Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...) on the pathway to an eventual certification process for clinical ethics consultants. (shrink)

By considering the history of bioethics and international humanitarian law, Joseph J. Fins contends that bioethics as an academic and moral community should stand in solidarity with Ukraine as it defends freedom and civility.

As scholars envision a new regulatory or statutory neurorights schema it is important to imagine unintended consequences if reforms are implemented before their implications are fully understood. This paper critically evaluates provisions proposed for a new Chilean Constitution and evaluates this movement against efforts to improve the diagnosis of, and treatment for, individuals with disorders of consciousness within the broader context of disability law, international human rights, and a capabilities approach to health justice as advanced by Amartya Sen and Martha (...) Nussbaum. Framed in this way, any neurorights regime would need to satisfy several criteria. First it would be obliged to balance both positive and negative rights in the furtherance of human capabilities. Second, it would need to be future oriented and informed about the science it sought to regulate and not fall prey to science fiction fantasies that remain ungrounded in reality. Third, it would need to be specific and avoid generalizations that would lead to conceptual confusion and litigation that could delay scientific progress. Finally, it would need to harmonize novel neurorights with long-established norms in international disability and human rights law. A failure to meet these criteria will destine any novel neurorights regime to the periphery. At this juncture Chile’s nascent constitutional venture into neurorights fails to satisfy these criteria. While there yet may be a role for a more capacious and bivalent articulation of neurorights that account for capabilities and precedent, the current Chilean neurorights reforms are vague and premature. As such they should undergo additional scholarly scrutiny and should not be adopted by other jurisdictions. (shrink)

Many theories of complex cognitive-motor skill learning are built on the notion that basic cognitive processes group actions into easy-to-perform sequences. The present work examines predictions derived from laboratory-based studies of motor chunking and motor preparation using data collected from the real-time strategy video game StarCraft 2. We examined 996,163 action sequences in the telemetry data of 3,317 players across seven levels of skill. As predicted, the latency to the first action is delayed relative to the other actions in the (...) group. Other predictions, inspired by the memory drum theory of Henry and Rogers, received only weak support. (shrink)

Joseph J. Kockelmans provides a clear and systematic treatment of the central themes and topics of Heidegger's later writings, focusing on the all-important question of the relationship of truth and Being. If we are to understand Heidegger's thought, Kockelmans explains, we must conceive it as a path or way, rather than as a finished system. Adopting this approach himself, Kockelmans leads us with scholarly care through the wide range of issues that Heidegger wrote about between roughly 1935 and 1965. (...) After a discussion of Heidegger's own effort to learn to think, subsequent chapters present Heidegger's views on such matters as the meaning of Being; the ontological difference; heaven and earth; gods and mortals; and language, art, science, technology, ethics, and politics. In conclusion, Kockelmans reflects on the task of thinking in an age when classical philosophy has reached its logical end. (shrink)

In Wittgenstein on Meaning, Colin McGinn argues that the skeptical argument that Kripke distills from Wittgenstein's rule-following considerations generates at most what might be called meaning skepticism (the non-factuality view of meaning), and not concept skepticism (the non-factuality view of concepts). If correct, this would mean the skeptical reasoning is far less significant than Kripke thinks. Others have seemed to agree with McGinn. I argue that McGinn is wrong here--that, in fact, Kripke's skeptical reasoning has a straightforward extension to concepts. (...) Whether the reasoning succeeds, however, is another matter, which I do not address here. (shrink)

Husserl's Original View on Phenomenological Psychology* JOSEPH J.KOCKELMANS Some forty years ago Edmund Husserl spoke publicly for the first time of a ...

Research in education and cognitive development suggests that explaining plays a key role in learning and generalization: When learners provide explanations—even to themselves—they learn more effectively and generalize more readily to novel situations. This paper proposes and tests a subsumptive constraints account of this effect. Motivated by philosophical theories of explanation, this account predicts that explaining guides learners to interpret what they are learning in terms of unifying patterns or regularities, which promotes the discovery of broad generalizations. Three experiments provide (...) evidence for the subsumptive constraints account: prompting participants to explain while learning artificial categories promotes the induction of a broad generalization underlying category membership, relative to describing items (Exp. 1), thinking aloud (Exp. 2), or free study (Exp. 3). Although explaining facilitates discovery, Experiment 1 finds that description is more beneficial for learning item details. Experiment 2 additionally suggests that explaining anomalous observations may play a special role in belief revision. The findings provide insight into explanation’s role in discovery and generalization. (shrink)

