Frank Koughan and Walt Bogdanich's response to my article, reminds me of the Shakespearean line, My article was not about the specifics of the 60Minutes April 13, 1997, story on NHBD at the Cleveland Clinic Foundation (CCF), even though the story formed the basis for the reflection. I did not attack the critics, though I do believe that bioethicists are accountable for their scholarly and public pronouncements. Although I do not see why the 60Minutes' story should be treated with deference, (...) my article was designed to raise questions for a primarily bioethics audience about the involvement of bioethicists in media coverage of bioethics topics. I am flattered that they took notice of my piece, but think their efforts to set the record straight only obfuscate matters further. (shrink)
Frank Koughan and Walt Bogdanich's response to my article, “From Pittsburgh to Cleveland: NHBD Controversies and Bioethics,” reminds me of the Shakespearean line, “The lady protests too much, methinks.” My article was not about the specifics of the 60 Minutes April 13, 1997, story on NHBD at the Cleveland Clinic Foundation , even though the story formed the basis for the reflection. I did not attack the critics, though I do believe that bioethicists are accountable for their scholarly and public (...) pronouncements. Although I do not see why the 60 Minutes' story should be treated with deference, my article was designed to raise questions for a primarily bioethics audience about the involvement of bioethicists in media coverage of bioethics topics. I am flattered that they took notice of my piece, but think their efforts to set the record straight only obfuscate matters further. (shrink)
The realities and myths of long-term care and the challenges it poses for the ethics of autonomy are analyzed in this perceptive work. The book defends the concept of autonomy, but argues that the standard view of autonomy as non-interference and independence has only a limited applicability for long term care. The treatment of actual autonomy stresses the developmental and social nature of human persons and the priority of identification over autonomous choice. The work balances analysis of the ethical concepts (...) associated with autonomy with discussion of the implications of the ethical analysis for long term care. A central chapter involves a phenomenological analysis of four general features of everyday experience (space, time, communication, and affectivity) and explores their practical implications for long term care. This work concludes with a discussion of the advantages associated with a phenomenologically-inspired treatment of actual autonomy for the ethics of long-term care. (shrink)
Friedrich Nietzsche has emerged as one of the most important and influential modern philosophers. For several decades, the book series Monographien und Texte zur Nietzsche-Forschung (MTNF) has set the agenda in a rapidly growing and changing field of Nietzsche scholarship. The scope of the series is interdisciplinary and international in orientation reflects the entire spectrum of research on Nietzsche, from philosophy to literary studies and political theory. The series publishes monographs and edited volumes that undergo a strict peer-review process. The (...) book series is led by an international team of editors, whose work represents the full range of current Nietzsche scholarship. (shrink)
This piece offers a retrospective review of a plenary speech at the 1969 Annual Meeting of the American Public Health Association by the leading environmentalist of the Nixon administration, attorney and judge Russell Train. Train's talk, titled “Prescription for a Planet,” can be seen as an early argument for uniting environmental health and public health as the two main determinants of both individual and population health and for the inclusion of these fields in the then‐new field of “bioethics.”.
This paper offers an exposition of what the question of method in ethics consultation involves under two conditions: when ethics consultation is regarded as a practice and when the question of method is treated systematically. It discusses the concept of the practice and the importance of rules in constituting the actions, cognition, and perceptions of practitioners. The main body of the paper focuses on three elements of the question of method: canon, discipline, and history, which are treated heuristically to outline (...) what the question of method in ethics consultation fully involves. (shrink)
How closely involved with hospital ethics committees should patients and their families become? Should they routinely have access to committees, or be empowered to initiate consultations? To what extent should they be informed of the content or outcome of committee deliberations? Seeing ethics committees as the locus of competing responsibilities allows us to respond to the questions posed by a patient rights model and to acknowledge more fully the complex moral dynamics of clinical medicine.
"Berkeley's Analysis of Perception" is an internal analysis of the development and consequences of Berkeley's interpretation of the perceptual process. It seeks to show that the implications of Berkeley's understanding of perception lead to conclusions later formulated in phenomenalistic theories of perception.
The realities of long‐term care call for a refurbished, concrete concept of autonomy that systematically attends to the history and development of persons and takes account of the experiences of daily living.
