Several approaches to clinical ethics consultation (CEC) exist in medical practice and are widely discussed in the clinical ethics literature; different models of CECs are classified according to their methods, goals, and consultant’s attitude. Although the “facilitation” model has been endorsed by the American Society for Bioethics and Humanities (ASBH) and is described in an influential manual, alternative approaches, such as advocacy, moral expertise, mediation, and engagement are practiced and defended in the clinical ethics field. Our Clinical Ethics Center in (...) Paris was founded in 2002 in the wake of the Patients’ Rights Act, and to date it is the largest center that provides consultation services in France. In this article we shall describe and defend our own approach to clinical ethics consultation, which we call the “Commitment Model,” in comparison with other existing models. Indeed commitment implies, among other meanings, continuity through time, a series of coherent actions, and the realization of important social goals. By drawing on a recent consultation case, we shall describe the main steps of our consultation procedure: interviews with major stakeholders, including patients and proxies; case conferences; and follow up. We shall show why we have chosen the term “commitment” to represent our approach at three different but interrelated levels: commitment towards patients, within the case conference group, and towards society as a whole. (shrink)

BackgroundPatient skepticism concerning medical innovations can have major consequences for current public health and may threaten future progress, which greatly relies on clinical research.The primary objective of this study is to determine the variables associated with patient acceptation or refusal to participate in clinical research. Specifically, we sought to evaluate if distrust in pharmaceutical companies and associated psychosocial factors could represent a recruitment bias in clinical trials and thus threaten the applicability of their results.MethodsThis prospective, multicenter survey consisted in the (...) administration of a self-questionnaire to patients during a pulmonology consultation. The 1025 questionnaires distributed collected demographics, socio-professional and basic health literacy characteristics. Patients were asked to rank their level of trust for pharmaceutical companies and indicate their willingness to participate in different categories of research.Logistic regression was used to determine factors contributing to “trust” versus “distrust” group membership and willingness to participate in each category of research.ResultsOne thousand patients completed the survey, corresponding to a response rate of 97.5%. Data from 838 patients were analyzed in this study.48.3% of respondents declared that they trusted pharmaceutical companies, while 35.5% declared distrust. Being female, inactive in the employment market, and not-knowing the name of one’s disease are factors related to declared distrust. Distrust-group membership is associated with unwillingness to participate in certain categories of trials such as pre-marketing and industry-sponsored trials.ConclusionDistrust in pharmaceutical companies is associated with a specific patient profile and with refusal to participate in certain subcategories of trials. This potential recruitment bias may explain the under-representation of certain categories of patients such as women in pre-marketing drug trials. (shrink)

Dans ce livre passionnant aux allures d’enquête policière, Laurence Giordano nous mène sur les traces de trois orphelins – Nicolas, Marie et Michel Bryck – qui sans elle seraient restés sans voix et sans histoire, comme la vaste majorité du petit peuple du xixe siècle. C’est avec la découverte d’une lettre de Marie dans un carton concernant les « Orphelins du choléra des épidémies de 1832 et de 1839 » des archives départementales de Paris que l’historienne ouvre ce (...) récit, qui déroge aux règle... (shrink)

1 Knowledge and Justification This book is an investigation of one central problem which arises in the attempt to give a philosophical account of empirical ...

