This book brings phenomenology, the main player in the continental tradition of philosophy, to bioethics. Medical science and emerging technologies are examined as endeavours that bring enormous possibilities in relieving human suffering but also great risks in transforming our fundamental life views.

Justin Garson introduces the distinction between two views on Madness we encounter again and again throughout history: Madness as dysfunction, and Madness as strategy. On the latter view, Madness serves some purpose for the person experiencing it, even if it’s simultaneously harmful. The strategy view makes intelligible why Madness often holds a certain allure – even when it’s prima facie terrifying. Moreover, if Madness is a strategy in Garson’s metaphorical sense – if it serves a purpose – it makes sense (...) to use consciously chosen strategies for living with Madness that doesn’t necessarily aim to annihilate or repress it as far as possible. In this paper, we use our own respective stories as case studies. We have both struggled to resist the allure of Madness, and both ended up embracing a kind of Pyrrhonian scepticism about reality instead of clinging to sane reality. (shrink)

Fredrik Svenaeus' book is a delight to read. Not only does he exhibit keen understanding of a wide range of topics and figures in both medicine and philosophy, but he manages to bring them together in an innovative manner that convincingly demonstrates how deeply these two significant fields can be and, in the end, must be mutually enlightening. Medicine, Svenaeus suggests, reveals deep but rarely explicit themes whose proper comprehension invites a careful phenomenological and hermeneutical explication. Certain philosophical approaches, (...) on the other hand - specifically, Heidegger's phenomenology and Gadamer's hermeneutics - are shown to have a hitherto unrealized potential for making sense of those themes long buried within Western medicine. Richard M. Zaner, Ann Geddes Stahlman Professor of Medical Ethics, Vanderbilt University. (shrink)

This paper investigates the question of what an organ is from a phenomenological perspective. Proceeding from the phenomenology of being-in-the-world developed by Heidegger in Being and Time and subsequent works, it compares the being of the organ with the being of the tool. It attempts to display similarities and differences between the embodied nature of the organs and the way tools of the world are handled. It explicates the way tools belong to the totalities of things of the world that (...) are ready to use and the way organs belong to the totality of a bodily being able to be in this very world. In so doing, the paper argues that while the organ is in some respects similar to a bodily tool, this tool is nonetheless different from the tools of the world in being tied to the organism as a whole, which offers the founding ground of the being of the person. However, from a phenomenological point of view, the line between organs and tools cannot simply be drawn by determining what is inside and outside the physiological borders of the organism. We have, from the beginning of history, integrated technological devices (tools) in our being-in-the-world in ways that make them parts of ourselves rather than parts of the world (more organ- than tool-like), and also, more recently, have started to make our organs more tool-like by visualising, moving, manipulating, and controlling them through medical technology. In this paper, Heidegger’s analysis of organ, tool, and world-making is confronted with this development brought about by contemporary medical technology. It is argued that this development has, to a large extent, changed the phenomenology of the organ in making our bodies more similar to machines with parts that have certain functions and that can be exchanged. This development harbours the threat of instrumentalising our bodily being but also the possibility of curing or alleviating suffering brought about by diseases which disturb and destroy the normal functioning of our organs. (shrink)

The relevance of the Aristotelian concept ofphronesis – practical wisdom – for medicine and medical ethics has been much debated during the last two decades. This paper attempts to show how Aristotle’s practical philosophy was of central importance toHans-Georg Gadamer and to the development of his philosophical hermeneutics, and how,accordingly, the concept of phronesiswill be central to a Gadamerian hermeneutics of medicine. If medical practice is conceived of as an interpretative meeting between doctor and patient with the aim of restoring (...) the health of the latter, then phronesis is the mark of the good physician, who through interpretation comes to know the best thing todo for this particular patient at this particular time. The potential fruitfulness of this hermeneutical appropriation of phronesis for the field of medical ethics is also discussed. The concept can be (and has been) used in critiques of the conceptualization of bioethics as the application of principle-based theory to clinical situations, since Aristotle’s point is exactly that problems of praxis cannot be approached in this way. It can also point theway for alternative forms of medical ethics, such as virtue ethics or a phenomenological andhermeneutical ethics. The latter alternative would have to address the phenomena of healthand the good life as issues for medical practice. It would also have to map out in detail the terrain of the medical meeting and the acts of interpretation through which phronesis is exercised. (shrink)

