The Search for the Legacy of the USPHS Syphilis Study at Tuskegee is a collection of essays from experts in a variety of fields seeking to redefine the legacy of the infamous Tuskegee Syphilis Study. The essayists place the legacy of the study within the evolution of racial and ethnic relations in the United States. Contributors include two leading historians on the study, two former United States Surgeons General, and other prominent scholars from a wide range of fields.

As a result of in-house discussions stimulated by previous Gonzaga engineering ethics conferences, Coffman Engineers began the implementation of what is to be a company-wide ethics training program. While preparing a curriculum aimed at consulting engineers, we found very little guidance as to how to proceed with most available literature being oriented towards the academic environment. We consulted a number of resources that address the teaching of engineering ethics in higher education, but questioned their applicability for the Consulting Engineering environment. (...) This lack of guidance led us to informal research into the ethical knowledge and attitudes of both consulting engineers and engineering students. Some of our findings were unexpected, and suggest that a simpler approach to teaching ethics to working professionals might be preferred to that typically promoted in higher education. (shrink)

The volume documents, and makes an original contribution to, an astonishing period in twentieth-century philosophy—the progress of Arne Naess's ecophilosophy from its inception to the present. It includes Naess's most crucial polemics with leading thinkers, drawn from sources as diverse as scholarly articles, correspondence, TV interviews and unpublished exchanges. The book testifies to the skeptical and self-correcting aspects of Naess's vision, which has deepened and broadened to include third world and feminist perspectives. Philosophical Dialogues is an essential addition to the (...) literature on environmental philosophy. (shrink)

Este relato de experiência apresenta resultados da pesquisa sobre a Saúde em Santo Amaro: a partir dos saberes tradicionais das rezadeiras/benzedeiras que teve por objetivo analisar as práticas medicinais e espirituais com o sagrado. A pesquisa etnográfica foi realizada com as rezadeiras, dessa forma, estabelecendo fronteiras com os rituais de cura, fé e devoção, nos processos de aprendizagem, aos mais variados tipos de doenças, as rezas e as curas, sendo assim, realizadas por elas. As rezadeiras/benzedeiras são mulheres cujo valor histórico, (...) tornando-se as suas benzeduras símbolo de resistência humana, na sua prática sobre as benzeduras. Entretanto, vale fomentar na pesquisa, sobretudo, as suas práticas também estão relacionadas a conhecimentos católicos, indígena, africana, com seus “cânticos” e “rezas” religiosas, trazendo consigo o desejo da fé de resultar o seu trabalho por alcances estabelecidos nas suas práticas reverenciadas assim as pessoas que procuram por elas. O objeto é tentar caminhar ao longo da história, em conjunto com as práticas religiosas, percebendo as inúmeras implicações produzidas pela sociedade. O contexto etnográfico da pesquisa foi na cidade de Santo Amaro. Palavras-chave: Saúde, Benzedeira, Espiritualidade. (shrink)

Is there an alternative course to one which sets up hypotheses as to the nature of poetry and then proceeds to illustrate them? Happily, there is. Rather than beginning with the hypothesis we may begin with the fact, and let what may emerge. That is, rather than beginning with some notion of the nature of poetry, we may begin with individual poems and discover what we may of their nature or form. This procedure evidently involves four phases: examination of the (...) characteristics of individual poems, discovery, by comparison with other poems, of likenesses and differences, decision as to which of these likenesses and differences are relevant to poetic form, and the statement of form itself. Once we have discovered a given form, we shall be in a position to discuss the principles underlying the construction of such form, the various possibilities of such construction, and what constitutes excellence in a given form. Elder Olson, poet, critic, and Distinguished Service Professor in the department of English at the University of Chicago, is the author of six volumes of verse, including Collected Poems and Olson's Penny Arcade, and of numerous works of literary criticism. His previous contributions to Critical Inquiry are "The Poetic Process" and "On Value Judgments in the Arts" , the title essay on his most recent collection of criticism. Among the many awards which he has received are the Academy of American Poets award, the Longview Foundation award, the Emily Clark Balsh award and, for Olson's Penny Arcade, the Society of Midland Authors award. Both his poetry and his criticism are the subject of a book by Thomas E. Lucas. Part II of "A Conspectus of Poetry" will appear in the Winter 1977 issue of Critical Inquiry. (shrink)

