Hospital systems commonly face the challenge of determining just ways to allocate scarce drugs during national shortages. There is no standardised approach of how this should be instituted, but principles of distributive justice are commonly used so that patients who are most likely to benefit from the drug receive it. As a result, clinical indications, in which the evidence for the drug is assumed to be established, are often prioritised over research use. In this manuscript, we present a case of (...) a phase II investigational trial of intravenous thiamine for delirium prevention in patients undergoing haematopoietic stem cell transplantation to emphasise several shortcomings in the overarching prioritisation of clinical over research uses of scarce drugs. Specifically, we present the following considerations: clinical use may not have stronger evidence than research use; a strong scientific rationale for research use may outweigh the claim for clinical indications in which there is weak evidence; treatment within the context of a clinical trial may be the standard of care; and research use may not only benefit patients receiving the treatment but also offers the prospect of improving future clinical care. In summary, we argue against allocation schemes that prohibit all research uses of scarce drugs and instead recommend that allocation schemes include a balanced approach that weighs risks and benefits of access to scarce drugs irrespective of the research versus clinical use designation. (shrink)

Acts of violence and murder have historically proved difficult to accommodate in standard accounts of the formula of universal law (FUL) version of Kant’s Categorical Imperative (CI). In “Murder and Mayhem,” Barbara Herman offers a distinctive account of the status of these acts that is intended to be appropriately didactic in comparison to accounts like the practical contradiction model. I argue that while Herman’s account is a promising one, the distinction she makes between coercive and non-coercive violence and her response (...) to concerns with the classification of the latter as imperfect duties raise significant questions about the status of some duties. I suggest that we look, instead, to Kant’s treatment of suicide in The Metaphysics of Morals for an account of norms of non-violence and, in particular, to the connection between this duty and concerns with inner freedom and moral health. I argue that we can use this account to inform our general understanding of duties prohibiting killing and violence, and that the resulting account is a promising one. (shrink)

The almost 300 articles contain not only historical accounts but also some indication of the state of present day study in classical philosophy.

There is a familiar problem in moral theories that recognize positive obligations to help others related to the practical room these obligations leave for ordinary life, and the risk that open-ended obligations to help others will consume our lives and resources. Responding to this problem, Kantians have tended to emphasize the idea of limits on positive obligations but are typically unsatisfactorily vague about the nature and extent of these limits. I argue here that aspects of Kant’s discussion of duties of (...) virtue owed to ourselves suggest a useful metric we can use in discussing these limits and that generalizing this account and combining it with elements of Barbara Herman’s view, offers us an attractive model of moral deliberation with the resources we need to engage the critic’s challenge properly. (shrink)

Immanuel Kant was a German philosopher. He is a central figure of modern philosophy, and set the terms by which all subsequent thinkers have had to grapple. He argued that human perception structures natural laws, and that reason is the source of morality. His thought continues to hold a major influence in contemporary thought, especially in fields such as metaphysics, epistemology, ethics, political philosophy, and aesthetics.

The early essays in this volume proceed on the assumption that a compatability system can be fashioned that will not only bring religious knowledge claims into harmony with scientific claims, but will also show there to be a fundamental similarity of method in religious and scientific thinking. They are not, however, unambiguously successful. Consequently Wiebe sets out in the succeeding essays to seek an understanding of the religion/science relationship that does not assume they must be compatible. The examination, in the (...) final analysis, reveals a fundamental contradiction in the compatability system building programme which suggests that religious belief is beyond legitimation. (shrink)

Understanding Hume’s theory of space and time requires suspending our own. When theorizing, we think of space as one huge array of locations, which external objects might or might not occupy. Time adds another dimension to this vast array. For Hume, in contrast, space is extension in general, where being extended is having parts arranged one right next to the other like the pearls on a necklace. Time is duration in general, where having duration is having parts occurring one aft (...) er another like the notes of a song. Hume’s diff erent view stems from his empiricism, his reliance on experience and observation as the foundation of our concepts. Nothing in our experience suggests a single vast array of locations. Rather, we simply notice that bodies are similar insofar as they have lengths that can be compared. Likewise, nothing in our experience suggests a single dimension of time. Rather, we simply notice that diff erent successions are similar insofar as they have durations that can be compared. Th eorizing that these observations show there to be a single multidimensional array goes well beyond the evidence for Hume. As a skeptic, he fi nds himself unable to assent to theories that stray too far beyond the deliverances of the senses. For Hume, the ideas of space and time are each a general idea of simple—partless— objects arrayed in a certain manner. He argues that the structures of the ideas of space and time refl ect the structures of space and time. Th erefore, space and time are not infi - nitely divisible, and they are ways simple objects are arrayed. Consequently, there is no such thing as empty space nor time without change. (shrink)

David Hume is famous as a sceptical philosopher but the nature of his scepticism is difficult to pin down. Hume's True Scepticism provides the first sustained interpretation of Part 4 of Book 1 of Hume's Treatise: his deepest engagement with sceptical arguments, in which he notes that, while reason shows that we ought not to believe the verdicts of reason or the senses, we do so nonetheless. Donald C. Ainslie addresses Hume's theory of representation; his criticisms of Locke, Descartes, (...) and other predecessors; his account of the imagination; his understanding of perceptions and sensory belief; and his bundle theory of the mind and his later rejection of it. (shrink)

