Unconsented episiotomies and other procedures during labour are commonly reported by women in several countries, and often highlighted in birth activism. Yet, forced caesarean sections aside, the ethics of consent during labour has received little attention. Focusing on episiotomies, this paper addresses whether and how consent in labour should be obtained. We briefly review the rationale for informed consent, distinguishing its intrinsic and instrumental relevance for respecting autonomy. We also emphasise two non-explicit ways of giving consent: implied and opt-out consent. (...) We then discuss challenges and opportunities for obtaining consent in labour and birth, given its unique position in medicine.We argue that consent for procedures in labour is always necessary, but this consent does not always have to be fully informed or explicit. We recommend an individualised approach where the antenatal period is used to exchange information and explore values and preferences with respect to the relevant procedures. Explicit consent should always be sought at the point of intervening, unless women antenatally insist otherwise. We caution against implied consent. However, if a woman does not give a conclusive response during labour and the stakes are high, care providers can move to clearly communicated opt-out consent. Our discussion is focused on episiotomies, but also provides a useful starting point for addressing the ethics of consent for other procedures during labour, as well as general time-critical medical procedures. (shrink)

We read commentaries on our feature article ‘The ethics of consent during labour and birth: episiotomies’1 with gratitude and interest. Nearly all commenting authors agree that consent for in-labour procedures is necessary and ideally given at the point of intervening. Both Shalowitz & Ralston and Stirrat note that this is already required by professional statements and guidelines in the USA2 and UK3, respectively, but also note that practice does not yet conform. The Americans authors helpfully emphasise the importance of multilevel (...) institutional measures for closing this gap, including consent policies and reporting mechanisms, as well as ongoing education.2 The UK writer seconds the role for education within wider shared decision-making and informed choice approaches, and generously commends our paper for close study by all maternity care providers. Others add a cautionary note. Lee applauds all our recommendations, but notes our proposals cannot fully secure autonomy because of, among others, epistemic injustice and other power differentials.4 Kumar-Hazard and Dahlen worry that opt-out consent is equal to substitute decision-making; weakens women’s rights; and is open to abuse.5 Nelson and Clough object to our willlingness to work within a flawed conceptual framework, which ought to be challenged.6 We agree that there are limits to what our proposal can do. It cannot rectify unequal distributions of epistemic credibilities, either in general or in any particular interaction. Risk communication is never neutral;7 “even the most well-meaning healthcare professionals …. (shrink)

Martin Heidegger's commitment to the idea that _Dasein_ is ultimately gender neutral, as well as several other major aspects of his thought, raises significant questions for feminist philosophers. The fourteen essays included in this volume clearly illustrate the ways in which feminist readings can deepen our understanding of his philosophy. They illuminate both the richness and the limitations of the resources his work can provide for feminist thought. This volume engages the full scope of Heidegger's writings from_ Being and Time (...) _through his latest work, from his readings of the ancient Greek poets to his critique of modern technology. At the same time, it reflects a wide range of contemporary feminist concerns: the significance of gender difference; the role of the body in philosophical thought; the relationship between philosophy and the natural world, and between philosophy and the domestic realm; and the aspiration to move forward into a new, more just, political world. Included in this volume are important new essays by Ellen Armour, Carol Bigwood, Jack Caputo, Tina Chanter, Trish Glazebrook, Jennifer Gosetti, Luce Irigaray, Dorothy Leland, Mechthild Nagel, Gail Stenstad, and the editors—as well as a valuable historical and theoretical Introduction by Patricia Huntington, the first of Jacques Derrida's "Geschlecht" articles, and an important 1997 essay by Iris Marion Young. (shrink)

