Jian Zhou,* Weiqiang Ju,* Xiaopeng Yuan, Xiaofeng Zhu, Dongping Wang, Xiaoshun HeOrgan Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China *These authors contributed equally to this work: Hyperosmolar nonketotic hyperglycemic coma is a serious, rare complication induced by methylprednisolone pulse therapy for acute rejection after orthotopic liver transplantation. Herein, we report an unusual case of a 58-year-old woman who experienced acute rejection at 30 months after OLT, only one case in which (...) HNKHC resulted in MP pulse therapy for acute rejection in all 913 recipients in our center. The general morbidity of HNKHC was 1.09‰ in this study. HNKHC is characterized by rapid onset, rapid progression, and a lack of specific clinical manifestations. High-dose MP management was a clear risk factor. The principle of treatment included rapid rehydration, low-dose insulin infusion, and correcting disorders of electrolytes and acidosis. In conclusion, clinicians considering MP pulse therapy after OLT should be alert to the occurrence of HNKHC. Keywords: liver transplantation, complications, hyperosmolar nonketotic hyperglycemic coma, methylprednisolone pulse therapy, principle of treatment. (shrink)

Chad A Witt, Ramsey R Hachem Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, Saint Louis, MO, USA: The role of donor-specific antibodies to human leukocyte antigens and the burden of antibody-mediated rejection in lung transplantation remain enigmatic. Over the past several years, evidence has been emerging that humoral immunity plays an important role in the development of both acute and chronic lung allograft dysfunction. Multiple case reports and case series (...) have identified lung allograft recipients with clinical findings consistent with acute AMR. However, there is currently no widely accepted definition for AMR in lung transplantation, and this has been a significant barrier to furthering our understanding of this form of rejection. Nonetheless, the development of DSA after transplantation has consistently been identified as an independent risk factor for persistent and high-grade acute cellular rejection and CLAD. This has raised the possibility that chronic AMR may be a distinct phenotype of CLAD although evidence supporting this paradigm is still lacking. Additionally, antibodies to lung-restricted self-antigens have been associated with primary graft dysfunction early and the development of CLAD late after transplantation, and emerging evidence underscores significant interactions between autoimmunity and alloimmunity after transplantation. There is currently an active International Society for Heart and Lung Transplantation working group that is developing an operational definition for AMR in lung transplantation. This will be critical to improve our understanding of this form of rejection and conduct clinical trials to identify optimal treatment strategies. This review will summarize the literature on DSA and AMR in lung transplantation and discuss the impact of antibodies to self-antigens on lung allograft dysfunction. Keywords: antibody-mediated rejection, donor-specific antibodies, lung transplantation. (shrink)

Wana Manitpisitkul1, Sabrina Lee2, Matthew Cooper31Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD, USA; 2Solid Organ Transplant Program, University of Utah Health Care, Salt Lake City, UT, USA; 3Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA: Addition of mycophenolate mofetil to calcineurin-based immunosuppressive therapy has led to a significant improvement in graft survival and reduction of acute rejection in renal transplant recipients. However, in clinical practice, MMF dose reduction, interruption, or discontinuation due (...) to hematological and gastrointestinal side-effects occurred in up to 50% of the patients. Large retrospective analyses have demonstrated that patients requiring MMF dose manipulation due to adverse events experienced a higher rate of rejection and graft loss. Enteric-coated mycophenolate sodium was developed with the goal of improving upper GI side-effects. Here, we review the efficacy and safety of EC-MPS in de novo kidney transplant recipient, and in stable renal transplant patients who were converted from MMF. The changes in GI-related adverse events using patient-reported outcome instruments are also reviewed.Keywords: enteric-coated mycophenolate sodium, mycophenolate mofetil, kidney transplant, efficacy, gastrointestinal tolerability. (shrink)

Bradford C Bemiss, Chad A WittDepartment of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO, USA: Chronic rejection is a major cause of death after the first year following lung transplantation. Bronchiolitis obliterans is the most common pathologic finding on biopsy, characterized by fibrous granulation tissue, which obliterates the lumen of the bronchiole. Clinically, in the absence of tissue for pathology, BO syndrome refers to a progressive irreversible drop in the (...) forced expiratory volume in 1 second. Recently, a broader definition of chronic rejection, termed "chronic lung allograft dysfunction", has been used to encompass a more inclusive definition of posttransplant dysfunction. Recently, the lung transplant community has come to realize that chronic rejection may be the final common result after repetitive epithelial insults. Acute rejection, infection, and alloreactivity to mismatched HLA antigens are a few of these insults that damage the surface of the bronchioles. Recent evidence of autoimmunity to the normally hidden structural proteins collagen V and K-α1 tubulin have been correlated with a BO phenotype as well, perhaps correlating the epithelial damage with a mechanism for developing BO lesions. Many immunomodulatory medications and treatments have been studied for effectiveness for the treatment of chronic lung allograft dysfunction. New drugs, which more precisely target the immune system, are being developed and tested. Further study is required, but recent advances have improved our understanding of the pathogenesis and potential intervention for this common and deadly complication of lung transplantation.Keywords: lung transplant, bronchiolitis obliterans syndrome, rejection. (shrink)

The increasing shortage of donor kidneys available for transplantation combined with an ageing population has resulted in the use of expanded-criteria donor (ECD) kidneys. These kidneys are associated with an increased risk of delayed graft function, acute rejection and reduced graft survival. This paper will cover the use of ECDs and the presentation of risk to patients receiving these organs.

Leah Andress,1 Anjali Gupta,2 Nida Siddiqi,3 Kwaku Marfo2,3 1University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice, Buffalo, 2Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine Department of Abdominal Organ Transplant Program, Bronx, 3Montefiore Medical Center, Department of Pharmacy, Bronx, NY, USA: Rabbit anti-thymocyte globulin has proven benefit as induction therapy in renal transplant recipients, achieving reduced acute rejection rates and better short-term allograft function, with slightly higher rates of complications (...) such as infections and malignancy. Compared with other agents, the most benefit from rATG induction has been observed in renal transplant recipients at high immunologic risk for rejection. However, in special populations, such as pediatrics, the elderly, and hepatitis C-positive and human immunodeficiency virus-positive renal transplant recipients, additional information is needed to delineate the absolute benefit of rATG induction compared with other induction agents. Selection of rATG as the choice of induction therapy in renal transplant recipients should be guided by a cost-effective approach in balancing efficacy, safety, and cost. This review summarizes the published literature on efficacy, safety, and cost of rATG induction in renal transplantation. Keywords: anti-thymocyte globulin, renal transplantation, induction therapy. (shrink)

I. Confronted with the acuteness of the socio-economic problems the two major labour organizations have in 1976 strengthened their «Common Trade Unions' Front» in view of their negotiations with employers and with the government, to which the trade unions have submitted a common platform.The common front, that has its antecedents on the local, regional and professional level has never been and never will be of a permanent nature, some sort of organic unit. Each confederation maintains its own identity and the (...) front is meant to be re-animated according to the circumstances.II. From the employers' side representatives of employers' organizations have «as a personal point of view» and, no doubt, as a preliminary approach, launched the idea that a new and very comprehensive «social pact» should be negotiated. The socialist trade unions clearly tend to reject this idea, since it maywell lead to a further integration in the capitalist system, whereas the christiandemocratic union seems to be rather in favour of such a pact.In the present state of affairs the probability that it be realized is rather low indeed. (shrink)

One objection to enhancement technologies is that they might lead us to live inauthentic lives. Memory modification technologies (MMTs) raise this worry in a particularly acute manner. In this paper I describe four scenarios where the use of MMTs might be said to lead to an inauthentic life. I then undertake to justify that judgment. I review the main existing accounts of authenticity, and present my own version of what I call a “true self” account (intended as a complement, (...) rather than a substitute, to existing accounts). I briefly describe current and prospective MMTs, distinguishing between memory enhancement and memory editing . Moving then to an assessment of the initial scenarios in the light of the accounts previously described, I argue that memory enhancement does not, by its very nature, raise serious concerns about authenticity. The main threat to authenticity posed by MMTs comes, I suggest, from memory editing. Rejecting as inadequate the worries about identity raised by the President’s Council on Bioethics in Beyond Therapy , I argue instead that memory editing can cause us to live an inauthentic life in two main ways: first, by threatening its truthfulness, and secondly, by interfering with our disposition to respond in certain ways to some past events, when we have reasons to respond in such ways. This consideration allows us to justify the charge of inauthenticity in cases where existing accounts fail. It also gives us a significant moral reason not to use MMTs in ways that would lead to such an outcome. (shrink)

