An unlearned carpenter of my acquaintance once said in my hearing: “There is very little difference between one man and another; but what little there is, is very important.” – William James (1890) On the question of “the individual and the community in pragmatism,” most people would probably think first of Dewey’s influential ideas about the individual and society: his conception of education as preparation for responsible citizenship, perhaps, or his critique of the “ragged individualism” o...

In lieu of an abstract, here is a brief excerpt of the content:Medical Tourism:Crossing Borders to Access Health CareHarriet Hutson Gray (bio) and Susan Cartier Poland (bio)Traveling abroad for one's health has a long history for the upper social classes who sought spas, mineral baths, innovative therapies, and the fair climate of the Mediterranean as destinations to improve their health. The newest trend in the first decade of the twenty-first century has the middle class traveling from developed countries to (...) those with emerging economies to avoid treatment delays, prohibitive costs for life-saving procedures, or simply high costs for elective surgery. Others leave to have access to assisted suicide in countries that have legalized it: Belgium, The Netherlands, and Switzerland. This new era of globalization in health care has arrived without the benefit of international standards, government oversight, or ethical and legal review.Howard Staab, a self-employed carpenter from North Carolina, flew to India for his medically necessary heart surgery, scheduled a side trip to the Taj Mahal, and returned home to work in North Carolina. He spent a total of less than $10,000, instead of the $200,000 required from the local hospital (I, Milstein and Smith 2006).At first blush, the outsourcing of medical care to India seems to be a particular solution for a particular problem. However, the particularity of Mr. Staab is not unique. His experience is emblematic of those patients in the United States with a medical need for major and elective procedures, but who also must bear the total cost of these procedures. These middle-class, under-insured Americans go abroad.In tandem with increasingly aggressive marketing campaigns, American hospitals and companies have begun to leverage their connections in Asia to grow the medical tourism business into a major economic force. What are the consequences of this?Several authors point to the effect on the host country's population, particularly the poor, to be pushed farther down the queue to receive adequate, affordable care. Resources are applied to the foreign trade instead of building the local [End Page 193] medical infrastructure. Another potential problem is the obligation of the home-country physician to provide follow-up care. What are the legal ramifications when the procedure was illegal to begin with? Are there opportunities for redress for medical errors?These factors may be converging into a "perfect storm" for health care in the U.S., in which the potential participation of the major insurance companies in promoting offshore care will be the tipping point in the precarious structure that represents the economic currents in health care. Third-party administrators and self-funded employers may be on the cutting edge in 2009 by providing incentives to employees to travel overseas for care.I. Economic ConsiderationsConnell, John. Medical Tourism: Sea, Sun, Sand and... Surgery. Tourism Management 27: 1093–1100, 2006.As evidence of the interest of traditional tour operators in this newer twist on the industry, the author explores medical tourism as an element of the growth of world tourism. In promoting medical tourism, he urges consideration of such issues as the privatization of health care, the foundational role of technology, and uneven access to health resources.Dunn, Philip. Medical Tourism Takes Flight. H and HN: Hospitals and Health Networks: 40–44, November 2007.Writing for U.S. health care executives, Dunn emphasizes that the reality of medical tourism competes with the local medical center for patients and their insurance dollars in a significant way. He examines the possibility that U.S. insurance plans soon may offer to pay for what is currently a cash only business and that the economic impact to the local medical center could be significant or even devastating.Frontiers of Health Services Management [Selected Articles] 24 (2), Winter 2007.In "Managing Healthcare Services in the Global Marketplace" (pp. 3–18), Bruce J. Fried and Dean M. Harris consider legal, ethical, and financial implications of the international workforce. In "Globalization of Health Care" (pp. 19–30), Lynn Schroth and Ruthy Khawahja point out that the transfer of comprehensive management expertise and intellectual property from U.S. medical centers to international sites is driving the success of collaboration between U.S. and foreign health care centers. In "Is... (shrink)

