Recent scholarship has inquired into the socio-historical, discursive genesis of trauma. Trauma and the Ontology of the Modern Subject, however, seeks what has not been actualized in trauma studies - that is, how the necessity and unassailable intensity of trauma is fastened to its historical emergence. We must ask not only what trauma means for the individual person's biography, but also what it means to be the historical subject of trauma. In other words, how does being human in this current (...) period of history implicate one's lived possibilities that are threatened, and perhaps framed, through trauma? Foucauldian sensibilities inform a critical and structural analysis that is hermeneutically grounded. Drawing on the history of ideas and on Lacan's work in particular, John L. Roberts argues that what we mean by trauma has developed over time, and that it is intimately tied with an ontology of the subject; that is to say, what it is to be, and means to be human. He argues that modern subjectivity - as articulated by Heidegger, Levinas, and Lacan - is structurally traumatic, founded in its finitude as self-withdrawal in time, its temporal self-absence becoming the very conditions for agency, truth and knowledge. The book also argues that this fractured temporal horizon - as an effect of an interrupting Otherness or alterity - is obscured through the discourses and technologies of the psy-disciplines (psychiatry, psychology, and psychotherapy). Consideration is given to social, political, and economic consequences of this concealment. Trauma and the Ontology of the Modern Subject will be of enduring interest to psychoanalysts and psychotherapists as well as scholars of philosophy and cultural studies. (shrink)

Reviews the book, Enjoy your symptom: Jacques Lacan in Hollywood and out by Slavoi Zizek. The following reviews one of Slavoi Zizek's books, Enjoy your symptom: Jacques Lacan in Hollywood and out. Zizek's book and this review aim to address the relevance of Lacan for many of the ethical questions that arise when psychology begins to envision its own concepts and practices as culturally embedded. The matrix of discourse, power, and subject is most often articulated in psychology through the ideas (...) of Foucault, but Lacan illuminates the same field of effects with closer attention given to the specifics of language, the body, the individual, and intersubjectivity. Lacan most obviously addresses the role of speech in a clinical setting. But the implications reach further and Slavoi Zizek takes the Lacanian intervention into the social order. At present Zizek represents the most explicit and uncompromising Lacanian reader of contemporary culture. 2012 APA, all rights reserved). (shrink)

Many legal arguments pertaining to equal rights for gay and lesbian families have relied upon empirical research on the `healthy' childraising environment of these families. While neither disputing recent legal gains nor diminishing their importance, this article looks at some of the conceptual categories that drive this research. The limitations of such research, as salutary as it is, are typically understood in terms of their obvious political context. Such research avoids highlighting any differences between gay/lesbian families and traditional families because (...) an emphasis on such differences feeds cultural stereotypes that are damaging to non-traditional families. This article takes a different tack, looking at how the concepts that frame research are based in binaries and fantasies about families and sex that we argue are too limiting. It assumes that the elision of sexuality within such studies is symptomatic of a broader repression of a variety of meanings of family. In response, the article brings in queer theory and psychoanalysis to broaden our approach to understanding new forms of family and kinship initiated by gay and lesbian families. The article addresses single household lesbian families that are most frequently the object of empirical research. (shrink)

This essay reviews four longer arguments regarding the status of critical thinking on psychology. The commentary understands criticality as somehow sitting at the edge of theory itself. Given Psychology's perpetual identity crisis, the question of its edges and thus where criticality should nibble is brought to bear on the basic premises of the paper. Two of the papers are addressed in terms of the implied metapsychology they would presuppose and where that might break down . Two essays are addressed in (...) terms of being a form of reading: one founded in adumbrations of desire and the other in a faith in science. The authors are asked if their work might not be informed by recent trends philosophy of science and through particular psychoanalytic lenses. 2012 APA, all rights reserved). (shrink)

This essay is primarily an exposition of a Lacanian view of subjectivity, as one that is literally informed by the fact of speaking. The genesis within speaking is related to a possible bridge between the social and the subjective that has troubled psychology for decades. The inherence of alterity to the structuration of the subject is described as part of this exposition. This intrinsic otherness as a self-difference and as a framing of the speaking act is described as a way (...) to reexamine recalcitrance and everyday problems in diversity. It is argued that diversity, far from being a dalliance or trite new set of rules for civil behavior, taps into a problematic of the subject. Ways of understanding the encounter with the other, as might follow from Lacan's work, are articulated within the context of religious law and of the social contract in current late capitalist society. Each foray into a particular instance of encountering diversity is framed within the overall exposition of subjective structuration. 2012 APA, all rights reserved). (shrink)

