The website Rotten Tomatoes, located at www.rottentomatoes.com, is primarily an online repository of movie reviews. For each movie review document, the site provides a link to the full review, along with a brief description of its sentiment. The description consists of a rating (“fresh” or “rotten”) and a short quotation from the review. Other research (Pang, Lee, & Vaithyanathan 2002) has predicted a movie review’s rating from its text. In this paper, we focus on the quotation, which is a main (...) attraction to site users. A Rotten Tomatoes quotation is typically about one sentence in length and expresses concisely the reviewer’s opinion of the movie. To illustrate, Curtis Edmonds’s review of the documentary Spellbound is encapsulated, “Hitchcock couldn’t have asked for a more suspenseful situation.” A.O. Scott’s review of Once upon a Time in Mexico is encapsulated, “A noisy, unholy mess, with moments of wit and surprise that ultimately make its brutal tedium all the more disappointing.” A reader can infer from these statements whether or not the overall sentiment is favorable, and get an impression about why. Consequently, we refer to them as sentiment summaries. (shrink)

Ralph Wendell Burhoe was a leading figure in relating religion and science in the second half of the twentieth century. His autodidactic style and character as a public intellectual resulted in a vision that is comprehensive in its concern for the salvation of society. He does not fit easily into academic frameworks, even though he has been influential upon scholars who work in academia. This article discusses some conundrums posed by his work. There are also brief presentations of the concerns (...) that motivated Burhoe, his style of work, and the content of his vision. (shrink)

This article provides current Schwartz Values Survey (SVS) data from samples of business managers and professionals across 50 societies that are culturally and socioeconomically diverse. We report the society scores for SVS values dimensions for both individual- and societal-level analyses. At the individual-level, we report on the ten circumplex values sub-dimensions and two sets of values dimensions (collectivism and individualism; openness to change, conservation, self-enhancement, and self-transcendence). At the societal-level, we report on the values dimensions of embeddedness, hierarchy, mastery, affective (...) autonomy, intellectual autonomy, egalitarianism, and harmony. For each society, we report the Cronbach’s α statistics for each values dimension scale to assess their internal consistency (reliability) as well as report interrater agreement (IRA) analyses to assess the acceptability of using aggregated individual level values scores to represent country values. We also examined whether societal development level is related to systematic variation in the measurement and importance of values. Thus, the contributions of our evaluation of the SVS values dimensions are two-fold. First, we identify the SVS dimensions that have cross-culturally internally reliable structures and within-society agreement for business professionals. Second, we report the society cultural values scores developed from the twenty-first century data that can be used as macro-level predictors in multilevel and single-level international business research. (shrink)

"Judicious in every respect: selection, translation and structuring of the texts, footnotes, bibliography, and index.... The book of choice for undergraduate courses." --Edward M. Galligan, University of North Carolina.

The legacy of Herman Dooyeweerd, that colossus of reformational thinking, presents us not only with the gifts of his systematic genius, but also with the riddles of his unperfected work, which now have become a part of our own unfinished work. Not the least of these riddles and not the least of our unfinished work confront us in the legacy of Dooyeweerd’s anthropological reflections. As he indicates in the conclusion of his monumental New Critique, all of his previous investigations are (...) nothing but preliminaries that implicitly converge upon the ultimate problems of philosophical anthropology. The question of man, in effect, constitutes the fundamental implicit theme of Dooyeweerd’s philosophy. (shrink)

