Intuition in medical and moral reasoning -- Moral intuitionism -- The place of Aristotelian phronesis in clinical reasoning -- Aristotle's practical syllogism: accounting for the individual through a theory of action and cognition -- Individual and statistical physiognomy: the art and science of making the invisible visible -- Clinical intuition versus statistical reasoning -- Contingency and correlation: the significance of modeling clinical reasoning on statistics -- Abduction: the intuitive support of clinical induction -- Conclusion: medical ethics beyond ontology.

Neil Levy (2011) argues that neuroethics as a new discipline distinct from bioethics provides methodological tools to evaluate the validity of our moral intuitions. This naturalistic claim that mor...

Despite its phenomenal success since its inception in the early nineteen-nineties, the evidence-based medicine movement has not succeeded in shaking off an epistemological critique derived from the experiential or tacit dimensions of clinical reasoning about particular individuals. This critique claims that the evidence-based medicine model does not take account of tacit knowing as developed by the philosopher Michael Polanyi. However, the epistemology of evidence-based medicine is premised on the elimination of the tacit dimension from clinical judgment. This is demonstrated through (...) analyzing the dichotomy between clinical and statistical intuition in evidence-based medicine’s epistemology of clinical reasoning. I argue that clinical epidemiology presents a more nuanced epistemological model for the application of statistical epidemiology to the clinical context. Polanyi’s theory of tacit knowing is compatible with the model of clinical reasoning associated with clinical epidemiology, but not evidence-based medicine. (shrink)

I will apply dietetic measures for the benefit of the sick according to my ability and judgment. I will keep them from harm and injustice. The Hippocratic Oath formulates the ethical principle of medical beneficence and its negative formulation non-maleficence. It relates medical ethics to the traditional end of medicine, that is, to heal, or to make whole. First and foremost, the duty of the physician is to heal, and if this is not possible at least not to harm. This (...) ethical principle helped to establish the necessary trust between physician and patient in the pre-modern era when most of medicine was nothing more than a set of placebos (Shapiro 1960). Beginning in the seventeenth-century, Western .. (shrink)

Over the past several decades the ‘affective revolution’ in cognitive psychology has emphasized the critical role affect and emotion play in human decision-making. Drawing on this affective literature, various commentators have recently proposed strategies for managing therapeutic expectation that use contextual, symbolic, or emotive interventions in the consent process to convey information or enhance comprehension. In this paper, we examine whether affective consent interventions that target affect and emotion can be reconciled with widely accepted standards for autonomous action. More specifically, (...) the ethics of affective consent interventions is assessed in terms of key elements of autonomy, comprehension and voluntariness. While there may appear to be a moral obligation to manage the affective environment to ensure valid informed consent, in circumstances where volunteers may be prone to problematic therapeutic expectancy, this moral obligation needs to be weighed against the potential risks of human instrumentalization. At this point in time we do not have enough information to be able to justify clearly the programmatic manipulation of human subjects' affective states. The lack of knowledge about affective interventions requires corresponding caution in its ethical justification. (shrink)

The title of my paper, “Affecting the Body and Transforming Desire,” (Braude 2012a) is inspired from Plato’s Symposium, where the physician Eryximachus presents a purely neurophysiological discourse on love. James Giordano’s and Gerrit Glas’s commentaries on my paper have the timbre of a contemporary symposium, in this instance to discern the nature of suffering. Thus, I take Giordano’s and Glas’s commentaries to be generally sympathetic to my offering, although providing further critical insights that deepen the multidimensional understanding of suffering (...) and the correct ethical and medical response. From different perspectives both commentators zone in on one central aspect of my analysis, that is .. (shrink)

This article applies the anthropological concept of liminality to reconceptualize palliative care ethics. Liminality possesses both spatial and temporal dimensions. Both these aspects are analyzed to provide insight into the intersubjective relationship between patient and caregiver in the context of palliative care. Aristotelian practical wisdom, or phronesis, is considered to be the appropriate model for palliative care ethics, provided it is able to account for liminality. Moreover, this article argues for the importance of liminality for providing an ethical structure that (...) grounds the doctrine of double effect and overcomes the impasse of phronesis in the treatment of the terminally ill. (shrink)