This paper introduces the philosophy of Grace Andrus de Laguna in order to renew interest in it. I show that, in the 1910s and 1920s, she develops ideas and arguments that are also found playing key roles in the development of analytic philosophy decades later. Further, I describe her sympathetic, but acute, criticism of pragmatism and Heideggerian ontology, and situate her work in the tradition of American, speculative philosophy. Before 1920, we will see, de Laguna appeals to multiple realizability (...) to undermine reductionism in science, to support perspectival, scientific realism and, with help from a private language argument, to favour the view that mental states are classified by behavioural, teleological roles over what came to be called ‘type physicalism’. Her view of speech, mostly developed in the 1920s, tells us that its primary role is coordinating group behaviour rather than expressing thoughts. Belief is understood in terms of its causal role, including its causal relations to other kinds of mental states, when coordinating group behaviour. Thought is similarly understood. In developing her theory of mind, de Laguna rejects the pragmatist claims that belief can be reduced to dispositions to behaviour and that thought’s function is to address specific, rather than general, problems. She also favours meaning holism and rejects the analytic–synthetic distinction. In later work, de Laguna argues that individuals’ activity of self-maintenance brings universals, conceived of as irreducible potentialities, into being and makes them increasingly determinate. Further, she identifies the existence of all individuals with forms of self-maintenance and takes the existence of people to include maintenance of the cultural world. Such a unified treatment of existence, she holds, permits making its evolution intelligible. Heidegger’s view of being is rejected for not permitting this. All de Laguna’s work, we will see, fits a vision of philosophy as the systematic, imaginative and naturalistic examination of being as well as a source of criticism of science. (shrink)

Are there cases in which agents ought to give up on satisfying an obligation, so that they can avoid a temptation which will lead them to freely commit an even more significant wrong? Actualists say yes. Possibilists say no. Both positions have absurd consequences. This paper argues that common-sense morality is committed to an inconsistent triad of principles. This inconsistency becomes acute when we consider the cases that motivate the possibilism–actualism debate. Thus, the absurd consequences of both solutions are (...) unsurprising: any proposed solution will have consequences incompatible with common moral practice. Arguments for denying one of the principles are considered and rejected. The paper then suggests that the inconsistent moral commitments originate in an inconsistent picture of human agency. Revisionary pictures of human agency are considered. It is argued that a quasi-Platonic picture of agency, similar to that advocated by Gary Watson 1977, is the most promising. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 39.3 (2001) 351-383 [Access article in PDF] Hume's Pyrrhonian Skepticism and the Belief in Causal Laws Graciela De Pierris Hume endorses in no uncertain terms the normative use of causal reasoning. The most striking example of this commitment is Hume's argument in the Enquiry against the possibility of miracles. The argument sanctions, in particular, the use of scientific reflection on uniform experience issuing (...) in causal laws of nature (E 114): "A miracle is a violation of the laws of nature; and as a firm and unalterable experience has established these laws, the proof against a miracle, from the very nature of the fact, is as entire as any argument from experience can possibly be imagined." 1 These words should give us pause; for how can Hume so confidently say, after his skeptical conclusions concerning our causal beliefs, that "a firm and unalterable experience has established" the laws of nature, and that we can therefore produce "proofs" against miracles? The Treatise gives rise to the same puzzle. In this text, too, Hume confidently prescribes methodical reflection based on causal reasoning. For example, in Book One, Part Three, Section Fifteen, Hume offers eight "Rules by which to judge of causes and effects." These rules are more than descriptions of our natural causal inferences. They are meant to guide us in making better causal inferences; in Hume's words they "ought to regulate" our probable reasoning since (T 149): "by them we learn to distinguish the accidental circumstances from the efficacious causes." 2Moreover, Hume consistently takes Newtonian science as a model for the proper employment of causal inferences in inquiries into matters of fact and, [End Page 351] in particular, as a model to be followed in his own science of human nature. 3 This paradigm of what the science of nature ought to be is understood by Hume as an inductive, experimental inquiry. 4 In the Enquiry, for example, Hume uses the label "sciences" for "politics, natural philosophy, physic, chemistry, &c." and in the preceding discussion argues that these sciences are not a priori but are based on causal reasoning (E 164-165). Thus, there are for Hume inquiries into matters of fact and existence that amount to more than blindly following natural propensities and habit. The sciences and many of our causal inferences in common life involve more than mere belief as a sentiment. They involve, in addition, careful reflection that results in improved causal inferences and thus provides normative standards. Yet, in thus upholding the normative use of causal reasoning in science and in everyday life, Hume appears to contradict his own radical skeptical conclusions concerning our knowledge of causation and induction. I here propose a novel way to resolve this puzzle.To acknowledge the existence of a puzzle, however, amounts to accepting the now controversial view that Hume provides, and takes at face value, a radical skeptical argument concerning our knowledge of causation and induction. 5 Moreover, the attempt to resolve this puzzle involves rejecting the suggestion [End Page 352] that Hume, without awareness or concern, happily holds flatly inconsistent views. 6 It also goes against the more sophisticated suggestion that Hume lightly alternates among different psychological moods, or perhaps different perspectives, which might eventually issue in results that contradict each other but are sufficiently localized so as to prevent serious conflict. Such a view might lead us to conceive Hume's texts as an unstructured and arbitrary patchwork of reflections, driven by different psychological moods or by the embellishments of a radiant literary style. This kind of reading is unacceptable as an interpretative tool, however, as H. J. Paton has acutely noted in his criticism of the patchwork interpretation of Kant's Critique of Pure Reason. 7 For such a reading would place no constraints at all on the task of establishing which parts of Hume's text belong to which moods or perspectives. The suggestion that Hume offers an unstructured patchwork of reflections masks the novel and systematic distinction Hume draws between his radical philosophical... (shrink)

In _A Philosophy of the Unsayable_, William Franke argues that the encounter with what exceeds speech has become the crucial philosophical issue of our time. He proposes an original philosophy pivoting on analysis of the limits of language. The book also offers readings of literary texts as poetically performing the philosophical principles it expounds. Franke engages with philosophical theologies and philosophies of religion in the debate over negative theology and shows how apophaticism infiltrates the thinking even of those who attempt (...) to deny or delimit it._ In six cohesive essays, Franke explores fundamental aspects of unsayability. In the first and third essays, his philosophical argument is carried through with acute attention to modes of unsayability that are revealed best by literary works, particularly by negativities of poetic language in the oeuvres of Paul Celan and Edmond Jabès. Franke engages in critical discussion of apophatic currents of philosophy both ancient and modern, focusing on Hegel and French post-Hegelianism in his second essay and on Neoplatonism in his fourth essay. He treats Neoplatonic apophatics especially as found in Damascius and as illuminated by postmodern thought, particularly Jean-Luc Nancy’s deconstruction of Christianity. In the last two essays, Franke treats the tension between two contemporary approaches to philosophy of religion—Radical Orthodoxy and radically secular or Death-of-God theologies. _A Philosophy of the Unsayable _will interest scholars and students of philosophy, literature, religion, and the humanities. This book develops Franke's explicit theory of unsayability, which is informed by his long-standing engagement with major representatives of apophatic thought in the Western tradition. "William Franke is an articulate spokesman for what cannot be said not only with regards to modern European poetry but also with respect to contemporary theology. _A Philosophy of the Unsayable _is essential reading for everyone working in religion and literature and in modern theology." — Kevin Hart, Edwin B. Kyle Professor of Christian Studies, University of Virginia __ "By now, it would seem that there could be no more to say about not-saying. Apophatic language and negative theology have been accused of meaninglessness, nihilism, and even ill-concealed ontologies. In this lovely and surprising book, William Franke not only deftly undoes these criticisms but shows that apophasis underlies and strangely grounds all language and thought, even of those very discourses that most vigorously reject it. _A Philosophy of the Unsayable_ demonstrates with elegance that there is indeed more to say, and more that is both meaningful and important." — Karmen MacKendrick, Le Moyne College__ "William Franke is an eminent scholar in comparative literature, who is schooled in philosophy and religion. He is recognized as one of the most creative contemporary thinkers working at the double intersection of philosophy and literature and philosophy and theology. _A Philosophy of the Unsayable_ shows an intellectual grasp of a dizzying array of discourses and sheds real light on all thinkers who are discussed." — Cyril O'Regan, Huisking Professor of Theology, University of Notre Dame_. (shrink)

George Berkeley (1685-1753) is the superstar of Irish Philosophy. He entered Trinity College, Dublin, in 1700 and became a fellow in 1707. In 1724 he resigned his Fellowship to become Dean of Derry, and in 1734 he was made Bishop of Cloyne. He settled in Oxford in 1752 and died the following year. The work of George Berkeley is marked by its diversity and range. His writings take in such topics as mathematics, psychology, politics, health, economics, deism and education, as (...) well as that with which he is most associated - philosophy. Whatever topic he dealt with, his grasp of the subject matter was always impressive and his criticisms of his contemporaries often acute. Among the most noteable of the British Empiricists, he took his starting point from Locke's new 'way of ideas', but he rejected abstract ideas and the possibility of real existence outside perception. It is for this doctrine that he is most known - that there is no such thing as matter, and that things are collections of ideas which can exist only in our minds and only for so long as they are perceived. This philosophy, summed up in his phrase 'to be is to be perceived', he termed 'immaterialism'. A.C. Fraser's collection includes a series of what were previously unpublished notes by Berkeley on all the main topics of his philosophy. This, the 1901 edition, was the first complete edition of his works. (shrink)

