Unexpected discoveries in nonequilibrium physics and nonlinear dynamics are changing our understanding of complex phenomena. Recent research has revealed fundamental new properties of matter in far-from-equilibrium conditions, and the prevalence of instability-where small changes in initial conditions may lead to amplified effects.

A Second level Master in “Clinical Bioethics Consultation” has been organized in Italy to offer an opportunity to offer an adequate training to carry out an ethics consultation in different health fields. The master has been promoted and realized by different institutions: Catholic University of Sacred Hearth in Rome, Insubria University in Varese, “Federico II” University in Naples, Lanza Foundation in Padua and the Local Health and Social Care Unit n.7 in Veneto Region. The aim of the master is train (...) ethics consultants to offer help regarding a correct decision, which will take by others. The choice must be as much as possible shared between patient, family and health care team. Ethics consultation can be primarily request by the physicians, nurses and health care staff such as support about a choice that wants to be the most appropriate and to clarify a dilemma between different options. Secondly an ethics consultation can be demand by the patient and the family members to find a clarification about their dilemmas and future choices. Also the administrative staff could ask the consultation, when it need to better explain ad example about a specific clinical case or a question concerned the health policy. (shrink)

Patient-and-family-centered care (PFCC) is critical in end-of-life (EOL) settings. PFCC serves to develop and implement patient care plans within the context of unique family situations. Key components of PFCC include collaboration and communication among patients, family members and healthcare professionals (HCP). Ethical challenges arise when the burdens (e.g., economic, psychosocial, physical) of family members and significant others do not align with patients’ wishes. This study aims to describe the concept of vulnerability and the ethical challenges faced by HCPs in these (...) circumstances. Further, it assesses the contribution of clinical ethics consultation (CEC) in assisting HCPs to face these difficult ethical conundrums. Two clinical cases are analyzed using the Circle Method of CEC. The first regards the difficulty faced by the doctor in justifying treatments previously agreed upon between the patient and his/her friends. The second regards the patient’s concern about being a burden on their family. Family burdens in EOL settings challenge PFCC in that patient autonomy may be disregarded. This compromises shared decision-making between the patient, family and HCPs as a core component of PFCC. In their ability to promote a collaborative approach, CECs may assist in the successful implementation of PFCC. (shrink)

Assumindo que o “tornar-se cristão” é o eixo que sustenta toda a produção literária de Søren Kierkegaard, o escopo deste ensaio é tentar delinear o conceito de paixão apresentado em Temor e Tremor como uma condição necessária para a efetivação dos movimentos dialéticos que possibilitam o desenvolvimento da fé. Efetivamente, é através do pseudônimo Johannes de Silentio que Kierkegaard apresenta sua ode à fé. Neste sentido, é sobre o esteio da narrativa apresentada em Temor e Tremor acerca da fé demonstrada (...) por Abraão (quando Deus solicitou-lhe a vida de Isaac em sacrifício) que destacaremos a importância que o mencionado pseudônimo atribui à paixão como fundamento que precede e, substancialmente, compõe a fé última: aquela que só emerge ante ao absurdo, mas que, uma vez conquistada, assoma como possibilidade para a fuga do desespero da existência e para a construção de sentido para a vida humana. (shrink)

A new assessment of baron d’Holbach (1723-1789), his works, his circle and his legacy, gathering together generations of d’Holbach scholars to analyse multiple aspects of his diverse intellectual commitment from fresh perspectives.

The COVID-19 virus is severely testing the Italian healthcare system, as the requests for intensive treatment are greater than the real capacity of the system to receive patients. Given this emergency situation, it follows that citizens are limited in their freedom of movement in order to limit infection, and that in hospitals a significant number of critical situations must be faced. This brief contribution aims to offer a reflection on the public and clinical role of the bioethicist: a figure able (...) to promote dialogue between the world of medicine and the community, and to face ethical dilemmas even in emergent clinical settings. (shrink)

The Italian debate about the role of clinical ethics and ethics consultation has brought about the need to create a working group of Healthcare Ethics Consultation. The group began to take shape an...

Cette introduction présente et contextualise les articles publiés dans la section spéciale dont le but est d’analyser l’interprétation de la pensée hellénistique chez les philosophes continentaux très influents tels que : Agamben, Arendt, Blumenberg, Foucault, Heidegger et Stiegler. Les articles prêtent une attention particulière à trois directions de recherche. Ils examinent tout d’abord l’influence de la pensée hellénistique sur ces auteurs et la façon dont ils ont interprété, utilisé et mésinterprété l’héritage des philosophies hellé-nistiques. Deuxièmement, les articles analysent les hypothèses (...) in-terprétatives et les préjugés qui ont caractérisé ces interprétations. Enfin, ils nous permettent de comprendre plus clairement pourquoi plusieurs philosophes continentaux se sont intéressés à la philosophie ancienne. Les rédacteurs invités résument les conclusions pro-visoires de cette section spéciale en soulignant que les interprétations continentales de la pensée hellénistique représentent un thème particulièrement intéressant dans le cadre de la recherche historico-philosophique actuelle. (shrink)

