In The Community of Advantage, Robert Sugden advocates an opportunity-oriented framework for normative analysis, positions it a substitute for behavioral welfare economics, and criticizes the latte...

A selection of speeches and essays from the author's second decade as president of Yale University.

This article analyses domestic and foreign reactions to a 2008 report in the British Medical Journal on the complementary and, as argued, synergistic relationship between palliative care and euthanasia in Belgium. The earliest initiators of palliative care in Belgium in the late 1970s held the view that access to proper palliative care was a precondition for euthanasia to be acceptable and that euthanasia and palliative care could, and should, develop together. Advocates of euthanasia including author Jan Bernheim, independent from but (...) together with British expatriates, were among the founders of what was probably the first palliative care service in Europe outside of the United Kingdom. In what has become known as the Belgian model of integral end-of-life care, euthanasia is an available option, also at the end of a palliative care pathway. This approach became the majority view among the wider Belgian public, palliative care workers, other health professionals, and legislators. The legal regulation of euthanasia in 2002 was preceded and followed by a considerable expansion of palliative care services. It is argued that this synergistic development was made possible by public confidence in the health care system and widespread progressive social attitudes that gave rise to a high level of community support for both palliative care and euthanasia. The Belgian model of so-called integral end-of-life care is continuing to evolve, with constant scrutiny of practice and improvements to procedures. It still exhibits several imperfections, for which some solutions are being developed. This article analyses this model by way of answers to a series of questions posed by Journal of Bioethical Inquiry consulting editor Michael Ashby to the Belgian authors. (shrink)

Public health ethics is emerging as a new field of inquiry, distinct not only from public health law, but also from traditional medical ethics and research ethics. Public health professional and scholarly attention is focusing on ways that ethical analysis and a new public health code of ethics can be a resource for health professionals working in the field. This article provides a preliminary exploration of the ethical issues faced by public health professionals in day-to-day practice and of the type (...) of ethics education and support they believe may be helpful. (shrink)

Public health ethics is emerging as a new field of inquiry, distinct not only from public health law, but also from traditional medical ethics and research ethics. Public health professional and scholarly attention is focusing on ways that ethical analysis and a new public health code of ethics can be a resource for health professionals working in the field. This article provides a preliminary exploration of the ethical issues faced by public health professionals in day-to-day practice and of the type (...) of ethics education and support they believe may be helpful. (shrink)

Collected for the first time in a single volume are essays which examine the developments in three fundamental biological disciplines - embryology, evolutionary biology, and genetics. These disciplines were in conflict for much of the twentieth century and the essays in this collection examine key methodological problems within these disciplines and the difficulties faced in overcoming the conflicts between them. Burian skilfully weaves together historical appreciation of the settings within which scientists work, substantial knowledge of the biological problems at stake (...) and the methodological and philosophical issues faced in integrating biological knowledge drawn from disparate sources. The final chapter describes what recent findings in development biology and genetics can tell us about the history and development of animals. Written in a clear, accessible style this collection should appeal to students and professionals in philosophy of science, and the philosophy and history of biology. (shrink)

En este artículo se analiza el proceso de formación de la nacionalidad latinoamericana, así como las pistas que ayuden a descubrir las características de nuestra identidad, reconociendo el mestizaje como definitorio de nuestro ser y quehacer como latinoamericanos. Se advierten las potencialidades que se desprenden de la riqueza que significa la diversidad étnica y cultural de la región. La integración de América Latina es vista como un reto que nuestros pueblos deben asumir, partiendo de una concepción que supere la visión (...) puramente economicista y se afirme en la dimensión humana y solidaria. Finalmente se examinan las tareas que las universidades deberían asumir para contribuir a hacer realidad ese desafío, tales como auspiciar estudios e investigaciones interdisciplinarias sobre las posibilidades de diseñar un proyecto latinoamericano de Desarrollo Humano, Endógeno y Sostenible, además de contribuir a crear una conciencia integracionista y establecer institutos de estudios latinoamericanos, entre otros aspectos. (shrink)

In his article “Storied Bodies, or Nana at Last Unveil’d” , Peter Brooks makes the claim that, for a certain dominant mode of nineteenth-century narrative, the female sexual organ is the occult source of the narrative dynamic. On a superficial reading, Brooks’s piece might appear to empower women by putting their sexuality at the generative origin of the story. But the opposite is the case: his argument reflects rather than critiques the misogynist strategies of the texts he discusses. I will (...) begin my analysis of his article with a brief return to the story by Barbey d’Aurevilly whose climactic scene Brooks offers as “a kind of allegory of the cultural story [he has] been delineating” . Charles Bernheimer is professor of romance languages and chair of the program in comparative literature and literary theory at the University of Pennsylvania. The author of Flaubert and Kafka and Figures of Ill Repute , he is currently working on a study of fin-de-siècle literature and art, The Decadent Subject. (shrink)

