The volume is divided into three sections.

The global crisis of the COVID-19 pandemic has considerably accelerated the adoption of teleconsultation—a form of consultation between patient and health care professional that occurs via videoconferencing platforms. For this reason, it is important to investigate the way in which this form of interaction modifies the nature of the clinical encounter and the extent to which this modification impacts the healing process. For this purpose, I will refer to insights into the clinical encounter as a face-to-face encounter drawn from the (...) phenomenology of medicine (R. Zaner, K. Toombs, E. Pellegrino). I will also take into account a criticism that has been expressed by various contemporary phenomenologists (H. Dreyfus, T. Fuchs, L. Dolezal, H. Carel), namely, that due to the lack of physical proximity to the other in all types of online encounters, such encounters lack significant features that are present in face-to-face encounters, with the most important of these being the possibility of attaining an empathetic perception of the other and a sense of embodied risk. As these elements are essential features of the clinical encounter, the aim of this paper is to determine whether teleconsultation exhibits these features. To do that, I will integrate phenomenological philosophy with qualitative research drawing materials from both the philosophical tradition, particularly with respect to the concepts of the face-to-face encounter and embodied risk (A. Schutz and H. Dreyfus), and qualitative research study regarding patient experiences of teleconsultation. I will argue that teleconsultation does involve both the possibility of perceiving the other empathetically and the possibility of experiencing a sense of embodied risk. (shrink)

Argument-mapping software abounds, and one of the reasons is that using the software has been shown to teach/promote/improve critical thinking skills. These positive results are very encouraging, but they also raise the question of whether the computer tutorial environment is producing these results, or whether learning argument mapping, even with just paper and pencil, is sufficient. Based on the results of two empirical studies, I argue that the basic skill of being able to represent an argument diagrammatically plays an important (...) role in the improvement of critical-thinking skills. While these studies do not offer a direct comparison between the two methods, it is important for anyone wishing to employ argument mapping in the classroom to know that significant results can be obtained even with the most rudimentary of tools. (shrink)

The first part of this study offers a synoptic overview of Alfonso de la Torre’s selective engagement with Maimonidean philosophy in the first part of his Visión Deleitable. Our analysis is complemented with some comparative notes on the reception of Maimonides’s thought in late medieval Spain. Visión Deleitabl e’s fate will be examined in comparison to two other 15th century works of Jewish or converso authorship that also broached the Guide for the Perplexed for the benefit of Christian readers: the (...) Old Spanish translation of Maimonides’s Guide by Pedro de Toledo and Moshe Arragel’s commentary on his Bible translation for the Christian Master of Calatrava, don Luis de Guzmán. (shrink)

Knowing Nature brings together political ecologists and science studies scholars to showcase the key points of encounter between the two fields and how this ...

"Science is rooted in conversations," wrote Werner Heisenberg, one of the twentieth century's great physicists. In Quantum Dialogue, Mara Beller shows that science is rooted not just in conversation but in disagreement, doubt, and uncertainty. She argues that it is precisely this culture of dialogue and controversy within the scientific community that fuels creativity. Beller draws her argument from her radical new reading of the history of the quantum revolution, especially the development of the Copenhagen interpretation. One of several (...) competing approaches, this version succeeded largely due to the rhetorical skills of Niels Bohr and his colleagues. Using extensive archival research, Beller shows how Bohr and others marketed their views, misrepresenting and dismissing their opponents as "unreasonable" and championing their own not always coherent or well-supported position as "inevitable." Quantum Dialogue, winner of the 1999 Morris D. Forkosch Prize of the Journal of the History of Ideas, will fascinate everyone interested in how stories of "scientific revolutions" are constructed and "scientific consensus" achieved. "[A]n intellectually stimulating piece of work, energised by a distinct point of view."—Dipankar Home, Times Higher Education Supplement "[R]emarkable and original. . . . [Beller's] arguments are thoroughly supported and her conclusions are meticulously argued. . . . This is an important book that all who are interested in the emergence of quantum mechanics will want to read."—William Evenson, History of Physics Newsletter. (shrink)

