We have studied a number of long-term meditators in previous studies. The purpose of this study was to determine if there are differences in baseline brain function of experienced meditators compared to non-meditators. All subjects were recruited as part of an ongoing study of different meditation practices. We evaluated 12 advanced meditators and 14 non-meditators with cerebral blood flow SPECT imaging at rest. Images were analyzed with both region of interest and statistical parametric mapping. The CBF of long-term meditators was (...) significantly higher compared to non-meditators in the prefrontal cortex, parietal cortex, thalamus, putamen, caudate, and midbrain. There was also a significant difference in the thalamic laterality with long-term meditators having greater asymmetry. The observed changes associated with long-term meditation appear in structures that underlie the attention network and also those that relate to emotion and autonomic function. (shrink)

Specialists and primary care physicians play an integral role in treating the twin epidemics of pain and addiction. But inadequate access to specialists causes much of the treatment burden to fall on primary physicians. This article chronicles the differences between treatment contexts for both pain and addiction — in the specialty and primary care contexts — and derives a series of reforms that would empower primary care physicians and better leverage specialists.

What is conscientious objection? -- Should conscientious objectors be accommodated? -- Assessing objectors' beliefs and reasons -- Accommodation and conscientious provision.

This state-of-the-science volume brings together an array of leading authorities to comprehensively review theory and research in this burgeoning area.

Terrorism is commonly viewed as a form of war, and as a form of war, the morality of terrorism seems to turn on the usual arguments regarding the furtherance of political objectives through coercive means. The terrorist argues that his options for armed struggle are limited, and that the use of force against civilians is the only way he can advance his cause. But this argument is subject to a powerful response. There is the argument from consequences, which asserts that (...) terrorism is almost always counterproductive, even assuming the terrorist’s political objectives are legitimate. There is the argument from rights, which claims that terrorism violates the basic human rights of (at least) its civilian victims, and is therefore morally objectionable regardless of its consequences. And there is the argument from virtue, which notes that slaughtering civilians requires no skill or courage and therefore generates no honor or glory, making the terrorist not a virtuous warrior but a vicious one. But terrorism is not only a means of political coercion. It is also, in the view of many terrorists, a means of retribution. It is a means of exacting punishment on a political community the terrorist believes is collectively responsible for grievous wrongs certain members of that community have committed. And viewed as a means of retribution, the usual arguments made against terrorism-as-coercion have no moral force. To explain why terrorism-as-retribution is morally wrong, we must attack the notion of collective responsibility on which the terrorist relies. (shrink)

Historically associated with military service, conscientious objection has become a significant phenomenon in health care. Mark Wicclair offers a comprehensive ethical analysis of conscientious objection in three representative health care professions: medicine, nursing and pharmacy. He critically examines two extreme positions: the 'incompatibility thesis', that it is contrary to the professional obligations of practitioners to refuse provision of any service within the scope of their professional competence; and 'conscience absolutism', that they should be exempted from performing any action contrary (...) to their conscience. He argues for a compromise approach that accommodates conscience-based refusals within the limits of specified ethical constraints. He also explores conscientious objection by students in each of the three professions, discusses conscience protection legislation and conscience-based refusals by pharmacies and hospitals, and analyzes several cases. His book is a valuable resource for scholars, professionals, trainees, students, and anyone interested in this increasingly important aspect of health care. (shrink)

A US Department of Health and Human Services Final Rule, Protecting Statutory Conscience Rights in Health Care, and a proposed bill in the British House of Lords, the Conscientious Objection Bill, may well warrant a concern that—to borrow a phrase Daniel Callahan applied to self-determination—conscientious objection in health care has “run amok.” Insofar as there are no significant constraints or limitations on accommodation, both rules endorse an approach that is aptly designated “conscience absolutism.” There are two common strategies to counter (...) conscience absolutism and prevent conscientious objection in medicine from running amok. One, non-toleration, is to decline to accommodate physicians who refuse to provide legal, professionally accepted, clinically appropriate medical services within the scope of their clinical competence. The other, compromise or reasonable accommodation, is to impose constraints on accommodation. Several arguments for non-toleration are critically analyzed, and I argue that none warrants its acceptance. I maintain that non-toleration is an excessively blunt instrument to prevent conscientious objection in medicine from running amok. Instead, I defend a more nuanced contextual approach that includes constraints on accommodation. (shrink)