Is there an alternative course to one which sets up hypotheses as to the nature of poetry and then proceeds to illustrate them? Happily, there is. Rather than beginning with the hypothesis we may begin with the fact, and let what may emerge. That is, rather than beginning with some notion of the nature of poetry, we may begin with individual poems and discover what we may of their nature or form. This procedure evidently involves four phases: examination of the (...) characteristics of individual poems, discovery, by comparison with other poems, of likenesses and differences, decision as to which of these likenesses and differences are relevant to poetic form, and the statement of form itself. Once we have discovered a given form, we shall be in a position to discuss the principles underlying the construction of such form, the various possibilities of such construction, and what constitutes excellence in a given form. Elder Olson, poet, critic, and Distinguished Service Professor in the department of English at the University of Chicago, is the author of six volumes of verse, including Collected Poems and Olson's Penny Arcade, and of numerous works of literary criticism. His previous contributions to Critical Inquiry are "The Poetic Process" and "On Value Judgments in the Arts", the title essay on his most recent collection of criticism. Among the many awards which he has received are the Academy of American Poets award, the Longview Foundation award, the Emily Clark Balsh award and, for Olson's Penny Arcade, the Society of Midland Authors award. Both his poetry and his criticism are the subject of a book by Thomas E. Lucas. Part II of "A Conspectus of Poetry" will appear in the Winter 1977 issue of Critical Inquiry. (shrink)

When we discuss the value of a work of art we are confronted immediately with two difficulties: the terms we use, and the peculiar character of art. No one, to my knowledge, has ever doubted that an artist produces a form of some kind, and that in any discussion of art as art that form must somehow be considered; but the terms we use generally have no reference to form. We miss the form in various ways We use terms that (...) are nonartistic—that is, terms that refer to something external to the work, as when we speak of the subject of a painting, of what was depicted rather than the depiction of it, though we know full well that what we respond to is not what was depicted but the depiction of it. "This is a play about Oedipus— what does that tell us of the diverse forms produced by Sophocles, Seneca, Dryden, Voltaire, Gide, Cocteau? Or again, we use terms which are analogical, for example, the "rhythm" of a painting; the difficulty with these is that they are ambiguous and also that, while they may relate to the work, they can designate it only insofar as there is similarity between it and the analogue. Again, we use terms which seem to designate a single form when in fact they refer to forms of the utmost heterogeneity, as when we speak of "the novel"; this usually arises out of the indiscriminate application of the term over some considerable span of history, so that the "historical slippage" of meaning is gradual and goes unnoticed. As the term broadens in meaning to include more and more heterogeneous forms, the essence of each is lost, and the term comes to apply only to accidental analogies between the forms. In the end very little can then be said, involving only the most abstract and general accidents of likeness. Henry James' The Art of Fiction, Percy Lubbock's The Craft of Fiction, and E.M. Forster's Aspects of the Novel illustrate this condition perfectly. The complaint that it is impossible to discuss tragedy because the term has been diversely employed and its proffered justification stem from this condition. The complaint and the justifications are both trivial, and the solution of the difficulty is simple. All that is necessary is to distinguish the different senses of the term by distinguishing the different things to which it is applied. Language is ambiguous, and we use it ambiguously; this in no way implies that the ambiguities cannot be cleared up. Finally, we may use terms which indeed have reference to the form of the work but place the part for the whole; that is, terms which are elements in its definition but do not constitute the complete definition. Thus we designate something, not through the form proper but through the device or method used, as in "drama," "sculpture," "etching," "collage," or through the means or medium, as in "charcoal sketch," "watercolor," "oil painting." The point is not that the object is not, say, a drama or a watercolor; of course it is. The point is rather that these terms do not as such refer to the form and refer to it completely. If in fact they stipulated form, all charcoal sketches would be alike in form, and all oil paintings, and all dramas. One consequence of speaking in such a fashion is that we are likely to confuse the method with the form and talk of, say, "the nature of drama" as though all drama were of the same "nature," whereas the dramatic method is used in a wide variety of forms; or to confuse the medium or means with the form and to assure that the work can have no properties beyond those of its medium, as though artists did not exist and all art were simply nature.Elder Olson, poet and critic, has received numerous awards for his verse . Among his many works are Tragedy and the Theory of Drama, and The Theory of Comedy. His contributions to Critical Inquiry are "The Poetic Process"" , Part 1 of a "Conspectus of Poetry", and Part 2 of a "Conspectus of Poetry". (shrink)

