on the foundational authority of the family, rather than the state’s supposed interests in obtaining organs for transplantation. (shrink)

Background: This research explores how public awareness and attitudes toward donation and transplantation policies may contribute to Spain's success in cadaveric organ donation. Materials and Methods: A representative sample of 813 people residing in Andalusia (Southern Spain) were surveyed by telephone or via Internet between October and December 2018. Results: Most participants trust Spain's donation and transplantation system (93%) and wish to donate their organs after death (76%). Among donors, a majority have expressed their consent (59%), and few nondonors have (...) expressed their refusal (14%). Only a minority are aware of the presumed consent system in force (28%) and feel sufficiently informed regarding the requirements needed to be an organ donor (16%). Participants mainly consider that relatives should represent the deceased's preferences and be consulted when the deceased's wishes are unknown, as is the case in Spain. Conclusion: Public trust in the transplant system may contribute to Spain's high performance in organ donation. High levels of societal support toward organ donation and transplantation do not correspond with similar levels of public awareness of donation and transplantation policies in Spain. (shrink)

Under which conditions may physicians who are requested to treat permanently unconscious patients refuse to do so? Wasserman et al. (2023) maintain that refusals on the basis of supposed futility are unethical as they amount to passing off personal value judgments as medical expertise. Instead, unwillingness to carry out an intervention should be framed as conscientious objection. I argue that referring to futility with regard to a patient’s presumed quality of life is appropriate if – and only if – (...) a total and irreversible loss of consciousness has been diagnosed with adequate certainty. The diagnosis turns a graded notion into a binary affair: conscious awareness is a necessary condition of any degree of quality of life to be meaningfully ascribed to an organism. Consequently, the complete absence of consciousness precludes such an ascription; further treatment is then indeed futile from a quality-of-life standpoint. (shrink)

With aims to both increase organ supply and better reflect individual donation preferences, many nations worldwide have shifted from ‘opt‐in’ to ‘opt‐out’ systems for post‐mortem organ donation (PMOD). In such countries, while a prospective donor's willingness to donate their organs/tissues for PMOD was previously ascertained—at least partially—by their having recorded positive donation preferences on an official register prior to death, this willingness is now presumed or inferred—at least partially—from their not having recorded an objection to PMOD—on an official organ (...) donation register. Using evidence regarding the presence and prevalence of selective donation preferences, and via exploration of how appeals to donation preferences are used to both motivate and legitimate shifts to opt‐out frameworks, this paper draws attention to a set of previously unexplored problems for opt‐out organ donation arising in contexts where: (a) individuals demonstrate selective post‐mortem organ/tissue donation preferences, (b) legislation provides prospective donors with the opportunity to selectively permit/refuse the donation of certain organs/tissues in line with these preferences. While selective preferences pose few problems for opt‐in systems where a selective occasion is built into the process of signing the donor register, this is not the case for opt‐out systems. The loss of this selective occasion can cause significant problems where appeals to preferences motivate/legitimate shifts to opt‐out but evidence regarding variable preferences does not feed into determinations regarding organ/tissue exclusions. The nature of these problems depends on how the authorization aspect of ‘opt‐out’ systems is framed (e.g. as presumed consent, deemed consent or, given the role of familial consent in many jurisdictions as consent in name only). (shrink)

Opt-out systems of postmortem organ procurement are often supposed to be justifiable by presumed consent, but this justification turns out to depend on a mistaken mental state conception of consent. A promising alternative justification appeals to the analogical situation that occurs when an emergency decision has to be made about medical treatment for a patient who is unable to give or withhold his consent. In such cases, the decision should be made in the best interests of the patient. The (...) analogous suggestion to be considered, then, is, if the potential donor has not registered either his willingness or his refusal to donate, the probabilities that he would or would not have preferred the removal of his organs need to be weighed. And in some actual cases the probability of the first alternative may be greater. This article considers whether the analogy to which this argument appeals is cogent, and concludes that there are important differences between the emergency and the organ removal cases, both as regards the nature of the interests involved and the nature of the right not to be treated without one’s consent. Rather, if opt-out systems are to be justified, the needs of patients with organ failure and/or the possibility of tacit consent should be considered. (shrink)

A recent view about disagreement (Karczewska 2021) takes it to consist in the tension arising from proposals and refusals of these proposals to impose certain commitments on the interlocutors in a conversation. This view has been proposed with the aim of solving the problem that “faultless disagreement” – a situation in which two interlocutors are intuited to be both in disagreement and not at fault – poses for contextualism about predicates of taste. In this paper, I consider whether this view (...) applies equally well to disagreements involving aesthetic adjectives. I show, first, that it applies quite straightforwardly to predicates like “beautiful,” which presumably generate faultless disagreement. However, aesthetic adjectives like “beautiful” don’t exhaust the aesthetic sphere. A term like “balanced,” for example, while still perspectival, is said to have a more “objective” feel and usually doesn’t generate faultless disagreement: when the novice and the expert disagree on using such a term, we take it that the expert is right and the novice is wrong. I argue that Karczewska’s view has trouble explaining this difference in the profile of the two types of aesthetic predicates vis-à-vis the generation of disagreement. I also consider possible ways of coping with this problem, but I then reject them and propose a different one that is suitable for most views in the debate. (shrink)

The article by Jessica Pierce and Christina Kerby, raises some important but seldom asked questions about the use of natural resources in healthcare. They take for their example latex gloves, which are in wide everyday use, especially since the establishment of principles of universal precautions in infection control as a reaction to the spread of HIV. They trace the production of latex gloves back through rubber processing to their origins in Malaysian rubber plantations and elsewhere. They then ask, but do (...) not answer, some hard questions about the ethics of our relationship as patients to the impact of the materials we use on communities and the environment. To draw out their theme more starkly, consider the rumor widespread in South America that some babies purportedly adopted by Northerners are sold and cut up for their organs. Suppose this story were true; suppose your donated organ were obtained in this way. You would probably be so revolted by the immorality of its acquisition that you would refuse to accept it. But now take a morally more ambiguous case, as Pierce and Kerby intend. Suppose that the process of obtaining latex gloves is part of the gradual erosion of the Malaysian environment, and that workers in latex factories are poorly paid. Now, should or would you refuse to use latex gloves? Should or would you even be more selective in their use? The practice of universal precautions presumes a virtually unlimited supply of gloves; yet to react to resource scarcity with selective precautions hazards discrimination. Is there any way philosophically to balance the local justice issue of discrimination in comparison to injustice on a global scale and to future generations? (shrink)

The purpose of this paper is to show how micro-argumentation mechanisms of presumptive reasoning and reasoning from best explanation can be used for explaining some cases of presupposition cancellation. It will be shown how the relationship between presupposition triggers and pragmatic presuppositions can be analyzed in terms of presumptive and non-presumptive polyphonic articulation of an utterance, resulting in different types of commitments for the interlocutors. This approach is grounded on the two interconnected notions of presumptions and commitments. In some complex (...) cases of presupposition “suspension,” the speaker presumes the hearer’s acceptance of and commitment to propositions that cannot be presumed as such, namely that do not belong to the common ground, or that have been explicitly rejected as being commonly shared. This phenomenon triggers a complex type of reasoning that can be represented as an abductive pattern, grounded on hierarchies of presumptions and aimed at providing an interpretation that solves this conflict of presumptions. Several cases of suspension of presupposition will be investigated as resulting from non-presumptive polyphonic articulations, in which different voices responsible for distinct commitments are distinguished. By indirectly reporting an element of discourse, the speaker can refuse to take responsibility for the presupposed proposition, and correct the commitments that may result for him. This polyphonic treatment of utterances shows how and why a presupposition is suspended, and identifies the conflicting presumptions that can be further solved through reasoning from best explanation. This reasoning can result in a different reconstruction of the developed logical form of utterance or of its illocutionary force. (shrink)

One way of increasing the supply of organs available for transplant would be to switch to an opt-out system of donor registration. This is typically assumed to operate on the basis of presumed consent, but this faces the objection that not all of those who fail to opt out would actually consent to the use of their cadaveric organs. This paper defuses this objection, arguing that people's actual, explicit or implicit, consent to use their organs is not needed. It (...) borrows David Estlund's notion of ‘normative consent’ from the justification of political authority and applies it to the case of organ donation. According to this idea, when it is wrong to withhold consent to something, the moral force of that lack of consent may be null and void. If it is wrong of a person to refuse to donate their cadaveric organs to others, then it may be that their actual consent is not needed. This supports an opt-out system, which provides protection for those who have genuine reasons to refuse donation, and spares the worries as to what the deceased would actually have wanted. (shrink)

Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation wishes. Second, (...) families can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (shrink)

After the publication of Wittgenstein’s posthumous work the question was raised whether that work involved idealist tendencies. The debate also engaged Wittgenstein’s immediate students. Resistance to presumed idealist positions had been ideologically central to G.E. Moore, Bertrand Russell and other representatives of realism and early analytic philosophy. While Wittgenstein disagreed with them in key respects, he accepted their tendentious definition of ‘idealism’ at face value and bequeathed it to his students. The greatest flaw in the Realists’ view on idealism (...) was their assumption of symmetry between realist and idealist approaches. For Realists, the chief task of philosophy was to establish what kinds of thing exist, and they took Idealists to offer an alternative account of that. However, the Idealists’ guiding concern was rather to investigate the subjective conditions of knowledge. In this respect, Wittgenstein’s conception of philosophical method was closer to theirs than to that of the Realists. This is especially obvious in his rejection of Moore’s idea of immediate knowledge. Ultimately, the trouble with Wittgenstein was not that he endorsed any kind of idealist ontology. It was his refusal to deliver the expected realist ontological messages on the supposed question of whether reality is independent of language or otherwise. (shrink)