This article examines Grotius’ lifelong support for Dutch expansion overseas. As noted in other publications of mine, Grotius cooperated closely with the directors of the Dutch East India Company (VOC) in the years 1604–1615. Right up to his arrest for high treason in August 1618, he contributed towards Dutch government discussions about the establishment of a West India Company (WIC). Three years of imprisonment at Loevestein Castle and, following his escape, long years of exile could not weaken his dedication to (...) the cause. His relatives in Holland, in particular his brother Willem de Groot and his brother-in-law Nicolaas van Reigersberch, kept him up-to-date on the fortunes of the VOC and WIC. His expertise on maritime affairs was in high demand. For example, Cardinal Richelieu invited him in November 1626 to become actively involved in the establishment of a French East India Company. As itinerant ideologue of empire, Grotius sought to further his own career and those of his nearest family members, without damaging the interests of the United Provinces. Through Willem de Groot and Nicolaas van Reigersberch, he provided informal advice on Dutch imperial policy to the VOC directors and government officials in The Hague. He was rewarded with the appointment of his brother and his second son, Pieter de Groot, as VOC lawyers (ordinaris advocaten) in 1639 and 1644, respectively. They served as his proxies in diplomatic disputes involving the VOC, the States General and the Portuguese ambassador in autumn 1644, when Pieter and Willem de Groot wrote a defense of VOC claims to the cinnamon-producing areas of Ceylon (modern-day Sri Lanka), liberally citing De Jure Belli ac Pacis. Grotius’ vision of empire hardly changed in the course of 40 years. In his view, the Dutch had gone to the Indies as merchants, not conquerors, and should regulate themselves according to natural law and the law of nations. Thus he contributed to the creation of two political orders, one for Europe and one for the Indies. European diplomatic relations counted for little beyond the Line. VOC and WIC officials could act as judges and executioners in their own cause, without reference to indigenous rulers, other colonial powers, or even the political authorities back home. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 26.1 (2002) 216-223 [Access article in PDF] Notes and Fragments Genre Fiction and "The Origin of the Work of Art" Nancy J. Holland I FIRST, A CONFESSION. Like, I suspect, many of my readers, I am an unpublished fiction writer. Unlike most of the closet fiction writers in academia, however, I write genre fiction. The question that immediately follows is how that writing is related to (...) the intellectual work I do in philosophy.This question, of course, is open to a broad range of answers, from the possibility that the two aren't related at all, to potential Freudian answers it might take years of therapy to unearth. Teaching informs one's life, however, as much as the reverse, and in teaching Martin Heidegger's "The Origin of the Work of Art" to my Metaphysics class last year, I began to understand at least one dimension of the appeal that writing genre fiction has for me as a philosopher.But first, let me explain what I mean by genre fiction. In what follows, I will be referring primarily to four forms of genre fiction that have clear roots in the nineteenth century in Western Europe and North America: two gender-segregated genres, the western and the romance, and two gender-marked genres, science fiction and detective novels. I will be comparing these to two other forms of "popular culture" that also developed in the nineteenth century and have, I would argue, similar relationships to the older, more "legitimate," more elite art forms which they closely resemble: photography 1 and popular music, [End Page 216] especially those forms of popular music such as ragtime, blues, jazz, and rock that are informed by the African-American experience in the United States. 2These "low brow" art forms all appear to have arisen out of the growth of the middle class in developing parts of the world during the nineteenth century and the correlative confluence of greater leisure, greater aggregate prosperity, and higher levels of education across a broader spectrum of society. Further, these art forms all combine the surface appearance of their respective "high brow" correlate arts with the reassurance of repetition that is the cornerstone of the folk arts with which they are also correlated. Each of these forms of popular culture balances itself, then, between a demand for more and more "works of art" (and/or class aspirations based on the appearance of such) and a demand for the familiar in a rapidly changing, materially challenging world.Thus, photography gives us a frozen and thereby purified visual reality, an icon of memory to which we can return at will. The truth it reveals is most often starker than that of folk painting and portraiture, but also gives the appearance of being free from the subjectivity of the artist. Great iconic photographs such as the kiss on V-E day, I have heard it said, become more real than the reality they encapsulated.Popular music similarly combines often amazing musical complexity (which is not unknown, although rarer, in western folk music) with the reassurance of a form that not only repeats itself within a song, but also between songs of the same genre. Thus, blues can be recognized by both the minor chords in its melodies and the characteristic rhyme pattern of its lyrics. Moreover, most western popular music, even to some extent free-form jazz, has a familiar and reassuring beginning-middle-end structure, both melodically and dynamically, that locates a listener immediately within the song's "story-arc." 3This same beginning-middle-end structure is one clear hallmark of genre fiction. Another is repetition. We all immediately know the plot of a detective novel or science fiction adventure: where it will begin, what the key stages of the story will be, and how it will end—not just happily, but with a specific form of reassuring outcome, be it the victory of well-intentioned intelligence over cunning evil or humanity's ability to survive even the most alien (and so most familiar) of threats. At... (shrink)