The DSM-5 Alternative Model for Personality Disorders dimensionally defines personality pathology using severity of dysfunction and maladaptive style. As the empirical literature on the clinical utility of the AMPD grows, there is a need to examine changes in diagnostic profiles and personality expression in treatment over time. Assessing these changes in individuals diagnosed with borderline personality disorder is complicated by the tendency for patients to cycle through multiple therapists over the course of treatment leaving the potential for muddled diagnostic clarity (...) and disjointed case conceptualizations. Following patient trajectories across therapists offers a unique opportunity to examine the AMPD’s sensitivity to and utility for capturing personality stability and change over time for patients with BPD. This article demonstrates the utility of the AMPD for two clinical cases in three distinct ways: highlighting heterogeneity in BPD between patients, comparing improvements in personality severity and style over time, and elucidating profile change across therapist ratings. We present two patients diagnosed with DSM-5 Section II BPD, crossing between two therapists over the course of 3 years of psychodynamic psychotherapy. Treating clinicians rated patients for their respective treatment phases using the Level of Personality Functioning Scale, capturing severity, and the Personality Inventory for the DSM-5, capturing style. AMPD diagnostic profiles differentiated patients with BPD in both severity and style, and captured within-patient change beyond within-therapist response bias. Results indicated greater improvements in personality severity while personality style remained more stable. Implications for the patients’ treatment progress and associated challenges are discussed, as are considerations for the utility of the AMPD in therapy. (shrink)

The first view I shall investigate holds that the art form of tragedy expresses or contains certain eternal, acultural, and ahistorical facts which are "tragic" and present as such in the real or extra-artistic worlds; these facts are merely composed in tragedy as its content such that tragedy may be said to embody some perennial statement or thought about the things that are. The assumption here is that "tragedy" is a noun which can literally be applied to describe certain facts (...) or events we encounter in the everyday world. This term has been more specifically understood to refer to the fact of death , to a way of existence or human existence generally, or to a relationship existing between man and the world, or man and other men, or man and himself . Though tragedy certainly has its preferred topics, and these have sources in a world outside any given world which the particular tragedy constructs, there is surely a distinction between the world in general, with its facts, relationships, significances, and interpretations, and the particular world created by a given tragedy. This purely aesthetical creation of its own facts, relationships, significances, and interpretations is what I shall henceforth call the worked world of tragedy. Leon Rosenstein is currently working on "Hegelian Sources of Freud's Social and Political Philosophy," a four-article series to appear during 1977. He is an associate professor of philosophy at San Diego State University. (shrink)

Let me repeat one of my main points of my article: that "all three subjects of tragedy—plot, character, and thought—are reciprocal and correlative concretizations of a particular action and that thought bears this relation and makes its appearance with respect to each . . . in a definite way."1 This would be "understanding the interdependence or reciprocity of the three objects of imitation as functioning dynamically within an organic unity" . Thus, in one of the instances to which Ford refers, (...) the question I raise as to disjunction of the three subjects of tragedy is not a question for me at all, except rhetorically, since it is based upon the suggestion of Jones, a view which I reject, but the mention of which allowed me to consider its possibilities first. In the other instance, and again with respect to Jones, the "double awkwardness" to which Jones originally refers is alleviated through clarification and interpretation by Jones himself, whose position in this matter I expand upon and interpret more widely. Thus, there is no "disjunction," and there is no "doubleness" of plot and action, nor, as I myself went on to show, any tripleness and quadrupleness either in relation of action, plot, character, and thought. Really, what we have here are different ontological orders of the subject of tragedy, a relation between the general and specific, the abstract and concrete, the concept and its instance, a relation like that of energy to the incandescent light . · 1. "On Aristotle and Thought in the Drama," Critical Inquiry 3 : 561. Leon Rosenstein is an associate professor of philosophy at San Diego State University. (shrink)

