This essay uses Solzhenitsyn’s Cancer Ward to explore the exilic effects of illness and pain. The novel is uniquely suited for such an analysis given the theme of exile that predominates both in the narrative and in the composition of multiple characters within that narrative. I argue that illness, and in particular pain, is a liminal state, an existential hinterlands. The ethical approach to literature and medicine may suggest, as a response to these exilic effects, the need to (...) cultivate connection and empathy by sharpening the moral imagination. If pain and illness exile the sufferer, the imperative to reach out takes on ethical content. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bringing Cancer Care to Those who Don't Have ItLawrence N. ShulmanI have been treating cancer patients in the Harvard Medical School hospitals since 1977, and in those 35 years we have made tremendous progress. Though work still needs to be done, and far too many patients still die of cancer, many are cured. In particular, children and young adults have a high rate of cure from (...) such diseases as Hodgkin's lymphoma, non-Hodgkin's lymphoma, acute lymphoblastic leukemia, and childhood sarcoma. Patients with breast cancer in the US have a greater than 80% chance for long-term survival. The death rate from cervical cancer in the US is very low. These results have been achieved by making diagnoses earlier, in many cases surgical excision, and often systemic therapies such as chemotherapy, hormonal therapy, radiation therapy, and more recently by using so-called "targeted" therapies—those directed at particular molecular characteristics of the cancer cells.Princess Dina Mired has said that the opportunity to survive cancer should not be an accident of geography. In cases where we already have effective and inexpensive tools to cure cancer, these treatments should be considered a basic human right, a life-saving medical service.I met Patty, a young woman living in the U.S. during November of her senior year in high school, after she discovered a small lump above her left collar bone. Though she felt entirely well, she called her primary care doctor who saw her the next day, felt the enlarged lymph node, and referred her to a surgeon, who did a biopsy later that week. Her primary care doctor also called me, and we scheduled a visit when the pathology results were available. The following week the pathologist notified Patty's pediatrician that the biopsy showed Hodgkin's lymphoma. When I met Patty, she was a bright and focused young woman, waiting to hear about her college applications and enjoying her senior year. Her cancer diagnosis was completely out of context with her life as she planned it, but with the support of her family and boyfriend, she seemed prepared to take things one step at a time. A PET CT scan demonstrated a modest mass in the mediastinum (chest), but no other disease. She was in an early stage of the disease with an excellent prognosis. We recommended and administered six months of chemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine—four chemotherapy agents that are off-patent, and relatively inexpensive. She lost her hair, not a trivial issue for her, but otherwise felt reasonably well during the treatment. She was determined to graduate with her classmates, and was able continue to attend school and keep up with her work. In June, seven months into her cancer diagnosis and treatment, she graduated with honors, and was on track to enroll in college in September.Like other 18-year-old women with Hodgkin's lymphoma, Patty had an over 80% chance for cure with the potential for a long and productive life ahead of her because we could perform a biopsy, make a diagnosis, and safely and effectively treat her with four inexpensive, off-patent, chemotherapy drugs. She had nearly the same likelihood of living a long and fruitful life as her classmates, and had the same chances for childbearing. In my line of work, with the knowledge we now possess, to allow someone like Patty to die without a chance of curative care is simply unacceptable. Treatment of curable cancers should be considered on par with the right to clean water, adequate nutrition, treatment for infectious disease, and access to maternal and child healthcare services.But in many places in the world, people with cancers we could easily eradicate in Boston have no access to cancer services, and do die unnecessarily. The local healthcare infrastructure has no [End Page E10] capacity to evaluate a patient, perform or process a biopsy, make a diagnosis, or treat the patient with potentially curative surgery, chemotherapy and radiation. I have rounded on the wards of hospitals in developing countries, stopping to talk with numerous patients like Patty: young women, some of whom might have had Hodgkin's lymphoma, but no... (shrink)