There are many different kinds of libertarianism. The first is right libertarianism, which received its most powerful expression in Robert Nozick’s Anarchy, State and Utopia (1974), a book that still sets the baseline for discussions of libertarianism today. The second, I will call faux libertarianism. For reasons I will explain in this paper, most ‘man-on-the-street’ libertarians and most politicians who claim to be libertarians are actually this kind of libertarian. And third, there is left libertarianism, which is what I shall (...) spend most of this paper explicating. But I will not simply be surveying the views of those who identify as left libertarians and put this forth as if I were engaged in an exegetical exercise. Instead, what I shall set forth is a kind of manifesto, a statement of why I consider myself a left libertarian, one that takes this approach to political morality well beyond where it was left around the end of the last century by the previous generation of left libertarians. My hope is to provide those who find certain left libertarian ideas attractive a guide by which they can explain and harmonise their own views, recognise left libertarianism as a distinct comprehensive political doctrine, and feel more open to identify themselves as left libertarian too. (shrink)

Evidence-based medicine (EBM) has thus far failed to adequately account for the appropriate incorporation of other potential warrants for medical decision making into clinical practice. In particular, EBM has struggled with the value and integration of other kinds of medical knowledge, such as those derived from clinical experience or based on pathophysiologic rationale. The general priority given to empirical evidence derived from clinical research in all EBM approaches is not epistemically tenable. A casuistic alternative to EBM approaches recognizes that five (...) distinct topics, 1) empirical evidence, 2) experiential evidence, 3) pathophysiologic rationale, 4) patient goals and values, and 5) system features are potentially relevant to any clinical decision. No single topic has a general priority over any other and the relative importance of a topic will depend upon the circumstances of the particular case. The skilled clinician must weigh these potentially conflicting evidentiary and non-evidentiary warrants for action, employing both practical and theoretical reasoning, in order to arrive at the best choice for an individual patient. (shrink)

In response to physicians who refuse to provide medical services that are contrary to their ethical and/or religious beliefs, it is sometimes asserted that anyone who is not willing to provide legally and professionally permitted medical services should choose another profession. This article critically examines the underlying assumption that conscientious objection is incompatible with a physician’s professional obligations (the “incompatibility thesis”). Several accounts of the professional obligations of physicians are explored: general ethical theories (consequentialism, contractarianism, and rights-based theories), internal morality (...) (essentialist and non-essentialist conceptions), reciprocal justice, social contract, and promising. It is argued that none of these accounts of a physician’s professional obligations unequivocally supports the incompatibility thesis. (shrink)

It is argued that the primary aim of institutional management is to protect the moral integrity of health professionals without significantly compromising other important values and interests. Institutional policies are recommended as a means to promote fair, consistent, and transparent management of conscience-based refusals. It is further recommended that those policies include the following four requirements: (1) Conscience-based refusals will be accommodated only if a requested accommodation will not impede a patient’s/surrogate’s timely access to information, counseling, and referral. (2) Conscience-based (...) refusals will be accommodated only if a requested accommodation will not impede a patient’s timely access to health care services offered within the institution. (3) Conscience-based refusals will be accommodated only if the accommodation will not impose excessive burdens on colleagues, supervisors, department heads, other administrators, or the institution. (4) Whenever feasible, health professionals should provide advance notification to department heads or supervisors. Formal review may not be required in all cases, but when it is appropriate, several recommendations are offered about standards and the review process. A key recommendation is that when reviewing an objector’s reasons, contrary to what some have proposed, it is not appropriate to adopt an adversarial approach modelled on military review boards’ assessments of requests for conscientious objector status. According to the approach recommended, the primary function of reviews of objectors’ reasons is to engage them in a process of reflecting on the nature and depth of their objections, with the objective of facilitating moral clarity on the part of objectors rather than enabling department heads, supervisors, or ethics committees to determine whether conscientious objections are sufficiently genuine. (shrink)

