In lieu of an abstract, here is a brief excerpt of the content:The “Wider View”: André Hellegers’s Passionate, Integrating Intellect and the Creation of BioethicsWarren Thomas Reich* (bio)AbstractThis article provides an account of how André Hellegers, founder and first Director of the Kennedy Institute of Ethics at Georgetown University, laid medicine open to bioethics. Hellegers’s approach to bioethics, as to morality generally and also to medicine and biomedical science, involved taking the “wider view”—a value-filled vision that integrated and gave (...) meaning to what otherwise was disparate, precarious, and conflicting. This article shows how Hellegers’s wider view of bioethics was shaped by events in his own life, his resultant sense of the precariousness of life and health, his commitment to religious inclusiveness, his research in fetal medicine, his clinical experience in obstetrics, his role in the struggle to change the teaching of the Roman Catholic Church on fertility control, and his developing concepts of health and disease. Hellegers was committed to and worked toward bioethics as a self-consciously interdisciplinary field in which the contributing disciplines adapt to each other—rather than sustain themselves as autonomous disciplines—to create a dynamic and complex intellectual, clinical, and social activity.André Hellegers’s personality and life were like that of a meteor: brief appearance on the scene; high-speed, flaming trajectory; quick burn-out; its smallest residue worth examining for ages to come. You had to watch carefully, for otherwise you might miss what he was about—what he was really about. He had an unusually probing and unflagging mind, coupled with the ability to make people think; and in a very real sense, that is what he was always about. André was an extremely effective communicator. He was like Fred Astaire: he had flair and charm, and no matter how crowded the room, you instantly knew when he entered it. Like Astaire, he had a deep intensity and striving for perfection while making his art always look like great fun. He was an engaging [End Page 25] story-teller who also knew how to stun intelligent people with his insightful, often ironic and humorous thinking that got to the bottom of things very quickly, leaving his interlocutors with a huge agenda for further reflection. Yet in spite of all this alluring talent, André never attracted attention to himself in a vain way. Even as raconteur, he was always working, getting people to think and talk.There were three great passions in Hellegers’s life that enabled him to inspire and shape bioethics as he did. He had a passionate intellect that was constantly probing for new clarity at new levels of understanding and values, and he had the ability to infect other people with his intellectual passion. André Hellegers was deeply rooted in a Catholicism scarcely imaginable in the United States—an open, historically-conscious, northern European faith that kept him free of ideology while providing him a foundation on which he built a rich ecumenicity of theological and philosophical bioethics. Finally, and perhaps most decisively for his founding work in bioethics, Hellegers pushed and probed to get a world that was almost totally unaccustomed to communicating over disciplinary lines (incredibly, virtually no interdisciplinary conferences had taken place before his day) to dialogue and collaborate across the barriers of medicine, politics, and religion.IntroductionThe customary way of writing a history of someone’s involvement in the origins of something—say, the origins of a nation or, I suppose, the origins of bioethics—certainly would not customarily start with the foregoing type of vignette. It would have as its purpose to discuss such things as issues, events that raised issues, methods pursued and applied, and outcomes achieved. However, in this modest account of some of the major contributions of the late André E. Hellegers, M.D., to the development of the field of bioethics, I intend to focus on a different level of historical inquiry, one that portrays and explains the person, his world-view, and his motivation, as well as the cultural forces and events that conspired to make Hellegers and the people with whom he came into contact vibrant with a sense of innovative and creative—not to mention urgent—inquiry. I believe that... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Revisiting the Launching of the Kennedy Institute: Re-visioning the Origins of BioethicsWarren Thomas Reich (bio)Twenty-five years ago, on October 1, 1971, at a press conference held at Georgetown University, the Joseph and Rose Kennedy Institute for the Study of Human Reproduction and Bioethics, later called the Kennedy Institute of Ethics, was officially inaugurated. To revisit that event—and the Institute’s five founding collaborators who spoke at it—provides an opportunity (...) to re-vision some of the most significant intellectual, moral, cultural, and political factors that shaped both this Institute and the then-nascent field of bioethics.Eunice Kennedy Shriver, who spoke at the press conference, was intensely committed to a new sort of philanthropy that would effect socio-political change in favor the dignity and well-being of the mentally disadvantaged. As executive vice-president of the Joseph P. Kennedy, Jr. Foundation, she had already applied the Foundation’s vision and resources to the task of harnessing the best of the “biological revolution” of the 1960s to prevent developmental disorders. Prompted by the values at stake in the care of the disadvantaged, she turned the Foundation toward the creation of the Institute in 1971.Just prior to the opening of the Institute, Mrs. Shriver had produced and appeared as introducer in a highly influential film, “Who Shall Survive?”, which dealt with a “mongoloid baby” who was allowed to die in the newborn clinic because of its condition. Showcased at a highly publicized symposium involving 2000 people (Editorial 1971) and widely discussed in the press, the film helped to establish neonatal ethics as paradigmatic for the emerging field of bioethics (Bedeviling Question 1971; Rothman 1991, pp. 190–221). Undoubtedly under the influence of her involvement in the publicizing of those issues, Mrs. Shriver commented at the press conference that she hoped the Institute would re-emphasize the value of children in face of the widespread feeling that children are a burden (Kennedys 1971, p. 19).At the press conference, then president of Georgetown University, Robert J. Henle, S.J., announced the Kennedy Foundation’s grant of $1.35 million to establish the Institute. Henle was undoubtedly alert to the fact that certain issues, such