Bainbridge’s well known “Ironies of Automation” Analysis, design and evaluation of man–machine systems. Elsevier, Amsterdam, pp 129–135, 1983. https://doi.org/10.1016/B978-0-08-029348-6.50026-9) laid out a set of fundamental criticisms surrounding the promises of automation that, even 30 years later, remain both relevant and, in many cases, intractable. Similarly, a set of ironies in technologies for sensor driven self-quantification is laid out here, spanning from instrumental problems in human factors design to much broader social problems. As with automation, these ironies stand in the (...) way of many of the promised benefits of these wearable technologies. It is argued here that without addressing these ironies now, the promises of wearables may not come to fruition, and instead users may experience outcomes that are opposite to those which the designers seek to afford, or, at the very least, those which consumers believe they are being offered. This paper describes four key ironies of sensor driven self-quantification: know more, know better versus no more, no better; greater self-control versus greater social control; well-being versus never being well enough; more choice versus erosion of choice. (shrink)

The past two decades have been a time of heightened interest in the moral aspects of the practice of medicine. This interest has been reflected in medical education by the establishment of medical humanities programs in both preclinical and clinical education in many medical schools. It has also been reflected in the literature with a dramatic increase in journal articles on medical ethics as well as the development of medical ethics in textbooks. A number of journals have developed that (...) are specifically devoted to medical ethics, including The Journal of Medical Ethics, The Journal of Medicine and Philosophy, The Journal of Medical Humanities, Theoretical Medicine, Cambridge Quarterly of Healthcare Ethics, just to name a few. The literature includes both theoretical foundations and conceptual analyses of particular issues as well as practical advice and general suggestions for how to implement programs in medical humanities. (shrink)

Background The fourth section of the 1967 Abortion Act states that individuals (including health care practitioners) do not have to participate in an abortion if they have a conscientious objection. A conscientious objection is a refusal to participate in abortion on the grounds of conscience. This may be informed by religious, moral, philosophical, ethical, or personal beliefs. Currently, there is very little investigation into the impact of conscientious objection on service users in Britain. The perspectives of service users are imperative (...) in understanding the real-world consequences and potential impact of conscientious objection and should be considered when creating and reviewing policies and guidelines. This research provided a platform for women and those who can become pregnant to share their experiences and opinions at a time when these voices are largely excluded in the great tradition of Western political philosophy and law-making processes. Method Five service users were interviewed using a narrative interview approach to uncover their abortion journeys and experiences of conscientious objection. Findings The findings were presented as found poems and uncovered that doctors are not always: informing service users that they have a conscientious objection to abortion, giving service users enough information to access abortion (indirect referral), treating them non-judgmentally, and providing medically correct information. Service users did not experience burdens such as long waiting times and were still able to access legal abortion. However, service users did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred and/or were mistreated. Conclusions Findings indicate that conscientious objection could work in practice. However, it is currently failing some individuals on an emotional level, as not all doctors are adhering to guidelines. Conscientious objection in Britain needs to be addressed, to ensure service users receive fair, impartial, non-judgmental care. (shrink)

High moral standards and adherence to a moral code have long been strong tenets of the profession of medicine, even though there have been occasional lapses that have led to renewed calls for a revitalization of moral integrity in medicine. Certainly, a moral component has generally been held to be an important aspect of the concept of a physician.

The medical ethicist is a fairly recent addition to the clinical setting. The following four potential roles of the clinical ethicist are identified and discussed: consultant in difficult cases, educator of health care providers, counselor for health care providers and finally patient advocate to protect the interests of patients. While the various roles may sometimes overlap, the roles of educator and counselor are viewed as being more congruent with the education and training of medical ethicists than are the roles of (...) consultant and patient advocate. (shrink)