Modal conventionalism is the view that two crucial forms of sameness are mind-dependent. There is no phenomenon of sameness in kind, on this view, except in virtue of our conventions for individuating nature’s kinds; there is no phenomenon of numerical sameness across time, for an individual member of some natural kind, except in virtue of our conventions for individuating such members.1 Modal conventionalism has its realist opponents. These opponents have argued, following Kripke’s lead more than thirty years ago (Kripke 1972), (...) that the boundaries of at least many of nature’s kinds are carved out by nature itself, and not by our classifi catory practices (e.g., Millikan 2000: passim, e.g., pp. 25 and 72). But they have not generally argued, with anything approaching the same vigor, that modal conventionalism is wrong in its other main claim. They have not in general argued that the world-given connections among properties, that make those properties mind-independently be membership conditions for some natural kind, at the same time make those properties mind-independently be persistence conditions for the members of the kind—properties the departure of which constitutes a ceasing-to-exist for the object that formerly had them. On the contrary, opponents of modal conventionalism have.. (shrink)

James decides that the best price today on pork chops is at Supermarket S, then James makes driving motions for twenty minutes, then James’ car enters the parking lot at Supermarket S. Common sense supposes that the stages in this sequence may be causally connected, and that the pattern is commonplace: James’ belief (together with his desire for pork chops) causes bodily behavior, and the behavior causes a change in James’ whereabouts. Anyone committed to the idea that beliefs and desires (...) are states installed by evolution must, it seems, think something similar. For how can one see beliefs and desires as conferring selective advantage if not by supposing that, by causing bodily behavior in their subjects, they brought about changes in their subjects’ surroundings? Yet many, many philosophers currently think or worry that mental causation is illusory (see, e.g., Heil and Mele 1993, or Macdonald and Macdonald 1995). Any physical changes which a mental state appears to cause can be viewed as a complex event involving microparticles, and for any such complex event, many philosophers suppose, there will have been previous microphysical occurrences sufficient to cause it. Barring routine overdetermination of such complex events, the apparent causation of mental events seems to be excluded. Nor does it help to say that some salient segment of the previous microphysical event just is the mental event, differently described (Davidson 1970). For describing the previous events as microphysical seems to spotlight the very features in virtue of which they did their causal work; the mental features seem epiphenomenal (Yablo 1992b: pp. 425-36; Yablo 1992a). This paper argues that the complex physical events, which mental events seem excluded from causing, are not caused at all. For they are either accidents, in something like Aristotle’s sense (Sorabji 1980: pp. 3-25), or coincidences, in a sense which David Owens has recently sharpened (Owens 1992). (shrink)

To be a realist about modality, need one claim that more exists than just the various objects and properties that populate the world—e.g. worlds other than the actual one, or maximal consistent sets of propositions? Or does the existence of objects and properties by itself involve the obtaining of necessities (and possibilities) in re? The latter position is now unpopular but not unfamiliar. Aristotle held that objects have essences, and hence necessarily have certain properties. Recently it has been argued that (...) the identity of any property is tied to the natural laws in which it figures, which entails that the occurrence of properties involves the obtaining of nomological necessities ([24], pp. 206-33 and 234-60; [23]; cf. [25] and [6]). Somewhat less recently, Wittgenstein ([28], p. 168) worried that the reality of at least some properties—precise shades of colors being a prime example—involved the obtaining in re of certain impossibilities. This paper argues that Wittgenstein’s worries were right, and not just concerning some properties, but all properties whatever. That there are objects and properties in the world at all, then, amounts to there obtaining modal states of affairs. This argument supplements, rather than replaces, the others. The position on property incompatibility advanced here actually helps defend Aristotelian essentialism against epistemological objections, or so I have argued ([15]). And while this paper’s position on property incompatibility diverges from the idea that a property’s nomic profile is essential to it—more on this in the next section—it is at least compatible with the thought that the necessity involved in the laws of nature enters into ontology at the ground level. (shrink)

As a disabled activist, I much prefer Aristotle's concept of ‘eu zen’, or ‘living well’ to that of ‘well-being’. ‘Eu zen’ is part of Aristotle's treatise on ‘eudaimonia’, which Grayling describes as: ‘…. a strong and satisfying sense of well-being and well-doing, of flourishing as only a rational and feeling human individual can flourish when his life and relationships are good’ (emphasis added). Aristotle's concepts are preferable because they promote ‘well-being’ through familial, social and civic activity, whilst recognising that such (...) activity requires resources, both human and material. These concepts are akin to those advocated by disabled people within the ‘independent living movement’; i.e. that the individual's ‘choice’, ‘control’, ‘dignity’ and ‘freedom’, over their lives and lifestyles, are supported by an inclusive community. However, both sets of principles are now being undermined by neoliberal managerial social work practice, which not only deny basic human rights which underpin ‘eu zen’, but lead to fear and a sense of ‘commodification’ or de-personalisation among disabled recipients. Relevant examples will come from experience, both personal as well as that from other disabled people. (shrink)

