Trauma-informed care in pediatrics is an organizing principle for health care delivery that is based on the science of toxic stress and the insights of attachment theory. In their groundbreak...

My paper challenges an influential distinction between pain and suffering put forward by physician-ethicist, Eric Cassell. I argue that Cassell’s distinction is philosophically untenable because he contrasts suffering with an outdated theory of pain. In particular, Cassell focuses on one type of pain, the interpretation of nociception induced by noxious stimuli such as heat or sharp objects; yet since the late 1970s, pain scientists have rendered both nociception and noxious stimuli unnecessary for pain. I argue that this discrepancy between Cassell’s (...) distinction and pain science produces three philosophical problems for his distinction: first, he frames his distinction too generally, concentrating on only one type of pain to the neglect of others, such as neuropathy; second, it is possible that Cassell’s understanding of pain may include suffering; and third, Cassell gives examples of pain and suffering manifesting independently of each other, but it is possible that these cases may instead exemplify differences between nociceptive and non-nociceptive types of pain. Due to these problems, I conclude that Cassell’s distinction currently lacks a difference. I call for new efforts to articulate the differences, if any, between pain and suffering. (shrink)

Eric Cassell famously defined suffering as a person’s severe distress at a threat to their personal integrity. This article draws attention to some problems with the concept of distress in this theory. In particular, I argue that Cassell’s theory turns on distress but does not define it, which, in light of the complexity of distress, problematizes suffering in three ways: first, suffering becomes too equivocal to apply in at least some cases that Cassell nevertheless identifies as suffering; second, Cassell’s account (...) does not explain what sort of experience suffering is, resulting in theoretical and practical difficulties in distinguishing it from other medical conditions; third, there is good reason to believe that, in medical contexts, ‘distress’ just means ‘suffering’ or some cognate concept not yet distinguished from it, rendering Cassell’s theory circular. I consider a rebuttal to my objections and reply, concluding that Cassell’s theory of suffering needs a definition of distress to settle what the nature of suffering really is. (shrink)

My paper challenges an influential distinction between pain and suffering put forward by physician-ethicist, Eric Cassell. I argue that Cassell’s distinction is philosophically untenable because he contrasts suffering with an outdated theory of pain. In particular, Cassell focuses on one type of pain, the interpretation of nociception induced by noxious stimuli such as heat or sharp objects; yet since the late 1970s, pain scientists have rendered both nociception and noxious stimuli unnecessary for pain. I argue that this discrepancy between Cassell’s (...) distinction and pain science produces three philosophical problems for his distinction: first, he frames his distinction too generally, concentrating on only one type of pain (interpreted nociception) to the neglect of others, such as neuropathy; second, it is possible that Cassell’s understanding of pain may include suffering; and third, Cassell gives examples of pain and suffering manifesting independently of each other, but it is possible that these cases may instead exemplify differences between nociceptive and non-nociceptive types of pain. Due to these problems, I conclude that Cassell’s distinction currently lacks a difference. I call for new efforts to articulate the differences, if any, between pain and suffering. (shrink)

Schlusslogische Letztbegründung is a collection of essays in honor of Kurt Walter Zeidler. Mr. Zeidler is a distinguished Kant- and Neo-Kantian-scholar who has reconstructed Kant's concept of transcendental logic in connection with the logic of the concept of Hegel and the logic of symbolization of Peirce. (cf. Zeidler: Grundriss der transzendentalen Logik, 3rd ed., Wien 2017) He has most notably inquired intensively into the relation of transcendental logic to philosophy of science (cf. Zeidler: Prolegomena zur Wissenschaftstheorie, Wien 2000) and to (...) phenomenology (cf. Zeidler: Vermittlungen. Zum antiken und neueren Idealismus, Wien 2016). He has also published several studies on Neo-Kantianism (cf. Zeidler: Provokationen. Zu Problemen des Neukantianismus, Wien 2018). This is refelected in the collection of essays by distinguished scholars who discuss and critically examine Zeidler's work. It includes contributions by Steinar Mathisen (Oslo), Wolfdietrich Schmied-Kowarzik (Vienna), Werner Flach (Lichtenau), Thomas Knoppe (Straberg), Geert Edel (Wyk/Föhr), Martin Bunte (Münster), Reinhard Hiltscher (Dresden), Walter Tydecks (Bensheim), Christian Krijnen (Amsterdam), Hartwig Wiedebach (Zürich), Max Gottschlich (Linz), Thomas Sören Hoffmann (Hagen), Rudolf Meer (Kaliningrad), Hans-Jürgen Müller (Frankfurt am Main), Robert König (Vienna), Ulrich Blau (Marburg), Karen Gloy (Luzern/Munich), Reinhold Breil (Aachen), Erhard Oeser (Vienna), Hans-Dieter Klein (Vienna), Hans Martin Dober (Tübingen), Kurt Walter Zeidler (Vienna) and Lois Marie Rendl (Vienna). (shrink)

