As bioethics gains more prominence in public policy debates, it is time to more fully reflect on the following: what is its role in the public square, and what limitations relate to and barriers impede its fulfilment of this role? I contend we should consider the how of bioethics (as a policy influencer) rather than simply focus on the who or what of bioethical enquiry. This is not to suggest considerations of latter categories are not important, only that too little (...) attention has been paid to parallel or resulting policy involvement—involvement that will require specialised skills and knowledge that we can develop with a proactive (vs reactive) stance. Moreover, and equally critically, this how of public policy involvement will require more transparency regarding influences (eg, philosophical, ideological, cultural, socio-political) on what bioethicists bring to the table and what constituency base each represents—a humility as to the scope of one's role. In this vision, bioethics is not one single person or belief system for a policymaker to call to guide or give support to a position; rather, it offers tools—formed and utilised by a diverse disciplinary range of individuals—to help guide ethical analysis of biomedical endeavours, with the goal of infusion and diffusion of ethical enquiry and prioritisation in health policymaking, and greater humility among bioethicists who inform this discussion. (shrink)

Medical-legal partnerships (MLPs) — collaborative endeavors between health care clinicians and lawyers to more effectively address issues impacting health care — have proliferated over the past decade. The goal of this interdisciplinary approach is to improve the health outcomes and quality of life of patients and families, recognizing the many non-medical influences on health care and thus the value of an interdisciplinary team to enhance health. This article examines the unique, interrelated ethical issues that confront the clinical and legal partners (...) involved in MLPs. We contend that the ethical precepts of the clinical and legal professions should be seen as opportunities, not barriers, to further the interdisciplinary nature of MLPs. The commonalities in ethical approaches represent a potential bridge between legal and health care advocacy for patient/client well-being. Bioethics has a role to play in building and analyzing this bridge: bioethics may serve as a discourse and method to enhance collaboration by highlighting common ethical foundations and refocusing legal and clinical partners on their similar goals of service for patients/clients. This article explores this bridging role of bioethics, through a series of case studies. It concludes with recommendations to strengthen the collaborations. (shrink)

Medical-legal partnerships — collaborative endeavors between health care clinicians and lawyers to more effectively address issues impacting health care — have proliferated over the past decade. The goal of this interdisciplinary approach is to improve the health outcomes and quality of life of patients and families, recognizing the many non-medical influences on health care and thus the value of an interdisciplinary team to enhance health. There are currently over 180 MLPs at over 200 hospitals and health centers in the United (...) States, with increasing federal interest and potential legislative support of this model.This article examines the unique, interrelated, and often similar ethical issues that confront the clinical and legal partners involved in MLPs. We contend that the ethical precepts of the clinical and legal professions should be seen as opportunities, not barriers, to further the interdisciplinary nature of MLPs. (shrink)

Law is now routinely included in the medical school curriculum, often incorporated into bioethics and/or practice of medicine coursework. There seems to lack, however, a systematic understanding of what works in terms of getting across an effective depth and breadth of legal knowledge for medical students — or what such would even look like. Moreover, and more critically, while some literature addresses these what, when, how, and who questions, a more fundamental question is left unanswered: why teach law in medical (...) school? This article suggests a process to reveal a more consensual understanding of this latter question. The author highlights findings and recommendations of some of the leading literature to date related to teaching law in medical schools, and also recent U.K. projects addressing legal teaching in medical schools. Reflecting on these materials and activities, the author suggests that we take a “pause” before we argue for more or different legal topics within the medical curriculum. Before we alter the curricula for more and/or different “law,” first, it is critical to have a meaningful, stakeholder-driven, consensus-seeking discussion of the goals of legal education: why do we think it matters that medical students learn about “the law”? (shrink)

[T]each the law to empower physicians individually and collectively to use the law and law colleagues to serve patients and promote public welfare; in short to better foster the goals of the medical profession.And yet:[A]ntipathy appears to be deeper and more pervasive than ever before, making it hard to imagine that relations between attorneys and physicians can get much worse.It has long been recognized that an understanding of at least some core legal rules and concepts is an important piece of (...) medical training. To address this, law is now typically part of the core medical school curriculum, often incorporated into bioethics and/or practice of medicine coursework — whether as part of a distinct course or series of courses or threaded through the curriculum. While often this education focuses on rules, some have recommended that it also include fundamentals of legal reasoning, and go beyond knowledge to include skills, attitudes, and behaviors vis-à-vis the law. (shrink)

This article describes implementation of a longitudinal curriculum in public health law, building on doctrinal coursework with skills-based coursework and opportunities for interdisciplinary, community-based engagement and service learning. It specifically describes development of a Policy Practicum, giving an example of how law students can learn policy skills and skills of effective community coalition work through a healthy homes partnership, highlighting areas where the curriculum can incorporate interdisciplinary education. It offers lessons learned during the curriculum-building process, and concludes with a more (...) intensive service-learning strategy through the development of a Policy Lab. (shrink)

Cultural effects can influence the results of causal genetic analyses, such as Mendelian randomisation, but the potential influences of culture on genotype–phenotype associations are not currently well understood. Different genetic variants could be associated with different phenotypes in different populations, or culture could confound or influence the direction of the association between genotypes and phenotypes in different populations.

