Ethics and the Clinical Encounter explores the moral dimensions of clinical medicine and the phenomenon of illness, to determine what ethics must be in order to be fully responsive to clinical encounters. Written in a lively and conversational style with minimal technical terminology, and enhanced by actual experience or real clinical situations, this volume lays out a clinical ethics methodology both in practical and theoretical terms. Here's what the experts had to say: Professor Zaner has provided us with a remarkably (...) lucid and trenchant discussion of the interface of philosophy and the field of medicine. He brings into play an extraordinary range of historial knowledge, extensive observations based on firsthand experience with medical practices, and an acute sense of philosophical argumentation. This is a work that will be an exemplary and indispensable text in the philosophy of medicine for years to come. -- Calvin Schrag... it is a highly original contribution usable in a number of fields.... It really has no competition.... The genius of Zaner's approach is to ground ethics from the 'bottom up' and to direct us to the concrete particulars of therapeutic encounters wherein lie moral and ethical matters... meaty, challenging, and ultimately rewarding.... -- Paul R. Dokecki Richard M. Zaner founded the Center for Clinical and Research Ethics at Vanderbilt University Medical Center. Having established Vanderbilt's first Hospital Ethics Committee (1985), he served as co-chair of VUMC's Ethics Committee since its inception in 1990. Zaner has published five original books, edited ten, and translated four more, and has published more than 100 sections of books and professional journals. (shrink)

Early in the first volume of his Ideen zu einer reinen Phiinomeno logie und phiinomenologischen Philosophie, Edmund Husserl stated concisely the significance and scope of the problem with which this present study is concerned. When we reflect on how it is that consciousness, which is itself absolute in relation to the world, can yet take on the character of transcendence, how it can become mundanized, We see straightaway that it can do that only by means of a certain participation in (...) transcendence in the first, originary sense, which is manifestly the transcendence of material Nature. Only by means of the experiential relation to the animate organism does consciousness become really human and animal (tierischen), and only thereby does it achieve a place in the space and in the time of Nature. l Consciousness can become "worldly" only by being embodied within the world as part of it. In so far as the world is material Nature, consciousness must partake of the transcendence of material Nature. That is to say, its transcendence is manifestly an embodiment in a material, corporeal body. Consciousness, thus, takes on the characteristic of being "here and now" (ecceity) by means of experiential (or, more accurately, its intentive) relation to that corporeal being which embodies it. Accordingly, that there is a world for consciousness is a conse quence in the first instance of its embodiment by 2 that corporeal body which is for it its own animate organism. (shrink)

Tested the 2-process theory of detection, search, and attention presented by the current authors in a series of experiments. The studies demonstrate the qualitative difference between 2 modes of information processing: automatic detection and controlled search; trace the course of the learning of automatic detection, of categories, and of automatic-attention responses; and show the dependence of automatic detection on attending responses and demonstrate how such responses interrupt controlled processing and interfere with the focusing of attention. The learning of categories is (...) shown to improve controlled search performance. A general framework for human information processing is proposed. The framework emphasizes the roles of automatic and controlled processing. The theory is compared to and contrasted with extant models of search and attention. (shrink)

This honest, forthright, and beautifully-written book introduces readers to the human variations on medical topics spoken of in abstract in the daily news--euthanasia, assisted suicide, abortion, "extreme procedures", genetic testing, experimental surgeries--and to the people who must agonize over those decisions regarding themselves and their loved ones.

This article reviews the historical and current controversies about the nature of clinical ethics consultation, as a way to focus on the place and responsibility of ethics consultants within the context of clinical conversation — interpreted as a form of dialogue. These matters are approached through a particularly compelling instance of the controversy that involves several major figures in the field. The analysis serves to highlight very significant questions of the nature and constraints of clinical situations, and the moral responsibility (...) and legal accountability that are especially important for clinical ethics consultants. (shrink)

I agree with Norris et al. that feedback to a phonemic level is never necessary, but disagree strongly with their reason why this is true. I believe the available evidence indicates that there is no feedback because there is no phonemic level employed in the perceptual processing of speech.