Many clinical ethics services issue recommendations about ethical controversies that arise in patient care. Their role is configured to be arbiters of moral permissibility, rendering verdicts on which option of those available constitute the morally superior course of action. They produce moral judgements on questions, such as: Should dialysis be started or foregone? Should life-sustaining care be withdrawn or continued? Is it permissible for the clinician to refuse a course of treatment desired by a particular patient or family? But decisions (...) in such cases presume a type of expertise that ethics consultants do not plausibly possess: i.e., the insight to know whose values – which ethical priorities – should trump in situations that are morally ambiguous and normatively contested. This is especially worrisome against the backdrop of the values-pluralism that exists in diverse, heterogeneous societies. This kind of authoritative response to moral uncertainty teeters on hubris, and can have a profoundly negative impact on the lives touched by these decisions. This chapter will argue that the moral arrogance that stems from a conviction of expertise is one of the gravest dangers of contemporary clinical ethics consultation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"What Is Philosophy?"The Status of World Philosophy in the ProfessionRobert C. SolomonThe question "What is philosophy?" is both one of the most virtuously self-effacing and one of the most obnoxious that philosophers today tend to ask. It is virtuously self-effacing insofar as it questions, with some misgivings, its own behavior, the worth of the questions it asks, and the significance of the enterprise itself. It is obnoxious when it (...) refuses to question its own behavior but instead takes that same behavior as the exclusive standard to delegitimize any other activity that dares to call itself "philosophy." Thus, for most of this century, Anglo-American and most European philosophers have simply ignored the rich philosophical traditions of Africa, Asia, Latin and Native America, and the rest of the world. Some leading African American and African European philosophers have dismissed "ethnophilosophy" as "not philosophy," presumably to protect their own analytic credentials. Universities as far flung as Singapore, Sierra Leone, and New Delhi have prided themselves on their fidelity to Oxbridge philosophy. It seems that the globalization of free market economics goes with the globalization of one brief moment in philosophy, with similarly devastating effects on local cultures and the rich varieties of human experience.Philosophy might be thought of as made up of two components: critical thinking and passionate vision. But "critical thinking" does not necessarily imply the hermeneutics of suspicion, skepticism, or intellectual paranoia—all too often the trademarks of the bright young professional philosopher. One can be "critical," that is, reflective, while at the same time be committed, even devoted, to an idea or a way of thinking. The emphasis on passionate vision, however, is just as essential, and any philosophy that doesn't include both components just isn't worthy of the name. Without passionate vision, we get that utterly eviscerated focus on forms of argumentation—philosophia minimalia—devoid of "empirical" content (that is to say, content) and, as far as most people are concerned, devoid of any interest. Without critical reflection, we get gullibility and the worst of New Age philosophy, accepting of any kind of nonsense, just because it stirs the passions. But simply to assume that philosophy must be as rigorously self-questioning as modern European and Anglo-American philosophy is a subtle form of ethnic chauvinism. It eliminates from the realm of philosophy not only African ethnophilosophy and Latin and Native American and South Pacific mythology but a good deal of the philosophy of religion, the basis (for better or worse) of the development of Western philosophy over much of the past two thousand years. [End Page 100]I have just withdrawn from a recent dispute, in a respectable and supposedly eclectic philosophy journal, in which my worst fears in this regard were rather bluntly confirmed. I had made the point mentioned above—rather matter-of-factly, I thought—that if (analytic) philosophy dismisses or ignores modes of thinking that are not obviously self-critical and are presented poetically instead of by way of positions to be argued for, then a good deal of the world's philosophy, including a good deal of Western philosophy, would be left out of the arena. The journal's board reacted indignantly, to put it mildly, to the suggestion that anything should count as "philosophy" that was not sufficiently self-critical in just this sense. But what about the millennium or so of religious philosophy in the West? Does anyone believe that thinkers like Anselm, or Alvin Plantiga for that matter, are seriously skeptical of the truth of Christianity, as they go through their admittedly brilliant argumentative routines? For that matter, to what extent is the emphasis on logical form and argument subjected to scrutiny in contemporary analytic philosophy? (As one of the foremost practitioners of that art commented, "Metaphilosophy makes me sick.")Some of the hostility to world philosophy, to be sure, turns on the conflict between philosophy and religion, which may have its origins in ancient and medieval philosophy but emerges full-blown with the Enlightenment and its campaign against "superstition." But many people and a good many cultures do not distinguish between philosophy and religion. If we consider the word "philosophy... (shrink)

This thoughtful, learned, well-written, extensively illustrated, and heavily documented study deserves to be regarded as a landmark in art history. Traditional art history has dealt for the most part with the “fine arts” (chiefly painting, drawing, sculpture, and architecture), whereas other human creations that take physical form (such as furniture, ceramics, textiles, and metal and glass items), whether utilitarian or decorative (or both at once), are considered “craft” or “applied art” and are studied by folklorists, anthropologists, and archaeologists and often (...) displayed in different museums. Cooke wishes to break down this “hierarchical taxonomy,” this “fragmented, hierarchical field,” that emerged from Western Europe's “misunderstanding of art,” which valued “the cerebral over the manual.” His goal, in other words, is to outline “a more inclusive human history of art”— “a connected art history.” This phrase from his subtitle refers not simply to connecting “fine art” with “applied art” but also to crossing temporal and regional boundaries. Still another act of connecting is to examine all parts of an object's life history, and thus the three main divisions of the book deal with the making of objects, their circulation from one person and place to another (and “their ability to transmit ideas” in the process), and their meaning for the persons who possessed or encountered them.Over the years I have repeatedly said that all objects made by human beings are worthy of preservation and study because they bring us into direct contact with the past and, as part of our surroundings, affect our thoughts in the present. Every object, I have argued, including copies of a single printed edition of a book (so-called duplicates), is an independent witness to the past. I am particularly pleased, therefore, to welcome a major book that explores in detail, with a wealth of examples from many centuries and cultures, the place of objects in human history. Cooke's pursuit is “object-driven,” beginning with the nature of the materials and finally coming to “the inherent power of the object itself to influence human thought and action.” (Compare the subtitle of Sherry Turkle's 2007 anthology Evocative Objects: Things We Think With.) Cooke's refusal to separate “materials” from “people,” or “technologies” from “values,” reminds me of John Szarkowski's approach to photographs. In Photography until Now (1989), Szarkowski points out that histories of photography generally treat technical matters separately from artistic ones—a split between the “empirical” and the “intuitive” that he finds indefensible, for “these two ways of knowing meet in the process of making things.” He adds, “The meeting can be cordially symbiotic or aggressively competitive, but its resolution defines the character and meaning of the thing that is made.” This statement has been a favorite of mine as an elegant characterization of the nature of art, and it is one that Cooke would clearly agree with.Cooke does not discuss photography, but he makes clear that he is not attempting a “comprehensive history that charts the complete ebb and flow of objects over time.” Rather, his book is meant to be a “suggestive guide” to the “principles of material literacy,” a “kit of tools for future complex constructions of history.” Even so, I find some of the omissions puzzling. Why, for example, are glass objects not taken up, when he so thoroughly deals with other common materials? More serious, in my opinion, is the exclusion of the fine arts. (Of the 215 illustrations, five are of oil paintings and one is of a Japanese print, but they are present only as the sources for information drawn from their pictorial content; one Hogarth engraving is shown because its image was often reproduced on punch bowls; and there is a very brief passage on the “uneasy relationship” between sculpture and material culture, but no sculptures are illustrated or used as examples for discussion.) Presumably Cooke felt it was unnecessary for his book to encompass the fine arts after demonstrating that functional objects are just as sophisticated artistically and culturally as products of the fine arts are. Yet those products also belong to the universe of “entangled objects” (How could they not?), and it would have been illuminating to see them adduced among the examples Cooke cites. One could argue that by excluding them—and by referring to the makers of the objects he does discuss as “artisans” and “craftspeople”—he comes close to reinforcing the division he wishes to eliminate.Less easy to explain is Cooke's omission of books, for they have been one of the largest and most widely circulated classes of utilitarian objects. Most people never think about books as objects, treating them only as disposable receptacles for transmitting verbal texts in tangible form (which is why so many books are destroyed when their texts supposedly become available in another form). Such people do not realize that texts have connections with their physical embodiments. (For example, books, whether manuscript or printed, often contain clues revealing how their texts were affected by the production process; and readers’ attitudes toward texts can be influenced by their presentation.) Cooke, however, with his deep understanding of the way objects function and his impressive knowledge of the scholarship, cannot be one of these uninformed people. He would obviously be aware of the vast literature devoted to leather and cloth bookbindings and their decoration, as well as to the myriad styles of letters and the varieties of paper and parchment; he would also know how letterforms and binding designs reflect a complex interplay of social, political, and artistic forces. Bibliographers have long studied books as Cooke advocates studying other objects: “working from the inside out,” beginning with the evidence in books themselves for reconstructing the routines that were followed in their creation. And book historians are recognizing the necessity for an international approach like Cooke's, since many of the books circulating in one country originated in other countries. Books would have been a prolific additional source for illustrating Cooke's analyses.My admiration for Cooke's book is not altered by these few disappointments. Even without discussions of paintings, sculptures, and books, it is still exhilarating in its scope and depth. One hopes that art and material-culture historians will pay attention to it. But it ought to have a wider audience, for the daily lives of all of us would be enriched by a greater appreciation of the objects that make up a significant part of our environment. (shrink)

Though animal ethics in sport obviously applies most urgently to cases of animals at mortal risk (e.g., hunting and bullfighting) or vulnerable to various types of abuse (e.g., doping and harmful training practices), less obvious domains bear scrutiny as well. Here I examine whether we can strictly take not just riders but horses to be players in equine sports. There is an apparent tension in the concept of equestrian prowess, a peculiar blend of skills and attitudes, between regarding horses as (...) subjects of persuasion or collaboration and treating them as objects of control. As our understanding of animal cognition and behaviour continues to improve, it becomes increasingly clear that animal intelligence and agential capacities are far greater than we formerly presumed. In this light, using Suits’s theory of games, I argue that horses are game players that sometimes consent (or assent) and sometimes refuse to play equine sports. Drawing on recent accounts of horse-rider partnership and on my own equestrian background, I conclude by sketching a utopian vision of what equine sports could be. (shrink)