According to linguistic conventionalism, necessities are to be explained in terms of the conventionally adopted rules that govern the use of linguistic expressions. A number of influential arguments against this view concerns the ‘Truth-Contrast Thesis’. This is the claim that necessary truths are fundamentally different from contingent ones since they are not made true by ‘the facts’. Instead, they are supposed to be something like ‘true in virtue of meaning’. This thesis is widely held to be a core commitment of (...) the conventionalist position, and the view is frequently rejected on the grounds that this thesis is untenable. I argue that this line of reasoning is mistaken. While the thesis should be rejected, it is not, I argue, entailed by linguistic conventionalism – nor was it invariably accepted by the paradigmatic conventionalists. (shrink)

This article develops a phenomenological exploration of chronic pain from a first-person perspective that can serve to enrich the medical third-person perspective. The experience of chronic pain is found to be a feeling in which we become alienated from the workings of our own bodies. The bodily-based mood of alienation is extended, however, in penetrating the whole world of the chronic pain sufferer, making her entire life unhomelike. Furthermore, the pain mood not only opens up the world as having an (...) alien quality, it also makes the world more lonesome and poor by forcing the sufferer to attend to the workings of her own body. To suffer pain is to find oneself in a situation of passivity in relation to the hurtful experiences one is undergoing. In making the body and the world more unhomelike places to be in, pain also tends to rob a person of her language. Severe pain is hard to describe because it pushes the person towards the borderlines of imaginable experience and because it makes it hard to see any meaning and purpose in the situation one has been forced into. The analysis of chronic pain in the article is guided by the attempts made by Maurice Merleau-Ponty, Jean-Paul Sartre, and Martin Heidegger to understand the nature of human embodiment and existence, and also by descriptions of chronic pain found in the Swedish author Lars Gustafsson’s novel The Death of a Beekeeper. (shrink)

This article offers a new account of the moral substance of shame. Through careful reflection on the motives and intentional structure of shame, I defend the claim that shame is an egocentric and morally blind emotion. I argue that shame is rooted in our desire for social affirmation and constituted by our ability to sense how we appear to others. What makes shame egocentric is that in shame we are essentially concerned about our own social worth and pained by the (...) perception of our self as socially worthless. In itself, shame entails no morally pertinent concern about others or understanding of what is morally significant. I contrast shame with the possibility of relating to others—and to oneself—with love and care. Indeed, I propose that love is essential for moral understanding and motivation. The argument of the article unfolds through critical appraisals of the main strategies for defending the moral value of shame. First, against the claim that shame entails respect for others, I argue that shame's sensitivity to the opinions of others is motivated by egocentric self-concern. Second, against the view that shame over failures to live up to moral values is morally valuable, I argue that regardless of whether the values guiding our shame are moral or not, the perspective of shame is oblivious to their moral meaning. Third, against the claim that shame is crucial for self-understanding, I argue that the desire for affirmation that drives shame is a powerful source of self-deception. (shrink)

Reviews work on moral judgment motivational internalism from the last two decades.

This paper presents and explicates the theory of empathy found in Edith Stein’s early philosophy, notably in the book On the Problem of Empathy, published in 1917, but also by proceeding from complementary thoughts on bodily intentionality and intersubjectivity found in Philosophy of Psychology and the Humanities published in 1922. In these works Stein puts forward an innovative and detailed theory of empathy, which is developed in the framework of a philosophical anthropology involving questions of psychophysical causality, social ontology and (...) moral philosophy. Empathy, according to Stein, is a feeling-based experience of another person’s feeling that develops throughout three successive steps on two interrelated levels. The key to understanding the empathy process á la Stein is to explicate how the steps of empathy are attuned in nature, since the affective qualities provide the energy and logic by way of which the empathy process is not only inaugurated but also proceeds through the three steps and carries meaning on two different levels corresponding to two different types of empathy: sensual and emotional empathy. Stein’s theory has great potential for better understanding and moving beyond some major disagreements found in the contemporary empathy debate regarding, for instance, the relation between perception and simulation, the distinction between what is called low-level and high-level empathy, and the issue of how and in what sense it may be possible to share feelings in the empathy process. (shrink)