More laws obtain in the world,it appears, than just those of microphysics –e.g. laws of genetics, perceptual psychology,economics. This paper assumes there indeedare laws in the special sciences, and notjust scrambled versions of microphysical laws. Yet the objects which obey them are composedwholly of microparticles. How can themicroparticles in such an object lawfully domore than what is required of them by the lawsof microphysics? Are there additional laws formicroparticles – which seems to violate closureof microphysics – or is the ``more'' (...) acoincidental outcome of microphysics itself? This paper argues that the appearance ofviolation is illusory, and the worry aboutcoincidence misleading. We cannot expect tounderstand the special sciences at the level ofthe microparticles. (shrink)

The dialogue is a common search for truth, because its aim is to gain insight into reality through the interplay of its participants. The dialogue form, i.e. an exchange of thought processes, reflects the structure of the human mind which is involved in an ongoing process of reflections and constructions. This process mirrors consciously and unconsciously the centrifugal and centripetal movements of the human body and of all organic matter. For these reasons, I argue that the praxis of dialogue represents (...) a truly human lifestyle, not limited to one specific worldview. Its form reveals implicitly various levels of meaning. (shrink)

It is widely supposed that, in Hilary Putnam’s phrase, there are no “ready-made objects” (Putnam 1982; cf. Putnam 1981, Ch. 3). Instead the objects we consider real are partly of our own making: we carve them out of the world (or out of experience). The usual reason for supposing this lies in the claim that there are available to us alternative ways of “dividing reality” into objects (to quote the title of Hirsch 1993), ways which would afford us every bit (...) as much practical and cognitive mastery as we now possess. Hence there is no warrant for supposing that the objects recognized by such alternative schemes are any less real than the objects we actually consider real—unless we are to appeal to a “God’s-eye perspective”, which virtually no one wants to do. The reasonable conclusion, many philosophers suppose, is that any system of objects exists only relative to a particular conceptual scheme or system of predicates. Our system of objects is, in this sense, partly of our own making. But this claim should not be heard as a reaffirmation of the idealism of Fichte or Husserl. It is more accurate to take it merely as a claim about sameness and difference among the objects of the world. It is the claim that sameness and difference, whether at the level of kinds or of individual objects, do not obtain mind-independently, but only relative to a conceptual scheme or predicate system (see, e.g., Putnam 1981, pp. 53-54). That is, whether two objects are of the same kind, and whether one and the same individual object now exists at such-and-such.. (shrink)

This is an interesting and useful book with essays by Lewis White Beck, Ernst Cassierer, Hermann Cohen, Richard Hönigswald, Hansgeorg Hoppe, Edmund Husserl, Ram Adhar Mall, Jeffrie G. Murphy, Alois Riehl, Wolfgang Stegmüller, Martha E. Williams. All thirteen essays or notes reprinted concern the relationship between Hume and Kant. Its publication follows the 200th anniversary of the appearance of the Kritik der reinen Vernunft. Common to both philosophers is the view that scientific knowledge depends on the knowledge of man. In (...) a long introduction the editor briefly recalls Hume's place in the history of philosophy. Turning to Kant he points out that Kant realized that if we take Hume's view of causality seriously, it cannot but lead to scepticism. Thus he felt obliged to look for a foundation of the sciences in the trans-subjective structure of the human mind. However, Kant never became an empiricist, but still subscribed to what Russell called a "pre-Humean rationalism." Nevertheless there is a convergence between both philosophers: Hume feels that one cannot go beyond the presence of percepts in one's own consciousness. Now Kant is equally convinced that our theoretical knowledge is limited to appearances. What lies beyond the appearances--das Ding an sich--cannot be reached. (shrink)