A key topic within the field of the phenomenology of medicine has been the relationship between body and self in illness, including discussions about the otherness and mineness of the body. The aim of this article is to distinguish between different meanings of bodily otherness and mineness in illness with reference to the interpretation of the body as “saturated phenomenon,” inspired by the phenomenology of Jean-Luc Marion. With the help of Marion’s ideas it is possible to distinguish between two meanings (...) of bodily otherness and of mineness (objective and non-objective forms). These distinctions support and elaborate on ideas already found in the phenomenology of medicine and offer further insights into the nature of the experience of illness. (shrink)

Nowadays, managing change in complex services requires that middle management re-designs its objects and professional practices, in order to cope with new needs. It seems therefore crucial to activate training settings that allow managers to: develop research and analytical skills on their own work practices and professional objects; face and manage conflict, related to every change, that represents an opportunity to reflect and review one's own practices; and build new and shared repertories of managerial practices, able to support a better (...) form of living and working together within the management community. Moving from these hypotheses, inside the setting of a training intervention conducted in an educational service, the article discusses a specific tool used to generate opportunity of exchange, and reflection, within a challenging framework of change. (shrink)

This essay looks closely at metaphors and other figures of speech that often feature in how Americans talk about dementia, becoming part of cultural narratives: shared stories that convey ideas and values, and also worries and fears. It uses approaches from literary studies to analyze how cultural narratives about dementia may surface in conversations with family members or health care professionals. This essay also draws on research on a notable social effect of legalizing medical aid in dying: patients may find (...) it easier to bring up a range of concerns, regardless of whether they have any interest in hastening their own death. The essay proposes that health care professionals rethink an idea prominent within their own culture: that conversations about the end of a person's life are inherently difficult. This framing may make it hard for people facing dementia to bring up their concerns about what lies ahead. We suggest a different way to think about these conversations, using the metaphor of “opening the door” to represent inviting a patient to bring up issues of deepest concern. (shrink)

While feelings of disgust and repulsion are experienced and accepted as part of care practices of nurses who work in palliative care, they are often silenced. Working alongside two palliative care nurses in a hospice setting, we engaged in a narrative inquiry to inquire into their experiences of disgust. The study took place in a palliative care setting in a large urban city in Germany. We understand care practices as actions that follow a logic of care. According to a logic (...) of care, actions are situated within a social context, given by specific relationships including power, and individual needs. Various aspects of disgust are visible in the experiences of the participants and highlighted in the narrative threads of disgust and silence, disgust and protection, and disgust and boundaries. Embedded in the experience of disgust of nurses working in palliative care, we see that there are borderlands of care that challenge who we are and are becoming. Opening discussion about disgust in nursing makes visible the complexity of care. (shrink)

Problem-Based Learning has become an increasingly popular instructional method for a variety of disciplines at all levels. Many studies and meta-analyses of these studies have shown the efficacy of this method for developing knowledge and skills. I adopted this method for teaching Engineering Ethics at Carnegie Mellon University, which has as its main course objectives the development of moral reasoning skills, as well as collaboration and communication skills, with special attention given to ethical dilemmas that may arise in the normal (...) course of an engineer’s professional career. In the most recent iteration of the course, I used the Engineering and Science Issues Test as a pretest and posttest to test the development of my students’ moral reasoning skills over the course of the semester. Based on the results of these tests, I argue that the students in my Engineering Ethics course did in fact significantly develop their moral reasoning skills. (shrink)

Interpretation of first four sutras of Brahmasūtra of Bādarāyaṇa on the basis of Śaṅkarācārya's commentary on Vedanta.

