We read with interest the extended essay published from Riisfeldt and are encouraged by an empirical ethics article which attempts to ground theory and its claims in the real world. However, such attempts also have real-world consequences. We are concerned to read the paper’s conclusion that clinical evidence weakens the distinction between euthanasia and normal palliative care prescribing. This is important. Globally, the most significant barrier to adequate symptom control in people with life-limiting illness is poor access to opioid analgesia. (...) Opiophobia makes clinicians reluctant to prescribe and their patients reluctant to take opioids that might provide significant improvements in quality of life. We argue that the evidence base for the safety of opioid prescribing is broader than that presented, restricting the search to palliative care literature produces significant bias as safety experience and literature for opioids and sedatives exists in many fields. This is not acknowledged in the synthesis presented. By considering additional evidence, we reject the need for agnosticism and reaffirm that palliative opioid prescribing is safe. Second, palliative sedation in a clinical context is a poorly defined concept covering multiple interventions and treatment intentions. We detail these and show that continuous deep palliative sedation is a specific practice that remains controversial globally and is not considered routine practice. Rejecting agnosticism towards opioids and excluding CDPS from the definition of routine care allows the rejection of Riisfeldt’s headline conclusion. On these grounds, we reaffirm the important distinction between palliative care prescribing and euthanasia in practice. (shrink)
BackgroundMoral case deliberation as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics support on the level of health care regulation, employees of regulatory bodies are regularly confronted with moral challenges. This pilot study describes and evaluates the use of MCD at the Dutch Health Care Inspectorate.The objective of this pilot study is to investigate: 1) the current way of dealing with (...) moral issues at the IGZ; 2) experience with and evaluation of MCD as clinical ethics support, and 3) future preferences and needs regarding clinical ethics support for dealing with moral questions at the IGZ.MethodsWe performed an explorative pilot study. The research questions were assessed by means of: 1) interviews with MCD participants during four focus groups; and 2) interviews with six key stakeholders at the IGZ. De qualitative data is illustrated by data from questionnaires on MCD outcomes, perspective taking and MCD evaluation.ResultsProfessionals do not always recognize moral issues. Employees report a need for regular and structured moral support in health care regulation. The MCD meetings are evaluated positively. The most important outcomes of MCD are feeling secure and learning from others. Additional support is needed to successfully implement MCD at the Inspectorate.ConclusionWe conclude that the respondents perceive moral case deliberation as a useful form of clinical ethics support for dealing with moral questions and issues in health care regulation. (shrink)
Chacun des livres de Paul Ricœur est structuré comme un récit ; il naît d’un problème résiduel, et résistant, qui a échappé aux précédents, et qui constitue comme leur zone d’ombre ; de telle sorte qu’ils se présentent tous comme limités parce que la question à laquelle ils sont confrontés est délimitée. Mais, en se déplaçant sur le terrain de l’involontaire,...
“Guy Bennett-Hunter dans «Tillich and Divine lneffabililty» affirme l‘étroite correlation entre l’affirmation tillichienne de l’ineffabilité divine et le rejet de l’ontothéologie. L’affirmation de leur incompatibilité lui semble une contribution majeure de Tillich à la pensée religieuse. Guy Bennett-Hunter part des déclarations bien connues où Tillich affirme que l’on ne saurait, à proprement parler, attribuer l’existence a Dieu puisque Dieu est «être même au-delà de l’essence et de l’existence». En d’autres termes, Dieu «mystére de l’être», «fondement et abîme de la raison», (...) résiste à la connaissance coneeptuelle et à l’articulation linguistique.” — Anne Marie Reijnen & France Farago. (shrink)
Cet ouvrage se veut une réhabilitation du "langage ordinaire" cherchant à dévoiler ses "virtualités" et à "jeter un pont entre ce langage et celui de la philosophie" pour leur mutuelle sauvegarde. Il s'agit d'une entreprise phénoménologique qui, malheureusement, repose sur des soi-disant "évidences", sur une sorte de terrorisme argumentait opposant le bien (ce qui est vivant, spontané, dynamique, etc.) au mal (ce qui est inerte, mort, pétrifié, etc.), et sur la simple affirmation de ce que les "gens ordinaires" sont censés (...) éprouver. La quête du "langage ordinaire" devient ainsi quelque chose d'assez extraordinaire! (shrink)
This article deals with the question of how ethicists respond to practical moral problems emerging in health care practices. Do they remain distanced, taking on the role of an expert, or do they become engaged with nurses and other participants in practice and jointly develop contextualized insights about good care? A basic assumption of dialogical ethics entails that the definition of good care and what it means to be a good nurse is a collaborative product of ongoing dialogues among various (...) stakeholders engaged in the practice. This article discusses the value of a dialogical approach to ethics by drawing on the work of various nursing scholars. We present a case example concerning the quality of freedom restrictions for intellectually disabled people. Issues for discussion include the role and required competences of the ethicist and dealing with asymmetrical relationships between stakeholders. (shrink)
Moral case deliberation as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics...