In this article I aim at developing a phenomenology ofillness through a critical interpretation of the worksof Sigmund Freud and Martin Heidegger. The phenomenonof ``Unheimlichkeit'' – uncanniness and unhomelikeness– is demonstrated not only to play a key role in thetheories of Freud and Heidegger, but also toconstitute the essence of the experience of illness.Two different modes of unhomelikeness – ``The minduncanny'' and ``The world uncanny'' – are in thisconnection explored as constitutive parts of thephenomenon of illness. The consequence I draw (...) fromthis analysis is that the mission of health careprofessionals must be not only to cure diseases, butactually, through devoting attention to thebeing-in-the-world of the patient, also to open uppossible paths back to homelikeness. This mission canonly be carried out if medicine acknowledges the basicimportance of the meaning-realm of the patient's life– his or her life-world characteristics. (shrink)

In this paper I develop a phenomenology of falling ill by presenting, interpreting and developing the basic model we find in Jean-Paul Sartre's Being and Nothingness. The three steps identified by Sartre in this process are analysed, developed further and brought to a five- step model: pre-reflective experience of discomfort, lived, bodily discomfort, suffered illness, disease pondering, and disease state. To fall ill is to fall victim to a gradual process of alienation, and with each step this alienating process is (...) taken to a new qualitative level. Consequently, the five steps of falling ill have not only a contingent chronological order but also a kind of logical order, in that they typically presuppose each other. I adopt Sartre's focus on embodiment as the core ground of the alienation process, but point out that the alienation of the body in illness is not only the experience of a psychic object, but an experience of the independent life of one's own body. This facticity of the body is the result neither of the gaze of the other person, nor of a reflection adopting the outer perspective of the other in an indirect way, but is a result of the very otherness of one's own body, which addresses and plagues us when we fall ill. I use examples of falling ill and being a patient to show how a phenomenology of falling ill can be helpful in educating health-care personnel about the ways of the lived body. (shrink)

This article is an attempt to analyse the experience of embodiment in illness. Drawing upon Heidegger' sphenomenology and the suggestion that illness can be understood as unhomelike being-in-the-world, I try to show how the way we live our own bodies in illness is experienced precisely as unhomelike. The body is alien, yet, at the same time, myself. It involves biological processes beyond my control, but these processes still belong to me as lived by me. This a priori otherness of the (...) body presents itself in illness in an uncanny and merciless way. The unhomelike breakdown of our everyday being-in-the-world suffered in illness is explored through Heidegger's notion of the world being a “totality of relevance”, a pattern of meaning played out between different “tools”. The lived body is compared to a broken tool that alters and obstruct sour way of being “thrown” and “projecting” ourselves in the meaning patterns of the world through feelings,thoughts and actions. The similarities and differences between this unhomelikeness of illness and the specific unhomelikeness of authentic understanding,reached according to Heidegger in existential anxiety,are discussed. In order to illustrate how the lived body can present itself as “broken” and “other” to its owner, and in what way this unhomelike experience calls for help from health-care professionals, I make use of a clinical example of a severe and common disease: stroke. (shrink)

Empathy is a thing constantly asked for and stressed as a central skill and character trait of the good physician and nurse. To be a good doctor or a good nurse one needs to be empathic—one needs to be able to feel and understand the needs and wishes of patients in order to help them in the best possible way, in a medical, as well as in an ethical sense. The problem with most studies of empathy in medicine is that (...) empathy is poorly defined and tends to overlap with other related things, such as emotional contagion, sympathy, or a caring personality in general. It is far from clear how empathy fits into the general picture of medical ethics and the framework of norms that are most often stressed there, such as respect for autonomy and beneficience. How are we to look upon the role and importance of empathy in medical ethics? Is empathy an affective and/or cognitive phenomenon only, or does it carry moral significance in itself as a skill and/or virtue? How does empathy attain moral importance for medicine? In this paper I will attempt to show that a comparison with the Aristotelian concept of phronesis makes it easier to see what empathy is and how it fits into the general picture of medical ethics. I will argue that empathy is a basic condition and source of moral knowledge by being the feeling component of phronesis, and, by the same power, it is also a motivation for acting in a good way. (shrink)

In this paper, we argue that there are reasons to believe that an implicit bias for normalcy influences what are considered medically necessary treatments in psychiatry. First, we outline two prima facie reasons to suspect that this is the case. A bias for ‘the normal’ is already documented in disability studies; it is reasonable to suspect that it affects psychiatry too, since psychiatric patients, like disabled people, are often perceived as ‘weird’ by others. Secondly, psychiatry's explicitly endorsed values of well-being (...) and function are hard to measure directly, which is why we see simpler box-ticking conceptions of recovery used in large research studies. This need not be problematic, but might lead to researchers and clinicians focusing too much on treatments that promote easy-to-measure proxies for recovery, instead of what actually matters to psychiatric patients themselves. Next, we provide examples of treatments and treatment decisions within two areas – self-injury and psychosis – which are hard to explain unless we assume that an implicit and harmful normalcy bias is at work. We conclude with some suggestions for clinicians and future research. (shrink)