Overview * Part I: Introduction * Philip Appleman, Darwin: On Changing the Mind * Part II: Darwin’s Life * Ernst Mayr, Who Is Darwin? * Part III: Scientific Thought: Just before Darwin * Sir Gavin de Beer, Biology before the Beagle * Thomas Robert Malthus, An Essay on the Principle of Population * William Paley, Natural Theology * Jean Baptiste Pierre Antoine de Monet Lamarck, Zoological Philisophy * Charles Lyell, Principles of Geology * John Herschell, The Study of Natural (...) Philosophy * William Whewell, Astronomy and General Physics Considered with Reference to Natural Theology * Alfred Russel Wallace, On the Tendency of Varieties to Depart Indefinitely from the Original Type * Part IV: Selections from Darwin’s Work * The Voyage of the Beagle * o Chapter I. St. Jago-Cape de Verd Island o Chapter XVII. Galapagos Archipelago * On the Tendency of Species to Form Varieties; and On the Perpetuation of Varieties and Species by Natural Means of Selection * o I. Extract from an unpublished Work on Species, by C. Darwin, Esq.... o II.of Letter from C. Darwin, Esq., to Prof. Asa Gray, Boston, U.S., dated Down, September 5th, 1857 * An Historical Sketch of the Progress of Opinion on the Origin of Species, previously to the : Publication of This Work The Origin of Species * o Introduction o Chapter I. Variation under Domestication o Chapter II. Variation under Nature o Chapter III. Struggle for Existence o Chapter IV. Natural Selection o Chapter VI. Difficulties on Theory o Chapter IX. On the Imperfections of the Geological Record o Chapter XIII. Mutual Affinities of Organic Beings: Morphology: Embryology: Rudimentary Organs o Chapter XIV. Recapitulation and Conclusion * The Descent of Man * o Introduction o Chapter I. The Evidence of the Descent of Man from Some Lower Form o Chapter II. On the Manner of Development of Man from Some Lower Form o Chapter III. Comparison of the Mental Powers of Man and the Lower Animals o Chapter VI. On the Affinities and Genealogy of Man o Chapter VIII. Principles of Sexual Selection o Chapter XIX. Secondary Sexual Characters of Man o Chapter XX. Secondary Sexual Characters of Man-continued o Chapter XXI. General Summary and Conclusion * Part V: Darwin’s Influence on Science * THE VICTORIAN OPPOSITION TO DARWIN * o David L. Hull, Darwin and His Critics o Adam Sedgwick, Objections to Mr. Darwin’s Theory of the Origin of Species o Sir Richard Owen, Darwin on the Origin of Species o Fleeming Jenkin, Review of the Origin of Species * VICTORIAN SUPPORTERS OF DARWIN * o Joseph Dalton Hooker, Flora Tasmaniae o Thomas Henry Huxley, On the Relations of Man to the Lowe Animals o Charles Lyell, Principles of Geology o Alfred Russel Wallace, The Debt of Science to Darwin * DARWIN AND THE SHAPING OF MODERN SCIENCE * o Scientific Method in Evolution o National Academy of Sciences, Evolution and the Nature of Science o Richard Dawkins, Explaining the Very Improbable o Lewis Thomas, On the Uncertainty of Science o Noretta Koetge, Postmodernisms and the Problem of Scientific Literary o Richard Dawkins, Science and Sensibility o The Neo-Darwinian Synthesis o Peter Bowler, The Evolutionary Synthesis o The Human Genealogy o Adam Kuper, The Chosen Primate o Ian Tattersall, Out of Africa Again... and Again? o Stephen Jay Gould, The Human Difference o Punctuated Equilibrium o Stephen Jay Gould, [On Punctuated Equilibrium] o Niles Eldredge, The Great Stasis Debate o Rethinking Taxonomy o Kevin Padian, Darwin’s Views of Classification o David L. Hull, Cladistic Analysis o Kevin Padian and Luis M. Chiappe, Cladistics in Action: The Origin of Birds and Their Flight o Evolution as Observable Fact o James L. Gould and William T. Keeton with Carol Grant Gould, How Natural Selection Operates o Peter r. Grant, Natural Selection and Darwin’s Finches o John A. Endler, Natural Selection in the Wild * Part VI: Darwinian Patterns in Social Thought * COMPETITION AND COOPERATION * o Richard Hofstadter, The Vogue of Spencer o Andrew Carnegie, The Gospel of Wealth o Peter Kropotkin, Mutual Aid o Martin A. Nowak, Robert M. May, and Karl Sigmund, The Arithmetics of Mutual Help * NATURE AND NURTURE * o Edward O. Wilson, Sociobiology: The New Synthesis o Stephen Jay Gould, Biological Potentiality vs. Biological Determination o Barbara Ehrenreich and Janet McIntosh, The New Creationism: Biology under Attack * EVOLUTION AND GENDER * o Elizabeth Cady Stanton, The Woman’s Bible o Nancy Makepeace Tanner, On Becoming Human o Evelleen Richards, Darwin and the Descent of Woman o James Eli Adams, Woman Red in Tooth and Claw * EVOLUTION AND OTHER DISCIPLINES * o Edward O. Wilson, [On Consilience] o Randolph H. Nesse and George C. Williams, Evolution and the Origin of Disease o Steven Pinker, How the Mind Works o Steve Jones, The Set within the Skull * Part VII: Darwinian Influences in Philosophy and Ethics * John Dewey, The Influence of Darwin on Philosophy * Daniel C. Dennett, Darwin’s Dangerous Idea: Natural Selection as an Algorithmic Process * Michael Ruse Darwinian Epistemology * Thomas Henry Huxley, Evolution and Ethics * Julian Huxley, Evolutionary Ethics * Michael Ruse and Edward O. Wilson, The Evolution of Ethics * Frans de Waal, Good Natured: The Origin of Right and Wrong in Humans and Other Animals * Matt Ridley, The Origins of Virtue * Part VIII: Evolutionary Theory and Religious Theory * MAINSTREAM RELIGIOUS SUPPORT FOR EVOLUTION * o Pope John Paul II, Message to the Pontifical Academy of Sciences o Central Conference of American Rabbis, On Creationism in School Textbooks o United Presbyterian Church in the U.S.A., Evolution and Creationsim o The Lutheran World Federation, [Statement on Evolution] o The General Convention of the Episcopal Church, Resolution on Evolutionism and Creationism o Unitariuan Universalist Association, Resolution Opposing "Scientific Creationism" * FUNDAMENTALIST CREATIONISM * o Eugene C. Scott, Antievolution and Creationism in the United States o The Scopes Trial o Thomas McIver, Orthodox Jewish Creationists o Harun Yahya, [Islamic Creationism] o Seami Srila Prabhupada, [A Hare Krishna on Darwinian Evolution] o Institute for Creation Research, Tenets of Creationism o Henry M. Morris, Scientific Creationism o Thomas J. Wheeler, Review of Morris o Richard D. Sjolund and Betty McCollister, Evolution at the Grass Roots o Richard D. Sjolund, [Creationism versus Biotechnology] o Betty McCollister, [The Politics of Creationism] o Molleen Matsumara, What Do Christians Really Believe about Evolution? o National Center for Science Education, Seven Significant Court Decisions Regarding Evolution/Creation Issues * PERSONAL INCREDULITY AND ANTIEVOLUTIONISM * o Richard Dawkins, [The Argument from Personal Incredulity] o Phillip E. Johnson, Darwin on Trial o Eugenie C. Scott, Review of Johnson o Michael Behe, Darwin’s Black Box o Robert Dorit, Review of Behe o Michael Ruse, Darwin’s New Critics on Trial * SCIENTISTS’ OPPOSITION TO CREATIONISM * o American Association for the Advancement of Science, Forced Teaching of Creationist Beliefs in Public School Science Education o American Institute of Biological Sciences, Resolution Oposing Creationism in Science Courses o National Association of Biology Teachers, Statement on Teaching Evolution o National Academy of Sciences, Frequently Asked Questions about Evolution and the Nature of Science * FUNDAMENTALIST CREATIONISM AND THE VALUE OF SATIRE * o Michael Shermer, Genesis Revisted: A Scientific Creation Story o Philip Appleman, Darwin’s Ark * Part IX: Darwin and the Literary Mind * DARWIN’S LITERARY SENSIBILITY * o Charles Darwin, Autobiography o L. Robert Stevens, Darwin’s Humane Reading o George Levine, Darwin and Pain: Why Science Made Shakespeare Nauseating o Gillian Beer, Darwin’s Plots * DARWIN’S INFLUENCE ON LITERATURE * o Lionel Stevenson, Darwin among the Poets o George Levine, Darwin among the Novelists o Joseph Wood Krutch, The Tragic Fallacy o Herbert J. Muller, Modern Tragedy o Philip Appleman, Darwin-Sightings in Recent Literature. (shrink)

I anledning af Judith Butlers forelæsning om klimasorg på KU er jeg blevet bedt om at besvare spørgsmålet om, hvad man kan bruge Butlers tænkning til i dag og om den stadig er aktuel. Min første tanke var at besvare spørgsmålet med svaret: Man kan bruge Butlers tænkning til ALT! Men for at fokusere mit svar, har jeg besluttet mig for at gennemgå Butlers tænkning i forhold til spørgsmålet om prekære liv og vold og ikke-vold, og hvordan disse emner udspringer (...) af Butlers tænkning om køn i 1990’erne. /// In connection with Judith Butler's lecture on climate grief at KU, I have been asked to answer the question of how Butler's thinking could be used today and whether it is still relevant. My first thought was to answer the question with the answer: You can use Butler's thinking for EVERYTHING! However, to focus my answer, I have decided to review Butler's thinking in relation to the issues of precarious lives and violence and non-violence and how these issues stem from Butler's thinking on gender in the 1990s. (shrink)

