The Pairizhang (day-to-day accounts) found in Huizhou were mostly written by the pupils in old-style private school. They seem similar to a dairy in some way with the activities of family members (mostly male) as the main contents. However, they differ from modern diaries in many ways. It was a common practice in Wuyuan County to keep day-to-day accounts in the late Qing Dynasty and the Republic of China. By analyzing the 5 accounts found there, many underlying (...) facts can be revealed, such as the time allocation of the main labor force, the composition of the peasant’s family economy, the general situation of productive activity and the days and ranges of their outdoor activity, etc. All these findings can help us have a better understanding of the peasants’ life in Huizhou at that time. (shrink)

The average person makes hundreds of decisions each day. They range from the ordinary and mundane to life altering events. May decisions we are faced with have little effect of our lives. They deal with simple problems and require simple choices. However, there are those decisions which impact our lives and the lives of those around us in very significant and consequential ways."--Back cover.

This paper discusses the nature and the status of inference to the best explanation. We outline the foundational role given IBE by its defenders and the arguments of critics who deny it any place at all ; argue that, on the two main conceptions of explanation, IBE cannot be a foundational inference rule ; sketch an account of IBE that makes it contextual and dependent on substantive empirical assumptions, much as simplicity seems to be ; show how that account avoids (...) the critics ' complaints and leaves IBE an important role ; and sketch how our account can clarify debates over IBE in arguments for scientific realism. (shrink)

Standard models in quantitative linguistics assume that word usage follows a fixed frequency distribution, often Zipf's law or a close relative. This view, however, does not capture the near daily variations in topics of conversation, nor the short-term dynamics of language change. In order to understand the dynamics of human language use, we present a corpus of daily word frequency variation scraped from online news sources every 20 min for more than 2 years. We construct a simple time-varying model with (...) a latent state, which is observed via word frequency counts. We use Bayesian techniques to infer the parameters of this model for 20,000 words, allowing us to convert complex word-frequency trajectories into low-dimensional parameters in word usage. By analyzing the inferred parameters of this model, we quantify the relative mobility and drift of words on a day-to-day basis, while accounting for sampling error. We quantify this variation and show evidence against “rich-get-richer” models of word use, which have been previously hypothesized to explain statistical patterns in language. (shrink)

This paper examines how scientists conceptualize their research methodologies. Do scientists raise concerns about vague criteria and genuine uncertainties in experimental practice? If so, what sorts of issues do they identify as problematic? Do scientists acknowledge the presence of value judgments in scientific research, and do they reflect on the relation between epistemic and non-epistemic criteria for decisionmaking? We present findings from an analysis of qualitative interviews with 63 scientific researchers who talk about their views on good research practice. We (...) argue that analysts of science should care about scientists’ conceptualizations of the criteria and of the practical judgments that scientific inquiry involves. While scientists’ accounts of their own research methodologies alone do not give us a full picture of how science really works, they can point us to areas of concern. They can inspire and direct philosophical reflections about how science works. Throughout the interviews, the participating researchers provided specific examples from their own research contexts as illustrations of their methodological points. These examples reveal that scientists often struggle to evaluate the quality of their data, to figure out whether the available evidence confirms their hypothesis, whether a replication was successful, or to what extent they can rely on peer-reviewed papers. General ideas about good research methods do not directly translate into specific evaluation criteria or strategies that can guide research and help validate empirical data. (shrink)

This paper examines how scientists conceptualize their research methodologies. Do scientists raise concerns about vague criteria and genuine uncertainties in experimental practice? If so, what sorts of issues do they identify as problematic? Do scientists acknowledge the presence of value judgments in scientific research, and do they reflect on the relation between epistemic and non-epistemic criteria for decisionmaking? We present findings from an analysis of qualitative interviews with 63 scientific researchers who talk about their views on good research practice. We (...) argue that analysts of science should care about scientists’ conceptualizations of the criteria and of the practical judgments that scientific inquiry involves. While scientists’ accounts of their own research methodologies alone do not give us a full picture of how science really works, they can point us to areas of concern. They can inspire and direct philosophical reflections about how science works. Throughout the interviews, the participating researchers provided specific examples from their own research contexts as illustrations of their methodological points. These examples reveal that scientists often struggle to evaluate the quality of their data, to figure out whether the available evidence confirms their hypothesis, whether a replication was successful, or to what extent they can rely on peer-reviewed papers. General ideas about good research methods do not directly translate into specific evaluation criteria or strategies that can guide research and help validate empirical data. (shrink)

