There has been increased interest in what the philosophical subdiscipline of phenomenology can contribute to medical humanities due to its dual emphases on practicality and its attempt to understand the experience of others, thus positioning it as a potentially helpful conceptual toolkit to guide clinical care. Using various figures from the phenomenological tradition, most prominently Martin Heidegger and Martin Buber, the authors illuminate relevant philosophical concepts, employ them in various examples, and provide three principles revolving around empathy, communication, and listening (...) to patients’ individual values to guide medical professionals who practice the art of medicine in cancer care settings. (shrink)

The American Recovery and Reinvestment Act of 2009 (ARRA) required healthcare providers in the United States to adopt and demonstrate meaningful use of electronic health records (EHRs) by January 1, 2014. In many ways, EHRs mark a notable improvement over paper medical records as they are more easily accessible and allow for electronic searching and sharing of medical history. However, as EHRs have become mandated by ARRA, many nurses now rely upon computers far more heavily during nurse–patient interactions, thereby decreasing (...) the level of direct interpersonal communication between the two. There is evidence that eye contact between nurses and patients positively affects patient satisfaction. Above and beyond the issue of patient satisfaction is the more basic ethical issue of respecting the patient as a person. The author argues that the templates used in electronic health systems have the possibility of eroding the respect for humanity that is the hallmark of nurse–patient relationships, as signalled by the American Nurses Association’s first principle in their Code of Ethics. Using concepts from philosophers Martin Heidegger and Emmanuel Levinas, the author provides guidance as to what an ethical interaction between nurse and patient should look like in an age of EHRs. (shrink)

Communication between medical professionals and patients is an important aspect of therapy and patient satisfaction. Common barriers that get in the way of effective communication in this sphere include: (1) gender, age, and cultural differences; (2) physical or psychological discomfort or pain; (3) medical literacy; and (4) distraction due to technological factors or simply being overworked. The author examines these communicative barriers from a philosophical lens and then utilizes Martin Heidegger’s phenomenology and hermeneutics to provide guidance for medical professional–patient interactions. (...) The phenomenological approach espoused emphasizes the particular, contextual nature of such interactions, and thus is opposed to abstract, theoretical principles. Heidegger’s hermeneutics provides a philosophical approach to communication that may guide the back-and-forth interpretation that should happen between medical professionals and patients to achieve effective communication. (shrink)

Western liberal intellectuals often find themselves in a precarious situation with regard to whether or not they should celebrate and endorse Friedrich Nietzsche as a philosopher who we should all unequivocally embrace into our Western philosophical canon. While his critique of the Western philosophical tradition and his own creative insights are unprecedented and immensely important, his blatant inegalitarianism and remarks against women are often too difficult to stomach. This paper attempts to introduce Western philosophers to Chuang Tzu, a Chinese thinker (...) who shares much of Nietzsche’s style and philosophy, but also espouses a thoroughgoing egalitarianism. It does so by comparing Nietzsche and Chuang Tzu in regard to their methods, style, and philosophical beliefs, with a particular emphasis on the naturalism and perspectivism found in each thinker’s philosophy. The hope is to provide Western liberal-minded intellectuals interested in Nietzsche and in equality with another perspective to bolster their thinking. (shrink)

Direct-to-consumer pharmaceutical advertising is pervasive in the United States. Beyond its effect on consumer behavior, DTCPA changes the relationship between individuals and physicians. The author provides a brief history of pharmaceutical advertising in the United States. The author then analyzes the current commonly used marketing techniques of pharmaceutical companies and argues that pharmaceutical companies are “irrational authorities” in Erich Fromm’s sense of the term since they seek to exploit persons. Using concepts from various philosophers from the Continental tradition, with a (...) particular emphasis on the work of Michel Foucault, the author analyzes the power relations involved in DTCPA and ultimately argues that DTCPA subtly undermines the contemporary paradigm of patient autonomy while simultaneously depending upon it by treating health consumers as “dividuals,” that is, as porous entities to be manipulated. (shrink)

Iris Marion Young’s classic paper on the phenomenology of pregnancy chronicles the alienating tendencies of technology-ridden maternal care, as the mother’s subjective knowledge of the pregnancy gets overridden by the objective knowledge provided by medical personnel and technological apparatuses. Following Fredrik Svenaeus, the authors argue that maternal care is not necessarily alienating by looking specifically at the proper attention paid by sonographers in maternal care when performing ultrasound examinations. Using Martin Heidegger’s philosophy as a theoretical lens, the authors argue that (...) sonographers who cultivate technical mastery, build patient rapport, explain the process and significance of the ultrasound, and understand the patient’s world are able to provide excellent patient care. The authors utilize Hans-Georg Gadamer’s hermeneutics to show how sonographers can frame the ultrasound in a way that acknowledges both the subjective knowledge of the mother and the objective data obtained by the sonographer through the use of technology. Ultimately, the authors argue that the common practice of framing the ultrasound as the chance to “meet the baby” is inappropriate, as it exacerbates the tendency to regard objective knowledge as the only legitimate knowledge in medical contexts. They recommend a more balanced approach that elicits a fusion of horizons between the patient’s subjective knowledge and the objective data that is obtained by the sonographer via the ultrasound, thus respecting and bolstering patient autonomy. (shrink)

This work is an attempt to provide the scaffolding of a viable environmental ethics using the later writings of Martin Heidegger.

Philosophy is commonly criticized for being too abstract and detached from practical spheres. Upon chronicling how philosophy has gained this reputation, the authors explore the philosophical fields of phenomenology and hermeneutics that have explicitly attempted to merge philosophy with everyday life contexts. In recent decades, phenomenology and hermeneutics have been applied to healthcare. In the realm of nursing, Patricia Benner's nursing theory is especially informed by phenomenology, which is briefly explored through her relationship with one of her mentors, the philosopher (...) Hubert Dreyfus. The authors then turn their attention to Hans-Georg Gadamer's philosophy in an attempt to mine concepts relevant to the practice of nursing. Gadamer juxtaposed the human sciences from the natural sciences and thought that both needed different approaches: whereas natural sciences are guided by episteme, that is, universal knowledge, human sciences are guided by phronesis, that is, practical wisdom. Gadamer's philosophy is especially helpful in understanding how to cultivate phronesis in nursing wherein a nurse relies upon one's clinical experience to masterfully navigate each unique patient relationship. Nurses must serve as authorities in the realm of healthcare but also be open to the authority of their patients, who ultimately choose their course of treatment in our contemporary era of patient autonomy. Gadamer's philosophy can help us understand why phronesis requires not only practice but also reflection on that practice to be appropriately cultivated. The authors apply this to the realm of nursing in showing how both practice—clinically and via simulation—and reflection—through journaling or dialogue—are necessary for phronesis to emerge. (shrink)

A book chapter in the volume Punk Rock and Philosophy: Research and Destroy on how punk rock can be interpreted through the lens of Friedrich Nietzsche's philosophy.

