BackgroundMedical ethics has recently seen a drive away from multiple prescriptive approaches, where physicians are inundated with guidelines and principles, towards alternative, less deontological perspectives. This represents a clear call for theory building that does not produce more guidelines. Phronesis (practical wisdom) offers an alternative approach for ethical decision-making based on an application of accumulated wisdom gained through previous practice dilemmas and decisions experienced by practitioners. Phronesis, as an ‘executive virtue’, offers a way to navigate the practice virtues for any (...) given case to reach a final decision on the way forward. However, very limited empirical data exist to support the theory of phronesis-based medical decision-making, and what does exist tends to focus on individual practitioners rather than practice-based communities of physicians.MethodsThe primary research question was: What does it mean to medical practitioners to make ethically wise decisions for patients and their communities? A three-year ethnographic study explored the practical wisdom of doctors (n = 131) and used their narratives to develop theoretical understanding of the concepts of ethical decision-making. Data collection included narrative interviews and observations with hospital doctors and General Practitioners at all stages in career progression. The analysis draws on neo-Aristotelian, MacIntyrean concepts of practice- based virtue ethics and was supported by an arts-based film production process.ResultsWe found that individually doctors conveyed many different practice virtues and those were consolidated into fifteen virtue continua that convey the participants’ ‘collective practical wisdom’, including the phronesis virtue. This study advances the existing theory and practice on phronesis as a decision-making approach due to the availability of these continua.ConclusionGiven the arguments that doctors feel professionally and personally vulnerable in the context of ethical decision-making, the continua in the form of a video series and app based moral debating resource can support before, during and after decision-making reflection. The potential implications are that these theoretical findings can be used by educators and practitioners as a non-prescriptive alternative to improve ethical decision-making, thereby addressing the call in the literature, and benefit patients and their communities, as well. (shrink)

Ethical decision making in medicine has recently seen calls to move towards less prescriptive- based approaches that consider the particularities of each case. The main alternative call from the literature is for better understanding of phronesis concepts applied to decision making. A well-cited phronesis-based approach is Kaldjian’s five-stage theoretical framework: goals, concrete circumstances, virtues, deliberation and motivation to act. We build on Kaldjian’s theory after using his framework to analyse data collected from a three-year empirical study of phronesis and the (...) medical community. The data are a set of narratives collected in response to asking a medical community what making ethically wise decisions means to them. We found that Kaldjian’s five concepts are present in the accounts to some extent but that one of the elements, motivation, is constructed as playing a different, though still crucial role. Rather than being an end-stage of the process as Kaldjian’s framework suggests, motivation was constructed as initiating the process and maintaining the momentum of taking a phronesis-based approach. The implications for medical ethics decision-making education are significant as motivation itself is a highly complex concept. We therefore theorise that motivation is required for leading in, continuing and completing the actions of the ethical decision taken. Appreciating the central importance of motivation through the whole of Kaldjian’s framework has implications for cultivating the virtues of phronesis and courage to take the right course of action. (shrink)

Jean Baudrillard is widely recognized as one of the most important and provocative writers of our age. Variously termed “France’s leading philosopher of postmodernism” and “a sharp-shooting Lone Ranger of the post-Marxist left,” he might also be called our leading philosopher of seduction or of mass culture. Following his acclaimed _America_ and _Cool Memories_, this book is the third in a series of personal records in hyperreality. Idiosyncratic, outrageous, and brilliantly original, Baudrillard here casts his net widely and combines autobiographical (...) memories with further reflections on America, the crisis of cultural production, new ideas in fiction/theory, and the “verbal fornication” of the postmodern. In this wide-ranging discussion of events and ideas, Baudrillard moves between poetry and waterfalls, strikes and stealth bombers, Freud and La Cicciolina, shadows and simulacra, deconstruction and the zodiac, Reagan’s smile and Kennedy’s death, the “curse” on South America and the future of the West, the last tango of French intellectual life and the exemplary disappearing act of Italian politics. Writing at the site where the philosophic and the poetic merge, he once again offers us commentary in the form of the riveting insight, the short distillation of reality that establishes its truth with the force of recognition. _Cool Memories II_, Baudrillard’s latest commentary on the technopresent and future, an installment of his reflections on the reality of contemporary western culture, will entice all readers concerned with postmodernism and the current state of theory. (shrink)

Writing in 2007, French social philosopher André Gorz was remarkably prophetic, foretelling the international economic meltdown of 2008: “The real economy is becoming an appendage of the speculative bubbles sustained by the finance industry—until that inevitable point when the bubbles burst, leading to serial bank crashes and threatening the global system of credit with collapse and the real economy with a severe, prolonged depression.” This prescient article is collected in _Ecologica _alongside many of Gorz’s final writings and interviews, which together (...) offer practical and often path-breaking set of solutions to our current economic and political problems. In his writings Gorz condemns the speculative global economic system and anatomizes its terminal crisis. Advocating an exit from capitalism through the self-limitation of needs and the networked use of the latest technologies, he outlines a practical, democratically based solution to our current predicament. Compiled by Gorz, _Ecologica_ is intended as a final distillation of his work and thought, a guide to the survival of our planet. It is a work of _political, _rather than scientific ecology—Gorz aruges that the key to planetary survival is not a surrender to environmental experts and eco-technocrats, but a switch to non-consumerist modes of living that would amount to a type of cultural revolution. Praise for André Gorz “To my mind the greatest of modern French social thinkers.”—Herbert Gintis, author of _Schooling in Capitalist America_ “Gorz’s work was always within the Utopian tradition—a label he welcomed but which was used pejoratively by his opponents.... Many of his derided early warnings about globalization and environmental degradation have become commonplace discourses in political debates today. Ultimately, Gorz’s Utopianism was expressed in a very practical sense—we never know how far along the road we are if we have no idea of the destination.”—_Independent _ __. (shrink)

