Marie-Anne Boivin a été en son temps une des sages-femmes françaises les plus célèbres. Son parcours professionnel et scientifique est présenté ici, illustrant l’espace laissé aux femmes dans les professions médicales. Reconnue d’abord pour ses ouvrages techniques concernant l’obstétrique, elle sort de son champ traditionnel de compétence pour aborder de façon novatrice la gynécologie naissante, à l’instar des médecins, avec son Traité pratique des maladies de l’utérus (1833), devenu un classique. Cette œuvre scientifique lui vaut un succès d’estime, mais ne (...) lui permet pas d’atteindre une véritable reconnaissance institutionnelle dans son pays. (shrink)

Obstetrics and gynaecology always has reputation for being a highly litigious. The field of obstetrics and gynaecology is surrounded by different circumstances that stimulate the doctors to practice defensive..

BackgroundObstetrics and gynaecology always has reputation for being a highly litigious. The field of obstetrics and gynaecology is surrounded by different circumstances that stimulate the doctors to practice defensive medicine.MethodsThis study was directed to assess the extent and the possible effect of defensive medicine phenomenon on medical decision making among different grades of obstetric and gynaecologic Sudanese doctors, and to determine any experience of medical litigations with respect to sources and factors associated with it.ResultsA total of 117 (...) class='Hi'>doctors were approached, their distribution according to job description was as follow: consultants registrars and specialists. The majority 89.7 % had the impression that litigation against doctors are increasing and 27.6 % had a direct experience of litigation. In this study less than one half of the surveyed doctors knew the concept of defensive medicine and 71.8 % reported practicing one or another form of defensive medicine. The different sources of the litigations reported by the doctors included: maternal death, perinatal death, other {misdiagnosis, intra-uterine fetal death, uterine perforation, rupture uterus}, fetal distress, injury to viscera and shoulder dystocia. In this study the experience of medical litigation was significantly observed among those who worked in area of blame culture. In logistic regression model, there was no significant difference between those who knew the concept of defence medicine and those who didn’t.ConclusionThere should be strategic plan to reduce the practice of defensive medicine and medical litigation against doctors. (shrink)

Introduction The provision of abortion services in the Republic of Ireland is legally restricted. Recent legislation that has been implemented allows for abortion if there is a real and substantial risk to the woman's life, but in general Irish women must travel abroad for abortion services. The aims of this study were to investigate the clinical experiences of Irish obstetric non-consultant hospital doctors that work in this environment and to assess their attitudes towards termination of pregnancy. Methods We conducted (...) an online cross-sectional descriptive survey of 184 Irish obstetric NCHDs. Quantitate and qualitative analysis was performed. Results There was a 28% response rate. 88% of respondents thought that ToP should be permitted for fatal fetal abnormality if the parents choose, 96% if the woman's health is severely affected and 86% in cases of rape and incest. Over 90% of respondents believed a woman's health suffers because of the need to travel abroad to undergo a ToP. Physical, psychological and social reasons were explored. The research also highlights that obstetric trainees are actively involved in the provision of preabortion and postabortion care. Conclusions The clinical experiences and opinions of the respondents suggest that the current legal availability of abortion in Ireland is insufficient to guide best clinical practice and does not represent the views of those that provide obstetric care. (shrink)

Background This paper examines the degree of agreement among simple dichotomous self-report, validated screening results, and biochemical screening results of prenatal alcohol and other drug use among pregnant women. Method Secondary analysis was conducted on a cohort of pregnant women 16 years or older, presenting for prenatal care in the greater Cape Town, South Africa. Dichotomous verbal screening is a standard of care, and pregnant patients reporting alcohol and other drug use in dichotomous verbal screenings were asked to engage in (...) screening using the Alcohol Smoking and Substance Involvement Screening Test and urinalysis. Results Significant agreements between dichotomous and ASSIST scores were observed. A higher rate of self-reported alcohol use was detected, relative to urine screening with a predictive value of 34.9; while underreporting of illicit substance use was observed with an overall predictive value of 50.0. Conclusion Dichotomous verbal screening was considered valid after comparison with the ASSIST; however, combined use with urine screenings can be recommended especially for identifying illicit substance use in order to accurately detect alcohol and other drug use in pregnancy, so that women can be identified and referred for appropriate interventions where needed. (shrink)

