Policy officials often assert that the U.S. has the best health care system in the world, but a recent scorecard on U.S. health system performance finds that the U.S. achieves a score of only 65 out of a possible 100 points on key indicators of performance in five key domains: healthy lives, access, quality, equity, and efficiency, where 100 represents the best achieved performance in other countries or within the U.S. The U.S. should aim higher by adopting a set of (...) policies that will extend affordable health insurance to all; align financial incentives for health care providers to enhance value and achieve savings; organize the health care system around the patient to ensure that care is accessible and coordinated; meet and raise benchmarks for high-quality, efficient care; and ensure accountable national leadership and public-private collaboration. The incoming president and Congress should aspire to have the best health system in the world — not just assert it — and can do so by learning from examples of excellence within the U.S. and abroad. (shrink)

On the eve of the presidential inauguration, the U.S. health system faces rising costs of care, growing numbers of uninsured, wide variations in quality of care, and mounting public dissatisfaction. Despite spending more on health care than any other country, a recent Commonwealth Fund Commission on a High Performance Health Care System National Scorecard reports that the United States is lagging far behind other major industrialized countries — all of which provide universal health insurance — in five key domains: healthy (...) lives, access, quality, equity, and efficiency. U.S. national performance is well below benchmarks of top performance set by other countries or high performing states, hospitals, or health plans within the United States, with broad disparities in experience depending on geographic location, income, race/ethnicity, and insurance coverage. National leadership is required to manage the growing health care crisis in the United States and improve care for all Americans. (shrink)

Was Descartes a Cartesian Dualist? In this controversial study, Gordon Baker and Katherine J. Morris argue that, despite the general consensus within philosophy, Descartes was neither a proponent of dualism nor guilty of the many crimes of which he has been accused by twentieth century philosophers. In lively and engaging prose, Baker and Morris present a radical revision of the ways in which Descartes' work has been interpreted. Descartes emerges with both his historical importance assured and his philosophical importance (...) redeemed. (shrink)

Millikan’s theory of content purports to rely heavily on the existence of isomorphisms between a system of representations and the things in the world which they represent — “the mapping requirement for being intentional signs” (Millikan 2004, p. 106). This paper asks whether those isomorphisms are doing any substantive explanatory work. Millikan’s isomorphism requirement is deployed for two main purposes. First, she claims that the existence of an isomorphism is the basic representing relation, with teleology playing a subsidiary role — (...) to account for misrepresentation (the possibility of error). Second, Millikan relies on an isomorphism requirement in order to guarantee that a system of representations displays a kind of productivity. This seemingly strong reliance on isomorphism has prompted the objection that isomorphism is too liberal to be the basic representing relation: there are isomorphisms between any system of putative representations and any set, of the same cardinality, of items putatively represented. This paper argues that all the work in fixing content is in fact done by the teleology. Deploying Millikan’s teleology-based conditions to ascribe contents will ensure that there is an isomorphism between representations and the things they represent, but the isomorphism ‘requirement’ is playing no substantive explanatory role in Millikan’s account of content determination. So an objection to her theory based on the liberality of isomorphism is misplaced. The second role for isomorphism is to account for productivity. If some kind of productivity is indeed necessary for representation, then functional isomorphism will again be too liberal a constraint to account for that feature. The paper suggests an alternative way of specifying the relation between a system of representations and that which they represent which is capable of playing an explanatory role in accounting for Millikan’s type of productivity. In short, the liberality of isomorphism is no objection to Millikan’s teleosemantics, since the isomorphism ‘requirement’ need play no independent substantive role in Millikan’s account of representation. (shrink)

The American Society for Bioethics and Humanities has created a quality attestation process for clinical ethics consultants; the pilot phase of reviewing portfolios has begun. One aspect of the QA process which is particularly challenging is assessing the interpersonal skills of individual clinical ethics consultants. We propose that using case simulation to evaluate clinical ethics consultants is an approach that can meet this need provided clear standards for assessment are identified. To this end, we developed the Assessing Clinical Ethics Skills (...) tool, which identifies and specifies specific behaviors that a clinical ethics consultant should demonstrate in an ethics case simulation. The aim is for the clinical ethics consultant or student to use a videotaped case simulation, along with the ACES tool scored by a trained rater, to demonstrate their competence as part of their QA portfolio. The development and piloting of the tool is described. (shrink)