This paper provides a philosophical critique of professional stereotypes in medicine. In the course of this critique, we also offer a detailed analysis of the concept of care in health care. The paper first considers possible explanations for the traditional stereotype that caring is a province of nurses and women, while curing is an arena suited for physicians and men. It then dispels this stereotype and fine tunes the concept of care. A distinction between ‘caring for’ and ‘caring about’ (...) is made, and concomitant notions of parentalism are elaborated. Finally, the paper illustrates, through the use of cases, diverse models of caring. Our discussion reveals the complexity of care and the alternative modes of caring in health care. (shrink)

Following a brief consideration of two contrasting purposes for teaching the medical humanities, a description is given of a film discussion elective course. In contrast to the usual teaching of medical ethics which is primarily a cognitive activity emphasizing the development of a code of principles such as justice, autonomy, and beneficence, the film discussion elective was primarily an affective activity emphasizing the development of an ethical ideal of caring, relatedness, and sensitivity to others. The pass/fail elective, offered for one (...) credit each quarter for two quarters, met once a week for one hour for twenty-four weeks. Each week a film was shown followed by a group discussion. A wide variety of social issues were covered. The objective of the course was to increase the ethical sensitivity of the medical students through promotion of introspection and reflection on social issues. A brief discussion is given of the importance and appropriateness of using film to promote the affective focus of medicine on the relief of suffering. Examples are given of how the course achieved its objective. A detailed description of the resource materials is provided. (shrink)

This study investigates the three major educational philosophies behind the medical humanities programs in the United States. It summarizes the characteristics of the Cultural Transmission Approach, the Affective Developmental Approach, and the Cognitive Developmental Approach. A questionnaire was sent to 415 teachers of medical humanities asking for their perceptions of the amount of time and effort devoted by their programs to these three philosophical approaches. The 234 responses constituted a 54.6% return. The approximately 80:20 gender ratio of males to females (...) and other demographic data on age and educational background were consistent with other studies of the field of medical humanities.Reflections on the results in Table II indicate that some changes need to take place in the teaching of the medical humanities if the perceived ideal is to be achieved. In order for the current teachers of the medical humanities to think that the appropriate philosophies behind the teaching of the medical humanities are being implemented as they should be, much less time and effort need to be devoted to the Cultural Transmission Approach. With no other published reports on the educational philosophies behind the medical humanities programs, this study created a new knowledge base about this relatively young and rapidly emerging field. (shrink)

A study of physicians and medical students was conducted to determine the various philosophical positions they hold with respect to ethical decision-making in medicine and their epistemological presuppositions in relationship to the subjective-objective controversy in value theory. The study revealed that most physicians and medical students tend to be objectivists in value theory, i.e., believe that value judgements are knowledge claims capable of being true or false and are expressions of moral requirements and normative imperatives emanating from an external (...) value structure or moral order in the world, but that most physicians and medical students are inconsistent in the philosophical foundations of their medical ethical decision-making, i.e., in decision-making regarding values they tend to hold beliefs which are incompatible with other beliefs they hold about values. The study also revealed that most physicians and medical students think more emphasis should be placed upon medical ethics in medical education. (shrink)

A study of clinical medical ethicists was conducted to determine the various philosophical positions they hold with respect to ethical decision making in medicine and their various positions' relationship to the subjective-objective controversy in value theory. The study consisted of analyzing and interpreting data gathered from questionnaires from 52 clinical medical ethicists at 28 major health care centers in the United States. The study revealed that most clinical medical ethicists tend to be objectivists in value theory, i.e., believe that (...) value judgments are knowledge claims capable of being true or false and therefore expressions of moral requirements and normative imperatives emanating from an external value structure or moral order in the world. In addition, the study revealed that most clinical medical ethicists are consistent in the philosophical foundations of their ethical decision making, i.e., in decision making regarding values they tend not to hold beliefs which are incompatible with other beliefs they hold about values. (shrink)