Reale points out that the good and the demiurgic intelligence are radically distinct, a conclusion denied by J. Seifert in the last paper of the book. Fourteen characteristics of the idea of the good are listed by T. A. Szlezák. It is obvious, he argues, that the theory of principles of Plato’s unwritten doctrines is not identical with what Republic 6 and 7 say about the good, but there is no real opposition. In the next paper, however, H. W. Ausland, (...) after a sober evaluation of the esoteric teachings, suspects that Reale and Szlezák succumb to a certain romanticism. According to L. Brisson, the good belongs to the sphere of being, even if it is not being ; it is not in every way beyond being. Plotinus was the first to place it above being. M. Erler shows what must be the attitude of the philosopher with regard to the information orally received by him. Although Plato did not want to define the good, he pointed out several of its characteristics. The good, M. Migliori notes, combines in itself beauty, proportion, and unity. The Philebus pursues the doctrine of the Republic and goes into the direction of the unwritten doctrines. The ultimate reality, however, is beyond our understanding. E. Cattanei attempts to explain how for Plato mathematics is a way of access to the knowledge of the good. R. Ferber, on the other hand, stresses that Plato nowhere directly says that the essence of the good is the one. Beauty, symmetry, and truth are not the good itself. According to C. Gill, Gadamer demystified the idea of the good, a view which shows some common ground with the position of analytical philosophy: the good is not a transcendent entity. M. Vegetti, however, upholds the transcendent character of the good as a cause of being. G. A. Press argues that over the past hundred years Plato was considered a dogmatic philosopher, and it was believed that the leading speaker in the dialogues states Plato’s own views, but the situation is far more complex. Plato wants us to acquire a vision rather than propositional knowledge. The idea of the good should not be accorded a special position. C. Rowe tries to demystify some current interpretations, whereas F. Ferrari insists on the causality of the good, and sees Plato’s teaching as the origin of the entire tradition of negative theology. Yet some texts give the impression that the good belongs to the ontological order. C. Porebski reminds us that problems of ethics are the starting point of what Plato says about the good in the Republic. According to F. Trabattoni, Aristotle’s description of Plato’s theory of principles is wrong and his philosophy differs fundamentally from Plato’s. The School of Tübingen is a prisoner of Aristotle’s interpretation. Plato’s reluctance to describe the good in detail may mark the beginning of a skeptic trend in the Academy. The Parmenides tells us, E. Berti says, that one has first to remove all hypotheses before a definition of the Good can be given. E. Moutsopoulos draws attention to some simplistic and wrong qualifications of Plato’s thought as related to idealism and mentions Kant and Hegel’s attitudes with regard to Platonism. J. F. Crosby points to a clear leaving behind of the Socratic “no one knowingly does wrong” in the Alcibiades 216b: as Plato explains in the Protagoras, one may live according to one’s lower appetite or follow the insight of the rational soul. G. Santos makes a strong stand in favor of the identity of goodness and reality. L. P. Gerson examines theories of Platos’s development: there is no evidence of a theory of the form of the good earlier than the Republic. Aristotle, J. Dudley writes, upheld an ethical ideal resembling that of Plato, substituting the contemplation of the unmoved mover for that of the idea of the good. In the last paper J. Seifert argues that Plato identified the demiurge and the good. (shrink)

It is not without a certain emotion that one opens this book devoted to the memory of a great scholar of medieval thought who worked and lived in the certainty that there cannot be a conflict between the Christian faith and science. In a significant essay, Benedict M. Ashley defends the idea of the philosophy of nature as continuous or identical with natural science. Ashley does allow, however, for so many divergences between philosophy of nature and natural science due to (...) later developments in science that this identification must be qualified. Steven E. Baldner points out some of the contradictions of Hartshorne's atomism: Hartshorne denies change and real causality. Anthony J. Celano recalls that Robert Kilwardby was very much aware that happiness as described by Aristotle is quite different from the beatitude promised by the Christian faith. The order of the divine entitative attributes in the Summa theologiae I, qq. 3-11 has baffled many a commentator. Lawrence Dewan connects it with some texts of Aristotle's Metaphysics. Jeremiah Hackett studies Roger Bacon's Moralis philosophia. Dealing with Luther's attitude toward St. Thomas, Denis R. Tanz accepts Erasmus's verdict that the weight given to Thomas in theology was an important factor in propelling Luther out of the Roman Catholic orbit. This opinion, however, confounds appearances with the real reason for leaving, namely, estrangement from several central positions of Catholic doctrine. It is a tribute to the Catholicity of Thomas that after 1519 Luther came to identify the Pope, the Church and all scholastic doctors with the Thomists and said that the Church had become the synagogue of the papists and the Thomists: Thomas had been made the arbiter of heresy. Mark F. Johnson stresses the sapiential character of the sacra doctrina. Mark D. Jordan wrestles with the question why Thomas wrote his Aristotelian commentaries. Arguing in the line of Owens's interpretation he reduces their importance with regard to Thomas's own positions. Jordan seems to think that Thomas's philosophy cannot be formulated without his theology, an explanation which is hardly satisfactory. Armand Maurer submits some reflections on St. Thomas's notion of presence. The question to what extent Albert the Great contributed to Aquinas's treatises of the morality of human acts and of natural law is examined by Ernest J. McCullough. Walter H. Principe points out how, according to Aquinas, food is assimilated into the veritas humanae naturae. Eric A. Reitan retraces Weisheipl's analysis of Aristotle's Physics and of St. Thomas' Commentary: the axiom, "whatever is moved, is moved by another" can be understood only within the context of the general science of nature. In his Liber de causis et processu universitatis Albert came to hold the same position as Thomas on the demonstrability of creation and of its beginning in time. Two final articles concern the difficulties underlying Aristotle's arguments in Physics 7 and 8, and Aquinas and Newton on causality: William Wallace connects Newton's universal gravitation with the axiom that nothing acts on itself. (shrink)