Since philosophy is a notoriously difficult subject, one may think that the concept of adding rigor to a philosophy course is misguided. Isn’t reading difficult texts by Immanuel Kant or Friedrich Nietzsche enough to categorize a class as academically rigorous? This question is based on the misguided assumption that academic rigor has only to do with course content. While course content is a component of academic rigor, other aspects such as higher-order thinking, as well as how an instructor designs and (...) grades assignments, contribute to the level of academic rigor in a course. The author provides several ways to increase the level of academic rigor in a philosophy course based upon Bloom’s Taxonomy using examples from an introductory ethics course and then provides recommendations as to how to grade to promote academic rigor. (shrink)

Anthropogenic climate change has become a hot button issue in the scientific, economic, political, and ethical sectors. While the science behind climate change is clear, responses in the economic and political realms have been unfulfilling. On the economic front, companies have marketed themselves as pioneers in the quest to go green while simultaneously engaging in environmentally destructive practices and on the political front, politicians have failed to make any significant global progress. I argue that climate change needs to be framed (...) as an ethical issue to make serious progress towards the path to a sustainable human civilization. In an effort to motivate the urgency needed to confront climate change, I argue that climate change seriously affects human beings living here and now, and if one cares about unnecessarily harming fellow innocent living human beings, then one should care about one’s own environmental impact related to climate change. Since this argument does not depend upon any specific philosophical, religious, or ethical tradition but applies regardless of one’s particular background, I hope to induce genuine concern among all human beings regarding this issue. (shrink)

When the question is posed as to when Chinese thought influenced Western philosophy, people often turn to the philosophy of the German rationalist Christian Wolff, whose 1721 speech on the virtues of Confucianism led to his academic indictment and eventual ousting from the University of Halle in 1723. In his speech, Wolff lauds the Chinese for attaining virtues by natural revelation rather than appealing to Christian revelation, which made their accomplishments all the more impressive in his eyes (Fuchs 2006). According (...) to Kanamori (1997), the audience of Wolff’s speech “criticized it as the product of atheistic thoughts because they thought that the speaker valued Chinese morality as highly as Christian morals, which were formulated by divine revelation” (p. 299). The worry, in other words, was that Wolff was corrupted by Chinese thought since the atheism of Confucianism may have influenced Wolff’s own views. Almost invariably, Gottfried Wilhelm von Leibniz’s name is involved in conversations that question the Chinese influence on Western philosophy, but it is typically tempered by the standard scholarly interpretation of the Leibniz-China connection, which is that Leibniz respected Chinese thought but was not influenced by it. I will argue against this standard scholarly interpretation by showing how Leibniz could have been influenced by Chinese thought. In particular, I propose that Leibniz’s conception of monads, which is something that we only see after his engagement with Chinese thought, may have been influenced by the Huayan Buddhist concept of li, which creeps into the Neo-Confucianism with which Leibniz had exposure. Should my argument be persuasive, this means that Chinese thought influenced the Western world sooner than has been previously believed. (shrink)

Although the Libertarian Party has gained traction as the third biggest political party in the United States, the philosophical grounding of the party, which is exemplified by Robert Nozick’s entitlement theory is inherently flawed. Libertarianism’s emphasis on a free market leads to gross inequalities since it has no regard for sacred rights other than one’s right to freedom from interference from the government beyond what is essential for societal functioning. I argue that Nozick’s entitlement theory leads to indirect injustice and (...) is therefore an unfitting philosophical theory, which means that the Libertarian Party’s platform is flawed. (shrink)

Humans face wide ranging and global challenges in the Anthropocene, the most prominent of which is anthropogenic climate change. One initial pivot towards sustainability, particularly in my home country of the United States, has been to rely heavily on technological innovation powered most obviously by engineers. Using the climate activist Greta Thunberg's speech at the 2018 United Nations Climate Change Conference as my inspiration, I try to show how some of the technology based solutions only entrench what I call the (...) “Bestance” mentality, that is, the fundamental stance or orientation toward the natural world in the Anthropocene wherein all entities show up as mere resources. Upon showing the various ways in which traditional ethical approaches and environmental philosophical approaches have proved unhelpful in navigating the challenges of the Anthropocene, I try to demonstrate and how a Heideggerian ecophenomenological approach can help us not only understand how the world appears to many of us in the Anthropocene, but also what a more graceful way of being might look like in Heidegger's concept of “dwelling.” Using specific examples of current technologies pervasively normalized in the United States, including hydraulic fracturing, horizontal drilling, desalination, and artificial nitrogen based fertilization, I use Heidegger's philosophical concepts to show how the land, sea, and air can show up as Bestand in the Anthropocene, that is, merely materials on hand to be manipulated in order to serve human interests. (shrink)

In recent decades, phenomenology has been utilized not only as a conceptual framework from which to understand medical encounters in healthcare settings, but also to guide medical professionals in providing care. In the realm of physical therapy, phenomenology has been touted as a philosophically-based avenue to aid in helping to understand what it means to be a patient. The works of Edmund Husserl and Martin Heidegger have been utilized as paths to approach phenomenologically-informed care in physical therapy. However, to our (...) knowledge, no significant connection has been made in regard to the work of Hans-Georg Gadamer’s phenomenology and hermeneutics in the realm of physical therapy. The authors aim to close that gap by showing the ways in which Gadamer’s philosophy can help physical therapists provide phenomenologically-informed patient care. They begin by outlining some of the touchpoints between phenomenology and healthcare and then introduce Gadamer as a figure who deserves attention in the question of how to apply phenomenology to healthcare settings. Upon analyzing Gadamer’s account of what it means to experience an altered body, they outline Gadamer’s understanding of tact, practical knowledge, and good sense in order to show how to understand at a conceptual level what it means to empathize with patients on the path to building therapeutic alliance, that is, a cooperative working relationship. They then look closely at Gadamer’s hermeneutics and particularly his comments on how to cultivate a fusion of horizons in order to attempt to help guide physical therapists in theoretically understanding how to empathize with their patients. Ultimately, they argue that physical therapists who practice phenomenologically-informed care, which they call “hermeneutical healing,” are positioned well to form strong working relationships with their patients. (shrink)