This paper takes a feminist look back at Derrida’s work roughly from “Plato’s Pharmacy” to Politics of Friendship, setting it in the context of three other sets of writings: Plato’s Lysis and Phaedrus; French philosophy in the mid-twentieth century, especially the ethical and political thought of Maurice Merleau-Ponty and Simone de Beauvoir; and contemporary re-visions of two Greek tragedies, Oedipus and Orestes/Electra. What brings these disparate themes together are Derrida’s thought, the work of Martin Heidegger, and my life in the (...) wake of Derrida’s death. (shrink)

This paper takes a feminist look back at Derrida’s work roughly from “Plato’s Pharmacy” to Politics of Friendship, setting it in the context of three other sets of writings: Plato’s Lysis and Phaedrus; French philosophy in the mid-twentieth century, especially the ethical and political thought of Maurice Merleau-Ponty and Simone de Beauvoir; and contemporary re-visions of two Greek tragedies, Oedipus and Orestes/Electra. What brings these disparate themes together are Derrida’s thought, the work of Martin Heidegger, and my life in the (...) wake of Derrida’s death. (shrink)

This article examines Grotius’ lifelong support for Dutch expansion overseas. As noted in other publications of mine, Grotius cooperated closely with the directors of the Dutch East India Company (VOC) in the years 1604–1615. Right up to his arrest for high treason in August 1618, he contributed towards Dutch government discussions about the establishment of a West India Company (WIC). Three years of imprisonment at Loevestein Castle and, following his escape, long years of exile could not weaken his dedication to (...) the cause. His relatives in Holland, in particular his brother Willem de Groot and his brother-in-law Nicolaas van Reigersberch, kept him up-to-date on the fortunes of the VOC and WIC. His expertise on maritime affairs was in high demand. For example, Cardinal Richelieu invited him in November 1626 to become actively involved in the establishment of a French East India Company. As itinerant ideologue of empire, Grotius sought to further his own career and those of his nearest family members, without damaging the interests of the United Provinces. Through Willem de Groot and Nicolaas van Reigersberch, he provided informal advice on Dutch imperial policy to the VOC directors and government officials in The Hague. He was rewarded with the appointment of his brother and his second son, Pieter de Groot, as VOC lawyers (ordinaris advocaten) in 1639 and 1644, respectively. They served as his proxies in diplomatic disputes involving the VOC, the States General and the Portuguese ambassador in autumn 1644, when Pieter and Willem de Groot wrote a defense of VOC claims to the cinnamon-producing areas of Ceylon (modern-day Sri Lanka), liberally citing De Jure Belli ac Pacis. Grotius’ vision of empire hardly changed in the course of 40 years. In his view, the Dutch had gone to the Indies as merchants, not conquerors, and should regulate themselves according to natural law and the law of nations. Thus he contributed to the creation of two political orders, one for Europe and one for the Indies. European diplomatic relations counted for little beyond the Line. VOC and WIC officials could act as judges and executioners in their own cause, without reference to indigenous rulers, other colonial powers, or even the political authorities back home. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:246 HISTORY OF PHILOSOPHY lish a line of succession from Schleiermacher to Stenzel and further on to some of the most recent Platonic scholars in Germany. In this connection the peculiar character of Platon der Erzieher is a side issue. Gaiser seems only moderately interested in paideia and even tries to free Stenzel from the suspicion that he should have considered paideia as the essence of Platonism. Some sentences (...) in Stenzel's book which might suggest such an opinion are said to be "consciously one-sided formulations" (p. viii, note 7). Gaiser's true interest is Plato's ontology. Nothing explains his stand better than his endorsement of H. J. Kr~imer's representative work Arete bei Platon und Aristoteles. Kr~imer, whose major objective is a reconstruction of what he thinks was Plato's esoteric philosophy, has emphatically declared that he arrived at his results by pursuing the method and the factual interests of Stenzel. Gaiser's attempt to locate Stenzel's position must be understood in the light of this and perhaps similar declarations.1 This is not the place to discuss those of