The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing p...

In the clinical setting, questions of medical ethics raise a host of perplexing problems, often complicated by conflicting perspectives and the need to make immediate decisions. In this volume, bioethicists and physicians provide a nuanced, in-depth approach to the difficult issues involved in bioethics consultation. Addressing the needs of researchers, clinicians, and other health professionals on the front lines of bioethics practice, the contributors focus primarily on practical concerns -- whether ethics consultation is best done by individuals, teams, or committees (...) how an ethics consult service should be structured the need for institutional support and techniques and programs for educating and training staff -- without neglecting more theoretical considerations, such as the importance of character or the viability of organizational ethics. (shrink)

Clinical ethics committees, with their typical threefold function of education, policy formation, and consultation, are present in nearly all U.S. hospitals today, and they are increasingly common in other healthcare settings such as long-term care and even home care. Ethics committees are at least as prevalent in Canadian hospitals as they are in U.S. hospitals, and their presence is growing in Europe, much of Asia, and Central and South America. Although ethics committees serve a variety of needs, their ultimate goal (...) ought to be to promote ethical practices or, in other words, to engender the integration of ethics into the life of the medical center. Of the three primary functions of ethics committees, ethics consultation has historically been the most controversial and problematic, and consult services in many healthcare institutions have struggled to thrive. (shrink)

This paper argues that the type of conscience claims made in last decade’s spate of cases involving pharmacists’ objections to filling birth control prescriptions and cases such as Ms. Means and Mercy Health Partners of Michigan, and even the Affordable Care Act and the Little Sisters of the Poor, as different as they appear to be from each other, share a common element that ties them together and makes them fundamentally different in kind from traditional claims of conscience about which (...) a practical consensus emerged in the 1980s and 1990s. This difference in kind is profoundly significant; so much so, we contend, that it puts them at odds with the normative basis for protecting conscience claims in United States health care settings in the first place, making them illegitimate. Finally, we argue that, given the illegitimacy of these contemporary claims of conscience, physicians and other health professionals must honor their well-established standing obligations to provide informed consent and refer or transfer care even if the service requested or needed is at odds with their own core moral beliefs—a requirement that is in line with the aforementioned practical consensus on traditional claims of conscience. (shrink)

The crisis in donor organ and tissue supply is one of the most difficult challenges for transplant today. New policy initiatives, such as the driver's license option and requiredrequest, have been implemented in many states, with other initiatives, such as mandatedchoice and presumedconsent, proposed in the hopes of ameliorating this crisis. At the same time, traditional acquisition of organs from human cadavers has been augmented by living human donors, and nonheartbeating human donors, as well as experimental animal and artificial sources. (...) Despite these efforts, the crisis persists and is perhaps most tragic when it threatens the lives of children, driving parents to sometimes desperate measures. Herein, we address one very controversial step some parents have taken to obtain matching tissue or organs for their needy children—that is, having a child, in part, for the purpose of organ or tissue procurement. (shrink)

Volume 19, Issue 11, November 2019, Page 73-75.

In “Consensus, Clinical Decision Making, and Unsettled Cases,” David M. Adams and William J. Winslade make multiple references to both editions of the American Society of Bioethics and Humanities (ASBH) Core Competencies for Healthcare Ethics Consultation in their discussion of two assumptions that are supposed to be at the heart of the facilitated consensus model’s inability to handle unsettled cases; that is, that:1. Consultants “should maintain a kind of moral impartiality or neutrality throughout the process,” “explicitly condemn[ing] anything resembling a (...) substantive ‘ethics’ recommendation,” and2. “What counts as the proper set of allowable options among which the parties are to deliberate will itself always be clearly discernible.”Herein, I argue that neither of these assumptions is required by ASBH’s ethics facilitation approach. I then conclude by suggesting that, despite their fundamentally mistaken interpretation of the ASBH approach—perhaps even because of it—Adams and Winslade have made two important contributions to the ethics consultation literature. (shrink)

Volume 20, Issue 7, July 2020, Page 125-128.

