Habermas's paradigm of communicative action is usually taken to be pretty much dominated by consensus, "Yes-saying." What if this were a radically one-sided perception? We take up this unorthodox position by arguing that "no-saying" in this paradigm is typically overlooked and underemphasized. To demonstrate this, we consider how negativity is figured at the most basic onto-ethical level in communicative action, as well as expressed in civil disobedience, a phenomenon to which Habermas assigns the remarkable role of "touchstone" (Prufstein) of constitutional (...) democracy. Once the importance of no-saying is drawn out, the paradigm looks distinctly less hostile to dissensus and agonism in democratic life. (shrink)

From a phenomenological perspective, skin is an important boundary. My model here is the psychology of interpersonal relations . It is the behaviour of O that is visible from the perspective of P, the perceiver. Whether or not one is justified in going beyond the evidence available is a matter of some controversy in psychological circles e.g. between behaviourists and gestalt psychologists . Here the skin is an important boundary, at least in the visual modality. The divergence in perspective between (...) actor and observer is due to the fact that they occupy two different points in space/time . There is less of a divergence in perspective between speaker and listener since they could both be one and the same person . Skinner , in a pun on his own name, observed that in speech skin is not at all an important boundary. The implications for social psychology of this asymmetry between vision and speech are explored more fully . An attempt is made to identify when the skin is and when it is not a significant boundary. The history of psychology is briefly reviewed in the light of this distinction. (shrink)

Taking its departure from current debates over social capital, this article presents new textual findings in a backward-revealing conceptual history. In particular, it analyzes the texts and contexts of Lyda J. Hanifan who was rediscovered by Robert Putnam as having (allegedly first) used the term; it offers discoveries of earlier uses of the term and concept-most notably by John Dewey-thereby introducing critical pragmatism as another tradition of social capital; and it recovers features of the critique of political economy in (...) the nineteenth century-from Bellamy to Marshall to Sidgwick to Marx-that assessed "capital from the social point of view," especially cooperative associations. While it ends with Marx's use of "social capital," Dewey is its central figure. The article concludes by returning to the present and offering work, sympathy, civic education, and a critical stance as emergent themes from this conceptual history that might enrich current debates. (shrink)

How should we read Jürgen Habermas, and is it possible to defend a nonfoundationalist conception of communicative reason? In “‘No-Saying’ in Habermas,” Stephen K. White and Evan Robert Farr read Habermas’s writings on civil disobedience through the idea of no-saying, which they believe to be “just as primordial” as consensus or yes-saying in Habermas’s theory of communicative reason. By underlining this otherwise underdeveloped aspect of no-saying in Habermas’s work, White and Farr believe that it is possible to (...) avoid an unwarranted emphasis on consensus and to salvage a non-foundationalist conception of communicative reason. In developing their argument, White and Farr use my deconstructive reading of Habermas’s writings on civil disobedience as a point of contrast, and this gives me the opportunity to clarify the strategy of the deconstructive reading and the differences over foundationalism that divide my deconstructive approach from White and Farr’s reconstruction of Habermas’s communicative paradigm. I argue (1) that they misconceive the relationship between the deconstruction and the deconstructed text and (2) that they end up defending a view of communicative voice too uncritical of what it means to have a voice. (shrink)

Today's medicine is spiritually deflated and morally adrift; this book explains why and offers an ethical framework to renew and guide practitioners in fulfilling their profession to heal. What is medicine and what is it for? What does it mean to be a good doctor? Answers to these questions are essential both to the practice of medicine and to understanding the moral norms that shape that practice. The Way of Medicine articulates and defends an account of medicine and medical ethics (...) meant to challenge the reigning provider of services model, in which clinicians eschew any claim to know what is good for a patient and instead offer an array of "health care services" for the sake of the patient's subjective well-being. Against this trend, Farr Curlin and Christopher Tollefsen call for practitioners to recover what they call the Way of Medicine, which offers physicians both a path out of the provider of services model and also the moral resources necessary to resist the various political, institutional, and cultural forces that constantly push practitioners and patients into thinking of their relationship in terms of economic exchange. Curlin and Tollefsen offer an accessible account of the ancient ethical tradition from which contemporary medicine and bioethics has departed. Their investigation, drawing on the scholarship of Leon Kass, Alasdair MacIntyre, and John Finnis, leads them to explore the nature of medicine as a practice, health as the end of medicine, the doctor-patient relationship, the rule of double effect in medical practice, and a number of clinical ethical issues from the beginning of life to its end. In the final chapter, the authors take up debates about conscience in medicine, arguing that rather than pretending to not know what is good for patients, physicians should contend conscientiously for the patient's health and, in so doing, contend conscientiously for good medicine. The Way of Medicine is an intellectually serious yet accessible exploration of medical practice written for medical students, health care professionals, and students and scholars of bioethics and medical ethics. (shrink)

