Medical ethics could be better understood if some basic theoretical aspects of practices in health care are analysed. By discussing the underlying ethical principles that govern medical practice, the student should also become familiar with the notion that medical ethics is much more than the external application of socially accepted moral standards. Professions in general and medicine in particular have internal values that command their moral virtuosity at the same time as their technical excellence. Three examples where clinical practice can (...) be clearly shown to require an ethical analysis are given: medical praxiology illustrates the motives, means and aims of physicians and patients; clinical decision-making as a practical syllogism that reaches prescriptive conclusions based on medical knowledge and the patient's wishes/intentions. Finally, diagnostics as an ethical bayesian approach is discussed, where the patient informedly decides the benefits and risks of further testing. (shrink)

Human beings are essentially vulnerable in the view that their existence qua humans is not given but construed. This vulnerability receives basic protection from the State, expressed in the form of the universal rights all citizens are meant to enjoy. In addition, many individuals fall prey to destitution and deprivation, requiring social action aimed at recognising the specific harms they suffer and providing remedial assistance to palliate or remove their plights.Citizens receive protection against their biologic vulnerability by means of an (...) in rem right to health [care], which is more an attitude of protection than a specific programme. When individuals become susceptible, that is, biologically weak or diseased, they also increase their predisposition to additional harm, and require social actions to treat their demeaned condition. Such assistance takes the form of positive healthcare rights.Research on human beings has been slow to observe that the subjects recruited are susceptible, especially so if research is done in less developed countries. By mislabelling them as vulnerable – a characteristic they share with all humans – sponsors avoid registering the deprivation these people suffer, and the ethical obligation to offer them remedial help.The distinction between vulnerability and susceptibility also marks the difference between being intact but fragile – vulnerable – and being injured and predisposed to compound additional harm – susceptible. Awareness of this difference should give additional force to the rejection of double standards in research ethics. (shrink)

The so-called European principles of bioethicsare a welcome enrichment of principlistbioethics. Nevertheless, vulnerability, dignityand integrity can perhaps be moreaccurately understood as anthropologicaldescriptions of the human condition. Theymay inspire a normative language, but they donot contain it primarily lest a naturalisticfallacy be committed. These anthropologicalfeatures strongly suggest the need todevelop deontic arguments in support of theprotection such essential attributes ofhumanity require. Protection is to beuniversalized, since all human beings sharevulnerability, integrity and dignity, thusfundamenting a mandate requiring justice andrespect for fundamental human (...) rights.Being a feature of all humanity, vulnerabilityis improperly extended to designatedestitute individuals and populations. Rather,they are in a state of fallen vulnerability,for they already are harmed in some way, andhave become deprived of their range ofcapabilities. These individuals are destituteand are no longer in command of theirfundamental human rights. They have lost thestatus of unharmed vulnerability;identifying them as susceptible – vulnerated andno longer only vulnerable – stresses thepoint that bioethics demands specific socialaction to palliate or remove their distress.When harm does occur – in the form of disease,for example –, individuals are no longervulnerable – for they have ceased to be intact–, they become susceptible to additionaldeprivations and sickness; integrity isdemeaned and dignity is offended, leading tostates of dysfunction that require specificremedial social practices, aimed at treatingand removing injuries.The main point this paper addresses is thatvulnerability – as well as dignity and integrity – are descriptive characteristics ofhuman beings qua humans, which are not normative in themselves, but fundamental enoughto inspire bioethical requirements of protection and respect for human rights in thewake of social justice. A clear distinction must be made in regard to human beings who areinjured by poverty, sickness, discriminating deprivations or suffer otherdestitutions, having ceased to be only vulnerable for they are no longer intact. Theseindividuals and populations require more than protection, their needs must be met byspecific care and remedial measures to be identified and instigated by bioethics quaapplied ethics. (shrink)

Summary Care and cure have been described as different kinds of ethical approaches to clinical situations. Female concerns in nursing care have been contrasted with masculine, cure orientated physician's attitudes. Ethics in such different voices may have sociologic determinants, but they do not represent intrinsic distinctions. Medicine has shown a divergent development, on the one hand stressing cure in a deterministic and instrumental way, on the other hand being aware that disease is as much a pathographic as a biographic, care‐requiring (...) existential situation. Disease is a breakdown of the living organism, to be cured by therapeutic efforts, but it is also the distressing failure of the lived body, requiring concern and care. Based on Lévinas’ ethics of encounter, it is suggested that any interpersonal relatedness is based on concern for the other, being grounded on an essentially ethical interaction. The clinical encounter is a paradigm of such ethics‐based relationships, which necessarily builds on awareness of the other qua other, and is concerned with fulfilling the therapeutic mandate. Caring for the other means doing one's best to help her/him, so that care and cure are inextricably interwoven, although care is the more fundamental form of human relatedness. Thus, neither gender nor professional tasks can allow for a caring attitude to develop without curing concerns, just as trying to cure without caring is unthinkable. (shrink)

