The Treatment Escalation Plan (TEP) was introduced into our trust in an attempt to improve patient involvement and experience of their treatment in hospital and to embrace and clarify a wider remit of treatment options than the Do Not Resuscitate (DNR) order currently offers. Our experience suggests that the patient and family are rarely engaged in DNR discussions. This is acutely relevant considering that the Mental Capacity Act (MCA) now obliges these discussions to take place. The TEP is a form (...) that the doctor completes, ideally with the competent patient or close relative, documenting what treatment options would be appropriate if that patient were to become acutely unwell. Ventilation of the lungs, cardiac resuscitation, renal replacement therapy, intravenous fluids and antibiotics are all discussed. The study evaluated patient and relative experiences with the TEP. 55 patients or their relatives were interviewed regarding their experience of the TEP and thoughts regarding the process. 96% of patients and relatives evaluated thought that the TEP was a good idea. Free text comments were all positive and only 34% of patients claimed to feel anxious when completing the form. Following this study, the TEP has been expanded hospital wide and into the community within our trust. Discussions are currently taking place in hospitals within our region to introduce the TEP form into other local trusts. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:nook REVIEWS 689 if everyone behaves as if everyone is saved the result is a world in which God could appear and not be crucified. To be sure, there is a chance of an infinite life. Pascal believed human beings are potentially infinite--as is shown by our capacity for extending our knowledge to the infinite--but we are also potentially nothing, as is shown by the fact that the person (...) never really appears in our scientific accounts. It is through God that our infinity is to be achieved, and so betting on God is also betting on ourselves in a perfectly intelligible way. This involw~s a notion of infinity not explored in any of these essays, which makes it possible to share with God without changing the divine nature (or losing ours). This sharing is a payoff which cannot be attained by.just any act. Our lives may also be endless and possessed of positive value because they are not lived in hell, but this is icing on a cake which you are supposed to eat anyhow. Still, though Pascal might have taught the authors a thing or two, he would have found this book handy for some of its new conceptual analyses and some of its classic essays. Ian Hacking's 1972 analysis of what he takes to be three different arguments in Pascal remains a good starting point and John K. Ryan's historical article of 1945 still has useful things to say about Tillotson, whose maximization-of-utility argument really was the one many commentators have taken to be Pascal's. (But Ryan misses much of the background in the combination of scepticism and fideism in Charron and La Mothe le Vayer.) Among the others Jeff Jordan does a good job on the "many gods" objections, Richard Foley's account of pragmatic grounds for belief adds some clear insights (though his account of rationality is open to some objections), and Thomas V. Morris's account of the problems of wagering and evidence will be a handy reference point. Edward F. McClennen's account of finite decision is a necessary counterpart to Sorensen's infinity paper, and Philip L. Quinn opens some of the moral issues involved in all such wagers. Finally, George Schlesinger's assessment of the subtleties of theistic argument well repays the time spent reading it. The bibliography is useful and up-to-date. The editor would probably cheerfully admit his book's shortcomings as a work in the history of philosophy, but the volume must nevertheless have a place on the bookshelf of everyone for whom these issues are central. LESI,IE ARMOUR Universityof Ottawa G. W. Leibniz. De Summa Rerum: MetaphysicalPapers, z675-76. Translated, with an Introduction and Notes, by G. H. R. Parkinson. The Yale Leibniz. New Haven: Yale University Press, 1992. Pp lxiv + 145. Cloth, $37.oo. The YaleLeib,niz, under the general editorship of Daniel Garber and Robert C. Sleigh, Jr., will provide scholarly editions of Leibniz's original texts along with an English translation on facing pages. As the general editors explain in their introduction, each volume in the series will be "a collection of texts that constitute a natural unit," each will be edited and translated by a specialist who will also contribute an introduction, and 690 JOURNAL OF THE HISTORY OF PHILOSOPHY 33:4 OCTOBER i99 5 each will include writings most of which either have not been published or, if published, have not been translated. The first volume of The Yale Leibniz, edited by G. H. R. Parkinson, is a tantalizing beginning. In it, Parkinson has collected, translated, and introduced some of the most interesting papers from the Academy edition's Series VI, Vol. 3, first published in 198o. In this volume the Academy editors have placed under the title of De Summa Return those papers which Leibniz wrote between late 1675 and December 1676 and which treat problems in the philosophy of mathematics (especially those of the infinite) and in metaphysics and philosophical theology. The papers are enormously important. Toward the end of his Paris stay (which lasted from March, 1672 to October 4, 1676) and after a breakthrough in his work on... (shrink)