In “Bioethics and the Whole: Pluralism, Consensus, and the Transmutation of Bioethical Methods into Gold,” Patricia Martin identifies themes common to three emerging approaches to clinical bioethics--clinical pragmatism, ethics facilitation, and mediation-in order to develop an “ethical consensus method” that can serve as a “practical, step-by-step guide” for decision making She is to be applauded both for her identification of themes common to these three approaches and for her contribution to what we hope will be a growing literature on practical (...) methods for problem solving in clinical bioethics that take seriously the ideal of consensus. After a few preliminary remarks concerning Martin's working model, we focus the majority of our commentary on the notion of “consensus,” which is at the heart of her “ethical consensus method,” and the three approaches from which it is drawn. (shrink)

In “Bioethics and the Whole: Pluralism, Consensus, and the Transmutation of Bioethical Methods into Gold,” Patricia Martin identifies themes common to three emerging approaches to clinical bioethics--clinical pragmatism, ethics facilitation, and mediation-in order to develop an “ethical consensus method” that can serve as a “practical, step-by-step guide” for decision making She is to be applauded both for her identification of themes common to these three approaches and for her contribution to what we hope will be a growing literature on practical (...) methods for problem solving in clinical bioethics that take seriously the ideal of consensus. After a few preliminary remarks concerning Martin's working model, we focus the majority of our commentary on the notion of “consensus,” which is at the heart of her “ethical consensus method,” and the three approaches from which it is drawn. (shrink)

In “Bioethics and the Whole: Pluralism, Consensus, and the Transmutation of Bioethical Methods into Gold,” Patricia Martin identifies themes common to three emerging approaches to clinical bioethics--clinical pragmatism, ethics facilitation, and mediation-in order to develop an “ethical consensus method” that can serve as a “practical, step-by-step guide” for decision making She is to be applauded both for her identification of themes common to these three approaches and for her contribution to what we hope will be a growing literature on practical (...) methods for problem solving in clinical bioethics that take seriously the ideal of consensus. After a few preliminary remarks concerning Martin's working model, we focus the majority of our commentary on the notion of “consensus,” which is at the heart of her “ethical consensus method,” and the three approaches from which it is drawn. (shrink)

La aplicación de la versión tradicional –estructurada en cuatro partes– de la doctrina católica del doble efecto a dos casos de conflicto materno-fetal –la histerectomía en el caso de cáncer de útero, y la craneotomía en el caso de parto obstruido–, ha originado cierta confusión entre los partidarios de las versiones –estructuradas en dos partes contemporáneas– del doble efecto. Aunque la craneotomía, no la histerectomía, fue prohibida de acuerdo a la DDE tradicional, pocos partidarios de las versiones contemporáneas de la (...) DDE consideran que estos casos sean significativamente diferentes. ¿La aplicación tradicional de la DDE a estos dos casos puede entenderse? Si así es, ¿esta aplicación sorprendente puede arrojar luz a los debates contemporáneos sobre el doble efecto? Este artículo trata estas dos preguntas. Se divide en tres apartados: en el apartado I se ofrece una panorámica sobre la génesis histórica –en la casuística católica romana– de las versiones de la DDE articuladas en cuatro partes; en el apartado II se discute las aplicaciones habituales de la DDE tradicional en cuatro partes a una serie de casos, y se presta una atención particular al análisis ortodoxo de los dos procedimientos de aborto terapéutico mencionados, la histerectomía y la craneotomía. Tras exponer tres concepciones de la acción intencional, la tomista, la davidsoniana y la goldmaniana, se muestra que desde ninguna de ellas esos casos pueden distinguirse en virtud de la intención; en el apartado III se lleva a cabo un análisis de lo que se denomina el principio de prioridad causal, que da sentido a la aplicación tradicional de la DDE a estos y otros casos. El artículo concluye explicando por qué se pensó que las tres primeras condiciones de la DDE tradicional, que se reducen a una en las versiones modernas del doble efecto, estaban relacionadas pese a ser diferentes. Por último, sugiero que los desafíos que propiciaron el desarrollo del principio de prioridad causal aclaran otros desafíos similares que deben ser afrontados por cualquier versión moderna adecuada del doble efecto. (shrink)