Michel Foucault’s “Standing Vigil for the Day to Come” was a review of Roger Laporte’s novel, La Veille, published by Gallimard earlier that year. Although Laporte’s work never received the wide readership it deserved, Foucault held it in high esteem, praising it in his assessment as one of the “most original” and “most difficult” of his time and, subsequently, urging Derrida to read it. This article is most appropriately situated in the series of literary reviews Foucault composed between 1961 and (...) 1966, in which his marked attempts to understand the relationship between language and thought drew him to the works of Roussel, Klossowski, Hölderlin, Mallarmé, and, of course, Laporte. Foucault finds Laporte’s treatment of the subject-matter particularly satisfying because it provides a non-reductive account of thought and its relationship to language; thought is neither identical with nor distinct from language. Foucault sees Laporte as relying on an important Nietzschean insight that thought is both too funda- mental and too archaic to be reduced to philosophy or to require a Cartesian ego. In this way La Veille is naturally of interest to Foucault because it deals with the relationship of a writer to an anonymous other; it is this other — not the writer — that makes writing possible. With the role of the subject de-emphasized, Foucault finds in Laporte a starting point for talking about language in contemporary literature and thought in post- Cartesian philosophy. (shrink)

This is the definitive companion to the study of the philosophy of history. It provides an accessible and comprehensive introduction to all the major philosophical concepts, issues and debates raised by history. Ideal for undergraduate students in philosophy and history, the structure and content closely reflect the way the philosophy of history is studied and taught. -/- The book offers a lucid treatment of existing approaches to the philosophy of history and also breaks new ground by extending the major debates (...) in this area of growing philosophical interest. Subjects examined include: the centrality of historical language; objections to historical truth and realism; the relationship between the philosophy of history and the philosophy of science; historical interpretation and narrative; philosophical accounts of historical reasoning from the evidence. The text clearly presents and criticizes the arguments of the major philosophers and historians who have contributed to our understanding of the philosophy of history. -/- Mark Day's rigorous analysis is supplemented by useful pedagogical features, including key examples from historical and philosophical writing; summaries of core debates; study questions; and guides to further reading. (shrink)

What is one who takes normativity seriously to do if normativity can neither be discovered lurking out there in the world independently of us nor can it be sufficiently grasped from a merely explanatory perspective? One option is to accept that the normative challenge cannot be met and to retreat to some form of moral skepticism. Another possibility has recently been proposed by Christine Korsgaard in The Sources of Normativity where she aims to develop an account of normativity which is (...) grounded in autonomy. Furthermore, she argues that on her account reasons are "essentially public" and that this captures how it is that we can obligate one another. In this paper I argue that there is a serious tension between her account of normativity and the publicity of reasons-namely, that if reasons are essentially public, then it is not possible for individuals to legislate laws for themselves. However, I then argue that if we revise her conception of normativity such that it is understood to involve collective rather than individual legislation that it may then be possible to account for interpersonal reasons. (shrink)

This is the first comprehensive study of the sublime in Lucan. Drawing upon renewed literary-critical interest in the tradition of philosophical aesthetics, Henry Day argues that the category of the sublime offers a means of moving beyond readings of Lucan's Bellum Civile in terms of the poem's political commitment or, alternatively, nihilism. Demonstrating in dialogue with theorists from Burke and Kant to Freud, Lyotard and Ankersmit the continuing vitality of Longinus' foundational treatise On the Sublime, Day charts Lucan's complex and (...) instructive exploration of the relationship between sublimity and ethical discourses of freedom and oppression. Through the Bellum Civile's cataclysmic vision of civil war and metapoetic accounts of its own genesis, through its heated linguistic texture and proclaimed effects upon future readers and, most powerfully of all, through its representation of its twin protagonists Caesar and Pompey, Lucan's great epic emerges as a central text in the history of the sublime. (shrink)

In this paper I critically evaluate Ronald Dworkin's attempt in Life's Dominion to understand sacred value as a form of intrinsic value which is grounded in investment. I argue that there are two problems with Dworkin's conception of intrinsic value. First, it does not allow him to distinguish, as he must, between incremental and sacred values. Secondly, sacred value qua intrinsic value is not the kind of value which can be grounded in investment. I argue that both of these problems (...) are an implication of a realist conception of intrinsic value. Nevertheless, investment does seem to play a role in our judgements about intrinsic value and in light of this I aim to develop an alternative account of intrinsic value whichcan make sense of this. (shrink)

The thesis of underdetermination presents a major obstacle to the epistemological claims of scientific realism. That thesis is regularly assumed in the philosophy of science, but is puzzlingly at odds with the actual history of science, in which empirically adequate theories are thin on the ground. We propose to advance a case for scientific realism which concentrates on the process of scientific reasoning rather than its theoretical products. Developing an account of causal–explanatory inference will make it easier to resist the (...) thesis of underdetermination. For, if we are not restricted to inference to the best explanation only at the level of major theories, we will be able to acknowledge that there is a structure in data sets which imposes serious constraints on possible theoretical alternatives. We describe how Differential Inference, a form of inference based on contrastive explanation, can be used in order to generate causal hypotheses. We then go on to consider how experimental manipulation of differences can be used to achieve Difference Closure, thereby confirming claims of causal efficacy and also eliminating possible confounds. The model of Differential Inference outlined here shows at least one way in which it is possible to ‘reason from the phenomena’. (shrink)

