Objectives: To report the attitudes and opinions of subjects in US clinical trials about whether or not, and why, they should receive post-trial access (PTA) to the trial drug, care and information. Design: Focus groups, short self-administered questionnaires. Setting: Boston, Dallas, Detroit, Oklahoma City. Participants: Current and recent subjects in clinical trials, primarily for chronic diseases. Results: 93 individuals participated in 10 focus groups. Many thought researchers, sponsors, health insurers and others share obligations to facilitate PTA to the trial drug, (...) if it benefited the subject, or to a therapeutic equivalent. Some thought PTA obligations include providing transition care (referrals to non-trial physicians or other trials, limited follow-up, short-term drug supply) or care for long-term adverse events. Others held, in contrast, that there are no PTA obligations regarding drugs or care. However, there was agreement that former subjects should receive information (drug name, dosage received, market approval date, long-term adverse effects, trial results). Participants frequently appealed to health need, cost, relationships, reciprocity, free choice and sponsor self-interest to support their views. Many of their reasons overlapped with those commonly discussed by bioethicists. Conclusion: Many participants in US trials for chronic conditions thought there are obligations to facilitate PTA to the trial drug at a “fair” price; these views were less demanding than those of non-US subjects in other studies. However, our participants’ views about informational obligations were broader than those of other subjects and many bioethicists. Our results suggest that the PTA debate should expand beyond the trial drug and aggregate results. (shrink)

Language’s intentional nature has been highlighted as a crucial feature distinguishing it from other communication systems. Specifically, language is often thought to depend on highly structured intentional action and mutual mindreading by a communicator and recipient. Whilst similar abilities in animals can shed light on the evolution of intentionality, they remain challenging to detect unambiguously. We revisit animal intentional communication and suggest that progress in identifying analogous capacities has been complicated by (i) the assumption that intentional (that is, voluntary) production (...) of communicative acts requires mental-state attribution, and (ii) variation in approaches investigating communication across sensory modalities. To move forward, we argue that a framework fusing research across modalities and species is required. We structure intentional communication into a series of requirements, each of which can be operationalised, investigated empirically, and must be met for purposive, intentionally communicative acts to be demonstrated. Our unified approach helps elucidate the distribution of animal intentional communication and subsequently serves to clarify what is meant by attributions of intentional communication in animals and humans. (shrink)

This book describes and analyzes the levels of experience that long-distance running produces. It looks at the kinds of experiences caused by long-distance running, the dimensions contained in these experiences, and their effects on the subjective life-world and well-being of an individual. Taking a philosophical approach, the analysis presented in this book is founded on Maurice Merleau-Ponty's phenomenology of the body and Martin Heidegger's fundamental ontology. Running is a versatile form of physical exercise which does not reveal all of its (...) dimensions at once. These dimensions escape the eye and are not revealed to the runner conceptually, but rather as sensations and emotions. Instead of concentrating on conceptual analysis, this book explores the emotions and experiences and examines the meaning that running has in runners' lives. Using the participative method, in which the author is both the research subject and the researcher, the book contributes to the philosophy of physical exercise. The research made by Koski is exceptional, and not only because of the topic itself, which also is out of the ordinary. Koski has been fortunate to discover a topic which offers immensely great opportunities to explore and present basic human philosophical themes in a new, fascinating conceptual environment. Emeritus Prof. Lauri Routila I don't know of anyone who has done this in English, certainly not to your depth. -- This project in unique, wonderful, and important Amby Burfoot. (shrink)

The novel coronavirus pandemic (COVID-19) has had far-reaching effects on public health around the world. Attempts to prevent the spread of the disease by quarantine have led to large-scale global socioeconomic disrup- tion. During the outbreak, public authorities and politicians have struggled with how to manage widespread ignorance regarding the virus. Drawing on insights from social epistemology and the emerging interdisciplinary field of ignorance studies, this article provides evidence that the temporality of non- knowing and its intersection with knowing is (...) a force that leads political decision-making during a crisis. Illuminating the epistemic analysis with statements given by the Finnish government to the media in decision- making documents and in press conferences, this paper proposes that a crisis situation, itself, seems to demand from political decision-makers dynamic action while simultaneously knowing little (‘non-knowing’) about the different fronts of tackling the pandemic. We conclude that non-knowing must be recognized explicitly as an enduring and central condition in deci- sion-making, which we call ‘epistemic humility.’. (shrink)