For years now, unionization has been under vigorous attack. Membership has been steadily declining, and with it union bargaining power. As a result, unions may soon lose their ability to protect workers from economic and personal abuse, as well as their significance as a political force. In the Name of Liberty responds to this worrying state of affairs by presenting a new argument for unionization, one that derives an argument for universal unionization in both the private and public sector from (...) concepts of liberty that we already accept. In short, In the Name of Liberty reclaims the argument for liberty from the political right, and shows how liberty not only requires the unionization of every workplace as a matter of background justice, but also supports a wide variety of other progressive policies. (shrink)

Typically, a refusal to provide a medical service is an instance of conscientious objection only when the medical service is legal, professionally accepted, and clinically appropriate. That is, conscientious objection typically occurs only when practitioners reject prevailing norms or practices. Insofar as refusing to provide antibiotics for a viral infection does not violate prevailing clinical norms, there is no need for the physician in Case 1 to justify his refusal to provide antibiotics by appealing to his conscience.1 By contrast, insofar (...) as emergency contraception is legal and does not violate prevailing norms of good medical practice, the physician in Case 6 cannot justify his refusal to provide EC by... (shrink)

Previous discussions of the evolution of the self have diverged greatly in their estimates of the date at which the capacity for self-thought emerged, the factors that led self-reflection to evolve, and the nature of the evidence offered to support these disparate conclusions. Beginning with the assumption that human self-awareness involves a set of distinct cognitive abilities that evolved at different times to solve different adaptive problems, we trace the evolution of self-awareness from the common ancestor of humans and apes (...) to the beginnings of culture, drawing upon paleontological, anthropological, biological, and psychological evidence. These data converge to suggest that that modern self-thought appeared just prior to the Middle-Upper Paleolithic transition, approximately 60,000 years ago.Recto running head: Evolution of the Self. (shrink)

For a long time, economic growth has been seen as the most promising source of funds to use toward reducing economic inequality, as well as a necessity if we are aiming at achieving full employment. But one of the most troubling aspects of the recent exponential rise in economic inequality is that this rise has occurred despite continued economic growth. Increases in national income have gone almost exclusively to the super-rich, while real wages for almost everybody else have stagnated or (...) even declined. And while the unemployment rate dropped significantly before the coronavirus pandemic hit, good, permanent, high-wage jobs with benefits had by then often been replaced by temporary, part-time, low-wage jobs without benefits, leaving even the employed feeling economically insecure. And now, of course, unemployment is again skyrocketing, and it is unclear how long it might take to come down. As a result, we have now arrived at a point of reckoning: can we continue to believe that liberal capitalism is the most promising combination of economic and political ideologies for securing a prosperous and just future? If not, what might replace it? Is the problem capitalism, or is it liberalism? Are we up against economic forces that we cannot influence or control, or is it our political will and the liberal values we endorse that are being tested? This paper looks at all these questions, and suggests how we might think about the prospects for a liberal future. (shrink)

Electronegativity, described by Linus Pauling described as “The power of an atom in a molecule to attract electrons to itself” (Pauling in The nature of the chemical bond, 3rd edn, Cornell University Press, Ithaca, p 88, 1960), is used to predict bond polarity. There are dozens of methods for empirically quantifying electronegativity including: the original thermochemical technique (Pauling in J Am Chem Soc 54:3570–3582, 1932), numerical averaging of the ionisation potential and electron affinity (Mulliken in J Chem Phys 2:782–784, 1934), (...) effective nuclear charge and covalent radius analysis (Sanderson in J Chem Phys 23:2467, 1955) and the averaged successive ionisation energies of an element’s valence electrons (Martynov and Batsanov in Zhurnal Neorganicheskoi Khimii 5:3171–3175, 1980), etc. Indeed, there are such strong correlations between numerous atomic parameters—physical and chemical—that the term “electronegativity” integrates them into a single dimensionless number between 0.78 and 4.00 that can be used to predict/describe/model much of an element’s physical character and chemical behaviour. The design of the common and popular medium form of the periodic table is in large part determined by four quantum numbers and four associated rules. However, adding electronegativity completes the construction so that it displays the multi-parameter periodic law operating in two dimensions, down the groups and across the periods, with minimal ambiguity. (shrink)