This paper discusses the problems of an ontological value of the variable in Russell’s philosophy. The variable is essential in Russell’s theory of denotation, which among other things, purports to prove Meinongian being outside of subsistence and existence to be logically unnecessary. I argue that neither Russell’s epistemology nor his ontology can account for the ontological value of the variable without running into qualities of Meinongian being that Russell disputed. The problem is that the variable cannot be logically grounded by (...) Russell’s theory of denotation. As such, in so far as being is concerned, Meinong and Russell’s theories are much closer than is typically thought. The arguments are supported with concerns raised by Russell, Frege, and Moore regarding the ontological value of the variable. The problem can be summarised as follows: the variable is the fundamental denoting-position of a formal theory that is meant to explain the structure of the ontological. If such a formal theory is meant to ground the ontological, then the formal must also represent the actual structure of the ontological. Yet the variable, the fundamental symbol of denotation in a theory that defines objects, is ontologically indefinable. (shrink)

This article attempts to chart a course beyond the 'impasse of the political' in Derridean deconstruction that avoids both the ontologization of ethics in Levinas and the recourse to morality in Habermasian discourse ethics. Instead, it presents an account of the decision in a terrain of undecidability through the concept of affinity. This mode of ethico-political activity, when combined with Foucault's analytics of power and Deleuze and Guattari's schizoanalysis, provides the outlines of a project of radical social transformation that could (...) achieve greater nuance with regard to 'actually existing' democracy and justice than has so far been achieved within deconstructive political theory. At the level of social structure, such a project is commensurate with a move away from subject positions associated with the system of liberal-capitalist nation-states, in favour of identifications produced by a locus of 'coming' communities. Key Words: affinity • Critchley • deconstruction • Deleuze and Guattari • Derrida • ethics • Foucault • Laclau and Mouffe • politics. (shrink)

Mill holds a metaphysical theory about the nature of things which is of the sensationalist or phenomenalist variety, and which he derives admittedly from the idealism of Berkeley. This metaphysical theory is introduced into a discussion in which he is attempting something different, namely, to offer a rival psychological account to Hamilton's intuitionist one of how it is that men possess that familiar but complex conception, Nature or the external world. It will be convenient to consider his psychological theory first.

What is one doing when one improvises music, as one does in jazz? There are two sorts of account prominent in jazz literature. The traditional answer is that one is organizing sound materials in the only way they can be organized if they are to be musical. This implies that jazz solos are to be interpreted with the procedures of written music in mind. A second, more controversial answer is offered in David Sudnow's pioneering account of the phenomenology of improvisation, (...) Ways of the Hand. Sudnow claims that learning to improvise at the piano is concerned centrally with copying the bodily ways of one's mentors and finding how one's instructable hands and the keyboard come to answer to one another, so that "to define jazz ... is to describe the body's ways." But despite its greater sensitivity over the traditional account, Sudnow's account is flawed both as a description of how improvisatory skill is acquired and as a model for describing the interest of jazz. My critique of Sudnow compares his account to Augustine's account of learning language, and finds that Wittgenstein's criticisms of Augustine extend to Sudnow. I offer a third approach to understanding improvised music, one which treats the procedures of improvisation as derived from, and importantly at play in, our everyday actions. (shrink)

Despite the recent proliferation of scientific, clinical, and narrative accounts of auditory verbal hallucinations, the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucinatory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowledge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate methodologies to analyze a wider range of first-person accounts (...) of AVH at 3 contextual levels: cultural, social, and historical; experiential; and biographical. We go on to show that there are significant potential benefits for voice hearers, clinicians, and researchers. These include informing the development and refinement of subtypes of hallucinations within and across diagnostic categories; “front-loading” research in cognitive neuroscience; and suggesting new possibilities for therapeutic intervention. In conclusion, we argue that an interdisciplinary approach to the phenomenology of AVH can nourish the ethical core of scientific enquiry by challenging its interpretive paradigms, and offer voice hearers richer, potentially more empowering ways to make sense of their experiences. (shrink)

In this introduction we present the orthodox account of auditory verbal hallucinations, a number of worries for this account, and some potential responses open to its proponents. With some problems still remaining, we then introduce the problems presented by the phenomenon of thought insertion, in particular the question of how different it is supposed to be from AVHs. We then mention two ways in which theorists have adopted different approaches to voices and thoughts in psychosis, and then present the motivation (...) and composition of this special issue. (shrink)

