Pope Francis's has described his vision for a synodal Church, not simply as a once off programme of renewal, but as God's desire for the Church of the third millennium. As such, it aims to concretise the ecclesiology of the Second Vatican Council, making the Church today more manifestly one of communion, participation, and mission. It differs from previous synods and Councils in history in that it more directly invites and involves all the baptised in a direct process of (...) class='Hi'>listening and discernment to the voice of the Holy Spirit. This paper aims to understand from a theological perspective how listening will work in a synodal Church, by exploring firstly what we mean by the ecclesiology of communion from the Council. Such an ecclesiology, manifesting the equal dignity of the faithful in Christ, will ground listening at the level of participation in God as well as acknowledging the gift of infallibility given to the whole Church. It means calling on the Holy Spirit to help discern how and where, the apostolic deposit of faith has been received by members of the body. It also explores what we mean by listening to the sensus fidei of the whole body and how the authority of laity and hierarchy operate both in united but distinct ways within a synodal process grounded in communion ecclesiology. Overall, such listening is to be done carefully for the sake of the Church's mission as the sacrament of salvation to the world. (shrink)

The focus of this paper is the moral and scientific value of ‘expertise by experience’, that is, knowledge based on personal experience of ill mental health as a form of expertise in mental health research. In contrast to individualistic theories of personal autonomy and the first-person in bioethics, my account of shared decision-making is focussed on how a relational approach to the ‘person’ and ‘patient values’ can throw new light on our understanding of ‘voice’ in mental health research. The (...) mistake, I argue, is to think that a commitment to listening to the patient voice in the process of perspective taking implies a threat to ‘objectivity’ in clinical practice and the very concept of evidence in the philosophy of science more generally. Instead, I use Helen Longino's account of epistemic validity in philosophy of science to argue that narrative experience and ‘patient perspective’ should be understood as an ongoing dynamic partnership working between the different stakeholders’ knowledge perspectives. I also address the connection between expertise by experience and the psychiatric significance of the personal self for the entrenched topics of agency, self-hood, personal identity, and self-knowledge in psychiatric diagnosis. In contrast to identity politics, my model of shared decision-making preserves a critical distance between perspective-taking and value itself in self/other appraisal as the gold standard for good clinical practice. (shrink)

Previous research has investigated factors that contribute to the development of different risk-taking behaviors, such as can occur on lab-based behavioral risky decision making tasks. On several of the most common tasks, participants must develop an adequate understanding of the relative risks and benefits associated with each decision in order to learn to decide advantageously. However, contextual factors can affect the decision making process and one’s ability to weigh the risks and benefits of a decision. The (...) present study investigates the extent to which music may be an additional contextual factor that can disrupt decision making and other executive functions. Across four studies we examine whether having music playing passively in the background or having participants actively listen to music affects performance on measures of risky decision making, working memory, processing speed, and problem solving. Participants reported greater distraction for rock music than classical music in the passive listening studies but did not report any differences in distraction across conditions in the active listening studies. Despite this self-reported increased level of distraction, few significant differences were found in task performance across groups and across studies. The Angling Risk Task was sensitive to differences in risk by condition, with music leading to greater risk-taking in a passive listening study, but less risk-taking in an active listening study, compared to no music. The extent to which music serves as a contextual factor disrupting performance on measures of risky decision making and other executive functions may depend in part on whether individuals are actively versus passively listening to the music. (shrink)

In light of the widespread existence of financial and non-financial issues that contribute to the appearance or fact of conflict of interest, it is proposed that conflict of interest should generally be assumed, no matter the source of financial support or the expressed declarations of conflicts and even with respect to one’s own work. No new model is advanced for modification of peer-review processes or for elaboration of author declarations of interest. Researchers should be assessing the quality of published work (...) as best they can and make their own decisions on the appropriate use of the work. While some apparent sources of conflict are likely more obvious and serious than others, even subtler biases can influence scientific reports. Ignoring peer-reviewed contributions because of conflict-of-interest concerns is discouraged. Listening skeptically to all sources, including yourself, is encouraged. (shrink)

Out of a concern for keeping suicidal patients alive, some psychotherapists may use hard persuasion or coercion to keep them in treatment. However, more recent evidence-supported interventions have made respect for patient autonomy a cornerstone, showing that the effective interventions that promote the wellbeing of suicidal patients also prioritize respect for patient autonomy. This article details how psychotherapists can incorporate respect for patient autonomy in the effective treatment of suicidal patients by listening to them, explaining treatments to them, involving (...) them in decisions, and inviting evaluations from them on the process and progress of their treatment. It also describes how processes that respect patient autonomy can supplement interventions that directly address some of the drivers of suicide. (shrink)

Recently, calls have grown louder for more stakeholder democracy that is, letting stakeholders participate in the process of organizing, decision‐making, and governance in corporations, especially in the area of Corporate Social Responsibility (CSR) activities. Despite the relevance of the subject, the impact of customer involvement in CSR on their company‐related attitudes and behaviors still represents a major research void. The paper at hand develops a conceptual framework of consumer involvement in CSR based on the existing literature, theories of stakeholder (...) democracy, and organizational boundaries as well as drawing from the qualitative focus group interviews (N = 24). The framework is tested on a large scale, two‐time point field‐experimental study (N = 3,397). More specifically, consumer reactions to three degrees of customer involvement (i.e., information, feedback, and dialogue) are tested in two different CSR domains (i.e., company‐internal business process vs. company‐external philanthropic CSR). Results indicate that the customer involvement in CSR has a more beneficial effect in terms of strengthening customer outcomes in CSR domains that directly affect external stakeholders of the company (i.e., philanthropic CSR) than in domains that mainly concern company‐internal stakeholders (i.e., business process CSR). (shrink)

ObjectiveIn this study, we extend the impact of mindfulness to the concept of least-worst decision-making. Least-worst decisions involve high-uncertainty and require the individual to choose between a number of potentially negative courses of action. Research is increasingly exploring least-worst decisions, and real-world events (such as the COVID-19 pandemic) show the need for individuals to overcome uncertainty and commit to a least-worst course of action. From sports to business, researchers are increasingly showing that “being mindful” has a range of positive (...) performance-related benefits. We hypothesized that mindfulness would improve least-worst decision-making because it would increase self-reflection and value identification. However, we also hypothesized that trait maximization (the tendency to attempt to choose the “best” course of action) would negatively interact with mindfulness.MethodsThree hundred and ninety-eight participants were recruited using Amazon MTurk and exposed to a brief mindfulness intervention or a control intervention (listening to an audiobook). After this intervention, participants completed the Least-Worst Uncertain Choice Inventory for Emergency Responders (LUCIFER).ResultsAs hypothesized, mindfulness increased decision-making speed and approach-tendencies. Conversely, for high-maximizers, increased mindfulness caused a slowing of the decision-making process and led to more avoidant choices.ConclusionsThis study shows the potential positive and negative consequences of mindfulness for least-worst decision-making, emphasizing the critical importance of individual differences when considering both the effect of mindfulness and interventions aimed at improving decision-making. (shrink)

Public engagement in ethically laden pandemic planning decisions may be important for transparency, creating public trust, improving compliance with public health orders, and ultimately, contributing to just outcomes. We conducted focus groups with members of the public to characterize public perceptions about social distancing measures likely to be implemented during a pandemic. Participants expressed concerns about job security and economic strain on families if businesses or school closures are prolonged. They shared opposition to closure of religious organizations, citing the need (...) for shared support and worship during times of crises. Group discussions elicited evidence of community-mindedness, while some also acknowledged strong self-interest. Participants conveyed desire for opportunities for public input and education, and articulated distrust of government. Social distancing measures may be challenging to implement and sustain due to strains on family resources and lack of trust in government. (shrink)

This study examined the impact of ethics training engagement on unethical decision-making in the workplace. Participants were randomly assigned to one of the two conditions. Next, a baseline measurement of ethical ideology was collected using the Ethics Position Questionnaire and participants then engaged in ethics training based on the condition to which they were randomly assigned. They then had the option to read along or listen to a hypothetical scenario about an employee faced with the opportunity to make an (...) unethical decision, and completed the Unethical Decision Questionnaire. Results showed that participants in the passive learning condition were significantly more likely to perceive an unethical situation as ethical compared to participants in the active learning ethics training condition. Additionally, participants in the passive learning condition were significantly more likely to engage in unethical decision-making than participants in the active learning condition. The current findings contribute to the existing literature by providing evidence that active learning in ethics training programs could reduce unethical decision-making within the workplace. (shrink)

During the past two years, colleagues and I at The Hastings Center have worked on a project, funded by the John S. and James L. Knight Foundation, that seeks to improve the quality of public deliberation, particularly about science. Specifically, we seek to improve the public's capacity for civic learning, which is our term for the ability of people living in a democracy to learn at least the basics of complex policy issues, discuss them, and make civically responsible decisions about (...) them. There are no quick fixes. The forces that have undermined trust in society and that inhibit a mutually respectful deliberation about these issues have built up over centuries. (shrink)