It is common wisdom that today’s medicine focuses too much on treating those who are sick and too little on preventing the sickness in the first place. This essay proposes that Jesus’ teaching in the Sermon on the Mount challenges that assumption and the preventive medicine to which it has given rise. In light of Jesus’ teaching, the essay identifies four apparent problems with much of preventive medicine. It then offers four heuristics that might form a basic Christian logic for (...) medicalizing risk—for discerning when and why it would be fitting, wise, and faithful for Christians to make use of medicine to avoid future illness and death. (shrink)

Uncivil behavior by leaders may be viewed as an effective way to motivate employees. However, supervisor incivility, as a form of unethical supervision, may be undercutting employees’ ability to do their jobs. We investigate linkages between workplace incivility and perceived work ability, a variable that captures employees’ appraisals of their ability to continue working in their jobs. We draw upon the appraisal theory of stress and social identity theory to examine incivility from supervisors as an antecedent to PWA, and to (...) investigate job involvement and grit as joint moderators of this association. Results from data collected in two samples of working adults provided evidence for three-way interactions in relation to PWA. Among employees with high levels of grit, there was no significant relation between supervisor incivility and PWA, regardless of employee job involvement. However, we found some evidence that for those low in grit, having high job involvement was associated with a stronger relationship between supervisor incivility and PWA. Findings attest to the importance of unethical supervisor behavior, showing the potential for supervisor incivility to erode PWA, as well as the importance of grit as a potential buffer. (shrink)

It is often said that the world is explained by laws of nature together with initial conditions. But does that mean initial conditions don’t require further explanation? And does the explanatory role played by initial conditions entail or require that time has a preferred direction? This chapter looks at the use of the ‘initialness defence’ in physics, the idea that initial conditions are intrinsically special in that they don’t require further explanation, unlike the state of the world at other times. (...) Such defences commonly assume a primitive directionality of time to distinguish between initial and final conditions. Using the case study of the time-asymmetry of thermodynamics and the so-called ‘past hypothesis’ — the hypothesis that the early universe was in a state of very low entropy —, I outline and support a deflationary account of the initialness defence that does not pre- suppose a basic directionality of time, and argue that there is a relevant explanatory asymmetry between initial conditions and the state of systems at other times only if certain causal conditions are satisfied. Hence, the initialness defence is available to those who reject a fundamental direction of time. (shrink)

While science is taken to differ from non-scientific activities in virtue of its methodology, metaphysics is usually defined in terms of its subject matter. However, many traditional questions of metaphysics are addressed in a variety of ways by science, making it difficult to demarcate metaphysics from science solely in terms of their subject matter. Are the methodologies of science and metaphysics sufficiently distinct to act as criteria of demarcation between the two? In this chapter we focus on several important overlaps (...) in the methodologies used within science and metaphysics in order to argue that focusing solely on methodology is insufficient to offer a sharp demarcation between metaphysics and science, and consider the consequences of this for the wider relationship between science and metaphysics. (shrink)

Abordaré la crítica de Axel Honneth a la primera Escuela de Frankfurt y su aparente omisión de Herbert Marcuse. Defenderé a Marcuse contra algunas de las críticas hechas por Honneth a la teoría crítica temprana de la Escuela de Frankfurt. Luego argumentaré que Marcuse siempre estuvo en busca de una subjetividad radical, incluso cuando advirtió contra los mecanismos unidimensionales en curso de producción de sujetos. Finalmente, mostraré que Honneth también construye su proyecto en torno a la búsqueda de una subjetividad (...) radical, pero aborda el problema a través de una teoría de la intersubjetividad que complementa el proyecto de Marcuse. (shrink)