Aureli advances a fresh, spirited and combative account of the idea of ‘autonomy’, connecting Italian architectural debates from the 1960s with the politics of class-autonomy that was being developed and advanced by workerist theorists such as Raniero Panzieri, Mario Tronti and Toni Negri. Aureli’s account focuses on Aldo Rossi’s architectural ideas and the project of the No-Stop City proposed by the young avant-garde group Archizoom. The Project of Autonomy is not simply envisaged as an historical exploration of the 1960s; primarily, (...) it is conceived as an intervention in current architectural theory, drawing on the author’s interest in Tronti’s politics to challenge the contemporary popularity of a broadly post-Negrian ‘autonomism’. This review questions aspects of Aureli’s reading of Rossi and Manfredo Tafuri. Furthermore, although Aureli’s discussion of Red Vienna opens up onto vital questions of strategies for social change, which remain pertinent to contemporary arguments over ‘enclaves’ or ‘zones’ of resistance, his antagonism towards Tafuri prevents his argument from either exploring or advancing the debate which he has initiated. (shrink)

In this paper, we show that the question of the relative importance of innate characteristics and institutional arrangements in explaining human difference was vehemently contested in Britain during the first half of the nineteenth century. Thus Sir Francis Galton’s work of the 1860s should be seen as an intervention in a pre-existing controversy. The central figure in these earlier debates—as well as many later ones—was the philosopher and economist John Stuart Mill. In Mill’s view, human nature was fundamentally shaped by (...) history and culture, factors that accounted for most mental and behavioral differences between men and women and among people of different classes, nationalities, and races. Indeed, Mill’s whole program of social reform depended on the assumption that human differences were not fixed by nature. To identify the leading figures in these disputes about difference and the concrete context in which they occurred, we explore three debates in which Mill played a key role: over the capacities and rights of women, the viability of peasant proprietorship in India and Ireland, and the status of black labor in Jamaica. The last two draw our attention to the important colonial context of the nature–nurture debate. We also show that ideas that for us seem of a piece were not always linked for these earlier thinkers, nor did views on innateness necessarily have the political correlates that we now take for granted. (shrink)

Although primary source work is a major component of undergraduate history degrees in many countries, the topic of how best to support this work has been relatively unexplored. This article addresses the pedagogical support of primary source work by reviewing relevant literature to identify the challenges undergraduates face in interpreting sources, and examining how in two courses carefully articulated course design and supportive teaching activities assisted students to meet these challenges. This fine-grained examination of the courses is framed within a (...) socio-cultural account of learning. The findings show how a skilful drawing of students into the interpretive/discursive practices of source analysis was associated with an epistemological reframing of historical knowledge and dialogical forms of teaching that helped the students to take forward a dialectical engagement with sources. The benefits of an ‘integrated’ approach to source work that fosters students’ affective and intellectual engagement with historical interpretive practices are highlighted. (shrink)

Starting from the 2009 Istanbul Biennial, with its Brechtian curatorial theme, this essay considers the Left’s varying responses to art’s so-called ‘political turn’. Discussion ranges from the local and regional context of the Biennial’s function as part of Turkey’s bid to join the EU, through to a longer theoretical perspective on the critical debates over ‘art and life’, artistic autonomy and heteronomy, and the revival in avant-gardism. The authors propose that the standard accounts of the intimate connection between the (...) commodity and art have become politically counterproductive. They suggest that Marxist analysis needs to develop a more complexly-articulated philosophical reflection on the relation between economy, politics, and art ‐ and between political and aesthetic praxes ‐ if it is to advance its longstanding contributions to considerations of ‘aesthetics and politics’. (shrink)

Critical accounts of race have drastically changed the landscapes of the social, the political, and the intimate. Philosophical perspectives on racial identity and difference hold out transformative possibilities for aesthetics. Revealing the entanglement of analytical concepts and day-to-day life with racial meaning, such approaches challenge the field of aesthetics to encounter its methodologies with a fresh look. How can aesthetics rethink itself by rethinking race and empire? What shape do aesthetic themes take in light of the historical, spatial, imaginative, (...) affective, sensory, and sexual registers of racial subjectivity and the pervasiveness of racist and neocolonial constellations? How do art and the aesthetic reflect, or critically engage, racialization? What forms and idioms enable us to articulate the racial ethics and politics that shape our various conscious and unconscious aesthetic projects? (shrink)

v. 1. The history of philosophy and science from ancient times to the present day -- v. 2. The origin of the mental capacities and dispositions of man and their normal, abnormal and supernormal manifestations.