as abortion and terminating the lives of infants, would be perceived [End Page 323] as highly controversial when raised at a Catholic university. Not surprisingly, reporters at the press conference raised provocative questions about how Georgetown University would reconcile Catholic moral doctrine with the Institute’s broadly-based inquiries. Henle replied tersely that the Institute “will be a ‘truly ecumenical and catholic effort,’ defining catholic in its classical meaning of universal” (Helping 1971). The reporters might have found it quite ironic that within a few years Georgetown’s ecumenical vision had provided the intellectual environment that permitted the Institute to become famous for development of the first systematic, secular (principle-based) approach to bioethics (Reich 1995).Father Henle was probably also aware that by launching the Kennedy Institute he was creating the first institute principally devoted to ethics research ever established at a university. It took a special sort of university to take this first step into bioethics research and policymaking. In 1971, ethics was regarded as belonging to religion, and religion was generally regarded as suspect academically. While it was difficult, in that atmosphere, for a nonreligious university to take such a bold step, Henle’s Georgetown University offered a promising setting that could scarcely have been found in any other university. It departed from the common mold of Catholic-college-as-indoctrination-center, yet it had an explicit and unashamed commitment to the investigation of religious and secular values in an environment of academic freedom. It was an increasingly cosmopolitan university, committed to developing the best of secular scholarship. Furthermore, Henle was willing to experiment with as-yet unproven interdisciplinary studies.Sargent Shriver—god-father of the Kennedy Institute, chairman of its first Advisory Board, and a constant dialogue partner of his friend and the Institute’s founding director, Dr. André Hellegers—was intensely interested in linking scientific progress with religious belief, unfettered moral debate, and commitment to disadvantaged humans.At the inaugural event, the new Institute was described as... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Laying Medicine Open: Innovative Interaction Between Medicine and the HumanitiesLaurence B. McCullough and Warren Thomas ReichThe past three decades have witnessed the emergence and remarkable success of the fields of bioethics and medical humanities. The intellectual landscape of medicine and that of the humanities have been remarkably altered in the process. Twenty-five to 30 years ago in the United States there existed but a few courses in (...) what came to be called “bioethics” in departments of philosophy, religious studies, and theology in colleges and universities, a handful of programs of teaching in medical schools such as the University of Texas Medical Branch at Galveston and Pennsylvania State University School of Medicine at Hershey, and but one independent research center (the Hastings Center) and one university-based research center (the Kennedy Institute of Ethics at Georgetown University). Articles on bioethics began to appear in the peer-reviewed medical, nursing, and humanities literature and some books were published. There was only one journal in bioethics, The Hastings Center Report (which consolidated two previously separate journals from the Hastings Center). Graduate programs in bioethics and medical humanities in colleges and universities and fellowship training in bioethics and medical humanities in medical schools did not exist. Very little existed in colleges, universities, and medical schools in other countries. Now, of course, everything is different.Teachers, scholars, and students of bioethics and medical humanities should not take these remarkable changes for granted, for they represent a sustained and innovative interaction between medicine and the humanities. We have chosen the metaphor of “laying medicine open” to characterize the history of bioethics and medical humanities of the past three decades. This surgical metaphor was used in eighteenth-century Britain by a number of writers who wanted to make medical science and practice more accessible to the sick and to the lay public more generally (Lawrence 1975). We use the metaphor to characterize the efforts of teachers and [End Page 1] scholars over the past three decades and more to make the value-laden dimensions of biomedical science and practice and of health care policy more accessible to patients and to the lay public more generally. The result of this laying open of medicine has gone a long way toward bringing closer together the two cultures of science and the humanities that had, as C. P. Snow famously described, become significantly isolated from each otherAlbert Jonsen (1998) has recently contributed the first book-length history of what he calls the “birth” of bioethics, adding to the work of other scholars such as Warren Reich (1994; 1995) and Robert Baker (1993) and, before them, Corrado Viafora (1990) and David Rothman (1991). The articles in this issue of the Kennedy Institute of Ethics Journal make additional contributions to the developing understanding of the history of the past thirty years of interaction between medicine and the humanities.Laurence McCullough provides an historical context for the three accounts of the recent laying open of medicine that follow. McCullough examines two times in the history of medicine when it has been laid open to accountability (in addition to its being laid open to and by bioethics and medical humanities). The first laying open occurred in the work of the eighteenth-century Scottish physician and philosopher John Gregory, who set out to create a profession of medicine in a true moral sense of a fiduciary profession by making medicine accountable for its scientific and moral quality. The second occurred in the late twentieth century in which the managed practice of medicine in general, and managed care in particular, have begun to lay medicine open to accountability for its scientific and moral quality, as well as its cost and, at least in the public sector, its accessibility. McCullough argues that, just as Gregory responded to the ethical challenges of medicine laid open more than two centuries ago, bioethics should respond to the ethical challenges in the current laying open of medicine.Warren Reich provides an account of André Hellegers, whose premature death left an enormous gap in the field that will never be filled. Reich claims that Hellegers was engaged substantially in much more than the laying open of medicine: he... (shrink)

