What does it mean to know something - scientifically, anthropologically, socially? What is the relationship between different forms of knowledge and ways of knowing? How is knowledge mobilised in society and to what ends? Drawing on ethnographic examples from across the world, and from the virtual and global "places" created by new information technologies, Anthropology and Science presents examples of living and dynamic epistemologies and practices, and of how scientific ways of knowing operate in the world. Authors address the nature (...) of both scientific and experiential knowledge, and look at competing and alternative ideas about what it means to be human. The essays analyze the politics and ethics of positioning "science", "culture" or "society" as authoritative. They explore how certain modes of knowing are made authoritative and command allegiance (or not), and look at scientific and other rationalities - whether these challenge or are compatible with science. (shrink)
This systematic introduction to Buddhist ethics is aimed at anyone interested in Buddhism, including students, scholars and general readers. Peter Harvey is the author of the acclaimed Introduction to Buddhism (Cambridge, 1990), and his new book is written in a clear style, assuming no prior knowledge. At the same time it develops a careful, probing analysis of the nature and practical dynamics of Buddhist ethics in both its unifying themes and in the particularities of different Buddhist traditions. The book (...) applies Buddhist ethics to a range of issues of contemporary concern: humanity's relationship with the rest of nature; economics; war and peace; euthanasia; abortion; the status of women; and homosexuality. Professor Harvey draws on texts of the main Buddhist traditions, and on historical and contemporary accounts of the behaviour of Buddhists, to describe existing Buddhist ethics, to assess different views within it, and to extend its application into new areas. (shrink)
The following interview was conducted on July 13, 2009 at the JFK Institute for Graduate Studies, Freie Universität in Berlin, shortly after a conference, entitled “Class in Crisis: Das Prekariat zwischen Krise und Bewegung,” at which Harvey delivered a keynote address. The conference, organized by the Rosa Luxemburg Foundation, engaged the political, socio-economic, and conceptual dimensions of the so-called precariat class. The precariat (das Prekariat or la précarité) is typically defined by short-term employment, persistent marginalization, and social insecurity—something of (...) a fragmented urban underclass whose precariousness is increasingly evident in traditionally middle-class economic life. While the concept of the precariat has yet to take root in English-language social theory, the work of Loïc Wacquant (who also delivered a keynote at the Berlin conference), for example, has been popularizing it. (shrink)
Neoliberalism - the doctrine that market exchange is an ethic in itself, capable of acting as a guide for all human action - has become dominant in both thought and practice throughout much of the world since 1970 or so. Its spread has depended upon a reconstitution of state powers such that privatization, finance, and market processes are emphasized. State interventions in the economy are minimized, while the obligations of the state to provide for the welfare of its citizens are (...) diminished. David Harvey, author of 'The New Imperialism' and 'The Condition of Postmodernity', here tells the political-economic story of where neoliberalization came from and how it proliferated on the world stage. While Thatcher and Reagan are often cited as primary authors of this neoliberal turn, Harvey shows how a complex of forces, from Chile to China and from New York City to Mexico City, have also played their part. In addition he explores the continuities and contrasts between neoliberalism of the Clinton sort and the recent turn towards neoconservative imperialism of George W. Bush. Finally, through critical engagement with this history, Harvey constructs a framework not only for analyzing the political and economic dangers that now surround us, but also for assessing the prospects for the more socially just alternatives being advocated by many oppositional movements. (shrink)
In 1990, when the Berlin Wall fell and the Cold War ended, economic and political analysts declared the world a safer place. But not political journalist Robert Harvey. The roar of international optimism only intensified the pangs of his geopolitical anxiety. In 1995, in The Return of the Strong, he warned Western democracies that the tides of economic globalization were sweeping the world toward a new crisis. Unfortunately, the attack on the World Trade Center in New York City on (...) September 11, 2001, justified Harvey's alarm. It also prompted him to revise and update his analysis of the dangers facing the free world. Global Disorder not only examines the precarious state of world affairs in the aftermath of 9/11 but also offers far-reaching proposals for the reform of global security. In light of the emergence of the United States as the world's first megapower, Harvey explores the sources of international tension that have increasingly commanded the attention of the West and lays out the perils inherent in the globalization of capitalism without political or economic control. He presents constructive measures that he believes the West—especially the United States—must undertake to restore stability around the world and truly ensure international security. (shrink)