ABSTRACT:Central to the United Nations Framework setting out the human rights responsibilities of corporations proposed by John Ruggie is the principle that corporations have a responsibility to respect human rights in their operations whether or not doing so is required by law and whether or not human rights laws are actively enforced. Ruggie proposes that corporations should respect this principle in their strategic management and day-to-day operations for reasons of corporate (enlightened) self-interest. This paper identifies this as a serious weakness (...) and argues that identifying the responsibility to respect human rights as an explicitly ethical obligation to be respected for that reason would provide a much stronger justificatory foundation for respecting the principle seen from a corporate perspective, given that corporations are accountable to their shareholders for their deployment of the firm’s financial resources. (shrink)

ArgumentThe discovery of electron diffraction by George Paget Thomson in Aberdeen and Clinton J. Davisson and Lester H. Germer at the Bell Labs has often been portrayed as an example of independent discovery. Neither team was particularly interested in the developments of the nascent quantum theory but they both ended up demonstrating one of the most striking experimental consequences of the new physics. This paper traces the aftermath of this discovery and the way electron diffraction immediately turned from empirical evidence (...) of a highly novel theory into a technique for applied and technological research. Thomson was the first to design an “electron diffraction camera,” an instrument that soon found its place in laboratories around the world. I discuss the role played by Davisson and Germer, and by Thomson in the development of electron diffraction as a “research technology,” taking into account their specific institutional settings and research cultures. While Davisson and Germer remained in the industry-oriented Bell Labs, Thomson moved to Imperial College in 1930 where collaboration first, and competition later with George I. Finch was also relevant for the consolidation of an instrument that eventually became widely known as the “Finch Camera.”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Unique Response to Death:Day of the Dead Fiestas and Communal Articulations of ResistanceDenise Meda-LambruIntroductionPhilosophers such as Octavio Paz and Emilio Uranga theorize death grounded in Mexican circumstances to show an intimate relational dynamic with life. In their view, death is embedded in the everydayness of the living. Carlos A. Sánchez, in "Death and the Colonial Difference," explains that the Mexican idea of death reveals much about the life (...) and the situatedness of those who subscribe to the relational dynamic between life and death. Death is linked to the living, especially for those who are situated in inferiorized positions. In the accounts promoted by Paz and by Uranga, the historical and social conditions of lived experience provide the context for how death is conceived, and, subsequently, treated. They advance Mexican conceptions of death and provide interesting perspectives into how some colonized peoples are resisting narrow narratives of death. This is to say that their approaches do not grant the dominant assumption that death is merely a biological event or a life event ceasing the life of the individual. In this essay, I examine their critiques of dominant assumptions of death to elaborate on conceptions of death contextualized within historical and social entanglements, namely, a Mexican analysis of death. In particular, I utilize Paz's work on Day of the Dead fiestas to study communal practices and theorize the ritual dimensions of the life and death relationship. Through an examination of a Mexican approach to death, I contend that rituals of death help locate the non-dominant social logics that engender resistant activity and cultivate a distinct interconnected communal relation.To develop this position, I clarify the historical and social distinctions between Mexican and Anglo-American approaches to death and analyze literature promoting a Mexican view of death. Ultimately, I share a similar view [End Page 31] with Paz, Uranga, and Sánchez who charge that there is a unique Mexican idea of death. However, to be clear, my interest in their work does not assume they represent the Mexican view of death (Brandes, Skulls to the Living). Rather, I am interested in exploring how their discussions of death, from a particular socio-historical situation, reveal ways in which colonized peoples refuse dichotomous narratives of death. Sánchez's work, in particular, provides valuable insights into the Mexican relation with death, particularly the role of coloniality/modernity with temporality. Lastly, as I return to Paz's own discussion of death, I refer to the sensibilities and practices relevant to the resistant dimensions of a Mexican relationship with death. An analysis of Paz's focus on fiestas offers a focus distinct from Sánchez in that it pays significant attention to the ritual dimensions of death and helps illustrate the resistant responses to hegemonic social norms. Thus, paying attention to communal practices, this essay emphasizes the relationship between death rituals and deviant activity to dominant modes of being.What Is Death? Examining the DistinctionsScholars have noted a distinction between the logics involved in European and Anglo-American approaches to death and those of Mexican people. Emilio Uranga asserts that "[f]or the North American (el norteamericano), death is a reality that must be hidden, a phenomenon that is silenced and masked as much as possible so that it will not disturb, with its impertinence, the flow of a life that unfolds in radical dedication to [self]-realization and work" (qtd. in Sánchez 180). Paz shares a similar view of this concealment. He writes that "the word death is not pronounced in New York, in Paris, in London, because it burns the lips" ("Day of the Dead" 57). Paz describes death for the Euro-Anglo as one that is treated as a stinging topic to be avoided. In both Uranga's view and Paz's view, the Euro-Anglo phenomenon of death is not socially discussed or regarded as part of the daily lived realities of the subject. If we take their accounts as at least generally accurate, then for Anglos, death is something that is to be treated as separate from life.1In distinction, however, the Mexican attitude toward death is described as... (shrink)

As financial turmoil in Europe preoccupies political leaders and global markets, it becomes more important than ever to understand the forces that underpin the European Union, hold it together and drive it forward. This timely book provides a gripping account of the realities of power politics among European states and between their leaders. Drawing on long experience working behind the scenes, Luuk van Middelaar captures the dynamics and tensions shaping the European Union from its origins until today. It is a (...) story of unexpected events and twists of fate, bold vision and sheer necessity, told from the perspective of the keyplayers – from de Gaulle to Havel, Thatcher to Merkel. Van Middelaar cuts through the institutional complexity by exploring the unforeseen outcomes of decisive moments and focusing on the quest for public legitimacy. As a first-hand witness to the day-to-day actions and decisions of Europe’s leaders, the author provides a vivid narrative of the crises and compromises that united a continent. By revisiting the past, he sheds fresh light on the present state of European unification and offers insights into what the future may hold. (shrink)