Recently published consensus recommendations on pediatric decision-making by Salter and colleagues (2023) did not address neonatal decision-making, due to the unique complexities of neonatal care. This essay explores three areas that impact neonatal decision-making: legal and policy considerations, rapid technological advancement, and the unique emotional burdens faced by parents and clinicians during the medical care of neonates. The authors evaluate the six consensus recommendations related to these considerations and conclude that the consensus recommendations apply to neonates.

Objectives To characterize the prevalence and content of pediatric triage policies.Methods We surveyed and solicited policies from U.S. hospitals with pediatric intensive care units. Policies were analyzed using qualitative methods and coded by 2 investigators.Results Thirty-four of 120 institutions (28%) responded. Twenty-five (74%) were freestanding children’s hospitals and 9 (26%) were hospitals within a hospital. Nine (26%) had approved policies, 9 (26%) had draft policies, 5 (14%) were developing policies, and 7 (20%) did not have policies. Nineteen (68%) institutions shared (...) their approved or draft policy. Eight (42%) of those policies included neonates. The polices identified 0 to 5 (median 2) factors to prioritize patients. The most common factors were short- (17, 90%) and long- (14, 74%) term predicted mortality. Pediatric scoring systems included Pediatric Logistic Organ Dysfunction-2 (12, 63%) and Score for Neonatal Acute Physiology and Perinatal Extensions-II (4, 21%). Thirteen (68%) policies described a formal algorithm. The most common tiebreakers were random/lottery (10, 71%) and life cycles (9, 64%). The majority (15, 79%) of policies specified the roles of triage team members and 13 (68%) precluded those participating in patient care from making triage decisions.Conclusions While many institutions still do not have pediatric triage policies, there appears to be a trend among those with policies to utilize a formal algorithm that focuses on short- and long-term predicted mortality and that incorporates age-appropriate scoring systems. Additional work is needed to expand access to pediatric-specific policies, to validate scoring systems, and to address health disparities. (shrink)

Honor walks are ceremonies that purportedly honor organ donors as they make their final journey from the ICU to the OR. In this paper, we draw on Ronald Grimes’ work in ritual studies to examine honor walks as ceremonial rituals that display medico-technological power in a symbolic social drama (Grimes, 1982). We argue that while honor walks claim to honor organ donors, ceremonies cannot primarily honor donors, but can only honor donation itself. Honor walks promote the quasi-religious idea of donation (...) as a “good death,” and mask the ambiguity and discomfort inherent in organ donation to promote greater acceptance by the medical community. While some goods may be achieved through honor walks, particularly for donor families, it is still important to examine the negative work done by this practice. (shrink)

Medical trainees should learn from the actions of Nazi physicians to inform a more just contemporary practice by examining the subtle assumptions, or moral orientations, that led to such heinous actions. One important moral orientation that still informs contemporary medical practice is the moral orientation of elimination in response to suffering patients. We propose that the moral orientation of presence, described by theologian Stanley Hauerwas, provides a more fitting response to suffering patients, in spite of the significant barriers to enacting (...) such a moral orientation for contemporary trainees. (shrink)

In recent years, increasingly advanced artificial intelligence (AI), and in particular machine learning, has shown great promise as a tool in various healthcare contexts. Yet as machine learning in medicine has become more useful and more widely adopted, concerns have arisen about the “black-box” nature of some of these AI models, or the inability to understand—and explain—the inner workings of the technology. Some critics argue that AI algorithms must be explainable to be responsibly used in the clinical encounter, while supporters (...) of AI dismiss the importance of explainability and instead highlight the many benefits the application of this technology could have for medicine. However, this dichotomy fails to consider the particular ways in which machine learning technologies mediate relations in the clinical encounter, and in doing so, makes explainability more of a problem than it actually is. We argue that postphenomenology is a highly useful theoretical lens through which to examine black-box AI, because it helps us better understand the particular mediating effects this type of technology brings to clinical encounters and moves beyond the explainability stalemate. Using a postphenomenological approach, we argue that explainability is more of a concern for physicians than it is for patients, and that a lack of explainability does not introduce a novel concern to the physician–patient encounter. Explainability is just one feature of technological mediation and need not be the central concern on which the use of black-box AI hinges. (shrink)