The Dutch system of obstetric care is often recommended for midwife-attended births, the high number of home deliveries, and the low rate of intervention during pregnancy and labour. In this contribution, the question is addressed whether processes of medicalization can be demonstrated in the Dutch midwife practice. Medicalization of pregnancy and childbirth is often criticized because it creates dependency on the medical system and infringement of the autonomy of pregnant women. It is concluded that medicalization is present in the practice (...) of Dutch independent midwives, however it is less clear and outspoken than in hospital policies. (shrink)

Background: Obstetric labor and childbirth are mostly regarded as a physiological process, whereas social, cultural, psychological and transcendental aspects have received less attention. Labor support has been suggested to promote labor progress. The aim of this study was to investigate whether continuous labor support by a midwife promotes labor progress and vaginal delivery.Material and Methods: A randomized controlled study at a university hospital in Sweden in 2015–17. Primiparous women with singleton pregnancy and spontaneous labor onset were randomized to continuous support (...) or standard care during delivery. The primary outcome was the duration of active labor. Secondary outcomes were delivery mode, women's need of labor analgesia and satisfaction with delivery, maternal cortisol levels, and neonatal morbidity.Results: Continuous support was followed by shorter active labor 11.0 ± 5.7 h compared to 13.7 ± 3.9 h with standard care. Women in the continuous support group tended to have lower cortisol levels and low cortisol during the first and second stages of labor were correlated with shorter active labor. Continuous support was followed by spontaneous delivery in 73%, instrumental delivery in 24% and emergency cesarean section in 3% in contrast to standard care which was followed by spontaneous delivery in 62%, instrumental delivery in 24% and cesarean in 14%. The continuous support group received combined analgesic methods more often. Women's satisfaction with delivery and neonatal morbidity were comparable.Conclusion: Continuous labor support was followed by shorter active labor compared to standard care. Women with continuous support had a high rate of vaginal delivery and tended to have lower cortisol levels during all stages of active labor reflecting a lower stress level. Low cortisol was correlated to shorter active labor. Based on these results, we recommend continuous labor support for all primiparous women during active labor. (shrink)

Politicians, employers, courts, and health insurance companies are often discussed as problematically preventing access to birth control. However, doctors have more direct control over women's health and quietly have been much more effective at preventing patients' access to contraception. Obstetrician/Gynecologists routinely deny their patients access to contraception ostensibly in the name of health by withholding birth control until patients undergo yearly pap smears. I argue that those in the medical field are motivated by similarly sexist concerns as those in (...) other major institutions in the United States, but that they are often overlooked in discussions of biomedical ethics. After providing background, I argue that using birth control as a bargaining chip to control patients is morally impermissible, is paternalistic, and is contrary to consent. I next argue that sexism explains, though does not justify, this practice. I discuss the medical harms of routine pap smears and withholding birth control. These claims make medical malpractice likely. Withholding birth control to coerce individuals seeking medical care is medical malpractice, paternalistic, violates autonomy, and is contrary to consent. (shrink)

In France between 1780 and 1815, doctors opened a broad correspondence with medical faculties and public officials about foetal anomalies . Institutional and legal reforms forced doctors to encounter monstrous births with greater frequency, and they responded by developing new ideas about heredity and embryology to explain malformations to public officials. Though doctors achieved consensus on pathogenesis, they struggled to apply these ideas in forensic cases, especially with doubtful sex. Medical networks simultaneously allowed doctors to explore (...) obstetrical techniques, as licensing regulations forced practitioners into emotional encounters with child anomalies. Doctors thus developed a new ethics for treating monstrosities, viewing them as pathological specimens, forensic objects, and obstetrical tragedies. (shrink)

