Almost 60,000 people in the United States with end stage renal disease are waiting for a kidney transplant. Because of the scarcity of organs from deceased donors live kidney donors have become a critical source of organs; in 2001, for the first time in recent decades, the number of live kidney donors exceeded the number of deceased donors. The paradigm used to justify putting live kidney donors at risk includes the low risk to the donor, the favorable risk-benefit ratio, the (...) psychological benefits to the donor, altruism, and autonomy coupled with informed consent; because each of these arguments is flawed we need to lessen our dependence on live kidney donors and increase the number of organs retrieved from deceased donors. An "opting in" paradigm would reward people who agree to donate their kidneys after they die with allocation preference should they need a kidney while they are alive. An "opting in" program should increase the number of kidneys available for transplantation and eliminate the morally troubling problem of "organ takers" who would accept a kidney if they needed one but have made no provision to be an organ donor themselves. People who "opt in" would preferentially get an organ should they need one at the minimal cost of donating their kidneys when they have no use for them; it is a form of organ insurance a rational person should find extremely attractive. An "opting in" paradigm would simulate the reciprocal altruism observed in nature that sociobiologists believe enhances group survival. Although the allocation of organs based on factors other than need might be morally troubling, an "opting in" paradigm compares favorably with other methods of obtaining more organs and accepting the status quo of extreme organ scarcity. Although an "opting in" policy would be based on enlightened self-interest, by demonstrating the utilitarian value of mutual assistance, it would promote the attitude that self-interest sometimes requires the perception that we are all part of a common humanity. (shrink)

Cancer has long been a cultural touchstone: a metaphor of devastation and a spectre of social as well as bodily anomie and loss. Yet recent years have witnessed significant transformations in perceptions of cancer, particularly in perceptions of the cancer patient. This paper is concerned with the ‘struggles of subjectivity’ emergent in this transvalued cancer culture. Explored from the standpoint of the ‘bad patient’, and drawing on media and cultural methodologies, the paper will consider the convergence of medicine, morality and (...) popular iconography as they are embedded in the imageries, imaginaries and representational economies of the cancer culture industry. Of particular concern in this context are the (re)composures of the patient, as liminal figure, caught between clinical imperative and cultural fantasy. (shrink)

In part I of this paper I argue that on his theory of the mind as the idea of an actually existing body Spinoza is unable to account for the ability of the mind to have adequate knowledge, and I suggest that his theory of the eternity of the mind can be viewed as his solution to this problem. In part II I deal with the question of the meaning of ‘eternity’ in Spinoza, in regard both to God and the (...) human mind, and I sketch a line of thought which I believe may have provided him with further motivation for his theory that a part of the mind is eternal. (shrink)

This introductory article provides a contextual and theoretical overview to this special issue of Body & Society. The special issue presents five selected case studies – focusing on the contexts of transplantation, psychiatry, amputation and war, and a transvalued media ecology of cancer – to offer meditations on a number of interlinked questions. The first of these is the entanglement of biomedical governance – political/economic as well as self-disciplinary – with the nexus of estrangement, which can denote both the distancing (...) of otherness and self-division. Second is the realm of feeling, of phantasmatic projection and of the ways in which the biopolitical becomes reciprocally, discursively, enmeshed in a wider cultural imaginary. Third is the shifting terrain of gender and feminist politics, a key dimension of which is the necessary reworking of feminist thought in the wake of a radically altered biomedical and biotechnological landscape. Under the rubric of Estranged Bodies, the collection considers themes of dissolution and the fragility of the body/subject read through bodily catastrophe, radical body modification and extreme medical intervention. Also considered is the notion of assemblage – the provisional coming together of disparate parts – which encourages a rethinking of questions of reconstituted, displaced and re-placed bodies. (shrink)

(2002). Clinical Research Should Not Be Permitted to Escape the Ethical Orbit of Clinical Care. The American Journal of Bioethics: Vol. 2, No. 2, pp. 27-28.

