In healthcare practice, care providers are confronted with decisions they have to make, directly affecting patients and inevitably harmful. These decisions are tragic by nature. This study investigates the role of Moral Case Deliberation in dealing with tragic situations. In MCD, caregivers reflect on real-life dilemmas, involving a choice between two ethical claims, both resulting in moral damage and harm. One element of the reflection process is making explicit the harm involved in the choice. How harmful are our decisions? We (...) investigated how facilitators of MCD experience the importance of addressing harm in MCD and what participants learn from reflecting on harm. The study was qualitative, focusing on the views and experiences of the facilitators of MCD. Semi-structured interviews were conducted with facilitators of MCD. The research focuses on the subjective experiences of facilitators. Grounded Theory was used for analysis. The results show two main categories. The first concerns the awareness of tragedy. Within this category, five themes were discerned: making explicit that there is no solution, visualizing consequences, uncovering pain, focusing on emotion, and exploring perspectives on harm. The second category concerns the support for healthcare professionals in dealing with the tragedy of the choices they face. In this category, five themes came forward: acknowledging, offering comfort, managing harm, consideration through dialogue and repairing harm. Our study shows that addressing harm in MCD in tragic situations provides an important moral learning opportunity for participants. By formulating and becoming aware of harm, MCD aids healthcare professionals in the task they are faced with, namely making difficult and painful choices. MCD helps healthcare professionals to repair moral damage, making clear at the same time that harm cannot be undone. (shrink)

In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on (...) the views and experiences of the participants. A case study design is used by conducting semi-structured interviews with health care professionals who both played a role in the treatment of the patient and attended the MCD. The results show that MCD helps people to deal with tragic situations. An important element of MCD in this respect is making explicit the dilemma and the damage, demonstrating that there is no simple solution. MCD prompts participants to formulate and share personal experiences with one another and thus helps to create a shared perception of the situation as tragic. The article concludes that MCD contributes to the sharing of tragic experiences, and fosters mutual interaction during a tragedy. Its value could be increased through explicit reflection on the aspect of contingency that characterises tragedy. (shrink)

Moral Case Deliberation is intended to assist healthcare professionals faced with difficult dilemmas in their work. These are situations that involve emotions. During Moral Case Deliberation, participants are invited to reflect on moral views and deliberate on them. Emotions are not explicitly addressed. This article aims to elucidate the role of emotions in Moral Case Deliberation, by analysing experiences of Moral Case Deliberation facilitators. Our research shows the role of emotions varies according to the phase of the Moral Case Deliberation (...) process. One negative aspect of emotions is that they can obstruct the Moral Case Deliberation discussion or distract from the moral question. A positive aspect is that they bring the dilemma into sharper focus. Devoting attention to emotions can help to ensure that responsible decisions are made, while also increasing the moral resilience of participants. (shrink)

The human blood coagulation system comprises a series of linked glycoproteins that upon activation induce the generation of downstream enzymes ultimately forming fibrin. This process is primarily important to arrest bleeding (hemostasis). Hemostasis is a typical example of a molecular machine, where the assembly of substrates, enzymes, protein cofactors and calcium ions on a phospholipid surface markedly accelerates the rate of coagulation. Excess, pathological, coagulation activity occurs in “thrombosis”, the formation of an intravascular clot, which in the most dramatic form (...) precipitates in the microvasculature as disseminated intravascular coagulation. Thrombosis occurs according to a biochemical machine model in the case of atherothrombosis on a ruptured atherosclerotic plaque, but may develop at a slower rate in venous thrombosis, illustrating that the coagulation machinery can act at different velocities. The separate coagulation enzymes are also important in other biological processes, including inflammation for which the rapid conversion of one coagulation factor by the other is not a prerequisite. The latter role of coagulation enzymes may be related to the old and probably maintained function of the coagulation machine in innate immunity. BioEssays 25:1220–1228, 2003. © 2003 Wiley Perioicals, Inc. (shrink)

The ‘Bolivarian Revolution’ in Venezuela under Hugo Chávez has reignited debate in Latin America and internationally on the questions of socialism and revolution. This forum brings together six leading intellectuals from different revolutionary traditions and introduces their reflections on class-struggle, the state, imperialism, counter-power, revolutionary parties, community and communes, workplaces, economy, politics, society, culture, race, gender, and the hopes, contradictions, and prospects of ‘twenty-first-century socialism’ in contemporary Venezuela.

