Medical discourse in the contemporary United States is rife with military metaphors. These metaphors have come under vigorous criticism over the last few decades but to no avail; the militaristic tendency has proven tenacious. This essay suggests that its tenacity stems, at least in part, from a dualistic understanding of medicine unaddressed by prior criticisms. For an alternative, this essay turns to Augustine of Hippo, balancing close readings of works that deal explicitly with medical themes—The Catholic Way of Life and (...) the Manichean Way of Life (De moribus) and The Nature of the Good (De natura boni)—with a constructive approach. By adapting Augustine's privative account of evil, we can understand disease as a condition of loss and treatment as a task of restoration. This reconfiguration shifts the focus of our interpretive discourses from malicious invaders to a fuller affirmation of the lived experiences of those who are ill. (shrink)

The model of atonement presented in Anselm of Canterbury's Cur Deus Homo has aroused a host of worries from theologians. The gist of their criticism is that Anselm inscribes redemptive violence into theology and thus encourages passive acquiescence to abusive power structures or even licenses the violence of abusers. Some suggest that the way forward would be to jettison Anselm's account and develop alternatives that are not liable to the same abuses. This paper argues that while alternatives may be desirable, (...) Cur Deus Homo looms so large in theological imaginations as to defy jettisoning. We should instead try to perform better readings. This paper presents a close reading of this text as a monastic meditation on mortality oriented less toward resolving a problem of systematic theology than drawing readers into a renewed experience of devotion to God. To do that, Anselm works to rewrite the meaning of human mortality, making it less about the necessity of losing one's life and more about the possibility of a gift of death. The ethical paradigm that emerges is far from a complete moral vision, but is still more alluring than the one about which Anselm's contemporary critics worry. (shrink)

The greatest philosopher of the twentieth century may not have been Wittgenstein, or Russell, or Quine (and he certainly wasn’t Heidegger), but he may have been a somewhat obscure and conservative Australian named David Stove (1927-94). If he wasn’t the greatest philosopher of the century, Stove was certainly the funniest and most dazzling defender of common sense to be numbered among the ranks of last century’s thinkers, better even—by far—than G. E. Moore and J. L. Austin. The twentieth century (...) was not a period in which philosophers distinguished themselves as essayists, or even as capable of writing interestingly on any subject outside their speciality (or even within it). Stove, though, was an essayist, polemicist, and wit of the highest order, rather like a super-intelligent H. L. Mencken. A heavyweight admirer was once led to write that “Reading Stove is like watching Fred Astaire dance. You don’t wish you were Fred Astaire, you are just glad to have been around to see him in action.”. (shrink)

Adaptive immunity is unique to the vertebrates, and the molecules involved (including immunoglobulins, T cell receptors and the major histocompatibility complex molecules) seem to have diversified very rapidly early in vertebrate history. Reconstruction of gene phylogenies has yielded insights into the evolutionary origin of a number of molecular systems, including the complement system and the major histocompatibility complex (MHC). These analyses have indicated that the C5 component of complement arose by gene duplication prior to the divergence of C3 and C4, (...) which suggests that the alternative complement pathway was the first to evolve. In the case of the MHC, phylogenetic analysis supports the hypothesis that MHC class II molecules evolved before class I molecules. The fact that the MHC‐linked proteasome components that specifically produce peptides for presentation by class I MHC appear to have originated before the separation of jawed and jawless vertebrates suggests that the MHC itself may have been present at this time. Immmune system gene families have evolved by gene duplication, interlocus recombination and (in some cases) positive Darwinian selection favoring diversity at the amino acid level. (shrink)

SummaryThe Gainj of highland Papua New Guinea do not use contraception but have a total fertility rate of only 4·3 live births per woman, one of the lowest ever recorded in a natural fertility setting. From an analysis of cross-sectional demographic and endocrinological data, the causes of low reproductive output have been identified in women of this population as: late menarche and marriage, a long interval between marriage and first birth, a high probability of widowhood at later reproductive ages, low (...) effective fecundability and prolonged lactational amenorrhoea. These are combined with near-universal marriage, a low prevalence of primary sterility and a pattern of onset of secondary sterility similar to that found in other populations. Of all the factors limiting fertility, by far the most important are those involved in birth spacing, especially lactational amenorrhoea. (shrink)

