An estimated 1.2 to 2.3 million Hindus live in the United States. End-of-life care choices for a subset of these patients may be driven by religious beliefs. In this article, we present Hindu beliefs that could strongly influence a devout person’s decisions about medical care, including end-of-life care. We provide four case examples (one sacred epic, one historical example, and two cases from current practice) that illustrate Hindu notions surrounding pain and suffering at the end of life. Chief among those (...) is the principle of karma, through which one reaps the benefits and penalties for past deeds. Deference to one’s spouse or family is another important Hindu value, especially among Hindu women, which can impact the decision-making process and challenge the Western emphasis on autonomy. In addition, the Hindu embrace of astrology can lead to a desire to control the exact time of death. Confounding any generalizations, a Hindu patient may reject or accept treatments based on the individual patient’s or family’s interpretation of any given tradition. Through an awareness of some of the fundamental practices in Hinduism and the role of individual interpretation within the tradition, clinicians will be better able to support their Hindu patients and families at the end of life. (shrink)

Introduction -- In search of global traits -- Habitual virtuous actions and automaticity -- Social intelligence and why it matters -- Virtue as social intelligence -- Philosophical situationism revisited -- Conclusion.

PARTI The Philosophical Situation: A Critical Appraisal We must begin with the mistake and find out the truth in it. That is, we must uncover the source of ...

As average lifespans stretch to new lengths, how are human values impacted? Should our values change over the course of our ever-increasing lifespans? Nancy S. Jecker introduces a new concept, the life stage relativity of values, which holds that at different life stages, different ethical concerns should take center stage. For Jecker, the privileging of midlife values raises fundamental problems of fairness, and reveals large gaps in ethical principles and theories. Jecker introduces a new philosophical framework that reflects the (...) life stage relativity of values and shows its relevance to practice and policy. (shrink)

Why mediation? -- What makes bioethics mediation unique? -- Before you begin a bioethics mediation program -- The stages of bioethics mediation -- Techniques for mediating bioethics disputes -- How to write a bioethics mediation chart note -- Mediation with a competent patient : Mr. Samuels's case -- Mediation with a dysfunctional family : Mrs. Bates's case -- A complex mediation with a large and involved family : Mrs. Leonari's case -- Discharge planning for a dying patient : a role-play (...) -- An at-risk pregnancy : a role-play -- HIV and postsurgical complications in the ICU : a role-play -- Treating the dying adolescent : a role-play -- She didn't mean it : a role-play -- Don't tell mama : a role-play -- An at-risk pregnancy : a role-play transcript -- HIV and postsurgical complications in the ICU : a role-play transcript -- She didn't mean it: a role-play transcript -- Don't tell mama : a role-play transcript. (shrink)

This book is a rich collection of philosophical essays radically interrogating key notions and preoccupations of the phenomenological tradition. While using Heidegger’s Being and Time as its permanent point of reference and dispute, this collection also confronts other important philosophers, such as Kant, Nietzsche, and Derrida. The projects of these pivotal thinkers of finitude are relentlessly pushed to their extreme, with respect both to their unexpected horizons and to their as yet unexplored analytical potential. A Finite Thinking shows that, paradoxically, (...) where the thought of finitude comes into its own it frees itself, not only to reaffirm a certain transformed and transformative presence, but also for a non-religious reconsideration and reaffirmation of certain theologemes, as well as of the body, heart, and love. This book shows the literary dimension of philosophical discourse, providing important enabling ideas for scholars of literature, cultural theory, and philosophy. (shrink)

This is the most systematic, the most radical, and the most lucid treatise on freedom that has been written in contemporary Continental philosophy. Finding its guiding motives in Kant's second Critique and working its way up to and beyond Heidegger and Adorno, this book marks the most advanced position in the thinking of freedom that has been proposed after Sartre and Levinas. If we do not think being itself as a freedom, we are condemned to think of freedom as a (...) pure 'idea' or 'right', and being-in-the-world, in turn, as a blind and obtuse necessity. Since Kant, philosophy and our world have relentlessly confronted this schism. To combat this renunciation of freedom, one must think the experience of freedom in thought itself: what it is that, simply in order for there to be thinking, must partake of freedom. (shrink)

If anything marks the image, it is a deep ambivalence. Denounced as superficial, illusory, and groundless, images are at the same time attributed with exorbitant power and assigned a privileged relation to truth. In this collection of writings on images and visual art, the author explores this through an extraordinary range of references.

