RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

(Report assembled for the Workshop of the AMIA Working Group on Formal Biomedical Knowledge Representation in connection with AMIA Symposium, Washington DC, 2005.) Best practices in ontology building for biomedicine have been frequently discussed in recent years. However there is a range of seemingly disparate views represented by experts in the field. These views not only reflect the different uses to which ontologies are put, but also the experiences and disciplinary background of these experts themselves. We asked six questions related (...) to biomedical ontologies to what we believe is a representative sample of ontologists in the biomedical field and came to a number conclusions which we believe can help provide an insight into the practical problems which ontology builders face today. (shrink)

Human coalitions frequently persist through multiple, overlapping membership generations, requiring new members to cooperate and coordinate with veteran members. Does the mind contain psychological adaptations for interacting within these intergenerational coalitions? In this paper, we examine whether the mind spontaneously treats newcomers as a motivationally privileged category. Newcomers—though capable of benefiting coalitions—may also impose considerable costs (e.g., they may free ride on other members, they may be poor at completing group tasks). In three experiments we show (1) that the mind (...) categorizes coalition members by tenure, including newcomers; (2) that tenure categorization persists in the presence of orthogonal and salient social dimensions; and (3) that newcomers elicit a pattern of impressions consistent with their probable ancestral costs. These results provide preliminary evidence for a specialized component of human coalitional psychology: an evolved concept of newcomer. (shrink)

Various attempts have been made recently to bring Husserl into the contemporary analytic discussion on sensory illusion and hallucination. On the one hand, this has resulted in a renewed interest in what one might call a ‘phenomenology of sense-deception.’ On the other hand, it has generated contrasting—if not utterly incompatible—readings of Husserl’s own account of sense perception. The present study critically evaluates the contemporary discourse on illusion and hallucination, reassesses its proximity to Husserl’s reflection on sensory perception, and highlights the (...) philosophical limits and structural deficiencies of the current debate in light of some of Husserl’s insights. The analysis first provides a synopsis of the argumentative structures, aims, and assumptions informing the conjunctivism-disjunctivism debate. This assessment is then critically elaborated through the lens of Husserlian phenomenology in its historical and theoretical distance from the recent debate. Contrary to certain readings of Husserl, the reconstruction of some cardinal phenomenological themes provides all the elements necessary to dislocate his own account from the conjunctivism-disjunctivism dispute, by means of both a ‘global’ and a ‘local’ analysis, and both exegetically and theoretically. Most importantly, a ‘return’ to Husserl shows the philosophical untenability of the whole controversy as not only leaving untouched the core problem of perception but also altering some of its essential traits. This critique of the image of experience portrayed in the contemporary discussion is conducted through a phenomenological clarification of perception as a distinct ‘structure of rules’ of consciousness and, more specifically, by means of a descriptive analysis centered on the core notion of horizonal-intentionality. (shrink)

The present study seeks to accomplish three goals: to shed light on the problem of reason in Husserl’s co-inherited philosophical project, to elucidate his transcendental critique of reason, and to present Husserl's idea of reason in its distinctive features. A historical excursus first provides a frame to understand the necessity of a critique of reason, its proper subject-matter, and its function for the project of genuine philosophy. In particular, this historical reflection identifies the form that a critique must assume in (...) order to fulfil its philosophical-scientific task. The focus is then directed at Husserl's methodological recalibration of the problem of reason. Husserl's ‘prinzipielle Kritik’ is elucidated in his transcendental reassessment of the headings ‘reason’ and ‘unreason,’ and is thought in connection to the concept of Selbstbesinnung. Lastly, Husserl’s idea of reason is reconstructed in relation to, and in disambiguation from, the concepts of self-evidence, logos, synthesis, fulfilment, positing, etc. Reason, as teleological rule and structural form of transcendental subjectivity, is clarified in its dependence on, and irreducibility to, the problems of constitution and in light of the question of its objective/subjective character. (shrink)

The present study attempts to reconstruct Husserl’s account of empirical illusion and hallucination and disclose the significance of sense-deception in Husserl’s phenomenology. By clarifying the relation between the “leibhaftige presence” and “existence” of perceived objects, I shall be able to contend that illusion and hallucination are nullified, invalid perceptions. Non-existence or in-actuality is a form of invalidity: the Ungültigkeit of what demands its insertion in the totality of actual existence. Husserl elaborates an ex-negativo account of in-actuality, in which sensory deception (...) refers to a modal modification, which is always relative and contextual in relation to the total nexus of experience in its intersubjectively validated and harmonious unfolding. (shrink)

ABSTRACTThe aim of this article is to shed light on the political ambitions of Agamben’s book The Time That Remains. First, the article examines Agamben’s political messianism in The Time That Remains by taking into account the question of political theology. Second, the article elaborates on a number of important concepts and ideas that are at the forefront of Agamben’s political messianism. Third, the author elucidates the general framework within which one has to view Agamben’s political messianism. In the fourth (...) and last part of the article, the author assesses the innovative nature of Agamben’s political messianism by sketching out a comparison between The Time That Remains and Heidegger’s phenomenological interpretation of Paul the apostle. (shrink)

