Medical nihilism is the view that we should have little confidence in the effectiveness of medical interventions. Jacob Stegenga argues persuasively that this is how we should see modern medicine, and suggests that medical research must be modified, clinical practice should be less aggressive, and regulatory standards should be enhanced.

Personal authenticity is out of fashion amongst analytic philosophers. Yet, Kierkegaard, Nietzsche, Heidegger, Sartre and Camus were clearly preoccupied by its theoretical and practical viability. In this study, Jacob Golomb illuminates the writings of these philosophers in an attempt to explain their particular ethical stance on the subject. This book will prove invaluable reading for students and teachers of philosophy, literature and education and indeed for anyone who has ever empathized with Camus's Meursault, Sartre's Matthieu or Nietzsche's Zarathustra.

This article examines some of the interactions between law, science, and society taking place during a trial. By focusing on a restricted set of scientific and nonscientific actors engaged in negotiating the meaning, relevance, and reliability of scientific evidence, the article illustrates how the categories—law, science, and society—are inextricably interrelated in the legal negotiations and outcome. The introduction of scientific evidence into adversarial legal settings produces strategies, opinions, and claims that are not shaped solely by scientists, lawyers, or legal processes. (...) The situated law-science negotiations provide a site where social order and scientific knowledges are mutually constituted. The outcome of specific law-science interactions will be open to a range of readings and constraints that are not reducible to some putatively correct scientific understanding nor adequately described as the distortion of scientific evidence by the legal system. (shrink)

Are evolution and creation irreconcilably opposed? Is 'intelligent design' theory an unhappy compromise? Is there another way of approaching the present-day divide between religious and so-called secular views of the origins of life? Jacob Klapwijk offers a philosophical analysis of the relation of evolutionary biology to religion, and addresses the question of whether the evolution of life is exclusively a matter of chance or is better understood as including the notion of purpose. Writing from a Christian point of view, (...) he criticizes creationism and intelligent design theory as well as opposing reductive naturalism. He offers an alternative to both and an attempt to bridge the gap between them, via the idea of 'emergent evolution'. In this theory the process of evolution has an emergent or innovative character resulting in a living world of ingenious, multifaceted complexity. (shrink)

In order to entertain the argument to be presented here, you have to begin by casting away a presupposition. The ultimate aim will be to restore it again as a presupposition, but the immediate aim will be to test for and make clear its undoubted worth and usefulness by imagining what happens to our knowledge-system when we remove it.

Harms of medical interventions are systematically underestimated in clinical research. Numerous factors—conceptual, methodological, and social—contribute to this underestimation. I articulate the depth of such underestimation by describing these factors at the various stages of clinical research. Before any evidence is gathered, the ways harms are operationalized in clinical research contributes to their underestimation. Medical interventions are first tested in phase 1 ‘first in human’ trials, but evidence from these trials is rarely published, despite the fact that such trials provide the (...) foundation for assessing the harm profile of medical interventions. If a medical intervention is deemed safe in a phase 1 trial, it is tested in larger phase 2 and 3 clinical trials. One way to think about the problem of underestimating harms is in terms of the statistical ‘power’ of a clinical trial—the ability of a trial to detect a difference of a certain effect size between the experimental group and the control group. Power is normally thought to be pertinent to detecting benefits of medical interventions. It is important, though, to distinguish between the ability of a trial to detect benefits and the ability of a trial to detect harms. I refer to the former as power-B and the latter as power-H. I identify several factors that maximize power-B by sacrificing powerH in phase 3 clinical trials. If a medical intervention is approved for general use, it is evaluated by phase 4 post-market surveillance. Phase 4 surveillance of harms further contributes to underestimating the harm profile of medical interventions. At every stage of clinical research the hunt for harms is shrouded in secrecy, which further contributes to the underestimation of the harm profiles of medical interventions. (shrink)

I defend a radical interpretation of biological populations—what I call population pluralism—which holds that there are many ways that a particular grouping of individuals can be related such that the grouping satisfies the conditions necessary for those individuals to evolve together. More constraining accounts of biological populations face empirical counter-examples and conceptual difficulties. One of the most intuitive and frequently employed conditions, causal connectivity—itself beset with numerous difficulties—is best construed by considering the relevant causal relations as ‘thick’ causal concepts. I (...) argue that the fine-grained causal relations that could constitute membership in a biological population are huge in number and many are manifested by degree, and thus we can construe population membership as being defined by massively multidimensional constructs, the differences between which are largely arbitrary. I end by showing that positions in two recent debates in theoretical biology depend on a view of biological populations at odds with the pluralism defended here. 1 Introduction2 Biological Population, Broad and Narrow3 Difficulties with Narrow Biological Population Conditions3.1 Against the genealogical condition3.2 Against the conspecificity condition3.3 Against the proximity condition3.4 Against the typology condition4 Causal Connectivity5 Massively Multidimensional Population Constructs6 Population Uniqueness and Natural Selection6.1 Statisticalism and its discontents6.2 Price at what price?7 Conclusion. (shrink)