SummaryThe effects of infant suckling patterns on the post-partum resumption of ovulation and on birth-spacing are investigated among the Gainj of highland New Guinea. Based on hormonal evidence, the median duration of lactational anovulation is 20·4 months, accounting for about 75% of the median interval between live birth and next successful conception. Throughout lactation, suckling episodes are short and frequent, the interval changing slowly over time, from 24 minutes in newborns to 80 minutes in 3-year olds. Maternal serum prolactin concentrations (...) decline in parallel with the changes in suckling patterns, approaching the level observed in non-nursing women by about 24 months post-partum. A path analysis indicates that the interval between suckling episodes is the principal determinant of maternal prolactin concentration, with time since parturition affecting prolactin secretion only in so far as it affects suckling frequency. The extremely prolonged contraceptive effect of breast-feeding in this population thus appears to be due to a slow decline in suckling frequency with time since parturition and absence of a decline over time in hypothalamic–pituitary responsiveness to the suckling stimulus. (shrink)

First published in 1962, contains the William James Lectures delivered at Harvard University in 1955. It sets out Austin's conclusions in the field to which he directed his main efforts for at least the last ten years of his life. Starting from an exhaustive examination of his already well- known distinction of performative utterances from statements, Austin here finally abandons that distinction, replacing it by a more general theory of 'illocutionary forces' of utterances which has important bearings on (...) a wide variety of philosophical problems. (shrink)

BackgroundThe objective of this study was to evaluate the nature and extent of reproducible and transparent research practices in neurology publications.MethodsThe NLM catalog was used to identify MEDLINE-indexed neurology journals. A PubMed search of these journals was conducted to retrieve publications over a 5-year period from 2014 to 2018. A random sample of publications was extracted. Two authors conducted data extraction in a blinded, duplicate fashion using a pilot-tested Google form. This form prompted data extractors to determine whether publications provided (...) access to items such as study materials, raw data, analysis scripts, and protocols. In addition, we determined if the publication was included in a replication study or systematic review, was preregistered, had a conflict of interest declaration, specified funding sources, and was open access.ResultsOur search identified 223,932 publications meeting the inclusion criteria, from which 400 were randomly sampled. Only 389 articles were accessible, yielding 271 publications with empirical data for analysis. Our results indicate that 9.4% provided access to materials, 9.2% provided access to raw data, 0.7% provided access to the analysis scripts, 0.7% linked the protocol, and 3.7% were preregistered. A third of sampled publications lacked funding or conflict of interest statements. No publications from our sample were included in replication studies, but a fifth were cited in a systematic review or meta-analysis.ConclusionsCurrently, published neurology research does not consistently provide information needed for reproducibility. The implications of poor research reporting can both affect patient care and increase research waste. Collaborative intervention by authors, peer reviewers, journals, and funding sources is needed to mitigate this problem. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

McCoy and colleagues (2023) offer a reflective framework for data ethics and governance with several historical bioethics principles as a foundation. Their framework is one among a plethora of othe...

Humanitarian health care practitioners working outside familiar settings, and without familiar supports, encounter ethical challenges both familiar and distinct. The ethical guidance they rely upon ought to reflect this. Using data from empirical studies, we explore the strengths and weaknesses of two ethical models that could serve as resources for understanding ethical challenges in humanitarian health care: clinical ethics and public health ethics. The qualitative interviews demonstrate the degree to which traditional teaching and values of clinical health ethics seem insufficient (...) for addressing all the realities of health care practice during humanitarian missions. They equally suggest that greater good orientations of public health ethics can thwart the best intentions of health care professionals wanting to attend to the interests of individual patients. Even though neither is complete on its own for helping guide health professionals on field missions, taken together these models have much to offer. At the same time, the narratives of the humanitarian health care workers illustrate how some of the crucial differences between public health ethics and clinical ethics generate tensions in humanitarian health practice. We offer an analysis of some of the complexities this creates for humanitarian health care ethics, and consider ways of adjudicating between the two models. (shrink)

_The Foundations of Arithmetic_ is undoubtedly the best introduction to Frege's thought; it is here that Frege expounds the central notions of his philosophy, subjecting the views of his predecessors and contemporaries to devastating analysis. The book represents the first philosophically sound discussion of the concept of number in Western civilization. It profoundly influenced developments in the philosophy of mathematics and in general ontology.

