We use Homer and Sun Tzu as a background to better understand and reformulate confrontation, anger and violence in medicine, contrasting an unproductive ‘love of war’ with a productive ‘art of war’ or ‘art of strategy’. At first glance, it is a paradox that the healing art is not pacific, but riddled with militaristic language and practices. On closer inspection, we find good reasons for this cultural paradox yet regret its presence. Drawing on insights from Homer's The Iliad and The (...) Odyssey, we argue for better understanding of confrontation, anger, bullying, intimidation and violence in medicine in order to change the culture. For example, equating medicine with war is not a given condition of medicine but a convenient metaphor with historical origins and a historical trajectory. Other, non-martial metaphors, such as medicine as collaboration, may be more appropriate in an age of team-based care. Taking lessons from Homer, we suggest three key ways in which cold-hearted confrontation and anger in medicine can be transformed into productive, warm-hearted engagement: the transformation of angry impulse into reflection, moral courage and empathy. Thinking with Homer can offer an aesthetically and morally charged alternative to the current body of literature on topics, such as anger in doctors, and how this may be ‘managed’, without recourse to an instrumental economy where emotions are viewed as commodities, and emotional responses can be ‘trained’ through communication skills courses. (shrink)

In the operating theater, the micro-politics of practice, such as interpersonal communications, are central to patient safety and are intimately tied with values as well as knowledge and skills. Team communication is a shared and distributed work activity. In an era of "professionalism," that must now encompass "interprofessionalism," a virtue ethics framework is often invoked to inform practice choices, with reference to phronesis or practical wisdom. However, such a framework is typically cast in individualistic terms as a character trait, rather (...) than in terms of a distributed quality that may be constituted through intentionally collaborative practice, or is an emerging property of a complex, adaptive system. A virtue ethics approach is a necessary but not sufficient condition for a collaborative bioethics within the operating theater. There is also an ecological imperative - the patient's entry into the household (oikos) of the operating theater invokes the need for "hospitality" as a form of ethical practice. (shrink)

Michel Foucault's analysis of "the birth of the clinic" describes the genesis of a unified discourse that, in retrospect, has shaped western medicine for two centuries. However, in looking prospectively toward a 21st century medicine, Foucault's analysis is necessary but not sufficient. To better critically address medicine and medical education in the era of simulation, we could draw on frameworks developed by futurists such as Jean Baudrillard. Foucault's analysis does not account for contemporary, complex developments of the clinical gaze as (...) the gaze is distributed across practitioners in increasing use of sophisticated, representational diagnostic imaging. Further, Foucault's antihumanist rhetoric sometimes strays into the antihumane, and this is disturbing for those who support the development of patient-centered medicine. Yet we are increasingly teaching aspects of medicine, such as communication, in simulated learning environments in which complex reality is absent, perhaps inadvertently creating an "inhumanity" in medical education. (shrink)

Inclusion of the humanities in undergraduate medicine curricula remains controversial. Skeptics have placed the burden of proof of effectiveness upon the shoulders of advocates, but this may lead to pursuing measurement of the immeasurable, deflecting attention away from the more pressing task of defining what we mean by the humanities in medicine. While humanities input can offer a fundamental critical counterweight to a potentially reductive biomedical science education, a new wave of thinking suggests that the kinds of arts and humanities (...) currently used in medical education are neither radical nor critical enough to have a deep effect on students’ learning and may need to be reformulated. The humanities can certainly educate for tolerance of ambiguity as a basis to learning democratic habits for contemporary team-based clinical work. William Empson’s ‘seven types of ambiguity’ model for analyzing poetry is transposed to medical education to: (a) formulate seven values proffered by the humanities for improving medical education; (b) offer seven ways of measuring impact of medical humanities provision, thereby reducing ambiguity; and (c) --as a counterweight to (b) – celebrate seven types of ambiguity in contemporary medical humanities that critically reconsider issues of proof of impact. (shrink)

Next SectionIn a series of previous articles, we have considered how we might reconceptualise central themes in medicine and medical education through ‘thinking with Homer’. This has involved using textual approaches, scenes and characters from the Iliad and Odyssey for rethinking what is a ‘communication skill’, and what do we mean by ‘empathy’ in medical practice; in what sense is medical practice formulaic, like a Homeric ‘song’; and what is lyrical about medical practice. Our approach is not to historicise medicine (...) and medical education, but to use thinking with Homer as a medium and metaphor for questioning the habitual and the taken-for-granted in contemporary practice. In this article, we tackle the complex theme of ‘translation’. We use the lens of translation studies to examine the process of turning the patient's story into medical language. We address the questions: what makes a ‘good’ translation? What are the consequences of mistranslation and poor translation? And, while things are inevitably lost in translation, does this matter? (shrink)