Public engagement in ethically laden pandemic planning decisions may be important for transparency, creating public trust, improving compliance with public health orders, and ultimately, contributing to just outcomes. We conducted focus groups with members of the public to characterize public perceptions about social distancing measures likely to be implemented during a pandemic. Participants expressed concerns about job security and economic strain on families if businesses or school closures are prolonged. They shared opposition to closure of religious organizations, citing the need (...) for shared support and worship during times of crises. Group discussions elicited evidence of community-mindedness, while some also acknowledged strong self-interest. Participants conveyed desire for opportunities for public input and education, and articulated distrust of government. Social distancing measures may be challenging to implement and sustain due to strains on family resources and lack of trust in government. (shrink)

Should you wash your hands? -- Are workarounds ethical? -- Turfing, bending, and gaming -- Dirty hands and the semiclear conscience -- Problems of humanity -- Ethics without heroics : foreseeing moral problems in complex systems.

' this volume will make a significant contribution to a more adequate understanding of the 'nature of scientific knowledge and inquiry' ' ISIS Vol.79,No.1,1988.

Are the laws of nature consistent with contingency about what happens in the world? That depends on what the laws of nature actually are, but it also depends on what they are like. The latter is the concern of this chapter, which looks at three views that are widely endorsed: ‘Humean’ regularity accounts, laws as relations among universals, and disposition/powers accounts. Given an account of what laws are, what follows about how much contingency, and of what kinds, laws allow? In (...) all three cases, the authors argue, the root idea of what laws are does not settle the issue of whether they allow contingency. Advocates of the different accounts may argue for one view or another on the issue, but this will be an add-on rather than a consequence of the basic view about what laws are. -/- . (shrink)

Advance directives have been lauded by scholars and supported by professional organizations, Congress, and the United States Supreme Court. Despite this encouragement, only a small number of capable patients execute living wills or appoint health care agents. When patients do empower proxies, doctors may be uncertain about the scope of their duties and obligations to these persons who, in theory, stand in the shoes of the patient. This article argues for a conscious focus on the ethical duties, emotional supports, and (...) guidance owed by physicians to health care agents. (shrink)

Cases where analogy has played a significant role in the formation of a new scientific concept are well-documented. Yet, how is it that genuinely new representations can be constructed from existing representations? It is argued that the process of ‘generic modeling’ enables abstraction of features common to both the domain of the source of the analogy and of the target phenomena. The analysis focuses on James Clerk Maxwell's construction of the electromagnetic field concept. The mathematical representation Maxwell constructed turned out (...) to be a system of abstract laws that when applied to electromagnetic systems yield laws of a dynamical system that will not map back onto the mechanicals domains used in their construction. (shrink)

What does it mean to say that this person at this time is 'the same' as that person at an earlier time? If the brain is damaged or the memory lost, how far does a person's identity continue? In this book two eminent philosophers develop very different approaches to the problem.

Partly because physicians can “never say never,” partly because of the seduction of modern technology, and partly out of misplaced fear of litigation, physicians have increasingly shown a tendency to undertake treatments that have no realistic expectation of success. For this reason, we have articulated common sense criteria for medical futility. If a treatment can be shown not to have worked in the last 100 cases, we propose that it be regarded as medically futile. Also, if the treatment fails to (...) restore consciousness or alleviate total dependence on intensive care, we propose such treatment be judged futile. This definition provides clear end points and encourages the profession to review data from the past and perform, prospective clinical studies that not only report treatments that work but also treatments that do not work. We have also argued that, in a variety of settings, physicians have no ordinary ethical obligation to offer futile interventions. Although physicians should inform, and discuss all decisions to withhold or withdraw medical treatments with patients, they need not obtain the patient's permission to desist from futile interventions. (shrink)

In recent years, scholars have begun to lay the groundwork to justify a distinct application of ethics to the field of public health. They have highlighted important features that differentiate public health ethics from bioethics, especially public health’s emphasis on population health rather than issues of individual health. Articulations of public health ethics also tend to emphasize the role of social justice compared to the predominance of autonomy in the bioethical literature. Now that the field of public health ethics is (...) developing a unique focus and a language of its own, including a code of ethics disseminated by the American Public Health Association, the future of public health ethics may well be global health ethics, focusing on issues of global justice. As public health ethics evolves from its nascent stage of reflection to a place of action and application in the national and global arenas, two interrelated developments will need to occur: public health professionals, including practitioners, policymakers, and scholars, will need a richer understanding of the ethical challenges practitioners face on a daily basis and scholars will need to develop useful tools that practitioners may employ for identifying and tackling these ethical challenges. (shrink)

From the earliest photographic attempts to represent tropical hybrid races to depictions of disease in new tropical medicines, Picturing Tropical Nature offers ...