This chapter discusses imaginary technologies that do not exist yet but are expected to be implemented in clinical work in the near future. Adopting a phenomenological view on the politics of organizational time, we illuminate how the rhetoric of futurity and protentional anticipation dominate managerial acts in healthcare organizations. This future-oriented management includes strategies of risk assessment, investments in emerging technologies, and other actions to reduce external uncertainty and move towards an enhanced capacity to cope with potential challenges. However, we (...) suggest that potentially harmful consequences of emerging technologies cannot be established reliably in advance by investigation, experiments, and risk assessments. The phenomenological notion of embodied information infrastructure allows us to consider how visions of complex technologies intertwine with clinical practices in healthcare professionals’ work. We use two examples of imaginary technologies—automated decision-making systems and care robotics—to concretize how the line between imaginary technologies and existing technologies becomes increasingly volatile in healthcare organizations. (shrink)

During the corona pandemic, politicians have been forced to make urgent decisions under pressure while balancing between challenging options: protecting citizens’ health or causing major social and economic difficulties through security measures. Part of the dilemma has been whether the chosen security measures are oversized, causing fundamental economic and social problems, or not sufficiently enough, thus putting people’s lives at risk. In illustrating our discussion with actions taken by press conferences (PCs) of the Finnish Government, we discuss how nonknowing has (...) governed political decision-making in the corona crisis and how tackling the pandemic has required politicians and experts to develop a capability of dealing with the epistemic conditions of nonknowledge. When information about the virus was constantly updated, the epistemic states of ‘not-yet-known’ or ‘partly-known’ substantially affect the rhythms in which political decisions are made in managing the spread of COVID-19. We suggest that Prime Minister Marin and her cabinet developed a policy of epistemic humility where the legitimation of decision is not based on scientific knowledge but rather on the temporality of nonknowing. The crisis created a favourable momentum for addressing issues of nonknowing in politics, which are easily kept outside of the public attention. (shrink)

Levinas and the Philosophy of Religion Jeffrey L. Kosky Reveals the interplay of phenomenology and religion in Levinas’s thought. "Kosky examines Levinas’s thought from the perspective of the philosophy of religion and he does so in a way that is attentive to the philosophical nuances of Levinas’s argument.... an insightful, well written, and carefully documented study... that uniquely illuminates Levinas’s work." —John D. Caputo For readers who suspect there is no place for religion and morality in postmodern philosophy, Jeffrey L. (...) Kosky suggests otherwise in this skillful interpretation of the ethical and religious dimensions of Emmanuel Levinas’s thought. Placing Levinas in relation to Hegel and Nietzsche, Husserl and Heidegger, Derrida and Marion, Kosky develops religious themes found in Levinas’s work and offers a way to think and speak about ethics and morality within the horizons of contemporary philosophy of religion. Kosky embraces the entire scope of Levinas’s writings, from Totality and Infinity to Otherwise than Being, contrasting Levinas’s early religious and moral thought with that of his later works while exploring the nature of phenomenological reduction, the relation of religion and philosophy, the question of whether Levinas can be considered a Jewish thinker, and the religious and theological import of Levinas’s phenomenology. Kosky stresses that Levinas is first and foremost a phenomenologist and that the relationship between religion and philosophy in his ethics should cast doubt on the assumption that a natural or inevitable link exists between deconstruction and atheism. Jeffrey L. Kosky is translator of On Descartes’ Metaphysical Prism: The Constitution and the Limits of Onto-theo-logy in Cartesian Thought by Jean-Luc Marion. He has taught at Williams College. Indiana Series in the Philosophy of Religion—Merold Westphal, general editor May 2001 272 pages, 6 1/8 x 9 1/4, bibl., index, append. cloth 0-253-33925-1 $39.95 s / £30.50. (shrink)