E. Haavi Morreim's book, Holding Health Care Accountable , insightfully describes several features of the current crisis in malpractice in relation to the health care marketplace. In this essay, I delineate the key and eminently practical guide for reform that she lays out. I argue that her insights bring us to more fundamental aspects than immanent medical economy and accountability - aspects that are ignored at present. I describe the features of immanent economy and how they tend to cover over (...) epistemological and existential finitude in medicine, show how economy can in fact create new medical knowledge, and show that necessary error is a real feature of day-to-day medical practice. The current system, even with Morreim's reforms, remains at the level of immanent economy, but with modifications may point to the features of medicine that transcend medical knowledge and economy. The gifts of medicine cannot be reduced to the immanent medical economy, and any attempt to do so results in crisis. A health care that points to finitude and fallibility is one that points to the mystery of human existence and mortality. Any health care financing system that helps to delineate finitude - both epistemological and existential - is one that will give patients a new lease on living and dying. (shrink)

In this chapter we use methods of corpus linguistics to investigate the ways in which mathematicians describe their work as explanatory in their research papers. We analyse use of the words explain/explanation (and various related words and expressions) in a large corpus of texts containing research papers in mathematics and in physical sciences, comparing this with their use in corpora of general, day-to-day English. We find that although mathematicians do use this family of words, such use is considerably less prevalent (...) in mathematics papers than in physics papers or in general English. Furthermore, we find that the proportion with which mathematicians use expressions related to ‘explaining why’ and ‘explaining how’ is significantly different to the equivalent proportion in physics and in general English. We discuss possible accounts for these differences. (shrink)

When aggression is conceptualised in terms of a cost-benefit ratio, sex differences are best understood by a consideration of female costs as well as male benefits. Benefits must be extremely high to outweigh the greater costs borne by females, and circumstances where this occurs are discussed. Achievement of dominance is not such a circumstance and evidence bearing upon women's egalitarian relationships is reviewed. Attempts to explain sex differences in terms of sexual dimorphism, sex-of-target effects, social control, and socialisation are found (...) to be inadequate. The suggestion that the stigmatisation of female aggreession arises not from patriarchal imposition but from statistical rarity (resulting from evolutionary pressures) is given serious consideration. Two hypotheses (“internal read-out” versus social/epidemiological representations) are described to explain the relationship between sex differences in behaviour and corresponding lay explanations. (shrink)

Crossing the road within the traffic system is an example of an action human agents perform successfully day-to-day in complex systems. How do they perform such successful actions given that the behaviour of complex systems is often difficult to predict? The contemporary literature contains two contrasting approaches to the epistemology of complex systems: an analytic and a post-modern approach. We argue that neither approach adequately accounts for how successful action is possible in complex systems. Agents regularly perform successful actions (...) without obeying (explicit or implicit) algorithmic rules (as the analytic approach suggests) and without an existential leap to action (as the post-modern approach suggests). We offer an alternative: A common-sense pragmatist epistemology, one that focuses on the kind of actions making up most agents’ successful moment-to-moment actions in complex systems. Successful actions obtain when agents apply ceteris paribus rules-of-thumb during predictive and decisional practices while achieving some desired goal. (shrink)

General Series Editors: Gay Wilson Allen and Sculley Bradley Originally published between 1961 and 1984, and now available in paperback for the first time, the critically acclaimed Collected Writings of Walt Whitman captures every facet of one of America's most important poets. In discussing letter-writing, Whitman made his own views clear. Simplicity and naturalness were his guidelines. ”I like my letters to be personal—very personal—and then stop.“ The six volumes in The Correspondence comprise nearly 3,000 letters written over a half (...) century, revealing Whitman the person as no other documents can. This volume, together with Volume V, covers the last seven years of Whitman’s life, giving an almost day-by-day account of his long struggle with various ailments, his stoical acceptance of constant pain, but also his continuing energy. This period saw his supervision and publication of two complete editions of Leaves of Grass, as well as November Boughs and Good-bye My Fancy. Although Whitman himself admitted that many of his later poems were “pot boilers,” designed primarily to make money, his recognition and popularity continued to grow as his health declined. His poems were printed seemingly everywhere and the volume of critical commentary increased. Unlike many of his contemporaries, Whitman did not suffer from neglect of indifference. (shrink)