ABSTRACT How should physicians act when faced with corporal punishment, such as amputation, or torture? In most cases, the answer is clear: international law, UN resolutions and universal codes of medical ethics absolutely forbid physicians from countenancing torture and corporal punishment in any form. An acute problem arises, however, in decent societies, but not necessarily liberal states, that are, nonetheless, welcome in the world community. The decent society is often governed, in whole or in part, by religious laws, and (...) while these states abridge various human rights they are peace loving, generally tolerant, and offer their citizens wide avenues for political participation. Under these circumstances the prohibition against corporal punishment and torture weakens, often compelling physicians to participate. This is true in two cases. In Rawls’ hypothetical nation of Kazanistan, Islamic law is the order of the day, and amputations and corporal punishment play an integral part in the execution of traditional Islamic justice. In Israel, torture is sometimes used to elicit the information needed to thwart impending terror attacks. In each case, a physician's participation is essential. In light of the near universal condemnation that accompanies torture and corporal punishment, physicians can only appeal to norms anchored in collective well‐being and concern for life that override respect for human dignity in these societies. Western societies have consistently rejected this reasoning, but it is part and parcel of life in the decent society. (shrink)

George Berkeley (1685-1753) is the superstar of Irish Philosophy. He entered Trinity College, Dublin, in 1700 and became a fellow in 1707. In 1724 he resigned his Fellowship to become Dean of Derry, and in 1734 he was made Bishop of Cloyne. He settled in Oxford in 1752 and died the following year. The work of George Berkeley is marked by its diversity and range. His writings take in such topics as mathematics, psychology, politics, health, economics, deism and education, as (...) well as that with which he is most associated - philosophy. Whatever topic he dealt with, his grasp of the subject matter was always impressive and his criticisms of his contemporaries often acute. Among the most noteable of the British Empiricists, he took his starting point from Locke's new 'way of ideas', but he rejected abstract ideas and the possibility of real existence outside perception. It is for this doctrine that he is most known - that there is no such thing as matter, and that things are collections of ideas which can exist only in our minds and only for so long as they are perceived. This philosophy, summed up in his phrase 'to be is to be perceived', he termed 'immaterialism'. A.C. Fraser's collection includes a series of what were previously unpublished notes by Berkeley on all the main topics of his philosophy. This, the 1901 edition, was the first complete edition of his works. (shrink)

Can metaphysics ever really be compatible with science? In this paper, I investigate the implications of the methodological approach to metaphysical theorizing known as naturalized metaphysics. In the past, metaphysics has been rejected entirely by empirically-minded philosophers as being too open to speculation and for relying on methods which are not conducive to truth. But naturalized metaphysics aims to be a less radical solution to these difficulties, treating metaphysical theorizing as being continuous with science and restricting metaphysical methods to empirically (...) respectable ones. I investigate a significant difficulty for naturalized metaphysics: that it lacks the methodological resources to comparatively evaluate competing ontological theories, or even to distinguish adequately between them. This objection is more acute when applied to robust realist versions of naturalized metaphysics, since the realist should be able to say which theory is true of the objective world. If this objection holds, then it seems that the commitment to naturalized metaphysics, or to robust realism about the categories and processes in metaphysics, will have to be relaxed. (shrink)

ABSTRACT How should physicians act when faced with corporal punishment, such as amputation, or torture? In most cases, the answer is clear: international law, UN resolutions and universal codes of medical ethics absolutely forbid physicians from countenancing torture and corporal punishment in any form. An acute problem arises, however, in decent societies, but not necessarily liberal states, that are, nonetheless, welcome in the world community. The decent society is often governed, in whole or in part, by religious laws, and (...) while these states abridge various human rights they are peace loving, generally tolerant, and offer their citizens wide avenues for political participation. Under these circumstances the prohibition against corporal punishment and torture weakens, often compelling physicians to participate. This is true in two cases. In Rawls’ hypothetical nation of Kazanistan, Islamic law is the order of the day, and amputations and corporal punishment play an integral part in the execution of traditional Islamic justice. In Israel, torture is sometimes used to elicit the information needed to thwart impending terror attacks. In each case, a physician's participation is essential. In light of the near universal condemnation that accompanies torture and corporal punishment, physicians can only appeal to norms anchored in collective well‐being and concern for life that override respect for human dignity in these societies. Western societies have consistently rejected this reasoning, but it is part and parcel of life in the decent society. (shrink)

John Kinsella is an important literary witness to the acknowledgement of native title in Australia, and Indigenous rights more generally. His writings also bear witness to continuing forces of resistance to those rights in Australian society. This paper traces Kinsella’s engagement with the Mabo case, the 1992 legal decision that recognised native title as part of Australian law, and rejected the fiction that Australia was terra nullius at the time of British colonisation. Focusing on “Graphology: Canto 5” and other texts, (...) it argues that Kinsella presents a sustained reflection on the implications and the limits of this decision, in law and in wider cultural understandings and practices, through poetic allusions, paratexts and personal commentary. His writing since the mid-1990s reveals an acute awareness of how imported concepts of property and law are concealed within Western poetic traditions such as pastoral. To counter the effects of this ideology, Kinsella interpolates and appropriates terms from the discourse of property law, juxtaposing them against other ways of understanding and living in the land. In several collections, but especially in Jam Tree Gully, he seeks to develop an ethically reflective account of ownership of land taken from others, critiquing the dominant idea of property and articulating an alternative way of living in the land based on co-existence. The rights of the dispossessed traditional owners are central to a new mode of “writing the land.”. (shrink)

The following article is a response to the position paper of the Hastings Center, “Ethical Challenges of Chronic Illness”, a product of their three year project on Ethics and Chronic Care. The authors of this paper, three prominent bioethicists, Daniel Callahan, Arthur Caplan, and Bruce Jennings, argue that there should be a different ethic for acute and chronic care. In pressing this distinction they provide philosophical grounds for limiting medical care for the elderly and chronically ill. We give a (...) critical survey of their position and reject it as well as any attempt to characterize the physician-patient relationship as a commercial contract. We emphasize, as central features of good medical practice, a commitment to be the patient's agent and a determination to acquire and be guided by knowledge. These commitments may sometimes conflict with efforts to have the physician serve as an instrument of social and economic policies limiting medical care. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Nietzsche and the Promise of Philosophy by Wayne KleinDeborah Carter MullenWayne Klein. Nietzsche and the Promise of Philosophy. Albany: State University of New York Press, 1997. Pp. xviii + 256. Paper, $19.95.Wayne Klein states in his Introduction to Nietzsche and the Promise of Philosophy that “Nietzsche’s texts are anomalous…because they explicitly and inexorably force us to question our assumptions about meaning, understanding and writing in a way that (...) few other philosophical texts have” (5). From its beginning, Klein’s book challenges the reader to think beyond the dualism of the literal and figurative meaning of words. For Klein, this task is central to understanding both the content and style of Nietzsche’s writings; or rather, it is essential to the recognition that ‘content’ and ‘style’ cannot be thought separately, especially when reading a poet-philosopher such as Nietzsche who meditates extensively on the intrinsic connection of the two. In his following chapters, Klein provides the reader with an innovative way of reading Nietzsche’s corpus, a strategy of interpretation which is acutely aware that Nietzsche’s philosophy is inseparable from Nietzsche’s rhetoric (6).Chapter One questions both Heidegger’s and Kaufmann’s interpretations of Nietzsche, which, according to Klein, “share a common conviction that Nietzsche’s thought can only be understood properly if it is abstracted from its context and read against the backdrop of his philosophy as a whole” (42). Klein also criticizes Nehamas’ reading of Nietzsche which endeavors to discover “thematic connections and continuities among Nietzsche’s writings, without attempting to take the texts on their own terms as texts” (50). Ultimately, Klein views all three readers as offering an interpretation of Nietzsche in which “the ‘what’ of Nietzsche’s writings is thoroughly divorced from the ‘how’ ” (42).Klein’s strongest evidence for his position of Nietzsche as philosopher-rhetorician is presented in Chapters Two and Three. In Chapter Two, Klein argues against the view [End Page 639] of Maudemarie Clark that (l) Nietzsche’s later writings affirm a “common-sense” or empirical view of truth, and therefore, (2) Nietzsche’s earlier rhetorical descriptions of truth ought to be rejected by the reader who desires to understand Nietzsche’s mature thought (58–59). Through a detailed reading of Nietzsche’s 1872–73 Course on Rhetoric and the 1873 “On Truth and Lies in an Extra-Moral Sense,” Klein presents a convincing case that Nietzsche’s analysis in his early writings of truth as metaphor, metonymy, and synecdoche does not “deny that words can be true, but that with respect to their multifarious origins they are not principally concerned with truth as correspondence or identity” (70). Instead—with Heidegger’s concept of aletheia as the horizon—Klein suggests that Nietzsche’s early writings “insist on a radical undecidability between literal and figurative discourse” which leads Nietzsche to embrace “a conception of shining truth,” i.e., the veiled “shining forth of appearance” (78, 83). This notion of truth as shine or shining forth allows Klein to link Nietzsche’s earliest writings to later works such as Beyond Good and Evil and Twilight of the Idols in their portrayals of truth. Further-more, once this connection is established, Klein can challenge Clark’s reading that Nietzsche’s mature view of truth implicitly acknowledges an empirical dualism of “the true” and “the false.”After establishing that the division between style and content is an ontological dichotomy which Nietzsche’s work rejects, Klein can utilize this fundamental ambiguity between Nietzsche the philosopher and Nietzsche the rhetorician to reconsider specific concepts put forward in Nietzsche’s other writings. Chapter Three interprets The Birth of Tragedy in this vein; however, the most provocative re-reading of Nietzsche occurs in Chapter Four, where Klein brings into question Nietzsche’s “naturalism,” his reliance in his later criticisms of metaphysics and morality upon a seemingly “essentialistic understanding” of central concepts such as the will to power, life, physiology, and sickness and health (141). By returning to Nietzsche’s early writings in his analysis of the later works, Klein concludes that “the pseudo-normative concepts of life, nature, and the will to power” can be read as “contingent interpretations of existence... (shrink)