This paper has two aims. The first is to defend a recent critique of the leading medical theory of suffering, which alleges too narrow a focus on violent experiences of suffering. Although sympathetic to this critique, I claim that it lacks a counterexample of the kinds of experiences the leading theory is said to neglect. Drawing on recent clinical cases and the longer intellectual history of suffering, my paper provides this missing counterexample. I then answer some possible objections to my (...) defence, before turning to my second aim: an expansion of my counterexample into a spectrum of suffering that varies according to the selves and purposes that suffering affects. Next, I connect this spectrum to the tolerability of suffering, which I distinguish from its affective intensity. I conclude by outlining some applications of this distinction for the psychometric reliability of assessment instruments that measure suffering in clinical contexts. (shrink)

This essay discusses the instructional value of mathematical proofs using different interpretations of the analysis cum synthesis method in Apollonius’ Conics as a case study. My argument is informed by Descartes’ complaint about ancient geometers and William Thurston’s discussion on how mathematical understanding is communicated. Three historical frameworks of the analysis/synthesis distinction are used to understand the instructive function of the analysis cum synthesis method: the directional interpretation, the structuralist interpretation, and the phenomenological interpretation. I apply these interpretations to the (...) analysis cum synthesis method in order reveal how the same underlying mathematical activity occurs at different levels of scale: at the level of an individual proof, at the level of a collection of proofs, and at the level of a single line within a proof. On the basis of this investigation, I argue that the instructive value of mathematical proof lies in engendering in the reader the same mathematical activity experienced by the author themselves. (shrink)

Eric Cassell famously defined suffering as a person’s severe distress at a threat to their personal integrity. This article draws attention to some problems with the concept of distress in this theory. In particular, I argue that Cassell’s theory turns on distress but does not define it which, in light of the complexity of distress, problematizes suffering in three ways: first, suffering becomes too equivocal to apply in at least some cases that Cassell nevertheless identifies as suffering; second, Cassell’s account (...) does not explain what sort of experience suffering is, resulting in theoretical and practical difficulties in distinguishing it from other medical conditions; third, there is good reason to believe that in medical contexts, ‘distress’ just means ‘suffering’ or some cognate concept not yet distinguished from it, rendering Cassell’s theory circular. I consider a rebuttal to my objections and reply, concluding that Cassell’s theory of suffering needs a definition of distress to settle what the nature of suffering really is. (shrink)

There is a need to feminize the research on entrepreneurs — to include the experiences of women in what we know to be true about entrepreneurs and the entrepreneurial process. This paper highlights some of the most significant methodological problems in researching women's entrepreneurial experience, problems which in the past, have prevented researchers from gaining an understanding of this experience, and which continues to stand in the way of developing female perspectives. Instead of using the existing male-based models, new approaches (...) are called for in incorporating women's experiences into entrepreneurship theory. This paper outlines the state of research and suggests future directions for developing research on women as entrepreneurs. (shrink)

This paper shows how the mythology surrounding rape enters into a criterion of reasonableness which operates through the legal system to make women vulnerable to unscrupulous victimization. It explores the possibility for changes in legal procedures and presumptions that would better serve women's interests and leave them less vulnerable to sexual violence. This requires that we reformulate the criterion of consent in terms of what is reasonable from a woman's point of view.