The target article suggests that taste is not based on the traditional four basic tastes, but rather is a continuum subserved by cross-fiber integration. This commentary describes evidence indicating that the traditional concept is valid, and that with suitable precautions, it is possible to match natural substances using mixtures representing fundamental tastes.

After writing my response to the commentaries, I sat back and reflected on the fascination and frustration of work on this topic. There is the ancient fascination of trying to understand the nature of the sensory bridge linking us to the external world. Also, discussing the measurability of sensation brings to the surface concepts we use and take for granted when we are working in other areas of psychology; and it holds them before us for critical examination. The frustration lies (...) chiefly in the difficulty of formulating concepts clearly, in a way understood by all. At least when constructing the original Tower of Babel, workers hearing strange words knew that communication was not occurring. The psychophysical Tower of Babel sometimes has workers using the same words, but with different meanings. Much of my response is based on attempts to clarify concepts and clear up confusions. (shrink)

Block has attempted to reduce the confusion and controversy concerning the term “consciousness” by suggesting that there are two forms or types of consciousness, each of which has several characteristics or properties. This suggestion appears to further becloud the topic, however. Perhaps consciousness cannot be defined adequately and should not be considered as a topic that can be studied scientifically.

This paper is devoted to an examination of the discovery, characterization, and analysis of the functions of microRNAs, which also serves as a vehicle for demonstrating the importance of exploratory experimentation in current (post-genomic) molecular biology. The material on microRNAs is important in its own right: it provides important insight into the extreme complexity of regulatory networks involving components made of DNA, RNA, and protein. These networks play a central role in regulating development of multicellular organisms and illustrate the importance (...) of epigenetic as well as genetic systems in evolution and development. The examination of these matters yields principled arguments for the historicity of the functions of key biological molecules and for the indispensability of exploratory experimentation in contemporary molecular biology as well as some insight into the complex interplay between exploratory experimentation and hypothesis-driven science. This latter result is not only important for philosophy of science, but also of practical importance for the evaluation of grant proposals, although the elaboration of this latter claim must be left for another occasion. (shrink)

History of science, it has been argued, has benefited philosophers of science primarily by forcing them into greater contact with "real science." In this paper I argue that additional major benefits arise from the importance of specifically historical considerations within philosophy of science. Loci for specifically historical investigations include: (1) making and evaluating rational reconstructions of particular theories and explanations, (2) estimating the degree of support earned by particular theories and theoretical claims, and (3) evaluating proposed philosophical norms for the (...) evaluation of the degree of support for theories and the worth of explanations. More generally, I argue that theories develop and change structure with time, that (like biological species) they are historical entities. Accordingly, both the identification and the evaluation of theories are essentially historical in character. (shrink)

We will give a new cosmological argument for the existence of a being who, although not proved to be the absolutely perfect God of the great Medieval theists, also is capable of playing the role in the lives of working theists of a being that is a suitable object of worship, adoration, love, respect, and obedience. Unlike the absolutely perfect God, the God whose necessary existence is established by our argument will not be shown to essentially have the divine perfections (...) of omnipotence, omniscience, omnibenevolence, and sovereignty. Furthermore, it is not even shown that he is contingently omnipotent and omniscient, just powerful and intelligent enough to be the supernatural designer-creator of the exceedingly complex and wondrous cosmos that in fact.. (shrink)