This paper progresses the original argument of Richard Ratzan that formal presentation of the medical case history follows a Homeric oral-formulaic tradition. The everyday work routines of doctors involve a ritual poetics, where the language of recounting the patient's ‘history’ offers an explicitly aesthetic enactment or performance that can be appreciated and given meaning within the historical tradition of Homeric oral poetry and the modernist aesthetic of Minimalism. This ritual poetics shows a reliance on traditional word usages that crucially act (...) as tools for memorisation and performance and can be linked to forms of clinical reasoning; both contain a tension between the oral and the written record, questioning the priority of the latter; and the performance of both helps to create the Janus-faced identity of the doctor as a ‘performance artist’ or ‘medical bard’ in identifying with medical culture and maintaining a positive difference from the patient as audience, offering a valid form of patient-centredness. (shrink)

The connection between William of Ockham's philosophy and his politics has long been a subject of debate among scholars. Many have seen his nominalist epistemology, which asserts that the individual thing is the object of knowledge, as contributing towards his focus on the individual in his political thought. In her most recent article, ‘Ockham’s Right Reason and the Genesis of the Political as „Absolutist”’, Janet Coleman supports this argument concerning the influence of Ockham's philosophical individualism upon his political individualism. But (...) she also provides a different and, I believe, more important argument as to how Ockham's philosophical epistemology is connected to his politics: that what man can know about himself and others through right reason is Ockham's starting point for analysing human authority. This article attempts to support Coleman's argument that the role of right reason in the life of the individual has significant consequences for Ockham's notion of political rule. This is done through a detailed analysis of the specific role of right reason in Ockham's theory of the virtuous act, and how this treatment of right reason can be said to influence Ockham's notion of the purpose and methodology of political rule. Specifically, Ockham's notion of right reason in his ethical theory plays out in his political theory by defining the limitations of political knowledge, and thereby creating a pronounced discontinuity between the function of the individual as a self-ruler and the function of the political ruler. (shrink)

The juxtaposition between scholasticism and humanism is a commonplace in the scholarship of medieval political thought. Several scholars have argued that scholastic political theory is concerned with the institutional arrangements necessary for the well being of the city, while humanist political theory focuses on the role of the ruler in bringing about this well being. This paper argues that by looking at a much neglected text of the major scholastic figure St Thomas Aquinas, the De Regimine Principum, it can be (...) shown that he, like the humanists of his era, affords the ruler a central place in his political theory. Aquinas' adaptation of Aristotelian teleology, however, differentiates his theory from humanist political theory, allowing him to create the concept of a ‘scholastic ruler'. Specifically, Aquinas portrays the ruler as an artist, assigning him the roles of making the city, and making virtuous subjects. (shrink)

The New South Wales union movement embraced the principles of heritage and conservationism in the 1970s through the imposing of “green bans” – a strategy wherein union members refused to work on construction projects that were a threat to the state’s natural or built environment. Led by radicals like Builders Labourers’ Federation leader Jack Mundey, the green bans were seen in several sectors as a departure from the traditional “Old Left” priorities of securing workers’ wages and conditions. Rather than a (...) hard shift towards radicalism, this article proposes that the green bans were instead reflective of an already existing conservationist tradition in the New South Wales union movement. This reinterpretation is predicated on a content analysis of extant historical material such as contemporaneous news articles, personal memoirs, transcripts of political speeches and archival documents related to the policing of left-wing activism in the 1960s and 1970s. The results show that an existing tradition of engagement with a broad spectrum of social issues in the New South Wales union movement predates the emergence of the New Left, including the commitment to environmental justice principles that underpinned the green bans. (shrink)

The medical humanities are often implemented in the undergraduate medicine curriculum through injection of discrete option courses as compensation for an overdose of science. The medical humanities may be reformulated as process and perspective, rather than content, where the curriculum is viewed as an aesthetic text and learning as aesthetic and ethical identity formation. This article suggests that a “humanities” perspective may be inherent to the life sciences required for study of medicine. The medical humanities emerge as a revelation of (...) value inherent to an aesthetic medicine taught and learned imaginatively. (shrink)