Contemporary critical approaches to bioethics increasingly present themselves as “relational,” though the meaning of relationality and its implications for bioethics seem to be many and varying. I argue that this confusion is due to a multiplicity of relational approaches originating from distinct theoretical lineages. In this article, I identify four key differences among commonly referenced relational approaches: the scope and nature of relationships considered, the extent of the determining influence on individual selfhood, and the integrity of individual selfhood. Importantly, these (...) four differences carry consequences for the usage of relational approaches within academic and clinical bioethics. I show that these differences attach to multiple objects of critique within mainstream bioethics and imply distinct metaethical commitments. Although I issue a cautionary note about combining relational approaches from distinct lineages, I close by suggesting that many such approaches may have their use, drawing on Susan Sherwin's sense of bioethical theories as lenses. (shrink)

Ronald Mercer - Levinas and the Philosophy of Religion - Journal of the History of Philosophy 40:3 Journal of the History of Philosophy 40.3 410-411 Book Review Levinas and the Philosophy of Religion Jeffrey L. Kosky. Levinas and the Philosophy of Religion. Bloomington: Indiana University Press, 2001. Pp. xxiv + 223. Cloth, $39.95. Emmanuel Levinas's thought has been a sleeping giant in continental philosophy, having influence upon many of his contemporaries while drawing minimal attention to himself. In the last (...) few years, however, as evidenced by the explosion of secondary literature on Levinas, it is clear that scholars are awakening to Levinas's importance. Jeffrey Kosky's work, Levinas and the Philosophy of Religion, joins this secondary.. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 41.4 (2003) 571-572 [Access article in PDF] Simon Critchley and Robert Bernasconi, editors. The Cambridge Companion to Levinas. New York: Cambridge University Press, 2002. Pp. xxx + 292. Cloth, $65.00. Paper, $23.00. The goal of the Cambridge Companion to Philosophy series has been to "dispel the intimidation" that students and non-specialists often experience when faced with the works of a "difficult and challenging (...) thinker" (i). Indeed, Emmanuel Levinas would qualify as such a thinker, whose work is firmly rooted in two traditions: (1) the admittedly abstruse and seminal phenomenologies of Edmund Husserl and Martin Heidegger and (2) Judaism, including the Talmudic tradition, the philosophy of Franz Rosenzweig, as well as Levinas's experience with rampant anti-Semitism in twentieth-century Europe. The imminent danger in producing a collection with the express intent of making a challenging thinker accessible is that the force of the thought may become undermined by the process of simplification. The Cambridge Companion to Levinas, however, achieves its goal as a book that not only elucidates Levinas but also provides numerous essays that even the Levinasian scholar will find useful.Simon Critchley and Robert Bernasconi are directly responsible for the success of the Companion. These two editors have proven themselves as adept collaborators in the area of Levinasian philosophy with their earlier contribution to Indiana University Press's series Studies in Continental Thought: Re-reading Levinas (Simon Critchley and Robert Bernasconi, editors [Bloomington: Indiana University Press, 1991]). This new cooperative effort offers essays that introduce Levinas's thought from the perspective of some of the many fields upon which he has had an influence including the philosophy of language, art, feminism, Judaism, phenomenology, and the philosophy of religion.Even with the many tangential fields to which Levinas's thought contributes, the Companion often refers to Derrida's metaphor which describes Levinas's work as a wave, the "same" wave, crashing on the beach with increasing demand. Derrida, however, is also partly responsible for the intensifying return of Levinas's work. Derrida's critique of Levinas's Totality and Infinity was the impetus behind Levinas's subsequent focus on language and the problematic of "how" one speaks of that which is outside being. Certainly, the Companion could have spent the majority of its pages outlining this philosophical, textual conversation, but such an explication would have compromised the accessibility of this introductory text to the non-specialists to whom this series caters. The editors, instead, chose to avoid Derrida's difficult critique while having a significant concentration of essays that deal with Levinas's philosophy of language. This allows neophyte students of Levinas to discover his intricate thought on language without necessary knowledge of the context as well as provide those scholars interested in the debate access to the most contemporary thought on the matter—at least from the Levinasian perspective. Readers are assured, then, that the Companion covers the difficult concepts of the speaking face from the early period to the later distinction of the "saying" and the "said," inspired by Derrida's critique.The Companion, unfortunately, seems one sided concerning an important aspect of Levinas's philosophy. Throughout his entire corpus, Levinas attributes his thought to the seminal work of Edmund Husserl, continually inviting his readers to begin again with Husserl's phenomenology. Rudolph Bernet contributes to this collection an outstanding analysis of Levinas's critique of Husserl, describing some of the departures that Levinas makes from Husserl's phenomenology. The rest of the Companion, however, makes note to downplay Levinas's positive indebtedness to phenomenology. Hillary Putnam promises to explain Levinas with a "minimum of reliance on any prior knowledge of the two great 'H's (Husserl/Heidegger)" (40). Adhering to her word, in an otherwise insightful essay, means that the phenomenological issue remains superficial. While it is never absent, Bernet's essay seems to have set the tone, placing Levinas in a position of opposition with Husserl with a minimum of discussion of what Levinas has called his adherence to the "spirit" of phenomenology. To the Companion's credit... (shrink)