The decline of religion and ever increasing influence of science pose acute ethical issues for us all. Can we reject the literal truth of the Gospels yet still retain a Christian morality? Can we defend any 'moral values' against the constant encroachments of technology? Indeed, are we in danger of losing most of the qualities which make us truly human? Here, drawing on a novelist's insight into art, literature and abnormal psychology, Iris Murdoch conducts an ongoing debate with major (...) writers, thinkers and theologians—from Augustine to Wittgenstein, Shakespeare to Sartre, Plato to Derrida—to provide fresh and compelling answers to these crucial questions. (shrink)

Let Rhoda Speak Again: Identity, Uncertainty, and Authority in Virginia Woolf's The Waves Performing a rereading of Virginia Woolf's 1931 experimental modernist masterpiece of The Waves, in this article I focus on the elusive and conflicted character of Rhoda, whose significance has been either overlooked or marginalized in the available criticism of the narrative. By pointing out a number of problems in the existing scholarship devoted to Rhoda, I propose to define her as a transgressive figure of uncertainty through which (...) Woolf develops a critique of the unitary self. My point of departure for the following essay is Toril Moi's perspective on Woolf's oeuvre as openly feminist and deconstructive. Consequently, I begin with Moi's emphasis on Woolf's commitment to the problematization of the Western male humanism's underlying concept of the unitary self. Drawing from a number of critical and philosophical perspectives, I turn to Kim L. Worthington's idea of subjectivity as a sustained process of interpersonal narrativization in order to offer a more nuanced account of Rhoda's identity as compound and implicated in the dynamics of inter-subjective processes. I also consider Rhoda's much criticized rejection of identity vis-à-vis Woolf's strategy of impersonality, and, contrasting it with Maurice Merleau-Ponty's phenomenological concepts of the flesh and anonymous existence, I contend that Rhoda renounces the unitary selfhood, which corroborates Moi's critique of Woolf. Through a close analysis of Rhoda's position versus the other characters, as well as by examining how Rhoda's ego boundaries are delineated in the narrative, I demonstrate that Woolf's conflicted heroine emerges as an astute critic of gendered reality, since she is the one who most acutely feels the dualistic nature of selfhood and it is chiefly through her that Woolf points to the need to overcome this dualism. Shannon Sullivan's feminist revision of the Merleau-Pontian perspective on the anonymity and the body as well as the Deweyan notion of transactionality further helps to elucidate the ways in which Rhoda's experimental and subversive discourse engages in a polemic with the Cartesian conceptualization of identity presupposed on the dualism of mind and body simultaneously inquiring about a possibility of a non-dualistic and non-unitary conception of subjectivity. As a consequence, Rhoda gains authority and agency through uncertainty which prompts her to adopt an uncompromisingly and insistently questioning stance. Finally, I suggest reconsidering Rhoda's suicide as a metaphorical act of ‘distancing,’ as discussed by Zygmunt Bauman, via Adorno, in his 2006 Liquid Fear, another context for approaching Rhoda's uncertainty. (shrink)

An approach to testing theories describing a multiverse, that has gained interest of late, involves comparing theory-generated probability distributions over observables with their experimentally measured values. It is likely that such distributions, were we indeed able to calculate them unambiguously, will assign low probabilities to any such experimental measurements. An alternative to thereby rejecting these theories, is to conditionalize the distributions involved by restricting attention to domains of the multiverse in which we might arise. In order to elicit a crisp (...) prediction, however, one needs to make a further assumption about how typical we are of the chosen domains. In this paper, we investigate interactions between the spectra of available assumptions regarding both conditionalization and typicality, and draw out the effects of these interactions in a concrete setting; namely, on predictions of the total number of species that contribute significantly to dark matter. In particular, for each conditionalization scheme studied, we analyze how correlations between densities of different dark matter species affect the prediction, and explicate the effects of assumptions regarding typicality. We find that the effects of correlations can depend on the conditionalization scheme, and that in each case atypicality can significantly change the prediction. In doing so, we demonstrate the existence of overlaps in the predictions of different "frameworks" consisting of conjunctions of theory, conditionalization scheme and typicality assumption. This conclusion highlights the acute challenges involved in using such tests to identify a preferred framework that aims to describe our observational situation in a multiverse. (shrink)

David Hume’s position on religion is, broadly speaking, “politic”: instrumental and consequentialist. Religions should be tolerated or not according to their effects on political peace and order. Such theories of toleration are often rejected as immoral or unstable. The reading provided here responds by reading Hume’s position as one of radically indirect consequentialism. While religious policy should serve consequentialist ends, making direct reference to those ends merely gives free reign to religious-political bigotry and faction. Toleration, like Hume’s other “artificial virtues” (...) (justice, fidelity to promises, allegiance to government), is a universally useful response to our universal partiality—as established uniformity, however tempting, is not. This implies that toleration can progress through political learning, becoming broader and more constitutionally established over time. A sophisticated Humean approach thus shares the stability and normative attractiveness of respect- or rights-based arguments while responding more acutely and flexibly to problems the former often slights: antinomian religious extremism; underdefined political agency; and internationalized, politicized religious movements. (shrink)

Definition of the problem: Every decision for or against life-sustaining measures in ICUs is a result of different factors, the kind and course of the illness, probable prognosis, age of the patient, but also character, experience and knowledge of the acting staff members. These factors may combine in an accidental way. The aim of the investigation was to evaluate these factors as far as possible. Arguments and conclusion: 287 physicians from intensive care units (ICU) in 43 hospitals were interviewed. In (...) a questionnaire, 6 case vignettes of severely ill patients served for hypothetical reasons and eventually decisions to act. Maximum medical activity was recommended in university hospitals, but acute lifesustaining measurements were equally accepted in all three kinds of hospitals. Other factors – such as duration of medical activity of the doctors, years of experience in intensive care medicine, motivations to act, sex and life attitude, but also the age of the patients – were of no significance. Because of the traditional close cooperation in ICUs, the nursing staff was also interviewed. For reanimation, intubation/artificial ventilation and pain relief therapy there where no differences in the group of doctors. These were significant in invasive diagnostic and therapeutic measurements, which were generally rejected earlier and more easily by the nursing staff. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Language, Truth, and Literary Interpretation: A Cross-cultural ExaminationYanfang TangReflections on the philosophy of language in China and the West suggest that philosophers’ critiques of language center on two issues: its inadequacy and its metaphoricity. The former indicates the inability of the signifier to capture the multiplicity of the signified, whereas the latter reflects the semantic surplus of the signifier over its referent. While modern Western philosophers focus on the (...) metaphoricity, frequently referred to as the “play,” of the sign, philosophers in traditional China targeted what they believed to be the inherent inadequacies of words in their discussions. 1 Both aspects of language are considered the cause of equivocal or ineffective speech, and thus of impediment to correct understanding, and yet philosophers of the two cultural traditions have come to different conclusions about reading or literary study.To Western philosophers and literary critics, the metaphoricity of language incurs a serious problem for reading. Because the sign, in its incessant play, always points to more than is needed to the point that its real reference is blurred or covered up, correct reading of a literary text becomes impossible. Such phrases, frequently appearing in contemporary critical writings as “the tyranny of words,” “the indeterminacy of meaning,” and “the unreadable text,” testify to the widespread concern about the problems of language in the West. On the other hand, despite their acute awareness of the intrinsic deficiency of words, Chinese philosophers and poets never gave up their hope in the efficacy [End Page 1] of writing and literary understanding. Indeed, the enterprise of creative writing and literary criticism boomed in China at the time when the philosophical aphorism that “words do not exhaust meaning” (yan bu jin yi) was brought home to almost every poet and critic flourishing between the third and fourth centuries. For the following one and a half millennia the question of the objectivity of meaning, the crux of Western post-structuralist discourse and quarrels, has never been raised in Chinese philosophical or literary discussions. This wide contrast of outlooks on reading informed by the same disillusionment with language is rather intriguing. To account for this phenomenon this article attempts to look at the differences in the way language is perceived and practiced in China and the West. It shall also probe into the concepts of truth underlying the two cultural traditions because such an inquiry sheds some important light on the different perceptions people in the two parts of the world hold concerning language and literary practice.Metaphoricity: The Way In or Out of the Dilemma?It is interesting to say that while twentieth-century discoveries about the metaphoricity of language have made some Western critics conclude that “all reading is misreading” and that “there is no such a thing as an objective meaning,” this same awareness—that language is essentially metaphorical in nature, that it always says more than what it appears to—posed a solution for Chinese philosophers and poets to get out of the linguistic dilemma in which they found themselves. But before we enter the topic, let us first look at the dominant views of language in each cultural tradition. First, as Yip Wai-lim and others have demonstrated, the Chinese philosophical tradition began with a rejection of language as a reliable means for cognition and expression. 2 Philosophers in ancient China viewed language, or in their own terminology, words, as an instrument for expressing ideas in the mind or describing objects in the world, but they considered them inherently limited and thus unable to carry out their tasks effectively. The earliest statement of this conception is recorded in the ancient classic the Book of Changes, where it says: “Writing does not exhaust words, and words do not exhaust meaning.” 3 Attributed to Confucius and thus also representing Confucian ideas, 4 this statement was elaborated, amplified, and developed into a systematic argument by Daoist (Taoist) philosophers Lao [End Page 2] Zi and Zhuang Zi (369?-286? bc). Approaching the issue from the perspective of Dao (Tao), these founders of Daoist school viewed language as intrinsically limited in its function of representing Dao. This is because Dao, the cosmic principle or pattern, is dynamic in... (shrink)