Ricoeur, dans "La métaphore vive", distingue trois entités linguistiques (le mot, la phrase et le discours) et quatre disciplines (rhétorique classique, sémiotique, sémantique, herméneutique), dont les deux premières se situent au même niveau, celui du mot. On retrace la genèse de cette division tripartite, puis on montre que la position subalterne qu'elles assigne à la sémiotique est injustifiée et que, pour respecter le "relatif pluralisme des formes et des niveaux de discours", il vaut mieux se situer dans la perspective d'un (...) cadre sémiologique global. (shrink)
Is the tendency to morally prioritize humans over animals weaker in children than adults? In two pre-registered studies (N = 622), 5- to 9-year-old children and adults were presented with moral dilemmas pitting varying numbers of humans against varying numbers of either dogs or pigs and were asked who should be saved. In both studies, children had a weaker tendency to prioritize humans over animals than adults. They often chose to save multiple dogs over one human, and many valued the (...) life of a dog as much as the life of a human. While they valued pigs less, the majority still prioritized ten pigs over one human. By contrast, almost all adults chose to save one human over even one hundred dogs or pigs. Our findings suggest that the common view that humans are far more morally important than animals appears late in development and is likely socially acquired. (shrink)
Thomas Jefferson and Philosophy: Essays on the Philosophical Cast of Jefferson’s Writings is a collection of essays on topics that relate to philosophical aspects of Jefferson’s thinking over the years. Much historical insight is given to ground the various philosophical strands in Jefferson’s thought and writing on topics such as political philosophy, moral philosophy, slavery, republicanism, wall of separation, liberty, educational philosophy, and architecture.
In its comprehensive overview of Alain Locke's pragmatist philosophy this book captures the radical implications of Locke's approach within pragmatism, the critical temper embedded in Locke's works, the central role of power and empowerment of the oppressed and the concept of broad democracy Locke employed.
Contrary to standard assumptions, reasoning is often an emotional process. Emotions can have good effects, as when a scientist gets excited about a line of research and pursues it successfully despite criticism. But emotions can also distort reasoning, as when a juror ignores evidence of guilt just because the accused seems like a nice guy. In _Hot Thought_, Paul Thagard describes the mental mechanisms -- cognitive, neural, molecular, and social -- that interact to produce different kinds of human thinking, (...) from everyday decision making to legal reasoning, scientific discovery, and religious belief, and he discusses when and how thinking and reasoning should be emotional. Thagard argues that an understanding of emotional thinking needs to integrate the cognitive, neural, molecular, and social levels. Many of the chapters employ computational models of various levels of thinking, including HOTCO models and the more neurologically realistic GAGE model. Thagard uses these models to illuminate thinking in the domains of law, science, and religion, discussing such topics as the role of doubt and reasonable doubt in legal and other contexts, valuable emotional habits for successful scientists, and the emotional content of religious beliefs. Identifying and assessing the impact of emotion, Thagard argues, can suggest ways to improve the process of reasoning. (shrink)
Using 2D seismic data and well logs from the Kribi-Campo subbasin in the south Cameroon margin, we have analyzed the postrift succession with the aim of deriving a chronostratigraphic chart and identifying stratigraphic traps. The Kribi-Campo subbasin related to the rifting between Africa and South America could be divided into a structurally complex eastern depocenter and a relatively less disturbed western depocenter in which a break-up unconformity approximately 107.5 Ma underlined the beginning of postrift history. We have used the modern (...) concepts of sequence stratigraphy to identify and characterize seven second-order sequences and one third-order sequences grouped into three megasequences from Albian to Recent. Sequence 1 was characterized by a retrogradation overlying a lowstand progradational pattern. The SS2 and SS3 sequences were deposited during a highstand normal regression. From Paleocene to Eocene, the deposition of sequences SS4–SS5 was controlled by the development of submarine fan turbiditic system related to a forced regression of coastline. From the Middle Miocene to