The purpose of this article is to discuss an external whistleblowing event that occurred after all internal whistleblowing through the hierarchy of the organization had failed. It is argued that an organization that does not support those that whistle blow because of violation of professional standards is indicative of a failure of organizational ethics. Several ways to build an ethics infrastructure that could reduce the need to resort to external whistleblowing are discussed. A relational ethics approach is presented as a (...) way to eliminate the negative consequences of whistleblowing by fostering an interdependent moral community to address ethical concerns. (shrink)

My strategy is to examine a recent trend in philosophical discussions of responsibility, a trend that tries, but I think ultimately fails, to give an acceptable analysis of the conditions of responsibility. It fails due to what at first appear to be deep and irresolvable metaphysical problems. It is here that I suggest that the condition of sanity comes to the rescue. What at first appears to be an impossible requirement for responsibility---the requirement that the responsible agent have created her- (...) or himself---turns out to be the vastly more mundane and non controversial requirement that the responsible agent must, in a fairly standard sense, be sane. (shrink)

We applaud Sedlakova and Trachsel’s work and their description of conversational artificial intelligence (CAI) as possessing a hybrid nature with features of both a tool and an agent (Sedlakova and...

Carazan's dream : Kant's early theory of freedom -- Kant's archimedean moment : remarks in observation concerning the feeling of the beautiful and the sublime -- Rousseau, Count Verri, and the true economy of human nature : lectures on anthropology, 1772-1781 -- The paradox of autonomy -- Moral hesitation in religion within the boundaries of bare reason -- Kant's true politics : Völkerrecht in toward perpetual peace and the metaphysics of morals -- Kant as educator : conflict of the faculties, (...) part one -- Archimedes revisited : honor and history in the conflict of the faculties, part two -- Kant's Jewish problem. (shrink)

The Rejected Body argues that feminist theorizing has been skewed toward non-disabled experience, and that the knowledge of people with disabilities must be integrated into feminist ethics, discussions of bodily life, and criticism of the cognitive and social authority of medicine. Among the topics it addresses are who should be identified as disabled; whether disability is biomedical, social or both; what causes disability and what could 'cure' it; and whether scientific efforts to eliminate disabling physical conditions are morally justified. Wendell (...) provides a remarkable look at how cultural attitudes towards the body contribute to the stigma of disability and to widespread unwillingness to accept and provide for the body's inevitable weakness. (shrink)

Her careful building of positions, her unique approaches to analyzing problems, and her excellent insights make this an important work for feminists, those ...

In the piece, “What Should ChatGPT Mean for Bioethics?” Professor Cohen proposes that the introduction of AI generally, and generative AI specifically, requires that patients be informed of, and co...

