This article provides an introduction to the articles in this theme issue. This collection examines epistemological, ontological, moral and political questions in medicine in light of the philosophical ideas of Charles Taylor. A synthesis of Taylor's relevant work is presented. Taylor has argued for a conception of the human sciences that regards human life as meaningful–deriving meaning from surrounding horizons of significance. An overview of the interdisciplinary articles in this issue is presented. This collection advances our thinking in the philosophy (...) of medicine as well as the philosophy of Charles Taylor. (shrink)

We maximally extend the quantum‐mechanical results of Muller and Saunders ( 2008 ) establishing the ‘weak discernibility’ of an arbitrary number of similar fermions in finite‐dimensional Hilbert spaces. This confutes the currently dominant view that ( A ) the quantum‐mechanical description of similar particles conflicts with Leibniz’s Principle of the Identity of Indiscernibles (PII); and that ( B ) the only way to save PII is by adopting some heavy metaphysical notion such as Scotusian haecceitas or Adamsian primitive thisness. We (...) take sides with Muller and Saunders ( 2008 ) against this currently dominant view, which has been expounded and defended by many. *Received July 2008; revised May 2009. †To contact the authors, please write to: F. A. Muller, Faculty of Philosophy, Erasmus University Rotterdam, Burg. Oudlaan 50, H5–16, 3062 PA Rotterdam, The Netherlands; e‐mail: [email protected] , and Institute for the History and Foundations of Science, Utrecht University, Budapestlaan 6, IGG–3.08, 3584 CD Utrecht, The Netherlands; e‐mail: [email protected] . M. P. Seevinck, Institute for the History and Foundations of Science, Utrecht University, Budapestlaan 6, IGG–3.08, 3584 CD Utrecht, The Netherlands; e‐mail: [email protected]. (shrink)

Many research ethics guidelines now oblige researchers to offer research participants the results of research in which they participated. This practice is intended to uphold respect for persons and ensure that participants are not treated as mere means to an end. Yet some scholars have begun to question a generalised duty to disclose research results, highlighting the potential harms arising from disclosure and questioning the ethical justification for a duty to disclose, especially with respect to individual results. In support of (...) this view, we argue that current rationales for a duty of disclosure do not form an adequate basis for an ethical imperative. We review policy guidance and scholarly commentary regarding the duty to communicate the results of biomedical, epidemiological and genetic research to research participants and show that there is wide variation in opinion regarding what should be disclosed and under what circumstance. Moreover, we argue that there is fundamental confusion about the notion of “research results,” specifically regarding three core concepts: the distinction between aggregate and individual results, amongst different types of research, and across different degrees of result veracity. Even where policy guidance and scholarly commentary have been most forceful in support of an ethical imperative to disclose research results, ambiguity regarding what is to be disclosed confounds ethical action. (shrink)

We review some of the essential novel ideas introduced by Bohm through the implicate order and indicate how they can be given mathematical expression in terms of an algebra. We also show how some of the features that are needed in the implicate order were anticipated in the work of Grassmann, Hamilton, and Clifford. By developing these ideas further we are able to show how the spinor itself, when viewed as a geometric object within a geometric algebra, can be given (...) a meaning which transcends the notion of the usual metric geometry in the sense that it must be regarded as an element of a broader and more general pregeometry. (shrink)

"M. F. Simone Roberts's A Poetics of Being-Two is animated by a lively and engaging voice, drawing readers in with a sense of serious purpose working (delightfully) in tandem with a sense of humor. Roberts's aesthetics and her close readings of Yves Bonnefoy, St-John Perse, and Jorie Graham clearly demonstrate the literary effectiveness of Irigarayan sexual difference as an analytic trope, even as they emphasize the philosophical and political possibilities sexual difference opens up for feminism, environmentalism, and all levels of (...) contemporary cultural critique and activism."—Gail M. Schwab, Hofstra University -/- In An Ethics of Sexual Difference, Irigaray calls for a new poetics in the sense of both art and life. Rather than a critique from within philosophy, A Poetics of Being-Two tests Irigaray's ethics by extending it to other sites of cultural production. Where Irigaray's method finds stirrings and repressions of sexual difference in philosophy, this project explores that tension in poetics. Building from Irigaray's ethics, the book describes a poetics of being-two as concerns gendered subjectivity in literary poetics and then traces the on-going emergence of a poetics of being-two in the post-symbolist poetic tradition. Irigaray scholars will be interested in the sustained interpolation of Irigaray's ethical concepts as principles for a critical aesthetics and in their hermeneutic application in reading a literary tradition. Readers in comparative literature will find the first sustained feminist engagements with the major French poets Bonnefoy and Perse and an elucidation of their influence on the Pulitzer Prize winning poet Jorie Graham. (shrink)