(2001). The Care-Based Ethic of Nazi Medicine and the Moral Importance of What We Care About. The American Journal of Bioethics: Vol. 1, No. 1, pp. 64-74.

A historical understanding of the virtue of consolation, as contrasted to empathy, compassion, or sympathy, is developed. Recent findings from neuroscience are presented which support and affirm this understanding. These findings are related to palliative care and its current practice in bioethics.

A cuarenta años del inicio del fecundo diálogo entre las ciencias de la vida y los estudios humanísticos, que el nacimiento de la bioética ha hecho posible, se advierte la necesidad de evaluar algunos a,spectos -entre los cuales las posibilidades futuras de la bioética, y también su origen- desde un punto de vista particular: el del outsider. Se trata de aceptar el reto, para nuestra identidad moral, de trasladar la atención del estudio de casos particulares, del punto de vista del (...) insidel~ al estudio de problemas en los extremos de la disciplina. El outsider intelectual desafra a la bioética convencional, examinando los eventos reprobables de nuestro tiempo, permitiendo de este modo valorar, a veces repensándolas y refórmulándolas, las responsabilidades de nuestras disciplinas normativas. Un ejemplo en este sentido es dado por un profesor de anestesia de la Universidad de Harvard: Henry Beecher que saliendo de la fr'ontera de la profesión médica se interesó por la condición de vulnerabilidad de los sujetos de experimentación denunciando. (shrink)

Book reviewed in this article: Encyclopedia of Bioethics. Warren T. Reich, editor‐in‐chief.