This essay investigates what a nuanced and revisionary interpretation of Fichte’s Critical-idealist philosophy could reveal about its impact on the philosophic thought of Friedrich Schlegel. It argues that Schlegel sees the Wissenschaftslehre through the lens of the distinction Fichte famous draws between the “spirit” (Geist) and the “letter” (Buchstaben) of a philosophy. He considers the spirit of the Wissenschaftslehre to lie in its acute awareness of its own limitation as a work of art and its letter in the deductive (...) or demonstrative form it inevitably assumes upon being expounded. In the face of the discrepancy, Schlegel rejects the letter of the Wissenschaftslehre in favor of its spirit. (shrink)

Objective: To identify the frequency and nature of care conflict dilemmas that United States long-term care providers encounter, response strategies, and use of ethics resources to assist with dispute resolution. Design: An online cross-sectional survey was distributed to the Society for Post-Acute and Long-Term Care Medicine (AMDA). Results: Two-thirds of participants, primarily medical directors, have rejected surrogate instructions and 71% have managed family conflict. Conflict over treatment decisions and issues interpreting advance directives were frequently reported. Half of facilities lack (...) a formal dispute mediation policy. Only five respondents have called an ethics consult for assistance. Conclusion: Ethically tense care conflicts commonly arise in long-term and post-acute care facilities. Few facility procedures incorporate ethics resources into actual practice. Recommendations are made to create actionable policy, increase access to ethics services, and support staff skill development in order to improve the end-of-life care experiences for patients, families, and care facility staff. (shrink)

The Supreme Court has ruled in the case of Y that there is no requirement to seek the approval of the Court of Protection in decisions to withdraw clinically assisted nutrition and hydration from patients in a prolonged disorder of consciousness.1 Mr Y was 52-year-old man who suffered a cardiac arrest after a myocardial infarction as a result of coronary artery disease. It was not possible to resuscitate him for well over 10 min, resulting in severe cerebral hypoxia which caused (...) extensive brain damage. Mr Y’s family and the NHS Trust treating him agreed that Mr Y would not want to be kept alive through the provision of CANH given his poor prognosis. They sought a declaration that it was not mandatory for applications of withdrawal of CANH to come before the court, which was granted by Mrs Justice O’Farrell in the first instance.2 Permission was granted for the appeal to ‘leapfrog’ the Court of Appeal and to proceed to the Supreme Court for consideration. In the interim, Mr Y died after contracting acute respiratory sepsis, but the Supreme Court determined that the appeal should go ahead in light of the general importance of the issues raised. In delivering the opinion of the Supreme Court on 30 July 2018, Lady Justice Black rejected the historical distinction that had been drawn between patients in PDOC and non-PDOC patients, in a way that had justified judicial involvement for patients in PDOC but not for others.3 She was clear that the correct approach to all cases involving CANH was to make a decision based on what was in the best interests of the patient. She further outlined that: > The documentation supplied to us shows that the difficulty that there is in assessing the patient and in …. (shrink)

A child of the era of decolonization, Claire Denis grew up in various regions of France’s subSaharan colonial lands, and was brought back to the ‘métropole’ as a teenager in the 1960s.She has thus had a double practice of foreignness, abroad, and in her ‘own’ country, whichshe did not know and where, in similar yet fundamentally different ways than in Africa, shefelt like an outsider again. As the daughter of a colonial administrator – a childhoodbeautifully evoked in her first feature, (...) Chocolat – she had stood as a highly visibleembodiment of the Western presence on colonial soil. On her return to France, she wouldlive through the more banal experience of becoming an invisible intruder, an exile at‘home’– a theme explored in her subsequent works. From the start, Denisthus drew on her personal knowledge of feeling rootless to explore issues that haveremained at the heart of her filmmaking: the deeply perplexing questions of identity andalienation, assimilation and rejection, desire and fear inseparable from the post-colonialmalaise that affects France with particular acuteness. (shrink)

A significant part of hegemonic masculinity is proving one’s heterosexuality though sexual experiences. Peer pressure to conform is particularly acute for adolescent boys and young men. We analyze interviews with 87 boys in middle school, high school, and college about how their masculinity goals and subsequent achievement of those goals influence their navigation of pressure to engage in sexual relations with girls and women to “prove” themselves. Our findings show that, while boys and young men recognize dominant notions of (...) hegemonic masculinity, most do not subscribe to those uncritically. Rather, they struggle to balance personal ideas about masculinity with consistent pressure from others to demonstrate their heterosexuality. As a result, they employ various strategies to negotiate such pressures, including avoidance, acceptance, and outright rejection of this particular expectation. These strategies, however, ultimately contribute to a broader gender culture among adolescents in which expectations and privileges associated with hegemonic masculinity that dominate U.S. culture remain largely unchallenged. (shrink)

This essay investigates what a nuanced and revisionary interpretation of Fichte’s Critical-idealist philosophy could reveal about its impact on the philosophic thought of Friedrich Schlegel. It argues that Schlegel sees the Wissenschaftslehre through the lens of the distinction Fichte famous draws between the “spirit” (Geist) and the “letter” (Buchstaben) of a philosophy. He considers the spirit of the Wissenschaftslehre to lie in its acute awareness of its own limitation as a work of art and its letter in the deductive (...) or demonstrative form it inevitably assumes upon being expounded. In the face of the discrepancy, Schlegel rejects the letter of the Wissenschaftslehre in favor of its spirit. (shrink)

introduced the concept of effective demand in the nascent science of economics; his discussions of astronomy were acute enough to raise Duhem’s interest. Neither are Buridan’s credentials as a nominalist in doubt, although investigation into his precise relation to William of Ockham continues: he rejected all abstract entities, whether universals, common natures, the complexe significabile, or types above and beyond tokens; for Buridan, every thing which exists is a concrete individual. His anti-realism included an epistemological component as well, for (...) Buridan maintained that the source of all knowledge is experience. (shrink)