The elimination of child marriage is a goal that ranks high on the agendas of civil society organizations, national governments, and multilateral institutions. To date, however, there has been very little scholarship on the historical debates over the definition of child marriage. This article examines the history of age-restricted marriage as it was debated during the development of human rights instruments in the post-World War II era. Using archives of the United Nations and affiliated organizations, we detail how and why (...) efforts to establish a universal minimum age for marriage were repeatedly unsuccessful. We illustrate how the current, commonly used definition of child marriage—as marriage before the age of 18—has never been agreed upon in a legally binding international convention but was seemingly established through a discursive innovation that borrowed principles from the 1989 Convention on the Rights of the Child. (shrink)

A generation ago, we adopted a national system for the protection of human subjects in research. Today, that system is facing new challenges. Many argue that the system has failed to evolve in concert with dramatic changes in the research environment. Accordingly, efforts are underway to reform the existing process to make it both more efficient and more effective. At the same time, many are also reexamining the system in more fundamental ways — going well beyond considerations of policies and (...) compliance and raising questions that go to the very foundations of what constitutes an ethical conduct of human research.Experimentation involving human subjects is a necessary step in the process of translating scientific discovery and technological advancement into procedures and products that offer the prospect of better lives for all of us. It helps us to better understand why we do the things we do and believe what we believe. (shrink)

A generation ago, we adopted a national system for the protection of human subjects in research. Today, that system is facing new challenges. Many argue that the system has failed to evolve in concert with dramatic changes in the research environment. Accordingly, efforts are underway to reform the existing process to make it both more efficient and more effective. At the same time, many are also reexamining the system in more fundamental ways — going well beyond considerations of policies and (...) compliance and raising questions that go to the very foundations of what constitutes an ethical conduct of human research.Experimentation involving human subjects is a necessary step in the process of translating scientific discovery and technological advancement into procedures and products that offer the prospect of better lives for all of us. It helps us to better understand why we do the things we do and believe what we believe. (shrink)

This project explores vaccine hesitancy through an artist–scientist collaboration. It aims to create better understanding of vaccine hesitant parents’ health beliefs and how these influence their vaccine-critical decisions. The project interviews vaccine-hesitant parents in the Netherlands and Finland and develops experimental visual-narrative means to analyse the interview data. Vaccine-hesitant parents’ health beliefs are, in this study, expressed through stories, and they are paralleled with so-called illness narratives. The study explores the following four main health beliefs originating from the parents’ interviews: (...) perceived benefits of illness, belief in the body’s intelligence and self-healing capacity, beliefs about the “inside–outside” flow of substances in the body, and view of death as a natural part of life. These beliefs are interpreted through arts-based diagrammatic representations. These diagrams, merging multiple aspects of the parents’ narratives, are subsequently used in a collaborative meaning-making dialogue between the artist and the scientist. The resulting dialogue contrasts the health beliefs behind vaccine hesitancy with scientific knowledge, as well as the authors’ personal, and differing, attitudes toward these. (shrink)

Along with Husserl's _Ideas_ and Heidegger's _Being and Time_, _Being Given_ is one of the classic works of phenomenology in the twentieth century. Through readings of Kant, Husserl, Heidegger, Derrida, and twentieth-century French phenomenology, it ventures a bold and decisive reappraisal of phenomenology and its possibilities. Its author's most original work to date, the book pushes phenomenology to its limits in an attempt to redefine and recover the phenomenological ideal, which the author argues has never been realized in any of (...) the historical phenomenologies. Against Husserl's reduction to consciousness and Heidegger's reduction to _Dasein_, the author proposes a third reduction to givenness, wherein phenomena appear unconditionally and show themselves from themselves at their own initiative. _Being Given_ is the clearest, most systematic response to questions that have occupied its author for the better part of two decades. The book articulates a powerful set of concepts that should provoke new research in philosophy, religion, and art, as well as at the intersection of these disciplines. Some of the significant issues it treats include the phenomenological definition of the phenomenon, the redefinition of the gift in terms not of economy but of givenness, the nature of saturated phenomena, and the question "Who comes after the subject?" Throughout his consideration of these issues, the author carefully notes their significance for the increasingly popular fields of religious studies and philosophy of religion. _Being Given_ is therefore indispensable reading for anyone interested in the question of the relation between the phenomenological and the theological in Marion and emergent French phenomenology. (shrink)