For most of the two hundred years or so that have passed since the publication of the Wealth of Nations, Adam Smith's writings on political and economic questions have been viewed within a liberal capitalist perspective of nineteenth- and twentieth- century provenance. This essay in interpretation seeks to provide a more historical reading of certain political themes which recur in Smith's writings by bringing eighteenth-century perspectives to bear on the problem. Contrary to the view that sees Smith's work as marking (...) the point at which 'politics' was being eclipsed by 'economics', it claims that Smith has a 'politics' which goes beyond certain political attitudes connected with the role of the state in economic affairs. It argues that he employs a consistent mode of political analysis which cannot be encompassed within the standard liberal capitalist categories, but can be understood by reference to the language and qualities of contemporary political debate, and of the eighteenth-century science of politics cultivated by Montesquieu and, above all, Hume, particularly as revealed by recent scholarship. A concluding chapter draws the various strands of the interpretation together to form a portrait of what Smith might legitimately be said to have been doing when he wrote on these matters. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Medieval Troubadour Mobilized in the French Resistance *Roy RosensteinIntroduction: The Place of Poetry under VichyRien ne semblait plus anachronique que d’interroger, inter arma, le silence des Muses médiévales....Frank 1In Chantons sous l’occupation André Halimi details how raucously the band played on in wartime Paris. 2 If Vercors in 1941 advocated the practice of silence and Sartre in 1945 maintained that Paris had been dead for the four years (...) of the Nazi occupation, Halimi and others have shown that Parisians [End Page 499] sang, danced, and laughed during the Occupation as never before. 3 Rarely had so many plays been staged, so many movies been produced. 4 While in other Nazi-occupied countries the theaters and restaurants remained closed, thus preserving a modicum of national dignity in defeat, in France the arts thrived and la vie mondaine accelerated its pace. Journalist Henri Amouroux rightly explains how cinema and theater provided more than entertainment and why they were periodically the target of curfews. In these wartime performances a seemingly insignificant phrase could take on a rich contemporary context. Thus a line like “toute la fleur du royaume se trouve en prison” in Montherlant’s La reine morte invariably provoked applause. Whether the text was classical or contemporary in origin, the audience “seized upon all the passages that could be linked to the current situation.” 5 In this broad sense, Resistance literature came to include any “poetry written and/or distributed in France during the Occupation, and which the reader sees as implicitly or explicitly conveying hostility to Nazism and Collaboration.” 6Between 1940 and 1944 French audiences escaped their national misfortunes more through literature than through film and drama combined. “Never, perhaps, had literature played such a momentous part in the daily life of French readers,” wrote the late Henri Peyre in 1945. 7 As is often noted, the intellectual Resistance “fut surtout poétique.” 8 Every page of poetry, past or present, seemed to remind wartime readers of their current circumstances. One young poète résistant is categorical: “Never before had poetry played such a decisive role in history.” 9 Pierre Brunel of the Sorbonne is just as emphatic in confirming [End Page 500] the judgment of contemporary scholars and Resistance fighters alike: “During the war years, French poetry found a singleness of purpose and an audience that it had never enjoyed before.” 10In anticipation of more comprehensive treatments of French Resistance poetry sens large, the present study proposes a necessarily modest and certainly partial approach to the role of poetry in the French Resistance. Following the general groundwork of Seghers, Gaucheron, Higgins, and others, it undertakes to track, if only schematically, the reaction to France’s fall as polarized across three territories—in American exile, in Vichy France, and in German camps—through a focus on one exemplary twelfth-century troubadour. Concurrently with the “nouvelle floraison poétique” hailed by André Rousseaux in 1941, 11 Jaufre Rudel was one earlier poet who enjoyed a resurgence of interest during the war. With respect to this troubadour, to date only Dietmar Rieger has mentioned in passing an oblique reference to Rudel’s trademark distant love in Aragon’s “Pour un chant (national)”: “Jaufre’s love from afar is set against a love for France.” 12 This particular troubadour’s legend and lyrics assumed new dimensions through their immediate relevance not only for Aragon but for all French nationals, both imprisoned at home and exiled abroad. Literary historian René Dumesnil observed as early as 1941 with respect to pre-war French classics: “Present circumstances give them new depth and extend their range.” 13 Regarding France’s medieval literature, a modern critic has noted how “the troubadours, just as much as Tristan, Roland, Lancelot, Perceval, or even Yseult..., emerge as agents of unity, even of unanimity, around whom it is still possible to muster the French people in 1940.” 14 [End Page 501]As has been observed for centuries, “Frenchmen abroad seldom wholly give up the idea of going back to France some time or other.” 15 All French patriots and expatriates, wherever they found themselves after the Armistice in June 1940, whether... (shrink)

Argues that a pluralistic understanding of truth can foster productive conversations about common concerns involving religion, science, ethics, politics, economics, and ecology without falling into relativism. In this book, Donald A. Crosby defends the idea that all claims to truth are at best partial. Recognizing this, he argues, is a necessary safeguard against arrogance, close-mindedness, and potentially violent reactions to differences of outlook and practice. Crosby demonstrates how “partial truths” are inevitably at work in conversations and debates about religion, (...) science, morality, economics, ecology, and social and political progress. He then focuses on the concept in the discipline of philosophy, looking at a number of distinctions that are taken to be strictly binary—those between fact and value, continuity and novelty, rationalism and empiricism, mind and body, and good and evil—and demonstrates how in all of these cases, each on its own can offer only an incomplete picture. Partial Truths and Our Common Future invites ongoing dialogue with others for the sake of mutual enlargements of understanding rather than mere civility, and provides incentive for continuing open-minded and shared inquiries into the important issues of life. “This is a transdisciplinary philosophical work that moves with grace across traditions, time periods, and thinkers. It is a master class in the existential and public relevance of philosophy and a rare example of a book that is both timely and timeless.” — Michael S. Hogue, author of The Promise of Religious Naturalism. (shrink)

On Indic philosophy, classical literature, and modern Indian philosophers; contributed articles, with introductions to the contributors.