Rationing in healthcare remains very much a taboo topic. Before COVID-19, it rarely received public attention, even when it occurred in everyday practices, mainly in the form of implicit rationing, as it continues to do today. There are different definitions, types and levels of healthcare rationing, according to different perspectives. With the aim of contributing to a more coherent debate on such a highly emotional healthcare issue as rationing, here are provided a number of reflections from a patient advocate perspective (...) which are specifically focused on bedside rationing, the most troublesome level, both for patients and clinicians, particularly in regard to cancer care. Oncology, with its numerous expensive therapies and increasing number of patients, is undeniably one of the main areas contributing to the increase in healthcare costs. However, the fixed budgets of today's publicly financed health systems cannot allow unlimited access to the potentially beneficial treatments to all patients. Bedside rationing constitutes the last phase of many decision-making processes occurring at different interrelated levels (macro-levels), both inside and outside healthcare systems, which implicitly and inevitably result in a bottleneck determined by the upstream decisions themselves. Shifting from implicit to explicit bedside rationing essentially means moving from a paternalistic to a citizen-before-patient approach; this implies, first of all, a cultural change. Practical bedside rationing is an ethically complex topic, but one that needs to be urgently addressed in a transparent and open debate. In this scenario, the oncological community – patients, patient advocates and clinicians – can and should play an important role. (shrink)

info:eu-repo/semantics/publishedVersion.

This study assessed self-reported health-related quality of life and psychological adjustment in 43 adolescents and young adults with congenital melanocytic nevi and examined associations with sociodemographic variables, characteristics of the CMN, perceived social reactions, and cognitive emotion regulation strategies. Outcome measures included the Pediatric Quality of Life Inventory™ 4.0 and the Strengths and Difficulties Questionnaire. Findings suggest impaired psychosocial health and psychological adjustment in youth with CMN compared to community norms. Impairments were associated with higher age of participants, lower socioeconomic (...) status, visibility of the skin lesion, perceived stigmatization, poorer perceived social support, and maladaptive cognitive emotion regulation strategies, but not with sex of participants, extent of the skin lesion, and surgical removal of the nevus. Implications for clinical practice and future research are discussed. (shrink)

Ce texte a déjà paru dans Tradurre. Pratiche, teorie, strumenti, n° 10, Primavera 2016. F. Scotto, Il senso del suono. Traduzione poetica e ritmo, Roma, Donzelli, 2013, 224 p. Ce mot « rythme » ne m'est pas clair. Je ne l'emploie jamais. Paul Valéry Nel suo vastissimo trattato Critique du rythme. Anthropologie historique du langage, Henri Meschonnic si sofferma sulla scorretta etimologia che fonda il mito del ritmo, ossia quella che ricollega il ῥυθμός al movimento del mare : seguendo - (...) Recensions. (shrink)

In the literature, the pragmatic dimension of metaphors has been clearly acknowledged. Metaphors are regarded as having different possible uses, especially pursuing persuasion. However, an analysis of the specific conversational purposes that they can be aimed at achieving in a dialogue and their adequacy thereto is still missing. In this chapter, we will address this issue focusing on the classical distinction between the explanatory and persuasive uses of metaphors, which is, however, complex to draw at an analytical level and often (...) blurred and controversial also from a theoretical point of view. Building on the analysis of explanation in different theories and fields of study, we show how it can be conceived as characterized by a cognitive and a pragmatic dimension, where the transference of understanding is used pragmatically for different dialogical goals - such as informing, making a joint decision, and most importantly persuading. In this sense, the cognitive effects of understanding are not incompatible with a persuasive dialogical purpose. This theoretical proposal will be applied to examples drawn from the medical context, to show how a pragmatic approach to explanation can account for the complexity of the cases that can be found in actual dialogical contexts. (shrink)