David Harvey : On peut difficilement imaginer vérification plus spectaculaire de ce que tu prédis depuis très longtemps dans tes théories que l’actuelle crise du système financier mondial. Y a-t-il des aspects de la crise qui t’ont surpris ?Giovanni Arrighi : Ma prédiction était très simple. Dans The Long Twentieth Century, je qualifiais de crise annonciatrice d’un régime d’accumulation le début de la financiarisation et je faisais remarquer qu’après un certain temps – en général environ un demi-siècle – la (...) crise terminale suivait. L’hypothèse fondamentale est que toutes ces expansions financières ne pouvaient pas tenir parce qu’elles amenaient à la spéculation plus de capital qu’il n’était possible d’en gérer – en d’autres termes, ces expansions financières avaient tendance à créer des bulles de différentes sortes. Je prévoyais que cette expansion financière mènerait à une crise terminale parce que, aujourd’hui comme dans le passé, les bulles ne peuvent pas tenir. (shrink)
Should advance directives (ADs) such as living wills be employed to direct the care of the severely demented? In considering this question, I focus primarily on the claims of Rebecca Dresser who objects in principle to the use of ADs in this context. Dresser has persuasively argued that ADs are both theoretically incoherent and ethically dangerous. She proceeds to advocate a Best Interest Standard as the best way for deciding when and how the demented ought to be treated. I put (...) forth a compromise position: both ADs and the Best Interest Standard have roles to play in guiding the care of the severely demented. (shrink)
Dispositionalist accounts of colour concepts are now largely discarded. But a number of recent and influential objections to this type of theory can be readily answered providing the dispositionalist account contains the key elements it should-which actual versions in the literature do not. I explicate some of the conceptual components needed in such an account once we correctly understand the anthropocentricity of the colour concepts involved. When these components are incorporated into dispositionalism, including one crucial distinction in particular, some powerful (...) seeming objections against this revised dispositionalism fail. In addition, dispositionalism has extra advantages over the far more popular physicalist theories, and I therefore contend that we should explore vigorously this kind of enriched dispositionalist account. (shrink)
My paper addresses a number of questions raised in the Statesman by the Eleatic Visitor’s identification of certain ontological conditions for the existence of art of due measure, and therefore of all the technai . My view is that evidence relevant to these questions can be found in the Philebus , and specifically, in an ontological doctrine presented at 23c–27c. What emerges from an examination of the Statesman and Philebus is a highly developed conception of technê , one that affords (...) a place for such ordinary human activities within the broader framework of Plato’s philosophy. (shrink)
In this essay, I argue that popular entertainment can be understood in terms of Husserl’s concepts of epochē, reduction and constitution, and, conversely, that epochē, reduction and constitution can be explicated in terms of popular entertainment. To this end I use Husserl’s concepts to explicate and reflect upon the psychological and ethical effects of an exemplary instance of entertainment, the renowned Star Trek episode entitled “The Measure of a Man.” The importance of such an exercise is twofold: (1) to demonstrate, (...) once again, the fecundity of the methodological procedures Husserl bequeathed to us; more than any other philosopher, he tapped into the fundamental manners in which we lose, make and remake the meanings of our lives; and (2) to demonstrate how popular entertainment, similarly, plays a central role in the making and remaking of the meanings of our lives. If my zig-zag procedure between Husserl’s philosophy and popular entertainment is productive and cogent, in addition to elucidating Husserl’s philosophy, it will demonstrate the reality-generating potency and the constitutive power of entertainment in the contemporary world. Entertainment, via ourselves, has become the primary producer of the meanings via which consciousness constitutes the world. (shrink)
Following an extensive review of the moral intensity literature, this article reports the findings of two studies (one between-subjects, the other within-subject) that examined the effect of manipulated and perceived moral intensity on ethical judgment. In the between-subjects study participants judged actions taken in manipulated high moral intensity scenarios to be more unethical than the same actions taken in manipulated low moral intensity scenarios. Findings were mixed for the effect of perceived moral intensity. Both probable magnitude of consequences (a factor (...) consisting of magnitude of consequences, probability of effect, and temporal immediacy) and social consensus had a significant effect; proximity did not. In the within-subject study manipulated moral intensity had a significant effect on ethical judgment, but perceived moral intensity did not. Regression of ethical judgment on age, gender, major, and the three perceived moral intensity factors was significant between-subjects, but not within-subject. Ethical judgment was found to be a more robust predictor of intention than perceived moral intensity using a within-subject design. (shrink)
The aim of this paper is to present a significant current British case of the application of an ethical approach to banking practice — it relates to issues of stakeholder dialogue, corporate strategy, and marketing.The Co-operative bank traces its organisational origins to the 1870s, and its founding principle to the beginnings of the co-operative movement in the 1830s.
