The use of evidence in medicine is something we should continuously seek to improve. This book seeks to develop our understanding of evidence of mechanism in evaluating evidence in medicine, public health, and social care; and also offers tools to help implement improved assessment of evidence of mechanism in practice. In this way, the book offers a bridge between more theoretical and conceptual insights and worries about evidence of mechanism and practical means to fit the results into evidence assessment procedures.
Evidence-based medicine has always required integration of patient values with ‘best’ clinical evidence. It is widely recognized that scientific practices and discoveries, including those of EBM, are value-laden. But to date, the science of EBM has focused primarily on methods for reducing bias in the evidence, while the role of values in the different aspects of the EBM process has been almost completely ignored.
Grief research in philosophy agrees that one who grieves grieves over the irreversible loss of someone whom the griever loved deeply, and that someone thus factored centrally into the griever’s sense of purpose and meaning in the world. The analytic literature in general tends to focus its treatments on the paradigm case of grief as the death of a loved one. I want to restrict my account to the paradigm case because the paradigm case most persuades the mind that grief (...) is a past-directed emotion. The phenomenological move I propose will enable us to respect the paradigm case of grief and a broader but still legitimate set of grief-generating states of affairs, liberate grief from the view that grief is past directed or about the past, and thus account for grief in a way that separates it from its closest emotion-neighbor, sorrow, without having to rely on the affective quality of those two emotions.If the passing of the beloved causes the grief but is not what the grief is about, then we can get at the nature of grief by saying its temporal orientation is in the past, but its temporal meaning is the present and future—the new significance of a world with the pervasive absence that is the world without the beloved. The no-longer of grief is a no-longer oriented by a past that is referred a present and future. Looking at the griever’s relation to time can tell us much about the pain and the object of grief, then. As the griever puts the past before himself with a certainty about this world “henceforth,” a look at the griever’s lived sense of the fi nality of the irreversibly lost liberates grief from the tendency in the literature to be reduced to a past-directed emotion, accounts for grief ’s intensity, its affective force or poignancy, and thus enables us to separate grief from sorrow according to its intentionalobject in light of the temporal meaning of these emotions. (shrink)
The role of mechanistic evidence tends to be under‐appreciated in current evidence‐based medicine, which focusses on clinical studies, tending to restrict attention to randomized controlled studies when they are available. The EBM+ programme seeks to redress this imbalance, by suggesting methods for evaluating mechanistic studies alongside clinical studies. Drug approval is a problematic case for the view that mechanistic evidence should be taken into account, because RCTs are almost always available. Nevertheless, we argue that mechanistic evidence is central to all (...) the key tasks in the drug approval process: in drug discovery and development; assessing pharmaceutical quality; devising dosage regimens; assessing efficacy, harms, external validity, and cost‐effectiveness; evaluating adherence; and extending product licences. We recommend that, when preparing for meetings in which any aspect of drug approval is to be discussed, mechanistic evidence should be systematically analysed and presented to the committee members alongside analyses of clinical studies. (shrink)
Evidence-based medicine, the dominant approach to assessing the effectiveness of clinical and public health interventions, focuses on the results of association studies. EBM+ is a development of EBM that systematically considers mechanistic studies alongside association studies. In this paper we provide several examples of the importance of mechanistic evidence to coronavirus research. Assessment of combination therapy for MERS highlights the need for systematic assessment of mechanistic evidence. That hypertension is a risk factor for severe disease in the case of SARS-CoV-2 (...) suggests that altering hypertension treatment might alleviate disease, but the mechanisms are complex, and it is essential to consider and evaluate multiple mechanistic hypotheses. To be confident that public health interventions will be effective requires a detailed assessment of social and psychological components of the mechanisms of their action, in addition to mechanisms of disease. In particular, if vaccination programmes are to be effective, they must be carefully tailored to the social context; again, mechanistic evidence is crucial. We conclude that coronavirus research is best situated within the EBM+ evaluation framework. (shrink)
This book explores the problem of time and immanence for phenomenology in the work of Edmund Husserl, Martin Heidegger, Maurice Merleau-Ponty, and Jacques Derrida. Detailed readings of immanence in light of the more familiar problems of time-consciousness and temporality provide the framework for evaluating both Husserl's efforts to break free of modern philosophy's notions of immanence, and the influence Heidegger's criticism of Husserl exercised over Merleau-Ponty's and Derrida's alternatives to Husserl's phenomenology. Ultimately exploring various notions of intentionality, these in-depth analyses (...) of immanence and temporality suggest a new perspective on themes central to phenomenology's development as a movement and raise for debate the question of where phenomenology begins and ends. (shrink)
One of the guiding principles of modern medical and health sciences is the discovery and description of the modes of origin and the actions of pathogenic precursors of disease. This principle facilitates the design of interventions to reduce the burden of mortality and morbidity in individuals and populations. This enterprise is challenging because of the complexity of the pathogenic mechanisms involved. Although highly intricate descriptions of these mechanisms have been developed, they have mainly been at the biological level. In this (...) article, we focus on a relatively underexplored aspect of the complexity of pathogenic process: the integration of biological with social and behavioral causes in the same.. (shrink)
Following an analysis of the work of Stanley Cavell, Arthur Danto, Umberto Eco, Susan Sontag, and other philosophers of the 1960s who made aesthetics more responsive to contemporary art, Kelly considers Sontag's aesthetics in greater detail ...