It has been proposed that the implicate order can be given mathematical expression in terms of an algebra and that this algebra is similar to that used in quantum theory. In this paper we bring out in a simple way those aspects of the algebraic formulation of quantum theory that are most relevant to the implicate order. By using the properties of the standard ket introduced by Dirac we describe in detail how the Heisenberg algebra can be generalized to produce (...) an algebraic structure in which it is possible to describe space translations in a way that is analogous to the description of rotations in a Clifford algebra. This approach opens up the possibility of going beyond the limits of the present quantum formalism and we discuss briefly some of the new implications. (shrink)

Background: Expanded newborn screening generates incidental results, notably carrier results. Yet newborn screening programmes typically restrict parental choice regarding receipt of this non-health serving genetic information. Healthcare providers play a key role in educating families or caring for screened infants and have strong beliefs about the management of incidental results. Methods: To inform policy on disclosure of infant sickle cell disorder (SCD) carrier results, a mixed-methods study of healthcare providers was conducted in Ontario, Canada, to understand attitudes regarding result management (...) using a cross-sectional survey (N = 1615) and semistructured interviews (N = 42). Results: Agreement to reasons favouring disclosure of SCD carrier results was high (65.1%–92.7%) and to reasons opposing disclosure was low (4.1%–18.1%). Genetics professionals expressed less support for arguments favouring disclosure (35.3%–78.8%), and more agreement with arguments opposing disclosure (15.7%–51.9%). A slim majority of genetics professionals (51.9%) agreed that a reason to avoid disclosure was the importance of allowing the child to decide to receive results. Qualitatively, there was a perceived “duty” to disclose, that if the clinician possessed the information, the clinician could not withhold it. Discussion: While a majority of respondents perceived a duty to disclose the incidental results of newborn screening, the policy implications of these attitudes are not obvious. In particular, policy must balance descriptive ethics (ie, what providers believe) and normative ethics (ie, what duty-based principles oblige), address dissenting opinion and consider the relevance of moral principles grounded in clinical obligations for public health initiatives. (shrink)

Objectives: Efficient procedures for obtaining informed (proxy) consent may contribute to high influenza vaccination rates in nursing homes. Yet are such procedures justified? This study’s objective was to gain insight in informed consent policies in Dutch nursing homes; to assess how these may affect influenza vaccination rates and to answer the question whether deviating from standard informed consent procedures could be morally justified. Design: A survey among nursing home physicians. Setting & Participants: We sent a questionnaire to all (356) nursing (...) homes in the Netherlands, to be completed by one of the physicians. Results: We received 245 completed questionnaires. As 21 institutions appeared to be closed or merged into other institutions, the response was 73.1% (245/335). Of all respondents 81.9% reported a vaccination rate above 80%. Almost 50% reported a vaccination rate above 90%. Most respondents considered herd immunity to be an important consideration for institutional policy. Freedom of choice for residents was considered important by almost all. Nevertheless, 106 out of 245 respondents follow a tacit consent procedure, according to which vaccination will be administered unless the resident or her proxy refuses. These institutions show significantly higher vaccination rates (p < 0.03). Conclusions: In our discussion we focus on the question whether tacit consent procedures can be morally justifiable. Such procedures assume that vaccination is good for residents either as individuals or as a group. Even though this assumption may be true for most residents, there are good reasons for preferring express consent procedures. (shrink)