In this paper, classical pragmatism is used as a method, not as a substantial ethical theory, to develop “moral pragmatics.” Moral pragmatics offers a constructive approach for making progress where traditional ethical theories converge, and it innovates ethical deliberation. Assuming widespread agreement that real moral problems need practical solutions, the paper addresses two related problems: the missing link between ethical theories and moral practice, and the question of who is in charge of finding such solutions. It argues that “conscience” can (...) create a link between ethical knowledge and moral practice, and that this partly discharges “the ethicist” from the task of solving problems that are not really, or not only, hers. Two specific methodological innovations are suggested that go beyond admonitions to render ethics sensitive to context. Instead, a reevaluation of “casuistry” and a sensitivity for “finding the right words” give an idea of how to achieve this goal. (shrink)

Political ecology and science studies have found fertile meeting ground in environmental studies. While the two distinct areas of inquiry approach the environment from different perspectives—one focusing on the politics of resource access and the other on the construction and perception of knowledge—their work is actually more closely aligned now than ever before. Knowing Nature brings together political ecologists and science studies scholars to showcase the key points of encounter between the two fields and how this intellectual mingling creates a (...) lively and more robust ecological framework for the study of environmental politics. The contributors all actively work at the interface between these two fields, and here they use empirical material to explore questions of theoretical and practical import for understanding the politics that surround nature-society relations, from wildlife management in the Yukon to soil fertility in Kenya. In addition, they examine how various environmental knowledge claims are generated, packaged, promoted, and accepted (or rejected) by the different actors involved in specific cases of environmental management, conservation, and development. Finally, they ask what is at stake in the struggles surrounding environmental knowledge, how such struggles shape conceptions of the environment, and whose interests are served in the process. (shrink)

The word “philosophy” comes from the Greek “philos” (meaning love) and “sophia” (meaning wisdom); thus philosophy literally is the “love of wisdom.” Whatever else philosophy may be, most people agree that it still retains this spirit of its etymological roots, and that when we are engaged in philosophy we are pursuing wisdom for the sake of itself. Wisdom, however, is not the same thing as knowledge or information. We aren’t merely trying to amass list of interesting ideas, or believe anything (...) that sounds good. Wisdom is, at least in part, the reflection on and critical evaluation of what we ourselves and others around us believe about some very heady topics. (shrink)

During the last few decades, many thinkers have advocated for the importance of the phenomenological approach in developing the understanding of the lived experience of illness. In their attempts, they have referred to ideas found in the history of phenomenology, most notably, in the works of Edmund Husserl, Martin Heidegger, Maurice Merleau-Ponty and Jean-Paul Sartre. The aim of this paper is to sketch out an interpretation of illness based on a yet unexplored conceptual framework of the phenomenology of French thinker (...) Jean-Luc Marion. Focusing on concepts of the saturated phenomenon and flesh, the paper develops an interpretation of illness as the saturated phenomenon, which highlights a variety of dimensions of illness already elaborated within the phenomenology of medicine, such as the affective dimension of illness, the disruptive dimension of illness, the transformed perception of the self in illness, mineness of flesh in illness and the inexpressible and hermeneutical dimension of illness. In addition to that, the paper explores some of the consequences the proposed interpretation of illness offers regarding the nature of illness and health. It is argued that illness in its essence is very similar to the experience of other saturated phenomena, suggesting that the difference between them does not lie within the character of the affective givenness, but rather within the dynamic relationship between the affective givenness and its conceptualization. It is also shown that the experience of health is compatible with the experience of saturation and thus is not limited to the tacit and harmonious background state. (shrink)

Bioethical concerns about the potential for abuse in medical aid in dying (MAID) have focused primarily on the risk of coercion (Battin et al. 2007; Foley and Hendin 2002). Accordingly, the require...

This article examines the making of Romanian diplomatic practices during the first two decades of the Cold War by analyzing the activity of the Romanian Institute for Cultural Relations with the Foreign Countries in the field of architecture. I investigate how transnational cultural exchanges conducted jointly by party members and architects adjusted the professional careers of the latter. Questions related to what was good or bad, which images were still valid iconic representations of the country, what values the architects should (...) share, or how to depict architecturally modernisation and the nation dominated the IRRCS debates. Using archival information consisting of reports of cultural activities abroad, foreign travelers’ statements, itineraries, exhibitions’ materials and photographic records etc., I address Romania’s self-representation practices at home and abroad constructed in relation to the Other – the Easterner and Westerner, in close connection to the shift in the country’s economic interests. (shrink)

Supercommentary on Siddhāntabindu of Madhusūdana Sarasvatī, exegesis of Daśaślokī, treatise of the Advaita school in Indic philosophy, by Śaṅkarācārya.

