In lieu of an abstract, here is a brief excerpt of the content:"To make a difference...":Narrative Desire in Global MedicineByron J. Good and Mary-Jo DelVecchio GoodIf, as Arthur Frank (2002) writes, "moral life, for better and worse, takes place in storytelling," this collection of narratives written by physicians working in field settings in global medicine gives us a glimpse of some aspects of moral experience, practice, and dilemmas in settings of poverty and low health care resources. These essays are (...) written from the midst of practice, in diverse settings in Africa, South Asia, Latin America, the Caribbean, and the United States. The majority of the writers are practitioners of contemporary 'global medicine'—physicians from North America or Europe who spend part of their lives flying into settings of poverty or special need to practice medicine and work with on-going collaborative clinical and public health systems—while a smaller number are working in the societies in which they were born. Although a few work for classic humanitarian organizations or have developed their own local NGO's, the great majority are engaged in the 'hybrid life' described by Robert Riviello and noted by Renée Fox, moving between academic medical centers and distant health care systems that are supported by local governments, major international organizations and funding agencies, and international NGO's like Partners in Health. These diverse forms of practice have become a common model for contemporary clinicians engaged in what has emerged as a new discipline of global health or global medicine, and these narratives give us a glimpse of some of the enduring, as well as newly emerging, forms of moral practice and ethical dilemmas characteristic of today's global medicine.Many of these stories are filled with the tension and pathos that makes clinical narratives powerful to read. Physicians are forced to make unfathomable decisions about whether to resuscitate and keep a baby alive, using all means available, or to let the infant die, whether to carry out a procedure that will save an infant in birth but would put the mother at risk, about how to deal with a cancer found in a very advanced state. However, virtually all of the stories transcend these classical stories of the decisions physicians are forced to make by being placed in settings of great scarcity of resources, which stand in particular contrast to the academic medical settings in North America or Europe where many of these global medicine specialists have trained and many continue to practice. The unspeakable inequality of resources emerges throughout these narratives as a kind of master theme, as the underlying moral, as opposed to plot, which gives meaning and sense to the stories. For those who practice medicine in such settings, global inequalities and scarcity of medical resources are deeply felt. They produce the rage that Jeffrey Deal describes. ("I learned to despise American churches during that time, a time when my world encompassed a dying newborn in Sudan, as well as the air conditioned padded seats [End Page 121] of our affluent suburban church.") They produce the distinctive experiences of helplessness and pain felt by clinicians who cannot separate how they would be able to treat such a patient at home from how they have to practice in these settings. For those clinicians working in their own societies, scarcity of resources often produces deep anger at the corrupt governments that fail to support basic human services for the great majority of their population. ("We were temporary actors performing in the cynical play of scarcity on permanent display in Port-au-Prince," writes Haitian physician Paul Pierre about his experience prior to joining Partners in Health.)But for those who regularly travel back and forth across the divide between rich and poor, whether across national boundaries or within their own society, the challenge to live a moral life is unendingly complicated. While becoming a part of a struggle for global justice with colleagues and advocates from both sides of the divide, few of the narrators can avoid personal feelings of ambivalence and guilt at being able to easily move from one side of that divide to the other back home. Many fantasize about giving up their lives in the north to devote themselves... (shrink)

This chapter studies the role of the will in Emil Kraepelin's writings. Kraeplin was a German neuropsychiatrist during the nineteenth and early twentieth century, and his reflections on German society are used as a basis for examining various issues in this chapter. The chapter also briefly reports a survey of the place of the will and pathologies of the will in Kraepelin's psychology and reflections on political and social issues in Germany after the First World War.