At the outset of this chapter, I want to echo the praise offered by all of the contributors to this volume for Finder’s outstanding, thoughtful and self-critical narrative of the case of 83 year old Mrs. Hamadani and her fiercely devoted children. The brocade account is carefully woven, like a fine Persian tapestry, to convey the rich complexity of an actual ethics consultation as it transpires not over hours, but rather over days, weeks, months and even, as in this case, (...) years. Mrs. Hamadani’s narrative so told is replete with questions worthy of critical reflection. What is an appropriate role for ethics consultation in healthcare? How can an autonomy-centric culture accommodate community-centric cultural difference? How can or should the voice of the patient be heard when she cannot speak for herself and the much louder and anguished voices of others demand to be heard? What are the bounds of acceptable medical treatment and how should care teams respond when patient or family demands threaten to push care givers to cross those bounds? What is an appropriate response for ethics consultants when they are asked to take over a case or prevent a colleague from interacting with an unwilling family? Do the motivations of patients, family, or members of the care team in calling ethics consultants necessarily shape the consultant’s role? And so the list goes on, as the variety of commentaries which comprise the majority of this volume, as well as the multitude of discussions that you, the readers, will inevitably have with colleagues, students, and friends make abundantly clear. (shrink)

In this essay, I proceed by, first, laying out H. Tristram Engelhardt's argument for the principle of permission as the proper foundation for a secular bioethic. After considering how a number of commentators have tried to undermine this argument, I show why it is immune to some of these advances. I then offer my own critique of Engelhardt's project. This critique is two pronged. First, I argue that Engelhardt is unable to establish his own foundation for a secular bioethic. This (...) inability leaves him with only contingent points of departure for a secular bioethic, some of the more salient of which he has ignored. Second, I argue that even if Engelhardt's project succeeds, it is in danger of being irrelevant in a practical sense because it ignores important contextual dimensions of the peculiar enterprise we call bioethics. Ultimately, the proper foundations for a relevant secular bioethic, I argue, must appeal to certain contingent features of the context that gives rise to the need for it. (shrink)

BackgroundFew comparative studies of clinical ethics consultation practices have been reported. The objective of this study was to explore how American and Japanese experts analyze an Alzheimer's case regarding ethics consultation.MethodsWe presented the case to physicians and ethicists from the US and Japan (one expert from each field from both countries; total = 4) and obtained their responses through a questionnaire and in-depth interviews.ResultsEstablishing a consensus was a common goal among American and Japanese participants. In attempting to achieve consensus, the (...) most significant similarity between Japanese and American ethics consultants was that they both appeared to adopt an "ethics facilitation" approach. Differences were found in recommendation and assessment between the American and Japanese participants. In selecting a surrogate, the American participants chose to contact the grandson before designating the daughter-in-law as the surrogate decision-maker. Conversely the Japanese experts assumed that the daughter-in-law was the surrogate.ConclusionOur findings suggest that consensus building through an "ethics facilitation" approach may be a commonality to the practice of ethics consultation in the US and Japan, while differences emerged in terms of recommendations, surrogate assessment, and assessing treatments. Further research is needed to appreciate differences not only among different nations including, but not limited to, countries in Europe, Asia and the Americas, but also within each country. (shrink)

Clinicians' fear of malpractice litigation is the most significant obstacle to the open reporting of medical mistakes. Without open reporting of medical mistakes, however, root cause analysis of mistakes cannot be done, thus undermining efforts to implement safeguards to minimize the occurrence of future mistakes. Efforts to prevent medical mistakes, therefore, must first directly address cliniciansÕ fear of malpractice litigation. In this paper, we explore the relationship between the current malpractice system and cliniciansÕ fear of litigation. Ultimately, we argue that (...) both the prevention of medical mistakes and the goals of malpractice litigation itself will be better served if substantial malpractice reform is undertaken. (shrink)

Health care workers have not gone along with President Bush's request that they be vaccinated against smallpox in order to prepare the nation's health care system for a terrorist attack using the virus. But there is no professional moral obligation to receive the vaccination—either as a matter of public health or as a matter of national security.