What is the common element linking the right to health care and the right of free speech, the right to leisure and the right of free association, the right to work and the right to be protected? Debates on the rights of man abound in the media today, but all too often they remain confused and fail to recognize the fundamental political conceptions on which they hinge. Several French theorists have recently attempted a new account of rights, one that would (...) replace the discredited Marxist view of rights as mere formalities concealing the realities of class domination. In this final volume of _Political Philosophy_, Luc Ferry and Alain Renaut summarize these efforts and put forward their own set of arguments. (shrink)

The task of this paper is to clarify the status and implications of Levinas's insistence on the necessity of subjectivity to the ethical relation. Focusing in particular on the discussion of substitution in Otherwise than Being, it is argued that the description of subjectivity as substitution enables Levinas to articulate the necessity of the subject to the approach of the other in a manner which avoids the transcendental character which such claims to necessity usually embody. This argument proceeds from an (...) initial characterization of substitution within the constellation of themes pursued by Levinas in Otherwise than Being to a detailed examination of the first four sections of the Substitution chapter. The essay concludes by noting the unity of the ethical exceeding of the transcendental character of subjectivity with the project which animates Levinas's work from its beginnings: the exceeding of the ontological by the ethical. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Eschatology, Sacred and Profane* PHILIP MERLAN LET ME BEGINthis paper with a double motto. The first is from a German poet, C. F. Meyer. It reads in my own translation: "We hosts of the dead ones--more numerous are we--than you who tread the earth and you who sail the sea." The second is a piece of statistical information for the correctness of which, however, I cannot vouchsafe. It (...) reads: "From the time when man first appeared, 77 billion people have been born. Thus, today's population of about 3 billion represents only 4 per cent of all men ever born" (Universitas 6 [1964], p. 423). With these two mottoes in mind let me proceed. Kant is one of the great representatives of the belief both in a goal to history and in progress. As he sees it, this goal is one world-wide society living under one law, which law coincides with the demands of morality, or as we could also say, in which legality and morality at least do not conflict. Kant is convinced that nature will by-and-by compel man to establish this world-wide society characterized, among other things, by eternal peace. Thus, Kant is an optimist with regard to the future. Yet, he is profoundly pessimistic with regard to the past. For him, history is one long chain of sufferings inflicted on man by man; and on the whole he has a very dim view of man's nature. The synthesis of his pessimism with his optimism is contained in a remarkable sentence which we find in one of his last writings--1793, when Kant was 69. The title is On the Adage--This May be Right in Theory, But Is Inapplicable to Practical Purposes, and here he says: When one contemplates the evil which in the course of history man has inflicted on man, one would be inclined to give up in despair. But there is one thought on the thinking of which our mind will cheer up. It is the thought: things will improve in the future. This kind of cheer will be entirely benevolent and unselfish, for this improvement will take place after we * I am indebted for the posthumous edition of this paper of my late husband Philip Merlan to Professor Frederick Sontag of Pomona College. My husband prepared this paper for, and read it to, various philosophical groups. In the course of these readings, he made numerous pencil additions. Thus, what Professor Sontag has done, is to change the tone to suit a printed presentation and to work the additions into the text as the logic of the arguments and notes seemed to dictate. Franciszka Merlan. [193] 194 HISTORY OF PHILOSOPHY have been buried for a long, long time. We ourselves will not be able to harvest what we ourselves have helped to plant. (WW8, 273-13) In whose name did Kant speak? Who are the altruists who feel cheered up by the prospect of a goal which they themselves will not live to reach? No easy answer can be found in Kant's writings. However it would not be surprising if Kant, a Rousseauian in so many respects, retained some of Rousseau's belief in the innate goodness of man (in spite of his pietistic heritage which encourages him to see man as thoroughly corrupt). Thus, he expects everybody to be capable of this altruistic attitude. We all do then cheer up when we think of the prospects for mankind. This means that our altruism permits us in some way to participate in mankind's bright future, to reach the goal, if I may say so, in hope and expectation, though not physically. For Kant the problem of history was never in the center of his own interest, nor would he have admitted that it is of central importance for man. Hegel's attitude is quite different. Man's participation in history is Hegel's main topic. At this point let me remind you briefly of Hegel's fundamental ideas. The enlightenment and romanticism produced two highly characteristic interpretations of religion. According to the former, the kernel of every religion is morality. According to the latter, the... (shrink)

How do we know right from wrong, good from bad, help from hindrance, and how can we judge the behaviour of others? Ethics are the rules and guidelines that we use to make such judgements. Often there are no clear answers, which make this subject both interesting and potentially frustrating. In this book, the authors offer readers the opportunity to develop and express their own opinions in relation to ethics in psychology. There are many psychological studies that appear to have (...) been harmful or cruel to the people or animals that took part in them. For example, memory researchers carried out studies on a man who had no memory for over forty years, but because he had no memory he was never able to agree to the studies. Is this a reasonable thing to do to someone? Comparative psychologist Harry Harlow found that he could create severe and lasting distress in monkeys by keeping them in social isolation. Is this a reasonable thing to do even if we find out useful things about human distress? If you were able to use psychological techniques to break someone down so that they revealed information that was useful to your government, would you do it? If so, why? If not, why not? These ethical issues are not easy to resolve and the debates continue as we encounter new dilemmas. This book uses examples from psychological research to look at: key ethical issues ethical guidelines of psychologists socially sensitive research ethics in applied psychology the use of animals in research This book is essential reading for undergraduate and pre-undergraduate students of psychology and related subjects such as philosophy and social policy. (shrink)

This article provides current Schwartz Values Survey data from samples of business managers and professionals across 50 societies that are culturally and socioeconomically diverse. We report the society scores for SVS values dimensions for both individual- and societallevel analyses. At the individual- level, we report on the ten circumplex values sub- dimensions and two sets of values dimensions. At the societal- level, we report on the values dimensions of embeddedness, hierarchy, mastery, affective autonomy, intellectual autonomy, egalitarianism, and harmony. For each (...) society, we report the Cronbach' s? statistics for each values dimension scale to assess their internal consistency as well as report interrater agreement analyses to assess the acceptability of using aggregated individual level values scores to represent country span sp. (shrink)