Responding to serious environmental problems, requires urgent and fundamental shifts in our day-to-day lifestyles. This paper employs a qualitative, cross-cultural approach to explore people’s subjective self-reflections on their experiences of pro-environmental behavioral spillover in three countries; Brazil, China, and Denmark. Behavioral spillover is an appealing yet elusive phenomenon, but offers a potential way of encouraging wider, voluntary lifestyle shifts beyond the scope of single behavior change interventions. Behavioral spillover theory proposes that engaging in one pro-environmental action can catalyze the performance (...) of others. To date, evidence for the phenomenon has been mixed, and the causal processes governing relationships between behaviors appear complex, inconsistent and only partly understood. This paper addresses a gap in the literature by investigating accounts of behavioral spillover in three diverse cultural settings using qualitative semi-structured interviews. The analysis shows that while around half of participants overall who were questioned recalled spillover effects, the other half had not consciously experienced spillover. There were few significant differences across cultures, though some forms of spillover effects were reported more in some cultures than others. More environmentally-engaged participants across all three countries were significantly more likely to experience spillover than those who were less engaged. Accounts of within-domain spillovers were most commonly reported, mainly comprising waste, resource conservation and consumption-related actions. Accounts of between-domain spillover were very rare. Recollection of contextual and interpersonal spillover effects also emerged from the interviews. Our findings suggest that more conscious behavioral spillover pathways may be limited to those with pre-existing environmental values. Behavioral spillover may comprise multiple pathways incorporating conscious and unconscious processes. We conclude that targeting behavioral catalysts that generate more socially diffuse spillover effects could offer more potential than conventional spillover involving a single individual. (shrink)

By questioning the validity of some of our basic concepts, such as space, object, and causality, quantum physics contributes quite decisively to the dramatic changes now taking place in our world picture. Veiled Reality provides a detailed view of the reasons why such a questioning arises, a survey of the corresponding conceptual and theoretical problems, and a comprehensive, up-to-date account, useful to scientists and epistemologists alike, of the various ways present-day physicists tackle these problems.The book deals with the E.P.R. reality (...) criterion, local causality, and quantum measurement including relativistic quantum collapse, decoherence theories, consistent histories approaches, and ontologically interpretable theories. Questions bearing on the connection between counterfactuality and realism, intersubjective agreement, and limits of the bearing of the verbs “to have” and “to be,” follow naturally from the analysis and are thoroughly examined. Finally, distinguishing between empirical reality and a veiled independent reality whose only knowable features are structural yields a clue to a plausible interpretation of current physics.Accessible to readers with only very elementary background in modern physics, Veiled Reality offers nonspecialists, including students in physics and philosophy, easy access to basic problems in the foundation of physics. (shrink)

In light of the ramifications for Spenserian hermeneutics in the Proems to Books Two (“unseen” reality) and Three (“living art”) of The Faerie Queene, this essay reads Prince Arthur’s account of his dream-vision of Gloriana (1.9) as an allegory for how the reader ideally should encounter and make meaning from the poet’s text. Spenser’s concept of “living art” echoes Dante’s “living language,” and both show the influence of Augustine, especially as regards the readerly agency called for in the Christian Doctrine (...) and the Confessions. Places of textual obscurity (the “unseen”) mark opportunities for the reader to exercise and develop the capacity to generate interpretations, a process both the effect and the cause of virtue. This process is figured in Arthur’s memory of his dream of the Faerie Queen and how it inspires him to pursue her. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. (shrink)

Peter Koestenbaum and Peter Block offer you a new perspective forviewing the workplace through the lens of philosophy so that youmay have a better understanding of how to reclaim your freedom andaccountability and encourage the same in others. They provide aradical new approach to your work-a-day life that will bring truemeaning and power to your work. Freedom and Accountability at Work offers you the information youneed to: * Gain strength and meaning by transforming your thinking on howyou view anxiety, doubt, (...) death, and guilt * Find new ways to bring spiritual and ethical values into yourworkplace * Engage in profound change that will help you overcome cynicismthat comes from superficial change * Replace your loss of organizational loyalty and safety with asense of freedom and accountability "Both Koestenbaum and Block are such passionate men who bringtogether what we all seek in our work life-meaning, insight, andhumanness. Bless them for this book." --Joyce DeShano, board chair, Ascension Health. (shrink)

The day to day experiences of answering machine messages, written notes, postcard messages, etc. and our intuitions regarding these seem to contradict the traditional assumptions in the semantics of indexicals. The primary analytical scope of the article is to undertake an analysis of Allyson Mount’s convergence of perspectives-based account of indexical reference and see whether it is able to successfully meet the challenges faced by Stefano Predelli’s intended context of interpretation approach towards the semantics of indexicals, thereby providing a viable (...) solution to the Answering Machine Paradox. (shrink)