He shows us that Kierkegaard's expressed intent is to provide readers with the opportunity to choose or reject Christ. He explores the question of who Kierkegaard understands Jesus to be and why he believes that faith or history alone cannot answer this question, claiming that history is meaningful only when it is understood from the perspective of "sacred history." Kierkegaard's Livingroom explores what "sacred history" is, why it is so important to us, and why it depends on an incarnate God. (...) Mercer argues that Kierkegaard is not tilting at windmills but responding to Hegel's view of history and Kant's view of faith, showing that Kierkegaard has much to contribute to the debates on liberalism and post-modernism. (shrink)

In Kierkegaard's Livingroom David Mercer weaves his way through the Philosophical Fragments, bringing the reader a new understanding of Kierkegaard's work. Placing the Philosophical Fragments in the context of Kierkegaard's others works, Mercer's commentary shows how literary style and character are used to reveal the nature of history and time.

Donald Davidson holds that metaphors have no linguistic meaning in addition to their literal meaning. Max Black and Frank B. Farrell each contends that Davidson’s view is inconsistent with the fact that metaphors are appropriate objects of explication and evaluation. However, as I show, Davidson’s view actually is entirely consistent with this fact. I also argue that Black’s and Farrell’s own accounts of metaphor imply that sometimes the linguistic meaning of a sentence is other than a product of the meanings (...) of its words and its logical form, and I give a reason why accounts of metaphor with this implication are best rejected. E.M. Zemach, for his part, agrees with Davidson about what metaphors mean, but contends that, on Davidson’s recent account of language and interpretation, all metaphors turn out to be true; metaphors express novel or impractical but nonetheless literally true comparisons or categorizations. Zemach, however, I argue, has neglected the distinction between how speakers actually apply their words to things and their standards of correct application. (shrink)

The Routledge Handbook of Feminist Bioethics, edited by Wendy A. Rogers et al., presents a thorough, contemporary understanding of feminist bioethics, linking feminist efforts to other critical approaches in the field of bioethics. A more demanding standard for feminist scholarship is set by engaging gender at its intersections with race, class, sexuality, and ability––intersections that require bioethicists to attend to issues like incarceration and transmisogynistic violence that are less frequently tackled in the field. Editors and contributors alike in this volume (...) show that long‐standing feminist conceptual interventions, especially those regarding the significance of relationality and epistemic marginalization, provide key tools for a coalition of critical approaches to bioethics. (shrink)

“Care robots” offer technological solutions to increasing needs for care just as economic imperatives increasingly regulate the care sector. Ethical critiques of this technology cannot succeed without situating themselves within the crisis of social reproduction under neoliberal capitalism. What, however, constitutes “care” and its status as a potential critical resource, and how might care robots damage this potential? Although robots might threaten norms of care, I argue that they are by no means necessarily damaging. Critiques of care robots must not (...) entrench exclusionary images of the ideal carer. Instead, critical reflection on their use should trouble dominant paradigms of care. (shrink)

The crisis of Covid‐19 has forced us to notice two things: our human interdependence and American society's tolerance for what Nancy Krieger has called “inequalities embodied in health inequities,” reflected in data on Covid‐19 mortality and geographies. Care is integral to our recovery from this catastrophe and to the development of sustainable public health policies and practices that promote societal resilience and reduce the vulnerabilities of our citizens. Drawing on the insights of Joan Tronto and Eva Feder Kittay, we argue (...) that the ethics of care offers a critical alternative to utilitarian and deontological approaches and provides a street‐ready framework for integration into public health deliberations to anchor public policy and investments concerning the recovery and future well‐being of America's citizens and society. (shrink)