The field of consciousness studies has long benefitted from the investigation of non- ordinary states of consciousness, both spontaneous and facilitated by mind-altering agents. In the present study, I look at the implications of spontaneous near-death experiences and experiences facilitated by the dissociative anaesthetic ketamine. These experiences reputedly have similar phenomenologies, such as a feeling of dying, motion through darkness, entering another realm, visions of light, and a sense of separation from the physical body. To assess whether ketamine and near-death (...) experiences really are similar, I undertake a systematic comparison of 36 accounts of NDE-like experiences under ketamine with 36 accounts of NDE that resulted from cardiac arrest or other life-threatening circumstances in which wakefulness was maintained . The results suggest that ketamine and near- death experiences are indeed similar, which might be taken to imply that NDEs have a purely chemical or psychophysiological basis. However, this conclusion is not inevitable, and I draw upon the intriguing 'spatial' or 'situated' characteristic of ketamine and near-death experiences to suggest an alternative to both neuropsychological reductionism and a straightforward post-mortem survival theory. To develop the idea of a dynamic interrelation of consciousness and 'place', I draw on contemporary Japanese philosophies of body-mind. (shrink)

Our brains readily decode facial movements and changes in social attention, reflected in earlier and larger N170 event-related potentials (ERPs) to viewing gaze aversions vs. direct gaze in real faces (Puce et al. 2000). In contrast, gaze aversions in line-drawn faces do not produce these N170 differences (Rossi et al., 2014), suggesting that physical stimulus properties or experimental context may drive these effects. Here we investigated the role of stimulus-induced context on neurophysiological responses to dynamic gaze. Sixteen healthy adults (...) viewed line-drawn and real faces, with dynamic eye aversion and direct gaze transitions, and control stimuli (scrambled arrays and checkerboards) while continuous electroencephalographic (EEG) activity was recorded. EEG data from 2 temporo-occipital clusters of 9 electrodes in each hemisphere where N170 activity is known to be maximal were selected for analysis. N170 peak amplitude and latency, and temporal dynamics from event-related spectral perturbations (ERSPs) were measured in 16 healthy subjects. Real faces generated larger N170s for averted vs. direct gaze motion, however, N170s to real and direct gaze were as large as those to respective controls. N170 amplitude did not differ across line-drawn gaze changes. Overall, bilateral mean gamma power changes for faces relative to control stimuli occurred between 150-350 ms, potentially reflecting signal detection of facial motion. Our data indicate that experimental context does not drive N170 differences to viewed gaze changes. Low-level stimulus properties, such as the high sclera/iris contrast change in real eyes likely drive the N170 changes to viewed aversive movements. (shrink)

By the end of the seventeenth century, high culture had banished astrology as a mixture of superstition and imposture. The great astrological treatises of the past - in particular the Ptolemaic Tetrabiblos (whose very authenticity was cast into doubt) - stopped being published; a hodgepodge of minor writings, mostly preserved in manuscript form, lay mouldering in oblivion in the far recesses of libraries. It was only in the latter decades of the eighteenth century that the learned world began once again (...) to pay attention to the ancient art, when historians of ancient religions and science began to realize the impossibility of exploring their subjects without taking into account a presence that could be neither denied nor underestimated. The history of astrology then began to take shape as a specific field of study, and historicophilological research was able to employ it as a tool for penetrating the tie between mythos and logos, at the origin of western civilization. Along with the image of the Greek miracle, an overly simplistic and schematic definition of reason and science began to decline. It was necessary to isolate, as Hermann Usener sought to do, the “wild germ of science” and to acknowledge the fact that logic and magic bloom on the same stem, as Aby Warburg has often reminded us, with reference to Jean Paul. (shrink)

In a letter to Lorenzo di Pierfrancesco dei Medici, dating from 1477 to 1478, the Platonist philosopher Marsilio Ficino develops the classical theme of the correspondence between man and cosmos on the basis of the astrological techniques. The inner heaven, a term of the relationship between macrocosm and microcosm, takes the form of what astrologers call the birth theme: the series of astral positions at the moment of birth and related to its place. Taking up Origen’s theme of the inner (...) heavens, he systematically applies the theory of planet-signs to deciphering underlying themes of individual personality. (shrink)