A critical review of four recent works that reflect current conflicts and tensions among feminists regarding new reproductive technologies: In Search of Parenthood by Judith Lasker and Susan Borg; Ethics and Human Reproduction by Christine Overall; Made to Order, Patricia Spallone and Deborah Steinberg, eds. and Reproductive Technologies: Gender, Motherhood and Medicine, Michelle Stanworth, ed. Their positions are evaluated against the background of growing feminist dialogue about the future of reproduction and the bearing of reproductive innovations on such related issues (...) as racism, sexuality, motherhood and abortion. (shrink)

A significant portion of the practice of medicine is dependent on individual acts of medical altruism. Many of these acts, such as the donation of blood, gametes, stem cells, and organs, entail varying degrees of bodily intrusion and, for the altruist, various combinations of discomfort, risk, and expense. Discussion of the ethics of altruism has typically been fragmented under various rubrics such as blood donation, organ and tissue transplantation, health information, and the assisted reproductive technologies. The ethics of these specific (...) examples of altruism are best explored in conjunction with a broader discussion of their relatively neglected mother discipline, altruism in medicine.David Steinberg, M.D., is a board certified internist, hematologist, and oncologist. He is Chief of the Section of Medical Ethics at the Lahey Clinic Medical Center in Burlington, Massachusetts, and Clinical Assistant Professor of Medicine at the Harvard Medical School.FootnotesThis work was made possible by a grant in memory of Harold Karp by the Karp Family Foundation. (shrink)

Overview CHARLES E. CATON The part of philosophy known as the philosophy of language, which includes and is sometimes identified with the part known as ...

Kidney donation by young children and the mentally retarded has been supported by court decisions, arguments based on obligations inherent in family relationships, an array of contextual factors, and the principle of beneficence. These justifications for taking organs from people who cannot protect themselves are problematic and must be weighed against our obligation to protect the vulnerable. A compromise solution is presented that strongly protects young children and the mentally retarded but does not abdicate all responsibility to relieve suffering. Guidelines (...) are proposed that prohibit the retrieval of kidneys from young children and the mentally retarded but permit one exception. They would allow retrieval of a kidney when the consequence to a first order relative with whom the donor has a meaningful and valuable relationship is otherwise imminent death. This would be done in accordance with additional guidelines that minimize harm to the donor. Since most patients with end stage renal disease can be maintained on dialysis the need for a kidney to prevent death should be an uncommon occurrence. This compromise is proposed as a solution to a dilemma that exists because two ethical principles are in conflict and one cannot be honored without violating the other. (shrink)

I would have preferred that the Special Section on Children as Organ Donors had focused on the donation of a specific organ because morally relevant differences are obscured when the subject is discussed in general terms. The donation of a lobe of liver and peripheral blood or bone marrow stem cells does not result in the permanent loss of vital tissue because these organs regenerate; however, a kidney does not regenerate and its donor loses a vital organ permanently. Liver tissue (...) and peripheral blood or bone marrow stem cells are typically required to save a life, but, because most patients with end-stage renal disease can be kept alive on dialysis, the donation of a kidney is rarely life saving. Also, donor risk is organ specific; for example, it is more dangerous to donate a lobe of liver than it is to donate peripheral blood or bone marrow stem cells. (shrink)

This paper examines the Bourne trilogy to explore several characteristics of what we term the bioconvergent age. First, we consider the imagined and actual interfaces of bioconvergence—of body, gadgetry, and electronic communications. We explore the ways in which the bioconvergent tendencies represented in and by Bourne reflect and cultivate a cultural unconscious deeply seduced by and imbricated in surveillant governmentality. Second, we consider the ways in which the trilogy achieves its effects through the deployment of both hyperrealism and verisimilitude. In (...) this context, we explore the filmic interpellation of audiences into a fantasy of omnipotence and omni-science, on the one hand, and the underlying phantasy of a zero-sum world that uncouples morality from affect, on the other. Thus, we consider the ways in which Bourne articulates two interlinked phenomena—a distinctively American romance with the sociopathic/heroic subject and a paranoid, dystopic world that is and seems seductively real. Our third theme is the Bourne journey through an obsessional spiral of paranoia, action, and reaction. Here we explore the trilogy as a social description of the expulsive and retentive tendencies of the bioconvergent age, where the demand for instantaneity drives out all other considerations (morality, reason, connection) and where the lost subject, in his interminable quest for himself, remains lost. (shrink)

