Main Response Topics ? Introduction ? Open display and public evaluation ? Publicity versus patient privacy ? Facial tissue donation ? Validity of Louisville Instrument for Risk Acceptance ? Patients' understanding of risk ? Face versus hand transplantation ? Rejection rates/risks ? Patient compliance ? Exit strategy ? Functional recovery ? Societietal implications ? Psychological implications ? Conclusion: Uncertainty likely to persist.

All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies' obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic. We argue that an ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability. All parties' obligations should be coordinated and mutually consistent. For (...) instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges. Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others. (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all (...) further questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

This article focuses on the ways that sexual risk behaviors are related to race, class, and gender among low-income, culturally diverse women in South Florida. Data concerning sexual risk and gender are presented in terms of race and class variations. Results indicate that, in general, these women have a high degree of knowledge about acquired immune deficiency syndrome, a quite contemporary awareness of women's gendered subordination, and a lack of trust in heterosexual relationships. Attitudes, beliefs, and knowledge, however, are not (...) translated into sexual behaviors with men partners that would reduce their vulnerability to infection with the human immunodeficiency virus. The data indicate that race is a major factor that places women into an underclass position. Consequently, without socioeconomic resources, gendered behaviors have a direct influence on sexual risk. Multivariate analyses indicate that those women who are sex workers are significantly more likely to negotiate safe sex with clients than with main partners. The research not only challenges mainstream thinking about race, class, and gender but also provides overdue information on the vulnerability of women to HIV infection. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

_John Dewey and Continental Philosophy_ provides a rich sampling of exchanges that could have taken place long ago between the traditions of American pragmatism and continental philosophy had the lines of communication been more open between Dewey and his European contemporaries. Since they were not, Paul Fairfield and thirteen of his colleagues seek to remedy the situation by bringing the philosophy of Dewey into conversation with several currents in continental philosophical thought, from post-Kantian idealism and the work of Friedrich Nietzsche (...) to twentieth-century phenomenology, hermeneutics, and poststructuralism. This unique volume includes discussions comparing and contrasting Dewey with the German philosophers G. W. F. Hegel, Friedrich Nietzsche, Martin Heidegger, and Hans-Georg Gadamer on such topics as phenomenology, naturalism, organicism, contextualism, and poetry. Others investigate a series of connections between Dewey and contemporary French philosophy, including the notions of subjectivity, education, and the critique of modernity in Michel Foucault; language and politics in Jacques Derrida; and the concept of experience in Gilles Deleuze. Also discussed is the question of whether we can identify traces of _Bildung_ in Dewey’s writings on education, and pragmatism’s complex relation to twentieth-century phenomenology and hermeneutics, including the problematic question of whether Heidegger was a pragmatist in any meaningful sense. Presented in intriguing pairings, these thirteen essays offer different approaches to the material that will leave readers with much to deliberate. _ John Dewey and Continental Philosophy_ demonstrates some of the many connections and opportunities for cross-traditional thinking that have long existed between Dewey and continental thought, but have been under-explored. The intersection presented here between Dewey’s pragmatism and the European traditions makes a significant contribution to continental and American philosophy and will spur new and important developments in the American philosophical debate. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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This exploratory study of ethical decision making by individuals in organizations found moral intensity, as defined by Jones (1991), to significantly influence ethical decision making intentions of managers. Moral intensity explained 37% and 53% of the variance in ethical decision making in two decision-making scenarios. In part, the results of this research support our theoretical understanding of ethical/unethical decision-making and serve as a foundation for future research.