This is the first article in a two-part series describing subject and family perspectives from the central thalamic deep brain stimulation for the treatment of traumatic brain injury using the Medtronic PC + S first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury, with subjects who were deemed capable of providing voluntary informed consent. In this article, we report on interviews conducted prior to surgery wherein we asked participants about their experiences recovering from (...) brain injury and their perspectives on study enrollment and participation. We asked how risks and benefits were weighed, what their expectations and fears were, and how decisions were reached about trial participation. We found that informed consent and enrollment decisions are fraught. Subjects and families were often split, with subjects more focused on putative benefits and families concerned about incremental risk. Both subjects and families viewed brain injury as disruptive to personal identity and relationships. As decisions were made about study enrollment, families struggled with recognizing the re-emergent agency of subjects and ceding decision-making authority to subjects who had previously been dependent upon them for protection and guidance. Subjects and family members reported a hope for the relief of cognitive disabilities, improved quality of life, normalization of interpersonal interactions, and a return to work or school as reasons for study participation, along with altruism and a desire to advance science. Despite these aspirations, both subjects and families appreciated the risks of the intervention and did not suffer from a therapeutic misconception. A second essay to be published in the next issue of Cambridge Quarterly of Healthcare Ethics—Clinical Neuroethics will describe interviews conducted after surgery, the effects of cognitive restoration for subjects, families, and challenges presented to the social structures they will call upon to support them through recovery. This subsequent article will be available online prior to its formal publication in October 2023. (shrink)

Edmund Husserl EDMUND GUSTAVE ALBRECHT HUSSERL was born in Prossnitz, Moravia, on April 8, 1859. After receiving his secondary education in Vienna, ...

Language, meaning, and ek-sistence, by J. J. Kockelmans.--Heidegger's conception of language in Being and time, by J. Aler.--Poetry and language in Heidegger, by W. Biemel.--Heidegger's topology of being, by O. Pöggeler.--Thinking and poetizing in Heidegger, by H. Birault.--Hermeneutic and personal structure of language, by H. Ott.--Ontological difference, hermeneutics, and language, by J. J. Kockelmans.--The world in another beginning: poetic dwelling and the role of the poet, by W. Marx.--Panel discussion.--Heidegger's language: metalogical forms of thought and grammatical specialties, by E. Schöfer.--M. (...) Heidegger's "ontological difference" and language, by J. Lohmann.--Bibliography (p. 365-368). (shrink)

In Edmund Husserl's Phenomenology, Joseph J. Kockelmans provides the reader with a biographical sketch and an overview of the salient features of Husserl's thought. Kockelmans focuses on the essay for the Encyclopedia Britannica of 1928, Husserl's most Important effort to articulate the aims of phenomenology for a more general audience. Included are Husserl's text -- in the original German and in English translation on facing pages -- a synopsis, and an extensive commentary that relates Husserl's work as a whole (...) to the essay for the Encyclopedia. (shrink)

: This essay appropriates the understanding of ethics developed by Michel Foucault in his courses at the Collège de France from 1980 until his death in 1984, with the aim of formulating a progressive environmental politics. As such, it attempts to navigate some of the long–standing divides between the movement for animal rights and environmental ethics proper, finding in the practice of vegetarianism a form of self-relation that is conducive to critical forms of speech and politics. The final phase of (...) Foucault's work is replete with insights into how the care of the self can serve as a resistance to forms of power and political stasis. This paper presents these unpublished materials, allowing for a glimpse of the unknown Foucault, and reinterprets vegetarianism as a form of self-practice that is linked with truth and critical speech. (shrink)

Emotion regulation is one of the major foci of study in the fields of emotion and emotional development. This article proposes that to properly study emotion regulation, one must consider not only an intrapersonal view of emotion, but a relational one as well. Defining properties of intrapersonal and relational approaches are spelled out, and implications drawn for how emotion regulation is conceptualized, how studies are designed, how findings are interpreted, and how generalizations are drawn. Most research to date has been (...) conducted from an intrapersonal perspective, and the shortcomings of this approach for understanding emotion regulation are highlighted. The article emphasizes major conceptual and methodological steps required for a fuller description of the process of emotion regulation. (shrink)

Book reviewed in this article: How We Die. By Sherwin B. Nuland. New York: Alfred A. Knopf.

: This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in (...) moral problem solving are discussed. (shrink)

This book was completed by the early 1960s and published in 1984 but it has not lost its topicality, for it contains an important re-assessment of the relations of two main streams of contemporary philosophy - the Analytical and the Dialectic. Adherents and critics of these traditions tend to assurnethat they are diametrically opposed, that their roots, concerns and approaches contradict each other, and that no reconciliation is possible. In contradistinction Russell derives both traditions from the common root of the (...) dissatisfaction with the arguments against speculative philosophy. These according to the author leave a lacuna - certain elementsof our Weltanschaaung have been removed, but they cannot be removed without replacement lest we have an incomplete world view, so incomplete in fact that it cannot be viable. According to Russell part of this vacuum is taken up by the analytical tradition but this tradition is not capable of taking up the remainder of it. That portion of the vacant space is however taken up by the dialectical tradi tion, which in turn cannot itself handle the whole of the problem. Thus the two reactions to the demise of speculative philosophy appear to be complementary in at least this sense. But the author goes further, for according to hirn the analytical arguments themselves clearly point to the emergence of dialectical problems, and the dialectical problems themselves need some such background to arise. (shrink)

