Situations in which patients lack medical decision-making (MDM) capacity raise ethical challenges, especially when the patients decline care that their surrogate decision makers and/or clinicians agree is indicated. These patients are a vulnerable population and should receive treatment that is the standard of care, in line with their the values of their authentic self, just as any other patient would. But forcing treatment on patients who refuse it, even though they lack capacity, carries medical and psychological risks to the patients (...) and the hospital staff. It is also often impractical to force some treatments, especially in the long term. For example, independent of the ethical “should” question, how would one force hemodialysis for the rest of a patient’s life, or force a surgery that requires weeks of post-operative physical therapy? In this article we present a novel algorithm that can help clinicians with ethical and practical decision making, with the goals of achieving the best outcomes for patients and reducing moral distress for their caretakers and clinicians. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Most authors who discuss willpower assume that everyone knows what it is, but our assumptions differ to such an extent that we talk past each other. We agree that willpower is the psychological function that resists temptations – variously known as impulses, addictions, or bad habits; that it operates simultaneously with temptations, without prior commitment; and that use of it is limited by its cost, commonly called effort, as well as by the person's skill at executive functioning. However, accounts are (...) usually not clear about how motivation functions during the application of willpower, or how motivation is related to effort. Some accounts depict willpower as the perceiving or formation of motivational contingencies that outweigh the temptation, and some depict it as a continuous use of mechanisms that interfere with re-weighing the temptation. Some others now suggest that impulse control can bypass motivation altogether, although they refer to this route as habit rather than willpower.It is argued here that willpower should be recognized as either or both of two distinct functions, which can be calledresolveandsuppression. Resolve is based on interpretation of a current choice as a test case for a broader set of future choices, which puts at stake more than the outcome of the current choice. Suppression is inhibiting valuation of (modulating) and/or keeping attention from (filtering) immediate alternatives to a current intention. Perception of current choices as test cases for broader outcomes may result in reliable preference for these outcomes, which is experienced as an effortlesshabit– a successful result of resolve, not an alternative method of self-control. Some possible brain imaging correlates are reviewed. (shrink)

ABSTRACT The list of proposed addictions has recently grown to include television, videogames, shopping, day trading, kleptomania, and use of the Internet. These activities share with a more established entry, gambling, the property that they require no delivery of a biological stimulus that might be thought to unlock a hardwired brain process. I propose a framework for analyzing that class of incentives that do not depend on the prediction of physically privileged environmental events: people have a great capacity to coin (...) endogenous reward; we learn to cultivate it, and, where it is entrapping, to minimize it, by managing internally generated appetites for it. The basic method of cultivating endogenous reward is to learn cues that predict when best to harvest the reward that has been made possible by the growth of these appetites. This hedonic management occurs in the same motivational marketplace as the instrumental planning that seeks environmental goods in the conventional manner, and presumably obeys the same laws of temporal difference learning; but these laws are no longer limiting. Furthermore, instrumental contingencies often provide the most productive structure for hedonic management as well, for reasons that I discuss; but the needs of hedonic management create incentives both to pursue instrumental goals in a suboptimal manner and to avoid noticing how the hedonic incentive affects this pursuit. The result is the apparent irrationality that is often observed in process addictions. (shrink)