BackgroundThis study aimed to ask a sample of the general population about their preferences regarding doctors holding discretionary powers in relation to disclosing cancer diagnosis and prognosis.MethodsThe researchers mailed 443 questionnaires to registered voters in a ward of Tokyo which had a socio-demographic profile similar to greater Tokyo's average and received 246 responses (response rate 55.5%). We describe and analysed respondents' attitudes toward doctors and family members holding discretionary powers in relation to cancer diagnoses disclose.ResultsAmongst respondents who (...) wanted full disclosure about the diagnosis without delay, 117 (69.6 %) respondents agreed to follow the doctor's discretion, whilst 111 (66.1 %) respondents agreed to follow the family member's decision. For respondents who preferred to have the diagnosis and prognosis withheld, 59 (26.5 %) agreed to follow the doctor's decision, and 79 (35.3 %) of respondents agreed with following family member's wishes.ConclusionsThe greater proportion of respondents wants or permits disclosure of cancer diagnosis and prognosis. In patients who reveal negative attitudes toward being given a cancer disclosure directly, alternative options exist such as telling the family ahead of the patient or having a discussion of the cancer diagnosis with the patient together with the family. It is recommended that health professionals become more aware about the need to provide patients with their cancer diagnosis and prognosis in a variety of ways. (shrink)

Background: Upper limb functional exercise has a positive effect on promoting the rehabilitation of upper limb function. However, little is known, about what drives postoperative patients to engage in and even maintain the advised exercises. This study integrated the health action process approach and the theory of planned behavior theory to investigate the psychosocial determinants on the initiation and maintenance of ULFE in breast cancer patients. In addition, this study also tests key hypotheses relating to reasoned and implicit pathways (...) to ULFE and its maintenance among postoperative patients with breast cancer.Methods: Purposive sampling was used to recruit patients from two breast cancer wards in a provincial hospital in Jiangsu, China. Patients completed self-reported questionnaire about constructs from integrated theories concerning ULFE at an initial time point : task self-efficacy, positive outcome expectations, negative outcome expectations, risk perception, attitude behavior, subjective norm, perceived behavioral control, behavioral intention, and ULFE-in hospital. Three months later, patients self-reported: maintenance self-efficacy, action planning, coping planning, recovery self-efficacy, and ULFE-maintenance.Results: The model has a good fit. For behavioral intention of ULFE, subjective norm and perceived behavioral control were positively directly related to behavioral intention. Regarding the initiation of ULFE, perceived behavioral control and behavioral intention had a direct positive relation to ULFE-IH. In the maintenance of ULFE, action planning, coping planning, maintenance self-efficacy, and recovery self-efficacy all had significant positive relation on ULFE-M. In addition, maintenance self-efficacy had a significant positive association on action planning, coping planning, and recovery self-efficacy. Coping planning was significantly predicted by behavioral intention. Additionally, behavioral intention is a mediator of subjective norm and perceived behavioral control to ULFE-IH. Action planning, coping planning, and recovery self-efficacy are mediators of maintaining self-efficacy to ULFE-M.Conclusions: This study presents the first attempt to integrate the health behavior model in ULFE in postoperative patients with breast cancer. The study has shown that the HAPA-TPB integrated model has good applicability and effectiveness to explain and predict ULFE initiation and maintenance. Future work can be considered to develop appropriate intervention strategies based on this integrated behavioral theory. (shrink)

Introduction: Conversion and the practice of transformation -- The philosophical structure of Jonathan Edwards's religious affections -- Habit, habit change, and conversion in C.S. Peirce -- Reconstructing faith : religious overcoming in Dewey's pragmatism -- Transforming obligation in William James -- Dwelling in absence: the reflective origin of conversion -- Creative transformation : the work of conversion -- The evasion of conversion in recent American philosophy.