This book offers a systematic attempt to explore the point of convergance between feminist theory and the work of Michel Foucault.

This book reassesses theories of agency and gender identity against the backdrop of changing relations between men and women in contemporary societies.

My essay consists of three parts. In the first section, I review the historical context of Baroque aesthetics as it is developed during the late 16th and 17th centuries in Europe and then I track its development in Latin America into the third quarter of the 18th century. The principled excess of the Baroque, to adapt Cyrano de Bergerac’s formulation cited below, was designed for theological and imperial purposes. Secondly, I address more recent literature and literary theory. Why, in the (...) early 20th century, did Latin American poets, novelists, essayists and critics begin to rediscover, recover and reconstitute Baroque modes of expression? What was it about this Catholic, monarchical, colonizing aesthetic that now seemed suited to postcolonial purposes? I refer to several theorists and writers who pioneered and/or inspired the 20th-century idea of the New World Baroque as a rebellious retort to Europe rather than a passive reflection. My third section considers how to teach the politics of Baroque aesthetics, and why Baroque aesthetics remains relevant today. (shrink)

Embedded pragmatic clinical trials (PCTs), like other types of randomized comparative-effectiveness research (CER) studies, are sometimes conducted without informed consent. Indeed, authors of both...

"Foucault: A Critical Introduction offers a comprehensive and accessible introduction to the work of one of the twentieth century's most influential thinkers. Unlike most books on Foucault, this book offers an assessment of all Foucault's work, including his final writings on governmentality and the self. McNay argues that the later work initiates an important shift in his intellectual concerns which alters any retrospective reading of his writings as a whole." "Throughout, McNay is concerned to assess the normative and political implications (...) of Foucault's social criticism. She goes beyond the level of many commentators to look at the values from which Foucault's work springs, and reveals the implicit assumptions underlying his social critique. McNay also discusses Foucault's position in the modernity/postmodernity debate, his own ambivalence toward Enlightenment thought and his place in recent developments in feminist and cultural theory. The result is an invaluable book which clearly outlines the central themes of Foucault's work, while offering a fresh appraisal of his thought."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved. (shrink)

This article argues that the failure of certain theories of reflexive identity transformation to consider more fully issues connected to gender identity leads to an overemphasis on the expressive possibilities thrown up by processes of detraditionalization. By ignoring certain deeply embedded aspects, some theories of reflexive change reproduce the `disembodied and disembedded' subject of masculinist thought. The issues of disembodiment and disembeddedness are explored through a study of the work of Pierre Bourdieu on `habitus' and the `field'. The idea of (...) habitus yields a more dynamic theory of embodiment central to a feminist understanding of gender identity as a durable but not immutable norm. The idea of the `field' provides a more differentiated analysis of the social context in which the reflexive transformation of gender identity unfolds. This in turn offers a way of thinking of possible transformations within gender identity as uneven and non-synchronous phenomena. (shrink)

This book offers a systematic attempt to explore the point of convergance between feminist theory and the work of Michel Foucault.

This article considers Foucault’s analysis of ordoliberal and neoliberal governmental reason and its reorganization of social relations around a notion of enterprise. I focus on the particular idea that the generalization of the enterprise form to social relations was conceptualized in such exhaustive terms that it encompassed subjectivity itself. Self as enterprise highlights, inter alia, dynamics of control in neoliberal regimes which operate through the organized proliferation of individual difference in an economized matrix. It also throws into question conceptions of (...) individual autonomy that underpin much political thought and upon which ideas about political resistance are based. Self as enterprise also problematizes the viability of Foucault’s later work on ethics of the self as a practice of resistance. I go on to argue that Foucault’s discussion of an unresolved clash in civil society between monarchical and governmental power, between law and norm, offers an elliptical but more promising account of opposition to normalizing bio-power. (shrink)