RECENT PHILOSOPHICAL ATTENTION TO THE LANGUAGE OF DISEASE HAS FOCUSED PRIMARILY ON THE QUESTION OF ITS VALUE-NEUTRALITY OR NON-NEUTRALITY. PROPONENTS OF THE VALUE-NEUTRALITY THESIS SYMBOLICALLY COMBINE POLITICAL AND OTHER CRITICISMS OF MEDICINE IN AN ATTACK ON WHAT THEY SEE AS VALUE-INFECTED USES OF DISEASE LANGUAGE. THE PRESENT ESSAY ARGUES AGAINST TWO THESES ASSOCIATED WITH THIS VIEW: A METHODOLOGICAL THESIS WHICH TENDS TO DIVORCE THE ANALYSIS OF DISEASE LANGUAGE FROM THE CONTEXT OF THE PRACTICE OF MEDICINE AND A SUBSTANTIVE THESIS WHICH (...) HOLDS THAT DISEASE LANGUAGE IS EVALUATIVELY NEUTRAL. IN PARTICULAR, THE ESSAY CRITICALLY FOCUSES ON THE VALUE NEUTRAL POSITION ADOPTED BY CHRISTOPHER BOORSE, WHICH HE TERMS A FUNCTIONAL THEORY OF DISEASE. THE ARGUMENT CONCERNS WHETHER OR NOT ONE CAN HAVE VALUE NEUTRAL DESCRIPTION OF DISEASE STATES OR WHETHER DISEASE LANGUAGE ESSENTIALLY INVOLVES VALUES. (shrink)

_African-American Philosophers_ brings into conversation seventeen of the foremost thinkers of color to discuss issues such as Black existentialism, racism, Black women philosophers within the academy, affirmative action and the conceptual parameters of African-American philosophy.

While there is no denying the relevance of ethical knowledge and analytical and cognitive skills in ethics consultation, such knowledge and skills can be overemphasized. They can be effectively put into practice only by an ethics consultant, who has a broad range of other skills, including interpretive and communicative capacities as well as the capacity effectively to address the psychosocial needs of patients, family members, and healthcare professionals in the context of an ethics consultation case. In this paper, I discuss (...) how emotion can play an important interpretive role in clinical ethics consultation and why attention to the role of defense mechanisms can be helpful. I concentrate on defense mechanisms, arguing first, that the presence of these mechanisms is understandable given the emotional stresses and communicative occlusions that occur between the families of patients and critical care professionals in the circumstances of critical care; second, that identifying these mechanisms is essential for interpreting and managing how these factors influence the way that the “facts” of the case are understood by family members; and, third, that effectively addressing these mechanisms is an important component for effectively doing ethics consultation. Recognizing defense mechanisms, understanding how and why they operate, and knowing how to deal with these defense mechanisms when they pose problems for communication or decision making are thus essential prerequisites for effective ethics consultation, especially in critical care. (shrink)

Pursuing Trayvon Martin: Historical Contexts and Contemporary Manifestations of Racial Dynamics explores the historical implications of the fatal shooting of the unarmed black teen, Trayvon Martin, by George Zimmerman, in 2012. The book telescopes various themes that are important to a broad market, including race, masculinity, racial profiling, racist stereotyping, black youth and police violence, and racism.

In this article, I argue that African-American philosophy emerges from a socio-existential context where persons of African descent have been faced with the absurd in the form of white racism (This paper is a substantially revised version on an earlier article. See Yancy, G. (2011). African-American Philosophy through the Lens of Socio-Existential Struggle. Philosophy & Social Criticism, Volume 37: 551–574). The concept of struggle, given the above, functions as both descriptive and heuristic vis-à-vis the meaning of African American philosophy. Expanding (...) upon Charles Mills’ concept of non-Cartesian sums, I demonstrate the inextricable link between Black lived experience, struggle, and the morphology of meta-philosophical assumptions and philosophical problems specific to African-American philosophy. Because of the philosophical pretensions of white Western philosophy, with it claims to universal truth and objective knowledge, the particularity of African-American philosophical concerns with questions of embodiment and race is often deemed ersatz or non-philosophical. In this article, I argue that whiteness as the transcendental norm is productive of a form of ignorance endemic to Western philosophical practices that are myopic and hegemonic. Finally, African-American philosophy is theorized as a gift, as a critical counter-narrative that can be deployed to fissure Western philosophy’s narcissism. (shrink)