The aim of this paper is to analyze an Intensive Care Unit case that required ethics consultation at a University Hospital in Northern Italy. After the case was resolved, a retrospective ethical analysis was performed by four clinical ethicists who work in different healthcare contexts. Each ethicist used a different method to analyze the case; the four general approaches provide insight into how these ethicists conduct ethics consultations at their respective hospitals. Concluding remarks examine the similarities and differences among the (...) various approaches and offer a reflection concerning the possibility of a shared resolution to the case. The authors’ efforts to come to a tentative consensus may serve as an example for professionals working in medical contexts that reflect an increasing pluralism of values. This article aims to respond to some of these concerns by illustrating how different methods in clinical ethics would be used when considering a real case. The goal is not to establish the best model on a theoretical level, but to learn from actual practice in order to see if there are common elements in the different methods, and to validate their pertinence to clinical ethics consultation. (shrink)

An examination of verbal hallucinations and thought insertion as examples of "alienated self-consciousness.".

En este trabajo consideramos los discursos políticos y económicos actuales proponiendo el fenómeno start-up como el síntoma de un cambio profundo en la gubernamentalidad neoliberal y un nuevo episodio en la larga historia de las prácticas de organización de la fuerza de trabajo, de su gobierno y movilización. Nos basamos en los textos de Michel Foucault y en la literatura neomanagerial actual para analizar las recientes transformaciones de la racionalidad neoliberal. Con este punto de partida, proponemos que el emprendedor neoliberal (...) del yo, el empresario de sí mismo, tal y como lo concibió Foucault, se está transformando, además, en una especie de inversor de sí mismo administrando permanentemente sus activos personales y buscando constantemente la autoevaluación y la autovalorización en la lógica del rendimiento.In this paper we consider the political and economic discourses hyping the «start-up phenomenon» as the symptom of a deep change in neoliberal governmentality and a new episode in the long history of the practices of workforce government and mobilisation. After pointing out the recent transformations of neoliberal rationality of government, we concentrate on the forms of subjectification implied by what could be defined as the start-up subject: the typically neoliberal entrepreneur of the self is thus transforming into a sort of investor of the self permanently managing his personal assets and incessantly searching for self-evaluation and self-valorisation. (shrink)

That Jehovah’s Witnesses may refuse lifesaving blood transfusions is a morally accepted feature of contemporary medical practice. The principle of respect for autonomy supports this, and there is seldom reason to interfere with this choice because it rarely harms another individual. Advances in surgical technique have made it possible for transplant surgeons to perform bloodless organ transplant, enabling Jehovah’s Witnesses to benefit from this treatment. When the transplant organ is a directed donation from a family member or friend, no ethical (...) dilemma arises. However, when a Jehovah’s Witness cannot identify a living donor and wishes to be listed for organ transplant, the transplant team may face an ethical dilemma. On the one hand, it wishes to provide care to the patient that is compatible with her or his preferences. On the other hand, the team may wonder if it is fair to other patients who need an organ and will accept blood transfusion to include the Jehovah’s Witness patient on a waiting list for a donated organ. If the Jehovah’s Witness patient is listed and receives an organ, then a patient who also needs an organ, and who is willing to accept all care to optimize the success of the transplant, may be denied an organ.To frame the ethical dilemma outlined above we present an anonymized case of a Jehovah’s Witness woman in urgent need of a kidney, who was referred to one of the authors’ institution’s transplant center. We review the evolution of the Jehovah’s Witness position on blood transfusion and the medical community’s efforts to provide care that accommodates this religious commitment. If Witnesses are to be denied transplant in the name of justice, there must be an ethically sound reason. We identify two rationales in the literature: (1) this allocation is unacceptable because it will cost lives; (2) resources should be allocated to patients who comply with the standard of care. We argue that neither apply to this dilemma. We also emphasize the importance of examining the data on outcomes of transplant with and without transfusion. Our interpretation of the published data on transplant without transfusion is that the outcomes are similar. We conclude that, in the absence of data that resources are risked, it is not ethical to refuse to include a Jehovah’s Witness patient on a waiting list for an organ. Finally, we reflect on the heterogeneity in transplant institutes’ polices for accepting Jehovah’s Witness patients. (shrink)