This book is neither a biography nor an in-depth interpretation of Berkeley's philosophical system. There are numerous details about Berkeley's life, social relationships, and intellectual contributions, but Berman neither explores these matters in comprehensive depth nor claims to do so. What, then, does he do? Berman's answer is: "Advancing chronologically, I have focussed on Berkeley as homo religiosus". He uses biographical details to portray Berkeley as a Christian thinker who acted on his commitment both in and out of his study. (...) Berman also locates Berkeley's writings in their specific intellectual and social contexts while tracing a career that spanned over forty years and encompassed a wide range of interests and disciplines, from theology to economics. Attention is paid, for example, to Berkeley's Guardian essays and to Siris, which is characterized as his most popular book during his lifetime. Philosophers now concentrate almost exclusively on the Principles of Human Knowledge and Three Dialogues between Hylas and Philonous, regarding their author only as a technical thinker offering immaterialism as a solution to free-standing philosophical problems. It is therefore salutary to be informed about the wide range of Berkeley's writings and regard them as diverse expressions of Christian idealism, a religiously inspired outlook about God, nature, and humanity which issued in, but transcends, immaterialism, the technical philosophical position. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 119 Der Verf. bedient sieh in Verfolgung seines Ziels der fibliehen historischen Methode, die er mit Meistersehaft handhabt. Doch ist er keineswegs ein typischer Vertreter des modernen Historismus. Als Philosoph ist er gefesselt von den Problemen, die sich in der dreifachen Thematik seiner Untersuehung verbergen. Er begibt sich in die Gesehichte, aber doch nur, um yon Zeit zu Zeit aus ihr herauszutreten und i)berlegungen nachzugehen, die er (...) selbst, anlfifilieh einer methodologisehen Bemerkung in der Einleitung, als eine "Typologie yon LSsungen" (3) bezeiehnet. Aber das ist ein understatement, keine exakte Besehreibung. Die unbefangene und nfiehterne Kfihnheit dieser seiner trans-historisehen Reflexionen durehweht als ein frischer Luftzug die Welt der Gelehrsamkeit und Vielbelesenheit, die sich in diesen Seiten aufbaut. Freilieh, wo der Verf. selbst steht, gibt er uns nur gelegentlieh zu verstehen, so z.B. wenn er mit Entsehiedenheit die averroistisehe Depotenzierung des Einzelnen gegenfiber der Mensehheir zurfickweist. Aber, wiederum im Zusammenhang mit Averroes, legt er Gedanken zu der berfihmten oder auch berfiehtigten Lebre yon der doppelten Wahrheit vor, die uns in Zweifel darfiber lassen, ob und wie weit sich der Verf. hier verbirgt oder d~couvriert. M. gesellt sich nicht zu denen, die Averroes entlasten woUen, indem sie die fatale Lehre als eine spatere Zutat erkl~ren. Vielmehr mSchte er das Anathema dadurch fortnehmen, daB er die grobe und beleidigende Darstellung der Lehre dutch eine subtile Deutung ersetzt, die sie als konsequent, als vernfinftig und schlie61ich als wahr erscheinen l~Bt (107 ft.). Der Mensch, so argumentiert er, drfickt sich in einer Mehrheit yon "Sprachen" (universes of discourse) aus, die sich nieht ineinander fibersetzen lassen--der Sprache der Kunst, der Dichtung, der Philosophie, der Religion usw. So kann ein und derselbe Menseh ohne Selbstwidersprueh oder Unredliehkeit als Philosoph sagen: die individuelleSeele ist sterblich, als Gl~ubigerhingegen: sie ist unsterblich. Denn sowohl "Seele" wie "Individuum" wie aueh "Unsterblichkeit" meinen etwas anderes je nach dem universe of discourse, dem philosophischen oder religiSsen, in welchem sie gebraueht werden. Freilich, man kann den Versueh maehen, in langagestart in einer der vielen langues zu reden, und die Theologie kann nicht umhin, eben dies zu wagen. Ffir die Theologie aber~ so bekennt der Verf., ist kein Raum in seinem "scheme of things" (109). Das ist ein erschreckendes Wort, und nieht blofi ffir den, der die Theologie erhalten mSchte. Denn es besteht begrfindete Sorge, dab der Ruin der zwisehen den versehiedenen langues zerriebenen Theologie auch die Philosophiepulverisiert. Die verschiedenen"Spraehen" miissen doch wohl in der einen mensehlichen Person sinnvoll zusammengeordnet sein. Welche Wissenschaft aber wenn nicht die Philosophie darf sich diese Zusammenordnung zum Gegenstand ihres Forschens und Sagens machen? Wir schliefien also unseren Bericht fiber ein bedeutendes Buch mit einer Frage, nicht aber der Kritik oder gar des Besser-wissen-wollenswegen, sondern um auszudrficken, dab der Autor uns nicht nur als gelehrter Kenner unterrichtet, sondern als Philosoph zum Denken zwingt. Mi~nchen, Germany HELMUT KUHN Diogenis Laertii Vitae Philosophorum. Recognovit brevique adnotatione critica instruxit H. S. Long. 1 vol. in2. (Oxford: 1964.Pp. xx ~ xiv W 597. $11.20.) Der Hg erinnert uns, dass seit der Cobetsehen (1850), leider apparatlosen, keine kritische Ausgabe des Diogenes im ganzen ersehlenen ist. Immerhin gibt es abet die Ubersetzung yon M. Gigante (DiogeneLaerzio, Vite dei filosofi, Bari 1962), die so annotiert ist, dass sie vielfach anstatt einer Edition gebraucht werden kann. Man bedauert, dass der Hg sie offenbar noch nicht benutzen konnte (sein Buch ist wohl 1964erschienen, doch ist die Vorrede 1961datiert). Der Hg schliesst sich der Meinung an, dass nut 3 der existierenden Diogenes-Hss den Wert unabh~ngiger Zeugen besitzen. Vorsichtiger beurteilt den Sachverhalt z.B.H. Erbse in: Geschichte der Text~berlieferung, I. Band (1961), S. 306f., doch wollen wir die These des Hg akzeptieren. Wie allgemein zugestanden, gehen diese drei auf eine gemeinsame Vorlage zur~iek. Unter diesen Ums~nden ist es die Pflicht des Hg, uns verl~sslich und eindeutig fiber den Text dieser drei (BFP aus dem 12.u. 13.Jh.) zu informieren, eine Entscheidung zu treffen, wo diese 120 HISTORY OF PHILOSOPHY nicht tibereinstimmen, darfiber hinaus Textverderbnisse anzuzeigen und womSglich zu emendieren, entweder dureh eigene Vermutungen (in Buch VI und IX, e. 19% des Ganzen, habe ich nur zwei gefunden, beide einleuehtend... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:238 HISTORY OF PHILOSOPHY that enigmatic Swiss iatrochemist sympathetically. In any event, Dr. King's sympathetic approach to Paracelsus manages to throw considerable light on the Paracelsian advice to all future physicians: Don't read books! Read the stars, but read them "in Neo-Platonic fashion" (p. 114)! While the author is "judicious" about Galen and Paracelsus in particular, he is far from being so when it comes to Friedrich Hoffmann, a (...) medical materialist and "systematist" from Halle in the eighteenth century. Paradoxically enough, Dr. King has a marked antipathy for the doctor of "sympathy " himself (p. 173). Incidentally, the only other physician in the book who is not liked--apparently for his being polemical (p. 215)--is a famous fellow-pathologist of the last century, Rudolf Virchow. Still, it is only fair to add that the author acknowledges fully Virchow's important contributions to the field of cellular pathology. Finally, Dr. King not only has his likes and dislikes as to the medical men he actually selects from modern medicine to represent changes in theory of disease, but he seems also to have a definite bias in another and more serious sense. With the exception of the Epilogue and Chapter IV, which includes Vesalius and Harvey as well as Hoffmann, all the episodes of modern medicine deemed worthy of study derive from the Germanic world. Curiously enough, although there is no discussion of the germ theory of disease as such in the book, there is mention of Koch, but not of Pasteur. And French physiologist Claude Bernard, the great medical philosopher who tried to do in the nineteenth century for scientific medicine what American pathologist Lester King is attempting in the twentieth, is conspicuous by his absence in The Growth of Medical Thought. PATRICKROMANELL University of Oklahoma Siimtliche Werke von Plato. (Reinbeck b. Hamburg: Rowohlt, 1959-1963. 6 volumes -- Rowohlts Klassiker der Literatur und der Wissenschaft. Griechische Philosophie.) Diese Taschenbiicherausgabe enth~ilt die meisten der von Schleiermacher iibersetzten Dialoge und ffigt die Briefe, den Timaios, den Kritias und die Nomoi in der Obersetzung von H. und F. H. Miiller hinzu. Die Ordnung entspricht offenbar der von den Herausgebern (W. F. Otto, E. Grassi und G. Plamb/Sck) angenommenen chronologischen Reihenfolge. Ausgelassen sind: Minos, Alkibiades H und Theages, Nebenbuhler, Kleitophon und die Epinomis--offenbar weil sie die Herausgeber fiir unecht halten. Die Obersetzung einer Reihe von Dialogen (bes. Parmenides, Politikos, Philebos, Timaios, Kritias) wurde einer Durchsicht unterzogen; leider teilen uns BOOK REVIEWS 239 die Herausgeber nicht mit, von wem. Jedem Dialog geht eine Gliederung voran; jeder Band ist mit einer recht brauchbaren Bibliographie versehen. Es ist erstaunlich zu erfahren, dass der erste Band, erstmalig in 1957 erschienen, in 1963 eine Auflage von 78000 erreicht hat; bleiben auch die Auflageziffern der fibrigen B~inde dahinter zurfick, so sind sie doch genfigend eindrucksvoll. Man wfinscht, der Verlag m6chte doch, durch diesen Erfolg ermutigt, das nach Obgesagtem noch Fehlende--und dazu noch Platons Gedichte--in einem Erg~inzungsband bringen, wie immer man fiber die Echtheit der Stficke denkt. Der stilistische Unterschied zwischen den ~bersetzungen von Schleiermacher (erstmalig: 1804-1810) und von H. und F. H. Mfiller ist ausserordentlich. Dies ist nicht etwa auf die gr6ssere Sprachmeisterschaff Schleiermachers zurfickfiihren. Vielmehr liegt seiner Obersetzungsmethode eine h6chst interessante Theorie zugrunde (die F. A. Wolff, der Schleiermachers ~bersetzung verhShnt und Wilamowitz, der sie als ungeniessbar bezeichnet hatte, offenbar unbekannt war). Dieser Theorie zufolge ist es die Aufgabe des ~2bersetzers, den Leser besffindig daran zu erinnern, dass er nur eine l~bersetzung vor sich hat. Einem ~bersetzer, der sich brfistet, dass sich sein Text so liest, wie ihn der Autor geschrieben h~itte, wenn er in der Sprache des ~bersetzers und seines Publikums gedacht h~itte, sollte erwidert werden "Daffir bin ich dir so dankbar, wie ich es w~ire, wenn du mir das Bild eines Mannes zeigtest und sagtest--So wiirde er ausgesehen haben, wenn ihn mit seiner Mutter ein anderer Vater gezeugt h~tte." In anderen Worten: da sich Inhalt und Ausdruck nicht abtrennen lassen, sollte der f2bersetzer, start das Original seiner Sprache anzueignen, vielmehr--wir gebrauchen hier den bekannten Brechtschen Begriff--im Leser einen Verfremdungseffekt erzeugen. Wie man sieht, ist Schleiermachers ~3bersetzungstheorie jeder "rationalistischen " strikte... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BEING AND ONE THEOLOGIAN I PROPOSE EXPLORING the view of being of one theologian whose work has received wide attention both in Germany and America. Wolfhart Pannenberg is known primarily through his formulation of the seven controversial theses in (and on the subject of) Revelation as History (1961), and through his development of this approach into a full-fledged theological methodology "from below" in Jesus'God and Man (1964) and Theology (...) a:ttd the Philosophy of Scienc :e (1973). Yet philosophers and theologians have not failed to notice that some rather interesting and novel ontological speculation has accompanied the work of this philosophically oriented theologian, speculation that could represent the seed of a novel approach to contemporary ontology. Now Pannenberg's passing references to God',s being, and to being in general, could be criticized from a theological perspective ; perhaps he would even prefer a treatment along such lines. However, another line of approach also suggests itself: if one can show that Pannenberg is advocating a way of viewing being in general, how does his approach fare when taken as the foundation of a SY'stematic ontology? Is it more at home in olassical philosophical thought about being or, if not, what contemporary influences does it reflect? Of course, for manyif not most-theologians, to attempt such an abstraction would be to tear their theology asunder, joint from marrow. For example, Barth's doctrine of the becoming God, as Eberhart Jiingel has admirably shown, is designed to do justice only to the God of revelation, and is meant to be taken as prior to all philosophical speculation about God's being and being in general.1 1 Eberhart Jiingel, Gottes Sein ist in Werden (Tiibingen, 1965), e.g. pp. 9f, 73ff; cf. Barth's Kiroh7iohe Dogmatik, II/I, pp. 202f. 645 646 PHILIP CLAYTON But lying at the heart of Pannenberg's theology is the refusal to shield his theology in this way. Theology is the science of God as the all-determining reality (TPS 302ff),2 and faith cannot defend any statement that reason fails to verify (Jesus 109). As his recent anthropology sorties into behavioral psychology, sociobiology and philosophical anthropology to produce an" anthropology in theological perspective" rather than a theological anthropology, so we may also expect a readiness on Pannenberg's part to consider his ontological statements as " ontological hypotheses" (if this is not a contradictio in adjecto ), to be tested by means of their" fit" with general speculation on the nature of being. Indeed, in BQT II: 237 and TPS, Chapter 5, he explicitly asks us to try the biblical understanding of reality in the court of the " contemporary experience of reality." Elsewhere, in a direct discussion of ontology, Pannenberg uses theological subject matter as an "example" meant to " contribute to a better understanding " of the philosophical issues involved (TKG 132f). 1. The Pannenbergian Ontology Assuming the validity of my admitted abstraction and of an unashamedly philosophical rather than theological analysis, what is this "novel" view of being found in Pannenberg's writings? Pannenberg holds that "futurity" is fundamental for Jesus' message (TKG 54). All reality is "eschatologically oriented "-in philosophical terms, referred to (bezogen auf) the future-and God is "the God of the coming kingdom" (BQT II: 237), "the God of history" (Grundfragen 112-28), "the power of the future" (TKG 57). This is not merely an 2 In the following I will use the common abbreviations for Pannenberg's works: 'TPS' for Theology and the Philosophy of Science (Philadelphia, 1976) ; ' BQT' for Basic Questions in Theology, 2 vols. (Philadelphia, 1971) ; 'Jesus' for Jesus-God and },fan, 2nd ed" (Philadelphia, 1968); 'TKG' for Theology and the Il.ingdom of God (Philadelphia, 1969) ; 'Idea' for The Idea of God and Human F1'eedom (Philadelphia, 1973); 'Anth' for Anthropolgy in Theological Perspective (Philadelphia, 1984) ; and 'Grundfragen' for Grundfragen systematisoher Theologie, Band 2 (Gottingen, 1980). BEING AND ONE THEOLOGIAN 647 epistemological thesis, emphasizing, say, the limitedness of our knowledge of the divine; " God in his very being is the future of the world" (TKG 61). If this is so, what is God's ontological status now? "It is necessary to say," Pannenberg writes, "that, in a restricted... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 95 direction, it opens a field of pure philosophy, unencumbered by surds such as finite man. Only if the Phenomenology is taken as a monographic work on man can there be difficulty. Let us hasten to add that, on the very premises of his book, Loewenberg's criticism of Hegel is tentative rather than apodictic; its harshness is relieved through the dialogue form. And perhaps, the interlocutors will, (...) as one of them suggests, "resume (their) conversations with fresh minds at a later date" (p. 371). They might find that they have to go beyond the limits of exoteric discussion. Or, conversely, they might find that exoteric treatment can yield no more than an anthropological reading and is, in fact, bound up with it. If Loewenberg 's extant commentary did no more than demonstrate this negative point, however implicitly,it would be of great merit. But there is of course much more: there is the substance of Loewenberg's commentary, largely unaffected by the above counter-representations. Theoretical problems aside, the supreme value of the book lies in its clarity and perceptiveness, in the "sense" it makes of the Phenomenology. Of a kind all its own, it will henceforth serve as the preferred entrance to Hegel. KLAUS HARTMANN Bonn, W. Germany Arthur Hfibscher, editor. XXXVIlI. Schopenhauer-Jahrbuch ]~r das Jahr 1957. (Frankfurt/ Main: Waldemar Kramer, 1967.Pp. v + 244.) Schopenhauer: Philosophe de l'Absurde. By Clement Brosset. (Paris: Presses Universitaires de France, 1967.Pp. ix [i] -b 107.Paper, F. 7.--) Manches in dem Jahrbuch ist rein anekdotisch; manches bio- oder bibliographisch. Einiges h~ngt nur sehr lose mit Schopenhauer zusammen; so der liingste Beitrag (K. Engisch, "Todesstrafe--ja oder nein?,") mit nfitzlicher historischer und systematiseher Ubersieht, die zum Ergebnis kommt, dass die Argumente gegen die Todesstrafe iiberwiegen. Von gesetzgeberischen Interessen getragen ist such G. Zoebe, "Sind die Tiere rechtlos?" Der zweitliingste Beitrag (H. Voigt, 'r0ber Schopenhauers Erkenntnistheorie,') enth~ilt eine Art von Variationen sum Thema des Zusammenhanges zwischen Charakter und Schicksah Man freut sich, dass ein Inder (Kanti Chandra Pandey) sich fiber Schopenhauers Kenntnis des Hinduismus und Buddismus eehr anerkennendausspricht. Das Bild der Sehopenhauerschen Philosophie, wie es uns im Jahrbuch begeguet ist das uns vertraute: Pessimismus, ErlSsung durch Kunst, Mitleid, Verneinung des Willens. Aber nach Brosset erfassen diese Kategorien nur die sekund~ren Charaktere der Schopenhauerschen Philosophie. In ihrem wirklich wertvollen Kern sei diese Philosophie erstens Vorl~uferin der yon Brosset so genannten genealogischen Philosophie eines Marx, Nietzsche und Freud; allerdings letzten Endes ein Versager, da sie auf das eigentliche Anliegen der genealogischen Philosophie, n~mlich die Ableitung konkreter und spezifischer Ideen (bei Schopenhauer: der Intelligenz) aus der Umformung unbewusster Tatbestiinde (bei Schopenhauer: des Willens), nicht eingehe, sondern sich mit der Feststellung begniigt, dass die Wurzel der (bewussten) InteUigenz der (unbewusste) Wille ist. Zweitens sei Schopenhauer der erste, der seine Philosophie auf der Urerfahrung der Grundlosigkeit (Brosset zieht den Ausdruck Absurdit~t vor), daher Unausdenkbarkeit oder Unergrfindlichkeit des Seins im ganzen, aufbaut. Auf diese Erfahrung (die Frage, 'Warum nicht Nichts?' ist unbeantwortbar) reagiere der Menseh mit Angst. Die Notwendigkeit und die Zweckm~issigkeit, die die Welt im ganzen charskterisieren, seien selbst kontingent und zwecklos. Manchmal scheint mir Brosset die Originalitiit seiner Interpretationen zu iiberseh~tzen; insbesondere seine Erkl~rung der Blindheit des Willens (S. 26f.) rennt wohl offene Tfiren ein. PHILIP MERLAN ~cripps College, Claremont, California... (shrink)