The Oprah Winfrey Show provides an interesting set of contradictions. On the one hand, it appears to challenge common-sense assumptions about relationships, specifically heterosexual relationships (for example, by consistently raising issues of sexual violence within a heterosexual context). Yet, at the same time, Oprah's presentation often works to reinforce precisely the norms she seeks to challenge. Through a close analysis of a selection of programme clips from one particular programme among many about relationships, sexuality and families, this article will consider (...) the ways in which the Oprah Winfrey Show both problematizes and yet normalizes the boundaries of heterosexuality. Here we shall discuss both the resolute exposure and exploration of what could be termed the casualities of normative (and compulsory) heterosexuality and, paradoxically, its recuperation as a ‘rational’ ideal. In exploring the ways in which this recuperation takes place, we shall begin with a brief consideration of two of the key discourses which shape the show: the discourse of therapy and that of kinship. Our analysis of the sexual politics of the Oprah Winfrey Show in these terms will focus on the programme, ‘How to Make Love Last’ (18 January 1993). Like so many other programmes, ‘How to Make Love Last’ intends to highlight and deal with problems within heterosexual relationships as distressing but solvable (through the medium of therapeutic self-help). At another level, however, the programme also (unwittingly) reveals a different order of problems which, ironically, can only be reinforced by the mode of rescue proposed and staged. (shrink)

It is argued that organ donation from a patient to the patient's physician is ethically dubious because donation decisions will be inappropriately influenced and the negative public perceptions will result in more harm than good. It is suggested that to protect the perception of the physician–patient relationship, avoid cynicism about medicine’s attitude to patient welfare and maintain trust in the medical profession, a new professional boundary should be established to prevent physicians from receiving organs for transplantation donated by their patients.

Almost 60,000 people in the United States with end stage renal disease are waiting for a kidney transplant. Because of the scarcity of organs from deceased donors live kidney donors have become a critical source of organs; in 2001, for the first time in recent decades, the number of live kidney donors exceeded the number of deceased donors. The paradigm used to justify putting live kidney donors at risk includes the low risk to the donor, the favorable risk-benefit ratio, the (...) psychological benefits to the donor, altruism, and autonomy coupled with informed consent; because each of these arguments is flawed we need to lessen our dependence on live kidney donors and increase the number of organs retrieved from deceased donors. An “opting in” paradigm would reward people who agree to donate their kidneys after they die with allocation preference should they need a kidney while they are alive. An “opting in” program should increase the number of kidneys available for transplantation and eliminate the morally troubling problem of “organ takers” who would accept a kidney if they needed one but have made no provision to be an organ donor themselves. People who “opt in” would preferentially get an organ should they need one at the minimal cost of donating their kidneys when they have no use for them; it is a form of organ insurance a rational person should find extremely attractive. An “opting in” paradigm would simulate the reciprocal altruism observed in nature that sociobiologists believe enhances group survival. Although the allocation of organs based on factors other than need might be morally troubling, an “opting in” paradigm compares favorably with other methods of obtaining more organs and accepting the status quo of extreme organ scarcity. Although an “opting in” policy would be based on enlightened self-interest, by demonstrating the utilitarian value of mutual assistance, it would promote the attitude that self-interest sometimes requires the perception that we are all part of a common humanity. (shrink)

In the summer of 2009, we conceived a special issue of MediaTropes on the theme of “bioconvergence.” We sent out an initial circular to measure interest and solicited abstracts from scholars across disciplines. We received so many engaging and excellent contributions that we decided to publish two volumes of this special issue. Volume I appears here, while the publication of Volume II is anticipated in early 2012. The contributions to this volume examine, from a range of angles, the ways in (...) which living bodies, media, and technologies “converge.” The starting proposition of this special issue is that bodies are technologized and conceived increasingly in technical and biotechnological terms, while correspondingly, techniques and technologies have become increasingly “bodied.” Moreover, both tendencies are pointedly and pervasively mediatized as bodies and technologies constitute intercutting currents of spectacle and digitality in public and cultural life... (shrink)

Ḳitsur Ḥovat ha-levavot me-Rabenu Asher mi-Lunil -- Ḳitsur Ḥovat ha-levavot mi-sefer Tsedah la-derekh -- Ḳitsur Ḥovat ha-levavot ʻAśarah hilulim -- Ḳitsur Ḥovat ha-levavot Margaliyot ṭovot.