A given but otherwise random environmental time series impinging on the input of a certain biological processor passes through with overwhelming probability practically undetected. A very small percentage of environmental stimuli, though, is ‘captured’ by the processor's nonlinear dissipative operator as initial conditions, and is ‘processed’ as solutions of its dynamics. The processor, then, is in such cases instrumental in compressing or abstracting those stimuli, thereby making the external world to collapse from a previous regime of a ‘pure state’ of (...) suspended animation into a set of stable complementary and mutually exclusive eigenfunctions or ‘categories'. The characteristics of this cognitive set depend on the operator involved and the hierarchical level where the abstraction takes place. Depending on the context, the transition from one state to another occurs in such a cognitive operator. The chaotic itinerancy may play a crucial role for this process. In this paper we model the dynamics which may underlie such a cognitive process and the role of the thalamo-cortical pacemaker of the brain. In order to model them, conceptualization by the notion of ‘attractor ruin’ in high-dimensional dynamical systems is necessary. (shrink)

The method of philosophy. Introduction to part I -- Thought experiments -- Reflective equilibrium -- What is philosophy? Introduction to Part II and Part III -- The nature of the philosophical enterprise -- The nature of intuitive judgements -- Experimental philosophy. Empirical inquiries versus armchair investigations -- Against experimental philosophy.

Hume's Reception in Early America: Expanded Edition brings together the original American responses to one of Britain's greatest men of letters, David Hume. Now available as a single volume paperback, this new edition includes updated further readings suggestions and dozens of additional primary sources gathered together in a completely new concluding section. From complete pamphlets and booklets, to poems, reviews, and letters, to extracts from newspapers, religious magazines and literary and political journals, this book's contents come from a wide variety (...) of sources published in colonial America and the early United States between 1758 and 1850. As well as classics by Thomas Jefferson, John Adams and Alexander Hamilton, it contains scores of unknown and hard-to-locate items, many of which have not been reprinted since their original publication. These responses are divided into four parts covering Hume's Essays; his Philosophical Writings; his History of England; and his Character and Death. Each of those parts has a separate introductory essay, and every selection is introduced by a short headnote that sets the piece in its historical context and provides bibliographical references. Packed with new insights into Hume and American thought and culture, Hume's Reception in Early America reveals the relevance and impact of Hume on American political, philosophical, historical, religious, and aesthetic debates. (shrink)

Biological evolution is a complex blend of ever changing structural stability, variability and emergence of new phe- notypes, niches, ecosystems. We wish to argue that the evo- lution of life marks the end of a physics world view of law entailed dynamics. Our considerations depend upon dis- cussing the variability of the very ”contexts of life”: the in- teractions between organisms, biological niches and ecosys- tems. These are ever changing, intrinsically indeterminate and even unprestatable: we do not know ahead of (...) time the ”niches” which constitute the boundary conditions on selec- tion. More generally, by the mathematical unprestatability of the ”phase space”, no laws of mo- tion can be formulated for evolution. We call this radical emergence, from life to life. The purpose of this paper is the integration of variation and diversity in a sound concep- tual frame and situate unpredictability at a novel theoretical level, that of the very phase space. Our argument will be carried on in close comparisons with physics and the mathematical constructions of phase spaces in that discipline. The role of symmetries as invariant preserving transformations will allow us to under- stand the nature of physical phase spaces and to stress the differences required for a sound biological theoretizing. In this frame, we discuss the novel notion of ”enablement”. Life lives in a web of enablement and radical emergence. This will restrict causal analyses to differential cases. Mutations or other causal differ- ences will allow us to stress that ”non conservation princi- ples” are at the core of evolution, in contrast to physical dynamics, largely based on conservation principles as sym- metries. Critical transitions, the main locus of symmetry changes in physics, will be discussed, and lead to ”extended criticality” as a conceptual frame for a better understanding of the living state of matter. (shrink)

Editor James Fetzer presents an analytical and historical introduction and a comprehensive bibliography together with selections of many of Carl G. Hempel's most important studies to give students and scholars an ideal opportunity to appreciate the enduring contributions of one of the most influential philosophers of science of the 20th century.

One of Hume's most well-known works and a masterpiece of philosophy, A Treatise of Human Nature is indubitably worth taking the time to read.

Lycan not only uses the numerous arguments against materialism, and functionalist theories of mind in particular, to gain a more detailed positive view of the ..

This is a welcome reprint of a book that continues to grow in importance.

Throughout his career, Schelling assigns knowledge of the absolute first principle of philosophy to intellectual intuition. Schelling's doctrine of intellectual intuition raises two important questions for interpreters. First, given that his doctrine undergoes several changes before and after his identity philosophy, to what extent can he be said to “hold onto” the same “sense” of it by the 1830s, as he claims? Second, given that his doctrine of intellectual intuition restricts absolute idealism to what he calls a “science of reason”, (...) which he says cannot prove the absolute’s existence, what other doctrine does he require in order to prove this? I will answer these questions by tracing the shifts in Schelling’s doctrine of intellectual intuition from the 1790s to the 1830s and drawing out its evolving methodological role within his science of intelligibility. (shrink)

Includes bibliographical references and index.

A model for the ideal state includes discussions of the nature and application of justice, the role of the philosopher in society, the goals of education, and the effects of art upon character.