Freedom of expression is considered a basic human right, and yet most countries have restrictions on speech they deem harmful. Following the genocide of the Tutsi, Rwanda passed a constitution (2003) and laws against hate speech and other forms of divisionist language (2008, 2013). Understanding how language shaped “recognition harms” that both constitute and fuel genocide also helps account for political decisions to limit “divisionist” discourse. When we speak, we make expressive commitments, which are commitments to the viability and value (...) of ways of speaking. This article explores reasons a society would decide to say, “We don’t talk that way around here,” thus taking control of its own expressive commitments. Understanding the scope of the law in Rwanda promises to help clarify limits to hate speech and other forms of derogatory discourse (including images). Ultimately, the argument is that wherever recognition harms are a significant factor in social and political life, changing permissible expressive commitments is crucial to social and political repair. (shrink)

The use of qualitative research in empirical bioethics is becoming increasingly popular, but its implementation comes with several challenges, such as difficulties in aligning moral epistemology and methods. In this paper, we describe some problems that empirical bioethics researchers may face; these problems are related to a tension between the different poles on the spectrum of scientific paradigms, namely a positivist and interpretive stance. We explore the ideas of narrative construction, ‘genres’ in medicine and dominant discourses in relation to empirical (...) research. We also reflect on the loss of depth and context that may occur with thematic or content analyses of interviews, and discuss the need for transparency about methodologies in empirical bioethics. Drawing on insights from narrative approaches in the social sciences and the clinical-educational discipline of Narrative Medicine, we further clarify these problems and suggest a narrative approach to qualitative interviewing in empirical bioethics that enables researchers to ‘listen (and read) in new ways’. We then show how this approach was applied in the first author’s research project about euthanasia decision-making. In addition, we stress the important ethical task of scrutinizing methodologies and meta-ethical standpoints, as they inevitably impact empirical outcomes and corresponding ethical judgments. Finally, we raise the question whether a ‘diagnostic’, rather than a ‘problem-solving’, mindset could and should be foregrounded in empirical ethics, albeit without losing a commitment to ethics’ normative task, and suggest further avenues for theorizing about listening and epistemic (in)justice in relation to empirical (bio)ethics. (shrink)

During the last thirty years different methods have been proposed in order to manage and resolve ethical quandaries, specially in the clinical setting. Some of these methodologies are based on the principles of Decision-making theory. Others looked to other philosophical traditions, like Principlism, Hermeneutics, Narrativism, Casuistry, Pragmatism, etc. This paper defends the view that deliberation is the cornerstone of any adequate methodology. This is due to the fact that moral decisions must take into account not only principles and ideas, (...) but also emotions, values and beliefs. Deliberation is the process in which everyone concerned by the decision is considered a valid moral agent, obliged to give reasons for their own points of view, and to listen to the reasons of others. The goal of this process is not the reaching of a consensus but the enrichment of one's own point of view with that of the others, increasing in this way the maturity of one's own decision, in order to make it more wise or prudent. In many cases the members of a group of deliberation will differ in the final solution of the case, but the confrontation of their reasons will modify the perception of the problem of everyone. This is the profit of the process. Our moral decisions cannot be completely rational, due to the fact that they are influenced by feelings, values, beliefs, etc., but they must be reasonable, that is, wise and prudent. Deliberation is the main procedure to reach this goal. It obliges us to take others into account, respecting their different beliefs and values and prompting them to give reasons for their own points of view. This method has been traditional in Western clinical medicine all over its history, and it should be also the main procedure for clinical ethics. (shrink)

In 1965, Claude Chabrol created La Muette – a fifteen-minute homage to Paris’s sixteenth district. In this short movie, Chabrol uses silence to ask some fundamental questions about the nature of human coexistence: the movie is seen, or better heard, from the perspective of a boy who, ignored by his parents, does not manage to say a word throughout; provoked by this imposed restriction, the boy decides to become not only “mute” but also “deaf.” His decision, however, results in (...) tragic consequences. In La Muette, Chabrol reminds us that the question of coexistence already posed by Virgil in his Eclogues, and signified by sound that freely resounds, has never ceased to be asked. In this Collision, I use the term “post-pastoral” to connect Virgil and Chabrol, and to open a discussion on sonically signified freedom. (shrink)

Decision making is an area of profound importance to a wide range of specialities - for psychologists, economists, lawyers, clinicians, managers, and of course philosophers. Only relatively recently, though, have we begun to really understand how decision making processes are implemented in the brain, and how they might interact with our emotions. 'Emotion and Reason' presents a groundbreaking new approach to understanding decision making processes and their neural bases. The book presents a sweeping survey of the science (...) of decision making. It examines the brain mechanisms involved in making decisions, and controversially proposes that many of our perceptual actions are essentially decision making processes. Whether looking, listening, hearing, or moving, we choose to attend to certain stimuli, at the expense of others. In some psychiatric disorders the inability to respond selectively to certain stimuli can be harmful - such pathologies of decision making are additionally considered. Berthoz also considers how many decision making processes involve an internal dialogue with our other self, and how this dialogue with our "doppelganger" might be represented in the brain. He considers the important implications that a neuroscience of decision making can have for the judiciary - how we apportion blame and responsibility; for economics - with discussion of the growing field of neuroeconomics; and for theories of management. Lastly he examines decision making and creativity - if perception relies in part on decision making processes, how might this alter our view of the artistic process. Written by a neuroscientist of international fame and accessible for both scientists and non-scientists, this book is the most exhaustive examination of the science of decision making yet. (shrink)

Mrs. Smith's eyes filled with tears as she said, “I feel like I've done something wrong. Are they punishing me because I've been refusing therapy and won't go to a nursing home?” She acknowledged that she hadn't always listened to her doctors but said that she knew better now and wanted to go home and see if she could make it work. Many staff members at our rehabilitation hospital had explained their safety concerns to her, and some had enlisted her (...) adult daughter, with whom she lived, to convince her too. The rehabilitation team had called on the ethics consultation service, of which I am a part, to help figure out whether Mrs. Smith had the capacity to make an informed refusal of discharge recommendations. (shrink)

The aim of this article is to generate knowledge about parents’ participation in life-and-death decisions concerning their very premature and/or critically ill infants in hospital neonatal units. The question is: what are parents’ attitudes towards their involvement in such decision making? A descriptive study design using in-depth interviews was chosen. During the period 1997-2000, 20 qualitative interviews with 35 parents of 26 children were carried out. Ten of the infants died; 16 were alive at the time of the interview. (...) The comparative method (grounded theory) was used to analyse the data. The analysis was carried out continuously and in parallel with data collection. Six categories were revealed by the analysis: indecision and uncertainty (ambivalence); information and communication; participate, but do not decide; seeming to be included; the parents’ child; and individual consideration. The findings appear to indicate that parents agree that they should not have the final word in decisions concerning their infants’ future life or death. Such a responsibility would put too heavy a burden on parents who lack the medical knowledge and the professional experience needed to make such a decision, and would be likely to lead to them experiencing strong feelings of guilt. The findings show that parents should be well informed and listened to during the whole decision-making process. Their primary concern was how nurses and physicians communicate with parents who are experiencing a crisis, and how this serious information is presented. (shrink)

Out of 288 Hong Kong cancer patients, 92.3% include themselves in decision-making, 71% prefer joint decision-making: with family, with doctor, with doctor plus family, with family minus doctor, and with doctor minus family. <5% want decision-making by “doctor-alone” and <1% desire decision-making by “family-alone”. Harmony, communication and responsibility are reasons for family participation. Most patients prefer “specialist” for information, followed by “family”, “friends”, and “GP”. Trust in doctors and prospects for controlling/curing disease are important factors in (...) decision-making. Patients want to participate and be listened to rather than make decisions. Doctors should not disclose information to family without patients’ permission, nor withhold information from patient [End Page 109] on family’s request. Only 25% of patients have discussed post-competent treatment with others and 7% have heard of Advance Directive ; 24% refuse to discuss it. After AD has been explained to them, 66% remain reluctant to sign one, preferring to leave oral instructions or appoint family as proxy decision-makers. The family’s decision-making role increases when patients become incompetent. The top reason for signing AD is to receive preferred post-competent treatments, and for not signing it, difficulty with making a prospective decision. The implications of these findings will be discussed. (shrink)

When I finally got eye glasses as a teenager, after denying the need for far too long, I was repeatedly surprised by the world that everyone else had been seeing all along. Leaves on the trees, graffiti by the highway—I was astonished, amazed, and suddenly informed. It is easy to assume we are seeing all we need to see, knowing all we need to know, until something jars us from this false comfort and compels us to reconsider. So it is (...) with thinking about the current state of doctor‐patient decisions. The unfocused view has physicians listening to patients and clearly communicating information about illnesses and treatment options, patients making good use of high‐quality data to craft sound decisions, and doctors joining patient preference with provider beneficence to optimize decisions. The reassuring outlook finds physician paternalism defeated, patients empowered, and all right with the world. Peter Ubel cannot let that fiction stand. In Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together, Ubel reminds us that our work in actualizing patient autonomy and fostering patient participation in critical health decisions remains far from over. (shrink)

Background As more people are living longer, they become frail and are affected by multi-morbidity, resulting in increased demands from the ambulance service. Being vulnerable, older patients may have reduced decision-making capacity, despite still wanting to be involved in decision-making about their care. Their needs may be complex and difficult to assess, and do not always correspond with ambulance assessment protocols. When needing an ambulance, older patients encounter ambulance clinicians who are under high workloads and primarily consider themselves (...) as emergency medical care providers. This situates them in the struggle between differing expectations, and ethical conflicts may arise. To resolve these, providing ethical care, focussing on interpersonal relationships and using ethical competence is needed. However, it is not known whether ambulance clinicians possess the ethical competence required to provide ethical care. Thus, the aim of this study was to deductively explore their ethical competence when caring for older patients with reduced decision-making ability. Methods A qualitative deductive and exploratory design was used to analyse dyadic interviews with ambulance clinicians. A literature review, defining ethical competence as comprising ethical sensitivity, ethical knowledge, ethical reflection, ethical decision-making, ethical action and ethical behaviour, was used as a structured categorization matrix for the analysis. Results Ambulance clinicians possess ethical competence in terms of their ethical knowledge, highlighting the need for establishing an interpersonal relationship with the older patients. To establish this, they use ethical sensitivity to interpret the patients’ needs. Doing this, they are aware of their ethical behaviour, signifying how they must act respectfully and provide the necessary time for listening and interacting. Conclusions Ambulance clinicians fail to see their gut feeling as a professional ethical competence, which might hinder them from reacting to unethical ways of working. Further, they lack ethical reflection regarding the benefits and disadvantages of paternalism, which reduces their ability to perform ethical decision-making. Moreover, their ethical knowledge is hampered by an ageist approach to older patients, which also has consequences for their ethical action. Finally, ambulance clinicians show deficiencies regarding their ethical reflections, as they reflect merely on their own actions, rather than on their values. (shrink)

A commentary on “Men and Abortion Decisions,” by John Hardwig, in the March‐April 2015 issue.

