While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in (...) implementing system-wide ethics consultation services. Specifically, we identify four models for organizing, developing, and enhancing ethics consultation activities within a system created through acquisitions: train-the-trainer, local capacity-building, circuit-riding, and consolidated accountability. We note each model’s benefits and challenges. To our knowledge, this is the first paper to consider the broader landscape of issues affected by consolidation. We anticipate that clinical ethicists, volunteer consultants, and hospital administrators will benefit from our recommendations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Genealogy of SilenceChōra and the Placelessness of Greek WomenAdam KnowlesIsn’t excess that which the philosopher... must bring back, within measure?—Luce Irigaray, The Forgetting of Air in Martin HeideggerAnd if I must make some mention of the virtue of those wives who will now be in widowhood, I will indicate all with a brief word of advice. To be no worse than your proper nature [phuseōs], is a great (...) honor for you; and great honor is hers, whose reputation among males is least, whether for praise or for blame.—PericlesIntroductionPhilosophy in the twentieth century is mapped upon a terrain of silence. At the turn of the century Sigmund Freud sought to translate the silent language of the unconscious, as Friedrich Nietzsche heralded an untimely voice that could not yet be heard.1 Ludwig Wittgenstein and Martin Heidegger, foundational thinkers in analytic and continental philosophy respectively, each placed silence at the core of his most influential works.2 In the phenomenological tradition, Maurice Merleau-Ponty and Emmanuel Levinas prominently thematized silence,3 while the subsequent generation of poststructuralist, [End Page 1] deconstructionist, and feminist thinkers such as Hélène Cixous, Jacques Derrida, Michel Foucault, Jean-François Lyotard, and Luce Irigaray all grappled with silence in various forms.4 Among these works, Lyotard’s theory of the differend, a term that describes an ontological gap of incommunicability, is now a standard term for addressing questions of silence, silencing, the ethics of sayability and trauma.5 Later, in queer theory, Eve Kosofsky Sedgwick’s closet became a complex synonym for many forms of silence and silencing.6Beyond this philosophical concern for silence and silencing, a number of similar themes emerged in the art and literature of the twentieth century, demonstrating both the creative and destructive force of silence.7 In literature, dramatists such as Samuel Beckett and Harold Pinter brought silence to the stage, while poets and novelists like Adrienne Rich and Virginia Woolf traced the presence of silence in language, each thematizing the power of silencing in unique ways.8 In music, John Cage famously utilized silence as an element of his compositions and filmmakers such as Ingmar Bergmann and Chantal Akerman likewise crafted silence to structure the cinematic spaces of their works.9 Silence became one of the most persistent themes of philosophy in the twentieth century, both implicitly and explicitly. Could one even go so far as to say that a certain silence haunted philosophy in the twentieth century?Amid this abundance of artistic and philosophical work on silence, “breaking the silence” became the watchword for emancipatory projects pursued by groups such as first-wave feminists, postcolonial scholars, race theorists, and campaigns for social justice.10 These emancipatory projects sought to disrupt processes of silencing by locating, recovering, and translating marginalized voices from the silencing of oppression and disenfranchisement. Though essential political interventions at the historical moment when they emerged, these projects of recovery soon met with the critique of the politics of representation best exemplified by thinkers such as Gayatri Chakravorty Spivak and Toril Moi.11 Spivak and Moi effectively argued that recovering and speaking for silenced and marginalized voices entails a further form of silencing. These critiques showed that projects of recovering silence from the archives, history, literature, art, culture, and everyday practices of living were constrained by the very concept of silence they employed. As a result, any naive politics of granting a voice and breaking silence became impossible after the 1980s. From this point onward the deconstructive critique of representation folded silence back into itself, destroying any simple binary of empowered speech and disempowered silence. Even despite this powerful deconstruction of the speech/silence binary, philosophy, to the extent that it still operates within representational schemes and a speech/silence binary, still remains haunted by the specter of silence—a silence that carries with it a deeply gendered heritage. Pursuing rigorous analyses of the manifold structures of silence and silencing remains an urgent ethical and political task for feminist philosophy. [End Page 2]This essay seeks to contribute to that task by arguing that, in order to critically engage with the many... (shrink)

