This article is intended to revive, through a critical reinterpretation, the bio-psychosocial model of George Engel. Engel’s first description in 1977, was very broad, encompassing too many aspects of medicine. In his later work, he focused his model as an epistemology for clinical medicine. However, what medicine mostly retained were minor aspects of the 1977 article, namely a multi-factorial approach to the etiology of diseases and a call to complement biomedicine with a psychosocial concern in order to re-humanize medicine. We (...) suggest that, properly understood as a clinical epistemology, Engel’s model retains its transformative potential for contemporary medicine.Our discussion begins with a.. (shrink)

Objective journalism is blamed frequently for all sorts of journalistic failures and weaknesses, but the critiques typically are flawed because their authors fail to understand objectivity or to define it precisely. This defense of objective journalism defines objectivity and suggests that it is indispensable in a free society, summarizes major critiques of and alternatives to objectivity, and proposes that critics and defenders might serve journalism best by seeking common ground.

In many of his writings, Castoriadis argues that ‘the discovery of the imagination’ occurs in the works of Aristotle, Kant, Fichte, Freud, Heidegger and Merleau-Ponty. Although he has systematically encountered and interrogated the works of Aristotle, Kant, Freud, and Merleau-Ponty, the work of Fichte remains an enigmatic absence within the orbit of Castoriadis' work. This study is an attempt to address this enigma through a close reading of Fichte’s The Science of Knowledge.

Weiming’s program of overcoming the enlightenment mentality and throws a critical light on his conceptions of religious or spiritual Confucianism, of a Confucian modernity, and of the multiple modernities theory in general. It defends a unitary rather than multiple concept of modernity in terms of the realization of a morally controlled principle of free subjectivity and tries to show how Confucianism, understood as a secular ethics, could contribute to this goal.

Montaigne’s writings on medicine and the body have always been seen as part of a larger project about knowing ourselves. Responding to medical developments that seemed to privilege the anatomical body over the mind or the emotions, Montaigne defended the humoral link between mind and body. His essays make use of word play, puns, and anecdotes based on his own experience and reports from antiquity to counter what he perceived to be an increasingly one-sided approach to medicine. The result is (...) a witty but nuanced argument for a more balanced outlook to what is now known as psychosomatic medicine. (shrink)

Empirical studies show that though there is more room for improvement, much progress has been made toward gender equality since the second wave of feminism. Evidence also suggests that women’s advancements have been more dramatic in the public sphere of work and politics than in the private sphere of family life. We argue that this lopsided gender progress may be traced to uneven changes in gender attitudes. Using data from more than 27,000 respondents who participated in the General Social Survey (...) from 1977 through 2016, we show that gender attitudes have more than one underlying dimension and that these dimensions have changed at different rates over time. Using latent class analysis, we find that the distribution of respondents’ attitudes toward gender equality has changed over the past 40 years. There has been an increase in the number of egalitarians who support equality in public and private spheres, while the traditionals who historically opposed equality in both domains have been replaced by ambivalents who feel differently about gender equality in the public and private spheres. Meanwhile, successive birth cohorts are becoming more egalitarian, with Generation-Xers and Millennials being the most likely to hold strong egalitarian views. The feminist revolution has succeeded in promoting egalitarian views and decreasing the influence of gender traditionalism, but has yet to convince a substantial minority that gender equality should extend to both public and private spheres of social life. (shrink)

This paper examines the case of the internal auditor from a sociological and ethical perspective. Is it appropriate to extend the designation of professional to internal auditors? The discussion includes criteria from the sociology literature on professionalism. Further, professional ethical codes are compared. Internal auditors' code of ethics is found to have a strong moral approach, contrasting to the more instrumental approach of certified professional accountants. Internal auditors are noted as using their code of ethics to help resolve professional ethical (...) dilemmas. (shrink)

