The pinnacle of the physician's clinical skills is his ability to develop the autonomy of his patients in the management of their health affairs. To do this requires the forging of a relationship in which patients' attitudes toward their health and illness are products of the doctor-patient relationship rather than unilateral behavior by either one. Modern medicine is beset with problems that make it difficult for physicians to develop and exercise the skills that lead to patient autonomy. An erosion of (...) public confidence in physicians is being caused by several mojar forces that include: (1) the power of science over life; (2) medical technology's dehumanizing effect; (3) legalization of medical ethics; and (4) industrialization and commercialization of medical care. To restore the kind of confidence that makes the physician an effective proponent of his patient's autonomy will require a major emphasis upon all aspects of medical ethics in the medical curriculum and in medical practice. Clinical investigation of this subject is highly appropriate. Clinical faculties should be developed in greater numbers who are authorities in the humanities as well as in science. Our medical schools need also to develop and to utilize models of health care in which relations with patients are personalized, continuous, and comprehensive so that ethical ideals such as patient autonomy can be demonstrated by precept and example, and can also be researched. (shrink)
: The medical and clinical promise of stem cell research is widely heralded, but moral judgments about it collide. This article takes general stock of such judgments and offers one specific resolution. It canvasses a spectrum of value judgments on sources, complicity, adult stem cells, and public and private contexts. It then examines how debates about abortion and stem cell research converge and diverge. Finally, it proposes to extend the principle of "nothing is lost" to current debates. This extension links (...) historic discussions of the ethics of direct killing with unprecedented possibilities that in vitro fertilization procedures yield. A definite normative region to inhabit is located, within a larger range of rival value judgments. The creation of embryos for research purposes only should be resisted, yet research on "excess" embryos is permissible by virtue of an appeal to the "nothing is lost" principle. (shrink)
On some occasions of self-reference there can be two equally viable forms available to speakers: individual self-reference and collective self-reference. This means that selection of one or the other in talk-in-interaction can — akin to the selection of terms for reference to non-present persons — be guided by such considerations as recipient design and action formation. As a strategy for investigating the selection of self-reference terms, this article examines repairs to self-reference that change the form of reference from individual to (...) collective and vice versa. We first identify two repair operations found in the domain of self-reference: aggregation and extraction and then we track the use of both operations across a range of positions in the repair initiation opportunity space. Finally we consider some of the interactional uses of aggregation and extraction repairs in resolving sources of troubles associated with speaker epistemic authority and responsibility for described actions. (shrink)
In this introduction to the special issue of Discourse Studies on `Referring to Self and Others in Conversation' we briefly survey the history of conversation analytic work on reference to persons from Sacks and Schegloff's pioneering seven-page paper to the most recently published work. We then introduce the contributions to the special issue.
The usual strawsonian account of referring won't do for fictional entities. The problem is that we still don't have a sufficiently clear notion of ordinary referring, And the root of this problem is that referring is still perceived in terms of a paradigm relation of a description to an existing thing. But that relation is preceded by the more fundamental relation of thought to an object of thought, Whether real or imaginary. The conclusion reached is that fictional reference is an (...) institutionalized partial use of ordinary referring, Parasitic on it though leading a legitimate life of its own. (shrink)
We agree that much of language evolution is likely to be adaptation of languages to properties of the brain. However, the attempt to rule out the existence of language-specific adaptations a priori is misguided. In particular, the claim that adaptation to cannot occur is false. Instead, the details of gene-culture coevolution in language are an empirical matter.
A defense of the embattled concept of aesthetic distance is achieved by reinstating a prominent feature of distance ignored in the current controversy. Distance is not the only supposed psychological posturing discussed by bullough, But also the space which is necessary to art between the art medium and the world represented therein. Examples from painting, Film and absurdist literature are discussed in terms of the historical tension between medium "opacity" and "transparency" in order to show how total transparency is avoided (...) to create the space between the art medium and reality, Without which art can neither "say" anything nor even exist. (shrink)
Blocker argues that the literary problem of absurdity is basically a metaphysical problem of being, focusing on the metaphysical distinction of being as essence and being as existence. This book compares philosophical prose with the fiction writing of four major absurdist writers—Camus, Sartre, Ionesco, and Beckett.