Reality medical television, an increasingly popular genre, depicts private medical moments between patients and healthcare providers. Journalists aim to educate and inform the public, while the participants in their documentaries—providers and patients—seek to heal and be healed. When journalists and healthcare providers work together at the bedside, moral problems precipitate. During the summer of 2010, ABC aired a documentary, Boston Med, featuring several Boston hospitals. We examine the ethical issues that arise when journalism and medicine intersect. We provide a framework (...) for evaluating the potential benefits and harms of reality medical television, highlighting critical issues such as informed consent, confidentiality, and privacy. (shrink)

As an ethicist trained in narrative, I wondered what I could offer Dr. Darcy at this point, two weeks after the events he described. And what might I have offered those involved if they had called an ethics consult at the time? One of this physician's implicit questions was, “How might this have unfolded in a better way?”When difficult choices must be made, how can a narrative approach help? A narrativist focuses less on principles, rules, and law than would a (...) philosopher or a lawyer. This is not to say that we ignore the law or are unaware of bioethical principles. But where do we go from there? Narrative offers a mode of engagement that asks different kinds of questions than those that law or philosophy might ask about moral agency, context, and values. (shrink)

This collection addresses a post-WWII shift in the hierarchy of scientific explanations, where the highest goal moves from reductionism towards some ...

For the theorists of crisis, the revolutionary state comes into existence through violence, and due to its inability to provide an authoritative katechon (restrainer) against internal and external violence, it perpetuates violence until it self-destructs. Writing during extreme economic depression and growing social and political violence, the crisis theorists––Joseph de Maistre, Juan Donoso Cortés, and Carl Schmitt––each sought to blame the chaos of their time upon the Janus-faced postrevolutionary ideals of liberalism and socialism by urging a return to pre-revolutionary moral (...) and religious values. They are united by three counterrevolutionary principles, all of which are purported to remedy revolutionary violence: traditional constitutional fidelity, the philosophy of the decision, and opposition to bourgeois liberalism. This essay is followed by the first complete English translation and publication of Donoso’s letter of October 24, 1851, which contains Donoso’s only reference to the “discussing class,” a political entity later popularized by Schmitt in his 1922 work Political Theology. (shrink)

The doctor patient relationship starts with a story. Doctors' notes, a patient's chart, the recommendations of ethics committees and insurance justifications all hinge on written and verbal narrative interaction. The "practice" of narrative profoundly affects decision making, patient health and treatment and the everyday practice of medicine. In this edited collection, the contributors provide conceptual foundations, practical guidelines and theoretical considerations central to the practice of narrative ethics.

The Hastings Center addresses fundamental ethical issues in the areas of health, medicine, and the environment as they affect individuals, communities, and societies. With a small staff of senior researchers at the Center and drawing upon national and international experts, The Hastings Center pursues interdisciplinary research and education that includes both theory and practice. Founded in 1969 by philosopher Daniel Callahan and psychoanalyst Willard Gaylin, The Hastings Center is the oldest independent, nonpartisan, interdisciplinary research institute of its kind in the (...) world. From its earliest days The Hastings Center has understood that the moral problems arising from rapid advances in medicine and biology are set within a broad intellectual and social context. The Center's collaborations with policy-makers, in the private as well as the public sphere, assist them in analyzing the ethical dimensions of their work. (shrink)

Some theories of goodness are descriptively rich: they have much to say about what makes things good. Neo-Aristotelian accounts, for instance, detail the various features that make a human being, a dog, a bee good relative to facts about those forms of life. Famously, such theories of relative goodness tend to be comparatively poor: they have little or nothing to say about what makes one kind of being better than another kind. Other theories of goodness—those that take there to be (...) absolute goodness—are comparatively rich: they offer grounds for judging some types of things better than others because they have more absolute goodness. Moorean accounts, for example, can tell us that humans and human experiences are superior to bees and blades of grass. But such theories tend to be descriptively poor: they struggle to tell us in virtue of what this is so. In this essay we motivate and flesh out a view that splits the difference between accounts of goodness as relative and accounts of goodness as absolute. Such a view holds promise only if the mechanics of this kind of metaphysics of goodness can be worked out. Here we present a view on which the paradigm for absolute goodness is God and the paradigm for each kind of relative goodness is a divine idea. (shrink)