``What Does a Right to Physician-Assisted Suicide (PAS) Legallyentail?''''Much of the bioethics literature focuses on the morality ofPAS but ignores the legal implications of the conclusions thereby wrought. Specifically, what does a legal right toPAS entail both on the part of the physician and the patient? Iargue that we must begin by distinguishing a right to PAS qua``external'''' to a particular physician-patient relationship from a right to PAS qua ``internal'''' to a particular physician-patientrelationship. The former constitutes a negative claim right (...) inrem that prohibits outside interference with the exercise of aright to PAS while the latter can provide the patient witha positive claim right in personam to obligatory assistancefrom his physician. Importantly, I argue that the creation of sucha patient right, however, originates with the physician who may exercise an unqualified right of first refusal prior to promisingto help her patient commit suicide. In doing so, I hope to establishthat explicit physician promises of assistance in dying shouldbecome legally binding. As such, current PAS law in both theNetherlands and Oregon is in need of substantive modification. (shrink)
Responding to claims to the contrary, this essay shows how liberal education, the education of critical exposure, indoctrinates students into a style of belief and belief formation. It argues that a common liberal view about what constitutes freedom from indoctrination is precisely the form of indoctrination feared by many conservative communitarians. While I support the style and procedures of liberal education, I argue that we cannot excise all indoctrinating components from it by semantic, logical or epistemic analyses of what indoctrination (...) or education means. (shrink)
The complex global business environment has created a host of problems for managers, none of which is more difficult to address than bullying in the workplace. The rapid rate of change and the everincreasing complexity of organizational environments of business throughout the world have increased the opportunity for bullying to occur more frequently. This article addresses the foundations of bullying by examining the nature' (i.e., bullying behavior influenced by the innate genetic make-up of an individual) and the nurture' (i.e., individuals (...) learn to be bullies and environments allow the behavior to perpetuate) arguments for the occurrence of bullying behavior. In addition, guidelines are presented for managers in global organizations to use in assessing and monitoring bullying activities in global organizations. (shrink)
In this paper we report a study of the approach of six U.K. water and electricity companies towards managing the relationship with their ''green'' stakeholders. Stakeholders are accorded increasing importance in political discourse and stakeholder theory is emerging as a promising framework for the analysis of corporate social performance.We studied the companies'' general approach towards green stakeholders, their dealings with specific stakeholder groups and whether they emphasised the consultation or the information aspect of stakeholder management. We found that none of (...) the six companies had a systematic stakeholder approach that extended to all potential green stakeholders. Rather, the importance of specific stakeholder groups seemed to be determined by managers'' intuition and by the stance that the stakeholders themselves displayed towards the company. (shrink)
At least four different frameworks — psychiatric, cognitive, functional and decision-making — are used in the evaluation of competence, all of which remain more or less unrelated in the literature. In the first section of this paper we consider various meanings of competence, in order to arrive at a definition of the term relevant to the medical and legal setting. Patient or client competence, we conclude, refers to the practical abilities that individuals employ in pursuing their own autonomous goals in (...) life. We then show how a systematic categorization of these practical abilities — which we call a taxonomy of practical judgment — allows us to show when the traditional frameworks for the evaluation of competence may or may not be useful in the evaluation of a particular competence.In the final section we explore some of the normative considerations underlying the taxonomy. For instance, competence is not only related to intrinsic abilities but to resources available in the community. Here we touch on questions related to the fair distribution of community resources. (shrink)
Abstract The Suttas indicate physical conditions for success in meditation, and also acceptance of a not?Self life?principle (primarily viññana) which is (usually) dependent on the mortal physical body. In the Abhidhamma and commentaries, the physical acts on the mental through the senses and through the ?basis? for mind?organ and mind?consciousness, which came to be seen as the ?heart?basis?. Mind acts on the body through two ?intimations?: fleeting modulations in the primary physical elements. Various forms of r?pa are also said to (...) originate dependent on citta and other types of r?pa. Meditation makes possible the development of a ?mind?made body? and control over physical elements through psychic powers. The formless rebirths and the state of cessation are anomalous states of mind?without?body, or body?without?mind, with the latter presenting the problem of how mental phenomena can arise after being completely absent. Does this twin?category process pluralism avoid the problems of substance?dualism? (shrink)