The measurement of sensory intensity has had a long history, attracting the attention of investigators from many disciplines including physiology, psychology, physics, mathematics, philosophy, and even chemistry. While there has been a continuing doubt by some that sensation has the properties necessary for measurement, experiments designed to obtain estimates of sensory intensity have found that a general rule applies: Equal stimulus ratios produce equal sensory ratios. Theories concerning the basis for this simple psychophysical rule are discussed, with emphasis given to (...) the physical correlate theory, which considers judgments of subjective magnitudes to be based upon estimates of physical dimensions that vary regularly with changes in degree of stimulation. For the most thoroughly investigated sensory scales, brightness and loudness, the physical correlate is considered to be distance. Our “tacit knowledge” of the sensory effects of changing distance plays an essential role in matching motor activities to environmental conditions and in ensuring accurate perceptual evaluations through brightness and loudness constancies. In psychophysical experiments, subjects apparently use this same tacit knowledge when required to estimate relative subjective magnitudes. The evidence related to the physical correlate theory is summarized, and it is concluded that, while under appropriate conditions we demonstrate considerable skill in evaluating environmental relationships, we are quite unable to estimate the neurophysiological nature or quantity of sensory response. A psychophysics devoted to studying conditions required for accuracy and conditions producing errors in the perception of environmental relationships would seem to be more valuable than one devoted to subjective magnitudes. (shrink)

In this volume, fourteen scholars, many of them contemporaries of Professor Frank, engage with his legacy with important and seminal works which take some of ...

In an overview of the essays in this project, a number of clinical ethics issues receive emphasis. (1) One cluster concerns the ethical concerns presented within the relationship between the providers (doctor, nurse, etc.) and patient (and family), as distinct from those associated with being a clinical ethics consultant invited into a situation to assist. (2) Distinct from these are ethical issues intrinsic to the ways in which clinical encounters are variously written about (from chart notes to published articles). (3) (...) Finally, there is a set of issues connected with the major characteristics of clinical encounters, in view of which it is imperative to be specifically attentive to the fine details and complex interactions among patient, doctor, family, and others, within a specific social context. Keeping these matters in mind helps to clarify the differences between consulting (talking and listening) and writing about consultations, as well as among the various kinds of writing about clinical encounters. (shrink)

In what sense does time exist? Is it an objective feature of the external world? Or is its real nature dependent on the way man experiences it? Has modern science brought us closer to the answer to St. Augustine's exasperated outcry, 'What, then, is time?' ? Ever since Aristotle, thinkers have been struggling with this most confounding and elusive of philosophical questions. How long does the present moment last? Can we make statements about the future that are clearly true or (...) clearly false? And if so, must we be fatalists? This volume presents twenty-three discussions of the problem of time. A section on classical and modern attempts at definition is followed by four groups of essays drawn largely from contemporary philosophy, each preface with an introduction by the editor. First, in a chapter entitled 'The Static versus the Dynamic Temporal', four philosophers advance solutions to McTaggart's famous proof of time's unreality. In the next two sections, the discussion turns to the meaning of the 'open future' and to the much-debated nature of 'human time'. Finally, modern science and philosophy tackle Zeno's celebrated paradoxes. The essays by Adolf Grnbaum, Nicholas Rescher, and William Barrett are published for the first time in this volume. (shrink)

In what sense does time exist? Is it an objective feature of the external world? Or is its real nature dependent on the way man experiences it? Has modern science brought us closer to the answer to St. Augustine's exasperated outcry, 'What, then, is time?'? Ever since Aristotle, thinkers have been struggling with this most confounding and elusive of philosophical questions. How long does the present moment last? Can we make statements about the future that are clearly true or clearly (...) false? And if so, must we be fatalists? This volume presents twenty-three discussions of the problem of time. A section on classical and modern attempts at definition is followed by four groups of essays drawn largely from contemporary philosophy, each preface with an introduction by the editor. First, in a chapter entitled 'The Static versus the Dynamic Temporal', four philosophers advance solutions to McTaggart's famous proof of time's unreality. In the next two sections, the discussion turns to the meaning of the 'open future' and to the much-debated nature of 'human time'. Finally, modern science and philosophy tackle Zeno's celebrated paradoxes. The essays by Adolf Grnbaum, Nicholas Rescher, and William Barrett are published for the first time in this volume. (shrink)