These twelve essays, written by philosophers, examine the usefulness, objectivity, and range of applicability of interpretive methods in ethics and politics, with the goal of isolating the role of methodology to allow debate to focus on substantive conflicts.
This paper presents Anthony Steinbock's broad theory of moral emotions and specifically the distinction he draws between the temporal orientation and the temporal meaning of emotions. The latter distinction is used in order to provide phenomenological descriptions of, and distinctions between, patience and impatience. The paper takes leading clues from Steinbock’s work in an effort to “do” phenomenology in a way that clarifies these specific natural attitude intentionalities.
Arthur C. Danto has long defended essentialism in the philosophy of art, yet he has been interpreted by many as a historicist. This essentialism/historicism conflict in the interpretation of his work reflects the same conflict both within his thought and, more importantly, within modern art itself. Danto's strategy for resolving this conflict involves, among other things, a Bildungsroman of modern art failing to discover its essence, an essentialist definition of art provided by philosophy which is indemnified against history, and a (...) thesis about the end of art once it has been defined. Is this strategy successful, or does it result, as I argue, in a philosophical disenfranchisement of art of precisely the type that Danto himself has criticized? (shrink)
The first reference of its kind surveys the full breadth of critical thought on art, culture, and society--from classical philosophy to contemporary critical theory. Featuring 600 original articles by distinguished scholars from many fields and countries, it is a comprehensive survey of major concepts, thinkers, and debates about the meaning, uses, and value of all the arts--from painting and sculpture to literature, music, theater, dance, television, film, and popular culture. Of special interest are in-depth surveys of Western aesthetics and broad (...) coverage of non-Western traditions and theories of art. The work includes cross references, bibliographies, and an index. (shrink)
A four-volume reference work that surveys how philosophers, art historians, and others reflect critically on art and culture. The first comprehensive reference work on aesthetics that presents articles on the history of Western and non-Western aesthetics along with extensive accounts of the contemporary debates.
Often neglected as an influence on phenomenology, Bergson's thought has resurfaced and brought challenges to phenomenology. In a series of original essays and translations, leading scholars of contemporary continental philosophy seek to redress this oversight and inaugurate a long over due dialogue and yet pertinent to the future of continental philosophy. This thematically focused collection reintroduces Bergson to the dominant discourse in continental philosophy (phenomenology), reevaluates phenomenologists' readings of Bergson (e.g., Heidegger, Sartre, Merleau-Ponty, Levinas, and Henry), and examines Bergsonian challenges (...) to phenomenological methods and issues. What emerges is not only a revitalized Bergson read on his own terms, but also a view of the vibrance of Bergson's thought and its central contributions to perennial issues in phenomenology and contemporary continental philosophy: including dualism, intentionality, subjectivity and selfhood, science, time, ethics, freedom, life and affectivity. (shrink)
The second edition of the Encyclopedia of Aesthetics is an unparalleled reference resource that surveys the full breadth of critical thought on art, culture, and nature, from classical philosophy to contemporary critical theory. The four-volume first edition, published in 1998, effected a revival of aesthetics that created a receptive context for the contemporary importance of the field. Spanning six volumes and 815 articles, the new edition of the Encyclopedia has been updated and expanded to reflect the rapidly evolving character of (...) the discipline. Renowned contributors from diverse fields provide analyses of the major artists, movements, and theories that continue to inform scholarly research on aesthetics. The updated Encyclopedia of Aesthetics contains 250 new entries that incorporate innovative fields of inquiry, such as animal aesthetics and diaspora criticism, as well as significant new developments in art, including digital media and street art. Additionally, the second edition offers enhanced coverage of non-Western cultural areas and related issues, such as post-colonialism, globalization, and primitivism. In so doing, it extends the scope of critical aesthetics, seeking to create a more open environment for aesthetics in academia, culture, and art. With bibliographic references and images, the Encyclopedia of Aesthetics is an essential work that is of use to artists, scholars, students, and all others interested in art-from painting and sculpture to literature, music, theater, film, and more. (shrink)
Although philosophers have characteristically taken the view that art is a vehicle of some universal meaning or truth, art historians emphasize the concrete, historical location of the individual work of art. Is aesthetics capable of sustaining these two approaches? Or, as Michael Kelly argues: Is art actually determined by its historical particularity? His book covers the views of four philosophers--Heidegger, Adorno, Derrida, and Danto--ultimately iconoclasts, despite their significant philosophical engagement with the arts.