O artigo apresenta o livro O fogo e o relato. Ensaios sobre criação, escrita, arte e livros, do filósofo italiano Giorgio Agamben, discutindo alguns dos limiares poéticos do seu pensamento político. Parte-se de alguns dos debates subentendidos de Agamben com Jacques Derrida sobre linguagem e literatura, passa-se pelo ato poético como ato de resistência, define-se a potência inoperante presente em gestos de interrupção discursiva e chega-se à discussão sobre vida e obra em contexto biopolítico. Seguindo a ordem dos capítulos, mas (...) sem pretender esgotá-los, o pressuposto do artigo é de que o italiano, que tem a poesia e a literatura geralmente vinculada a uma espécie de “primeira fase” de sua obra, também na série biopolítica nomeada Homo Sacer lançou mão da poesia e da literatura como forte estratégia de resistência e abertura de limiares ante a lógica que se desenha do poder soberano. Se, por um lado, o livro pode ser lido como formando um círculo hermenêutico, os capítulos, por outro lado, permitem ao leitor perceber as principais linhas em que filosofia, literatura, poesia e política se entrecruzam para o pensador italiano. Por isso, também, recorreu-se à relação direta de alguns argumentos expostos em O fogo e o relato tanto com noções e argumentos presentes em outros livros de Agamben, quanto pontualmente com outros interlocutores. (shrink)

This is a response to Erman and Moller's response to our reply to their 'Political Legitimacy in the Real Normative World', both also in this journal.

Negli anni che intercorrono fra la prima e l'ultima stesura della Scienza nuova vedono la luce in Europa le opere di Montesquieu e di Voltaire, di Lamettrie e di Hume, di Tindal e di Berkeley, di Morelly e di D'Alembert, Nell'Europa del suo tempo Vico fu senza dubbio un pensatore 'isolato'. Tale isolamento è stato di volta in volta interpretato come arretratezza e come capacità di divinazione - le pagine della Scienza nuova sono State interpretate come l'espressione tipica di una (...) rinnovata visione cristiana della storia o come un'anticipata polemica antilluministica e un precorrimento dei temi della cultura romantica e della filosofia di Hegel. 'Da un angoletto morto della storia', lavorando sui testi del secolo precedente, Vico affrontava comunque alcuni grandi problemi che resteranno al centro della cultura romantica, di quella positivistica, delle discussioni sullo storicismo. (shrink)

Is there more to the recent surge in political realism than just a debate on how best to continue doing what political theorists are already doing? I use two recent books, by Michael Freeden and Matt Sleat, as a testing ground for realism’s claims about its import on the discipline. I argue that both book take realism beyond the Methodenstreit, though each in a different direction: Freeden’s takes us in the realm of meta-metatheory, Sleat’s is a genuine exercise in grounding (...) liberal normative theory in a non-moralistic way. I conclude with wider methodological observations. I argue that unlike communitarianism (the previous contender for the discipline’s renewal), realism has the potential to open new vistas, though their novelty is to a large extent relative to the last forty years or so: realism is best thought of as a return to a more traditional way of doing political philosophy. (shrink)

In this paper, I introduce a new species of elusive reason–reasons that it is impossible for an agent to act, or be motivated to act, for–and I show how this kind of elusive reason undermines a plausible claim about normative reasons, the Motivational Constraint. To defend the existence of this new kind of elusive reason, I respond to the objection that our intuitions are tracking another normative or evaluative phenomenon, such as reasons to have certain affective responses or reasons for (...) others to act. In addition, because accepting the new kind of elusive reason requires affirming the claim that S acts for a reason p only if S regards p as a reason to A, I develop an account of what it is for S to regard p as a reason to A. Finally, as part of arguing for the former claim, I argue that the idea of being moved to A for a reason p entails the idea of being moved to A in light of p, which itself entails the idea of regarding p as a reason. (shrink)

In *How Propaganda Works* Jason Stanley argues that democratic societies require substantial material equality because inequality causes ideologically flawed belief, which, in turn, make demagogic propaganda more effective. And that is problematic for the quality of democracy. In this brief paper I unpack that argument, in order to make two points: (a) the non-moral argument for equality is promising, but weakened by its reliance on a heavily moralised conception of democracy; (b) that problem may be remedied by whole-heartedly embracing a (...) more realistic conception of democracy. That conception is at least compatible with Stanley’s argument, if not implicit in parts of it. (shrink)

This paper provides a critical overview of the realist current in contemporary political philosophy. We define political realism on the basis of its attempt to give varying degrees of autonomy to politics as a sphere of human activity, in large part through its exploration of the sources of normativity appropriate for the political and so distinguish sharply between political realism and non-ideal theory. We then identify and discuss four key arguments advanced by political realists: from ideology, from the relationship of (...) ethics to politics, from the priority of legitimacy over justice and from the nature of political judgement. Next, we ask to what extent realism is a methodological approach as opposed to a substantive political position and so discuss the relationship between realism and a few such positions. We close by pointing out the links between contemporary realism and the realist strand that runs through much of the history of Western political thought. (shrink)