The import of Petrarch's description of Laura extends well beyond the confines of his own poetic age; in subsequent times, his portrayal of feminine beauty became authoritative. As a primary canonical text, the Rime sparse consolidated and disseminated a Renaissance mode. Petrarch absorbed a complex network of descriptive strategies and then presented a single, transformed model. In this sense his role in the history of the interpretation and the internalization of woman's "image" by both men and women can scarcely be (...) overemphasized. When late-Renaissance theorists, poets, and painters represented woman's body, Petrarch's verse justified their aesthetic choices. His authority, moreover, extended beyond scholarly consideration to courtly conversation, beyond the treatise on beauty to the after-dinner game in celebration of it. The descriptive codes of others, both ancients and contemporaries, were, of course, not ignored, but the "scattered rhymes" undeniably enjoyed a privileged status: they informed the Renaissance norm of a beautiful woman.1· 1. On this "thoroughly self-conscious fashion," see. Elizabeth Cropper, "On Beautiful Women, Parmigianino, Petrarchismo, and the Vernacular Style," Art Bulletin 58 1976): 374-94.Nancy Vickers is an assistant professor of French and Italian at Dartmouth College. She has published articles on Dante and Petrarch and has recently completed a book, The Anatomy of Beauty: Woman's Body and Renaissance Blazon. (shrink)

Ethical challenges in public health can have a significant impact on the health of communities if they impede efficiencies and best practices. Competing needs for resources and a plurality of values can challenge public health policymakers and practitioners to make fair and effective decisions for their communities. In this paper, the authors offer an analytic framework designed to assist policymakers and practitioners in managing the ethical tensions they face in daily practice. Their framework is built upon the following set of (...) six considerations: determining population-level utility of the proposed action; demonstrating evidence of need and effectiveness of actions; establishing fairness of goals and proposed implementation strategies; ensuring accountability; and, assessing expected efficiencies and costs associated with the proposed action. Together, these considerations create a structured guide to assist decision-makers in identifying potential ethical challenges and in assessing the moral considerations that underlie public health practice - and possibly even, if the conditions are met, reduce the creation of ethical tension. Although the authors’empirical experiences provide the basis for the framework advanced here, their approach remains to be tested and evaluated by public health practitioners. (shrink)

A topic of special importance when it comes to responsibility and implicit bias is responsibility for knowledge. Are there strategies for becoming more responsible and respectful knowers? How might we work together, not just as individuals but members of collectives, to reduce the negative effects of bias on what we see and believe, as well as the wrongs associated with epistemic injustice? To explore these questions, Chapter 9 introduces the concept of epistemic responsibility, a set of practices developed through the (...) cultivation of basic epistemic virtues, such as open-mindedness, epistemic humility, and diligence that help knowers seek information about themselves, others, and the world. (shrink)

Historical dynamics around feminism, race, and rape discouraged extensive early Black involvement in anti-rape work in the United States. In Los Angeles, concern among women of color in the movement and a state initiative to fund poorly served areas converged to produce two new Black rape crisis centers in the mid-1980s. Ironically, state funding, an otherwise conservative influence on the anti-rape movement, has facilitated the progressive goal of expanding racial and ethnic diversity in the Los Angeles anti-rape movement. Racially homogeneous (...) organizations contributed more to diversifying the movement than integration within organizations. Despite differences in political perspective, women from older feminist groups and the new community-oriented centers now successfully work in coalition. (shrink)

In 1997, the United States incarcerated over 1.7 million persons in local jails and in state and federal prisons. These inmates are disproportionately poor and persons of color. Many lack adequate access to health care before incarceration and present to correctional services with major unaddressed medical problems.Convictions for drug possession and use have increased the number of injection drug users with HIV and AIDS in prisons. Determinate sentencing and “three strikes and you’re out” laws have increased the number of inmates (...) who are aging and dying during their sentences. Their feelings reflect those of Larry Rideau, sentenced to life without parole and founder of The Angolite—an award-winning prison newspaper at Louisiana's Angola Prison—“The dream of getting out, you equate with heaven. Dying in prison you equate with hell.”. (shrink)

How one reacts to lying depends on individual temperament, intellectual training and value commitments, freedom status,, consideration of consequences, emotional resilience an...