Beginning with this issue, the "Review Essays" section of the journal has been renamed "Critical Assessments." The new name more accurately describes not only the content of the section but also the journal's methods of assessment. Submissions to the section are peer reviewed; published essays are catalogued and indexed like the rest of the content of Perspectives in Biology and Medicine.Where many journals publish reviews on the assets and liabilities of newly published books, the Critical Assessments section of Perspectives in (...) Biology and Medicine aims for robust, engaging essays, written in an informal style about important new books, and also about important new articles. Books are a typical means of publishing... (shrink)

In 1957, D. J. Ingle, the first editor of Perspectives in Biology and Medicine, explained why he thought a new journal was needed for scientists and physicians already inundated by publications. With professional journals increasingly focused on smaller and smaller systems and preoccupied with publishing data, he decided that readers needed a forum in which there was space for leisurely interpretation, speculation, and exploration of new ideas. Ingle intended for the journal to reach into all fields of biology and medicine. (...) The journal would welcome scholarly writing from any discipline that could offer new insight and informed thinking to “take stock” of the results and implications of current research. He.. (shrink)

In the summer of 2017, much of the world was riveted by the case of Charlie Gard, a baby in London whose parents wanted an experimental treatment and whose doctors thought that further treatment would be futile. The case worked its way through the British courts and, eventually, was even heard by the European Court of Human Rights. Pope Francis and President Trump weighed in. If nothing else, the case revealed how controversial the issues around medical futility and shared decision-making (...) still are. Many ethical issues resolve over time. Discussions about disagreements lead to discovery of common ground. That doesn’t seem to be the case with the issue of medical futility and, particularly, with... (shrink)

If you travel through airports, you can’t help but notice it. Jodi Picoult’s novels are everywhere. From Charlotte to Kansas City to Los Angeles, airport bookstores are consistently stocked with three or four or more of her most recent heavy volumes of fiction. Read one and you might mutter that it seems designed for a relatively mindless flight from one coast to the other. Read several and you might agree with National Public Radio’s disparaging view that the books are “lurid (...) tales of family strife . . . garnished heavily with medical jargon, legalese, and a punitive finger pointed at a mother.” It’s not hard to find negative comments about Picoult’s novels. Janet Maslin, writing for the New York .. (shrink)

We are sad to say that Advisory Board member Renée Fox died on September 23rd. Renée was an extraordinary friend of Perspectives in Biology and Medicine, celebrating and contributing to its uniqueness over many years.Renée was a pioneer in medical sociology who spent most of her career at the University of Pennsylvania. Her research used participant-observation to explore the work of physicians. In Experiment Perilous, she examined troubling practices of doctors who conducted research on their own patients at the Peter (...) Bent Brigham Hospital in Boston. In The Courage to Fail, written with Judith Swazey, she focused on dangers to patients as their physicians used them as experimental subjects to develop... (shrink)

Donald Davidson has made enormous contributions to the philosophy of action, epistemology, semantics and philosophy of mind and today is recognized as one of the most important analytical philosophers of the late twentieth century. _Donald Davidson: Truth, Meaning and Knowledge_ addresses * Davidson's writings on epistemology and theory of language with their implications of ontology and philosophy of mind * the central issue of whether truth is the ultimate goal of enquiry, challenged by contributions from Richard Rorty and Paul Horwich (...) * Davidson's approach to semantics and applied linguistics as addressed by Kirk Ludwig, Gabriel Segal, Peter Pagin, Stephen Neale, Herman Cappelen and Ernie Lepore and Reinaldo Elugardo * Davidson's advances in the philosophy of mind in relation to the views of Williard V. Quine, John McDowell and Peter F. Strawson, in essays by Roger Gibson and Anita Avramides. (shrink)