Recent philosophical attention to the language of disease has focused primarily on the question of its value-neutrality or non-neutrality. Proponents of the value-neutrality thesis symbolically combine political and other criticisms of medicine in an attack on what they see as value-infected uses of disease language. The present essay argues against two theses associated with this view: a methodological thesis which tends to divorce the analysis of disease language from the context of the practice of medicine and a substantive thesis which (...) holds that disease language is evaluatively neutral. In particular, the essay critically focuses on the value neutral position adopted by Christopher Boorse, which he terms a functional theory of disease. The argument concerns whether or not one can have value neutral description of disease states or whether disease language essentially involves values. (shrink)
Authority is an uneasy, political notion. Heard with modern ears, it calls forth images of oppression and power. In institutional settings, authority is everywhere present, and its use poses problems for the exercise both of individual autonomy and of responsibility. In medical ethics, the exercise of authority has been located on the side of the physician or the health care institution, and it has usually been opposed by appeal to patient autonomy and rights. So, it is not surprising, though still (...) ironic, that ethics consultation, which develops from this patient rights-dominated ethic, should itself bring forth questions of authority. Nonetheless, it does.Insofar as authority has been discussed in ethics consultations, it has been understandably approached from the broad perspective of legitimation and power, which are common themes in social and political treatments of authority. These treatments have dominated twentieth-century discussions of authority, which primarily view authority as legitimate power. (shrink)
RECENT PHILOSOPHICAL ATTENTION TO THE LANGUAGE OF DISEASE HAS FOCUSED PRIMARILY ON THE QUESTION OF ITS VALUE-NEUTRALITY OR NON-NEUTRALITY. PROPONENTS OF THE VALUE-NEUTRALITY THESIS SYMBOLICALLY COMBINE POLITICAL AND OTHER CRITICISMS OF MEDICINE IN AN ATTACK ON WHAT THEY SEE AS VALUE-INFECTED USES OF DISEASE LANGUAGE. THE PRESENT ESSAY ARGUES AGAINST TWO THESES ASSOCIATED WITH THIS VIEW: A METHODOLOGICAL THESIS WHICH TENDS TO DIVORCE THE ANALYSIS OF DISEASE LANGUAGE FROM THE CONTEXT OF THE PRACTICE OF MEDICINE AND A SUBSTANTIVE THESIS WHICH (...) HOLDS THAT DISEASE LANGUAGE IS EVALUATIVELY NEUTRAL. IN PARTICULAR, THE ESSAY CRITICALLY FOCUSES ON THE VALUE NEUTRAL POSITION ADOPTED BY CHRISTOPHER BOORSE, WHICH HE TERMS A FUNCTIONAL THEORY OF DISEASE. THE ARGUMENT CONCERNS WHETHER OR NOT ONE CAN HAVE VALUE NEUTRAL DESCRIPTION OF DISEASE STATES OR WHETHER DISEASE LANGUAGE ESSENTIALLY INVOLVES VALUES. (shrink)
George J. Stack traces the sources of ideas and theories that have long been considered the exclusive province of Friedrich Nietzsche to the surprisingly radical writings of the American essayist and poet, Ralph Waldo Emerson. Nietzsche and Emerson makes us see Emerson's writings in a new, more intensified light and presents a new perspective on Nietzsche's philosophy. Stack traces how the rich theoretical ideas and literary images of Emerson entered directly into the existential dimension of Nietzsche's thought and hence (...) into the stream of what has been considered a distinctively European intellectual movement. Book jacket. (shrink)
This paper discusses the importance of Richard M. Zaners work on clinical ethics for answering the question: what kind of doing is ethics consultation? The paper argues first, that four common approaches to clinical ethics – applied ethics, casuistry, principlism, and conflict resolution – cannot adequately address the nature of the activity that makes up clinical ethics; second, that understanding the practical character of clinical ethics is critically important for the field; and third, that the practice of clinical ethics is (...) bound up with the normative commitments of medicine as a therapeutic enterprise. (shrink)
Authority is an uneasy, political notion. Heard with modern ears, it calls forth images of oppression and power. In institutional settings, authority is everywhere present, and its use poses problems for the exercise both of individual autonomy and of responsibility. In medical ethics, the exercise of authority has been located on the side of the physician or the health care institution, and it has usually been opposed by appeal to patient autonomy and rights. So, it is not surprising, though still (...) ironic, that ethics consultation, which develops from this patient rights-dominated ethic, should itself bring forth questions of authority. Nonetheless, it does. Insofar as authority has been discussed in ethics consultations, it has been understandably approached from the broad perspective of legitimation and power, which are common themes in social and political treatments of authority. These treatments have dominated twentieth-century discussions of authority, which primarily view authority as legitimate power. (shrink)
American healthcare -- Bioterror and bioart -- State of emergency -- Licensed to torture -- Hunger strikes -- War -- Cancer -- Drug dealing -- Toxic tinkering -- Abortion -- Culture of death -- Patient safety -- Global health -- Statue of security -- Pandemic fear -- Bioidentifiers -- Genetic genocide.
