The idea of creation as the free, spontaneous, and joyous play (līlā) of the gods has been a pervasive motif in Indian thought since Vedic times. In the tradition of Advaita Vedānta, however, where the sole Reality is Brahman alone, divine playfulness is given an illusionistic interpretation and līlā becomes an expression of the deceptive power of māyā.

Today's medicine is spiritually deflated and morally adrift; this book explains why and offers an ethical framework to renew and guide practitioners in fulfilling their profession to heal. What is medicine and what is it for? What does it mean to be a good doctor? Answers to these questions are essential both to the practice of medicine and to understanding the moral norms that shape that practice. The Way of Medicine articulates and defends an account of medicine and medical ethics (...) meant to challenge the reigning provider of services model, in which clinicians eschew any claim to know what is good for a patient and instead offer an array of "health care services" for the sake of the patient's subjective well-being. Against this trend, Farr Curlin and Christopher Tollefsen call for practitioners to recover what they call the Way of Medicine, which offers physicians both a path out of the provider of services model and also the moral resources necessary to resist the various political, institutional, and cultural forces that constantly push practitioners and patients into thinking of their relationship in terms of economic exchange. Curlin and Tollefsen offer an accessible account of the ancient ethical tradition from which contemporary medicine and bioethics has departed. Their investigation, drawing on the scholarship of Leon Kass, Alasdair MacIntyre, and John Finnis, leads them to explore the nature of medicine as a practice, health as the end of medicine, the doctor-patient relationship, the rule of double effect in medical practice, and a number of clinical ethical issues from the beginning of life to its end. In the final chapter, the authors take up debates about conscience in medicine, arguing that rather than pretending to not know what is good for patients, physicians should contend conscientiously for the patient's health and, in so doing, contend conscientiously for good medicine. The Way of Medicine is an intellectually serious yet accessible exploration of medical practice written for medical students, health care professionals, and students and scholars of bioethics and medical ethics. (shrink)

While science is taken to differ from non-scientific activities in virtue of its methodology, metaphysics is usually defined in terms of its subject matter. However, many traditional questions of metaphysics are addressed in a variety of ways by science, making it difficult to demarcate metaphysics from science solely in terms of their subject matter. Are the methodologies of science and metaphysics sufficiently distinct to act as criteria of demarcation between the two? In this chapter we focus on several important overlaps (...) in the methodologies used within science and metaphysics in order to argue that focusing solely on methodology is insufficient to offer a sharp demarcation between metaphysics and science, and consider the consequences of this for the wider relationship between science and metaphysics. (shrink)

It is common wisdom that today’s medicine focuses too much on treating those who are sick and too little on preventing the sickness in the first place. This essay proposes that Jesus’ teaching in the Sermon on the Mount challenges that assumption and the preventive medicine to which it has given rise. In light of Jesus’ teaching, the essay identifies four apparent problems with much of preventive medicine. It then offers four heuristics that might form a basic Christian logic for (...) medicalizing risk—for discerning when and why it would be fitting, wise, and faithful for Christians to make use of medicine to avoid future illness and death. (shrink)

Haeusermann et al. (Citation2023) draw three overall conclusions from their study on closed loop neuromodulation and self-perception in clinical treatment of refractory epilepsy. The first is that closed-loop neuromodulation devices did not substantially change epileptic patient’s personalities or self-perception postoperatively. The second is that some patients and caregivers attributed observed changes in personality and self-perception to the epilepsy itself and not to the DBS treatments. The third is that the devices provided participants with novel ways to make sense of their (...) illness. These findings further demonstrate a misalignment between some neuroethicists’ concerns about putative postoperative changes to personality, and the empirical evidence for such changes. Haeusermann et al. nonetheless concede that “neurotechnology directed at persisting rather than episodic clinical phenomena could have greater implications for personality or self-perception, either because they operate more continuously or are directed at clinical phenomena that are more stably integrated into patients’ self-concepts” (41). We acknowledge that the hypothesis that participants did not report changes because they were only episodically and not continually stimulated offers an interesting line for future investigation. Nonetheless, we would like to propose that potential postoperative personality changes might be correlated with the pathophysiology itself, rather than the stimulation effects of the technology. Generally, we advance the view that unintended effects solely induced by the technology cannot be excluded per se. Regardless, this comment aims to highlight that ethicists’ starting premise should be that patients suffering from diverse pathophysiology, or patients who are treated with stimulation in different brain regions and with differing parameters, would likely not react in the same way to treatment. (shrink)