Recent age, the SS6, SS7, and SS8 sequences have been characterized by the development of sigmoidal-oblique clinoforms of a deltaic system well observed in the northern part of the study area. We have studied a new undocumented phase of forced regression of Mio-Pliocene in age within the postrift sequence SS7. The forced regression phases are associated with the Paleogene and Neogene uplift. Relative sea-level curves were constructed and compared with the existing published curves. The processes involved in the formation of these sequences were interpreted as a combination of tectonics, sediment supply, and sea-level changes. Potential reservoirs embedded within the sequences include channel fill, shingled turbidites, slope fan, and basin-floor fan complex. (shrink)
This chapter sharpens the book’s criticism of exclusivist responsible to religious multiplicity, firstly through close critical attention to arguments which religious exclusivists provide, and secondly through the introduction of several new, formal arguments / dilemmas. Self-described ‘post-liberals’ like Paul Griffiths bid philosophers to accept exclusivist attitudes and beliefs as just one among other aspects of religious identity. They bid us to normalize the discourse Griffiths refers to as “polemical apologetics,” and to view its acceptance as the only viable form (...) of pluralism. This reasoning may seem initially plausible, but on closer examination his and other’s defence of the reasonableness of exclusivist responses to religious multiplicity fall apart. Informed by our study of luck-leaning theological explanations of religious difference and the counter-inductive thinking they exemplify, I argue that exclusivist responses to religious multiplicity are best explained by personal and group bias, and that a discourse between exclusivist authors or sects is beyond the pale of reasonable disagreement. Our study of descriptive (psychological) and prescriptive (religious) fideism in the first sections of Chapter Five suggests that we turn back to formal features of doxastic methods (i.e., of how people process), features that may be straightforwardly tested for in studies utilizing scales of religious orientation. These formal features allow us to better recognize not only the multiplicity of models of faith that religious adherents adhere to, but also that the relationship between forms of fideism is scalar: there is a spectrum of views running from rationalism to fideism, and at the fideistic end from moderate to strong forms of religious fideism. I further explain why developing tests and markers for a high degree of fideistic orientation is important to all those who study religion. The second half of the chapter turns to criticism or censure of exclusivist attitudes to religious multiplicity, in contrast to apologetic defenses of exclusivism. While we have examined the close connections between fideism and fundamentalism, and again between fundamentalism and exclusivism in earlier chapters, a sharper focus reveals an important but little-recognized distinction reflected in the literature: the distinction between religion-specific (or particularist) and mutualist exclusivism. The mutualist doesn’t talk just about the right of adherents of one specific religion to assert exclusivism, but the adherents of any and all “home” religions. I argue that some previously unrecognized problems for the reasonableness of exclusivist responses to religious multiplicity are brought to light when we make the distinction between the two basic ways to understand the claim that exclusivists are making. I put particularist (Barth, Lindbeck, Plantinga) and mutualist (Griffiths, Gellman, Margalit, D’Costa) defenses of exclusivism on the horns of a dilemma, and argue that despite the popularity it presently enjoys among post-liberal theologians, a close examination reveals that the very conceptual coherence of mutualist exclusivism is in serious doubt. (shrink)
Sur la définition de la métaphore et sur son rôle, un débat majeur a opposé Jacques Derrida et Paul Ricoeur. Cet ouvrage enregistre les plaidoiries du pseudo-apôtre de la métaphore "morte" et du champion de la métaphore métaphoriquement vive. Il les met en perspective en citant à comparaître les théoriciens du trope de la ressemblance depuis Aristote jusqu'à Searle, depuis la poétique et la rhétoriques anciennes jusqu'à la pragmatique contemporaine. Ce procès de la métaphore dissout l'opposition du mort et (...) du vif. Il montre que l'écart entre les théories substitutives, comparatistes,interactives et pragmatiques de la métaphore procède de l'occultation des lieux partagés, dont le dévoilement incite à la complémentarité plutôt qu'à la disqualification réciproque. Il montre également que le débat actuel qui tente de conquérir le rôle cognitif de la métaphore à l'encontre d'une fonction décrétée "ornementale" relève d'une perspective d'emblée rétrécie qui néglige sa polyvalence fondamentale. (shrink)