As the field of clinical ethics consultation sets standards and moves forward with the Quality Attestation process, questions should be raised about what ethical issues really do arise in practice. There is limited data on the type and number of ethics consultations conducted across different settings. At Loyola University Medical Center, we conducted a retrospective review of our ethics consultations from 2008 through 2013. One hundred fifty-six cases met the eligibility criteria. We analyzed demographic data on these patients and conducted (...) a content analysis of the ethics consultation write-ups coding both the frequency of ethical issues and most significant, or key, ethical issue per case. Patients for whom ethics consultation was requested were typically male, white, between 50 and 69 years old, of non-Hispanic origin, and of Roman Catholic faith. Nearly half were in the intensive care unit and 44.2 % died in the hospital. The most frequent broad ethical categories were decision-making, goals of care/treatment, and end-of-life. More specifically, capacity, patient’s wishes/autonomy, and surrogate decision maker were the most frequent particular ethical issues. The most common key ethical issues were withdrawing/withholding treatment, patient wishes/autonomy, and capacity. Our findings provide additional data to inform the training of clinical ethics consultants regarding the ethical issues that arise in practice. A wider research agenda should be formed to collect and compare data across institutions to improve education and training in our field. (shrink)

We argue that environmental aesthetics, and specifically the concept of aesthetic integrity, should play a central role in a public environmental philosophy designed to communicate about environmental problems in an effective manner. After developing the concept of the “aesthetic integrity” of the environment, we appeal to empirical research to show that it contributes significantly to people’s sense of place, which is, in turn, central to their well-being and motivational state. As a result, appealing to aesthetic integrity in policy contexts is (...) both strategically and morally advisable. To provide a concrete illustration of the ways in which such appeals can play a role in policy making, we examine a specific case study in which attention to aesthetic integrity contributed to blocking a proposed development. The case yields at least four lessons: (1) aesthetic integrity can be a practically effective framing device; (2) local deliberative settings are particularly conducive for addressing it; (3) it can serve as an umbrella under which multiple other issues can be brought to the fore; and (4) judgments about aesthetic integrity need not be entirely objective in order for them to play a productive role in the policy sphere. (shrink)

Several prominent debates in biology, such as those surrounding adaptationism, group selection, and punctuated equilibrium, have focused on disagreements about the relative importance of a cause in producing a phenomenon of interest. Some philosophers, such as John Beatty have expressed scepticism about the scientific value of engaging in these controversies, and Karen Kovaka has suggested that their value might be limited. In this paper, I challenge that scepticism by giving a novel analysis of relative significance controversies, showing that there are (...) three forms they can take. I argue that these controversies can have significant epistemic upshots, in that they help scientists form predictions about new instances of the phenomenon of interest. Finally, using two historical examples, I show how engaging in these controversies can improve our understanding of causal relationships. (shrink)

Louisa Shea explores modernity's debt to Cynicism by examining the works of thinkers who turned to the ancient Cynics as a model for reinventing philosophy and ...

European Journal of Philosophy, Volume 29, Issue 4, Page 712-730, December 2021.

The field of clinical ethics consultation has matured into a multidisciplinary profession, with clinical ethics consultants (CECs) being trained in bioethics, philosophy, theology, law, medicine, n...