Background While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians' attitudes about prenatal surgery for lethal and non-lethal conditions and to elucidate characteristics associated with these attitudes. Methods Survey of 1200 paediatric surgeons, neonatologists and maternal–fetal medicine specialists. Results Of 1176 eligible physicians, 670 responded. In the setting of a lethal condition for which prenatal surgery would likely result in the child (...) surviving with a severe disability, most respondents either disagreed or strongly disagreed that they would recommend the surgery. Male physicians were twice as likely to recommend surgery for the lethal condition, as were physicians who believe that abortion is morally wrong. Older physicians were less likely to recommend surgery. For non-lethal conditions, most respondents agreed that they would recommend prenatal surgery, even if the surgery increases the risk of prematurity or fetal death. Compared with MFMs, surgeons were less likely to recommend such surgery, as were physicians not affiliated with a fetal centre, and physicians who were religious. Conclusion Physician’s attitudes about prenatal surgery relate to physicians’ beliefs about disability as well as demographic, cultural and religious characteristics. Given the variety of views, parents are likely to receive different recommendations from their doctors about the preferable treatment choice. (shrink)

Background:While there have been studies exploring moral habitability and its impact on the work environments of nurses in Western countries, little is known about the moral habitability of the work environments of nurses and midwives in resource-constrained settings.Research objective:The purpose of this research was to examine the moral habitability of the work environment of nurses and midwives in Ghana and its influence on their moral agency using the philosophical works of Margaret Urban Walker.Research design and participants:A critical moral ethnography was (...) conducted through the analysis of interviews with 30 nurses and midwives, along with observation, and documentary materials.Ethical considerations:After receiving ethics approval, signed informed consent was obtained from participants before data collection.Results:Five themes were identified: (1) holding onto the values, identities, and responsibilities of being a midwife/nurse; (2) scarcity of resources as limiting capacity to meet caring responsibilities; (3) gender and socio-economic inequities shaping the moral-social context of practice; (4) working with incoherent moral understandings and damaged identities in the context of inter- and intra-professional relationships; and (5) surviving through adversity with renewed commitment and courage.Discussion:The nurses and midwives were found to work in an environment that was morally uninhabitable and dominated by the scarcity of resources, overwhelming and incoherent moral responsibilities, oppressive conditions, and workplace violence. These situations constrained their moral agency and provoked suffering and distress. The nurses and midwives negotiated their practice and navigated through morally uninhabitable work environment by holding onto their moral values and commitments to childbearing women.Conclusion:Creating morally habitable workplaces through the provision of adequate resources and instituting interprofessional practice guidelines and workplace violence prevention policies may promote safe and ethical nursing and midwifery practice. (shrink)

By their very nature, overseas medical missions (and even domestic medical charities such as free clinics ) are designed to serve vulnerable populations. If these groups were capable of protecting their own interests, they would not need the help of medical volunteers: their medical needs would be met through existing government health programs or by utilizing their own resources. Medical volunteerism thus seems like an unfettered good: a charitable activity provided by well-meaning doctors and nurses who want to give (...) of their time, skills, and resources to help those who would not otherwise be able to take care of their medical needs. In this article, I argue that if medical volunteerism is to be good, however, it must always meet certain basic ethical requirements. These requirements may be (and perhaps often are) overlooked in the rush to organize and carry out short-term medical missions. I illustrate my point with special reference to short-term medical missions designed to provide surgical repair of obstetric vesico-vaginal fistula, a condition in which the tissues that normally separate the bladder from the vagina are destroyed by obstetric trauma, leading to continuous and unremitting incontinence in the affected woman. (shrink)