Tversky and Kahneman (1974) originally discussed three main heuristics: availability, representativeness, and anchoring-and-adjustment. Research on judgemental forecasting suggests that the type of information on which forecasts are based is the primary factor determining the type of heuristic that people use to make their predictions. Specifically, availability is used when forecasts are based on information held in memory; representativeness is important when the value of one variable is forecast from explicit information about the value of another variable; and anchoring-and-adjustment is employed (...) when the value of a variable is forecast from explicit information about previous values of that same variable. Although there has been increased emphasis on the adaptiveness of heuristics and increased interest in specifying their use in terms of computational models, this way of structuring our knowledge about judgemental forecasting continues to be a useful one. I use it to frame discussion of some recent debates in the area. (shrink)
This essay brings Critical Whiteness Studies into liberationist Christian ethics in order to analyze white Protestant responses to the 1969 Black Manifesto, which demanded reparations from white churches. The essay's primary argument is that the absence of a sense of white moral agency among white Protestants manifested itself in behaviors and rhetoric that ensured whiteness went unacknowledged, which caused Protestant responses to the Manifesto to fail. A related argument is that white behavior and rhetoric were particularly dramatic because of the (...) call for reparations. Reparations assume that race is a material relationship in which there has been a perpetrator and a victim, rendering the acknowledgment of white agency unavoidable. This essay thus analyzes several ways in which whites can be seen turning away from white selves, turning a scrutinizing gaze instead to Black selves and, in the process, absenting white agency from the work of racial justice. (shrink)
In this essay we show how certain tendencies of theself are enhanced and hindered by technologicallyorganized places. We coordinate a cognitive andbehavioral technology for the control of personalidentity with the technologically totalizedenvironments that we call synthetic sites. Weproceed by describing Mihaly Csikszentmihalyi''sstrategy for intensifying experience and organizingthe self. Walt Disney World is then considered as theexample, par excellence, of a synthetic sitethat promotes ordered experience via self-shrinkage. Finally, we reflect briefly on problems andpossibilities of human life lived in a world (...) that canbe described with increasing accuracy as anarchipelago of synthetic sites. (shrink)
The disruption -- Capital assembled -- Capital goes to work -- Capital goes to market -- Capital evolves -- The geography of it all -- Creative destruction on the land -- What is to be done? And who is going to do it?
In 1991, Jones developed an issue-contingent model of ethical decision making in which moral intensity is posited to affect the four stages of Rest’s 1986 model (awareness, judgment, intention, and behavior). Jones claimed that moral intensity, which is “the extent of issue-related moral imperative in a situation” (p. 372), consists of six characteristics: magnitude of consequences (MC), social consensus (SC), probability of effect (PE), temporal immediacy (TI), proximity (PX), and concentration of effect (CE). This article reports the findings (...) of two studies that analyzed the factor structure of moral intensity, operationalized by a 12-item Perceived Moral Intensity Scale (PMIS) adapted from the work of Singhapakdi et al. [1996, Journal of Business Research, 36, 245–255] and Frey [2000, Journal of Business Ethics, 26, 181–195]. The two items that were purported to measure CE were dropped due to their inability to effectively tap into the characteristic proposed by Jones. Factor analyses of the remaining 10 items supported a 3-factor structure, with the MC, PE, and TI items loading on the first factor, the PX items loading on the second factor, and the SC items loading on the third factor. These factors were labeled: Probable Magnitude of Consequences, Proximity, and Social Consensus. The authors conclude that moral intensity consists of three characteristics, rather than the six posited by Jones. (shrink)
The previous papers raise a number of issues. How should we develop task typologies both to separate judgement from related cognitive tasks and to classify tasks within the judgement domain? Are there grounds for selecting between models of judgement when empirical tests fail to do so? What techniques can be used to find out more about the cognitive processes underlying judgement behaviour? I discuss these issues and give a brief assessment of the current state of play in this rapidly changing (...) area. (shrink)
Background Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. Methods Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying (...) ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9); 2) Deputy chief provincial coroners (N = 5); 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12). Results After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. Conclusion Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia. (shrink)
This paper reports on a research project on "the status and understanding of business ethics in contemporary China". The project was funded by The British Council and conducted by means of visits to Chinese companies, Ministries and Universities, in preparation for a seminar which was held in Beijing.
