The recent interest in wisdom in professional health care practice is explored in this article. Key features of wisdom are identified via consideration of certain classical, ancient and modern sources. Common themes are discussed in terms of their contribution to ‘clinical wisdom’ itself and this is reviewed against the nature of contemporary nursing education. The distinctive features of wisdom (recognition of contextual factors, the place of the person and timeliness) may enable their significance for practice to be promoted in more (...) coherent ways in nursing education. Wisdom as practical knowledge (phronesis) is offered as a complementary perspective within the educational preparation and practice of students of nursing. Certain limitations within contemporary UK nursing education are identified that may inhibit development of clinical wisdom. These are: the modularization of programmes in higher education institutions, the division of pastoral and academic support and the relationship between theory and practice. (shrink)

Background:Moral distress occurs when constraints prevent healthcare providers from acting in accordance with their core moral values to provide good patient care. The experience of moral distress in nurses might be magnified during the current Covid-19 pandemic.Objective:To explore causes of moral distress in nurses caring for Covid-19 patients and identify strategies to enhance their moral resiliency.Research design:A qualitative study using a qualitative content analysis of focus group discussions and in-depth interviews. We purposively sampled 31 nurses caring for Covid-19 patients in (...) the acute care units within large academic medical systems in Maryland and New York City during April to June 2020.Ethical considerations:We obtained approval from the Institutional Review Board at the University of Maryland, Baltimore.Results:We identified themes and sub-themes representative of major causes of moral distress in nurses caring Covid-19 patients. These included (a) lack of knowledge and uncertainty regarding how to treat a new illness; (b) being overwhelmed by the depth and breadth of the Covid-19 illness; (c) fear of exposure to the virus leading to suboptimal care; (d) adopting a team model of nursing care that caused intra-professional tensions and miscommunications; (e) policies to reduce viral transmission (visitation policy and PPE policy) that prevented nurses to assume their caring role; (f) practicing within crisis standards of care; and (g) dealing with medical resource scarcity. Participants discussed their coping mechanisms and suggested future strategies.Discussion/Conclusion:Our study affirms new causes of moral distress related to the Covid-19 pandemic. Institutions need to develop a supportive ethical climate that can restore nurses’ moral resiliency. Such a climate should include non-hierarchical interdisciplinary spaces where all providers can meet together as moral peers to discuss their experiences. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Plotinus and the Parmenz'des B. DARRELL JACKSON IN 1928 E. R. DODDSARGUED that the first two hypotheses of Plato's Parmenides are the primary source of Plotinus' doctrines of the One and of Nous. I Dodds' main evidence was a list of parallels between the Parmenides and the Enneads? He argued further that the Neoplatonic interpretation of the Parmenides as positive metaphysics was neo-Pythagorean in origin. Several Plotinus scholars (...) have accepted and extended Dodds' view of the importance of the Parmenides for Plotinus. This group includes ]~mile Br6hier, ~ A. H. Armstrong, 4 Hans-Rudolf Schwyzer, 5 and Paul Henry. n But Dodds' position is by no means universally accepted. Elmer O'Brien has recently argued that the Plotinian One was derived ultimately from Philo and mediated to Plotinus through Albinus and Numenius. 7 He says that Dodds' case, though good, is not convincing. It. A. Wolfson has been the great advocate of the Philonic origin of Plotinus' views. According to Wolfson, the doctrines attributed by Plotinus to Plato are not Plato's but mainly Philo's. 8 Others see Plotinus in varying degrees of dependence upon Plato. Philip Merlan holds that Plotinus is more in debt to the immediate successors of Plato and to Aristotle's interpretation of Plato than to the Platonic writings themselves. 9 C. J. de Vogel sees Plotinus as dependent upon Plato for a hierarchy of being which was accepted and elaborated by various middle Platonists and Gnostics. 1~According to de Vogel, the Parmenides wus not importan% in this hierarchy tradition, n In this article I shall re-examine Dodds' position. I believe the case for Plotinus' dependence upon the Parmenides can be strengthened. I shall try to do this by examining the systematic relation of Plotinus' thought to the Parmenides. Dodds x"The Parmenides of Plato and the Origin of the Neoplatonic 'One'," The Classical Quarterly, XXII (1928), 129-142. 2Ibid., 132 f. *In the introductions to Enneads V.3 (esp. pp. 43 f., 46 f.), V.5 (pp. 87 ft.), VI.4-5 (pp. 161163,165-168),and VI.7 (pp. 49, 60) in his Bud~ edition and translation of the Enneads (Paris, 1931-38). 4The Architecture of the Intelligible Universe in the Philosophy of Plotinus (Cambridge, at the University Press: 1940), pp. 14-28. In his article "Plotinos", Vol. 21, pt. 1 of Paulys Real-Encyclopgdie der Klassischen Altertumswissenschaft, 1951, cols. 552-554. eIntroduction to the second edition of Stephen MacKenna's translation of the Ennead.~ (New York: Pantheon Books Inc., n. d.), pp. xli-xliv. Elmer O'Brien (ed. and trans.), The Essential Plotinus (New York: Mentor, 1964),p. 15. 8"Albinus and Plotinus on Divine Attributes," Harvard Theological Review, XXXXV (1952), 115. 9From Platonism to Neoplatonism (2n ed. rev.; The Hague: Martinus Nijhoff, 1960). 10"On the Neoplatonic Character of Platonism and the Platonic Character of Neoplatonism," Mind, LXIII (1953), 43-64. 11Ibid., 58. [3]5] 316 HISTORY OF PHILOSOPHY considered only parallel terminology. I shall in addition look at parallel argumentation and conclusions. Furthermore, since Dodds accounts only for Plotinus' first two hypostases, I shall consider the relation of the third hypostasis (soul) to the Parmenides. My primary interest is not the source of Plotinus' interpretation of the Parmenides but the way he carries that interpretation out. TM The former issue has often been focal in the literature on this subject. ~8It is certain thay many of the ideas used by Plotinus were already in circulation. But it is equally certain that in his combination of these ideas of a hierarchy, of transcendence, etc., Plotinus is original. I shall argue that this originality of combination is largely determined by an interpretation of the Parmenides. I should add that I am not concerned with whether Plotinus' interpretation is correct. ~4 In the following pages I shall attempt to show three things: (1) how Plotinus explicitly interprets the Parmenides, (2) to what extent he draws upon the language of the Parmenides, and (3) to what extent Plotinus' system may be understood by its relation to the Parmenides. I. Plotinus' Interpretation of the Parmenides The obvious place to begin an analysis of Plotinus' relation to the Parmenides is Enneads V... (shrink)