Three ethical conflicts in particular are paradigmatic of what we define as “clerkship ethics.” First, a distinction that differentiates the clerkship student from the practicing physician involves the student’s principal role as a learner. The clerkship student must skillfully balance her commitment to her own education against her commitment to patient care in a fashion that may compromise patient care. While the practicing physician can often resolve the tension between these two goods when they come into conflict, the clerkship student (...) is left with a more ambiguous set of choices. Second, evaluative scrutiny during clinical clerkships often forces medical students to balance doing what is morally fitting against the perceived expectations of the medical teams in which they work. Third and finally, a deeply entrenched culture of medical hierarchy presents a particular challenge to innovation and improvement in ethics education during the clerkship years. Students regard faculty as exemplars, but are not provided with the tools to assess when technical medical competence is not matched by moral competence; moreover, these faculty are unlikely to have experienced the ethics education in which students are asked to demonstrate mastery. (shrink)

Background: There are numerous benefits to ethics consultation services, but little is known about the reasons different professionals may or may not request an ethics consultation. Inter-professional differences in the perceived utility of ethics consultation have not previously been studied.Methods: To understand profession-specific perceived benefits of ethics consultation, we surveyed all employees at an urban tertiary children’s hospital about their use of ethics committee services (n = 842).Results: Our findings suggest that nurses and physicians find ethics consultations useful for different (...) reasons; physicians were more likely to report normative benefits, while nurses were more likely to report communicative and relational benefits.Conclusions: These findings support an open model of ethics consultation and may also help ethics committees to better understand consultation requests and remain attuned to the needs of various professional groups. (shrink)

Loneliness in medicine is a serious problem not just for patients, for whom illness is intrinsically isolating, but also for physicians in the contemporary condition of medicine. We explore this problem by investigating the ideal physician-patient relationship, whose analogy with friendship has held enduring normative appeal. Drawing from Talbot Brewer and Nir Ben-Moshe, we argue that this appeal lies in a dynamic form of companionship incompatible with static models of friendship-like physician-patient relationships: a mutual refinement of embodied virtue that draws (...) both persons together. The ideal physician-patient relationship has a dialectical character that fosters each member's improvement of phenomenologically recognizing and embodying moral virtues. A key component of this dynamic is a commitment to the common goal of the patient's health, realized through joint interactivities and conversations over time. The physician's presence to the patient's suffering—understood best as an alienating phenomenological condition for the patient—orients and discloses possibilities for virtuous caregiving by structuring the meanings of the goals, conversations, and joint narrative constitutive of their relationship. Presence to suffering, paradoxically, is perhaps an important prerequisite for this dynamic partnership. These activities dialectically build an interpretive horizon of understanding through which moral goods and character refinement—in and for the other—may become revealed for both persons in their shared being-in-the-world. This analysis of suffering, mood, and revealing of (possible) moral goods has implications for addressing the modern problem of loneliness for patients and physicians, who are increasingly inhibited from building flourishing relationships with each other. (shrink)

The consensus recommendations by Salter and colleagues (2023) regarding pediatric decision-making intentionally omitted adolescents due to the additional complexity their evolving autonomy presented. Using two case studies, one focused on truth-telling and disclosure and one focused on treatment refusal, this article examines medical decision-making with and for adolescents in the context of the six consensus recommendations. It concludes that the consensus recommendations could reasonably apply to older children.