Les instruments de musique nous permettent de fabriquer des sons musicaux, c'est-à-dire des sons désindicialisés (proposés pour eux-mêmes à l'écoute sans assignation à leur cause) et articulés les uns aux autres en un système réel ou supposé. Mais la fabrication n'est pas la seule voie de production de tels sons. Ils peuvent aussi simplement être produits par une décision d'écoute - par une oreille a priori capable d'installer cette désindicialisation et cette articulation, autrement dit par l'oreille d'un être parlant. Ce (...) n'est donc pas parce qu'ils font de la musique que les êtres humains ont un « corps harmonique», c'est parce qu'ils ont acquis un corps harmonique (un corps d'être parlant) qu'ils peuvent faire et entendre de la musique. Cela pourrait aussi expliquer pourquoi nous pouvons être sourds à certaines formes de musique. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 33.3 (2000) v-vii [Access article in PDF] On Feminizing the Philosophy of Rhetoric Molly Meijer Wertheimer When asked to define his editorial policies in choosing articles to publish in Philosophy and Rhetoric, Henry W. Johnstone Jr. disavowed following any strict editorial guidelines; instead, he gave two examples to show how selection worked as a process. In one case, he agreed to publish an "off the wall (...) article" by a distinguished classicist; in another, he accepted an unusually long article--a "behemoth"--by an eminent rhetorician. These examples demonstrate what was to me one of Henry's most unusual and endearing traits as an editor and scholar: he was willing always to go wherever the argument led. It was probably in this spirit that he agreed to publish a special issue on "Feminizing the Philosophy of Rhetoric." I want to thank him posthumously for that decision. As "guest editor" of the issue, I feel privileged to present four well-written essays and two reviews that lead the readers of Philosophy and Rhetoric to consider some philosophical issues that emerge when we overlap concepts of "gender," "culture," and "rhetoric."The essays in this issue explore tactics women have used to get their messages across to others who would not--even could not--entertain speech seriously if presented by a woman. In the first essay, "Unveiling Esther as a Pragmatic Radical Rhetoric," Susan Zaeske reads the Book of Esther as a rhetorical manual of exile and empowerment. She traces features of the narrative that were useful as a model of rhetorical behavior early on, as well as appropriations that were made throughout the Middle Ages, Antebellum South, and even in our own day. Her essay emphasizes the riskiness to the speaker that is often entailed by the act of speaking, especially when the listener is "all-powerful" (199); when "his decisions are based not on careful deliberation, but on who influences him the most, usually by prodding his sense of power and manliness" (200). In the narrative, the speaker, Queen Esther, is depicted as utterly thoughtful, careful, well planned and well timed. She seems very much in control of an "indirect" rhetoric. Says Zaeske, "[T]he book teaches that direct, resistant rhetoric is ineffective, even dangerous, while clever, indirect, noncon- frontational methods will succeed in gaining the desired end--power" (202). [End Page v] This is a "conciliatory strategy wise women are forced to use in the patriarchal world" (qtd. on p. 202). And this kind of strategy is contrasted to the defiant rhetoric of Vashti, the former queen, Esther's predecessor, who was banished for saying no to one of the king's commands. Silence and supplication, according to Zaeske, when adopted self-consciously as strategies, are effective with hostile, neanderthal-type auditors. They are "radical," at least in the sense that they are "extreme."Nan Johnson, in her essay "Reigning in the Court of Silence: Women and Rhetorical Space in Postbellum America," furthers discussion of women's rhetorical options. In Zaeske's essay, women assume positions of supplicants or petitioners, or they stand defiant in the face of an oppressive listener (the king). The former are idolized; the latter are demonized. Centuries later, in the fifty years following the Civil War, similar representations of women appeared in conduct literature. Johnson describes a media blitz of ideas and images in etiquette and other self-help manuals that sought to define rhetorical behaviors and actions appropriate for men and women. Some of the writings idolized the "quiet woman" of the home, who reigned silently as queen stitching together via indirection a rhetoric of nurturance that moved beyond the home only through the actions of husbands and sons. This kind of rhetoric was viewed as a natural consequence of femininity. Other writings demonized the woman who spoke from the public platform as a teacher, preacher, and advocate, and who needed a rhetorical education to do so effectively. Many writings highlighted the negative consequences of rhetorical experience to women (who risked their femininity and the love of their families) and to their families (who risked the true source of... (shrink)

Intersex people first began to publicly tell their stories in the 1990s. Twenty years on, these narratives, scorching in their candor, attest to a continuing failure to bear witness to or to acknowledge some of the most painful experiences we inflict on one another. More than anecdotes, these narratives provide a first–person reflection on care and thus represent a type of long–term follow–up that is largely absent in clinical literature. Out of respect for their courage, we owe these narratives serious (...) consideration. Clinicians who must make daily decisions that may alter patients’ lives may distance themselves from negative outcomes and stories like those told here to avoid professional regret. Honest self–appraisal and accepting regret open the door to feeling guilty, devalued and ashamed, but experiencing these emotions can be a crucial first step in changing clinical practice. (shrink)