Recognition of conscientious objection seems reasonable in relation to controversial and contentious issues, such as physician assisted suicide and abortion. However, physicians also advance conscience‐based objections to actions and practices that are sanctioned by established norms of medical ethics, and an account of their moral force can be more elusive in such contexts. Several possible ethical justifications for recognizing appeals to conscience in medicine are examined, and it is argued that the most promising one is respect for moral integrity. It (...) is also argued that an appeal to conscience has significant moral weight only if the core ethical values on which it is based correspond to one or more core values in medicine. Finally, several guidelines pertaining to appeals to conscience and their ethical evaluation are presented. (shrink)

Approximately 1500 years ago John Philoponus proposed a simple and compelling argument for the existence of God: (1) Whatever comes to be has a cause of its coming to be; (2) The universe came to be; (3) Therefore, the universe has a cause of its coming to be. Due to the influence of William Lane Craig — analytic philosopher, Christian apologist, champion of Philoponus’s position, and author of The Kalam Cosmological Argument — this argument and the family of subarguments that (...) support it have come to be known as the Kalam Cosmological Argument (KCA). The term kalam comes from Medieval Arabic philosophy and broadly means "natural theology" or "philosophical theism." Despite being one of the most widely discussed and hotly debated arguments in philosophy today, it has been more than twenty-five years since any systematic presentation of the argument as a whole has been attempted. The present book helps remedy that situation, laying bare the logical structure of the KCA as it has emerged from continuous philosophical refinement. A handy taxonomy of major objections and replies to the KCA has been included as an aid to understanding the argument and its background literature. This book breaks new ground by arguing that future progress on the KCA requires that the argument be situated within a substance-based metaphysics. In addition to providing an analytic account of substances, this book describes a modal theory sensitive to the possibilities and necessities that obtain for substances. With these conceptual tools, the characteristic thought-experiments supporting the KCA can be properly assessed. (shrink)

Spiritual Traditions and the Virtues provides a philosophical appreciation of the spiritual life, showing how a certain conception of spiritual well-being, rooted in Thomas Aquinas's account of the virtues, can generate a distinctive vision of human life, and the possibilities for spiritual fulfilment.

In Liberalism with Excellence, Matthew Kramer makes an argument for how excellence may enter in into liberalism, despite liberalism’s strong commitment to neutrality. Kramer seeks to challenge not only the uncompromising rejection of this position by liberals such a Jonathan Quong, but also the so-called “blended” approach of “soft-perfectionist” scholars such as Joseph Raz and George Sher. In this essay, I do not so much challenge Kramer’s approach as offer an alternative for accomplishing the same thing. Under my proposal, certain (...) forms of excellence and neutrality can both be accommodated as long as state support for the form of excellence at issue is proportional to the support for such a form of excellence within the relevant polity, competing forms of excellence are non-rivalrous, and no one is forced to embrace a form of excellence with which they disagree. My proposal is therefore not what Ronald Dworkin derogatively characterized as “a checkerboard solution.” Rather than allowing the state to support contrary moral positions at one and the same time, it is a solution that takes morally compatible but nevertheless competing conceptions of excellence seriously, and exhibits neutrality by giving them proportional rather than full support. This neither forces anyone to pursue the particular forms of excellence the state supports nor prevents them from pursuing some other form of excellence entirely or, if they wish, no form of excellence at all. (shrink)

: This paper examines the obligations of pharmacy licensees and pharmacists in the context of conscience-based objections to filling lawful prescriptions for certain types of medications—e.g., standard and emergency contraceptives. Claims of conscience are analyzed as means to preserve or maintain an individual's moral integrity. It is argued that pharmacy licensees have an obligation to dispense prescription medications that satisfy the health needs of the populations they serve, and this obligation can override claims of conscience. Although efforts should be made (...) to respect the moral integrity of pharmacists and accommodate their claims of conscience, it is argued that the health needs of patients and the professional obligations of pharmacists limit the extent to which pharmacists may refuse to assist patients who have lawful prescriptions for medically indicated drugs. (shrink)

Many people have been enraged lately by the enormous increases in certain generic prescription drugs. But free marketeers defend these prices by arguing that they simply represent what the market will bear, and in a capitalist society there is accordingly nothing wrong with charging them. This paper argues that such a defense is actually contrary to the very principles that free marketeers claim to embrace. These prices are not only unjust and exploitative, but government interference with them would not render (...) the market less free, at least if what it means for a market to be “free” is properly understood. Everyone, even free marketeers with a libertarian or neoliberal bent, should accordingly be against this kind of profiteering. (shrink)