In this commentary, I respond to an ethical analysis of a case study, reported by Jankowski and Burcher, in which a woman gives birth to an infant with a known heart anomaly of unknown severity, at home, attended by a midwife. Jankowski and Burcher argue that the midwife who attended this family acted unethically because she knowingly operated outside of her scope of practice. While I agree that the authors’ conclusions are well supported by the portion of the story they (...) were able to gather, the fact that the midwife and mother declined to engage in the ethics consult that informs their piece means that critical segments of the narrative are left untold. Some important additional considerations emerge from these silences.I explore the implicit assumptions of the biotechnical embrace, the roles of the political economy of hope and the obstetric imaginary in driving prenatal testing, and institutional blame for the divisiveness of the home-hospital divide in the United States. The value of Jankowski and Burcher’s case study lies in its ability to highlight the intersections and potential conflicts between the principles of beneficence, patients’ autonomy, and professional ethics, and to begin to chart a course for us through them. (shrink)

In this special issue of The Journal of Clinical Ethics, different views on both the ethical desirability of women delivering in hospitals or at home with midwives are discussed. What careproviders, including midwives, should recommend to mothers in regard to the place of giving birth is considered. Emotional concerns likely to be of importance to mothers, fathers, midwives, and doctors are also presented. Finally, possible optimal approaches at the levels of both policy and the bedside are suggested.

January 2018, the American College of Obstetrics and Gynecology issued a position statement opposing the punishment of women for self‐induced abortion. To those unfamiliar with emerging trends in abortion in the United States and worldwide, the need for the declaration might not be apparent. Several studies suggest that self‐induced abortion is on the rise in the United States. Simultaneously, prosecutions of pregnant women for behavior thought to harm the fetus are increasing. The ACOG statement responds to both trends by urging (...) doctors to honor the integrity and confidentiality inherent in the doctor‐patient relationship. Seen in the context of the larger battle over legal abortion, the statement has far broader implications. By acknowledging the role doctors play in enforcing pregnancy‐related crimes, the ACOG position statement wisely anticipates the ways in which doctors will be implicated should access to legal abortion be further restricted. To understand the need for the ACOG directive, you must first understand that the story of what will happen if abortion becomes a crime in the United States is not to be found in history books; it is staring at us across our southern border. (shrink)

Current efforts to think holistically about mental disorder may be assisted by considering the integrative strategies used by Hildegard of Bingen, a twelfth-century abbess and healer. We search for integrative strategies in the detailed records of Hilde-gard’s treatment of the noblewoman Sigewiza and in Hildegard’s more general writings. Three strategies support Hildegard’s holistic thinking: the use of narrative approaches to mental illness, acknowledging interdependence between perspectives, and applying principles of balance to the relationships between perspectives. Applying these three strategies to (...) the present-day conceptualization and treatment of mental disorder could move us toward a more thoroughly integrated understanding of the field. (shrink)

Daniel Taylor and Dawn Goodwin present a case study of the Morecambe Bay Inquiry (MBI), which examined the high rate of maternal and neonatal deaths over a period of 9 years (2004–2013), within the small maternity unit of Furness General Hospital (FGH), one of the three hospitals comprising Morecambe Bay Hospitals Trust.1 They examine this through a conceptual lens, and provide a solution involving changes in medical education. This commentary explores both these elements. First, they use the lens of ‘Normalisation (...) of Deviance’ (NoD) to explain organisational failure. However, other available lenses such as ‘Sociology of Disasters’, ‘Organisational Silence’ and ‘Comfort-seeking Behaviour’ may point to different problems and solutions. More justification for their choice of the lens of NoD would have been useful. Similarly, more justification for their focus on a cluster of five ‘serious untoward incidents’ (SUIs) occurring in 2008 would also have been useful. They suggest that before 2008, the perinatal mortality rate was low, patient satisfaction was high and recent level 2 accreditation of maternity services by the Clinical Negligence Scheme for Trusts all suggested standards of care within the obstetric department were adequate. This stream of positive signals is likely to have contributed towards a genuine belief of safe operation within the maternity unit by staff and board members. However, as they acknowledge, the first problem can be seen in 2004. According to the MBI,2 there were SUIs in the years before and after 2008, but this …. (shrink)