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

The comorbidity of chronic pain and opioid addiction is a serious problem that has been growing with the practice of prescribing opioids for chronic pain. Neuroimaging research has shown that chronic pain and opioid dependence both affect brain structure and function, but this is the first study to evaluate the neurophysiological alterations in patients with comorbid chronic pain and addiction. Eighteen participants with chronic low back pain and opioid addiction were compared with eighteen age- and sex-matched healthy individuals in a (...) pain-induction fMRI task. Unified structural equation modeling (SEM) with Lagrange multiplier (LM) testing yielded a network model of pain processing for patient and control groups based on 19 a priori defined regions. Tests of differences between groups on specific regression parameters were determined on a path-by-path basis using z-tests corrected for the number of comparisons. Patients with the chronic pain and addiction comorbidity had increased connection strengths; many of these connections were interhemispheric and spanned regions involved in sensory, affective, and cognitive processes. The affected regions included those that are commonly altered in chronic pain or addiction alone, indicating that this comorbidity manifests with neurological symptoms of both disorders. Understanding the neural mechanisms involved in the comorbidity is crucial to finding a comprehensive treatment, rather than treating the symptoms individually. (shrink)

Against the background of the exclusion of many feminist methodologies from mainstream philosophy, and in light of the methodological challenges of providing accounts of experience responsive to the lives of agents, in this paper I return to early feminist philosophers of emotion to highlight how they anticipate and respond to methodological criticisms. Sue Campbell (1956–2011) was one philosopher who used methodological quandaries to strengthen her account of the formation and expression of feelings (Campbell ). By rereading selected texts (...) together intentionally for their structural and methodological strategies, I emphasize the power of formal characteristics to make insightful claims about experience possible. I consider how feminist philosophers of “experienced agency” can put these strategies to use in facing ongoing methodological criticisms, taking as a case study an account of how it can feel to act responsibly against injustice. (shrink)

This case describes an adolescent in a crisis of a chronic medical condition whose situation is complicated by substance abuse and mental illness. D. Micah Hester provides an analytic approach, teasing apart the multiple layers of medical, developmental, and moral issues at hand and describing possible responses and outcomes. Amy T. Campbell examines existing legal guidelines for adolescent decision making, arguing that greater space exists for clinical discretion in these matters than commonly thought. Cheryl D. Lew discusses the development (...) of agency in adolescent patients, the ideal of autonomous decision making in the context of impairment and chronic illness, and the obligation of healthcare teams to examine an adolescent patient’s decisions in relation to her identity. (shrink)

We often talk of people as being more or less imaginative than one another – as being better or worse at imagining – and we also compare various feats of imagination to one another in terms of how easy or hard they are. Facts such as these might be taken to suggest that imagination is often implicitly understood as a skill. This implicit understanding, however, has rarely (if ever) been made explicit in the philosophical literature. Such is the task of (...) this chapter. I first attempt to flesh out several conditions for an activity to count as a skill. I then attempt to show how imagination can meet such conditions. The chapter concludes with an attempt to answer various worries that might be raised to the claim that imagination should be thought of as a skill. (shrink)

"Il faudrait que quelqu'un chez vous fasse un roman sur un intellectuel d'Europe centrale sous le coup des derniers événements. Pas seulement pour la curiosité psychologique. Pour apprendre à voir ce que vous n'aimez pas regarder", écrivait le phénoménologue tchèque Jan Patocka, en juillet 1949, à son ami Robert Campbell, philosophe et mathématicien français, auteur, en 1945, du premier ouvrage consacré aux écrits et à la pensée de Jean-Paul Sartre. Mieux qu'un roman, la correspondance amicale et philosophique que les (...) deux hommes échangeront pendant une trentaine d'années, avec deux hiatus dus aux aléas des circonstances, publiques et privées, depuis le lendemain de la Seconde Guerre mondiale, à travers le virage totalitaire de l'"autre Europe", le relatif dégel des années 1960 et l'avant-"printemps de Prague", jusqu'à l'engagement de Patocka dans le mouvement de la Charte 77 pour la défense des droits de l'homme, représente, dans ses trois dimensions indissolublement enchevêtrées de l'intime-quotidien, de l'historico-politique et de la pensée, un document d'une rare valeur précisément en ce sens. Un document qui nous met sous les yeux un exemple concret de ce que Patocka nomme "la vie dans l'idée". (shrink)