Reason and Value collects 15 new papers by leading contemporary philosophers on themes from the work of Joseph Raz. Raz has made major contributions in a wide range of areas, including jurisprudence, political philosophy, and the theory of practical reason; but all of his work displays a deep engagement with central themes in moral philosophy. The subtlety and power of Raz's reflections on ethical topics make his writings a fertile source for anyone working in this area. Especially significant are his (...) explorations of the connections between practical reason and the theory of value, which constitute a sustained and penetrating treatment of a set of issues at the very center of moral philosophy as it is practiced today. The contributors to the volume acknowledge the importance of Raz's contributions by engaging critically with his positions and offering independent perspectives on the topics that he has addressed. The volume aims both to honour Raz's accomplishments in the area of ethical theorizing, and to contribute to an enhanced appreciation of the significance of his work for the subject. (shrink)

This paper explores the relationship between science and ethics and its implications for educational refonn and environmental change. It is a personal account of my search to find a place for ethics in an environmental science dass and how, in the process, the dass itself is being transfonned. I document how I have come to believe that the dassroom is a model of the world: within my own development, thetransfonnation of a course is implicated and, within the development of the (...) course, the potential transfonnation of an educational system and the world is enfolded. (shrink)

This paper explores the relationship between science and ethics and its implications for educational refonn and environmental change. It is a personal account of my search to find a place for ethics in an environmental science dass and how, in the process, the dass itself is being transfonned. I document how I have come to believe that the dassroom is a model of the world: within my own development, thetransfonnation of a course is implicated and, within the development of the (...) course, the potential transfonnation of an educational system and the world is enfolded. (shrink)

The Nature of God explores a perennial problem in the philosophy of religion.

Edward O. Wilson's sociobiology, as advocated in On Human Nature, is often criticized for its sensationalism and its anthropomorphisms. Critics have not recognized, however, that the so?called anthropomorphisms are essential to sociobiology, in so far as it seeks to address the humanities, and that the sensationalism derives from them. They are not just the sloppiness usually found in popularizations. Section I reviews the grounds for these criticisms and then ends by demonstrating that it is no less a confusion to label (...) these misuses of language ?anthropomorphisms?. Section II analyzes the style of reasoning, characteristic of scientism in general and sociobiology in particular, that sanctions misuses of language such as Wilson's. The flaw in this reasoning is that it depends upon the very language it sets out to debunk, in a way that renders its own arguments unintelligible. (shrink)

This study examines the issues associated with the disinvestment of U.S. interests from South Africa that took place in the mid-80s from the perspective of three dominant moral theories: utility, rights, and justice. By examining the issues in light of these three theories, the paper attempts to establish a decision framework from which managers and investors can evaluate similar decisions they are facing around the world today. Similarly, the reading may prove useful to educators who incorporate discussions of ethical decision (...) making into the classroom.Training in business ethics too often takes a strictly utilitarian perspective, or worse, a relativistic one. This study attempts to illustrate how utilitarian theory and related rights and justice issues can he interwoven into the heuristics associated with the contemporary concepts of corporate social responsibility. (shrink)

Despite All Critique (2014) -- World Politics and Western Reason (1980) -- The Doubled Outsides of the Modern International (2005) -- The Subject of Security (1995) -- The Protection of Nature and the Nature of Protection (2005) -- Social Movements/World Politics (1994) -- Europe is Not Where It is Supposed to Be (2000) -- They Seek it Here, They Seek it There : Looking for Politics in Clayoquot Sound (2003) -- Violence, Modernity, Silence : From Weber to International Relations (1993) (...) -- Hobbes, Origins, Limits (2011) -- War, Terror, Judgement (2002) -- International, Imperial, Exceptional (2005) -- Which Democracy for Which Demos? (2013) -- The Political Theory of Boundaries and the Boundaries of Political Theory : Interview With Raia Prokhovnik (2012). (shrink)

Digitalisation of health and the use of health data in artificial intelligence, and machine learning (ML), including for applications that will then in turn be used in healthcare are major themes permeating current UK and other countries’ healthcare systems and policies. Obtaining rich and representative data is key for robust ML development, and UK health data sets are particularly attractive sources for this. However, ensuring that such research and development is in the public interest, produces public benefit and preserves privacy (...) are key challenges. Trusted research environments (TREs) are positioned as a way of balancing the diverging interests in healthcare data research with privacy and public benefit. Using TRE data to train ML models presents various challenges to the balance previously struck between these societal interests, which have hitherto not been discussed in the literature. These challenges include the possibility of personal data being disclosed in ML models, the dynamic nature of ML models and how public benefit may be (re)conceived in this context. For ML research to be facilitated using UK health data, TREs and others involved in the UK health data policy ecosystem need to be aware of these issues and work to address them in order to continue to ensure a ‘safe’ health and care data environment that truly serves the public. (shrink)