In the _Nichomachean Ethics_, Aristotle defines three kinds of friendship: utility, pleasure, and virtue. The characters in the films of Sean Baker fit into none of these categories. Friendship is central to all of Baker’s films, but it takes the non-Aristotelian form of “friends, no matter what,” which I interpret as a description of the aporia of friendship, of an impossible friend, or a friend in the realm of fantasy. In other words, friends are only friends when they resist everything (...) friends are supposed to do. Betrayal, lies, and complications sit at the heart of this new definition. One mechanism for this kind of friendship is _mourning_. Friends are only friends when friendship is mourned, or when it is part of a crypt, or a vault for losses that are too traumatic to confront fully, as set out in the work of Sigmund Freud, Jacques Derrida, Nicolas Abraham and Mária Török, and developed by Laurence Rickels. This reading of mourning puts a particular spin on fantasy, for if fantasy is generally assumed to be about wish-fulfillment, then when fantasy reaches into the crypt for inspiration, it is retooled into a vehicle for confronting what is too hard to face. This is the function of friendship in Baker’s films: his friends are Judas figures going against their friends in order to keep their friendship alive. In _Tangerine_ (2015), two transgender sex workers in West Hollywood develop their friendship around a fight over a man. In _Starlet_ (2012), a young woman hides a secret from her elderly female friend, and this friendship is only saved when another actress betrays this secret. In these films, friendship is paradoxically formed by attempting to ruin friendship. Thought on fantasy and mourning will help in defining this type of non-Aristotelian friendship, as well as Freud’s work on the “ambivalence of feeling” from his writing on the First World War. (shrink)

This book is concerned with the alleged capacity of the human mind to arrive at beliefs and knowledge about the world on the basis of pure reason without any dependence on sensory experience. Most recent philosophers reject the view and argue that all substantive knowledge must be sensory in origin. Laurence BonJour provocatively reopens the debate by presenting the most comprehensive exposition and defence of the rationalist view that a priori insight is a genuine basis for knowledge. This important (...) book will be at the centre of debate about the theory of knowledge for many years to come. (shrink)

In “Internalism and Externalism,” Laurence BonJour suggests that the contemporary epistemological debate over internalism and externalism concerns the formulation of the justification or warrant condition in an account of knowledge. The internalist requires that for a belief to meet this condition, all of the necessary elements must be cognitively accessible to the believer, whereas the externalist claims that at least some such elements do not need to be accessible to the believer. BonJour gives an overview of this dispute. He (...) suggests that the opposition between the two views is less straightforward than has usually been thought. He proposes, in addition, that each of them has valuable roles to play in major epistemological issues, even though the internalist approach is more fundamental in an important way. (shrink)

CHAPTER ONE Moral Character and Moral Theories Social interaction is the thread from which the fabric of moral character is woven.1 For it is social ...

One of the most important recent developments in the study of concepts has been the resurgence of interest in nativist accounts of the human conceptual system. However, many theorists suppose that a key feature of neural organization—the brain’s plasticity—undermines the nativist approach to concept acquisition. We argue that, on the contrary, not only does the brain’s plasticity fail to undermine concept nativism, but a detailed examination of the neurological evidence actually provides powerful support for concept nativism.

Laurence Goldstein gives a straightforward and lively account of some of the central themes of Wittgenstein's writings on meaning, mind, and mathematics.

" Now Laurence Lampert sets out to fulfill this prophecy by providing a section by section interpretation of this philosophical masterpiece that emphasizes its unity and depth as a comprehensive new teaching on nature and humanity.According ...

In this incisive new book one of Britain's most eminent philosophers explores the often overlooked tension between voluntariness and involuntariness in human cognition. He seeks to counter the widespread tendency for analytic epistemology to be dominated by the concept of belief. Is scientific knowledge properly conceived as being embodied, at its best, in a passive feeling of belief or in an active policy of acceptance? Should a jury's verdict declare what its members involuntarily believe or what they voluntarily accept? And (...) should statements and assertions be presumed to express what their authors believe or what they accept? Does such a distinction between belief and acceptance help to resolve the paradoxes of self-deception and akrasia? Must people be taken to believe everything entailed by what they believe, or merely to accept everything entailed by what they accept? Through a systematic examination of these problems, the author sheds new light on issues of crucial importance in contemporary epistemology, philosophy of mind, and cognitive science. (shrink)