The challenge of handling fictional discourse is to find the best way to resolve the apparent inconsistencies in our ways of speaking about fiction. A promising approach is to take at least some such discourse to involve pretense, but does all fictional discourse involve pretense? I will argue that a better, less revisionary, solution is to take internal and fictionalizing discourse to involve pretense, while allowing that in external critical discourse, fictional names are used seriously to refer to fictional characters. (...) I then address two objections to such realist theories of fiction: One, that they can’t adequately account for the truth of singular nonexistence claims involving fictional names, and two, that accepting that there are fictional characters to which we refer is implausible or ontologically profligate. (shrink)

The authors offer ways to encourage and educate Americans to participate in the public deliberations that make democracy work and lay out the principles of..

The most widely debated conception of democracy in recent years is deliberative democracy--the idea that citizens or their representatives owe each other mutually acceptable reasons for the laws they enact. Two prominent voices in the ongoing discussion are Amy Gutmann and Dennis Thompson. In Why Deliberative Democracy?, they move the debate forward beyond their influential book, Democracy and Disagreement.What exactly is deliberative democracy? Why is it more defensible than its rivals? By offering clear answers to these timely questions, Gutmann and (...) Thompson illuminate the theory and practice of justifying public policies in contemporary democracies. They not only develop their theory of deliberative democracy in new directions but also apply it to new practical problems. They discuss bioethics, health care, truth commissions, educational policy, and decisions to declare war. In "What Deliberative Democracy Means," which opens this collection of essays, they provide the most accessible exposition of deliberative democracy to date. They show how deliberative democracy should play an important role even in the debates about military intervention abroad.Why Deliberative Democracy? contributes to our understanding of how democratic citizens and their representatives can make justifiable decisions for their society in the face of the fundamental disagreements that are inevitable in diverse societies. Gutmann and Thompson provide a balanced and fair-minded approach that will benefit anyone intent on giving reason and reciprocity a more prominent place in politics than power and special interests. (shrink)

Bailey (2021) offers a clever argument for the compatibility of determinism and moral responsibility based on the nature of intrinsic intentions. The argument is mistaken on two counts. First, it is invalid. Second, even setting that first point aside, the argument proves too much: we would be blameworthy in paradigm cases of non-blameworthiness. I conclude that we cannot reason from intentions to responsibility solely from the “inside out”—our possessing a blameworthy intention cannot tell us whether this intention is also blameworthy (...) in deterministic worlds. (shrink)

I offer a new interpretation of Heidegger’s analysis of anxiety in Being and Time as an account of the relationship between individual agents and the public normative practices of their communities. According to a prominent recent interpretation, Heidegger’s discussions of anxiety, death and the “call of conscience” together explain how we can respond to the norms of our practices as reasons and subject them to critical reflection. I argue that this is only part of the story. Anxiety is an occasion (...) for Dasein to take responsibility for its ongoing activity of interpreting the possibilities for living and acting made available by the normative practices of its community, which is presupposed and overlooked from the perspective of everyday Dasein. Public normativity underdetermines Dasein’s conception of what it would mean to take up any of the possibilities available in its world as a way of living its own life. (shrink)

While Roman Ingarden is well known for his work in aesthetics and studies in ontology, one of his most important and lasting contributions has been largely overlooked: his approach to a general ontology of social and cultural objects. Ingarden himself discusses cultural objects other than works of art directly in the first section of “The Architectural Work”1, where he develops a particularly penetrating view of the ontology of buildings, flags, and churches. This text provides the core insight into how his (...) more lengthy studies of the ontology of works of art in The Literary Work of Art and the rest of The Ontology of the Work of Art, combined with the ontological distinctions of Der Streit um die Existenz der Welt, may be used to understand social and cultural objects. The view that results, I will argue, is based in foreseeing problems with the reductivist and projectivist views that remain popular, and is capable of resolving central problems still thought to plague those who would offer a theory of cultural objects. (shrink)

