Providing a model for the transformative work that is required going forward, The Crisis of US Hospice Care illustrates the potential of hospice for facilitating a new way of living our last days and for having the best death possible.

An attempt to reduce disability discrimination can do more harm than the ostensible discrimination itself. Such is the case with Shavelson et al.’s (2023) argument for equal access to medical aid i...

Disability rights advocates have traditionally denigrated charity as politically counterproductive and inherently demeaning. This article argues that this perspective mischaracterizes charity of a religious kind. Religious charity, I argue, must be understood immanently, through an exploration of the virtues cultivated in particular religious organizations. I consider two Catholic charities: L’Arche, a community for intellectually disabled people, and the end-of-life care facility Our Lady of Perpetual Help Home. At each organization, individual acts of charity are emblematic of an underlying virtue that (...) I call caritas or charity-love. This transforms them into gestures that advance goals that are consonant with those of the disability rights movement. In the case of Our Lady, this is even true of pity, perhaps the most despised emotion of the disability rights tradition. But while disability rights advocates have characterized pity as essentially devaluing disabled people, at Our Lady, it is an emotion that freely circulates, undoing hierarchical distinctions between ability and disability, and even human and divine. This redefined notion of pity—which I term misericordia—can, I conclude provide a new foundation for disability politics, one that radicalizes the goals of the disability rights movement, while also positing objectives that go beyond legal compliance. (shrink)

Dominant Western discourses of motherhood have depicted disabled women as incapable of being mothers. In contrast to these representations, recent literature in disability studies has argued that disabled women can provide maternal care and should therefore retain custody over their children. This literature is commendable, but its emphasis on custodial rights excludes from the category of “mother” those disabled women who cannot maintain child custody. In this article, I challenge this exclusion via an account of my experience with my two (...) mothers: my biological mother, who relinquished custody over me because of her inability to provide care, and my maternal grandmother, who raised me as her child. Theorizing this account, I argue that disability studies must adopt a conception of motherhood that recognizes both alternative kinship structures and mothers whose disabilities preclude them from fulfilling normative conceptions of maternal care. I develop such a conception by synthesizing Judith Butler's theorization of queer kinship with Donald Winnicott's rethinking of the maternal subject. I conclude by drawing on this flexible conception of motherhood to argue that my disabled mother's relinquishing of custody over me to her own mother was the very gesture in which she accepted and adopted a maternal role. (shrink)

The article presents and analyzes different approaches of U.S. bioethicists in comprehending the Nazi medical crimes after 1945. The account is divided into two sections: one dealing with discussions on research ethics and the Nuremberg Code up until the 1970s and the other ranging from the 1970s to the present and highlighting bioethics' engagement with Nazi analogies. The portrayal of different bioethical scholars, institutions, and documents—most notably Henry K. Beecher, Jay Katz, the Belmont Report, the Hastings Center, Arthur L. Caplan, (...) and Robert M. Veatch—provides a nuanced interpretation of the motives that bioethicists held and the strategies that they applied to establish an understanding of the Nazi medical crimes and their relation to contemporary bioethical issues. In this, the different approaches shared a common goal: To integrate the Nazi medical crimes into an ethical framework by means of selective acknowledgments and representation of their history. (shrink)

What issues should bioethics be looking at in the next forty years? Rather than take on new issues, I believe bioethicists should rethink our approach to bioethical topics more generally. Doing so will require refashioning the field itself, but such a reinvention is the only way we can help bioethics live up to its initial ideals and be relevant to our society.Thinking about the future of bioethics should begin with a fundamental question: Is bioethics even necessary? Most bioethicists would certainly (...) think so, and they might find confirmation in histories of the field like David Rothman's Strangers at the Bedside, in which bioethics was a response to the collapse of doctor-patient relations in the midtwentieth .. (shrink)