Aesth. Hegel, Aesthetics Aesth. Ed. Schiller, On the Aesthetic Education of Man CI1PR Marx, Critique of Hegel's Philosophy of Right Civil War Marx, The Civil War in France CPE Marx, Critique of Political Economy Em. Hegel, Enzyklopadie der ...

Locke, Eden and Two States of Nature: The Fortunate Fall Revisited PHILIP VOGT TWO STATES OF NATURE, not one, figure in the political writings of John Locke. The more frequently discussed of the two, the "State of Nature" proper, is defined in the second of the Two Treatises of Government as the condition of perfect freedom abandoned by mankind upon the advent of political society.' Whether Locke viewed this "state" as a purely theoretical construct or as an actual moment (...) in human history is open to debate. 2 There is no basis, however, for doubting his belief in the literal reality of that other state of nature, the Garden of Eden. In Eden, mankind in the person of Adam-turned-rebel ob- tained its perfect, prepolitical freedom in exchange for the bliss of perfect obedience to a divinely ordained "Law of Nature." Without reference to man's tenancy of nature in both its prepolitical and prelapsarian states, Locke's discus- sion of the equilibrium struck in political society between obedience and free- dom is incomprehensible. Likewise, reference to both states is required for Valuable comments on the preliminary drafts of this article were given by Nancy Struever, Peter Vinten-Johansen, J. G. A. Pocock, Kirstie McClure, John Marshall, Carol Pech, Edward Schneider and two anonymous referees for the Journal of the History of Philosophy. 'John Locke, Two Treatises of Government, ed. Peter Laslett , II/ii/4. 9 While Locke.. (shrink)