This study investigated the effect of stroking vs. simple human presence on later reactions of dairy cows to routine veterinary handling. While in two groups of cows the experimenter stroked the ventral part of the neck or the withers for three consecutive weeks, the third group was exposed to close visual presence. After the treatment period the cows were subjected to rectal palpation. The three groups differed significantly in stepping during rectal palpation, which occurred less often in Neck- and Withers-animals (...) than in control animals. Heart rate increase was significantly higher in the control group than in the two stroking groups. Previous stroking led to fewer stress reactions during the rectal palpation, possibly due to a combined effect of improved relationship towards and thus perception of humans and lasting anti-stress effects of tactile stimulation. (shrink)

This study investigated the effect of stroking vs. simple human presence on later reactions of dairy cows to routine veterinary handling. While in two groups of cows the experimenter stroked the ventral part of the neck or the withers for three consecutive weeks, the third group was exposed to close visual presence. After the treatment period the cows were subjected to rectal palpation. The three groups differed significantly in stepping during rectal palpation, which occurred less often in Neck- and Withers-animals (...) than in control animals. Heart rate increase was significantly higher in the control group than in the two stroking groups. Previous stroking led to fewer stress reactions during the rectal palpation, possibly due to a combined effect of improved relationship towards and thus perception of humans and lasting anti-stress effects of tactile stimulation. Keywords: cattle; tactile stimulation; human–animal relationship; animal welfare. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hildegard and HolismSuzanne M. Phillips (bio) and Monique D. Boivin (bio)Keywordsbiopsychosocial, integration, medieval, mental illnessWe appreciate the careful and enriching commentary offered by Kroll and by Radden on our paper about holistic views of mental illness in the writings of the twelfth-century abbess and healer Hildegard of Bingen. Both reviewers are well-established figures in the study of historical perspectives on mental illness, an area that we have just begun (...) to explore. We are glad for the opportunity to respond to their observations and thereby to continue the dialogue.First, we would like to clarify our purpose in preparing this paper. Nowhere do we claim that Hildegard used a biopsychosocial model of mental illness, either in addressing the needs of the particular case of Sigewiza, or more generally in her writings on illness and health. In fact, we agree with Kroll (2007, 370), when he states that Hildegard did not use a biopsychosocial model. We use the term “biopsychosocial” only three times in the paper, always by contrast with what we see in Hildegard’s writings. The present-day biopsychosocial model focuses on getting a range of perspectives on the table, encouraging the consideration of biological, psychological, and social issues when thinking about mental illness. This is a good thing, but we argue that it does not go far enough. Specifically, there has been insufficient attention to ways these perspectives might interact.How, then, might we describe Hildegard’s way of conceptualizing mental illness? In place of the label “biopsychosocial model,” Kroll suggests that Hildegard’s approach could be described as a “religious model” (p. 372). Here we disagree. By our reading, Hildegard’s description of mental illness involves religious components, certainly, but also humoral, astrological, interpersonal, community, and intrapsychic components. Radden correctly notes that we are not so much interested in the particular components as we are in their interactions. We are attracted to Hildegard’s writings because she attends to these interactions. Our students, like Kroll’s (p. 371), are curious about mind–body relationships, which represent one example of the interplay between components. Our concern is that the current biopsychosocial model often fails to satisfy our own, and our students’, interest in the nature of those interactions. Our hope is that Hildegard’s writings might help us to think more richly about the interactions.As Radden (2007, 373) points out, present-day psychiatrists and psychologists do in fact use mul-ticausal accounts of depression. And we agree that such accounts need not be reductionistic (Kroll, 371). But we also recognize that psychology and psychiatry have well-established reductionist (more specifically, materialist) habits. To borrow [End Page 377] Kroll’s phrase, the biological model threatens “to swallow all other models” (p. 371). We must guard against such reductionism, given the habits of our disciplines. As we noted, McHugh and Slavney (1998) respond to that threat by building walls between the perspectives, suggesting that we might use different perspectives when thinking about different sorts of problems. We think that there ought to be more synthetic, holistic ways of responding to that threat, and we are hopeful that Hildegard’s writings can help us to develop those.At a basic level, we see Hildegard asking different questions than people ask today. On the first page of his commentary, for example, Kroll poses the question of “which of these three modalities [bio-, psycho-, social] may be sufficient” (p. 369) in the particular medieval text. We found that the sufficiency of one modality or another does not concern Hildegard. We are not able to speak to the general point that Kroll raises, that one or another element is emphasized depending on the goal of the medieval text; we can report our experience in reading Hildegard, where we found no sense in which one or another component is privileged. Even though Hildegard operated within a thoroughly religious context, we did not find examples of her subsuming other factors under religion. Everything interacts with spiritual concerns, to be sure, but everything also interacts with the biological, and with the interpersonal, and with the astrological. Although it may seem odd to us post-Darwinian thinkers, Hildegard’s model is essentially... (shrink)