This paper investigates the emotive (or expressive) meaning of words commonly referred to as “loaded” or “emotive,” which include slurs, derogative or pejorative words, and ethical terms. We claim that emotive meaning can be reinterpreted from a pragmatic and argumentative perspective, which can account for distinct aspects of ethical terms, including the possibility of being modified and its cancellability. Emotive meaning is explained as a defeasible and automatic or automatized evaluative and intended inference commonly associated with the use of specific (...) terms, which can be represented and assessed considering its logical structure and its defeasibility conditions. This automatic inference is conceived as part of the connotation of an ethical term, and is not necessarily stable. By means of quasi-definitions, it is possible to modify the emotive meaning while maintaining the descriptive one, automaticizing the inferences drawn from an ethical word. Through examples drawn from the recent US presidential campaign, we show how re-contextualization and emotive contexts can affect emotive meaning. (shrink)

The mnemonic arts and the idea of a universal language that would capture the essence of all things were originally associated with cryptology, mysticism, and other occult practices. And it is commonly held that these enigmatic efforts were abandoned with the development of formal logic in the seventeenth century and the beginning of the modern era. In his distinguished book, Logic and the Art of Memory Italian philosopher and historian Paolo Rossi argues that this view is belied by an (...) examination of the history of the idea of a universal language. Based on comprehensive analyses of original texts, Rossi traces the development of this idea from late medieval thinkers such as Ramon Lull through Bruno, Bacon, Descartes, and finally Leibniz in the seventeenth century. The search for a symbolic mode of communication that would be intelligible to everyone was not a mere vestige of magical thinking and occult sciences, but a fundamental component of Renaissance and Enlightenment thought. Seen from this perspective, modern science and combinatorial logic represent not a break from the past but rather its full maturity. Available for the first time in English, this book (originally titled Clavis Universalis) remains one of the most important contributions to the history of ideas ever written. In addition to his eagerly anticipated translation, Steven Clucas offers a substantial introduction that places this book in the context of other recent works on this fascinating subject. A rich history and valuable sourcebook, Logic and the Art of Memory documents an essential chapter in the development of human reason. (shrink)