This paper extends the discussion of guanxi beyond instrumental evaluations and advances a normative assessment of guanxi. Our discussion departs from previous analyses by not merely asking, Does guanxi work? but rather Should corporations use guanxi? The analysis begins with a review of traditional guanxi definitions and the changing economic and legal environment in China, both necessary precursors to understanding the role of guanxi in Chinese business transactions. This review leads us to suggest that there are distinct types of, and (...) uses for guanxi. We identify the potentially problematic aspects of certain forms of guanxi from a normative perspective, noting among other things, the close association of particular types of guanxi with corruption and bribery. We conclude that there are many different forms of guanxi that may have distinct impacts on economic efficiency and the well-being of ordinary Chinese citizens. Consistent with Donaldson and Dunfee (1999), we advocate a particularistic analysis of the different forms of guanxi. (shrink)

We present two studies that examine the effects of guanxi on multiple social groups from the perspective of Chinese business people. Study 1 (N = 203) tests the difference in perceived effects of six guanxi contextualizations. Study 2 (N = 195) examines the duality of guanxi as either helpful or harmful to social groups, depending on the contextualization. Findings suggest guanxi may result in positive as well as negative outcomes for focal actors and the aggregate.

An exceptional collection of letters, postcards, original writings, and photographs The First World War witnessed an unprecedented mobilization of philosophers and their families: as soldiers at the front; as public figures on the home front; as nurses in field hospitals; as mothers and wives; as sons and fathers. In Germany, the war irrupted in the midst of the rapid growth of Edmund Husserl's phenomenological movement – widely considered one of the most significant philosophical movements in twentieth century thought. Philosophers at (...) the Frontoffers a documentary history of phenomenology in the First World War. Through an exceptional collection of primary source materials (letters, postcards, original writings, photographs) from the Husserl Archives in Leuven, the Bayerische Staatsbibliothek, and the Archives of the University of Göttingen, the complex narratives of how the war affected the lives and thought of central figures in the phenomenological movement are charted. Key figures such as Edmund Husserl, his sons Wolfgang and Gerhart, Max Scheler, Edith Stein, Adolf Reinach, Martin Heidegger, and others are included in this collection of materials. The volume includes reproductions of original material, as well as German transcription of all texts and their English translation. (shrink)

Deleuze and Foucault had a long, complicated and productive relationship, in which each was at various times a significant influence on the other. This collection combines 3 original essays by Deleuze and Foucault, in which they respond to each other's work, with 16 critical essays by key contemporary scholars working in the field. The result is a sustained discussion and analysis of the various dimensions of this fascinating relationship, which clarifies the implications of their philosophical encounter.

Gottlob Frege (1848–1925) was unquestionably one of the most important philosophers of all time. He trained as a mathematician, and his work in philosophy started as an attempt to provide an explanation of the truths of arithmetic, but in the course of this attempt he not only founded modern logic but also had to address fundamental questions in the philosophy of language and philosophical logic. Frege is generally seen (along with Russell and Wittgenstein) as one of the fathers of the (...) analytic method, which dominated philosophy in English-speaking countries for most of the twentieth century. His work is studied today not just for its historical importance but also because many of his ideas are still seen as relevant to current debates in the philosophies of logic, language, mathematics and the mind. The Cambridge Companion to Frege provides a route into this lively area of research. (shrink)

Our aim in this article is to define the difficulties that clinical ethics services encounter when they are asked to demonstrate the value a clinical ethics service (CES) could and should have for an institution and those it serves. The topic emerged out of numerous related presentations at the Un- Conference hosted by the Cleveland Clinic in August 2018 that identified challenges of articulating the value of clinical ethics work for hospital administrators. After a review these talks, it was apparent (...) that the field of clinical ethics may be at a crisis of sorts due to increased pressure to provide explicit measures to healthcare institutions to concretely demonstrate that CESs make a valuable difference in healthcare delivery. In this article, we grapple with how to satisfy the need for demonstrable value in a field in which metrics alone may not capture the scope of clinical ethics practice. We suggest that capturing the value of a CES has been difficult because the benefits of ethics consultation may be overt or attributable to the CES, but are often hidden due to the systems-level and process-oriented nature of clinical ethics work. Part of the difficulty in demonstrating the value of CESs is capturing and conveying all of the ways the integration of a CES throughout an institution positively affects patients, families, visitors, healthcare professionals, administrators, and the institution itself. Our aim is to (1) elucidate the multifaceted value added by a CES, including value that tends to be hidden and (2) suggest how to demonstrate value to others in a way that is not simplistic or reductionistic. (shrink)

