To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration (VA) facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients (n = 32) and managers (n = 38); semi-structured interviews with managers (n = 31), clinicians (n = 55), and ethics committee chairpersons (n = 21). Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly (...) distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions. (shrink)
In response to Mader's and Deutscher's questions, the author defends her approach to reading Irigaray and Butler, which entails extending the ideas of these thinkers into areas of thought with which they do not engage directly themselves. This involves relating Irigaray's ideas to the tradition of the philosophy of nature and interpreting Butler as offering, in spite of her focus on the genealogy of claims about sex, also a theory of sex itself, a theory of sex as an effect entirely (...) of gender. This approach to reading differs from Irigaray's own reading method of expanding and transforming philosophies in light of their constitutive exclusions. An example of this, explored here, is Irigaray's expansion and transformation of Merleau-Ponty's late ontology of flesh in light of its constitutive exclusion, the "maternal sojourn." This article also asks whether rhythmic sexual difference, which the author has attempted to differentiate from biological sex difference, ultimately remains tied to biological sex difference. This commentary suggests that it does but that reference to biological sex difference need not be politically problematic. Finally, the author asks whether the metaphysics of potentials and tendencies that she attributes to Irigaray impedes social change by inevitably reinstalling the actual as the horizon of possibility. Irigaray's strategy of reading texts and cultures for their constitutive exclusions offers a solution to this problem. (shrink)
In this much-anticipated work, distinguished authors MaryBeth Ingham and Mechthild Dreyer present an accessible introduction to the philosophy of the thirteenth century Franciscan John Duns Scotus. Based on their expert knowledge of Scotus, this text brings together key insights of Scotus's theory of cognition, metaphysics, and ethics in a comprehensive and unified manner. The authors use critical texts and the most recent scholarship on Scotus to introduce the intricate vision of the Subtle Doctor to a wide audience. (...) This volume offers a point of entry into the world of medieval philosophy and its connection to questions belonging to natural theology: the existence of God, divine freedom, and perfection. It presents important historical information on Scotus himself, but additionally on the philosophical context in which he taught. The authors explicate his thought in light of the dominant questions of the late thirteenth century. The integrative and comprehensive presentation of the essential elements of Scotus's philosophical vision makes this book an excellent resource. Basic concepts are explained for the non-specialist, while helpful discussions of Scotus's conceptions will be useful for those already familiar with his work. MaryBeth Ingham is Professor of Philosophy and Associate Academic Vice President at Loyola Marymount University. In addition to numerous articles and reviews, her most recent works include Scotus for Dunces: An Introduction to the Subtle Doctor and The Harmony of Goodness: Mutuality and Moral Living According to John Duns Scotus. Mechthild Dreyer, author of numerous works published in German, is Professor of Scholastic Philosophy at theUniversity of Mainz, Germany. Her recent works include Scotus's Theoremata (coedited with Hannes Mvhle)in Scotus Opera Philosophica, Vol. 2, and Nikolaus von Amiens: Ars fidei catholicae. (shrink)
This paper examines E. W. Beth's work in the philosophy of physics, both from a historical and a systematic point of view. Beth saw the philosophy of physics first of all as an opportunity to illustrate and promulgate a new and modern general approach to the philosophy of nature and to philosophy tout court: an approach characterized negatively by its rejection of all traditional metaphysics and positively by its firm orientation towards science. Beth was successful in defending (...) this new ideology, and became its leading Dutch representative in the first two decades after the second world war. Beth also contributed importantly to the method of the philosophy of physics in a narrower sense, by proposing and promoting the semantic approach in the formal analysis of physical theories. Finally, he worked on several specific foundational questions; but he was probably too much of a logician to leave his mark in this area. (shrink)
: If liberal theory is to move forward, it must take the political nature of family relations seriously. The beginnings of such a liberalism appear in Mary Wollstonecraft's work. Wollstonecraft's depiction of the family as a fundamentally political institution extends liberal values into the private sphere by promoting the ideal of marriage as friendship. However, while her model of marriage diminishes arbitrary power in family relations, she seems unable to incorporate enduring sexual relations between married partners.
