Dans la médecine occidentale, le patient fut longtemps conçu comme un enfant à sauver, incapable ne serait-ce que de recevoir, de manière raisonnable, le savoir du médecin. Après la seconde Guerre Mondiale, la découverte des expérimentations scientifiques intolérables menées sur l’homme, mais aussi le vent libéral et individualiste des années 60, le progrès des biotechnologies, la démocratisation des savoirs ont favorisé l’émergence d’un nouveau paradigme et d’une nouvelle discipline : la bioéthique. Aujourd’hui, le médecin ne peut plus imposer son traitement (...) au malade, il doit, par respect de son autonomie, chercher à obtenir son consentement libre et éclairé. Les normes médicales et sociales, autrefois coercitives, voire transcendantes, sont aujourd’hui discutées et interrogées au regard des préférences et des valeurs individuelles. Des comités d’éthique pluridisciplinaires sont chargés de prendre en compte les demandes des patients qui ne cessent de bousculer les normes établies. (shrink)

How does Plato view his philosophical antecedents? Plato and his Predecessors considers how Plato represents his philosophical predecessors in a late quartet of dialogues: the Theaetetus, the Sophist, the Politicus and the Philebus. Why is it that the sophist Protagoras, or the monist Parmenides, or the advocate of flux, Heraclitus, are so important in these dialogues? And why are they represented as such shadowy figures, barely present at their own refutations? The explanation, the author argues, is a complex one involving (...) both the reflective relation between Plato's dramatic technique and his philosophical purposes, and the very nature of his late philosophical views. For in these encounters with his predecessors we see Plato develop a new account of the principles of reason, against those who would deny them, and forge a fresh view of the best life - the life of the philosopher. (shrink)

ABSTRACT This essay focuses on two underlying presumptions that impinge on the effort of UNESCO to engender universal agreement on a set of bioethical norms: the conception of universality that pervades much of the document, and its disregard of structural inequalities that significantly impact health. Drawing on other UN system documents and recent feminist bioethics scholarship, we argue that the formulation of universal principles should not rely solely on shared ethical values, as the draft document affirms, but also on differences (...) in ethical values that obtain across cultures. UNESCO's earlier work on gender mainstreaming illustrates the necessity of thinking from multiple perspectives in generating universal norms. The declaration asserts the ‘fundamental equality of all human beings in dignity and rights’1 and insists that ‘the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition’2 yet it does not explicitly recognize disparities of power and wealth that deny equal dignity and rights to many. Without attention to structural (as opposed to merely accidental) inequities, UNESCO's invocation of rights is so abstract as to be incompatible with its avowed intention. (shrink)

Plato's Socrates denies that he knows. Yet he frequently claims that he does have certainty and knowledge. How can he avoid contradiction between his general stance about knowledge and his particular claims to have it? Socrates' disavowal of knowledge is central to his defence in the Apology. For here he rebuts the accusation that he teaches – and thus corrupts – the young by telling the jury that he cannot teach just because he knows nothing. Hence his disavowal of knowledge (...) is important to Socrates. Why does he make this claim? And how then can he justify engaging in any philosophical activity at all? (shrink)

Plato's Socrates denies that he knows. Yet he frequently claims that he does have certainty and knowledge. How can he avoid contradiction between his general stance about knowledge (that he lacks it) and his particular claims to have it?Socrates' disavowal of knowledge is central to his defence in theApology. For here he rebuts the accusation that he teaches – and thus corrupts – the young by telling the jury that he cannot teach just because he knows nothing. Hence his disavowal (...) of knowledge is important to Socrates. Why does he make this claim? And how then can he justify engaging in any philosophical activity at all? (shrink)

& A college development officer is offered a generous gift by a donor whose identity would embarrass the institution. Should the development officer accept? & A volunteer lies about his level of giving, but classmates believe him and match his "gift." Should donors be told the truth? & A development officer must explain to a donor the difference between naming an endowed chair and selecting the person to fill the chair. Where is the line between reasonable donor expectations and intrusion? (...) "There was a time, barely a generation ago, when most college fund raising was a placid, back-porch operation... That pattern, like so much in higher education, began to change dramatically... On the heels of all this change comes this splendid volume by Deni Elliot. The new fund-raising environment raises a host of ethical questions that were largely unknown or unrecognized by earlier generations of fund raisers... The great value of this book is that it provides some clear-eyed guidance through the ethical thicket that is modern higher education fund raising. The great charm of the book is that it provides this important service with such eloquence and good taste... Anyone involved in modern fund raising will find something of value in this book." -- G. Calvin MacKenzie, Academe "This volume provides college and university development officers and administrators practical help with recognizing difficult ethical situations and discerning the correct ethical response. It can also serve as a guide for donors who wonder what's reasonable for them to expect from fund raisers." -- Resources in Education Contributors: Allen Buchanan, James A. Donahue, Marilyn Batt Dunn, Deni Elliott, Bernard Gert, Judith M. Gooch, Bruce R. Hopkins, Frank Logan, Mary Lou Siebert, Holly Smith, and Eric B. Wentworth. (shrink)