Bashabi Fraser is known the world over as a Scottish-Bengali aka diasporic writer. Further she has also been slotted as a feminist scholar with a huge corpus on Tagore. This essay proves the fallacy of such pigeon-holeing of Fraser and shows that she is as mainstream as Yeats and even before that, like unto Blake. The essay also makes a point for rejecting every other mode of poetry except the Romantic mode. It established the Vedantic nature of the poetic genius. (...) The endnotes are copious and comment on how/why/(what of) Fraser should compulsory reading at which age. The essay speaks at length on the nature of poetry. It stresses the value of Vedanta in assessing true poetry written even in English. This essay is also valuable since it has within it acute observations on Fraser as a Tagore scholar. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 41.4 (2003) 559-560 [Access article in PDF] Elmar J. Kremer and Michael J. Latzer, editors. The Problem of Evil in Early Modern Philosophy. Toronto: University of Toronto Press, 2001. Pp. vi + 179. Cloth, $60.00. What can be added to classical defenses of the problem of evil? Did Voltairenotrelieve us from taking seriously the theodicies of early modern thinkers in Candide when Pangloss (...) avers that spectacles exist because noses were made to support them? Do we not rightfully regard Malebranche's ingenious appeal to God's simplicity and uniformity to explain malformed offspring as little more than a curiosity? Yet, the editors of this volume claim that the "theodicy problem was no mere idle puzzle of dogmatics, but a problem of immense social significance, a problem which cut to the heart of the philosophical and theological projects of the very best minds of the age" (5). Several essays in this volume bear out the editors' claim, and to a modern reader, show how the problem of evil was intricately woven into the philosophical ideas of early modern thought.The problem of evil is especially acute for many of the seventeenth-century authors surveyed in this volume who held that God is the total and efficient cause of the universe. God's constant involvement in physical events meant that defects, deformities, and natural disasters fell into the framework of the traditional problem of evil. Hence, physical evil became the preoccupation of natural philosophers and theologians alike. We learn that Leibniz, Malebranche, and Spinoza chose to limit God's will rather than His wisdom, whereas Descartes opted to limit God's wisdom. The odd man out is Bayle who crafted a third position that emphasized God's benevolence at the expense of His wisdom and will.The essays found in this volume are just a sampling of views in the period, but it is more than a good start. Freddoso's essay on Francisco Suarez sets the tone for the problem of explaining the causal origin of human evil. Freddoso shows how Suarez distinguished concurrent from original causes in order to credit God for His supreme causal role yet absolved Him of blame for the existence of moral defectiveness. Latzer, in his essay on Rene Descartes, perhaps overstates the case in attributing to Descartes a theodicy grander than that of Leibniz, but he draws on the Fourth Meditation account of error to provide a plausible and nuanced reconstruction of his views on evil.There are two essays on Baruch Spinoza. Hunter's essay lays out an argument for Spinoza as a radical Christian reformer touching on Spinoza's views on providence. Nadler notes in his essay that Spinoza ought to have rejected the whole question of theodicy as incoherent, but shows how the matter is a good deal more complicated. Nadler then introduces us to the Medieval Jewish tradition, from which Spinoza is said to have drawn his views leading to a denial of personal immortality. [End Page 559]Moreau's essay on Nicholas Malebranche is rich in historical context and philosophical interpretation. Malebranche is shown to be a critical and original thinker on the problem of evil. Moreau lauds Malebranche's philosophical and moral courage in his bold assertion that physical evil is not a negation but rather a real phenomenon requiring explanation.Larivière and Lennon argue that Bayle held a third position rarely seen in the period: that God's benevolence trumps considerations of both His wisdom and will. Bayle develops a "moral solution" to the problem of evil wherein God's benevolence requires that humans possess an autonomy of conscience whose exercise makes error and heresy morally possible and justifiable.The final three essays in the volume rightly focus on aspects of Leibniz's response to the problem of evil. Kremer shows how, in the case of Leibniz's treatment of the fate of infants who die unbaptized, Leibniz abandons the Augustinian approach to the problem of evil and calculates the fate of all creatures on the basis of what produces... (shrink)

Jewish ethics like Judaism itself has often been charged with being "particularistic," and in modernity it has been unfavorably compared with the universality of secular ethics. This charge has become acute philosophically when the comparison is made with the ethics of Kant. However, at this level, much of the ethical rejection of Jewish particularism, especially its being beholden to a God who is above the universe to whom this God prescribes moral norms and judges according to them, is (...) also a rejection of Christian (or any other monotheistic) ethics, no matter how otherwise universal. Yet this essay argues that Jewish ethics that prescribes norms for all humans, and that is knowable by all humans, actually constitutes a wider moral universe than does Kantian ethics, because it can include non-rational human objects and even non-human objects altogether. This essay also argues that a totally egalitarian moral universe, encompassing all human relations, becomes an infinite, totalizing universe, which can easily become the ideological justification (ratio essendi) of a totalitarian regime. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Enchantment of Art: Abstraction and Empathy from German Romanticism to ExpressionismDavid MorganA familiar tradition since the eighteenth century has invested art with the power to heal a decadent human condition. Inheriting this ability from religion—the romantic enthusiast Wilhelm Wackenroder considered artistic inspiration to originate in “divine inspiration” in the case of his hero, Raphael 1 —art eventually replaced institutionalized belief in an evolutionary schedule of cultural development determined (...) by German idealism. Hegel, for instance, theorized the evolution of spirit from religion to art as a qualitative advancement over time. Rejecting the metaphysics of German idealism, Friedrich Nietzsche nevertheless contended that “Art raises its head where religions decline.” By assuming the “feelings and moods” of religion which had been dismantled by enlightenment, Nietzsche claimed that art gave new form to the life of feeling and imbued human endeavors with a “loftier, darker coloration.” 2 In the early twentieth century Wassily Kandinsky believed that the “spiritual in art” was the historical manifestation of an “inner necessity” that was in itself timeless and universal. Kandinsky portrayed the “life of the spirit” as “a large acute-angled triangle divided horizontally into unequal parts.” In a kind of “trickle down” aesthetic, the compartments of the triangle move slowly upward toward the apex, which is inhabited by the solitary genius of an age whose vision gradually elevates all those who occupy the lower stages. 3 [End Page 317]The point for proponents of the spiritual in art from romanticism to expressionism (and beyond) was to find in works of art what can best be described as an enchantment. 4 As the negotiation of the gaps or disjunctures separating human beings from complete power over their lives, enchantment conjoins the plane of immediate human experience to a desirable state of affairs through the mediation of such symbolic devices as rituals, incantations, or charms. Thus, evil can be warded off by the use of an apotropaic amulet, and fertility can be enhanced by the recitation of a suitable prayer or the performance of a certain ritual. In a modern analogy a sense of impotence is often alleviated by a trip to the mall where the bored therapeutically lose themselves in symbolic acts of self-renewing consumption. In the traditions of philosophy and science, systems of representation such as astrology, the microcosm, the harmony of the spheres, the great chain of being, the celestial hierarchies, or the mechanisms of theurgy and divination situate humanity within a cosmos that follows a particular order accessible to and in some degree manipulable by human beings. Enchantment consists of an apparatus of belief whose form of representation or enactment is thought to exert influence over the realities it configures.But enchantment is not limited to the spells and magic of premodern metaphysics (or modern consumerism). By means of religion, morality, and aesthetics, Nietzsche once averred, “man likes to believe that... he is touching the heart of the world.” 5 This study will focus on the manner in which art as constructed within the idealist tradition of German art theory functioned as an enchantment. Specifically, it will explore what the history of ideas about abstraction and empathy has to tell us about the spiritualization or enchantment of art. After identifying the philosophical and aesthetic wherewithal of enchantment in nineteenth-century Germany, attention focusses on Franz Marc’s early twentieth-century theorization of abstraction. It is certainly more customary to study Kandinsky, whose writings and early efforts at abstraction are much better known, but Marc’s ideas offer more immediate connections to German intellectual history and clarify the aims of his abstract art as a strategy of enchantment. Moreover, Marc was unusually articulate and wrote often, exploring ideas and artistic efforts with great insight. Focusing on Marc therefore offers a corrective to the historiography that has favored Kandinsky’s writings. Finally, Marc differed from his Russian friend over the cause of the war. Manifesting a difference that is portentous for this study, Kandinsky left Germany for Russia in 1914, while Marc enthusiastically took up arms for the fatherland. Given these circumstances and the unfortunate tendency of art historians to valorize expressionist art rather than situate it in the ideological context of... (shrink)

According to Karl Popper, the evolution of science, logically, methodologically, and even psychologically, is an involved interplay of acute conjectures and blunt refutations. Like biological evolution, it is an endless round of blind variation and selective retention. But unlike biological evolution, it incorporates, at the stage of selection, the use of reason. Part I of this two-part paper begins by repudiating the common beliefs that Hume’s problem of induction, which compellingly confutes the thesis that science is rational in the (...) way that most people think that it is rational, can be solved by assuming that science is rational, or by assuming that Hume was irrational (that is, by ignoring his argument). The problem of induction can be solved only by a non-authoritarian theory of rationality. It is shown also that because hypotheses cannot be distilled directly from experience, all knowledge is eventually dependent on blind conjecture, and therefore itself conjectural. In particular, the use of rules of inference, or of good or bad rules for generating conjectures, is conjectural. Part II of the paper expounds a form of Popper’s critical rationalism that locates the rationality of science entirely in the deductive processes by which conjectures are criticized and improved. But extreme forms of deductivism are rejected. The paper concludes with a sharp dismissal of the view that work in artificial intelligence, including the JSM method cultivated extensively by Victor Finn, does anything to upset critical rationalism. Machine learning sheds little light on either the problem of induction or on the role that logic plays in the development of scientific knowledge. (shrink)