Two important aspects of the relationship between peer review and innovation includes the acceptance of articles for publication in journals and the assessment of applications for grants for the funding of research work. While there are well-known examples of the rejection by journals of first choice of many papers that have radically changed the way we think about the world outside ourselves, such papers do get published eventually, however tortuous the process required. With grant applications the situation differs in that (...) the refusal of a grant necessarily curtails the possible research that may be attempted. Here there are many reasons for conservatism and reservation as to the ability of a grant allocation process based on peer review to deliver truly innovative investigations. Other methods are needed; although such methods need not be applied across the board, they should constitute the methods whereby some 10–20% of the grant monies are assigned. The nomination of prizes for specific accomplishments is one way of achieving innovation although this presumes that investigators or institution already have available the money necessary to effect the innovations; otherwise it is a question of the selection and funding of particular individuals or institutions and requiring them to solve particular problems that are set in the broadest of terms. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Religion and the Body in Medical ResearchCourtney S. Campbell (bio)AbstractReligious discussion of human organs and tissues has concentrated largely on donation for therapeutic purposes. The retrieval and use of human tissue samples in diagnostic, research, and education contexts have, by contrast, received very little direct theological attention. Initially undertaken at the behest of the National Bioethics Advisory Commission, this essay seeks to explore the theological and religious questions embedded (...) in nontherapeutic use of human tissue. It finds that the “donation paradigm” typically invoked in religious discourse to justify uses of the body for therapeutic reasons is inadequate in the context of nontherapeutic research, while the “resource paradigm” implicit in scientific discourse presumes a reductionist account of the body that runs contrary to important religious values about embodiment. The essay proposes a “contribution paradigm” that provides a religious perspective within which research on human tissue can be both justified and limited.The retrieval and use of human tissue samples for diagnostic, therapeutic, research, and educational purposes represent further developments in scientific study of the human body as a source of medical information. Following the completion of its examination of the ethical and policy issues pertaining to human cloning in the spring of 1997, the National Bioethics Advisory Commission (NBAC) returned to the set of questions for which it had been originally constituted, including ethical issues that arise in human subjects research. One issue that proved controversial for the human genetics subcommittee of NBAC was the scientific, philosophical, and legal status of tissue and other body parts (usually surgical specimens) that had been retrieved from patients (not research subjects) who had given general consent to the use of their body materials for research and educational purposes. The subcommittee addressed questions about the adequacy of general versus specific [End Page 275] consent, the scientific merits of identifiable versus anonymous samples and claims about patient confidentiality, and the justification for patient refusals and requests that the materials be returned to the patient or discarded rather than made available for scientific research. In an effort to better understand the ramifications of research on human tissue, the subcommittee commissioned several background papers that examined these questions from ethical, legal, research, and religious perspectives. What follows is a modified version of the report on religious considerations originally presented to the genetics subcommittee of NBAC.The central question examined in this article is whether tissue banking for purposes of research presents distinctive theological issues or prompts objections from religious communities or scholars. Religious discussion of human organs and tissues has focused largely on donation for therapeutic purposes (what I describe as the “donation paradigm”); hence, there is very little direct consideration of nontherapeutic uses of such tissue. It is possible, however, to describe implications and suggest inferences by considering (1) religious attitudes to the human body and to organs, tissues, and cells removed from the body, and (2) religious discussions of modes of transfer of body parts, such as donations, offerings, sales, and abandonment. By and large, this discussion will reflect themes that emerge from the central Western religious traditions, with some attention given to Eastern and Native perspectives.The Body: Religious Holism, Scientific Reductionism, Private PropertyThe human body as an organic totality has long been the subject of theological reflection and a symbol for religious communities. However, much less attention has been devoted to the religious status of organs, tissues, cells, and DNA. The reflection of religious scholars and communities on the status of body parts has been prompted by the necessity to confront practical questions in personal and public health and in communal life, such as justifications for surgery, autopsies, organ donation, or burial. Scientific and research interest in parts of the body can sometimes conflict with religious values about bodily integrity. Indeed, E. Richard Gold cites the “disparate claims of scientific investigation and religious belief on the body” as the exemplary case of incommensurate values regarding the body. According to Gold (1996, p. 149), “The body, from a scientific viewpoint, is a source of knowledge of physical development, aging, and disease. From a religious perspective, the body is understood [End Page 276] as a sacred object, being created in the image... (shrink)

Organ donation has gained much attention as the need for transplant exceeds the supply of organs. Various proposals have been put forward to address the organ shortage challenge, ranging from offering incentives to donors, addressing family refusals to donations and instituting presumed consent laws. Presumed consent as the favoured approach has not been universally effective in increasing actual transplants despite its appeal. Few considerations have been given to the broader ethical climate influencing the organ donation debate. This paper (...) examines the ethical climate surrounding organ donation and identifies the challenges existing within such environments. It explores care ethics and its application to the donation system, demonstrating how it can influence the organ donation phases. The conclusion drawn from the analysis is that a caring ethical climate in the pre, during and post-transplant system respects donor autonomy, addresses family reluctance to agree to donation, facilitates the needs of the donee and creates an environment that promotes non-maleficence for all stakeholders. (shrink)