Based on the distinction between living body and lived body, we describe the disease-subject as representing the impact of disease on the existential life-project of the subject. Traditionally, an individual's subjectivity experiences disorders of the body and describes ensuing pain, discomfort and unpleasantness. The idea of a disease-subject goes further, representing the lived body suffering existential disruption and the possible limitations that disease most probably will impose. In this limit situation, the disease-subject will have to elaborate a new life-story, a (...) new character or way-of-being-in-the-world, it will become a different subject. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hermeneutics, Neuroscience and PsychiatryMichael T. H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM (bio)Hermeneutic practice in mental health has been a theme in Philosophy, Psychiatry, & Psychology (PPP) since its very beginnings. In this essay I argue that hermeneutics, the theory and practice of interpretation, promotes therapeutic interaction between mental health professionals, patients and their family.Why does this patient present in such a way at this particular (...) point in time? The distressing symptoms are there. The changes in behavior are obvious. Impairments of functions are hurting. A mental illness clearly runs in the family. There were early losses of loved ones, physical abuse at home, bullying by peers and self-medication with drugs and alcohol. Three in four adults with a mental illness first experienced that before they turned 24. The brain goes through major reorganization during adolescence and early adulthood. If synaptic pruning went wrong, psychoses emerged. When stresses activated the hypothalamic–pituitary–adrenal axis the elevated cortisol level impacted the size and function of the hippocampus and amygdala in the genetically vulnerable; anxiety, depression, bipolar, and personality disorders developed. The patient needs a voice/language to describe all these experiences and events and the psychiatrist needs a discourse to make sense of them.Eisenberg laments the swings between "brainlessness" and "mindlessness" in psychiatry. Engel argues for a "biopsychosocial" discourse. The major challenge for psychiatry is how to organize clinical information of different nature (categories, dimensions, narratives; i.e., objective vs. subjective, personal vs. interpersonal) into a coherent and comprehensible account for us all. Mental illnesses are not only neuropsychiatric spectrum disorders but also dysfunctions of social relationship and environmental/ecological adaptation. Psychiatry as a clinical neuroscience per se lacks the semantics to address the rich interactions between the physical, psychological, social, cultural, and spiritual in the illness experience of our patients. Explanation in the diagnostic formulation (objective scientific discourse on cause and effect) and understanding in the patient narrative (subjective ordinary everyday discourse on significance and meaning) are irreducible to each other (Wong, 2018). They instead interact with one another to achieve an integrative formulation, not through merging different discourses into a single assertion/monologue but via the dialectic/dialogue of "explaining more in order to understand better," as Ricoeur puts it, and between "the whole and the parts," as Schleiermacher highlights.This "therapeutic hermeneutic circle" of "explanation vs understanding" and "the whole vs the parts" includes symptoms behavior function and life events. It correlates between bio-psychosociocultural-spiritual dimensions/perspectives and does not reduce them to any particular/single [End Page 13] stance. The whole integrates the parts and the parts enrich the whole. It explains but does not explain away. It understands through an articulation of meaning and significance. This discourse is a multilayered (bio-psycho-social-cultural-spiritual) personal narrative that formulates diagnosis and care in a correlative (linking different voices/discourses) and non-reductive (no particular voice/discourse is prejudiced against) manner that is comprehensible to us all (Wong, 2021).PPP will be an excellent forum for discussing clinical hermeneutics in the future. In this digital era of social media and virtual reality, hermeneutics has the never-ending task to tackle the unprecedented challenges to meaning illness and health posed by polarizing discourses.Michael T. H. Wong Michael T.H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM, is Hon Clinical Professor, Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, HKSAR, China. Michael is Chair, Section of Philosophy & Humanities in Psychiatry, World Psychiatric Association. He is an Organizational Partner & International Lead with The Collaborating Centre for Values-Based Practice in Health and Social Care, St Catherine's College Oxford. He is Advisor to the Chinese Health Foundation of Australia.ReferencesWong M. T. H. (2018). Ricoeur and the third discourse of the person: From philosophy and neuroscience to psychiatry and theology. London: Lexington Books. Google ScholarWong, M. T. H. (2021). Values, meanings, hermeneutics and mental health. In Stoyanov, D., Fulford, K. M. W. F., Stanghellini, G., Van Staden, W., & Wong, M. TH. (Eds.), International perspectives in values-based mental health practice: Case studies and commentaries (pp. 341–349... (shrink)

In this paper, we outline the policy implications of mobile health research conducted at the international level. We describe the manner in which such research may have an international dimension and argue that it is not likely to be excluded from conventionally applicable international regulatory tools. We suggest that closer policy attention is needed for this rapidly proliferating approach to health research.