In the two feature articles for this volume, Gruber et al and Buonomano & Rovelli focus on what the former call the 'two-times problem', in short, the apparent lack of fit between time as described by physical science and our own temporal experience, where 'experience' involves things like memory, anticipation, and perception of change and motion. In this short note I'll make the case that the twotimes problem is less serious than it is often made out to be in the (...) specific case of features like 'passage ' and 'presentness' that are central to the 'A-theory' of time ---the theory that holds time to be composed of dynamic regions of 'past', 'present' and future', and for time to genuinely flow or pass.My contention is three-fold: (1) the two-times problem is better understood as a three-times problem: rather than a conflict between 'physical' and 'manifest' time, what we have in the case of time is differences between the time of physics, the time of experience, and the 'folk' concept of time. (2) Understanding the problem in this way helps deflate certain problems about the relationship of these three pictures; the time of experience and the time of physics are less obviously in a problematic conflict than often supposed; and the folk concept of time is what brings in problematic features of time hard to fit with either the time of physics of experience. (3) Understanding the time of experience as independent from the folk concept of time better fits the actual aims of the... (shrink)

Uncivil behavior by leaders may be viewed as an effective way to motivate employees. However, supervisor incivility, as a form of unethical supervision, may be undercutting employees’ ability to do their jobs. We investigate linkages between workplace incivility and perceived work ability, a variable that captures employees’ appraisals of their ability to continue working in their jobs. We draw upon the appraisal theory of stress and social identity theory to examine incivility from supervisors as an antecedent to PWA, and to (...) investigate job involvement and grit as joint moderators of this association. Results from data collected in two samples of working adults provided evidence for three-way interactions in relation to PWA. Among employees with high levels of grit, there was no significant relation between supervisor incivility and PWA, regardless of employee job involvement. However, we found some evidence that for those low in grit, having high job involvement was associated with a stronger relationship between supervisor incivility and PWA. Findings attest to the importance of unethical supervisor behavior, showing the potential for supervisor incivility to erode PWA, as well as the importance of grit as a potential buffer. (shrink)

It is often said that the world is explained by laws of nature together with initial conditions. But does that mean initial conditions don’t require further explanation? And does the explanatory role played by initial conditions entail or require that time has a preferred direction? This chapter looks at the use of the ‘initialness defence’ in physics, the idea that initial conditions are intrinsically special in that they don’t require further explanation, unlike the state of the world at other times. (...) Such defences commonly assume a primitive directionality of time to distinguish between initial and final conditions. Using the case study of the time-asymmetry of thermodynamics and the so-called ‘past hypothesis’ — the hypothesis that the early universe was in a state of very low entropy —, I outline and support a deflationary account of the initialness defence that does not pre- suppose a basic directionality of time, and argue that there is a relevant explanatory asymmetry between initial conditions and the state of systems at other times only if certain causal conditions are satisfied. Hence, the initialness defence is available to those who reject a fundamental direction of time. (shrink)

This is _the_ leading introduction 200to professional values and ethics in social work. Frederic G. Reamer provides social workers with a succinct and comprehensive overview of the most critical issues relating to professional values and ethics, including the nature of social work values, ethical dilemmas, and professional misconduct. Conceptually rich and attuned to the complexities of ethical decision making, _Social Work Values and Ethics_ is unique in striking the right balance between history, theory, and practical application. For the third (...) edition, Reamer has updated the content and strengthened the relevance of the case material. Also new to the third edition: o Discussion of the moral dialogue between practitioner and cliento Coverage of virtue ethicso Practical discussion of concepts underlying social work ethicso Expanded application of the National Association of Social Workers Code of Ethics to ethical dilemmas in the professiono A look at the historical evolution of ethical standards in social worko New vignettes, illustrating difficult ethical decisionso More guidance on informed consent and termination of serviceso Discussion questions at the end of each chaptero A section on how to conduct a social work ethics audit. (shrink)

. Computational chemistry grew in a new era of “desktop modeling,” which coincided with a growing demand for modeling software, especially from the pharmaceutical industry. Parameterization of models in computational chemistry is an arduous enterprise, and we argue that this activity leads, in this specific context, to tensions among scientists regarding the epistemic opacity transparency of parameterized methods and the software implementing them. We relate one flame war from the Computational Chemistry mailing List in order to assess in detail the (...) relationships between modeling methods, parameterization, software and the various forms of their enclosure or disclosure. Our claim is that parameterization issues are an important and often neglected source of epistemic opacity and that this opacity is entangled in methods and software alike. Models and software must be addressed together to understand the epistemological tensions at stake. (shrink)