continent. 2.2 (2012): 66–75 ~*~ We’re Doomed. Pessimism is the night-side of thought, a melodrama of the futility of the brain, a poetry written in the graveyard of philosophy. Pessimism is a lyrical failure of philosophical thinking, each attempt at clear and coherent thought, sullen and submerged in the hidden joy of its own futility. The closest pessimism comes to philosophical argument is the droll and laconic “We’ll never make it,” or simply: “We’re doomed.” Every effort doomed to failure, every (...) project doomed to incompletion, every life doomed to be unlived, every thought doomed to be unthought. Pessimism is the lowest form of philosophy, frequently disparaged and dismissed, merely the symptom of a bad attitude. No one ever needs pessimism, in the way that one needs optimism to inspire one to great heights and to pick oneself up, in the way one needs constructive criticism, advice and feedback, inspirational books or a pat on the back. No one needs pessimism, though I like to imagine the idea of a pessimist activism. No one needs pessimism, and yet everyone—without exception—has, at some point in their lives, had to confront pessimism, if not as a philosophy then as a grievance—against one’s self or others, against one’s surroundings or one’s life, against the state of things or the world in general. There is little redemption for pessimism, and no consolation prize. Ultimately, pessimism is weary of everything and of itself. Pessimism is the philosophical form of disenchantment—disenchantment as chanting, a chant, a mantra, a solitary, monophonic voice rendered insignificant by the intimate immensity surrounding it. In pessimism, the first axiom is a long, low, funereal sigh. ~*~ We’re Still Doomed. No one has time for pessimism. After all, there are only so many hours in a day. Whatever our temperament, happy or sad, engaged or disengaged, we know pessimism when we hear it. The pessimist is usually understood as the complainer, forever pointing out what is wrong with the world without ever once offering a solution. But more often than not pessimists are the quietest of philosophers, submerging their own sighs within the lethargy of discontent. What little sound it makes is of interest to no one—“I’ve heard it all before,” “tell me something I don’t know,” sound and fury, signifying nothing. In raising problems without solutions, in posing questions without answers, in retreating to the hermetic, cavernous abode of complaint, pessimism is guilty of that most inexcusable of Occidental crimes—the crime of not pretending it’s for real. Pessimism fails to live up to the most basic tenet of philosophy—the “as if.” Think as if it will be helpful, act as if it will make a difference, speak as if there is something to say, live as if you are not, in fact, being lived by some murmuring non-entity both shadowy and muddied. Had it more self-assurance and better social skills, pessimism would turn its disenchantment into a religion, possibly calling itself The Great Refusal. But there is a negation in pessimism that refuses even such a Refusal, an awareness that, from the start, it has already failed, and that the culmination of all that is, is that all is for naught. Pessimism tries very hard to present itself in the low, sustained tones of a Requiem Mass, or the tectonic rumbling of Tibetan chant. But it frequently lets loose dissonant notes at once plaintive and pathetic. Often, its voice cracks, its weighty words abruptly reduced to mere shards of guttural sound. ~*~ Maybe It’s Not So Bad, After All. If we know pessimism when we hear it, this is because we’ve heard it all before—and we didn’t need to hear it in the first place. Life is hard enough. What you need is a change of attitude, a new outlook, a shift in perspective... a cup of coffee. If we have no ears for pessimism, this is because it is always reducible to something as reliably mutable as a voice. If pessimism is so frequently disparaged, it is because it brings everyone down, determined as it is to view each day as a bad day, if only by virtue of the fact that it is not yet a bad day. For pessimism the world is brimming with negative possibility, the collision of a bad mood with an impassive world. In fact, pessimism is the result of a confusion between the world and a statement about the world, a confusion that also prevents it from fully entering the hallowed halls of philosophy. If pessimism is so often dismissed, this is because it is often impossible to separate a “bad mood” from a philosophical proposition (and do not all philosophies stem from a bad mood?) The very term “pessimism” suggests a school of thought, a movement, even a community. But pessimism always has a membership of one—maybe two. Ideally, of course, it would have a membership of none, with only a scribbled, illegible note left behind by someone long forgotten. But this seems unrealistic, though one can always hope. ~*~ Anatomy of Pessimism. Though it may locate itself at the margins of philosophy, pessimism is as much subject to philosophical analysis as any other form of thought. Pessimism’s lyricism of failure gives it the structure of music. What time is to the music of sorrow, reason is to a philosophy of the worst. Pessimism’s two major keys are moral and metaphysical pessimism, its subjective and objective poles, an attitude towards the world and a claim about the world. For moral pessimism, it is better not to have been born at all; for metaphysical pessimism, this is the worst of all possible worlds. For moral pessimism the problem is the solipsism of human beings, the world made in our own image, a world-for-us. For metaphysical pessimism, the problem is the solipsism of the world, objected and projected as a world-in-itself. Both moral and metaphysical pessimism are compromised philosophically; moral pessimism by its failure to locate the human within a larger context, and metaphysical pessimism by its failure to recognize the complicity in the very claim of realism. This is how pessimism makes its music of the worst, a generalized misanthropy without the anthropos . Pessimism crystallizes around this futility—it is its amor fati , rendered as musical form. ~*~ Melancholy of Anatomy. There is a logic of pessimism that is fundamental to its suspicion of philosophical system. Pessimism involves a statement about a condition . In pessimism each statement boils down to an affirmation or a negation, just as any condition boils down to the best or the worst. With Schopenhauer, that arch-pessimist, the thinker for whom the philosopher and the curmudgeon perfectly overlap, we see a no-saying to the worst, a no-saying that secretly covets a yes-saying (through asceticism, mysticism, quietism), even if this hidden yes-saying is a horizon at the limits of comprehension. With Nietzsche comes the pronouncement of a Dionysian pessimism, a pessimism of strength or joy, a yes-saying to the worst, a yes-saying to this world as it is. And with Cioran yet another variation, futile yet lyrical, a no-saying to the worst, and a further no-saying to the possibility of any other world, in here or out there. With Cioran one approaches, but never reaches, an absolute no-saying, a studied abandonment of pessimism itself. The logic of pessimism moves through three refusals: a no-saying to the worst (refusal of the world-for-us, or Schopenhauer’s tears); a yes-saying to the worst (refusal of the world-in-itself, or Nietzsche’s laughter); and a no-saying to the for-us and the in-itself (a double refusal, or Cioran’s sleep). Crying, laughing, sleeping—what other responses are adequate to a life that is so indifferent? ~*~ Cosmic Pessimism. Both moral and metaphysical pessimism point to another kind, a pessimism that is neither subjective nor objective, neither for-us nor in-itself, and instead a pessimism of the world-without-us. We could call this a cosmic pessimism ... but this sounds too majestic, too full of wonder, too much the bitter aftertaste of the Great Beyond. Words falter. And so do ideas. And so we have a cosmic pessimism, a pessimism that is first and last a pessimism about cosmos , about the necessity and possibility of order. The contours of cosmic pessimism are a drastic scaling-up or scaling-down of the human point of view, the unhuman orientation of deep space and deep time, and all of this shadowed by an impasse, a primordial insignificance, the impossibility of ever adequately accounting for one’s relationship to thought—all that remains of pessimism is the desiderata of affects—agonistic, impassive, defiant, reclusive, filled with sorrow and flailing at that architectonic chess match called philosophy, a flailing that pessimism tries to raise to the level of an art form (though what usually results is slapstick). ~*~ Song of Futility. An ethics of futility pervades pessimism. Futility, however, is different from fatality, and different again from simple failure (though failure is never simple). Failure is a breakage within the heart of relations, a fissure between cause and effect, a fissure hastily covered over by trying and trying again. With failure, there is always plenty of blame to go around; it’s not my fault, it’s a technical difficulty, it’s a miscommunication. For the pessimist, failure is a question of “when,” not “if”—failure as a metaphysical principle. Everything withers and passes into an obscurity blacker than night, everything from the melodramatic decline of a person’s life to the banal flickering moments that constitute each day. Everything that is done undone, everything said or known destined for a kind of stellar oblivion. When scaled up in this way, failure becomes fatality. Fatality is the hermeticism of cause and effect. In fatality, everything you do, whatever you do, always leads to a certain end, and ultimately to the end—though that end, or the means to that end, remain shrouded in obscurity. Nothing you do makes a difference because everything you do makes a difference. Hence the effects of your actions are hidden from you, even as you deceive yourself into thinking that, at last, this time you will outwit the order of things. By having a goal, planning ahead, and thinking things through carefully, we attempt, in a daily Prometheanism, to turn fatality to our advantage, to gain a glimpse of an order that seems buried deeper and deeper in the fabric of the universe. But even fatality has its comforts. The chain of cause and effect may be hidden from us, but that’s just because disorder is the order we don’t yet see; it’s just complex, distributed, and requires advanced mathematics. Fatality still clings to the sufficiency of everything that exists... When fatality relinquishes even this idea, it becomes futility. Futility arises out of the grim suspicion that, behind the shroud of causality we drape over the world, there is only the indifference of what exists or doesn’t exist; whatever you do ultimately leads to no end, an irrevocable chasm between thought and world. Futility transforms the act of thinking into a zero-sum game. ~*~ Song of the Worst. At the center of pessimism lies the term pessimus , “the worst,” a term as relative as it is absolute. The worst is about as bad as it gets, “the worst” as “the best” in disguise, shrouded by the passage of time or the twists and turns of fortune. For the pessimist, “the worst” is the propensity for suffering that gradually occludes each living moment, until it eclipses it entirely, overlapping perfectly in death... which, for the pessimist, is no longer “the worst.” Pessimism is marked by an unwillingness to move beyond “the worst,” something only partially attributable to a lack in motivation. In pessimism “the worst” is the ground that gives way beneath every existent—things could be worse, and , things could be better. “The worst” invariably implies a value judgment, one made based on scant evidence and little experience; in this way, pessimism’s greatest nemesis is its moral orientation. Pessimism’s propositions have all the gravitas of a bad joke. Perhaps this is why the true optimists are the most severe pessimists—they are optimists that have run out of options. They are almost ecstatically inundated by the worst. Such an optimism is the only possible outcome of a prolonged period of suffering, physical or metaphysical, intellectual or spiritual. But does this not also describe all the trials and tribulations of each day—in short, of “life?” It seems that sooner or later we are all doomed to become optimists of this sort (the most depressing of thoughts...) ~*~ Song of Doom. Rather than serving as a cause for despair, gloom and doom are the forms of consolation for any pessimist philosophy. Neither quite affects nor quite concepts, gloom and doom transform pessimism into a mortification of philosophy. Doom is not just the sense that all things will turn out badly, but that all things inevitably come to an end, irrespective of whether or not they really do come to an end. What emerges from doom is a sense of the unhuman as an attractor, a horizon towards which the human is fatally drawn. Doom is humanity given over to unhumanity in an act of crystalline self-abnegation. Gloom is not simply the anxiety that precedes doom. Gloom is literally atmospheric, climate as much as impression, and if people are also gloomy, this is simply the by-product of an anodyne atmosphere that only incidentally involves human beings. Gloom is more climatological than psychological, the stuff of dim, hazy, overcast skies, of ruins and overgrown tombs, of a misty, lethargic fog that moves with the same languorousness as our own crouched and sullen listening to a disinterested world. In a sense, gloom is the counterpoint to doom—what futility is to the former, fatality is to the latter. Doom is marked by temporality—all things precariously drawn to their end—whereas gloom is the austerity of stillness, all things sad, static, and suspended, a meandering smoke hovering over cold lichen stones and damp fir trees. If doom is the terror of temporality and death, then gloom is the horror of a hovering stasis that is life. At times I like to imagine that this realization alone is the thread that connects the charnel ground Aghori and the graveyard poets. ~*~ Song of Spite. There is an intolerance in pessimism that knows no bounds. In pessimism spite begins by fixing on a particular object of spite—someone one hardly knows, or someone one knows too well; a spite for this person or a spite for all of humanity; a spectacular or a banal spite; a spite for a noisy neighbor, a yapping dog, a battalion of strollers, the meandering idiot walking in front of you on their smart phone, large loud celebrations, traumatic injustices anywhere in the world regurgitated as media blitz, spite for the self-absorbed and overly performative people talking way too loud at the table next to you, technical difficulties and troubleshooting, the reduction of everything to branding, spite of the refusal to admit one’s own errors, of self-help books, of people who know absolutely everything and make sure to tell you, of all people, all living beings, all things, the world, the spiteful planet, the inanity of existence... Spite is the motor of pessimism because it is so egalitarian, so expansive, it runs amok, stumbling across intuitions that can only half-heartedly be called philosophical. Spite lacks the confidence and the clarity of hatred, but it also lacks the almost cordial judgment of dislike. For the pessimist, the smallest detail can be an indication of a metaphysical futility so vast and funereal that it eclipses pessimism itself—a spite that pessimism carefully places beyond the horizon of intelligibility, like the experience of dusk, or like the phrase, “it is raining jewels and daggers.” ~*~ Song of Sleep. A paraphrase of Schopenhauer: what death is for the organism, sleep is for the individual. Pessimists sleep not because they are depressed, but because for them sleep is a form of ascetic practice. Sleep is the askesis of pessimism. If, while sleeping, we have a bad dream, we abruptly wake up, and suddenly the horrors of the night vanish. There is no reason to think that the same does not happen with the bad dream we call “life.” ~*~ Song of Sorrow. Nietzsche, commenting on pessimism, once castigated Schopenhauer for taking things too lightly. He writes: ...Schopenhauer, though a pessimist, really —played the flute. Every day, after dinner: one should read his biography on that. And incidentally: a pessimist, one who denies God and the world but comes to a stop before morality—who affirms morality and plays the flute... what? Is that really—a pessimist? We know that Schopenhauer did possess a collection of instruments, and we also know that Nietzsche himself composed music. There is no reason to think that either of them would ever banish music from the Republic of philosophy. But Nietzsche’s jibes at Schopenhauer are as much about music as they are about pessimism. For the pessimist who says no to everything and yet finds comfort in music, the no-saying of pessimism can only be a weak way of saying yes—the weightiest statement undercut by the flightiest of replies. The least that Schopenhauer could’ve done is to play the bass. I’m not a big fan of the flute, or, for that matter, wind instruments generally. But what Nietzsche forgets is the role that the flute has historically played in Greek tragedy. In tragedy, the flute ( aulos ) is not an instrument of levity and joy, but of solitude and sorrow. The Greek aulos not only expresses the grief of tragic loss, but it does so in a way that renders weeping and singing inseparable from each other. The classicist Nicole Loraux calls this the mourning voice . Set apart from the more official civic rituals of funerary mourning, the mourning voice of Greek tragedy constantly threatens to dissolve song into wailing, music into moaning, and the voice into a primordial, disarticulate anti-music. The mourning voice delineates all the forms of suffering—tears, weeping, sobbing, wailing, moaning, and the convulsions of thought reduced to an elemental unintelligibility. In the collapsed space between the voice that speaks and the voice that sings, pessimism discovers its mourning voice. Pessimism: the failure of sound and sense, the disarticulation of phone and logos . Have we rescued Schopenhauer from Nietzsche? Probably not. Perhaps Schopenhauer played the flute to remind himself of the real function of the mourning voice—sorrow, sighs, and moaning rendered indistinguishable from music, the crumbling of the human into the unhuman. Failure par excellence of pessimism. ~*~ Song of Nothing. In Buddhist thought, the First Noble Truth of existence is encapsulated in the Pali term dukkha , conventionally translated as “suffering,” “sorrow,” or “misery.” The Buddhist teachings are clear, however, that this is an objective claim, and not simply one point of view among others. Existence is suffering and sorrow—and yet this is not, the teachings tell us, a pessimistic attitude. It is likely that Schopenhauer, reading the Buddhist texts available to him, recognized some filiation with the concept of dukkha . But dukkha is a multi-faceted term. There is, certainly, dukkha in the usual sense of the suffering, strife, and loss associated with living a life. But this is, in turn, dependent on the finitude and temporality of dukkha , existence as determined by impermanence and imperfection. And this ultimately points to the way in which both suffering and finitude are grounded by the paradoxical groundlessness of dukkha as a metaphysical principle—the insubstantiality and the emptiness of all that is. Beyond what is worse to me, beyond a world ordered for the worst, there is the emptiness of dukkha as an impersonal suffering... the tears of the cosmos. In this context, it is easy to see how Schopenhauer’s pessimism attempts to compress all the aspects of dukkha into a nothingness at the core of existence, a Willlessness coursing through the Will. Though one thing for certain is that with Schopenhauer we do not find the “ever-smiling” countenance of Buddhism—or do we? The texts of the Pali Canon also contain lists of the different types of happiness—including the happiness of renunciation and the strange happiness of detachment. But Buddhism considers even the different types of happiness as part of dukkha , in this final sense of nothingness or emptiness. Perhaps Schopenhauer understood Buddhism better than he is usually given credit for. Thus the experiment of Schopenhauer’s philosophy—the point at which a Western pessimus and an Eastern dukkha overlap or exchange glances. Empty sorrow, a lyricism of indifference. The result is a strange, and ultimately untenable, nocturnal form of Buddhism. ~*~ Cioran once called music a “physics of tears.” If this is true, then perhaps metaphysics is its commentary. Or its apology. ~*~ Pessimism would be more mystical were it not for its defeatism. Mysticism is much too proactive for the pessimist, and pessimism too impassive even for the mystic. At the same time, there is something enviable about mysticism—despite its sufferings. There is a sense in which pessimists are really failed mystics. ~*~ You, the Night, and the Music. In a suggestive passage, Schopenhauer once noted that, “music is the melody to which the world is the text." Given Schopenhauer’s view on life—that life is suffering, that human life is absurd, that the nothingness before my birth is equal to the nothingness after my death—given all this, one wonders what kind of music Schopenhauer had in mind when he described music as the melody to which the world is text—was it opera, a Requiem Mass, a madrigal, or perhaps a drinking song? Or something like Eine kleine Nachtmusik , a little night music for the twilight of thought, a sullen nocturne for the night-side of logic, an era of sad wings sung by a solitary banshee. Perhaps the music Schopenhauer had in mind is music eliminated to non-music. A whisper would suffice. Perhaps a sigh of fatigue or resignation, perhaps a moan of despair or sorrow. Perhaps a sound just articulate enough that it could be heard to dissipate. ~*~ Teach me to laugh through tears. ~*~ Pessimism always falls short of being philosophical. My back aches, my knees hurt, I couldn’t sleep last night, I’m stressed-out, and I think I’m finally coming down with something. Pessimism abjures all pretenses towards system—towards the purity of analysis and the dignity of critique. We didn’t really think we could figure it out, did we? It was just passing time, taking a piss, something to do, a bold gesture put forth in all its fragility, according to rules that we have agreed to forget that we made up in the first place. Every thought marked by a shadowy incomprehension that precedes it, and a futility that undermines it. That pessimism speaks, in whatever voice, is the singing testimony to this futility and this incomprehension—take a chance and step outside, lose some sleep and say you tried... ~*~ Is there a music of pessimism? And would such a music be audible? ~*~ The impact of music on a person compels them to put their experience into words. When this fails, the result is a faltering of thought and language that is itself a kind of music. Cioran writes: “Music is everything. God himself is nothing more than an acoustic hallucination.” ~*~ If a thinker like Schopenhauer has any redeeming qualities, it is that he identified the great lie of Western culture—the preference for existence over non-existence. As he notes: “If we knocked on the graves and asked the dead whether they would like to rise again, they would shake their heads.” In Western cultures it is commonly accepted that one celebrates birth and mourns death. But there must be a mistake here. Wouldn’t it make more sense to mourn birth and celebrate death? Strange though, because the mourning of birth would, presumably, last the entirety of that person’s life, so that mourning and living would the be same thing. ~*~ To the musical idea of the harmony of the universe corresponds the philosophical principle of sufficient reason. Like the music of mourning, pessimism gives voice to the inevitable breakdown of word and song. In this way, music is the overtone of thought. ~*~ The Patron Saints of Pessimism. The patron saints of pessimism watch over suffering. Laconic and sullen, the patron saints of pessimism never seem to do a good job at protecting, interceding, or advocating for those who suffer. Perhaps they need us more than we need them. Lest we forget, there do exist patron saints of philosophy, but their stories are not happy ones. There is, for instance, the fourth century Saint Catherine of Alexandria, or Catherine of the Wheel, named after the torture device used on her. A precocious fourteen year old scholar, Catherine was subject to continual persecution. After all forms of torture failed—including the “breaking wheel”—the emperor finally settled for her decapitation, a violent yet appropriate reminder of the protector of philosophers. There are also patron saints of music and musicians, but theirs too are sad stories. In the second century, Saint Cecilia was also subject to persecution and torture. As she knelt to receive the blade that would separate her head from her body, she ardently sang a song to God. It took three attempts before she was fully decapitated, all the while she continued, perhaps miraculously, to sing. Does pessimism not deserve its own patron saints, even if they are unworthy of martyrdom? But in our search, even the most ardent nay-sayers frequently lapse into brief moments of enthusiasm—Pascal’s love of solitude, Leopardi’s love of poetry, Schopenhauer’s love of music, Nietzsche’s love of Schopenhauer, and so on. Should one then focus on individual works of pessimism? We could include Kierkegaard’s trilogy of horror— Sickness Unto Death , The Concept of Dread , and Fear and Trembling —but all these are undermined by their fabricated and unreliable authors. Besides, how can one separate the pessimist from the optimist in works like Unamuno’s The Tragic Sense of Life , Shestov’s Postetas Clavium , or Edgar Saltus’ under-read The Philosophy of Disenchantment ? Even in cases where the entire corpus of an author is pessimistic, the project always seems incomplete—witness Cioran’s trajectory, from his first book, On the Heights of Despair , to the last unpublished notebooks of acrid and taut aphorisms. And this is to say nothing of literary pessimism, from Goethe’s sorrowful Werther, to Dostoevsky’s underground man, to Pessoa’s disquiet scribbler; Baudelaire’s spleen and ennui, the mystical Satanism of Huysmans and Strindberg, the hauntologies of Mário de Sá-Carniero, Izumi Kyoka, H.P. Lovecraft, grumpy old Beckett... even the great pessimist comedians. All that remains are singular, perhaps anomalous statements of pessimism, a litany of quotes and citations crammed into fortune cookies. Patron saints are traditionally named after a locale, either a place of birth or of a mystical experience. Perhaps the better approach is to focus on the places where pessimists were forced to live out their pessimism—Schopenhauer facing an empty Berlin lecture hall, Nietzsche mute and convalescent at the home of his sister, Wittgenstein the relinquished professor and solitary gardener, Cioran grappling with Alzheimer’s in his tiny writing alcove in the Latin Quarter. ~*~ There’s a ghost that grows inside of me, damaged in the making, and there’s a hunt sprung from necessity, elliptical and drowned. Where the moving quiet of our insomnia offers up each thought, there’s a luminous field of grey inertia, and obsidian dreams burnt all the way down. ~*~ If pessimism has any pedagogical value, it is that the failure of pessimism as a philosophy is inextricably tied to the failure of pessimism as voice. I read the following, from Shestov’s The Apotheosis of Groundlessness : When a person is young he writes because it seems to him he has discovered a new almighty truth which he must make haste to impart to forlorn humankind. Later, becoming more modest, he begins to doubt his truths: and then he tries to convince himself. A few more years go by, and he knows he was mistaken all round, so there is no need to convince himself. Nevertheless he continues to write, because he is not fit for any other work, and to be accounted a superfluous person is so horrible. (shrink)