In lieu of an abstract, here is a brief excerpt of the content:Secrecy and Autonomy in Lewis CarrollSusan ShererVictorian novels quiver with morbid secrets and threatening discoveries. Unseen rooms, concealed doors, hidden boxes, masked faces, buried letters, all appear (and disappear) with striking regularity in the fiction of Victorian England. So many of these secret spaces contain children, and especially little girls, little girls in hidden spaces. The young Jane Eyre sits behind a curtain in the hidden window seat, escaping (...) the vindictive wrath of John Reed. Repulsed by her angry brother, Maggie Tulliver flees to the house attic, fantasizing that her family will fear that she has died. Little Dorrit withdraws from the common space of the Marshalsea into her private room above the prison, and Little Nell hides behind trees and walls, silently observing clandestine meetings. Finally the seven-year-old Alice falls down a rabbit-hole into a Wonderland, the dreamspace of her own psyche.Of these images, none can be more embedded in our cultural imagination than the child Alice dropping into the subterranean well of Wonderland. Indeed, of the many celebrated scenes in the Alice narratives, the most memorable, most potent, most quoted is Alice’s initial descent to the bottom of the rabbit-hole. The lastingness of this scene seems even greater when we realize that, although neither Carroll in Alice’s Adventures Underground nor Tenniel in the first edition of Wonderland illustrated the moment with a picture, it still became (along with the Mad Hatter’s tea party) one of the signature images of the Alice stories. Why, we must ask, did the Victorians retain, with a powerful tenacity, this vision of a little girl moving through a tight space toward the hidden world of Wonderland?The answer to this question is not—at least not wholly—that the scene simply represents a child’s metaphorical progress through the [End Page 1] birth canal 1 and that this, in turn, symbolizes some kind of rite of passage, a movement towards some deeper knowledge. For then how do we explain Alice’s conspicuous lack of internal development in both stories? Indeed, for a narrative that thematizes motion, Alice’s psychical growth remains disturbingly static. Throughout both narratives, Alice displays little emotional variation, for when she is not frustrated or anxious, she is, for the most part, vapid or expressionless. In fact, one is immediately struck by her coolness and indifference as she drops through the rabbit-hole. 2 Thus, because scene changes in Wonderland and Looking-Glass rarely betoken any emotional or intellectual modulations, Alice’s falling into Wonderland signals no internal transition.But the image does relocate her body and within this fictive world, location is everything. The scene gestures Alice’s departure, her separation, her movement towards an autonomy of which every child dreams when, in play, retreating to a hidden space. A child’s impulse to hide, to create a secret space, is one of the most compelling of all human wishes, the wish for autonomy and autarchy—“to be cut off from the word and yet owner of the world.” 3 Throughout Victorian literature, the fantasy of autonomy sets children dreaming of far-away worlds and hidden gardens. The young Cathy and Heathcliff flee to the isolated moors, filling the open, empty space with dreams of unrestricted freedom. Little Dorrit envisages the locked garden behind the Marshalsea as an alternative world to the foul prison atmosphere. And what are the Brontës’s Angria and Gondol but disconnected, self-governing realms imagined from the standpoint of childhood powerlessness? The image, then, of Alice’s fall begins to fulfill this powerful wish for autonomy, which culminates, finally, in Alice’s self-coronation at the end of Looking-Glass. Yet it is only within the child’s willing imagination that a secret space can encroach so closely upon autonomy, for as we shall see, secrecy and autonomy are irreconcilable not only in the demanding world of realism, but even in the more elastic world of Carrollian fantasy.IAlice’s descent into Wonderland and her entrance into the Looking-Glass kingdom would seem like ripe metaphors for Carroll to explore the thoughts and fantasies of Alice’s psyche. What could be more... (shrink)

The Unity of Reason is the first major study of Kant's account of reason. It argues that Kant's wide-ranging interests and goals can only be understood by redirecting attention from epistemological questions of his work to those concerning the nature of reason. Rather than accepting a notion of reason given by his predecessors, a fundamental aim of Kant's philosophy is to reconceive the nature of reason. This enables us to understand Kant's insistence on the unity of theoretical and practical reason (...) as well as his claim that his metaphysics was driven by practical and political ends. Neiman begins by discussing the historical roots of Kant's conception of reason, and by showing Kant's solution to problems which earlier conceptions left unresolved. Kant's notion of reason itself is examined through a discussion of all the activities Kant attributes to reason. In separate chapters discussing the role of reason in science, morality, religion, and philosophy, Neiman explores Kant's distinctions between reason and knowledge, and his difficult account of the regulative principles of reason. Through examination of these principles in Kant's major and minor writings, The Unity of Reason provides a fundamentally new perspective on Kant's entire work. (shrink)

Continuing the debate over whether consciousness causes behaviour or plays no functional role in it, leading scholars discuss the question in terms of neuroscience, philosophy, law, and public policy.

