This paper seeks to ascertain the ways in which Adonis and his ritual lament were used by Classical men and women in their constructions of their own gender and the other. The evidence from Classical Athens turns out to originate mainly among men and thus outside the cult, from which men were excluded; the myths and descriptions of the rite that we possess say more about men's attitudes toward themselves and toward women than about the celebrants' motives. Nevertheless, women's attitudes (...) toward Adonis may be inferred from the social circumstances in which the Attic cult arose. Care must be taken to distinguish the different interests represented in the extant evidence . Marcel Detienne's influential structuralist interpretation of the cult has rightly dissociated Attic Adonis from similar Near Eastern figures and contextualized him in Classical Athenian society. Detienne's interpretation, however, has limitations, since it treats Adonis only as a representative of the unmanly and unproductive, and tends to ignore the different uses to which men and women could put Adonis and his rite. For example, the proverb "more fruitless than the gardens of Adonis" originated in male discourse, and does not necessarily reflect women's views. In comedy Adonis and the Adonia become a foil for masculine values; not only does this tell us nothing of what the celebrants thought, but awareness of the many strategies of self-definition available to Athenian men compels us to entertain other constructions of Adonis in other discursive milieus. Finally, although little testimony remains from the woman's perspective, we may speculate that in democratic Athens, restrictions on traditional female mourning rituals and the polarization of the sexes would have made such a private cult as the Adonia attractive to women. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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The aim of this investigation is to explore the role of argumentation schemes in enthymeme reconstruction. This aim is pursued by studying selected cases of incomplete arguments in natural language discourse to see what the requirements are for filling in the unstated premises and conclusions in some systematic and useful way. Some of these cases are best handled using deductive tools, while others respond best to an analysis based on defeasible argumentations schemes. The approach is also shown to work reasonably (...) well for weak arguments, a class of arguments that has always been difficult to analyze without the principle of charity producing a straw man. (shrink)

Particle theories intend to describe the fundamental constituents from which all matter is constructed and the interactions among them. These constituents include atoms and molecules as well as their subatomic constituents, nuclei and their component parts including elementary particles. We consider an alternative to the usual particle theories, but dealing with the same phenomena. We call these theories ‘QT’s’. This is an attempt to provide a formal description of the essential features of elementary particle theories within the framework of metatheoretical (...) structuralism. (shrink)

It is argued that John Rawls’ theory of social justice as well as the contract argument for it are misleading, if not actually mistaken, in that they appear to take institutional features of societies as fundamental objects of moral evaluation. An alternative view: is expounded. Principles involving institutional features are only contingently related to principles involving the distribution of things people care about. These distributions are taken as the fundamental objects of moral evaluation. Social, political and economic institutions are means (...) to achieve more desirable distributions. It is argued that the alternative provides a more accurate reconstruction of the moral foundations of social-democratic liberalism than does Rawls’ theory. (shrink)

A method of using co-citation data to identify scientific specialties and trace their development through time is outlined. These are related to the structuralist "theory net" construct. The method is purely "theoretical in that no algorithms for implementing the method are suggested. Even at this theoretical level, the discussion is incomplete in several ways. Important formal properties of some of the concepts employed remain to be clarified. The specific way these constructs relate to theory nets remains to be specified in (...) detail. (shrink)

Recent stories of corporate insiders avoiding losses and, in some cases, generating enormous personal profits as their companies crumbled have led investors to question the integrity of American business and the fairness of the United States stock markets. The SEC tries to ensure the fairness of the stock markets by making and enforcing laws against unfair practices such as insider trading. In the United States, when insiders trade stock based on non-public information, they have broken the law and betrayed the (...) trust that has been placed in them.This study used student subjects to test the relationship between the likelihood of trading based on insider information and subjective probabilities of deterrents and motivations for insider trading. Expected gain, guilt, cynicism, and fairness of laws were the determinants that had a significant relationship with the intent to trade based on insider information. This study also found support for prospect theory with regard to insider trading. The results indicate that subjects are more likely to trade based on insider information to avoid a loss than to achieve an abnormal gain. The study also finds evidence of social desirability response bias. (shrink)

