What are the resources and needs, the strengths and the vulnerabilities of patients, of society, or of nature? How do we evaluate the societal potential of scientific discovery? It is fairly well assured that we are influencing the terms of existence of many inhabitants of this planet, from flora to fauna to humans. Moreover, history has shown that while technologies can be used neutrally, they can be (and have been) used to the great benefit – or the great detriment – (...) of human life and the fate of the world as a whole. How various types of knowledge and technological ability will be deployed is up to us, individually and collectively. How such information and ability should be deployed, and for what reasons, are questions at the core of bioethical inquiry. These are the "expanding horizons in bioethics" to which this volume refers. This volume is comprised of fourteen essays. It is a rare gathering of scholarly opinion, featuring well-known experts from a diversity of disciplines. The topics addressed are of immediate concern to the public. The essays ask questions about human nature, genetic technologies, reproductive rights, human subjects research, and environmental issues – all in provocative and challenging new ways. Yet the themes that emerge throughout the volume are of enduring interest to anyone concerned about the interactions of scientific development, ethics, and society. This volume is of interest to students and teachers of bioethics and related topics, as well as to professionals working in these disciplines. (shrink)

In At the Will of the Body , Arthur Frank told the story of his own illnesses, heart attack and cancer. That book ended by describing the existence of a "remission society," whose members all live with some form of illness or disability. The Wounded Storyteller is their collective portrait. Ill people are more than victims of disease or patients of medicine they are wounded storytellers. People tell stories to make sense of their suffering when they turn their diseases (...) into stories, they find healing. Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known--Gilda Radner's battle with ovarian cancer--to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilties. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic. Frank identifies three basic narratives of illness in restitution, chaos, and quest. Restitution narratives anticipate getting well again and give prominence to the technology of cure. In chaos narratives, illness seems to stretch on forever, with no respite or redeeming insights. Quest narratives are about finding that insight as illness is transformed into a means for the ill person to become someone new. (shrink)

In this book, Professor Adkins undertakes an examination of certain key value-words in the period between Homer and the end of the fifth century. The behavior of these words both affected and was affected by the nature of the society in which their usage developed. The author shows how only with a complete understanding of the implications and significance of these value-words can the essence of the Greeks and their society be grasped.

Contemporary health care often lacks generosity of spirit, even when treatment is most efficient. Too many patients are left unhappy with how they are treated, and too many medical professionals feel estranged from the calling that drew them to medicine. Arthur W. Frank tells the stories of ill people, doctors, and nurses who are restoring generosity to medicine--generosity toward others and to themselves. The Renewal of Generosity evokes medicine as the face-to-face encounter that comes before and after diagnostics, pharmaceuticals, (...) and surgeries. Frank calls upon the Roman emperor Marcus Aurelius, philosopher Emmanuel Levinas, and literary critic Mikhail Bakhtin to reflect on stories of ill people, doctors, and nurses who transform demoralized medicine into caring relationships. He presents their stories as a source of consolation for both ill and professional alike and as an impetus to changing medical systems. Frank shows how generosity is being renewed through dialogue that is more than the exchange of information. Dialogue is an ethic and an ideal for people on both sides of the medical encounter who want to offer more to those they meet and who want their own lives enriched in the process. The Renewal of Generosity views illness and medical work with grace and compassion, making an invaluable contribution to expanding our vision of suffering and healing. (shrink)

Arthur Collins's succinct, revisionist exposition of Kant's _Critique of Pure Reason_ brings a new clarity to this notoriously difficult text. Until recently most readers, ascribing broadly Cartesian assumptions to Kant, have concluded that the _Critique_ advances an idealist philosophy, because Kant calls it "transcendental idealism" and because the work abounds in apparent confirmations of that interpretation. Collins maintains not only that this reading of Kant is false but also that it conceals Kant's real achievements. To counter it, he addresses (...) the themes and passages in the _Critique_ that seem to require an idealist thesis and shows how they may be better understood without ascribing any idealist philosophy to Kant. His account coheres with Kant's explicit "refutations" of idealism, it fits Kant's rejection of the imputation of idealism to him by early critics and readers, and it validates Kant's contention that the second edition of the _Critique_ changes the expression but not the doctrine of the first. (shrink)

The literary criticism of the Greeks and Romans furnishes some of the most baffling documents which have come down to us from antiquity. Nor could it be otherwise. Few elements of language can be at once so ephemeral and so elusive as the overtones of words used in aesthetic contexts; even in our own language it is only with a conscious effort that the appropriate overtones of words used by quite recent critics can be recalled. Such recall must be much (...) more difficult where the reader is concerned with a dead language; in the case of some terms it may well be virtually impossible; but where the ancient critic is discussing ethical criteria for literature, as Aristotle does in Poetics 13, the modern interpreter is in a somewhat better position, for ethical terms are used in wider contexts, contexts which involve action, and there is more opportunity for studying their usage and endeavouring to recapture their elusive overtones. (shrink)