Those inclined to believe in the existence of propositions as traditionally conceived might seek to reduce them to some other type of entity. However, parsimonious propositionalists of this type are confronted with a choice of competing candidates – for example, sets of possible worlds, and various neo-Russellian and neo-Fregean constructions. It is argued that this choice is an arbitrary one, and that it closely resembles the type of problematic choice that, as Benacerraf pointed out, bedevils the attempt to reduce numbers (...) to sets – should the number 2 be identified with the set Ø or with the set Ø, Ø? An “argument from arbitrary identification” is formulated with the conclusion that propositions (and perhaps numbers) cannot be reduced away. Various responses to this argument are considered, but ultimately rejected. The paper concludes that the argument is sound: propositions, at least, are sui generis entities. (shrink)

One way to work toward intercultural understanding is through interreligious dialogue, given the centrality that religion often has in a culture. David Burrell has suggested that Maimonides and Aquinas can offer us principles for interreligious dialogue. In particular, he argues that their negative theology shows us the impossibility of one tradition claiming a better understanding of God than those advanced by other traditions. This should lead religious traditions away fromcompetition and toward dialogue. In my paper, I propose a critique of (...) Burrell’s thesis, arguing for a different interpretation of Maimonides and Aquinas and adifferent understanding of interreligious dialogue. While it is true that Maimonides and Aquinas have a well-developed sense of the limits of our theological knowledge, they do not draw the conclusion that these limitations necessarily make all understandings of God equal. I think Maimonides and Aquinas show us instead that the firmest basis for interreligious dialogue is the recognition that some genuine knowledge of the divine is available to all, regardless of religious tradition. (shrink)

“Perfect Day” by Lou Reed and “Village Ghetto Land” by Stevie Wonder are prime examples of “melic” irony in song—cases in which expressive irony is achieved through the interplay and tension between a song’s lyrics and its musical accompaniment. But how exactly can a song achieve this ironic effect, especially if, as formalists maintain, music on its own is incapable of meaning, much less communicative irony? In this paper, I illuminate this type of irony by applying a Gricean account of (...) verbal irony to song. I explore the complexities of this application, and suggest that, through ironic interplay with lyrics, the music of a song can acquire semantic capacities of its own. (shrink)

In this book, Joseph G. Morgan examines the career of Wesley Fishel, a political scientist who vigorously supported American intervention in the Vietnam War, which he deemed a "great, and tragic, American experiment." Morgan demonstrates how Fishel continued to champion the prospect of an independent South Vietnam, even when Vietnamese resistance and infighting among American and Vietnamese leaders undermined this effort. Morgan also analyzes how opponents of the war questioned Fishel's scholarly integrity and his academic collaboration with the US (...) government in implementing Cold War policies. (shrink)

In 'A Puzzle about Belief' Saul Kripke appeals to a principle of disquotation that allows us to infer a person's beliefs from the sentences to which she assents (in certain conditions). Kripke relies on this principle in constructing some famous puzzle cases, which he uses to defend the Millian view that the sole semantic function of a proper name is to refer to its bearer. The examples are meant to undermine the anti-Millian objection, grounded in traditional Frege-cases, that truth-value is (...) not always maintained when co-referential names are intersubstituted in belief reports. I argue here that our disquotational practice is sensitive to certain shifts in conversational context, and it is only if we overlook these shifts - if we 'misdisquote' - that we can draw the conclusions Kripke wants to draw from his examples. In the wake of this conclusion, I provide a 'contextualist' treatment of Kripke's puzzle cases. I show how this treatment is motivated by certain norms of rationality, and I defend these norms against an intriguing 'anti-Cartesian' theory of mind. Throughout the paper, I develop the larger implications that my treatment of Kripke's argument has for the semantic theory of names and belief reports, and, more generally, for our picture of the relation between linguistic behaviour and our states of mind. (shrink)

There has been much discussion of whether there could be objects A and B that are “individuatively vague” in the following way: object A and object B neither determinately stand in the relation of identity to one another, nor do they determinately fail to stand in this relation. If there are objects of this type, then we would have a genuine case of metaphysical vagueness, or “vagueness-in-the-world.” The possibility of vague objects in this sense strikes many as incoherent. The possibility’s (...) very description not only seems to talk of two objects but, much worse, it seems to point to a feature that distinguishes them: unlike object A, object B is not determinately identical to object A. This suspicion of incoherence is voiced in the famous arguments given against the possibility by Gareth Evans and Nathan Salmon. But the status of those arguments and others is uncertain. Here I present a new argument against vague objects — or more precisely, against the possibility of individuatively vague objects that satisfy an important and common additional condition that I will call “Democracy.” Since my argument turns on a connection between what is indeterminate and what is possible, I call it “the modal argument.”. (shrink)