World peace was a common theoretical consideration among philosophers during Europe’s Enlightenment period. The first robust essay on peace was written by Charles Irénée Castel de Saint- Pierre, which sparked an intellectual debate among prominent philosophers like Jean- Jacques Rousseau and Jeremy Bentham, who offered their own treatises on the concept of peace. Perhaps the most influential of all such writings comes from Immanuel Kant, who argues that world peace is no “high- flown or exaggerated notion” but rather a natural (...) result of the rational progression of the human species. U.S. President Woodrow Wilson, the mastermind behind the formation of the League of Nations in 1920 that provided the scaffolding to today’s United Nations, read Kant’s philosophy while he was a student at the College of New Jersey (now Princeton University). Some have argued that it is no coincidence that the per-son responsible for embarking upon the first serious political pursuit of world peace on a global scale was familiar with Kant. Indeed, William Galston claims that “Woodrow Wilson’s Fourteen Points [for world peace] were a faithful transcription of both the letter and spirit of Kant’s Perpetual Peace.”3 Historical connections aside, the question remains as to whether Kant’s philosophy is a viable conception of peace in a contemporary context. Using the conceptual distinction of positive and negative peace provided by Johan Galtung, I argue that Kant’s philosophy does provide the scaffolding for a viable conception of peace. In particular, I provide particular examples as to what social rights must be included in a Kantian model of peace. (shrink)

Informed consent has become the most obvious instantiation of patient autonomy in contemporary medicine, though as a practice it does not encompass all spheres of medicine. While diagnostic radiological procedures carry some risk due to the use of radiation, there is no standardized practice of informed consent in the United States. The authors describe the ethical justification of informed consent, the legal background surrounding it, and a brief history of radiology and radiological protection. They ultimately argue that informed consent should (...) become a common practice in computed tomography given the risks involved due to radiation exposure, especially considering the overuse of this technology, since it respects patient autonomy. (shrink)

A book chapter for the volume Eco-Anxiety and Planetary Hope: Experiencing the Twin Disasters of COVID-19 and Climate Change using Nietzsche's philosophy and primarily based on archival research done by William A. B. Parkhurst.

Using Michel Foucault’s conception of pervasive power, the purpose of this chapter is to analyse the contemporary paradigm of online surveillance from a philosophical perspective by unpacking the power dynamics involved in online surveillance, ultimately arguing, with McKenzie Wark, that there is an asymmetry of power that puts individual persons at risk. I then turn to Martin Heidegger’s notion of Gelassenheit as a helpful way to think through what an intentional stance towards online surveillance might look like that does not (...) escape the paradigm but is at least conscious of its influence. Finally, I utilise Immanuel Kant’s ethics and political philosophy to provide recommendations as to the appropriate ethical relationships that should exist between individual persons, governments, and corporations, ultimately arguing that respect for personal autonomy – that is, the right to choose our lives in accordance with our interests – must be at the forefront of conversations regarding the ethics of online surveillance. (shrink)

There have been significant changes in the ways in which humans experience music from the time of the publication of Gadamer’s Truth and Method in 1960 until today. While music was formally listened to in “earthier” formats, whether that be through live concerts or huddled around vinyl record players, we now live in a digital age in which music is largely experienced through what we can refer to as more “liquidated” formats, such as music streaming services or smart speakers and (...) similar modalities in which the music is plugged into an easily accessible system whose very accessibility makes the music easily disposable. Using concepts from Gadamer’s hermeneutics, I think through what it means for music to be in these various formats. While certain modes of musical experience allow for the possibility of auditory Ereignis, that is, a musical event so full of meaning that it is capable of transforming one’s world, others more easily relegate the experience of music to episodic insignificance, that is, as lacking inner coherence. Ultimately, I argue that it matters how we experience music and in which contexts, since those very choices can render the musical elements of our lives as meaningful or meaningless. (shrink)

A philosophical interpretation of the Corleone moral code as represented in the first Godfather film through the lenses of Aristotle and Nietzsche.

Shan shui art is a traditional style of Chinese landscape painting that has had a lasting impact on Chinese culture. This paper attempts to view a masterpiece of this genre of art – the artwork entitled ›Hermit Dwelling in the Qingbian Mountains‹ by Wang Meng – from the perspective of Hans-Georg Gadamer’s philosophy of art in order to show how such an artwork can convey an ontological insight for those who experience it. Instead of viewing the artwork as simply an (...) aesthetically pleasing landscape and thereby relegating the experience to the realm of feeling as is common in modern Western approaches to art, I argue that the artwork is best understood as imparting meaning into our lives by opening up a new perspective on reality. Specifically, I show the Daoist principles and concepts that underlie shan shui art at work in Wang Meng’s masterpiece. The Gadamerian approach adopted provides an appropriate avenue to respect Wang Meng’s artwork and other paintings in the shan shui genre on their own terms for those embracing a contemporary Western aesthetic sensibility. (shrink)

This volume, the first to tackle Heidegger and music, features contributions from philosophers, musicians, educators, and musicologists from many countries throughout the world, utilizes Heidegger’s philosophy to shed light on the place of music in different contexts and fields of practice.

Humans face wide-ranging and global challenges in the Anthropocene, the most prominent of which is anthropogenic climate change. One initial pivot towards sustainability, particularly in my home country of the United States, has been to rely heavily on technological innovation powered most obviously by engineers. Using the climate activist Greta Thunberg ’ s speech at the 2018 United Nations Climate Change Conference as my inspiration, I try to show how some of the technology- based solutions only entrench what I call (...) the “ Bestance” mentality, that is, a fundamental stance or orientation toward the natural world in the Anthropocene wherein all entities show up as mere resources. Upon showing the various ways in which traditional ethical approaches and environmental philosophical approaches have proved unhelpful in navigating the challenges of the Anthropocene, I try to demonstrate how a Heideggerian ecophenomenological approach can help us not only understand how the world appears to many of us in the Anthropocene, but also what a more graceful way of being might look like in Heidegger ’ s concept of “ dwelling.” Using specific examples of current technologies pervasively normalized in the United States, including hydraulic fracturing, horizontal drilling, desalination, and artificial nitrogen-based fertilization, I use Heidegger ’ s philosophical concepts to show how the land, sea, and air can show up as Bestand in the Anthropocene, that is, mere materials on hand to be manipulated in order to serve human interests. Ithen utilize Heidegger ’ s notion of dwelling as a useful concept to guide a more graceful way of living in which we respect the way in which things unfold on their own terms using examples similarly embedded in the land, sea and air. (shrink)