Since 1900, debates about the justification of punishment have also been debates about the cause of crime. In the early twentieth century, the rehabilitative ideal of punishment viewed mental illness and dysfunction in individuals as the cause of crime. Starting in the 1970s, retributivism identified the immorality of human agents as the source of crime, which dovetailed well with the “tough-on-crime” political milieu of the 1980s and 1990s that produced mass incarceration. After surveying these historical trends, Wirts argues for a (...) social critical view that crime is best understood as a product of an unjust society, not faulty human beings. This view should take the lessons learned by the critiques of rehabilitation, however, and resist the tendency to reduce human beings to recipients of social services. (shrink)

The topic of professionalism has dominated the content of major academic medicine publications during the past decade and continues to do so. The message of this current wave of professionalism is that medical educators need to be more attentive to the moral sensibilities of trainees, to their interpersonal and affective dimensions, and to their social conscience, all to the end of skilled, humanistic physicians. Urgent calls to address professionalism from such groups as the Association of American Medical Colleges, the American (...) Board of Internal Medicine, and the Accreditation Council for Graduate Medical Education, among others. In fact, at the 2004 annual meeting of the AAMC six separate presentations addressed professionalism with such titles as "Evaluating Humanism and Professionalism," Professionalism: Expectation, Education, Evaluation," or "Toward Assessing Professional Behaviors of Medical Students through Peer Observations". Professionalism, then, has become part of the current academic medicine parlance, used by administrators, clinical faculty, residency programs, and professional organizations with an expectation of shared meanings and goals. All of these stakeholders focus on what has become a consistent list of attributes deemed to be the essence of professionalism, which usually include variations on altruism, duty, excellence, honor and integrity, accountability, and respect. In fact, most of the scholarly work to date has been listing, describing, decrying, and measuring/evaluating it. In this collection of essays, we don’t argue with these attributes. Instead, we ask questions of the discourse from which they arise, how the specialized language of academic medicine disciplines has defined, organized, contained, and made seemingly immutable a group of attitudes, values, and behaviors subsumed under the label "professional" or "professionalism." This collection aims to be a critical text, one that questions the profession’s beliefs about the nature of its work and how such beliefs are enacted in medical education, particularly as they fuel the professionalism discourse. In addition, we will scrutinize how the discourse is enacted in both the formal and hidden curriculum, and in the larger medical environment. (shrink)

