This new and up-to-date edition of a book that has been central to political philosophy, history, and revolutionary thought for two hundred years offers readers a dire warning of the consequences that follow the mismanagement of change. Written for a generation presented with challenges of terrible proportions--the Industrial, American, and French Revolutions, to name the most obvious--Burke's Reflections of the Revolution in France displays an acute awareness of how high political stakes can be, as well as a keen ability to (...) set contemporary problems within a wider context of political theory. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:President’s Council on BioethicsEdmund D. Pellegrino (bio) and F. Daniel Davis (bio)Approximately two weeks before what was to have been its final meeting, the White House dissolved the President’s Council on Bioethics by terminating the appointments of its 18 members. The letters of dismissal, dated 10 June 2009, informed the members that their service on the Council would end with the close of business the next day.The Council’s term (...) was set to expire on 30 September 2009. After President Obama’s election in November and during the transition, we were advised to proceed on the assumption that the Council would be permitted to cease on that date. Reasons for the abrupt move to disband the Council are unknown. We have accepted the fact that we Council members served at the pleasure of the President and that he simply exercised his rightful prerogative. No explanation is therefore required.Some observers have speculated that the action was retaliatory. They related to the fact that several members of the Council disagreed with the President’s stem cell policy in a signed statement published in the Hastings Center’s Bioethics Forum. Others have speculated that the move was pre-emptive. At its final meeting, scheduled for 25–26 June, the Council was set to sign-off on two of its final publications. One was a comprehensive report on the ethics of organ transplantation, and the other a white paper entitled Health Care and the Common Good. The aim was immediately to release the latter as a contribution to the intensifying debate about health care reform. Health Care and the Common Good could well have aided rather than impeded the President’s drive to better control health care costs and achieve universal coverage. The Council report attempted to ground both goals in the ethical framework of, as the title indicates, the common good of all Americans.In his letter terminating the members’ appointments, Assistant to the President for Presidential Personnel Don Gips said that the President “recognizes the values of having a commission of experts in bioethical issues to provide objective and non-ideological bioethics advice to his administration.” Gips went on to say that the President is “currently rethinking the purposes and goals of such a bioethics commission, and is carefully considering a revitalized mission and mandate.” And, [End Page 309] responding to media enquiries, White House press officer Reid Cherlin explained that the President’s Council was terminated because it was a “philosophically leaning advisory group” and, according to a New York Times account by Nicholas Wade, “because it favored discussion over developing a shared consensus.” As for the ultimate outcome of the President’s “rethinking,” Cherlin indicated that President Obama will appoint a new commission with the mandate of offering “practical policy options” in bioethics.In the light of our experiences with the Council, we leave it with hopes that certain questions of national importance will be addressed. In light of the nature of federal advisory commissions, what is or are the proper roles of a national bioethics commission? If the aim is to provide advice and counsel to the President or, perhaps to the U. S. Congress, is that advice best rendered as a group consensus or as an in-depth exploration of the inevitably conflicting ethical perspectives on a given issue? How should such a commission be constituted—with what sorts of individuals? And what is the nature of the expertise that they individually and collectively bring to the commission’s functions? If the commission is to promote public debate and discussion, how exactly should it go about that task? And how is the efficacy of a commission to be assessed? Such questions inevitably lead us deep into contested territory, as the experience of this Council has shown: into the intersections of politics, religion, and science and into the relations between practice and theory—between policy and what some seem to deride as “philosophy.” Indeed, policy without an underlying philosophy is an edifice without a foundation; philosophy without policy is a foundation without an edifice.At the last meeting of the Council in March 2009, we launched a discussion of these questions with the... (shrink)

This response to Kevin WildesÕs article in the previous issue of the Kennedy Institute of Ethics Journal addresses several major points of disagreement between Pellegrino and Wildes regarding the nature and scope of a philosophy of medicine, in particular how it is derived and by what method of philosophical enquiry it is best pursued.