In December of 1899, Sir John Scott Burdon-Sanderson delivered an address to the Middlesex Hospital Medical Society in London on the relation between science and medicine. Commenting specifically on the future of medicine in the upcoming century, he criticized the gap between scientific research in academic settings and the practice of medicine in the clinical setting. He ends by stating that “all depends on whether you accept the proposition I have submitted to you—namely, that the science of medicine, even more (...) than the art, holds the promise of the future” (Burdon-Sanderson 1900, 255). Burdon-Sanderson’s proposition was actualized in the United States through the Flexner Report of 1910, which helped to universalize what medical education would come to look like in the country: the emphasis was placed squarely on science, rather than art (Flexner 1910). While there are still gaps between clinical practice and scientific research, there is no doubt that modern medicine is scientific medicine. There is also no doubt that scientific medicine leads to better health outcomes (Duffin 2010).However, some have argued that the emphasis of medicine as a science has left the art of medicine behind, to the detriment of modern medicine. Thomas Duffy, for instance, an internist at the Yale School of Medicine, states that the aftermath of the Flexner Report “created an excellence in science that was not balanced by a comparable excellence in clinical caring” (2011,276). Indeed, at the onset of our current century, many called for a reinvestment in the art of medicine so as to balance the emphasis on science (The Commonwealth Fund 2002; Committee on the Roles of Academic Health Centers in the 21 st Century 2003; Association of American Medical Colleges 2004). The burgeoning field of medical humanities—that is, the interdisciplinary field dedicated to demonstrating “how the arts and humanities inform and 2elevate the work of healing” (Campo 2005)—is evidence that such calls have been heard. While we surely want to celebrate scientific medicine, there are certain areas of medical practice where the art of medicine is as important, if not more important , as the science of medicine. We argue that one of those areas is the sphere of cancer care in which health professionals are asked not only to treat patients with cancer, but also to help them navigate through what is oftentimes one of the scariest, most vulnerable, and suffering-ridden times of their lives. Using concepts from the phenomenological tradition, we aim to provide philosophical clarity to situations in the medical setting in which health professionals must treat the whole person, rather than simply the person’s body, in order to provide proper patient care, thus highlighting an element of the art of medicine. We end by providing three principles that we think can help guide phenomenologically-informed cancer care. (shrink)

Having sold more than 100 million records worldwide, KISS has come to be one of the best selling bands of all-time. From their over-the-top stage personas and theatrics to their eclectic merchandising endeavors that span from condoms to caskets, KISS has lived up to their famous tagline as “the hottest band in the world.” This chapter analyzes the band—and the brand—that is KISS through the lenses of the philosophies of Friedrich Nietzsche and Mikhail Bakhtin. KISS’s music can be properly understood (...) as an embodiment of what Nietzsche calls the Dionysian in The Birth of Tragedy. As opposed to the measured and calm restraint that is found in Apollonian music, Dionysian music praises the raw, instinctual and the libidinous aspects of life. Songs like “Shout it Out Loud” that embrace the party life and songs like “I Was Made For Lovin’ You” that celebrate sex are exemplars of the Dionysian. KISS, however, is much more than their music. KISS brings to life what Bakhtin refers to as carnival wherein ordinary social conventions are turned upside down and a freer, unrestricted, and playful world emerges that proclaims the joyful relativity of all order and structure. The KISS Kondom, which is marketed as a condom that offers “Love Gun Protection,” demonstrates the levity that often accompanies Bakhtinian carnival, as does the KISS Kasket, a coffin licensed by the band that dons the famous KISS logo and pictures of the band members in their iconic make-up. By manifesting carnival, KISS taps into what Bakhtin refers to as the latent sides of human nature that otherwise remain hidden and thereby teach us all to lighten up a bit. While most of us can’t “rock and roll all nite and party every day,” KISS reminds us that the sometimes sterile status quo needs to be loosened up every once in a while and swapped out for a more playful world. (shrink)

The current breakdown in the relationship between humans and the rest of the natural world is evident in the crisis of anthropogenic climate change. This critical situation has prompted intellectuals to think through a proper name for our contemporary era. Some opt for the “Anthropocene,” the era of humans, which highlights the uniquely human role in planetary destruction. Others prefer the “Capitalocene” to emphasize capitalism’s role in the crisis. Still others argue that our era is marked by an age of (...) information, which the author labels the “Pliroforicene” since pliroforia roughly means “information” in ancient Greek. Having discussed the pros and cons of these labels, the author discusses conscious rebellions against the Capitalocene and the Pliroforicene through the lenses of the work of sociologist Erik Olin Wright and philosopher Richard Polt. The author then argues that Martin Heidegger’s concept of Gelassenheit, which is defined as a comportment towards beings in which one is open to the ways in which they reveal themselves as they are rather than subsuming them into one’s own interests, may prove to play a crucial role in our contemporary era, regardless of what we call it since it allows us to respect the integrity of things. (shrink)

The events on January 6th should signal to us just how divided the United States is as a country and prompt us to think through some of the challenges we face—as well as what we can reasonably hope for in terms of restoring a belief in the most coveted ideals of American democracy as outlined in the Declaration of Independence, namely, the right to life, liberty, and the pursuit of happiness. Upon analyzing Trump’s rise to political power via the lenses (...) of Hannah Arendt’s concept of ideology and Louis Althusser’s notion of interpellation, I try to find hope through these dark times through looking at the increased momentum of the Black Lives Matter movement and the Youth Climate Movement, two social movements I interpret through the frame of Johan Galtung’s conception of positive peace, that is, as potential infrastructural social systems aligned with social justice that we should enact to promote human flourishing. (shrink)

Shan Shui art is a traditional style of Chinese landscape painting that has had a lasting impact on Chinese culture. This paper attempts to view a masterpiece of this genre of art – the artwork entitled ›Hermit Dwelling in the Qingbian Mountains‹ by Wang Meng – from the perspective of Hans-Georg Gadamer’s philosophy of art in order to show how such an artwork can convey an ontological insight for those who experience it. Instead of viewing the artwork as simply an (...) aesthetically pleasing landscape and thereby relegating the experience to the realm of feeling as is common in modern Western approaches to art, I argue that the artwork is best understood as imparting meaning into our lives by opening up a new perspective on reality. Specifically, I show the Daoist principles and concepts that underlie shan shui art at work in Wang Meng’s (c. 1308–1385) masterpiece. The Gadamerian approach adopted provides an appropriate avenue to respect Wang Meng’s artwork and other paintings in the shan shui genre on their own terms for those embracing a contemporary Western aesthetic sensibility. (shrink)

Magnetic resonance (MR) imaging has proven to be a highly effective medical imaging technique that produces detailed cross-sectional images of organs, tissues, and skeletal structures. Because of its versatility, MR imaging has been called “one of the most powerful diagnostic tools in contemporary clinical medicine.”1 MR imaging is advantageous because it does not rely on potentially harmful ionizing radiation used in other imaging techniques; however, the MR imaging scanner can cause considerable anxiety for individuals with claustrophobia, a fear of confined (...) spaces. The MR imaging scanner is designed as a large tube with a table in the middle. During examinations, the patient lies supine on the table, is slid into the scanner tube, and must remain still so that the MR imaging technologist can produce the precise images needed to facilitate an accurate diagnosis. Depending on the imaging required, the procedure can last from 20 to 50 minutes, which can be distressful for people with claustrophobia because the enclosed space might trigger anxiety-inducing feelings and thoughts. Using concepts from the philosophical tradition of phenomenology, this article attempts to describe what a patient experiences when they feel claustrophobic and to provide clinical strategies that MR technologists can use to navigate situations in which the scanner poses a risk of inducing a claustrophobia-related anxiety episode. (shrink)

Book Review of Kevin Aho's One Beat More: Existentialism and the Gift of Mortality (Polity, 2022).