Throughout her work, Audre Lorde maintains that her self-preservation in the face of oppression depends on acting from the recognition and valorization of her feelings as a deep source of knowledge. This claim, taken as a portrayal of agency, poses challenges to standard positions in ethics, epistemology, and moral psychology. This article examines the oppositional agency articulated by Lorde’s thought, locating feeling, poetry, and the power she calls “the erotic” within her avowed project of self-preservation. It then explores the implications (...) of taking seriously Lorde’s account, particularly for theorists examining ethics and epistemology under nonideal social conditions. For situations of sexual intimacy, for example, Lorde’s account unsettles prevailing assumptions about the role of consent in responsibility between sexual partners. I argue that obligations to solicit consent and respect refusal are not sufficient to acknowledge the value of agency in intimate encounters when agency is oppositional in the way Lorde describes. (shrink)

Discussions of sexual ethics often focus on the wrong of treating another as a mere object instead of as a person worthy of respect. On this view, the task of sexual ethics becomes putting the other’s subjectivity above their status as erotic object so as to avoid the harms of objectification. Ward and Anderson argue that such a view disregards the crucial, moral role that erotic objecthood plays in sexual encounters. Important moral features of intimacy are disclosed through the (...) experience of being an erotic object for another, as well as in perceiving another as an erotic object. Drawing on phenomenology, especially the insights of Simone de Beauvoir, Ward and Anderson argue that erotic encounters are shaped by the human condition of ambiguity, where being an object for others is intertwined with bodily agency. Because sexual agency is complex in this way, theories of sexual ethics and responsibility must widen their focus beyond transparent communication and authoritative expressions of will. (shrink)

Some theories of goodness are descriptively rich: they have much to say about what makes things good. Neo-Aristotelian accounts, for instance, detail the various features that make a human being, a dog, a bee good relative to facts about those forms of life. Famously, such theories of relative goodness tend to be comparatively poor: they have little or nothing to say about what makes one kind of being better than another kind. Other theories of goodness—those that take there to be (...) absolute goodness—are comparatively rich: they offer grounds for judging some types of things better than others because they have more absolute goodness. Moorean accounts, for example, can tell us that humans and human experiences are superior to bees and blades of grass. But such theories tend to be descriptively poor: they struggle to tell us in virtue of what this is so. In this essay we motivate and flesh out a view that splits the difference between accounts of goodness as relative and accounts of goodness as absolute. Such a view holds promise only if the mechanics of this kind of metaphysics of goodness can be worked out. Here we present a view on which the paradigm for absolute goodness is God and the paradigm for each kind of relative goodness is a divine idea. (shrink)

BackgroundThe prognosis of patients undergoing lung cancer treatment might be influenced by mental health status. Resilience is one of the important predictors to reflect the mental health status. It has been shown that patients with higher levels of social support, self-care self-efficacy, and positive coping have greater resilience. This study aimed to determine the mediating role of self-efficacy and positive coping in the relationship between social support and psychological resilience in patients with lung cancer.MethodThis is a cross-sectional study (...) that was conducted in in the oncology departments and thoracic surgical wards of four tertiary hospitals in Hunan Province, China, between November 2016 and November 2017. Three hundred and three patients who were undergoing treatment for lung cancer volunteered their participation in the study. Participants completed questionnaires, including the Chinese version of the Perceived Social Support Seale Scale, the Chinese version of Strategies Used by People to Promote Health Scale, and the Chinese version of the Connor-Davidson Resilience Scale.ResultsMediation analysis indicated that self-care self-efficacy and social support partially mediate the effect of social support on resilience. Direct paths from social support to self-efficacy, self-efficacy to positive coping, positive coping to psychological resilience, self-efficacy to psychological resilience, and social support to psychological resilience were significant. The indirect paths from social support to self-efficacy and self-efficacy to psychological resilience were also significant. The chain mediation from social support to self-efficacy, self-efficacy to positive coping, and positive coping to resilience were significant.ConclusionSelf-efficacy and positive coping play an important role in the relationship between social support and resilience in patients receiving cancer treatment. Social support not only directly influenced psychological resilience but also indirectly influenced psychological resilience through self-efficacy and positive coping. (shrink)

