Ben Laurence argues for a political philosophy that unifies theory and practice in pursuit of change. He shows that the task of political philosophy is not complete until the political philosopher asks the question "What is to be done?" and deliberates about the answer with agents of change.

Incivility among physicians, between physicians and learners, and between physicians and nurses or other healthcare professionals has become commonplace. If allowed to continue unchecked by academic leaders and medical educators, incivility can cause personal psychological injury and seriously damage organisational culture. As such, incivility is a potent threat to professionalism. This paper uniquely draws on the history of professional ethics in medicine to provide a historically based, philosophical account of the professional virtue of civility. We use a two-step method of (...) ethical reasoning, namely ethical analysis informed by pertinent prior work, followed by identifying the implications of clearly articulated ethical concepts, to meet these goals. The professional virtue of civility and the related concept of professional etiquette was first described by the English physician-ethicist Thomas Percival (1740–1804). Based on a historically informed philosophical account, we propose that the professional virtue of civility has cognitive, affective, behavioural and social components based on a commitment to excellence in scientific and clinical reasoning. Its practice prevents a dysfunctional organisational culture of incivility and sustains a civility-based organisational culture of professionalism. Medical educators and academic leaders are in a pivotal and powerful position to role model, promote and inculcate the professional virtue of civility as essential to an organisational culture of professionalism. Academic leaders should hold medical educators accountable for discharge of this indispensable professional responsibility. (shrink)

Bioethics has a founding story in which medical paternalism, the interference with the autonomy of patients for their own clinical benefit, was an accepted ethical norm in the history of Western medical ethics and was widespread in clinical practice until bioethics changed the ethical norms and practice of medicine. In this paper I show that the founding story of bioethics misreads major texts in the history of Western medical ethics. I also show that a major source for empirical claims about (...) the widespread practice of medical paternalism has been misread. I then show that that bioethics based on its founding story deprofessionalizes medical ethics. The result leaves the sick exposed to the predatory power of medical practitioners and healthcare organizations with only their autonomy-based rights to non-interference, expressed in contracts, to protect them. The sick are stripped of the protection afforded by a professional, fiduciary relationship of physicians to their patients. Bioethics based on its founding story reverts to the older model of a contractual relationship between the sick and medical practitioners not worthy of intellectual or moral trust (because such trust cannot be generated by what I call ‘deprofessionalizing bioethics’). On closer examination, bioethics based on its founding story, ironically, eliminates paternalism as a moral category in bioethics, thus causing bioethics to collapse on itself because it denies one of the necessary conditions for medical paternalism. Bioethics based on its founding story should be abandoned. (shrink)

In his Disrupted Dialogue: Medical Ethics and the Collapse of Physician-Humanist Communication Robert Veatch presents a scholarly tour de force of eighteenth- and nineteenth-century Anglophone medical ethics to demonstrate how the easy communication between physicians and humanists in the Scottish Enlightenment progressively dissipated as medicine became detached from humanistic disciplines. In this paper I offer two comments—that the discourse of medical ethics in the Scottish Enlightenment was a discourse of Baconian moral science and that nineteenth-century medical ethics in the United (...) States became detached from that discourse. The result was that a principal resource for physicians at the birth of bioethics, the American Medical Association’s Principles of Medicine Ethics of 1957, did not equip physicians with the conceptual tools they needed to formulate and address the ethical challenges that became the agenda of bioethics. The paper opens with a brief portrait of Robert Veatch, the author’s connections to him, and his little-known role as an impresario of the classical music of the Blue Ridge and Appalachia. (shrink)

Despite its prominence in the abortion debate and in public policy, the discourse of ‘unborn patient’ has not been subjected to critical scrutiny. We provide a critical analysis in three steps. First, we distinguish between the descriptive and normative meanings of ‘unborn child.’ There is a long history of the descriptive use of ‘unborn child.’ Second, we argue that the concept of an unborn child has normative content but that this content does not do the work that opponents of abortion (...) want it to do, namely, to establish the independent moral status of fetuses and their rights, the right to life in particular. Third, we argue that the normative content of ‘unborn child’ should be dependent moral status, not independent moral status. We conclude that the ethical concept of the fetus as a patient should replace the discourse of “unborn child” when that phrase is used normatively. (shrink)

ELSI efforts long have been troubled by critiques that they privilege scientific frameworks and grant scientists the power to set ethical agendas. As the first director of the Human Genome Project’...

Nancy Jecker (2013) mounts a sustained and formidable critique of Norman Daniels's prudential lifespan account (PLA) as a reliable basis for justice between age groups in the responsible allocation...