Stenzel's theories which are at best touched upon in Platon der Erzieher or even the theories of those who proclaim to be his heirs. There is, however, one point on which I insist. Gaiser tries to link Stenzel with Heidegger and points to the interest which Stenzel took in Heidegger in his later years. Platon der Erzieher appeared in the same year as Sein und Zeit. I believe that the two works belong to entirely different worlds. Whereas Heidegger powerfully broke up new dimensions of thought, the philosopher Stenzel, for better or worse, represents a period which had reached its end when he died in 1934. ERNST MORITZ MANASSE North Carolina College at Durham Anonymous Prolegomena to Platonic Philosophy. Introduction, Text, Translation and Indices by L. G. Westerink. (Amsterdam: North-Holland Publishing Co., 1962. Pp. lii + 69.) L. G. Westerink, whose interest in the Alexandrian commentators on Plato has already borne ample and distinguished fruit in his editions of the Alcibiades commentaries of Olympiodorus and Proclus and of Damascius' lectures on the Philebus, has now further enriched our knowledge of Platonic studies in the sixth century A.D.by publishing a new critical text of a little-known set of introductory lectures to Plato, which originated in the Alexandrian school. The importance of the present work is indicated by the facts that the last critical text of these prolegomena, which forms part of a tenth-century manuscript in the Vienna National Library (Vindob. 1Cf. also Gaiser's new book Platons Ungeschriebene Lehre (Stuttgart, 1963), which appeared after this review was written. BOOK REVIEWS 247 phil. gr. 314), was published over a century ago by K. F. Hermann in his Appendix Platonica, and that the most recent commentary is that of L. Skowronski in a dissertation published in 1884. In other words, nothing substantial had appeared on the Prolegomena after the publication of the Commentaria in Aristotelem Graeca, and Westerink's great merit consists in bringing to bear upon the present work the insights gained from a study of these Aristotelian commentaries. For the same professors taught both Plato and Aristotle at Alexandria, and not only did their teaching of one color their views on the other, but they frequently borrowed ideas, quotations, stories, and even phrases from one another. The chief aim of the Introduction (pp. ix-l) is to investigate the authorship of the Prolegomena, which the almost unanimous agreement of scholars since 1675 (the one exception is Beutler in RE s.v. "Olympiodorus") had attributed to Olympiodorus. W. begins by establishing the Alexandrian background of these lectures and by discussing, one by one, the characteristic beliefs of the various members of the school and the way in which these are reflected in introductory lectures to Aristotle. This is followed by a painstaking analysis of the sources of the Prolegomena and finally the conclusion that the present text belongs "in the immediate surroundings of Olympiodorus and Elias" (p. xlix). Discrepancies between the biography of Plato here and in Olympiodorus' commentary on the A lcibiades militate, according to W., against Olympiodorus' authorship, although... (shrink)

ABSTRACT Politics, religion and legal argumentation were inextricably intertwined in the reception of John Selden’s Mare Clausum/The Closed Sea (1635). The work’s writing and printing history is closely tied to Stuart foreign policy, particularly James I’s and Charles I’s attempts to tax the Dutch herring fisheries. Mare Clausum’s immediate impact on European international relations has received little attention from historians so far. It is clear, however, that government authorities in London, The Hague and Venice expected an official reply from Hugo (...) Grotius, author of Mare Liberum/the Free Sea (1609) and Swedish ambassador in Paris. Yet the latter declined to assist the Dutch authorities in this matter, blaming them for his imprisonment in 1618–1621 and his second banishment from Holland in 1632. The antipathy was mutual. The Dutch authorities abhorred Grotius’ pleas for religious tolerance and commissioned his Calvinist kinsman Dirk Graswinckel to respond to Selden instead. Graswinckel had already published Libertas Veneta/venetian Liberty (1634), a learned defense of the Republic of Venice’s political interests. In ‘Vindiciae maris liberi’/vindication of the Free Sea (written 1636–1637), he tried –but arguably failed – to reconcile Dutch claims to freedom of navigation, trade and fishing with Venetian claims to the Adriatic. It never appeared in print. (shrink)

