This book brings together, in systematic and generalized form, the main outlines of a conceptual scheme for the analysis of the structure and processes of social systems. It carries out Pareto's intention by using the "structural-functional" level of analysis.

This book offers an in-depth analysis of the cognitive and ethical role of emotion, particularly empathy, in medical practice. The author explains how doctors can use empathy in diagnosing and treating patients without jeopardizing their objectivity or projecting their own values on to patients.

Here is a thoroughly updated edition of a classic in palliative medicine. Two new chapters have been added to the 1991 edition, along with a new preface summarizing where progress has been made and where it has not in the area of pain management. This book addresses the timely issue of doctor-patient relationships arguing that the patient, not the disease, should be the central focus of medicine. Included are a number of compelling patient narratives. Praise for the first edition "Well (...) written. . .should be read by everyone in medical practice or considering a career in medicine."---JAMA. "Memorable passages, important ideas, and critical analysis. This is a book that clinicians and educators should read."---New England Journal of Medicine. (shrink)

Cultural forces such as film create and reinforce rigidly-defined images of a doctor's identity for both the public and for medical students. The authoritarian and hierarchical institution of medical school also encourages students to adopt rigidly-defined professional identities. This restrictive identity helps to perpetuate the power of the patriarchy, limits uniqueness, squelches inquisitiveness, and damages one's self-confidence. This paper explores the construction of a physician's identity using cultural theorists' psychoanalytic analyses of gender and race as a framework of analysis. Cultural (...) theorists' politically-motivated work provides an excellent point of departure for destabilizing parts of the authoritarian medical hierarchy that can damage a student's professional development. Drawing on such discourse, this paper examines the processes by which a doctor's identity becomes rigidly defined and fixed by daily training. It finally proposes a way for a medical student to extrapolate himself from the current definitions of this identity and create a broader, more malleable concept of professional identity by defining himself from outside of, rather than through, difference. (shrink)

In western discourse the notion of the contagious, the unclean or the contaminated is never just a neutral descriptor but carries the weight of all that stands against—and paradoxically secures—the categories of normative ontology and epistemology. Set against the ideal closure and invulnerability of the self's “clean and proper body,” this paper investigates the condition of disability as a potentially contaminatory threat. But the given precarious psychic constitution of the subject, and the ontological insecurity of self performativity, can we reconfigure (...) vulnerability not as a term of weakness, but as the very possibility of becoming? (shrink)

In this paper, we propose analogies between medical discourse and Edward Said's “Orientalism.” Medical discourse, like Orientalism, tends to favor institutional interests and can be similarly dehumanizing in its reductionism, textual representations, and construction of its subjects. To resist Orientalism, Said recommends that critics—“intellectuals”—adopt the perspective of exile. We apply Said's paradigm of intellectual-as-exile to better understand the work of key physician-authors who cross personal and professional boundaries, who engage with patients in mutually therapeutic relationships, and who take on the (...) public responsibility of representation and advocacy. We call these physician-authors “medical intellectuals” and encourage others to follow in their path. (shrink)

An eminent scholar of modern culture argues that the Enlightenment—the importance of which has been vigorously debated in recent years—was a more complex phenomenon than either its detractors or advocates assume. “Ranging as it does over art, morality, religion, science, philosophy, social theory, and a good deal besides, [Dupré’s book] is a marvel of scholarly erudition.... Formidably well-researched,... [this] would make an excellent introduction to Enlightenment ideas for the general reader.”—Terry Eagleton, _Harper’s Magazine _“This immensely readable book will cause readers (...) to rethink the Enlightenment and to see its positive aspects. It will also add crucial historical perspective to current discussions of modernity.”—Donald Verene, Emory University. (shrink)

Introducing the work of three French feminists - Julia Kristeva, Luce Irigaray and Michele L Doeuff - "Sexual Subversions" provides access to the work of these writers. In doing so this book raises some key issues of relevance to feminist research, addressing debates around the nature of feminist theory; the relationship between feminist thinking theory; the relationship between feminist thinking and male-dominated areas of knowledge; the strategies appropriate for developing non-patriarchal or woman-centered knowledges. No book on French feminists would be (...) complete without including the contributions of Kristeva and Irigaray. The inclusion of Le Doeuff's work, which brings a different perspective to bear on the question of sexual difference, provides a counterbalance to literary appropriations of French feminism by Anglo-American readerships. Kristeva, Irigaray and Le Doeuff are the focal points of this study, precisely because each highlights the differences of the others, revealing the frameworks to which the others are committed. Nevertheless, while these writers do not present a common political or theoretical position or form a school, each does address the question of women's autonomy from male definition, affirms the sexual specificity of women, seeks out a femininity women can use to question the patriarchal norms and ideals of femininity and rejects the preordained positions patriarchy allots to woman. This book is intended for students and researchers in women's studies, philosophy and feminism. (shrink)