continent. 1.1 (2011): 27-32. “My”—what does this word designate? Not what belongs to me, but what I belong to,what contains my whole being, which is mine insofar as I belong to it. Søren Kierkegaard. The Seducer’s Diary . I can’t sleep till I devour you / And I’ll love you, if you let me… Marilyn Manson “Devour” The role of poetry in the relationalities between people has a long history—from epic poetry recounting tales of yore; to emotive lyric poetry; to (...) rude, irreverent limericks; to Hallmark cards which have ditties that allow one to cringe, and somehow fall in love at the same moment. Without going into a notion of aesthetics, or attempting to choose which form of poetry is superior, we might want to consider why the form of poetry itself has long been a part of relationality. And whilst doing so, we might always keep in mind that poetry—especially poetry that moves, transports us—is the form that Plato has been warning us about, particularly if we want to become good citizens.As Avital Ronell teaches us in Stupidity : the poet, irremediably split between exaltation and vulgarity, between the autonomy that produces the concept within intuition and the foolish earthly being, functions as a contaminant for philosophy—a being who at least since Plato, has been trying to read and master an eviction notice served by philosophy. The poet as genius continues to threaten and fascinate, menacing the philosopher with the beyond of knowledge. Philosophy cringes (287). And considering that the philosopher is the lover of wisdom, we might begin to ask ourselves why one lover is warning against another—if the philosopher is in love with wisdom, then is the poet perhaps his rival, his challenger, for that very love? For, one must also remember that Plato—through Socrates—mentions constantly that Homer is his favourite. Moreover, by adopting both his own voice, whilst mixing it with Socrates’, Plato is adopting the form of poetry that he warns most about—the warning almost serves more as a homage to poetry than anything else. Here, we might open the register that one of the main reasons that he ejects a particular kind of poet is on the grounds of effecting effeminacy on the populace—good poetry moves you, affects you, transports you, shifts you beyond reason, puts you “out of your mind.” However, Plato also teaches us that rhetoric in its highest form requires divine inspiration by way of the daemon, or the muse. This moment of divine intervention is one that seizes—perhaps even ceases—you; putting you “beyond yourself.” In other words, a good rhetorician must always already be open to the possibility of otherness—the same otherness that possibly resides in the feminine. One could also trace this back to the poet that he both loved, and feared, most—Homer. Perhaps the effect of effeminacy that Homer's poetry opened is precisely the source of its power: through listening to Homer, one's body, one’s habitus is opened to the possibility of the feminine. And here, one must remember that the source of all learning—and all teaching—also lies in mimesis, in repetition, in habit. Once the habitus is opened to the possibility of invasion, of intervention, of otherness, there is quite possibly no possibility of distinguishing whether the mimesis is that of reproduction, or if there is always already a productive aspect to it. And by extension, if learning cannot be controlled, the very notion of teaching itself is shifted from a master-student relationality to one where the master is potentially changed as well—the relationality between the master and the student is not only inter-changing, but one cannot even know who is teaching, or learning, at any point. All that can be said is that they are in a relationality; which means that one is ultimately unable to locate the locus of knowledge, of wisdom—the site of which Plato is attempting to convince us is the sole domain of the philosopher. And it is this that philosophy is cringing from. To compound matters, philosophy is striving for wisdom; which can only come from the Gods. In other words, this is a gift that has to be bestowed on them—and more than that, wisdom is always already exterior to one’s control and knowledge. At best, it is the role of one to recognise the gift, to answer the call as it were. Here, if we listen carefully, we can hear the echo of Alexander Graham Bell, and the telephone. And as we are attempting to respond to the call of wisdom—the call that both poetry and philosophy are listening out for—it might be helpful to recall the agreement between Alexander Graham Bell and his brother Melville. In the biography, Alexander Graham Bell and the Conquest of Solitude , Robert V. Bruce notes that Aleck and Melly made a “solemn compact that whichever of us should die first would endeavour to communication with the other if it were possible to do so” (63). Since Melville was the one who passed on first, this pact put the onus on Aleck to receive the call of his brother. If you take into consideration the fact that until Melville’s death, both brothers had been working on an early prototype of the telephone, the instrument of distant sound can be read as an attempt by Aleck to maintain the possibility of keeping in touch with Melly, of hearing the voice from beyond. However, this was a connection that was not premised on any knowing, reason, or rationality; it was rather, one that was based on hope, and born out of love. And here, if we eves-drop on a cross-line with The Telephone Book , we can pick up the voice of Avital Ronell once again and hear, “the connection to the other is a reading—not an interpretation, assimilation, or even a hermeneutic understanding, but a reading” (380). In other words, the telephone can be read as the openness to the possibility of responding to the other; one that might always remain unknown. Even in this day of caller-identification, we can never know for sure who the other person on the line is until we pick up: hence, the only decision we can make—the effects of which we remain blind to until it affects us—is to either pick up or not, to either respond or not. And it is not as if the decision to pick up comes without risks: each time we answer a call, we run the risk of it ruining our day. Even when we don’t know who the caller is, perhaps especially when we don’t know who the person on the other end of the line is—and here one only has to think of prank calls—we are leaving ourselves completely open to being affected by another. Thus, philosophy finds itself in the position of Vladimir and Estragon. Since they have no idea who Godot is, they can never know if or when he shows up—thus, if he (and we are taking his gender on the word of the boy, some boy—we don’t even know if it is the same boy—who comes round in the evening) has already come, they would not be in the position to know it. And even if someone comes to them and announces that “I am Godot,” the wait would not be over—without referentiality to the name, they would have to take on faith that that person is indeed Godot. Hence, all they can know is that they are waiting for Godot; and Godot is the name of that waiting itself. All philosophy can know is that it is waiting; and wisdom is the name of that waiting itself. Which brings us to Tina Turner’s eternal question, “what’s love got to do, got to do with it?” In order to begin to consider that, we have to first attempt to examine the notion of love itself. Perhaps we might begin to consider what the difficulty of the statement “I love you.” For, if love is a relationality between two persons—both of whom remain singular, and are attempting to respond to each other—this suggests that neither of them subsume the other under themselves. In other words, the other remains wholly other. If this is so, then the “you” in the statement always remains shrouded in mystery. And even if the “you” was replaced with the name of the person, the veiling remains: for, names refer both to the singularity that is the person, and also every other person bearing that name, at exactly the same time. To compound matters, the only time one has to utter a persons name is in their absence—thus, the correspondence of a name to that particular person is at best an affect of memory. And if we consider the notion of memory, we have to also open the register of forgetting—bringing along with it the problem that there is no object to forgetting. For instance, when one utters “I forgot,” all one is uttering is the fact that one has forgotten, and nothing more—the moment there is an object to the statement, one has strictly speaking remembered what one has forgotten. Moreover, we have no control over when forgetting happens to us. And since it is always already exterior to us, affects us, and has no necessary object, there is no reason to believe that every moment of memory might not bring with it a moment of forgetting. Hence, whenever we utter a name—even if we accept the correspondence between the utterance and the person in front of us—all we are doing is uttering the fact that we are naming. Thus, it is not so much that ‘a rose by any other name would smell as sweet’ but more appropriately, ‘a rose is a rose is a rose’—the relationality between its name and the phenomenon of its sweet smell can only be established after that moment of naming, that instance of catachresis. So, whenever one utters “I love you,” not only is it a performative statement, it is the very naming of that love—all you are doing is establishing a relationality between you and the other. And since there is no necessary referent—one is naming that referentiality as one utters it—this suggests that it is always already a symbolic statement; without which the mystery of the other cannot me maintained. In other words, one cannot love the other without maintaining this symbolic distance—through a ritual; in this case the utterance “I love you.” This might be why Valentine’s Day seems to provoke such a massive reaction: the most common one from people (besides florists) being, Valentine’s Day is mere commercialism. Those among the nay-sayers who maintain a soft spot for Karl Marx would proceed to call it the commodification of relationships; those who prefer the Gods would claim that the sanctity of relationships has been profaned; the gender theorists would note how the fact that males buy the gifts only serves to highlight the unequal power-relation between the genders. Whichever side and variation of the arguments they choose boils down to this: the discomfort lies in the fact that they are confronted with the notion of relationships moving into a mediated sphere. The underlying logic is that love is between two persons only; it should not only remain between them, but more pertinently, be an unmediated experience between two persons. Which of course completely misses the point. For, if we reopen the register that relationships are the result of a negotiation between two persons, there must then be a space between them for this very negotiation to occur. Otherwise, all that is happening is, one person is subsuming the other within their own sphere of understanding; effectively effacing the other. If that were the case, there would no longer be any relationality; all negotiation is gone and the other person is a mere extension of the self—one is in a masturbatory relationality with one’s imaginary. Hence, any relationship must always already carry with it the unknown, and possibly always unknowable. The other person is an enigma, remains—must remain—enigmatic to you. This is the only way in which the proclamation “I love you” remains singular, remains a love that is about the person as a singular person—and not merely about the qualities of the person, what the person is. For, if the mystery of the other is unveiled, then the love for the other person is also a completely transparent love: one that you can know thoroughly, calculate; a check-list. And if they are knowable, this suggests that they can also be negated, and hence, the love can also go away. Only when the love for the other person is an enigmatic one, one that cannot be understood, can that love potentially be an event—and if it is an event, then strictly speaking, it cannot be known before it happens; at best, it can be glimpsed as it is happening, or perhaps even only realised retrospectively. At the point in which it happens, it is a love that comes from elsewhere: this strange phenomenon is best captured in the colloquial phrase, I was struck by love;” or even more so by, “I was blinded by love.” This is a blinding to not only the subject of the encounter—the self—but also of the very object of that encounter, the “you”—all that can be said is that there is an encounter. And it is for this reason Cupid is blind: not just because love is random (and can happen to anyone at any time), but more importantly because even after it happens, both the reason you are in love, and the person you are in love with, remain blind to you. Since there is an unknowable relationality with the other person, the only way you can approach it is through a ritual. This is the lesson that religions have taught us: since one is never able to phenomenally experience the God(s), one has no choice but to approach them symbolically. These rituals are strictly speaking meaningless—the actual content is interchangeable—as it is the form that is important. Rituals allow us momentary glimpses at secrets; and secrets are never about their content(s). Rather, secrets entail the recognition that they are secrets; the secret lies in their form as secret. This can be seen when we consider how group secrets work: since the entire group knows the secret, clearly the content of the secret is not as important as the fact that only members within the group are privy to this secret. Occasionally the actual content can be so trivial that even other people outside the group might know the information; they just do not realize its significance. For instance, if I used my date of birth as my bank-account password, merely knowing when I was born would not instantly give you the key to my life savings. In order for that to happen, you would have had to recognise the significance of the knowledge of my birthday. This means that you have to know that you know something. Since the God(s) are, strictly speaking, unknowable, this suggests that rituals put one in a position to potentially experience the God(s). The meaningless gestures on Valentine’s Day play precisely this ritualised role. It is not so much what you give the other person, but the fact that you give it to them. The gift in this sense is very much akin to an offering; the gift opens the possibility of an exchange. Gift-giving does not guarantee that you will like what is returned; there is always a reciprocation of the gift, but what is returned to you is never known in advance, until the moment it is received. This means that the worst thing that one can do is not give the gift: that would be akin to a cutting off of all possibilities, a complete closing of all communication with the other person. This at the same time also means that you cannot wait for the other person to give you something before you get them their gift: if that were the scenario, the reciprocal gift would be nothing more than a calculated return. The only manner in which both persons can give true gifts is to offer them independently of the other person, whilst keeping them in mind. In this way, the two gifts are always already both uncalculated (in the sense of not knowing what the return is) and also a reciprocation for the other (without knowing whether the other person actually has a gift in the first place). Naturally, this would seem like an irrational, even stupid, way of buying gifts. But it is precisely the stupidity involved that saves the relationship from being banal—more importantly, stupidity prevents it from entering the mere profane. This is not to say that an enigmatic love cannot end—of course it can. However, the difference lies in the fact that if the relationality is wholly transparent, it is subsumed under reason—completely predictable, within the self, and thus never open to the possibility of otherness, exteriority, musing. A love that is an event is one that is also open to the possibility of the divine, the sacred—always already closer to the possibility of wisdom. If we establish that both love and wisdom are exterior, to our knowledge, and the finitude to our selves, this suggests that both are names for the possibility of openness to otherness. In other words, and what choice do we have here but to use the words of the other, the philosopher—the lover of wisdom—is a name for one who is waiting, and nothing more. But that still leaves us with the question of this uncomfortable relationality between philosophy and poetry. But before we address that question, we have to take a momentary detour, and consider the whether it is possible to call one a poet. For, if we take the notion of a poet to be one who reaches the highest levels of rhetoric (beyond the lawyer, and the orator, who only aim to either please the crowds, or convince by way of sophistry), then we must also acknowledge that one can only become a poet at the moment of seizing, the point of inspiration, by the muses. Without this divine moment, all (s)he can do is practice her craft. As no one can control when the muses make their appearance, one could always be practising in vain—in some way, one is always already practising to be least in the way when the muse whispers into one’s ear; one is practising so as not to be vain. And since one cannot know when the muse will appear, there is no time frame to the practising—unlike the lawyer who speaks against a clock, poetry knows no time; the only time that matters is the time appropriate to poetry itself. Thus, all the poet (if one can use this term) is practising for the possibility of effacing her/him self—and waiting. Thus, in order for poetry to occur, in order to be seized, the poet—along with all her concerns—must cease. In other words, there is no poet; there is only the possibility of poetry. However, even as there is no time frame to this waiting, even as all we can say is that poetry is a name for waiting, the one who is practising is always already also in time. And since (s)he is in a symbolic relationality with the possibility of poetry, this suggests that the practising is her sacrifice, and time is precisely what she is sacrificing. Here, it might be helpful to turn to a strange source when it comes to poetry—Georges Bataille—and consider his teachings in the first volume of The Accursed Share where he reminds us that, the “essence [of sacrifice] is to consume profitlessly .” This is where each exchange is beyond rationality, beyond calculability, beyond reason itself, “unsubordinated to the ‘real’ order and occupied only with the present.” He continues: Sacrifice destroys that which it consecrates. It does not have to destroy as fire does; only the tie that connected the offering to the world of profitable activity is severed, but this separation has the sense of a definitive consumption; the consecrated offering cannot be restored to the real order.” (58) Since there is no need for a physical change in the object of sacrifice—“it does not have to destroy as fire does”—this suggests that the tie is severed symbolically. Hence, there is an aspect of trans-substantiation in this sacrifice: the form remains the same; in fact there is no perceivable change—this is the point at which all phenomenology fails—but there is always already a difference, an absolute separation from the “real order,” from logic, calculability, reason. The object of sacrifice, the victim [,] is a surplus taken from the mass of useful wealth…Once chosen, he is the accursed share , destined for violent consumption. But the curse tears him away from the order of things…” (59). And it is this tearing away from the order of things—the order of rationality—that “restores to the sacred world that which servile use has degraded, rendered profane” (55). For, only when it is no longer useful, when it is no longer abstracted—subjected, subsumed under—merely a use-value, can the object be an object as such, can a subject be a subject as such; be a singularity. Thus, it is never so much who or what is sacrificed, but the fact that there is a sacrifice. So even as (s)he is sacrificing her time to poetry, it is always already beyond her knowledge whether what (s)he is doing is actually preparing her for poetry or not—all (s)he can know is that she is sacrificing and nothing more. Hence, all (s)he can do is to open her self to the possibility of this relationality—all (s)he can do is be in love with poetry. At the moment the muse whispers into her ear, (s)he ceases to be, and becomes a medium for poetry—and since this possession is always already beyond our cognitive knowledge, this is also a moment of divine wisdom. In other words, there is no difference between poetry and wisdom—the moment of poetry is the moment of wisdom. And this might be the very reason for the philosopher’s aversion to poets. Not so much because they may corrupt the youth (this is after all the aim of all thinking, all philosophy), but precisely because in order to do so, the philosopher must wait for a moment of possession, for divine musing, for poetry. Hence, all thought, all thinking, all philosophy, is nothing but the waiting for the possibility of poetry itself. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Fitness, Fatness, and Aesthetic Judgments of the Female Body:What the AMA Decision to Medicalize Obesity means for other Non–Normal Female BodiesSara R. Jordan“I’ll be happy to refer you to our dietician to get you on a program to help you get your weight under control before it becomes a problem”.As my new physician spun around out of the examination room door, my head spun faster. I had heard (...) the phrase “get your weight under control” twice that morning, but the contexts in which the phrase was uttered could not have been more different.At 7:30 a.m., my fitness trainer was imploring me to get my weights under control as I struggled under a bar, laden with slightly less than my body weight, to do a final set of front squats. At 11:15 a.m., my new general practitioner was imploring me to get my weight under control, by which he meant to learn how to reduce my body mass index (BMI) to match the chart prominently displayed on his office wall. The exhortation to get my weight under control meant such radically different things in these two contexts that it was difficult to comprehend the meaning of the phrase.I am 5’4” and 158 pounds. This gives me a BMI of 27.3, which means that I am considered overweight; right in the middle of the category of overweight. Or, according to the definition of the BMI found on the calculator pinned to the National Heart Lung and Blood Institutes (NHLBI) webpage, I am over fat. If the BMI is, “a measure of body fat based on height and weight that applies to adult men and women” then I carry a health–threatening percentage of body fat. If my fitness trainer, with his 12 point skin–fold caliper test is correct, my body fat percentage of 17% is within the limits expected of female (non–endurance) athletes. In terms of health, then, I am a paradox: according to one standard, I am healthy and fit, according to another, I am unhealthy and fat.As this new physician picked apart my weight, suggesting I should lose between 15 and 20 pounds to bring myself to “full health”, I found myself quite annoyed. He was a small, rail thin, man with greying hair, tired eyes, unpressed khakis, and a beaten pair of black–ish grey “Crocs” on his feet. He looked disheveled and as if he had not seen the inside of a weights room in his life. As I listened to him address my history, current vitals, and how being overweight in my 30s could lead to being [End Page 101] “fat and 40”, I looked him over and made a snap judgment of “I could bench (press) you [right out this window]”. While I was angry with his delivery, I tried to remind myself that he was an overworked physician in a multi–lingual office, trying to operate under a new paradigm in healthcare policy, practice, and diagnostic categories. Specifically, prompted by the medicalization of the condition of obesity by the American Medical Association, my physician was reflecting the professional wisdom that I suffer from a condition needing preventive treatment. He was trying to be a good practitioner to recommend preventive treatment, but to me, he was being a terrible physician.The AMA Declares Obesity a DiseaseThe declaration by the American Medical Association in 2013 that the condition of being obese is one that requires medical treatment is one that I, on the face of it, support. By inviting the medicalization of the condition, the AMA opens the door for individuals who wage a deeply personal battle with their weight to find support in their physicians’ offices and from their insurance companies. Yet, the blunt tools that are used to assess these conditions raise my ire, emotionally and intellectually.Intellectually, the use of the BMI calculator for snap diagnosis of all individuals makes easy sense. It is an easily comprehended tool and, for a normally distributed population, such a simple tool is an excellent choice. But, it stands to treat outliers like me poorly. Outliers, such as particularly fit... (shrink)