The Palgrave Handbook of Practical Animal Ethics is a recent addition to anthologies in the field, joining The Oxford Handbook of Animal Ethics, and The Routledge Handbook of Animal Ethics. Edited by Andrew Linzey and Clair Linzey of the Oxford Centre for Animal Ethics, the book boasts more than 30 contributors, many of them philosophers, but also including sociologists, scientists, theologians, lawyers, psychologists, and animal advocates. The editors were intentionally multidisciplinary in their approach, noting that “there is currently no book (...) series that is a focus for multidisciplinary research in the field,” and calling attention to the need not only for philosophical inquiry into what we owe animals, but also into the “social, legal, cultural, religious and political” influences that “legitimate animal abuse” (p. viii).The book is divided up into four sections: “The Ethics of Control,” “The Ethics of Captivity,” “The Ethics of Killing,” and “The Ethics of Causing Suffering.” Each of these sections includes an editorial introduction and multiple entries spanning diverse issues, including animal research, animal agriculture, hunting, fishing, zoos, the role of animals in religion, the role of language in structuring thought about nonhuman animals, and others. Similarly, the chapters span issues affecting many species, including farmed animals, fish, deer, elephants, whales and dolphins, rodents, companion animals (e.g., dogs and cats), and others.While the book is billed as a “practical” handbook of animal ethics, it does wade into some conceptual territory, tackling such issues as the ethical permissibility of confining and controlling animals, the question of whether (painless) death harms nonhuman animals, and the comparative wrongness of killing humans and nonhuman animals. This said, it largely stays away from more detailed discussion of normative ethical theory and the moral standing of nonhuman animals, focusing instead on the specific ways that humans treat nonhuman animals. In focusing more on practical than theoretical ethics, the Palgrave Handbook of Practical Animal Ethics both complements and differentiates itself from some other anthologies in the field.The book has several strengths to recommend it, the first being the logic of its organization. The ethically problematic aspects of humans’ treatment of nonhuman animals frequently map onto one or more of the categories of causing suffering, killing, and confining. The organization of chapters under these section headings helps to provide a rational structure to the text, as well as an easy way for the reader to navigate which sections they would like to tackle first (although there is some overlap between sections). With this, the explicit and sustained focus on the ethics of control (section 1) is a welcome and differentiating feature of the text. Much prior work in animal ethics has addressed questions of harming and killing animals, but the ethical permissibility of control per se has received comparatively lesser attention.The multidisciplinary nature of the book is also a selling point. In any anthology on animal ethics, the reader can expect entries from academic philosophers, but the book's inclusion of empirical scientific reviews, sociological and legal analyses, and work in discourse analysis are strengths. One danger in focusing exclusively on what we ought to think and do is that it ignores the influences on how we actually think and act. Many of the book's entries address these influences and thus round out the normative analysis.The middle two sections of the book seem most successful to this reviewer. The section on the ethics of killing contains two well-argued conceptual chapters, coupled with practical analyses of fishing, deer hunting, and religious perspectives on killing nonhuman animals. While animal research and animal agriculture are not directly addressed in this section, the conceptual arguments can be applied to the killing of nonhuman animals in these contexts. The section on the ethics of captivity is not as conceptually strong but contains excellent empirical chapters on the welfare of elephants, whales, and dolphins in captivity. Prior work in normative ethics has established how confinement can be harmful to nonhuman animals by directly causing suffering or depriving them of opportunities for satisfaction (see, e.g., DeGrazia, 2002). However, it is important to complement such theoretical frameworks with substantiation of how captivity actually is harmful to nonhuman animals in virtue of the interests they have and how captivity infringes upon such interests. These chapters argue that captivity is fundamentally (and not conditionally) incompatible with the welfare of elephants, whales, and dolphins.If I have one criticism of the book, it is that it could be stronger on certain conceptual issues. Acknowledging its practical and not theoretical focus, it is nonetheless true that if controlling, confining, killing, and causing suffering to nonhuman animals is wrong, then it is important to say something about why it is wrong—even if that explanation amounts to a short synopsis of more theoretical work done elsewhere. While the question of killing is addressed well, the section on the ethics of causing suffering does not address directly why (or under what conditions) causing suffering is wrong. The chapters in this section are worthwhile reading and review practices causing animal suffering in a variety of contexts. Nonetheless, some additional conceptual front matter would have strengthened the section overall.From a conceptual standpoint, the sections on the ethics of control and captivity seem to hang together. Confinement is a form of control and might be argued against on the grounds that it deprives nonhuman animals of opportunities for satisfaction, directly causes physical injury, or causes psychological distress, anxiety, or boredom. These kinds of arguments fit into interest-based accounts of animal welfare, which in turn can be subsumed under a principle of nonmaleficence: We should not cause harm to animals under some specified set of conditions; confinement harms animals in ways x, y, or z; therefore, we should not confine animals in this way.While such interest-based arguments do make an appearance in the text, several of the book's authors also elaborate an autonomy-based argument against control and confinement: Nonhuman animals have their own kind of autonomy, and just as infringing upon the autonomy of paradigmatic persons is wrong, infringing upon nonhuman animals’ autonomy is also wrong. The problem with this argument is that different kinds of autonomy are likely to be at stake. The wrongness of infringing upon paradigmatic persons’ autonomy is often explained by the facts that we are self-conscious, capable of abstract thought (including language use), and capable of intentionally choosing the kind of life that we want to live (e.g., relating to long-term projects or schemes of personal ethics). It could be argued that because nonhuman animals are not capable of exercising this kind of autonomy, they therefore cannot be harmed by its infringement.Some of the book's authors chip away at this presumption, noting (inter alia) that nonhuman animals have desires to move around and do things that are thwarted by confinement or control, that these desires constitute a form of agency, and that (following previous scholarship) nonhuman animals possess some forms of self-awareness. Specifically, the chapters from Valéry Giroux and Carl Saucier-Bouffard, Lori Gruen, and Carlos Naconecy consider such arguments. Naconecy draws upon David DeGrazia's (2009) analysis of animal self-awareness in making his argument. Though the issue deserves more treatment than I can give it here, it seems that nonhuman animals’ autonomy and self-awareness, even if granted, are of a different sort than that possessed by paradigmatic persons. Specifically, (most) nonhuman animals cannot feel wronged by having their preferences overridden because they are not the kinds of beings who are capable of abstractly considering themselves as autonomous and worthy of self-direction. They may desire things, and thwarting these desires might sometimes harm them, but that is a different kind of argument.Infringing upon nonhuman animals’ (more limited kind of) autonomy might nonetheless be wrong, but if different sorts of autonomy are at stake, then moral arguments relating to paradigmatic persons cannot be directly transposed to nonhuman animals. Some additional argument(s) must be supplied, but (on my reading) the book's contributors stop short of this. Nonetheless, as stated above, the ethics of control and questions of nonhuman animals’ autonomy are not as well trod as other issues in animal ethics. Despite my taking issue with some of the details, the discussions contained in the book's first two sections are worthy reading and help to advance the field.Overall, the book's chapters are well written and cogently argued, and given its breadth, different readers will find different things to value in it. The Palgrave Handbook of Practical Animal Ethics is a welcome addition to the literature. (shrink)