Current efforts to think holistically about mental disorder may be assisted by considering the integrative strategies used by Hildegard of Bingen, a twelfth-century abbess and healer. We search for integrative strategies in the detailed records of Hilde-gard’s treatment of the noblewoman Sigewiza and in Hildegard’s more general writings. Three strategies support Hildegard’s holistic thinking: the use of narrative approaches to mental illness, acknowledging interdependence between perspectives, and applying principles of balance to the relationships between perspectives. Applying these three strategies to (...) the present-day conceptualization and treatment of mental disorder could move us toward a more thoroughly integrated understanding of the field. (shrink)

After reviewing the literature on current knowledge about consciousness in humans, we present a state-of-the art discussion on consciousness and related key concepts in animals. Obviously much fewer publications are available on non-human species than on humans, most of them relating to laboratory or wild animal species, and only few to livestock species. Human consciousness is by definition subjective and private. Animal consciousness is usually assessed through behavioural performance. Behaviour involves a wide array of cognitive processes that have to be (...) assessed separately using specific experimental protocols. Accordingly, several processes indicative of the presence of consciousness are discussed: perception and cognition, awareness of the bodily-self, self-related knowledge of the environment (including social environment). When available, specific examples are given in livestock species. Next, we review the existing evidence regarding neuronal correlates of consciousness, and emphasize the difficulty of linking aspects of consciousness to specific neural structures across the phyla because high-level cognitive abilities may have evolved independently along evolution. Several mammalian brain structures (cortex and midbrain) are involved in the manifestations of consciousness, while the equivalent functional structures for birds and fishes would likely be the pallium/tectum and midbrain. Caution is required before excluding consciousness in species not having the same brain structures as the mammalian ones as different neural architectures may mediate comparable processes. Finally, specific neurophysiological mechanisms appear to be strongly linked to the emergence of consciousness, namely neural synchrony and neural feedback. Considering the limited amount of data available and the few animal species studied so far, we conclude that different manifestations of consciousness can be observed in animals but that further refinement is still needed to characterize their level and content in each species. Further research is required to clarify these issues, especially in livestock species. (shrink)

Extinct megafaunal mammals in the Americas are often linked to seed-dispersal mutualisms with large-fruiting tree species, but large-fruiting species in Europe and Asia have received far less attention. Several species of arboreal Maloideae (apples and pears) and Prunoideae (plums and peaches) evolved large fruits starting around nine million years ago, primarily in Eurasia. As evolutionary adaptations for seed dispersal by animals, the size, high sugar content, and bright colorful visual displays of ripeness suggest that mutualism with megafaunal mammals facilitated the (...) evolutionary change. There has been little discussion as to which animals were likely candidate(s) on the late Miocene landscape of Eurasia. We argue that several possible dispersers could have consumed the large fruits, with endozoochoric dispersal usually relying on guilds of species. During the Pleistocene and Holocene, the dispersal guild likely included ursids, equids, and elephantids. During the late Miocene, large primates were likely also among the members of this guild, and the potential of a long-held mutualism between the ape and apple clades merits further discussion. If primates were a driving factor in the evolution of this large-fruit seed-dispersal system, it would represent an example of seed-dispersal-based mutualism with hominids millions of years prior to crop domestication or the development of cultural practices, such as farming. (shrink)