Given the increasing complexity of living in a global village, countries and regions that are parts of larger political entities frequently have considered the option of separating or seceding an ideal solution to their problems with a larger center of power. Isolation, a form of “freedom from,” has the potential of offering them free rein or “freedom to” manage their affairs for their own sake. Francophone playwrights and filmmakers have found the dialectical interplay between “freedom from” and “freedom to” fertile (...) dramatic soil for plays and films. Some of them work in both of these and other genres. These works seem to ask the same question: Is it desirable or possible to achieve both, even in ideal isolation, without suffering cultural stagnation or repeating the abuse of power on the part of the political center that led to the separation? This article explores the answers to this question given in the plays of Aimée Césaire, Anne Hébert, and Wajdi Mouawad within the greater context for this issue found in J. M. Coetzee’s Waiting for the Barbarians and Azouz Begag’s Un Mouton dans la baignoire and in francophone films by Raoul Peck, Bertrand Tavernier, Claire Denis, Rachid Bouchareb, Ousmane Sembène, Michael Haneke, and Mathieu Kasovitz. (shrink)

The influential French chemist Marcelin Berthelot spoke against the use of Dalton's atomic theory and Avogadro's hypothesis in the second half of the nineteenth century. This paper argues that Berthelot conceded that atomism might be acceptable as a system of conventions, but he feared the power of such conventions in constructing a realistic picture of atoms which was not warranted empirically. Equally, Berthelot's anti-atomism was a last-ditch effort to assert the place of chemistry within the tradition of natural history and (...) to deny the possible reduction of chemical science to the laws of nineteenth-century physics. (shrink)

There are many kinds of negation and denial. Perhaps the most common is the Boolean negation not that applies to propositions-in-extension, i.e. truth-values. The others are, inter alia, the property of propositions of not being true which applies to propositions; the complement function which applies to sets; privation which applies to properties; negation as failure applied in logic programming; negation as argumentation ad absurdum, and many others. The goal of this paper is neither to provide a complete list, nor to (...) analyse all of them. Rather, I am going to deal with negation of propositions that come attached with a presupposition that is entailed by the positive as well as negated form of a given proposition. However, there are two kinds of negation, namely internal and external negation. I am going to prove that while the former is presupposition-preserving, the latter is presupposition-denying. This issue has much in common with the difference between topic and focus articulation within a sentence. Whereas articulating the topic of a sentence activates a presupposition, articulating the focus frequently yields merely an entailment. The main contribution of this paper is the proof that the two kinds of negation are not equivalent. While the Russellian wide-scope (external) negation gets the truthconditions of a sentence right for a subject occurring as a focus, Strawsonian narrow-scope (internal) negation is validly applicable for a subject occurring as the topic. I also deal with other kinds of presupposition triggers, in particular factive attitudes and prerequisites of a given property. My background theory is Transparent Intensional Logic (TIL). TIL is an expressive logic apt for the analysis of sentences with presuppositions, because in TIL we work with partial functions, in particular with propositions with truth-value gaps. Moreover, the procedural semantics of TIL make it possible to uncover the hidden semantic features of sentences, make them explicit and logically tractable. (shrink)

according to a certain interpretative tradition, Aristotle is committed to prime matter—an indefinite, indeterminate, and unknowable material substratum that exists as pure potentiality and underlies, among other features, the elements and their mutual transformations.1 This interpretative tradition has come under attack from various sources; among such sources are those who wish to deny Aristotle’s commitment to a material substratum that is ontologically more basic than the elements, and who instead affirm the conclusion that Aristotle’s account of nature and change does (...) not require prime matter.2A different objection to the interpretative tradition is voiced by those who wish to maintain Aristotle’s commitment... (shrink)

In recent years, eating disorders among American girls and women have become a subject of national concern. Conventional explanations of eating problems are usually framed in the language of psychology, medicine, feminism, or sociology. Although they differ in theory and approach, these interpretations are linked by one common assumption--that female preoccupation with food and body is an essentially secular phenomenon. In Starving for Salvation, Michelle Lelwica challenges traditional theories by introducing and exploring the spiritual dimensions of anorexia, bulimia, and related (...) problems. Drawing on a range of sources that include previously published interviews with sufferers of eating disorders, Lelwica claims that girls and women starve, binge, and purge their bodies as a means of coping with the pain and injustice of their daily lives. She provides an incisive analysis of contemporary American culture, arguing that our dominant social values and religious legacies produce feelings of emptiness and dissatisfaction in girls and women. Trapped in a society that ignores and denies their spiritual needs, girls and women construct a network of symbols, beliefs, and rituals around food and their bodies. Lelwica draws a parallel between the patriarchal legacy of Christianity, which associates women with sin and bodily cravings, and the cultural preference for a thin female body. According to Lelwica, these complimentary forces form a popular salvation myth that encourages girls and women to fixate on their bodies and engage in disordered eating patterns. While this myth provides a sense of meaning and purpose in the face of uncertainty and injustice, Lelwica demonstrates that such rigid and unhealthy devotion to the body only deepens the spiritual void that women long to fill. Although Lelwica presents many disturbing facts about the origins of eating disorders, she also suggests positive ways that our society can nourish the creative and spiritual needs of girls and women. The first step, however, is to acknowledge that female preoccupation with thinness and food signifies a strong desire for fulfillment. Until we recognize and contest the religious legacies and cultural values that perpetuate eating disorders, many women will continue to turn to the most accessible symbolic and ritual resources available to them--food and their bodies--in an attempt to satiate their profound spiritual hunger. (shrink)