If man has no nature - if our intellect and understanding are products of our own activities - do we possess a key to self-modification? Are we free to re-make mankind? Sartre champions the romantic idea that we can - by sheer determination - begin afresh. Oakeshott is struck by the vandalism of such a project - he seeks to defend political culture from degradation by meddling academics. The Radical and Conservative understanding of social order and the human self are (...) compared in this in-depth analysis of two contrasting philosophies. (shrink)

In the two feature articles for this volume, Gruber et al and Buonomano & Rovelli focus on what the former call the 'two-times problem', in short, the apparent lack of fit between time as described by physical science and our own temporal experience, where 'experience' involves things like memory, anticipation, and perception of change and motion. In this short note I'll make the case that the twotimes problem is less serious than it is often made out to be in the (...) specific case of features like 'passage ' and 'presentness' that are central to the 'A-theory' of time ---the theory that holds time to be composed of dynamic regions of 'past', 'present' and future', and for time to genuinely flow or pass.My contention is three-fold: (1) the two-times problem is better understood as a three-times problem: rather than a conflict between 'physical' and 'manifest' time, what we have in the case of time is differences between the time of physics, the time of experience, and the 'folk' concept of time. (2) Understanding the problem in this way helps deflate certain problems about the relationship of these three pictures; the time of experience and the time of physics are less obviously in a problematic conflict than often supposed; and the folk concept of time is what brings in problematic features of time hard to fit with either the time of physics of experience. (3) Understanding the time of experience as independent from the folk concept of time better fits the actual aims of the... (shrink)

The medical profession’s increasing acceptance of “physician aid-in-dying” indicates the ascendancy of what we call the provider-of-services model for medicine, in which medical “providers” offer services to help patients maximize their “well-being” according to the wishes of the patient. This model contrasts with and contradicts what we call the Way of Medicine, in which medicine is a moral practice oriented to the patient’s health. A steadfast refusal intentionally to harm or kill is a touchstone of the Way of Medicine, one (...) unambiguously affirmed by Christians through the centuries. Moreover, physician aid-in-dying contradicts one of the distinctive contributions that the Christian era brought to medicine, namely, a taken-for-granted solidarity between medical practitioners and those suffering illness and disability. Insofar as medical practitioners cooperate in aid-in-dying, they contradict this solidarity and undermine the trust that patients need to allow themselves to be cared for by physicians when they are sick and debilitated. (shrink)

Market metaphors have come to dominate discourse on medical practice. In this essay, we revisit Peter Berger and colleagues’ analysis of modernization in their book The Homeless Mind and place that analysis in conversation with Max Weber’s 1917 lecture “Science as a Vocation” to argue that the rise of market metaphors betokens the carry-over to medical practice of various features from the institutions of technological production and bureaucratic administration. We refer to this carry-over as the product presumption. The product presumption (...) foregrounds accidental features of medicine while hiding its essential features. It thereby confounds the public understanding of medicine and impedes the professional achievement of the excellences most central to medical practice. In demonstrating this pattern, we focus on a recent article, “Physicians, Not Conscripts—Conscientious Objection in Health Care,” in which Ronit Stahl and Ezekiel Emanuel decry conscientious refusals by medical practitioners. We demonstrate that Stahl and Emanuel’s argument depends on the product presumption, ignoring and undermining central features of good medicine. We conclude by encouraging conscientious resistance to the product presumption and the language it engenders. (shrink)

Cognitive science has recently made some startling discoveries about temporal experience, and these discoveries have been drafted into philosophical service. We survey recent appeals to cognitive science in the philosophical debate over whether time objectively passes. Since this research is currently in its infancy, we identify some directions for future research.

