Thank God someone wrote this book. This reviewer has often wondered why there hasn't been more scholarship on the relationship between evolutionary theory, particularly Charles Darwin, and the early pragmatists. Since thinkers like John Dewey and Jane Addams often use the language of evolutionary theory in suggestive ways when discussing social-ethical matters, without explicating precisely where they hew to and depart from the theory itself, it's incumbent on their readers to articulate these relations. Eddy proves an excellent guide through the (...) diversity of evolutionary theory itself, and the diversity of responses to it, which serve as compelling intellectual groundwork for highlighting Dewey's and Addams's... (shrink)
To address the burden of maternal morbidity and mortality in low- and middle-income countries, research with pregnant women in these settings is increasingly common. Pregnant women in LMIC-context may experience vulnerability related to giving consent to participate in a clinical trial. To recognize possible layers of vulnerability this study aims to identify factors that influence the decision process towards clinical trial participation of pregnant women in an urban middle-income setting. This qualitative research used participant observation, in-depth interviews, and focus group (...) discussion with medical staff and pregnant women eligible for trial participation, at a regional hospital in Accra, Ghana. Besides lack of familiarity with modern scientific concepts, specific factors influencing the decision-making process were identified. These include a wide power difference between health provider and patient, and a different perception of risk through externalization of responsibility of risk management within a religious context as well as a context shaped by authority. Also, therapeutic misconception was observed. The combination of these factors ensued women to rely on the opinion of the medical professional, rather than being guided by their own motivation to participation. Although being a woman per se should not render the label of being vulnerable, this study shows there are factors that influence the decision process of pregnant woman towards trial participation in a LMIC context that can result in vulnerability. The identification of context-specific factors that can create vulnerability facilitates adaptation of the design and conduct of research in a culturally competent manner. (shrink)
The art of interpretation has traditionally been an integral part of medical practice, but little attention has been devoted to its theory. Hermeneutics or the study of interpretation has grown as a methodological interest primarily within the humanities. Borrowing from the medieval fourfold sense of scripture, which organizes interpretive activity both logically and comprehensively, I propose a hermeneutical model of clinical decision-making. According to the model, a patient is analogous to a literary text which may be interpreted on four levels: (...) (1) the literal facts of the patient's body and the literal story told by the patient, (2) the diagnostic meaning of the literal data, (3) the praxis (prognosis and therapeutic decisions) emanating from the diagnosis, and (4) the change effected by the clinical encounter in both the patient's and clinician's life-worlds. The model is illustrated through application to a medical case. (shrink)
Essays by Thomasma and ten Have recommend hermeneutical clinical ethics. The use Thomasma makes of hermeneutics is not radical enough because it leaves out basic interpretation of clinical practice and focuses narrowly on ethical principles and rules. Ten Have, while failing to notice that the hyperreality of clinical ethics is a feature of all language, rightly distinguishes four characteristic parameters of a thoroughgoing interpretive clinical ethics: experience, attitudes and emotions, community, and ambiguity. Suggestions are made for implementing hermeneutical ethics in (...) clinical teaching. (shrink)
Those most intimate with the works of H. Richard Niebuhr, who return to them time after time for theological and ethical sustenance, know that they exemplify a more interesting thinker than his brother, Reinhold. Of course, Reinhold was and remains the more public figure, read seriously in his time by politicians and theologians, celebrated by our current president, and enjoying renewed scholarly interest resulting in new editions of out-of-print works and a number of critical studies. Meanwhile, H. Richard continues to (...) exert decisive influence on American Protestant thought. Such diverse thinkers as Paul Ramsey, James Gustafson, Stanley Hauerwas, William Schweiker, Kathryn Tanner, Gordon Kaufman, Emilie Townes .. (shrink)
Placing politics in an ecological perspective that discerns an inextricable connection between human political agency and the forces of nonhuman nature would seem to be a difficult task. While we have grown accustomed to understanding our personal capacities for thought and action as well as the shape of our intimate relations as aspects of our natural inheritance, our political life and reflection remain rife with human exceptionalism. We understand animals to have rudimentary reasoning skills and physical capabilities incredible to us. (...) We also understand some animals gather in social groupings held together by mutual dependence for fulfilling affective needs. But it is difficult to imagine that animals have .. (shrink)
Il faut savoir gré à l'éditeur Gérard Monfort de poursuivre sa politique de traduction d'ouvrages étrangers d'histoire de l'art en publiant le livre de J.F. Hamburger, paru en 1997 aux Presses de l'Université de Californie, sous le titre Nuns as Artits. The Visual Culture of a Medieval Convent. L'objet de ce livre passionnant et novateur, dont il faut souligner également la qualité de la traduction, est un ensemble rare, découvert fortuitement par l'auteur, de dessins coloriés, ..