In Briefings on Existence, Alain Badiou calls for a radical atheism that would refuse the Heideggerian pathos of a “last god” and deny the affliction of finitude. I will argue that Jean-Luc Nancy’s deconstruction of monotheism, as well as his thinking of the world, remains resolutely atheistic, or better atheological, precisely because of Nancy’s insistence on finitude and his appeal to the Heideggerian motif of the last god. At the same time, I want to underline the danger of Nancy’s maintenance (...) of the word “god” to name the infinite opening of the world right at [à même] the world, by considering it as a Derridean paleonymy. (shrink)

This article tackles caste-based poverty by a focus on the position of Dalit women in India. Of 200 million Dalits, nearly 50% are women, often referred to a ‘thrice Dalit’, as they suffer from the triple oppressions of poverty, being female and being female Dalits. They are frequently let down by both the Dalit movement itself as well as the women’s movement in India that focuses more on social problems like dowry deaths—more relevant for caste women and not those outside (...) the caste system. Many Dalit women are denied access to education, to meaningful employment, health provision and are the first to suffer the negative effects of globalization. Access to upper caste wells is forbidden. Worst of all, Dalit women are exposed to many forms of violence and are frequently raped as a way to humiliate Dalit men. The degrading work of ‘scavenging’—removing human excrement-falls mostly on Dalit women, since men are more likely to be ‘upwardly-mobile’. Despite all of this, a new strength now emerges in challenging caste boundaries, contributing to self esteem and a stronger sense of identity. The strong spirituality of Dalit women has sustained strength through songs and stories, and in some cases by subverting patriarchy through ironically re-shaping traditional myths. The article ends by suggesting forms of action from Church, society and feminist theology to show solidarity and effect social change for Dalit women. (shrink)

Contrary to Michael Miller, I maintain that Descartes’s language test adequately distinguishes humans from non-human animals, and that the bonobosKanzi and Panbanisha have not passed it. Miller accepts Descartes’s language test as a good test for true language usage, but denies that it is an adequate test for the presence or absence of reason. I argue that it is a good test for reason, for normal rational beings eventually recognize the desirableness of knowledge of the world for its own sake (...) as well as the fact that such knowledge can be increased by conversing with others. I also argue that the tests administered to the bonobos in question are inadequate for determining true language usage, as they could be passed by animals merely capable of associative learning. (shrink)

As a political movement inspired by a belief in fundamental equality and committed to eradication of embodied injustices, feminists have illuminated the politics of exclusion—the use of law and policy to grant rights, opportunities, privileges, and immunities to particular elite men while denying them to marginalized others. With the theorization of gender as an analytical category, feminist scholars have investigated how manifold policies have discursively produced hierarchies of citizenship structured by gender, race, and sexuality. This chapter provides an overview of (...) feminist contributions to policy studies, including key critiques of mainstream policy scholarship, an examination of feminist policy interventions and their mixed results ranging from attempts to eradicate sex discrimination in law and policy, the creation of women’s policy agencies, and the shift to gender mainstreaming. The chapter concludes with a discussion of the politics of equality, comparing nondiscrimination and equal opportunity approaches with structural and substantive conceptions of equality. (shrink)

This paper addresses the notorious logic and semantic difficulties encountered by Lévinas in articulating his ethics of alterity. Tracing the philosophical genesis of this question in Descartes and Heidegger, it recognises Lévinas's claim that there can be no ontological foundation for ethics because ontology would reduce ethics to a form of mathematical ratio. Lévinas is unwilling to deny his phenomenological experience of a desire for goodness and unable to deny his despair at his ontological alienation from the good and so (...) he is driven to seek an irrational link between the human being and a metaphysical ‘good beyond being’. Retrieving an ancient gnostic neo-Platonist working of the same problem from the work of Hans Jonas, the paper reconsiders Lévinas's reading of Plato, specifically his understanding of Socrates’ exposition of erosin the Phaedo, in order to illustrate how his ethics of alterity may allow the human being to refer irrationally to the good beyond being. (shrink)