A large slice of contemporary phenomenology of medicine has been devoted to developing an account of health and illness that proceeds from the first-person perspective when attempting to understand the ill person in contrast and connection to the third-person perspective on his/her diseased body. A proof that this phenomenological account of health and illness, represented by philosophers, such as Drew Leder, Kay Toombs, Havi Carel, Hans-Georg Gadamer, Kevin Aho, and Fredrik Svenaeus, is becoming increasingly influential in philosophy of medicine (...) and medical ethics is the criticism of it that has been voiced in some recent studies. In this article, two such critical contributions, proceeding from radically different premises and backgrounds, are discussed: Jonathan Sholl’s naturalistic critique and Talia Welsh’s Nietzschean critique. The aim is to defend the phenomenological account and clear up misunderstandings about what it amounts to and what we should be able to expect from it. (shrink)

This paper presents a phenomenological account of empathy inspired by the proposal put forward by Edith Stein in her book On the Problem of Empathy, published originally 1917. By way of explicating Stein’s views, the paper aims to present a characterization of empathy that is in some aspects similar to, but yet essentially different from contemporary simulationist theories of empathy. An attempt is made to show that Stein’s proposal articulates the essential ingredients and steps involved in empathy and that her (...) proposal can be made even more comprehensive and elucidating by stressing the emotional aspect of the empathy process. Empathy, according to such a phenomenological proposal, is to be understood as a perceptual-imaginative feeling towards and with the other person’s experiences made possible by affective bodily schemas and being enhanced by a personal concern for her. To experience empathy does not necessarily or only mean to experience the same type of feeling as the target does; it means feeling alongside the feeling of the target in imagining and explicating a rich understanding of the experiences of the very person one is facing. (shrink)

According to possibilism, or non-actualism, fictional characters are possible individuals. Possibilist accounts of fiction do not only assign the intuitively correct truth-conditions to sentences in a fiction, but has the potential to provide powerful explanatory models for a wide range of phenomena associated with fiction (though these two aspects of possibilism are, I argue, crucially distinct). Apart from the classic defense by David Lewis the idea of modeling fiction in terms of possible worlds have been widely criticized. In this article, (...) I provide a defense of a possibilist account against some lines of criticism. To do so, I assume that names for fictional characters are directly referential and a possible-worlds model that accommodates transworld identity. On this background, I argue, it is possible to construct an elegant model of fictional discourse using familiar models of information exchange in ordinary discourse, and I sketch how this model can be used to i) make a natural distinction between fictional and counterfactual discourse, ii) account for creativity, and iii) sustain a natural definition of truth-in-fiction that avoids certain familiar objections to possibilism. Though I set aside questions about the metaphysical commitments of a possible-world interpretation here, there is accordingly reason to think that the battle over possibilist treatments of fiction will have to be fought over metaphysical foundations rather than technical shortcomings. (shrink)

In this paper I present and compare the ideas behind naturalistic theories of health on the one hand and phenomenological theories of health on the other. The basic difference between the two sets of theories is no doubt that whereas naturalistic theories claim to rest on value neutral concepts, such as normal biological function, the phenomenological suggestions for theories of health take their starting point in what is often named intentionality: meaningful stances taken by the embodied person in experiencing and (...) understanding her situation and taking action in the world.Although naturalism and phenomenology are fundamentally different in their approach to health, they are not necessarily opposed when it comes to understanding the predicament of ill persons. The starting point of medical investigations is what the patient feels and says about her illness and the phenomenological investigation should include the way diagnoses of different diseases are interpreted by the person experiencing the diseases as an embodied being. Furthermore, the two theories display similarities in their emphasis of embodiment as the central element of health theory and in their stress on the alien nature of the body displayed in illness. Theories of biology and phenomenology are, indeed, compatible and in many cases also mutually supportive in the realm of health and illness. (shrink)