Róisín Lally’s Sustainability in the Anthropocene provides a wealth of essays on the philosophical meanings and implications of renewable technologies, as well as glimpses of novel ways toward a sustainable future that integrate deeply meaningful ways of being for humans. The edited collection features some of the most reputable thinkers in the philosophy of technology, such as Don Ihde, Babette Babich, and Trish Glazebrook, as well as some newcomers with novel perspectives that need to be taken into consideration not only (...) for fellow philosophers, but for anyone interested in the future of our increasingly vulnerable planet. The book is divided into four parts: defining sustainability, exploring the relationship between sustainability and particular renewable technologies, investigating sustainability and design, and finally examining sustainability and ethics. The authors engage in applications of various philosophers from the Continental tradition, most prominently the work of Martin Heidegger. I provide a brief summary of the various sections and highlight key arguments while providing some commentary with an aim to keep the conversation going. (shrink)

Même si ce livre ne compte pas plus d’une centaine de pages, l’analyse qu’il offre de Heidegger et de sa relation à l’environnement s’avère plutôt exhaustive. Si Casey Rentmeester le fait débuter par une brève histoire du développement de la philosophie environnementale, précisant comment cette discipline a largement affaire à l’éthique appliquée et l’éthique normative, il y explique bientôt comment des philosophes tels que Naess, Thomson et Toadvine emploient aujourd’hui des méthodes non-traditionnelles — ecofeminism, ecophenomenology, deep ecology — (...) pour explorer des aspects négligés par le courant philosophique qui y domine. Avant de s’appuyer sur l’œuvre heideggérienne pour répondre aux questions peu examinées par cette tradition de pensée, l’A. décrit brièvement la manière dont certains des représentants de celle-ci — Siedel, Zimmerman et Foltz notamment — se servent de celle-là pour mieux saisir la position de l’homme dans la nature. À l’en croire, son but est double : utiliser d’abord la critique phénoménologique de la métaphysique établie par Heidegger pour montrer comment, au sein de cette dernière, notre compréhension de l’être a mené à une destruction de l’environnement, puis penser avec Heidegger pour chercher à ce problème une réponse post-métaphysique qu’il s’agirait d’esquisser si tant est qu’il y en ait une. Or, tel est le cas pour Casey Rentmeester, qui se tourne en définitive vers le taoïsme pour lui emprunter son image d’un environnement durable. (shrink)

In his excellent and stimulating paper1, Professor Rothblatt remarked “The irony of Newman’s perpetual reincarnation is that none of the structural or even conceptual features of the university as he knew and loved them has survived him, not even this university which may on an occasion such as this revere him as a spiritual ancestor.” [p. 1] What can one say to that remark except to admit its truth. However, that is not the only irony to be discovered. Despite the (...) ritual invocation of Newman at UCD conferrings and on special occasions such as this, he did not in fact found UCD. He did found the Catholic University of Ireland, or perhaps he didn’t, if Colin Barr’s thesis in his recent book is to be believed! Wherever the truth lies in this matter, I am happy to be able to announce that UCD now has at least one cast-iron connection with Newman in that the International Centre for Newman Studies, directed by Dr Teresa Iglesias, will be inaugurated on the 21st of this month in Newman House. (shrink)

It is axiomatic that the fuller and more integrated interpretation of scientific discoveries and data lies within the domain of the philosopher. This statement has all the more force when we come to deal with the problem of Life and its origins. In his book, Dr. Fothergill rightly takes for granted that eventually all life goes back to God for its origin, but his primary concern is the origin of life on the earth. Arguing that before we look for the (...) origin of life we must try to find out what life itself is, he examines the various theories of abiogenesis and points out that they all fail to find a real distinction between the living and the non-living. They all assume that fundamentally a living organism is nothing more than a complex physicochemical system in equilibrium. The proponents of these theories while readily admitting the enormous complexity of the organic molecules that take part in biological reactions, yet with incredible naiveté postulate that these have evolved from simpler peptides which in turn have been synthetised from simple inorganic molecules like carbon dioxide and ammonia in the primaeval oceans. While even fairly complex polypeptides have been built up in vitro, their synthesis from a mixture of inorganic chemicals has never been observed. (shrink)

Dr Casey argues that the classical virtues of courage, temperance, practical wisdom and justice, which are largely ignored in modern moral philosophy, centrally define the good for Man. Success, pride and worldliness remain part of our moral thinking. The conflict between these values leads to contradictions in our understanding of the moral life.

When someone says she believes that God exists, is she expressing the same kind of mental state as when she says she thinks that a lake bigger than Lake Michigan exists⎯i.e., does she refer to the same kind of cognitive attitude in both cases? Using evidence from linguistic corpora (Study 1) and behavioral experiments (Studies 2-4), the current work provides evidence that individuals typically use the word “believe” more in conjunction with statements about religious credences and “think” more in conjunction (...) with factual statements, pointing to two different understandings of claims made with these two terms. These patterns do not appear to reflect low-level differences based on the amount of consensus surrounding a particular claim, the extent to which the truth of a particular claim is known to the participant, or linguistic differences between religious and factual statements. We discuss implications of these findings for religious cognition (e.g., as supporting the theory that religious credences are qualitatively distinct from factual beliefs) as well as cognitive processes more broadly. Finally, we relate the present findings to prior theoretical work on differences between factual belief and religious credence. (shrink)