Criticises G. E. Moore’s highly influential proposal that ascriptions of agent ability implying freedom of choice or action, what the agent could do, are analyzable as conditional statements regarding what the agent would do under certain circumstances. Austin objects against Moore that some uses of ‘if’ are non-conditional and goes on to examine the uses of these non-conditional cases. Moore’s proposal also lies at the heart of some compatibilist theories of free will and determinism. Austin argues determinism to (...) be a pseudo-problem, so long as it remains a notion that is not itself clear cut. (shrink)

Austin attacks the view that language is referential, based on the simplistic division of utterances into the ‘descriptive’ and ‘evaluative’, using his notion of performative utterances. Such utterances, in the appropriate circumstances, are neither descriptive nor evaluative, but count as actions, i.e., create the situation rather than describing or reporting on it. In saying ‘I promise to go’ one is making a promise, not stating that one is making it. A performative promise is not, and does not involve, the (...) statement that one is promising. It is an act of a distinctive sort, the very sort named by the performative verb. And, according to Austin, making explicit what one is doing is not describing what one is doing or stating that one is doing it. (shrink)

Business Ethics: A European Review, EarlyView.

Austin takes on the problem of other minds, of how to respond to the question ‘how do you know?’, if this question is raised with regard to the thoughts, feelings, sensations, minds of other creatures. This problem has traditionally been understood as the problem of justifying our belief in the existence of other minds. Austin argues that believing in other persons, in authority and testimony, is an essential part of the act of communicating, and as such is an (...) irreducible part of our experience. While we can state certain advantages of communicative performances, there is no justification for our doing them as such. (shrink)

Deals with the question of whether there is a use of ‘is true’ that is the primary or generic name for that which at bottom we are always saying ‘is true’. Austin discusses the views that truth is primarily a property of beliefs and of true statements. He goes on to argue that the word ‘true’ denotes the validity of an intended correspondence between a representation and what it represents, and dismantles confusions about the meaning of the words that (...) underlie such a view, such as ‘fact that’ and ‘corresponds’. (shrink)

Recently, shifting societal attitudes towards animals have resulted in an increasing challenge to the ‘social license’ to use animals in competitive sport. Against that background, this paper explores whether the use of animals in competitive sport is ever justifiable from the perspective of three commonly used ethical theories: deontology, utilitarianism and virtue ethics. In so doing, it recognises the importance of human understanding of animals as sentient beings. The author argues that when deontology, utilitarianism and virtue ethics are each used (...) to consider the question ‘Is the use of animals in sport ethically justifiable?’, only absolutist rights theory leads to a negative conclusion. Specified rights theory, utilitarianism and virtue ethics all allow for the human use of animals in sport. However, the author then goes onto argue that even if one does not accept an absolutist rights point of view and does believe that the use of animals in sport is generally ethically justifiable, that use should be limited by fulfilment of certain ‘qualifying constraints’: (a) minimisation of negative welfare effects and maximisation of positive welfare effects, to enable ‘good lives’ for animals (b) identification of and mitigation against avoidable, unnecessary risk and (c) compliance with governing body regulations and the law. (shrink)

On the meta-level, ‘A Plea for Excuses’, sometimes regarded as the manifesto of ordinary language philosophy, illustrates Austin’s method of approaching philosophical issues, by patiently analysing the subtleties of ordinary language, by example. On the object level, the key distinction with regard to human actions that appear to be worthy of blame, Austin holds to be between a justification, which denies that the performed action was wrong, and an excuse, which instead denies that the agent was responsible for (...) performing it. Austin gives careful attention to particular cases of exculpatory speech, including precise word order and varying emphasis, etymological studies, and the special function of adverbial qualifying phrases, and shows how legal precedents and abnormal psychology may also be helpful in understanding why some efforts to excuse fail. In the final analysis, excuses are properly seen as setting limits to the ascription of moral responsibility, by stating explicitly how they differ from the more usual cases. (shrink)

Taking Rom Harré's social constructionism as a focus we point to and discuss the issue of the a priori psychological subject in social constructionist theory. While Harré indicates that interacting, intending beings are necessary for conversation to occur, he assumes that the primary human reality is conversation and that psychological life emerges from this social domain. Nevertheless, we argue that a fundamental and agentive psychological subject is implicit to his constructionist works. Our critical analyses focus upon Harré's understandings of persons, (...) human development and human agency. Our intention is neither to suggest that this latent entity must be understood in a Cartesian sense nor is it to ask for an explicit accounting of an autonomous agent. Rather, our claim is simply that psychological subjectivity is reflexively entailed in Harré's human psychology. We suggest that this pertains more generally to social constructionist theory. (shrink)

Austin discusses the existence, origin, and resemblance of concepts, primarily by discussing the meaning of ‘concept’ and ‘universal’. He argues that, although sometimes it may not be harmful to talk about concepts, we neither understand the meaning of ‘concept’, nor the meaning of ‘acquiring and possessing concepts’, nor a view of concept resemblance as non-sensuous acquaintance or awareness, challenging philosophers who couch their theories in such terms to illuminating them first.