In lieu of an abstract, here is a brief excerpt of the content:Secrecy and Autonomy in Lewis CarrollSusan ShererVictorian novels quiver with morbid secrets and threatening discoveries. Unseen rooms, concealed doors, hidden boxes, masked faces, buried letters, all appear (and disappear) with striking regularity in the fiction of Victorian England. So many of these secret spaces contain children, and especially little girls, little girls in hidden spaces. The young Jane Eyre sits behind a curtain in the hidden window seat, escaping (...) the vindictive wrath of John Reed. Repulsed by her angry brother, Maggie Tulliver flees to the house attic, fantasizing that her family will fear that she has died. Little Dorrit withdraws from the common space of the Marshalsea into her private room above the prison, and Little Nell hides behind trees and walls, silently observing clandestine meetings. Finally the seven-year-old Alice falls down a rabbit-hole into a Wonderland, the dreamspace of her own psyche.Of these images, none can be more embedded in our cultural imagination than the child Alice dropping into the subterranean well of Wonderland. Indeed, of the many celebrated scenes in the Alice narratives, the most memorable, most potent, most quoted is Alice’s initial descent to the bottom of the rabbit-hole. The lastingness of this scene seems even greater when we realize that, although neither Carroll in Alice’s Adventures Underground nor Tenniel in the first edition of Wonderland illustrated the moment with a picture, it still became (along with the Mad Hatter’s tea party) one of the signature images of the Alice stories. Why, we must ask, did the Victorians retain, with a powerful tenacity, this vision of a little girl moving through a tight space toward the hidden world of Wonderland?The answer to this question is not—at least not wholly—that the scene simply represents a child’s metaphorical progress through the [End Page 1] birth canal 1 and that this, in turn, symbolizes some kind of rite of passage, a movement towards some deeper knowledge. For then how do we explain Alice’s conspicuous lack of internal development in both stories? Indeed, for a narrative that thematizes motion, Alice’s psychical growth remains disturbingly static. Throughout both narratives, Alice displays little emotional variation, for when she is not frustrated or anxious, she is, for the most part, vapid or expressionless. In fact, one is immediately struck by her coolness and indifference as she drops through the rabbit-hole. 2 Thus, because scene changes in Wonderland and Looking-Glass rarely betoken any emotional or intellectual modulations, Alice’s falling into Wonderland signals no internal transition.But the image does relocate her body and within this fictive world, location is everything. The scene gestures Alice’s departure, her separation, her movement towards an autonomy of which every child dreams when, in play, retreating to a hidden space. A child’s impulse to hide, to create a secret space, is one of the most compelling of all human wishes, the wish for autonomy and autarchy—“to be cut off from the word and yet owner of the world.” 3 Throughout Victorian literature, the fantasy of autonomy sets children dreaming of far-away worlds and hidden gardens. The young Cathy and Heathcliff flee to the isolated moors, filling the open, empty space with dreams of unrestricted freedom. Little Dorrit envisages the locked garden behind the Marshalsea as an alternative world to the foul prison atmosphere. And what are the Brontës’s Angria and Gondol but disconnected, self-governing realms imagined from the standpoint of childhood powerlessness? The image, then, of Alice’s fall begins to fulfill this powerful wish for autonomy, which culminates, finally, in Alice’s self-coronation at the end of Looking-Glass. Yet it is only within the child’s willing imagination that a secret space can encroach so closely upon autonomy, for as we shall see, secrecy and autonomy are irreconcilable not only in the demanding world of realism, but even in the more elastic world of Carrollian fantasy.IAlice’s descent into Wonderland and her entrance into the Looking-Glass kingdom would seem like ripe metaphors for Carroll to explore the thoughts and fantasies of Alice’s psyche. What could be more... (shrink)

Allowing algorithms to guide or determine decision-making in ethically complex situations, and eventually satisfying the need for good clinical ethics consultation work, is a philosophically intere...

: Chronic illness is a major cause of disability, especially in women. Therefore, any adequate feminist understanding of disability must encompass chronic illnesses. I argue that there are important differences between healthy disabled and unhealthy disabled people that are likely to affect such issues as treatment of impairment in disability and feminist politics, accommodation of disability in activism and employment, identification of persons as disabled, disability pride, and prevention and "cure" of disabilities.