Descartes a entrepris de détruire la pratique aristotélicienne de la philosophie : à son savoir seulement probable, les Regulae, puis les Essais opposent une science certaine d'objets clairs et distincts. Mais cette instauration concerne aussi, peut-être même d'abord, l'idéal pratique qu'Aristote ne cesse de viser dans les sciences théorétiques : le sage parvient à la félicité par l'exercice même d'une connaissance si parfaite qu'elle imite celle du dieu, qui pense sa pensée en acte et éternellement. Descartes met décidément en crise (...) la félicité par la contemplation, dont la pensée médiévale avait hérité d'Aristote. Pourtant, une autre figure de la félicité se dégage tout aussi indiscutablement de l'entreprise cartésienne : la méthode, la certitude scientifique qu'elle permet et les principes métaphysiques qui assurent l'une et l'autre restent, à chaque moment, solidaires d'une attitude et d'une ambition proprement morales - la volonté infinie aboutit à la générosité, où la considération du bon usage de notre libre-arbitre permet le - contentement de soi-même -. Ainsi la philosophie atteint-elle, pour Descartes aussi, à une félicité. Mais à une félicité volontaire et non plus contemplative. On tentera donc d'abord de mesurer, dans différents champs de la philosophie cartésienne, l'impact de la certitude jusque sur les questions d'éthique ; ensuite, de souligner la référence constante, quoique souvent implicite, de Descartes à la félicité telle qu'Aristote la visait ; enfin, de suivre leur dialogue au fil conducteur de leurs versions divergentes, mais complices, de l'admiratio et du thaumazein. (shrink)

The influential political philosopher Leo Strauss has been credited by conservatives with the recovery of the great tradition of political philosophy stretching back to Plato. Among Strauss's most enduring legacies is a strongly negative assessment of Nietzsche as the modern philosopher most at odds with that tradition and most responsible for the sins of twentieth-century culture--relativism, godlessness, nihilism, and the breakdown of family values. In fact, this apparent denunciation has become so closely associated with Strauss that it is often seen (...) as the very core of his thought. In Leo Strauss and Nietzsche, the eminent Nietzsche scholar Laurence Lampert offers a controversial new assessment of the Strauss-Nietzsche connection. Lampert undertakes a searching examination of the key Straussian essay, "Note on the Plan of Nietzsche's Beyond Good and Evil." He shows that this essay, written toward the end of Strauss's life and placed at the center of his final work, reveals an affinity for and debt to Nietzsche greater than Strauss's followers allow. Lampert argues that the essay comprises the most important interpretation of Nietzsche ever published, one that clarifies Nietzsche's conception of nature and of human spiritual history and demonstrates the logical relationship between the essential themes in Nietzsche's thought--the will to power and the eternal return. (shrink)

This major study of Hegel's intellectual development up to the writing of The Phenomonology of Spirit argues that his work is best understood in the context of the liberalisation of German Protestantism in the eighteenth century.

La recherche des causes apparaît à la fois comme un impérieux besoin de l'esprit humain et, sous la plume de nombreux acteurs du développement historique des connaissances, comme un obstacle. L'examen comparé des tendances majeures du raisonnement commun et des théories scientifiques actuellement enseignées fait apparaître des écarts importants quant à leur statut du point de vue de la causalité. " Donc ", " alors ", " ensuite " : ce trio de vocables résume la question que posent la part (...) de l'implication logique et celle des relations temporelles entre cause et effet. La causalité au sens où les physiciens l'entendent se distingue ainsi du lien qu'une relation pose entre grandeurs prises au même instant. Le débat rejoint ainsi la notion de fonction - et son nécessaire développement vers les fonctions de plusieurs variables - ainsi que celle des associations probabilistes entre grandeurs. Cet ouvrage invite à un examen croisé de la manière dont ce thème est abordé dans différentes disciplines (mathématiques, sciences physiques, biologie, histoire-géographie), sous le double regard de la didactique et de l'épistémologie. (shrink)

A comprehensive defence of the rationalist view that insight independent of experience is a genuine basis for knowledge.

Johnathan Cohen's book provides a lucid and penetrating treatment of the fundamental issues of contemporary analytical philosophy. This field now spans a greater variety of topics and divergence of opinion than fifty years ago, and Cohen's book addresses the presuppositions implicit to it and the patterns of reasoning on which it relies.