In recent years, social workers have raised a new concern about the appearance of a new category among the working poor. Even employed, there are people so overburdened by the cost of living and so under compensated that they cannot afford a place to sleep. Contrary to popular opinion, according to the website for the Coalition for the Homeless, forty-four percent of the homeless in first world countries actually have jobs. In _No Fixed Abode_, Marc Augé’s pathbreaking ethnofiction—a fictional ethnography—a (...) man named Henri narrates his strange existence in the margins of Paris. By day he walks the streets, lingers in conversation with the local shopkeepers, and sits writing in cafés, but at night he takes shelter in an abandoned house. From here, we see a progressive erosion of Henri’s identity, a loss of bearings, and a slow degeneration of his ability to relate to others. But then he meets the artist Dominique, whose willingness to share her life with him raises questions about who he has become and about what a person needs in order to be a part of society. This is a book about how we live in geographical space and how work and patterns of domicile affect our status and our inner being. Despite the apparent simplicity of the fictional premise, Augé’s book asks serious questions about the nature of our culture. (shrink)

Philosopher Jean-Paul Sartre counted among his friends and associates some of the most esteemed intellectuals, writers, and artists of the twentieth century. In _Portraits_, Sartre collected his impressions and accounts of many of his notable acquaintances, in addition to some of his most important writings on art and literature during the early 1950s. _Portraits_ includes Sartre’s preface to Nathalie Sarraute’s _Portrait of a Man Unknown_ and his homages to André Gide, Albert Camus, and Maurice Merleau-Ponty. The essay on Merleau-Ponty casts (...) considerable light on the recent history of French philosophy, particularly with regard to dominant post-war political conceptions. Featured as well are lengthy studies of Sartre’s close friend Paul Nizan and of the young André Gorz that are no less revealing, as well as Sartre’s “Reply to Albert Camus,” which sealed the ideological and personal break between the two writers on its publication in 1952. Alongside these major writings are fascinating articles on Tintoretto and a number of contemporary artists, including Giacometti and Masson. Finally, _Portraits _concludes with two travelogue-style accounts of Sartre’s time in Italy. This new translation by Chris Turner presents these essays in their complete form as originally intended by Sartre when he first published _Situations IV_ in France and is thus essential reading for anyone interested in the artistic and intellectual history of the time. (shrink)

As a maverick philosopher unafraid of challenging the ideas and methods of his colleagues, Clément Rosset’s work attempts to connect sometimes-lofty academic philosophy with the concerns of everyday life. For decades, he has worked to illuminate some of the most obscure metaphysical issues, often using popular film, theatre, novels, and comic books to illustrate his ideas, and as a result he has gained a reputation as both a happy sage and a singular mind. In _The Real and Its Double,_ expertly (...) translated by Chris Turner, Rosset takes on the question of the Real and humanity’s natural ability to sidestep and bypass it. The key to this type of evasion, Rosset suggests, is a certain form of oracular thinking that lies buried in the origins of Western metaphysics and psychology. Here, Rosset eschews the prolix and paradoxical psychological theories of Derrida and Lacan in favor of an exceptional lucidity that speaks to his Nietzschean-tragic love of life. If good philosophy can be defined as expressing complicated things in a simple way, then here, in one of his best-known works, Rosset has proven himself a master. (shrink)

A prolific essayist, novelist, translator, philosopher, and a critic of rare elegance, Pascal Quignard returns anew to the major questions of existence in _The Silent Crossing_, a haunting homage to life and liberty, to society and solitude, and to the binding and unbinding that constitute the weft of our lives. Drawing on materials from across many cultures, Quignard makes an effort to establish shared human values as the breeding ground for a modern Enlightenment. Considering atheism as a spiritual liberation, suicide (...) as a free act, and the rejection of society as a free choice, the author explores philosophical themes that have run through human civilizations—most often as heresies—from our earliest days. In his search for freedom, Quignard questions the binding dependency of religion, querying how, in a world where all forms of society presuppose that someone is looking over our shoulders, we can be free. These reflections, he implies, are the essential spiritual exercise for our times. Few voices in contemporary French literature are more distinct than that of Quignard. By reading this fragmentary, episodic assemblage of intimate experiences and borrowed tales, we open up a space of liberty, creating for the reader space for meditation and, perhaps, liberation. _“_Pascal Quignard is undoubtedly the most iconoclastic of contemporary French authors.”—Catherine Argand, _Lire_ “Quignard has redefined historical fiction as both hoax and enigma.”—_Burning Deck_ on _Wooden Tablets: Apronenia Avitia_. (shrink)

Chris Turner argues that Stephen Harper's attack on basic science, science communication, environmental regulations, and the environmental NGO community is the most vicious assault ever waged by a Canadian government on the fundamental principles of the Enlightenment. From the closure of Arctic research stations as oil drilling begins in the High Arctic to slashed research budgets in agriculture, dramatic changes to the nation's fisheries policy, and the muzzling of government scientists, Harper's government has effectively dismantled Canada's long-standing scientific tradition. Drawing (...) on interviews with scientists whose work has been halted by budget cuts and their colleagues in an NGO community increasingly treated as an enemy of the state, The War on Science paints a vivid and damning portrait of a government that has abandoned environmental stewardship and severed a national commitment to the objective truth of basic science as old as Canada itself. (shrink)