This essay explores the nexus between Buddhist discourse, moral reasoning, and aspects of indigenous ethnopsychology in a Shan community in northern Thailand. I suggest that these three strands of thought are routinely braided together in intricate ways and, furthermore, that some version of this conceptual arrangement is necessary in order for any moral thinking to take place. That is, all moral thought entails some conception of the way the world is structured (a conception that may or may not be based (...) on religion) and some ethnotheory of human nature, both of which are culturally mediated. Finally, I discuss the implications of this view for our understanding of human agency and autonomy. (shrink)

After explaining why colleges cannot avoid teaching ethics across their undergraduate curricula, this chapter shows how an outcomes-based approach can be used to more effectively cultivate students' capacity for ethical deliberation.

Too often in a hospital setting, forgiveness is thought to be automatic—given if a physician makes the apology. But this is cheap grace: a forgiveness achieved without the participation of the injured party. We must remember that forgiveness must be given, and devise new practices to see that it can be.

Authors James Wilson and David Hunter (2010) take on the critics of research “overregulation,” defending institutional review boards (IRBs) and their role in research in three ways. According to Wi...

In “Surmounting Elusive Barriers: The Case for Bioethics Mediation,” Bergman argues that professionals trained in bioethics, reluctant to acquire the skills of mediation, would better be replaced by a cadre of mediators with some bioethics knowledge, to which I respond, “yes … but.”.

Norman Daniels' and Daniel Callahan's recent work attempts to develop and deepen theories of justice in order to accommodate intergenerational moral issues. Elsewhere, I have argued that Callahan's arguments furnish inadequate support for the age rationing policy he accepts. This essay therefore examines Daniel's account of age rationing, together with the complex theory of age-group justice that buttresses it. Sections one and two trace the main features of Daniels' prudential lifespan approach. Section three calls into question the theory's conformity to (...) liberal tenets. The next section attempts to show that the outcome of the prudential approach fails to match our considered judgments. The brief final section offers a broader perspective on the task of articulating a liberal theory of age-group justice. Keywords: elderly, age-group justice, biomedical model of disease, rationing, liberalism, distributive justice CiteULike Connotea Del.icio.us What's this? (shrink)

Drawing on metaphors of travel and tourism, I distinguish between epistemological stances that clinicians can adopt when attempting to understand how patients experience their world and their illness. I argue for a particular stance, called world traveling, that involves a shift in clinicians' own commitments, perceptions, and values. I identify barriers to this model but also suggest ways a version of world traveling may be implemented.

Moral distress is a well-documented phenomenon in the nursing profession, and increasingly thought to be implicated in a nation-wide nursing shortage in the US. First identified by the philosopher Andrew Jameton in 1984, moral distress has also proven resistant to various attempts to prevent its occurrence or at least mitigate its effects. While this would seem to be bad news for nurses and their patients, it is potentially good news for philosophical counselors, for whom there is both socially important and (...) philosophically interesting work to be done. In an effort to encourage such work, this paper explicates the philosophical (as opposed to more purely psychological or institutional) contours of the problem. A subsequent paper, titled 'A Philosophical Counseling Approach to Moral Distress,' will highlight ways in which such a response would differ from the strategies so far deployed within the nursing profession. (shrink)

At any time, basic assumptions about language have a direct effect on the writing of history. The structure of language is related to the structure of knowledge and thus to the definition of historical reality, while linguistic competence gives insights into the relation of ideas and action. Within the framework of these ideas, and drawing on recent work in linguistic theory, including that of the French structuralists. Professor Struever studies the major shift in attitudes toward language and history which the (...) Renaissance represents. One of the essential innovations of Renaissance Humanism is the substitution of rhetoric for dialectic as the dominant language discipline; rhetoric gives the Humanists their cohesion as a lay intellectual elite, as well as the force and direction of their thought. The author accepts the current trend in classical studies, the rehabilitation of the Sophists which finds its source in Nietzsche and includes the work of Rostagni, Untersteiner, and Buccellato, to reinstate rhetoric as the historical vehicle of Sophistic insight. Originally published in 1970. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These paperback editions preserve the original texts of these important books while presenting them in durable paperback editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

The ethical dimensions of an aging society are larger than the experience of chronic illness, the moral concerns of health care professionals, or the allocation of health care resources. What, then, is the role of bioethics in an aging society, beyond calling attention to these problems? Once we’ve agreed that aging is morally important and that population‐level aging across wealthy nations raises ethical concerns that cannot be fixed through transhumanism or other appeals to transcend aging and mortality through technology, what (...) is our field’s contribution? We argue that it is time for bioethics to turn toward social justice and problems of injustice and that part of doing so is articulating a concept of good citizenship in an aging society that goes beyond health care relationships. (shrink)

