Transplantation continues to push the frontiers of medicine into domains that summon forth troublesome ethical questions. Looming on the frontier today is human facial transplantation. We develop criteria that, we maintain, must be satisfied in order to ethically undertake this as-yet-untried transplant procedure. We draw on the criteria advanced by Dr. Francis Moore in the late 1980s for introducing innovative procedures in transplant surgery. In addition to these we also insist that human face transplantation must meet all the ethical requirements (...) usually applied to health care research. We summarize the achievements of transplant surgery to date, focusing in particular on the safety and efficacy of immunosuppressive medications. We also emphasize the importance of risk/benefit assessments that take into account the physical, aesthetic, psychological, and social dimensions of facial disfiguration, reconstruction, and transplantation. Finally, we maintain that the time has come to move facial transplantation research into the clinical phase. (shrink)

This essay has three aims. We wish to emphasize that (1) one of the main theses of Jaspers’ General Psychopathology is that our knowledge is limited to particular points of view within which alone evidence can be interpreted and assessed; (2) this early position of Jaspers (already present in the 1913 edition) has found indirect support recently in a carefully reasoned book by the prestigious philosopher of natural science, Ronald N. Giere, entitled Scientific Perspectivism (2006); and (3) Jaspers’ conviction regarding (...) the perspectivalism of knowledge remained powerfully influential throughout all his thought, even in his later philosophy. (shrink)

The clinical ethics propounded by Richard Zaner is unique. Partly because of his phenomenological orientation and partly because of his own daily practice as a clinical ethicist in a large university hospital, Zaner focuses on the particular concrete situations in which patients and their families confront illness and injury and struggle toward workable ways for dealing with them. He locates ethical reality in the clinical encounter. This encounter encompasses not only patient and physician but also the patients family and friends (...) and indeed the entire lifeworld in which the patient is still striving to live. In order to illuminate the central moral constituents of such human predicaments, Zaner discusses the often-overlooked features of disruption and crisis, the changed self, the patients dependence and the physicians power, the violation of personal boundaries and their necessary reconfiguring, and the art of listening. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 327-329 [Access article in PDF] Husserlian Comments on Blankenburg's "Psychopathology of Common Sense" Osborne P. Wiggins, Michael Alan Schwartz, and Jean Naudin In this essay, Wolfgang Blankenburg sketches his influential view that some of the disturbances of schizophrenia in particular can be interpreted as a pathology of common sense. We think it important at the outset, however, to avoid possible misunderstandings (...) of Blankenburg's point. It is perhaps unfortunate that this point is expressed by use of the phrase, "common sense." As Blankenburg's own essay shows, even among the learned, "common sense" has no definite or univocal meaning. Therefore, it is entirely possible to find many people who, under some conception of "common sense," appear to lack common sense and yet should not be deemed schizophrenic. Consequently, it is probably best to avoid the ambiguous phrase "common sense" altogether and seek to comprehend Blankenburg's point in other terms. That is precisely what we shall attempt here. We do endorse Blankenburg's view. Moreover, we shall pursue his suggestions that a Husserlian phenomenology of our experience of the life-world may provide the basis for developing the kind of psychopathology he seeks. Our ultimate aim, however, is for this phrase "common sense" to vanish into the Husserlian phenomenology we offer, so that all the other meanings of common sense will not threaten Blankenburg's position with misunderstandings.Our comments must remain a mere sketch. Since, however, Husserl's phenomenology is not well known, we shall have to devote some time to outlining those features of it that we deem relevant here.For Husserl, every mental process is an awareness of something. In his terminology, it is "intentional." No mental process occurs in isolation, however. It rather occurs within a concatenation of many other mental processes. Some of these co-occurring mental processes intend the same object; they intend other aspects of the object. For example, a woman may be aware of the color of a dress she is considering wearing. Hence, one process in her mental life is (visually) aware of the brown color. But another process in her mental life may be intending it as a "party dress." And yet another process in her mental life may be (tactually) intending the texture of the cloth. Because all of these mental processes (and many others) intend the same object, namely, the dress, Husserl says that they are synthesized with one another. "Synthesis," then, connotes a multiplicity of mental processes united with one another through intending the same object.Now Husserl believed that it is because the many processes occurring in our mental lives [End Page 327] synthetically intend the many objects we encounter that we experience ourselves as inhabiting a world of objects. If these syntheses failed to occur, we would not experience the world or ourselves as parts of this world. These syntheses make it possible for us to experience objects and events as related to one another in the manifold spatial, causal, temporal, social, political, religious, and other relationships that we do in fact experience. Husserl thus contends that our mental lives "constitute" the world for us. Mental life can accordingly be viewed as "world-constituting." Mental life is thus the condition for the possibility of there being a world of objects for us, to modify Kant's phrase. Husserl thought his notion of world-constituting consciousness sufficiently similar to Kant's for him to appropriate the latter philosopher's concept of "transcendental." Husserl also then spoke of "transcendental consciousness" and the study of this consciousness as "transcendental philosophy."Husserl made many distinctions among kinds of mental processes and their correlative objects. We shall here explicate only one such distinction. Mental processes must be distinguished as those that are actively generated by an ego and those that are not produced by an ego. The latter kind of mental process occurs automatically or, as Husserl writes, "passively." Husserl calls the first kind of mental process "active." Having mentioned him, however, we should also briefly characterize the "ego... (shrink)