BackgroundFear of abandonment and aloneness play a key role in the clinical understanding interpersonal and attachment-specific problems in patients with borderline personality disorder and has been investigated in previous functional Magnet Resonance Imaging studies. The aim of the present study was to examine how different aspects of attachment representations are processed in BPD, by using for the first time an fMRI attachment paradigm including personalized core sentences from the participants’ own attachment stories. We hypothesized that BPD patients would show increased (...) functional involvement of limbic brain regions associated with fear and pain when presented personalized attachment relevant stimuli representing loneliness compared to healthy controls.MethodsWe examined the attachment classifications of 26 female BPD patients and 26 female HC using the Adult Attachment Projective Picture System. We used an fMRI-adapted attachment paradigm to investigate the neural correlates of attachment. All participants were presented three personalized sentences extracted from their AAP attachment narrative, combined with standardized AAP pictures representing being alone or in interactive attachment situations.ResultsAs expected, the classification of unresolved attachment was significantly greater in BPD compared to HC. BPD patients showed increased fMRI-activation in brain areas associated with fear, pain, and hyperarousal than HC when presented with personalized attachment-relevant alone stimuli. In particular, pictures with monadic attachment situations induced greater anterior medial cingulate cortex, anterior insula, amygdala, thalamus and superior temporal gyrus activation in the patient group.ConclusionThe results point to increased fMRI-activation in areas processing emotional distress and painful experiences in BPD patients. In particular, the emotional cascade reflecting attachment distress was evoked by combining monadic pictures, representing abandonment and aloneness, with the patients’ personalized narrative material. Our results confirmed and replicated previous results that illustrate once again the high relevance of aloneness and feelings of abandonment for BPD in the context of attachment trauma. Moreover, our results support the hypothesis of hypermentalization in response to attachment distress as a core feature of social-cognitive impairment in BPD associated with common treatment implications across different therapeutic orientations. (shrink)

The Rebellion of Muḥammad al-Nafs al-Zakiyya in 145/762: Ṭālibīs and Early ʿAbbāsīs in Conflict. By Amikam Elad. Islamic History and Civilization, vol. 118. Leiden: Brill, 2016. Pp. xi + 527. $245, €176.

From one of our most outspoken feminist critics, this collection explores various ways in which the body can be rethought of as a site of knowledge rather than as a medium to move beyond or dominate.

Charles Bernheimer described decadence as a "stimulant that bends thought out of shape, deforming traditional conceptual molds." In this posthumously published work, Bernheimer succeeds in making a critical concept out of this perennially fashionable, rarely understood term. Decadent Subjects is a coherent and moving picture of fin de siècle decadence. Mature, ironic, iconoclastic, and thoughtful, this remarkable collection of essays shows the contradictions of the phenomenon, which is both a condition and a state of mind. In seeking to (...) show why people have failed to give a satisfactory account of the term decadence, Bernheimer argues that we often mistakenly take decadence to represent something concrete, that we see as some sort of agent. His salutary response is to return to those authors and artists whose work constitutes the topos of decadence, rereading key late nineteenth-century authors such as Nietzsche, Zola, Hardy, Wilde, Moreau, and Freud to rediscover the very dynamics of the decadent. Through careful analysis of the literature, art, and music of the fin de siècle including a riveting discussion of the many faces of Salome, Bernheimer leaves us with a fascinating and multidimensional look at decadence, all the more important as we emerge from our own fin de siècle. (shrink)

Erich Bernheimer verfolgt mit dem hier vorliegenden Werk - anknüpfend an die Ästhetik des Naturphilosophen Gustav Fechner - "die analytische Durchforschung der Faktoren des ästhetischen Genusses, die Fechner in seiner `Vorschule der Ästhetik' begonnen hatte... fortzusetzen und die Faktoren brauchbar zu kategorisieren" (Vorwort) anhand der beiden Teile "die Kunstbetrachtung" und "Das Kunstschaffen", untersucht dabei z. B. die Arten der Kunstbetrachtung, Normen und Werte für den Betrachtenden, die Dynamik des Kunstschaffens, Werte und Normen des Schaffens und noch weitere Gesichtspunkte. Nachdruck (...) der Originalausgabe aus dem Jahr 1913. (shrink)