In 1997, five decades after the publication of the landmark Hempel-Oppenheim article "Studies in the Logic of Explanation"(, 1970) Wesley Salmon published Causality and Explanation, a book that re-addresses the issue of scientific explanation. He provided an overview of the basic approaches to scientific explanation, stressed their weaknesses, and offered novel insights. However, he failed to mention Mary Hesse's approach to the topic and analyze her standpoint. This essay brings front and center Hesse's approach to scientific explanation formulated in (...) the 1960s and argues that rereading Hesse's account one can overcome the criticisms addressed towards another influential theory of explanation that of Bas van Fraassen's. Furthermore, it could bring the traditional philosophy of science into a fruitful conversation with science and technology studies and gender studies in science, technology and medicine. (shrink)
During a smallpox epidemic in April 1721, Lady Mary Wortley Montagu asked Dr. Charles Maitland to "engraft" her daughter, thus instigating the first documented inoculation for smallpox (_Variola_ virus) in England. Engrafting, or variolation, was a means of conferring immunity to smallpox by placing pus taken from a smallpox pustule under the skin of an uninfected person to create a local infection. The introduction of infectious viral matter, however, could trigger fullblown smallpox, and the practice was controversial for both (...) this reason and the pervasive conviction that it was immoral to intentionally infect a human body. Eventually, engrafting was phased out altogether in favor of vaccination, a much safer procedure established by Edward Jenner in the late eighteenth century. Montagu's decision was influenced by her experiences in Constantinople, where she had spent a year, and where engrafting was commonplace. As a smallpox survivor herself, Montagu had taken an interest in Turkish inoculation practices, and had had her son Edward engrafted while in Turkey. She was not the first person to import the idea of smallpox inoculation to England, nor the first English person to have their child inoculated (other English children had been inoculated while visiting Turkey), yet she quickly became known for importing and popularizing smallpox inoculation. At the request of her acquaintances, she took her inoculated daughter with her on a round of visits into elite households to demonstrate the safety of the procedure. The reputation she gained was both positive and negative: monuments were erected in her honor, encomiastic poems were published, and Voltaire declared her "a woman of as fine a genius, and endued with as great a strength of mind as any of her sex in the British Kingdoms"; however, anti-inoculationists ridiculed her, some society figures regarded her warily, and Alexander Pope satirized her in his poetry.
Montagus pioneering role in the smallpox debate is undoubtedly significant: she instigated the first smallpox inoculation on English soil, and she was largely responsible for making the practice acceptable in elite circles. My interest in this essay is in the nature and significance of Montagus reputation as an inoculation pioneer. I will argue that her reputation was based on the particular combination of her social position as a Whig and an aristocratic woman; her interest in progressive and enlightened forms of social, political, and scientific thought; her standing in influential literary circles; and, not least, the force of her own personality. In broad terms, I offer Montagus involvement in the smallpox debate as a case study in a new kind of public role becoming available to elite women in the early eighteenth century a role that caused considerable discomfort among her peers and in the medical community, and one that stimulated a widespread controversy in print publications of the day. (shrink)
This article discusses the work of Dr Mary Louisa Gordon, who was appointed as the first English Lady Inspector of Prisons in 1908, and remained in post until 1921. Her attitude towards and treatment of women prisoners, as explained in her 1922 book Penal Discipline, stands in sharp contrast to that of her male contemporaries, and the categorisation of her approach as ‘feminist’ is reinforced by her documented connections with the suffragette movement. Yet her feminist and suffragist associations also (...) resulted in the marginalisation and dismissal of her work, such that Mary Gordon and Penal Discipline are virtually unknown today. Nevertheless, her insights into the position and needs of women prisoners retain a striking contemporary relevance. (shrink)
Both the Beth definability theorem and Craig's lemma (interpolation theorem from now on) deal with the issue of the entanglement of one language L1 with another language L2, that is to say, information transfer—or the lack of such transfer—between the two languages. The notion of splitting we study below looks into this issue. We briefly relate our own results in this area as well as the results of other researchers like Kourousias and Makinson, and Peppas, Chopra and Foo.Section 3 (...) does contain one apparently new theorem. (shrink)
Mary is confined to a black-and-white room, is educated through black-and-white books and through lectures relayed on black-and white television. In this way she learns everything there is to know about the physical nature of the world. She knows all the physical facts about us and our environment, in a wide sense of 'physical' which includes everything in completed physics, chemistry, and neurophysiology, and all there is to know about the causal and relational facts consequent upon all this, including (...) of course functional roles. If physicalism is true, she knows all there is to know. For to suppose otherwise is to suppose that there is more to know than every physical fact, and that is just what physicalis.. (shrink)
Feared and admired in equal measure, Mary Midgely has carefully, yet profoundly challenged many of the scientific and moral orthodoxies of the twentieth century. The Essential Mary Midgley collects for the first time the very best of this famous philosopher's work, described by the Financial Times as "commonsense philosophy of the highest order." This anthology includes carefully chosen selections from her best-selling books, including Wickedness, Beast and Man, Science and Poetry and The Myths We Live By . It (...) provides a superb and eminently accessible insight into questions she has returned to again and again in her renowned sharp prose, from the roots of human nature, reason and imagination to the myths of science and the importance of holism in thinking about science and the environment. It offers an unrivalled introduction to a great philosopher and a brilliant writer, and also includes a specially written foreword by James Lovelock. (shrink)
This ar ti cle ex tends, from a philo soph i cal and an thro po log i cal point of view, the re cent dis - cus sions as to what is met a phoric. Lan guage phi - los o phers have con trib uted to the un der stand ing of the na ture and func tion of met a phors, but their com ments have been tra ..