Healthcare-associated infections due to multidrug-resistant organisms continue to increase in incidence. To control the transmission of these pathogens, such as methicillin-resistant Staphylococcus aureus , some have advocated active surveillance cultures of all hospitalized patients, followed by institution of contact precautions. While there has been extensive debate about the effectiveness of this approach in reducing infections, little attention has been given to the ethical issues raised by the intervention. Active surveillance for multidrug-resistant organisms is a quality improvement measure and ethical implications (...) arise through the potential to inadvertently cause harm. Unintended adverse effects may include decreased contact with healthcare workers, increased depression and anxiety, and increased rates of noninfectious adverse events among patients placed in contact precautions. The potential risks and benefits are not distributed fairly; patients placed in contact precautions are exposed to the risks, while those not isolated experience the benefit. Ethical challenges involve a conflict between the interests of the individual patient and the patient population not already colonized with the organism. For healthcare systems, active surveillance increases the complexity of bed management, exacerbating problems with patient placement, patient throughput, emergency department overcrowding and ambulance diversion for some hospitals. It also poses ethical dilemmas regarding societal resource allocation. Investing in an unproven or marginally beneficial quality improvement activity such as this must be balanced against other public health priorities competing for scarce resources. CiteULike Connotea Del.icio.us What's this? (shrink)

The revised classic on the professional and legal standards of school psychology This completely updated edition of the leading ethics and law guide provides ...

Nobilitas is a study of the history of aristocratic philosophy from ancient Greece to the early twentieth century that aims at providing an alternative to the liberal democratic norms, which are propagated today as the only viable socio-political system for the world community. Jacob reveals that, contrary to popular belief, the social and cultural development of European civilization has, for twenty-five centuries, been based not on democratic or communist notions but, rather on aristocratic and nationalist notions. Beginning with the (...) political philosophies of Plato and Aristotle, and continuing through Renaissance and Baroque aristocratic philosophers, the German Idealists, and English and Italian nationalists, the study ends with the transformation of aristocratic philosophy in nineteenth century Germany into racist elitism. As such, the study includes a survey of the philosophical bases of racism and anti-Semitism. These topics have been systematically excluded from academic and political debate since the end of the last Great War. This study is a pioneering work in understanding and changing political ideologies. (shrink)

At the moment of its decline, we clearly see that painting in oils developed an original poetics, and one that was all of a piece, throughout a renascent and modern West. From its birth and during a development lasting half a millennium we see it— in Florence, Bruges, Venice, Rome, Toledo, Nuremberg, Amsterdam and Paris—attentive to the sources of signification: languages, rites, myths, theater, tools, techniques and sciences and the urban context that wove them all together. In each case, for (...) one or the other of them, it brought a new relationship to the way of life and then left them to their social order of assimilation, keeping the initial contact for those who would be interested. It studded the West with centers of production that carried the practice and knowledge of art to their limits; engaged with the collective imagination, it punctuated history with decisive works, in which the desire to paint takes action and explains it. Marked by an impatience for change, oil painting revealed itself in a rapport with creativity akin to the other works of civilization. It is at the level of the bases of invention of the imaginary—which are in any expression the most profound structures—that the unfolding of oil painting is tightly bound. The establishment of modern national languages, the orderly rise, around a syntax and because of architecture, sculpture, music, song, tragedy, the systematic construction of scientific and technical expression, arose and grew quickly in importance in Western Europe during the same centuries as painting and with reciprocal correspondence. Dürer “who was the first to publish a treatise in which is collected all knowledge having to do with the expression of forms… wrote in his native tongue and in so doing was revealed as the creator of technical and scientific German.”. (shrink)

Nietzsche described himself as the first psychologist of the West. His interpreters, however, have seldom regarded his works as contributions to psychology. This book gives the psychological perspective a central role and uses it as a guide through Nietzsche's aphoristic maze toward the centre of his thought, method, aims and ramifications. Psychology thus serves as the path to his philosophy and leads to a reconstruction of his substantive theses, including the morality of positive power. By exploring Nietzsche's depth psychology in (...) detail, the book clarifies his basic purpose: to entice readers into uncovering and reactivating their own sources of creative power. (shrink)

In recent decades a number of criminal convictions have been reversed on appeal, partially on the basis of problems associated with the use of scientific evidence adduced by the prosecution during the trial. These miscarriage of justice cases have received considerable attention from news media, legal commentators, criminologists and in formal public inquiries. Most responses to these cases have been critical of the scientific evidence originally relied upon at trial. Few commentators have been critical of, or even reflective about, the (...) scientific evidence used to acquit. Generally, their analyses have utilized idealized images of science and scientists. In contrast, by importing the concept of methodological symmetry from science studies, this paper aims to identify and explore the conceptual disparity (or asymmetry) between the assessment of scientific evidence used to convict and the scientific evidence used to acquit. In order to illustrate some of the limits to conventional approaches to miscarriages of justice as well as examine the judicial use of scientific evidence this will be undertaken in relation to the successful appeal of the Birmingham Six. (shrink)