The mortality and morbidity resulting from noncommunicable diseases including cancer in sub- Saharan Africa are predicted to overtake that of infectious diseases by the year 2030. Esophageal cancer is on the increase in Tanzania. This study estimates risk factors for esophageal cancer, ethical issues and the level of awareness of cancer related services among adults in rural Kilimanjaro. A cross sectional descriptive study was conducted of adults aged 18 years and above in three wards, namely, Kahe, (...) mabogini and Arusha Chini, Moshi Rural District, Kilimanjaro region. Face-to-face interviews were conducted with a total of 419 individuals. The mean age was 36.47 =13.49) years. Of those who participated, 211 were male and 60% reported to have completed primary education. A majority of participants were knowledgeable about esophageal cancer risk factors. Overall, 15% and 23% of the participants reported to have been smoking and drinking alcohol, respectively. Male respondents were almost three times more likely to be smokers as compared to female respondents. Moreover, people who were self-employed were about five times more likely to be smokers as compared to those who were unemployed.. Male respondents were almost two times more likely to be drinkers as compared to female respondents. Overall, the level of awareness of cancer related health services was about 70%. The study findings confirm that despite a good level of knowledge about risk factors for esophageal cancer, the practice of exposure to risk factors is alarmingly high. Awareness of where to seek cancer related health services was high with hospitals been mentioned by the majority though there was low understanding on modalities of treatment among adults in Rural Kilimanjaro. Intervention measures should aim at further increasing knowledge of cancer risk factors and reduce the practice of such risks. Ethical matters including truth telling, ageism and autonomy need to be addressed to improve the perception of cancer related health issues and health seeking behaviour. (shrink)

Arguing for a new direction in postmodern theological thinking, away from the liberalism and nihilism of those who name themselves postmodern theologians, the ...

A dominant strand of philosophical thought holds that natural kinds are clusters of objects with shared properties. Cluster theories of natural kinds are often taken to be a late twentieth-century development, prompted by dissatisfaction with essentialism in philosophy of biology. I will argue here, however, that a cluster theory of kinds had actually been formulated by William Whewell (1794-1866) more than a century earlier. Cluster theories of kinds can be characterized in terms of three central commitments, all of which are (...) present in Whewell’s work on classification. Like contemporary cluster theorists, Whewell claims that kinds are united by similarity, that many kinds do not have essences, and that there are “gaps” between kinds. Moreover, Whewell advises taxonomists to look for consilience (roughly, convergence) between different classificatory schemes, a recommendation that reinforces the identification of natural classes with property clusters. Thus Whewell was not only an early cluster theorist, but one with important insights into what a cluster theory of kinds means for the practice of classification. (shrink)

An important volume connecting classical studies with feminism, Feminism and Ancient Philosophy provides an even-handed assessment of the ancient philosophers' discussions of women and explains which ancient views can be fruitful for feminist theorizing today. The papers in this anthology range from classical Greek philosophy through the Hellenistic period, with the predominance of essays focusing on topics such as the relation of reason and the emotions, the nature of emotions and desire, and related issues in moral psychology. The volume contains (...) some new, ground-breaking essays on Plato, Aristotle, and the Stoics, as well as previously published pieces by established scholars like Martha Nussbaum and Julia Annas. It promises to be of interest to an interdisciplinary audience including those working in classics, ancient philosophy, and feminist theory. (shrink)