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

While the importance of mechanisms in determining causality in medicine is currently the subject of active debate, the role of mechanistic reasoning in clinical practice has received far less attention. In this paper we look at this question in the context of the treatment of a particular individual, and argue that evidence of mechanisms is indeed key to various aspects of clinical practice, including assessing population-level research reports, diagnostic as well as therapeutic decision making, and the assessment of treatment effects. (...) We use the pulmonary condition bronchiectasis as a source of examples of the importance of mechanistic reasoning to clinical practice. (shrink)

Process philosophy was on the periphery of academic thinking for much of the twentieth century. Whereas the focus of intellectual development was for the most part on scientific analysis, process philosophy argued for a more encompassing synthesis as well. Although the drive — the corpus delecti of formal research assessment funding exercises — for separate, discrete and latterly measurable bodies of knowledge arrived at from within increasingly autonomous academic disciplines has undoubtedly led to significant advance in many areas it has, (...) at the same time, rendered opaque the interconnectedness of all things and thereby diminished the perceived value of ideas developed in one field, in terms of their relevance to others. At its heart, this trend has arisen from a reliance upon a metaphysics of stasis; things are constant and can thus be analysed and re-analysed into ever finite and thoroughly separate elements. In contrast, a metaphysics of process suggests that change and interconnectedness are the predominant characteristics of nature. As such, it provides new directions for contemporary thought by enabling the development of ideas via an otherwise unavailable framework of coherence and comprehensiveness. One area in which process thought has proved helpful is organisation studies. This paper examines the role of interpersonal trust in organisations from a Whiteheadian perspective. As such, it aims to show how Whitehead’s thinking can be applied to complex human experiences in such a way as to reveal the nature of the processes that go toward their development. The paper begins with a theoretical explication of trust derived from the contemporary social scientific literature. The development of trust, a key component of human society, is argued to be a subjective and processual phenomenon. In the light of this discussion the paper uses appropriate elements of Whitehead’s Philosophy of Organism to provide a description of trust’s development in an individual for another individual, and its consequent impact on their cooperative behaviour. It thereby attempts to uncover the hitherto inaccessible micro-processes that go towards the development and continuation of interpersonal trust in organisational settings. In so doing, the paper seeks to demonstrate the explanatory power of an aspect of Whitehead’s work, his elucidation of human ‘emotional experience’, that is perhaps too often overlooked as a comparatively minor and non-technical use of his categoreal scheme. (shrink)

In a provocative 1974 article entitled “Harvesting the Dead,” Willard Gaylin explored potential uses of “neomorts,” or what are currently referred to as “heart-beating cadavers”—that is, humans determined to be dead by neurological criteria and whose cardiopulmonary function is medically maintained by ventilators, vasopressors, and so forth. Medical research was one of the potential uses Gaylin identified. He pointed out that tests of drugs and medical procedures that would have unacceptable health risks if performed on living human subjects could be (...) performed on neomorts without any health risks. According to Gaylin, the potential benefits of such research could be enormous, including not subjecting patients to ineffective or harmful medical procedures and eliminating delays in providing effective therapies to dying patients. (shrink)

The design studio and the associated design review can be regarded as the signature pedagogy of architectural education, where students garner the essence of what it means to be an architect. Here,...

Discussions of appeals to conscience by healthcare professionals typically focus on situations in which they object to providing a legal and professionally permitted service, such as abortion, sterilization, prescribing or dispensing emergency contraception, and organ retrieval pursuant to donation after cardiac death. “Negative claims of conscience” will designate such appeals to conscience. When healthcare professionals advance a negative claim of conscience, they do so to secure an exemption from ethical, professional, institutional, and/or legal obligations or requirements to provide a healthcare (...) service. (shrink)