ABSTRACT Because of the existence of severely defective humans it is commonly held that whatever consideration is due to all humans is also due to many other animals, and that therefore speciesism, or the readiness to prefer the interest of humans to those of other animals, is unjustified. After criticism of this reasoning a ‘naturalised’ speciesism, acknowledging, for example, the affinities between species, is articulated and defended. A key to this defence is the separation of the task of specifying morally (...) significant differences between humans and other animals from the task of justifying the extension of consideration to defective humans. The conclusion is that more traditional vices than speciesism are chiefly to blame for the shabby treatment of animals by humans. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Tincture of the Doctor's TimeHolland KaplanI first thought of Mr. H as a "difficult patient" while reading the written hand-off I received on him as I was preparing to take over an inpatient general medicine service—"He leaves all the time to smoke." I don't think the statement was meant to imply anything about the patient; if anything, it may have been included for context to prepare me for (...) the patient's intermittent absence. But, reading this, I felt a familiar sense of annoyance rising in my chest. Every few months, I take care of a patient who seems to never be in his room. The patient is consistently out smoking, in the cafeteria, or in another unknown location, seemingly doing an undisclosed activity. This is frustrating because it means I have to work around the patient's schedule of smoke breaks and jaunts to the cafeteria to evaluate the patient on a daily basis. The thoughts inevitably cross my mind: Does this patient even want care in the hospital if he's never in his room? Is he actually sick enough to need to be in the hospital if he's able to spend so much time outside of the hospital? Why is he leaving so frequently—is he doing drugs?This particular patient had been in perfect health until two months before I met him when he was shot multiple times during an encounter at a gas station. One of the bullets had lodged in his back, shattering a vertebra. Another had decimated the bones in his right upper arm, which were now held in place by screws and plates. Several had landed in his abdomen, necessitating the removal of part of his bowel. Finally, a bullet had sliced through the lower part of his right kidney, shredding his ureter and mandating surgical reconstruction of his urinary system. After over a month in the intensive care unit with multiple reparative surgeries, he was discharged to a rehabilitation facility. But he started having fevers and fast heart rates; ultimately, he was admitted to the hospital again for multiple infected fluid collections that had formed at the sites of his surgeries. He left the hospital prior to getting treated for these infections, purportedly "against medical [End Page 12] advice." And now, several weeks later, he was here in the hospital for the same reason.The first time I went to see Mr. H, he was, of course, not in his room. I went to the nursing station to ask if the clerk knew where he was. She knowingly said, "Oh yeah, he goes out a lot. I can give him a call to let him know the doctor is here to see him if you'd like." I assented, thanked the clerk for calling him, and proceeded, annoyed, in seeing the rest of my patients. I considered how I would address Mr. H's behavior when I was finally able to talk to him. I had seen others take many different approaches—negotiation about the timing and frequency of these extramural expeditions, ultimatums about getting discharged, mandating urine drug screens upon return, and silent, frustrated tolerance. I resolved to wait to speak to him to determine which approach might be most suitable. An hour later, I received a call from the clerk that Mr. H had returned to his room to see me.The first time I met Mr. H, he informed me he had taken the bus to midtown to make a run to the grocery store. I was internally incredulous. He felt well enough to go to the grocery store? Why was he in the hospital then? At that moment, I opted not to discuss his frequent departures yet, as I was frustrated and realized I wouldn't be able to identify the best way to address them. I reviewed his medical issues with him, asked specific questions about how he was feeling, performed a physical exam, and reiterated his current plan of care. Mr. H made it very clear that he would like to get out of the hospital as soon as possible. I tried to set the expectation that he... (shrink)