Moral dissensus is a distinct feature of our time. This is not only true of our post-modern culture in general, but also of business culture specifically. In this paper I start by explaining how modernist rationality has produced moral dissensus without offering any hope of bringing an end to it in the foreseeable future. Opting for a form of post-modernist rationality as the only viable way of dealing with moral dissensus, I then make an analysis of a number of ways (...) proposed by both specialists in the field of business ethics, as well as philosophers to deal with moral decision-making in this situation of moral dissensus. The conclusion reached is that none of these attempts succeeds in coming to terms with moral dissensus. I then formulate an alternative approach to moral decision-making which I call: Rational interaction for moral sensitivity. After explaining this approach, I defend it against some of the most obvious objections that might be raised against it in a business environment. When you''re talking birth control, what blocks it and freezes it out is that it''s not a matter of more or fewer babies being argued. That''s just on the surface. What''s underneath is a conflict of faith, of faith in empirical social planning versus faith in the authority of God as revealed by the teachings of the Catholic Church. You can prove the practicality of planned parenthood till you get tired of listening to yourself and it''s going to get nowhere because your antagonist isn''t buying the assumption that anything socially practical is good per se. Goodness for him has other sources which he values as much as or more than social practicality. (Robert M. Pirsig, Zen and the Art of Motorcycle Maintenance.). (shrink)

The purpose of this paper is to show problems encountered in the clinical setting by analyzing a case of a senile demented patient and to reexamine the validity of existing ethical principles and procedures. It will be argue that although existing ethical guidelines and procedures are ordinarily quite useful, ethical decisions based on them could sometimes be inconclusive because unknowabililty and uncertainty inherent to real life situations such as the care of the demented elderly patient exist. It will also be (...) claimed that in the face of uncertainty and unknowability all we can do is try to be a virtuous person on behalf of the patient although it is unknown about what the virtuous clinician who are imaginative, compassionate, benevolent, empathic, trustworthy, fair, altruistic, moderate, and modest would do for the demented patient. In the situation where we cannot surely know what is right or what is good, arrogance could be the worst character that clinicians, ethicists, and philosophers could have. Therefore, what is left to us is, I would argue, keeping listening to others, keep thinking what is good with humility and keep questioning the ethical validity of what we have done and what we will do in the name of the patient’s benefits. No one can be modest without recognizing unknowability in reality and one’s own limitations in ability to judge about what is good for patients. (shrink)