Critical reflection on the importance of shaping disability-friendly - or disability-inclusive - congregations has enjoyed increasing attention in the field of practical theology in recent years. Moreover, the development of disability theology is a testament to the fact that practical theologians and the wider church community have taken serious notice of the realities and experiences of people with disabilities in our time. Nevertheless, even before the task of engaging in theological reflection from a disability perspective commences, it is necessary that (...) theologians acquaint themselves with the various models of disability that shape people's perceptions and ideas about people with disabilities. Guided by the principles of the interpretive task of practical theological investigation and cognizant of the importance of models of disability in shaping perceptions regarding people with disabilities, this article seeks to provide a brief overview of nine of the most dominant models of disability that are prevalent in our time. We shall utilise the typological approach to theoretical analysis in order to outline the basic characteristics of the various models. (shrink)

Subjective experience is transformed into objective reality for societal members through cultural idea systems that can be represented with theory and data models. A theory model shows relationships and their logical implications that structure a cultural idea system. A data model expresses patterning found in ethnographic observations regarding the behavioral implementation of cultural idea systems. An example of this duality for modeling cultural idea systems is illustrated with Arabic proverbs that structurally link friend and enemy as concepts through a culturally (...) defined computational system. Computational systems also generate new concepts, as will be illustrated through a theory model for the structure of a .. (shrink)

The evolutionary trajectory from non-human to human forms of social organization involves change from experiential- to relational-based systems of social interaction. Social organization derived from biologically and experientially grounded social interaction reached a hiatus with the great apes due to an expansion of individualization of behaviour. The hiatus ended with the introduction of relational-based social interaction, culminating in social organization based on cultural kinship. This evolutionary trajectory links biological origins to cultural outcomes and makes evident the centrality of distributed forms (...) of information for both the boundary and internal structure of human societies as these evolved from prior forms of social organization. (shrink)

This article discusses ‘Notes on Language Games’, written by Harold Garfinkel in 1960 and never before published, one of three distinct versions of his famous ‘Trust’ argument, i.e., that constitutive criteria define shared events, objects, and meanings. The argument stands in contrast to an approach to cultural anthropology that was becoming popular in 1960 called ‘ethnoscience’. In this previously unknown manuscript, Garfinkel proposes that cultural events and language events are the same, in that both are created through constitutive commitments to (...) interactional systems. The best-known version of the Trust argument (Garfinkel, 1963) emphasizes Schutz, while other versions build on Parsons (Garfinkel 2019). In this third version, the Trust conditions are elaborated in terms of Wittgenstein’s language games. Various strands of Garfinkel’s thinking about culture, language and interaction are interwoven. That Garfinkel was working with Parsons in 1960 to document a contractual basis for social events and their assembly practices in ‘systems of interaction’, a constitutive practice argument with roots in Durkheim’s work, is yet another strand. The article highlights how the Trust argument is the key to everything, not only ethnomethodology, but also Garfinkel’s attempt to develop a general sociology of culture, language and interaction. (shrink)

The emergence of the virtual network enterprise represents a dynamic response to the crisis of the vertical bureaucracy type of business organisation. However, its key performance criteria—interconnectedness and consistency—pose tremendous challenges as the completion of the distributed tasks of the network must be integrated across the barriers of missing face-to-face clues and cultural differences. The social integration of the virtual network involves the creation of identities of the participating nodes, the building of trust between them, and the sharing of tacit (...) and explicit knowledge among them. The conventional organisation already doing well in these areas seems to have an edge when going virtual. The paper argues that the whole question of management and control must be reconsidered due to the particular circumstances in the ‘Network Society’. The paper outlines a suggestion for an exploratory, socio-technical research approach combining the dimensions of context, subject and action with the twin objectives of contributing to the enhancement of collaborative capabilities in virtual teams as well as improving the insights into the nature of virtual work. (shrink)