This paper evaluates four recent randomized clinical trials in which the informed consent of participants was either not sought at all, or else was conducted with critical information missing from the consent documents. As these studies have been taking place, various proposals to conduct randomized clinical trials without consent have been appearing in the medical literature. Some of the explanations offered for why it is appropriate to bypass consent or disclosure requirements appear to represent a fundamental misunderstanding of applicable government (...) regulations and even the research enterprise. Others are the result of conceptual disagreements about the importance and application of traditional research ethics norms to ‘comparative effectiveness research’ and modern research environments. Common among these explanations, however, is a failure to appreciate when a research intervention, rather than merely an observation or review of data, is taking place. Review committees and investigators are failing to see, or choosing to ignore, interventions in the lives of research subjects. When these studies have come to light, government agencies with oversight authority have done little or backed down. Prestigious medical journals have published research results knowing that the required consent was not obtained, or they have stood by the published studies even after the inadequacy of consent is discovered. This article critically examines this erosion of consent in theory and practice and calls for restoring the requirement of informed consent to its proper place as a priority in human subjects research. (shrink)

The physician-researcher conflict of interest has thus far eluded satisfactory solution. Most attempts to deal with it focus on improving informed consent. But those attempts are not successful and may even make things worse. Research subjects are already voluntarily undertaking the risks of research — we should not ask them to go it alone — to undergo medical “treatment” without medical “care.” The only effective solution is that in much clinical research, each research subject should have a doctor independent from (...) the research study. (shrink)

This article presents a fairness principle for evaluating decision-making based on predictions: a decision rule is unfair when the individuals directly impacted by the decisions who are equal with respect to the features that justify inequalities in outcomes do not have the same statistical prospects of being benefited or harmed by them, irrespective of their socially salient morally arbitrary traits. The principle can be used to evaluate prediction-based decision-making from the point of view of a wide range of antecedently specified (...) substantive views about justice in outcome distributions. (shrink)

We explore the extent to which Boards use executive compensation to incite firms to act in accordance with social and environmental objectives (e.g., Johnson, R. and D. Greening: 1999, Academy of Management Journal 42(5), 564-578; Kane, E. J.: 2002, Journal of Banking and Finance 26, 1919-1933.). We examine the association between executive compensation and corporate social responsibility (CSR) for 77 Canadian firms using three key components of executives' compensation structure: salary, bonus, and stock options. Similar to prior research (McGuire, J., (...) S. Dow and K. Argheyd: 2003, Journal of Business Ethics 45(4), 341-359), we measure three different aspects of CSR, which include Total CSR as well as CSR Strengths and CSR Weaknesses. CSR Strengths and CSR Weaknesses capture the positive and negative aspects of CSR, respectively. We find significant positive relationships between: (1) Salary and CSR Weaknesses, (2) Bonus and CSR Strengths, (3) Stock Options and Total CSR; and (4) Stock Options and CSR Strengths. Our findings suggest the importance of the structure of executive compensation in encouraging socially responsible actions, particularly for larger Canadian firms. This in turn suggests that executive compensation can be an effective tool in aligning executives' welfare with that of the "common good", which results in more socially responsible firms (Bebchuk, L., J. Fried and D. Walker: 2002, The University of Chicago Law Review 69, 751-846; Zalewski, D.: 2003, Journal of Economic Issues 37(2), 503-509). In addition, our findings suggest the importance of institutional context in influencing the association between executive compensation and CSR. Further implications for practice and research are discussed. (shrink)

Many current abortion regulations represent an over-medicalization of abortion or a corruption of abortion's true medical nature, with disproportionate consequences to women with lower incomes and lesser means. This article explores the effects of unnecessary and harmful abortion restrictions on women living in poverty. A brief summary of the major abortion rights cases explains how the Constitution, as currently interpreted, vests the government and sometimes the medical profession with the power to protect women's health, rather than granting this power to (...) women themselves. The article then argues for a new approach for protecting women's health and respecting their dignity by reframing reproductive rights as health rights that women themselves can assert. (shrink)

The importance of unconscious cognition is seeping into popular consciousness. A number of recent books bridging the academic world and the reading public stress that at least a portion of decision-making depends not on conscious reasoning, but instead on cognition that occurs below awareness. However, these books provide a limited perspective on how the unconscious mind works and the potential power of intuition. This essay is an effort to expand the picture. It is structured around the book that has garnered (...) the most attention, Malcolm Gladwell’s Blink , but it also considers Gut Feelings by Gerd Gigerenzer and How Doctors Think by Jerome Groopman . These books help deepen the . (shrink)