The most important distinction in value theory is the subjective-objective distinction which determines the epistemological status of value judgments about medical intervention. Ethical decisions in medical intervention presuppose one of three structures of justification — namely, an inductive approach, a deductive approach which can be either consequentialist or non-consequentialist, and a uniquely ethical approach. Inductivism and deductivism have been discussed extensively in the literature and are only briefly described here. The uniquely ethical approach which presupposes value objectivism is analyzed in (...) detail. This method involves a purely ethical inference which moves from facts to values directly with an emphasis on reason which involves a non-logical justification (as opposed to illogical). It involves the use of natural practical arguments which have an imperative conclusion but no imperative premise and exhibit a value-requiredness between two states of affairs. (shrink)

A study of nurses and nursing students was conducted to determine the various philosophical positions they hold with respect to ethical decision-making in nursing and their relationship to the subjective-objective controversy in value theory. The study revealed that most nurses and nursing students tend to be subjectivists in value theory, i.e., believe that value judgments are purely personal, private expressions of one's own opinion or inner-feelings and not believe that value judgments are knowledge claims capable of being true or false (...) and therefore not expressions of moral requirements and normative imperatives emanating from an external value structure or moral order in the world. In addition, the study revealed that most nurses and nursing students are inconsistent in the philosophical foundations of their ethical decision-making, i.e., in decision-making regarding values they tend to hold beliefs which are incompatible with other beliefs they hold about values. (shrink)

On May 11th a round table discussion was held on the subject "The Interactions of Science and Art under the Conditions of the Revolution in Science and Technology ," organized by the editorial boards of the journals Voprosy filosofii and Voprosy literatury.

The enormous growth in medical humanities programs during the past decade has resulted in an extensive literature concerning the content of the discipline and the issues that have been addressed. Comparatively little attention, however, has been devoted to the structure of the discipline of medical humanities concerning the process or the theoretical aspects of the pedagogy of teaching the discipline. This report explicitly addresses the pedagogical aspects of the discipline by comparing and contrasting two different basic approaches to the discipline (...) referred to as the classical humanities approach and the humanistic psychology approach which roughly approximate the cognitive and affective approaches respectively. These two approaches are compared and contrasted in terms of their goals, objectives, methods of implementation, philosophical assumptions and evaluational techniques. (shrink)

After noting why the issue of the use of animals in medical education and research needs to be addressed, this article briefly reviews the historical positions on the role of animals in society and describes in more detail the current positions in the wide spectrum of positions regarding the role of animals in society. The spectrum ranges from the extremes of the animal exploitation position to the animal liberation position with several more moderate positions in between these two extremes. Then (...) the philosophical issue of the moral agency of animals is discussed in terms of an explication of the concept of rights and the concept of personhood. Further research is suggested concerning institutional policies regarding medical students who refuse to do physiology dog labs or other assignments which involve the suffering and/or death of animals. (shrink)

This article examines how digital epidemiology and eHealth coalesce into a powerful health surveillance system that fundamentally changes present notions of body and health. In the age of Big Data and Quantified Self, the conceptual and practical distinctions between individual and population body, personal and public health, surveillance and health care are diminishing. Expanding on Armstrong’s concept of “surveillance medicine” to “quantified self medicine” and drawing on my own research on the symbolic power of (...) statistical constructs in medical encounters, this article explores the impact of digital health surveillance on people’s perceptions, actions and subjectivities. It discusses the epistemic confusions and paradoxes produced by a health care system that increasingly treats patients as risk profiles and prompts them to do the same, namely to perceive and manage themselves as a bundle of health and security risks. Since these risks are necessarily constructed in reference to epidemiological data that postulate a statistical gaze, they also construct or make-up disembodied “individuals on alert”. (shrink)

Only recently have ethicists been invited into the clinical setting to offer recommendations about patient care decisions. This paper discusses this new role for ethicists from the perspective of content and process issues. Among content issues are the usual ethical dilemmas such as the aggressiveness of treatment, questions about consent, and alternative treatment options. Among process issues are those that relate to communication with the patient. The formal ethics consult is discussed, the steps taken in such a consult, and whether (...) there should be a fee charged. We conclude with an examination of the risks and benefits of formal ethics consults. (shrink)