CHAPTER I THE MORAL SITUATION "For you see, Collides, our discussion is concerned with a matter in which even a man of slight intelligence must take the ...

When the translator and editor of the German edition of Bayle’s Historical and Critical Dictionary, Johann Christoph Gottsched, sug gested to Johann Georg Wachter that he supply an explanation of his views on Spinoza for inclusion in the eponymous article, he gladly obliged. Wachter, a failed university professor in Duisburg who had since managed to find employment in the council library in Gottsched’s adopted home town of Leipzig, had good reasons for doing this. Not only had his Elucidarius cabalisticus been (...) fiercely attacked in the Respublica litteraria as being the work of a new cabbalist evidently out to defend atheism and other purported evils of Spinoza’s philosophy, but also he appeared in that book to have adopted a philosophical position diametrically opposed to the one he had held just a few years earlier. His Der Spinozismus Im Jüdenthumb, which he had published in 1699 after a year-long stay in Amsterdam and which had been directed against a certain Moses Germanus, had after all sought to defend natural religion against Spinoza’s phi losophy by attacking those elements in it which were seen to represent the greatest threat to an understanding of God and the duties of man based solely on rational knowledge, in particular, its fundamental pantheism. In effect, while Wachter had there used the demonstration of the cabbalistic roots and the detrimental ethical consequences of Spinoza’s philosophy to show that Christianity and Judaism are fundamentally irreconcilable, he now used the first part of that demonstration as the basis for presenting the theory contained in the Ethics as a tenable philosophical theology. (shrink)

When the translator and editor of the German edition of Bayle’s Historical and Critical Dictionary, Johann Christoph Gottsched, sug gested to Johann Georg Wachter that he supply an explanation of his views on Spinoza for inclusion in the eponymous article, he gladly obliged. Wachter, a failed university professor in Duisburg who had since managed to find employment in the council library in Gottsched’s adopted home town of Leipzig, had good reasons for doing this. Not only had his Elucidarius cabalisticus been (...) fiercely attacked in the Respublica litteraria as being the work of a new cabbalist evidently out to defend atheism and other purported evils of Spinoza’s philosophy, but also he appeared in that book to have adopted a philosophical position diametrically opposed to the one he had held just a few years earlier. His Der Spinozismus Im Jüdenthumb, which he had published in 1699 after a year-long stay in Amsterdam and which had been directed against a certain Moses Germanus, had after all sought to defend natural religion against Spinoza’s phi losophy by attacking those elements in it which were seen to represent the greatest threat to an understanding of God and the duties of man based solely on rational knowledge, in particular, its fundamental pantheism. In effect, while Wachter had there used the demonstration of the cabbalistic roots and the detrimental ethical consequences of Spinoza’s philosophy to show that Christianity and Judaism are fundamentally irreconcilable, he now used the first part of that demonstration as the basis for presenting the theory contained in the Ethics as a tenable philosophical theology. (shrink)

When the translator and editor of the German edition of Bayle’s Historical and Critical Dictionary, Johann Christoph Gottsched, sug gested to Johann Georg Wachter that he supply an explanation of his views on Spinoza for inclusion in the eponymous article, he gladly obliged. Wachter, a failed university professor in Duisburg who had since managed to find employment in the council library in Gottsched’s adopted home town of Leipzig, had good reasons for doing this. Not only had his Elucidarius cabalisticus been (...) fiercely attacked in the Respublica litteraria as being the work of a new cabbalist evidently out to defend atheism and other purported evils of Spinoza’s philosophy, but also he appeared in that book to have adopted a philosophical position diametrically opposed to the one he had held just a few years earlier. His Der Spinozismus Im Jüdenthumb, which he had published in 1699 after a year-long stay in Amsterdam and which had been directed against a certain Moses Germanus, had after all sought to defend natural religion against Spinoza’s phi losophy by attacking those elements in it which were seen to represent the greatest threat to an understanding of God and the duties of man based solely on rational knowledge, in particular, its fundamental pantheism. In effect, while Wachter had there used the demonstration of the cabbalistic roots and the detrimental ethical consequences of Spinoza’s philosophy to show that Christianity and Judaism are fundamentally irreconcilable, he now used the first part of that demonstration as the basis for presenting the theory contained in the Ethics as a tenable philosophical theology. (shrink)