John Milbank argues for a new Christendom on the grounds that the "narrated practice" of Christianity provides our only hope for peaceful harmony amid differences. He defends this claim on the basis of a "pragmatic linguistic idealism," in which our various narrative traditions compete to appeal to our taste; he decisively rejects the possibility of any other criteria of evaluation or of a mutually critical dialogue. This oppositional stance toward other perspectives reveals the instability of Milbank's position, however, in that (...) it denies the possibility of harmony among differences upon which his defense of Christianity depends. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy of Music Education Review 12.1 (2004) 17-29 [Access article in PDF] Intersections Form, Feeling, and Isomorphism Mary J. Reichling University of Louisiana at Lafayette These three concepts hold meanings that differ among musicians and aestheticians. In this essay I shall explore them in the writings of Susanne Langer. Contemporary musicians and aestheticians continue today to engage Langer albeit some favorably and others with disdain. Whatever their reasons, she (...) remains a dominant force in the philosophy of music.1 My purpose is not to defend her against her detractors, but rather to examine and to elucidate various aspects of these three concepts in her writing, as they are fundamental to an understanding of her aesthetic theory and to the construction of a philosophy of music and music education.First, I consider the broad and complex notion of form and the various ways Langer employs it in her aesthetic theory. Next, the rather all-encompassing idea of feeling as Langer conceives it is studied in relation to the form of the musical work. The intersection of form and feeling in the concept of isomorphism concludes the discussion. [End Page 17] Form In her various writings Langer uses several adjectives associated with the word "form" which seem to organize well into three groups. The first concerns the dynamic, living, organic, and vital qualities of form; the second speaks to its logical and abstract nature; and the last relates to the emotional or feeling aspect of form including expressive and significant characteristics.2 These groupings overlap and intertwine, but focusing on each specifically rather than all as a totality offers important insights.Form as dynamic, living, organic, and vital suggests metaphorical reference. Obviously the form is not physically, biologically, alive; reference is to the apparent movement, growth, and aliveness of the musical form as it is heard or performed. Thus this idea of form implies an actual performance to be realized or perceived. Langer is sometimes criticized for giving little attention to the actual making of music, that is, performance, yet her theory assumes music as heard. Essential to perceiving a dynamic form or hearing a feeling is a processual event, namely, performance or listening to a performance. Rarely a professional musician or gifted amateur might be able to engage this concept of form by reading through a score and hearing the music in imagination.Dynamic form parallels Eduard Hanslick's notion of tonend bewegte Formen. One might object that Hanslick and Langer are in conflict as Hanslick opposes while Langer supports the conviction that form is expressive of feeling, but that is moving beyond the matter at hand and suggests a superficial reading of both Hanslick and Langer. Hanslick asserts emphatically that music's meaning is not the arousal of emotion but does not deny feeling in music; Langer holds the same view. But Hanslick allows that "the words content and form are used not in the purely logical, but in an artistic sense." To me this suggests that he recognizes a nonliteral or metaphorical interpretation. He writes about the relationship of musical tones as "fraught with significance... congruity and opposition, their separating and combining, their soaring and subsiding-this is what comes in spontaneous forms before our inner contemplation and pleases us as beautiful." Certainly this parallels Langer's description of dynamic form.3 What is significant is that both philosophers are addressing the fluid, processual, active, movement-of-notes-through-time nature of musical form.The premise that forms are created by motion, are dynamic, is easily grasped by offering some examples. Fast cameras are able to take a series of photos of the movements of a pianist's hands giving still pictures of the moving forms created while performing a given passage.4 Alternately, forms are created by the movements of clouds or fog through the mist and early light; they are, in effect, quite literally moving forms. Cartoon characters generate moving forms through the [End Page 18] use of many drawings or more recently by means of computer animation. Time is a dynamic or moving form which we divide into hours... (shrink)