Levinas scholarship in English has come a long way since his major philosophical works were translated some 35 years ago. Almost all the writings appear in English, and it is not a great exaggeration to say that the major theses have been explained and the major problems exposed. The task now is to make this seeming point of arrival into a new beginning. For students interested in exploring new directions in Levinas studies, a reading of Maurice Blanchot could prove immensely (...) rewarding. Companions since they first encountered one another at Strasbourg when each was not yet 20 years old, Levinas and Blanchot remainedfriends until Levinas’s death in 1996 and Blanchot’s in 2003. While we can only imagine the significance the friendship had for each of them, for the rest of us it proved what Jacques Derrida called “a grace, a blessing for our times.”. (shrink)

Levinas holds that ethics provides a figure of philosophical thought that is not ordered metaphysically and so allows us to explicate the significance of God whose fate is not linked with that of metaphysics, and his descrip- tion of ethics permits philosophy to bypass historical revelations pre- served by religious traditions as it articulates this significance of God. Nevertheless, Levinas's attempt to save the name "God" for that which responsibility witnesses is troubled in several ways: the responsible self cannot tell, (...) and cannot tell us, whether its responsibility witnesses God since (1) both it and God are outside the order (metaphysics and consciousness) where identification would be possible and (2) the anonymity of this God and the trauma suffered by the self are disturbingly close to the menace of the anonymous il y a as that anonymity has been described in Levinas's earlier work. (shrink)

Does Descartes belong to metaphysics? What do we mean when we say "metaphysics"? These questions form the point of departure for Jean-Luc Marion's groundbreaking study of Cartesian thought. Analyses of Descartes' notion of the _ego_ and his idea of God show that if Descartes represents the fullest example of metaphysics, he no less transgresses its limits. Writing as philosopher and historian of philosophy, Marion uses Heidegger's concept of metaphysics to interpret the Cartesian corpus—an interpretation strangely omitted from Heidegger's own history (...) of philosophy. This interpretation complicates and deepens the Heideggerian concept of metaphysics, a concept that has dominated twentieth-century philosophy. Examinations of Descartes' predecessors and his successors clarify the meaning of the Cartesian revolution in philosophy. Expertly translated by Jeffrey Kosky, this work will appeal to historians of philosophy, students of religion, and anyone interested in the genealogy of contemporary thought and its contradictions. (shrink)

A number of art projects are currently tackling the medical domain. This activity stems from a perceived need to increase the transparency and democracy of the medical domain, and it often questions the power relations and the one-dimensionality in current medical practices. This article sheds light on how artists process medical themes, elaborates on research elements embedded in art making processes, and considers the relevance of artists' projects for researchers from other disciplines. It deliberates on the author's media and performance (...) art practice in exploring the doctor-patient relationship and discusses the artistic methods and techniques employed. The article promotes the personal, imaginative, and figurative characteristics in the discussion and signification of the body in medicine. (shrink)

The dissertation focuses on the work of Emmanuel Levinas. In claiming "ethics is first philosophy," Levinas helps overcome the perceived indifference to ethical concerns among post-modern thinkers. However, it is often overlooked that this claim is as much about philosophy as it is about the importance of ethics. The dissertation explains why Levinas' philosophy turns to ethics and what philosophy is capable of once it has adopted this ethical figure. ;The first section is devoted to Levinas' Totality and Infinity. There, (...) Levinas argues that ethics reorients philosophy by accomplishing the metaphysical desire for beings as such, what Levinas calls the absolutely other. A reading of Jacques Derrida's essay "Violence and Metaphysics" shows that Totality and Infinity is profoundly determined by a theological conceptuality and correlatively by forgetting the ontological difference. This suggests that the primacy of ethics depends on an anterior instance, thus rendering Levinas' first philosophy secondary. ;The second section of the dissertation positions Levinas' ethical philosophy within the tradition of phenomenological philosophy and its quest for a subject who is first or ultimate. Whereas Husserl practiced the reduction to the point where it reached consciousness, Levinas practices it to a point beyond that: responsibility. Ethics intervenes as a supplement to Husserl's phenomenology: ethics is added to phenomenology in order to explain its possibility at the same time as it replaces phenomenology with ethical descriptions. This section concludes by contesting the privilege that Levinas accords to ethics in the phenomenology of the subject. It does so by showing that Heidegger's Dasein analytic offers phenomenological philosophy a similar subject. ;The third section argues that in responsibility, phenomena appear which do not appear when the subject is consciousness. These include religious phenomena. The phenomenology of responsibility can thus be the basis for a philosophy of religion. Like the modern philosophy of religion figured in Hegel and Nietzsche, it articulates the rationality or significance of religious phenomena without recourse to the dogmatic authority of faith or historical tradition. However, a philosophy of religion issued from Levinas surpasses the origin of this tradition in the death of God and end of metaphysics. (shrink)