The author critically examines and rejects alvin plantinga's defense of the free will theodicy, As presented in chapter six of plantinga's "god and other minds". If the author's arguments are correct, Then any attempt on the part of the rational apologist to explain evil by reference to man's free will must be considered futile. Since the arguments presented will be seen as supporting natural atheology (which, For plantinga, Is "the attempt...To show that, Given what we know, It is impossible or (...) unlikely that God exists"), The article ends with the claim that both rational apologetics and natural atheology are conceptually confused, And that this confusion can be traced to their failure to understand the nature of religious belief. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 341 if you started asking them questions about possible worlds. But Bradley's contribution is to have given us a painstaking and thorough reading of some extremely tightly wound and important aspects of the Tractatus, to have brought that text into direct contaot with con· temporary issues, and to have made progress toward showing that how· ever remarkable we thought the Tractatus was, it is still more remarkable (...) than that. JOHN CHURCHILL Hendrix College Conway, Arkansas The Human Person: Animal and Spirit. By DAVID BRAINE. Notre Dame, Indiana: University of Notre Dame Press, 1992. Pp. xxv + 555. $32.95 (cloth). Any study in philosophical anthropology that rejects both mate· rialism and dualism, and seeks to set forth a " holistic " alternative, may be met in many quarters with some skepticism today-especially if that alternative seeks to accommodate itself to religious teaching regarding the soul's continued existence after death. For, it will be asked, on the one hand, how can it deny that the esse of the human being ceases at death (538) without affirming some sort of dualism? On the other hand, unless it is some sort of soft-headed New Age philosophy (which this most certainly is not), how can it sustain its claim to "holism" while rejecting the monolithic materialism of those whom Walker Percy once described as our "brain engineers, neuropharmacologists, and chemists of the synapses "? The challenge is " how to produce an account which allows the human person to continue exist· ing after death, and even to have body restored to it, while remaining completely faithful to the insight that it belongs to human nature to be bodily," and, at the same time, to " avoid reerecting the soul into a complete substance" (xix). The peculiar obstacle faced by such a project is the pervasive proclivity towards reductionism in modern accounts of human nature stemming from the impress of both materialism and dualism. Both analyze the human person into an aggregate of parts in certain relations, the behavior of the whole being ·the result of the interactions of these parts. " In all this the materialist has exactly the same picture as the dualist. Indeed, unless the mental can first be represented as inner, logically independent of anything in the ' outer man ' and the ' world,' there is no way in which it can be identified with a brain-process or 342 BOOK REVIEWS state" (3). So whether one thinks of the mind as an independent en· tity (as in dualism), or not (as in materialism), the body is left to be accounted for by the brain engineers and their aggregates of physi· ological, anatomical, neurological, and chemical causes. And since materialism involves no complicating questions about causal interaction between the physical and the mental (as in dualism), it is usually preferred on grounds of its simplicity-all causation being subsumed under the physical. In this ambitious tome, David Braine, a philosopher at the University of Aberdeen, offers a thoroughgoing analysis and critique of such views, whereby he undertakes to overturn these ways of viewing human nature and to offer a holistic alternative. He sets forth a framework for understanding things like perceiving, doing, and speaking as irreducibly the acts of the psychosomatically integrated beings to which we normally attribute them-an understanding that conforms to the ordinary experience of such acts in ourselves and in others. He seeks to expose how materialist arguments repeat the mistakes of the dualists by reducing human beings (and other animals) to their aggregate parts, segmented sequences, and their interrelations. He takes issue with the arguments of recent analytical philosophers (such as Davidson and Dummett) in detail, and sets forth a holistic alternative-both with re· spect to the human person as " animal" and as " spirit." As to the human as "animal," Braine notes, accordingly, that "it is the bodily animal being as such, not just its mind, which is an ' I ', a ' he or she ', a focalized subject in relation to the world. The primary reason why human behaviour cannot be simulated by a computer does not lie in things special to human beings, but in the fact that this fo. calized psychophysical structure which they share with the... (shrink)

À partir d'une condition humaine définie en termes d'échec et de conscience malheureuse, la « mauvaise foi » chez Sartre et les « stades de l'existence » chez Kierkegaard ouvrent sur une quête d'authenticité qui est une tâche permanente pour l'homme, qui requiert de lui une « conversion » qui est toujours à refaire. Une esthétique du jeu correspond au niveau symbolique aux exigences de cette recherche, mais c'est l'ironie qui semble le plus à même d'assumer les paradoxes de l'éthique (...) recherchée et ceux du discours philosophique qui prétend en rendre compte.Having defined the human condition in terms of failure and unhappy consciousness, Sartre's "bad faith" and Kierkegaard's "stages of life" introduce a quest for authenticity which is a permanent task for man and requires a "conversion" which must be constantly reaffirmed. An aestheticism of play corresponds to the form of this quest on a symbolic level, but it is irony which seems to best express the paradoxes of such an ethic, as well as those of the philosophical discourse attempting to capture it. (shrink)

As the first ontologist, Parmenides has a special place in the history of philosophy, not only because of his originality, but also because of the greatness of his particular attempt in the philosophy of being. His stature is such that any later attempt in the inquiry into being must measure itself against his achievement. His famous philosophical poem, which we have in fragments, is a permanent challenge to later philosophers. Thus Plato could describe Parmenides as ‘a man to be respected (...) and at the same time feared’. And in our own day Martin Heidegger has said that. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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Whether its title, ύπέρ τοῦ μ γεννᾶν is authentic or not, the work transmitted as ‘Book X’ of Aristotle's History of Animals deals with a wide range of possible causes for failure to conceive and generate offspring. It sets out by saying that these causes may lie in both partners or in either of them, but in the sequel the author devotes most of his attention to problems of the female body. Thus he discusses the state of the uterus, the (...) occurrence and modalities of menstruation, the condition and position of the mouth of the uterus, the emission of fluid during sleep , physical weakness or vigour on awakening after this nocturnal emission, the occurrence of flatulence in the uterus and the ability to discharge this, moistness or dryness of the uterus, wind-pregnancy, and spasms in the uterus. Then he briefly considers the possibility that the cause of infertility lies with the male, but this is disposed of in one sentence: if you want to find out whether the man is to blame, the author says, just let him have intercourse with another woman and see whether that produces a satisfactory result . The writer also acknowledges that the problem may lie in a failure of two otherwise healthy partners to match sexually, or as he puts it, to ‘run at the same pace’ ἲσοδρομῆσαι during intercourse, but he does not go into this possibility at great length , and he proceeds to discuss further particulars on the female side. (shrink)