Imagination is celebrated as our vehicle for escape from the mundane here and now. It transports us to distant lands of magic and make-believe, and provides us with diversions during boring meetings or long bus rides. Yet the focus on imagination as a means of escape from the real world minimizes the fact that imagination seems also to furnish us with knowledge about it. Imagination seems an essential component in our endeavor to learn about the world in which we live--whether (...) we're planning for the future, aiming to understand other people, or figuring out whether two puzzle pieces fit together. But how can the same mental power that allows us to escape the world as it currently is also inform us about the world as it currently is? Ten original essays grapple with this neglected question; in doing so, they present a diverse array of positions ranging from cautious optimism to deep-seated pessimism. Blending perspectives from philosophy of mind, cognitive science, epistemology, aesthetics, and ethics, Knowledge Through Imagination sheds new light on the epistemic role of imagination. (shrink)

Mossner's Life of David Hume remains the standard biography of this great thinker and writer. First published in 1954, and updated in 1980, it is now reissued in paperback in response to increased interest in Hume. E. C. Mossner was Emeritus Professor of English at the University of Texas at Austin. 'Mossner's work is a quite remarkable scholarly achievement; it will be an indispensable tool for Hume scholars and a treasure-trove of information for all students of the intellectual and literary (...) history of the eighteenth century' Richard H. Popkin in the Philological Quarterly. (shrink)

An incisive examination of bioethics and American healthcare, and their profound affects on American culture over the last sixty years, from two eminent scholars. An eye-opening look at the inevitable moral choices that come along with tremendous medical progress, Everybody Wants to Go to Heaven but Nobody Wants to Die is a primer for all Americans to talk more honestly about health care. Beginning in the 1950s when doctors still paid house calls but regularly withheld the truth from their patients, (...) Amy Gutmann and Jonathan D. Moreno explore an unprecedented revolution in health care and explain the problem with America’s wanting everything that medical science has to offer without debating its merits and its limits. The result: Americans today pay far more for health care while having among the lowest life expectancies and highest infant mortality of any affluent nation. Gutmann and Moreno—“incisive, influential, and pragmatic thinkers” (Arthur Caplan)—demonstrate that the stakes have never been higher for prolonging and improving life. From health care reform and death-with-dignity to child vaccinations and gene editing, they explain how bioethics came to dominate the national spotlight, leading and responding to a revolution in doctor-patient relations, a burgeoning world of organ transplants, and new reproductive technologies that benefit millions but create a host of legal and ethical challenges. With striking examples, the authors show how breakthroughs in cancer research, infectious disease, and drug development provide Americans with exciting new alternatives, yet often painful choices. They address head-on the most fundamental challenges in American health care: Why do we pay so much for health care while still lacking universal coverage? How can medical studies adequately protect individuals who volunteer for them? What’s fair when it comes to allocating organs for transplants in truly life-and-death situations? A lucid and provocative blend of history and public policy, this urgent work exposes the American paradox of wanting to have it all without paying the price. (shrink)

This book showcases the best in modern medieval and religious scholarship, deploying spirited and progressive approaches to the study of Christian mysticism and the philosophy of religion. The volume explores excessive forms of desire and eroticism at play within Christian mystical texts and the historiographical, theological, and philosophical problems bound up in the interrogation of extraordinary experiences of the divine. Amy Hollywood examines how feminist and queer studies have changed the history of mysticism and how the study of religion in (...) general has altered our understanding of what is true, what is real, and what it means to research a historical subject. Ideal for novices and experienced scholars alike, this volume models cutting-edge methods for the ethical study of divine embodiment and religious experience in the Middle Ages. It makes a forceful case for thinking about religion as both belief and practice, in which traditions marked by change are passed down through generations, laying the groundwork for their own critique. Through a provocative integration of medieval sources and texts by Derrida, Butler, Asad, and Chakrabarty this book redefines what it means to engage critically with history and those embedded within it. (shrink)

In recent analytic metaphysics, the view that ‘ordinary inanimate objects such as sticks and stones, tables and chairs, simply do not exist’ has been defended by some noteworthy writers. Thomasson opposes such revisionary ontology in favour of an ontology that is conservative with respect to common sense. The book is written in a straightforward, methodical and down-to-earth style. It is also relatively non-specialized, enabling the author and her readers to approach problems that are often dealt with in isolation in a (...) more unified way.Thomasson's arguments are mainly counter-attacks on six ‘eliminativist’ arguments against ordinary objects. A causal redundancy argument espoused by Trenton Merricks holds that to suppose that there are ordinary objects is to suppose that these objects have distinctive causal powers. However, the casual efficacy of a baseball, for example, is exhausted by that of some suitably arranged …. (shrink)

The animal advocacy movement(s) -- Sport hunting : environmental stewardship, cultural ritual, or blood sport? -- Zoos and aquaria : species conservation, education, or unethical imprisonment? -- Fur : "green" or irredeemably cruel product? -- Industrial animal agriculture: injustice writ large -- Reconciliation and the way forward.