Building Better Health Care Leadership for Canada explains the development and implementation of the Executive Training in Research Application program. Managed and funded by the Canadian Health Services Research Foundation in partnership with the Canadian Medical Association, the Canadian Nursing Association, and the Canadian College of Health Care executives, EXTRA is a two-year national fellowship program that uses the principles of adult learning theory as well as practical projects to educate senior health care leaders in making more consistent use of (...) research evidence in their management roles. Fellows apply the theory learned in residency sessions and educational activities to projects within their home organizations. The authors identify the imperative for better use of evidence, outline the core elements of the curriculum, and capture the real-world experience of regional leaders and fellows involved in making specific changes informed by research-based evidence within their organization. Contributors include Jean-Louis Denis, Terrence Sullivan, Owen Adams, Malcolm Anderson, Lynda Atack, Robert Bell, Sam G Campbell, Sylvie Cantin, Ward Flemons, Dorothy Forbes, J. Sonja Glass, Paula Goering, Karen Golden-Biddle, Jeffrey S. Hoch, Paul Lamarche, Ann Langley, John N. Lavis, Jonathan Lomas, Margo Orchard, Raynald Pineault, Brian D. Postl, Christine Power, Trish Reay, Jean Rochon, Denis A. Roy, Andrea Seymour, Samuel B. Sheps, Micheline Ste-Marie, Nina Stipich, David Streiner, Carl Taillon, and Muriah Umoquit. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Mary Margaret Mackenzie THE TEARS OF CHRYSES: RETALIATION IN THE ILIAD1 ATHEORY of punishment is a systematic justification of the practice of punishment. Before the emergence of true penology in classical Greece—in Plato's Laws for example—penal transactions are associated only with pre-philosophic rationalizations. But such rationalizations must, nevertheless, be regarded as the antecedents of a formalized theory of punishment. In order to understand the classical approach to punishment, therefore, (...) we should look to the early literature for evidence, descriptive or evaluative, of the penological antecedents. To begin at the beginning, this article will consider the Iliad. Yet this procedure begs questions. First of all, a critic might deny the propriety of the use of literary evidence in a study of a philosophical problem. The objection is twofold—both against the treatment of literature as philosophy and against the assumption of continuity in the transition from non-philosophical to explicitly philosophical sources. To this the answer lies partly in the nature of Greek culture. Until the sophistic age there existed no moral philosophy as such—and yet the Greeks were capable of considering and solving moral problems, such as the questions surrounding the practice of punishment. Thus while we should distinguish between this unphilosophical approach and the systematic analyses of the philosopher, the problems with which they deal remain the same. Second, Homer depicts a fictional society: it is a common contention that we therefore have no grounds for attributing consistency or historical reality to any of the institutions described in the poems. Thus the proposition is that, not content with inventing a story to tell, Homer imagined all the trappings of the fiction as well—the conventions and the sentiments bear no relation to conventions or values of his own or any other time. The same argument might be applied to other literary works which make no claim to historicity. But its plausibility depends upon an inflated notion of fiction in which nothing of the 4 Philosophy and Literature story approaches the familiar experiences of its hearers. It is, of course, more reasonable to suppose that fiction generally derives its impact from familiarity, and that Homer's popularity was founded in his appeal to the audience's imagination in the context of their own lives. Thus while the story itself is fiction, it is associated with fact in its detail—the commonplaces of social life and human reaction among which the heroes move. Our task is to look to the commonplaces, for here will be found the social practices and the assumptions which Homer's audience would take for granted. Finally, we may generally suppose that the context of a particular source is determined chiefly by its antecedents. If, however, we are to treat the Homeric poems as the earliest Greek literary sources available to us, there is a major difficulty in this establishment of context: the absence of antecedent. The discussion of Homeric society has been severely hampered by the lack of contemporary referents and by the consequent temptation to import our own values as yardsticks for the measuring of the idiosyncracies of Homeric thought. To a large extent this is a useful enterprise; it is possible, for instance, to point out the differences between Homeric military structure and our own, or between the kingship system and the political structures of later Greek societies. On the other hand, as soon as the discussion turns to values, the issue becomes complicated; to compare two values, in our own society and in the Homeric poems, tends to presuppose some common ground where there need be none, to assume that the way we might translate a word reflects significantly upon its original use. This third difficulty gives rise to an eristic dilemma, common in the history of ideas: how do we know that a transaction is a punishment unless we already know that it is a punishment? Or if we are uncertain whether punishment occurs (and if we have no common language to help in the identification), where should we look for it? Further, having established the area in which punishment should occur, what criteria are to be employed to determine whether in fact it does? The first... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Incorporating Religion into Psychiatry:Evidenced–Based Practice, Not a Bioethical DilemmaMary D. MollerFor over sixteen years I was the owner and clinical director of an advanced practice nurse–managed outpatient rural psychiatric clinic staffed by APNs, a social worker, a licensed counselor and several graduate students. Many of our patients were victims of severe and often brutal trauma and abuse suffered at the hands of family, friends, and various professionals including spiritual (...) leaders. We also uncovered sources of abuse suffered from those involved in occult practices ranging from seemingly innocent white witchcraft (Wicca, Paganism, New Age) that includes such activities as astral projection and remote viewing to the darkest possible black witchcraft (perpetrating evil, incanting evil spirits, casting spells and hexes, creating dissociative identities) such as occurs in ritual abuse and satanic rites. Both types of witchcraft also typically involved family, friends, various professionals, and spiritual leaders. Recognizing the controversy surrounding the reality of witchcraft I am sharing a story that I hope will help break down the barriers that prevent many patients from receiving the treatment that would provide the most benefit to recovery.Seeking services for these patients led me on an intense personal and professional journey that included a profound Christian born–again experience at almost 50 years of age. My professional career grew in nearly indescribable terms as a result of the incorporation of prayer and deliverance ministry as part of the services we selectively provided. Today I always include assessment of spiritual experiences a patient has as well as spiritual supports that are available with every new patient intake. For patients who indicate that prayer is one of their supports, I ask if they would like prayer at the conclusion of the session. The gratitude that is expressed by individuals who appreciate being able to pray with a psychiatric provider is often profound.In the field of psychiatry there has been a long–standing and distinct taboo regarding incorporating religious and spiritual aspects of life experience into treatment unless it is to frame most of these discussions within the context of psychosis. This stems from the advent of psychoanalysis in which religion was deemed a neurosis and atheism became the goal. Some still hold to that belief and there certainly remains controversy regarding the incorporation of prayer into routine outpatient or inpatient care. The essential starting point is the determination of accurate differential diagnosis, which can often be a lengthy process. The clinician must be careful about distinguishing between religious experiences and religious delusions, and often this takes time to sort out. The determination of the etiology of hearing the voice of God or the devil or demons must be carefully parsed and framed within the context of the situation and culture the patient describes. If the clinician denies the existence of God or the devil or demons or the practice of witchcraft, the patient’s descriptions of such experiences will be quickly [End Page 206] labeled psychotic. The patient may then experience a lengthy hospitalization and treatment with psychotropic medications that can have an extremely negative effect on the possibility of recovery. Once I witnessed the level of healing that occurs with carefully administered spiritual interventions that are related to specific spiritual experiences that are based on the patient’s belief system, there was no going back to using only allopathic medication and non–spiritual psychosocial interventions, even in spite of the criticisms from others. The key is to understand and respect the patient’s belief system, if this is not congruent with the practitioner’s belief system, then practitioner must refer out.In the United States, an increasing persecution of Christianity and a devaluing of the Judeo–Christian heritage of our Constitution are creating a climate of intolerance to the expression of religious values resulting in an expectation that Christians should compromise their beliefs for the sake of political correctness. As a doctorally prepared psychiatric–mental health advanced practice nurse I experienced a profound born–again Christian experience that ultimately led to study of the Hebrew roots of Christianity and I now worship in a Messianic Jewish synagogue. It is impossible for me to not include the concept of spirituality into... (shrink)