La pensée de Lévinas, du début jusqu’à la fin, est animée par le souci de libérer le moi du « mal de l’être » – c’est-à-dire, de l’expérience de l’être anonyme et irrémissible, sans fin ni commencement, que Lévinas nomme il y a. Dans les premiers ouvrages , l’autofondation du sujet répond à ce souci, mais cette tentative de libération échoue en tant qu’elle condamne le sujet à la présence toujours présente de lui-même et à sa persévérance dans l’effort d’être. (...) La notion de substitution que développera pleinement Autrement qu’être réussit là où la tentative des premiers ouvrages a échoué. La substitution dans la responsabilité libère la subjectivité mais, selon un paradoxe essentiel, la libère en la rendant otage de l’autre. Si la substitution dans la responsabilité est en effet l’événement de la subjectivation, comme le soutient Lévinas, alors il n’y a pas d’éthique sans libération et pas de libération sans éthique.Levinas’ thought, form start to finish, was animated by a concern for liberation of the self form the « evil of Being » – that is, form the experience of anonymous, irremissible Being without start or finish, which Levins names there is. In the early works , the autofoundation of the subject responds to this concern, but this attempt at liberation falls short as it condemns the subject to the ever present presence of itself and its perseverance in the effort of existing. The notion of substituion, developed most fully in Autrement qu’être, then succeeds xhere the aerlier effort failed. Substitution in responsibility liberates subjectivity, but, according to an essential paradox, liberates it as hostage of the other. If substitution in responsibility is indeed the event of subjectification, as Levinas argues, then there is no ethics without liberation, and no liberation without ethics. (shrink)

The phenomenological project of Jean-Luc Marion’s Being Given (namely, to free phenomenological possibility to the unconditional self-giving of all phenomena) should be distinguished from the theological project of his God without Being (to think God unconditionally and absolutely). In freeing phenomenological possibility to the self-giving of all phenomena (on the model of the saturated phenomenon), and in proposing a new figure of the subject who receives phenomena (the gifted), Marion’s phenomenology provides the conceptual means for a philosophy of religion that (...) admits the phenomenonality of unconditional revelation. And yet, thereremain striking parallels between the unconditional, self-giving phenomenon as it is described in the phenomenology of Being Given and the unconditional, self-giving God of the theological God without Being. This essay concludes by offering a framework for interpreting these parallels without claiming that the saturated phenomenon transforms phenomenology into theology and without claiming that phenomenological givenness limits revelation to its philosophical possibility. (shrink)

We take our bearings from Francesco Negri — Although many persons attribute the origin of letter writing to various causes, I however believe that one to be closer to the truth that we have received, handed down by memory, from the ancient stories of Turpilius: namely, that the letter was invented for no other purpose than that we should make absent friends once more present [absentes amicos presentes redderemus] and that by regarding [intuentes] their letters we mightfor a time restore (...) the friendship interrupted by intervals of time and space; for since friendship is accustomed to making its foundation in daily companionship,when this thing is missing it seems indeed to weaken not a little.and hear in this passage the resonance of Aristotle:Is it then the same way with friends as with lovers, for whom seeing [to horon] the beloved is their greatest contentment, and the thing they choose over the other senses, since it is especially through seeing that love is present and comes to be present, so that for friends, too, living together [suzèn] is the most choiceworthy thing? For friendship is a sharing in common [koinònia]. (EN 1171b29–33)The audible connection with Aristotle is faint. Negri’s work is securely placed against the background of the increasing formalization of the art of letter writing in the Middle Ages and its Renaissance development, in which he figured prominently. The genealogy that he proposes, whose forebear is an all but forgotten Roman playwright, belongs to an account of literary tradition in which Cicero is the exemplary figure. Nonetheless, it is in St. Jerome that he finds the likely source of his attribution. (shrink)