Bioethics has paid surprisingly little attention to the special problems faced by women and to feminist analyses of current health care issues other than ...

We propose that the crucial difference between human cognition and that of other species is the ability to participate with others in collaborative activities with shared goals and intentions: shared intentionality. Participation in such activities requires not only especially powerful forms of intention reading and cultural learning, but also a unique motivation to share psychological states with others and unique forms of cognitive representation for doing so. The result of participating in these activities is species-unique forms of cultural cognition and (...) evolution, enabling everything from the creation and use of linguistic symbols to the construction of social norms and individual beliefs to the establishment of social institutions. In support of this proposal we argue and present evidence that great apes understand the basics of intentional action, but they still do not participate in activities involving joint intentions and attention. Human children's skills of shared intentionality develop gradually during the first 14 months of life as two ontogenetic pathways intertwine: the general ape line of understanding others as animate, goal-directed, and intentional agents; and a species-unique motivation to share emotions, experience, and activities with other persons. The developmental outcome is children's ability to construct dialogic cognitive representations, which enable them to participate in earnest in the collectivity that is human cognition. Key Words: collaboration; cooperation; cultural learning; culture; evolutionary psychology; intentions; shared intentionality; social cognition; social learning; theory of mind; joint attention. (shrink)

Plato articulates a deep perplexity about inquiry in ?Meno's Paradox??the claim that one can inquire neither into what one knows, nor into what one does not know. Although some commentators have wrestled with the paradox itself, many suppose that the paradox of inquiry is special to Plato, arising from peculiarities of the Socratic elenchus or of Platonic epistemology. But there is nothing peculiarly Platonic in this puzzle. For it arises, too, in classical Indian philosophical discussions, where it is formulated with (...) great clarity, and analysed in a way that casts it in a new light. We present three treatments of the puzzle in Indian philosophy, as a way of refining and sharpening our understanding of the paradox, before turning to the most radical of the Indian philosophers to tackle it. The Indian philosophers who are optimistic that the paradox can be resolved appeal to the existence of prior beliefs, and to the resources embedded in language to explain how we can investigate, and so move from ignorance to knowledge. Highlighting this structural feature of inquiry, however, allows the pessimist philosopher to demonstrate that the paradox stands. The incoherence of inquiry is rooted in the very idea of aiming our desires at the unknown. Asking questions and giving answers rests on referential intentions targeting objects in a region of epistemic darkness, and so our ?inquiry sceptic? also finds structurally similar forms of incoherence in the pragmatics of interrogative discourse. (shrink)

Every action, touch, utterance, and look, every listening, taste, smell, and feel is a living question; but it is no ordinary propositional one-by-one question, rather it is a plenisentient sensing and probing non-propositional enquiry about how our world is, in its present continuous sense, and in relation to how we anticipate its becoming. I will take this assumption as my first premise and, by using the notion of enkinaesthesia, I will explore the ways in which an agent’s affectively-saturated co-engagement with (...) its world establishes patterns of co-articulation of meaning within the anticipatory affective dynamics and the experiential entanglement necessary for expedient action and adaptation. In advancing this thesis I will reject the minimalist notions of embodiment by amplifying and extending the claims made by the most radical of the embodied mind theories. Crucially, I will offer a new wave of embodiment theory which has at its core the radical extension of sensorimotor affect into the life and being of other agents where their experience is for us both direct and immediate. This I will present as an immanent intercorporeality. (shrink)