Ciudad Cayalá in Guatemala brands itself as the country’s first private city. I turn to Hannah Arendt to show how and why Cayalá does not and cannot provide the space of appearance she argues is needed to support the possibility of political action. I show how Arendt provides two apparently distinct phenomenological accounts in The Human Condition—one historically-oriented and the other politically-oriented—that articulate how Cayalá fails in its aspiration to privatize the political. Yet the apparent divergence between her accounts raises (...) concern about her relevance for liberatory feminist projects. To demonstrate how and why Arendt’s political phenomenology is aligned with certain feminist aims, I also generate a Cayaláian reading of Arendt to demonstrate the coherence of her two phenomenological accounts through interpreting her thinking by way of Cayalá’s architecture. This article enacts a dialogue between Arendt and Cayalá, mediated by feminist and architectural theory, concerning why efforts toward the privatization of cities will fail. (shrink)

In this paper, I answer the question,how do we collaborate well with others?I first look at cases of good collaboration, contrasting them briefly with some cases of poor collaboration; I then describe the similarities between the good cases, such as shared aims, shared planning of projects, shared norms among collaborators. The conclusion is that collaborating well involves shared norms, derived both from societal norms and from a well‐ordered relationship between participants; a shared vision derived from shared knowledge and open communication (...) grounded in relationship; and open‐mindedness and thoughtful disagreement, which depend on mutual respect and trust between participants. (shrink)

Volume 20, Issue 3, March 2020, Page 27-29.

Volume 19, Issue 11, November 2019, Page 69-70.

Agriculture is a serious contributor to pollution and other environmental harms, making it an important site of action for the development of environmentally friendly products and practices. However, farmer adoption of such options is varied and dependent on a wide range of factors including the visual appeal of sustainable farming. Recent studies have shown that negative aesthetics related to more environmentally friendly ways of farming can delay or prevent adoption of such practices. Drawing on the concepts of good farming, cultural (...) capital, and the aesthetics of waste, this paper aims to assess the status of biodegradable plastic mulch in relation to a range of alternative and conventional specialty crop growers’ aesthetic perceptions. BDM has the potential to significantly reduce non-biodegradable polyethylene mulch waste, thus addressing serious environmental and human health concerns. However, the aesthetics of BDM may present a challenge. BDM looks identical to PE plastic, and its degradation throughout the season results in scraps in the soil. To investigate aesthetics as a possible barrier to BDM adoption, we conducted five photo-elicitation focus groups with specialty crop growers in Washington State. Results indicate that alternative growers are slightly more adverse to the aesthetics of BDM, especially because of its ‘plastic’ appearance. Conventional growers had higher rates of BDM adoption, even though they felt a strong aesthetic aversion to the messy nature of BDM degradation. Confidence in the product, particularly as a result of education and experience, was believed to be the key to overcoming this negative aesthetic. Study participants offered a variety of ways to enhance the acceptability of BDM, such as making the mulch brown instead of black. These findings have wider implications for the acceptance and adoption of practices that, although environmentally friendly, have an unattractive visual element. (shrink)

Reflection in medical education is becoming more widespread. Drawing on our Jesuit Catholic heritage, the Loyola University Chicago Stritch School of Medicine incorporates reflection in its formal curriculum and co–curricular programs. The aim of this type of reflection is to help students in their formation as they learn to step back and analyze their experiences in medical education and their impact on the student. Although reflection is incorporated through all four years of our undergraduate medical curriculum, this essay will focus (...) on three areas where bioethics faculty and medical educators have purposefully integrated reflection in the medical school, specifically within our bioethics education and professional development efforts: 1) in our three–year longitudinal clinical skills course Patient Centered Medicine (PCM), 2) in our co–curricular Bioethics and Professionalism Honors Program, and 3) in our newly created Physician’s Vocation Program (PVP). (shrink)

This article represents conversations with the American composer Libby Larsen in which she described her beliefs about music, music education, and the dilemmas that our current system faces as we seek to provide relevant and meaningful music education to our students. Our conversation explores such topics as cognitive psychology, music theory, cultural practices and developments in American culture, and current music education practices. Larsen brought up many questions about music education in America, providing some suggestions for the future and posing (...) problems for which the solution may require a great deal of imagination by music education teachers. The article is structured as a Socratic dialogue, in which Larsen constructs an inductively strong argu- ment for making radical changes to current music education practice. (shrink)