The factor structure of the Multidimensional Ethics Scale (MES; Reidenbach and Robin: 1988, Journal of Business Ethics 7, 871–879; 1990, Journal of Business Ethics 9, 639–653) was examined for the 8-item short form (N = 328) and the original 30-item pool (N = 260). The objectives of the study were: to verify the dimensionality of the MES; to increase the amount of true cross-scenario variance through the use of 18 scenarios varying in moral intensity (Jones: 1991, Academy of Management Review (...) 16, 366–395); and, to examine the items for measurement precision using item-response theory (IRT) methods. Results of confirmatory and exploratory factor analysis failed to conclusively support the hypothesized 3- (short form) or 5-factor (long form) structure; both instruments were instead dominated by a general factor. Item response theory analyses using Samejima’s (1969, Psychometrika Monograph Supplement 34, (4, Pt. 2)) graded response model revealed that many items in the 30-item pool performed very well, and suggested that a different collection of items be used to form a short-form version of the MES. Our proposed 10-item instrument includes more discriminating items than the 8-item version, and has the added advantage of including two items from each of the five ethical philosophies represented in the original 30-item pool. (shrink)
The one sphere of life where a claimed right to privacy is most sympathetically received is in the inner realm of the mind. I will look briefly at Joseph Tussman’s claim that a government is not only entitled but morally required to be concerned with and involved in the minds of the nation’s citizens. I then further explore reasons why the realm of the mind matters not only morally but politically. There are consequentialist reasons, but more interestingly there are non-consequentialist (...) reasons on the basis of which I introduce the concept of “authentic social justice.” In particular, there are relevant insights to be gainedby reflecting on forms of oppression that are subtle but serious in nature, forms that involve neither violence nor the use of law. (shrink)
This paper examines one approach to the ethics of companion animals, which emerges from the dominant historical tradition and is increasingly familiar in everyday life as well as in work on companion animals in the social sciences. I label it the “utilization with welfare-safeguards” model, or, more gently worded, “seeking benefits while ensuring welfare.” Some of the “benefits” considered are complex ones (like guiding the sight impaired) and others simpler (like reducing stress or providing affection). I explore several problems involved (...) in this approach (including the sometimes jarring inappropriateness of “benefit” terminology). I then offer an alternative account where the primary moral obligation toward companion animals is to develop, nurture, respect, and protect the loving relationship between them and their human companions, since thriving in such a relationship, I claim, has become part of their evolved telos (to use Bernard Rollin’s term)or evolved nature. This priority naturally leads to ensuring welfare, but the highly pro-active approach involved takes the obligation beyond standard welfare provision and “TLC” (“tender loving care”). Some implications of this position are explored. (shrink)
Three problems are raised for Nicholas Georgalis’s recent work: (1) a problem with regard to the supposed noninferential knowledge of minimal content, (2) a problem with the “necessary condition” Georgalis stipulates for the legitimate application of a first-person methodology to a science of the mind, and (3) a problem with regard to denying phenomenal content to intentional acts.
In Australia, the twin discoveries that resulted in Dolly the Sheep and the isolation of human embryonic stem cells in the 1990s prompted the then Minister for Health to request that the Australian Health Ethics Committee (AHEC) examine the issue of cloning and stem-cell science more closely. It is the AHEC’s job to report—in an ad hoc manner at the Minister’s request—on “any issues deemed to be pertinent to the Australian community.” Cloning and stem-cell science were big news worldwide, and (...) the Australian Government needed to be seen to act on it. What happened next was partly a reflection of the cultural values of the Australian community, and partly an expression of the social context of the use of .. (shrink)
Is there really an ethical crisis? We propose that the situation is not as bad as many would have us believe. We have attempted to present an alternative explanation for some earlier reports of an ethical crisis. This has resulted in a number of research propositions. We are optimistic that there are, in spite of reports to the contrary, an overwhelming majority of ethical people populating our business community.