The COVID-19 Pandemic a stress test for clinical medicine and medical ethics, with a confluence over questions of the proportionality of resuscitation. Drawing upon his experience as a clinical ethicist during the surge in New York City during the Spring of 2020, the author considers how attitudes regarding resuscitation have evolved since the inception of do-not-resuscitate orders decades ago. Sharing a personal narrative about a DNR quandry he encountered as a medical intern, the author considers the balance of patient rights (...) versus clinical discretion, warning about the risk of resurgent physician paternalism dressed up in the guise of a public health crisis. (shrink)

Der folgende Artikel ist im Jahr 2003 unter dem Titel „Clinical Pragmatism: A Method of Moral Problem Solving“ in dem Sammelband „Pragmatic bioethics“ erschienen, welcher sich mit der Bedeutung der pragmatistischen Philosophie für die Praxis befasst. In dem vom Internisten und Bioethiker Joseph J. Fins, dem Thoraxchirurgen Matthew D. Bacchetta und dem Philosophen und Medizinethiker Franklin G. Miller verfassten Beitrag wird der pragmatistische Ansatz in der klinischen Ethik anhand eines Fallbeispiels gleichzeitig beschrieben, begründet und demonstriert. Obgleich die Denkrichtung der (...) pragmatistischen Philosophie sowohl wissenschaftstheoretisch wie praktisch hoch bedeutsam ist – ohne diese ist weder die heutige sozialwissenschaftliche Forschung noch die angewandte, insbesondere die klinische Ethik denkbar –, werden pragmatistische Ansätze im deutschsprachigen Raum bis heute eher rudimentär rezipiert. (shrink)

Patient narratives from two investigational deep brain stimulation trials for traumatic brain injury and obsessive‐compulsive disorder reveal that injury and illness rob individuals of personal identity and that neuromodulation can restore it. The early success of these interventions makes a compelling case for continued post‐trial access to these technologies. Given the centrality of personal identity to respect for persons, a failure to provide continued access can be understood to represent a metaphorical identity theft. Such a loss recapitulates the pain of (...) an individual's initial injury or illness and becomes especially tragic because it could be prevented by robust policy. A failure to fulfill this normative obligation constitutes a breach of disability law, which would view post‐trial access as a means to achieve social reintegration through this neurotechnological accommodation. (shrink)

If ever I summon before me my highest ideals of men and medicine, I find them sprung from the spirit of Osler. —Wilder Penfield, M.D. Neuroethics is a recently coined term that is shaping our cultu...

The application of neuroimaging technology to the study of the injured brain has transformed how neuroscientists understand disorders of consciousness, such as the vegetative and minimally conscious states, and deepened our understanding of mechanisms of recovery. This scientific progress, and its potential clinical translation, provides an opportunity for ethical reflection. It was against this scientific backdrop that we convened a conference of leading investigators in neuroimaging, disorders of consciousness and neuroethics. Our goal was to develop an ethical frame to move (...) these investigative techniques into mature clinical tools. This paper presents the recommendations and analysis of a Working Meeting on Ethics, Neuroimaging and Limited States of Consciousness held at Stanford University during June 2007. It represents an interdisciplinary approach to the challenges posed by the emerging use of neuroimaging technologies to describe and characterize disorders of consciousness. (shrink)

Although Shanker & King disregard the behavioral paradigm, their arguments are reminiscent of those in Skinner 's Verbal Behavior. Like S&K, Skinner maintained that communication is not appropriately characterized as the transmission of information between individuals. In contrast to the paradigm advocated by S&K, however, the behavioral paradigm emphasizes prediction and control as important scientific goals.

This paper discusses the relationship between Kantian idealism and Marxian materialism. Part I examines the reasons this relationship is misconstrued to be predominantly a matter of practical philosophy and turns to the neglected works of Alfred Sohn-Rethel and Richard Seaford to outline the importance of money for understanding Kant’s theoretical work. Part II considers an objection that Kant confuses the commodity form for the transcendental object of experience. I am ultimately concerned with defusing the accusation that the identity of the (...) commodity with a Kantian thing renders Kantian idealism “bourgeois” in the pejorative sense. Money is implicated, historically and conceptually, in the very intelligibility of metaphysics. In that case, Kantian idealism and Marxian materialism are two sides of the same coin. (shrink)