This paper examines the market response to the events leading up to the passage of Section 1502 of the Dodd-Frank Wall Street Reform and Consumer Protection Act to explore whether investors value mandatory human rights disclosures of conflict mineral usage. Using a sample of 3639 US registrants from January 1, 2008 to September 30, 2014, we document a significant negative stock market reaction to the passage of the Act. Using a sample of 1206 filers, we also find a negative market (...) reaction to conflict mineral disclosures under the Act. The market reaction is more negative and limited to companies that source their minerals from the DRC and adjoining countries, companies with prior records of human rights violations, and companies with ambiguous disclosures. However, the market appears to reward firms that use risk-mitigation strategies. This paper provides preliminary evidence that the mandatory disclosure of conflict mineral information on Form SD poses a threat to firms’ legitimacy, resulting in a net cost to investors. The results of this study provide economic justification for companies with poor records of conflict mineral sourcing to improve their practices for the purpose of avoiding the high costs that will arise if they are forced to disclose human rights abuses related to conflict mineral use. (shrink)

How do we access the authentic self in order to live fulfilling, meaningful lives? In straightforward terms, The Heart of the Matter: Gifts in Strange Wrapping Paper explains a simple but extraordinarily powerful technique called the See, Feel, Hear Challenge that enables people to easily gain entry into the storehouse of their subconscious core beliefs. In the process, it cracks the coded messages that those beliefs release in the form of disease, suffering, addictions, unhappy relationships, and victimized circumstances. Based in (...) the latest findings in neuroscience and neurocardiology, this book guides readers to an uncomplicated understanding of the astounding power of our emotions and how life automatically delivers experiences that trigger negative reactions that subconsciously impact us. These emotions form the foundation of core beliefs that create unhealthy attitudes and dis-ease patterns that keep us from experiencing the authentic, satisfying lives we desire. Using clear examples and true stories from clients, Dr. Weissman’s latest work demonstrates how we can release these stored emotions and their wisdom via the See, Feel, Hear Challenge. It then explains how to use this simple method to evoke feelings that positively impact the quantum field, remolding our bodies, minds, and everyday lives into purposeful expressions of inner joy and radiant well-being. Whether you’re dealing with addictions, dysfunctional relationships, or illness, or are focused on becoming an Olympic champion, The Heart of the Matter gives you a potent tool for positive change and transformation that you can use for the rest of your life. (shrink)

Elliot R. Wolfson intervenes in the debate over Martin Heidegger and Nazism from a unique perspective, as a scholar of Jewish mysticism and philosophy who has been profoundly influenced by Heidegger's work. He reveals crucial aspects of Heidegger's thinking that betray an affinity with dimensions of Jewish thought.

Increasingly through the 1990s, tobacco control advocates questioned the practice of public institutions investing in tobacco company stocks. The questioning was framed in at least three ways. First, is it ethical to fund public expenditures with profits from a product that causes addiction and disease? Second, is it sound social policy to derive public income from a product that increases healthcare costs and reduces worker productivity? Finally, is it sound fiscal policy to invest in an historically profitable industry facing multiplying (...) legal and regulatory challenges? While the tobacco industry preferred to restrict discussion to the fiscal question, and offered an affirmative answer, its position was weakened by depressed stock prices brought on by actions of the industry as much as by tobacco control activism. As part of a campaign to restore its credibility as an investment vehicle with public fund managers, Philip Morris (PM) commissioned a report from the influential investment managers/advisors Wilshire Associates. However, Wilshire had only recently conducted such a study for the Washington State Investment Board (WSIB), assuring the board that the value tobacco stocks added to an investment portfolio – if any – was too small to be measured. Nonetheless, within a year, Wilshire produced a report for PM which appeared to laud the investment value of tobacco and to dismiss tobacco-excluded investment alternatives. This paper examines how Wilshire produced apparently diametrically opposed reports for clients with different interests. It reveals a pattern of potential conflicts of interest among tobacco companies, financial analysis firms, investment authorities, and institutional fund managers. It demonstrates substantial violations of two generally accepted ethical principles of business consulting: veracity and transparency. (shrink)