Contemporary sociosemiotics is a way to transcend borderlines between trends inside semiotics, and also other disciplines. Whereas semiotics has been considered as an interdisciplinary field of research par excellence, sociosemiotics can point directions at transdisciplinary research. The present article will try toconjoin the structural and the processual views on culture and society, binding them together with the notion of signification. The signification of space willillustrate the dynamic between both cultures and metacultures, and cultural mainstreams and subcultures. This paper pays attention (...) to the practice of sociocultural semiotisation of space and territorialisation by diverse examples and different sociocultural levels that imply semiotic cooperation between several members of groups that can be characterised as socii. We analyse territorialisation by graffiti, by furnishing spatial environment through artistic manners, by shaping the semiotic essence of cities through naming, renaming and translating street names, by pinning and structuring territories with monuments, by landmarking and mapping cultural space through individualisation of cities. We will see how principles of semiotisation of space are valid on different levels (individual and social, formal and informal, democratic and hegemonic, cultural and subcultural) and how these principles form a transdisciplinary object of study as ‘semiotisation of space’, and how space can be regarded as a genuinely transdisciplinary research object. Individual, culture, and society are connected in such an object both as constituents and as a background of study. (shrink)

Professor Rahn takes the approach to the analysis of Western art music developed recently by theorists such as Benjamin Boretz and extends it to address non-Western forms. In the process, he rejects recent ethnomusicological formulations based on mentalism, cultural determinism, and the psychology of perception as potentially fruitful bases for analysing music in general. Instead he stresses the desirability of formulating a theory to deal with all music, rather than merely Western forms, and emphasizes the need to evaluate an analysis (...) and compare it with other interpretations, and demonstrates how this may be done. The theoretical concepts which form the basis of Rahn's approach are discussed and applied: first to individual pieces of non-Western music which have enjoyed a fairly high profile in ethnomusicological literature, and second to repertoires or groups of pieces. The author also discusses the fields of anthropology and psychology, showing how his approach serves as a starting point for studies of perception and the concepts, norms, and values found in specific music cultures. In conclusion, he lists what he considers to be musical universals and takes up the more controversial issues implicit in his discussion. (shrink)

Name der Zeitschrift: Zeitschrift für Religionswissenschaft Jahrgang: 23 Heft: 2 Seiten: 258-284.

The issue of trust in the medical profession, in medical institutions, and in the healthcare system, implicitly, has been brought to the scientists’ attention lately, taking into account the erosion of trust, determined by the aggressive display in the media of medical personnel migration, of medical malpractice cases, of underfunding and bad management, of the high pressure on the system due to population ageing and to the increase in chronic disease incidence. Other explanations include the modifications in the attitudes, values, (...) and expectations of the public concerning the healthcare system, the emergence of private health insurances and of private institutions, and the erosion of trust in State institutions because of incertitude and economic crises. This paper seeks to pinpoint, in the scientific literature, the definition of trust in the healthcare system, the determinants of trust in the patient – physician – institution – system relationship and the importance of social capital in these types of relationships, as well as the way in which the relationship between the patient and the actors within the medical system is created and influences the patient’s quality of life in the context of chronic disease. (shrink)

The necessity of empirical research in the field of medical services provision is highlighted both by the numerous modifications within the legislative framework and by the dysfunctionalities within its existence. The study proposes to pinpoint the factors that may influence the quality of the physician–patient relationship. We identified factors at the level of communication between physician and patient, of empowering and involving the patient, of understanding the patient, of the patient’s way through the system, and of relating to a “second (...) opinion.” We also present solutions identified by physicians for optimising these relations. The study is based on the analysis of 12 interviews conducted with physicians within public and private institutions in Iaşi. The topics of discussion focused on the following aspects: physician–patient relationship, physician’s trust in the patient, particularities of trust relationship, patient empowerment and involvement, level of patient’s information, “the second opinion,” physician’s experience as a patient. The paper brings attention to the difficulties pinpointed by physicians, in their relation with both the institutions and the patients. The main aspects identified are related to the way in which the physician–patient relationship is shaped, to the difficulty of communicating the diagnosis. (shrink)