Abordaré la crítica de Axel Honneth a la primera Escuela de Frankfurt y su aparente omisión de Herbert Marcuse. Defenderé a Marcuse contra algunas de las críticas hechas por Honneth a la teoría crítica temprana de la Escuela de Frankfurt. Luego argumentaré que Marcuse siempre estuvo en busca de una subjetividad radical, incluso cuando advirtió contra los mecanismos unidimensionales en curso de producción de sujetos. Finalmente, mostraré que Honneth también construye su proyecto en torno a la búsqueda de una subjetividad (...) radical, pero aborda el problema a través de una teoría de la intersubjetividad que complementa el proyecto de Marcuse. (shrink)

The medical profession’s increasing acceptance of “physician aid-in-dying” indicates the ascendancy of what we call the provider-of-services model for medicine, in which medical “providers” offer services to help patients maximize their “well-being” according to the wishes of the patient. This model contrasts with and contradicts what we call the Way of Medicine, in which medicine is a moral practice oriented to the patient’s health. A steadfast refusal intentionally to harm or kill is a touchstone of the Way of Medicine, one (...) unambiguously affirmed by Christians through the centuries. Moreover, physician aid-in-dying contradicts one of the distinctive contributions that the Christian era brought to medicine, namely, a taken-for-granted solidarity between medical practitioners and those suffering illness and disability. Insofar as medical practitioners cooperate in aid-in-dying, they contradict this solidarity and undermine the trust that patients need to allow themselves to be cared for by physicians when they are sick and debilitated. (shrink)

This book is a unique introductory overview of decision theory. It is completely non-technical, without a single formula in the book. Written in a crisp and clear style it succinctly covers the full range of philosophical issues of rationality and decision theory, including game theory, social choice theory, prisoner's dilemma and much else. The book aims to expand the scope and enrich the foundations of decision theory. By addressing such issues as ambivalence, inner conflict, and the constraints imposed upon us (...) by our attachments to others, Frederic Schick reveals that our thinking is often more subtle than standard theories of rationality allow. Only a theory that respects that subtlety can illumine what is otherwise puzzling. The book contains many examples drawn from history and literature dealing with subjects such as love, war, friendship, and crime. (shrink)

One important concern regarding implantable Brain Computer Interfaces is the fear that the intervention will negatively change a patient’s sense of identity or agency. In particular, there is concern that the user will be psychologically worse-off following treatment despite postoperative functional improvements. Clinical observations from similar implantable brain technologies, such as deep brain stimulation, show a small but significant proportion of patients report feelings of strangeness or difficulty adjusting to a new concept of themselves characterized by a maladaptive je ne (...) sais quoi despite clear motor improvement. Despite the growing number of cases in the DBS literature, there is currently no accepted or standardized tool in neuroethics specifically designed to capture the phenomenological postoperative experience of patients implanted with DBS or BCI devices. Given potential risks of postoperative maladaptation, it is important for the field of neuroethics to develop a qualitative instrument that can serve as a shared method for capturing postoperative variations in patient experience of identity and agency. The goal of this article is to introduce an instrument we have developed for this purpose and call for further neuroethical efforts to assess the phenomenology of implantable brain device use. (shrink)

If man has no nature - if our intellect and understanding are products of our own activities - do we possess a key to self-modification? Are we free to re-make mankind? Sartre champions the romantic idea that we can - by sheer determination - begin afresh. Oakeshott is struck by the vandalism of such a project - he seeks to defend political culture from degradation by meddling academics. The Radical and Conservative understanding of social order and the human self are (...) compared in this in-depth analysis of two contrasting philosophies. (shrink)

Before the Darwinian revolution species were thought to be universals. Since then, numerous attempts have been made to propose new definitions. The twentieth-century German philosopher Nicolai Hartmann defined 'species' as an individual system of processes and a process of life of a higher-order. To provide a clear understanding of Hartmann's conception of species, I first present his method of definition. Then I look at Hartmann's Philosophie der Natur (1950) to present his concepts of "organism" and "species." And I end the (...) paper by pointing out two possible systematic inconsistencies. (shrink)