In 1992, the United States Supreme Court, in Planned Parenthood of Southeastern Pennsylvania v. Casey, upheld the ruling in Roe v. Wade, namely that women have a right “to choose to have an abortion before viability and to obtain it without undue interference from the State.”1 However, since this ruling, some states have imposed regulations that greatly limit this right by restricting access. Texas is a recent example of this. Two proposed restrictions in House Bill 2, which will be (...) discussed in detail below, will force all but eight clinics that are located in metropolitan areas to shut down. The U.S. Supreme Court put the proposed restrictions on hold in October 2014, allowing several clinics to remain open while the restrictions are being appealed in the U.S. Court of Appeals for the Fifth Circuit. If the restrictions are passed, however, those clinics will be forced to shut down and, as a result, many women in Texas will be required to travel more than 100 miles in order to access a safe and legal abortion. Much of the focus of these restrictions has been on women and rightly so. However, I want to turn the attention to physicians. The requirements exacerbate unfair treatment of abortion providers compared with other physicians. Abortion providers face threats from the public—some of which turn into violent attacks—and they are often ostracized by their fellow medical practitioners. There are so few abortion providers to begin with and the proposed requirements limit these physicians’ opportunities to practice the branch of medicine of their choosing. Although the HB 2 requirements may not result in an unconstitutional undue burden on physicians, the challenges created by the bill limit physicians’ abilities to provide abortions. As a result of these limits, HB 2 creates an unconstitutional undue burden for women seeking abortions by creating barriers directed at abortion providers and clinic staff who are willing and able to provide abortions. The first of the two controversial HB 2 requirements is the admitting privileges requirement: “A physician performing or inducing an abortion must, on the date the abortion is performed or induced, have active admitting privileges at a hospital that is located not further than 30 miles from the location at which the abortion is performed or induced.”2 The second requirement is the ambulatory surgical center requirement: “The minimum standards for an abortion facility must be equivalent to the minimum standards adopted under [Texas Health & Safety Code] [...] for ambulatory surgical centres.”3 In order to meet these state-mandated obligations, some abortion clinics would have to spend more than $1 million in upgrades if they wish to remain open. The District Court decided that the ambulatory surgical center requirement places an unconstitutional undue burden on women, and that the two requirements together place an undue burden on women in Texas and especially in the Rio Grande Valley where the nearest clinic is a couple hundred miles away.4 Later, the U.S. Court of Appeals for the Fifth Circuit reversed the District Court’s decision and argued, “the admitting privileges requirement is constitutional on its face.”5 While the regulations are being appealed, the Supreme Court granted a stay of injunction, allowing about twelve abortion clinics to reopen until a final decision regarding the regulations is made. The District Court ruled that the purpose of the two regulations was to create a substantial obstacle for women seeking abortions in Texas. While the defendants argued that the regulations were designed to make abortions safer and reduce risk, the Court decided that this was not the case. An abortion, especially a first-term abortion, is a very safe procedure and is safer than many other routine surgical procedures. As stated in Planned Parenthood v. Casey, “Unnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on the right.”6 The undue burden in this case is imposed, not through restricting women’s access directly, but by restricting physicians’ freedom to perform abortions. The admitting privileges requirement has reduced the number of physicians who can perform abortions and the ambulatory surgical center requirement has reduced the number of clinics where abortions can be performed. The American Medical Association states, “[t]he Principles of Medical Ethics of the AMA do not prohibit a physician from performing an abortion in accordance with good medical practice and under circumstances that do not violate the law.”7 This means that physicians are not required to perform abortions, except in emergency situations, but can as long as the procedure is done safely and does not violate the law. The new Texas regulations, however, are so restrictive that few abortion providers, limited to only four urban areas, can legally perform abortions. Physicians do not have an absolute right to perform abortions as opposed to women who have an absolute right to have access to an abortion. Physicians do face many challenges that other professionals face in terms of obtaining qualifications and finding work. Abortion providers, however, face challenges that most other physicians do not. The restrictions imposed by these regulations exacerbate unfair treatment toward abortion providers and place further obstacles in their path in terms of providing the service they want and are qualified to provide. Both abortion clinics and abortion providers are being treated differently from other medical clinics and physicians. For instance, “grandfathering of existing facilities and the granting of waivers from specific requirements is prohibited for abortion providers, although other types of ambulatory surgical facilities are frequently granted waivers or are grandfathered.”8 Many abortion clinics cannot afford the necessary upgrades. Furthermore, it is extremely expensive to open a brand new clinic that complies with the ambulatory surgical center requirements. Being grandfathered in would be the only option available to abortion clinics that cannot afford the upgrade. However, unfair treatment of abortion clinics and providers is preventing those clinics from being grandfathered into the new system. As a result, many abortion clinics may be forced to close. Admitting privileges are proving difficult or impossible for physicians both to obtain and, for those who have already been granted privileges, to keep. Dr. Sherwood Lynn, an obstetrician-gynecologist who has performed abortions for decades, describes the process of obtaining admitting privileges and the difficulties abortion providers face. After sending in an application a physician must wait for the hospital to send them the required materials, “but if the address of the practice on the application is of an abortion provider or clinic, [the hospital] won’t send [them] the package of materials required. [They] simply can’t apply.”9 Dr. Lynn and several other physicians have surmised that hospitals are only withholding privileges from qualified physicians who perform abortions and that other physicians do not face this discriminatory treatment. Hospitals have also revoked privileges granted to physicians after learning that the physicians perform abortions. For instance, in Texas two doctors, “received notices [...] informing them that their admitting privileges to the University General Hospital of Dallas have been revoked, with the hospital’s CEO claiming the hospital was unaware they were providing abortion care and that the hospital believed such care would damage its reputation.”10 What is curious about this revocation is that, “federal and state laws [...] forbid hospitals from discriminating against doctors who perform abortions,” and yet hospitals are clearly doing just that.11 Dr. Pamela Richter, another abortion provider in Texas, had her temporary admitting privileges revoked with no explanation and because of this, the clinic where she performed abortions, Reproductive Services, can no longer provide abortions at all.12 As the hospital gave no reason for the revocation, it not clear Dr. Richter’s privileges were revoked because she performs abortions. Dr. Richter, however, has performed over 17,000 abortions and her privileges were revoked soon after HB 2 was introduced.13 According to the Texas Hospital Association, giving admitting privileges to doctors who do not work for the hospital is expensive and time-consuming but this does not account for the fact that hospitals are revoking previously granted privileges from physicians whom they learn are providing abortion services.14 As mentioned previously, the District Court found that the admitting privileges requirement and the ambulatory surgical center requirement do not further ensure the health and safety of women undergoing an abortion. Several physicians have testified to this fact. Dr. Lynn stated in an interview: The admitting privileges requirements are [...] absolutely unnecessary. If you have a number of patients waiting for procedures, and something happens and a patient needs to be transferred to a hospital, you’re not going to leave everyone else and go to the hospital. That makes no sense. You’re going to refer that person to a gynecologist at the hospital. There is no safety issue involved here. If a patient shows up with an emergency, every hospital is required to admit that patient. They have to by law.15 It is rare that complications will arise from an abortion performed in a clinic. Dr. Richter, for example, has performed more than 17,000 abortions and not once had to send a patient to a hospital because of complications resulting from the procedure. According to Dr. Lynn even if abortion providers were granted privileges to hospitals, it is unlikely that they will exercise them. In essence, having admitting privileges at a hospital does nothing to further ensure the safety of an already safe procedure. The only result of the admitting privileges requirement is to limit certain physicians’ ability to perform legal abortions. Not only do the HB 2 requirements fail to further ensure the health and safety of women, the HB 2 requirements may actually create more health risks to women who cannot access the eight remaining clinics. The first risk is that the remaining clinics would have an influx of patients that they may not be able to handle, forcing women to wait longer for an appointment. As stated by the District Court, “[e]ven assuming every woman in Texas who wants an abortion [...] could travel to one of the four metropolitan areas where abortions will still be available, the cumulative results of HB 2 are that, at most, eight providers would have to handle the abortion demand of the entire state.”16 Furthermore, “[t]hat the State suggests that these seven or eight providers could meet the demand of the entire state stretches credulity.”17 Abortion is a time sensitive procedure. It is safest when performed early in a pregnancy. The increase in patients to these remaining clinics, assuming all women in Texas can access them, will increase wait times and may force women to have abortions later in pregnancy. In the worst-case scenario, a woman would not see an abortion provider at all before viability. Such instances may be rare, but they are possible. In such cases, women’s access to legal abortions becomes impossible and thereby violate the ruling in Roe. Clinics may be able to avoid the aforementioned problems if they hire more physicians. However, there are two barriers to hiring more physicians. First, as mentioned previously, admitting privileges to Texas hospitals are difficult, if not impossible, for abortion providers to obtain. Second, given the negative treatment of abortion providers by anti-abortion groups, many physicians are not willing to perform abortions. The harassment abortion providers face is unique to those physicians and many physicians will not perform abortions for that reason. In an article published in the Austin Chronicle, anti- abortion activist Abby Johnson, “discusses how her group investigated appraisal district records to find the new location of where an Austin abortion physician plans to work.”18 Johnson states, “These abortionists are feeling the pressure from the pro-life movement in Texas. I think they feel like they’re on the run. And that’s how we want to keep it.”19 If the HB 2 requirements are passed and there remain at most eight abortion providers in Texas, these activists will concentrate on those clinics and, “the dangerous impact of their intimidation tactics will be exacerbated.”20 Even if the number of physicians needed to meet the demand in Texas can obtain admitting privileges and work at one of the remaining clinics, they may choose not to do such work because they are putting themselves at risk. The harm abortion providers face from such anti-abortion groups is not unique to Texas. There are stories from all over the country and from other countries where abortion is legal of physicians receiving death threats. Dr. George Tiller, an abortion provider in Kansas, was killed outside his church and had received numerous death threats prior to this. The HB 2 requirements are making it so that abortion providers either cannot provide their services any longer or will face increased threats and increased danger to themselves. Physicians are allowed to conscientiously object to providing medical interventions in certain circumstances for moral and religious reasons. However, there are limits on this right. According to the American Congress of Obstetricians and Gynecologists, “[w]hen conscientious refusals conflict with moral obligations that are central to the ethical practice of medicine, ethical care requires that the physician provide care despite reservations or that there be resources in place to allow the patient to gain access to care in the presence of conscientious refusal.”21 I would argue fear for one’s safety in the face of immediate threats is perhaps a stronger ground on which to refuse to provide care than a personal belief that abortion is immoral or against one’s religion. ACOG also states, “[p]roviders with moral or religious objections should either practice in proximity to individuals who do not share their views or ensure that referral processes are in place so that patients have access to the service that the physician does not wish to provide.”22 This responsibility has been largely disputed by the medical community but in cases of rape, incest, and health risks to women, referrals must be made without exception. However, under the requirements of HB 2, working in proximity to an abortion provider may not be possible because they are so geographically limited. Referrals are supposed to be made within reason. Some areas of Texas, such as the Rio Grande Valley, are up to 200 miles away from the nearest clinic that would remain open if HB 2 is passed. Referrals may simply not be feasible given the geographical distances and the decreasing number of available physicians. As mentioned above, there are two risks to the health and safety of women as a result of HB 2. The second of these is that if a woman cannot access one of the remaining clinics, she may seek out a more convenient but illegal and unsafe abortion, which is far more likely to result in a dangerous complication. Dr. Lynn states, “[b]ecause of the restrictions lawmakers impose, women will seek abortions illegally, and we’re going to see a rise in septic abortions.”23 Some areas of Texas might effectively revert back to a pre-Roe era where abortions were performed in unsanitary conditions by unqualified people resulting in dangerous medical complications far more often than legal abortion procedures do now. Physicians like Dr. Lynn who want to prevent this from happening generally cannot do so without facing legal sanction. Physicians have a duty to provide safe medical care and if they cannot obtain admitting privileges, they cannot exercise this duty. ACOG released a statement expressing their objections to the new requirements. They state that HB 2 is, “plainly intended to restrict the reproductive rights of women in Texas through a series of requirements that improperly regulate medical practice and interfere with the patient-physician relationship.”24 Executive Vice-President of ACOG, Hal C. Lawrence III stated: The Texas bills set a dangerous precedent of a legislature telling doctors how to practice medicine and how to care for individual patients. ACOG opposes legislative interference, and strongly believes that decisions about medical care must be based on scientific evidence and made by licensed medical professionals, not the state or federal government.25 Abortion is one of only a few areas of medicine where the legislature imposes so many regulations restricting particular physicians’ ability to practice medicine. Not only are abortions providers being regulated by the state, they are also facing clear discrimination from others within the medical community. The state is closing down clinics that do not meet the ambulatory surgical center requirements and hospitals are denying physicians admitting privileges because they perform abortions. In summary, abortion providers are being discriminated against both by the legislature and other members of the medical community. Other physicians who do not perform abortions are not denied admitting privileges on discriminatory grounds. Clinics that cannot afford upgrades to become an ambulatory surgical center are being grandfathered in, while abortion clinics are being forced to close down. Ob-Gyns who conscientiously object to performing abortions and who are not located in close proximity to at least one abortion provider cannot effectively fulfill their duty to refer patients. Lastly, given the barriers these regulations will create, there will likely be a rise in complications resulting from abortions provided under grossly unsafe conditions. Physicians, whose duty it is to provide safe and effective medical care, are being denied the right to exercise this duty. While this denial may not be unconstitutional, it is certainly unjust and discriminatory and creates obstacles that other physicians do not face. Most importantly, these obstacles are creating an undue burden for women. The HB 2 requirements do not increase the health and safety of abortions; all they do is create substantial obstacles for women. In light of these observations, the requirements seem to me to be in clear violation of Casey, in which it was decided that, “[u]nnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on that right.”26 These regulations do just what Casey was meant to prohibit and this is accomplished through limiting physicians’ ability to practice safe abortions across the state of Texas. Therefore, the HB 2 requirements may not impose an undue burden on doctors but they do impose an undue burden on women. PDF available: Rachel Hill, "Texas HB 2," Voices in Bioethics. References: 1 Planned Parenthood of Southeastern Pennsylvania v. Casey, pg. 2. 2 Whole Women’s Health v. Lakey, pg. 2. 3 Ibid. 4 Ibid., 4. 5 Ibid., 2. 6 Planned Parenthood v. Casey, pg. 16 7 AMA Code of Medical Ethics, “Opinion 2.01 – Abortion,” American Medical Association. 8 Whole Women’s Health v. Lakey, pg. 10. 9 Dr. Sherwood Lynn, “A Texas Ob-Gyn Details the Horrific Consequences of Abortion Restrictions,” Cosmopolitan. 10 Feminist Newswire, “Texas Hospitals Revoke Admitting Privileges to Abortion Providers,” Feminist Majority Foundation Blog. 11 Ibid. 12 Ibid. 13 Ibid. 14 Glenn Hegar, “Texas Hospital Association’s Statement of Opposition to Section 2 of the Committee Substitute for Senate Bill 5,” Texas Hospital Association. 15 Dr. Lynn, “A Texas Ob-Gyn.” 16 Whole Women’s Health v. Lakey, pg. 10. 17 Ibid. 18 Mary Tuma, “Undercover Audio Reveals Anti-Abortion Tactics: Anti-abortion activists monitor and track providers, patients,” Austin Chronicle. 19 Ibid. 20 Ibid. 21 Committee on Ethics, “The Limits of Conscientious Refusal in Reproductive Medicine,” The American Congress of Obstetricians and Gynecologists. 22 Ibid. 23 Dr. Lynn, “A Texas Ob-Gyn.” 24 “Ob-Gyns Denounce Texas Abortion Legislation: Senate Bill 1 and House Bill 2 Set Dangerous Precedent,” The American Congress of Obstetricians and Gynecologists. 25 Ibid. 26 Planned Parenthood v. Casey, pg. 16. (shrink)