In our ‘The Professional Virtue of Civility and the Responsibilities of Medical Educators and Academic Leaders’,1 we provided an historically based conceptual account of the professional virtue of civility and the role of leaders of academic health centres in creating and sustaining an organisational culture of professionalism that promotes civility among healthcare professionals and between medical educators and learners. We emphasised that any adequate understanding of the virtues, including professional virtues, has cognitive, affective, behavioural and social components. Some of the (...) commentators expand on these components in important ways. Xuhao et al emphasises the importance of role models, especially in the hierarchical context of medical education.2 The hierarchy of faculty in the senior position and junior doctors and other learners below them has characterised medical education for centuries. Xuhao et al rightly call for academic leaders to shape this hierarchy in a morally responsible way, by becoming ‘exemplary role models’.2 Berry, a clinician manager, in critiquing our account, calls for an increased appreciation for the psychological and environmental factors that might explain why uncivil behaviour occurs.3 …. (shrink)

L’objet de cette contribution est de montrer comment le recours « aveugle » aux caractères et au formalisme transforme, pour Leibniz, l’exercice de l’attention. Plus précisément, il s’agira de montrer en s’appuyant sur divers opuscules que le formalisme permet à la fois d’épargner l’attention, de la concentrer, de l’élargir, de la séquencer et de la transformer en un exercice collectif.

Leibniz’s conception of the relativity of motion has been discussed at length for a very long time. This paper doesn’t aim to give a full solution to this question, but to contribute to the debate by clarifying how the principle of relativity is introduced, justified and used in the “Dynamica”. Four different principles are identified : one purely geometrical, and three (meta) physical principles, which express God’s wisdom : a principle of equivalence of hypotheses linked to the action/reaction principle, a (...) Galilean principle of relativity and a general principle which apply not only to rectilinear motions but also to circular ones. I argue that to appreciate the coherence of Leibniz’ approach, we should distinguish these principles more sharply than he himself did and pay more attention to their status : are they consequences of the definition of motion, consequences of the physical laws or necessary conditions for any physical theory? (shrink)

Cette étude s’annonce dans le prélude (p. 9-17) comme une réflexion délibérément affranchie des critères historiques et des écoles doctrinales pour dégager d’une « constellation » d’images choisies les lignes-forces de la notion complexe (« contradictoire », préfère l’auteur) de ravissement, qui épouse à la fois les termes de la dépossession et de la possession, de l’extériorité et de l’intériorité, de l’actif et du passif, de l’absence et de la présence, de la perte de soi et de sa conquête....

_From the Eye of the Storm: Regional Conflicts and the Philosophy of Peace_ presents to the reader a cross section of an emerging field of study: the philosophy of peace. The editors bring together articles that explore the philosophic implications of many recent regional conflicts. Reflecting the diversity and vitality and any new field of study, this volume contains five sections: Conceptual Foundations; America's Homefront; Desert Storm Assessments; _Jihad, Intifada_, and Other Mideast Concerns; and Latin American Issues. The topics of (...) the articles include war, militarism, patriotism, nationalism, nonviolence, conscientious objection, feminist peace, the media, the ethics of the Gulf War, the Israeli-Palestinian conflict, Islamic pacifism, and Latin American resistance. A concluding postscript assesses prospects for achieving peace and change within our fast changing international scene. This volume has an extensive bibliography of writings concerning peace and conflict and is suited to professional and student audiences. (shrink)

Emmanuel Levinas’s philosophy demonstrates that intelligence is ultimately at the behest of responsibility. He is one of a number of philosophers who made the paradigm shift from an individualized notion of self to a social conception of self. He used the language of his teachers, Husserl and Heidegger, to move beyond their philosophies to a fundamental paradigm shift, in which ethics is prior to epistemology.

Laurence Lampert is well-known for philosophical studies on Nietzsche, Plato, and Leo Strauss. His work is animated by the notion that Nietzsche is the key figure in Strauss's thought and that Strauss is a Nietzschean in disguise. In How Socrates Became Socrates, Lampert brings his work on Nietzsche into conversation with his work on Plato, showing how the "mature" Socrates is himself a Nietzschean avant la lettre, and that this is how Strauss understands him, bringing to completion a decades-long (...) philosophical project in thrilling fashion. (shrink)