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 11.2 (2001) 115-116 [Access article in PDF] The Ethics of Medical Mistakes: Historical, Legal, and Institutional Perspectives Introduction In late 1999, the Institute of Medicine (IOM) released its report on medical errors, To Err is Human: Building a Safer Health System. The report estimated almost 50,000 deaths per year nationally due to medical mistakes, making it a leading cause of death. IOM speculated that (...) more than half of the deaths related to medical error are preventable. The IOM report shocked the public and medical professionals alike, sparking a national discussion of how to make the health care system safer. This multifaceted issue has profound implications for all aspects of health care, from the very personal--e.g., the relationship of caregiver and patient--to the societal--e.g., a nation's responsibility to its citizens.On 15 May 2000, the University of Pittsburgh Medical Center hosted an ethics conference devoted to the topic of medical mistakes. The goal was to bring together experts from various disciplines, before an audience of both providers and patients, to discuss medical mistakes and their implications. In this issue of the Kennedy Institute of Ethics Journal, we present selected papers resulting from that conference. These papers reflect not only the original oral presentations, but also much of the discussion those presentations generated. Three key perspectives on the ethics of medical mistakes are offered: historical, legal, and institutional.Rosa Lynn Pinkus offers a revealing historical perspective on the ethics of medical mistakes. In analyzing the history of mistake reporting in neurosurgery, she shows how the notion of a mistake developed only as the notion of a standard of practice emerged. Although much of managed care is directed toward systematically fostering a standard of care, this pursuit is relatively new in health care. One might speculate that as more standards are created, mistakes--defined as deviations from standard practice--must increase. If deviation from standard practice is overly castigated, however, then needed innovation in practice may be stifled. Interestingly, as Pinkus discusses, medical malpractice suits quickly followed the emergence of practice standards, driving the initial open reporting of mistakes underground. [End Page 115]Taking up the issue of medical malpractice, Thomas May and Mark Aulisio consider the ramifications of the current malpractice system for mistake prevention. The current system, they argue, while failing to adequately achieve its purported goals of deterring medical mistakes and compensating victims, itself creates a climate that deters the open reporting of mistakes by engendering fear and shame in clinicians. According to May and Aulisio, this failure to report medical mistakes openly has serious ramifications. Chief among these is the inability to do root cause analysis of mistakes, and then, where possible, to implement safeguards to minimize the occurrence of future mistakes. Ultimately, both the prevention of medical mistakes and the goals of malpractice litigation itself will be better served if substantial malpractice reform is undertaken.Andy Thurman argues that even in the current climate institutions ought to have a policy (and practice) of admitting to and openly reporting medical mistakes. Thurman argues that doing so not only is the right thing to do, but is also in the interest of institutions. Interestingly, he contends that failing to admit and openly report mistakes is both at odds with the mission of health care institutions and puts them at higher risk of litigation, and liability. In light of this, Thurman then suggests an institutional process for handling medical mistakes.Michael DeVita concedes that disclosing mistakes is widely supported by the health professionals' principles of ethics, but argues that there are a number of factors that conspire to make doing so a very difficult task. In analyzing an index case, DeVita contends that platitudes about being honest are not nearly enough to foster honest behavior and that policies that offer specific guidance on handling unfavorable events are needed in health care institutions.Finally, we conclude with the policy on disclosure of unfavorable events (this terminology is chosen because it includes both iatrogenic and natural diseases and conditions) that resulted from... (shrink)

The first reported successful kidney transplantation occurred in 1954, between twins. Since then, organ donation and transplantation has become less a medical marvel than a common expectation of patients with a variety of diseases resulting in organ failure. Those expectations have caused demand for organs to skyrocket far beyond available supply, fueling an organ shortage and resulting in over 60,000 patients on transplant waiting lists. In this special issue, our contributors attempt to shed new light on some of the many (...) old ethical questions raised by transplant in the contemporary context of extreme scarcity. (shrink)