Karl Jaspers' phenomenology remains important today, not solely because of its continuing influence in some areas of psychiatry, but because, if fully understood, it can provide a method and set of concepts for making new progress in the science of psychopathology. In order to understand this method and set of concepts, it helps to recognize the significant influence that Edmund Husserl's early work, Logical investigations, exercised on Jaspers' formulation of them. We trace the Husserlian influence while clarifying the main components (...) of Jaspers' method. Jaspers adopted Husserl's notions of intuition, description, and presuppositionlessness, transforming them when necessary in order to serve the investigations of the psychopathologist. Jaspers also took over from Wilhelm Dilthey and others the tools of understanding (Verstehen) and self-transposal. The Diltheyian procedures were integrated into the Husserlian ones to produce a method that enables psychiatrists to define the basic kinds of psychopathological mental states. (shrink)

Basing ourselves on the writings of Hans Jonas, we offer to psychosomatic medicine a philosophy of life that surmounts the mind-body dualism which has plagued Western thought since the origins of modern science in seventeenth century Europe. Any present-day account of reality must draw upon everything we know about the living and the non-living. Since we are living beings ourselves, we know what it means to be alive from our own first-hand experience. Therefore, our philosophy of life, in addition to (...) starting with what empirical science tells us about inorganic and organic reality, must also begin from our own direct experience of life in ourselves and in others; it can then show how the two meet in the living being. Since life is ultimately one reality, our theory must reintegrate psyche with soma such that no component of the whole is short-changed, neither the objective nor the subjective. In this essay, we lay out the foundational components of such a theory by clarifying the defining features of living beings as polarities . We describe three such polarities: 1) Being vs. non-being: Always threatened by non-being, the organism must constantly re-assert its being through its own activity. 2) World-relatedness vs. self-enclosure: Living beings are both enclosed with themselves, defined by the boundaries that separate them from their environment, while they are also ceaselessly reaching out to their environment and engaging in transactions with it. 3) Dependence vs. independence: Living beings are both dependent on the material components that constitute them at any given moment and independent of any particular groupings of these components over time. We then discuss important features of the polarities of life: Metabolism; organic structure; enclosure by a semi-permeable membrane; distinction between "self" and "other"; autonomy; neediness; teleology; sensitivity; values. Moral needs and values already arise at the most basic levels of life, even if only human beings can recognize such values as moral requirements and develop responses to them. (shrink)

This essay introduces a thematic issue focused on the contributions to clinical ethics and the philosophy of medicine by Richard M. Zaner. We consider the apparent divorce of Zaners philosophical roots from his recent narrative immersions into the blooming, buzzing confusions of clinical-moral lifeworlds. Our considerations of the Zanerian context and origins of the clinical encounter introduce the fundamental questions faced by Zaner and his commentators in this issue, questions about the role of ethics consultants, moral authority, and clinical truths.

This chapter contains section titled: Communities and Persons A Phenomenological Distinction between Community and Society Community Society The Self and its Social Roles Dispositional Vectors and the Shaping of Personality The Personality The Sociopathic Personality Type Conclusion.

This article by Louis Sass, Josef Parnas, and Dan Zahavi takes us into the midst of a debate over recent developments in phenomenological psychiatry. In "Phenomenological Psychopathology and Schizophrenia: Contemporary Approaches and Misunderstandings" (Sass et al. 2011), Sass et al. are responding to criticisms of their position lodged by Aaron L. Mishara in "Missing Links in Phenomenological Clinical Neuroscience: Why We Are Still Not There Yet" (Mishara 2007). In their reply, Sass et al. offer several helpful clarifications and justifications of (...) their position, a position they have advanced in numerous important articles and books in the past. We are grateful for these clarifications and additional .. (shrink)