Theories of discourse bring to realism new ideas about how knowledge develops and how representations of reality are influenced. We gain an understanding of the conceptual aspect of social life and the processes by which meaning is produced. This collection reflects the growing interest realist critics have shown towards forms of discourse theory and deconstruction. The diverse range of contributions address such issues as the work of Derrida and deconstruction, discourse theory, Eurocentrism and poststructuralism. What unites all of the contributions (...) is a sense that it is essential to provide a realist alternative to the hitherto dominance of social constructionism, hermeneutics and postmodernism, over many of the issues discussed. By developing a realist perspective the different authors attempt to embed discourse within the structured nature of the reality of the world. Realism can situate language, discourse and ideology within context specific, or 'causally efficacious' circumstances. Realism can help to uncover issues of power, representation, and subjectivity and how discursive and other social practices produce real effects. This can help us understand the manner in which social structures are reproduced through various forms of ideology and discourse. And by knowing this, we can start to address questions concerning human emancipation and how the world is to be transformed. (shrink)

For most of the past generation, clinicians have been taught to treat patients' pain until the patient says it is relieved. The opioid crisis has forced both clinicians and patients to reconsider that approach. This essay considers how Christians in particular might assume and seek to overcome their experiences of persistent pain. Wise and faithful responses to pain, especially chronic pain, can take their bearings from how early Christians made sense of the place of both medicine and suffering in a (...) faithful life. This results in not asking medicine to resolve persistent pain, especially not through the use of opioids. Resisting the impulse to medicalize chronic pain will require patience on the part of those who suffer, and both patience and fortitude on the part of the clinicians to whom they present. (shrink)

Winner of the 1975 National Book Award, this brilliant and widely acclaimed book is a powerful philosophical challenge to the most widely held political and social positions of our age--liberal, socialist, and conservative.

Practitioners of palliative medicine frequently encounter patients suffering distress caused by uncontrolled pain or other symptoms. To relieve such distress, palliative medicine clinicians often use measures that result in sedation of the patient. Often such sedation is experienced as a loss by patients and their family members, but sometimes such sedation is sought as the desired outcome. Peace is wanted. Comfort is needed. Sedation appears to bring both. Yet to be sedated is to be cut off existentially from human experience, (...) to be made incapable of engaging self-consciously in any human action. To that extent, it seems that to lose consciousness is to lose something of real value. In this paper, I describe how sedation and the question of intentionally bringing about sedation arise in the care of patients with advanced illness, and I propose heuristics to guide physicians, including Christian physicians, who seek to relieve suffering without contradicting their profession to heal. (shrink)

This is a paradigmatic work of contemporary philosophy.

Robert Stern investigates how scepticism can be countered by using transcendental arguments concerning the necessary conditions for the possibility of experience, language, or thought. He shows that the most damaging sceptical questions concern neither the certainty of our beliefs nor the reliability of our belief-forming methods, but rather how we can justify our beliefs.

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

It is an unresolved question in quantum mechanics whether quantum states apply to individual quantum systems, or to ensembles of quantum systems. We show by way of a thought experiment that quantum states apply only to ensembles of quantum systems. A further unresolved question is whether quantum systems possess ontic states. If a quantum state is the state of an ensemble, as we claim, the answer to this question is that quantum states are not ontic. However, a notable recent result (...) in quantum foundations shows that if there are any ontic states at all, then the quantum state must be ontic. Collectively, these two results imply that there are no ontic states. We examine the assumptions required for these results, and suggest that the retrospective effect on state preparations by entangling measurements provides good reason for relaxing the assumption of preparation independence at the ontic level. (shrink)

Robert Hanna presents a fresh view of the Kantian and analytic traditions that have dominated continental European and Anglo-American philosophy over the last two centuries, and of the connections between them. But this is not just a study in the history of philosophy, for out of this emerges Hanna's original approach to two much-contested theories that remain at the heart of contemporary philosophy. Hanna puts forward a new 'cognitive-semantic' interpretation of transcendental idealism, and a vigorous defense of Kant's theory (...) of analytic and synthetic necessary truth, making this compelling reading for all who are interested in these fundamental philosophical issues. (shrink)

Doctors often refuse patients' REQUESTS, even when patients request interventions that are legal and permitted by the medical profession. This is a fact about the practice of medicine so familiar that it is easy to overlook.Doctors' refusals are neither new nor infrequent, and only a small minority occasion any controversy. Surgeons refuse to operate when they believe a surgery is unlikely to succeed. Physicians refuse medications when they believe the medications are unlikely to be helpful. Clinicians refuse requested interventions because (...) of concerns about safety or efficacy, and they refuse because of less tangible concerns that are no less real. Some pediatricians refuse to supplement the growth hormone of boys... (shrink)