The dream of a community of philosophers engaged in inquiry with shared standards of evidence and justification has long been with us. It has led some thinkers puzzled by our mathematical experience to look to mathematics for adjudication between competing views. I am skeptical of this approach and consider Skolem's philosophical uses of the Löwenheim-Skolem Theorem to exemplify it. I argue that these uses invariably beg the questions at issue. I say ?uses?, because I claim further that Skolem shifted his (...) position on the philosophical significance of the theorem as a result of a shift in his background beliefs. The nature of this shift and possible explanations for it are investigated. Ironically, Skolem's own case provides a historical example of the philosophical flexibility of his theorem. Our suspicion ought always to be aroused when a proof proves more than its means allow it. Something of this sort might be called ?a puffed-up proof?. Ludwig Wittgenstein, Remarks on the foundations of mathematics (revised edition), vol. 2, 21. (shrink)

Wegner makes an excellent case that our sense of ownership of our actions depends on multiple factors, to such an extent that it could be called virtual or even illusory. However, two other core functions of will are initiation of movement and maintenance of resolution, which depend on our accurate monitoring of them. This book shows that will is not an imponderable black box but, rather, an increasingly accessible set of specific functions.

The proliferation of ethics committees and ethics consultation services has engendered a discussion of the issue of the expertise of those who provide clinical ethics consultation services. In this paper, I discuss two aspects of this issue: the cognitive dimension or content knowledge that the clinical ethics consultant should possess and the practical dimension or set of dispositions, skills, and traits that are necessary for effective ethics consultation. I argue that the failure to differentiate and fully explicate these dimensions contributes (...) to the confusion over the issue of expertise and fuels, at least partly, the controversies about expertise (or authority) in ethics and the legitimacy of the use of ethical knowledge in clinical ethics consultation. (shrink)

Drawing from the lives of Ossie Davis, Frantz Fanon, Malcolm X, and W. E. B. Du Bois, as well as his own experience, and fully updated to account for what has transpired since the rise of the Black Lives Matter movement, Yancy provides an invaluable resource for students and teachers of courses in African American Studies, African American History, Philosophy of Race, and anyone else who wishes to examine what it means to be Black in America.

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

This scarce antiquarian book is a facsimile reprint of the original. Due to its age, it may contain imperfections such as marks, notations, marginalia and flawed pages. Because we believe this work is culturally important, we have made it available as part of our commitment for protecting, preserving, and promoting the world's literature in affordable, high quality, modern editions that are true to the original work.

Volume 19, Issue 6, June 2019, Page 1-3.

Best known for his influential History of Greece, the historian and politician George Grote wrote this account of Plato's dialogues as a philosophical supplement to the History. First published in 1865 and written in dialogic form, Grote's account of Plato's works includes substantial footnotes and marginalia. This first volume focuses on Plato's early and transitional dialogues, all of which feature Socrates. It also includes a preface to the whole project which discusses the meaning and importance of philosophy itself, and (...) extensive introductory material on pre-Socratic philosophy, the life of Plato and history of the Platonic canon. With three volumes each running to over six hundred pages, Grote's scholarship is formidably comprehensive. The publication of Plato and the Other Companions of Sokrates confirmed him as one of the greatest authorities on Plato in the nineteenth century. (shrink)

This article provides a Foucauldian analysis of whiteness as a philosophical, political, anthropological and epistemological regime, undergirded by a power/knowledge nexus, which shapes what it meansto embody whiteness vis-a-vis the Black body/self. As a specific historically constructed standpoint, one that takes itselfas a “universal” value, and through a genealogical reading, whiteness is revealed as akind of emergence (Entstehung), a reactive value-creating power which shapes how the Black body/self is disciplined and how the Black body/selfcomes to introject a self-denigrating episteme. This (...) introjected episteme is explored as being fueled by white ressentiment. Coming under normalizing disciplinary techniques of whiteness, which is historically demonstrated, it is argued that Blacks carne to intemalize a form of self-ressentiment. Through the existentially rich narrative text of Toni Morrison’s The Bluest Eye, the author shows that Pecola Breedlove, though a fictional character, is the racially distorted (and racially self-hating) product of certain contingent interpersonal and historical practices that once genealogically revealed create the possibility of radically dismantling their impact. (shrink)