This paper addresses the notorious logic and semantic difficulties encountered by Lévinas in articulating his ethics of alterity. Tracing the philosophical genesis of this question in Descartes and Heidegger, it recognises Lévinas's claim that there can be no ontological foundation for ethics because ontology would reduce ethics to a form of mathematical ratio. Lévinas is unwilling to deny his phenomenological experience of a desire for goodness and unable to deny his despair at his ontological alienation from the good and so (...) he is driven to seek an irrational link between the human being and a metaphysical ‘good beyond being’. Retrieving an ancient gnostic neo-Platonist working of the same problem from the work of Hans Jonas, the paper reconsiders Lévinas's reading of Plato, specifically his understanding of Socrates’ exposition of erosin the Phaedo, in order to illustrate how his ethics of alterity may allow the human being to refer irrationally to the good beyond being. (shrink)

Nondirective genetic counseling developed as a means of promoting informed and independent decision-making. To the extent that it minimizes risks of coercion, this counseling approach effectively respects client autonomy. However, it also permits clients to make partially informed, poorly reasoned or ethically questionable choices, and denies counselors a means of demonstrating accountability for the use of their services. These practical and ethical tensions result from an excessive focus on noncoercion while neglecting the contribution of adequate information and deliberative competence to (...) autonomous decision-making. A counseling approach that emphasizes the role of deliberation may more reliably produce thoroughly reasoned decisions. In such an approach, characterized by dialogue, counselors are responsible for ensuring that decisions are fully informed and carefully deliberated. Counseling remains nonprescriptive, but in the course of discussion counselors may introduce unsolicited information and/or challenge what they believe are questionable choices. By this means clients can be better assured that the decisions they make are fully considered, while counselors demonstrate a limited degree of professional accountability. (shrink)

This essay focuses on two underlying presumptions that impinge on the effort of UNESCO to engender universal agreement on a set of bioethical norms: the conception of universality that pervades much of the document, and its disregard of structural inequalities that significantly impact health. Drawing on other UN system documents and recent feminist bioethics scholarship, we argue that the formulation of universal principles should not rely solely on shared ethical values, as the draft document affirms, but also on differences in (...) ethical values that obtain across cultures. UNESCO's earlier work on gender mainstreaming illustrates the necessity of thinking from multiple perspectives in generating universal norms. The declaration asserts the ‘fundamental equality of all human beings in dignity and rights’1 and insists that ‘the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition’2 yet it does not explicitly recognize disparities of power and wealth that deny equal dignity and rights to many. Without attention to structural inequities, UNESCO's invocation of rights is so abstract as to be incompatible with its avowed intention. (shrink)

Medicine seeks to overcome one of the most fundamental fragilities of being human, the fragility of good health. No matter how robust our current state of health, we are inevitably susceptible to future illness and disease, while current disease serves to remind us of various frailties inherent in the human condition. This article examines the relationship between fragility and uncertainty with regard to health, and argues that there are reasons to accept rather than deny at least some forms of uncertainty. (...) In situations of current ill health, both patients and doctors seek to manage this fragility through diagnoses that explain suffering and provide some certainty about prognosis as well as treatment. However, both diagnosis and prognosis are inevitably uncertain to some degree, leading to questions about how much uncertainty health professionals should disclose, and how to manage when diagnosis is elusive, leaving patients in uncertainty. We argue that patients can benefit when they are able to acknowledge, and appropriately accept, some uncertainty. Healthy people may seek to protect the fragility of their good health by undertaking preventative measures including various tests and screenings. However, these attempts to secure oneself against the onset of biological fragility can cause harm by creating rather than eliminating uncertainty. Finally, we argue that there are good reasons for accepting the fragility of health, along with the associated uncertainties. (shrink)

Au polyhandicap sévère, la société a réagi de trois manières différentes : par une « hémiplégie » visuelle d’abord, en l’ignorant, par une atteinte de son narcissisme, liée à sa culpabilité de le rejeter, et par une effraction enfin des enveloppes familiales. Pour les familles et les équipes éducatives, c’est la rencontre pérenne avec la différence, le traumatisme, mais aussi avec le déni. Même si historiquement cette prise en compte évolue, un travail de lien est à réaliser, ce que l’auteure (...) illustre par diverses situations issues de sa pratique. (shrink)

In the Origins of Totalitarianism, Hannah Arendt makes the unexpected statement that totalitarian violence "is expressed much more frighteningly in the organization of its followers than in the physical liquidation of its opponents." Of course, her intention is not to deny the radical physical violence of totalitarianism but rather to understand the distinctive features of totalitarian terror. In order to fully understand the importance of what Arendt is describing, we should compare this first moment of the analysis with another assertion (...) that seems just as paradoxical and that is also in The Origins of Totalitarianism: noting totalitarianism's contempt for facts and reality, Arendt remarks that the propaganda of totalitarian movements is "invariably as frank as it is mendacious." Totalitarian propaganda does not just lie about the aims and real actions of totalitarian movements or regimes: it also gives itself the organization required to change the real world and make it "true" to its assertions, though they be utterly absurd and utterly monstrous. Through totalitarian organization the natural bonds of solidarity and communication are broken; they are replaced by distrust and informing. The objective is to pervert human plurality into a mass of fragmented individuals, to suppress the common world and substitute it with alienation from the world, from others, and from oneself. From then on, everything is blurred for the outside observer who would still like to distinguish between adherence to the regime out of conviction and submission through terror, organization, and indoctrination. The issue of knowing whether this enthusiasm is forced or sincere loses much of its pertinence. Let us keep this important point in mind when we pass judgment too rapidly on the "fanaticism" of Islamic crowds streaming down the streets of Teheran or any other totalitarian theocracy. (shrink)