While the COVID-19 pandemic riveted public attention on questions regarding how to respond reasonably to risk of illness, everyday medical care involves more mundane forms of pharmaceutical risk management for conditions like high blood pressure, prediabetes, or high cholesterol. This essay, and the collection it introduces, explore medicalization of risk as a theological problem, drawing on resources such as the Sermon on the Mount that caution us about the potential dangers of risk management to Christian discipleship. Medicalization of risk threatens (...) to become an idol that promises immanent security at the cost of one’s relationship with God and others. It misleads contemporary society as to the true human end and medicine’s own capabilities to provide temporal salvation. The essays in this special issue illustrate these problems with respect to pharmaceutical risk management. (shrink)

One of our great behavioral scientists, the bestselling author of Behave, plumbs the depths of the science and philosophy of decision-making to mount a devastating case against free will, an argument with profound consequences Robert Sapolsky's Behave, his now classic account of why humans do good and why they do bad, pointed toward an unsettling conclusion: We may not grasp the precise marriage of nature and nurture that creates the physics and chemistry at the base of human behavior, but (...) that doesn't mean it doesn't exist. Now, in Determined, Sapolsky takes his argument all the way, mounting a brilliant (and in his inimitable way, delightful) full-frontal assault on the pleasant fantasy that there is some separate self telling our biology what to do. Determined offers a marvelous synthesis of what we know about how consciousness works-the tight weave between reason and emotion and between stimulus and response in the moment and over a life. One by one, Sapolsky tackles all the major arguments for free will and takes them out, cutting a path through the thickets of chaos and complexity science and quantum physics, as well as touching ground on some of the wilder shores of philosophy. He shows us that the history of medicine is in no small part the history of learning that fewer and fewer things are somebody's "fault"; for example, for centuries we thought seizures were a sign of demonic possession. Yet, as he acknowledges, it's very hard, and at times impossible, to uncouple from our zeal to judge others and to judge ourselves. Sapolsky applies the new understanding of life beyond free will to some of our most essential questions around punishment, morality, and living well together. By the end, Sapolsky argues that while living our daily lives recognizing that we have no free will is going to be monumentally difficult, doing so is not going to result in anarchy, pointlessness, and existential malaise. Instead, it will make for a much more humane world. (shrink)

In this article, we first give a normative account of the doctor–patient relationship as: oriented to the good of the patient’s health; motivated by a vocational commitment; and characterized by solidarity and trust. We then look at the difference that Christianity can, and we believe, should, make to that relationship, so understood. In doing so, we consolidate and expand upon some claims we have made in a forthcoming book, Ethics and the Healing Profession.1.

Classical American pragmatism: the pragmatist -- Enlightenment-and its problematic semantics -- Analyzing pragmatism: pragmatics and pragmatisms -- A Kantian rationalist pragmatism: pragmatism -- Inferentialism, and modality in Sellars's arguments against -- Empiricism -- Linguistic pragmatism and pragmatism about norms: an arc of -- Thought from Rorty's eliminative materialism to his pragmatism -- Vocabularies of pragmatism: synthesizing naturalism and -- Historicism -- Towards an analytic pragmatism: meaning-use analysis -- Pragmatism, expressivism, and anti-representationalism: -- Local and global possibilities.

What role should the physician's conscience play in the practice of medicine? Much controversy has surrounded the question, yet little attention has been paid to the possibility that disputants are operating with contrasting definitions of the conscience. To illustrate this divergence, we contrast definitions stemming from Abrahamic religions and those stemming from secular moral tradition. Clear differences emerge regarding what the term conscience conveys, how the conscience should be informed, and what the consequences are for violating one's conscience. Importantly, these (...) basic disagreements underlie current controversies regarding the role of the clinician's conscience in the practice of medicine. Consequently participants in ongoing debates would do well to specify their definitions of the conscience and the reasons for and implications of those definitions. This specification would allow participants to advance a more philosophically and theologically robust conversation about the means and ends of medicine. (shrink)