Medical advances in transplantation techniques have driven an exponential increase in the demand for transplantable organs. Unfortunately, policy efforts to bolster the organ supply have been less than effective, failing to provide a stopgap for ever-increasing numbers of patients who await organ transplantation. The number of registrations on waiting lists exceeded 65,245 in early 1999, a 325% increase over the 20,000 that existed 11 years earlier in 1988. Regrettably, more than 4,000 patients die each year while awaiting transplantation.
The paper treats several ontological questions about certain nineteenth-century and contemporary medical and scientific conceptualizations of hereditary relation. In particular, it considers the account of mid-nineteenth century psychiatric thought given by Foucault in Psychiatric Power: Lectures at the Collège de France, 1973–1974 and Abnormal: Lectures at the Collège de France, 1974–1975 . There, Foucault argues that a fantastical conceptual prop, the ‘metabody,’ as he terms it, was implicitly supposed by that period’s psychiatric medicine as a putative ground for psychiatric pathology. (...) After presenting the heart of Foucault’s thought on the ‘metabody,’ the paper investigates the possibility that a contemporary version of a ‘metabody’ may operate today as a conceptual analog of the nineteenth-century psychiatric theory and practice that Foucault began to expose in the texts examined here. It speculates that we might identify a contemporary genetic version of a ‘metabody’ in a particular current conception of the gene as replicator, an item marked by an ambiguous temporal ontology. (shrink)
In recent works, Luce Irigaray offers arguments for the establishment of sexed rights that rely upon certain presuppositional accounts of the development of relational sexuate identity and difference. The paper advances a series of objections to these accounts, in addition to examining some of Irigaray's proposals concerning women's indefinition, the category of the neuter, and female genealogy. Supplementing Luce Irigaray's argument that mother-daughter genealogy is under-symbolized in present Occidental cultures, it suggests, for reasons consonant with Irigaray's general project, additional corrective (...) representation of paternal genealogy in terms of father-daughter relations. (shrink)
This analysis explores the phenomenology of suffering and temporal, genetic and social developmental aspects of suffering for seriously ill older adults. A phenomenological account of suffering is advanced using oral history data from in-depth interviews with a seriously ill, frail elderly woman. The analysis evaluates how a phenomenological account of suffering may inform ethics in end-of-life decision making, and may provide a further basis for an integrated ethical and gerontological response to suffering in palliative social work practice with seriously ill (...) older adults at the end of life. Levinas’s ethical philosophy and conceptualizations of the non-totalizing relation of self to other, disinterest, and radical passivity are employed to help reframe an approach to the ethical relation and the nature of obligation in end-of-life care, expanding consciousness of suffering and its meanings in an intersubjectively experienced world. Differences in Husserl’s account of the other and the concept of alterity in Levinas’s ethics are explored in the context of phenomenology as a descriptive science that respond directly to the pragmatic concerns of the analysis. (shrink)
Visuospatial neglect after stroke is often characterized by a disengage deficit on a cued orienting task, in which individuals are disproportionately slower to respond to targets presented on the contralesional side of space following an ispilesional cue as compared to the reverse. The purpose of this study was to investigate the generality of the finding of a disengage deficit on another measure of cued attention, the temporal order judgment (TOJ) task, that does not depend upon speeded manual responses. Individuals with (...) right hemisphere stroke with and without spatial neglect and older healthy controls were tested with both a speeded RT cueing task and an unspeeded TOJ-with-cuing task. All stroke patients evidenced a disengage deficit on the speeded RT cueing task, although the size and direction of the bias was not associated with the severity of neglect. In contrast, few neglect patients showed a disengage deficit on the TOJ task. This discrepancy suggests that the disengage deficit may be related to task demands, rather than solely due to impaired attentional mechanisms per se. Further, the results of our study show that the disengage deficit is neither necessary nor sufficient for neglect to manifest. (shrink)