Charging others with hypocrisy often acts as a way of rejecting the practical reasons they attempt to give (Herstein, 2017). There are some merits to a practice of rejecting reasons. To accept others’ provided reasons as valid is to affirm their authority in the relevant normative domain (Isserow and Klein, 2017). Conversely, to reject these reasons as invalid is to undermine the reason-givers’ authority in the domain. However, this practice can be rife with abuse—if we allow charges of ‘Hypocrite!’ to (...) take hold too broadly, we risk compromising the entire enterprise of reason-giving. I propose that one form of such abuse has already entered into our normative vocabulary with the concept of ‘hypocritical advice.’ At best, this term plays a superfluous role in our normative vocabulary; at worst, its vagueness perpetuates a vicious practice of reason-rejecting. Regardless of the severity of its impact on normative discourse, I will argue herein that we should do away with talk of ‘hypocritical advice.’ -/- I begin by echoing a standard distinction between second- and third-personal reasons and the corresponding types of authority that ground agents’ abilities to give reasons of each kind (sec. 2). After briefly discussing the connection between authority and hypocrisy (sec. 3), I argue that most purported cases of hypocritical advice-giving rest on a confusion between an utterance as communicating second- or third-personal reasons (sec. 4). Against recent suggestions that reasons given unambiguously as advice can be hypocritical, I demonstrate that the basis for rejecting third-personal reasons given in hypocritical advice is an interestingly different one than for rejecting second-personal reasons given through blame (sec. 5). I close with some final considerations against keeping ‘hypocritical advice’ in our normative vocabulary. (shrink)