Background Partnering with patients in healthcare research now benefits from a strong rationale and is encouraged by funding agencies and research institutions. However, this new approach raises ethical issues for patients, researchers, research professionals and administrators. The main objective of this review is to map the literature related to the ethical issues associated with patient partnership in healthcare research, as well as the recommendations to address them. Our global aim is to help researchers, patients, research institutions and research ethics boards (...) reflecting on and dealing with these issues. Methods We conducted a scoping review of the ethical issues and recommendations associated with partnering with patients in healthcare research. After our search strategy, 31 peer reviewed articles published between 2007 and 2017 remained and were analyzed. Results We have identified 58 first-order ethical issues and challenges associated with patient partnership in research, regrouped in 18 second-order ethical themes. Most of the issues are transversal to all phases and stages of the research process and a lot of them could also apply to patient-partnership in other spheres of health, such as governance, quality improvement, and education. We suggested that ethical issues and challenges of partnered research can be related to four ethical frameworks: 1) Research ethics; 2) Research integrity; 3) Organizational ethics, and 4) Relational ethics. Conclusions We have identified numerous ethical issues associated with the recent approach of patient-partnership in research. These issues are more diverse than the issues associated with a more traditional research approach. Indeed, the current discussion on how we address ethical issues in research is anchored in the assumption that patients, as research participants, must be protected from risk. However, doing research with, and not on, the patient involves changes in the way we reflect on the ethical issues associated with this approach to research. We propose to broaden the ethical discussion on partnered research to not only rely on a research ethics framework, but to also frame it within the areas of research integrity, organizational ethics and relational ethics. (shrink)

Star Wars Episode VII: The Force Awakens is not the hero’s journey as George Lucas previously conceptualized it. Instead, the story line of The Force Awakens leads me to believe that it creates a new iteration of the hero myth. It follows the contemporary heroine’s journey while conforming to the essential construct of the hero monomyth. First, the contemporary heroine’s journey focuses primarily on the greater good and secondarily on her own personal journey, which is the converse of the traditional (...) hero’s journey. Second, the contemporary heroine’s self is awakened and called to adventure in a different way than the traditional hero. Third, the traditional hero receives guidance on his journey, while the contemporary heroine pushes ahead alone, striving to save her society from despair. (shrink)

Based on newly discovered texts, this book explores the barely known but tremendously influential thought of the Tibetan Buddhist teacher, Mabja Jangchub Tsöndrü.This Tibetan Buddhist master exercised significant influence on the interpretation of Madhyamaka thinking in Tibet during the formative phase of Tibetan Buddhism and plays a key role in the religious thought of his day and beyond. The book studies the framework of Mabja’s philosophical project, holding it up against the works of both his own Madhyamaka teachers as well (...) as those of central authors of the later "classical period". The emerging account of the evolution of Madhyamaka in Tibet reveals a striking pattern of transformative appropriations. This, in turn, affords us insights into the nature and function of tradition in Tibetan religious culture and Mahāyāna Buddhism at large. Innovation is demanded for both the advancement and consolidation of tradition. This ground-breaking book is an invaluable contribution to the study of Tibetan philosophy. It is of great interest to Buddhist practitioners, specialists in Buddhist philosophy and Tibetan Buddhism. (shrink)