Is there an effect of depressed mood on the interpretation of ambiguity? Are depressed individuals biased to interpret ambiguous information in a negative manner? We used a cross-modal semantic priming task to look for evidence of a negative interpretative bias. Participants listened to ambiguous prime sentences (e.g., Joan was stunned by her final exam mark) and made lexical decisions to target words presented immediately after the sentence offset or after a delay of 1000 ms or 2000 ms. For the semantically (...) related targets, the target was negatively related (distress), positively related (success), or neutrally related (grades) to the ambiguous prime. The experiment was conducted with and without a negative mood induction. The expectation was that depressed participants would be more likely to consider the negative interpretations of the ambiguous primes and would therefore experience larger priming effects for negatively related targets. Although there were large priming effects for all semantically related targets, there was no evidence of a negative interpretative bias. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:News from the President’s Council on BioethicsF. Daniel Davis (bio) and Diane M. Gianelli (bio)As most readers of this column already know, the President's Council on Bioethics went through a major transition during the past year when Leon Kass—in October 2005—handed the chairman's gavel over to Georgetown University's Edmund Pellegrino. Dr. Kass has remained on the Council as a member.1When the gavel change took place, the Council's phone started (...) ringing. Everyone wanted to know the same thing: What topics would the Council take up this term? Dr. Pellegrino's answer was always the same: The Council's agenda would be established through a consultative process with the members themselves and with an eye to those problems and controversies in bioethics to which we, as a body, can make a contribution.Taking its cue from the list of potential topics suggested by members, the Council—over the course of the next several meetings—listened to experts on such topics as children and bioethics (with a focus on children in clinical research), organ transplantation, and that oft-cited-but-hard-to-define concept, "human dignity."The latter topic entered the arena of discussion because it is a concept that is cited frequently in the bioethics literature, and it is also one that has figured prominently in Council discussions and documents. Although the concept is widely invoked, there is no universal understanding of what it means, and it is not easy to encapsulate into a one-size-fits-all definition. Indeed, some critics maintain that appeals to human dignity are fig leaves used to camouflage unconvincing arguments. So between December 2005 and April 2006, the Council devoted several sessions to various perspectives on "human dignity: its meaning, its foundations, and its relevance to bioethics." After hearing from James Childress, Patricia Churchland, Daniel Sulmasy, and Paul Weithman2 on the topic, the Council decided to issue a volume of approximately 20 essays, some by Council members and others by scholars from a variety of relevant disciplines.3 The volume is expected to encompass a broad array of opinion on the topic of human dignity and is scheduled to be published next spring."Children" were also the focus of several sessions during the past year. The Council's last report addressed care giving for the elderly.4 After it was issued, several members suggested it was time to focus on the youngest members of [End Page 375] society. The challenge, of course, was to find a topic that was both timely and relevant—and one about which the Council was uniquely qualified to make a contribution. A number of experts in a variety of related fields testified before the Council about possible issues it could explore: newborn screening for genetic disorders; decision-making standards for those who lack capacity; ethical issues in neonatal and pediatric intensive care; pharmacology and psychiatric disorders in children; and children and clinical research. In addition, a number of groups and individuals involved in related topics met with staff to discuss their interests and concerns.This exploratory engagement with facets of the broad topic of children and bioethics led the Council to focus, more narrowly, on a cluster of issues concerning newborn screening for genetic disorders—a topic on which it is likely that the Council will issue a white paper, possibly by next summer. The stimulus for this particular focus has been the American College of Medical Genetics's recommendation that all newborns in the U.S. be screened for a panel of 29 disorders.5 Currently, each state decides for its residents which conditions are subject to mandated screening, so it is possible to get early diagnoses of treatable disorders in one geographical area but not in another. Proponents of screening find the federal approach to mandated screening more equitable. Potential ethical problems, however, exist with the proposal. Some want to ensure that newborns are screened only for treatable conditions on grounds that it would be too burdensome to discover one is carrying the gene for a late-onset disease that cannot be prevented. Others want to make sure that insurance coverage for individuals and their families is... (shrink)

The English language now dominates scientific communications. Yet, many scientists have English as their second language. Their English proficiency may therefore often be more limited than that of a ‘native speaker’, and their scientific contributions (e.g. manuscripts) in English may frequently contain linguistic features that disrupt the fluency of a reader’s, or listener’s information processing even when the contributions are understandable. Scientific gatekeepers (e.g. journal reviewers) sometimes cite these features to justify negative decisions on manuscripts. Such justifications may rest on (...) the prima facie plausible assumption that linguistic characteristics that hinder fast and easy understandability of scientific contributions are epistemically undesirable in science. I shall raise some doubts about this assumption by drawing on empirical research on processing fluency and its biasing effects. I also argue that directing scientists with English as a foreign language toward approaching ‘native-level’ English can have the negative consequence of reducing their potential to make scientific belief formation more reliable. These points suggest that one seemingly compelling justification for linguistically discriminating against scientific contributions in ‘non-native’ English is questionable and that the common insistence by scientific gatekeepers on ‘native-like’ English may be epistemically harmful to science. (shrink)

This essay examines the terms of the Judicial Oath sworn by the judges in the Athenian courts during the classical period. There is general agreement that the oath contained four basic clauses: to vote in accordance to the laws and decrees of the Athenian people, to vote about matters pertaining to the charge, to listen to both the accuser and defendant equally, and to vote or judge with one’s most fair judgment . Some scholars believe that the fourth clause gave (...) judges the right to vote according to their conscience and to ignore the law if they found it unjust. The first part of the essay shows that this clause gave judges the right to make decisions solely on the basis of their most just judgment only where the laws gave no clear guidance. It was a default clause invoked only twice in the extant orations; it was never used as justification to ignore the written laws. The second part addresses the view that the courts took political factors into account during trials. Although some trials involved leading politicians, the courts were bound by their oath to decide whether the defendant was guilty of the charge brought by the accuser. The only part of a trial where a defendant might mention his political achievements or his public largesse was at during the assessment of the penalty in a trial on a public charge. (shrink)

Although the field of surgical ethics focuses primarily on informed consent, surgical decision‐making, and research ethics, some surgeons have started to consider ethical questions regarding justice and solidarity with poor and minoritized populations. To date, those calling for social justice in surgical care have emphasized increased diversity within the ranks of the surgical profession. This article, in contrast, foregrounds the agency of those most affected by injustice by bringing to bear an ethic of accompaniment. The ethic of accompaniment is (...) born from a theological tradition that has motivated work to improve health outcomes in those at the margins through its emphasis on listening, solidarity against systemic drivers of disease, and proximity to individuals and communities. Through a review of surgical ethics and exploration of a central patient case, we argue for applying an ethic of accompaniment to the care of surgical patients and their communities. (shrink)

This paper concerns Jacques Derrida's reading of S0ren Kierkegaard's interpretation of the biblical story of Abraham's sacrifice. Abraham's decision to listen to God's command and sacrifice to Him his beloved son is based on his personal faith which conflicts with general morality. On the basis of this story, Derrida argues that we often witness similar conflicts between religion and morality, demonstrating that responsibility is ultimately based on something irresponsible, i.e. something secret. The paper finally discusses Derrida's logic of ultimates.

This paper concerns Jacques Derrida's reading of S0ren Kierkegaard's interpretation of the biblical story of Abraham's sacrifice. Abraham's decision to listen to God's command and sacrifice to Him his beloved son is based on his personal faith which conflicts with general morality. On the basis of this story, Derrida argues that we often witness similar conflicts between religion and morality, demonstrating that responsibility is ultimately based on something irresponsible, i.e. something secret. The paper finally discusses Derrida's logic of ultimates.

The coronavirus pandemic has given an old question new traction: what exactly is the meaning of appeals to expert authority in politics? Though basing political decisions on the best available scientific and technical knowledge may be a plain task on the surface, and calls for ‘listening to science’ regularly maintain this perception, the relationship between expertise and politics is complicated. Given the particular centrality of expertise to global governance practices and institutions, what would an international political theory of expertise (...) look like? Two recent volumes on the subject offer highly original answers to this question. Read alongside each other, Lucile Maertens and Marieke Louis’ Why International Organizations Hate Politics and Jens Steffek’s International Organization as Technocratic Utopia bring to the fore the technocratic legacies and depoliticising tendencies of global governance. In this review essay, I first discuss the historical emergence of technocratically-inspired international organisations as portrayed by Jens Steffek, and then turn to Lucile Maertens’ and Marieke Louis’ practitioner-centred account of how depoliticisation works and is best understood analytically. I then offer a comparative discussion and propose that, with the help of both books, we can picture global governance as driven by a search for utopia. (shrink)