The article discusses the challenges, benefits, and risks that, from a bioethical perspective, arise because of the the development of eHealth projects. The conceptual framework of the research is based on H. Jonas’ principles of the ethics of responsibility and B.G. Yudin’s anthropological ideas on human beings as agents who constantly change their own boundaries in the “zone of phase transitions.” The article focuses on the events taking place in the zone of phase transitions between humans and machines in eHealth. (...) It is shown that for innovative practices related to digitalization and datafication in medicine, it is needed to rethink central bioethical concepts of personal autonomy and informed consent. In particular, the concept of broad or open informed consent is discussed, which allows the idea of moral responsibility in the field of biomedical technologies to be extended to events of uncertain future. The authors draw attention to the problems associated with the emergence of new autonomous subjects/agents (machines with artificial intelligence) in relationship between doctors and patients. The humanization of machines occurring in eHealth is accompanied by a counter trend – the formation of conceptions and practices of the quantified self. There emerges the practices of self-care and bio-power (M. Foucault) caused by the datafication and digitization of personality. The authors conclude that bioethics should proactively develop norms for the evolving interaction between doctor and patients. (shrink)

The article discusses the challenges, benefits, and risks that, from a bioethical perspective, arise because of the the development of eHealth projects. The conceptual framework of the research is based on H. Jonas’ principles of the ethics of responsibility and B.G. Yudin’s anthropological ideas on human beings as agents who constantly change their own boundaries in the “zone of phase transitions.” The article focuses on the events taking place in the zone of phase transitions between humans and machines in eHealth. (...) It is shown that for innovative practices related to digitalization and datafication in medicine, it is needed to rethink central bioethical concepts of personal autonomy and informed consent. In particular, the concept of broad or open informed consent is discussed, which allows the idea of moral responsibility in the field of biomedical technologies to be extended to events of uncertain future. The authors draw attention to the problems associated with the emergence of new autonomous subjects/agents in relationship between doctors and patients. The humanization of machines occurring in eHealth is accompanied by a counter trend – the formation of conceptions and practices of the quantified self. There emerges the practices of self-care and bio-power caused by the datafication and digitization of personality. The authors conclude that bioethics should proactively develop norms for the evolving interaction between doctor and patients. (shrink)

BackgroundSystems medicine is the name for an assemblage of scientific strategies and practices that include bioinformatics approaches to human biology ; “big data” statistical analysis; and medical informatics tools. Whereas personalized and precision medicine involve similar analytical methods applied to genomic and medical record data, systems medicine draws on these as well as other sources of data. Given this distinction, the clinical translation of systems medicine poses a number of important ethical and epistemological challenges for researchers (...) working to generate systems medicine knowledge and clinicians working to apply it.DiscussionThis article focuses on three key challenges: First, we will discuss the conflicts in decision-making that can arise when healthcare providers committed to principles of experimental medicine or evidence-based medicine encounter individualized recommendations derived from computer algorithms. We will explore in particular whether controlled experiments, such as comparative effectiveness trials, should mediate the translation of systems medicine, or if instead individualized findings generated through “big data” approaches can be applied directly in clinical decision-making. Second, we will examine the case of the Riyadh Intensive Care Program Mortality Prediction Algorithm, pejoratively referred to as the “death computer,” to demonstrate the ethical challenges that can arise when big-data-driven scoring systems are applied in clinical contexts. We argue that the uncritical use of predictive clinical algorithms, including those envisioned for systems medicine, challenge basic understandings of the doctor-patient relationship. Third, we will build on the recent discourse on secondary findings in genomics and imaging to draw attention to the important implications of secondary findings derived from the joint analysis of data from diverse sources, including data recorded by patients in an attempt to realize their “quantified self.”SummaryThis paper examines possible ethical challenges that are likely to be raised as systems medicine to be translated into clinical medicine. These include the epistemological challenges for clinical decision-making, the use of scoring systems optimized by big data techniques and the risk that incidental and secondary findings will significantly increase. While some ethical implications remain still hypothetical we should use the opportunity to prospectively identify challenges to avoid making foreseeable mistakes when systems medicine inevitably arrives in routine care. (shrink)