The United States National Preparedness System has evolved significantly in the recent past. These changes have affected the system structures and goals for disaster response. At the same time, actors such as private businesses have become increasingly involved in disaster efforts. In this paper, we begin to fill the gap in the cross-sector literature regarding interactions that have systemic impacts by investigating how the simultaneous processes of systemic change and intensifying cross-sector interaction worked and interacted in the context of the (...) preparedness system. We examine these inter-linkages through a qualitative study in the setting of Hurricane Sandy. Drawing from systems theory, we develop a grounded model that provides an explanation for the system change and highlights how cross-sector interaction relates to the changes observed in the system. (shrink)

Alfred Schutz''s influence on American sociologists and sociology in the 1960s and 1970s is traced through the examination of the work of two of his students, Helmut Wagner and Peter Berger, and of Harold Garfinkel with whom he met and corresponded over a number of years. The circumstances of Schutz''s own academic situation, particularly the short period of his academic career in the United States and his location at the New School, are examined to consider how and in what ways (...) he was constrained from exerting an even wider influence. The two major areas of influence in American sociology that are examined are the sociology of knowledge and the early development of ethnomethodology. (shrink)

Bhaskar's philosophy supports society via a process of homeostasis to resist socioecological system disintegration by developing its values and ethics in response to endogenous and exogenous change. To the contrary, positivist (first generation) and hermeneuticist (second generation) approaches to systems theory have distorted humanity's mechanism of homeostasis because, amongst other things, they disallow the use of facts to guide values/actions. Since acting on knowledge is, ceteris paribus, a given in Bhaskar's approach, resolving socioecological system problems involves correcting the method of (...) homeostasis (our method of finding knowledge and acting on it) rather than correcting the consequences of the failure of homeostasis (the poorly informed action or inaction). This is reminiscent of Gandhi's approach to social transformation in which we trust the means to arrive at appropriate ends and it releases activists from having to be keepers of the moral high-ground or having to try to change people's behaviour. (shrink)

This article uses Betty Friedan’s idiosyncratic invocations of heart disease in her work from the 1960s through the 1990s, as well as her autobiographical comments about it and her theory of the feminine mystique, to grapple with a feminist articulation of heart disease. Although this leading cause of death for women in industrialized countries has been peripheral to feminist health discourse and most women’s preoccupations, heart disease played an interesting narrative role in Friedan’s work and life. Drawing on Friedan’s unconventional (...) philosophy of health provides an opportunity to problematize health awareness and reconsider the role of disease and health in feminist critique more generally. As we try to understand gendered stories of disease that are emerging at the dawn of the 21st century, rereading Friedan can help illuminate the limits, possibilities and dangers of framing heart disease as a ‘women’s health issue’. (shrink)

This article begins with arguments evident at the time of writing about the 5th revision of the Diagnostic and Statistical Manual of the American Psychiatric Association. The historical lineages of those arguments are international and not limited to the USA. The concern with psychiatric diagnosis both internationally and in the USA came to the fore at the end of the Second World War with the construction of the American Psychiatric Association’s Diagnostic and Statistical Manual and the World Health Organization’s classification (...) of ‘Diseases, Injuries and Causes of Death’. However, the linkage between categories of morbidity, assumptions about natural biological categories and treatment specificity with ‘magic bullets’ emerged in the middle of the 19th century in physical medicine. This article explores the legitimacy of current psychiatric diagnoses in the light of that international, not national, history of medical knowledge. In conclusion it explores judgements about current cultural imperialism and an older picture of Eurocentrism, which is now being refracted in more recent globalizing knowledge-claims about mental disorder. (shrink)

This article stems from an awareness that the ‘European social model’ is marked – in the discourse that proposes it and in the policies that attempt to implement it – by an original combination of the dimensions of economic competitiveness and social cohesion. Today, this combination is in the midst of a crisis whose nature and outcome are variously interpreted, in politics as in social sciences. The current debate would have much to gain from the use of several classic analytical (...) categories, which, though well enough known, are rarely if ever applied in this context. After a schematic presentation of the characteristics that discussion of the European model has now assumed, an institutional approach to interpreting it will be proposed which revolves around the Weberian concept of ‘legitimate order’. Particular attention will be devoted to the organizational means whereby policies are formulated and pursued, and the territorial dimension of policies and their effects will be discussed. The concluding remarks will present policy implications and considerations concerning the present crisis and possible developments of the European model, elaborated on the basis of the proposed methodological approach. (shrink)