Understanding the mental life of persons with psychosis/schizophrenia has been the crucial challenge of psychiatry since its origins, both for scientific models as well as for every therapeutic encounter between persons with and without psychosis/schizophrenia. Nonetheless, a preliminary understanding is always the first step of phenomenological as well as other qualitative research methods addressing persons with psychotic experiences in their life-world. In contrast to Rashed's assertions, in order to achieve such understanding, phenomenological psychopathologists need not necessarily adopt the transcendental-phenomenological attitude, (...) which, however, is often required if performing phenomenological philosophy. Additionally, in the course of these scientific endeavors, differences between persons with psychosis/schizophrenia and so-called normal people seem to have a methodological function and value driving the scientist in her enterprise. Yet, these differences do not extend to ethical dimensions, and therefore, do not by any means touch ethical equality. (shrink)

Husserlian reduction is a rigorous method for describing the foundations of psychiatric experience. With Jaspers we consider three main principles inspired by phenomenological reduction: direct givenness, absence of presuppositions, re-presentation. But with Binswanger alone we refer to eidetic and transcendental reduction: to establish a critical epistemology; to directly investigate the constitutive processes of mental phenomena and their disturbances, freed from their nosological background; to question the constitution of our own experience when facing a person with mental illness. Regarding the last (...) item, we suggest a specific kind of reduction, typically intersubjective from the start, which we call the ‘looking-glass reduction'. The schizophrenic experience -- understood as a ‘loss of taken-for-grantedness’ implying the constitutions of the body, of the other, and of internal time -- is a real ‘epochal provocation’ for the psychiatrist. As the horizon it opens seems to be both corporeal and narrative, this ‘provoking’ of an epoche in the attitude of the psychiatrist himself and the resistances it implies raise important issues regarding the general constitution of human experience. (shrink)

Schizophrenia, like other pathological conditions of mental life, has not been systematically included in the general study of consciousness. By focusing on aspects of chronic schizophrenia, we attempt to remedy this omission. Basic components of Husserl’s phenomenology (intentionality, synthesis, constitution, epoche, and unbuilding) are explicated and then employed in an account of chronic schizophrenia. In schizophrenic experience, basic constituents of reality are lost and the subject must try to explicitly re-constitute them. “Automatic mental life” is weakened such that much of (...) the world that is normally taken-for-granted cannot continue to be so. The subject must actively re-lay the ontological foundations of reality. (shrink)

This paper argues in favor of two related theses. First, due to a fundamental, biologically grounded world-openness, human culture is a biological imperative. As both biology and culture evolve historically, cultures rise and fall and the diversity of the human species develops. Second, in this historical process of rise and fall, abnormality plays a crucial role. From the perspective of a broader context traditionally addressed by speculative philosophies of history, the so-called mental disorders may be seen as entailing particular functional (...) advantages, and thus have a great impact on the course of human history. Nowadays, however, we live under a threat of cultural uniformity. While the diversity of the human species is cherished at the political level, it is being slowly eradicated through medical means. This paradox is a dangerous feature of contemporary globalized society that can lead to highly problematic consequences. (shrink)

Main Response Topics ? Introduction ? Open display and public evaluation ? Publicity versus patient privacy ? Facial tissue donation ? Validity of Louisville Instrument for Risk Acceptance ? Patients' understanding of risk ? Face versus hand transplantation ? Rejection rates/risks ? Patient compliance ? Exit strategy ? Functional recovery ? Societietal implications ? Psychological implications ? Conclusion: Uncertainty likely to persist.

Merleau-ponty's phenomenology of the intentional arc uniting body and world is viewed as grounded in the meaningfulness and materiality of both. the genetic constitution of the interrelated meaning and physicality of body and world is sketched in a phenomenological interpretation of jean piaget's ``the origin of intelligence in children''. from this sketch emerges an assertion of the priority of action over perception in prepredicative experience.

Friends, family, and the Association of the Advancement of Philosophy and Psychiatry community mourn the death of Osborne "Ozzie" Wiggins this past May 18. In many ways, his story contributes a large portion to the founding of the AAPP, this journal, and the philosophy/psychiatry community worldwide.I met Professor Wiggins as a sophomore at Southern Methodist University in Dallas in 1974. I was a student in his twentieth-century humanities class. I didn't know at the time that he was (...) in his early years as an academic, having recently obtained his PhD in philosophy from the New School for Social Research in New York. Moreover, I hadn't yet encountered a teacher who was so audacious as to tell his students on... (shrink)

This collection focuses on the introduction of phenomenology to the United States by the community of scholars who taught and studied at the New School for Social Research from 1954 through 1973. During those years, Dorion Cairns, Alfred Schutz, and Aron Gurwitsch--all former students of Edmund Husserl--came together in the department of philosophy to establish the first locus of phenomenology scholarship in the country. This founding trio was soon joined by three other prominent scholars in the field: Werner Marx, Thomas (...) M. Seebohm, and J. N. Mohanty. The Husserlian phenomenology that they brought to the New School has subsequently spread through the Anglophone world as the tradition of Continental philosophy. The first part of this volume includes original works by each of these six influential teachers of phenomenology, introduced either by one of their students or, in the case of Seebohm and Mohanty, by the thinkers themselves. The second part comprises contributions from twelve leading scholars of phenomenology who trained at the New School during this period. The result is a powerful document tracing the lineage and development of phenomenology in the North American context, written by members of the first two generations of scholars who shaped the field. Contributors: Michael Barber, Lester Embree, Jorge García-Gómez, Fred Kersten, Thomas M. T. Luckmann, William McKenna, J. N. Mohanty, Giuseppina C. Moneta, Thomas Nenon, George Psathas, Osborne P. Wiggins, Matthew M. Seebohm, and Richard M. Zaner. (shrink)