Independent on Sunday October 2nd One of the country's lead­ing philosophical counsellers, and chairman of the Society for Philosophy in Practice (SPP), Tim LeBon, said it typically took around six 50 ­minute sessions for a client to move from confusion to resolution. Mr LeBon, who has 'published a book on the subject, Wise Therapy, said philoso­phy was perfectly suited to this type of therapy, dealing as it does with timeless human issues such as love, purpose, happiness and emo­tional challenges. `Wise (...) Therapy, is part of a series aimed at promoting an integrative attitude as its ethos. Among all the many perspectives of psychotherapists and counselors, philosophy needs to take its place and needs to find its voice. Tim LeBon has provided an effective means by which counselors can bring philosophy into their work with clients' - APPA journal `Tim Le Bon's Wise Therapy is a comprehensible and well argued book dealing with the practical therapeutic applications of philosophical research that may well be of interest to philosophers but -- as the author himself intends -- will be of most obvious benefit to therapists and counselors, both by informing their dialogue with clients in new ways and by helping them become more informed about ways to resolve the ethical dilemmas arising within the context of their own work' - Metapsychology `A fascinating workshop for therapists and clients, backed up a thorough degree if philosophical acuity' - Journal of the Society for Existential Analysis `I strongly recommend the book for philosophers as well as practitioners, teachers, students and supervisors in counselling and psychotherapy' - Self and Society `Provides some additional and valuable arrows for the therapist's quiver' - Irvin Yalom, author of Love's Executioner `Like Aristotle, Tim LeBon examines what is said and extracts what is best from it…. There are many fascinating exercises designed to bring out and enlighten the client's values, conception of the good life, well-being, happiness, pleasure, and the proper place of reason in life…. Wise Therapy is well written and engaging. The case histories are illuminating examples of therapeutic techniques at work, the thought experiments are well designed, and the philosophical position adapted from the internal debates of the philosophers is level headed…. I recommend it highly to philosophers with an interest in counselling, and psychological counsellors with an interest in philosophy' - Jeff Mason, The Philosophers' Magazine `Tim LeBon has… authored a text which should become a staple on the philosophical counsellor's bookshelf…. Wise Therapy is a concise, well-written book…. His ability to relate philosophical concepts to counselling concerns is admirable and attests to the skill and knowledge he possesses as a working counsellor. But, by far the most important part of Tim LeBon's book to PC is the last chapter, "The Counsellor's Philosophical Toolbox"' - Craig Munns in The Examined Life ` Tim LeBon has done a good job of offering practical approaches to some of the most important and vexing issues that arise in counselling…. Tim LeBon's book contains helpful suggestions, practical information, and useful examples, and would make a good addition to the library of any counsellors willing to allow philosophy to turn mere client sessions into wise therapy' - Peter Raabe, Practical Philosophy Wise Therapy is an original and practical guide to how philosophy can benefit counselling and psychotherapy. Tim LeBon argues that therapy, informed by philosophy, can help clients make better decision and achieve emotional wisdom. He uses philosophical approaches to explore issues of right and wrong, the emotions and reasons, well-being and the meaning of life, and develops a 'counsellor's toolbox' of techniques that can help practitioners apply the wisdom of philosophy to good therapeutic practice. For counsellors who may find philosophical approaches to therapy useful, this work addresses key philosophical topics - the emotions, free will, the meaning of life and ethics. It is jargon-free where possible and assumes no previous philosophical training. From The Independent, 16th November 2004 Plato is my agony aunt It was the end of a love affair that broke her heart. Could the wisdom of the great philosophers show her how to be happy again? Claire Smith tries a novel form of therapy "The unexamined life is not worth living," Socrates said. Nor is the life you're left with after your boyfriend has left you for another woman - at least, that's how it felt in October last year when mine broke rank and went off with an art student from Cleveland, Ohio. We were over there for the opening of his new art exhibition. He'd flown over four days before me and had met her at a party. Supposedly, they "connected". The five months that followed were a roller-coaster of confusion, vitriol and despair. I knew there'd been problems in our relationship. We saw the world very differently; he delighted in the charm of the ordinary, I wanted maximum divinity. He walked; I galloped. He drank tea; I loathed the stuff. But, along the banks of the Thames, we'd made a promise to always stick together. Our love was something unique: "transcendental", I called it. And besides, we recycled. Surely a commitment to save the world would save our relationship? Alas, no. So there I was, a woman scorned. Hell truly hath no greater fury. And what made it worse was that I still believed in our transcendental love. If I wanted to change the way I was feeling, I needed to alter the way I was thinking. But how? A few bottles of wine and a sharp blow to the head might have done the trick. Fortunately, there's an older, more trusted way of turning your head on its head that counsellors are starting to use: philosophy. The idea of employing Plato as an agony aunt was begun in 1981 by the German philosopher Gerd Achenbach. Although philosophy spends a lot of its time asking real-life questions that affect real-life people - What is happiness? And is it always wrong to lie? - most of the debate goes on in ivory towers. What Achenbach and subsequent philosophers including Tim LeBon, the chairman of the UK's Society for Philosophy in Practice, wanted to do was "give practical application" to this gigantic library of great thoughts. So how does it work? Like most types of therapy, you sign up for a set of sessions. "Two would give you a new perspective on one issue; six would help you to make a major life-decision, like a career change; with 12 you can start to rethink your entire life philosophy," explains LeBon. Each session lasts 50 minutes and costs £50 - and, no, you don't have to have any previous knowledge of philosophy. "If you think of Friends, it would suit Ross and Chandler more than Joey," LeBon says. "It's for anyone who wants to make their emotions more intelligent. Or for those who have tried other kinds of therapy, and want something more cerebral." The first session begins with the patient venting off about whatever's troubling them. The rant over, the counsellor then picks out some key concepts that are crucial to the problem - in the case of heartbreak, it is love and happiness that come hurtling to the fore - and then gets the patient to define what they mean. So, what is love? What is happiness? To kick-start the patient's thinking, LeBon describes what a great philosopher had to say about it. In my case, he tells me what Plato wrote about love in his Symposium: that to stop man fighting the gods, Zeus decided to cut each human in two, so they would lose their strength. "This, then, is the source of our desire to love each other," Plato said. "Each of us is a 'matching half' of a human whole, because each was sliced like a flatfish, two out of one, and each of us is always seeking the half that matches him." This method of probing what we might think are "obvious" ideas, such as love and happiness, was devised by Socrates in the squares of Athens. "The only I thing I know is that I know nothing at all," he boasted. What Socrates showed was that although many of the thinkers of his time thought they knew what justice, happiness and goodness meant, their understanding was tied in to their personal agenda and world view, and, what's more, when pushed, their ideas often contradicted themselves. A bit like me on love. Whereas part of my understanding of love was something that gave life meaning, made it worth living and bound us together, I also believed that true love was "transcendental": that it was out of this world, and it didn't matter if the two people who loved each other couldn't get along in the day-to-day. Love was bigger than the mundane. But when it came to the next stage of the therapy, critical thinking - "to check out whether your assumptions stand up to examination" - I walked head first into a contradiction. If I think love's purpose is to make life worth living, but then say it's irrelevant to daily life, surely my two ideas of love are not compatible? As the cogs in my brain start to creak into motion, I feel myself taking a step back from my predicament: thinking about how I've been thinking. This idea I had of transcendental love might have started off as a romantic dream. But when the relationship stopped working, and I found myself feeling trapped and frustrated, I used it to justify the mechanics of a relationship that just didn't work in the daily grind. I used it to lie to myself. In the final stage, LeBon gets me to start thinking about how to go forward. "You can't change what has happened," he says. "You can't change that he's left you, or how you behaved in the relationship. So, as the Stoics did, let's work on controlling the controllables: the things that you can change." To work out what can be changed, he gets me to try out a thought experiment, a method often used in philosophy to imagine other worlds where people can have different codes of behaviour. Thought experiments shatter your preconceived ideas of how the world should be and let your imagination run wild to how the world could be. "I find Viktor Frankl very useful here, the Austrian psychiatrist and concentration-camp survivor who actually believed that everything in life happens for a purpose," LeBon says. "Suppose this break-up did happen for a reason that will work to your benefit," he suggests. "What might that be? The answer might be that you can now focus on something important that was denied in the relationship. Or - the Hollywood version - so you'll meet someone who is really right for you." Temporarily freed of any sense of responsibility for the relationship that was, and its sorry demise, the list came fast. I could now travel more; he didn't like me travelling on my own, but too often he didn't want to go anywhere, preferring to stay in his studio and make art. I'd love to meet someone with a similar sense of adventure to mine. For the first time in two years, I was being honest with myself about what I really wanted - listening to those voices that we all have inside our heads, and too often try to muzzle. So did philosophy save me? Well, I'm now dating a travel writer I have to run to keep up with. I still haven't got over the fact that my replacement came from Cleveland, Ohio. But I guess I never will. Tim LeBon can be reached by e-mail at [email protected] A FEW WORDS FROM THE WISE Compiled by Ed Caesar · "At the touch of love, everyone becomes a poet" - Plato · "There is always some madness in love. But there is also always some reason in madness" - Friedrich Nietzsche · "That man shall live as his own master and in happiness who can say each day 'I have lived'" - Horace · "The good of man is the active exercise of his soul's faculties in conformity with excellence or virtue... Moreover this activity must occupy a complete lifetime; for one swallow does not make spring, nor does one fine day; and similarly one day or a brief period of happiness does not make a man supremely blessed and happy" - Aristotle · "There is nothing on this earth more to be prized than friendship" - Thomas Aquinas · "Whatever you do... love those who love you" - Voltaire · "Happiness is not an ideal of reason but of imagination" - Immanuel Kant · "Happiness is a state of which you are unconscious. The moment you are aware that you are happy, you cease to be happy" - Jiddu Krishnamurti · "Love is an ideal thing. Marriage is a real thing" - Johann Wolfgang von Goethe I shrink, therefore I am Therapy has many answers, but some questions require the help of a philosopher, says Clint Witchalls Sunday November 21, 2004 The Observer Danny had worked in the City of London for 10 years. As a research analyst, stockbroker and fund manager, he'd made a lot of valuable contacts, earnt a lot of cash, and learnt some important business skills. However, as he approached his mid-thirties, he no longer felt good about himself or what he did for a living, and he found his colleagues cold and unfriendly. A chronic illness made him realise his mortality, and he began to reassess his priorities. Danny had been struggling with his career conundrum for nearly five years when he met David Arnaud, a philosophical counsellor. After a few soul-searching sessions, Danny arrived at a decision. Today, he teaches economics to sixth-formers, and he loves it. 'It's a much better lifestyle,' he says. Many people are turning to philosophical counsellors to get answers to questions such as: 'How do I make sense of myself?' 'What is important to me?' 'Where am I going?' These are perhaps not the sort of questions that require psychiatric intervention, but Arnaud, who recently completed the first empirical study of philosophical counselling in the UK, has found that within just five sessions the majority of clients, with important decisions to make, tend to move from a state of concern and confusion to a resolution. Modern philosophical counselling can be traced back to 1981, when the philosopher Gerd Achenbach opened the first practice near Cologne. Achenbach referred to the new discipline as 'therapy for the sane.' Today, there are hundreds of philosophical counsellors around the world, with the movement particularly strong in the US, Britain and the Netherlands. 'The dilemmas people face aren't always primarily psychological,' says Alex Howard, a philosophical counsellor from Newcastle. 'If people face problems that are social or economic, it doesn't make sense to define their problems in purely psychological terms.' Tim LeBon, a founder member of the Society for Philosophy in Practice (SPP) and author of Wise Therapy, adds: 'We are faced with far more life choices than our grandparents, yet have far fewer resources to deal with them. Our grandparents may have gone to a priest or to other family members for advice; most people don't trust these solutions any more and so want to make their own well-informed, well thought-out choices. Philosophical counselling can help these people - people in mid-life crises who are wondering how to make the most of the rest of their life. People who want to take stock of their values.' Where stressed executives might once have been prescribed a course of tranquillisers or antidepressants, they can now get a dose of Bertrand Russell instead: 'Success is too dearly purchased if all the other ingredients have been sacrificed to obtain it.' While some philosophical counsellors do recommend books for their clients to read, most sessions are about helping the client identify faulty thoughts. For example, a briefing in Aristotelian logic might show a client why their beliefs are erroneous. The person might infer that they're a screw-up because they've screwed up. The counsellor could point out that they're making an error called 'fallacy of composition' - that is, what's true of the part isn't necessarily true of the whole. In philosophical counselling, problems aren't pathologised as they are by the psychiatric profession, and the dialogue between client and counsellor is more like a meeting of equals, compared to many therapies where the client is treated like a patient and seen as someone who is, in some way, inadequate. 'Anybody can benefit from philosophical counselling,' says Howard. 'But it does require someone who is willing to take stock.' Lou Marinoff, author of international bestseller Plato Not Prozac! has done much to promote philosophical counselling. 'Some people who have stabilised their neurochemistry and validated their emotions now wish to examine or re-examine the criteria of their beliefs, the principles of their conduct, or the meaning of their lives,' he says. 'With whom shall they do this? Psychologists and psychiatrists can shed light on such issues - as can rabbis, priests, imams and gurus. Philosophers are now rejoining the ranks of helpers.' LeBon believes certain therapies (such as cognitive behavioural therapy) don't go far enough in helping their clients. 'For instance, if you are anxious about your relationship, a cognitive therapist would try to dispute your catastrophising and jump to conclusions to make you feel less anxious,' says LeBon. 'A philosophical counsellor would do this, but would also look for existential meaning in your anxiety - perhaps you really don't want to be in the relationship and that is what your anxiety is telling you.' LeBon also gives short shrift to psychoanalysts. 'There's very little evidence for the Freudian unconscious, and it's time to move on to more intellectually satisfying and helpful therapies,' he says. However, Alain de Botton, the man who popularised philosophy as self-help, isn't ready to bury psychologists and their ilk just yet. 'The truth is that psychoanalysis grew out of philosophy - it's not some completely new idea, and in fact, done properly, psychoanalysis is philosophical anyway. It may even be dangerous to the mental health of some people to suggest a philosopher rather than a properly trained analyst. The knowledge of analysts when it comes to many emotional problems is now much greater than that of most philosophers.' Guardian Unlimited © Guardian Newspapers Limited 2004. (shrink)