Recognizing that probability (the Greek doxa) was understood in pre-modern theories as the polar opposite of certainty (episteme), the author of this study elaborates the forms which these polar opposites have taken in some twentieth century writers and then, in greater detail, in the writings of Thomas Aquinas. Profiting from subsequent more sophisticated theories of probability, he examines how Aquinas’s judgments about everything from God to gossip depend on schematizations of the polarity between the systematic and the non-systematic: revelation/reason, science/opinion, (...) saints/philosophers, Aristotle/others. Post-medieval developments have provided the means to discern within Thomas’s thought both a logical theory and a kind of relative frequency theory of probability. The former depends on Aristotle’s theory of demonstration, the latter on his theory of an orderly cosmos; but each as used by Thomas lead to convictions that are sometimes naive, sometimes amusing or even terrifying. (shrink)

We consider the moral and social ingredients in physicians' relationships with patients of diminished capacity by considering certain claims made about friendship and the physician's role. To assess these claims we look at the life context of two patients as elaborated examples provided in two novels: Woman on the Edge of Time (1976) by Marge Piercy, a radical feminist; and It's Hard to Leave While the Music's Playing (1977) by I. S. Cooper, a prominent physician-researcher. At issue is how the (...) doctor-patient relationship should be structured. In question is whether the physician's friendship and professional expertise, together with the diminished capacity of the patient, authorize medical paternalism. From our examination, we find compelling insights against appealing to friendship both in good doctor-patient relationships and in more typical, not-so-good ones. (shrink)

John Wyclif has too frequently been described as "Morning Star of the Reformation" and only recently begun to be studied as a fourteenth-century English philosopher and theologian. This work draws on recent scholarship situating Wyclif in his fourteenth-century milieu to present a survey of his thought and writings as a coherent theological position arising from Oxford's "Golden Age" of theology. Lahey argues that many of Wyclif's best known critiques of the fourteenth-century Church arise from his philosophical commitment to an Augustinian (...) realism evocative of the thought of Robert Grosseteste and Anselm of Canterbury. This realism is comprehensible in terms of Wyclif's sustained focus on semantics and the properties of terms and propositions, a "linguistic turn" characterizing post-Ockham philosophical theology. Arising from this propositional realism is a strong emphasis on the place of Scripture in both formal and applied theology, which was the starting point for many of Wyclif's quarrels with the ecclesiastical status quo in late fourteenth-century England. This survey takes into account both Wyclif's earlier, philosophical works and his later works, including sermons and Scripture commentary. Wyclif's belief that Scripture is the eternal and perfect divine word, the paradigm of human discourse and the definitive embodiment of truth in creation is central to an understanding of the ties he believes relate theoretical and practical philosophy to theology. This connection links Wyclif's interest in the propositional structure of reality to his realism, his hermeneutic program, and to his agenda for reform of the Church. Lahey's survey also highlights Wyclif's rejection of Bradwardine's determinism in favor of a model of human freedom in light of God's perfect foreknowledge, and also explores the relation of Wyclif's spatiotemporal atomism to his rejection of transubstantiation. This is the first book-length, comprehensive survey of Wyclif's thought, and will be of interest to students of later medieval theology, philosophy, history, and literature. (shrink)

John Wyclif has too frequently been described as "Morning Star of the Reformation" and only recently begun to be studied as a fourteenth-century English philosopher and theologian. This work draws on recent scholarship situating Wyclif in his fourteenth-century milieu to present a survey of his thought and writings as a coherent theological position arising from Oxford's "Golden Age" of theology. Lahey argues that many of Wyclif's best known critiques of the fourteenth-century Church arise from his philosophical commitment to an Augustinian (...) realism evocative of the thought of Robert Grosseteste and Anselm of Canterbury. This realism is comprehensible in terms of Wyclif's sustained focus on semantics and the properties of terms and propositions, a "linguistic turn" characterizing post-Ockham philosophical theology. Arising from this propositional realism is a strong emphasis on the place of Scripture in both formal and applied theology, which was the starting point for many of Wyclif's quarrels with the ecclesiastical status quo in late fourteenth-century England. This survey takes into account both Wyclif's earlier, philosophical works and his later works, including sermons and Scripture commentary. Wyclif's belief that Scripture is the eternal and perfect divine word, the paradigm of human discourse and the definitive embodiment of truth in creation is central to an understanding of the ties he believes relate theoretical and practical philosophy to theology. This connection links Wyclif's interest in the propositional structure of reality to his realism, his hermeneutic program, and to his agenda for reform of the Church. Lahey's survey also highlights Wyclif's rejection of Bradwardine's determinism in favor of a model of human freedom in light of God's perfect foreknowledge, and also explores the relation of Wyclif's spatiotemporal atomism to his rejection of transubstantiation. This is the first book-length, comprehensive survey of Wyclif's thought, and will be of interest to students of later medieval theology, philosophy, history, and literature. (shrink)