We will show that there is a strong form of emergence in cell biology. Beginning with C.D. Broad's classic discussion of emergence, we distinguish two conditions sufficient for emergence. Emergence in biology must be compatible with the thought that all explanations of systemic properties are mechanistic explanations and with their sufficiency. Explanations of systemic properties are always in terms of the properties of the parts within the system. Nonetheless, systemic properties can still be emergent. If the properties of the components (...) within the system cannot be predicted, even in principle, from the behavior of the system's parts within simpler wholes then there also will be systemic properties which cannot be predicted, even in principle, on basis of the behavior of these parts. We show in an explicit case study drawn from molecular cell physiology that biochemical networks display this kind of emergence, even though they deploy only mechanistic explanations. This illustrates emergence and its place in nature. (shrink)

In this paper I want to do the following things. First I want to show that in the part of the Theaetetus where the relationship between knowledge and perception is examined, the concept of knowledge that is in question is very clearly characterized. We are left in no doubt as to what is to count as knowing. Secondly I want to unravel in some detail the case that Socrates puts on Protagoras’ behalf where he draws on what Protagoras actually wrote (...) (151 E-152C); as opposed to what he may have taught secretly to his pupils (152C-160D). Thirdly I wish to argue that if we let the dialogue speak for itself, it is manifest that this case put up on Protagoras’ behalf at 151 E-152C is not overthrown; it is not even shaken. (shrink)