This article is an analysis of the relationship between US hospice structure and the feeling of being a burden to others (FBO). A goal of US hospice care is to reduce the FBO. But in America, hospice is limited in its ability to do so because of the high caregiver burden it places on family members of dying people. Through a historical study, I show that this burden was excessive when the hospice system was created and has worsened over time. (...) Through three ethnographic vignettes, I demonstrate how this burden inculcates in dying people the FBO. I then examine the bioethical implications of this finding for the existing US debate about physician-assisted suicide (PAS). The presence of FBO due to insufficient hospice care supports arguments made by PAS opponents about the social pressure placed on dying people. This finding is not itself sufficient to resolve the “right to die” debate. But it provides the ground for a compromise, across the debate, to reduce the FBO by changing US hospice structure. The resulting consensus will further the goals of both PAS proponents and opponents. (shrink)

This article is an analysis of the relationship between US hospice structure and the feeling of being a burden to others. A goal of US hospice care is to reduce the FBO. But in America, hospice is limited in its ability to do so because of the high caregiver burden it places on family members of dying people. Through a historical study, I show that this burden was excessive when the hospice system was created and has worsened over time. Through (...) three ethnographic vignettes, I demonstrate how this burden inculcates in dying people the FBO. I then examine the bioethical implications of this finding for the existing US debate about physician-assisted suicide. The presence of FBO due to insufficient hospice care supports arguments made by PAS opponents about the social pressure placed on dying people. This finding is not itself sufficient to resolve the “right to die” debate. But it provides the ground for a compromise, across the debate, to reduce the FBO by changing US hospice structure. The resulting consensus will further the goals of both PAS proponents and opponents. (shrink)

This article is an analysis of the relationship between US hospice structure and the feeling of being a burden to others. A goal of US hospice care is to reduce the FBO. But in America, hospice is limited in its ability to do so because of the high caregiver burden it places on family members of dying people. Through a historical study, I show that this burden was excessive when the hospice system was created and has worsened over time. Through (...) three ethnographic vignettes, I demonstrate how this burden inculcates in dying people the FBO. I then examine the bioethical implications of this finding for the existing US debate about physician-assisted suicide. The presence of FBO due to insufficient hospice care supports arguments made by PAS opponents about the social pressure placed on dying people. This finding is not itself sufficient to resolve the “right to die” debate. But it provides the ground for a compromise, across the debate, to reduce the FBO by changing US hospice structure. The resulting consensus will further the goals of both PAS proponents and opponents. (shrink)

This article is an analysis of the relationship between US hospice structure and the feeling of being a burden to others. A goal of US hospice care is to reduce the FBO. But in America, hospice is limited in its ability to do so because of the high caregiver burden it places on family members of dying people. Through a historical study, I show that this burden was excessive when the hospice system was created and has worsened over time. Through (...) three ethnographic vignettes, I demonstrate how this burden inculcates in dying people the FBO. I then examine the bioethical implications of this finding for the existing US debate about physician-assisted suicide. The presence of FBO due to insufficient hospice care supports arguments made by PAS opponents about the social pressure placed on dying people. This finding is not itself sufficient to resolve the “right to die” debate. But it provides the ground for a compromise, across the debate, to reduce the FBO by changing US hospice structure. The resulting consensus will further the goals of both PAS proponents and opponents. (shrink)

Ms. X is a person with cerebral palsy and schizophrenia. She has intractable bedsores that are a result of her immobility and to poor wound care related to her delusional thinking. Despite intensive community support, the wounds have worsened to the point that she has needed multiple hospitalizations to prevent systemic sepsis, a life‐threatening condition. She is capable of placement decisions and wishes for independence at home but is incapable of making wound care decisions and does not appreciate that immediately (...) returning home from the hospital, instead of going into a special care facility, would likely result in sepsis. The resulting dilemma about discharge planning highlights the complexity involved in weighing concerns around mental illness and capacity for treatment and placement of care. The extent of the care that is required and available in a community or health care system and the slow but relatively certain progression of the symptoms also make the decision challenging. Two commentaries take very different approaches in exploring the question whether Ms. X should be supported to go home or to a special care facility. (shrink)