Public education is not just a way to organise and fund education. It is also the expression of a particular ideal about education and of a particular way to conceive of the relationship between education and society. The ideal of public education sees education as an important dimension of the common good and as an important institution in securing the common good. The common good is never what individuals or particular groups want or desire, but always reaches beyond such particular (...) desires towards that which societies as a whole should consider as desirable. This does, of course, put the common good in tension with the desires of individuals and groups. Neo-liberal modes of governance have, over the past decades, put this particular educational set up under pressure and have, according to some, eroded the very idea of the common good. This set of contributions reflects on this state of affairs, partly through an exploration of the idea of publicness itself – how it can be rearticulated and regained – and partly through reflections on the current state of education in the ‘north’ and the ‘south.’. (shrink)

Background Informed consent is often cited as the “cornerstone” of research ethics. Its intent is that participants enter research voluntarily, with an understanding of what their participation entails. Despite agreement on the necessity to obtain informed consent in research, opinions vary on the threshold of disclosure necessary and the best method to obtain consent. We aimed to investigate Australian researchers’ views on, and their experiences with, obtaining informed consent. Methods Semi-structured interviews were conducted with 23 researchers from NSW institutions, working (...) in various fields of research. Interviews were analysed and coded to identify themes. Results Researchers reported that consent involved information disclosure, understanding and a voluntary decision. They emphasised the variability of consent interactions, which were dependent on potential participants’ abilities and interests, study complexity and context. All researchers reported providing written information to potential participants, yet questioned the readability and utility of this information. The majority reported using signed consent forms to ‘operationalise’ consent and reported little awareness of, and lack of support in implementing more dynamic informed consent procedures, such as verbal informed consent, that was fit for the purposes of their studies. Views on Human Research Ethics Committees varied. Some reported inconsistent, arduous inputs on the information form and consent process. Others expressed reliance on HRECs for guidance, viewing them as institutional safeguards. Conclusions This study highlights the importance of transparent relationships, both between researchers and participants, and between researchers and HRECs. Where the relationship with study participants was reported as more robust, researchers felt that they were better able to ensure participants made better, more informed decisions. Where the relationship with HRECs was reported as more robust, researchers were more likely to view them as institutional safeguards, rather than as bureaucratic hindrances. Conscientious and mindful researchers are paramount to ensuring the procedure accommodates individual requirements. This study advocates that when designing ethical informed consent practices, researchers should be integrated as autonomous players with a positive input on the process, rather than, in the worst case, predatory recruiters to be curtailed by information forms and oversight. (shrink)

In this study, we propose considering membership in the Ethics Officer Association (EOA) as a proxy for the firm's commitment to ethical decision making, and we analyze the influence of firm- and CEO-specific characteristics on this commitment. While we observe a positive relationship between membership and firm size, we also document a negative relationship between EOA membership and the executive's time in position and, to a more modest extent, accounting returns. Pursuing this further, we present evidence that firms with past (...) legal issues may seek EOA membership as a signal of their intention to be compliant in the future. (shrink)

How can digitised assets of Galleries, Libraries, Archives and Museums be reused to unlock new value? What are the implications of viewing large-scale cultural heritage data as an economic resource, to build new products and services upon? Drawing upon valuation studies, we reflect on both the theory and practicalities of using mass-digitised heritage content as an economic driver, stressing the need to consider the complexity of commercial-based outcomes within the context of cultural and creative industries. However, we also problematise the (...) act of considering such heritage content as a resource to be exploited for economic growth, in order to inform how we consider, develop, deliver and value mass-digitisation. Our research will be of interest to those wishing to understand a rapidly changing research and innovation landscape, those considering how to engage memory institutions in data-driven activities and those critically evaluating years of mass-digitisation across the heritage sector. (shrink)

Winnipeg's North End has informed the Canadian mythology and influenced the national psyche. The North End also divides and defines the city of Winnipeg, shaping its politics and sense of identity. In these photographs, taken between the mid-1970s and the mid-1990s, John Paskievich set out to explore the North End he knew in his youth. What he found were traces of it, captured in the stillness in which the past still lingers and in the dignity and singularity of its inhabitants.