At first sight it may seem as if Imagination can easily be characterized as a continuous process of having images; but this is very soon found to be inadequate and misleading. On the one hand we have a great number of good witnesses who insist that in their best imaginative work they have made use of no images, or of very few; and on the other, everybody makes distinction between flights of fancy, for example, which certainly involve successions of images, (...) and true imagination. Perhaps a better method of approach is found when we examine how the material dealt with in the imaginative process is built together. In the flight of fancy image follows image, and the transition from one to the next seems to be determined by something in the nature of each individual step of the whole chain, or by each individual act of imaging. Thus the train as a whole is very apt, to the outsider, to appear jerky, ill-connected. (shrink)

This Festschrift in Professor Kristeller’s honor consists of contributions by scholars who have had some connection with Columbia University, his "intellectual home in the United States for three decades." It also includes a Tabula Gratulatoria listing many other friends from the United States and Europe. The editor’s opening essay provides an interesting and informative account of this scholar’s academic career, and should be read together with the complete annotated bibliography of his publications through 1974. The latter lists 149 "major publications" (...) and 220 "minor publications." Kristeller’s contributions to the history of Renaissance philosophy are well known to historians of philosophy, and deservedly so. Here reference should be made to his groundbreaking studies on Marsilio Ficino and Pomponazzi, and on others such as Pico della Mirandola and Petrarch, as well as on Renaissance Platonism, Aristotelianism in the Renaissance, Thomism in the Renaissance, Paduan Averroism, and Alexandrism. But he has also contributed greatly to the fields of medieval and Renaissance history, and especially to our understanding of Renaissance humanism, Renaissance music, and Renaissance art. He is universally recognized as one of the world’s foremost authorities on manuscript research, as is witnessed, for example, by the cooperative project, Catalogus Translationum et Commentariorum, which he founded, and by his Iter ltalicum. In all of these enterprises he has set an enviable example for other scholars by the exacting standards and the breadth of his expertise. It is only fitting, then, that the many essays in this Festschrift should reflect the breadth and depth of the scholarship so evident in the man to whom they are dedicated. Limitations of space will only permit us to list them here, with a few remarks reserved for those of more special interest to philosophers and historians of philosophy: Eugene F. Rice, Jr., "The De magia naturali of Jacques Lefèvre d’Etaples" ; Donald R. Kelley, "Louis Le Caron Philosophe", on Le Caron’s effort to bring together jurisprudence and classical, especially Platonic, philosophy; Richard H. Popkin, "The Pre-Adamite Theory in the Renaissance", with fascinating material about theories concerning men before Adam in La Peyrère and widely scattered earlier sources; Richard Lemay, "The Fly against the Elephant: Flandinus against Pomponazzi on Fate", on an unedited attack by an Augustinian Bishop against Pomponazzi’s espousal of the Stoic doctrine of fate; Martin Pine, "Pietro Pomponazzi and the Medieval Tradition of God’s Foreknowledge", on Pomponazzi’s solution to the problem of divine foreknowledge and human freedom inlight of his familiarity with earlier discussions by Boethius, Aquinas, Scotus, and Ockham; F. Edward Cranz, "Editions of the Latin Aristotle Accompanied by the Commentaries of Averroes", helpful to all who wish to consult late fifteenth- and sixteenth-century versions of the Latin Aristotle and especially the Latin Averroes; Josef Soudek, "A Fifteenth-Century Humanistic Bestseller: The Manuscript Diffusion of Leonardo Bruni’s Annotated Latin Version of the Aristotelian Economics" ; Edward P. Mahoney, "Nicoletto Vernia on the Soul and Immortality", which details a radical shift on Vernia’s part from an earlier Averroistic reading of Aristotle; Joan Kelly-Gadol, "Tommaso Campanella: The Agony of Political Theory in the Counter-Reformation", which attempts to account for some of the shifts and inconsistencies in Campanella’s political writings by placing them within the troubled personal and political circumstances of his life; Charles Trinkaus, "Protagoras in the Renaissance: An Exploration" ; Maristella de Panizza Lorch, "Voluptas, molle quoddam et non invidiosum nomen: Lorenzo Valla’s Defense of voluptas in the Preface to his De voluptate" ; Neal W. Gilbert, "Richard de Bury and the ‘Quires of Yesterday’s Sophisms"’, with much interesting material on the medieval tradition of sophismata, especially at Oxford; Malcolm Brown, "A Pre-Aristotelian Mathematician on Deductive Order" ; John H. Randall, Jr., "Paduan Aristotelianism Reconsidered", on evidence for influence of the Italian Aristotelian tradition on Galileo; William F. Edwards, "Niccoló Leoniceno and the Origins of Humanist Discussion of Method" ; C. Doris Hellman, "A Poem on the Occasion of the Nova of 1572" ; Edward Rosen, "Kepler’s Mastery of Greek" ; W. T. H. Jackson, "The Politics of a Poet: The Archipoeta as Revealed by his Imagery" ; John Charles Nelson, "Love and Sex in the Decameron" ; George B. Parks, "Pico della Mirandola in Tudor Translation" ; Richard Harrier, "Invention in Tudor Literature: Historical Perspectives" ; Helene Wieruszowski, "Jacob Burckhardt and Vespasiano da Bisticci " ; Morimichi Watanabe, "Gregor Heimburg and Early Humanism in Germany" ; Raymond de Roover, "Cardinal Cajetan on ‘Cambium’ or Exchange Dealings" ; and a series of text editions with introductions including Julius Kirshner, "Conscience and Public Finance: A Questio disputata of John of Legnano on the Public Debt of Genoa" ; John Mundy, "The Origins of the College of Saint-Raymond at the University of Toulouse" ; Charles B. Schmitt, "Girolamo Borro’s Multae sunt nostrarum ignorantionum causae " ; Guido Kisch, "An Unpublished Consiliumof Johannes Sichardus" ; Patricia H. Labalme, "The Last Will of a Venetian Patrician " ; Felix Gilbert, "The Last Will of a Venetian Grand Chancellor" ; Herbert S. Matsen, "Giovanni Garzoni to Alessandro Achillini : An Unpublished Letter and Defense" ; Theodore E. James, "A Fragment of An Exposition of the First Letter of Seneca to Lucilius Attributed to Peter of Mantua". The editor, his collaborators, and the contributors are all to be commended for the high quality of this volume.—J.F.W. (shrink)