Few thinkers have left such an influence across such a diverse range of studies as Michel Foucault has. This book pays homage to that diversity by presenting a multidisciplinary series of analyses dedicated to the question of power today.

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In the early pages of this study, Jean-Jacques Thomas confesses that it was not his intention to write a book on Perec. Rather, he was interested in the manner in which "French Theory" had taken root in American academia in the 1960s and 1970s, enabling figures such as Roland Barthes, Michel Foucault, Jacques Lacan, Jean-François Lyotard, Julia Kristeva, Jacques Derrida, Gilles Deleuze, and others to export their thought with such resounding success. During the same period, a variety of creative (...) writers, many of them associated with the nouveau roman, became widely known, respected, and indeed influential in American intellectual circles. Gradually, Thomas began to wonder why Georges Perec failed to achieve the... (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

Prudence, for Thomas Aquinas, is an intellectual virtue that requires coincident moral virtue for its sustainability. As such, prudence displays a way of living in which intellect, desire, and emotion are harmoniously integrated. This account resonates strongly with the aims of mindfulness practices within contemporary psychology and with the "interpersonal neurobiology" of Daniel Siegel, for whom health is understood as a context-responsive and narrative integration of cognition, emotion, and embodied experience that promotes and allows for stable self-identity and fulfilling (...) interpersonal relationships. Similarly, prudence for Aquinas is an integrative virtue, integrating intellect and will, theory and context, action and agent, reason and emotion, past and future, the individual and his or her community, and the proximate and ultimate ends of human life. Contemporary mindfulness practices are at their best a school for prudence, and thus they shed an interesting light on Aquinas's account. In turn, Aquinas's account of prudence offers theological parameters for Christian participation in contemporary mindfulness practices. (shrink)

Explores the core of Balibars work since 1980This collection explores Balibars rethinking of the connections between subjection and subjectivity by tracing the genealogies of these concepts in their discursive history. The 12 essays provide an overview of Balibars work after his collaboration with Althusser. They explain and expand his framework; in particular, by restoring Arabic and Islamic thought to the conversation on the citizen subject. The collection includes two previously untranslated essays by Balibar himself on Carl Schmitt and Thomas (...) Hobbes. Key FeaturesThe first English-language edited collection to focus on BalibarPresents and explains Balibars key contributions to political theory and the history of political philosophyIncludes two essays by Balibar himself on Carl Schmitt and Thomas Hobbes: 'Schmitts Hobbes, Hobbess Schmitt' and 'The Mortal God and his Faithful Subjects: Hobbes, Schmitt and the Antinomies of Secularism'Contributors include Atienne Balibar, Nancy Armstrong, Giorgos Fourtounis, Mohamed Moulfi. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

Introduction -- An improbable alliance : Peter Wollen's "The auteur theory" -- Visual stylometry : Barry Salt's "Statistical style analysis of motion pictures" -- Between Shakespeare and Sirk : Thomas Elsaesser's "Tales of sound and fury: observations on the family melodrama" -- From iconicity to semiotic articulation : Christian Metz's "cinema: language or language system?" and language and cinema -- Film as a specific signifying practice : Stephen Heath's "On screen, in frame: film and ideology" -- Against theories of (...) reflection : Laura Mulvey's "Visual pleasure and narrative cinema" -- Early cinema spectatorship : Tom Gunning's "The cinema of attraction(s): early film, its spectator, and the avant-garde" -- Another Lacan : "the universal: suture revisited" -- The death of the camera : Edward Branigan's "What is a camera?" -- Conclusion: teaching theory. (shrink)