The narrative ethicist imagines life as multiple points of view, each reflecting a distinct imagination and each more or less capable of comprehending other points of view and how they imagine. Each point of view is constantly being acted out and then modified in response to how others respond. People generally have good intentions, but they get stuck realizing those intentions. Stories stall when dialogue breaks down. People stop hearing others' stories, maybe because those others have quit telling their stories. (...) The narrative ethicist's job is to help people generate new imaginations that can restart dialogues. (shrink)

The literary criticism of the Greeks and Romans furnishes some of the most baffling documents which have come down to us from antiquity. Nor could it be otherwise. Few elements of language can be at once so ephemeral and so elusive as the overtones of words used in aesthetic contexts; even in our own language it is only with a conscious effort that the appropriate overtones of words used by quite recent critics can be recalled. Such recall must be much (...) more difficult where the reader is concerned with a dead language; in the case of some terms it may well be virtually impossible; but where the ancient critic is discussing ethical criteria for literature, as Aristotle does in Poetics 13, the modern interpreter is in a somewhat better position, for ethical terms are used in wider contexts, contexts which involve action, and there is more opportunity for studying their usage and endeavouring to recapture their elusive overtones. (shrink)

This is an original and stimulating collection of articles by scholars trained in classics, moral philosophy, political science, literature, and intellectual history. Its principal objective is to convey to the modern reader a sophisticated understanding of Homeric and Classical Greek morality and how it differs from our own. Some of the articles focus primarily on Greek value concepts, especially the concept of arete. Others compare those concepts to modern notions of virtue and tolerance, as well as to the work of (...) contemporary literary figures and philosophers, including T.S. Eliot, Alasdair Macintyre, John Wallace, and Philippa Foot. Throughout, the juxtaposition of ancient and modern ideas and the worldviews they presuppose makes these readings both intellectually exciting and revealing. (shrink)

"More than any thing else technology creates our world. It creates our wealth, our economy, our very way of being," says W. Brian Arthur. Yet, until now the major questions of technology have gone unanswered. Where do new technologies come from -- how exactly does invention work? What constitutes innovation, and how is it achieved? Why are certain regions -- Cambridge, England, in the 1920s and Silicon Valley today -- hotbeds of innovation, while others languish? Does technology, like biological (...) life, evolve? How do new industries, and the economy itself, emerge from technologies? In this groundbreaking work, pioneering technology thinker and economist W. Brian Arthur sets forth a boldly original way of thinking about technology that gives answers to these questions. The Nature of Technology is an elegant and powerful theory of technology's origins and evolution. It achieves for the progress of technology what Thomas Kuhn's The Structure of Scientific Revolutions did for scientific progress. Arthur explains how transformative new technologies arise and how innovation really works. Conventional thinking ascribes the invention of technologies to "thinking outside the box," or vaguely to genius or creativity, but Arthur shows that such explanations are inadequate. Rather, technologies are put together from pieces -- themselves technologies -- that already exist. Technologies therefore share common ancestries and combine, morph, and combine again to create further technologies. Technology evolves much as a coral reef builds itself from activities of small organisms -- it creates itself from itself; all technologies are descended from earlier technologies. Drawing on a wealth of examples, from historical inventions to the high-tech wonders of today, and writing in wonder fully engaging and clear prose, Arthur takes us on a mind-opening journey that will change the way we think about technology and how it structures our lives. (shrink)

Action explanations like ‘I am heading to the ferry because the bridge is closed,’ are supposed to require restatement: ‘I am... because I believe the bridge is closed,’ because (i) the objective claim may be false though the intended explanation is correct, and (ii) because objective circumstances have to be cognitively mediated if they are to bear on action. This supposition is rejected here. Restatements cannot withdraw the objective claim without withdrawing the explanation. In the context of reason‐giving, belief statements (...) do not function as assertions about the inner life. The fact that belief statements may be true though the belief itself is false creates the illusion of distinctive subject matters. The illusion is exploited by conceptions of belief positing stored representations. Even if there were such representations, retrieved for the sake of expressing previously acquired beliefs, the expression of belief must endorse p and cannot merely advert to the existence and content of a representation. The reverse of the standard philosophical view about restatement is actually correct. Wherever an agent correctly adduces a belief that an objective circumstance obtains in explaining his action, a de‐psychologizing restatement that merely makes the objective claim must be ascribable to the agent. (shrink)

One task of logic, Peirce held, is to classify arguments so as to determine the validity of each kind. His own classification is interesting because it includes a novel type of argument in addition to the two traditionally recognized types. It is the purpose of this paper to discuss what Peirce thought to be sufficiently distinctive about abduction to warrant calling it a new kind of argument. But since one finds in his writings on abduction a number of different views (...) it is first necessary to make a few remarks concerning the unity of Peirce's thought. (shrink)

The essays in this volume apply philosophical analysis to address three kinds of questions: What are the implications of genetic science for our understanding of nature? What might it influence in our conception of human nature? What challenges does genetic science pose for specific issues of private conduct or public policy?