Prosthetic devices that replace an absent body part are generally considered to be either cosmetic or functional. Functional prostheses aim to restore lost physical functioning. Cosmetic prostheses attempt to restore a “normal” appearance to bodies that lack limbs by emulating the absent body part’s looks. In this article, we investigate how cosmetic prostheses establish a normal appearance by drawing on the stories of the users of a specific type of artificial limb: the facial prosthesis. Given that prostheses are first and (...) foremost devices worn upon the body, such an analysis requires an understanding of the ways in which bodies and technologies interact. We thus interpret users’ stories by critically engaging with the work of disability researcher and Actor-Network theorist Myriam Winance, as well as with the postphenomenological scholarship of Don Ihde and Peter-Paul Verbeek. Using this framework, we explore users’ attempts to achieve a proper fit between their faces and their prostheses, the technological transparency such a fit enables, and the ways in which transparency mediates users’ everyday exchanges with others. We conclude that a normal appearance, when it is achieved by means of prosthetics, enables the device’s user to navigate a precarious social environment as they encounter and interact with others in public. (shrink)
Paul Tillich’s concept of God opposes the “interventionist” model of traditional Western theism. This paper attempts to determine whether, and in what sense, for Tillich, God may be said to act specifically to influence the course of historical events. It is argued that his concept of “Spiritual power” provides his answer. In clarification the concepts of “spirit,” “power,” “meaning,” “vocation,” “kairos,” and “the renunciation of power” are explored. According to Tillich, the vocations of specific social groups are empowered by (...) divine power, providing both gift and task. For Christians the vocation of Jesus the Christ to proclaim the coming Kingdom of God as the ultimate meaning of history provides the criterion by which concrete vocations may be judged. God acts by providing meaning, which must be chosen and achieved. Chez Paul Tillich, le concept de Dieu s’oppose au modèle « interventionniste » du théisme traditionnel en Occident. Cet article se propose de déterminer si, et en quel sens, d’après Tillich, on peut dire que Dieu agit pour influencer le cours des événements historiques. On soutient que son concept de « pouvoir Spirituel » fournit une réponse à cette question. Pour clarifier cette thèse, on explore les concepts d’esprit, de pouvoir, de sens, de vocation, de kairos et de renoncement au pouvoir. Selon Tillich, la vocation de groupes sociaux déterminés est animée d’un pouvoir divin conférant tout ensemble un don et une tâche. Pour les chrétiens, la vocation de Jésus le Christ, qui consiste à proclamer la venue du Royaume de Dieu comme le sens ultime de l’histoire, constitue le critère permettant de juger les vocations concrètes. Dieu agit en offrant un sens, qui doit être choisi et réalisé. (shrink)
Abstract Some philosophers find linguistic meaning mysterious. Two approaches suggest themselves for removing the felt mystery, or demystifying meaning. One involves providing a substantive account of meaning in meaning-free terms. Although this approach has come under serious attack in recent years, Paul Horwich has recently presented a version of the approach that might be thought impervious. A preliminary attempt is made to argue that Horwich's version is vulnerable to the considerations felt to undermine other versions of the substantive approach (...) to demystification. That leaves the second approach, quietism, which involves showing that although meaning is primitive it is un-mysterious. It is suggested that this approach is worthy of exploration. (shrink)