Bioethics as a field began some years before it was finally named in the early 1970s. In many ways, bioethics originated in response to urgent matters of the moment, including the controversy over disconnecting Karen Quinlan's respirator, the egregious paternalism of Donald Cowart's doctors in the famous “Dax” case, the abuse of research subjects in the notorious Tuskegee Syphilis Study, and the need to devise an intellectual framework for the development of federal regulations to protect human subjects of research. The (...) phrase “new and unprecedented” became a common description of the topics and issues to which people who later came to be called “bioethicists” responded. It should come as no surprise that bioethics and its practitioners soon came to the self-understanding that their work was new and unprecedented, much as the innovations of biomedical science and their clinical applications were thought to be. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Laying Medicine Open: Innovative Interaction Between Medicine and the HumanitiesLaurence B. McCullough and Warren Thomas ReichThe past three decades have witnessed the emergence and remarkable success of the fields of bioethics and medical humanities. The intellectual landscape of medicine and that of the humanities have been remarkably altered in the process. Twenty-five to 30 years ago in the United States there existed but a few courses in what came (...) to be called “bioethics” in departments of philosophy, religious studies, and theology in colleges and universities, a handful of programs of teaching in medical schools such as the University of Texas Medical Branch at Galveston and Pennsylvania State University School of Medicine at Hershey, and but one independent research center (the Hastings Center) and one university-based research center (the Kennedy Institute of Ethics at Georgetown University). Articles on bioethics began to appear in the peer-reviewed medical, nursing, and humanities literature and some books were published. There was only one journal in bioethics, The Hastings Center Report (which consolidated two previously separate journals from the Hastings Center). Graduate programs in bioethics and medical humanities in colleges and universities and fellowship training in bioethics and medical humanities in medical schools did not exist. Very little existed in colleges, universities, and medical schools in other countries. Now, of course, everything is different.Teachers, scholars, and students of bioethics and medical humanities should not take these remarkable changes for granted, for they represent a sustained and innovative interaction between medicine and the humanities. We have chosen the metaphor of “laying medicine open” to characterize the history of bioethics and medical humanities of the past three decades. This surgical metaphor was used in eighteenth-century Britain by a number of writers who wanted to make medical science and practice more accessible to the sick and to the lay public more generally (Lawrence 1975). We use the metaphor to characterize the efforts of teachers and [End Page 1] scholars over the past three decades and more to make the value-laden dimensions of biomedical science and practice and of health care policy more accessible to patients and to the lay public more generally. The result of this laying open of medicine has gone a long way toward bringing closer together the two cultures of science and the humanities that had, as C. P. Snow famously described, become significantly isolated from each otherAlbert Jonsen (1998) has recently contributed the first book-length history of what he calls the “birth” of bioethics, adding to the work of other scholars such as Warren Reich (1994; 1995) and Robert Baker (1993) and, before them, Corrado Viafora (1990) and David Rothman (1991). The articles in this issue of the Kennedy Institute of Ethics Journal make additional contributions to the developing understanding of the history of the past thirty years of interaction between medicine and the humanities.Laurence McCullough provides an historical context for the three accounts of the recent laying open of medicine that follow. McCullough examines two times in the history of medicine when it has been laid open to accountability (in addition to its being laid open to and by bioethics and medical humanities). The first laying open occurred in the work of the eighteenth-century Scottish physician and philosopher John Gregory, who set out to create a profession of medicine in a true moral sense of a fiduciary profession by making medicine accountable for its scientific and moral quality. The second occurred in the late twentieth century in which the managed practice of medicine in general, and managed care in particular, have begun to lay medicine open to accountability for its scientific and moral quality, as well as its cost and, at least in the public sector, its accessibility. McCullough argues that, just as Gregory responded to the ethical challenges of medicine laid open more than two centuries ago, bioethics should respond to the ethical challenges in the current laying open of medicine.Warren Reich provides an account of André Hellegers, whose premature death left an enormous gap in the field that will never be filled. Reich claims that Hellegers was engaged substantially in much more than the laying open of medicine: he... (shrink)

While it is well known that Leibniz and Berkeley adopted versions of phenomenalism, it is less well known that both thinkers also believed that knowledge of phenomenal nature, via the mechanical philosophy, is a necessary condition for human happiness. Yet an examination of their respective accounts of happiness reveals weighty differences, and these differences are rooted in their respective phenomenalisms. The upshot is the somewhat surprising conclusion that adhering to a certain type of phenomenalism can place restrictions on one’s account (...) of human happiness, for Berkeley could not, by the very logic of his phenomenalism, embrace Leibniz’s views on human happiness, nor could Leibniz embrace Berkeley’s. This is significant not only for understanding the systems of Leibniz and Berkeley, but it also illuminates any view that grounds the science of happiness in knowledge of a “material” world that is in some sense mind-dependent. (shrink)

An orthodoxy has arisen which claims that there is a crisis in the United States health care system such that the system needs to be reformed. This essay challenges that orthodoxy by showing that we do not have a health care system in the United States. We have a non-system of health care, just as we do for virtually all basic social institutions. Challenging the current orthodoxy surfaces two ethical issues that have been ignored: creating a health care system will (...) (a) cause resurgent paternalism and (b) pose a threat to moral pluralism. Keywords: Health care policy, managed care, paternalism, moral pluralism, institutional integrity, total quality management, continuous quality improvement CiteULike Connotea Del.icio.us What's this? (shrink)

