In critical care medicine, teaching and mentoring practices are extremely important in regard to attracting and retaining young trainees and faculty in this important subspecialty that has a scarcity of needed personnel in the USA. To this end, we argue that Foucault’s Technologies of the Self is critical background reading when endeavoring to effect the positive transformation of faculty into effective teachers and mentors.

Over 45 million Americans are uninsured or underinsured. Those living in poverty exhibit the worst health status. Employment, education, income, and race are important factors in a person's ability to acquire healthcare access. Having established that there are people lacking healthcare access due to multi-factorial etiologies, the question arises as to whether the intervention necessary to assist them in obtaining such access should be considered a privilege, or a right. The right to healthcare access is examined from the perspective of (...) Western thought. Specifically through the works of Aristotle, Immanuel Kant, Thomas Hobbes, Thomas Paine, Hannah Arendt, James Rawls, and Norman Daniels, which are accompanied by a contemporary example of intervention on behalf of the medically needy by the The Johns Hopkins Urban Health Institute. (shrink)

In his six 1983 lectures published under the title, Fearless Speech (2001), Michel Foucault developed the theme of free speech and its relation to frankness, truth-telling, criticism, and duty. Derived from the ancient Greek word parrhesia, Foucault's analysis of free speech is relevant to the mentoring of medical students. This is especially true given the educational and social need to transform future physicians into able citizens who practice a fearless freedom of expression on behalf of their patients, the public, the (...) medical profession, and themselves in the public and political arena. In this paper, we argue that Foucault's understanding of free speech, or parrhesia, should be read as an ethical response to the American Medical Association's recent educational effort, Initiative to Transform Medical Education (ITME): Recommendations for change in the system of medical education (2007). In this document, the American Medical Association identifies gaps in medical education, emphasizing the need to enhance health system safety and quality, to improve education in training institutions, and to address the inadequacy of physician preparedness in new content areas. These gaps, and their relationship to the ITME goal of promoting excellence in patient care by implementing reform in the US system of medical education, call for a serious consideration and use of Foucault's parrhesia in the way that medical students are trained and mentored. (shrink)

BackgroundMedical outliers present a medical, psychological, social, and economic challenge to the physicians who care for them. The determinism of Stoic thought is explored as an intellectual basis for the pursuit of a correct mental attitude that will provide aid and comfort to physicians who care for medical outliers, thus fostering continued physician engagement in their care.DiscussionThe Stoic topics of good, the preferable, the morally indifferent, living consistently, and appropriate actions are reviewed. Furthermore, Zeno's cardinal virtues of Justice, Temperance, Bravery, (...) and Wisdom are addressed, as are the Stoic passions of fear, lust, mental pain, and mental pleasure. These concepts must be understood by physicians if they are to comprehend and accept the Stoic view as it relates to having the proper attitude when caring for those with long-term and/or costly illnesses.SummaryPracticing physicians, especially those that are hospital based, and most assuredly those practicing critical care medicine, will be emotionally challenged by the medical outlier. A Stoic approach to such a social and psychological burden may be of benefit. (shrink)

Reflective thought (critical thinking) is essential to the medical student who hopes to become an effective physician. John Dewey, one of America's foremost educators in the early twentieth century, revolutionized critical thinking and its role in education. In the mid twentieth century Hannah Arendt provided profound insights into the problem of diminishing human agency and political freedom. Taken together, Dewey's insight regarding reflective thought, and Arendt's view of action, speech, and power in the public realm, provide mentors and teachers of (...) medical students guidance in the training of thought and the need for its effective projection at the patient's bedside and in the community. (shrink)

In Voltaire's work, Candide, a young, naïve man, who has been taught that humans live in the best of all possible worlds, is thrust into the world only to find that this may not be so. He learns over time to balance his optimism with the skepticism he acquires through experience. While today's medical students are not naïve like the character Candide, they, nonetheless, carry an impression of the ideal medical practice, along with the expectation of a successful medical practice. (...) Good mentors and role models are important to students in order to temper their optimism, control their skepticism, and to help them to be realistic, not only about their expectations of medical practice, but what society expects of them. (shrink)

INDUS-EM is India’s only level one conference imparting and exchanging quality knowledge in acute care. Specifically, in general and specialized emergency care and training in trauma, burns, cardiac, stroke, environmental and disaster medicine. It provides a series of exchanges regarding academic development and implementation of training tools related to developing future academic faculty and residents in Emergency Medicine in India. The INDUS-EM leadership and board of directors invited scholars from multiple institutions to participate in this advanced educational symposium that was (...) held in Thrissur, Kerala in October 2013. (shrink)

