The papers in the 2010 “Clinical Ethics” number of the Journal of Medicine and Philosophy explore issues along La Frontera, the borders and boundaries of clinical ethics. The first three papers in this “Clinical Ethics” number of the Journal explore borders and boundaries drawn within clinical ethics, concerning the moral standing of complementary and alternative medicine, palliative sedation, and induced abortion and feticide. The fourth and fifth papers explore the borders and boundaries between research ethics and clinical ethics.

It is well-recognized that uncertainty is an endemic feature and limitation of clinical judgment and practice that cannot be eliminated in many cases. Among the tasks of clinical ethics is the responsible management of uncertainties, first articulated in E. Haavi Morreim’s very nice concept of the "moral management of medical uncertainty." The papers in the 2012 Clinical Ethics issue of the Journal provide philosophically innovative and clinically applicable accounts of the varieties of uncertainty in clinical medicine and therefore in clinical (...) ethics: epistemic uncertainty, metaphysical uncertainty, and relational uncertainty. (shrink)

This paper introduces the 2011 number of the Journal on Clinical Ethics. Philosophical critical appraisal is essential for the success of philosophical analysis and argument in clinical ethics. To clear away conceptual underbrush, papers in this Clinical Ethics number of the Journal address genetic engineering, conscience-based objections to forms of health care, placebos, and preventing exploitation of patients to be recruited to become research subjects.

The five papers in the 2008 “Clinical Ethics” number of the journal address the conceptual and empirical foundations of clinical ethics. Three articles take up the concept of professionalism in medicine, exploring its possibilities and implications. The fourth article provides a distinctive, phenomenological account of the “placebo effect,” a vexing topic of surprising durability in the clinical setting. The final article, a systematic review of the qualitative literature on bedside rationing of resources, creates an empirical foundation for philosophical analysis and (...) argument of a distinctive kind. (shrink)

Central concepts and consensus views in clinical ethics are marked by instability. The papers in this number of the Journal take up two such central concepts, quality of life and moral status, and two such consensus views, that germ-line gene transfer should not be undertaken for the purposes of enhancement of human traits and that the ethical obligation of physicians to treat HIV infected patients rests on consent of the physician. One outcome of these philosophical investigations is that these two (...) concepts and consensus views are less stable than one might have thought. I explore the possibility of generalizing this outcome in a reflection on clinical ethics as the management of instability and incompleteness, including the instability and incompleteness of clinical ethics itself. In the course of this reflection I liken clinical ethics to abstract expressionism in mid-twentieth century Western art. (shrink)

We offer a critique of one prominent understanding of the principle of respect for autonomy and of analyses of medical paternalism based on that understanding. Our main critique is that understanding respect for autonomy as respect for freedom from interference is mistaken because it is overly influenced by four-alarm cases, because it fails to appreciate the full dimensions of legal self-determination (one of its main sources), because it conflates the research and therapeutic settings, and because it fails to appreciate themes (...) of authority and power that have historically shaped the principle of respect for freedom from interference. We argue that respect for autonomy involves more than just freedom from interference and, on this basis, offer a critique of prevailing accounts of medical paternalism. (shrink)

The paper illustrates how organic chemists dramatically altered their practices in the middle part of the twentieth century through the adoption of analytical instrumentation - such as ultraviolet and infrared absorption spectroscopy and nuclear magnetic resonance spectroscopy - through which the difficult process of structure determination for small molecules became routine. Changes in practice were manifested in two ways: in the use of these instruments in the development of 'rule-based' theories; and in an increased focus on synthesis, at the expense (...) of chemical analysis. These rule-based theories took the form of generalizations relating structure to chemical and physical properties, as measured by instrumentation. This 'Instrumental Revolution' in organic chemistry was two-fold: encompassing an embrace of new tools that provided unprecedented access to structures, and a new way of thinking about molecules and their reactivity in terms of shape and structure. These practices suggest the possibility of a change in the ontological status of chemical structures, brought about by the regular use of instruments. The career of Robert Burns Woodward (1917-1979) provides the central historical examples for the paper. Woodward was an organic chemist at Harvard from 1937 until the time of his death. In 1965, he won the Nobel Prize in Chemistry. (shrink)

In the article, questions from the field of philosophy of mathematics are studied. The author is driven by the need to achieve a balance between the philosophy of science and the history of science in formation of concepts of the science development. In this regard, the author justifies the reliance on the methodology of implicit knowledge, combined with the epistemology principle of criticism in studying the development of mathematics as the most expedient and effective. The author expresses the necessity of (...) criticizing the methodology of counterexamples typical for mathematical empiricism declared by I. Lakatos. In the article, an explanation of the concept of implicit knowledge, as well as the examples from mathematics are given. The author believes that application of the concept of implicit knowledge in philosophical and mathematical terms allows us to reveal the unique specificity of mathematical science deeper. The author concludes that it is necessary to recognize the fundamental importance of the methodology of implicit knowledge for the epistemology, as well as for the development of philosophy and methodology of science in general. (shrink)

The article is devoted to the nature of the topological intuition and disclosure of the specifics of topological heuristics in the framework of philosophical theory of knowledge. As we know, intuition is a one of the support categories of the theory of knowledge, the driving force of scientific research. Great importance is mathematical intuition for the solution of non-standard problems, for which there is no algorithm for such a solution. In such cases, the mathematician addresses the so-called heuristics, built on (...) the basis of guesswork, obtained by intuition. The author substantiates the conclusion that topological intuition significantly specific compared to a traditional mathematical intuitions of Euclidean geometry. Today topology is a rapidly developing field of modern mathematics, integrates nicely with other sections of mathematical science. In its most general form of the topology can be defined as the branch of mathematics that studies the properties of spatial figures, does not change under deformations. The topological intuition is an instrument for development of topology on the basis of typological heuristics, which is the result of applying topological intuition to the objects topology. The author demonstrates in detail providing with the examples the specificity of topological heuristics and establishes its interconnection with Euclidean geometry. The author draws the conclusion about the fundamentality of topological intuition, and that it, perhaps, is primary in relation to traditionally understood mathematical intuition. (shrink)

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