The medical humanities have been presented as a panacea for medical reductionism; a means for ‘humanizing’ medicine. However, there is a lack of consensus about the appropriate contributing disciplines and how curricula should be taught and assessed. This special issue critically examines the role of the medical humanities in medical education and their potential to serve, inadvertently or otherwise, as a tool of governance. The contributors, who include medical educators and medical practitioners, employ a range of perspectives for analysing the (...) pertinent issues. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Bridge From Analysis to Action:Psychodynamic Analyses of Religion and Michael S. Hogue's American ImmanenceAJ Turner (bio)I. IntroductionThe purpose of this essay is to work constructively with Michael S. Hogue's groundbreaking American Immanence: Democracy for an Uncertain World to demonstrate how psychodynamic analyses of religion are essential theoretical allies in the fight for resilient democracy. The "revolution in mind"1 that psychodynamic approaches contribute, especially in their analyses of religion, (...) both complements and complicates socio-political theory as a whole. In the improvisational spirit of "yes-and," the goal here is not to identify and decry the failures and shortcomings of Hogue's theopolitical vision but rather to inspire the recovery of a sibling discourse—a kind of "rebirth of a forgotten alternative"2—that also draws deeply from the American immanental tradition in order to add psychodynamic depth to Hogue's timely and important analysis. Psychodynamic theories of religion shed light on how symbolic identifications, including and especially ultimate concerns, structure personal and collective experience. By engaging religion and theology sympathetically, constructively, and creatively, theorists such as Rollo May, Gordon Allport, Karen Horney, Erich Fromm, and Ernest Becker departed from the skepticism, reductionism, and dismissal that characterized psychoanalytic analyses of religion in the wake of Freud.3 Each of these figures, and especially Becker whose work will be a focus in this essay, are noteworthy interlocutors for extending Hogue's theopolitical theorizing of resilient democracy, particularly in how they drew unique inspiration from the American immanental tradition [End Page 44] in their social analyses. In this respect, they provide a more robust theorization of the psychosocial conditions of the associational ethos needed to connect Hogue's conception of resilient democracy with forms of agonistic organization and democratic activism. Briefly stated, psychodynamic approaches are a helpful bridge for connecting these proposals to strategies of organization, their impediments, and collective action.In this way, both psychodynamic analyses of religion and Hogue's theopolitical innovation insist that no revolutionary political change is possible, and certainly not of the kind or scale needed to counter our wickedly entangled global crises, without a deep engagement with theological imaginaries. They differ, however, in their theoretical aims. Whereas Hogue compellingly argues for the political upshot of a theology deriving from the American immanental tradition, psychodynamic analysts of religion focus on the function of ultimate concerns in individual and collective life. In other words, American Immanence rests on a methodology of analyzing the philosophical and theological assumptions that have contributed to our climate crises and then presenting clear and compelling articulation of an alternative paradigm meant to open up new ways of being. In contrast psychodynamic analyses leverage conceptual clarity of psychic reality for the fundamentally therapeutic aim of transformation. At their best, both approaches share what could be called an etiological orientation to ontological questions in order to provide liberative alternatives through rational understanding and clarification, but the terrain, and thus the problems they hope to mitigate in their analyses are focused differently. Extending the visual metaphor, they are different lenses highlighting different areas of the same landscape. Furthermore, it must be said that neither are sufficient in themselves, but the psychodynamic theorists of religion to be highlighted in this essay share deeply with Hogue's heading in American Immanence.II. A Problematic AssumptionIn emphasizing and attempting to explain4 the role of non-rational processes in the both individual and social processes of perception and organization of experience, psychodynamic theories confound a widely held and problematic assumption that the triumph of rational analysis is the hallmark for building the society to which we should aspire. Political theory in general, [End Page 45] especially as it has taken its cues from a rationalist legacy about the inherently liberating force of Reason, has been weighted toward an assumption that its task of exposing the mystifications of power would suffice in inspiring more "rational" and therefore necessarily equitable social organization. This speaks to the longstanding socio-political interest in "consciousness raising" tactics, which are often meant to dispel "false consciousness." It even comes across in the emphases of Deweyan pragmatists on education. Psychologists of all stripes point out that this approach... (shrink)

A. W. Price explores the varying ways in which context is relevant to our reasoning about what to do.

The philosophy of Epictetus, a freed slave in the Roman Empire, has been profoundly influential on Western thought: it offers not only stimulating ideas but practical guidance in living one's life. A. A. Long, a leading scholar of later ancient philosophy, gives the definitive presentation of the thought of Epictetus for a broad readership. Long's fresh and vivid translations of a selection of the best of Epictetus' discourses show that his ideas are as valuable and striking today as they were (...) amost two thousand years ago. This is a book for anyone interested in what we can learn from ancient philosophy about how to live our lives. (shrink)

