In lieu of an abstract, here is a brief excerpt of the content:Medicine-Based Values?Åge Wifstad (bio)KeywordsEthics committees, judgment, common moralityToulmin's DiagnosisIn his classical article with the unforgettable title "How medicine saved the life of ethics" (Toulmin 1982), Stephen Toulmin claims that medicine saved ethics by giving the philosophers a positive reality check through medical challenges: (1) Ethics in medicine is a serious topic, not just something to discuss at seminars. If, for example, both A and B need treatment and (...) there are only enough resources for one, the fundamental interests of these two people compete against each other. (2) In clinical medicine, the individual case might demand a different approach than that suggested by theory. Similarly, an ethicist who is confronted by a diversity of medical cases becomes aware of the fact that solutions drawn from ethical theory can be irrelevant in practice. (3) The moral philosopher has often focused on the individual and his or her universal commitments. The fact that ethical dilemmas can have deep roots in practical challenges and must be understood within a certain context has been "forgotten." (4) In clinically relevant ethics, it is important to find solutions that all involved parties find reasonable. This revitalizes central Aristotelian schools of thought on, for example, ethical judgment and situational understanding.Today, there is a common understanding that in both the education of doctors and in the implementation of medical knowledge and technology there needs to be ethical guidelines and control. Toulmin wants us to see that the background for this agreement is multifaceted. It was not just the ethicists who saved the doctors. The doctors helped the ethicists to escape their academic isolation.Ethics CommitteesThe establishment of ethics committees is perhaps the most interesting example of this. Here it is especially clear how ethical judgment establishes a basis for decision making: Each case presented to an ethics committee is special because one cannot reference decisions made in similar cases. At the same time, we are expected to handle similar cases equally. Consideration of the concrete, individual case must be balanced with the principle of similar treatment. Second, as a committee member, one must interpret and respect ethical principles that cannot be easily defined. Every principle must be interpreted and implemented within a specific and concrete context. Third, one must consider the law, but seen isolated, the implications of relevant rules can be difficult to determine. Fourth, the status of principles and rules are open for interpretation. The most important example of this is the Declaration of Helsinki, which was established through cooperation between the worlds' doctors unions. The strength and end result of such a document can be discussed. Fifth, multiple but partly conflicting juridical and ethical considerations can be [End Page 179] relevant at the same time. An example: Decisions about confidentiality can prevent data gathering that is crucial in ensuring that a research project is scientifically acceptable. Two important ethical considerations are then put up against one another. As a sixth and final point, it can be mentioned that the ethics committee is expected to make a qualitative, scientific judgment. But what kind of quality judgment and how detailed it should be is up for discussion.Two Definitions of Ethical JudgmentThe fact that the committee must base their holistic decision on ethical judgment means that the committee, in an important sense of the word, stands freely: It can be difficult to refer to specific ethical rules or laws when making an external review of the committee's decision. Unless the committee has clearly not followed known principles and rules, then the committee is able to confront criticism by replying that the decision is based on holistic considerations, where many views have been taken into account. In this way, the usage of ethical judgment makes sure that the committee has freedom to act. The catch here is that the committee's responsibility becomes even more obvious. One cannot simply say that the decision is made based on rules and principles formulated by others, such as the state. The committee must, as a unit, be able to defend their decision.The complexity of the work of the committee can, however, make it more tempting to think about ethics in... (shrink)

A certain kind of externalism—"the view from nowhere"—lies at the heart of evidence-based medicine (EBM). As a consequence, the individual case glides out of focus. However, to judge to what extent external knowledge is applicable to an individual case, the clinician has to rely on some sort of knowledge of the case at hand. The article focuses on the tension between the externalism of EBM and the "internal evidence" one has to presuppose when making clinical judgments.