Nietzsche and Freud saw Christianity as metaphysical escapism, with Nietzsche calling the religion a "Platonism for the masses" and faulting Paul the apostle for negating more immanent, material modes of thought and political solidarity. Integrating this debate with the philosophies of difference espoused by Gilles Deleuze, Michel Foucault, Jacques Derrida, Jacques Lacan, and Pier Paolo Pasolini, Ward Blanton argues that genealogical interventions into the political economies of Western cultural memory do not go far enough in relation to the imagined (...) founder of Christianity. Blanton challenges the idea of Paulinism as a pop Platonic worldview or form of social control. He unearths in Pauline legacies otherwise repressed resources for new materialist spiritualities and new forms of radical political solidarity, liberating "religion" from inherited interpretive assumptions so philosophical thought can manifest in risky, radical freedom. (shrink)

A short definitive account of Keith Ward's theology, based on the philosophy of Personal Idealism. It records Ward's views about God, revelation, the kingdom of God, life after death, the incarnation, atonement, and Trinity. In summary, it is a concise and clear account of most central Christian doctrines, formed in the light of modern science and Idealist philosophy.

Global Media Ethics is the first comprehensive cross-cultural exploration of the conceptual and practical issues facing media ethics in a global world. A team of leading journalism experts investigate the impact of major global trends on responsible journalism. The first full-length, truly global textbook on media ethics; Explores how current global changes in media promote and inhibit responsible journalism; Includes relevant and timely ethical discussions based on major trends in journalism and global media; Questions existing frameworks in media ethics in (...) light of the impact of global media; Contributors are leading experts in global journalism and communication. (shrink)

(2013). Life, the Unhistorical, the Suprahistorical: Nietzsche on History. International Journal of Philosophical Studies: Vol. 21, No. 1, pp. 64-91. doi: 10.1080/09672559.2012.744532.

What is it to be an agent? One influential line of thought, endorsed by G. E. M. Anscombe and David Velleman, among others, holds that agency depends on practical rationality—the ability to act for reasons, rather than being merely moved by causes. Over the past 25 years, Velleman has argued compellingly for a distinctive view of agency and the practical rationality with which he associates it. On Velleman’s conception, being an agent consists in having the capacity to be motivated by (...) a drive to act for reasons. Your bodily movements qualify as genuine actions insofar as they are motivated in part by your desire to behave in a way that makes sense to yourself. However, there are at least two distinct ways of spelling out what this drive towards self-intelligibility consists in, both present in Velleman’s work. It might consist in a drive towards intelligibility in causal-psychological terms: roughly, a drive to maximize the rational coherence of your psychological states. Alternatively, it might consist in a drive towards narrative intelligibility: a drive to make your ongoing activity conform to a recognizable narrative structure, where that structure is understood emotionally. Velleman originally saw these options as basically equivalent, but later came to prioritize the drive towards causal-psychological intelligibility over that towards narrative intelligibility. I argue that this gets things the wrong way round—we should instead understand our capacities to render ourselves intelligible in causal-psychological terms as built upon a bedrock of emotionally suffused narrative understanding. In doing so, we resolve several problems for Velleman’s view, and pave the way for an embodied, embedded and affective account of practical rationality and agency. According to the picture that emerges, practical rationality is essential to agency, narrative understanding is essential to practical rationality, and the rhythms and structures patterning the ebb and flow of our emotional lives are essential to narrative understanding. (shrink)

Blanton Ward traces the current critical engagement of Agamben, Derrida and Zizek, among others, back to the 19th and early 20th century philosophers of early Christianity.

Ward Blondé ABSTRACT: In this paper, an evolutionary multiverse argument against naturalism is presented: E1. In an evolutionary multiverse, phenomena have variable evolutionary ages. E2. After some time T, the development of the empirical sciences will be evolutionarily conserved. E3. The phenomena with an evolutionary age above T are methodologically supernatural. Entities are classified ….