The spiritual geography of Russian cosmism. General characteristics ; Recent definitions of cosmism -- Forerunners of Russian cosmism. Vasily Nazarovich Karazin (1773-1842) ; Alexander Nikolaevich Radishchev (1749-1802) ; Poets: Mikhail Vasilyevich Lomonosov, (1711-1765) and Gavriila Romanovich Derzhavin (1743-1816) ; Prince Vladimir Fedorovich Odoevsky (1803-1869) ; Aleksander Vasilyevich Sukhovo-Kobylin (1817-1903) -- The Russian philosophical context. Philosophy as a passion ; The destiny of Russia ; Thought as a call for action ; The totalitarian cast of mind -- The religious and spiritual (...) context. The kingdom of god on earth ; Hesychasm: two great Russian saints ; The Third Rome ; Pre-Christian antecedents -- The Russian esoteric context. Early searches for "deep wisdom" ; Popular magic ; Higher magic in the time of Peter the Great ; Esotericism after Peter the Great ; Theosophy and anthroposophy -- Nikolai Fedorovich Fedorov (1829-1903), the philosopher of the common task ; The one idea ; The unacknowledged prince ; The village teacher ; First disciple: Dostoevsky and Tolstoy ; The Moscow librarian ; Last years: Askhabad: the only portrait -- The "common task" ; Esoteric dimensions of the "common task" ; Fedorov's legacy: projectivism, delo, regulation -- The religious cosmists. Vladimir Sergeevich Solovyov (1853-1900) ; Sergei Nikolaevich Bulgakov (1871-1944) ; Pavel Aleksandrovich Florensky (1882-1937) ; Nikolai Aleksandrovich Berdyaev (1874-1948) -- The scientific cosmists. Konstantin Edouardovich Tsiolkovsky (1857-1935) ; Vladimir Ivanovich Vernadsky (1863-1945) ; Alexander Leonidovich Chizhevsky (1897-1964) ; Vasily Feofilovich Kuprevich (1897-1969) -- Promethean theurgy. Life-creation ; Cultural immortalism ; God-building ; Re-aiming the arrows of Eros ; Technological utopianism ; Occultism -- Fedorov's twentieth century followers. Nikolai Pavlovich Peterson (1844-1919) and Vladimir Aleksandrovich Kozhevnikov (1852-1917) ; Svyatogor and the biocosmists ; New wine and the universal task ; Alexander Konstantinovich Gorsky (1886-1943) and Nikolai Alexandrovich Setnitsky (1888-1937) ; Valerian Nikolaevich Muravyov (1885-1932) ; Vasily Nikolaevich Chekrygin (1897-1922) -- Cosmism and its offshoots today. The N.F. Fedorov museum-library ; The Tsiolkovsky museum and Chizhevsky center ; ISRICA - Institute for Scientific Research in Cosmic Anthropoecology ; Lev Nikolaevich Gumilev (1912-1992) and neo-eurasianism ; The hyperboreans ; Scientific immortalism: Igor Vishev, Danila Medvedev ; Conclusions about the Russian cosmists. (shrink)

Twentieth-century developments in quantum physics, together with an emerging science of consciousness, have created the need for a new cosmology, or model of the universe. The theory of process contained in THE REFLEXIVE UNIVERSE places consciousness within the context of contemporary science. One of the central themes of this extraordinary work is that each successive organization of matter, from fundamental particles in physics to living organisms, expresses a particular stage in the evolution of mind. Starting with the photon, the basic (...) unit of light, and moving through atomic physics, molecular chemistry, the morphology of plants and animals and finally to levels of human evolution, Young develops his theory in vivid step-by-step detail. Consciousness, in his point of view, is not isolated from the material universe. It exists in a continuum, one in which physical and nonphysical realms can be linked and the teachings of mythology and religion can be integrated. To order: FAX: 415-883-9280; e-mail: [email protected]; or write: Anodos Foundation, c/o Publishers Services, P.O. Box 2510, Novato, CA 94948. Visa and MasterCard only. Trade STOP orders 40% plus postage. (shrink)

In the past two to three decades health behavior scientists have increasingly emphasized affect-related concepts in their attempts to understand and facilitate change in important health behaviors, such as smoking, eating, physical activity, substance abuse, and sex. This article provides a narrative review of this burgeoning literature, including relevant theory and research on affective response, incidental affect, affect processing, and affectively charged motivation. An integrative dual-processing framework is presented that suggests pathways through which affect-related concepts may interrelate to influence health (...) behavior. (shrink)

We discuss the important, but greatly under-researched, topic of the social aspects of human wayfinding during navigation. Wayfinding represents the planning and decision-making component of navigation and is arguably among the most common, real-world domains of both individual and group-level decision making. We highlight the myriad ways that wayfinding by people is not a solitary psychological process but is influenced by the actions of other people, even by their mere presence. We also present a novel and comprehensive framework for classifying (...) wayfinding in complex environments that incorporates the influence of other people. This classification builds upon the premises of previous wayfinding taxonomies and is further structured into four parts based upon (1) the nature of the interaction between the actors and (2) the time frame in which the interaction takes place. We highlight gaps in our current understanding of social wayfinding and outline future research opportunities. (shrink)