This guide is an exploration of political reality as understood by Eric Voegelin. Voegelin employed the revolutionary concepts found in ancient Greek noetic and Christian pneumatic philosophy that describe political reality and the means to know it. This guide begins with a biographical sketch of Voegelin, the historical milieu that inspired his resistance to "unreality" and terms and symbols he uses to identify the spiritual sickness he believes is destroying Western civilization's traditional basis of order, it then examines Voegelin's theories (...) of consciousness, philosophy and science fundamental to understanding reality. Given the extensive nature and volume of his work, a consolidation and explanation of it is offered, and an example on how to apply it is outlined. Critiques of Voegelin's work are detailed to outline weaknesses in his theories and methods. This guide concludes by defining political reality, how to use Voegelinian techniques to analyze reality, and how to live a life that cultivates the pursuit of human knowledge in keeping with Western philosophic traditions. Book jacket. (shrink)

Narrative analysis is well established as a means of examining the subjective experience of those who suffer chronic illness and cancer. In a study of perceptions of the outcomes of treatment of cancer of the colon, we have been struck by the consistency with which patients record three particular observations of their subjective experience: the immediate impact of the cancer diagnosis and a persisting identification as a cancer patient, regardless of the time since treatment and of the presence or absence (...) of persistent or recurrent disease; a state of variable alienation from social familiars, expressed as an inability to communicate the nature of the experience of the illness, its diagnosis and treatment; and a persistent sense of boundedness, an awareness of limits to space, empowerment and available time. These subjectivities were experienced in varying degree by all patients in our study. Individual responses to these experiences were complex and variable. The experiences are best understood under the rubric of a category we call “liminality”. We believe that all cancer patients enter and experience liminality as a process which begins with the first manifestations of their malignancy. An initial acute phase of liminality is marked by disorientation, a sense of loss and of loss of control, and a sense of uncertainty. An adaptive, enduring phase of suspended liminality supervenes, in which each patient constructs and reconstructs meaning for their experience by means of narrative. This phase persists, probably for the rest of the cancer patient’s life. The experience of liminality is firmly grounded in the changing and experiencing body that houses both the disease and the self. Insights into the nature of the experience can be gained from the Existentialist philosophers and from the history of attitudes to death. Understanding liminality helps us to understand what it is that patients with cancer seek from the system to which they turn for help. Its explication should therefore be important for those who provide health care, those who educate health care workers and those concerned to study and use outcomes as administrative and policy making instruments. (shrink)

High-dose chemotherapy and autologous stem cell transplantation is used to treat some advanced malignancies. It is a traumatic procedure, with a high complication rate and significant mortality. ASCT patients and their carers draw on many sources of information as they seek to understand the procedure and its consequences. Some seek information from beyond orthodox medicine. Alternative beliefs and practices may conflict with conventional understanding of the theory and practice of ASCT, and ‘contested understandings’ might interfere with patient adherence to the (...) strict and demanding protocols required for successful ASCT.The present study, conducted in Sydney, Australia, examines narrative-style interviews with 10 sequentially recruited ASCT patients and nine of their carers conducted at the time of transplant and three months later. Transcripts were read for instances of mention of alternative advice, and for instances of contested understanding of information relevant to the transplant.Patients and carer pairs expressed closely concordant views about alternative advice. Five pairs were consulting alternative practitioners. Contested understanding was expressed in four domains—understandings of the transplant itself and its underlying theory, of the relationship between the components of the ‘transplant’, of the nature and role of stem cells, and of beliefs about bodily function and life-style. Contested understandings of the transplant treatment were expressed as predominantly personal interpretations of orthodox informationPatients and carers seemed to recognise that alternative and conventional systems were discordant, yet they were able to separate the two, and adhere to each practice without prejudicing their medical treatment. A single case of late, post-transplant repudiation of Western medicine is discussed to emphasise some of the possible determinants of dissonance when it does occur. (shrink)