From his earliest work on personal identity to his last on the value of truthfulness, the ideas and arguments of Bernard Williams - in the metaphysics of personhood, in the history of philosophy, but especially in ethics and moral psychology - have proved sometimes controversial, often influential, and always worth studying. This book provides a comprehensive account of Williams's many significant contributions to contemporary philosophy. Topics include personal identity, various critiques of moral theory, practical reasoning and moral motivation, truth and (...) objectivity, and the relevance of ancient Greece to modern life. It not only positions Williams among these important philosophical topics, but also with regard to the views of other philosophers, including prominent forerunners such as Hume and Nietzsche and contemporary thinkers such as, Nagel, McDowell, MacIntyre and Taylor. The fragmentary nature of Williams's work is addressed and recurring themes and connections within his work are brought to light. (shrink)

In this book, Mark P. Fusco offers a historical, philosophical and theological review and appraisal of current research into quantum, post-modern, atheistic, mathematical, and philosophical theories that engage our interpretation of Hans Urs von Balthasar and Ferdinand Ulrich’s accounts of Ur-Kenosis. This cross-disciplinary approach inspires a new speculative metaphysical theory based on the representation of being as a holo-somatic ontology. Holocryptic metaphysics gives us a novel interpretation of transubstantiation as it is founded on the findings of quantum mechanical theory. (...) The quantum object and black hole’s properties present a new way to explain physical matter based on its holographic identity. This scientific theory for representing physical matter’s identity is recognized, for example, in the symmetry existing between a subatomic particle and its orbital shell, a single particle’s identity in relationship to its thermodynamic system, Hawking radiation, and black hole entropy. Further, the properties of quantum non-locality and teleportation signpost a new way to understand the Eternal Logos’ relationship to Jesus Christ and the Eucharist. (shrink)

Together again for the first time, Marx and Durkheim join forces in the pages of Disintegration: Bad Love, Collective Suicide, and the Idols of Imperial Twilight for a dialectical exploration of the moral economy of neoliberalism, animated, as it is not only by the capitalist chase for surplus value, but also by an immortal vortex of sacred powers. Classical sociology and psychoanalysis are reconstituted within Hegelian social ontology and dialectical method that differentiates between the ephemeral and free and the eternal (...) and fixed aspects of modern life. (shrink)

In this article I develop a model of theoretical understanding in science. This is a philosophical theory that specifies the conditions that are both necessary and sufficient for a scientist to satisfy the construction ‘S understands theory T ’. I first consider how this construction is preferable to others, then build a model of the requisite conditions on the basis of examples from elementary physics. I then show how this model of theoretical understanding can be made philosophically robust and provide (...) a more sophisticated account than we see from models of a similar kind developed by those working in the psychology of physics and artificial intelligence. 1 Introduction2 The Explicandum/Analysandum3 Analysis of ‘S understands T’ 4 The Inferential Model4.1 Which problems are we talking about?4.2 Does the solution have to be true?4.3 Does each cycle have to be correct for S to understand T?4.4 What is problem-solving reliability?4.5 Does every specific inference of a cycle have to be correct?4.6 Does each inference have to use a principle that is part of the theory?5 Theoretical Understanding and Conceptual Expertise: Empirical Considerations6 Conclusion: Inferential Model of Scientific Understanding and Our Traditional Problems. (shrink)

The vast majority of extant empirical research examining the relationship between corporate social performance and financial performance selects samples of only those firms which are observed engaging in CSP. In this study, the authors assert that firms’ efforts to pursue CSP and subsequently their appearance in social-choice investment advisory firms’ ranking databases are non-random. Studying the CSP–FP link using selected samples of only those firms whose social performance is ranked by SIA firms introduces a sample-selection bias which limits generalization of (...) results to a population of all firms, and at worst provides alternate explanations for observed relationships. The authors test these assertions on a large sample of public corporations in the United States over 6 years and find a sample-selection bias. Upon correction of this bias, this study confirms the positive impact of CSP on FP. (shrink)