This article reviews contemporary response to several contrasting strands of recent empirical work. It begins with discussing the scope and rationale of evidence law. Experimental studies on eyewitness memory and testimony illustrate the potential value of empirical studies to the practice of investigations, prosecutions, and appeals. This article discusses several lines of empirical inquiry employing diverse methodologies, experiments, surveys, and approaches and reviews their limitations, and implications and significance for the understanding and practice of law. Many of the contributions from (...) empirical legal studies are provisional and their precise value for practice is uncertain or ambiguous, but they raise important issues worthy of serious consideration. By identifying problems with eyewitness evidence and the limitations of many of the forensic sciences, and in many other ways, empirical and experimental studies have substantially outpaced legal experience. Indifference to empirical legal study is likely to reduce the social legitimacy of legal institutions. (shrink)

Over the last two decades judges (and regulators) in all common law jurisdictions have increased their reliance on published medical and scientific literature. During the same period biomedical research has undergone fundamental and unprecedented change. This article explores some of the changes to the location, organization and funding of biomedical research in order to assess their implications for liability and proof. Focusing on peer review and publication, along with reforms promoted by the editors of some of the world's pre-eminent general (...) medical journals (e.g. British Medical Journal, the Lancet, Journal of the American Medical Association and the New England Journal of Medicine), this article considers how judges might respond to recent findings which suggest that corporate sponsorship systematically biases biomedical research. Given that common law judges have been reforming rules of evidence and procedure in search of impartial expertise and privileging published biomedical research, how should they respond to the strategic manipulation of the scientific record? (shrink)

The relationship of word-meaning to speaker's-meaning has not been examined thoroughly enough. Some philosophical problems are solved and others made plainer if the full consequences of a proper relationship between these two is worked out.

Games, festivals, folklore, a derivation of them, and artistic expression are manifestations of symbolic invention. To compare them is to bring out the differences in the order of the symbolic production and have, as a consequence, a differentiated perception of the way they function. It is also to put them into a perspective of filial relationship. In fact, a genealogy appears with the processes that regulate the passage from one to the other of these means of expression. Through the successive (...) dissipation of structural stabilizations that are in turn play, festival and folklore, a generative order of complexity is established of which art, with its dynamics open to all expressive invention, is the end result. Finally, it is to discover at the end of the process the literary text, conceived as a work of art, surrounded by expression and preceded by it, appearing from then on according to one of the precepts of the theory of the text, as a production “of society and history” and as issuing from the social phenomenon in its entirety. “I am not only undertaking a study of a sociology of games,” wrote Roger Caillois. “My idea is to lay the foundations for a sociology beginning with games.” We would say of a sociology in which we would be permitted to glimpse the achievement of the task of explaining the entire social phenomenon itself. (shrink)

There are, it is said nowadays, “Renaissances,” in order to emphasize the diversity of expressions in this period of civilization and because of the concern for restoring the originality of the historical situations experienced at that time by the peoples of Europe. It is true that from the fourteenth to the fifteenth centuries, the Renaissance touched many areas in order to provide a response to challenges of the times. But even though these responses were varied, the world view was the (...) same. (shrink)

“Given the fact that the consciousness of man is a linguistic consciousness, all models superimposed on consciousness, including art, can be understood as secondary modeling systems, “ wrote Yuri Lotman in Introduction à la structure du texte artistique.

Pictures nowadays are a mass-produced commodity. They can be widely reproduced by various techniques including electronics. The natural means of communication, gesture and speech, have been replaced by photographs, films, television, posters, comic strips and magazines, all of which make up part of our environment. The invention and transmission of signs, which constitutes culture, no longer stems from a period of reflection, expressed through writing, whose compact print (originating from the Renaissance) never distracts us. Social dynamism, in generating culture, stands (...) on the level of an experience open to the configuration and the violence whose theatre is the world in its concrete space. (shrink)

Since its inception in 1994, scriptural reasoning has been practiced by academics and religious laypeople on an international scale. Scriptural reasoning is an activity or practice where Jews, Christians, and Muslims read and study together short passages from their traditionally sacred texts. In this book, Jacob L. Goodson describes this activity by giving a tour through modern philosophy and showing how certain arguments, ideas, and theories from modern philosophers help make sense of this inter-religious practice. According to Goodson, one (...) of the most interesting aspects of the practice of scriptural reasoning concerns how its driven by a tension between pragmatism and semiotics—what he calls purposefulness (pragmatism) vs. playfulness (semiotics) throughout the book. Can inter-religious practices only be playful, in terms of an academic “leisure activity”? Or do inter-religious practices need to strive toward a greater end or even a higher purpose, such as peace-making among the Abrahamic faiths or inter-religious friendships? In each individual chapter, Goodson explores this tension within the practice of scriptural reasoning. Utilizing Immanuel Kant’s deontology, Goodson concludes by demonstrating how the practice of scriptural reasoning might work if only two rules are in place while participating in it. (shrink)