According to Karl Popper, the evolution of science, logically, methodologically, and even psychologically, is an involved interplay of acute conjectures and blunt refutations. Like biological evolution, it is an endless round of blind variation and selective retention. But unlike biological evolution, it incorporates, at the stage of selection, the use of reason. Part I of this two-part paper begins by repudiating the common beliefs that Hume’s problem of induction, which compellingly confutes the thesis that science is rational in the (...) way that most people think that it is rational, can be solved by assuming that science is rational, or by assuming that Hume was irrational (that is, by ignoring his argument). The problem of induction can be solved only by a non-authoritarian theory of rationality. It is shown also that because hypotheses cannot be distilled directly from experience, all knowledge is eventually dependent on blind conjecture, and therefore itself conjectural. In particular, the use of rules of inference, or of good or bad rules for generating conjectures, is conjectural. Part II of the paper expounds a form of Popper’s critical rationalism that locates the rationality of science entirely in the deductive processes by which conjectures are criticized and improved. But extreme forms of deductivism are rejected. The paper concludes with a sharp dismissal of the view that work in artificial intelligence, including the JSM method cultivated extensively by Victor Finn, does anything to upset critical rationalism. Machine learning sheds little light on either the problem of induction or on the role that logic plays in the development of scientific knowledge. (shrink)

In Great Expectations, Charles Dickens gives us an account of Mrs. Gargery going into a rage that is as remarkable for its brevity as for its insight. ‘I must remark of my sister,’ says Pip, ‘that passion was no excuse for her, because it is undeniable that instead of lapsing into passion, she consciously and deliberately took extraordinary pains to force herself into it, and became blindly furious by regular stages.’1 What is remarkable about this passage is its descriptive richness, (...) that way it shows how many of our emotional reactions involve something more than spontaneity in their actual performance. All this we glean readily and grasp as true from being with others; the genius of Dickens is to carry what is so close to us unto the page. I suspect that in his own wry manner, Husserl too would have liked this passage. He held out for a method of describing concrete lived phenomena that would neither underinterpret nor over-interpret. Such a description would avoid the twin and complementary sins of stripping meaning away from the appearances and putting strangeness into them. Presupposing too little is just as erroneous as too much, and Husserl was acutely aware that ‘in the apprehension of a man very much is already included.’2 When the descriptive imperative is to the fore, Husserl’s studies of the other are notable for their rejection of psychophysical dualism. But when the Cartesian exclusion of contingent certainty triumphs, he adopts a methodological dualism that decomposes the ordinary and unitary experience of the Other. The criticisms of his Cartesian derivation the Other are by now quite familiar, and I will only rehearse them where they intersect with the main theses of this paper. What I would first like to establish is that Husserl’s Cartesian approach to the Other - beginning in Logical Investigations and culminating in the derivation of the alter ego from the monadic sphere of ownness - clashes with the account of bracketing and reduction in Ideas I.. (shrink)

Books of extracts are often written to celebrate a reputation, or to move the reader to greater exertions by the words of the great. Neither of these reasons account for the assembling of this selection. For the traditional book of extracts reflects a traditional conception of their role, and below this conception is rejected. Rather, these extracts are thought of as working documents, selected to provide an occasion for critical and reflective thought, and presented in an order designed to ease (...) the strain we always feel when we think warily, acutely, and yet receptively. This book then deals with that contribution to discussion made by four past educationists. It is interesting to note how long their writing has formed part of the subject-matter of courses, without any precise ideas as to where they fit in the scheme of things. The layout of this introduction and the ordering of the following extracts is intended to try and help meet present needs. (shrink)

In the early decades of the twentieth century the experience of time as crisis became the catalyst for a fundamental reorientation in the relationship between historical materialism and idealism, leading to the rejection of simplistic mechanical concepts of historical time. This reorientation represents a turning point in the history of European ideas, clearly evident in the work of two major thinkers of this period, usually associated with opposing political ideologies: the Marxist theorist Walter Benjamin and the liberal philosopher Benedetto (...) Croce. Based on a conceptual framework borrowed partly from Reinhart Koselleck, this article explains how the experience of acute crisis led both thinkers to develop a new understanding of historical time, which shows surprising parallels. Both authors used the reorientation in the relationship between idealism and materialism to criticize positivist approaches to the analysis of historical change and to reject deterministic accounts of the future. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Oberlin's First Philosopher* EDWARD H. MADDEN ASA MAHANWAS THE FroST president of Oberlin College (1835-50) and professor of moral philosophy--the usual pattern during these years of "academic orthodoxy" when Christianity was purveyed in American colleges as the philosophy.1 The orthodox professors argued philosophical points very little but rather "presented" and "illustrated" their basic truths. 2 In some ways Mahan fit the stereotype. He did not always probe deeply into (...) questions or always offer reasons for his conclusions. His books are full of phrases like "it could not be otherwise", "no one, it is presumed, will deny that", "it is intuitively evident", "everyone cannot but know", and so on. And he frequently cited other philosophers, as well as the Scriptures, as "authorities." He even cited lengthy passages from Jonathan Edwards whenever he could, even though he differed with Edwards on almost every major point f In more important ways Mahan, however, does not fit the stereotype. Unlike Francis Wayland and most of the other academic orthodoxy before 1850, he had read, and been influenced by, German and French philosophers as well as the Scottish realists. Mahan was particularly influenced by Kant and Cousin. An astute contemporary reviewer remarked that Mahan, like Cousin, was an eclectic. "His eclecticism degenerates sometimes into the merely aggressive, and he delights occasionally in strange and incongruous combinations of Kant, Coleridge, Cousin and himself, but showing here and there great vigor and acuteness, and very considerable philosophical ability." a The aggressiveness of Mahan also sets him apart from the rest of the orthodoxy. He was too fiery by temperament to pass up polemics and hence got to the heart of some basic philosophical problems. He attacked the Edwardian doctrine of determinism and was led, by the vigor of his attack, into what many nineteenth-century Christians considered heresy3 He attacked utilitarianism in all its forms, including Paley's, in a far more consistent and thorough fashion than Francis Wayland and the other followers of Scottish realism and English intuitionism. And first and foremost he vigorously attacked the moral philosophy of his colleague Charles Grandison Finney, famous evangelist, professor of theology, and president-to-be of Oberlin. The spiritedness of his criticisms frequently aroused the ire of his Oberlin colleagues, but the spirited- *Research for some of the material in this paper was made possible by a grant from the Penrose Fund of the AmericanPhilosophicalSociety. ~Cf. Herbert W. Schneider, A History o] American Philosophy (2nd ed.; New York: Columbia University Press, 1963),pp. 195-220; and Joseph L. Blau, Men and Movements in American Philosophy (New York: Prentice-Hall, Inc., 1952). 2Cf. E. H. Madden, "Francis Wayland and the Limits of Moral Responsibility," Proceedings o] the American Philosophical Bociety, Vol. 106 (1962),pp. 348-359. *Quoted by R. S. Fletcher in his History o] Oberlin College (Oberlin, Ohio, 1943),II, 701. 4Fletcher, I, 223-231. [57] 58 HISTORY OF PHILOSOPHY hess fortunately was accompanied by a "considerable philosophical ability" that merits close attention. I Mahan's critique of Edwards appears in his Doctrine o] the Will, first published in 1844. According to Mahan, "Edwards stands convicted of a fundamental error in philosophy, an error which gives form and character to his whole workmthe confounding of the Will with the Sensibility, and thus confounding the characteristics of the phenomena of the former faculty with those of the phenomena of the latter." 5 The trouble is that the whole of Edwards' work "is constructed without an appeal to Consciousness, the only proper and authoritative tribunal of appeal in the case." 8 If we attend carefully to consciousness, said Mahan, we can distinguish volition from the strongest desire and hence must distinguish between the separate faculties of will as personal activity and sensation as mere passive impression. The latter does not "act," it merely "suffers." The will is the moving force in life and unless it can be shown that there is some necessary connection between will and sensation--which, in fact, cannot be done--then it follows that the will is free, that is, the source of "personal activity." Mahan's rejection of universal determinism, of course, entailed the rejection of the Calvinistic doctrine of election... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Being Sure of One's Self: Hume on Personal Identity1 Corliss Gayda Swain A number of papers recently published on Hume's theory of personal identityhavebeen devoted to the question: Whyin the Appendix to the Treatise did Hume express complete or acute dissatisfaction with his account of personal identity in book 1 of that work?2 In this paper I shall argue that no adequate answer can be given to this (...) question because its presupposition—namely, that Hume discovered some reason to be dissatisfied with his account—is false. My thesis is that Hume did not write the section ofthe Appendix dealing with personal identity in order to raise new questions about the adequacy ofhisbook 1 account of the mind; he wrote it in order to defend that account by showing that alternative explanations of personal identity are incoherent.3 Very briefly, this defense is as follows. In the Appendix Hume considers two hypotheses concerning the nature of the human mind: the first is the hypothesis accepted by many of the modern philosophers, namely, that the mind is a thinking substance which is both unitary and simple; the secondis Hume's own account ofpersonal identity, according to which "the true idea of the human mind, is to consider it as a system ofdifferent perceptions or different existences, which are link'd togetherby the relation ofcause and effect."4 Drawing on arguments he had developed in Treatise 1.4.5 and 6, Hume shows in the Appendix that the first hypothesis, while pretending to account for the identityand simplicityofthe selfin terms ofamental substance and to offer a new foundation for knowledge, actually leads us into the same labyrinth of obscurities and contradictions in which the ancient philosophy was involved when it tried to account for the identity and simplicity of material objects in terms of material substances. The modern philosophy tried to solve the same kind of problem as did the ancients, using the same kind of resources as the ancients used, and for this reason it is involved in the same contradictions and obscurities when it tries to explain the nature of the mind as the ancients were when they tried to explain the nature of matter. Hume's response to this situationisnotmerelytorejectbothmetaphysical systemsbutalso to reject their formulation of the problems ofidentity through change and unity in diversity and thè attendant criterion ofadequacy for the solution. Hume is sceptical that the problem which both the ancient Volume XVII Number 2 107 CORLISS GAYDA SWAIN andthemodernmetaphysicians setthemselves canbe solved,5but this does not mean that he is sceptical about personal identity or his own account ofit. In book 1 Hume had argued that a proper understanding ofthe real problem of personal identity leads to a real solution. In the Appendix he is concerned to show that this solution is not a solution to the (insoluble) problem that so preoccupied the metaphysicians. It is Hume's insistence that the metaphysicians' problem is insoluble that seems to have led commentators to think that Hume was dissatisfied with his own solution to the problem ofpersonal identity. On this view, the labyrinth ofcontradictions in which Hume finds himselfin the Appendix is not a labyrinth he gets into upon accepting his own account of personal identity, but rather a labyrinth he finds himself in without that account. What the Appendix adds to Hume's positive account of personal identity is a clear statement of the destructive argument againstmetaphysical systems that try to have it both ways. Thus, the Appendix should be read not as a renunciation but as a defense. I. Hume's "Renunciation" Commentators who hold that Hume found a new problem that was connected with his book 1 account of personal identity seem to have some strong textual support for their view.6 In the introductory paragraph of the section in the Appendix dealing with personal identity, Hume says, "But upon a more strict review of the section concerningpersonal identity, I find myselfinvoWd in such a labyrinth, that, I must confess, I neither know how to correct my former opinions, nor how to render them consistent" (T 633).7 He confesses that his account ofpersonal identity is "very defective" (T 635) and claims that... (shrink)