It is not without a certain emotion that one opens this book devoted to the memory of a great scholar of medieval thought who worked and lived in the certainty that there cannot be a conflict between the Christian faith and science. In a significant essay, Benedict M. Ashley defends the idea of the philosophy of nature as continuous or identical with natural science. Ashley does allow, however, for so many divergences between philosophy of nature and natural science due to (...) later developments in science that this identification must be qualified. Steven E. Baldner points out some of the contradictions of Hartshorne's atomism: Hartshorne denies change and real causality. Anthony J. Celano recalls that Robert Kilwardby was very much aware that happiness as described by Aristotle is quite different from the beatitude promised by the Christian faith. The order of the divine entitative attributes in the Summa theologiae I, qq. 3-11 has baffled many a commentator. Lawrence Dewan connects it with some texts of Aristotle's Metaphysics. Jeremiah Hackett studies Roger Bacon's Moralis philosophia. Dealing with Luther's attitude toward St. Thomas, Denis R. Tanz accepts Erasmus's verdict that the weight given to Thomas in theology was an important factor in propelling Luther out of the Roman Catholic orbit. This opinion, however, confounds appearances with the real reason for leaving, namely, estrangement from several central positions of Catholic doctrine. It is a tribute to the Catholicity of Thomas that after 1519 Luther came to identify the Pope, the Church and all scholastic doctors with the Thomists and said that the Church had become the synagogue of the papists and the Thomists: Thomas had been made the arbiter of heresy. Mark F. Johnson stresses the sapiential character of the sacra doctrina. Mark D. Jordan wrestles with the question why Thomas wrote his Aristotelian commentaries. Arguing in the line of Owens's interpretation he reduces their importance with regard to Thomas's own positions. Jordan seems to think that Thomas's philosophy cannot be formulated without his theology, an explanation which is hardly satisfactory. Armand Maurer submits some reflections on St. Thomas's notion of presence. The question to what extent Albert the Great contributed to Aquinas's treatises of the morality of human acts and of natural law is examined by Ernest J. McCullough. Walter H. Principe points out how, according to Aquinas, food is assimilated into the veritas humanae naturae. Eric A. Reitan retraces Weisheipl's analysis of Aristotle's Physics and of St. Thomas' Commentary: the axiom, "whatever is moved, is moved by another" can be understood only within the context of the general science of nature. In his Liber de causis et processu universitatis Albert came to hold the same position as Thomas on the demonstrability of creation and of its beginning in time. Two final articles concern the difficulties underlying Aristotle's arguments in Physics 7 and 8, and Aquinas and Newton on causality: William Wallace connects Newton's universal gravitation with the axiom that nothing acts on itself. (shrink)

It is always difficult to present a collection of essays, and this the more so if written by twenty-eight authors. However, this imposing and beautifully printed volume has been planned very carefully, so that the various contributions create a fairly complete study of Aquinas’s thought in the Second Part of the Summa theologica. The essays have approximately the same length and are accompanied by numerous scholarly endnotes. L. E. Boyle recalls that St. Thomas’s intention was to connect moral theology to (...) dogmatics, the Second Part being foremost in his mind. It did indeed capture the attention of the students of his order. S. Pinckaers gives a fine survey of the sources used by Thomas in the I-II and brings out the place of the auctoritates in theology. S. J. Pope presents a compact summary of the contents of the Second Part but does not consider its relation to the Commentary on the Nicomachean Ethics. (shrink)