There is currently no consensus about a general account of hallucination and its object. The problem of hallucination has de facto generated contrasting accounts of perception, led to opposing epistemic and metaphysical positions, and, most significantly, exposed a manifold of diverging views concerning the intentionality of experience, in general, and perceptual intentionality, in particular. In this article, I aim to clarify the controversial status, experiential possibility, and intentional structure of hallucination qua distinctive phenomenon. The analysis will first detect a phenomenological, (...) Husserlian-informed concept of hallucination in its irreducibility to other kinds and modes of sensory experience. This will set the theoretical basis to develop an account of hallucination by means of a morphological description of those diversified structures of intentional consciousness that lend themselves to generate hallucinatory appearances. I will then describe both the turning of certain kinds of intentional experience into hallucinatory perceptions and the status of hallucinatory objects. This will support the possibility of hallucination in a strict and rigorous sense, elucidate the enigmatic claim that ‘in hallucination we are conscious of something while nothing truly appears,’ and offer a seminal perspective concerning the alleged problem that hallucinations pose on perceptual intentionality. With the aid of some crucial distinctions, I will then argue that hallucinations do not affect perceptual intentionality as a dyadic, relational structure. (shrink)

Phenomenological axiology (the theory of value) is the area of phenomenology that most explicitly deals with problems currently explored in metaethics. As one authoritative source describes it, metaethics is “the attempt to understand the metaphysical, epistemological, semantic, and psychological presuppositions and commitments of moral thought, talk, and practice” (Sayre-McCord 2014). However, the scope of axiology is broader than the scope of metaethics, which is concerned exclusively with...

Cette introduction présente et contextualise les articles publiés dans la section spéciale dont le but est d’analyser l’interprétation de la pensée hellénistique chez les philosophes continentaux très influents tels que : Agamben, Arendt, Blumenberg, Foucault, Heidegger et Stiegler. Les articles prêtent une attention particulière à trois directions de recherche. Ils examinent tout d’abord l’influence de la pensée hellénistique sur ces auteurs et la façon dont ils ont interprété, utilisé et mésinterprété l’héritage des philosophies hellé-nistiques. Deuxièmement, les articles analysent les hypothèses (...) in-terprétatives et les préjugés qui ont caractérisé ces interprétations. Enfin, ils nous permettent de comprendre plus clairement pourquoi plusieurs philosophes continentaux se sont intéressés à la philosophie ancienne. Les rédacteurs invités résument les conclusions pro-visoires de cette section spéciale en soulignant que les interprétations continentales de la pensée hellénistique représentent un thème particulièrement intéressant dans le cadre de la recherche historico-philosophique actuelle. (shrink)

Phenomenology and Experience emphasizes the central role of experience as a key theme of phenomenological research. Phenomenology is in a position to philosophically capture and articulate the multiple sides of human experience by disentangling philosophical reflection from traditional oversimplifications.

If we examine the discussion between Carnap and Heidegger about metaphysics, we can easily see that epistemological, logical, and ontological issues were at the forefront of that debate, whereas at...

The aim of this article is to demonstrate that even if Popper’s and Patočka’s interpretations of Plato originate in philosophical and intellectual traditions that have nothing or very little to do with each other, they share a common target, that is, modern biopower, which culminated in twentieth-century totalitarianism. If we examine Popper’s and Patočka’s interpretations of Plato from a biopolitical angle, it is possible to view them in a new light, that is, as two different, even opposing, intellectual and philosophical (...) approaches to the very same tragic events that European culture and politics experienced in the twentieth century. Despite the radically divergent results of their readings, Popper and Patočka share a starting point, that is, the effort to outline a genealogy of European cultural and intellectual history in the light of Plato. The first section of this article explains why and to what extent Popper’s and Patočka’s interpretations can be considered genealogical readings. The second section elaborates on their different approaches to the relationship between justice and power in Plato. The third section concentrates on the relationship between Plato and twentieth-century biopower. (shrink)

The aim of this paper is to analyze those passages of the Black Notebooks where Heidegger mentions Søren Kierkegaard and to see how Heidegger interprets Kierkegaard’s impact on his own philosophical thought. The paper intends to clarify whether, and to what extent, Heidegger’s rejection of an existentialist reading of his early thought is plausible and justified. The conclusions reached will be twofold. First, Heidegger tries to reinterpret his existential analytic by using the approach he has developed in his work after (...) Being and Time. In so doing, Heidegger tries to understate or diminish the Kierkegaardian background of his analytic of existence. Second, Heidegger’s retrospective self-interpretation argues for a continuity between the approach he develops in Being and Time and that which he calls the question of ‘the truth of beyng’. In so doing, he does not recognize the inconsistencies and mismatches that characterize his thought during the transition from the existential analytic to the philosophy of the event. The passages dealing with Kierkegaard in the Black Notebooks are important sources that allow us to note how problematic Heidegger’s self-interpretation is. (shrink)

ABSTRACTIn this short introductory contribution the guest editors of this special issue sketch its aim and context.