"Ce livre propose une enquête philosophique explorant le rapport à la mort dans nos sociétés. C’est une invitation à penser les liens humains à la fin de la vie. On évoque les liens intimes, mais également les liens sociaux encadrés par la loi. Dans un tel contexte, comment discerner les raisons anciennes et nouvelles convenant au bien de la cité? L’ouvrage s’adresse aux accompagnants en soins palliatifs. Il concerne également toute personne soucieuse pour elle-même et ses proches de réfléchir à (...) son voyage au bout de la vie. Nous sommes mortels, nous le savons et le fil de nos existences provoque des occasions de nous le rappeler. Dans la solitude de mourir s’inscrit l’appel à la compassion. Ainsi, pour les Grecs de l’Antiquité, l’image de la cigogne symbolisait la prise en charge des vieux par les jeunes, un signe de l’amitié politique. L’émergence de la culture palliative est intimement liée aux changements qui ont affecté l’évolution récente de la vie démocratique. Cette culture est née et s’est développée dans des circonstances politiques particulières. À l’observer, on peut déchiffrer certains codes de notre vie civique, ses aspirations, mais aussi ses ambiguïtés. Louis-André Richard propose d’examiner les questions actuelles en compagnie de Platon, d’Aristote, d’Augustin ou de Tocqueville. Grâce à eux, la philosophie, symbolisée par la sagesse de Minerve, est mise à contribution pour explorer la genèse et les métamorphoses de concepts comme la dignité et l’autonomie. Comment se déploie la dynamique de la raison et de la liberté à l’heure de notre mort? Tel est l’enjeu pour les roseaux pensants que nous sommes. Si notre frêle espèce appelle à la sollicitude de la cigogne, elle ne saurait négliger de convoquer aussi la sagesse de Minerve."--Résumé de l'éditeur. (shrink)

Introduction : a framework for public health ethics -- Moral considerations : bases and limits for public health -- The political and legal context of public health ethics -- Public health perspectives -- Surveillance and public health data : the foundation and eyes of public health -- Case finding : screening, testing, and tracing -- Immunization : protection through vaccination -- Containing communicable diseases : personal control measures -- Health communication -- Public health and the environment.

Amyotrophic lateral sclerosis (ALS; also called motor neuron disease) is a devastating medical condition that progressively robs patients of their ability to move, speak and eventually breathe. At present, many physicians are hesitant to propose tracheostomy and respiratory support in the terminal phase of ALS. In accordance with the principle of patient autonomy, physicians should respect the right of the ALS patient to accept or refuse any treatment, including mechanical ventilation. Also, in environments where euthanasia or physician-assisted death is legal, (...) such requests can be acceptable. At least two conditions are necessary for full autonomy. To have a claim on full autonomy, people need to have intact cognitive abilities, and to exercise this right they must be able to communicate. In the past, the first condition was in doubt (indeed, overlap with other neurodegenerative diseases is sometimes suspected and some patients with ALS are thought to have associated frontotemporal dementia) and the second was severely compromised in patients with devastating motor impairment (communication being limited to the twitch of a finger or the blink of an eye). In this issue of J Neurol Neurosurg Psychiatry, Lakerveld and colleagues1 investigated cognition in 11 patients with late stage ALS (see page 25). They showed preserved cognitive functioning (ie, language, executive function, intelligence, learning and long term memory) compared with healthy controls. Assessments were exclusively based on a ‘‘yes–no’’ response mode. Because of the absence of verbal and motor communication, the neuropsychological assessment of these patients is complicated, and adapted testing is needed. By using a ‘‘yes–no’’ response mode based on the remaining motor abilities of the patient, this study proves the possibility of assessing patients with minimal motor capacities. (shrink)

Les périodes de confinement sont des moments éprouvants. On a la sensation de perdre nos repères. Nous nous sentons déboussolés. On peut cependant saisir l’occasion de faire le point. Sous le regard de la réflexion philosophique, ce petit livre est une tentative pour éviter de perdre le nord. L’auteur propose de courtes réflexions puisées à même la littérature philosophique. Sans prétention, il s’agit de fournir des pistes rendant intelligibles nos conditions d’êtres confinés.

This paper explores the use of an ethics framework based on the Public Health Code of Ethics to guide rationing decisions during a pandemic flu crisis involving a shortage of ventilators. While the law provides public health officials with authority to act, public health officials, as community leaders and health department managers, must address complex questions about how they should use their legal authority, how they can ethically justify a particular action, how they should engage community stakeholders in decision making, (...) and how the process of public justification should take place. Recognising the need for a tool that could help public health officials manage ethical tensions in practice, such as allocation of scarce resources, the Public Health Leadership Society led efforts to develop a Public Health Code of Ethics. The 12 Principles in the Code were written to express the general norms implicit in the practice of public health professionals. The Code offers no hierarchical weighting of the different principles and anticipates that weights and specification of the principles would take place in the context of each community through a process of engagement between public health officials and community stakeholders about specific cases. We describe how public health officials can use the Code to guide deliberation in helping communities prepare to address the tragic choices when allocating scarce ventilators in an influenza pandemic. (shrink)