Workplace ostracism is a prevalent and painful experience. The majority of studies focus on negative outcomes of ostracism, with less work examining employees’ potential adaptive responses to it. Further, scholars have suggested that such responses depend on employee attributions, yet little research has taken an attributional perspective on workplace ostracism. Drawing on sociometer theory and attribution theory we develop and test a model that investigates why and under what circumstances ostracized employees engage in adaptive responses to ostracism. Specifically, we argue (...) that ostracized employees feel greater levels of shame and, in turn, are motivated to engage in greater ingratiation behavior toward their ostracizers. However, we predict that perceptions of ostracizers’ competence and warmth shape different attributional processes, which influence the degree to which the ostracized employee experience shame and, in turn, is motivated to engage in ingratiation behavior. Results of a three-wave, time-lagged survey support our prediction that shame mediates the relationship between coworker ostracism and ingratiation behavior. Moreover, results support our three-way interaction, such that coworkers who report higher levels of ostracism and who perceive their coworkers as more (vs. less) competent and more (vs. less) warm report higher shame, and, in turn, ingratiation behavior. Theoretical and practical implications, as well as avenues for future research, are discussed. (shrink)

_Metaphysics: A Contemporary Introduction_ is for students who have already completed an introductory philosophy course and need a fresh look at the central topics in the core subject of metaphysics. It is essential reading for any student of the subject. This Fourth Edition is revised and updated and includes two new chapters on Parts and Wholes, and Metaphysical Indeterminacy or vagueness. This new edition also keeps the user-friendly format, the chapter overviews summarizing the main topics, concrete examples to clarify difficult (...) concepts, annotated further reading at the end of each chapter, endnotes, and a full bibliography. Topics addressed include: the problem of universals the nature of abstract entities the problem of individuation the nature of modality identity through time the nature of time the nature of parts and wholes the problem of metaphysical indeterminacy the Realism/anti-Realism debate. Wherever possible, Michael J. Loux and Thomas M. Crisp relate contemporary views to their classical sources in the history of philosophy. As experienced teachers of philosophy and important contributors to recent debates, Loux and Crisp are uniquely qualified to write this book. (shrink)

The Eleatic Visitor speaks forcefully when he insists, ‘Necessarily, whenever there is speech, it is speech of something; it is impossible for it not to be of something’. For ‘if it were not of anything, it would not be speech at all; for we showed that it is impossible for there to be speech that is speech of nothing’. Presumably, at 263c10, when he claims to have ‘shown’ that it is impossible for speech to be of nothing, the Visitor is (...) referring back to the Parmenidean puzzles at Sophist 237ff. (shrink)

Little is in print on the development in Britain of university disciplines including the academic study of education. This paper provides a historical narrative of the study of adolescence from the 1870 Education Act to the contemporary day. Adolescence textbooks are examined in the context of changes in the education system, such as the demand for secondary education and the expansion of teacher education. Changing emphases in adolescence research are traced through various publications to illustrate curriculum developments. The important contributions (...) of Dame Olive Wheeler, Professor W. D. Wall and other leading writers on adolescence are evaluated. It is clear that in over a century of national educational provision British teachers have never faced a great choice of adolescence texts and the paper concludes with some reflections on this observation. (shrink)

“Practice” has become a ubiquitous term in the history of science, and yet historians have not always reflected on its philosophical import and especially on its potential connections with ethics. In this essay, we draw on the work of the virtue ethicist Alasdair MacIntyre to develop a theory of “communal practices” and explore how such an approach can inform the history of science, including allegations about the corruption of science by wealth or power; consideration of scientific ethics or “moral economies”; (...) the role of values in science; the ethical distinctiveness of scientific vocations; and the relationship between history of science and the practice of science itself. (shrink)

Todd Moody’s Zombie Earth thought experiment is an attempt to show that ‘conscious inessentialism’ is false or in need of qualification. We defend conscious inessentialism against his criticisms, and argue that zombie thought experiments highlight the need to explain why consciousness evolved and what function(s) it serves. This is the hardest problem in consciousness studies.

The role of evolutionary theory at the origin of life is an extensively debated topic. The origin and early development of life is usually separated into a prebiotic phase and a protocellular phase, ultimately leading to the Last Universal Common Ancestor. Most likely, the Last Universal Common Ancestor was subject to Darwinian evolution, but the question remains to what extent Darwinian evolution applies to the prebiotic and protocellular phases. In this review, we reflect on the current status of evolutionary theory (...) in origins of life research by bringing together philosophy of science, evolutionary biology, and empirical research in the origins field. We explore the various ways in which evolutionary theory has been extended beyond biology; we look at how these extensions apply to the prebiotic development of (proto)metabolism; and we investigate how the terminology from evolutionary theory is currently being employed in state-of-the-art origins of life research. In doing so, we identify some of the current obstacles to an evolutionary account of the origins of life, as well as open up new avenues of research. (shrink)

Comment on "The ethical 'elephant' in the death penalty 'room'". Arguments in defense of the death penalty typically fall into one of two groups. Consequentialist arguments point out beneficial aspects of capital punishment, normally focusing on deterrence, while non-consequentialist arguments seek to justify execution independently of its effects, for example, by appealing to the concept of retribution. Michael Keane's target article "The ethical 'elephant' in the death penalty 'room'" should, we believe, be read as an interesting new consequentialist defense of (...) physician involvement in capital punishment. (shrink)