The book was planned and written as a single, sustained argument. But earlier versions of a few parts of it have appeared separately. The object of this book is both to establish the existence of the paradoxes, and also to describe a non-Pascalian concept of probability in terms of which one can analyse the structure of forensic proof without giving rise to such typical signs of theoretical misfit. Neither the complementational principle for negation nor the multiplicative principle for conjunction applies (...) to the central core of any forensic proof in the Anglo-American legal system. There are four parts included in this book. Accordingly, these parts have been written in such a way that they may be read in different orders by different kinds of reader. (shrink)

Taste as Experience puts the pleasure of food at the center of human experience. It shows how the sense of taste informs our preferences for and relationship to nature, pushes us toward ethical practices of consumption, and impresses upon us the importance of aesthetics. Eating is often dismissed as a necessary aspect of survival, and our personal enjoyment of food is considered a quirk. Nicola Perullo sees food as the only portion of the world we take in on a daily (...) basis, constituting our first and most significant encounter with the earth. Perullo has long observed people's food practices and has listened to their food experiences. He draws on years of research to explain the complex meanings behind our food choices and the thinking that accompanies our gustatory actions. He also considers our indifference toward food as a force influencing us as much as engagement. For Perullo, taste is value and wisdom. It cannot be reduced to mere chemical or cultural factors but embodies the quality and quantity of our earthly experience. (shrink)

This book is the first extensive treatment of Husserl's phenomenology of time-consciousness. Nicolas de Warren uses detailed analysis of texts by Husserl, some only recently published in German, to examine Husserl's treatment of time-consciousness and its significance for his conception of subjectivity. He traces the development of Husserl's thinking on the problem of time from Franz Brentano's descriptive psychology, and situates it in the framework of his transcendental project as a whole. Particular discussions include the significance of time-consciousness for (...) other phenomenological themes: perceptual experience, the imagination, remembrance, self-consciousness, embodiment, and the consciousness of others. The result is an illuminating exploration of how and why Husserl considered the question of time-consciousness to be the most difficult, yet also the most central, of all the challenges facing his unique philosophical enterprise"--Provided by publisher. (shrink)

One of the many problems that would have t o be solved by a satisfactory theory of empirical knowledge, perhaps the most central is a general structural problem which I shall call the epistemic regress problem: the problem of how to avoid an in- finite and presumably vicious regress of justification in ones account of the justifica- tion of empirical beliefs. Foundationalist theories of empirical knowledge, as we shall see further below, attempt t o avoid the regress by locating a (...) class of empirical beliefs whose justification does not depend on that of other empirical beliefs. Extemalist theories, the topic of the present paper, represent one species of foundationalism. (shrink)

Descartes a entrepris de détruire la pratique aristotélicienne de la philosophie : à son savoir seulement probable, les Regulae, puis les Essais opposent une science certaine d'objets clairs et distincts. Mais cette instauration concerne aussi, peut-être même d'abord, l'idéal pratique qu'Aristote ne cesse de viser dans les sciences théorétiques : le sage parvient à la félicité par l'exercice même d'une connaissance si parfaite qu'elle imite celle du dieu, qui pense sa pensée en acte et éternellement. Descartes met décidément en crise (...) la félicité par la contemplation, dont la pensée médiévale avait hérité d'Aristote. Pourtant, une autre figure de la félicité se dégage tout aussi indiscutablement de l'entreprise cartésienne : la méthode, la certitude scientifique qu'elle permet et les principes métaphysiques qui assurent l'une et l'autre restent, à chaque moment, solidaires d'une attitude et d'une ambition proprement morales - la volonté infinie aboutit à la générosité, où la considération du bon usage de notre libre-arbitre permet le - contentement de soi-même -. Ainsi la philosophie atteint-elle, pour Descartes aussi, à une félicité. Mais à une félicité volontaire et non plus contemplative. On tentera donc d'abord de mesurer, dans différents champs de la philosophie cartésienne, l'impact de la certitude jusque sur les questions d'éthique ; ensuite, de souligner la référence constante, quoique souvent implicite, de Descartes à la félicité telle qu'Aristote la visait ; enfin, de suivre leur dialogue au fil conducteur de leurs versions divergentes, mais complices, de l'admiratio et du thaumazein. (shrink)