Na palestra proferida no ano de 1967, Theodor W. Adorno, um dos grandes pensadores da Escola de Frankfurt, começa ressaltando que não intenciona apresentar uma visão da direita radical na completude que o tema exige, mas sim apontar algumas das características de uma nova direita mais radical do que ele havia abordado em uma palestra no ano de 1959. Dessa forma, frente aos novos elementos socioeconômicos da recente queda do nazifascism, o filósofo alemão considerou necessário abordar novos aspectos do que (...) ele chamou de novo radicalismo de direita. (shrink)

“It's almost like putting salt in a wound, for this person who's already made a very difficult decision,” suggested Meghan Patterson, a licensed obstetrician-gynecologist whom we interviewed in our qualitative study of the experiences of North Carolina abortion providers practicing under the state's Woman's Right to Know Act. The act requires that women receive counseling with state-mandated information at least twenty-four hours prior to obtaining an abortion. After the law was passed, Patterson worked with clinic administrators, in consultation with a (...) lawyer, to write a script to be used in the state-mandated counseling procedure. She and her colleagues took particular steps to mitigate the effects of what she described as HB 854's “forced language”—such as referring to the “father of the child.” While HB 854 stipulated that patients must be informed of the medical risks associated with the particular abortion procedure as well as those of carrying the child to term, Patterson's script made explicit the magnitude of comparative risks, emphasizing that the risks of carrying a pregnancy to term are substantially greater than the risks of an early-term abortion. She felt that these contextualization strategies helped to facilitate trust and rapport in a clinical care situation that proved relationally and morally challenging. In this article, we take up and expand on this point by elucidating an empirically grounded approach to ethically justified care when health care providers face legal or institutional policy mandates that raise possible moral conflicts. Our approach builds on recent bioethics discourse addressing conscience in the practice of medicine. While the concept of conscience has broad philosophical underpinnings relating to moral judgment, agency, and discernments of right and wrong, debates in bioethics have tended to engage the concept primarily vis-à-vis rights of conscientious objection or refusal. Here, we suggest a broader frame for thinking about claims of conscience in health care. Our approach draws on the feminist bioethics and the ethics of care literatures to highlight how providers may be motivated by matters of conscience, including relational concerns, in the active provision of certain forms of care. What emerges are two possibilities: not only conscientious refusal to comply with a policy mandate but also conscientious compliance—working conscientiously within a mandate's confines. (shrink)

In this paper, I defend a novel skeptical view about moral disgust. I argue that much recent discussion of moral disgust neglects an important ontological question: is there a distinctive psychological state of moral disgust that is differentiable from generic disgust, and from other psychological states? I investigate the ontological question and propose two conditions that any aspiring account of moral disgust must satisfy: it must be a genuine form of disgust, and it must be genuinely moral. Next, I examine (...) two prominent accounts of moral disgust by John Kekes and Victor Kumar and argue that neither successfully establishes the existence of genuinely moral disgust: Kekes’ account does not satisfy the second condition, and Kumar’s view does not meet the first. I claim that an important general lesson can be drawn from my critiques of Kekes’ and Kumar’s accounts: to establish the existence of moral disgust, one must provide unequivocal evidence that genuinely moral disgust, not generic disgust or anger, is being elicited in response to relevant moral violations. I conclude by considering why we ought to be skeptical about the general prospect of giving a positive answer to the ontological question, given the available evidence. (shrink)