The Orthodox Church teaches that the bodies of those in Christ are to be regarded as sanctified by the hearing of the Word and faithful participation in the Sacraments, most particularly the Holy Eucharist; because of the indwelling Holy Spirit the consecrated bodies of Christians do not belong to them but to Christ; with respect to the indwelling Holy Spirit there is no difference between the bodies of Christians before and after death; whether before or after death, the Christian body (...) is also to receive the same veneration; and notwithstanding the physical corruptions that the body endures by reason of death, there remains a strict continuity between the body in which the Christian dies and the body in which the Christian will rise again. That is to say, it is the very same reality that is sown in corruption and will be raised in incorruption. Given such considerations, the notion of “selling” an integral part of a human being is simply outside the realm of rational comprehension. Indeed, it is profoundly repugnant to those Orthodox Christian sentiments that are formed and nourished by the Church's sacramental teaching and liturgical worship. One does not sell or purchase that which has been consecrated in those solemn ways that the Church consecrates the human body. (shrink)

In this incisive new book one of Britain's most eminent philosophers explores the often overlooked tension between voluntariness and involuntariness in human cognition. He seeks to counter the widespread tendency for analytic epistemology to be dominated by the concept of belief. Is scientific knowledge properly conceived as being embodied, at its best, in a passive feeling of belief or in an active policy of acceptance? Should a jury's verdict declare what its members involuntarily believe or what they voluntarily accept? And (...) should statements and assertions be presumed to express what their authors believe or what they accept? Does such a distinction between belief and acceptance help to resolve the paradoxes of self-deception and akrasia? Must people be taken to believe everything entailed by what they believe, or merely to accept everything entailed by what they accept? Through a systematic examination of these problems, the author sheds new light on issues of crucial importance in contemporary epistemology, philosophy of mind, and cognitive science. (shrink)

The book was planned and written as a single, sustained argument. But earlier versions of a few parts of it have appeared separately. The object of this book is both to establish the existence of the paradoxes, and also to describe a non-Pascalian concept of probability in terms of which one can analyse the structure of forensic proof without giving rise to such typical signs of theoretical misfit. Neither the complementational principle for negation nor the multiplicative principle for conjunction applies (...) to the central core of any forensic proof in the Anglo-American legal system. There are four parts included in this book. Accordingly, these parts have been written in such a way that they may be read in different orders by different kinds of reader. (shrink)

This book offers a unique synthesis of past and current work on the structure, meaning, and use of negation and negative expressions, a topic that has engaged thinkers from Aristotle and the Buddha to Freud and Chomsky. Horn's masterful study melds a review of scholarship in philosophy, psychology, and linguistics with original research, providing a full picture of negation in natural language and thought; this new edition adds a comprehensive preface and bibliography, surveying research since the book's original publication.

Given the fundamental role that concepts play in theories of cognition, philosophers and cognitive scientists have a common interest in concepts. Nonetheless, there is a great deal of controversy regarding what kinds of things concepts are, how they are structured, and how they are acquired. This chapter offers a detailed high-level overview and critical evaluation of the main theories of concepts and their motivations. Taking into account the various challenges that each theory faces, the chapter also presents a novel approach (...) to concepts that is organized around two ideas. The first is a pluralistic view of differing types of conceptual structure. The second is a model that treats concepts as atomic representations that are linked to various types of conceptual structures. (shrink)

Avian Flu Pandemic – Flight of the Healthcare Worker? Content Type Journal Article Pages 365-385 DOI 10.1007/s10730-009-9114-9 Authors Robert B. Shabanowitz, Geisinger Medical Center, Dept. of OB/GYN 100 North Academy Avenue Danville PA 17822-2920 USA Judith E. Reardon, Geisinger Medical Center Center for Health Research 100 North Academy Avenue Danville PA 17822-3003 USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume 21, Number 4.

Children with specific language impairment show a significant deficit in spoken language that cannot be attributed to neurological damage, hearing impairment, or intellectual disability. More prevalent than autism and at least as prevalent as dyslexia, SLI affects approximately seven percent of all children; it is longstanding, with adverse effects on academic, social, and economic standing. The first edition of this work established _Children with Specific Language Impairment_ as the landmark reference on this condition, considering not only the disorder's history, possible (...) origins, and treatment but also what SLI might tell us about language organization and development in general. This second edition offers a complete update of the earlier volume. Much of the second edition is completely new, reflecting findings and interpretations based on the hundreds of studies that have appeared since the publication of the first edition in 1997. Topics include linguistic details, word and sentence processing findings, genetics, neurobiology, treatment, and comparisons to such conditions as autism spectrum disorders, ADHD, and dyslexia. The book covers SLI in children who speak a wide range of languages, and, although the emphasis is on children, it also includes studies of adults who were diagnosed with SLI as children or are the parents of children with SLI. Written by a leading scholar in the field, Children with Specific Language Impairment offers the most comprehensive, balanced, and unified treatment of SLI available. (shrink)