This article identifies and compares meanings of wildfire risk mitigation for stakeholders in the Front Range of Colorado, USA. We examine the case of a collaborative partnership sponsored by government agencies and directed to decrease hazardous fuels in interface areas. Data were collected by way of key informant interviews and focus groups. The analysis is guided by the Circuit of Culture model in communication research. We found both shared and differing meanings between members of this partnership (the ‘‘producers’’) and other (...) stakeholders not formally in the partnership (the ‘‘consumers’’). We conclude that those promoting the partnership’s project to mitigate risk are primarily aligned with a discourse of scientific management. Stakeholders outside the partnership follow a discourse of community. We argue that failure to recognize and account for differences in the way risk mitigation is framed and related power dynamics could hamper the communicational efforts of the collaborative partnership and impact goals for fuels reduction. We recommend ways that both groups can capitalize on shared meanings and how agency managers and decision makers can build better working relationships with interface communities and other external stakeholders. (shrink)

In this conceptual article, the authors explore the possibilities of another approach to examining the human dimensions of wildland fire. They argue that our understanding of this issue could be enhanced by considering a cultural studies construct known as the ‘‘circuit of culture.’’ This cross-disciplinary perspective provides increased analytic power by accounting for the meaningful role of 5 cultural processes in terms of their location and interrelation within social experience. The authors compare the circuit of culture approach with a body (...) of recent literature focused on wildland fire. The authors make the case that this research has moved in a positive direction since wildland fire first ignited social scientific interest in the 1980s, but it is still missing key cultural processes. Ultimately, following the circuit allows us to make more nuanced statements about meaning, something much needed in the face of the wicked problem of wildland fire. (shrink)

Le canon 812 du Code de droit canon de 1983 exige que ceux qui enseignent une discipline théologique dans une université catholique aient un mandatum de la part de l’autorité ecclésiastique compétente. Entre insistances et rappels à l’ordre romains, s’en suivirent aux Etats-Unis neuf ans de consultations, discussions et conflits qui impliquèrent évêques, présidents d’universités et théologiens. Il y a là un fait théologique et ecclésial dont les Eglises d’autres pays n’ont pas fait la même expérience. L’examen des enjeux ecclésiologiques (...) de ces péripéties constitue l’objet de ces réflexions qui représentent ainsi une sorte de lettre théologique des Etats-Unis. Pourquoi l’acuité de la question dans ce pays ? Comment comprendre le mandatum avec l’emploi du concept de communion ? Qu’est-ce que ce mandatum comme fait historique et comme institution ecclésiale ? Telles sont les questions auxquelles tente de répondre J.G. Mueller dans cet article.Canon 812 of the Code of Canon Law of 1983 requires that those who teach a theological discipline in a Catholic university have a mandatum from the competent church authority. In between Rome’s insistence and calls to order, there followed nine years of consultations, discussions, and conflicts in the United States involving bishops, university presidents, and theologians. This is a theological and ecclesial fact of which Churches in other countries have not had the same experience. An examination of the ecclesiological stakes of these vicissitudes constitutes the subject of these reflections, which represents a sort of theological letter from the United States. Why the acuity of the question in this country? How can we understand the mandatum by using the concept of communion? What is this mandatum as a historical fact and as an ecclesiastical institution? Such are the questions that J.G. Mueller attempts to answer in this article. (shrink)