This book addresses core questions about the nature and structure of contemporary capitalism and the social dynamics and countervailing forces that shape modern life. From a robust and self-consciously sociological framework, it analyzes and interrogates such issues as the nature of the social, the power of the sacred, the nature of authority, the problem of representation, reification, alienation, utopia, and collective resistance. Historical materialism reveals that the scope of productive functions is broader than the crude realism of economism. Marx’s critical (...) theory of the commodity and his analysis of the capitalist regime of accumulation remain as vital as ever and serve as a guiding light for the continued exploration of the philosophical underpinnings of critical inquiry and praxis. (shrink)

Memory for spatial location is typically biased, with errors trending toward the center of a surrounding region. According to the category adjustment model, this bias reflects the optimal, Bayesian combination of fine-grained and categorical representations of a location. However, there is disagreement about whether categories are malleable. For instance, can categories be redefined based on expert-level conceptual knowledge? Furthermore, if expert knowledge is used, does it dominate other information sources, or is it used adaptively so as to minimize overall error, (...) as predicted by a Bayesian framework? We address these questions using images of geological interest. The participants were experts in structural geology, organic chemistry, or English literature. Our data indicate that expertise-based categories influence estimates of location memory—particularly when these categories better constrain errors than alternative categories. Results are discussed with respect to the CAM. (shrink)

This study examined health professionals’ (HPs) experience, beliefs and attitudes towards brain death (BD) and two types of donation after circulatory death (DCD)—controlled and uncontrolled DCD. Five hundred and eighty-seven HPs likely to be involved in the process of organ procurement were interviewed in 14 hospitals with transplant programs in France, Spain and the US. Three potential donation scenarios—BD, uncontrolled DCD and controlled DCD—were presented to study subjects during individual face-to-face interviews. Our study has two main findings: (1) In the (...) context of organ procurement, HPs believe that BD is a more reliable standard for determining death than circulatory death, and (2) While the vast majority of HPs consider it morally acceptable to retrieve organs from brain-dead donors, retrieving organs from DCD patients is much more controversial. We offer the following possible explanations. DCD introduces new conditions that deviate from standard medical practice, allow procurement of organs when donors’ loss of circulatory function could be reversed, and raises questions about “death” as a unified concept. Our results suggest that, for many HPs, these concerns seem related in part to the fact that a rigorous brain examination is neither clinically performed nor legally required in DCD. Their discomfort could also come from a belief that irreversible loss of circulatory function has not been adequately demonstrated. If DCD protocols are to achieve their full potential for increasing organ supply, the sources of HPs’ discomfort must be further identified and addressed. (shrink)

Mark Morford provides a lively, succinct, and comprehensive survey of the philosophers of the Roman World, from Cato the Censor in 155 BCE to the death of Marcus Aurelius in 180 CE. These men were asking philosophical questions whose answers had practical effects on people's lives in antiquity--and still do today--yet this is an era of philosophy somewhat neglected in recent decades. Morford puts this right by discussing the writings and ideas of numerous famous and lesser-known figures. Using extensive (...) and fully-translated quotations from their works, he illuminates each of the philosopher's meanings within the historical, political, and cultural contexts of their day. This book serves as the ideal introduction to the newcomer to Roman philosophy. (shrink)

In a vivid re-creation of late sixteenth-century Flemish intellectual life, Mark Morford explores the intertwined careers of one of the period's most influential thinkers and one of its most original artists: Justus Lipsius and Peter Paul Rubens. He investigates the scholarship of Lipsius (1547-1606), whose revival of Roman Stoicism guided his contemporaries during the revolt of the Netherlands from the rule of Spain and whose teaching prepared future leaders in church and state. Maintaining that Lipsius' thought reached Peter Paul (...) Rubens through his brother, Philip Rubens, Morford analyzes the artist's use of Stoic philosophical and political allegory, beginning with his painting The Four Philosophers. This book discusses the revival of Stoicism in northern Europe, focusing on Lipsius' editions of Tacitus and Seneca, his widely read handbooks on constancy and politics, and his interaction with leading scholars and public figures. As his letters reveal, Lipsius was inconsistent in his life and unsuccessful in reconciling Stoicism with Catholic doctrine; Rubens, although at first sympathetic to the doctrines of Lipsius, is shown to have later transcended their limitations. (shrink)