The fundamental presupposition of political philosophy is that the legitimate rule of one individual over another requires justification: political power may come out of the barrel of a gun but political authority does not. Classically, the philosopher of politics looked to nature. In the seventeenth century, however, the philosophical tide turns in a decidedly different direction: contractarianism. Political society becomes a consensual construct created through the heuristic vehicle of a hypothetical social contract. Simultaneously, within the confines of contractarianism itself, a (...) remarkable transformation occurs. The theory originates in the hands of Grotius, Hobbes and Pufendorf as a justificatory tool for political absolutism and, paradoxically, reaches its zenith in Locke with a firm commitment to constitutionalism. I explore this transformation in detail, culminating with what I term the “Lockean Synthesis.”. (shrink)
In this essay I describe how primary and secondary narcissism are the underlying and motivating psychological states for fundamentalist religious belief. I describe the psychodynamics that produce such a belief state and I make the case that the "fundamentalist personality" is best understood as a form of barely sublimated pathological narcissism. Given the brutality of the human condition, it is understandable why this psychological-metaphysical option is an enticing one, but I follow Ralph Ellis in the conclusion that the consequences of (...) such belief systems produce much more harm than benefit for individuals and humanity at Iarge. (shrink)
It is a commonsense view held by many citizens in democratic nations that whether or not a society is socially just depends on the nature of these major institutions and their functioning. On this view, social justice is so to with what philosophers have referred to as “realized, rather than abstract, institutions,” rather than, say, individual character or actions. I will examine one sensible sounding argument in support of this view, which I will call “The Effects Argument.” It is deceptively (...) simple in appearance and based on the claim that major social institutions have profound effects on the lives of individuals, effects that are far more significant and far-reaching than those typically brought about by individual action. Because of this vast potential, securing social justice means focusing on such major social institutions and on how they function. In short, social justice is the business and responsibility of those major institutions. Examining this argument, however, provides support for a wider vision of what is involved in achieving social justice and raises concern about the diminishing role of the individual in much of contemporary writings on social justice. Paradoxically, citizens in democratic states are especially in danger of expecting major social institutions to carry a loadthey cannot successfully bear. (shrink)
We consider the implications of trends in the number of U.S. farmers and food imports on the question of what role U.S. farmers have in an increasingly global agrifood system. Our discussion stems from the argument some scholars have made that American consumers can import their food more cheaply from other countries than it can produce it. We consider the distinction between U.S. farmers and agriculture and the effect of the U.S. food footprint on developing nations to argue there might (...) be an important role for U.S. farmers, even if it appears Americans don’t need them. For instance, we may need to protect U.S. farmland and, by implication, U.S. farmers, for future food security needs both domestic and international. We also explore the role of U.S. farmers by considering the question of whether food is a privilege or a right. Although Americans seem to accept that food is a privilege, many scholars and commentators argue that, at least on a global scale, food is a right, particularly for the world’s poor and hungry. If this is the case, then U.S. farmers might have a role in meeting the associated obligation to ensure that the poor of the world have enough food to eat. We look at the consequences of determining that food is a right versus a privilege and the implications of that decision for agricultural subsidies as well as U.S. agriculture and nutrition policies. (shrink)
Surgical devices are often marketed before there is good evidence of their safety and effectiveness. Our paper discusses the ethical issues associated with the early marketing and use of new surgical devices from the perspectives of the six groups most concerned. Health Canada, which is responsible for licensing new surgical devices, should amend their requirements to include rigorous clinical trials that provide data on effectiveness and safety for each new product before it is marketed. Industry should comply with all Health (...) Canada requirements to obtain licenses for new products. Until Health Canada requires effectiveness and safety data, industry should cooperate with physicians in appropriate studies before releasing new products and should make balanced presentations of all the available evidence. Surgeons should, before using a new surgical device, assess the evidence on its effectiveness and safety and ensure they are properly trained and competent in using the device. Surgeons should provide their patients with an evaluation of the available evidence and inform them about possible complications and the surgeon's level of experience with the new device. Patients, who should be given an honest evaluation of the available evidence, possible complications, and the surgeon's experience, should be encouraged to evaluate the evidence and information to their own satisfaction to ensure that fully informed consent is given. Health institutions, responsible for regulating practice within their walls, should review new devices for safety, effectiveness, and economic impacts, before allowing their use. They should also limit the use of new surgical devices to surgeons trained and competent in the new technology. Professional societies should provide guidance on the early adoption of new surgical devices and technologies. We urge all those involved in the development, licensing, and use of new surgical devices to aim for higher ethical standards to protect the health and safety of patients requiring surgery. The lowest acceptable ethical standard would require device manufacturers to provide surgeons with accurate and timely information on the efficacy and safety of their products, allowing surgeons and patients to evaluate the evidence (and the significance of information not yet available) before surgery. (shrink)
This essay attempts to understand the search for authenticity in terms of the breakdown of authority in the modern world. The sense of autonomy, I argue, emerges from the need to choose the authorities one will accept. The ever-increasing difficulty of choosing from among authorities is internalized and is experienced as a difficulty of choosing, or “finding” oneself. The shattered authorities on the outside become a fragmented self on the inside. The search for the authentic self, then, is the search (...) for an authority on the inside that has been broken and lost on the outside. The prospects for achieving such selfhood are criticially evaluated. (shrink)