ABSTRACTAs sports fans, we often experience what seem to be strong garden-variety emotions—everything from joy and euphoria to anger, dread and despair. In self-description, in physiology and even in phenomenology, these reactions to sporting events present themselves as genuine emotions. But we don’t act on these ‘sporting emotions’ in the ways one might expect. This is because these reactions are not genuine emotions. Or so I argue. Johan Huizinga suggested that play has a pretend ‘set aside’ ‘extra-ordinary’ character. And Kendall (...) Walton has argued that make-believe is involved in our emotional responses to fiction, as well as to sport. Here I articulate and extend the idea that sporting emotions centrally involve pretense and make-believe in ways that can meet some forceful objections. These extensions draw on a ‘double-consciousness’ I claim to find in the pretense of play. I end by saying why the proper characterization of our sporting emotions is important. (shrink)

The paper is a critical discussion of the rich and insightful final chapter of Mitchell Green’s Self-Expression . There, Green seeks to elucidate the compelling, but inchoate intuition that when we’re fully and most expertly expressing ourselves, we can ‘push out’ from within not just our inner representations, but also the ways that we feel. I question, first, whether this type of ‘qualitative expression’ is really distinct from the other expressive forms that Green explores, and also whether it’s genuinely ‘expressive’. (...) I then scrutinize the nature of the ‘qualitative congruences’ that lie at the heart of Green’s theory; and I wonder whether they can play the role Green claims they can in providing a novel account of artistic expression. (shrink)

Joseph G. Ramsey argues that Richard Wright’s 1940 novella “Bright and Morning Star” has been consistently misunderstood. What has been almost universally read as a narrative of communist heroism stages instead a heroic mistake. “Bright and Morning Star” is not a story primarily about heroic individual sacrifice, but about the ways collective struggle can fail.

In a seemingly offhand, often overlooked comment, Karl Marx deemed 'human corporeal organisation' the 'first fact of human history'. Following Marx's corporeal turn and pursuing the radical implications of his corporeal insight, this book undertakes a reconstruction of the corporeal foundations of historical materialism. Part I exposes the corporeal roots of Marx's materialist conception of history and historical-materialist Wissenschaft. Part II attempts a historical-materialist mapping of human corporeal organisation. Suggesting how to approach human histories up from their corporeal foundations, Part (...) III elaborates historical-materialism as 'corporeal semiotics'. Part IV, a case study of Marx's critique of capitalist socio-economic and cultural forms, reveals the corporeal foundations of that critique and the corporeal depth of his vision of human freedom and dignity. (shrink)