Market metaphors have come to dominate discourse on medical practice. In this essay, we revisit Peter Berger and colleagues’ analysis of modernization in their book The Homeless Mind and place that analysis in conversation with Max Weber’s 1917 lecture “Science as a Vocation” to argue that the rise of market metaphors betokens the carry-over to medical practice of various features from the institutions of technological production and bureaucratic administration. We refer to this carry-over as the product presumption. The product presumption (...) foregrounds accidental features of medicine while hiding its essential features. It thereby confounds the public understanding of medicine and impedes the professional achievement of the excellences most central to medical practice. In demonstrating this pattern, we focus on a recent article, “Physicians, Not Conscripts—Conscientious Objection in Health Care,” in which Ronit Stahl and Ezekiel Emanuel decry conscientious refusals by medical practitioners. We demonstrate that Stahl and Emanuel’s argument depends on the product presumption, ignoring and undermining central features of good medicine. We conclude by encouraging conscientious resistance to the product presumption and the language it engenders. (shrink)

Cognitive science has recently made some startling discoveries about temporal experience, and these discoveries have been drafted into philosophical service. We survey recent appeals to cognitive science in the philosophical debate over whether time objectively passes. Since this research is currently in its infancy, we identify some directions for future research.

Brief, accessible, and affordable, these pocket-sized volumes offer the essential introductions to the great philosophers of the Western tradition-from Plato to Wittgenstein.

For most of the past generation, clinicians have been taught to treat patients' pain until the patient says it is relieved. The opioid crisis has forced both clinicians and patients to reconsider that approach. This essay considers how Christians in particular might assume and seek to overcome their experiences of persistent pain. Wise and faithful responses to pain, especially chronic pain, can take their bearings from how early Christians made sense of the place of both medicine and suffering in a (...) faithful life. This results in not asking medicine to resolve persistent pain, especially not through the use of opioids. Resisting the impulse to medicalize chronic pain will require patience on the part of those who suffer, and both patience and fortitude on the part of the clinicians to whom they present. (shrink)

The Russian philosopher Nikolai Onufrievich Lossky adhered to an evolutionary metaphysics of reincarnation according to which the world is constituted of immortal souls or monads, which he calls ‘substantival agents.’ These substantival agents can evolve or devolve depending on the goodness or badness of their behavior. Such evolution requires the possibility for monads to reincarnate into the bodies of creatures of a higher or of a lower level on the scala perfectionis. According to this theory, a substantival agent can evolve (...) by being gradually reincarnated multiple times through a sort of process of metamorphosis from the level of the most elementary particles all the way up to the level of human beings or even higher. In ‘Ученiе Лейбница о перевоплощенiи какъ метаморфозѣ’, Lossky argues that the works of Leibniz contain scattered elements of such a systematic evolutionary doctrine of reincarnation as metamorphosis and he attempts to reconstitute this doctrine. The present article is intended as an historical introduction to the translation of Lossky’s ‘Leibniz’s Doctrine of Reincarnation as Metamorphosis.’. (shrink)

Introduction -- 1e Intermed consid -- Marx -- Simmel -- Weber -- Lukács -- 2e intermed consid -- Horkheimer -- Adorno -- 3e intermed consid -- Habermas I -- Habermas II -- Habermas III -- Conclusion -- Postscript -- Bibliography.

Practitioners of palliative medicine frequently encounter patients suffering distress caused by uncontrolled pain or other symptoms. To relieve such distress, palliative medicine clinicians often use measures that result in sedation of the patient. Often such sedation is experienced as a loss by patients and their family members, but sometimes such sedation is sought as the desired outcome. Peace is wanted. Comfort is needed. Sedation appears to bring both. Yet to be sedated is to be cut off existentially from human experience, (...) to be made incapable of engaging self-consciously in any human action. To that extent, it seems that to lose consciousness is to lose something of real value. In this paper, I describe how sedation and the question of intentionally bringing about sedation arise in the care of patients with advanced illness, and I propose heuristics to guide physicians, including Christian physicians, who seek to relieve suffering without contradicting their profession to heal. (shrink)

Philosophy is one of the most intimidating and difficult of disciplines, as any of its students can attest. This book is an important entry in a distinctive new series from Routledge: The Great Philosophers . Breaking down obstacles to understanding the ideas of history's greatest thinkers, these brief, accessible, and affordable volumes offer essential introductions to the great philosophers of the Western tradition from Plato to Wittgenstein. In just 64 pages, each author, a specialist on his subject, places the philosopher (...) and his ideas into historical perspective. Each volume explains, in simple terms, the basic concepts, enriching the narrative through the effective use of biographical detail. And instead of attempting to explain the philosopher's entire intellectual history, which can be daunting, this series takes one central theme in each philosopher's work, using it to unfold the philosopher's thoughts. (shrink)