We introduce generalized quantifiers, as defined in Tarskian semantics by Mostowski and Lindström, in logics whose semantics is based on teams instead of assignments, e.g., IF-logic and Dependence logic. Both the monotone and the non-monotone case is considered. It is argued that to handle quantifier scope dependencies of generalized quantifiers in a satisfying way the dependence atom in Dependence logic is not well suited and that the multivalued dependence atom is a better choice. This atom is in fact definably equivalent (...) to the independence atom recently introduced by Väänänen and Grädel. (shrink)

This article discusses how decentered understandings of addiction might benefit from ongoing debates in Lacanian psychoanalysis. Departing from recent critiques in critical addiction studies, it claims that psychoanalysis offers a framework that both challenges abstract, essentialist ontologies and recognises addiction as a valid phenomenon. Crucial to this framework is a notion of freedom linked to the symbolic break with bodily enjoyment, which, according to Lacan, lies at the origin of the constitution of subjectivity and which neither presupposes the existence of (...) a conscious will nor rejects freedom as a mere product of abstract bio-political governmentality. The article explores how, in Lacanian psychoanalysis, addiction is seen as a way of denying this freedom through the realisation of an enjoyment independent of the symbolic order. Moreover, the article argues that its definition of addiction allows for both a decentered understanding of addiction and a critical challenging of current societal processes of addictification. (shrink)

This paper will explore the relationship between selfhood and depression, by focusing upon the lived body's capacity to 'resonate'with the world and thus open up an 'attuned' space of meaning. Persons will become differently tuned in different situations because they embody different patterns of resonance -- what is most often referred to as different temperaments -- but the self may also suffer from idiosyncrasies in mood profile that develop into deficiencies of resonance, making the person in question ill. In many (...) cases of depression one might describe this as a being out of tune in the sense of being oversensitive to the sad, anxious, and boring tune qualities of the world. This phenomenological model allows us to describe a spectrum of various normal sensitivities which might favour certain moods over others, but also to identify pathologies, like depression, in which the body is out of tune and makes the being-in-the-world overwhelmingly unhomelike. (shrink)

In this paper I aim to show with the aid of philosophers Edith Stein and Peter Goldie, how empathy and other social feelings are instantiated and developed in real life versus on the Internet. The examples of on-line communication show both how important the embodied aspects of empathy are and how empathy may be possible also in the cases of encountering personal stories rather than personal bodies. Since video meetings, social media, online gaming and other forms of interaction via digital (...) technologies are taking up an increasing part of our time, it is important to understand how such forms of social intercourse are different from in real life meetings and why they can accordingly foster not only new communal bonds but also hatred and misunderstanding. (shrink)

Three metaphors appear to guide contemporary thinking about organ transplantation. Although the gift is the sanctioned metaphor for donating organs, the underlying perspective from the side of the state, authorities and the medical establishment often seems to be that the body shall rather be understood as a resource . The acute scarcity of organs, which generates a desperate demand in relation to a group of potential suppliers who are desperate to an equal extent, leads easily to the gift’s becoming, in (...) reality, not only a resource, but also a commodity . In this paper, the claim is made that a successful explication of the gift metaphor in the case of organ transplantation and a complementary defence of the ethical primacy of the giving of organs need to be grounded in a philosophical anthropology which considers the implications of embodiment in a different and more substantial way than is generally the case in contemporary bioethics. I show that Heidegger’s phenomenology offers such an alternative, with the help of which we can understand why body parts could and, indeed, under certain circumstances, should be given to others in need, but yet are neither resources nor properties to be sold. The phenomenological exploration in question is tied to fundamental questions about what kind of relationship we have to our own bodies, as well as about what kind of relationship we have to each other as human beings sharing the same being-in-the-world as embodied creatures. (shrink)

Frank Jackson's knowledge argument against physicalism has caused an extensive debate. In this paper, I sketch and examine a new argument against Jackson's view, an argument which appears to retain more of physicalism than other replies to Jackson. this argument draws strength from a causal theory of knowledge, and hold that there is no knowledge of epiphenomenal qualia, hence that Jackson's main conclusions from the thought experiment are incorrect. There are still problems with this argument, however, so the question remains (...) how much of the mental that can be accounted for in physicalist terms. (shrink)