Objective To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient–doctor encounters. Design Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. Setting A 500-bed general teaching hospital in Norway. Participants 71 doctors working in clinical non-psychiatric departments and their patients. Results The doctors were concerned about their patients' health and how their (...) medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. Conclusions The study suggests that the main failing of patient–doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof. (shrink)

Next SectionThe principle of respect for autonomy has shaped much of the bioethics' discourse over the last 50 years, and is now most commonly used in the meaning of respecting autonomous choice. This is probably related to the influential concept of informed consent, which originated in research ethics and was soon also applied to the field of clinical medicine. But while available choices in medical research are well defined, this is rarely the case in healthcare. Consideration of ordinary medical practice (...) reveals that the focus on patient choice does not properly grasp the moral aspects involved in healthcare. Medical decisions are often portrayed as if doctors and patients in confidence confront specific decisions about examinations or treatment, yet the reality often involves many different participants, with decisions being made over time and space. Indeed, most of the decisions are never even presented to patients, as it would be unethical to suggest something that is not medically justifiable. The options patients do confront are somewhat arbitrarily constructed within the narrow framework of both what is deemed to be medically appropriate and how the healthcare system is organised practically. While the autonomy discourse has proven valuable, a failure to distinguish between the fields of medical research and clinical medicine has generated a focus on patient choice that does not reflect what is really at stake in healthcare settings. This is alarming, because the current discourse misrepresents medical practice in a way that actually contributes to bioethical self-delusion. (shrink)

While certain substantial moral dilemmas in health care have been given much attention, like abortion, euthanasia or gene testing, doctors rarely reflect on the moral implications of their daily clinical work. Yet, with its aim to help patients and relieve suffering, medicine is replete with moral decisions. In this qualitative study we analyse how doctors handle the moral aspects of everyday clinical practice. About one hundred consultations were observed, and interviews conducted with fifteen clinical doctors from different practices. It turned (...) out that the doctors’ approach to clinical cases followed a rather strict pattern across specialities, which implied transforming patients’ diverse concerns into specific medical questions through a process of ‘essentialising’: Doctors broke the patient’s story down, concretised the patient’s complaints and categorised the symptoms into a medical sense. Patients’ existential meanings were removed, and the focus placed on the patients’ functioning. By essentialising, doctors were able to handle a complex and ambiguous reality, and establish a medically relevant problem. However, the process involved a moral as well as a practical simplification. Overlooking existential meanings and focusing on purely functional aspects of patients was an integral part of clinical practice and not an individual flaw. The study thus questions the value of addressing doctors’ conscious moral evaluations. Yet doctors should be aware that their daily clinical work systematically emphasises beneficence at the expense of others—that might be more important to the patient. (shrink)

A. H. Louie's More Than Life Itself is an exploratory journey in relational biology, a study of life in terms of the organization of entailment relations in living systems. This book represents a synergy of the mathematical theories of categories, lattices, and modelling, and the result is a synthetic biology that provides a characterization of life. Biology extends physics. Life is not a specialization of mechanism, but an expansive generalization of it. Organisms and machines share some common features, but organisms (...) are not machines. Life is defined by a relational closure that places it beyond the reach of physicochemical and mechanistic dogma, outside the reductionistic universe, and into the realm of impredicativity. Function dictates structure. Complexity brings forth living beings. (shrink)

This book argues for the use of nonideal theory in social ontology. The central claim is that a paradigm shift is underway in contemporary social ontology, from ideal to nonideal, and that this shift should be fully followed through. To develop and defend this central claim, the first step is to show that the key questions and central dividing lines within contemporary social ontology can be fruitfully reconstructed as a clash between two worlds, referred to as ideal and nonideal social (...) ontology. Ideal social ontology is characterized by consensus and cooperation, while nonideal social ontology is characterized by conflict and contestation. The second step is to show that, when taken together, objections to the standard model of ideal social ontology (the dominant version of ideal social ontology) imply that this model needs to be given up in favor of nonideal social ontology. In other words, we should look to nonideal rather than ideal social ontology for core concepts. The third step is to offer a positive account, called the power view, of nonideal social ontology. This account places the concept of social power at the core of a general theory of the social world and replaces the flat and narrow conception of power in ideal social ontology with a richer and more extensive conception. In addition, it rectifies a shortcoming in nonideal social ontology by attending to class, which has been notably and oddly overlooked in the literature. (shrink)

This companion is a cutting-edge primer to critical forms of the posthumanities and the feminist posthumanities, aimed at students and researchers who want to catch up with the recent theoretical developments in various fields in the humanities, such as new media studies, gender studies, cultural studies, science and technology studies, human animal studies, postcolonial critique, philosophy and environmental humanities. It contains a collection of nineteen new and original short chapters introducing influential concepts, ideas and approaches that have shaped and developed (...) new materialism, inhuman theory, critical posthumanism, feminist materialism, and posthuman philosophy. A resource for students and teachers, this comprehensive volume brings together established international scholars and emerging theorists, for timely and astute definitions of a moving target – posthuman humanities and feminist posthumanities. (shrink)