Early in the first volume of his Ideen zu einer reinen Phiinomeno logie und phiinomenologischen Philosophie, Edmund Husserl stated concisely the significance and scope of the problem with which this present study is concerned. When we reflect on how it is that consciousness, which is itself absolute in relation to the world, can yet take on the character of transcendence, how it can become mundanized, We see straightaway that it can do that only by means of a certain participation in (...) transcendence in the first, originary sense, which is manifestly the transcendence of material Nature. Only by means of the experiential relation to the animate organism does consciousness become really human and animal (tierischen), and only thereby does it achieve a place in the space and in the time of Nature. l Consciousness can become "worldly" only by being embodied within the world as part of it. In so far as the world is material Nature, consciousness must partake of the transcendence of material Nature. That is to say, its transcendence is manifestly an embodiment in a material, corporeal body. Consciousness, thus, takes on the characteristic of being "here and now" (ecceity) by means of experiential (or, more accurately, its intentive) relation to that corporeal being which embodies it. Accordingly, that there is a world for consciousness is a conse quence in the first instance of its embodiment by 2 that corporeal body which is for it its own animate organism. (shrink)

This article reviews current methods for evaluating models in the cognitive sciences, including theoretically based approaches, such as Bayes factors and minimum description length measures; simulation approaches, including model mimicry evaluations; and practical approaches, such as validation and generalization measures. This article argues that, although often useful in specific settings, most of these approaches are limited in their ability to give a general assessment of models. This article argues that hierarchical methods, generally, and hierarchical Bayesian methods, specifically, can provide a (...) more thorough evaluation of models in the cognitive sciences. This article presents two worked examples of hierarchical Bayesian analyses to demonstrate how the approach addresses key questions of descriptive adequacy, parameter interference, prediction, and generalization in principled and coherent ways. (shrink)

This book uses an incidence approach to look at the economic repercussions of birth defects. The authors investigate eighteen of the most clinically significant birth defects affecting 35,000 newborns each year in our country. Their assessments suggest that the annual cost of these eighteen birth defects, together, is more than eight billion dollars . The authors describe in detail their methodology and data sources while providing thorough accounts of each of the eighteen birth defects. Waitzman, Scheffler, and Romano break new (...) ground by using reports from the California Birth Defects Monitoring Program in order to provide cost estimates. They illustrate to the reader how cost estimates of specific birth defects can be used to justify prevention interventions and strategies. In chapter seven, they provide an important example, showing cost-benefit analysis of a program of folate supplementation of food to prevent neutral tube defects. Contents: List of Tables; Preface; Acknowledgements; Introduction; The Application of Cost-of-Illness Methodology To Birth Defects; The Direct Medical Costs of Birth Defects; Nonmedical Direct Costs of Birth Defects: Developmental Services and Special Education; The Indirect Costs of Birth Defects; Premature Mortality and Heightened Morbidity; An Assessment of Total Costs and Policy Implications; Description of Birth Defects; Description of Major Data Sources; Index. (shrink)

There has been in recent years a plethora of defences of theism from analytical philosophers: Richard Gale's important book is a critical response to these writings. New versions of cosmological, ontological, and religious experience arguments are critically evaluated, along with pragmatic arguments to justify faith on the grounds of its prudential or moral benefits. In considering arguments for and against the existence of God, Gale is able to clarify many important philosophical concepts including exploration, time, free will, personhood, actuality, (...) and the objectivity of experience. (shrink)

This study is a phenomenological inquiry into several relatively unexplored phenomena, including certain key methodological issues. It seeks to elicit and explicate the grounds of free-fantasy variation, which Husserl insists contains his “fundamental methodological insight” since it articulates “the fundamental form of all particular transcendental methods…” In the course of pursuing the full sense of this method and its grounds, the essay also uncovers the origins and eventual presence of “self” and explores the multiple connections among self, mental life, embodiment (...) and the surrounding world. To that end, it is necessary to take seriously Husserl’s otherwise odd declaration that “‘feigning’ [‘Fiktion’] makes up the vital element of phenomenology as of every other eidetic science…”, and thus that every philosopher must “fertilize” his or her “fantasy” through works of art and history as well as other areas and practices of human life. The essay offers an in-depth probing of several striking but largely unexplored phenomena: exemplifying and possibilizing, and concludes with an exploration of one of the most pervasive themes in phenomenological inquiry: intersubjectivity. (shrink)