Three very prominent arguments for atheism are (1) the argument from sub-optimality, (2) the problem of no best world, and (3) the evidential argument from gratuitous evil. To date, it has not sufficiently been appreciated that several important criticisms of these arguments have all relied on a shared strategy. Although the details vary, the core of this strategy is to concede that God either cannot or need not achieve the best outcome in the relevant choice situation, but to insist that (...) God must and can achieve an outcome that is good enough. In short, this strategy invokes divine satisficing in response to these arguments for atheism. (The widespread use of this strategy may have gone unnoticed because the appeal to divine satisficing is usually implicit.) In sections 1–3, the three arguments for atheism will be set out, and it will be shown that the relevant replies all employ this shared strategy. Section 4 will show that those who invoke divine satisficing have failed to establish that this is a coherent notion. Accordingly, these replies to three important arguments for atheism are, at present, incomplete. (shrink)

The doctrine of promissory fraud holds that a contractual promise implicitly represents an intent to perform. A promisor's conditional intent to perform poses a problem for that doctrine. It is clear that some undisclosed conditions on the promisor's intent should result in liability for promissory fraud. Yet no promisor intends to perform come what may, so there is a sense in which all promisors conditionally intend to perform. Building on Michael Bratman's planning theory of intentions, this article provides a theoretical (...) account of the distinction between “foreground” and “background” conditions on intentions in general and then explains why foreground conditions on a promisor's intent to perform are likely to result in material promissory misrepresentation, while background conditions are not. The difference between foreground and background conditions lies in whether the agent accepts the satisfaction of the condition for the purposes of her practical reasoning. A promisor's nonacceptance of a condition on her intent to perform is material because it is likely to affect her preperformance deliberations and investment in the transaction, as well as her willingness to seek agreement with the promisee on how to fill contractual gaps. (shrink)

Der Körper hat Konjunktur. Als ausgestellter, verfüg- und verführbarer begegnet er uns täglichim Übermaß. Es war nur eine Frage der Zeit, bis im Spiel der sich in den Wissenschafteneinander ablösenden turns auch ein corporeal (oder body) turn ausgerufen würde. Dabeibleibt im genannten turn der Gegenstand der Untersuchung nicht selten reduziert auf das, wasman im deutschen Sprachgebrauch »Körper« nennt: ein physisches Substrat, das wie ein Dingunter Dingen beschreibbar ist. Gegen diese Verkürzung stellt der Begri des »Leibes«,spätestens seit Edmund Husserl, eine präzise (...) theoretische Intervention in die wissenschaftlicheund philosophische Diskussion um Körper und Körperlichkeit dar: Dem objektiv beobachtbaren Körper, den wir haben, wird der lebendige Leib, der wir sind, gegenübergestellt. Diesem »Leib«, seiner Geschichte, seinen Varianten und seinem Versprechen gehen dieAutoren der vorliegenden Beiträge nach. Inhaltsübersicht Emmanuel Alloa/Thomas Bedorf/Christian Grüny/Tobias Nikolaus Klass: Einleitung I. Der Leibbegriff in der Phänomenologie Emmanuel Alloa / Natalie Depraz: Edmund Husserl – „Ein merkwürdig unvollkommenkonstituiertes Ding“ – Stefan Kristensen: Maurice Merleau-Ponty I – Körperschema undleibliche Subjektivität – Emmanuel Alloa: Maurice Merleau-Ponty II – Fleisch und Dierenz – David Espinet: Martin Heidegger – Der leibliche Sinn von Sein – Thomas Bedorf: EmmanuelLevinas – Der Leib des Anderen – Karel Novotný: Körper, Leib, Aektivität in Jan Pato č kasPhänomenologie der natürlichen Welt – Julia Scheidegger: Michel Henry – TranszendentaleLeiblichkeit – Jörg Sternagel: Bernhard Waldenfels – Responsivität des Leibes – Kerstin Andermann: Hermann Schmitz – Leiblichkeit als kommunikatives Selbst- und Weltverhältnis II. Zur Geschichte des Leibbegris Emmanuel Alloa: Archaische Leiblichkeit. Die griechische Antike und die Entdeckung desKörpers – Theresia Heimerl: Der Leib Christi und der Körper des Christen: Körper und Leib alszentrale Problemzonen des Christentums – Marc Rölli: Philosophische Anthropologie im 19. Jahrhundert – Zwischen Leib und Körper – Tobias Nikolaus Klass: Friedrich Nietzsche – Denkenam „Leitfaden des Leibes“ – Andreas Cremonini: Sigmund Freud – Der gelebte vs. derphantasmatische Leib – Uta Noppeney: Kurt Goldstein und Frederik Buytendijk – Der Leib-Begri in der organismischen Biologie – Volker Schürmann: Max Scheler und Helmuth Plessner– Leiblichkeit in der Philosophischen Anthropologie – Marion Lauschke: Ernst Cassirer und AbyWarburg – Kulturanthropologie III. Grenzen und Kritik des Leibbegris Christian Grüny: Theodor W. Adorno – Soma und Sensorium – Ulrich Johannes Schneider: Michel Foucault – Der Körper und die Körper – Burkhard Liebsch: Paul Ricoeur – Das leiblicheSelbst begegnet dem Widerstand des Anderen – Mirjam Schaub: Gilles Deleuze – Was weiß ein„Körper ohne Organe“ vom Leib? – Kathrin Busch: Jean-Luc Nancy – Exposition und Berührung– Shaun Gallagher: Embodiment: Leiblichkeit in den Kognitionswissenschaften – Marie-Luise Angerer: Gender und Performance – Ist leibliche Identität ein Konstrukt? – Thomas Bedorf/Selin Gerlek: Praxistheorien – Leibkörperliche Praktiken im Vollzug. (shrink)

