Contemporary health care often lacks generosity of spirit, even when treatment is most efficient. Too many patients are left unhappy with how they are treated, and too many medical professionals feel estranged from the calling that drew them to medicine. Arthur W. Frank tells the stories of ill people, doctors, and nurses who are restoring generosity to medicine--generosity toward others and to themselves. The Renewal of Generosity evokes medicine as the face-to-face encounter that comes before and after diagnostics, pharmaceuticals, (...) and surgeries. Frank calls upon the Roman emperor Marcus Aurelius, philosopher Emmanuel Levinas, and literary critic Mikhail Bakhtin to reflect on stories of ill people, doctors, and nurses who transform demoralized medicine into caring relationships. He presents their stories as a source of consolation for both ill and professional alike and as an impetus to changing medical systems. Frank shows how generosity is being renewed through dialogue that is more than the exchange of information. Dialogue is an ethic and an ideal for people on both sides of the medical encounter who want to offer more to those they meet and who want their own lives enriched in the process. The Renewal of Generosity views illness and medical work with grace and compassion, making an invaluable contribution to expanding our vision of suffering and healing. (shrink)

This is an original and stimulating collection of articles by scholars trained in classics, moral philosophy, political science, literature, and intellectual history. Its principal objective is to convey to the modern reader a sophisticated understanding of Homeric and Classical Greek morality and how it differs from our own. Some of the articles focus primarily on Greek value concepts, especially the concept of arete. Others compare those concepts to modern notions of virtue and tolerance, as well as to the work of (...) contemporary literary figures and philosophers, including T.S. Eliot, Alasdair Macintyre, John Wallace, and Philippa Foot. Throughout, the juxtaposition of ancient and modern ideas and the worldviews they presuppose makes these readings both intellectually exciting and revealing. (shrink)

Because statements like ‘This object is soluble in aqua regia’ involve the causal modalities, we call them causal dispositional statements. Now while this involvement has long been recognized, no thorough examination of its exact nature has ever been made. One purpose of this paper is to begin such an examination. In Sec. 2 we will suggest an analysis of causal dispositional statements, and in Sec. 3 we will discuss some philosophic issues to which this analysis is relevant.

We obtain 2 models in which AC is false and in which there are long sequences of consecutive large cardinals.

We show relative to strong hypotheses that patterns of compact cardinals in the universe, where a compact cardinal is one which is either strongly compact or supercompact, can be virtually arbitrary. Specifically, we prove if V “ZFC + Ω is the least inaccessible limit of measurable limits of supercompact cardinals + ƒ : Ω → 2 is a function”, then there is a partial ordering P V so that for , There is a proper class of compact cardinals + If (...) ƒ = 0, then the αth compact cardinal is not supercompact + If ƒ = 1, then the αth compact cardinal is supercompact”. We then prove a generalized version of this theorem assuming κ is a supercompact limit of supercompact cardinals and ƒ : κ → 2 is a function, and we derive as corollaries of the generalized version of the theorem the consistency of the least measurable limit of supercompact cardinals being the same as the least measurable limit of nonsupercompact strongly compact cardinals and the consistency of the least supercompact cardinal being a limit of strongly compact cardinals. (shrink)

The ethics of telling stories about other people become questionable as soon as humans learn to talk. But the stakes get higher when health care professionals tell stories about those whom they serve. But for all the problems that come with such stories, I do not believe it is either practical or desirable for bioethicists to attempt to legislate an end to this storytelling. What we need instead is narrative nuance. We need to understand how to tell respectful stories in (...) which the patients are fully acknowledged fellow participants, not one‐dimensional objects of a knowing gaze. The problem is not narration itself but a particular version of narrational privilege, and getting rid of that would have benefits far beyond practices of writing case studies. In this essay, I first offer four considerations that I have found either omitted or underemphasized in discussions of the ethics of telling stories about patients. I then sketch a model of medical storytelling that might be the basis for shifting the ethical question from whether to how. (shrink)

Starting with a model in which κ is the least inaccessible limit of cardinals δ which are δ+ strongly compact, we force and construct a model in which κ remains inaccessible and in which, for every cardinal γ < κ, □γ+ω fails but □γ+ω, ω holds. This generalizes a result of Ben-David and Magidor and provides an analogue in the context of strong compactness to a result of the author and Cummings in the context of supercompactness.