The physician-researcher conflict of interest, a long-standing and widely recognized ethical challenge of clinical research, has thus far eluded satisfactory solution. The conflict is fairly straightforward. Medical research and medical therapy are distinct pursuits; the former is aimed at producing generalizable knowledge for the benefit of future patients, whereas the latter is aimed at addressing the individualized medical needs of a particular patient. When the physician-researcher combines these pursuits, he or she serves two masters and cannot — no matter how (...) well-intentioned — avoid the risk of compromising the duties owed in one of the professional roles assumed. Because of the necessary rigidity of a research protocol, the more demanding of the two masters is frequently the research.The problem of the physician-researcher conflict has been evident since the first attempts to regulate human research in the United States. Otto E. Guttentag, a physician at the University of California School of Medicine in San Francisco, addressed the conflict in a 1953Sciencemagazine article. (shrink)

In today’s multi-cultural world and global economy, attention is often focused on the diversity of cultural values and practices and the need for management approaches to take these differing cultural environments into account. While there is much to be valued in this approach, the focus is often on how to navigate through distinct cultural practices in order to achieve a singular business aim, which falls within the current neoliberal paradigm of global trade. In addition, by focusing on differences in cultural (...) practices, rather than on similarities in underlying values, this approach fails to utilize an important way to achieve a greater degree of global integration in management. Despite striking cultural differences, it is possible to identify some enduring values that underlie what often appear to be quite discrete value paradigms, especially by looking at value paradigms that have endured for centuries, even millennia. This paper proposes to explore the values embedded in two such value paradigms or religious traditions, zen buddhism and Judaism, describing crucial core values in each and comparing and contrasting their ethical frameworks, in order to be able to evaluate their utility in today’s world and especially their significance for creating a more holistic, inclusive, and responsible management framework. The paper will begin by explicating the set of foundational values in each religious tradition. For example, zen buddhism, especially as expressed by Vietnamese monk Thich Nhan Hanh, utilizes the concepts of engaged mindfulness and inter-being to demonstrate the ways in which all global issues are linked together, and the collective responsibility that all humans bear for the state of our planet and the beings who live on it. This approach is inherently holistic and inclusive, and requires a management approach that takes into account the moral responsibility that we all carry. Likewise, the Jewish tradition, while using quite different terminology, also lays out a holistic and inclusive moral vision. Key concepts include the values of Tikkum Olam, to repair the world, and Tsedakah, which literally means justice or righteousness, but is commonly used to indicate charitable giving. The first value, to repair the world, emphasizes the collective moral responsibility to heal whatever damage has been done to the world in order to make the it a better place for all. It does not matter who has done the damage; what matters is each person’s obligation to improve the status quo, under the assumption that all our fates are linked together. The second value, justice and charity, is also considered to be a moral obligation, not simply a voluntary act of charity. The emphasis here is on anonymous giving, done in order to help others and without any expectation of receiving some benefit, such as positive publicity. As a moral obligation, it is not something that one should benefit from. Thus, the concept of tsekakah also emphasizes the inter-connectedness of all humanity. In addition, in the Torah, there are a series of rules about how to deal with others in business as well as the obligation, during harvest-time, to leave some grain in the fields for the less fortunate. In all, we see a focus on being mindful of others, on seeing our fates as interconnected, as in zen buddhism. The last section of the paper will explore some of the ways in which these moral imperatives can be utilized to undergird and buttress a more holistic, inclusive and responsible management approach. Some management models already include moral imperatives, such as corporal social responsibility, and this section will explore in greater detail how the above concepts have been more fully integrated into current management models. (shrink)

This article considers two themes in Butler's work: the dialectic of subject formation - that the autonomous subject is instituted through constraint - and the relation between the psyche and the social. With regard to the former, the introduction of a notion of historicity into a conception of the symbolic yields a concept of agency. Nonetheless, this concept of agency still lacks social specificity. By reconfiguring the psyche as an effect of the interiorization of social norms, Butler introduces the destabilizing (...) force of the category of the unconscious into constructivist accounts of identity. This sociocentric reworking of the psyche-social relations provides a nuanced account of gender identity, but it results in a negative model of action as the displacement of constraining social norms. It is also important for a conception of agency to include an account of the creative dimensions of action where actors actively appropriate conflicting socio-cultural values to institute new collective forms of identity. (shrink)