Two pediatric accidents in Jane Austen’s Persuasion and one in Margaret Oliphant’s The Doctor’s Family are examined from the point of view of trauma management with analysis of contributing risk factors, medical management, concerns of parents and bystanders, and course of recovery. Risk factors for injury are impulsivity, poor supervision, and parents who are unable to set limits. Medical attention is swift and competent, but no heroic measures are used; the management of the injuries, concussion with loss of consciousness and (...) dislocation of the collar bone, is consistent with the way these conditions are, for the most part, still managed today, and successful recovery depends on careful nursing and rest. Louisa Musgrove, who suffers a severe head injury, requires ten weeks of convalescence and undergoes a marked personality change, which we might today attribute in part to post-concussion syndrome but which may reflect contemporary debate about the biological basis of personality and behavior. A sudden traumatic injury to a child or adolescent changes the narrative abruptly, in fiction or in life, dividing a story into before and after, introducing grief and anxiety, and requiring that plans be rethought and personal relationships reshuffled with decisions about caretaking and nursing. (shrink)

The question of this work is the relationship between cognition and self-knowledge. That question is approached both by way of Kant on apperception and from the perspective of contemporary theories of mind which locate the origin of our cognitive life in interpersonal, interpretive practices, e.g., Sellars, Davidson, Dennett and Brandom. Kant does not integrate the social dimension into his account of cognition. In fact, many of his arguments for the apperception principle are beholden to a picture of mind which precludes (...) his recognizing the social dimension of cognition. Nonetheless, one can reconstruct a Kantian argument for the apperception principle within the framework of a theory which recognizes the constitutive role of interpretation in cognition. ;Chapter One explores the various ways that the priority of interpersonal interpretation has been claimed. These range from analyses of our talk of the mind as descriptive-predictive strategies to functionalist theories of mind to theories which emphasize the connection between interpreting language and attributing propositional attitudes and the normative dimension of interpretation . Chapter Two outlines seven interpretive questions that any reading of Kant on apperception must address, questions about what Kant means by 'apperception' and the character of the apperception principle. Chapter Three is an analysis of those Kantian arguments for the apperception principle which picture the mind as a private arena, arguments which are untenable from the perspective established in Chapter One. Chapter Four explores Sydney Shoemaker's argument for a functionalist version of Kant's apperception principle and argues that his approach is unsatisfactory. Chapter Five introduces Robert Brandom's theory of propositional attitudes with a discussion of Sellars' theory of sentence meaning and Davidson on the relationship between belief and meaning. Chapter Six then looks at what difference the ability to attribute oneself a propositional attitude might make on Brandom's theory. I argue against Brandom that having a belief or an intention presupposes the ability to explicitly say that one has that belief or intention. Chapter Seven returns to Kant and argues that the analysis and conclusion of Chapter Six are broadly Kantian. (shrink)

It is natural to wonder about contract law’s relationship to the morality of promises and agreements. This Chapter distinguishes two ways to conceive of that relationship. First, parties’ agreement-based moral obligations might figure into the explanation of contract law—into an account of its functions or justifications. Contract law might serve to enforce parties’ first-order performance obligations, to enforce second-order remedial obligations, to support the culture of making and keeping agreements more generally, or at least to do no harm to that (...) culture or to people’s ability to act morally. Second, contract can be understood as the legal analog to promise. Both contract and promise enable people to undertake new obligations to one another when they wish. Each is a type of normative power, the one legal, the other moral. The Chapter concludes by arguing that these two ways of thinking about contract law are not mutually exclusive. Contract law both imposes on parties to exchange agreements a legal obligation to perform for reasons independent of the parties’ possible contractual intent, and confers on them the power to undertake that legal obligation when they so intend because they so intend. (shrink)