Philosophical accounts of forgiveness ordinarily emphasize three components: i) the overcoming of hostile emotions toward the wrongdoer; ii) a change of heart toward the wrongdoer, which goes beyond the cessation of hostile emotions and involves the acquisition of a more positive attitude toward him or her; iii) a willingness to restore the relationship and proceed toward reconciliation. In this paper, I examine these three presumed components, endorsing the first but rejecting the second and the third as unnecessary features of (...) forgiveness. I thus argue that forgiveness is, first and foremost, a unilateral, intra-psychic process that does not necessarily lead to reconciliation or to the fostering of friendly relations. The paper has three parts. In the first part, I argue that overcoming resentment toward one’s assailant by coming to view oneself more favourably lies at the core of forgiveness. In the second part, I show that one need not be able to view one’s assailant in a different and more favourable light to be able to overcome one’s resentment and forgive one’s assailant. Furthermore, in the third part, I argue that a wholly negative view of the wrongdoer, moral hatred and a refusal to be reconciled with him or her are compatible with forgiving him or her. (shrink)

Although a pregnant woman can now refuse any medical treatment needed by the fetus, the Court of Appeal has acknowledged that ethical dilemmas remain, adverting to the inappropriateness of legal compulsion of presumed moral duties in this context. This leaves the impression of an uncomfortable split between the ethics and the law. The notion of a pregnant woman refusing medical treatment needed by the fetus is troubling and it helps little simply to assert that she has a legal right (...) to do so. At the same time, the idea that a pregnant woman fails in her moral duty unless she accepts any recommended treatment or surgery—however great the burdens—is also not without difficulty. This article seeks to find a way between these two somewhat polarized positions by arguing that, instead of being a question primarily about whether legally to enforce moral obligations, the «maternal—fetal conflict» begins with previously unrecognized difficulties in determining when a woman's prima facie moral rights invoked in the treatment context should «give way» to the interests of the fetus. This difficulty is mirrored within the law. Thus, how can we tell when a pregnant woman has the moral or legal duty to submit to a caesarean section? Seen in this way, the conflict is a problem which lies at the interface between moral and legal rights and duties, showing that there are important conceptual links between the ethics and the law. Against this background, this article explores the limits of a pregnant woman's right to bodily integrity by focusing upon the idea of her moral duty to aid the fetus through her body. Here we find difficulties in determining the existence and extent of this somewhat extraordinary duty. Such a duty is contrasted with both negative and positive duties toward others in the course of «general conduct». Attention to the social context of pregnancy and the refusal of treatment within this is also instructive. Overall, the purpose is to foster understanding and acceptance of the current legal position. (shrink)

Opt-out systems of postmortem organ procurement are often supposed to be justifiable by presumed consent, but this justification turns out to depend on a mistaken mental state conception of consent. A promising alternative justification appeals to the analogical situation that occurs when an emergency decision has to be made about medical treatment for a patient who is unable to give or withhold his consent. In such cases, the decision should be made in the best interests of the patient. The (...) analogous suggestion to be considered, then, is, if the potential donor has not registered either his willingness or his refusal to donate, the probabilities that he would or would not have preferred the removal of his organs need to be weighed. And in some actual cases the probability of the first alternative may be greater. This article considers whether the analogy to which this argument appeals is cogent, and concludes that there are important differences between the emergency and the organ removal cases, both as regards the nature of the interests involved and the nature of the right not to be treated without one’s consent. Rather, if opt-out systems are to be justified, the needs of patients with organ failure and/or the possibility of tacit consent should be considered. (shrink)

Being targeted by Nir Eyal's ingenious argument,1 I am pleased to have the opportunity to respond. It is fairly obvious that my utilitarian argument accomplishes what it is supposed to accomplish, namely a defence of the idea that the notion of informed consent should take roughly the form it takes in Western medicine. But does it fly in the face of commonsense moral thinking? I will argue that it does not.My argument is based on hedonistic utilitarianism.2 This means that it (...) is an instance of the general pattern of argumentation that Eyal presents. It takes slightly different forms in its defence of the place of informed content in research and in the clinic. For reasons of space I will focus exclusively on the clinic.The thrust of the argument is as follows. In many cases, we should allow people to refuse treatment for the simple reason that they presumably know best what is in their interest. As J S Mill used to argue, each person has a privileged position with respect to her own life, which, as it were, she experiences from the inside, and from which she cannot walk away. …. (shrink)

Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the role of the family (...) in the decision-making process. This study does not take into account any indirect effects of defaults, such as potential psychological and behavioural effects on individuals and their relatives. -/- Design Based on previous work regarding consent policies, we created a conceptual model of the decision-making process for deceased organ recovery that included any scenario that could be directly influenced by opt-in or opt-out policies. We then applied this model to internationally published data of the consent process to determine how frequently policy defaults could apply. -/- Main outcome measures We measure the direct impact that opt-in and opt-out policies have per se on deceased organ recovery. -/- Results Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. They only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The direct impact of consent policy defaults is typically circumscribed to a range of 0%–5% of all opportunities for organ recovery. Our study also shows that the intervention of the family improves organ retrieval under opt-in but hinders it under opt-out. -/- Conclusions This study may warn policy makers that, by emphasising the need to introduce presumed consent to increase organ recovery rates, they might be overestimating the influence of the default and underestimating the power granted to families. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:No Fun and Games Until Someone Loses an Eye: Transgression and Masculinity in Bataille and FoucaultJudith Surkis (bio)In August 1963 Critique published an “Hommage à Georges Bataille,” a special issue commemorating the death of its founder. How did the volume’s contributors go about the seemingly tricky business of pledging fealty to the philosopher of sovereignty? How did they profess loyalty to, in effect recognize, the sovereign subject known to (...) insistently refuse masterful identity?Apparently undisturbed by this difficulty, the articles written by Bataille’s acquaintances—Alfred Metraux, Michel Leiris, Raymond Queneau, André Masson, and Jean Piel amongst them—establish an explicitly fraternal relation to their contemporary. Piel begins his homage with an account of their initial encounter chez Queneau in 1927, noting his “impression of extraordinary fraternity, an impression which, through our last meeting days before his death, never diminished” [721]. Intermingling intellectual and personal history, these occasional pieces remember Bataille in a variety of contexts: the awakening of his interest in ethnology and work on Documents in the 1920s, his early “confrontations” with Hegel and work on Critique sociale and Contre-attaque in the 1930s, his sensitivity to events and developments in post-World-War-II Europe. While significantly diverse in focus, these articles manifest a similar approach, at once biographical and autobiographical, detailing the unfolding of shared intellectual amitié in favorite cafés, apartments, and studios. Bataille emerges here as a historical subject whose interests and investments, while multiple and, to use Leiris’s metonym, even “impossible,” are repeatedly linked to a variety of intellectual and political milieux.Michel Foucault’s “Preface to Transgression” assumes a more reverential tone than the pieces written by members of Bataille’s own generation. While framed as an explicit “homage” in its recognition of a certain debt to Bataille, Foucault’s essay also plays upon the contradiction of pledging loyalty to a “sovereign” who repeatedly renounces his own claim to mastery. Bataille’s death becomes an occasion on which to herald the “breakdown” and “shattering” of the masterful philosophical subject conventionally assumed to be in control of the “natural” language of dialectics [42–43]. For Foucault, a new possibility for philosophy is seen to arise in “the non-dialectical language of the limit which arises only in transgressing the one who speaks” [44], a transgression repeatedly performed, according to Foucault, in Bataille’s own writing and metaphorically enacted in and by his death. Bataille had, after all, proclaimed in the conclusion to Erotism: “To give transgression to philosophy as a foundation (it is the approach of my thought)...” Bataille’s theory of transgression aims to evoke a “world of play” in which “philosophy disintegrates” [275]. Yet, if the disintegration of philosophy in and through transgression is already Bataille’s “project,” we might inquire into why Foucault frames his article as a preface. [End Page 18]In introducing this presumably already achieved transgression, the “Preface” affects a curious, alternating temporality, a certain confusion of anteriority and posteriority. 1 At once following and preceding Bataille, Foucault remains out of sync and hence unable to coincide with Bataille in the shared amitié inscribed by the author’s contemporaries; it would appear that this generational gap introduces a certain shift in the recollection of Bataille’s legacy. Following in his footsteps, Foucault appropriates one of Bataille’s own disorienting gestures—the tactical use of prefaces, itself mentioned in the “Preface” [43]—in order to dislodge Bataille from his anterior position; instead, Bataille comes to epitomize the transgression predicted by Foucault’s “philosophical” preface. Bataille’s (and, by implication, Foucault’s own) “location” becomes confused and obscured; as I hope to show, Foucault is invested in achieving this state of indeterminacy for both himself and Bataille.To honor Bataille in death assumes a double significance for Foucault: it represents a “transgression of the philosopher’s being” which “has sent us to the pure transgression of his texts” [40] and simultaneously allows Foucault to sacralize Bataille. “Pure transgression” becomes liberated from the historically located being of the philosopher. And further, since the language of transgression is linked by Foucault to the “death of God,” Bataille becomes, in a sense, “deified” in the announcement and celebration of... (shrink)

To be satisfactory, a scholarly interpretation of a Greek tragedy must enable the present-day reader to see the play, so far as is possible, through the eyes of the fifth-century audience. If it does not, if it merely substitutes the predilections of a particular scholar for those of the reader, it is useless, and indeed worse than useless; for the reader unassisted by the interpretation of others may well examine the play critically for himself, while the reader with an interpretation (...) at his elbow is likely to make every effort to fit the ideas of the tragedian into the schema provided for him. Certainly, more and more interpretations are of the kind which assist the reader; but a significant number even of the most recent throw more darkness than light on their subject by refusing to acknowledge the whole context of value and belief in terms of which the tragedians wrote, and the audience watched, these dramas. The result of such misinterpretation is frequently, as in the case of the two I shall discuss here, to present for our admiration a more high-minded and uplifting drama than the one which Euripides wrote; but our concern is presumably not to achieve this end, but to understand Euripides and his audience. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 741 pointedly, what he is asking for is " the ' planned dissolution ' of the Latin Church into a considerable number of distinct, autonomous ' patriarchates ' " (p. 132). These suggestions, although not original, are intriguing. They deserve, however, more than three pages. What is needed is a detailed presentation of these changes, indicating their historical context, their advantages and disadvantages, and their practical implementation. (...) Despite the criticisms given above, there is much good material to be found in this crisply written book. I agree in general with Hill's judgment that Church authority should embody a collegial rather than a monarchical ecclesiology. He shows that the MC ecclesiology has a solid foundation in scripture and tradition and its cornerstone is the theology of the local Church. Furthermore, he is correct in insisting that the doctrines of collegiality and the priesthood of the faithful are urgent questions in contemporary ecclesiology and that they have broad ecumenical ramifications. He speaks convincingly of greater lay participation, local autonomy, consultation, and accountability. At the same time, his partisanship leads him to caricature the MP view. He will not persuade many MP supporters by criticizing their "highhanded authoritarianism and paternalism " (p. 53) and " ecclesiastical dishonesty " (p. 127) or by claiming that the Roman Curia " is neuro· tically obsessed with the matter of papal authority" (p. 114). Hill makes many valid and important points, but, on occasion, he weakens them by exaggeration. At times his partisan style overcomes his theo· logical substance. The Catholic University of America Washington, D.C. pATRICK GRANFIELD Many Paths: A Catholic Approach to Religious Pluralism. By EUGENE HILLMAN. Maryknoll, New York: Orbis Books, 1989. Pp. 95. A Christian theology of religions raises fundamental epistemological and methodological questions. Hillman comes to the debate from what Lindbeck has called an " experiential expressivist " background, that is, there is a tacit assumption that reality is experienced and then expressed, that reality precedes language rather than being disclosed and shaped through language. When such an outlook is applied to the theology of religions, the outcome is often the " discovery " of a common experience underlying all religions, despite their different expressions. The latter can be seen to vary according to climate, history, temperament, and so on. Such expressions are loose symbols for a 742 BOOK REVIEWS greater reality, which takes on an increasingly vague shape with the demise of the signifier. History can offer very little resistance to such a model, and the conflicts, differences, intractabilities, and real problems of religious plurality are slowly silenced, almost numbed into a drowsy calm. That history refuses to play this role, while theologies of religion are often demanding it, is indicative of the difficulties with such a model. Hillman's first book on this topic (The Wider Ecumenism, 1968) showed him to be a follower of Rahner. He stressed the universality of grace and its mediation through the historical and particular; he thereby argued for a wider ecumenism with regard to the world religions, in a model analogous to intra-Christian ecumenism. In this book, Hillman advances the same position, but now infused with a strong dose of Wilfred Cantwell Smith. He does not confront the theological criticisms made against either of his mentors. The book is divided into four lucid chapters. The first considers the meaning and role of religion, and much of Hillman's discussion is helpful. However, as the chapter proceeds, one finds that the definition of religion is not controlled by the particularities and intractable dif. ferences presented by the subject matter but rather by an experiential essentialism. Hillman uses Smith's distinction between "faith" and " belief " to two ends, one descriptive, the other evaluative. However he, like Cantwell Smith, conflates description with evaluation. Furthermore, he is untroubled that the subject matter under inspection does not easily yield to such distinctions. Descriptively, " belief " or the " cumulative tradition " involves the " myriad historico-cultural par· ticularizations " that go to make up a religion such as liturgies, doc· trines, ethical systems, practices, histories, and so on {20). Faith is basically an experience of " the tr,anscendent, which is presumably the same for every person," and can be distinguished from the "cumulative tradition, which is different for each people, nation or... (shrink)

One probable success (the case of Mrs Tonge) is not a great deal to set against the courts' overwhelming reluctance to play a part in challenging resource allocation decisions. Nevertheless, where such decisions are inherently unreasonable—for example, as Margaret Brazier has suggested,11 a refusal to treat patients because they are divorced, or because they are Labour Party members—a remedy would be available through the courts. Presumably gender biased rationing decisions would similarly be susceptible to judicial review, although there might (...) be evidential difficulties. Age-related denial of treatment would probably not in itself be considered to be ‘Wednesbury unreasonable’. If it could be shown that within the one health authority a particular patient or a group at a set age were denied treatment others at the same age received, there might be scope for an application to the courts. Evidence sufficient to satisfy judges ‘notoriously unwilling to overturn doctors' decisions’11 would be hard to collect.While courts cannot be expected to determine health care policy, their refusal to examine in any detail the decision-making processes of Health Service authorities has ratified ‘the opacity of current decision-making’.12 Instead of forcing authorities to take decisions in a reasoned and justified manner, the courts by their very conservative application of the Wednesbury decision have allowed them to hide from public scrutiny. (shrink)

In this article, I first criticize commonly held assumptions about what Islamic law is. I suggest that it is at best useless and at worst wrong to start with a label like ‘Islamic law’ to describe something that is presumed to be an instance of such a label. I identify the source of confusion, i.e. the postulate that there must be a kind of genealogical continuity between what people refer to as Islamic law and Islamic law as it is (...) found in the heterogeneous legacy of sharî’a and fiqh treatises. My contention is that Islamic law is what people consider as Islamic law, nothing more, nothing less, and that it is up to theologians, believers and citizens, not social scientists, to decide whether something does conform or not to some ‘grand tradition’. Second, I argue that instead of looking at the hypothetical Islamic-law model, which something like Egyptian personal status law would be an instance of, the task of social scientists is, rather, to describe the situations, the mechanisms and the processes through which people orient themselves to something they call ‘Islamic law’. This position is grounded on a principle of indifference that seeks to avoid any normative and evaluative engagement: the focus is put on the description of practices, not on their evaluation. Moreover, this position is based upon the refusal of any ironical standpoint. In other words, it denies that social scientists occupy any kind of overhanging position vis-a-vis the social that would allow them to ‘reveal’ to ‘self-deceived people’ the truth that is concealed from them because of their ‘lack of critical distance’, ‘ignorance’ and/or ‘bad faith’. Third, I ground this praxiological re-specification in examples drawn from Egyptian judicial activity in the field of personal status. (shrink)

Frankena sees moral point of view theories as steering a middle course between scepticism or relativism in ethics and absolutism or dogmatism. The constraints of a distinctive point of view limit the range of moral judgments, provide some basis to expect agreement between different moral judges, and generate standards if not of moral truth at least of moral acceptability. Since however these constraints arise only from the moral point of view, they are avoidable if the point of view is avoidable, (...) and do not impose absolute inescapable demands on every person. Frankena sees the judgments made from the moral point of view to include categorical ones, but since he does not characterize the point of view itself as either the final court of practical reason or as an inevitable point of view, the categorical judgments made from that point of view are themselves externally conditional on taking that view-point. The most that can be said is that when and if one takes that viewpoint, certain demands are inescapable and unconditional. The whole illocutionary act of making the categorical moral judgment is as it were limited by the condition that one’s hearers, including oneself as hearer, share the point of view. Made fully explicit, what I am calling the external conditional would take this form: “Provided that one takes the moral point of view, one must acknowledge the unconditional obligation to …”. This is quite different from claims like “If one is a parent one has obligations to one’s child,” which is itself presumably a claim which may have an implicit initial qualifier of the form “From the moral point of view …” or “From the legal point of view …”. It might of course also be saying “From the point of view of practical rationality as such, a point of view which one cannot refuse to take, and beyond which lies no more comprehensive or corrected point of view …”. Frankena distinguishes this ultimately authoritative practical judgment from a moral judgment, while nevertheless suggesting that practical reason will normally endorse what morality has decreed. It is not, however, part of the very meaning of “moral point of view” that that point be final or inescapable for human persons. (shrink)