This book is the most comprehensive treatment available of one of the most urgent - and yet in some respects most neglected - problems in bioethics: decision-making for incompetents. Part I develops a general theory for making treatment and care decisions for patients who are not competent to decide for themselves. It provides an in-depth analysis of competence, articulates and defends a coherent set of principles to specify suitable surrogate decisionmakers and to guide their choices, examines the value of advance (...) directives, and investigates the role that considerations of cost ought to play in decisions concerning incompetents. Part II applies this theoretical framework to the distinctive problems of three important classes of individuals, many of whom are incompetent: minors, the elderly and psychiatric patients. The authors' approach combines a probing analysis of fundamental issues in ethical theory with a sensitive awareness of the concrete realities of health care institutions and the highly personal and individual character of difficult practical problems. Its broad scope will appeal to health professionals, moral philosophers and lawyers alike. (shrink)

Research necessarily entails the close interrelation of concepts and arguments, including solutions to a range of meta-questions, whether acknowledged explicitly or not. Despite this, few detailed accounts currently exist that support researchers to develop their complex conceptual architectures, especially in critical realist spheres. Indeed, many published accounts often omit much of this ‘messiness’ that sits behind, yet is foundational to, research projects. Those accounts that do seek to portray how/why researchers have made decisions (e.g. about connections between research philosophy, methodology, (...) methods, theory and empirical evidence) tend to focus on one set of meta-questions, or occasionally on the relationships between two sets, at a time. Therefore, this paper presents a flexible framework – supported by specific examples from studies – that we hope will be useful in supporting researchers from all traditions, but especially critical realists, to carefully think through and develop more holistic connections in their conceptual architecture. (shrink)

Although parents are the default legal surrogate decision-makers for minor children in the U.S., shared decision making in a pluralistic society is often much more complicated, involving not just parents and pediatricians, but also grandparents, other relatives, and even community or religious elders. Parents may not only choose to involve others in their children’s healthcare decisions but choose to defer to another; such deference does not imply agreement with the decision being made and adds complexity when disagreements arise between surrogate (...) decision-makers for minor children and their physicians. I argue that clinicians and ethicists have a duty to consider voices marginalized by hierarchical structures, including but not limited to gender-based inequalities. This approach involves negotiating potential conflicts: between respecting differences of culture and religion, on one hand, and assuring that the wishes of those who are most invested in children’s lives are considered, on the other. (shrink)

The healthcare crisis that has developed in the last two decades during China's economic reform has caused healthcare and hospital financing reforms to be largely experienced by patients as a crisis in the patient–healthcare professional relationship (PPR) at the bedside. The nature and magnitude of this crisis were epitomized by the "Harbin Scandal"—an incident that took place in August 2005 in a Harbin teaching hospital in which the family of an elderly patient hospitalized in the intensive care unit (ICU) for (...) 66 days paid over RMB ¥6 million. The news was publicized globally and ended in the firing of six top hospital administrators including the hospital president and the ICU director. This paper seeks to show that the Chinese healthcare crisis is ultimately linked to a conflict of interests between patients and healthcare professionals (HCPs), which is inherent in the reformed healthcare system of China. Hence the crisis is, at its core, a crisis of fidelity and confidence that must be restored to the PPR. At the "macro" level, it is simplistic to blame the crisis on the failure of the market system, and at the "micro" level, it is naïve to expect that a contractual understanding of the PPR will effectively restore the confidence of patients. This paper will show that the fiduciary relationship and medical professionalism share similar attributes, with fidelity being the core value of both. It concludes that the loss of medical fidelity implies the dissolution of the PPR and the demise of the medical profession and challenges Chinese HCPs to keep their fidelity as a means to both protect their patients’ interests and to preserve their profession's survival. (shrink)

One hundred inpatients on an acute hospital elderly care unit and 43 of their relatives were interviewed shortly before hospital discharge. Eighty per cent of elderly patients and their relatives were aware of cardiopulmonary resuscitation (CPR). Television drama was their main source of information. Patients and relatives overestimated the effectiveness of CPR. Eighty-six per cent of patients were willing to be routinely consulted by doctors about their own CPR status, but relatives were less enthusiastic about routine consultation. Patients' and relatives' (...) views about the appropriateness of CPR did not differ significantly. Seventeen percent of patients did not desire CPR. However, 64 per cent of patients were ultimately willing to follow their doctor's advice about the appropriateness of CPR. The conclusion reached is that mentally competent, elderly patients but not their relatives should be routinely consulted about their own desire for CPR in order to avoid resuscitating patients against their wishes. Further research is required to find out how patients would feel about resuscitation if they were terminally ill or chronically confused, and how carers would feel about resuscitating such patients. (shrink)