For many Christians, personal experiences of God provide an important ground or justification for accepting the truth of the gospel. But we are sometimes mistaken about our experiences, and followers of other religions also provide impressive testimonies to support their religious beliefs. This book explores from a philosophical and theological perspective the viability of divine encounters as support for belief in God, arguing that some religious experiences can be accepted as genuine experiences of God and can provide evidence for Christian (...) beliefs. (shrink)

The Human A Priori is a collection of essays by A. W. Moore, one of them previously unpublished and the rest all revised. These essays are all concerned, more or less directly, with something ineliminably anthropocentric in our systematic pursuit of a priori sense-making. Part I deals with the nature, scope, and limits of a priori sense-making in general. Parts II, III, and IV deal with what are often thought to be the three great exemplars of the systematic pursuit of (...) such sense-making: philosophy in the case of Part II, ethics in the case of Part III, and mathematics in the case of Part IV. Much of the attention throughout is devoted to the work of other philosophers: Kant and Wittgenstein feature prominently, and five of the essays take the form of reviews or critical notices of recent work in philosophy. But the interest in never purely exegetical. One of the lessons that emerges from the essays, either in opposition to the views of these other philosophers or by invocation of their views, is that we humans achieve nothing of real significance in philosophy, ethics, or mathematics except from a human point of view, and hence that all three of these pursuits can be said to betoken what may reasonably be called 'the human a priori'. (shrink)

In this paper, we propose a new technique for the enhancing images. It will work on removing the noise contained in the image as well as improving its contrast based on three different enhancing transforms, we commence by embedding the image into a neutrosophic domain; where the image will be mapped in three different levels, a level of trueness, a level of falseness and a level of indeterminacy. Hence, we act separately on each level using the enhancement transforms. Finally, we (...) introduce a new analysis in the field of analysis and processing of images using the neutrosophic crisp set theory via Mat lab program where has been obtained three images, which helps in a new analysis to improve and retrieve images. (shrink)

As the world faces increasingly disparate challenges, science is being subjected to vehement demands from society calling for transparency, openness and public participation in science policy. This book provides a framework and a vision on how to conceive, discuss and evaluate the changes that occur in the relationship between science and society.