In this paper, a metaphysics is proposed that includes everything that can be represented by a well-founded multiset. It is shown that this metaphysics, apart from being self-explanatory, is also benevolent. Paradoxically, it turns out that the probability that we were born in another life than our own is zero. More insights are gained by inducing properties from a metaphysics that is not self-explanatory. In particular, digital metaphysics is analyzed, which claims that only computable things exist. First of all, it (...) is shown that digital metaphysics contradicts itself by leading to the conclusion that the shortest computer program that computes the world is infinitely long. This means that the Church-Turing conjecture must be false. Secondly, the applicability of Occam’s razor is explained by evolution: in an evolving physics it can appear at each moment as if the world is caused by only finitely many things. Thirdly and most importantly, this metaphysics is benevolent in the sense that it organizes itself to fulfill the deepest wishes of its observers. Fourthly, universal computers with an infinite memory capacity cannot be built in the world. And finally, all the properties of the world, both good and bad, can be explained by evolutionary conservation. (shrink)

Nietzsche distinguished between two forces in art: Apollonian, which represents order and reason, and Dionysian, which represents chaos and energy. Economists, Ward argues, have operated for too long under the assumption that their work reflects the scientific, Apollonian principals that inform physics when they simply do not apply to economics: 'constants' in economics stand in for variables, and the core scientific principles of prediction and replication are all but ignored by economists. Ward encourages economists to reintegrate the standard (...) rigor of the scientific method into their work while embracing the fact of the shape-shifting changeability of human beings. Economists can still aspire to scientific standards, as is demonstrated by the success of biology, in which there is considerable Dionysian variability. Economists must avoid the temptation to wish away dynamic complexity and diversity and must recognize, among other things, that the desire to take risks is fundamentally human. The second half of the book takes some first steps toward creating this new Dionysian Economics. (shrink)

Since modern physicists made more and more advances in precisely measuring the fundamental constants in nature, cosmologists have been confronted with this problem: how do we declare that nature’s constants are fine-tuned for the emergence of life? Many cosmologists assume nowadays that the big bang universe originates from a multiverse that consists of very many universes. Some of these must be fine-tuned for life. A fascinating question arises: Would there be any chance on a life after our death in this (...) multiverse? In this paper, I show two things about the multiverse. First, universes in the multiverse acquire an unlimited amount of additional fine-tuning for intelligent life over the course of many universe generations. Such additional fine-tuning may consist of travelling between universes and an afterlife on a distant planet. Second, evolutionary conservation in the evolution of universes in the multiverse provides a declaration why we observe a universe that roughly has the minimal fine-tuning to support intelligent life. (shrink)

Since modern physicists made more and more advances in precisely measuring the fundamental constants in nature, cosmologists have been confronted with this problem: how do we declare that nature’s constants are fine-tuned for the emergence of life? Many cosmologists assume nowadays that the big bang universe originates from a multiverse that consists of very many universes. Some of these must be fine-tuned for life. A fascinating question arises: Would there be any chance on a life after our death in this (...) multiverse? In this paper, I show two things about the multiverse. First, universes in the multiverse acquire an unlimited amount of additional fine-tuning for intelligent life over the course of many universe generations. Such additional fine-tuning may consist of travelling between universes and an afterlife on a distant planet. Second, evolutionary conservation in the evolution of universes in the multiverse provides a declaration why we observe a universe that roughly has the minimal fine-tuning to support intelligent life. (shrink)

Some of the series' finest lectures have been lost for many years, unavailable to the public in any form -- until now.

Nietzsche was a philosopher who prided himself, in deliberate contradistinction with previous philosophers, on his ‘historical sense’. But this leaves many questions unanswered about the precise role of the historical in Nietzsche’s philosophy. Perhaps most importantly, can the conception of genealogy in Nietzsche’s later philosophy, as a revised historical method, be taken to represent his mature philosophical methodology in general? I argue, firstly, that there is considerable continuity between Nietzsche’s conceptions of history in the early essay ‘On the uses and (...) disadvantages of history for life’ and those of his later philosophy. The former can therefore be used as a resource for understanding the latter. Through a reading of the early history essay I demonstrate that Nietzsche’s conception of the historical here is intimately bound up with the notion of the ‘unhistorical’ and that it is precisely renewed access to the unhistorical which is required in order for history to be conducive to the flourishing of humanity. I go on to contend that this holds for Nietzsche’s later writings as well, and that genealogy, being purely historical, must therefore be seen as one subsidiary part of a broader philosophy in which the unhistorical will play, literally, a vital role. (shrink)