This article develops a phenomenology of suffering with an emphasis on matters relevant to medical practice and bioethics. An attempt is made to explain how suffering can involve many different things—bodily pains, inability to carry out everyday actions, and failure to realize core life values—and yet be a distinct phenomenon. Proceeding from and expanding upon analyses found in the works of Eric Cassell and Elaine Scarry, suffering is found to be a potentially alienating mood overcoming the person and engaging her (...) in a struggle to remain at home in the face of loss of meaning and purpose in life. Suffering involves painful experiences at different levels that are connected through the suffering-mood but are nevertheless distinguishable by being primarily about my embodiment, my engagements in the world together with others, and my core life values. Suffering is in essence a feeling , but as such, it has implications for and involves the person’s entire life: how she acts in the world, communicates with others, and understands and looks upon her priorities and goals in life. Suffering-moods are typically intense and painful in nature, but they may also display a rather subconscious quality in presenting things in the world and my life as a whole in an alienating way. In such situations, we are not focused directly upon the suffering-mood—as in the cases of pain and other bodily ailments—but rather, upon the things that the mood presents to us: not only our bodies, but also other things in the world that prevent us from having a good life and being the persons we want to be. Such suffering may in many cases be transformed or at least mitigated by a person’s identifying and changing her core life values and in such a manner reinterpreting her life story to become an easier and more rewarding one to live under the present circumstances. (shrink)

Anorexia nervosa is a psychiatric disorder that seems to be closely related to the identity of the person suffering from it. This is referred to in the vast literature on anorexia nervosa by specifying the quality of symptoms as ‘egosyntonic’ (e.g., Vitousek, Watson, and Wilson 1998). The pursuit of excessive thinness is part of a search for identity in which the control of the body—its size and needs—becomes central (Gillett 2009). This need for control seems to be triggered by a (...) state of bodily alienation in which the body is perceived to be foreign and horrifying to its bearer. However, the relentless dieting and excessive exercise pursued by the anorexic person eventually lead to a state of starvation in which .. (shrink)

In this theoretical and explorative essay, two issues are discussed, which are based on personal experiences of teaching ethics. The first is what educational purpose does it serve to challenge students as ethical subjects while teaching a class? This issue is mainly discussed through an analysis of Gert Biesta’s works. He argues that an essential purpose for teachers is to enable students to appear as subjects. For this to happen, the teacher must “interrupt” the students by presenting that which challenges (...) his or her basic ethical preconceptions, which in turn forces the student to choose as a subject. However, if the teacher gives priority to such interruptions, s/he risks a conflict with his or her students. That gives rise to the second issue raised in the essay, whether the teacher should express his or her ethical perspectives while teaching ethics. The issue is discussed by analyzing Bruno Latour’s political philosophy. He argues that conflict is an essential feature in any democratic society where everyone’s concerns are presented. For that reason, he argues for the need of public “diplomats,” whose function is to enable an endeavor for peace. As diplomats, both their ethical agency and ability to judge what is worth highlighting is recognized. Thus, the essay concludes that a diplomatic teacher is someone who has the judgement to decide whether his or her ethical perspectives should be highlighted while teaching a class, or if it would disrupt an endeavor for peace. (shrink)

In this paper I explore health and illness through the lens of enactivism, which is understood and developed as a bodily-based worldly-engaged phenomenology. Various health theories – biomedical, ability-based, biopsychosocial – are introduced and scrutinized from the point of view of enactivism and phenomenology. Health is ultimately argued to consist in a central world-disclosing aspect of what is called existential feelings, experienced by way of transparency and ease in carrying out important life projects. Health, in such a phenomenologically enacted understanding, (...) is an important and in many cases necessary part of leading a good life. Illness, on the other hand, by such a phenomenological view, consist in finding oneself at mercy of unhomelike existential feelings, such as bodily pains, nausea, extreme unmotivated tiredness, depression, chronic anxiety and delusion, which make it harder and, in some cases, impossible to flourish. In illness suffering the lived body hurts, resists, or, in other ways, alienates the activities of the ill person. (shrink)

Heidegger’s thoughts on modern technology have received much attention in many disciplines and fields, but, with a few exceptions, the influence has been sparse in biomedical ethics. The reason for this might be that Heidegger’s position has been misinterpreted as being generally hostile towards modern science and technology, and the fact that Heidegger himself never subjected medical technologies to scrutiny but was concerned rather with industrial technology and information technology. In this paper, Heidegger’s philosophy of modern technology is introduced and (...) then brought to bear on medical technology. Its main relevance for biomedical ethics is found to be that the field needs to focus upon epistemological and ontological questions in the philosophy of medicine related to the structure and goal of medical practice. Heidegger’s philosophy can help us to see how the scientific attitude in medicine must always be balanced by and integrated into a phenomenological way of understanding the life-world concerns of patients. The difference between the scientific and the phenomenological method in medicine is articulated by Heidegger as two different ways of studying the human body: as biological organism and as lived body. Medicine needs to acknowledge the priority of the lived body in addressing health as a way of being-in-the-world and not as the absence of disease only. A critical development of Heidegger’s position can provide us with a criterion for distinguishing the uses of medical technologies that are compatible with such an endeavor from the technological projects that are not. (shrink)