The population of women farm operators continues to increase in the U.S. That growth, however, is mediated by research showing that women in agriculture experience persistent barriers to equality with men. The Feminist Agriculture Food Theory (FAST) developed by Sach et al. (The Rise of Women Farmers and Sustainable Agriculture, University of Iowa Press, Iowa City, (Sachs et al., The rise of women farmers and sustainable agriculture, University of Iowa Press, 2016) posits that in the face of these barriers, women (...) farmers in the Northeast are engaging in six strategies to increase their success. These include (1) increasing gender equality on their farms, (2) asserting an identity as a farmer, (3) gaining greater access to resources, (4) shaping new food and farming systems, (5) negotiating roles in agricultural organizations, and (6) forming women-centered farming organizations. While researchers have applied FAST to Michigan, it has not been examined at a national level. In this paper, then, we use the 2017 Census of Agriculture Data to measure how women in agriculture in the U.S. are faring on each aspect of FAST we can measure (strategies 1–5). We compare women to men farmers across these FAST strategies and across three different farm types: Non-Organic Non-Value-Added Farms, Organic Farms, and Value-Added Farms. Our findings suggest for FAST strategies 1 and 2 there is an increase in equity and ability to identify as a farmer for women on organic and value-added farms. However, our findings also suggest that for FAST strategies that require more institutional and structural resources (I.e. strategies 3–5), inequities persist across farm types. (shrink)

These considerations illuminate an ontology of the witch by first disclosing how “witch,” as a linguistic gesture, carries a world of meaning, ethics, and a culture of being originating in the body. Witches and witchcraft speak to a communal situatedness of being by acknowledging the power we have over ourselves, others, and that singular lack of control we often experience in everyday life. In dialogue with Ada Agada, Emmanuel Lévinas, and Maurice Merleau-Ponty, I offer an interpretation of the body schema (...) through what I call the “witching-body,” drawing on historical and anthropological examples of witchcraft as related to personhood, thus demonstrating how embodiment philosophy and ontology are already alive in everyday ritual and magical acts. I explain the other’s contradiction of everydayness and transcendence through the reflexivity of self-sensing-self and how aspects of our own body, such as organs and emotions, may be occult or other to us. The everydayness of witchcraft and the ungraspable ambiguity of the witch speak to this necessary transcendence we experience with everyday others; there is both a banality and an infinite plurality. We yearn to know the witch because through the embodied existential expressions of “witch” we find what constitutes being a person. (shrink)

In the 1920s and 30s, Heidegger developed three explicit readings of Plato’s Phaedrus. These readings emphasize different dimensions of Plato’s dialogue and, at times, seem even to contradict one another. Though Heidegger pursues quite different interpretations of the dialogue, he remains steadfast in praising this Platonic dialogue above all others. I argue that these explicit readings provide fertile ground for reconsidering Heidegger’s engagement with Plato and not just with Platonism. I further develop an argument that a fourth, implicit reading of (...) Phaedrus can be found in Heidegger’s own dialogical text from the late 1940s, “das abendländische Gespräch”. I suggest that it is in this conversational text, where Plato’s name is never once mentioned, that Heidegger manages his most authentic engagement with the Platonic dialogue and with Plato himself. (shrink)

Between 1944 and 1954, Heidegger wrote five dialogues – or conversations – that stage philosophical discussions. I argue these texts develop a yet unacknowledged Heideggerian pedagogy of conversation. From the characters he conjures to the topics of their discussions, Heidegger underscores the importance of teaching and learning differently in each conversation and shapes his own pedagogical sensibility. Each text uniquely elaborates a particular element of his pedagogy, including the importance of attending to attunement, making mistakes, coming together in community, poetic (...) interpretation, and the dangers of conversational language itself. Only in reading the conversations together does Heidegger’s conversational pedagogy emerge. Above all, the teacher must resist assuming an authoritative role with her students; the Heideggerian teacher must learn to silently gesture toward the locale of the question-worthy by preserving its alterity. (shrink)