In this chapter I invite the reader to consider the philosophical assumptions which underpin the early career aims and objectives of Barrie Kosky. A focus will be his “language” of opera, and the processes by which the audience is prompted to interpret it. The result will be to see how Kosky creates mystery and meaning while avoiding fantasy and escapism; and can express psychological truth while stimulating subjective interpretations. The point will be to show that Kosky’s oeuvre demonstrates a central (...) concept in the Kantian tradition of aesthetic theory regarding the key process in creative expression, and that is the evocation/communication of “aesthetic ideas”. (shrink)

Two years ago, the Journal of Law, Medicine & Ethics published volume 28, number 4, devoted to a symposium entitled Human Subjects Research and the Role of Institutional Review Boards - Conflicts and Challenges. I had the good fortune to be asked to serve as editor of that issue. In her introduction to the symposium, the then editor-in-chief of the journal, Ellen Wright Clayton, observed that the country is currently undergoing a major reexamination of how biomedical research is conducted. While (...) that reexamination has continued in the interim, some very recent events raise questions about the extent to which this will continue, at least in the short run, with equal vigor. The intervening years have witnessed a variety of new directions and events. The federal Office of Human Research Protections, directed by Dr. Greg Koski, who wrote a brief commentary for the last symposium,L has taken a new direction, strongly stressing the need for institutions and their institutional review boards ORBS) to engage in extensive educational and quality improvement efforts with both researchers and their own member. (shrink)

Two years ago, the Journal of Law, Medicine & Ethics published volume 28, number 4, devoted to a symposium entitled Human Subjects Research and the Role of Institutional Review Boards - Conflicts and Challenges. I had the good fortune to be asked to serve as editor of that issue. In her introduction to the symposium, the then editor-in-chief of the journal, Ellen Wright Clayton, observed that the country is currently undergoing a major reexamination of how biomedical research is conducted. While (...) that reexamination has continued in the interim, some very recent events raise questions about the extent to which this will continue, at least in the short run, with equal vigor. The intervening years have witnessed a variety of new directions and events. The federal Office of Human Research Protections, directed by Dr. Greg Koski, who wrote a brief commentary for the last symposium,L has taken a new direction, strongly stressing the need for institutions and their institutional review boards ORBS) to engage in extensive educational and quality improvement efforts with both researchers and their own member. (shrink)

This book, the first of its kind, surveys the career of the renowned Australian-German theatre and opera director Barrie Kosky. Its nine chapters provide multidisciplinary analyses of Barrie Kosky’s working practices and stage productions, from the beginning of his career in Melbourne to his current roles as Head of the Komische Oper Berlin and as a guest director in international demand. Specialists in theatre studies, opera studies, musical theatre studies, aesthetics, and arts administration offer in-depth accounts of Kosky’s unusually wide-ranging (...) engagements with the performing arts – as a director of spoken theatre, operas, musicals, operettas, as an adaptor, a performer, a writer, and an arts manager. Further, this book includes contributions from theatre practitioners with first-hand experience of collaborating with Kosky in the 1990s, who draw on interviews with members of Gilgul, Australia’s first Jewish theatre company, to document this formative period in Kosky’s career. The book investigates the ways in which Kosky has created transnational theatres, through introducing European themes and theatre techniques to his Australian work or through bringing fresh voices to the national dialogue in Germany’s theatre landscape. An appendix contains a timeline and guide to Kosky’s productions to date. (shrink)

As Kosky and Avram show, the work of Levinas represents a significant contribution because he takes seriously the challenge posed by the decay of religious traditions and other inherited frameworks of meaning and he insists on the unconditional character of the good. Nonetheless, critical questions about the adequacy of this contribution need to be pressed more forcefully. I suggest that from the point of view of theological ethics his work is problematic in three ways: He can give little guidance concerning (...) what values we ought to seek; in indentifying the good with the event of encountering the completely other, he falsely in- flates moral demands at the same time that he devalues commonalities; and he offers scant grounds for affirming the goodness of being. (shrink)

Author's ideas on the end of the world and afterlife.

What might be thought of as religious longings, he argues, are crucial aspects of enchanting secularity when developed through encounters with these works of art.