In this paper, an evolutionary multiverse argument against naturalism (EMAAN) is presented: E1. In an evolutionary multiverse, phenomena have variable evolutionary ages. E2. After some time T, the development of the empirical sciences will be evolutionarily conserved. E3. The phenomena with an evolutionary age above T are methodologically supernatural. Entities are classified according to whether they are (1) physical and spatiotemporal, (2) causally efficacious, and (3) either observed by or explanatorily necessary for the empirical sciences. While the conjunction of (1) (...) and (2) is taken to be sufficient for existence in reality, the negation of (3) defines methodological supernaturalness. EMAAN uses a generalization of evolutionary theory, namely cosmological natural selection, to argue that phenomena evolve that fulfill conditions (1) and (2), but not (3). This shows that methodologically supernatural phenomena have a clear epistemology according to a theory that is grounded in the commitments of naturalism. Supernatural phenomena are not observed by the empirical sciences because the empirical sciences themselves are supernaturally guided and predestined to develop according to an evolutionarily conserved plan. In spite of this scientific plan, there is room for afterlives and supernaturality in the everyday experience. (shrink)

Objectives: To quantify the use of do-not-resuscitate orders in a tertiary-care children’s hospital and to characterise the circumstances in which such orders are written.Design: Retrospective study conducted in a 500-bed children’s hospital in Taiwan.Patients: The course of 101 patients who died between January 2002 and December 2005 was reviewed. The following data were collected: age at death, gender, disease and its status, place of death and survival. There were 59 males and 42 females with a median age of 103 months (...) . 50 children had leukaemias, and 51 had malignancies other than leukaemia. The t test and the χ2 test were applied as appropriate.Results: The study found that 44% of patient deaths occurred in the paediatric oncology ward; 29% of patient deaths occurred in the intensive care unit; and 28% of patients died in their home or at another hospital. Other findings included the following: 46 of 101 patients died after attempted cardiopulmonary resuscitation and 55 died with a DNR order in effect. The mean age at death was 9.8 years in both groups with or without DNR orders.Conclusions: From the study of patient deaths in this tertiary-care children’s hospital, it was concluded that an explicit DNR order is now the rule rather than the exception, with more DNR orders being written for patients who have been ill longer, who have solid tumours, who are not in remission and who are in the ward. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 23-26 [Access article in PDF] The Complexity of Evil Behavior David E. Ward I WOULD LIKE TO BEGIN this reply by thanking the commentators. The reports of their clinical experience contained some interesting evidence regarding evil behavior that, I think, supports my thesis and their full frontal criticism has given me a chance to reemphasize how complex the problem of evil behavior (...) is.On the question raised by Steven Sverdlik, as to whether Kant was in possession of the idea of the unconscious: it never occurred to me that Kant's notion of the subreption of the will—the idea that we could somehow be deceived with regard to our true motives (1956, 121)—could be regarded as a reason for assuming that Kant had a concept of the unconscious. Certainly talk of being unsure of one's motives has been common currency in every age that has had the idea of acting out of duty as opposed to desire. This uncertainty allows us to think about unconscious motives and thus of a set of hidden mechanisms that might motivate our actions without our being aware of them. However, I think we would both agree that Kant nowhere articulates this hypothesis. Freud did articulate it. So I agree that I should have said that Kant was not in possession of a concept of unconscious mechanisms that may generate behavior in such a way as to be opaque to the agent involved.Sverdlik has two worries with regard to my thesis. The first concerns my characterization of evil behavior as wrongdoing for wrongdoing's sake. He believes that rather than insisting that all principled behavior must fit this formula, "Ward is really interested in wrongdoing that is non-impulsive and actuated by some principle, but not necessarily the satanic one." This is, indeed, exactly what I was interested in. It is the unconscious adherence to some principle that causes all the trouble for evil people. Sverdlik thinks that my proposal was "to attribute acceptance [of such principles] to the unconscious" and to maintain that though the agent does "not consciously accept it, [it] does do so unconsciously" (my emphasis). What I actually said was: In my account, there is a near-perfect dovetailing of the two different psychological perspectives—that of Kant's moral psychology (which lacks the resources to accommodate the possibility of evil) and that of Peck's psychiatric diagnosis of evil—that explains (on my construal) how an unconscious adherence to unacknowledged principles could be the driving power behind evil behaviour. What is the difference between unconscious acceptance of a principle and unconscious adherence to it? This difference can be illustrated in connection with Sverdlik's continuation of his argument: Ward suggests that the agent does not consciously accept it, but does so unconsciously. But why does the unconscious not see that it is not universalizable? And if it does see this, why does it proceed to act on it? Ward's picture of the unconscious must allow it to be rational enough to understand the narcissistic principle, for example, [protect your self-image at all costs] and to act on it. But if it is that rational, then it is puzzling that it does not draw the same conclusion [End Page 23] that the agent's conscious deliberation can and will draw. Therefore, if consciously acting on a non-universalizable principle is inexplicable, then so is unconsciously acting on it. According to my picture of the unconscious, what the unconscious is rational about are hypothetical principles: it sees the connection between means and ends with perfect rationality. When, in my article, I distinguished between categorical and hypothetical imperatives I pointed out that... it is clear that hypothetical principles like always dress in woolens can only motivate us if we already have a desire to be warm. Strictly speaking, hypothetical principles do not motivate us by themselves. They are only useful in specifying the means to an end that a rational person would follow if she wanted to satisfy a certain desire. (My emphasis.) I was assuming, then... (shrink)