Résumé Au sein d’une théologie considérée comme fondamentalement pratique, la théologie pratique comme sous-discipline se distingue par un intérêt particulier — empirique, herméneutique, critique et stratégique — pour les pratiques dont elle fait souvent son objet propre. Après avoir signalé quelques impacts de ce centrement sur la pratique, l’article présente quelques définitions de la pratique et quelques éléments d’histoire du concept. Il expose ensuite quelques traits des pratiques, en particulier avec Paul Ricoeur et Jürgen Habermas, conjuguant des perspectives sémantique, (...) pragmatique et communicationnelle. Il vise particulièrement à faire ressortir la richesse et la complexité de la pratique dont l’étude est trop souvent prise comme allant de soi et qui surprennent toujours celui qui s’y adonne.At the heart of a theology which is fundamentally considered to be practical, practical theology, as a sub-discipline, distinguishes itself by its particular empirical, hermeneutic, critical, and strategic interest in the practices with which it is concerned. After pointing out some of the impacts of this central concern with practice, the present article presents some definitions of practice as well as some historical background of the concept. It then examines some of the characteristics of practice, particularly in relation to Paul Ricoeur and Jürgen Habermas, while discussing semantic, pragmatic, and communicational perspectives. In particular, this article aims at highlighting the richness and complexity of practice. (shrink)
Since its emergence as an academic discipline in the early 1970s, feminist commentary and scholarship has prosecuted a critique of androcentric or sexist (gender exclusive) language, which has to some extent been successful. The struggle by women to occupy a positive linguistic space is continually being challenged by the endemic nature of masculine bias, which is realized through “indirect” or “subtle” sexism in the community. Seemingly innocuous words, like guy/guys, are frequently used to represent both men and women, reminiscent of (...) the previous use of man/men as gender inclusive common nouns. This raises the question of how to account for the persistence of such language use in spite of the fact that attention is regularly drawn to its problematic character. In this paper we approach the matter in a novel way, by appealing to work in the field of cognitive semantics, in particular the conceptual theory of metonymy. We propose that the relationship between the concepts of masculine and feminine as these are typically structured through language is indicative of a metonymy THE MASCULINE FOR THE FEMININE, in which the masculine “stands for” the feminine and in which lexical items are given as inclusive yet in effect refer to one (normative) gender. A corollary is that the feminine is subsumed (really or virtually) by the presence of the masculine and is made to disappear, and only reappears when she needs to be specified within the contextual frame. (shrink)
In late August 2012, artist Paul Thomas and philosopher Timothy Morton took a stroll up and down King Street in Newtown, Sydney. They took photographs. If you walk too slowly down the street, you find yourself caught in the honey of aesthetic zones emitted by thousands and thousands of beings. If you want to get from A to B, you had better hurry up. Is there any space between anything? Do we not, when we look for such a space, (...) encounter a plenitude of other things —a slice of plaster, an old vinyl record, a flattened piece of aluminum, painted metal surfaces, nameless interstitial powder, the reflection of sky, some letters of the alphabet, roughened concrete. Between what we take to be things there exist other things, as if the universe were jammed with entities like clowns in a crowded Expressionist painting. An abyss of things that emanates from them, not a yawning void that threatens to engulf them, but a sunlit nothingness filled with dust that seems to spray out of them like dry mist sparkling with firefly swarms. In these so-called spaces, we encounter the work of causality. Look: someone painted over this crack, some sunlight rippled in a mirage, a hole appeared. When we look for causes and effects, we don't encounter a basement of efficiently whirring machinery. Rather, we encounter these in-between spaces, where we had not thought to look. What we see are stage hands moving the scenery about—they are doing it in plain sight, the best place to hide, right in front of you, in the place we call the aesthetic dimension . In Tibetan Buddhism these spaces are called bardo , which just means the between. There is no such thing as a moment of your life that is not a between, according to this view. There is the between of living. There is the between of dying. There is the between of the transition between lives. There is the between of dreaming. There is the between of meditation. There is the between of two humans holding cameras walking down a street in Sydney. The between of two buildings, a space bursting with objects as if a billion jack in the boxes had exploded at once. Some of the lids are stuck, sometimes a nose bursts out and the hinge won't open any further; at other times, the jack in the box flies right out and pulps against the