Solid state physics, the study of the physical properties of solid matter, was the most populous subfield of Cold War American physics. Despite prolific contributions to consumer and medical technology, such as the transistor and magnetic resonance imaging, it garnered less professional prestige and public attention than nuclear and particle physics. Solid State Insurrection argues that solid state physics was essential to securing the vast social, political, and financial capital Cold War physics enjoyed in the twentieth century. Solid state’s technological (...) bent, and its challenge to the “pure science” ideal many physicists cherished, helped physics as a whole respond more readily to Cold War social, political, and economic pressures. Its research kept physics economically and technologically relevant, sustaining its cultural standing and policy influence long after the sheen of the Manhattan Project had faded. (shrink)

The contingentist/inevitabilist debate contests whether the results of successful science are contingent or inevitable. This article addresses lingering ambiguity in the way contingency is defined in this debate. I argue that contingency in science can be understood as a collection of distinct concepts, distinguished by how they hold science contingent, by what elements of science they hold contingent, and by what those elements are contingent upon. I present a preliminary taxonomy designed to characterize the full-range positions available and illustrate that (...) these constitute a diverse array rather than a spectrum. (shrink)

This work emerged from funded research examining collaboration among stake-holder organizations present at three U.S. nuclear weapons complex sites. The authors examine issues such as how and why stakeholder groups form collaborative alliances when dealing with the target organization, what leaders of stakeholder organizations actually think about when collaborating to deal with the target organization, and what outcomes result from the collaboration process. Drawing on stakeholder theory and research in interorganizational collaboration, the authors used an inductive, interview-based methodology to build (...) a model of collaboration among nonprofit stakeholder groups. The model contributes to the descriptive stream of stakeholder theory and, in turn, has implications for the instrumental stream. The model also offers implications for future researchers, leaders of stakeholder alliances, and leaders of target organizations. (shrink)

ABSTRACT This paper seeks to develop a philosophical framework for what I argue are the Nietzschean and Kantian aspects of professional boxing matches: narrative dissimulation and moral obligation. The overarching objective of the analysis is to shed a critical light on brief intervals of boxing competitions (the minute between rounds) that are crucial but often overlooked in the philosophical literature devoted to boxing and, indeed, combat sport more generally. Additionally, in characterizing more fully the philosophical complexities of cornerman and boxer (...) interactions in the flow of such a violent and dangerous sport, the analysis aims to make explicit some of what is unique—and uniquely problematic—to competing in and coaching professional pugilism and, by extension, other combat sports, such as mixed martial arts (MMA) and Muay Thai. (shrink)

ABSTRACT This paper seeks to develop a philosophical framework for what I argue are the Nietzschean and Kantian aspects of professional boxing matches: narrative dissimulation and moral obligation. The overarching objective of the analysis is to shed a critical light on brief intervals of boxing competitions (the minute between rounds) that are crucial but often overlooked in the philosophical literature devoted to boxing and, indeed, combat sport more generally. Additionally, in characterizing more fully the philosophical complexities of cornerman and boxer (...) interactions in the flow of such a violent and dangerous sport, the analysis aims to make explicit some of what is unique—and uniquely problematic—to competing in and coaching professional pugilism and, by extension, other combat sports, such as mixed martial arts (MMA) and Muay Thai. (shrink)

This article examines the interpretive dimensions of human action. Although it takes the reflexive sociology of Pierre Bourdieu as its starting point, the article attempts to develop a more robust hermeneutical account of the reflexivity of social actors and those who study them than Bourdieu himself has considered. It is argued that interpretation is best understood not as the homologous expression of inculcated structures but rather as context-sensitive and reflexively context-transforming action—or what the author wishes to characterize, respectively, as first- (...) and second-order thematizations of embeddedness. The article concludes by contrasting the author's position with the thick description of Clifford Geertz. (shrink)