Scholars have to date paid relatively little attention to the rules for deciding when a writing is integrated. These integration rules, however, are as dark and full of subtle difficulties as are other parts of parol evidence rules. As a way of thinking about Hanoch Dagan and Michael Heller’s The Choice Theory of Contracts, this Article suggests we would do better with tailored integration rules for two transaction types. In negotiated contracts between firms, courts should apply a hard express integration (...) rule, requiring firms to say when they intend a writing to be integrated. In consumer contracts, standard terms should automatically be integrated against consumer-side communications, and never integrated against a business’s communications. The argument for each rule rests on the ways parties make and express contractual choices in these types of transactions. Whereas Dagan and Heller emphasize the different values at stake in different spheres of contracting, differences among parties’ capacities for choice — or the “mechanics of choice” — are at least as important. (shrink)

This essay deals with the question which kind of fear it is that terror plays with, or which kind of fear terror tries to generate. First of all, the classically philosophical distinction of "Angst" and "Furcht" in Heidegger and Kierkegaard is surveyed in order to, then, in distinction from these forms of fear and following Hobbes, identify the specifically political form of fear, namely that of terror. In the foreground of this identification stand the residues of political theology which nourish (...) political terror. (shrink)

A medical narrative from a woman in her 90s describes her childhood bout with diphtheria in Kansas City, Missouri, apparently immediately after vaccination, her confinement in the “pest hospital,” and her treatment with what she understood as a blood transfusion from a donor who was found through a radio appeal. In this essay, we trace the narrative back to the institutions, medical practices, and historical context, examining both the underlying history of medical practice and scientific understanding that is reflected in (...) her experience and also the contexts of that history, including racial and religious attitudes. (shrink)

This essay, to appear in Contract, Status, and Fiduciary Law (Miller & Gold, 2016), explores three ways fiduciary obligations might be like contractual ones: in the methods lawmakers use or should use to determine the content of the obligation; in the private voluntary acts that generate the obligation; and in the fact that the obligation is a default that parties have the power to alter. The thesis is that to the extent that these similarities exist, they are not especially revealing. (...) Theorists who emphasize the similarities commonly treat contract law as a private power-conferring rule, then analogize the law of fiduciary obligations to it. In fact, the law of contract is more complex and serves a broader range of purposes than just giving private parties the ability to undertake legal obligations when they choose. Contract obligations are sometimes imposed for reasons other than party choice, and contract defaults and altering rules can be designed to serve other social purposes. A more nuanced understanding of the functions and design of contract law suggests that structural similarities between fiduciary obligations and contractual ones tell us less about the fiduciary obligations than we might have hoped. The explanation of why that is so, however, reveals important features both of contract law and of the law of fiduciary obligations. (shrink)

In recent years there has been a revival of interest in the philosophical study of contract law. In 1981 Charles Fried claimed that contract law is based on the philosophy of promise and this has generated what is today known as 'the contract and promise debate'. Cutting to the heart of contemporary discussions, this volume brings together leading philosophers, legal theorists, and contract lawyers to debate the philosophical foundations of this area of law.

We reflect on our experience co-teaching a medical humanities elective, “Pandemics and Plagues,” which was offered to undergraduates during the Spring 2021 semester, and discuss student reactions to studying epidemic disease from multidisciplinary medical humanities perspectives while living through the world Covid-19 pandemic. The course incorporated basic microbiology and epidemiology into discussions of how epidemics from the Black Death to HIV/AIDS have been portrayed in history, literature, art, music, and journalism. Students self-assessed their learning gains and offered their insights using (...) the SALG, describing how the course enhanced their understanding of the current pandemic. In class discussions and written assignments, students paid particular attention to issues of social justice, political context, and connections between past pandemics and Covid-19. Student responses indicate enhanced understanding of the scientific and medical aspects of epidemics and also increased appreciation of the insights to be gained from the medical humanities. We discuss co-teaching the class during a real-time, twenty-four-hour-news-cycle pandemic, and the ways in which that experience underlines the value of a “critical medical humanities” approach for undergraduates. (shrink)