Drug use and drug addiction are severely stigmatised around the world. Marc Lewis does not frame his learning model of addiction as a choice model out of concern that to do so further encourages stigma and blame. Yet the evidence in support of a choice model is increasingly strong as well as consonant with core elements of his learning model. I offer a responsibility without blame framework that derives from reflection on forms of clinical practice that support change and recovery (...) in patients who cause harm to themselves and others. This framework can be used to interrogate our own attitudes and responses, so that we can better see how to acknowledge the truth about choice and agency in addiction, while avoiding stigma and blame, and instead maintaining care and compassion alongside a commitment to working for social justice and good. (shrink)

Radical uncertainty plays a major role in the transformation of the social production of knowledge by questioning the centrality of scientific-technical expertise. Important changes are occurring in the discursive and social divisions characterizing the production and management of knowledge, but the ability of these innovations to cope with the challenge of radical uncertainty is doubtful. This seems to call for a reassessment of the forms of knowledge-related social cooperation, but the late modern public sphere does not provide favourable conditions for (...) this endeavour. Is there a way out of this impasse? The answer is difficult and conditional on many factors. However, Dewey's theory of inquiry and of the public sphere may offer a useful standpoint for further investigation. (shrink)

Volume 19, Issue 12, December 2019, Page 49-51.

Artikkelen er en analyse av to formaliserte etiske retningslinjer som skal gjelde i norske akademiske institusjoner. Den ene er utarbeidet for forvaltningen og den andre for forskningen. Analysen gjøres ved å sammenligne to dokumenter som inneholder etiske retningslinjer. Videre knyttes analysen til ulike «etos» som skiller forvaltningen og forskningen. Artikkelen går særlig inn på normene lydighet og frihet, som framstår som mest motsetningsfylte når de «møtes» i akademia. Det drøftes hvordan dette påvirker legitimiteten til akademia.Nøkkelord: akademia, byråkrati, etos, forskningsetikk, forvaltningsetikkEnglish (...) summary: Ethics on a collision course – when bureaucratic ethics and research ethics meetThe article is an analysis of two formal ethical guidelines for Norwegian academic institutions. One is prepared for the governmental bureaucracy and the other is research ethics. The analysis is done by comparing two documents containing the code of conduct for each field. Further analysis is related to the differing «ethos» that separates the bureaucracy from the research. The article dwells on the norms of obedience and freedom that emerge as the most contradictory. The closing discussion is on how this affects the legitimacy of academia. (shrink)

By referring to mundane practices as well as to more systematic or theoretical discourses (those of Krishnamurti and Buber), this article shows the utility of focusing on the negatory, apophatic aspects of reflexivity, i.e. on attempts at removing obstacles (mainly thinking, decision-making processes) which prevent the spontaneous emergence of open-ended self—self and self—other relationships.

In this article, I investigate the process of coordination between three ‘bodies’ of surgery: the patient-ensemble(s) constructed in pre-operative activities; the surgeon-body constructed with these ensembles in the operating room; and the body-world inhabited by the surgeon. This investigation is done through an ethnography of a neurosurgical clinic, with an analytical focus on the relationship between the spatial configuration of the body of the surgeon and the embodied practices of operating that this configuration demands. My argument is that coordination between (...) those three bodies is organized in the layered space into which the multiple ensembles of surgery are assembled. This relationship, I suggest, lies at the core of the power and technical expertise held by surgeons, and constitutes a challenge for explorations of other forms of articulation between subject body-worlds and the embodiment of power in subject-bodies. (shrink)