This article extends recent efforts to investigate Nietzsche through the lens of Bernard Williams and Williams through the lens of Nietzsche by focusing on their respective conceptions of, and attitudes toward, pessimism. Specifically, the article investigates whether Williams should be regarded as endorsing or manifesting tragic or Dionysian forms of pessimism, which Nietzsche valorizes under the term “pessimism of strength,” or whether he is better associated with the Schopenhauerian or romantic pessimism, or even the Socratic optimism, that Nietzsche rejects. The (...) answer is held to turn on the interpretation of Williams's obscure notion of “confidence.”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:NIETZSCHE AND MIMESIS by Mark P. Drost The phenomenon of imitation as it operates in Nietzsche's dieory of ecstasy is the central and most important element in his theory of tragedy and art in general. In Nietzsche's vision oftragedy we see diat this ecstasy is not limited to the individual artist, but it infects the tragic chorus and the spectators as well. Nietzsche's reinterpretation of the concept of (...) imitation is presented through the Apollonian and Dionysian artistic impulses which express themselves as distinct tendencies in die arts. In order to understand Nietzsche's concept of imitation one must trace the artwork back to the artist whose activity is an imitation of the Apollonian or die Dionysian state. The fusion of these artistic impulses in their highest development occurs in the chorus. The ecstatic impulse of the chorus results in a paradoxical act of self-displacement: a vision which exceeds the boundaries of the stage and diminishes die distance which is normally secured through the theatrical conventions of distance. We shall see how Nietzsche's vision oftragedy can be understood as a reinterpretation ofthe classical concept of imitation by contrasting it with Aristotle's theory. The classical concept ofart as imitation (mimesis) is best expressed in die Poetics ofAristotle. Under the term "mimesis" there is included an array of artistic activity, e.g., epic poetry, "the poetry of tragic drama, and, moreover comedy and dithyrambic poetry, and most flute-playing and lyre-playing" (1447al4). Since tragedy has its roots in poetry, the causes from which tragedy arises are similar to (if not identical with) the causes from which poetry arises. Poetic imitation itself appears to have two causes. First, imitation is natural to man from childhood (1448b2). Man is the most mimetic of creatures, and in childhood he learns by imitating the 309 310Philosophy and Literature people, diings, and events around him. Second, because he learns through them, man takes delight in seeing die images of things and recognizing that they are imitative. Since the pleasure of such recognition is so great, one can in fact take delight in seeing images ofthings which are painful to see in their original (1448b12). The former cause yields pleasure from the knowledge of the original while die second cause yields pleasure because one knows it is not an original. Thus the knowledge that what is being witnessed is an imitation is required for the mimetic pleasure to be experienced. Ifone has not seen the original, the pleasure one experiences is somediing different from die pleasure one takes in imitation (1448b6). It is not that imitation can never merely reproduce or copy its original in the manner of a perfect imitation, but artistic imitation requires that diere always be a sufficient difference between the representation and the original to allow for knowledge and die mimetic pleasure subsequent to it. The paradox of imitation is this: the more perfect the imitation is, the less it is known as a work ofimitation. In general, the greater die degree of the realism ofthe imitation, the greater is the need for some indication that it is art and not reality. With respect to this Arthur Danto says, "Mimesis itself, providing diat the conventions of dislocation are clear to the audience, in fact inhibits just those beliefs that would be activated widiout those conventions."1 The spectator could not obtain mimetic pleasure from the "perfect imitation" if the illusion it generated were so effective as to render the artistic medium completely transparent. The causes of mimetic pleasure are die fact diat one is presented widi an imitation and that one is aware of die difference (and/or similarity) between an object and its representation dirough an artistic medium which is never completely transparent. Although by perceiving an imitation we learn of the thing imitated, it is not essential to die concept ofimitation that there actually and empirically exist an original event or figure which explains the content of die imitation. Though the concept ofimitation is a relational concept, it is not so in the sense that there must be an originally existing personage or state ofaffairs against which we may measure the accuracy ofme mimetic representation. The... (shrink)