In the Nyāya school of Classical Indian Philosophy, the concept of word meaning is described in detail; however, the theory of metaphor seems to clash with the theory of word meaning. This paper explores the theory of meaning in the early Nyāya theory and whether metaphor is compatible with it. The Nyāya theory of meaning is a 'basis for application' (pravrttinimitta) model: words pick out references because of the conventions and practices of use. Yet, these words can come to refer (...) to something completely different by pushing off its conventional usage and taking on a metaphorical meaning. If the referent is determined on the basis of the properties it possesses, how it is possible that only some properties are applied to a referent in metaphorical cases when, conventionally, a referent must possess all of the properties before the word is applied to it? This paper will investigate three main questions: 1) what is the nature of a referent according to the Nyāya?; 2) what is the mechanism for metaphorical transfer that allow some properties to transfer and not others?; and 3) what are the philosophical implications of the Naiyāyikas understanding of meaning? (shrink)

This chapter suggests that Sellars' account of subjectivity as socially constructed, and hence conceptual at its illusory roots, presents a crisp and compelling perspective on cognitive life that captures Buddhist conceptions of transformative non-duality.

As a Madhyamaka philosopher, Taktsang Lotsawa Sherab Rinchen 1 is perhaps most widely known for his claim to have identified eighteen major contradictions in the thought of Tsongkhapa Losang Drakpa, a polemic discussion that appears in the Madhyamaka chapter of his encyclopedic Freedom from Extremes through Comprehensive Knowledge of Philosophy.2 In this article we will not pursue this critique, both renowned and infamous, but instead focus on Taktsang Lotsawa's own pragmatic hermeneutics of emptiness in context. Taktsang Lotsawa argues that *Svātantrika (...) 3 Mādhyamikas, in their drive to furnish the two... (shrink)

In this case-study, I examine examples which fall within the five categories of the re-use of texts in the Nyāya Sūtra, Nyāya Bhāṣya, and Nyāya Vārttika and note the form of quoting and embedment. It is found that the re-use of texts is prominent and that the category and method of embedding the re-used passages varies from author to author. Gautama embeds the most interlanguage quotations without acknowledging his sources and Uddyotakara re-uses the most quotations and paraphrases while acknowledging his (...) sources. Vātsyāyana re-uses the most direct quotations but only acknowledges his sources about half the time. Each author re-uses textual material for two reasons: to demonstrate his authority in this field; and to support his own arguments and to critique objections and opposing theories. Differences crop up in the methodologies of Gautama, Vātsyāyana, and Uddyotakara as the concept of an authority shifts over time, as the body of literature grows, and as new objections and opponents arise. (shrink)

In the acquisition of verbal knowledge, the Nyāya school outlines four conditions of a linguistic utterance that must be met: āsatti (temporal proximity), ākāṅkṣā (syntactic expectancy), tātparya (speaker intention), and yogyatā (semantic fitness). I will follow the traditional Nyāya view that is it one of the four necessary conditions that enable a hearer to gain verbal knowledge. The reasoning behind retaining tātparya as a condition (or cause) of verbal knowledge, is that it provides a resource with which to clarify ambiguity (...) when contextual factors cannot. It also provides a context for a hearer so that the primary (abhidhā) or secondary (lakṣaṇā) meaning of the word, or sentence is understood. In this sense, tātparya imparts the meaning of a work. Examples such as “Bring saindhava” or “Hari” make the case for the importance of tātparya in that the meanings of these terms are ambiguous unless the context is provided or the speaker intends to mean one referent rather than another. In this paper, I present the case that tātparya is the most important component of an accurate paraphrase, and it must be retained in order to preserve the original intention of the work. In other words, tātparya should be the primary constraint of an acceptable paraphrase. As a side comment to my aim, I discuss the notion of why paraphrase only needs to be sufficiently similar to the original work. (shrink)

Children's understanding of the human mind has been found to be related to many social and experiential factors such as interactions with peers (Astington & Jenkins, 1995), parental socioeconomic a...