This paper serves both as a discussion of Henry’s (Ethical Theory Moral Practice, 5:255–270, 2002) interpretation of Aristotle on the possibility of akrasia – knowing something is wrong and doing it anyway – and an indication of the importance of desire in Aristotle’s account of moral reasoning. As I will explain, Henry’s interpretation is advantageous for the reason that it makes clear how Aristotle could have made good sense of genuine akrasia, a phenomenon that we seem to observe in (...) the real world, while maintaining non-trivial distinctions between temperance (sôphrosunê), self-indulgence (akolasia), self-control (enkrateia) and akrasia. There are, however, some interpretive challenges that follow from Henry’s account and this paper is intended to explain and resolve those. (shrink)

The term “individuarian” describes a person who seeks leadership in service of his community—he is neither blatantly self-interested nor blindly communistic, but seeks to contribute positively to society. In _Individuarian Observations, _William J. Byron reflects on this concept and the place of individuarians in both the Catholic Church and an American society in the midst of crises and transitions. Byron’s sharp insights propose an alternative ethical model based on engaged social participants who are committed to advancing the common (...) good in these difficult times. (shrink)

In the first part of this paper, I argue that the positions set out in traditional debates about abortion are focused on the status of the fetus to the extent that they ignore the value and meaning of pregnancy as something involving persons other than the fetus. -/- In the second part of the paper, I build on Hilde Lindemann’s ideas by arguing that recognition of the related activities of calling a fetus into personhood and creating an identity as a (...) parent allow us to make sense of a variety of reactions to pregnancy and pregnancy loss while recognizing that pregnancy can and does have meaning for many people in many cases. (shrink)

Aristotle refers to some animal kinds as μέγιστα γένη, or greatest kinds. The goal of this paper is to make clear the nature and significance of these kinds. I argue that Aristotle thinks of greatest kinds as the most general kinds within a specified domain. I then consider the fact that Aristotle’s discussion of animals’ reproductive parts and modes of reproduction in Generation of Animals is organized around divisions related to the cause of each of the features being explained. I (...) conclude that, while classification is an important goal in Aristotle’s biological treatises, it is of little significance that some of the kinds he identifies are referred to as greatest kinds. The important divisions are, for Aristotle, the divisions that best serve his goal of explaining the various features of animals and these divisions sometimes group together and sometimes cut across the commonly recognized, including the greatest, animal kinds. (shrink)

Our goal in this article is to explicate the way, and the extent to which, euthanasia can be voluntary from both the perspective of the patient and the perspective of the health care providers involved in the patient’s care. More significantly, we aim to challenge the way in which those engaged in ongoing philosophical debates regarding the morality of euthanasia draw distinctions between voluntary, involuntary, and nonvoluntary euthanasia on the grounds that drawing the distinctions in the traditional manner (1) fails (...) to reflect what is important from the patient’s perspective and (2) fails to reflect the significance of health care providers’ interests, including their autonomy and integrity. (shrink)

In response to the view that death is bad when it ruins our lives by interrupting what gives our lives meaning, my approach in this paper is to consider the meaning of life as something that ends at death. With this, I focus on the meaning of life rather than our vulnerability to the badness of death. Specifically, I consider two responses to the myth of Sisyphus—one from Albert Camus and one from Thomas Nagel—both of which take our lives to (...) be absurd. Ultimately, I argue for a form of what Camus calls philosophical suicide by embracing categorical desires and life-projects as meaningful even in the absence of proof. (shrink)

Aristotle refers to some animal kinds as μέγιστα γένη, or greatest kinds. The goal of this paper is to make clear the nature and significance of these kinds. I argue that Aristotle thinks of greatest kinds as the most general kinds within a specified domain. I then consider the fact that Aristotle’s discussion of animals’ reproductive parts and modes of reproduction in Generation of Animals is organized around divisions related to the cause of each of the features being explained. I (...) conclude that, while classification is an important goal in Aristotle’s biological treatises, it is of little significance that some of the kinds he identifies are referred to as greatest kinds. The important divisions are, for Aristotle, the divisions that best serve his goal of explaining the various features of animals and these divisions sometimes group together and sometimes cut across the commonly recognized, including the greatest, animal kinds. (shrink)

I argue that attempts to explain the badness of death as a deprivation to the person who dies fail to defeat the ancient Epicurean argument that death is bad for us even. At the same time, I argue that the deprivation account of the badness of death provides a way for us to understand how death can be bad for the person who dies. In support of this paradoxical thesis I invoke a distinction between momentary well-being and narrative well-being—a distinction (...) which, while not entirely new, is insufficiently developed in the literature. (shrink)