In “Life After Privacy: Reclaiming Democracy in a Surveillance Society,” Firmin DeBrabander proposes that the stakes associated with the loss of personal privacy are even higher than is generally acknowledged. Personal privacy is a compelling issue, and his review of it is engaging and accessible. He is successful in demonstrating that powerful forces—corporations, governments, and partisan activists—have many ways of intruding on our private lives and thoughts. DeBrabander’s largest contribution to the ongoing dialogue about privacy, however, is an assertion that (...) the loss of privacy threatens democracy itself. Disturbingly, he may be right—although maybe not for all the reasons he claims.DeBrabander’s focus is on... (shrink)

It is argued, first, that although Spinoza's early Treatise on the Emendation of the Intellect does show evidence of a foundationalist approach to the justification of knowledge, there are good reasons to think he came to find such an approach unsatisfactory; and second, that the Ethics notion of certainty as adequate knowledge of one's knowledge is a justificational concept which is holistic in that any instance of such certainty depends on knowledge of the entire basic metaphysical system. Finally it is (...) shown that Spinoza's having come to hold a nonlinear view regarding the justificational structure of knowledge explains why he chose to present his philosophy in the geometric form, and why he never succeeded in formulating a method of discovery. (shrink)

This brief text assists students in understanding Spinoza's philosophy and thinking so that they can more fully engage in useful, intelligent class dialogue and improve their understanding of course content. Part of the "Wadsworth Philosophers Series," (which will eventually consist of approximately 100 titles, each focusing on a single "thinker" from ancient times to the present), ON SPINOZA is written by a philosopher deeply versed in the philosophy of this key thinker. Like other books in the series, this concise book (...) offers sufficient insight into the thinking of a notable philosopher better enabling students to engage in the reading and to discuss the material in class and on paper. (shrink)

s This article examines the iconic `Beggars' trilogy by feminist science fiction writer, Nancy Kress. These novels, produced in the early to mid-1990s, take as their `thought experiment' two points of rupture and contemporary cultural contestation: the advent of human genetic engineering and sleep, or, more specifically, the prospect of a sleepless society. I shall begin by situating my analysis of the Kress trilogy in this nexus of fields. I shall consider the interest of Kress's works for the sociology of (...) sleep as well as for a cultural analysis of science. In this context, and drawing in part on the work of Haran, I will suggest the particular value of science fiction as not only a site for, but also a source of, narrativized social theory. I shall introduce the notion of popular episteme as an analytic concept that aims to link the discursive to the social — that is, to theorize the relationship of textuality to materiality. In this context, I shall refer also to the psychoanalytic concept of `phantasy' as a point of convergence for both structures of feeling and structures of knowledge. I shall then introduce the Kress works, focusing particularly on the first novel Beggars in Spain, locating it in a period in which feminist science fiction saw a marked renaissance, and in which speculative theorizations of genetics formed a distinct subgenre. The analysis will then focus on three core themes emergent in the novels that, I shall argue, have profound contemporaneous resonance. These are the questions of: embodied capital; the political economy of what I will term fast time; and paranoia and the human condition. (shrink)

Genevieve Lloyd's Spinoza and the Ethics is written as a guidebook for novice readers of Spinoza. Why is such a book needed when there are already a number of others which can well serve the function of introducing Spinoza's philosophy to new readers? The answer is that Lloyd's book is distinctive in two ways. First, it provides a unique perspective on Spinoza, emphasizing aspects of his philosophy which are not typically rationalist. And second, Lloyd has made a particular effort not (...) only to introduce Spinoza's main doctrines, but also to acquaint readers with the diversity of the secondary literature devoted to them. (shrink)