The main aim of this article is to start a discussion of social pattern, a term that is commonly used in sociology but not specified or defined. The key question can be phrased as follows: Is it possible to transform the notion of social pattern from its current status in sociology as a proto-concept into a fully worked out concept? And if so, how can this be done? To provide material for the discussion we begin by introducing a few different (...) types of patterns that are currently being used (patterns in nature, cultural patterns, statistical patterns, and computationally generated patterns). This is followed by a suggestion for what a strictlysociologicalconcept of social pattern may look like. A useful and theoretically solid concept of social pattern can in our view be constructed by basing it on Weber’s concept of social action. This means thatboththe behavior of the actorsandthe meaning these invest their behavior with must be taken into account. The article ends with a brief discussion of how to use the concept of social patterns in an effective way and what may endanger such a use. (shrink)

Physicians often express frustration with the ‘system’ in which they work. Over time, this frustration may put them at risk of burnout and disengagement, which may impact patient care. In this study, we aimed to understand the nature of the system flaws that physicians identified in their published narratives and to explore their self-representation as agents of change. We reviewed all reflective narratives published in four medical journals between January 2015 and December 2017. By consensus, we identified those that addressed (...) system flaws. Using content and narrative analysis, we analyzed the types of flaws and the physicians’ orientation to the flawed system. We identified seven recurring system flaws—five related to medical culture: failures of communication, erosive impact of the hidden curriculum, inadequate health advocacy, frenzied pace of work, and experience of stigma. Less frequently, physicians’ narratives also exposed limited and disparate healthcare resources and restrictive institutional practices as impeding patient-centered care. Physicians expressed agency to create change foremost when writing about flaws related to medical culture. While physicians are challenged by system flaws, they strive to practice in ways that do not succumb to them. We saw tension between the elements outside the physician’s control and those within it. This tension becomes a source of distress when the compromises that emerge from system flaws move physicians away from the values that define their professional identity. (shrink)

While there is an extensive subfield in sociology studying the sources, content, and consequences of collective memory, the study of future projections has been much more fragmentary. In part, this has to do with the challenge of measurement; how do you measure something that has not happened yet? In this article, I argue that future projections can be studied via their externalizations in attitudes, narratives, performance, and material forms. They are particularly evident in what I call “sites of hyperprojectivity,” that (...) is, sites of heightened, future-oriented public debate about possible futures. As a pilot project, I examine contending narratives about possible futures in the online documents of the United Nations Conference on Sustainable Development and the accompanying “People’s Summit,” held in Rio de Janeiro in June 2012. I propose a framework for studying how public interventions into debates about “sustainable futures” and the “green economy” differ on various dimensions of projectivity, including their temporal reach, attention to contingency and causality, and network mapping of future actors. I present a preliminary analysis at the level of narrative and grammar, by analyzing the use of predictive, imperative, and subjunctive verb forms in both programmatic and oppositional texts. I close with a discussion of how different genres of future projection might be put to analytical use in studying processes of interest to social scientists, such as coalition formation, institution building, political mobilization, and policy change. (shrink)

Critical realism, especially as developed by Roy Bhaskar, embodies at its heart systemic and holistic concepts such as totality, emergence, open systems, stratification, autopoiesis and holistic causality. These concepts have their own long history of development in disciplines such as systems thinking and cybernetics, but there is an absence in Bhaskar’s writings, and that absence is a lack of any reference to the corresponding systems literature. The purpose of this paper is threefold: (i) to demonstrate the extent of this correspondence; (...) (ii) to show that critical realism can benefit from an exposure to these other discourses; and (iii) to show that systems thinking too can gain philosophically from critical realism. (shrink)