In this article, I propose a new model for understanding the function of representation in bioethics. Bioethicists have traditionally judged representations according to a mimetic paradigm, in which representations of bioethical dilemmas are assessed based on their correspondence to the “reality” of bioethics itself. In this article, I argue that this mimetic paradigm obscures the interaction between representation and reality and diverts bioethicists from analyzing the tensions in the representational object itself. I propose an anti-mimetic model of representation that is (...) attuned to how representations can both maintain and potentially subvert dominant conceptions of bioethics. I illustrate this model through a case study of Clint Eastwood’s film Million Dollar Baby. By focusing attention on the film’s lack of adherence bioethical procedures and medical science, critics missed how an analysis of its representational logic provides a means of reimagining both bioethics and medical practice. In my conclusion, I build off this case study to assess how an incorporation of representational studies can deepen—and be deepened by—recent calls for interdisciplinarity in bioethics. (shrink)

This book review essay discusses The Crisis of US Hospice Care: Family and Freedom at the End of Life (2019), by Harold Braswell.

What is the self? And how does it relate to the body? In the second edition of Personal Identity, Harold Noonan presents the major historical theories of personal identity, particularly those of Locke, Leibniz, Butler, Reid and Hume. Noonan goes on to give a careful analysis of what the problem of personal identity is, and its place in the context of more general puzzles about identity. He then moves on to consider the main issues and arguments which are the (...) subject of current debate, including the work of Bernard Williams and Derek Parfit, and makes new and challenging interpretations of them. This new edition contains additional material assessing the biological approach which has become increasingly popular in recent years, and extends the treatment of indeterminate identity to take account of the epistemic view of vagueness. This book covers the problem of personal identity from its origin in Locke's work to the most recent debates in the philosophical literature, and will be invaluablereading for any student of the topic. (shrink)

Thats logic. LEWIS CARROLL, Through the Looking Glass 1-1. The fundamental problem of this work is the question of the nature of scientific inference.

My purpose is to explore the possible lines of reply available to a defender of the neo‐Lockean position on personal identity in response to the recently popular ‘animalist’ objection. I compare the animalist objection with an objection made to Locke by Bishop Butler, Thomas Reid and, in our own day, Sydney Shoemaker. I argue that the only possible response available to a defender of Locke against the Butler–Reid–Shoemaker objection is to reject Locke's official definition of a person as a thinking, (...) intelligent thing and replace it with the concept of the self– the object of self‐reference – and that this response is equally obligatory for the neo‐Lockean in replying to the animalist. I explore other possibilities, including the position that there is no sense in talking about personal identity at all. (shrink)

One of three distinct approaches to his famous ‘Trust’ argument, this paper written by Garfinkel in 1960, and never before published, proposed a rethinking of rules, games and linguistic classifications in interactional terms consistent with Wittgenstein’s language games. Garfinkel had been working in collaboration with Parsons since 1958 to craft an approach to culture that would replace conceptual classification with the constitutive expectancies of interaction and systems of interaction. The argument challenged the work of cultural anthropologists influenced by zoology and (...) biology, who called themselves ‘ethnoscientists’ and studied culture in terms of linguistic classification systems. Garfinkel had proposed an alternative sociological ‘ethnoscience’ of culture and language that would focus on how culture was made, on how linguistic events are achieved, and on the rules of their making. This ‘Language Games’ approach followed Wittgenstein in seeking what Garfinkel called a literal description of cultural/linguistic events: meaning by ‘literal’, a step-by-step account of the constitutive and preferred rules participants use to create a recognizable event-in-a-language. Made famous three years later in version associated with Schutz, Garfinkel’s Trust argument also appears in a 1962 text (Parsons’ Primer, published in 2019) in a version built on Parsons. (shrink)

Considered ahead of its time since the first publication in 1981, Medical Choices, Medical Chances provides a telescope for viewing how developments in the fields of medical research, medical technology, and health care organization are likely to influence the doctor-patient relationship in the 21st Century. The book explores this intricate web of relationships among doctors, patients, and families and offers a new framework for mastering the emotional and intellectual challenges of uncertainty, while at the same time providing tools for all (...) concerned to regain control from managed care. It is a must-read for all those interested in medicine and where it is headed in the new millennium. (shrink)

This paper argues that realism issue in the social sciences is not one that can be decided by general philosophical arguments that evaluate entire domains at once. The realism issue is instead many different empirical issues. To defend these claims, I sort issues that are often run together, explicate and criticize several standard realist and antirealist arguments about the social sciences, and use the example of the productive/nonproductive distinction to illustrate the approach to realism questions that I favor.