Despite what you have heard over the years, the famous evil deceiver argument in Meditation One is not original to Descartes. Early modern meditators often struggle with deceptive demons. The author of the Meditations is merely giving a new spin to a common rhetorical device. Equally surprising is the fact that Descartes’ epistemological rendering of the demon trope is probably inspired by a Spanish nun, Teresa of Ávila, whose works have been ignored by historians of philosophy, although they were a (...) global phenomenon during Descartes’ formative years. In this paper, I first answer the obvious question as to why previous early modernists have missed something so important as the fact that Descartes’ most famous publication relies on a well-established genre and that his deceiver argument bears a striking similarity to ideas in Teresa’s final work, El Castillo Interior? I discuss the meditative tradition at the end of which Descartes’ Meditations stands, present evidence to support the claim that Descartes was familiar with Teresa’s proposals, contrast their meditative goals, and make a point-by-point comparison between the meditative steps in Teresa’s Interior Castle and those in Descartes’ Meditations which constitute their common deceiver strategy. My conclusion makes a case for a broader and more inclusive history of philosophy. (shrink)

while no one was looking, contextualism replaced rational reconstructionism as the dominant methodology among English-speaking early modern historians of philosophy. In this paper, I expose the contours of this silent revolution, show that rational reconstructionism is a thing of the past among early modern historians, and examine the current state of early modern scholarship.1 As the contextualist revolution has increasingly widened our perspective and revealed the period’s philosophical diversity, it has encouraged early modernists to develop new skills and expertise. I (...) propose here that current early modern historians are devoted to maximize... (shrink)

This commentary responds to “Home Care in America: The Urgent Challenge of Putting Ethical Care into Practice,” by Coleman Solis and colleagues, in the May‐June 2023 issue of the Hastings Center Report. More specifically, we respond to the authors’ call for “inquiry into the nature, value, and practice” of home care. We argue that the most urgently needed normative reset for thinking about care work is the replacement of dominant individualistic thinking with systemic thinking. Deepening a focus on the social, (...) economic, and historical forces that shape the state of contemporary care work will help bioethicists to argue more effectively for improvements to working conditions. In turn, better working conditions will ease the oppositional stance between caregivers and receivers that has been set up by the current system, enabling all parties involved to better pursue the feminist ethical ideal of care. (shrink)

This book offers a major reassessment of Leibniz's metaphysics. Christia Mercer has exposed the underlying doctrines of Leibniz's philosophy. By analysing Leibniz's early works she demonstrates that the metaphysics of pre-established harmony developed many years earlier than previously believed and for reasons which have not been understood. As a result of this analysis she has unearthed a philosophical school that Leibniz scholars have not recognized. A much deeper understanding of some of Leibniz's key doctrines emerges. Moreover, since the Leibniz (...) that is revealed here does not fit neatly into the standard accounts of the history of philosophy and science, Christia Mercer's study will prompt scholars to reconsider their basic assumptions about early modern philosophy and science. (shrink)

Introduction: The humanities enrich and transform the practice of medicine. What remains to be seen, however, is how best to integrate humanities into the medical curriculum to optimize both educational and patient-related outcomes. The present study considers the structure of an innovative student-driven humanities curriculum and seeks to understand its strengths and limitations, as well as make recommendations for improvement. Methods: The Penn State College of Medicine, University Park Regional Campus uses an inquiry-based approach to education, whereby students are responsible (...) for creating learning objectives in four core pillars of exploration: Foundational Science, Clinical Science, Health Systems Science, and Health Humanities. This study explores student-derived humanities learning objectives (HLO) across four years of the curriculum. Results: 420 HLOs met criteria for analysis and were coded as instrumental (developing direct clinical skill), non-instrumental (non-skill based), or both. Of these, 125 (30%) were instrumental, 239 (57%) were non-instrumental, and 56 (13%) were coded as both. Most instrumental HLO centered around communication skills. Non-instrumental HLO most commonly focused on bearing witness and critiquing a particular experience within a social and/or political context. Conclusions: Findings from this study contribute to the development of a humanities curriculum in a student-directed learning program. Non-instrumental HLO lacked a theoretical framework to guide student’s investigations to a deeper level of analysis. Student-directed learning offers many strengths, but can be enhanced through external direction from humanities trained faculty, particularly given that many medical students have a limited humanities background. (shrink)