Considerations of well-being or flourishing include Maslow’s and Rogers’ concepts of self-actualisation and actualising tendency. Recent empirical findings suggest that only a modest proportion of the population might be considered to be flourishing. Separate findings focused upon the nature and determinants of post-traumatic growth identify it as comparable to flourishing, and facilitated by supported accommodation to the trauma. This can be understood as reflecting self-actualisation. Empirical findings such as these provide ontological stability to a set of phenomena that share much (...) with ancient teachings extolling redemption through suffering. This framework challenges conventional healthcare policies and practices, but in ways that offer insights into how patient-centred approaches to chronic illness and disability might be better conceived and enabled. It also throws into doubt the rectitude of an economic model built around services and products designed to provide easy access to sources of immediate gratification. (shrink)

In this text, I discuss the concept of culture that ethnomethodology suggests. First, I will review the sources that Garfinkel refers to: While he draws heavily on Parsons’ conception of culture, he also criticizes it with reference to Schütz. I start the second part with examining Garfinkel conception of ethnos—that suffixes ‘ethnomethodology’—to then present six salient dimensions of the ethnomethodological conception of culture: recognizability; normatively interspersed knowledge and cooperative continuation; familiarity and trust; indexicality and vagueness; practice; and fractality and fragmentation. (...) The text ends with some thoughts comparing the ethnomethodological notion of culture to other conceptions. (shrink)

Contemporary sociology mirrors Western society in its general aversion and sensitivity to pain, and in its view of pain as an unproductive threat to cultures and identities. This highlights the deconstructive capacities of pain, and marginalizes collectively authorized practices that embrace it as constitutive of cultural meanings and social relationships. After exploring the particularity of this Western orientation to pain — by situating it against processes of instrumentalization and medicalization, and within a broader context of other social developments conducive to (...) a heightening of affect control — this article builds on Mauss’s analysis of ‘body techniques’ in suggesting that the cultural, physiological and psychological dimensions of pain can be combined in various ways. In examining this point further, we then compare contrasting religious engagements with pain as a way of detailing how it can be positively productive of cultural meanings and identities, and conclude by using these comparisons to illuminate the relationship between the current Western approach to pain and the Christian traditions that shaped the West historically. (shrink)

Phenomenology has contributed to healthcare by providing resources for understanding the lived experience of the patient and their situation. But within a burgeoning literature on the characteristic features of illness, there has not yet been an account appropriate to describe congenital illnesses: conditions which are present from birth and cause suffering or medical threat to their bearers. Congenital illness sits uncomfortably with standard accounts in phenomenology of illness, in which concepts such as loss, doubt, alienation and unhomelikeness presuppose prior health. (...) These accounts reflect, in different ways, Maurice Merleau-Ponty’s assumption that the ways of living of the ill contain allusions to fundamental, healthy functions. The originality of congenital illness complicates this assumption and demands its own original phenomenology. In this paper, I sketch my personal experience living with a single-ventricle heart condition. While some of this story may reflect my own idiosyncratic experience, I hope that much of it will resonate with the congenital illness experience. I argue that the phenomenological literature on illness, grounded in the notion of loss, does not describe the congenital illness experience. I show how a number of other patient-centred theories of health and illness which have been influential on phenomenology can and cannot elucidate congenital illness. In particular, I consider Georges Canguilhem’s account of the normal and the pathological; debates in disability; and the notion of illness as biographical disruption. I show that congenital illness results in the preadmission of its patients to a paradoxical logic of medical palliation, one product of which is existential maturity. (shrink)