The COVID‐19 pandemic exposes underlying inequalities in our socio‐economic and health systems, such as gender‐based violence (GBV). In emergencies, particularly ones that involve quarantine, GBV often increases. Policymakers must utilize community expertise, technology and existing global guidelines to disrupt these trends in the early stages of the COVID‐19 epidemic. Gender norms and roles relegating women to the realm of care work puts them on the frontlines in an epidemic, while often excluding them from developing the response. It is critical to (...) value women’s roles in society and include their voices in the decision‐making process to avoid unintended consequences and ensure a comprehensive response that caters to the needs of the most vulnerable groups. (shrink)

Wie muss ein ethischer Beratungsdienst strukturiert sein, damit er in moralischen Konfliktsituationen im klinischen Alltag angefragt wird und die Ratsuchenden ergebnisorientiert unterstützen kann? Nach welchen Kriterien lassen sich die Beratungsgespräche auswerten und bewerten? Zur Beantwortung dieser Fragen werden theoretisch fundierte Konzepte ethischer Fallbesprechung aus Nimwegen, Leuven und Basel herangezogen; dies geschieht vor dem Hintergrund der Erfahrungen mit der über zehnjährigen Entwicklung der ethischen Arbeit im Ev. Krankenhaus Bielefeld (EvKB). Als Resultat stellen wir einen strukturierten, multidisziplinären Ansatz vor, mit dem in (...) den Beratungsgesprächen die ethischen Dimensionen unterschiedlicher Vorstellungen herausgearbeitet und möglichst einvernehmlichen Lösungen zugeführt werden. Am Beispiel des EvKB lässt sich zeigen, dass der ethische Beratungsdienst auch in Zeiten knapper Ressourcen implementiert und praktiziert werden kann und eine Gesprächskultur schafft, die zu neuen Zielvariablen führt; hier spielen der Perspektivenwechsel und die Prozessgerechtigkeit eine zentrale Rolle und liefern zugleich Ansatzpunkte für unsere eigene Evaluationsstrategie. Zum aktuellen Stand der Evaluation klinischer Ethikberatung wird die internationale Literatur kritisch gewürdigt. Erste konzeptionelle Ansätze und Ergebnisse einer eigenen Evaluationsstrategie werden vorgestellt. Durch die Offenlegung hoffen wir, die Auseinandersetzung mit diesen Themen zu intensivieren. (shrink)

The inner ache: an experiential perspective on IonelinessThis paper examines the various theoretical approaches that have informed both the conceptualizations and the research approaches to investigations of loneliness. A focus on phenomenological and existential perspectives of loneliness can assist in an understanding of what is essentially a subjective distressing experience. The elderly, particularly those residing in nursing homes, are vulnerable to feelings of existential loneliness because following busy lives, often they are left without meaningful roles. Concomitant to this sense of (...) loss of meaning is an alteration in the perception of lived time. It is the purpose of this paper to stimulate research into what is a common but profoundly distressing experience. (shrink)

While research has consistently found that general distress and psychopathology are not predictive of sexual recidivism, examination of specific syndromes and their relationship to offending has revealed a potentially more complicated relationship. One proposed mechanism for the mixed findings with respect to major mental illness and sexual offending may be the confound of neurological injury. As identified in Mann et al. work on psychologically meaningful risk factors, mental illness represents an area in need of more study given the indirect influence (...) it may exert on risk. To this end, the current paper summarizes the study of the relationship between neurological injury, psychosis and problematic sexual behavior among two Canadian samples of forensic and civil psychiatric patients. In the first study we observed higher than expected rates of sexually-themed psychotic symptoms and problematic sexual behavior among a combined group of forensic and civil psychiatric patients. Indeed 70 percent of those individuals who engaged in PSB endorsed sexually-themed psychotic symptoms. While comorbidity is common amongst this group, brain injury appeared to represent a specific liability. Compared to those who did not engage in PSB, those who did were almost 4x more likely to have a documented history of brain injury. In the second study we sought to replicate this finding in a larger forensic sample of 1,240. However, the recorded rates of brain injury were significantly less, such that no relationship to PSB was observed. Based on the mixed findings to date, including our own data, questions remain about the nature of a potential shared vulnerability for psychosis and PSB previously postulated. Among psychiatrically complex individuals who engage in PSB, understanding etiology and links to risk are helpful, but perhaps more importantly is attention to the mechanisms through which symptoms confer risk and how best to treat and manage them. (shrink)