Internal Rhetorics: Toward a History and Theory of Self-Persuasion is a fitting title for Jean Nienkamp’s book. “Internal Rhetorics” appropriately labels the subject of the study being investigated. The term “internal rhetoric” can be seen as being—as Nienkamp observes—both “obvious and paradoxical”. It is obvious in that it is used in reference to the study of persuasive techniques we use on ourselves. It seems paradoxical, however, to those in the Western tradition who follow Plato in distinguishing the art of rhetoric (...) from the art of philosophy or thought. The study of internal rhetoric is thought by Nienkamp to be a study of mental activity—that of both clarification and of deliberation. As the study is developed, Nienkamp argues that mental activity consists of a number of voices interacting in an attempt to persuade the mind of their influence. This interaction is “internal” in the sense that it happens within the “scene” contributed by the body. (shrink)

Reasons and the Fear of Death is about reasons for acting. As the title suggests, Ewin concentrates specifically on the way in which the fear of death makes certain facts reasons for acting. The book is divided into seven chapters. The first is an introduction.

It has been proposed that performance in the think – no think task represents a laboratory analogue of the voluntary form of memory repression. The central prediction of this repression hypothesis is that performance in the TNT task will be influenced by emotional characteristics of the material to be remembered. This prediction was tested in two experiments by asking participants to learn paired associates in which the first item was either emotionally positive or emotionally negative . The second word was (...) always emotionally neutral . Consistent with the repression hypothesis, significant memory suppression was observed in both experiments following ‘no think’ instructions for memories associated with emotionally negative material. No suppression was observed for memories associated with emotionally positive information. Implications of these findings for the relationship between performance in the TNT task and the controversial notion of memory repression are considered. (shrink)

Existing accounts of meaning in reproductive contexts, especially those put forward in debates concerning abortion, tend to focus on the (moral) status of the fetus. This issue on miscarriage, pregnancy loss, and fetal death accomplishes a shift this conversation, in the direction of pushing past embryo-centric value judgments. To put it bluntly, the miscarried embryo is not the one who has to live with the experience. The essays in this special issue are a significant addition to the scarce literature on (...) miscarriage and fetal death. Contributions are from specialists in continental and analytical philosophy, feminism, bioethics, theoretical and applied ethics, social and political philosophy, social epistemology and philosophy of language, narrative, aesthetics, popular culture, and gender studies. As guest editors, we sought to offer a variety of approaches to the topic, to further the understanding of miscarriage and fetal death as important to many areas of philosophy, especially social philosophy. We suggest that the unchosenness and invisibility of miscarriage are central to its seeming irrelevance to social identities and social norms of testimony, recognition, and ascription of significance to experiences. (shrink)

The Alternative Model of Personality Disorders integrates several theoretical models of personality functioning, including interpersonal theory. The interpersonal circumplex dimensions of warmth and dominance can be conceptualized as traits similar to those in AMPD Criterion B, but interpersonal theory also offers dynamic hypotheses about how these variables that change from moment to moment, which help to operationalize some of the processes alluded to in AMPD Criterion A. In the psychotherapy literature, dynamic interpersonal behaviors are thought to be critical for identifying (...) therapeutic alliance ruptures, yet few studies have examined moment-to-moment interpersonal behaviors that are associated with alliance ruptures at an idiographic level. The current study examined the concurrent and cross-lagged relationships between interpersonal behaviors and alliance ruptures within each session in the famous Gloria films. Interpersonal behaviors as well as alliance ruptures were calculated at half minute intervals for each dyad. We identified distinct interpersonal patterns associated with alliance ruptures for each session: Gloria ’s warmth was positively related with withdrawal ruptures concurrently in the session with Carl Rogers; Gloria’s dominance and coldness were related with increased confrontation ruptures in the session with Fritz Perls concurrently, while her coldness was also predicted by confrontation ruptures at previous moments; lastly, both Gloria’s dominance and Albert Ellis’s submissiveness were positively related with withdrawal ruptures. These interpersonal patterns demonstrated the promise of using AMPD dimensions to conceptualize momentary interpersonal processes related to therapy ruptures, as well as the clinical importance of attuning to repetitive, dyad-specific interpersonal cues of ruptures within each session. (shrink)