The book starts with a scandal, that is, Socrates’s mortality as entailed in the Aristotelian syllogism,All men are mortal,Socrates is a man,Therefore, Socrates is mortal. The scandal pertains to the deduction of Socrates’s death from the logical connections of premises, which, according to Braude, renders it “meaningless.” But, what does this scandal have to do with a philosophical defense of intuition in medicine? For Braude, the scandal is emblematic of a crisis in medicine and philosophy—a crisis in which (...) human mortality is severed from its morality. Braude articulates the crisis with the following question:Where, therefore, between the cracks of universal logic and reifying medicine is there a place for the individual patient, for a response to the cry of pain to which medicine responds, or to the voice of injustice upon which moral philosophy is founded? For him, intuition provides a means to answer the question and thereby to resolve the crisis. It serves as “a bridge be .. (shrink)

Keith Augustine’s critical evaluation of the essay contest sponsored by the Bigelow Institute of Consciousness Studies (BICS) is an interesting but problematic review. It mixes reasonable and detailed criticisms of the contest and many of the winning essays with a disappointing reliance on some of the most trite and superficial criticisms of parapsychological research. Ironically, Augustine criticizes the winning essays for using straw-man arguments and cherry-picked evidence even though many of his own arguments commit these same errors.

This book addresses the perennial question: What is justice?

Critics of survival research often claim that the survival hypothesis is conceptually problematic at best, and literally incoherent at worst. The guiding intuition behind their skepticism is that there’s an essential link between the concept of a person (or personality or experience) and physical embodiment. Thus (they argue), since by hypothesis postmortem individuals such as ostensible mediumistic communicators have no physical body, there’s something wrong with the very idea of a postmortem person, personality or experience. However, critics can’t simply beg (...) the question and assert that physical embodiment is essential to personhood, personality, or experience, because the evidence suggesting survival is a prima facie challenge to the contrary. On the other hand, defenders of ostensible mediumistic communication need to explain how postmortem awareness and knowledge of the current physical world can occur without a physical body that experiences the world and represents it accurately enough to ground veridical postmortem reports. This paper will fi rst consider why survivalists face potentially serious problems in trying to make sense of apparent postmortem perception. Then it will consider a plausible—and arguably the only—way to deal with the issues. However, that solution turns out to be a double-edged sword. Ironically, the best way to deal with the problem of perspectival postmortem awareness may render the survival hypothesis gratuitous. (shrink)

“Business,” wrote a professor of marketing in 1929, “is the work of the world, humanity's chiefest task.” On the doorstep of the Depression, Prof. George R. Collins was selling business, by which he meant the business economy, an economic order based on the systematic management of money. I do not intend to enter the volatile controversy between Collins and those like Aldous Huxley who accused business people of being venal and crass. Rather, I intend to trace one likely path by (...) which many in 1929 had come to regard business as a redemptive activity and the business person as a redeemer. (shrink)

Historically, liberal political philosophy has had much to say about who is entitled to nationhood. But it has had rather less to say about how to determine the legitimate territorial boundaries of nations and even less to say about what some such nations, so situated, might owe to others. The object of this paper is to show that the foundational principles of liberalism can generate reasonably determinate solutions to these problems. That is, the very same set of basic rights that (...) liberalism ascribes to all persons is itself sufficient to determine which nations they are members of where those nations’ legitimate legal jurisdictions are located, and what amounts of wealth they each owe or are owed by other nations. (shrink)

During the Renaissance, the su was regarded primarily as a source of light which gave form to all things*; during the Enlightenment, paradoxically, the sun was regarded primarily as a source of heat. Paracelsian chemistry of the 1500s introduced salt as a third principle which embodied the other two, mercury and sulphur; salt was that universal mediating presence which represented earth. By the late 1700s salt was no longer a metaphysical principle but an acid-base compound, and volatile salts aroused most (...) interest. These changes in scientific perceptions of sun and salt ran parallel to one another: beginning as transcendent sources of form, sun and salt came to be considered manipulable sources of energy. Our r-;odern approach to energy derives from a period during which Europeans gradually lost their belief in the creative agency of two essentials to human life. (shrink)

A rational moral code must satisfy the condition of completeness. This same condition applies to a set of moral rights, where it takes the form of requiring that all the rights in that set be compossible: that their respective correlatively entailed duties be jointly fulfillable. Such joint fulfillability is guaranteed only by a set of fully differentiated individual domains. And if moral rights are to play any independent role in moral reasoning - any role logically independent of the values that (...) bring persons into conflict - those domains must be determined by rules which are not derived from those values. (shrink)

ḥeleḳ 1-3. Toldot Bet Hilel -- ḥeleḳ 4. [without special title].