This paper considers the advantages of incorporating Foucault's anti-essentialist theory of the body into feminist explanations of women's oppression. There are also problems in that Foucault neglects to examine the gendered character of the body and reproduces a sexism endemic in "gender neutral" social theory. The Foucauldian body is essentially passive resulting in a limited account of identity and agency. This conflicts with an aim of feminism: to rediscover and revalue the experiences of women.

Since the 1980s, the relationship between social class and education has been overshadowed by scholarship more generally targeting issues of race, gender, and representation. Today, with the global economy deeply immersed in social inequalities, there is pressing need for serious class-based analyses of schooling, family life and social structure. The Way Class Works is a collection of twenty-four groundbreaking essays on the material conditions of social class and the ways in which class is produced "on the ground" in educational institutions (...) and families. Written by the most visible and important scholars in education and the social sciences, these timely essays explore the production of class in and through the economy, family, and school, while simultaneously interrogating and challenging our understandings of social class as linked to race, gender, and nation. With essays by distinguished scholars and questions for further reflection and discussion, The Way Class Works will be an invaluable resource for students and scholars in education, sociology, and beyond. (shrink)

The medical profession has a tradition of presenting itself as exceptionally altruistic. This article challenges the idea that physicians are, or should be, more altruistic than other professionals or other people, and goes so far as to posit that even a professional aspiration of altruism can have negative consequences.

The AHP Code of Ethics requires members to serve the best interests of their clients, be clear and honest with them, and keep their secrets confidential. Members pledge to represent their skills and qualifications honestly and to make appropriate referrals to others more qualified when out of their depth.AHP stands for “Associated Hair Professionals,” or hair stylists, but their Code of Ethics looks a lot like the Hippocratic Oath and the current Principles of Medical Ethics of the American Medical Association. (...) All of these ethics statements emphasize honesty, confidentiality, competence, serving patients’ best interests, and willingness to refer to other qualified professionals. But it’s not just doctors and hair professionals who have Codes of Ethics. The SPCP — Society of Permanent Cosmetic Professionals —requires its members to “maintain high professional standards consistent with sound practices,” “conduct business relationships in a manner that is fair to all,” and avoid false or misleading statements to the effect that the application of permanent makeup is not tattooing, not permanent, and not painful. (shrink)

This paper explains why informed consent for randomized comparative effectiveness research must include risks of standard care. Disclosures of such risks are both legally and ethically required and, for reasons discussed in the paper, should remain so.

The fifth edition of the Ethics Manual examines emerging issues in medical ethics faced by internists and their patients and revisits older issues that are ...

In this paper we argue that transparency of machine learning algorithms, just as explanation, can be defined at different levels of abstraction. We criticize recent attempts to identify the explanation of black box algorithms with making their decisions (post-hoc) interpretable, focusing our discussion on counterfactual explanations. These approaches to explanation simplify the real nature of the black boxes and risk misleading the public about the normative features of a model. We propose a new form of algorithmic transparency, that consists in (...) explaining algorithms as an intentional product, that serves a particular goal, or multiple goals (Daniel Dennet’s design stance) in a given domain of applicability, and that provides a measure of the extent to which such a goal is achieved, and evidence about the way that measure has been reached. We call such idea of algorithmic transparency “design publicity.” We argue that design publicity can be more easily linked with the justification of the use and of the design of the algorithm, and of each individual decision following from it. In comparison to post-hoc explanations of individual algorithmic decisions, design publicity meets a different demand (the demand for impersonal justification) of the explainee. Finally, we argue that when models that pursue justifiable goals (which may include fairness as avoidance of bias towards specific groups) to a justifiable degree are used consistently, the resulting decisions are all justified even if some of them are (unavoidably) based on incorrect predictions. For this argument, we rely on John Rawls’s idea of procedural justice applied to algorithms conceived as institutions. (shrink)