Parties are back, and many are cheering. Party polarization has voters seeing stark differences between Democrats and Republicans and demonstrating more ideological constraint than previous generations. But these signs of a more “responsible” electorate are an illusion, because the public is no more knowledgeable than ever about the type of “information” it needs if it is to exercise effective control over the public‐policy outcomes it cares the most about. Indeed, polarization has produced a political environment where both voters and policy (...) makers may be less likely to learn about the potential consequences of their governing choices. The result is that holding elected politicians to account for policies treated as divisive ends in themselves has become easier—but that holding them accountable for policies intended as means to the achievement of consensual ends has become harder. (shrink)

Mirrored-self misidentification is the delusional belief that one's own reflection in the mirror is a stranger. In two experiments, we tested the ability of hypnotic suggestion to model this condition. In Experiment 1, we compared two suggestions based on either the delusion's surface features (seeing a stranger in the mirror) or underlying processes (impaired face processing). Fifty-two high hypnotisable participants received one of these suggestions either with hypnosis or without in a wake control. In Experiment 2, we examined the extent (...) to which social cues and role-playing could account for participants' behaviour by comparing the responses of 14 hypnotised participants to the suggestion for impaired face processing (reals) with those of 14 nonhypnotised participants instructed to fake their responses (simulators). Overall, results from both experiments confirm that we can use hypnotic suggestion to produce a compelling analogue of mirrored-self misidentification that cannot simply be attributed to social cues or role-playing. (shrink)

Die Reedition der von den Verfassern nunmehr Excerpta Vaticana et Laurentiana genannt wird, findet ihre Begründung darin, dass der Erstherausgeber, der berühmt Rechtshistoriker Contardo Ferrini offenbar auf eine Kollationierung beider Codices verzichtet hat und im Übrigen, aus welchen Gründen auch immer, bei der Edition selbst nicht unwesentliche Versehen verschuldet hat. Der Codex Vaticanus Palatinus ist wohl in der ersten Hälfte des 14. Jahrhunderts entstanden, der Codex Laurentianus 80.6 in der ersten Hälfte des 15. Jahrhunderts. Grundsätzlich sind die Verfasser der Meinung, (...) die mit zahlreichen plausiblen Argumenten vorgetragen wird, dass der Schreiber des Codex Laurentianus 80.6, ein gewisser Stephanus of Medea, als Vorlage den heutigen Codex Vaticanus Gr. 19 vor sich liegen hatte, und als intelligenter Kopist verschiedene Emendationen vorgenommen hat. Eine große Mehrheit der Fragmente der Excerpta Vaticana et Laurentiana von 1–193 muss einem Juristen Anatolius zugeschrieben werden. Jene Person, die sie zusammengestellt hat, muss ein altes Manuskript mit der Summa Codicis des Anatolius verwendet haben. In dieser Summa waren die Termini technici immer noch in lateinischer Sprache verfasst. Zur Selektion der Texte führen die Verfasser an, dass überdurchschnittlich großes Interesse dem Strafrecht und dem Familienrecht gewidmet ist, während etwa Eigentumserwerb, Erbrecht und große Teile des Obligationenrechtes kaum Behandlung finden. Die Exzerpierung der Summa Codicis muss aus diesem Grunde von jemand vorgenommen worden sein, der eine besondere Affinität gerade zu diesen Bereichen des Rechtes hatte. Nach diesen grundsätzlichen und grundlegenden Ausführungen, die ich allesamt nicht nur begrüße, sondern voll mittragen möchte, widmen sich die Verfasser kurz aber prägnant der Person des Anatolius (24–30). Ein Anatolius wird zusammen mit sieben anderen Antecessores in der Constitutio Omne genannt, sowie in der Constitutio Tanta vom 16. Dezember 533 als einer der vier Professoren, denen die Kompilation der Digesten anvertraut worden war. Er bekleidete die Funktion eines Magister Officiorum und wurde aus diesem Grunde als Vir Illustris bezeichnet. Anatolius entstammte einer Juristenfamilie aus Beirut und lehrte dort selbst als Professor. Zachariae von Lingenthal (Griechische Bearbeitung des Codex 70) und Van der Waal (Comentar 111) hatten die Ansicht vertreten, dass es zwei Anatoli gegeben habe: Der eine Mitglied der justinianischen Kompilation, der andere der Autor des Codex-Kommentares. Dem gegenüber vertreten die Autoren die Ansicht, dass Anatolius ein einziger gewesen sei, der, nachdem er maßgeblich an der Kompilation in Konstantinopel mitgearbeitet hatte, etwa zwischen 530 und 533 als Lehrer nach Beirut zurückgekehrt sei, um dort an einer der prestigeträchtigsten Universitäten des Reiches die neue juristische Studienordnung durchzusetzen und ruhmreich zu begründen. Der Kommentar des Codex diente dazu, einen grundsätzlichen lateinischen Text griechischen Studenten zu verdeutlichen, und zwar ausgehend von einer reinen Übersetzung bis zu einem juristischen Kommentar. Die Autoren lösen die Quellenproblematik derart, dass sie davon ausgehen, dass Anatolius das Buch 4 seines Kommentares noch in Konstantinopel vollendet und mit dem 8. Buch des Kommentares in Beirut wieder begonnen hat. Die klare und deutliche Argumentationsweise der Autoren, unpolemisch aber doch tiefgreifend, sollte in Zukunft übernommen werden. (shrink)