In the Metaphysics Aristotle explicitly identifies first philosophy, the science of "being qua being," with theology . But the treatise never explains how theology could also be a universal science of being. This dissertation will attempt to provide such an explanation. Its procedure will differ from past approaches by attempting to understand the programmatic remarks of VI.1 in the light of Aristotle's actual conception of god, his theology proper. ;Chapter two examines Aristotle's notion of god as a self-thinker. It argues (...) that the god of Metaphysics XII is not narcissistically engaged in self-contemplation. Rather, Aristotle's statements that god "thinks himself" are meant to express the fact that he is an essentially active mind and therefore a pure actuality. ;Chapter three examines what it means for something to be a pure actuality, and in particular, a purely actual mind. It argues, based on a comparison between god and the fullest actuality of human thought, that the content of the divine thinking is just the principles of "being qua being." ;Chapter four addresses directly Aristotle's conception of first philosophy. It argues that the conception of theology as a universal science of being is grounded in the application of two kinds of priority relations. Substance is the focal meaning ) of being, while god is the first of the series of three kinds of substance. ;In concluding, I first review Aristotle's conception of substance in Metaphysics VII. Following Frede , I contend that Aristotle understands sensible substance in its primary sense to be form. Accordingly, there are two grounds on which Aristotle may consistently and intelligently identify metaphysics with theology. As a pure form god is the first kind of substance. He is therefore the best example of a being, knowledge of which is necessary to understand being in general. As an essentially self-thinking, and therefore purely actual mind, god possesses the most universal knowledge. He is therefore the most appropriate object for a science of being qua being, for one comes to have knowledge of god by coming to know the principles of being qua being. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Ancient Quarrel Revisited:Literary Theory and the Return to EthicsJoseph G. KronickThe modern quarrel between theory and practice, like the ancient one between philosophy and poetry, is at once a practical one—at its heart is the question how we should live—and a pedagogical one—who or what is the proper teacher of virtue? Today, the quarrel is between theory and literature rather than between philosophy and poetry, a change that (...) has not been beneficial. The modern complaint against the abstractions of theory reflects a diminution in the quality of the argument. For the ancient Greeks, to ask about the virtuous life was to inquire into what it is to be human, for aretê, which is typically translated as "virtue," but is understood to mean "excellence" or "goodness," meant acting in accordance with what it is to be fully human. 1 The notion that "real issues," as one prominent theorist argues, belong to the realm of action and epistemological and ontological questions to the abstract realm of theory is a simplification of the more serious question of the relation of particulars to universals. It reverses the Platonic and Aristotelian hierarchy that makes thinking the highest form of activity. But something else is going on in this call to action: in denigrating thinking as abstract, it elevates doxa, opinion, in its place. Under the regime of doxa, two things occur: philosophy and poetry are looked upon as useless because utility becomes the criteria for measuring value, and singularity is looked upon with disdain, if it is, indeed, acknowledged at all, because to the extent the world as it appears is common to us all, doxa is not distinct or individual but uniform or the same. Philosophy and poetry share not only the stigma of being deemed useless, but they are dismissed as odd, singular, not common.This essay is concerned with the status of the singular in philosophy [End Page 436] and poetry. The ancient quarrel has not been settled, which may indeed be a good thing because the quarrel keeps alive the question, who is to speak for that which cannot be spoken of, the singular? Silence may be the appropriate response, yet to preserve the experience of that which resists language is the task of philosophy and poetry, hence the quarrel. A long tradition has it that the philosopher seeks universals, while the poet offers particular images of virtue, but at the heart of this argument over ethics is the question of how to account for the singular or unique. To do so, I turn to Socrates, whose singularity remains unaccounted for to this day.Socrates may be said to embody the very problem of the relation between philosophy and literature, for he left us no writings and exists for us primarily through the writings of Plato. Yet there is widespread acceptance of Plato's portrait of him, particularly as to Socrates' method, the elenchus, and his principle of the priority of definitions. However, Socrates' insistence upon the priority of definition is not an example of the philosopher elevating theory over experience but a practical issue involving the care of the self. Furthermore, in ancient Greece, moral and philosophical questions concerning the soul were as much the provenance of poetry as they were of philosophy. The search for truth is a practical matter concerning the conduct of life, but the Platonic philosopher wishes to give a rational account, or logos, that would link conduct to knowledge, whereas the poet's examples are bound to their representations. Nevertheless, to presume that Socrates was seeking a definition of virtue on the grounds that possession of the definition would translate into a good life is an absurdity, for he could never have sought after the knowledge of virtue if his mode of life depended upon the definition rather than on his character. 2The error is to accuse Socrates of placing abstract knowledge before virtuous conduct. When Socrates asks for a definition of the beautiful, for instance, he does not reject the answer, "the beautiful is a beautiful woman," because it confuses a particular with a universal (when compared to the beauty of the gods, the woman is... (shrink)

In this paper I consider how Aquinas has been interpreted by continental philosophers of religion and particularly in relation to the problem of ontotheology. A patient examination of the texts of those who have dealt with Aquinas reveals two basic problems. First, there is an underestimation of the radicality of Aquinas’s negative theology. Second, no account is taken of the way Aquinas understands the relationship between reason and revelation. Aquinas’s position on this relationship is even more crucial for the overcoming (...) of onto-theology than is his negative theology. From a Christian perspective, what is at stake in overcoming onto-theology is the issue of keeping philosophical theology from overstepping its bounds and intruding on the domain of revelation. Revelation is the final standard when it comes to God-talk. If negative theology is to be done properly, it must be integrated into a theological position like Aquinas’s that, while granting reason and revelation each their legitimate “autonomy,” gives priority to the latter in questions of theology. (shrink)