The following article is a response to the position paper of the Hastings Center, "Ethical Challenges of Chronic Illness", a product of their three year project on Ethics and Chronic Care. The authors of this paper, three prominent bioethicists, Daniel Callahan, Arthur Caplan, and Bruce Jennings, argue that there should be a different ethic for acute and chronic care. In pressing this distinction they provide philosophical grounds for limiting medical care for the elderly and chronically ill. We give a (...) critical survey of their position and reject it as well as any attempt to characterize the physician-patient relationship as a commercial contract. We emphasize, as central features of good medical practice, a commitment to be the patient's agent and a determination to acquire and be guided by knowledge. These commitments may sometimes conflict with efforts to have the physician serve as an instrument of social and economic policies limiting medical care. Keywords: acute, agent, autonomy, chronic, knowledge, obligations, rights CiteULike Connotea Del.icio.us What's this? (shrink)

My dissertation is concerned with Epicurus' attempt to reconcile libertarianism and atomism. I begin by offering my solution to 'the problem of the swerve,' arguing that Lucretius is claiming that swerves cause volitions 'from the bottom up' and that the attempts of scholars to construct a better position for Epicurus to have held were doomed to fail, since this is the only position open to the libertarian atomist. ;I also examine the swerve's role in cosmogony, arguing that 'the cosmogonic argument' (...) for the swerve is an afterthought, 'the libertarian argument' being Epicurus' chief argument for the swerve. ;I discuss the physics of the swerve as a minimal, oblique deviation of an atom from its course. And I explore its implications: atoms move at a speed greater than one minimal unit of distance per minimal unit of time, and there are no minimal units of space. ;Returning to the question of the swerve's role in action, I argue that a typical action involves a series of volitions each caused by a plurality of swerves by atoms of the mind's 'fourth nature.' And I argue that one's power to move at will is directly sensed, though also known through one's innate $\pi\rho\acute{o}\lambda\eta\psi\iota\varsigma$ of one's freedom. ;In the second half of my dissertation, I turn to the question of responsibility. I examine Epicurus' remarks about 'what is due to us' . I examine Epicurus' argument that Democriteans are self-refuting in espousing determinism and 'eliminative materialism.' I explain that Epicurus rejects only Democritus' ontology, not his epistemology . I examine Epicurus' discussion in On Nature of our 'notion of responsibility' , our responsibility as $\alpha\pi o\gamma\varepsilon\gamma\varepsilon\nu\nu\eta\mu\acute \varepsilon\nu\alpha$ , and our responsibility for our thoughts of the $\tau\acute\varepsilon\lambda o\varsigma$ and 'the criterion' . I explain what Epicurus means by the $\tau\acute\varepsilon\lambda o\varsigma$: pleasure, "katastematic" and "kinetic" . And finally, I argue that Epicurus fails to meet the challenge of 'psychological determinism'. (shrink)

In this paper I look at causality in the context of intervention research, and discuss some problems faced in the evaluation of causal hypotheses via interventions. I draw attention to a simple problem for evaluations that employ randomized controlled trials. The common alternative to randomized trials, the observational study, is shown to face problems of a similar nature. I then argue that these problems become especially acute in cases where the intervention is complex (i.e. that involves intervening in a (...) complex system). Finally, I consider and reject a possible resolution of the problem involving the simulation of complex interventions. The conclusion I draw from this is that we need to radically reframe the way we think about causal inference in complex intervention research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A New Look at Animal-to-Human Organ TransplantationCharles R. McCarthy (bio)The acute shortage of organs available for transplantation into human beings combined with a new scientific understanding of the immune systems of both humans and animals make it probable that animal-to-human solid organ transplants (xenografts) may soon be attempted at a frequency rate unknown in the past. 1 Optimism about successful animal-to-human organ transplantation is greater than at any (...) previous time. The creation of a reliable supply of animal organs appears to be technically feasible. At least five major transplant centers in the United States are currently considering plans to pursue xenotransplantation. Although, at the time of this writing, no federal guidelines prohibit animal-to-human organ transplantation, the institutions considering such programs are awaiting deliberations on the subject by the Institute of Medicine (IOM), the Food and Drug Administration (FDA), and the Department of Health and Human Services (DHHS).The demand for organs suitable for transplantation into human beings greatly exceeds the supply. According to the United Network for Organ Sharing (UNOS 1996a), approximately 44,000 patients in the United states awaited organ transplantation at the end of 1995. In 1994, more than 3,000 patients died while on the transplant waiting list, and the demand for transplantable organs increases annually (UNOS 1996b). The figures do not include the hundreds or perhaps thousands of patients who could profit from a transplant, but who do not meet the requirements of the UNOS waiting list. Even if efforts to persuade persons to donate organs are redoubled, and even if the consent to donate organs should become a legal presumption, there is little prospect of developing a sufficient supply of transplantable human organs to meet the growing demand.As technical and biological barriers to successful animal-to-human xenografts are lowered, the prospect of raising dedicated colonies of animals, genetically altered to reduce the chances that human hosts will reject organs derived from them, is being seriously discussed. 2 Such colonies do not exist at the present time. [End Page 183] However, if new techniques for animal-to-human transplantation prove successful, it is likely that animal colonies will be established to provide a ready and predictable supply of organs for transplantation to humans. Some believe that commercial investment in colonies of purpose-bred animals to serve as a source of transplantable organs is close at hand (Leventhal 1994).New drugs and new combinations of existing drugs have improved the chances of successful medical outcomes for patients who receive solid organ transplants. It is now recognized that serial application of immunosuppressive drugs can reduce the likelihood of both short- and long-term organ rejection (Makowka 1994). Improved understanding of both human and animal immune systems, insights into histocompatibility, new agents to control graft-versus-host disease, animal breeding programs for the production of transgenic animals, and improved surgical techniques have opened, as never before, the possibility of successful transfer of organs from animals to humans. Some rate the chances of good patient outcomes (usually measured in terms of time of patient survival) as high, others make more conservative predictions, but virtually all experts believe that the chances for successful human patient outcomes resulting from xenotransplantation are improved. Because many patients face immanent death unless their organs can be replaced, there can be little doubt that many humans will readily consent to xenotransplantation.History Suggests CautionDespite the advances in immunosuppression, the frequency of failure in past animal-to-human xenograft attempts should temper the optimism of the transplant community. To date, all efforts to prolong human life by implanting solid organs from animals into human recipients have failed. The first attempts at animal-to-human xenotransplantation early in the twentieth century resulted in the early death of all recipients (Neuhof 1923). More sophisticated efforts at xenotransplantation occurred in the late 1960s and early 1970s, a period when anti-rejection drugs began to make allografts more feasible. Although one human recipient of a xenograft survived for nine months (with poor quality of life), most patients died within a matter of minutes, hours, or a few days following the transplantation of organs from chimpanzees or baboons (Starzl... (shrink)