While there is no denying the relevance of ethical knowledge and analytical and cognitive skills in ethics consultation, such knowledge and skills can be overemphasized. They can be effectively put into practice only by an ethics consultant, who has a broad range of other skills, including interpretive and communicative capacities as well as the capacity effectively to address the psychosocial needs of patients, family members, and healthcare professionals in the context of an ethics consultation case. In this paper, I discuss (...) how emotion can play an important interpretive role in clinical ethics consultation and why attention to the role of defense mechanisms can be helpful. I concentrate on defense mechanisms, arguing first, that the presence of these mechanisms is understandable given the emotional stresses and communicative occlusions that occur between the families of patients and critical care professionals in the circumstances of critical care; second, that identifying these mechanisms is essential for interpreting and managing how these factors influence the way that the “facts” of the case are understood by family members; and, third, that effectively addressing these mechanisms is an important component for effectively doing ethics consultation. Recognizing defense mechanisms, understanding how and why they operate, and knowing how to deal with these defense mechanisms when they pose problems for communication or decision making are thus essential prerequisites for effective ethics consultation, especially in critical care. (shrink)
The proliferation of ethics committees and ethics consultation services has engendered a discussion of the issue of the expertise of those who provide clinical ethics consultation services. In this paper, I discuss two aspects of this issue: the cognitive dimension or content knowledge that the clinical ethics consultant should possess and the practical dimension or set of dispositions, skills, and traits that are necessary for effective ethics consultation. I argue that the failure to differentiate and fully explicate these dimensions contributes (...) to the confusion over the issue of expertise and fuels, at least partly, the controversies about expertise (or authority) in ethics and the legitimacy of the use of ethical knowledge in clinical ethics consultation. (shrink)
This paper discusses the importance of Richard M. Zaner’s work on clinical ethics for answering the question: what kind of doing is ethics consultation? The paper argues first, that four common approaches to clinical ethics – applied ethics, casuistry, principlism, and conflict resolution – cannot adequately address the nature of the activity that makes up clinical ethics; second, that understanding the practical character of clinical ethics is critically important for the field; and third, that the practice of clinical ethics is (...) bound up with the normative commitments of medicine as a therapeutic enterprise. (shrink)
To the uninitiated, academic philosophy can be intimidating. Its extensive history (over two millennia) and seemingly all-encompassing breadth and depth of study makes knowing everything about philosophy impossible. Philosophers are fortunate because they are expected to specialize in specific areas, but librarians are not as fortunate. Librarians often have collection development responsibilities for a variety of academic disciplines. Collection development in philosophy can seem like a world unto itself in part because philosophical inquiry reaches into other academic disciplines. Amongst academic (...) philosophers, there are different approaches or methodologies for doing philosophy, including eastern and western philosophy, as well as a divide between analytic and continental philosophers. In addition to growing the collection, the philosophy subject librarian may be called upon by philosophers and aspiring philosophers (i.e., students) for research assistance. To make matters more intimidating, philosophers seem to think and speak differently than others. The complex ideas and esoteric terminology that rarely finds its way outside of the philosophy classroom can make collection development, research services, and even simple faculty-to-librarian communication difficult. To succeed as a librarian subject specialist, you should work hard to develop an adequate understanding of the types of materials that are most valuable to your community. Cultivating this knowledge is critical because budgets are limited. This volume will help librarians thrust into the position of philosophy subject specialist to get up to speed and begin excelling in their new roles. The goal of this guide is to simplify collection development and research assistance for philosophy. To accomplish this, I will provide a brief overview of philosophy as a field and share the information you need to succeed in your role as the new philosophy selector. This volume will help to alleviate some of the communication barriers between philosophers and librarians and will provide practical advice, recommendations, and resources for building a strong philosophy collection. (shrink)