Cet article explore une dimension essentielle, et jusqu’à présent peu analysée, du langage machiavélien : les métaphores médicales et parmi celles-ci, plus spécialement les termes et expressions qui lui permettent d’énoncer ses thèses majeures sur l’ordre institutionnel propre à la liberté. L’enquête sur les sources de la théorie médicale en vigueur au tournant du 16ème siècle – le présocratique Alcméon de Crotone, le corpus hippocratique tel qu’il est transmis par Galien – montre à la fois l’importance du vocabulaire médical pour (...) Machiavel (les métaphores médicales ne sont donc en aucun cas de simples ornements) et les libertés qu’il prend à l’égard de cette source dans la formulation de ses idées politiques. L’analyse de cet usage oriente la réflexion vers une analyse du statut de l’idée de constitution mixte chez Machiavel : les institutions de la liberté correspondent-elles à cet idéal antique, formulé en Grèce, puis appliqué à la réalité romaine par Polybe, Cicéron et Denys d’Halicarnasse. En réalité, à travers sa pensée du conflit civil, Machiavel s’éloigne de manière radicale du modèle de la constitution mixte. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Mask of Enlightenment: Nietzsche’s ZarathustraKathleen Marie HigginsThe Mask of Enlightenment: Nietzsche’s Zarathustra, by Stanley Rosen; 286 pp. New York: Cambridge University Press, 1995, $18.95 paper.In Ecce Homo Nietzsche remarks that he wants to be read the way good old philologists read Horace. Stanley Rosen has fullled this Nietzschean wish. His Mask of the Enlightenment interprets Nietzsche’s Thus Spoke Zarathustra with astute attention, and it delivers on (...) Rosen’s stated aim of avoiding both the obscurantism of postmoderns and the selective attention of analytic philosophers. It is philological in the best sense, balancing its consideration of detail with a sense of the book’s larger context, as well as the context of textual predecessors to whom Nietzsche refers and responds.Rosen reads Nietzsche as a fundamentally political thinker, who seeks to transform humanity’s collective circumstances. The ultimate goal of this effort [End Page 193] is “to breed a new race of mankind” that would supersede the decadent existing race (p. 56). This positive aim, however, requires the destruction of the existing race to make room for the new one.Zarathustra, according to Rosen, is an artistic statement of these aspirations and a tactic for achieving them. From the beginning, Zarathustra calls for the appearance of the superman and the destruction of contemporary European culture. Aware of how far his contemporaries are from the superman, Zarathustra utilizes a double rhetoric, concealing his real intent from all but the select few.Zarathustra addresses noble lies to the crowd, which make his doctrines appear to be afrmative and salvational, but try to seduce the majority to their own self-destruction. Preaching the coming of the superman and the doctrine of eternal recurrence (the view that time recurs cyclically), Zarathustra’s real purpose is to accelerate nihilism and hasten the destruction of current European culture. This aim, however, is concealed by the seemingly afrmative character of these doctrines.Zarathustra’s esoteric message rests on Nietzsche’s materialistic reductionism, according to Rosen. Nietzsche understands reality, fundamentally, to be nothing but chaotic uctuations among accumulating points of force. Even the expression “will to power” suggests a more coherent ontological structure than reality exhibits. The doctrine of “will to power” is an exoteric idea that conceals Nietzsche’s belief that the world is a chaos of uctuating points of force. Will, subjectivity, and physics are all illusions that disguise a cruel and uncaring world.The doctrine of eternal recurrence, in its esoteric sense, reects this vision. Claiming that the sequence of temporal events recurs endlessly, the doctrine is an image for the universe’s spontaneous being, which has no inherent value. This vision is nihilistic, for it implies the illusory status of our subjective selves, any sense of progress, and even our scientic theories. If reality is ultimately chaos, our lives are meaningless.So understood, the doctrine of eternal recurrence is not obviously compatible with Zarathustra’s call for the superman. The superman project is doomed to fail, since eternal recurrence implies that the condition of decadence will recur, even if a superman is generated at some point. Eternal recurrence is also incompatible with amor fati, the love of fate that Zarathustra preaches. Eternal recurrence is an image of chance, of the random happening of force-points, while amor fati is a deterministic vision. Chance and necessity are the same in their human signicance. Both deny human freedom. Chance means that our behavior arises from the un-ordered movements of force points.One of the achievements of Rosen’s book is its mapping of such tensions within Zarathustra, tensions that motivate the drama of the book. These tensions are numerous. Zarathustra preaches the superman to those he seeks as followers, but followers are inherently incapable of the superman’s creative [End Page 194] spontaneity. Zarathustra’s bombast, used to attract attention, is in tension with the subtlety of his actual message. The activism implied by Zarathustra’s preaching is at odds with the fatalism of amor fati. The rank-ordering of human types, a feature of Zarathustra’s elitism, is incompatible with his inner doctrine that the world is chaos.Rosen concludes that some of these tensions... (shrink)