This edited volume explores the intersection of medicine and philosophy throughout history, calling attention to the role of quantification in understanding the medical body. Retracing current trends and debates to examine the quantification of the body throughout the early modern, modern and early contemporary age, the authors contextualise important issues of both medical and philosophical significance, with chapters focusing on the quantification of temperaments and fluids, complexions, functions of the living body, embryology, and the impact of quantified reasoning (...) on the concepts of health and illness. With insights spanning from the sixteenth century to the nineteenth century, this book provides a wide-ranging overview of attempts to ‘quantify’ the human body at various points. Arguing that medicine and philosophy have been constantly in dialogue with each other, the authors discuss how this provided a strategic opportunity both for medical thought and philosophy to refine and further develop. Given today’s fascination with the quantification of the body, represented by the growing profusion of self-tracking devices logging one’s sleep, diet or mood, this collection offers an important and timely contribution to an emerging and interdisciplinary field of study. -/- . (shrink)

We show how interest in “human enhancement” and "optimization” is rooted in a broader social phenomenon – the medicalization of life – and argue that the push to enhance and optimize human beings has a distinctively neoliberal character. Indeed, human enhancement and optimization practices reflect a growing tendency to apply market concepts and logic to individuals, who increasingly conceive of themselves as performative subjects. The Quantified Self is, we suggest, the Marketized Self. Moreover, the Quantified (...) class='Hi'>Self is not merely a symptom of the marketization of individuals but serves also to perpetuate that marketization: the Quantified Self threatens to become that concept which defines who the individual “really” is. We argue that this metaphysically weighty idea affects how we think about what is good for human beings. (shrink)

The phenomenon of the quantified self, which is especially addressed by sociology and medical humanities, is still quite disregarded by philosophy. Yet, the philosophical issues it raises are various and meaningful, from the realm of epistemology to the realm of ethics. Moreover, it may be read as a key symptom to investigate the complex technological era in which we live, starting from the meaning of contemporary technology itself from a philosophical perspective. I shall focus on one of the (...) epistemological issues raised by the phenomenon of the quantified self by arguing that it may be read in terms of epistemological anarchism, which also leads to other epistemological issues, such as a possibly detectable crisis of the notions of knowledge in general and science in particular as founded on the relationship between particularity and universality, as well as between reality and ideality. I shall select cases that are peculiarly representative of the founding epistemological stance I shall focus on. Yet, the reason why they deserve special attention is that they are also representative of an increasingly widespread attitude characterising not only the community of the quantified self but also, at least to some extent, anyone of us who may happen to use technologies to try to self-diagnose. (shrink)

Self-tracking devices point to a future in which individuals will be more involved in the management of their health and will generate data that will benefit clinical decision making and research. They have thus attracted enthusiasm from medical and public health professionals as key players in the move toward participatory and personalized healthcare. Critics, however, have begun to articulate a number of broader societal and ethical concerns regarding self-tracking, foregrounding their disciplining, and disempowering effects. This paper has two (...) aims: first, to analyze some of the key promises and concerns that inform this polarized debate. I argue that far from being solely about health outcomes, this debate is very much about fundamental values that are at stake in the move toward personalized healthcare, namely, the values of autonomy, solidarity, and authenticity. The second aim is to provide a framework within which an alternative approach to self-tracking for health can be developed. I suggest that a practice-based approach, which studies how values are enacted in specific practices, can open the way for a new set of theoretical questions. In the last part of the paper, I sketch out how this can work by describing various enactments of autonomy, solidarity, and authenticity among self-trackers in the Quantified Self community. These examples show that shifting attention to practices can render visible alternative and sometimes unexpected enactments of values. Insofar as these may challenge both the promises and concerns in the debate on self-tracking for health, they can lay the groundwork for new conceptual interventions in future research. (shrink)