The lexicographic power ΔΓ of chains Δ and Γ is, roughly, the Cartesian power Πγ∈Γ Δ, totally ordered lexicographically from the left. Here the focus is on certain powers in which either Δ = R or Γ = R, with emphasis on when two such powers are isomorphic and on when ΔΓ is 2-homogeneous. The main results are: (1) For a countably infinite ordinal α, Rα* +α ≃ Rα. (2) RR ≄ RQ. (3) For Δ a countable ordinal ≥ 2. (...) ΔR, with its smallest element deleted, is 2-homogeneous. (shrink)

Was Malthus a ‘Utilitarian’? This apparently simple-minded question is justified by on-going debate in the secondary literature. For example, in his study, The Classical Economists, D. P. O'Brien maintains that ‘only the two Mills, apart from Bentham himself, were really Utilitarians’. Against this we have the view of Lord Robbins that ‘We get the picture badly out of focus if we conceive that reliance on the principle of utility was confined to Bentham and his immediate circle.’ In this paper we (...) shall demonstrate the justice of the Robbins perspective with specific reference to the population issue. (shrink)

The phrase 'beyond historicism' is usually associated with Bielefeld historians like Hans Ulrich Wehler and Jürgen Kocka, who attempted to turn the study of history into a social science, but a better candidate would be the sociologist Niklas Luhmann, who happened to teach as well in Bielefeld during the 1970's and 1980's. Luhmann had little affinity with the project of his colleagues from the history department. He took the opposite view that the social sciences suffered from a naive enlightenment view (...) and should become more history minded. Like the historicists of the early nineteenth century Luhmann was indirectly inspired by the philosophy of Leibniz. Although Luhmann's theory of social systems may seem miles away from the daily interests of most historians, it can be interpreted as an Aufhebung of historicism. This will be demonstrated for two important concepts, the autopoietic system which incorporates the historicist notion of individuality and the concept of second order observation which can be read as an abstract redescription of what historicists meant by the historical method. (shrink)

Recent investigations on how people derive meaning from language have focused on task‐dependent shifts between two cognitive systems. The symbolic (amodal) system represents meaning as the statistical relationships between words. The embodied (modal) system represents meaning through neurocognitive simulation of perceptual or sensorimotor systems associated with a word's referent. A primary finding of literature in this field is that the embodied system is only dominant when a task necessitates it, but in certain paradigms, this has only been demonstrated using nouns (...) and adjectives. The purpose of this paper is to study whether similar effects hold with verbs. Experiment 1 evaluated a novel task in which participants rated a selection of verbs on their implied vertical movement. Ratings correlated well with distributional semantic models, establishing convergent validity, though some variance was unexplained by language statistics alone. Experiment 2 replicated previous noun‐based location‐cue congruency experimental paradigms with verbs and showed that the ratings obtained in Experiment 1 predicted reaction times more strongly than language statistics. Experiment 3 modified the location‐cue paradigm by adding movement to create an animated, temporally decoupled, movement‐verb judgment task designed to examine the relative influence of symbolic and embodied processing for verbs. Results were generally consistent with linguistic shortcut hypotheses of symbolic‐embodied integrated language processing; location‐cue congruence elicited processing facilitation in some conditions, and perceptual information accounted for reaction times and accuracy better than language statistics alone. These studies demonstrate novel ways in which embodied and linguistic information can be examined while using verbs as stimuli. (shrink)

This essay poses the question whether it is possible, given the relationship of a subject and the method of its examination, at present as opposed to the time when Savigny worked, to talk about the same subject, and if it is not, what are the consequences for the interpretation of law. The turbulent history of Europe in the 20th century, marked by the cataclysms of world wars, genocides, expulsions and upheavals, therefore the necessity of new beginnings, jointly with other factors (...) (e.g. technological optimism) resulted not only in the ebbing of influence for religion, morality and tradition, but also in a deconstruction of law. This includes fragmentation, loss of the ability to formulate and interpret the purpose of law, as well as relativization of the traditional ordering principles of law (particularly the non-contradiction condition and contextual consistency, hierarchical structure, relative stability of law and its language). The opening of the texture of law, its deconstruction, creates a new segment of legislation, namely judicial law-making arising from the uncertainty of normative premises. (shrink)