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 39.1 (2001) 23-47 [Access article in PDF] Suárez' Doctrine of Eternal Truths Amy D. Karofsky 1. Introduction The primary aim of this paper is to offer an interpretation of Suárez' doctrine of eternal truths as found in Metaphysical Disputation XXXI, chapter XII, sections 38-47. There, following the typical scholastic style, Suárez considers and rejects several theories before developing his own. Because it is (...) somewhat difficult to determine what view Suárez ultimately adopts, interpretations of this passage tend to vary. For example, Norman Wells suggests that the necessity and eternality of essential propositions is grounded in the intellect of the divine being. 1 Armand Maurer and John P. Doyle maintain that eternal truths are not grounded in the being of God, but rather in the real being of the essences themselves. 2 I will argue that none of these interpretations adequately expresses Suárez' project, for Suárez wants a solution to the problem of eternal truths that does not depend upon the will of the divine being and one that avoids any ontological commitment to unactualized, possible essences. 3 2. Explanation of the Problem of Eternal Truths Suárez begins the thirty-first disputation with a proof of the identity of essence and existence in finite creatures. The key premise in his argument is the claim that, lacking existence, an unactualized essence is not a being, but absolutely [End Page 23] nothing. 4 By 'being' Suárez means existing being, or a being that is created by God. 5 Unlike the essence of God, the essence of a creature is dependent for its being on the efficient causality of God. Prior to the creative act of God, then, the essence of a creature is not an existing being, hence not a being at all; the unactualized, possible essence is a non-being or nothing.From the claim that a nonexistent essence is absolutely nothing, the following problem arises:... si, ablata existentia, perit essentia, ergo propositiones illae in quibus praedicata essentialia de re praedicantur, non sunt necessariae, neque perpetuae veritatis... 6An essential proposition of the form "X is f" is a proposition in which an essential property f is attributed to an object X. If there are no X's in existence, then there is nothing of which f can be predicated. It would seem, then, that the proposition, "X is f" must be false. One might maintain, however, that even though there are no X's in existence, there is an essence (of) X that has the property f. And in this way, "X is f" remains true, even if there are no X's in existence.However, if one holds, as Suárez does, that the unactualized essence is absolutely nothing, then this solution will not work. For if there are no X's in existence, and if a nonexistent essence is absolutely nothing, then there is nothing of which the essential attribute can be predicated. Thus it appears that any proposition that purports to attribute a property to a nonexistent object must be false and so clearly it can be neither necessarily nor eternally true. Therefore, because Suárez believes that an unactualized essence is absolutely nothing, he seems to be committed to the claim that essential propositions are neither necessarily, nor eternally, true. I will refer to this problem as the Problem of Eternal Truths.Another way to illustrate the Problem of Eternal Truths is to see that there are two seemingly inconsistent propositions: AN: An unactualized, possible essence is absolutely nothing, and NE: True essential propositions are necessarily and eternally true. [End Page 24]Given that a proposition in which a property is attributed to an unactualized essence is false, if Suárez wants to assert the truth of AN, it would appear that he must deny the truth of NE, and, in so doing, reject the possibility of any science of creatures that deals only with necessary truths.Suárez considers three different solutions to this problem: (What I will call) the Aristotelian Solution, the Divine... (shrink)

Creations of the Mind: Essays on Artifacts and their Representation, ed. Stephen Laurence and Eric Margolis, Oxford: Oxford University Press, 2007.

Humans are moral creatures. Among all life on Earth, we alone experience rich moral emotions, follow complex rules governing how we treat one another, and engage in moral dialogue. But how did human morality evolve? And can humans become morally evolved? -/- In A Better Ape, Victor Kumar and Richmond Campbell draw on the latest research in the biological and social sciences to explain the key role that morality has played in human evolution. They explore the moral traits that (...) humans share with chimpanzees; how a more complex moral mind enabled Homo sapiens to arise and out-compete other human species; and the place of morality alongside historic revolutions in technology and social organization. Throughout the book, Kumar and Campbell argue that morality co-evolved with intelligence and complex sociality. Morality prevents societal collapse and enables complex knowledge. -/- After unearthing the ancient origins of human morality, Kumar and Campbell use evolutionary theory to deliver profound insights about how to advance moral progress and resist moral regress, such as reducing animal suffering on industrial farms; capitalizing on the recent revolution in gay rights to foster a nascent revolution in transgender rights; opposing intersectional inequality that impacts women and people of color in lower socioeconomic classes; and addressing major problems of global inequality, especially impending crises of injustice caused by anthropogenic climate change. Understanding how we evolved--and how we continue to evolve--can help us become a better ape. (shrink)