The paper aims to investigate the meaning of historicity in the light of Ágnes Heller’s interpretation of history as ‘being-in-common’. By touching on the problem of the modern world’s axiological pluralism, the issue of the legitimation of moral theories and the dilemma of morals, the paper analyses Heller’s conception of human goodness as an incontrovertible, inexplicable and mysterious ‘fact’ that is able to illuminate the path of human life and determine the opening of the individual onto the world with the (...) same wonder that marks the beginning of any philosophical attitude. (shrink)

Political realism is characterised by fidelity to the facts of politics and a refusal to derive political judgments from pre- political moral commitments. Even when they are not taken to make normative theorising impossible or futile, those characteristics are often thought to engender a conservative slant, or at least a tendency to prefer incremental reformism to radicalism. I resist those claims by distinguishing between three variants of realism—ordorealism, contextual realism, and radical realism—and contrasting them with both non-ideal theory and utopianism. (...) I then develop a version of radical realism as a form of debunking and vindicatory genealogy. Even though this new approach eschews both feasibility constraints (unlike non-ideal theory) and prescriptions about the ideal society (unlike utopianism), I show how it has more radical potential than morality-driven (and hence often ideological) political theory, and how it supports both open-ended, radical social critique and concrete forms of prefigurative political action. (shrink)

In this paper we show how a realistic normative democratic theory can work within the constraints set by the most pessimistic empirical results about voting behaviour and elite capture of the policy process. After setting out the empirical evidence and discussing some extant responses by political theorists, we argue that the evidence produces a two-pronged challenge for democracy: an epistemic challenge concerning the quality and focus of decision-making and an oligarchic challenge concerning power concentration. To address the challenges we then (...) put forward three main normative claims, each of which is compatible with the evidence. We start with a critique of the epistocratic position commonly thought to be supported by the evidence. We then introduce a qualified critique of referenda and other forms of plebiscite, and an outline of a tribune-based system of popular control over oligarchic influence on the policy process. Our discussion points towards a renewal of democracy in a plebeian but not plebiscitarian direction: Attention to the relative power of social classes matters more than formal dispersal of power through voting. We close with some methodological reflections about the compatibility between our normative claims and the realist program in political philosophy. (shrink)

In this rejoinder to Erman and Möller’s reply to our “Political Norms and Moral Values” we clarify the sense in which there can be specifically political values, and expound the practice-dependent notion of legitimacy adopted by our preferred version of political realism.

What is the point of ideology critique? Prominent Anglo-American philosophers recently proposed novel arguments for the view that ideology critique is moral critique, and ideologies are flawed insofar as they contribute to injustice or oppression. We criticize that view and make the case for an alternative and more empirically-oriented approach, grounded in epistemic rather than moral commitments. We make two related claims: (i) ideology critique can debunk beliefs and practices by uncovering how, empirically, they are produced by self-justifying power, and (...) (ii) the self-justification of power should be understood as an epistemic rather than moral flaw. Drawing on the recent realist revival in political theory, we argue that this genealogical approach has more radical potential, despite being more parsimonious than morality-based approaches. We demonstrate the relative advantages of our view by discussing the results of empirical studies on the contemporary phenomenon of neopatriarchy in the Middle East and North Africa. (shrink)