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) uses the conceptualization of psychopathology to make psychiatric diagnoses operational. The use of explicit operational criteria appears to be based on an implicit neo-positivist epistemology. Operationalism involves an excessive focus on quantitative descriptions of behavior manifestations, contesting that psychopathology is understood as a deviation from the normal or the average in a given population. Consequently, the normal and the psychopathological become homogeneous. Our analysis investigates if this neo-positivist epistemology narrows (...) psychopathology conceptualization and endanger integration with the hybrid biopsychosocial model of psychiatry. Based on Georges Canguilhem’s theorization of a qualitative approach to the individual organism who is in a state of morbidity, we show that the (psychiatric) pathology also contains differences in quality. Moreover, that humans are norm-producing organisms that actively respond to changes in their internal and external environment. In this regard, the operationalization of mental disorders could include the normativity in humans, i.e., the ability to produce norms. We argue this will mitigate the one-sided psychopathology conceptualization and strengthen the relationship between psychiatric nosology and psychiatry’s hybrid biopsychosocial model. (shrink)

When interacting with other people, we assume that they have their reasons for what they do and believe, and experience recognizable feelings and emotions. When people act from weakness of will or are otherwise irrational, what they do can still be comprehensible to us, since we know what it is like to fall for temptation and act against one’s better judgment. Still, when someone’s experiences, feelings and way of thinking is vastly different from our own, understanding them becomes increasingly difficult. (...) Delusions and psychosis are often seen as marking the end of intelligibility. In this paper, I argue first for the importance of seeing other people as intelligible as long as this is at all possible. Second, I argue, based on both previous literature and my own lived experience, that more psychotic phenomena than previously thought can be rendered at least somewhat intelligible. Besides bizarre experiences like illusions, hallucinations and intense feelings of significance, I also explain what it is like to lose one’s bedrock, and how this loss impacts which beliefs one has reason to reject. Finally, I give an inside account of some disturbances of reason, and show that there are important similarities between certain psychotic reasoning problems and common non-pathological phenomena. (shrink)

This article develops a new phenomenological analysis of the interpersonal motives and structure of shame. I pursue the argument that shame is rooted in our desire for social affirmation and conditioned by our ability to see ourselves as we appear to others. My central thesis is that shame is what we feel when, due to some trait or action of ours, we come to perceive ourselves as fundamentally despicable and non-affirmable. By showing how our urge for affirmation fuels and informs (...) our self-perception in shame, the analysis provides a better understanding of the simultaneously interpersonal and personal character of shame. Furthermore, it sheds new light on some central aspects of shame that have been insufficiently understood: on the emotional charge and quality of shame, on the role played by our values and identity in shame, and on the continuity, differences, and transfers between personal shame, social shame, and embarrassment. (shrink)

The guiding thesis of this chapter is that self-understanding is centrally an existential challenge. In particular, the chapter aims to lay bare the massive potential of our desire for social affirmation to influence and distort our self-understanding, mostly in a covert and unacknowledged fashion. To the extent that we are driven by this desire, we are primarily concerned with assessing, in an emotionally charged and self-deceptive manner, the social worth of our self, whereas we lack the will and ability to (...) understand ourselves in an open and unqualified manner. Ultimately, it is argued that whatever the cognitive demands of self-understanding and our ability to meet these demands may be, we can never know more about ourselves than we are existentially willing to face and acknowledge. (shrink)