This review of Jay Baruch's Tornado of Life: A Doctor's Journey through Constraints and Creativity in the ER considers the book's contributions, including its explorations of the clinical dilemma of working with patients’ stories that are fragmented, how easily clinicians can miss crucial parts of patients’ stories and how that affects care, and the “agonizing compromises” between what patients need and what institutions can provide. Baruch acknowledges, without any self‐indulgence, the shame that his work causes him, given the limitations of (...) what he can do. (shrink)

In my ideal academy of healing arts, students of all health-care professions would spend their first semester together, thinking only about suffering. No coursework on bodies, diseases, or basic science. No socialization into distinct professional identities. Just suffering from multiple perspectives: literary, philosophical, spiritual, historical, crosscultural. They would be led to ask what forms of suffering have been responded to in which ways, when, by whom. Whose suffering has been systematically ignored, and what finally led to the recognition of that (...) suffering? They would write about the unresolvable question of what aspects of suffering can be called universal, and what suffering might be local and... (shrink)

ABSTRACT:This symposium contribution argues that politicized responses to the COVID-19 pandemic mark the fracturing of the consensus that bioethics has been built upon. This consensus involved the mutual dependence of principles and stories: principles need stories to become applicable in clinical action, and stories need to reflect principles if they are to make generalized claims. Two mid-20th-century theorists, Erving Goffman and Walter Benjamin, each predicted the thinness of appeals to principles and to stories, respectively; their skepticism describes our moment. Anti–public (...) health responses to COVID restrictions show that principles now have radically different meanings within different factional groups, so appealing to them perpetuates divisions. Complementary to that, stories are told more as displays of group membership than as testimony of individual experience. The predictable future is that bioethics controversies will become more fraught. (shrink)

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

Who's afflicted? Early in Nicole Piemonte's book Afflicted: How Vulnerability Can Heal Medical Education and Practice, she quotes an email from a physician whose voice sets the problem and tone. He describes himself as someone “who has intended well” but then “nearly burned out because of the insidious process of physician formation that left me a mess at the threshold of the suffering of other human beings.” His confessional manifesto regrets “the sad things I have seen and done.” His narrative (...) then turns to redemption: “I was—pardon the sentiment—loved back into a good medical practice as a form of growing wisdom and care” (pp. x–xi). Afflicted is written for those who hear this voice speaking for many others. (shrink)

A collection of stories by bioethicists writing about their own illnesses displays the importance of microethics. From this perspective, ethics happens not in the application of principles to specific decisions, but rather in the moment-to-moment flow of clinical interaction, as healthcare workers and patients make decisions, especially in their use of language. Microethical issues that are common to multiple stories are described as dense junctures of ethical concern. Three junctures are discussed in detail: conflicts between medical and patient rationalities, issues (...) of how clinicians represent patients, and practices of truth telling. These junctures are illustrated with examples from the bioethicists’ personal stories of treatment. (shrink)

We construct a variety of inner models exhibiting features usually obtained by forcing over universes with large cardinals. For example, if there is a supercompact cardinal, then there is an inner model with a Laver indestructible supercompact cardinal. If there is a supercompact cardinal, then there is an inner model with a supercompact cardinal κ for which 2κ = κ+, another for which 2κ = κ++ and another in which the least strongly compact cardinal is supercompact. If there is a (...) strongly compact cardinal, then there is an inner model with a strongly compact cardinal, for which the measurable cardinals are bounded below it and another inner model W with a strongly compact cardinal κ, such that \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${H^{V}_{\kappa^+} \subseteq {\rm HOD}^W}$$\end{document}. Similar facts hold for supercompact, measurable and strongly Ramsey cardinals. If a cardinal is supercompact up to a weakly iterable cardinal, then there is an inner model of the Proper Forcing Axiom and another inner model with a supercompact cardinal in which GCH + V = HOD holds. Under the same hypothesis, there is an inner model with level by level equivalence between strong compactness and supercompactness, and indeed, another in which there is level by level inequivalence between strong compactness and supercompactness. If a cardinal is strongly compact up to a weakly iterable cardinal, then there is an inner model in which the least measurable cardinal is strongly compact. If there is a weakly iterable limit δ of <δ-supercompact cardinals, then there is an inner model with a proper class of Laver-indestructible supercompact cardinals. We describe three general proof methods, which can be used to prove many similar results. (shrink)