Towards the end of the Byzantine Empire many texts of the Latin Fathers were translated into Greek, beginning with the De Trinitate of Augustine. This flurry of translation spurred discussion on the authority of the Fathers. The Greeks were now confronted with the problem of what one should do when the (presumably infallible) Fathers justify apparent heresy (the Filioque)? This question became crucial after the Council of Florence and the fall of the Byzantine Empire. What is the definition of a (...) Father? A saint? A disciple? Is it possible to honour a Father and yet refuse to follow him on a particular point of doctrine? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:31 Hunie on Intuitive and Demonstrative Inference This paper is divided into four sections. The first section deals with Hume's attempt to resolve a dilemma concerning the objects of intuitive and demonstrative inference. In the second section I try to show that his resolution of the dilemma is hard to reconcile with his phenomenalist doctrine of the origin of ideas. In the third section I examine tne meaning of (...) "intuition" in Hume. Finally, in the fourth section I compare his view of mathematical inference with his view of causal inference, a kind of inference to which he tends to assimilate the former. What are the objects of intuitive and demonstrative inference in Hume supposed to be? In the Treatise they are co-extensive with four kinds of philosophical relations resemblance, contrariety, degrees in quality and proportions in quantity or numbers. The distinguishing characteristic of the group, according to Hume, is that they all depend entirely on the ideas which we compare together. Tne example he gives is that of a triangle 2 whose three angles are equal to two right ones. And this presumably is at the same time an example of a relation of proportion in quantity or numbers. Needless to say, what cries out for explanation here, apart from the notion of comparison with which we shall deal later, is the phrase "depend entirely upon the ideas." Hume himself does not provide the explanation. Consequently, a certain amount of speculation becomes inevitable. One fairly plausible although, as we shall see, not entirely satisfactory interpretation of the phrase in question would associate it with a thesis concerning the reducibility of relations between exemplars of properties to relations between the properties themselves. Thus it may 32 be argued that the equality holding between the three angles of a triangle and two right angles is reducible to an equality holding between certain of their properties. The properties would be the 180° that each set of angles exemplifies. Indirect evidence for this interpretation is provided by Hume's account of the relations of contiguity and distance, species presumably of relations of time and place, which do not, according to him, depend upon the ideas wnich are compared together. Indeed, these relations may be changed by "an alteration of their place, without any change on the objects themselves or on their 3 ideas." "The place" in its turn "depends on a hundred 4 different accidents which cannot be foreseen by the mind." Leaving aside Hume's failure or refusal to draw a clear distinction here between ideas and objects which probably has to do with his belated realization that only the latter have places and are contiguous to or distant from one another, one notes his insistence that an object's place is not an essential property of the object. For his use of the word "accident" in the above-quoted passage has very little to do with its ordinary use and everything to do with its logical one where it is contrasted with "essential." Furthermore, the sentence immediately preceding the one containing that passage gives some indication of what Hume takes its logical use to be : A determinate property is an accidental one if loss of that property does not affect the object's identity or, as he would put it, the object itself. Nor is the accidental nature of the property anything but reinforced by its dependence logical or otherwise upon other accidental properties which like all such properties require an appeal to observation and induction in order to determine whether they are exemplified by that object. The loss of an essential property, on the other hand, would affect the object's identity because such properties are contained in the very definition of the object. And it suffices to understand the definition - Hume's foreseeing by the 33 7 mind comes in here - in order to determine that the property is exemplified by the object. How does this account provide indirect evidence for our interpretation of Hume? The answer is relatively straightforward. According to that interpretation, relations which depend entirely on the ideas which we compare together are tnose where relations between exemplars of properties are reducible to relations between... (shrink)

BackgroundTo prevent the planet from catastrophic global warming a reduction of greenhouse gas emissions to net zero is required. Thus, divestment from fossil fuels must be a strategic interest for health insurers. The aim of this study was to analyse the implementation of environmental, social and governance criteria in German private health insurers’ investments.MethodsIn 2019 a survey about ESG strategies was sent to German private health insurance companies. The survey evaluated investment strategies and thresholds for the exclusion of sectors and (...) business practices, as well as company strategies for sustainable business development.FindingsGiven their business reports, German private health insurers manage assets of more than €350 billion. 11 of 40 insurance companies provided quantitative data, 10 refused to answer. According to quantitative data, €66 billion of assets is managed according to any ESG criteria; this equals an average of 76% of each company’s bonds. None of these insurers excluded the production and sale of fossil fuels. All excluded coal mining but only at high thresholds. For €226 billion, no data were provided.InterpretationThe findings are in contrast to the expected intrinsic economic interest of the insurers to stop global warming and improve public health. The majority of assets are managed in a highly problematic manner, especially the absence of capital allocated in fields contrary to medical ethics cannot be presumed. Lack of transparency is a major problem that limits clients in choosing the insurer who has the most advanced ESG criteria. (shrink)

Thomas Nevin's new reading of Nietzsche is at home on an island of misfit toys. Like Ariosto's Astolfo, who goes to the moon in search of Orlando's sanity only to find the good things that humanity has shed, Nevin has gone—not quite as far as the moon—in search of a true Christian. That Nietzsche might brook accommodation in his father's house, however, pleads convincingly that Luther may have wanted to reform the Church but ended up installing a lost-and-found box instead. (...) Late of the quincentenary of Luther's Ninety-Five Theses, Nevin has sorted through half a millennium of Christian miscellany and found the following items: one failed monk who refused to presume that he could love God; a late gnostic theosophist... (shrink)

Sacrifice, solidarity, and social decadence were essential themes not only for Patočka's philosophical work, but also for his personal life. In the "Varna Lectures" sacrifice is characterized uniquely as the privation of a clear telos, as counter-escapist, and as sutured to a comportment of finite life that is non-causal and non-purposive. In his Heretical Essays a similar hope is expressed to extract meaningfulness from use-value, and to deploy a Socratic and Christian "Care for the Soul" that can counteract the decadences (...) of our age. These interests and developments of the practice and notion of sacrifice point to Patočka's double-hereticism, both of the post-industrial age of technological advancement, and of what had become the unthought-through of the Christian tradition. In both senses, his theory of sacrifice is not unlike that of St. Paul, who saw the necessity of counter-acting the decadence and pompousness of the Corinthians by calling them to become "scum of the earth." This helps reveal how sacrifice presumes, in general, an operative notion of waste, and this paper seeks to lend further understanding to the relation between solidarity and sacrifice by developing, from out of Patočka's own work, precisely how waste figures prominently in such a relation. Waste may be refused by merit of being deemed to have no value; waste can mark a layer of expenditure of using "something up" in a way that overlooks its societal surplus; and waste could depict whatever is, like a wasteland, uncultivable and barren. Waste then is employed in the essay as a heuristic tool for understanding how the normalization of the relation between solidarity and sacrifice is in need of being inverted, and how this inversion has consequences also for how solidarity can be considered in relation to atonement. (shrink)

Singapore's Human Organ Transplant Act presumes that competent adults consent to donate their kidneys in the event of a fatal accident, unless they have refused in writing. No family consent is required. What can other countries wishing to implement a presumed‐consent model of organ donation learn from Singapore's experience?