In this book, I will discuss three main topics: the roots and aims of scientific knowledge, scientific knowledge in society, and science and values I understand scientific knowledge as being a planned and continuous production of the general and common knowledge of scientific communities. I begin my discussion with a brief analysis of the main differences between sciences, on the one hand, and everyday experience, philosophies, religions, and ideologies, on the other. I define the concept of science as a set (...) of family resemblances (in Wittgenstein's sense). The sciences can be distinguished along three lines, in terms of the difference between empirical and non-empirical sciences, differences in degrees of theoretical and methodological structure among individual sciences and scientific disciplines. Scientific knowledge is based upon some grounds, paradigmatic knowledge bases. Scientific knowledge is founded on a unified paradigmatic knowledge base. The latter includes fundamental theories, basic facts, generally accepted empirical regularities (laws), scientific research methods, scientific explanations, and established relations to other sciences. Scientific knowledge in general is defined well in classical terms by the definition that knowledge is a true and rationally-justified belief. In this connection, scientific truth is relative, depending on the given paradigmatic knowledge base and on the precision and accessibility of the measurements and observations involved. In the book's first part, I consider the production and testing of scientific hypotheses, scientific explanations, the structure of scientific theories, and the problem of scientific realism. I consider explanation an integral part of a wider nexus of heuristic and theoretical activities in science like giving reasons, understanding, clarification, and founding. Continuous production of scientific explanations is a necessary condition for the systematic reproduction of scientific knowledge. Accordingly, it does not suffice to describe them in terms of the logical structure of the arguments on which they are based, but rather, scientific explanations ought to be given complete with an epistemic and pragmatic context of the explanation. I consider especially deductive-nomological, inductive-statistical, dispositional, teleological-functional, and genetic explanations. I emphasize the ever-increasing importance of explanations by analogy and by model. Orthogonal to these distinctions lies the distinction between causal and epistemic explanation. Epistemic explanations relate scientific discoveries to epistemic progress, and causal explanations are these epistemic explanations that relate scientific discoveries to reality too. Causal explanations inform us that certain changes occur in the world as agents of other changes, or rather, that certain changes are real consequences of other changes. Thus, by having explanations of causes, we can intervene in the world to induce by design certain changes in some course of phenomena. I consider scientific theories as logically and epistemically ordered wholeness of scientific knowledge in a realm of research that enables us to construct useful models of reality. After the discussion of different 'statement' views on theories and different interpretations of the theory-experience relation, I introduce the 'model' theoretical (non-statement) views on theories, especially the structural theory of science. The model views on theories transcend the realism-antirealism dualism by introducing models between theory and reality. Therefore, the question of scientific realism is not merely whether and, if so, which element(s), of scientific theories represent reality, but rather which conditions suffice to infer from a theory that one of its models truly expresses reality. In other words, under which conditions do models of a theory represent models of reality? Generally, models are just as much images of reality in a theory as they are images of a theory in reality. The actual problem of scientific realism doesn't originate in the observable-unobservable distinction (even if this distinction is otherwise theoretically loaded), but rather in ontological quandaries, of the sort especially encountered in modern physical theories such as quantum mechanics, relativity theory, and cosmological theories, although they are known to arise in other sciences as well. Scientific theories may be real, even if they describe nothing about the world. However, such theories can be given this status only if their formal, mathematical postulates exhibit some formal homology between reality and mathematical forms. The very fact that it is possible to describe reality with the help of mathematics even in cases, where every (representational, conceptual) language and thought fall short, would indicate that even mathematics itself is, in some sense, a part of reality, although 'outside' of the empirical world. It follows we have to distinguish the non-empirical reality and the empirical world. Formal objectivity and non-arbitrariness of theories do not emerge from either our language or thoughts, or from the world of facts, causes, and effects, but rather from non-empirical reality, which frames the world as some kind of objective transcendental condition for the possibility of the existence of the world, thoughts, and language. In the second part of the book, I consider the incorporation of scientific work and scientific knowledge into modern society and its relations to values and ethics. Production of scientific knowledge goes on as a parallel distributed process of a special kind of social (shared) cognition. The central part of this cognition is the presentation of parts of the world by scientific (theoretical) models which are warranted by the shared and public practice of justification, and in reflective acting in the world as it would. I consider various formal concepts of collective propositional knowledge (distributed, mutual, common knowledge). Scientific knowledge is an achievement to be ascribed to a scientific community or, indirectly, to all those who apply or expand it, rather than to individuals per se. It presents the continuous and partially planned production of non-trivial common knowledge of the research communities in modern societies. However, besides common knowledge, shared dispositional knowledge (knowledge how of scientific teams) and shared knowledge by acquiring (knowledge of fundamental similarities and differences in scientific teams) are parts of the real body of scientific knowledge. Scientific common knowledge implies the projection into idealized universal knowledge of all real or potentially rational and well-informed individuals. The respect of scientific knowledge thus presents the norm of rationality. Science as the intensively shared and socially distributed kind of cognition enters into modern society as a special kind of work (general work), as a productive force (social invention drive), and as a form of capital (human, social, cultural, informational, etc.). However any of these categories can adequately represent the socio-economical role of science in modern societies, and we are still waiting for a more adequate general concept that would theoretically cover the 'scientification' of modern societies. My thesis is that the most important general effect of scientification is (and will be) the growth of social processes that structurally resemble parallel distributed shared social cognition of science, and not so much the rise of the use of scientific knowledge and scientifically based information in all kinds of production. Scientification of modern societies inevitably includes a much stronger need for moral and social responsibility of scientists for their work and its effects in their local society and the global world. This need comes in contradiction with the quite large accepted idea (and even the 'norm') on value-free research. I discuss to some degree different arguments for the absence of non-epistemic values and ethical reasoning from science and find them non-convincing. The sound idea of value-free research lies in the need for the absence of categorical value statements from scientific explanations and theoretical deductions. Values and ethical judgment have, and sometimes they even have to play an important role in another part of research and its application in science or outside it. Not the value-loudness of research is a danger for science but its blind, non-reflective use. It leads to the ideologization and politicization of science. A similar danger lies in the purely value-neutrality of research. It leads to the instrumentalization of science to the technical or bureaucratic means for 'any' aims. (shrink)

Catalog of the collection of the Madamkhand Museum of Art, named after the wife of Batzhargalyn Batbai︠a︡r, businessman and member of the Mongolian Khural.