This article accepts the proposition that old people want to be treated with dignity and that statements about dignity point to ethical duties that, if not independent of rights, at least enhance rights in ethically important ways. In contexts of policy and law, dignity can certainly have a substantive as well as rhetorical function. However, the article questions whether the concept of dignity can provide practical guidance for choosing among alternative approaches to the care of old people. The article explores (...) the paradoxical relationship between the apparent lack of specific content in many conceptions of dignity and the broad utility that dignity appears to have as a concept expressive of shared social understandings about the status of old people. (shrink)
This anthology brings together many of the more significant contributions to Cartesian scholarship, some of which reach far back as the 1930s. Altogether, there are well over 100 detailed analyses and discussions of salient aspects of Descartes' Promethean legacy. Because Descartes intended his system to embrace not only philosophy but also a complete scientific corpus, this collection covers both philosophical issues and scientific views: Volume 1 is devoted to questions of Cartesian Method and epistemology; Volumes 2 and 3 concentrate on (...) his metaphysics; and Volume 4 discusses Descartes' scientific views and achievements. The lucidity and originality of the essays, a number of which are already classics of Cartesian scholarship, will ensure that this anthology becomes a standard in Cartesian philosophy. An invaluable resource, Rene;e Descartes provides a large variety of introductions, analyses, criticisms, and appraisals of the problems which preoccupied Descartes and the solutions he propounded. (shrink)
This two-volume work bridges the gap between introductory expositions of logic or set theory on one hand, and the research literature on the other. It can be used as a text in an advanced undergraduate or beginning graduate course in mathematics, computer science, or philosophy. The volumes are written in a user-friendly conversational lecture style that makes them equally effective for self-study or class use. Volume II, on formal (ZFC) set theory, incorporates a self-contained 'chapter 0' on proof techniques so (...) that it is based on formal logic, in the style of Bourbaki. The emphasis on basic techniques will provide the reader with a solid foundation in set theory and provides a context for the presentation of advanced topics such as absoluteness, relative consistency results, two expositions of Godel's constructible universe, numerous ways of viewing recursion, and a chapter on Cohen forcing. (shrink)
Thomasma and Pellegrino''s  focus on the healing relationship as the way to give medical ethics a philosophical foundation contains a number of difficulties. Most importantly, their approach focuses philosophical analysis on an idealized view of the healing relationship in which the ideal of health is seen as an uncontroversial norm in the individual case. medical ethics is then characterized as an intrinsic part of the medical act itself. Philosophical inquiry seems limited to a description of the practice of medicine (...) in which ethical norms are embodied. Insufficient attention to methodology leaves unclear how this vision is to be achieved in philosophical reflection. (shrink)
Es werden vier verbreitete Verwendungsweisen des Wortes ‘Argument’ beschrieben, an Beispielen erläutert und dann schrittweise expliziert. Die wichtigsten Explikata sind: ‘eine Satzfolge x ist ein deskriptives Argument in Standardform’, ‘ein deskriptives Argument x in Standardform ist bei der subjektiven Wahrscheinlichkeitsverteilung p stark (bzw. schwach)’, ‘ein Aussagesatz x ist bei der subjektiven Wahrscheinlichkeitsverteilung p ein Argument für (bzw. gegen) einen Aussagesatz y’, ‘ein geordneter Tripel x von deskriptiven Argumenten in Standardform, von Argumentebenen und von Argumentsträngen ist eine deskriptive Argumenthierarchie in Standardform’, (...) ‘eine deskriptive Argumenthierarchie x in Standardform ist gültig (bzw. ungültig; stichhaltig; konsistent; inkonsistent; sichtlich zirkelhaft; stark (bzw. schwach) bei der subjektiven Wahrscheinlichkeitsverteilung p)’. (shrink)