Twenty Years After Communism is concerned with the explosion of a politics of memory triggered by the fall of state socialism in Eastern Europe, and it takes a comparative look at the ways that communism and its demise have been commemorated by major political actors across the region.

Founded in 1365, not long after the Great Plague ravaged Europe, the University of Vienna was revitalized in 1384 by prominent theologians displaced from Paris--among them Henry of Langenstein. Beginning with the 1384 revival, Michael Shank explores the history of the university and its ties with European intellectual life and the city of Vienna. In so doing he links the abstract discussions of university theologians with the burning of John Hus and Jerome of Prague at the Council of Constance (...) (1415-16) and the destruction of the Jewish community of Lower Austria (1421). Like most other scholars of the period, Henry of Langenstein (d. 1397) at one time believed that Aristotle's syllogistic was universally valid even in Trinitarian theology. In touch with the vibrant Jewish community in Vienna, Langenstein had high hopes of converting its members by logical argument. When he failed in his purpose, he lost his confidence in Aristotle's syllogistic as a universal tool of apologetics and handmaiden to Trinitarian theology. ("Unless you believe, you shall not understand," he quoted from Isaiah, in order to express his change of opinion.) During the next generation, the intellectual climate at the university changed from academic openness to increasing rigidity, and theologians turned from argument to persecution. Originally published in 1988. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

This volume provides a critical survey of the major figures and ideas of 20th century political philosophy.

This book presents a sympathetic yet critical treatment of the major philosophical attempts to define a viable project for philosophy in the face of historical changes. McCarthy, then, proposes a comprehensive, critical, and methodological strategy of epistemic integration that fully respects the progressive and pluralistic character of contemporary science and common sense. The programs of Frege, Husserl, Wittgenstein, Carnap, Sellers, Dewey, Quine, and Rorty are carefully presented and an assessment is made of their merits and limitations. This assessment results in (...) a defense of Lonergan’s integrative strategy — a nuanced philosophical strategy around which a gathering center could be built. McCarthy presents Lonergan’s work as containing the firm outline and partial execution of a philosophical project continuous with philosophy’s historic purposes and equal to the exigences of the present. The book examines a broad range of seminal topics and, after extended dialectical treatment of them, develops a coherent account of their interdependence. These topics include psychologism, intentionality, the limits of naturalism, semantical and epistemic realism, historical belonging, epistemic invariance, foundational analysis, the limitation of logic and of the linguistic turn, generalized empirical method, the interdependence of mind and language, the interplay of nature and history, and the critical appropriation of tradition. (shrink)

This critical study of Arendt explores the sources and dangers of political alienation in the West from the citizen republics of classical antiquity to the consumer societies of modern liberal democracies. It is a sympathetic appraisal of the high promise and great perils of the political life.

Why do we formulate arguments? Usually, things such as persuading opponents, finding consensus, and justifying knowledge are listed as functions of arguments. But arguments can also be used to stimulate reflection on one’s own reasoning. Since this cognitive function of arguments should be important to improve the quality of people’s arguments and reasoning, for learning processes, for coping with “wicked problems,” and for the resolution of conflicts, it deserves to be studied in its own right. This contribution develops first steps (...) towards a theory of reflective argumentation. It provides a definition of reflective argumentation, justifies its importance, delineates it from other cognitive functions of argumentation in a new classification of argument functions, and it discusses how reflection on one’s own reasoning can be stimulated by arguments. (shrink)