In the old days of descriptivism, fictional reference and non-fictional reference with proper names were treated on a par. Descriptivism was not an intuitive theory, but it meritoriously provided a unitary semantic account of names, whether referentially full or empty. Then the revolution of the new theory of reference occurred. This new theory is definitely more intuitive than descriptivism, yet it comes with a drawback: the referentially full use and the referentially empty use, notably the fictional use, of names are (...) semantically no longer on the same footing. How the use of names from fiction is referentially empty has even been seen as a symptom of its not being a use at all. In this paper, I ask the following question: can one keep the merits of the new theory of reference and still provide a unitary account of both fictional and non-fictional reference with names? My answer is positive, provided that one conceives proper names as a special kind of indexicals. (shrink)

Bien, Victor Readers here will be familiar with the book 'Limits to Growth' by the Club of Rome in the 1970s. As we know it was written in the same spirit as Thomas Malthus's 'Principle of Population'. Malthus's central thesis warned of the dire consequences of population growth outstripping the supply of food and other resources. This prediction never happened because Malthus had failed to take account of advances in technology. Similarly the dire forecasts by the Club of Rome that (...) key ingredients of the modern economy such as coal, oil and industrial metals would run out never materialised, as technological developments have always kept ahead. So why do I see the idea as still relevant? (shrink)

The Arabic documentary papyri are precious wit- nesses to the day-to-day written Arabic of their time. These texts exhibit consider- able variation in grammar and orthography. Classical Arabic and the prescriptive attitudes of the Arabic grammarians traditionally provided the lens through which the earliest documents of the Islamic period have been read. Since Classical Ara- bic was only fully canonized in the tenth century, approaching the early Arabic papyri, and the variation attested in them, through this standard is anachronistic. This (...) article seeks to understand the language of these documents on their own terms. It employs a quantitative approach to investigate the nominal case system, focusing on the form of ʾab in construct, producing a fine-grained analysis of how inflection operated in early documentary Arabic, and attempts to account for points of divergence within a historical and sociolinguistic framework. (shrink)

Inspired by Heidegger’s concept of the clearing of being, and by Wittgenstein’s ideas on human practice, Theodore Schatzki offers a novel approach to understanding the constitution and transformation of social life. Key to the account he develops here is the context in which social life unfolds—the "site of the social"—as a contingent and constantly metamorphosing mesh of practices and material orders. Schatzki’s analysis reveals the advantages of this site ontology over the traditional individualist, holistic, and structuralist accounts that have (...) dominated social theory since the mid-nineteenth century. A special feature of the book is its development of the theoretical argument by sustained reference to two historical examples: the medicinal herb business of a Shaker village in the 1850s and contemporary day trading on the Nasdaq market. First focusing on the relative simplicity of Shaker life to illuminate basic ontological characteristics of the social site, Schatzki then uses the sharp contrast with the complex and dynamic practice of day trading to reveal what makes this approach useful as a general account of social existence. Along the way he provides new insights into many major issues in social theory, including the nature of social order, the significance of agency, the distinction between society and nature, the forms of social change, and how the social present affects its future. (shrink)

The Holocaust marks a decisive moment in modern suffering in which it becomes almost impossible to find meaning or redemption in the experience. In this study, C. Fred Alford offers a new and thoughtful examination of the experience of suffering. Moving from the Book of Job, an account of meaningful suffering in a God-drenched world, to the work of Primo Levi, who attempted to find meaning in the Holocaust through absolute clarity of insight, he concludes that neither strategy works well (...) in today's world. More effective are the day-to-day coping practices of some survivors. Drawing on testimonies of survivors from the Fortunoff Video Archives, Alford also applies the work of Julia Kristeva and the psychoanalyst Donald Winnicot to his examination of a topic that has been and continues to be central to human experience. (shrink)

In this article I review significant contributions to the subfield of Embodied Cognition that formulate an inclusive account of the body's role in cognitive processes. I argue that a reconceptualization of the mind–body problem must take into account some notion of the self as a nonlocalized, transient phenomenon that emerges through day-to-day interaction. Drawing on literature from epistemology, phenomenology, and Conversation Analysis, I aim to revise contributions that rely on essentialized notions of the self and speaker, in terms of an (...) enactive and Conversation Analytic approach to selfhood and cognition. (shrink)

Healthcare ethics has to date had very little to say about the treatment of chronic illness. That is problematic. Chronic illness differs from other illnesses in that: 1. in most cases it cannot be cured; 2. patients can live with it for many years; and 3. its day to day management is typically carried out, not by healthcare professionals, but by the patient and/or members of their family. These features problematise key distinctions that underlie much existing work in healthcare ethics (...) — including those between beneficence and autonomy, between treatment and prevention, and between the recipient and provider of treatment. They also raise ethical questions that have not to date been addressed in any detail — including what healthcare professionals should do when patients are managing their illness poorly, or when changes occur that affect their patients. For these reasons chronic illness provides a lens through which to challenge the adequacy of existing approaches to healthcare ethics, exposing the gaps and false assumptions built into them. In doing so it also provides the materials to build a more philosophically adequate account of healthcare professionals’ moral obligations than exists to date. Providing such an account is the aim of this monograph. (shrink)