This innovative volume is an extended intellectual conversation about the ways personal lives are being undone and remade today. Examining the ethnography of the modern subject, this preeminent group of scholars probes the continuity and diversity of modes of personhood across a range of Western and non-Western societies. Contributors consider what happens to individual subjectivity when stable or imagined environments such as nations and communities are transformed or displaced by free trade economics, terrorism, and war; how new information and medical (...) technologies reshape the relation one has to oneself; and which forms of subjectivity and life possibilities are produced against a world in pieces. The transdisciplinary conversation includes anthropologists, historians of science, psychologists, a literary critic, a philosopher, physicians, and an economist. The authors touch on how we think and write about contingency, human agency, and ethics today. (shrink)

To be in business is first to be. To do in business, is to enhance one's being and the being of others; it ought never result in the diminishment of either. This article invites philosophical reflection on the purpose of business.To be and do in business looks for an explanation that goes beyond the meaning of work. The meaning of work is a worthy philosophical inquiry; the meaning of business is a separate question. The purpose of business is relational. Business (...) is doing for others on condition of receipt of something of fair value in return. It deals essentially with exchanges. Persons in business relate to other persons whose needs, preferences, and desires are met, to some degree of satisfaction, by the product or service the business is organized to provide — at a price. To meet the need, preference or desire is the purpose of business. (shrink)

This study investigates specific behavioral perceptual differences of ethics between practitioners and students enrolled in sales classes. Respondents were asked to indicate their beliefs to issues related to ethics in sales. A highly significant difference was found between mean responses of students and sales personnel. Managers indicated a greater concern for ethical behavior and less attention to sales than did the students. Students indicated a strong desire for success regardless of ethical constraints violated.

Pregnancy-based employment discrimination has long been a topic of interest for gender inequality scholars and civil rights agencies. Prior work suggests that employer stereotypes and financial interests leave pregnant women vulnerable to being fired. We still know little, however, about women’s interpretations of their terminations and how employers justify such decisions in the face of arguably protective laws. This article provides much needed, in-depth analyses of such dynamics and a relational account of pregnancy-based employment discrimination claims. Elaborating on theoretical expositions (...) of power and research surrounding the patriarchal character of organizational life, we draw on unique quantitative and qualitative data from verified cases of pregnancy-based firing discrimination. Our analyses reveal a two-pronged legitimation process where employers symbolically vilified pregnant workers while simultaneously amplifying ostensibly meritocratic organizational procedures and concerns. Pregnancy discrimination plaintiffs attempted to counter employer arguments. Yet, their limited power within the organizational hierarchy along with the culturally resonant nature of employer logics—logics that seem gender-neutral but that reify gendered assumptions and prioritize business profit—place pregnant women at a considerable disadvantage. Without attending to such cultural and structural power imbalances and the relational processes that undergird them, pregnancy discrimination will remain a significant problem. (shrink)

Pessimism is, roughly, the view that life is not worth living. In chapter 46 of the second volume of The World as Will and Representation, Arthur Schopenhauer provides an oft-neglected argument for this view. The argument is that a life is worth living only if it does not contain any uncompensated evils; but since all our lives happen to contain such evils, none of them are worth living. The now standard interpretation of this argument (endorsed by Kuno Fischer and Christopher (...) Janaway) proceeds from the claim that the value—or rather valuelessness—of life’s goods makes compensation impossible. But this interpretation is neither philosophically attractive nor faithful to the text. In this paper, I develop and defend an alternative interpretation (suggested by Wilhelm Windelband and Mark Migotti) according to which it is instead the actual temporal arrangement of life’s goods and evils that makes compensation impossible. (shrink)