Much of the recent discussion of problematic aspects of quantum-mechanical measurement centers around that feature of quantum theory which is called "the projection postulate." This is roughly the claim that a change of a certain sort occurs in the state of a physical system when a measurement is made on the system. In this paper an argument for the projection postulate due to von Neumann is considered. Attention is focused on trying to provide an understanding of the notion of "the (...) state of a physical system" which is compatible with the argument von Neumann offers. An attempt is made to formulate the argument in terms of an objectivistic interpretation of probability concepts. It is seen that such an interpretation does not provide a suitable way of understanding the argument. An attempt is made to illustrate the source of this failure in terms of a non-quantum-mechanical example. (shrink)

The theory of subjective probability and utility recently proposed by professor richard jeffrey has several unique features and appears to be in some ways distinctly more satisfactory than earlier theories. There is, However, One very important class of decision problems which is not discussed by professor jeffrey--Problems concerned with decisions about strategies for using information. The principal task of this paper is to point out some questions which arise in attempting to deal with these decision problems within jeffrey's theory. To (...) do this it will be necessary to examine in some detail jeffrey's discussion of the relation between his theory and those of ramsey and savage. (shrink)

Gilbert and Mulkay, in their paper ‘Experiments Are the Key’, present responses of scientists to questions about the development of the chemiosmotic hypothesis of energy coupling in oxidative and photophosphorylation, and infer from these responses both the meaninglessness of the concept ‘key experiment’ and the hopelessness of searching for any data as a bedrock for historical analysis. Gilbert and Mulkay's nihilism is, however, rooted in a lack of understanding of the specific scientific issues involved. A closer look at a proposed (...) ‘key experiment’ shows certain obvious characteristics that could be criteria for a ‘key experiment’ moreover, the actual scientific response to that experiment demonstrates its pivotal role in the development of the field. Instead of demonstrating the lack of empirical bases for scientific judgment, Gilbert and Mulkay demonstrate the necessity for identifying the crucial issues and pursuing them, in questioning the scientists as well as in examining other sources. (shrink)

Why do similar scientific enterprises garner unequal public approbation? High energy physics attracted considerable attention in the late-twentieth-century United States, whereas condensed matter physics – which occupied the greater proportion of US physicists – remained little known to the public, despite its relevance to ubiquitous consumer technologies. This paper supplements existing accounts of this much remarked-upon prestige asymmetry by showing that popular emphasis on the mundane technological offshoots of condensed matter physics and its focus on human-scale phenomena have rendered it (...) more recondite than its better-known sibling field. News reports about high energy physics emphasize intellectual achievement; reporting on condensed matter physics focuses on technology. And whereas frontier-oriented rhetoric of high energy physics communicates ideals of human potential, discoveries that smack of the mundane highlight human limitations and fail to resonate with the widespread aspirational vision of science – a consequence I call “the purloined letter effect.”. (shrink)

A major theme in biological research is the quest for mechanism, embodied in explanatory reductionism: the interpretation of phenomena through links to the entities and laws of more fundamental sciences. For example, the form of Starling's Law of the Heart, relating contractile force to heart volume, follows from the sliding-filament hypothesis of muscle contraction, a molecular concept. Although alternative mechanisms for muscle contraction and cardiac regulation could be deduced from biochemical principles, the formulation provides clear correspondence with the phenomena and (...) a deeper understanding of cardiac function. Moreover, even if the reduction provides no better formulation of the phenomenon, of the macro-regularity, it is still prized as a nearer approach to physical reality, as a step toward realizing fundamental unities and codifying general principles, and as a door to new experimental opportunities. (shrink)