Consciousness and evolution are complex phenomena. It is sometimes thought that if adaptation explanations for some varieties of consciousness, say, conscious visual perception, can be had, then we may be reassured that at least those kinds of consciousness are not epiphenomena. But what if other varieties of consciousness, for example, dreams, are not adaptations? We sort out the connections among evolution, adaptation, and epiphenomenalism in order to show that the consequences for the nature and causal efficacy of consciousness are not (...) as dire as has sometimes been supposed. (shrink)

Conscious perception, like the sight of a coffee cup, seems to involve the brain identifying a stimulus. But conscious input activates more brain regions than are needed to identify coffee cups and faces. It spreads beyond sensory cortex to frontoparietal association areas, which do not serve stimulus identification as such. What is the role of those regions? Parietal cortex support the ‘first person perspective’ on the visual world, unconsciously framing the visual object stream. Some prefrontal areas select and interpret conscious (...) events for executive control. Such functions can be viewed as properties of the subject, rather than the object, of experience – the ‘observing self’ that appears to be needed to maintain the conscious state. (shrink)

Philosophical arguments often assume that the folk tends towards moral objectivism. Although recent psychological studies have indicated that lay persons’ attitudes to morality are best characterized in terms of non-objectivism-leaning pluralism, it has been maintained that the folk may be committed to moral objectivism _implicitly_. Since the studies conducted so far almost exclusively assessed subjects’ metaethical attitudes via explicit cognitions, the strength of this rebuttal remains unclear. The current study attempts to test the folk’s implicit metaethical commitments. We present results (...) of a newly developed Implicit Association Test (IAT) for metaethical attitudes which indicate that the folk generally tend towards moral non-objectivism on the implicit level as well. We discuss implications of this finding for the philosophical debate. (shrink)

Well and Good presents a combination of "classic" and little-known cases in health care ethics. These cases, accompanied by information about the major ethical theories, give students a chance to grapple with the ethical challenges faced by health care practitioners, policy makers, and recipients. The authors' narrative style and leading questions provoke student interest and engagement, while allowing instructors the freedom to draw from the theoretical perspectives they consider most useful. This fourth edition includes an expanded discussion of feminist ethics, (...) and new cases addressing pandemic ethics, humanitarian aid, the social determinants of health, research and aboriginal communities, and a number of other emerging issues. (shrink)

Not long ago, I received an email from a man who had been trying to get his seven-year-old son interested in science, and teach him a little bit about the workings of the brain. He had been showing his son one of those diagrams of a brain with various regions labeled as "speech center," vision center," and the like (something similar to this, I suppose), when the little boy suddenly asked, "Daddy, which part of the brain does imagination come from?". (...) It was not on the diagram, and the father, although he studied human biology at college, realized he did not know the answer. As we do these days, he got on the internet to try to find out. It was not as easy as he might have expected. "Imagination" is certainly a word that is found on a lot of web pages, and there are plenty that seem to be devoted to celebrating or promoting it, but very few of them seem to have anything at all to say about what it is, how it works, or where in the brain it might be implemented. Eventually, he found his way to this site. Even here, however, he could find no straightforward answer to his son's apparently straightforward question. (The truth is, the question is not nearly as straightforward as it appears.) He thought I might be a good a person to ask, however, and sent me an email. What follows is a lightly revised version of the reply I sent. It is not written in terms that a seven-year-old could understand (I am not clever enough to do that), but neither is it pitched at the professional, academic level of most of the material on this site. I would like to think that it answers the question (inasmuch as it can be answered in the current state of scientific knowledge) in a way that a layperson should be able to understand, and that they might then be able to explain to a curious and intelligent child. If you want to know the detailed reasons, and see the citations to the scientific literature, that justify the claims made here, you can find them in the other articles on this site.. (shrink)

Fleming, Daniel J; Ryan, Thomas Three recent phrases of Pope Francis warrant attention and guide this article. First, there is his call for 'witnesses of God's love' in his tribute to modern martyrs. The second is 'the pedagogy of grace' and the work of the Spirit explained in 'Amoris Laetitia'. Third, from the same document, we find his discussion of accompaniment in the process of moral discernment within the church. With these as guideposts and drawing on recent studies in (...) moral philosophy and psychology, this article unfolds in five steps: setting the scene; witness in relation to moral understanding and intersubjectivity; intersubjectivity and conscience; a pedagogy of grace: Holy Spirit and nonbelievers; and a pedagogy of grace in relation to moral development. (shrink)

Questions about knowledge, and about the relation between logic and language, are at the heart of philosophy. Eleven distinguished philosophers from Britain and America contribute papers on such questions. All the contributions are examples of recent philosophy at its best. The first half of the book constitutes a running debate about knowledge, evidence and doubt. The second half tackles questions about logic and its relation to language.