To simplify the relation between desire and morality, and between personal and moral good, we can imagine a world of only two people; let us call them Adam and Eve, for the sake of tradition. This gives us two types of personal good: good for Adam and good for Eve. What is good for Adam (or Eve) is what tends to realise his or her desires in general, and, where desires conflict, realises the desires that are stronger (...) in the long-term. A benevolent and omniscient observer - let's call him Snake out of perversity - could therefore draw up two plans of action, one which is good for Adam and one which is good for Eve. However, at this point, Snake must choose sides, since obviously these goods are not always compatible. It is here that Snake must evolve into a moral being, since he must find a way to choose between good-for-Adam and good-for-Eve in order to produce a general good (even though we have not really decided what the general good might involve yet). (shrink)

Dans la dernière partie des Aveux de la chair, Michel Foucault offre une analyse minutieuse de la théorie de la libido en tant que « stigmate de l’involontaire dans l’acte sexuel d’après la faute » selon saint Augustin ; le thème est intimement lié à l’exégèse patristique et augustinienne du livre de la Genèse 1:28 (« Croissez et multipliez »), plus spécialement à la question de l’existence possible des rapports sexuels au paradis. Le présent article se propose d’étudier à la (...) fois les textes concernés de saint Augustin, l’analyse qu’en offre Foucault et les interprétations philosophiques et théologiques ultérieures de la pensée de l’évêque d’Hippone et du philosophe français. Augustin (et Foucault lecteur de saint Augustin) a-t-il déclaré que nos aïeux faisaient l’amour au paradis? La théologie augustinienne du mariage et de la sexualité est-elle, comme le dit le dernier Foucault, le fondement de « la morale de l’Occident chrétien »? Au demeurant, peut-on parler de la théologie augustinienne ou encore du christianisme comme « fondement », tout en respectant la méthode « généalogique », telle que Foucault l’a développée? (shrink)

Explores humanity's biological roots and astounding capacity for self-creation and self-alteration, examining freedom and choice, sexuality and love, conscience and justice, work and pleasure, and other issues.

In Out of Eden, Paul W. Kahn offers a philosophical meditation on the problem of evil. He uses the Genesis story of the Fall as the starting point for a profound articulation of the human condition.

Trust is a topic of longstanding philosophical interest. It is indispensable to every kind of coordinated human activity, from sport to scientific research. Even more, trust is necessary for the successful dissemination of knowledge, and by extension, for nearly any form of practical deliberation and planning. Without trust, we could achieve few of our goals and would know very little. Despite trust’s fundamental importance in human life, there is substantial philosophical disagreement about what trust is, and further, how trusting is (...) normatively constrained and best theorized about in relation to other things we value. This entry is divided into three sections, which explore key (and sometimes interconnected) ethical and epistemological themes in the philosophy of trust: (1) The Nature of Trust; (2) The Normativity of Trust, and (3) The Value of Trust. (shrink)

Milton's Socratic Rationalism focuses on the influence of Milton's years of private study of classical authors, chiefly Plato, Xenophon and Aristotle, on Paradise Lost. It examines the conversations of Adam and Eve as a mode of discourse closely aligned to practices of Socrates in the dialogues of Plato and eponymous discourses of Xenophon.

In response to Hud Hudson's The Fall and Hypertime, I raise the question as to whether it is constructive to to use the story of Adam, Eve, and the Fall to make a specific apologetic point that draws attention to a reading of the story that we would not otherwise want to affirm?

texte aujourd’hui fameux, repose sur un document connu également de la Vie latine d’Adam et Ève et que l’auteur qoumrânien a remanié. nowadays a famous text, depends on a document which is also known from the Latin Life of Adam and Eve, and which has been reworked by the author from Qumran.

This essay focuses on conceptual engineers who aim to improve other people's patterns of inference and attention by shaping their concepts. Such conceptual engineers sometimes engage in a form of epistemic paternalism that I call paternalistic cognitive engineering: instead of explicitly persuading, informing and educating others, the engineers non-consultatively rely on assumptions about the target agents’ cognitive systems to improve their belief forming. The target agents could reasonably regard such benevolent exercises of control as violating their sovereignty over their own (...) belief formation. This is a pro tanto reason against such engineering. In addition to the relevant projects of conceptual engineering, paternalistic cognitive engineering plausibly includes certain kinds of nudging and evidence suppression. I distinguish the sovereignty-based concern from other ethical worries about conceptual engineering and discuss how one might justify the relevant conceptual engineering projects despite the sovereignty-based reason against them. (shrink)

New Tenth Anniversary edition of this classic text with a new preface by the author, compares myths about meat-eating with myths about manliness, and seeks to ...