This paper is an analysis of the events recounted in 'Informed consent to septoplasty: An anecdote from the field.' As a commentary, it assesses the behavior of many agents who are parties to the story - physicians, nurses, friends of the patient, the patient's wife and the patient himself. This story is interesting for being mundane. The medical condition involved and the failures of care are not momentous. The patient's role as a medical ethicist led him to see things in (...) particular perspective and motivated or influenced his conduct sometimes not in the smartest of ways. Several accounts of informed consent are reviewed and used as measures of what happened. The moral vision behind informed consent, the rights and duties it implies and the elements of its contents are identified. No account was fulfilled. Some of the reasons and causes for this are discussed. Many sources of information and forces acting on the situation are explored. Post-operative experiences include severe irritation and discomfort as well as severe frustration and a sense of alienation and abandonment. The case communicates a hint about what physicians do not know in order to have informed consent occur. Physicians' lack of awareness about, e.g., post-operative experience means that they will not provide what the informed aspect of informed consent requires. Patients can feel abandoned and perhaps are abandoned in a variety of ways, subtle and not so subtle. A few issues besides informed consent are discussed (the roles of wives in working at their physician-husband's front desk, the language of reassurance). (shrink)

My aim in this paper is to correct Hume's gloss of the Crito both for the historical purpose of enhancing our understanding of the dialogue and for the philosophical aim of illuminating the grounds of morality and moral community. My thesis is that both Hume and Plato are sensitive to the human condition, which is manifestly a condition of inter- dependence, which means that rational, free, informed acceptance of a government depends on some government's prior parentalism.

This paper tells the story of events that led up to a septoplasty and the consequences that followed it. The patient is a medical ethicist. After scratching the inside of a nostril in 1976, he suffered with occasional bleeding and irritation for almost two decades. He tried topical treatment. As this failed, he sought help from an ENT specialist. The paper relates the conduct of the patient and others (friends in the medical field, the patient's spouse, nurses and anesthesiologists) vis-à-vis (...) informed consent. (shrink)

This essay announces the inauguration of a section ofTheoretical Medicine and invites submissions on the topic Method and Methodology in Medical Ethics. It offers some sketches of plausible meanings of method and of methodology and their relationships as these might apply to work in biomedical ethics. It suggests a broad range of issues, dilemmas or conflicts that may be addressed for help via method and/or methodology.

As Montaigne put it, on the highest throne in the world man sits on his arse. Usually this epigram makes people laugh because it seems to reclaim the world from artificial pride and snobbery and to bring things back to egalitarian values. But if we push the observation even further and say men sit not only on their arse, but over a warm and fuming pile of their own excrement—the joke is no longer funny. The tragedy of man's dualism, his (...) ludicrous situation, becomes too real. The anus and its incomprehensible, repulsive product represents not only physical determinism and boundness, but the fate as well of all that is physical: decay and death. [Becker, 1973, p. 31]. (shrink)