This article describes political discourse on domestic violence that obscures men's violence while placing the burden of responsibility on women. This perspective, which the author calls patriarchal resistance, challenges a feminist construction of the problem. Using a qualitative analysis of men's and political magazines, the author describes two main discursive strategies used in the resistance discourse: degendering the problem and gendering the blame. These strategies play a central role in resisting any attempts to situate social problems within a partiarchal framework. (...) It is argued that this is a political countermovement to the feminist constructions of domestic violence as opposed to a serious concern about women's violence and male victims. Three major implications this resistance discourse has are the normalization of intimate violence, the diversion of attention from men's responsibility and cultural and structural factors that foster violence, and the distortion of women's violence. (shrink)

Los autores conversan sobre la distinta relación que tienen con la filosofía las lenguas española y francesa, encontrando la explicación de esa diferencia principalmente en los “espíritus” que nos separan, no obstante nuestra considerable cercanía lingüística. Mientras que la Reforma y la Contrarreforma exigieron de Francia un “humanismo del saber objetivo, del individuo y del progreso”, la cultura española dio de sí “un paradójico humanismo de la fe, de la expansión y de los juegos de la apariencia”. El “espíritu de (...) la filosofía” (Descartes, el ancestro de Hegel) se desarrolló en el norte de Europa, y en la Europa mediterránea floreció más bien “el espíritu de la ficción” (el Cervantes de Unamuno, de Ortega, de Borges y de Kundera). La inquietud de un mundo que bien podría no ser sino sueño, o incluso locura –de la que terminará por resurgir, al lado del cervantino y del calderoniano, el cogito cartesiano–, es sin embargo una inquietud española en primer lugar, y eso es algo que amerita ser estudiado, y sobre todo pensado. Una clave muy importante para dicho estudio es la constatación, subrayada por Nancy en respuesta al problema de la calificación de nuestra filosofía como “mera literatura”, de la “pérdida de confianza en las aventuras del sentido” que ha caracterizado a la Modernidad (o al Occidente en su versión nórdica, ese “espíritu de la filosofía alemana” que tras el efecto del nazismo se mudó a Francia y a Estados Unidos). Ahí donde Unamuno señalaba la necesidad, antes que de europeizar a España, de “españolizar a Europa”, Jean-Luc Nancy reconoce que Occidente necesita atreverse, una vez más, a abrirse a la aventura, y al riesgo del pensamiento. (shrink)

Drug testing is widely deployed in the United States throughout the public and private sectors. This case study uses two emergent drug-testing technologies—hair analysis and the sweat patch—as examples of techniques of governance that should be subjected to the political equivalent of strict scrutiny. The article contributes to conceptual debates in science and technology studies, arguing that the study of social structure and subject formation should be integral rather than epiphenomenal to analysis in the transdisciplinary field of science and technology (...) studies. The article contextualizes the development and deployment of drug-testing technologies within the structural and epistemological categories of racial and ethnic difference, gender, sexuality, and class formation. Conflicts between proponents of the technologies and critical advocates who seek to constrain their use mark sites of productive theoretical engagement with structural sociology, racial formation theory, critical race theory, and feminist critique.1 Finally, the article demonstrates how STS analyses can contribute to the struggles of strategic counterpublics as they advocate for changing the meaning and material consequences of suspect technologies. (shrink)

This commentary shows how philosophical counseling offers an alternative way for consultants to facilitate "closure" in bioethical disputes.

In this timely, thoughtful book, which goes to the heart of feminist concerns in the context of larger social, ecological, and theological issues, Nancy R. Howell proposes an ecofeminist worldview based on the organic-relational philosophy of Alfred North Whitehead. In particular, the book explores the ways in which Whitehead's philosophy can help to establish interrelationships among various women's communities, the relationship between humanity and nature, and the theological process of relating the world to God. Howell strives to develop principles (...) that are compatible with the wide spectrum of women's voices from different racial backgrounds and social strata. Specifically, she moves beyond mere acknowledgment of differing perspectives within the woman's movement and seriously engages criticisms of race-privileged white feminism by African American and Latin American activists. A Feminist Cosmology calls for a self-critical reformation of feminist thought based on a more inclusive framework, one that takes into account the diversity of relationships among women, the deep interdependence of humanity and the ecosystem, and ultimately the variety of theological perspectives relating the world to God. (shrink)