In psychoanalysis, enlivenment is seen as residing in a sense of self, and this sense of self is drawn from and shaped by lived experience. _Enlivening the Self: The First Year, Clinical Enrichment, and the Wandering Mind _describes the vitalizing and enrichment of self-experience throughout the life cycle and shows how active experience draws on many fundamental functional capacities, and these capacities come together in support of systems of motivation; that is, organized dynamic grouping of affects, intentions, and goals. The (...) book is divided into three essays: Infancy – _Joseph Lichtenberg_ presents extensive reviews of observation and research on the first year of life. Based on these reviews, he delineates twelve foundational qualities and capacities of the self as a doer doing, initiating and responding, activating and taking in. Exploratory therapy – _James L. Fosshage _looks where therapeutic change is entwined with development. There are many sources illustrated for enhancing the sense of self, and _Frank M. Lachmann _pays particular attention to humor and to the role that the twelve qualities and capacities play in the therapeutic process. The wandering mind – _Frank M. Lachmann _covers the neuroscience and observation that "mind wandering" is related to the immediacy of the sense of self linking now with past and future. Throughout the book the authors’ arguments are illustrated with rich clinical vignettes and suggestions for clinical practice. This title will be a must for psychoanalysts, including trainees in psychoanalysis, psychiatry residents and candidates at psychoanalytic institutes and also graduate students in clinical and counselling psychology programs. (shrink)

As in other societies, medical professionalism in the Peoples’ Republic of China has been rapidly evolving. One of the major events in this process was the endorsement in 2005 of the document, “Medical Professionalism in the New Millennium: A Physician Charter,” by the Chinese Medical Doctor Association (hereafter, the Charter). More recently, a national survey, the first on such a large scale, was conducted on Chinese physicians’ attitudes toward the fundamental principles and core commitments put forward in the Charter. Based (...) on empirical findings from that study and comparing them to the published results of a similar American survey, the authors offer an in-depth interpretation of significant cross-cultural differences and important transcultural commonalities. The broader historical, socio-economic, and ethical issues relating to salient Chinese cultural practices such as family consent, familism (the custom of deferring decisions to family members), and the withholding of medical information, as well as controversial topics such as not respecting patients’ autonomy, are examined. The Chinese Survey found that Chinese physicians supported the principles of the Charter in general. Here we argue that Chinese culture and traditional medical ethics are broadly compatible with the moral commitments demanded by modern medical professionalism. Methodologically and theoretically—recognizing the problems inherent in the hoary but still popular habit of dichotomizing cultures and in relativism—a transcultural approach is adopted that gives greater (due) weight to the internal moral diversity present within every culture, the common ground shared by different cultures, and the primacy of morality. Genuine crosscultural dialogue, including a constructive Chinese-American dialogue in the area of medical professionalism, is not only possible, but necessary. (shrink)

Body-politic metaphors served historically as figurative vehicles to transmit assorted socio-political messages. Through an examination of the metaphors la mollesse and Adam Smith’s impartial spectator, this article will show that the language of eighteenth-century French and British writers was not simply heuristic or metaphorical. Contemporaries reacted to the growth of commerce and luxury, and the concomitant creation of new public spaces and forms of social interaction, by arguing that the corporeal mediated the social. I want to introduce the concept of (...) corporeal sociability: cognitive physiology and the network of the senses, contemporaries argued, contained the information necessary to assess novel forms of commerce and revealed that sociability was congenitally embodied. (shrink)

This article is an analysis of Anthony Giddens' attempt to articulate a globalization-friendly alternative to traditional social democracy (the `old' Left) and neo-liberal market fundamentalism (the `new' Right). Specifically, I focus on Giddens' insistence that globalization is not merely an economic phenomenon but also, and more profoundly, a political and cultural force of `time-space distanciation'. Whereas Giddens conceives of a direct causal connection between the disembedding forces of globalization and outcomes of democratization, I argue that such a conception is deeply (...) flawed. Indeed, rather than develop a politically useful explanatory social theory of the complex relationship between globalization and democracy, Giddens' `third way' theorizing merely hypostatizes the former by invoking it as a cause of the latter. I provide a series of arguments designed to highlight the weaknesses of Giddens' position, and conclude by questioning the general thesis that underlies Giddens' account of globalization. (shrink)