We listen to a cacophony of voices instructing us how to think and feel about nature, including our own bodies. The news media, wildlife documentaries, science magazines, and environmental NGOs are among those clamouring for our attention. But are we empowered by all this knowledge or is our dependence on various epistemic communities allowing our thoughts, sentiments and activities to be unduly governed by others? Drawing on over 30 years on research into the 'social constitution of nature', Making Sense of (...) Nature shows that what we call 'nature' is made sense of for us in ways that make it central to social order, social change and social dissent. By utilising insights and extended examples from anthropology, cultural studies, human geography, philosophy, politics, sociology, science studies, this interdisciplinary text asks whether we can better make sense of nature for ourselves, and thus participate more meaningfully in momentous decisions about the future of life - human and non-human - on the planet. This book shows how 'nature' can be made sense of without presuming its naturalness. The challenge is not so much to rid ourselves of the idea of nature and its 'collateral concepts' (such as genes) but instead, we need to be more alert to how, why and with what effects ideas about 'nature' get fashioned and deployed in specific situations. (shrink)

Listeners are able to quite accurately distinguish between different dialects of their native language, but little is known about the process of dialect identification and the phonetic cues listeners use to identify someone's regional origin. This study examines how different segments, acoustic between-dialect distance, and the listeners' knowledge about a dialect contribute to this process. Native speakers of Grison and Zurich German were asked to categorize isolated words spoken by eight speakers of Grison and eight speakers of Zurich German. Stimuli (...) contained either none, one, or two segmental cues to regional origin. The presence of one dialect-specific segment was enough to allow for an identification rate well above chance. Sensitivity measures and analysis of reaction time showed that the two dialect groups largely relied on the same segmental cues. Acoustic distance to the other dialect, quantified as Euclidean distance in the F1×F2 vowel space, generally facilitated dialect identification, but interacted with native speakers' general knowledge about the dialects: In segments which listeners explicitly associate with one of the two dialects, acoustic distance facilitated dialect recognition to a larger extent than in segments listeners are not aware of dialectal variation. The results suggest that, depending on the prior knowledge about a dialect, acoustic variation is weighted differently. Further analysis showed that Zurich listeners were more sensitive to the dialect differences, responded faster, and presented a more-marked own-dialect response bias than Grison listeners. These findings are in line with the status of Grison German as a marked and Zurich German as a neutral dialect and suggest that, depending on their own dialect's status, listeners used different decision strategies. (shrink)

We present a novel variant of decision making based on the mathematical theory of separable Hilbert spaces. This mathematical structure captures the effect of superposition of composite prospects, including many incorporated intentions, which allows us to describe a variety of interesting fallacies and anomalies that have been reported to particularize the decision making of real human beings. The theory characterizes entangled decision making, non-commutativity of subsequent decisions, and intention interference. We demonstrate how the violation of the Savage’s (...) sure-thing principle, known as the disjunction effect, can be explained quantitatively as a result of the interference of intentions, when making decisions under uncertainty. The disjunction effects, observed in experiments, are accurately predicted using a theorem on interference alternation that we derive, which connects aversion-to-uncertainty to the appearance of negative interference terms suppressing the probability of actions. The conjunction fallacy is also explained by the presence of the interference terms. A series of experiments are analyzed and shown to be in excellent agreement with a priori evaluation of interference effects. The conjunction fallacy is also shown to be a sufficient condition for the disjunction effect, and novel experiments testing the combined interplay between the two effects are suggested. (shrink)

What has concerned me most is the coherence of political philosophy in the light of what is not political philosophy. Reality, what is, is always richer than our knowledge of it. If we are to understand political things, we have to understand more than political things—things like history, science, literature, practical living, common sense, philosophy itself, and yes, the terms and content of revelation.

Listening and responding to patients’ stories for over 20 years as an emergency physician has strengthened my appreciation for the many ways that the skills and principles drawn from writing fiction double as necessary clinical skills. The best medicine doesn’t work on the wrong story, and the stories patients tell sometimes feel like first drafts—vital and fragile works-in-progress. Increasingly complex health challenges compounded by social, financial, and psychological burdens make for stories that are difficult to articulate and comprehend. In (...) this essay, I argue that healthcare providers need to think like creative writers and the skills and sensitivities necessary to story construction deserve a vital space in medical education. A thorough understanding of story anatomy and the imaginative flexibility to work stories into open spaces serve as antidotes to the reductive nature of clinical decision making and have implications as patient safety and risk management strategies. The examples that I have selected demonstrate how thinking like a creative writer functions at the bedside, providing tools for clinical excellence and empathy. This approach asks that we re-imagine the importance of story in clinical care: from a vehicle to a diagnosis to its place as a critical destination. (shrink)

A decision maker relies on information of parties affected by her decision. These parties try to influence her decision by selective disclosure of facts. As is well known from the literature, competition between the informed parties constrains their ability to manipulate information. We depart from this literature by introducing a cost to communicate. Our parties trade off their reporting cost against the effect on the decision. Some information is never revealed. In contrast to setups without communication (...) costs, our decision maker can benefit by ex ante committing to an ex post suboptimal decision rule. Moreover, committing ex ante not to listen to one of the parties may also be beneficial for the decision maker. (shrink)