Background Bioethical debates about privacy, big data, and public health surveillance have not sufficiently engaged the perspectives of those being surveilled. The data justice framework suggests that big data applications have the potential to create disproportionate harm for socially marginalized groups. Using examples from our research on HIV surveillance for individuals incarcerated in jails, we analyze ethical issues in deploying big data in public health surveillance. -/- Methods We conducted qualitative, semi-structured interviews with 24 people living with HIV who had (...) been previously incarcerated in county jails about their perspectives on and experiences with HIV surveillance, as part of a larger study to characterize ethical considerations in leveraging big data techniques to enhance continuity of care for incarcerated people living with HIV. -/- Results Most participants expressed support for the state health department tracking HIV testing results and viral load data. Several viewed HIV surveillance as a violation of privacy, and several had actively avoided contact from state public health outreach workers. Participants were most likely to express reservations about surveillance when they viewed the state’s motives as self-interested. Perspectives highlight the mistrust that structurally vulnerable people may have in the state’s capacity to act as an agent of welfare. Findings suggest that adopting a nuanced, context-sensitive view on surveillance is essential. -/- Conclusions Establishing trustworthiness through interpersonal interactions with public health personnel is important to reversing historical legacies of harm to racial minorities and structurally vulnerable groups. Empowering stakeholders to participate in the design and implementation of data infrastructure and governance is critical for advancing a data justice agenda, and can offset privacy concerns. The next steps in advancing the data justice framework in public health surveillance will be to innovate ways to represent the voices of structurally vulnerable groups in the design and governance of big data initiatives. (shrink)

In recent years, philosophers have looked to empirical findings about psychopaths to help determine whether moral agency is underwritten by reason, or by some affective capacity, such as empathy. Since one of psychopaths’ most glaring deficits is a lack of empathy, and they are widely considered to be amoral, psychopaths are often taken as a test case for the hypothesis that empathy is necessary for moral agency. However, people with autism also lack empathy, so it is reasonable to think that (...) any empirically-informed attempt to answer the question of whether empathy is necessary for moral agency should give due attention to autism as well as psychopathy. Jeanette Kennett’s thought-provoking paper ‘Autism, Empathy and Moral Agency’ (2002) is an early and arguably the most notable example of such an attempt. Kennett argues that although autistic people and psychopaths both lack empathy, autistic people possess a ‘reverence for reason’ that enables them to become capable moral agents. By contrast, psychopaths lack this rational capacity, and it is this defect of reason rather than an empathic impairment that explains why they are amoral. Kennett thus concludes that empathy is not necessary for moral agency. In this chapter, I challenge Kennett’s argument. First, I review the empirical evidence in order to demonstrate that there is a component of empathy called affective empathy that is impaired in psychopaths but largely preserved in autistics. As such, the claim that psychopaths and autistics share a common lack of empathy is unjustified. Second, I challenge Kennett’s claim that empathy plays no role in explaining the moral difference between psychopaths and autistics. Instead, I contend that the intact affective empathy of autistic people is a crucial component of their capacity to act from reverence for reason. (shrink)

A pattern of research findings indicates that excessive devotion to a favorite celebrity is linked to attitudes and behaviors that are psychologically unhealthy and may predict low life satisfaction. This study examines whether four common measures of life satisfaction predict admiration for celebrities in two university samples and one community sample of young adults. Our results showed significant correlations between celebrity admiration and two measures of life satisfaction. We also found that the predictors of life satisfaction correlate with each other (...) in ways that are consistent with previous research in positive psychology. Our research suggests an inverse relationship between celebrity admiration and life satisfaction. In addition, the results contribute to establishing the validity of four contemporary life satisfaction measures. (shrink)

On 19 July 2016, three medical organisations filed a federal lawsuit against representatives from several Vermont agencies over the Patient Choice and Control at End of Life Act. The law is similar to aid-in-dying laws in four other US states, but the lawsuit hinges on a distinctive aspect of Vermont's law pertaining to patients' rights to information. The lawsuit raises questions about whether, and under what circumstances, there is an ethical obligation to inform terminally ill patients about AID as an (...) end-of-life option. Much of the literature on clinical communication about AID addresses how physicians should respond to patient requests for assisted dying, but neglects the question of how physicians should approach patients who may not know enough about AID to request it. In this article, I examine the possibility of an affirmative duty to inform terminally ill patients about AID in light of ethical concerns about professional responsibilities to patients and the maintenance of the patient–provider relationship. I suggest that we should not take for granted that communication about AID ought to be patient-initiated, and that there may be circumstances in which physicians have good reasons to introduce the topic themselves. By identifying ethical considerations that ought to inform such discussions, I aim to set an agenda for future bioethical research that adopts a broader perspective on clinical communication about AID. (shrink)

Neste artigo discutimos como algumas questões políticas que permearam as fases da Psicologia Industrial, Psicologia Organizacional e da Psicologia do Trabalho ajudaram na construção do pluralismo teórico da subárea da Psicologia no contexto do trabalho, uma vez que essas se encontram hoje interagind..