Most elderly patients die with an order in place that they not be given cardiopulmonary resuscitation . Surveys have shown that many elderly in different parts of the world want to be resuscitated, but may lack knowledge about the specifics of cardiopulmonary resuscitation . Data from countries other than the US is limited, but differences in physician and patient opinions by nationality regarding CPR do exist. Physicians’ own preferences for CPR may predominate in the DNR decision making process for their (...) patients, and many physicians may not want the participation of the elderly or believe that it is necessary. More complete and earlier discussions of a wider range of options of care for patients at the end of life have been advocated. The process ought to include education for patients about the process and efficacy of CPR, and for physicians on how to consider the values and levels of knowledge of their patients, whose preferences may differ from their own. (shrink)

Faculty in a large, urban school of engineering designed a longitudinal study to assess the critical thinking skills of undergraduate students as they progressed through the engineering program. The Paul-Elder critical thinking framework was used to design course assignments and develop a holistic assessment rubric. This paper presents the analysis of the freshman course artifacts (baseline and course critical thinking assignments) and associated faculty scoring sessions for all three cohorts. A total of 649 first semester freshman students at least (...) 18 years old agreed to participate in the study. The majority were white males with a mean high school grade point average of 3.73, ACT composite score of 28.33, and final freshman engineering course grade of 3.57. There was a statistically significant positive relationship between the freshman course artifacts and the faculty scores. Data from the study are being used to enhance the critical thinking experiences for undergraduate engineering students. (shrink)

Several prominent cases have recently highlighted tension between the interests of individuals and those of the broader population in gaining access to health care resources. The care of Helga Wanglie, an elderly woman whose family insisted on continuing life support long after she had lapsed into a persistent vegetative state, cost approximately $750,000, the majority of which was paid by a Medi-gap policy purchased from a health maintenance organization. Similarly, Baby K was an anencephalic infant whose mother, believing that all (...) life is precious regardless of its quality, insisted that the hospital where her daughter was born provide mechanical ventilation, including intensive care, whenever respiratory distress threatened her life. Over the hospital's objections, courts ruled that aggressive care must be provided. Much of Baby K's care was covered by her mother's HMO policy. In the 1993 case of Fox v. HealthNet, a jury awarded $89 million to the family of a woman whose HMO had refused, as experimental, coverage for autologous bone marrow transplant in treating her advanced breast cancer. (shrink)

Several prominent cases have recently highlighted tension between the interests of individuals and those of the broader population in gaining access to health care resources. The care of Helga Wanglie, an elderly woman whose family insisted on continuing life support long after she had lapsed into a persistent vegetative state, cost approximately $750,000, the majority of which was paid by a Medi-gap policy purchased from a health maintenance organization. Similarly, Baby K was an anencephalic infant whose mother, believing that all (...) life is precious regardless of its quality, insisted that the hospital where her daughter was born provide mechanical ventilation, including intensive care, whenever respiratory distress threatened her life. Over the hospital's objections, courts ruled that aggressive care must be provided. Much of Baby K's care was covered by her mother's HMO policy. In the 1993 case of Fox v. HealthNet, a jury awarded $89 million to the family of a woman whose HMO had refused, as experimental, coverage for autologous bone marrow transplant in treating her advanced breast cancer. (shrink)

Political argument and institutions in the UnitedKingdom have frequently been represented as the products of ablend of nationalistic conservatism, liberal individualism andsocialism, in which consensus has been prized over ideology. This situation changed, as the standard story has it, with therise of Thatcherism in the late 1970s, and again with the arrivalof Tony Blair's ``New Labour'' pragmatism in the late 1990s. Solidarity as an element of political discourse makes itsappearance in the UK late in the day. It has been most (...) stronglylinked to the Third Way debate, as framed most influentially inthe work of Prof. Anthony Giddens.In this paper we review the history and pre-history of the debateon solidarity in the UK, focussing mostly on its implications forwelfare state reform. In particular we discuss the proposals forthe long-term care of the Elderly issued by the Royal Commissionon long-term care in 1999. In this context we critically examinethe idea that solidarity is a new concept in British politicalculture, and that it is a concept which has real political ``bite''in the project of welfare reform. We examine this through aconsideration of Giddens's attempted synthesis of politicalargument and social theory. (shrink)