A high level of complexity and a continuous and always changing relationship among its elements characterizes modern world society. As a result, a constant differentiation and specialization of diverging social fields aiming to reduce the uncertainty emerging from that complexity takes place. Paradoxically, as differentiation and specialization increase, they become a new source of uncertainty. In order to confront this self-producing ambiguity, some social operations develop structural interdependencies with a sufficient level of operational stability that distinguish them from their environment. (...) In this paper this is called contextual differentiation, i.e. the emergence of differentiated contexts of interaction, decision and symbolization that make possible a mutilayered concretization of social functions in supranational contexts. With regard to the differentiation of law, economy and sports this process is analyzed and illustrated in four case studies: the Bill & Melinda Gates Foundation, the Bank for International Settlements, FIFA, the game and its publics, and the international commercial arbitration. La sociedad mundial moderna se caracteriza por su alta complejidad, es decir, por la continuamente cambiante interrelación de sus elementos. El resultado de ello es una constante diferenciación y especialización de espacios sociales orientada a manejar la incertidumbre que esa complejidad genera. Paradójicamente, la diferenciación y especialización es nuevamente una fuente de complejidad. Para enfrentar esta ambigüedad auto-producida, determinadas operaciones sociales se distinguen por generar interdependencias estructurales que logran una estabilidad operacional suficiente para distinguirlas de su entorno. A ello se le denomina en este artículo diferenciación contextual, esto es, la emergencia de contextos diferenciados de interacción, decisión y simbolización que posibilitan una concretización múltiple de funciones sociales en espacios supranacionales. Esto se observa especialmente a propósito de la diferenciación del derecho, la economía y el deporte, y se ilustra con cuatro estudios de caso: la Bill & Melinda Gates Foundation, el Bank for International Settlements, la FIFA, el juego y sus públicos, y el arbitraje comercial internacional. (shrink)

The utilization of alternative medical therapies and practitioners has increased dramatically in the U.S. in the last two to three decades. This trend seems paradoxical when one considers the rapid advances taking place in biomedical knowledge and technology during this same time period. Observers both inside and outside of the medical profession have attempted to explain the rising popularity of alternative medicine by proposing that it signals a growing sense of dissatisfaction and disenchantment with professional biomedical practices on the part (...) of the lay public. This paper challenges this thesis and offers an alternative explanation, arguing that the rise of alternative medicine is a consequence of the success and expanding influence of biomedicine rather than its failure and declining authority. The argument presented draws primarily on Ulrich Beck’s “risk society” perspective and theory of “reflexive modernization,” with specific attention to his analysis of the “reflexive scientization” process. The application of this perspective allows us to understand the emergence and development of alternative medicine as an unanticipated consequence of the process of reflexive biomedicalization in the late modern era. (shrink)

Management of chronic illness implies significant changing the lifestyle, taking medication, watching the diet, introducing and maintaining exercise in daily life, etc. These actions represent elements of adherence to treatment and they reflect the responsibility of patient’s participation to healthcare. The increase in adherence to treatment and in the quality of care, implicitly, may depend on allotting the resources necessary within therapeutic effort and on the effectiveness of the partnership between patient and doctor. Assuming the medical decision as a team (...) may lead to solving the issue of non-adherence. Whereas the values of the functional parameters of the body represent an objective measurement of treatment efficiency and to some extent of adherence to it, implicitly, assessing the patient’s lifestyle involves understanding his experience, which is governed by subjectivity. This article has the following objectives: to analyze the definitions of adherence to treatment from a biomedical perspective and from the perspective of Chronic Care Model ; to identify the characteristics specific to the roles of acting participants to healthcare and to analyze the modifications of roles by the choice of theoretical model and to identify the determining factors of adherence to treatment. (shrink)

Against the background of current reforms in higher education, we analyze the traditional education of Japanese doctoral students in philosophy of education from Western and Japanese perspectives by focusing on learning as self-education, on being and learning with others, on the socialization into the profession, and on the study of the foreign subject. Imai's explication of the Japanese construction of the adult self as instrumental is compared to Gadamer's ideas on self-education and education with others. A significant element of doctoral (...) education in Japan involves the learning of certain forms ( kata ) of professional conduct: belonging to a group, occupying a clear position in the social hierarchy, and developing a close mentoring relationship that fosters strong feelings of loyalty, harmony and respect. Furthermore, reciprocal dependence ( amae ) is analyzed and contrasted with the Western ideal of autonomy and maturity. Finally, the study of the foreign subject is considered in light of Gadamer's and Hegel's notion of making a home in the alien. Saito affirms a cross-cultural reading of foreign philosophical texts, claiming that they destabilize the native culture and turn a teacher in philosophy of education into a translator and prophet of her own as well as the foreign culture. (shrink)