The Higgs mechanism gives mass to Yang-Mills gauge bosons. According to the conventional wisdom, this happens through the spontaneous breaking of gauge symmetry. Yet, gauge symmetries merely reflect a redundancy in the state description and therefore the spontaneous breaking can not be an essential ingredient. Indeed, as already shown by Higgs and Kibble, the mechanism can be explained in terms of gauge invariant variables, without invoking spontaneous symmetry breaking. In this paper, we present a general discussion of such gauge invariant (...) treatments for the case of the Abelian Higgs model, in the context of classical field theory. We thereby distinguish between two different notions of gauge: one that takes all local transformations to be gauge and one that relates gauge to a failure of determinism. (shrink)

Alvin Plantinga’s evolutionary argument against naturalism (EAAN) claims that if both naturalism (N) and evolutionary theory (E) are true, then all our beliefs are unreliable (premiss 1). Consequently, given N&E, the belief in N&E is unreliable (premiss 2) and N&E is self-defeating (conclusion). The empirical verification argument against naturalism (EVAAN) is more cautious and improves EAAN by withstanding a rejoinder of the evolutionary naturalist to premiss 1. EVAAN claims that non-abstract beliefs that are not empirically verifiable are unreliable, given N&E (...) (premiss 1a). This anticipates the evolutionary naturalist’s claim that empirical verifications play a crucial role in peer assessments and sexual selection of intelligence, and that, therefore, N&E makes empirically verifiable beliefs often reliable (premiss-1 rejoinder). However, even then it can be argued that the belief in N&E is unreliable, given N&E (premiss 2), because N&E is neither abstract, nor empirically verifiable (premiss 1b). EVAAN distinguishes reliably verifiable intelligence from metaphysical intelligence and claims that, if N&E is true, humans are lacking metaphysical intelligence. This paper also contains an argument against EAAN, by supporting the premiss-1 rejoinder. (shrink)