The case of Ashley X involved a young girl with profound and permanent developmental disability who underwent growth attenuation using high-dose estrogen, a hysterectomy, and surgical removal of her breast buds. Many individuals and groups have been critical of the decisions made by Ashley's parents, physicians, and the hospital ethics committee that supported the decision. While some of the opposition has been grounded in distorted facts and misunderstandings, others have raised important concerns. The purpose of this paper is to provide (...) a brief review of the case and the issues it raised, then address 25 distinct substantive arguments that have been proposed as reasons that Ashley's treatment might be unethical. We conclude that while some important concerns have been raised, the weight of these concerns is not sufficient to consider the interventions used in Ashley's case to be contrary to her best interests, nor are they sufficient to preclude similar use of these interventions in the future for carefully selected patients who might also benefit from them. (shrink)

This book is a guide to working with social science concepts. Concepts are the prisms through which we see the social world. They are foundational to the social science enterprise, and the quality of investigations hinges in part on how well researchers make use of them. Most social science concepts are drawn from ordinary language used in everyday ways; however, many social scientists "reconfigure" ordinary words to meet their research needs. They tinker with the meanings of words to fit their (...) theoretical aims and make them precise, useful tools of measurement and comparison. This book examines social science concepts through an interpretivist lens with the aim of providing concrete conceptual guidance for future research. Specifically, this book seeks to: 1) identify characteristic dangers that attend the making and use of reconfigured concepts; 2) lay out ways in which a select number of interpretivist approaches have been used to mitigate these dangers; 3) introduce practical tools that rework these interpretivist approaches into explicit and useable research methods; 4) show concretely how these elucidation tools can be gainfully used by social scientists working both within and outside of the interpretivist tradition. It will be an essential guide for social science research. (shrink)

What are the motivational bases that help explain the various normative judgements that social agents make, and the normative reasoning they employ? Answering this question leads us to consider the relationships between thoughts and emotions. Emotions will be described as thought-dependent and thought-directing, and as being intimately related to normativity. They are conceived as the grounds that motivate social agents to articulate their reasoning with respect to the values and norms they face and/or share in their social collective. It is (...) argued that because they are modes of thinking, emotions generate cognitive activities that relate to the making of evaluative and deontic judgements, the utterance of speech acts, the mastering of normative concepts and the building of arguments. Furthermore, each type of emotion generates its own constitutive judgements and structures normative thinking according to its own logic. The main thesis is that emotions provide sociological explanations for social agents’ thinking and speech, for emotions are precisely what motivate and, especially, structure normative reasoning and language. Being observable in language, emotions allow us to explain a) how social subjects reason and argue through norms and values, and b) how social subjects through their speech acts can contribute to the (un-)making of the social world. (shrink)

Recent proposals to punish athletes for taking drugs or to impose mandatory drug testing cannot be defended in ethical terms. Nor is it possible to distinguish consistently between ethical and unethical uses of restorative drugs, additive drugs, painkillers, and recreational drugs. We oppose drugs in sports because they violate the majority notion of acceptable behavior. But such opposition has more to do with defending the ideals of the community than with creating policies that are ethically sound.

We argue that a fashionable interpretation of the theory of natural selection as a claim exclusively about populations is mistaken. The interpretation rests on adopting an analysis of fitness as a probabilistic propensity which cannot be substantiated, draws parallels with thermodynamics which are without foundations, and fails to do justice to the fundamental distinction between drift and selection. This distinction requires a notion of fitness as a pairwise comparison between individuals taken two at a time, and so vitiates the interpretation (...) of the theory as one about populations exclusively. (shrink)

Intentional explanation, according to Elster, seeks to elucidate an action by showing that it was intentionally conducted, in order to bring about certain goals . Intentional actions furthermore, are rational actions: they imply that agents establish a connection between the goals they target and the means that are appropriate to reach them, by way of different beliefs about the means, the goals and the environment. But how should we understand intentional actions in the light of philosophical research on emotions, rationality, (...) and normativity? This question is the departure point of this article. Various philosophers have analyzed the relationships between rationality and emotion, those between emotion and normativity, and those between emotion and intentional action. Nonetheless, their theses are scattered and do not offer an integrative view on how rationality, normativity and emotions work from the standpoint of intentional explanation. By using de Sousa’s distinction between the epistemic and the strategic modes of rationality as a theoretical framework, this article proposes therefore to remedy this deficit by unifying these philosophical insights with the goal of elaborating a theory of intentional explanation which brings together rationality, normativity and emotions. (shrink)

This book, originally released in 1919, contains five lectures given by the author while he was Professor to the Inns of Court during the late 1800s. The lectures were revised to include notes & annotations by A.H.F. LeFroy.