Debate persists over the place of conscience in medicine. Some argue for the complete exclusion of conscientious objection, while others claim an absolute right of refusal. This paper proposes that claims of conscientious objection can and should be permitted if they concern kinds of actions which fall outside of the normative standard of medicine, which is the pursuit of health. Medical practice which meets this criterion we call medicine qua medicine. If conscientious refusal concerns something consonant with the health-restoring aims (...) of medicine, it entails a desertion of professional duty. If, however, it relates to something other than medicine qua medicine, it can rightly be refused. It thus becomes possible to test instances of conscientious objection to determine their validity, and thereby conserve both the principle of conscientious objection and define its scope. This test of conscience prevents arbitrary discrimination, and preserves doctors’ agency. It is a theoretical razor rooted in the pra... (shrink)

It is often assumed that engaging in a one‐on‐one dialogue with a tutor is more effective than listening to a lecture or reading a text. Although earlier experiments have not always supported this hypothesis, this may be due in part to allowing the tutors to cover different content than the noninteractive instruction. In 7 experiments, we tested the interaction hypothesis under the constraint that (a) all students covered the same content during instruction, (b) the task domain was qualitative physics, (c) (...) the instruction was in natural language as opposed to mathematical or other formal languages, and (d) the instruction conformed with a widely observed pattern in human tutoring: Graesser, Person, and Magliano's 5‐step frame. In the experiments, we compared 2 kinds of human tutoring (spoken and computer mediated) with 2 kinds of natural‐language‐based computer tutoring (Why2‐Atlas and Why2‐AutoTutor) and 3 control conditions that involved studying texts. The results depended on whether the students' preparation matched the content of the instruction. When novices (students who had not taken college physics) studied content that was written for intermediates (students who had taken college physics), then tutorial dialogue was reliably more beneficial than less interactive instruction, with large effect sizes. When novices studied material written for novices or intermediates studied material written for intermediates, then tutorial dialogue was not reliably more effective than the text‐based control conditions. (shrink)