This essay is an array of several taxonomies of values which bear on medicine. The first is a rather low-level list of types of values, meant to be adequate to observational data collection about human valuing. It proceeds to a discussion of levels of valuing so that senses of higher and lower values are articulated. Next, it offers a consideration of intrinsic versus extrinsic and of fundamental versus domestic (or mediating, enabling) values, along with the notions of a practice and (...) virtues. Finally it offers an analysis of clusters of value types along the lines of personal values, social values and professional values acting as interlocking force fields affecting the judgments, reactions and decisions of persons working in health care. In addition to the anticipated elucidation contained in the dialectic, two conclusions are intended: (1) the topic of values in medicine is staggeringly complex, and (2) a medical career is in the best sense a tragic fate in that a noble calling is doomed to many failures because of an inability to reconcile conflicts of values as much as because techniques cannot accomplish everything. (shrink)

The essays by Scott DeVito and Abraham Rudnick are on largely the same topics - the meanings of health(y), normal, disease, pathological, diagnosis , etc., and they contain compatible conclusions - that medical precepts are value-laden and less objective than some na?ve model of scientific objectivity would suggest. This commentary opens with a brief critique of each and ends with a more in-depth account, one complaint being how lacking in weight the analyses are. In the middle portion of this commentary, (...) I consider the sorts of values that are present in some case studies - values that give the project much more weight . These include the values, scientific and self-serving, that professionalism provides. I show how medicine and its disease-related concepts can be thought to evolve in many ways. (shrink)

There are many calls for a definitions personhood, but also many logical and Wittgensteinian reasons to think fulfilling this is unimportant or impossible. I argue that we can consider many contexts as language-games and consider the person as the key player in each. We can then examine the attributes, presuppositions and implications of personhood in those contexts. I use law and therapeutic psychology as two examples of such contexts or language-games. Each correlates with one of the classic “theories” of ethics-deontology (...) and consequentialism. But each is a large enough cluster to consider them as paradigms in a sense related to Thomas Kuhn's notion in The Structure of Scientific Revolutions. Showing the presuppositions about and “takes” on personhood together with the connections involved in the paradigms deepens the dilemmas we already know to be present. (shrink)

Concerning the thing of which I am most in earnest] I certainly have composed no work in regard to it, nor shall I ever do so in the future, for there is no way of putting it in words like other studies. (Plato, Seventh Letter 341c.

The variety of general issues and particular controversies in biomedical ethics can be understood as reflecting a deeper unity than normally supposed. The principle of plenitude and the paradigm of the "chain of Being" form the tie among the phenomena. They are defined, and their presence is tracked especially through some of the ideas and language in the debate about the ethics of abortion. Keywords: plenitude, great chain of Being, abortion, explanation CiteULike Connotea Del.icio.us What's this?

tracked the influence of the major Western historical paradigm of the great chain of being through various positions taken about abortion. This essay shows the paradigm's influence on our language – especially in animating the use of "god" and phrases like "playing god". This is important given the prevalence of religious values in bioethics debates and the pervasiveness of the language. I hunt unsuccessfully for a meaning that could serve as a moral principle, and I show how these phrases are (...) rooted in the paradigm. I conclude that all that such language can do is offer the pretense that there is a specific absolute ground for forbidding something which could otherwise be morally acceptable. But such language is nearly senseless, and worse still, it is immoral in that it cuts off reflection and debate. Keywords: play[ing] god, great chain of being, principle of plenitude CiteULike Connotea Del.icio.us What's this? (shrink)

This eloquent 1757 treatise examines how interactions with the physical world affect formulation of ideals related to beauty and art. Tremendously influential on the development of aesthetic theory, this formative dissertation was among the first explorations of the concept of the sublime and remains a thought-provoking study for modern readers.

The military-industrial complex (MIC) refers to a self-sustaining politico-economic system that perpetuates profitability in military supplies industries, de facto in multiple countries but primarily in the USA. It is made up of competing and/or collaborating entities -- the maintenance of which is on the whole financially advantageous to all concerned. The complex business objectives sought by participants are fostered in part by exalting technical possibilities but also in part by spreading fear as to dangers that are imminent and can be (...) countered only by maintaining the highest feasible level of military preparedness. (shrink)