This essay is concerned with some of Michel Foucault's writings on art. The author talks about the analyses of painting Foucault conducted during the period in which Foucault was developing the philosophical methodology known as archaeology. Despite archaeology's strong epistemological orientation, that methodology gives rise to a form of seeing that suspends the imperatives for the production of meaning that accrue around works of art. Some of the consequences of this suspension are explored in the final section of this essay (...) where the author describes archaeology as giving rise to an artistic‐philosophical thought that operates outside of the bounds of truth and falsity. The author contends that it is particularly well suited for approaching the artistic products created during and after the breakup of mimesis, the European cultural paradigm that articulated strong connections between art – considered as representation – and reality. (shrink)

Let’s face it, the humanities are in trouble. Last year, in The Chronicle of Higher Education, Thomas H. Benton warned prospective graduate students to avoid doctoral studies in the humanities. His rationale: a job market down 40%, the improbability of tenure, the more certain prospect of life as an adjunct, and eventual outright exile from one’s chosen field. Benton, the pen name of William Pannapacker, an associate professor of English at Hope College in Holland, Michigan, pulled no punches. His piece (...) was entitled, “Graduate School in the Humanities: Just Don’t Go.”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Why Rancière Now?Joseph J. Tanke (bio)I. IntroductionAs philosophy's representative at an art college, a question is put to me by my colleagues, students, and other art-world types frequently enough that it is worth considering systematically: Why Rancière now? The query is in large part prompted by a recent issue of Artforum devoted to the work of the French philosopher Jacques Rancière, the publication of which caps a seemingly (...) overnight ascendance within discussions of art and politics. The very temporality of the question indicates that the discovery of Rancière by art professionals is a relatively recent development. Why is this taking place now? To begin to answer this question, we must first understand something about the current relationship between theoretical discourse and artistic practice.That Rancière is only now beginning to be discussed within the art world is indeed surprising, given the long-standing reliance upon theoretical approaches and the fact that Baudrillard, Derrida, and Deleuze now function as standard reference points. While it would be incorrect to say that Rancière was an unknown quantity in the Anglophone world until recently, the sense of revelation suggested by the query "Why now?" must be understood in terms of the ongoing exchange between European theory and contemporary art. This is a conversation that, independent of one's perspective as to whether it has had positive or negative consequences, cannot be denied. With this relationship between Continental philosophy, art making, and critical discourses, one is justified in asking, Why is Rancière only now coming to be read with any seriousness in art circles? The point is sharpened when we note that Rancière's work, unlike that of some of the more [End Page 1] celebrated names, is more readily suited for an interface with critical art discourse, concerned as it is with aesthetic issues and the analysis of contemporary art.One might be tempted to find lurking behind our question a certain amount of suspicion about further incursions by theory and detect a sense of exasperation at having yet another French name to pronounce. Those of us who find this interaction between art and theory edifying, however, should not simply shrug off this question and attribute it to an aversion to philosophy, or to a backlash against the excess of the past two decades. Understanding the context in which the question is posed allows us to expand it. And, while not all would agree, I think it is safe to say that there is a tacit consensus that fruitful arrangements between art and philosophy can be forged. With this situation in mind, we might, therefore, transform our question into something like the following: What might Rancière contribute to the work of the nonphilosopher, placed, for good or ill, within a dispositif wherein art and European theory discourse about many of the same phenomena, but in different idioms? The advantage of this formulation, of course, is that it allows us to avoid many of the facile responses to our initial question, variations on a theme suggesting that Rancière is simply one of the few members of that esteemed generation of thinkers still living and that the turning to his work is indicative of a generalized anxiety about the future of theoretical developments. We might also, in thus expanding our question, sketch an answer directed at those working at the edges of their respective disciplines: philosophers, artists, critics, historians—in short, all those interested in questions of contemporary culture. In accordance with what Rancière describes as the fortuitous breakdown of specializations, my efforts in this essay are intended as a contribution to an interdisciplinary conversation that is grappling with the intellectual issues raised by works of art, their reception, and the historical discourses that are created around them.II. To Avoid Two Discourses of MourningThe temporality of our question, why now?, is hinted at by Rancière at various points throughout his own work and pertains to what might be characterized as the default theoretical position of art, that of "mourning." For Rancière, this mourning takes two major forms: spectacle and the impossible. The former finds its genesis... (shrink)

Rachlin's view of self-control as a sequence or chain of behaviors is contrasted with traditional behavioral analyses of self-control which emphasize a simplistic interpretation of the hyperbolic function relating small-sooner (SS) and larger-later (LL) reinforcers to specific behaviors. The validity of Rachlin's teleological analysis is examined in relation to the acquisition and steady-state performance of self-control behaviors. Central to an analysis of self-control is the functional difference between behavior under the control of SS and LL reinforcers, because SS-reinforced behavior is (...) more complex due to temporal parameters. (shrink)