In its institutionalized form, disability studies has historically drawn from political activism in the United States and the United Kingdom, particularly struggles that sought rights and recognition through the development of a social understanding of disability in opposition to the mainstream medical model.1 Recent work that expands the geographic scope of disability studies beyond these contexts has spurred debate about the challenges such a move poses to the foundations of the field. This essay responds to the field’s transnational turn by (...) interrogating recent work by Nirmala Erevelles, Jasbir Puar, and Robert McRuer that displaces the white, wealthy, and Western contexts that have grounded the landmark achievements of disability studies. At issue here are the category struggles that emerge when a concept confronts the conditions and limits of its own migration. (shrink)

Philosophy Compass, Volume 17, Issue 4, April 2022. -/- In a moment where needs for care are acute and their provision precarious, feminist care ethics has gained new relevance as a framework for understanding and responding to necessary interdependence. This article reviews and evaluates two long-standing critiques of care ethics in light of this recent research. First, I assess what I call the pluralist feminist critique, or the dispute over the ability of care ethics to address the needs and histories (...) of a range of marginalized subjects. I identify two forms of this critique: the first disputes the biased starting points shaping the development of the theory, and the second concerns the weaponization of care in support of domination. Although these critiques are well-established, I draw attention to recent responses that move care theory in generative directions. I argue that the pluralist feminist critique demands both self-critical transformation in dialog with other feminist schools of thought and a robust account of care ethics' normative authority. I then take up critiques those levied by mainstream ethicists concerned with care theory's adequacy as an ethical approach. I show that recent work on normative authority, conceptual uniqueness, and the grounding of responsibility must be engaged before care theory can be dismissed as “under-theorized.” In articulating these two sets of critiques and evaluating recent rebuttals to them, I argue for a pluralist feminist theory of care within which strands informed by varying philosophical schools and methods can coexist. (shrink)

In this paper, I examine the arguments offered by prominent ancient philosophers and medical theorists to justify the view that female bodies are imperfect or “mutilated” compared to male bodies from which it is supposed to follow that women are morally inferior to men. These arguments rendered men superior to women and justified the need for women to subjugate themselves to their procreative powers and to the wisdom of their superiors. Western sexism and misogyny has its roots here. It is (...) unsettling to witness the ease with which a few men writing millennia ago laid the groundwork for centuries of sexism and depressing to realize that many of our contemporaries embrace the residue of these ancient ideas. But it is important for us to understand how these sexist attitudes arose, how they maintained themselves, and how utterly contingent they are. (shrink)

Descartes intended to revolutionize seventeenth-century philosophy and science. But first he had to persuade his contemporaries of the truth of his ideas. Of all his publications, Meditations on First Philosophy is methodologically the most ingenuous. Its goal is to provoke readers, even recalcitrant ones, to discover the principles of “first philosophy.” The means to its goal is a reconfiguration of traditional methodological strategies. The aim of this chapter is to display the methodological strategy of the Meditations. The text’s method is (...) more subtle and more philosophically significant than has generally been appreciated. Descartes’ most famous work is best understood as a response to four somewhat separate philosophical concerns extant in the seventeenth century. Section 1 describes these. Section 2 discusses how Descartes uses and transforms them. A clearer sense of the Meditations’ methodological strategy provides a better understanding of exactly how Descartes intended to revolutionize seventeenth-century thought. (shrink)

The main goal of this chapter is to present the basic components of Anne Conway’s metaphysics of sympathy. To that end, I will explicate her concepts of God or first substance and second substance or Christ with special emphasis on the key role that the second substance plays in her philosophy. I argue that one of the keys to Conway’s system lies in her reinterpretation of the Christian narrative about suffering. She combines Christian imagery with ancient and modern ideas in (...) an attempt to create a philosophy that will appeal to people of all faiths and explain ‘all phenomena in the entire universe’ ). Christ’s role as a metaphysical and moral figure is crucial to Conway’s philosophy and helps explain her views about suffering and the importance of sympathy in her philosophy. (shrink)

Contributing Authors Include Oliver L. Reiser, Alvin Priestly Bradford, Irving J. Lee, And Others. Non-Aristotelian Methodology Applied For Sanity In Our Time.