The much-acclaimed present-day philosophical turn to the letters of Saint Paul points to a profound consonance between ancient and modern thought. Such is the bold claim of this study in which scholars from contemporary continental philosophy, new testamentary studies and ancient philosophy discuss with each other the meaning Paul's terms pistis, faith. In this volume, this theme discusses in detail the threefold relation between Paul and continental thought, the Graeco-Roman world, and political theology. It is shown that pistis does not (...) only concern a mode of knowing, but rather concerns the human ethos or mode of existence as a whole. Moreover, it is shown that the present-day political theological interest in Paul can be seen as an attempt to recuperate Paul’s pistis in this comprehensive sense. Finally, an important discussion concerning the specific ontological implications and background of this reinterpretation of pistis is examined by comparing the ancient ontological commitments to those of the present-day philosophers. Thus, the volume offers an insight in a crucial consonance of ancient and modern thought concerning the question of pistis in Paul while not forgetting to stipulate important differences. (shrink)

In this short introduction, the guest editors present the main themes of the special issue.

Surveys over the last twenty years have seen an ever-growing number of Americans disclaim religious affiliations and instead check the "none" box. In the first sociological exploration of organized secularism in America, Richard Cimino and Christopher Smith show how one segment of these "nones" have created a new, cohesive atheist identity through activism and the creation of communities. According to Cimino and Smith, the new upsurge of atheists is a reaction to the revival of religious fervor in American (...) politics since 1980. Feeling overlooked and underrepresented in the public sphere, atheists have employed a wide variety of strategies-some evangelical, some based on identity politics-to defend and assert themselves against their ideological opponents. These strategies include building and maintaining communities, despite the absence of the kinds of shared rituals, texts, and laws that help to sustain organized religions.Drawing on in-depth interviews with self-identified atheist, secularist, and humanist leaders and activists, as well as extensive observations and analysis of secular gatherings and media, Cimino and Smith illustrate how atheists organize and align themselves toward common goals, and how media-particularly web-based media-have proven invaluable in connecting atheists to one another and in creating a powerful virtual community. Cimino and Smith suggest that secularists rely not only on the Internet for community-building, but on their own new forms of ritual.This groundbreaking study will be essential reading for anyone seeking to understand the growing atheist movement in America. (shrink)

In the introduction to the volume, the editors explain the overarching aim of the volume and contextualize the main themes of its chapters. Even if the notions of biopolitics and biopower have played a crucial role in philosophy, the humanities, and the social sciences over the last decades, they have been used in various and at times diverging senses, which has also produced different narratives about the history of biopolitics. The main aim of the volume is to clarify whether and (...) to what extent the concept of biopolitics is applicable to antiquity. To answer such questions, the chapters collected in the volume address three main topics, namely the possible presence of biopolitical discourse in ancient thought, the extent to which the application of a biopolitical approach to ancient thought requires qualifications, and some influential contemporary interpretations of the relation between biopolitics and antiquity. (shrink)

A complete translation of Aristotle's classic that is both faithful and readable, along with an introduction that provides the modern reader with a means of understanding this seminal work and its impact on our culture. In this volume, Joe Sachs (translator of Aristotle's _Physics, Metaphysics,_ and the _Nicomachean Ethics _)also supplements his excellent translation with well-chosen notes and glossary of important terms. Focus Philosophical Library translations are close to and are non-interpretative of the original text, with the notes and a (...) glossary intending to provide the reader with some sense of the terms and the concepts as they were understood by Aristotle’s immediate audience. (shrink)

The volume studies, from different perspectives, the relationship between ancient thought and biopolitics, that is, theories, discourses, and practices in which the biological life of human populations becomes the focal point of political government. It thus continues and deepens the critical examination, in recent literature, of Michel Foucault's claim concerning the essentially modern character of biopolitics. The nine contributions comprised in the volume explore and utilize the notions of biopolitics and biopower as conceptual tools for articulating the differences and continuities (...) between antiquity and modernity and for narrating Western intellectual and political history in general. Without committing itself to any particular thesis or approach, the volume evaluates both the relevance of ancient thought for the concept and theory of biopolitics and the relevance of biopolitical theory and ideas for the study of ancient thought. The volume is divided into three main parts: part I studies instances of biopolitics in ancient thought; part II focuses on aspects of ancient thought that elude or transcend biopolitics; and part III discusses several modern interpretations of ancient thought in the context of biopolitical theory. (shrink)