This conversation analytic study investigates how couples manage conflicting knowledge claims when one of the persons has dementia. The data are video-recordings of 16 couples talking with a third party. The analysis focuses on the negotiation of epistemic rights, more precisely how partners initiate repair and correct claims made by the PWD on matters belonging to the latter’s epistemic domain. We identified three main practices for correcting the PWD: correcting the statement, thereby claiming epistemic authority for oneself and denying it (...) to the PWD, inviting the PWD to self-correct, thereby attributing some epistemic authority to the PWD, and disagreeing and providing reasons for one’s alternative claim, establishing a more symmetric epistemic gradient. The PWDs responses to the corrections displayed different degrees of acceptance, ranging from self-denigration to resistance and insistence. (shrink)

One challenge posed by climate change education is that, despite the scientific consensus on human induced climate change, the issue is controversial and politicised. A recent poll conducted in the USA revealed that 45% of respondents did not believe that human activity is a key cause of climate change, while 8.3% denied that climate change was occurring at all. The poll also found that those with conservative political beliefs were far more likely to deny anthropogenic climate change. The controversial nature (...) of climate change is a double-edged sword for educators—offering both benefits and risks. Controversial topics can be engaging for students, allowing them to critically examine competing perspectives, justify opinions and, thus, develop and practice critical thinking skills. On the other hand, they may provoke classroom conflict and expose teachers to backlash from students, parents, colleagues or even members of the public, including accusations of indoctrination. This risk has resulted in some teachers adopting problematic approaches to teaching about climate change, such as presenting students with an impartial account of ‘both sides’ of the debate. Some climate change sceptics groups have even developed their own curriculum materials and lobbied for their implementation in schools in order to provide students with a ‘balanced’ account of the issue. These problems, and suggestions for overcoming them, are explored by several papers in this special issue. (shrink)

In a world with limited resources, allocation of resources to certain individuals and conditions inevitably means fewer resources allocated to other individuals and conditions. Should a patient's personal responsibility be relevant to decisions regarding allocation? In this project we combine the normative and the descriptive, conducting an empirical bioethical examination of how both Norwegian and British doctors think about principles of responsibility in allocating scarce healthcare resources. A large proportion of doctors in both countries supported including responsibility for illness in (...) prioritization decisions. This finding was more prominent in zero‐sum scenarios where allocation to one patient means that another patient is denied treatment. There was most support for incorporating prospective responsibility (through patient contracts), and low support for integrating responsibility into co‐payments (i.e. through requiring responsible patients to pay part of the costs of treatment). Finally, some behaviours were considered more appropriate grounds for deprioritization (smoking, alcohol, drug use)—potentially because of the certainty of impact and direct link to ill health. In zero‐sum situations, prognosis also influenced prioritization (but did not outweigh responsibility). Ethical implications are discussed. We argue that the role that responsibility constructs appear to play in doctors' decisions indicates a needs for more nuanced—and clear—policy. Such policy should account for the distinctions we draw between responsibility‐sensitive and prognostic justifications for deprioritization. (shrink)

L'auteur s'intéresse à la Vie de Constantin le Juif et plus particulièrement à un phénomène qui avait échappé jusqu'alors à ses commentateurs: celui de "l'imitation divine" . Quand Constantin est sauvé d'un meurtre par une apparition de la Vierge, l'auteur de la Vie affirme qu'il ne s'agit pas de Marie elle-même, mais d'une grâce divine qui a pris son apparence. Ce concept se retrouve dans différentes vies de saints. Selon l'auteur, ce procédé semble vouloir rappeler au lecteur que l'influence (...) de Dieu sur ce monde est prépondérante et ne se "dilue" pas au travers des interventions de certains saints. (shrink)

In everyday conversation, messages are often communicated indirectly, implicitly. Why do we seem to communicate so inefficiently? How speakers choose to express a message (modulating confidence, using less explicit formulations) has been proposed to impact how committed they will appear to be to its content. This commitment can be assessed in terms of accountability – is the speaker held accountable for what they communicated? – and deniability – can the speaker plausibly deny they intended to communicate it? We investigated two (...) factors that may influence commitment to implicitly conveyed messages. In a preregistered online study, we tested the hypothesis that the degree of meaning strength (strongly or weakly communicated) and the level of meaning used by the speaker (an enrichment or a conversational implicature) modulate accountability and plausible deniability. Our results show that both meaning strength and level of meaning influence speaker accountability and plausible deniability. Participants perceived enrichments to be harder to deny than conversational implicatures, and strongly implied content as more difficult to deny than weakly implied content. Furthermore, participants held the speaker more accountable to content conveyed via an enrichment than to content conveyed via an implicature. These results corroborate previously found differences between levels of meaning (enrichment vs. implicature). They also highlight the largely understudied role of meaning strength as a cue to speaker commitment in communication. (shrink)

Adaptive preferences have been extensively studied in decision theory and feminist political theory, but not in experimental philosophy. In feminist contexts, the term is used to discuss cases in which women seem to accept abusive treatment and other conditions of oppression. According to one class of theories, women who accept abusive behavior are cognitively deficient: irrational, lacking autonomy, or not acting in accordance with their identity. Other theories deny this, saying that under certain conditions, accepting abuse can be a sound (...) response, given available alternatives. We survey lay opinions about a case in which a woman endures domestic violence and find that people often attribute adaptive attitudes and tend to see them as rational, free, and reflective of identity. We also examine lay normative judgments, including options about the right course of action, and the locus of blame, finding, for example, some tendency to blame the victim in such cases. Such attitudes are impacts by gender and political orientation. We also manipulated the cultural setting of our vignette, but found no impact. (shrink)