The case for reparations for grievous acts of historical injustice has been getting a lot of attention lately. But I aim to broaden the discussion in two ways. First, I am not only going to talk about reparations as a means of rectifying the injuries inflicted by slavery and the genocide of indigenous peoples, the theft of their land, and the ongoing ripple effects of these historic wrongs. I am also going to talk about reparations for a wider variety of (...) historical injustices, including, most importantly, the long-term economic oppression of women, and the historical exploitation of labor. Second, I am not going to base my argument on the principle of equality, as most people currently do, but on the principle of liberty, as it is understood by libertarians on both the right and the left, at least as long as they believe what they say they believe. Not because I think that egalitarian demands for reparations are wrong. Rather, my point is that the principle of liberty, which is often raised as a defense to claims based on the principle of equality, actually leads to exactly the same place. Finally, I will discuss one possible form of reparations that has largely been ignored, but which has a special connection to libertarian principles, and I will show how it can provide some real relief without provoking the opposition that society-wide redistributive remedies usually face. (shrink)

While unionization is usually evaluated as an aspect of freedom of association—the idea being that workers have the right to associate and form unions if they want and have an equal right not to do so if they don't, I argue that this is a mistake. Instead of merely allowing unions to form or not depending on the preferences of workers, I argue that unions are a basic and therefore necessary institution of a just society. After analyzing and criticizing the (...) schema developed by John Rawls for evaluating what constitutes a basic institution, I introduce a new principle that allows us to determine what should be considered a basic institution in the context of our existing social institutions and practices. I then apply this principle to unionization, and argue that while unions are subject to post-institutional regulation, just like firms are, their existence is demanded by pre-institutional principles of equality and liberty and therefore not optional. Not only are union shops consistent with our deepest moral principles, including our commitment to liberty, that commitment, when properly understood, actually requires that unionization be universal. (shrink)

Artificial intelligence, the "science and engineering of intelligent machines", still has yet to create even a simple "Advice Taker" [McCarthy, 1959]. We have previously argued [Waser, 2011] that this is because researchers are focused on problem-solving or the rigorous analysis of intelligence (or arguments about consciousness) rather than the creation of a "self" that can "learn" to be intelligent. Therefore, following expert advice on the nature of self [Llinas, 2001; Hofstadter, 2007; Damasio, 2010], we embarked upon an effort to design (...) and implement a self-understanding, self-improving loop as the totality of a (seed) AI. As part of that, we decided to follow up on Richard Dawkins' [1976] speculation that "perhaps consciousness arises when the brain's simulation of the world becomes so complete that it must include a model of itself" by defining a number of axioms and following them through to their logical conclusions. The results combined with an enactive approach yielded many surprising and useful implications for further understanding consciousness, self, and "free-will" that continue to pave the way towards the creation of safe/moral autopoiesis. (shrink)

This paper will demonstrate that the distinction between arguments and adverbials is reflected in initial phrase-structure, pace Larson (1988), rather than simply in the lexical entries of verbs.

In 2017, Partridge et al. published remarkable experimental results concerning the use of a new artificial womb technology (AWT) with lambs, developed at Children’s Hospital of Philadelphia, called...

The American Journal of Bioethics, Volume 11, Issue 11, Page 17-18, November 2011.

Exploitation and Economic Justice in the Liberal Capitalist State offers the first new, liberal theory of economic justice to appear in more than 30 years. The theory presented is designed to offer an alternative to the most popular liberal egalitarian theories of today and aims to be acceptable to both right and left libertarians too.

As with other fields of applied ethics, philosophers engaged in business ethics struggle to carry out substantive philosophical reflection in a way that mirrors the practical reasoning that goes on within business management itself. One manifestation of the philosopher’s struggle is the field’s division into approaches that emphasize moral philosophy and those grounded in the methods of social science. I claim here that the task for those who come to business ethics with philosophical training is to avoid unintentionally widening the (...) gap between philosophical theory and business management by emphasizing the centrality of practical wisdom to both good managment and to the moral life. Distinguishing my own approach from recent emphases on phronesis in management literature, I draw on the concepts of social practice and of narrative to tie practical reasoning to a company’s unique story. Practical reason, social practices and narrative are employed together to give an account of the art of management at Patagonia. The essay hopes to both provide a way for philosophers engaged with business ethics to see family resemblances between their practices and those of business management and to offer a pedagogical example useful for those in any discipline interested in viewing businesses ethically. (shrink)