Planned home birth has been considered by some to be consistent with professional responsibility in patient care. This article critically assesses the ethical and scientific justification for this view and shows it to be unjustified. We critically assess recent statements by professional associations of obstetricians, one that sanctions and one that endorses planned home birth. We base our critical appraisal on the professional responsibility model of obstetric ethics, which is based on the ethical concept of medicine from the Scottish and (...) English Enlightenments of the 18th century. Our critical assessment supports the following conclusions. Because of its significantly increased, preventable perinatal risks, planned home birth in the United States is not clinically or ethically benign. Attending planned home birth, no matter one’s training or experience, is not acting in a professional capacity, because this role preventably results in clinically unnecessary and therefore clinically unacceptable perinatal risk. It is therefore not consistent with the ethical concept of medicine as a profession for any attendant to planned home birth to represent himself or herself as a “professional.” Obstetric healthcare associations should neither sanction nor endorse planned home birth. Instead, these associations should recommend against planned home birth. Obstetric healthcare professionals should respond to expressions of interest in planned home birth by pregnant women by informing them that it incurs significantly increased, preventable perinatal risks, by recommending strongly against planned home birth, and by recommending strongly for planned hospital birth. Obstetric healthcare professionals should routinely provide excellent obstetric care to all women transferred to the hospital from a planned home birth. The professional responsibility model of obstetric ethics requires obstetricians to address and remedy legitimate dissatisfaction with some hospital settings and address patients’ concerns about excessive interventions. Creating a sustained culture of comprehensive safety, which cannot be achieved in planned home birth, informed by compassionate and respectful treatment of pregnant women, should be a primary focus of professional obstetric responsibility. (shrink)

In the academic year just past, the Expert Commission on Philosophical Disciplines of the Higher Certification Committee [VAK] processed 441 cases pertaining to the award of degrees and ranks. Of these, positive decisions were handed down in 333 cases, and negative decisions in 9 cases, while final decisions have not yet been taken on 99. Of the total number, 418 cases were examined, 114 of these for the degree of Doctor of Philosophical Sciences and 304 for Candidate in Philosophical Sciences, (...) and final decisions were taken on 323, while 95 were referred to further expert examination. (shrink)

What is colour vision for? In the popular imagination colour vision is for “seeing the colours” — adding hue to the achromatic world of shape, depth and motion. On this view colour vision plays little more than an ornamental role, lending glamour to an otherwise monochrome world. This idea has guided much theorising about colour within vision science and philosophy. However, we argue that a broader approach is needed. Recent research in the psychology of colour demonstrates that colour vision is (...) integral to a variety of visual processes, helping us to perform many types of visual tasks. We discuss some of this research and consider its implications for philosophical theories of colour. (shrink)

In a recent issue of this journal, P.E. Vermaas ([2005]) claims to have demonstrated that standard quantum mechanics is technologically inadequate in that it violates the 'technical functions condition'. We argue that this claim is false because based on a 'narrow' interpretation of this technical functions condition that Vermaas can only accept on pain of contradiction. We also argue that if, in order to avoid this contradiction, the technical functions condition is interpreted 'widely' rather than 'narrowly', then Vermaas, argument for (...) his claim collapses. The conclusion is that Vermaas' claim that standard quantum mechanics is technologically inadequate evaporates. (shrink)

The growing prevalence of obesity and related conditions such as Type II diabetes is held by many to be a major public health problem in developed countries, and increasingly in developing countries as well. If we wish to tackle this problem, it will be a major task. Individuals will have to change their consumption and exercise patterns, companies will have to improve the products they make and how they market them, nutrition experts and communities will have to redefine what is (...) acceptable and desirable in food practices and governments will have to lead and promote such societal-level changes in many different fields, including food policy, urban design, educational policies, agricultural subsidies and tax breaks, etc. This is all very difficult to achieve. In many people’s view, government action aiming at social change will be especially controversial and meet some resistance. New York …. (shrink)

A method originally conceived by Bohm for abstracting key features of the metric geometry from an underlying spinor ordering is generalized to the projective geometry. This allows the introduction of the spinor into a projective context and the definition of an associated geometric algebra. The projective spinor may then be regarded as defining a pregeometry for the projective space.