Personal Identity is a comprehensive introduction to the nature of the self and its relation to the body. Harold Noonan places the problem of personal identity in the context of more general puzzles about identity, discussing the major historical theories and more recent debates. The second edition of Personal Identity contains a new chapter on 'animalism' and a new section on vagueness.

general, abstract situation. On the other side, I know that graduate students and all mathematicians sometimes falter because their intuitive, ..

Coward (religious studies, U. of Calgary) explores the similarities and differences between the language theories of modern French philosopher Jacques Derrida and several traditional Indian schools of thought.

Carnap, R. Empiricism, semantics, and ontology.--Quine, W. V. Two dogmas of empiricism. Meaning and translation.--Sellars, W. Empiricism and the philosophy of mind.--Putnam, H. Brains and behaviour.--Popper, K. R. Science: conjectures and refutations.--Feyerabend, P. K. Science without experience. How to be a good empiricist--a plea for tolerance in matters epistemological.--Kuhn, T. S. Incommensurability and paradigms.--Hesse, M. Duhem, Quine and a new empiricism.--Chomsky, N. Recent contributions to the theory of innate ideas.--Putnam, H. The innateness hypothesis and explanatory models in linguistics.--Goodman, N. The (...) epistemological argument.--Quine, W. V. Linguistics and philosophy.--Edgley, R. Chomsky's theory of innate ideas.--Fodor, J. A. Methodological arguments for behaviorism.--Chomsky, N. Some empirical assumptions in modern philosophy of language.--Annotated bibliography (p. 319-326). (shrink)

Tarrant examines whether the relationship between Socrates and his young followers could ever have been treated by Plato in the same fashion as it is treated in the Platonic Theages, where the terminology of synousia is repeatedly applied to it. In minimizing the part played by knowledge and maximizing the role of the divine and of eros, the work creates a "Socrates" who conforms to the educational ideology of the Academy of Polemo in the period 314-270 BC.

I think it is important to try to make sense of these thoughts concerning the justificatory role of experiences, for I suspect that we are losing the ability to see why philosophers have traditionally been attracted to such thoughts. Coherentism and reliabilism, perhaps the two most currently popular theories of epistemic justification, appear simply to reject the idea that experiences can justify beliefs. Thus according to coherentism, the view that ‘a belief is justified by its coherence with other beliefs one (...) holds,’ it is only other beliefs, not experiences, that can justify beliefs. Although there is little consensus as to how the notion of coherence should be explicated, it is generally agreed that experiences are not the sort of thing that can cohere with beliefs. Reliabilism, by contrast, holds that ‘a belief is justified if and only if it is “well-formed,” i.e., it has an ancestry of reliable and/or conditionally reliable cognitive operations.’ In other words, according to reliabilism beliefs are justified, not by experiences, but by being caused by reliable belief-forming processes. Experiences may be formed in the course of such processes, but they need not be, and even when they are, they make no contribution to the justification of the beliefs that are formed as the result of those processes. What makes a belief-forming process justification-conferring, according to reliabilism, is simply that it is reliable, not that it gives rise to experiences. So neither coherentism nor reliabilism seems to allow any room for the traditional thought that experiences justify beliefs. (shrink)

Mysteries: remains of a hidden life -- Words on paper -- In search of a person behind the words -- A France of broken families -- Families -- Politiques -- Breaking with his father -- Aristocratic Paris -- Libertine Paris -- A political education -- Gearing up for war: mathematical inspirations -- Breda -- Military engineering -- Meeting Isaac Beeckman -- The Holy Roman empire -- Anxious dreams -- Curious meetings -- War and diplomacy in Europe -- Into Bohemia -- (...) To Hungary and disaster -- The Baltic and return to the Netherlands -- Again in France -- Paris and the rosicrucian scare -- The Valtellina and Rome -- The struggle for France -- Problems with the cardinal -- The campaign for La Rochelle -- Confrontation and departure -- The meetings -- Confrontation and conversation -- Becoming a sectarian -- Feeling threatened -- Exile -- Not yet concluded. (shrink)