Trope theory is a leading metaphysical theory in analytic ontology. One of its classic statements is found in the work of Donald C. Williams who argued that tropes qua abstract particulars are the very alphabet of being. The concept of an abstract particular has been repeatedly attacked in the literature. Opponents and proponents of trope theory alike have levelled their criticisms at the abstractness of tropes and the associated act of abstraction. In this paper I defend the concept of a (...) trope qua abstract particular by rejecting arguments that purport to show that tropes should not be understood as abstract and by arguing that the abstractness of tropes plays an indispensable role in one of our more promising trope-theoretic analyses of universals and of concrete objects. (shrink)

I. Ókor -- II. A középkor és a reneszánsz -- III. Az újkor.

On fundamentals of Vedanta and science; a study.

Desde la aparición, en 1927, de su obra central Ser y tiempo, Martin Heidegger ha sido y sigue siendo considerado por amplios sectores de opinión como el filósofo más importante del siglo XX. Frente a esta sobrevaloración del filósofo de los Bosques Negros, Heleno Saña procede, en su documentadísimo libro, a una crítica de la filosofía heideggeriana, intentando demostrar que está basada en una tergiversación e instrumentalización sistemáticas de la terminología y los conceptos esenciales de la filosofía clásica. El resultado (...) final de sus ejercicios hermenéuticos y sus continuos malabarismos lingüísticos, es un irracionalismo de índole claramente nihilista, por su culto implícito y explícito a la muerte. En este sentido es altamente significativo que a la biografía y a la filosofía heideggerianas pertenezcan su adhesión al nacionalsocialismo y la glorificación de Alemania como la “raza de los señores” por excelencia, tema al que Heleno Saña dedica la debida atención. Uno de los signos distintivos de este ensayo es el de la claridad con que expone sus tesis, de manera que el libro no está pensado solo para eruditos, sino para todas las personas interesadas en ampliar sus conocimientos culturales y filosóficos. (shrink)

La admirable riqueza cultural y artística del Renacimiento esconde una desoladora miseria y aquella "edad de la abundancia" contrasta con una inmensa pobreza. Lejos de ser una broma o una pesadilla, la celebrada Utopía de Tomás Moro fue antes que nada un desafío insoslayable, pues proponía que ninguna sociedad merece tal nombre si tolera la miseria de un solo pobre. Rico y pobre explora la cuestión en ese libro de 1516 y en otros del escritor londinense para concluir con un (...) esbozo de su vida a la luz de la pobreza como virtud indispensable y libertadora. He aquí un hombre afortunado que no fue indiferente ante el infortunio de tantos y que vio en la humanitas la virtud por excelencia que lleva a una constante atención y cuidado del prójimo. Inspirado por un cambio de actitud en su época, así como por su fe cristiana y la mejor tradición estoica, mostró una robusta preocupación sobre el tema subrayando el valor social que debe tener toda riqueza, tanto a nivel estatal como individual, destacando la grave obligación cívica de los ricos y la necesidad que tienen todos, ricos y pobres, de empeñarse en la práctica de cierto desprendimiento y generosidad si no quieren mermar su propia humanidad y fallecer en su avaricia. La percepción de la miseria había cambiado de tal manera que su remedio ya no podía estar en una u otra limosna en plazas e iglesias, sino en la acción bien pensada y perentoria de todo gobierno que se tenga por justo. Sir Tomás Moro, privilegiado desde la cuna y seguro en su trabajo profesional, vio la pobreza de tantos como un desastre social, pero uno que, al mismo tiempo, debería llevar a todo ser humano a ver en el desprendimiento y generosidad una excelencia o virtud que alumbra la "otra" libertad, y tan íntima y valiosa que en su caso brilló aun en la prisión y ante el horror de una muerte injusta y atroz." -- Page 4 of cover. (shrink)

A. A. Long’s study of Greek notions of mind and human selfhood is anchored in questions of universal interest. What happens to us when we die? How is the mind or soul related to the body? Are we responsible for our own happiness? Can we achieve autonomy? Long shows that Greek thinkers’ modeling of the mind gave us metaphors that we still live by.

Puede ser hoy marxista la teoría de la cultura? -- Reproducción social y subordinación ideológica de los sujetos -- Cómo se forman las culturas populares?