Jung: A Feminist Revision explores the relationship between feminist theory and Jungian studies. It combines an original student-friendly introduction to Jung, his life and work, his treatment of gender and the range of post-Jungian gender theory, with new research linking Jung to deconstruction, post-Freudian feminism, postmodernism, the sublime, and the postmodern body. Feminism has neglected Jung to its own detriment. While evaluating the reasons for this neglect, Jung: A Feminist Revision uses the diversity of feminist critical tools from historical analysis (...) to poststructuralism. In a fresh and illuminating study, this book provides both a critique of Jung and demonstrates his positive potential for future feminisms. New theories are explored which develop relationships between the work of Jung and Jacques Lacan, Luce Irigaray, Hélène Cixous, Julia Kristeva and Judith Butler. Particular attention is paid to the growth of post-Jungian studies of gender. This includes a cogent study of the tradition of Jungian feminism that looks to the feminine principle′ and narratives of goddesses. Jungian ′goddess′ feminism′s enduring appeal is re-examined in the context of postmodern re-thinking of subjectivity and gender. The book proposes a re-orientation of Jungian studies in its relationship to feminism. The result is an accessible text that introduces Jung and sets out his relevance to contemporary feminisms. This book will be essential reading for undergraduates and postgraduates studying feminist theory, psychoanalytical theory, literature and psychology. (shrink)

In "Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical?," Wilkinson (2021) argues that the use of frailty scores in ICU triage does not necessarily involve discrimination on the basis of disability. In support of this argument, he claims, “it is not the disability per se that the score is measuring – rather it is the underlying physiological and physical vulnerability." While we appreciate the attention Wilkinson explicitly pays to disability in this piece, we find the (...) distinction between disability and underlying vulnerability untenable both theoretically and practically. In this peer commentary, we begin with a brief overview of research in philosophy of disability concerning the meaning of the concept itself. We argue that this research demonstrates that many forms of disability do not involve underlying vulnerabilities, and, furthermore, that Wilkinson equivocates between "disability" understood as a medical category vs. "disability" understood as a feature of lived experience. We reject Wilkinson’s distinction on these grounds and offer further considerations to avoid disability discrimination in emergency and crisis standards of care contexts. (shrink)

Susan Sherwin ist eine kanadische Philosophin und Wegbereiterin der feministischen Ethik. Bis zu ihrer Emeritierung war sie lange Zeit Professorin an der Dalhousie University in Halifax, Kanada. In ihrem Text „Foundations, Frameworks, Lenses: The Role of Theories in Bioethics“ von 1999 plädiert sie für eine kritische Reflexion gängiger Metaphern in der Bioethik.

If you're woke, you're left. If you're left, you're woke. We blur the terms, assuming that if you're one you must be the other. That, Susan Neiman argues, is a dangerous mistake. The intellectual roots and resources of wokeism conflict with ideas that have guided the left for more than 200 years: a commitment to universalism, a firm distinction between justice and power, and a belief in the possibility of progress. Without these ideas, Neiman argues, they will continue to (...) undermine their own goals and drift, inexorably and unintentionally, towards the right. In the long run, they risk becoming what they despise. One of the world's leading philosophical voices, Neiman makes this case by tracing the malign influence of two titans of twentieth-century thought, Michel Foucault and Carl Schmitt, whose work undermined ideas of justice and progress and portrayed social life as an eternal struggle of us against them. A generation schooled with these voices in their heads, raised in a broader culture shaped by the ruthless ideas of neoliberalism and evolutionary psychology, has set about changing the world. It's time they thought again. (shrink)

We contest two claims: (1) that language, understood as the processing of abstract symbolic forms, is an instrument of cognition and rational thought, and (2) that conventional notions of turn-taking, exchange structure, and move analysis, are satisfactory as a basis for theorizing communication between living, feeling agents. We offer an enkinaesthetic theory describing the reciprocal affective neuro-muscular dynamical flows and tensions of co- agential dialogical sense-making relations. This “enkinaesthetic dialogue” is characterised by a preconceptual experientially recursive temporal dynamics forming the (...) deep extended melodies of relationships in time. An understanding of how those relationships work, when we understand and are ourselves understood, when communication falters and conflict arises, will depend on a grasp of our enkinaesthetic intersubjectivity. (shrink)