La teoría depredador-presa sugiere que los depredadores generalistas están vinculados a la estabilidad demográfica de las presas, mientras que los especialistas son desestabilizadores. En este artículo hemos hecho una revisión general de las consecuencias demográficas de diferentes estrategias de depredación y hemos intentado testar la hipótesis de que la caza de subsistencia se produce de forma oportunista, la caza de persecución sería la realizada por depredadores especializados y la caza recreativa por depredadores generalistas. Desde esta hipótesis, la caza de persecución (...) tendría efectos desestabilizadores, mientras que los efectos de la caza de subsistencia y recreativa serían neutrales o estabilizadores. Hemos encontrado poco apoyo empírico para esta hipótesis, pero también es cierto que contamos con escasa información de campo. Los cazadores de recreo principalmente cazan de forma oportunista y la caza de persecución muestra una respuesta funcional de tipo III, es decir, disminuye la intensidad de presas cuando lo hace la abundancia de presas y aumenta dicha intensidad ante cierto nivel de abundancia de presas. Sugerimos que los cazadores de recreo limitan los efectos desestabilizadores sobre las poblaciones de caza y que la caza no es un método eficaz de eliminación completa de especies invasoras. Instamos a la realización de nuevos estudios que cuantifiquen las respuestas de los cazadores a la abundancia de presas, en particular estudios que evalúen las respuestas de los cazadores de subsistencia y la persecución ilegal. (shrink)

We characterize the expressive power of extensions of Dependence Logic and Independence Logic by monotone generalized quanti ers in terms of quanti er extensions of existential second-order logic.

In this article I investigate the ways in which phenomenology could guide our views on the rights and/or wrongs of abortion. To my knowledge very few phenomenologists have directed their attention toward this issue, although quite a few have strived to better understand and articulate the strongly related themes of pregnancy and birth, most often in the context of feminist philosophy. After introducing the ethical and political contemporary debate concerning abortion, I introduce phenomenology in the context of medicine and the (...) way phenomenologists have understood the human body to be lived and experienced by its owner. I then turn to the issue of pregnancy and discuss how the embryo or foetus could appear for us, particularly from the perspective of the pregnant woman, and what such showing up may mean from an ethical perspective. The way medical technology has changed the experience of pregnancy—for the pregnant woman as well as for the father and/or other close ones—is discussed, particularly the implementation of early obstetric ultra-sound screening and blood tests for Down’s syndrome and other medical defects. I conclude the article by suggesting that phenomenology can help us to negotiate an upper time limit for legal abortion and, also, provide ways to determine what embryo–foetus defects to look for and in which cases these should be looked upon as good reasons for performing an abortion. (shrink)

Recently, there have been several attempts to use the kind of reasoning found in Fitch’s knowability paradox to argue for rather sweeping metaphysical claims: Jago (2020) uses such reasoning to argue that every truth has a truthmaker, and Loss (2021) does so to argue that every fact is grounded. This strategy has been criticized by Trueman (2021), who points out that the same kind of reasoning could be used to establish entirely opposite conclusions. In response, Jago (2021) has offered a (...) revised argument that is meant to avoid Trueman’s objection. I argue that this revised argument is in fact undermined by an objection quite similar to Trueman’s. (shrink)

Objectification is a real problem in medicine that can lead to bad medical practice or, in the worst case, dehumanization of the patient. Nevertheless, objectification also plays a major and necessary role in medicine: the patient’s body should be viewed as a biological organism in order to find diseases and be able to cure them. Listening to the patient’s illness story should not be replaced, but, indeed, developed by the physical examination of his body searching for the causes of his (...) complaints. Whereas phenomenologists have so far mainly been identifying the back sides of objectification in medicine, in this paper the aim is to analyze differences between detrimental objectifications and objectifications that do not deprive the patient of his subjectivity but, rather, at least in some cases, may lead the patient to feel more at home with his body. (shrink)

The paper presents an account of suffering as a multi-level phenomenon based on concepts such as mood, being-in-the-world and core life value. This phenomenological account will better allow us to evaluate the hardships associated with dying and thereby assist health care professionals in helping persons to die in the best possible manner. Suffering consists not only in physical pain but in being unable to do basic things that are considered to bestow meaning on one’s life. The suffering can also be (...) related to no longer being able to be the person one wants to be in the eyes of others, to losing one’s dignity and identity. These three types of suffering become articulated by a narrative that holds together and bestows meaning on the whole life and identity of the dying person. In the encounter with the patient, the health-care professional attempts to understand the suffering-experience of the patient in an empathic and dialogic manner, in addition to exploring what has gone wrong in the patient’s body. Matters of physician assisted suicide and/or euthanasia—if it should be legalized and if so under which conditions—need to be addressed by understanding the different levels of human suffering and its positive counterpart, human flourishing, rather than stressing the respect for patient autonomy and no-harm principles, only. In this phenomenological analysis the notions of vulnerability and togetherness, ultimately connecting to the political-philosophical issues of how we live together and take care of each other in a community, need to be scrutinized. (shrink)