This article explores how the intellectual and spiritual sensibilities of the French Catholic literary critic, Charles Du Bos (1882-1939), provide an insight into the construction of a particular "third-way" Catholic intellectual form of engagement during the interwar period. It is argued that the intellectual disposition underpinning Du Bos's third way rests fundamentally upon an accommodation of the "tragic." The evolving concept of tragedy in Du Bos's life and thought, before his conversion to Catholicism and beyond, facilitates his embrace of an (...) "ethic of responsibility," which is deployed in his third-way politico-ethical position on the Munich crisis of 1938. (shrink)

Dialogue, as a philosophical form, enables the exploration of the conditions, limits, and consequences of understanding arguments. Two philosophers who undertook to write dialogues—Plato and Heidegger—feature moments in philosophical conversation in which understanding, on its own, fails to convince an interlocutor of an argument. In this article, I examine the philosophical stakes of the collisions which unfold in Plato’s Gorgias, between Socrates and Callicles, and in Heidegger’s “Triadic Conversation,” between the Guide and the Scientist. Plato’s Socrates is ostensibly unsuccessful in (...) persuading Callicles to adopt his position while Heidegger’s Guide is able to support the Scientist in learning a new way of thinking. I argue that it is Heidegger’s attention to feeling as a philosophically significant phenomenon which can overcome trans-rational resistance which may persist even after truth has been determined. (shrink)

While the majority of surviving hagiography in the Celtic and other traditions is focused on male saints, studying hagiography of female saints can provide historians with crucial insight into how religion shaped medieval attitudes towards gender, and how women exercised power and agency within the existing societal confines shaped by Christianity. Initially, the glorification of female virginity in Celtic hagiography appears to demonize sexually active women while idealizing the rhetorical figure of the virgin. However, while Celtic hagiography certainly uses literary (...) symbolism, metaphor, and imagery to promote female virginity, as narrowly defined by patriarchal standards, the social structures created by Christian institutions also provided some of the only spaces in medieval communities wherein women could construct lives independent of men, access education, and exercise political and social power. Consequently, a more nuanced understanding of the feminist implications of Celtic hagiography and its depictions of female saints is necessary in historical study. (shrink)

This was presented at the 2019 Undergraduate Symposium.

The siren call of easy solutions to socio-agricultural problems is often studied as a reflection of anthropocentric ideologies espousing faith in human ingenuity to overcome, often with technological innovations, any hurdles thrown at us. This theme has been reflected especially strongly in my own research on pesticide resistance, with farmers continually referring to the necessity of an ‘easy button’ or ‘silver bullet’ (usually in the form of a new chemical herbicide) that will solve the extremely complex and multi-dimensional problem of (...) resistance. Drawing on my own research experiences, I examine parallels between this trend and Dr. David Connor’s 2022 Agriculture, Food, and Human Values Society presidential address, in which he emphasized the need to move from mono-disciplinary research with the target of explicit knowledge to transdisciplinary research engaged in co-creation of knowledge. Just as farmers have sought the ease and rewards of an easy button, so academics have often focused on simplistic, explicit knowledge generation to the exclusion of messy, complex approaches to real world problems. However, just as with farmers, academics as individuals are not necessarily to blame; there are structures and contextual factors constraining available choices, as well as a growing reflexive consideration of what our priorities should be. (shrink)

Catholic ethical teaching has increasingly relied on a concept of the common good for making and evaluating social decisions. The authors have argued that the common good is a maximal and ideal concept about which people and communities differ fundamentally. In practice, it does not resolve moral and social disagreements. The concept of the common harm is preferable because it is a minimal standard that can be more clearly identified and agreed for individuals and society, providing a basis for legislative (...) and social action. Bioethics and public health both have strong roots in doing no harm and preventing harm to both individuals and communities in society. The authors argue that the application of the concept of the common harm from these disciplines into wider use in the health professions and public policy would be beneficial. National Catholic Bioethics Quarterly 14.3 : 449–455. (shrink)