Altered Conditions provides a bold new intervention into existing theories of the human body and its meanings in a variety of cultural contexts. By exploring the history of medical narratives, especially medical case histories, as well as the exciting work that has been done in feminist and lesbian and gay studies, Julia Epstein poses a number of provocative questions about the relations between bodies, selves, and identities. Epstein focuses on a number of diagnoses that shed light on what is at (...) stake when cultures regulate human bodies, including hermaphroditism, birth malformations, and AIDS. She pays special attention to the regulation of sexual minorities and women and looks carefully at the ways in which cultures attempt to define and control behaviors seen as threatening or subversive. (shrink)

In At the Will of the Body , Arthur Frank told the story of his own illnesses, heart attack and cancer. That book ended by describing the existence of a "remission society," whose members all live with some form of illness or disability. The Wounded Storyteller is their collective portrait. Ill people are more than victims of disease or patients of medicine they are wounded storytellers. People tell stories to make sense of their suffering when they turn their diseases into (...) stories, they find healing. Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known--Gilda Radner's battle with ovarian cancer--to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilties. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic. Frank identifies three basic narratives of illness in restitution, chaos, and quest. Restitution narratives anticipate getting well again and give prominence to the technology of cure. In chaos narratives, illness seems to stretch on forever, with no respite or redeeming insights. Quest narratives are about finding that insight as illness is transformed into a means for the ill person to become someone new. (shrink)

Powers of Horror is an excellent introduction to an aspect of contemporary French literature which has been allowed to become somewhat neglected in the current emphasis on para-philosophical modes of discourse.".

Are our efforts to help others ever driven solely by altruistic motivation, or is our ultimate goal always some form of self- benefit (egoistic motivation)? This volume reports the development of an empirically-testable theory of altruistic motivation and a series of experiments designed to test that theory. It sets the issue of egoism versus altruism in its larger historical and philosophical context, and brings diverse experiments into a single, integrated argument. Readers will find that this book provides a solid base (...) of information from which questions surrounding the existence of altruistic motivation can be further investigated. (shrink)

Dans le but de d�fendre la th�se de la correspondance entre le comportement moral et le bonheur, j�analyse dans cet article le cas probl�matique des psychopathes. Les psychopathes sont des individus qui ne reculent devant aucun interdit moral pour satisfaire leurs d�sirs, et qui ne ressentent aucun remord ou scrupule face � leurs agissements. En ce sens, ils paraissent obtenir un ��ticket gratuit�� dans le domaine de la moralit�. Comment un d�fenseur de la th�se de la correspondance entre moralit� et (...) bonheur peut-il rendre compte du cas du psychopathe? Le psychopathe vient-il r�futer cette th�se, ou repr�sente-t-il plut�t une exception l�gitime? Je d�fendrai ici une solution alternative �; apr�s avoir propos� une version plausible de la th�se de la correspondance, je tenterai de d�montrer que les psychopathes ne sont pas heureux, et ce en vertu de caract�ristiques essentielles de la psychopathie. Leur statut de ��criminel en puissance�� et leur faible capacit� de contentement sont les deux �l�ments centraux qui m�am�neront � conclure que les psychopathes ne sont pas heureux. Loin de r�futer ou d��chapper � la th�se de la correspondance, le cas des psychopathes vient donc en r�alit� renforcer cette th�se. -/- My goal in this paper is to defend the idea of a general correspondence between happiness and morality, and I do so by analyzing the problematic case of psychopaths. Psychopaths are individuals who are not bothered by moral restrictions when it comes to satisfying their desires. They feel no remorse and have no scruples, and as such they appear to be �free-riders� in the realm of morality. The unusual case of psychopaths will therefore pose a problem to someone who argues that there is a correspondence between happiness and morality: should psychopaths be seen as refuting the correspondence rule, or are they merely a legitimate exception to that rule? I will propose an alternative explanation; after having presented a plausible version of the correspondence thesis, I will try to show that psychopaths, for reasons constitutive of their nature, really are not happy. Psychopaths� quasi-inevitable criminal behaviours as well as their low capacity for contentment are two central elements that lead me to argue that they are not happy. I therefore conclude that psychopaths, far from refuting the correspondence thesis, actually reinforce that thesis. (shrink)