Speciesism is the wrong of not acknowledging the moral qualities that non-human animals possess that are similar or equivalent or even superior to the moral qualities that human beings possess. However, since it is manifestly clear that no one thinks that apes are in any way obligated to human beings, it clearly cannot be a form of speciesism to be mindful of the differences on the basis of which that is so. In opposition to the advocates of the Great Ape (...) Project, my aim in this essay is to establish the quite minimal claim that apes should not have the same moral status as human beings because human beings have a far greater capacity for moral responsibility than do apes. The claim that I wish to establish is quite compatible with the claim that apes should be treated in a much more morally wholesome manner. (shrink)

Two new philosophical problems surrounding the gradation of certainty began to emerge in the 17th century and are still very much alive today. One is concerned with the evaluation of inductive reasoning, whether in science, jurisprudence, or elsewhere; the other with the interpretation of the mathematical calculus of change. This book, aimed at non-specialists, investigates both problems and the extent to which they are connected. Cohen demonstrates the diversity of logical structures that are available for judgements of probability, and explores (...) the rationale for their appropriateness in different contexts of application. Thus his study deals with the complexity of the underlying philosophical issues without simply cataloging alternative conceptions or espousing a particular "favorite" theory. (shrink)

Herbert Lionel Adolphus Hart was born in Yorkshire in 1907 to second generation Jewish immigrants. Having won a scholarship to Oxford University, he went on to become the most famous legal philosopher of the twentieth century. From 1932-40 H.L.A Hart practised as a barrister in London. He was pronounced physically unfit for military service in 1940, and was recruited by MI5, where he worked until 1945. During his time at the Bar he had continued to study philosophy and at M15 (...) his interest was further stimulated by his philosopher colleagues in M16, Stuart Hampshire and Gilbert Ryle. After the war, Hart returned to Oxford to take up a philosophy fellowship, later to become Professor of Jurisprudence. H.L.A Hart single-handedly reinvented the philosophy of law and influenced the nation's thinking in the 1960s on abortion, the legalization of homosexuality, and on capital punishment. Hart's approach to legal philosophy was at once disarmingly simple and breathtakingly ambitious, combining as it did the insights of Austin and Bentham and the new linguistic philosophy of J.L. Austin and Ludwig Wittgenstein. He sought to elucidate a concept of law which would be of relevance to all forms of law, wherever or whenever they arose: his bestselling book, The Concept of Law, has sold tens of thousands of copies worldwide. In 1941, he married Jenifer Williams (a high-ranking civil servant, later an Oxford academic) with whom he had four children. Their relationship was an enduring if unconventional one. In the early 1950s, Jenifer was rumoured to be having a long-standing affair with Isaiah Berlin, one of Hart's closest friends. She was also, falsely, accused by the Sunday Times of having been a Russian spy, an allegation which was all the more scandalous given Hart's position at MI5 during the War. Nicola Lacey draws on Hart's previously unpublished diaries and letters to reveal a complex inner life. Outwardly successful, Hart was in fact tormented by doubts about his intellectual abilities, his sexual identity and his capacity to form close relationships. Her biography also sheds fascinating light on the origins of his ideas, and assesses his overall contribution. Above all, it chronicles of a life which had a depth ands impact far greater than many of Hart's readers have realized. (shrink)

Nancy Jecker (2013) mounts a sustained and formidable critique of Norman Daniels's prudential lifespan account (PLA) as a reliable basis for justice between age groups in the responsible allocation...

Applies ancient wisdom to modern life with Taoist exercises designed to identify and strengthen the balance between the demands of society and one's true desires.

The life fantastic -- Bedtime stories -- The end of things -- Optical disillusions -- Double vision -- Backstage pass -- Romance languages -- Fellow-feeling -- Bolts from the blue -- Final fantasies.