In lieu of an abstract, here is a brief excerpt of the content:On Doing Theology and Buddhology:A Spectrum of Christian ProposalsAmos YongThis essay addresses the following questions: "Can/should Buddhists and Christians do theology/Buddhology together? If no, why not? If yes, why and how?" As a Pentecostal Christian systematician and comparativist, I review a number of volumes recently published in the field in light of these queries1 and situate them across a typological spectrum.2 I will conclude by providing my own constructive (...) theological response.3Evangelical VoicesKeith Yandell, the Julius R. Weinberg Professor of Philosophy at the University of Wisconsin, Madison, and Harold Netland, former missionary to Japan and longtime faculty member in philosophy of religion and intercultural studies at Trinity Evangelical Divinity School in Deerfield, Illinois—one of the most important evangelical seminaries in North America—have collaborated on a volume recently jointly released by two of the most important evangelical publishing houses, InterVarsity Press and Paternoster Press.4 These are senior evangelical scholars; between them, they have written or edited numerous books in the areas of philosophy of religion, epistemology, theology of pluralism, and theology of interreligious encounter, among other topics, along the way touching on many aspects of the subject matter in their coauthored book, Buddhism.5 How would they respond to the set of questions above? More particularly, how might we anticipate their response in light of their book?In contrast to previous evangelical engagements with Buddhist traditions, Yandell and Netland provide an exemplary model for future evangelical discussions of Buddhism in the following respects. First, they take the time to understand Buddhist traditions on their own terms, devoting the first half of their book to a historical exposition of Buddhism's emergence, growth, and development across Asia and the West. Second, both have familiarized themselves with the diversity of Buddhist debates and internal disputes, and thus recognize that Buddhists rarely speak with [End Page 103] one voice, especially on complex issues; this is important since it enables them, by and large, to avoid caricatures of Buddhist positions and of erecting straw-man arguments against Buddhist doctrines and ideas. Last but not least, Yandell and Netland do engage in negative apologetics against central Buddhist doctrines,6 as might be expected of evangelical scholars, but they undertake their critical analysis respectfully and with dialogical rhetoric quite different from the kinds of polemic deployed by prior generations of evangelicals.7Yet even given these advances, in the end, Yandell and Netland emphasize the incommensurability of Buddhism and Christianity. The final chapter of their book distinguishes Christian views of God versus Buddhist conceptions of ultimate reality, Jesus vis-à-vis the Buddha, and the human fall into sin needing gracious forgiveness over and against human ignorance needing enlightenment. Their concluding words assert: "These are not simply variations on a common theme, or different ways of expressing the same spiritual insight. The choice here is between two radically different perspectives on reality, on the nature of the human predicament, and the way to overcome it."8To be sure, Yandell and Netland have provided reasoned arguments for such a contrastive perspective, emphasizing especially what they feel to be the incoherence or unintelligibility of the Buddhist teachings that they examine. But if their evangelical readers agree with their conclusions, it will be only because they are not in the position to appreciate—the expositions of this volume notwithstanding—how Buddhists have wrestled with these issues over the millennia but yet come to peace with some of the answers that continue to mystify Yandell and Netland. More specifically, this book will probably appeal to evangelicals because they also presume the sort of either/ or logic at work in its central arguments. Put alternatively, the Buddhist worldview will remain baffling to most evangelicals because they either lack access to or refuse to avail themselves of the practices that give these ideas meaning. Such is the cost of staying primarily at the level of philosophical discourse and analysis.9This probably means that Yandell and Netland would answer "no" to the leading questions of this essay. Christians and Buddhists occupy, in their perspective, incommensurable religious and intellectual grounds. Sustained interreligious encounter can result only in the awareness of the differences... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.4 (2005) 335-342 [Access article in PDF] Psychoanalysis as a Hybrid of Religion and Science Quinton Deeley Keywords Freud, psychoanalysis, religion, science, evolution Introduction De Block's paper, "Freud as an Evolutionary Psychiatrist," discusses Freud's writ-ings—including a recently discovered paper on the evolution of psychopathology—to establish the Freudian "philosophy of man" that human beings are "ill to the core" (i.e., that mental illness is an inevitable (...) byproduct of human psychological processes). This perspective is then used as a basis for proposing a way in which psychoanalysis can be integrated with contemporary evolutionary psychology. However, this undertaking raises fundamental questions about psychoanalysis itself, which are addressed in this commentary. First, to what extent is a systematic theoretical unity imposed on, rather than discovered in, Freud's writings? Also, has De Block succeeded in grounding the Freudian philosophy of man in evolutionary theory, and how is this ambition affected by general questions about the scientific status and evidence for psychoanalytic conceptions? Further, if there is only limited experimental evidence for psychoanalytic concepts, how are claims to knowledge justified in psychoanalytic discourse, and how does this relate to the forms of epistemic justification found in religion and science? Finally, is psychoanalysis closer to religious or scientific discourse, and if it combines features of both, what kind of activity is it? The Exposition of the Freudian Philosophical Project The key claim of De Block's paper is that any evolutionary psychology faithful to Freud's account of human nature must be constrained by a fundamental premise: the psychological organization of human beings is such that "there is a quantitative, but not a structural, difference between psychiatric patients and so-called healthy or normal individuals" (2005, 323). From De Block's perspective, this reflects the Freudian perspective that the normal operation of psychological processes inevitably results in some degree of mental distress: "every repression produces symptoms, every defense mechanism produces more suffering than is strictly necessary" (2005, 321). As a result, "when Freud writes that there is only a gradual difference between neurotics and normals, he does not mean the normals are non-neurotic, but only that they suffer less under their neurosis" (2005, 318). This Freudian perspective is variously summarized throughout the paper; for example, "we think there is only one underlying motive of Freud's research, which [End Page 335] could also function as a cornerstone of a 'Freudian' philosophy. This underlying motive is the intuition that there is no substantial difference between the so-called normal human being and the mentally insane" (2005, 315).De Block's exposition of the Freudian account of human nature also emphasizes the doctrine of psychosexuality: "the Freudian philosophy of man presumes primarily that every human being has to react in some way of another to sexual problems" (2005, 317). One of the problems confronting any expositor of Freud is the fact that his voluminous writings show considerable development in his thought. This heterogeneity raises the question of the extent to which the coherence of Freudian theory as a systematic whole is imposed by expositors, rather than lying in the corpus itself. De Block's approach to this heterogeneity is to extract different kinds of relations between sexuality and psychopathology from Freud's writings (e.g., neurosis and the Oedipal instincts, psychosis and narcissism), and then to argue that they explain Freud's interest in less obviously sexual aspects of mind, behavior, and society. As De Block comments after his exegesis of different connections between sexuality and psychopathology: but probably, he [Freud] only meant that in neurosis, people wrestle first and foremost with love, in perversion with sex and violence, and in psychosis with identity and issues related to identity, such as death and "the meaning of life." At least, such an interpretation can explain why Freud—in some of his works—recognized the importance of problems like aggression, love, and death for the human psyche and human psychopathology...; he nevertheless refused to modify the primacy of sexuality in psychopathology. (2005, X) Whether all of Freud's explanations of psychological phenomena involve... (shrink)

Dans les sociétés modernes, le respect de l'autonomie est souvent considéré comme la voie royale menant à la reconnaissance de la valeur intrinsèque des personnes. Or, la philosophe américaine Sarah Conly refuse d'emprunter la voie de la sacralisation de l'autonomie. Puisant aux sources de la philosophie, de l'économie comportementale et de la psychologie sociale, elle montre plutôt le caractère irréfléchi de nos décisions et soutient en conséquence que certains de nos choix, présumés autonomes, sont en grande partie nuisibles à l'atteinte (...) de nos propres buts fondamentaux : être en santé, libre et heureux. Nous sommes des êtres rationnels, mais le sommes-nous vraiment dans notre vie de tous les jours? Croyons-nous vraiment être capables de toujours prendre les bonnes décisions? Pour Sarah Conly, dans de nombreux cas - sécurité routière, saine alimentation, retraite -, nos aspirations seraient mieux réalisées si l'Etat nous empêchait d'agir en fonction de nos seules intuitions ou convictions premières. Tel est le sens du paternalisme coercitif, dont l'auteure entend montrer les bienfaits. Une telle prise de position remet largement en question les vues habituelles sur la moralité, la démocratie ou la frontière séparant le public et le privé. (shrink)

Abstract:This essay takes up Huey Newton’s notion of revolutionary suicide. Against the objection that black suicide is merely reactive, Newton proposes that revolutionary suicide follows other principles and demonstrations. Revolutionary suicide is resistant but in ways that does not make it always possible to distinguish between resistance and reaction—in fact, Newton argues that black revolutionary suicide should be considered a life-affirmation, and that this affirmation reveals a will to power in a decidedly Nietzschean sense. This means—if we read suicide as (...) resistant in its reactions—that black affirmation cannot be read on the order of a sovereign decision (as a sacrificial relation to life and death); nor as will, representation, or as a refusal which always relates to an end (the end of oppression, or injustice). This is why, strictly speaking, Newton’s reading of revolutionary suicide is not to be confused with a classical notion of sovereignty (whether that of Bataille or Mbembe), nor with the political definition of self-murder as resistance (by Spivak, or Puar). At the end of this essay, the notion of revolutionary suicide is shown to be something else altogether. That is to say, revolutionary suicide serves not only to realize the form of the one and the multiple (according to a non-messianic and non-sacrificial economy), but also puts into question the presumed inescapable relation between blackness and state murder (due to the relentless nature of necropower and anti-blackness). (shrink)

Sacrifice, solidarity, and social decadence were essential themes not only for Patočka's philosophical work, but also for his personal life. In the "Varna Lectures" sacrifice is characterized uniquely as the privation of a clear telos, as counter-escapist, and as sutured to a comportment of finite life that is non-causal and non-purposive. In his Heretical Essays a similar hope is expressed to extract meaningfulness from use-value, and to deploy a Socratic and Christian "Care for the Soul" that can counteract the decadences (...) of our age. These interests and developments of the practice and notion of sacrifice point to Patočka's double-hereticism, both of the post-industrial age of technological advancement, and of what had become the unthought-through of the Christian tradition. In both senses, his theory of sacrifice is not unlike that of St. Paul, who saw the necessity of counter-acting the decadence and pompousness of the Corinthians by calling them to become "scum of the earth." This helps reveal how sacrifice presumes, in general, an operative notion of waste, and this paper seeks to lend further understanding to the relation between solidarity and sacrifice by developing, from out of Patočka's own work, precisely how waste figures prominently in such a relation. Waste may be refused by merit of being deemed to have no value; waste can mark a layer of expenditure of using "something up" in a way that overlooks its societal surplus; and waste could depict whatever is, like a wasteland, uncultivable and barren. Waste then is employed in the essay as a heuristic tool for understanding how the normalization of the relation between solidarity and sacrifice is in need of being inverted, and how this inversion has consequences also for how solidarity can be considered in relation to atonement. (shrink)

The problem of decision-making capacity in patients with dementia, such as those with early stage Alzheimer's, can be vexing, especially when these patients refuse life-sustaining medical treatments. However, these patients should not be presumed to lack decision-making capacity. Instead, an analysis of the patient's decision-making capacity should be made. Patients who have some degree of decision-making capacity may be able to make a choice about life-sustaining medical treatment and may, in many cases, choose to forgo treatment.

I discuss the attitude of Jewish law sources from the 2nd–:5th centuries to the imprecision of measurement. I review a problem that the Talmud refers to, somewhat obscurely, as impossible reduction. This problem arises when a legal rule specifies an object by referring to a maximized measurement function, e.g., when a rule applies to the largest part of a divided whole, or to the first incidence that occurs, etc. A problem that is often mentioned is whether there might be hypothetical (...) situations involving more than one maximal value of the relevant measurement and, given such situations, what is the pertinent legal rule. Presumption of simultaneous occurrences or equally measured values are also a source of embarrassment to modern legal systems, in situations exemplified in the paper, where law determines a preference based on measured values. I contend that the Talmudic sources discussing the problem of impossible reduction were guided by primitive insights compatible with fuzzy logic presentation of the inevitable uncertainty involved in measurement. I maintain that fuzzy models of data are compatible with a positivistic epistemology, which refuses to assume any precision in the extra-conscious world that may not be captured by observation and measurement. I therefore propose this view as the preferred interpretation of the Talmudic notion of impossible reduction. Attributing a fuzzy world view to the Talmudic authorities is meant not only to increase our understanding of the Talmud but, in so doing, also to demonstrate that fuzzy notions are entrenched in our practical reasoning. If Talmudic sages did indeed conceive the results of measurements in terms of fuzzy numbers, then equality between the results of measurements had to be more complicated than crisp equations. The problem of impossible reduction could lie in fuzzy sets with an empty core or whose membership functions were only partly congruent. Reduction is impossible may thus be reconstructed as there is no core to the intersection of two measures. I describe Dirichlet maps for fuzzy measurements of distance as a rough partition of the universe, where for any region A there may be a non-empty set of - _A, where the problem of impossible reduction applies. This model may easily be combined with probabilistic extention. The possibility of adopting practical decision standards based on -cuts is discussed in this context. I propose to characterize the uncertainty that was presumably capped by the old sages as U- uncertainty, defined, for a non-empty fuzzy set A on the set of real numbers, whose -cuts are intervals of real numbers, as U = 1/h 0 h log [1+]d, where h is the largest membership value obtained by any element of A and is the measure of the -cut of A defined by the Lebesge integral of its characteristic function. (shrink)

Political protests involving clashes with police are often delegitimized by governments for using “uncivil” and “violent” means. Drawing on a creative video clip made by a group of Gezi protestors, this paper theorizes an alternative response, which refuses the dichotomy between peaceful and violent struggles and instead seeks to transform the field of judgement. The protestors in the clip, by echoing a verse originally written by poet Cemal Süreya, reconstruct destructive activity – breaking billboards – playfully and detached from its (...) presumed ends. Placing their performances in conversation with Giorgio Agamben’s theory of mediality – means without end – I argue that the clip reconstructs political action in play-form, corroding the significance of the means-ends relationship. In doing so, it frustrates the usual grounds of judgement within which the meaning and value of protest activities are arbitrated. (shrink)