This book offers a new approach to the analysis of the multiple meanings of English modals, conjunctions, conditionals, and perception verbs. Although such ambiguities cannot easily be accounted for by feature-analyses of word meaning, Eve Sweetser's argument shows that they can be analyzed both readily and systematically. Meaning relationships in general cannot be understood independently of human cognitive structure, including the metaphorical and cultural aspects of that structure. Sweetser shows that both lexical polysemy and pragmatic ambiguity are shaped by our (...) metaphorical folk understanding of epistemic processes and of speech interaction. Similar regularities can be shown to structure the contrast among root, epistemic and speech act uses of modal verbs, multiple uses of conjunctions and conditionals, and certain processes of historical change observed in Indo-European languages. Since polysemy is typically the intermediate step in semantic change, the same regularities observable in polysemy can be extended to an analysis of semantic change. (shrink)

Ulrich Beck's best selling Risk Society established risk on the sociological agenda. It brought together a wide range of issues centering on environmental, health and personal risk, provided a rallying ground for researchers and activists in a variety of social movements and acted as a reference point for state and local policies in risk management. The Risk Society and Beyond charts the progress of Beck's ideas and traces their evolution. It demonstrates why the issues raised by Beck reverberate widely throughout (...) social theory and covers the new risks that Beck did not foresee, associated with the emergence of new technologies, genetic and cybernetic. The book is unique because it offers both an introduction to the main arguments in Risk Society and develops a range of critical discussions of aspects of this and other works of Beck. (shrink)

The Significance Argument (SA) for the irreducibility of consciousness is based on a series of new puzzle-cases that I call multiple candidate cases. In these cases, there is a multiplicity of physical-functional properties or relations that are candidates to be identified with the sensible qualities and our consciousness of them, where those candidates are not significantly different. I will argue that these cases show that reductive materialists cannot accommodate the various ways in which consciousness is significant and must allow massive (...) vagueness in conscious experience. I also will argue that a nonreductive theory of the conscious-of relation can easily provide a very satisfying, unified explanation of the ways in which this relation is significant. (shrink)

"These essays advance a reinterpretation of pivotal categories such as self-knowing, moral agency, and altruism.

Fieldwork in Familiar Places challenges the misconceptions about morality, culture, and objectivity that support these skepticisms, to show that we can take ...

Thus Plotinus (what is his status in the history of metaphysics and in the "Platonic" era, if one follows Heidegger's reading?), who speaks of presence, that is, also of morphē, as the trace of nonpresence, as the amorphous (to gar ikhnos tou amorphous morphē). A trace which is neither absence nor presence, nor, in whatever modality, a secondary modality.In his reading of Heidegger in his 2003 seminar, published as The Beast and the Sovereign, Derrida is particularly troubled by one particular (...) aspect of Heidegger: Heidegger's "superabundant use" of the language of Walten.1 "As you see," Derrida writes of Heidegger's use of Walten, "late in my life of reading Heidegger, I have just discovered a word that seems to .. (shrink)

Toward an ontology of the social-historical -- Proto-institutions and epistemological encounters -- Anthropological aspects of subjectivity: the radical imagination -- Hermeneutical horizons of meaning -- The rediscovery of physis -- Objective knowledge in review -- Rethinking the world of the living being -- Reimaging cosmology -- Conclusion: the circle of creation.

I will defend explication, in a Carnapian sense, as a strategy for revisionary ontologists and radical sceptics. The idea is that these revisionary philosophers should explicitly commit to using expressions like “S knows that p” and “Fs exist” differently from how these expressions are used in everyday contexts. I will first motivate this commitment for these revisionary philosophers. Then, I will address the main worries that arise for this strategy: the unintelligibility worry and the topic shift worry. I will focus (...) on the latter worry and provide a solution that makes use of a distinction between practically and theoretically oriented beliefs. On my view, the revisionary philosophers who admit to departing from the everyday language can still criticize everyday knowledge and existence claims, by arguing that while the language embedded in these claims is suitable for beliefs-1, it is not suitable for beliefs-2. (shrink)

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.