wall on the opposite side of the room. Time opens up. Each surface is a poem about the past. A myriad stories begin to proliferate, as if a thing were a crisscrossing of books, a whole library of them, each page whispering parts of paragraphs and broken pieces of word. The stories tell us things—they are quite literal, look, this guy painted part of this wall, then they came and stripped off the panel and touched up the holes. Form is the past. When you look at appearance, you are looking at the past. Where is the present? And essence is the future. The hints of unknown, unseen things, the absolute impossibility of grasping everything about this plastic pipe, the way photons entering the camera lens obey a speed limit and splash onto receptors, going into and out of coherence. At the electronic level, it's quite clear that causality is aesthetic. I can't see an electron without deflecting it. Everything is a refrigerator with a light on—or off—inside. For me, for you, for this arrangement of tiles sandwiched between a door and a slab of marble. To a photon, an electron is a refrigerator with a closed door, and a light that might be on—or off—inside. How can you know whether the light is on inside? Why, you open the door of course. But then you are looking at the past. You never see the light in the refrigerator before you open the door. This future is not a predictable future that is a specific number of now-points away. You will never reach it. You will never be able to sneak up from the side and see through the refrigerator. Nor can a photon see through the refrigerator of an electron. Nor can paint see through the refrigerator of this plastic pipe. You take a photo—click—the past appears, another open refrigerator. But the thing you have just made, the photograph, the graphing of the photons—it is another thing, another story. You can read the words, but the meaning always eludes you. It always lurks just off the edge of the sentence, just at the very edge of this ragged slice of paint, just at the edge of this building, between this one and that one. Thousands of secrets, everywhere. Masks that lie and tell the truth at the same time: this pink paint is not blue paint, that's true. But the thing, the thing in itself, that paint sliding off a brush onto that pipe—it is nowhere to be seen, like a light behind a closed door. When you walk too slowly down the street, you start walking into millions of levels of pastness, levels emitted not just by the humans or the dogs and cats, but also by this garbage can, this mottled pink surface pockmarked with nail holes. You walk surrounded by as many futures as there are things. You walk, or rather you occupy a peculiar shifting ground of nowness, created by the relative motion of the past sliding against the future, not touching. You begin to realize that the present does not exist. A thing is a train station where one train is always arriving and one train is always leaving. Hundreds of train stations everywhere, hundreds of relative motions. The idea of a universal, regular, atomic sequence of instants that contains everything is absolutely ludicrous, the philosophers have known this for thousands of years, and to hide the absurdity, to get from A to B, Houston to Sydney, crossing the International Date Line without too much laughter, you have embedded piezoelectric devices in as many pieces of hardware as possible, devices in which quartz talks to electrons, making train stations where the trains seem to run on time. When you walk too slowly down the street, you begin to realize that Zeno had a point. You can seemingly divide each moment, each step, infinitesimally. So perhaps there are no moments, no steps. Or perhaps time is not a box that everything goes in. Perhaps time is, as Einstein argued after all, a way that things send out ripples. Where one house touches another house, there arise hundreds of things, hundreds of meeting places (Old English thing , meeting place). Hundreds of times. I have a thing for you. Come over here, let's do a thing. Stay in the sunlight and shadow between worlds, in the sunlit canyon between this building and that building. See how paint touches this pipe, caressing then leaving, no one will notice if a surface is left exposed, not quite filled in. See how shadows are reflected in pale cream glass—see the luminous abyss of causality spreading out before your very eyes, right in front of security. All kinds of beautiful crimes are committed right here, and as American cars keep telling you, and you never notice, OBJECTS IN MIRROR ARE CLOSER THAN THEY APPEAR. They are here, or rather, here is them, and now is them. Kissing in the shadow. Tim Morton Rice University. (shrink)