When summarizing the findings of his 1896 Matter and Memory, Bergson claims: “That every reality has... a relation with consciousness—this is what we concede to idealism.” Yet Bergson’s 1896 text presents the theory of “pure perception,” which, since it accounts for perception according to the brain’s mechanical transmissions, apparently leaves no room for subjective consciousness. Bergson’s theory of pure perception would appear to render his idealistic concession absurd. In this paper, I attempt to defend Bergson’s idealistic concession. I argue that (...) Bergson’s account of cerebral transmissions at the level of pure perception necessarily entails a theory of temporality, an appeal to a theory of time-consciousness that justifies his idealistic concession. (shrink)
Ricoeur’s text divides into three parts corresponding to its title: the phenomenology of memory; the epistemology of history; and the hermeneutics of the human historical condition, its “emblem of vulnerability” being “forgetting”. That the words “memory” and “history” appear in the title proves unsurprising. But what of the title’s final word, “forgetting”? The putative “duty of memory” to “not forget” relegates forgetting to a via negativa, the “reverse side of memory”. Ricoeur, however, raises the prospect of a “right of forgetting”, (...) “a positive meaning” for forgetting that entails the “spirit of forgiveness” and “reconciliation”. By reconsidering forgetting, Ricoeur moves toward the praxis of forgiveness beyond epistemological reflections—including the phenomenology of memory and totalizing, Hegelian philosophies of history —and utilitarian ethico-politics, and redresses lacunae in Time and Narrative and Oneself as Another. (shrink)
For euthanasia the case is deceptively easy to make. When the suffering of others is ended by death we often feel relief. Commonly we accept that animals must sometimes, as the saying goes, be 'put out of their misery'. And, while most people who advocate euthanasia do not rely simply on our revulsion from suffering as though there were no other considerations, the public appeal of their view probably does rest largely on it.
ABSTRACT Frederick Douglass developed an aesthetic theory during the Civil War in four lectures entitled “Life Pictures,” “Lecture on Pictures,” “Age of Pictures,” and “Pictures and Progress.” But his aesthetic theory is underestimated by Douglass scholars and others, often in favor of his various types of aesthetic practice, such as photography, autobiography, and speeches. There are several reasons to give Douglass's aesthetic theory its due. First, we can recognize that Douglass self-consciously engaged in theory to combat the racist belief that, (...) being black, he was incapable of expounding any philosophy. Second, we can understand why he was convinced that art was able to contribute to abolition and racial equality. Third, we can better appreciate the aesthetics of Douglass's picture making, speeches, political activities, and lived experiences if we know more about his theoretical account of them. Prospectively, many key elements of contemporary critical aesthetic theory are present in Douglass's aesthetic theory. (shrink)
"Examine[s] the history of Marxist philosophical issues in particular, dialectical materialism as developed by French Communist Party intellectuals... Remarkably clear, deeply researched, and well-written."- Political Science Quarterly.
Those familiar with contemporary continental philosophy know well the defenses Husserlians have offered of Husserl’s theory of inner time-consciousness against post-modernism’s deconstructive criticisms. As post-modernism gives way to Deleuzean post-structuralism, Deleuze’s Le bergsonisme has grown into the movement of Bergsonism. This movement, designed to present an alternative to phenomenology, challenges Husserlian phenomenology by criticizing the most “important… of all phenomenological problems.” Arguing that Husserl’s theory of time-consciousness detailed a linear succession of iterable instants in which the now internal to consciousness (...) receives prejudicial favor, Bergsonism concludes that Husserl derived the past from the present and cannot account for the sense of the past, which differs in kind from the present. Consequently, everything on Husserl’s account remains present and his theory cannot accommodate for time’s passage. In this paper, I renew the Husserlian defense of Husserl’s theory of time-consciousness in response to the recent movement of Deleuzean Bergsonism. Section one presents Bergsonism’s notion of the past in general and its critique of Husserl’s theory of time-consciousness. Section two presents a rejoinder to Bergsonism’s critique of Husserl, questioning (1) its understanding of the living-present as linearly extended, (2) its conflation of the living-present with Husserl’s early schema-apprehension interpretation, and (3) its failure to grasp Husserl’s revised understanding of primary memory as a result of (2). In conclusion, I suggest that Husserl’s theory of retention might articulate a notion of the past more consistent with Bergson than Bergsonism itself. (shrink)
Any convincing theory of self-awareness must do the following: avoid what Henry terms “ontological monism”, the belief that there is only one kind of awareness, namely, object-awareness; for as long as we stick to OM, we remain wedded to the reflection theory of self-awareness and its well-known difficulties. And, account for the concrete personal facts about self-awareness: familiarity, unity, identity, etc. First, I go through the tradition, starting with Descartes, of accounts of self-awareness which fail to satisfy constraint. Second, I (...) discuss the standard solution to the problem of self-awareness found in Sartre’s pre-reflective self. I argue that Sartre’s pre-reflective self contains a residue of the bias of “ontological monism,” therefore satisfying neither nor. Third, I suggest an alternative in Kant’s transcendental subject, which possesses self-awareness independently of a cognitive attitude in the traditional sense of object-intentionality, and thereby intimates the beginnings of a phenomenology of the invisible. (shrink)