Increasingly, medicine is used to remodel, revise, and revamp as much as to heal and mend. It is tempting to say that people make merely personal choices about these new uses. But such choices have implications for everybody, and they ought to be made cautiously, slowly, and in a way that opens them to discussion.

Narrative ethics holds that if you ask someone what goodness is, as a basis of action, most people will first appeal to various abstractions, each of which can be defined only by other abstractions that in turn require further definition. If you persist in asking what each of these abstractions actually means, eventually that person will have to tell you a story and expect you to recognize goodness in the story. Goodness and badness need stories to make them thinkable and (...) to translate them into individual and collective actions. Yet after more than two decades of considering the issue, I do not believe that a collection of stories can by itself guide actions in ways that are sufficient to respond to ethical troubles in institutional settings. The question will always remain open for me, but my present belief is that narrative bioethics is always hyphenated, in the sense that guidance from stories needs to be allied with other ethical guidance. Each side of the hyphen qualifies the other side. The hyphenation I will argue for in this essay is “narrative-deontology.”. (shrink)

Because statements like ‘This object is soluble in aqua regia’ involve the causal modalities, we call them causal dispositional statements. Now while this involvement has long been recognized, no thorough examination of its exact nature has ever been made. One purpose of this paper is to begin such an examination. In Sec. 2 we will suggest an analysis of causal dispositional statements, and in Sec. 3 we will discuss some philosophic issues to which this analysis is relevant.

1. Introduction. It is generally admitted that a large part of man's knowledge is based on inductive arguments. Hence any philosophical theory concerning the nature of inductive arguments constitutes an epistemological theory. Any such philosophical theory of induction must, if it is to be satisfactory, take adequate account of Hume's criticism of inductive arguments. One way of treating his criticism is to say that the validity of inductive arguments is in an important sense relative to some broad factual assumptions about (...) the general nature of the universe and that these general factual assumptions are presupposed in a certain way by the users of inductive arguments. Let us call any theory of this general type a postulate theory of induction. (shrink)

Brian Garrett constructs cases satisfying Andy Hamilton’s definition of weak q‐memory. This does not establish that a peculiar kind of memory is at least conceptually coherent. Any ‘apparent memory experiences’ that satisfy the definition turn out not to involve remembering anything at all. This conclusion follows if we accept, as both Hamilton and Garrett do, a variety of first‐person authority according to which memory judgements may be false, but not on the ground that someone other than the remembering subject had (...) the remembered experience. Garrett’s brain‐bisection illustration sounds convincing, but only because we retain the idea that the subjects created by implanting a hemisphere each in two different bodies are entitled to say that they remember experiences before the surgery in the ordinary sense. To that extent the illustration presents a case of ordinary memory, not q‐memory. (shrink)

The ethics of telling stories about other people become questionable as soon as humans learn to talk. But the stakes get higher when health care professionals tell stories about those whom they serve. But for all the problems that come with such stories, I do not believe it is either practical or desirable for bioethicists to attempt to legislate an end to this storytelling. What we need instead is narrative nuance. We need to understand how to tell respectful stories in (...) which the patients are fully acknowledged fellow participants, not one‐dimensional objects of a knowing gaze. The problem is not narration itself but a particular version of narrational privilege, and getting rid of that would have benefits far beyond practices of writing case studies. In this essay, I first offer four considerations that I have found either omitted or underemphasized in discussions of the ethics of telling stories about patients. I then sketch a model of medical storytelling that might be the basis for shifting the ethical question from whether to how. (shrink)

A collection of stories by bioethicists writing about their own illnesses displays the importance of microethics. From this perspective, ethics happens not in the application of principles to specific decisions, but rather in the moment-to-moment flow of clinical interaction, as healthcare workers and patients make decisions, especially in their use of language. Microethical issues that are common to multiple stories are described as dense junctures of ethical concern. Three junctures are discussed in detail: conflicts between medical and patient rationalities, issues (...) of how clinicians represent patients, and practices of truth telling. These junctures are illustrated with examples from the bioethicists’ personal stories of treatment. (shrink)