This article explores the work of the contemporary sociologist and urban photographer, Camilo Vergara. The piece draws on early work in critical theory to characterize Vergara's work as `rescuing critique'. Specifically, the article maintains that it is only in the theoretical vocabulary of Walter Benjamin that the methodological uniqueness, historical sensitivity and critical thrust of Vergara's project can be adequately understood. Indeed, it is argued that what is truly distinct about Vergara's work is the decidedly Benjaminian way in which, in (...) the ruinous present of neoliberal `progress', it fuses the aesthetic power of images with an anamnestic obligation to the urban past. In such a fusion, Vergara's photo-ethnographies of America's new ghettos raise critical questions about what has – and might yet – become of such places, and those who inhabit them. (shrink)

When the late Heinz Kohut defined psychoanalysis as the science of empathy and introspection, he sparked a debate that has animated psychoanalytic discourse ever since. What is the relationship of empathy to psychoanalysis? Is it a constituent of analytical technique, an integral aspect of the therapeutic action of analysis, or simply a metaphor for a mode of observation better understood via ‘classical’ theory and terminology? The dialogue about empathy, which is really a dialogue about the nature of the analytic process, (...) continues in this two-volume set, originally published in 1984. In Volume I, several illuminating attempts to define empathy are followed by Kohut’s essay, ‘Introspection, Empathy, and the Semicircle of Mental Health.’ Kohut’s paper, in turn, ushers in a series of original contributions on ‘Empathy as a Perspective in Psychoanalysis.’ The volume ends with five papers which strive to demarcate an empathic approach to various areas of artistic endeavour, including the appreciation of visual art. Volume II continues the dialogue with a series of developmental studies which explore the role of empathy in early child care at the same time as they chart the emergence of the young child’s capacity to empathize. In the concluding section, ‘Empathy in Psychoanalytic Work,’ contributors and discussants return to the arena of technique. They not only theorize about empathy in relation to analytic understanding and communication, but address issues of nosology, considering how the empathic vantage point may be utilized in the treatment of patients with borderline and schizophrenic pathology. In their critical attention to the many dimensions of empathy – philosophical, developmental, therapeutic, artistic – the contributors collectively bear witness to the fact that Kohut has helped to shape new questions, but not set limits to the search for answers. The product of their efforts is an anatomical exploration of a topic whose relevance for psychoanalysis and psychotherapy is only beginning to be understood. (shrink)

Originally published in 1983 _Reflections on Self Psychology_ records the development of a powerful initiative to alter psychoanalytic theory and practice, and an evaluative questioning of this initiative. It presents a dialogue that developed at the Boston Symposium of 1980 between vigorous proponents of self psychology, equally energetic critics, and many participants between these polar positions. This book attempts to capture within its pages not only the content of what was presented, explored, and evaluated in Boston, but also a sense (...) of the people, about 1,000 strong, who exchanged their ideas on and off the podium – and the remarkable spirit of open inquiry that invigorated these proceedings. The book, as was the meeting, is organized to explore four subjects: the development of the self: infant research; the implications of self psychology for psychoanalytic practice; self psychology and psychotherapy; and the implications of self psychology for psychoanalytic theory. The final section of the book is devoted to an essay by Heinz Kohut that provides an integrated response to the issues and criticisms raised in the course of the symposium. This essay while based on extemporaneous responses by Kohut during different phases of the meeting, is, in its written version, a cohesive, carefully revised, and edited statement prepared in the mellowing period following the meeting and before Kohut’s untimely death. (shrink)

Placed in a historical context, sexuality was once so prominent in psychoanalytic writing that sexual drive and psychoanalysis were synonymous. The exciting discovery of childhood sexuality filled the literature. Then other discoveries came to the fore until sexuality slipped far in the background. This book evokes the excitement of the original discoveries of childhood sexual experience while linking childhood sensuality and sexuality to adult attachment, romantic, and lustful love. This revised perspective offers the general reader insight into contemporary psychoanalytic thought, (...) and presents clinicians with a perspective for exploring their patients sensuality and sexuality with renewed interest and knowledge. (shrink)