Stresses on healthcare systems and moral distress among clinicians are urgent, intertwined bioethical problems in contemporary healthcare. Yet conceptualizations of moral distress in bioethical inquiry often overlook a range of routine threats to professional integrity in healthcare work. Using examples from our research on frontline physicians working during the COVID-19 pandemic, this article clarifies conceptual distinctions between moral distress, moral injury, and moral stress and illustrates how these concepts operate together in healthcare work. Drawing from the philosophy of healthcare, we (...) explain how moral stress results from the normal operations of overstressed systems; unlike moral distress and moral injury, it may not involve a sense of powerlessness concerning patient care. The analysis of moral stress directs attention beyond the individual, to stress-generating systemic factors. We conclude by reflecting on how and why this conceptual clarity matters for improving clinicians’ professional wellbeing, and offer preliminary pathways for intervention. (shrink)

The global crisis of COVID-19 pandemic has considerably accelerated the use of teleconsultation (consultation between the patient and the doctor via video platforms). While it has some obvious benefits and drawbacks for both the patient and the doctor, it is important to consider—how teleconsultation impacts the quality of the patient-doctor relationship? I will approach this question through the lens of phenomenology of the body, focusing on the question—what happens to the patient objectification in teleconsultation? To answer this question I will (...) adopt a phenomenological approach combining both insights drawn from the phenomenological tradition, i.e., the concepts of the lived body and the object body, and the results from the phenomenologically informed qualitative research study on the patient experience of teleconsultation. The theoretical background against which I have developed this study comprises discussions within the field of phenomenology of medicine regarding the different sources of patient objectification within clinical encounter and the arguments concerning the negative impact that objectification has on the quality of care. I will argue that a factor that has frequently been identified within phenomenology of medicine as the main source of patient objectification in clinical encounters, namely, the internalized gaze of the clinician, is diminished during teleconsultation, increasing patient’s sense of agency, decreasing her sense of alienation and opening up the possibility for a closer relationship between the patient and the health care provider, all of which lead to the transformation of the hierarchical patient-health care professional relationship. (shrink)

Today, in both theory and practice, the concepts of corporate social responsibility and ethics are not necessarily related. Organizations can demonstrate high levels of social proactivity in their CSR policies with or without having laudable levels of ethical quality or virtuousness. This article introduces the concepts of organizational ethical quality to evaluate the moral excellence of CSR actions and policies, identifying and categorizing varying levels ranging from the absence of ethical virtuousness, termed immoral CSR, to high levels of moral CSR, (...) or ethical virtuousness. High MCSR is the product of both high levels of OEQ in conjunction with more proactive CSR policies based on social action. (shrink)

ABSTRACT:COVID-19 revealed health-care systems in crisis. Intersecting crises of stress, overwork, and poor working conditions have led to workforce strain, under-staffing, and high rates of job turnover. Bioethics researchers have responded to these conditions by investigating the ethical challenges of pandemic response for individuals, institutions, and health systems. This essay draws on pandemic findings to explore how empirical bioethics can inform post-pandemic translational bioethics. Borrowing from the concept of translational science in medicine, this essay proposes that translational bioethics should communicate (...) knowledge about ethical challenges in health-care work to support health systems change. The authors draw from their experience with the Study to Examine Physicians' Pandemic Stress (STEPPS), an interdisciplinary research project that investigates physicians' experiences at the front lines of the COVID-19 pandemic. Using STEPPS as an example of empirical bioethics with potential for translation, the authors review their research and discuss the ongoing process for translating their findings, focusing on how bioethics research and practice can contribute to supporting the health-care workforce. (shrink)