The notion of je ne sais quoi, whose rise characterises the decades in which the first scientific revolution marks a turning point in Western culture, tries to identify the human capacity for grasping what exceeds knowledge resulting from logos. But the further steps of the triumph of logos, starting from the second scientific revolution and its further developments, increasingly determine its fall. Moreover, th e recent history of Western culture may be read as follows: we have been increasingly entrusting our (...) understanding of what is and our prediction of what will be to an even more restricted form of rationality coinciding with logos, first, by progressively restricting logos to computation and, second, by progressively externalising computation from our minds to technologies, specifically algorithmic technologies. As such, should we think that computation is increasingly occupying the realm of je ne sais quoi by increasingly reckoning the unreckonable? The answer seems affirmative. In what follows, I shall critically focus on a promising case in point to try to understand the radical move from je ne sais quoi to computation: the case of the quantified self, which is addressed by medical humanities and sociology, but quite disregarded by philosophy – alternatively, I shall at least try to introduce the reasons why the case of the quantified self deserves a specifically philosophical study, starting from aesthetics and epistemology. (shrink)

While the Quantified Self has often been described as a contemporary iteration of Taylorism, this article argues that a more accurate comparison is to be made with what Anson Rabinbach has termed the “European Science of Work.” The European Science of Work sought to modify Taylor’s rigid and schematic understanding of the laboring body through the incorporation of insights drawn from the rich European tradition of physiological studies. This “softening” of Taylorist methods had the effect of producing a (...) greater “isorhythmia” or synchronicity between the bodily rhythms of workers and those of the mode of production itself and was embraced by employers as a way to dampen worker militancy. Through a discursive analysis of the promotion of sensor analytics by management consultants VoloMetrix and Humanyze, I argue that the contemporary quantification of the workplace represents a similar project of “soft domination,” as the intimate, bottom-up mode of surveillance it fosters seeks to more closely mold workers’ physiological and social rhythms to the structure of the workplace and the working day. (shrink)

This article presents the results of a discourse analysis of press coverage on the Quantified Self (QS) movement in the German and British (online) press between 2007 and 2018. The analysis is driven by two questions: What discursive patterns can be discerned within this coverage? And, what characterizes the translation of the experimental practices and imaginaries of this pioneer community into an overall societal reflection of deep mediatization? In essence, the article shows that the QS movement becomes a (...) ‘general signifier’ for a dystopian view of deep mediatization. So, while the QS movement itself understands its practices and community as self-empowering, self-reasoning, and experimental, the constructions of the QS movement in public discourse suggest the opposite. Paradoxically, however, another basic imaginary of the pioneer community is adopted and confirmed, namely that of the (simple) mutability of society as a consequence of digital media technologies. (shrink)

Remote monitoring of implantable cardioverter defibrillator (ICD) patients links patients wirelessly to the clinic via a box in their bedroom. The box transmits data from the ICD to a remote database accessible to clinicians without patient involvement. Data travel across time and space; clinicians can monitor patients from a distance and instantly know about cardiac events. Based on ethnographic fieldwork in two Danish hospitals, this article explores the configuration of the wireless ICD patient by following a number of patients through (...) hospitalisation, implantation, in-clinic follow-up, and remote monitoring. Wireless therapy, we argue, scripts the patient as data. In high-tech clinical encounters, data are enacted as extensions and copies of the patient, and even proxies that, in patients’ experiences, may turn into identity thieves. In illuminating the multiple positions that data take in such clinical encounters and in patients’ experiences we discuss the ambiguities that arise when patients go wireless. (shrink)

The author examines the impact of the technological capabilities of medicine to review the boundaries between enhancement and therapy, artificial and natural, normal and supernormal, revealed the relationship of medicalization trends and development of the «quantified self» movement, revealed some «garage biology» ideas in connection with the development of different practices of human transformation.

We characterize the generalized quantifiers Q which satisfy the scheme $QxQy\phi \leftrightarrow QyQx\phi$ , the so-called self-commuting quantifiers, or quantifiers with the Fubini property.

The growth of self-tracking and personal surveillance has given rise to the Quantified Self movement. Members of this movement seek to enhance their personal well-being, productivity, and self-actualization through the tracking and gamification of personal data. The technologies that make this possible can also track and gamify aspects of our interpersonal, romantic relationships. Several authors have begun to challenge the ethical and normative implications of this development. In this article, we build upon this work to provide (...) a detailed ethical analysis of the Quantified Relationship. We identify eight core objections to the QR and subject them to critical scrutiny. We argue that although critics raise legitimate concerns, there are ways in which tracking technologies can be used to support and facilitate good relationships. We thus adopt a stance of cautious openness toward this technology and advocate the development of a research agenda for the positive use of QR technologies. (shrink)

The controversy around the accommodation of conscientious objections in medicine persists, especially for such contentious services as abortions. COs are typically considered in their negativ...

This special issue is a follow-up on a previous issue in this journal on self-management in psychiatry and psychosomatic medicine. It is the concluding chapter of a research project that sought to unpack and develop the implications of an understanding of self-management in psychiatry and psychosomatic medicine as “management of the self.”Over the last, 20 years, self-management has gained a central place in treatment programs across various medical disciplines. It positions patients as “expert-clients,” who (...) share knowledge, responsibilities and expertise with health professionals, and it actively involves them in the management of their own care (Crawford, Lee, May, & Active Self-Care... (shrink)

The author examines the impact of the technological capabilities of medicine to review the boundaries between enhancement and therapy, artificial and natural, normal and supernormal, revealed the relationship of medicalization trends and development of the «quantified self» movement, revealed some «garage biology» ideas in connection with the development of different practices of human transformation.

The article’s aim is to explore human hand allograft recipients’ postoperative experience of disownership and their gradual experience of their new hand as theirs, with the aid of the work of the French phenomenologist Maurice Merleau-Ponty. Many have used a Merleau-Pontinian perspective in the analysis of embodiment. Far fewer have used it in medico-ethical analysis. Drew Leder’s phenomenologically based ethics of organ donation and organ sale is an exception to this tendency. The article’s second aim is to examine Leder’s phenomenologically (...) based ethics of organ donation and organ sale. Though I find parts of Leder’s approach promising, I also elaborate a line of reasoning that draws on Merleau-Ponty, that does allow us to argue for certain kinds of organ donation and against organ sale—and that avoids some of the problems with Leder’s approach. This alternative route builds on the concept of the integrity of the body-subject. (shrink)

Self-management interventions are a heterogeneous group of interventions that are regarded as important tools for the management of chronic diseases. They consist of a broad range of techniques and are available for a large variety of chronic organic as well as mental conditions or illnesses, which are by definition generally chronic. These interventions aim that the individual concerned takes substantial responsibility for managing the symptoms, treatment, and physical and psychosocial consequences associated with having a chronic medical condition, disability or (...) disease. Alternate terms used in this context, among others, are self-care... (shrink)

This article argues that corporate management in the United States has expanded its scope beyond office walls and encompasses many aspects of workers' daily lives. One new element of corporate training is the micromanagement of sleep; self-help books, newspaper reports, magazine articles, and consulting firms currently advise workers and supervisors on optimizing productivity by cultivating certain sleep habits. Although consultants and self-help books make specific recommendations about sleep, most medical research is inconclusive about sleep's benefits for human performance. (...) Using the ideas of Michel Foucault and Gilles Deleuze as a philosophical backdrop, this article examines the complex and often contradictory links between self-help, medicine, and corporate governance. (shrink)