Concerns are frequently raised about the extent to which formal consent procedures actually lead to “informed” consent. As part of a study of consent to high-risk medical procedures, we analyzed in-depth interviews with 16 health care professionals working in bone-marrow transplantation in Sydney, Australia. We find that these professionals recognize and act on their responsibility to inform and educate patients and that they expect patients to reciprocate these efforts by demonstrably engaging in the education process. This expectation is largely implicit, (...) however, and when it is not met, this can give rise to trouble that can have adverse consequences for patients, physicians, and relationships within the clinic. We revisit the concept of the sick role to formalize this new role expectation, and we argue that “informed” consent is a process that is usually incomplete, despite trappings and assumptions that help to create the illusion of completeness. (shrink)

BackgroundIn its 2015 decision in Montgomery v. Lanarkshire Health Board, the Supreme Court of the United Kingdom overruled the long-standing, paternalistic prudent doctor standard of care in favour of a new reasonable patient standard which obligates doctors to make their patients aware of all material risks of the recommended treatment and of any reasonable alternative treatment. This landmark judgment has been of interest to the rest of the common law world. A judicial trend of invoking Montgomery to impose (...) more stringent requirements on doctors is discernible in subsequent decisions since then.Main bodyIn this narrative review, without questioning the idea that properly informed patients should play a more active role in procedures affecting their own health in furtherance of their autonomy, safety, and consumer rights, we identify and analyse, with the aid of realistic clinical thought experiments, three practical conundrums that the Montgomery standard may inflict on the daily work of doctors, unfairly exposing them to arbitrary legal risks.ConclusionsThese conundrums pertain to the ascertainment of the risks that must be disclosed to the patient under the test of ‘materiality’; the legal uncertainty as to the scope of the exceptions; and the actual ability of doctors to cope with the pressures of time. These conundrums offer ripe opportunities to rethink the proper role of judicially developed medical law in modern health care practice. (shrink)

Focal brain metabolic effects detected by proton magnetic resonance spectroscopy (MRS) in obsessive-compulsive disorder (OCD) represent prospective indices of clinical status and guides to treatment design. Sampling bilateral pregenual anterior cingulate cortex (pACC), anterior middle cingulate cortex (aMCC), and thalamus in 40 adult patients and 16 healthy controls, we examined relationships of the neurometabolites glutamate+glutamine (Glx), creatine+phosphocreatine (Cr), and choline-compounds (Cho) with OCD diagnosis and multiple symptom types. The latter included OC core symptoms (Yale-Brown Obsessive-Compulsive Scale - YBOCS), depressive symptoms (...) (Montgomery-Åsberg Depression Rating Scale - MADRS), and general functioning (Global Assessment Scale - GAS). pACC Glx was 9.7% higher in patients than controls. Within patients, Cr and Cho correlated negatively with YBOCS and MADRS, while Cr correlated positively with the GAS. In aMCC, Cr and Cho correlated negatively with MADRS, while Cr in thalamus correlated positively with GAS. These findings present moderate support for glutamatergic and cingulocentric perspectives on OCD. Based on our prior metabolic model of OCD, we offer one possible interpretation of these group and correlational effects as consequences of a corticothalamic state of elevated glutamatergic receptor activity alongside below-normal glutamatergic transporter activity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:110 HISTORY OF PHILOSOPHY History of Aesthetics, Vol. I. Ancient Aesthetics. By Wladyslaw Tatarkiewicz. Ed. J. Harrell. Trans. Adam and Ann Czerniawski. (The Hague-Paris: Mouton and Warszawa: PWN-Polish Scientific Publishers, 1970. Pp. vii-352.) History of Aesthetics, Vol. II. Medieval Aesthetics. By WladySlaw Tatarkiewicz. Ed. C. Barrett. Trans. R. M. Montgomery. (The Hague-Paris: Mouton and Warszawa: PWN-Polish Scientific Publishers, 1970. Pp. vii-315.) These two volumes of Tatarkiewicz' monumental history (...) of aesthetics, the third volume (to 1700) of which is now being prepared for press, have been reviewed already in the major aesthetic journals in Europe and America following their publication in Polish. Since Polish is not one of my languages, I can say nothing about the adequacy of the (rather obscured) translators and their work. The editors of both volumes have done their difficult work thoroughly, though the usual inconsistencies of spelling and such creep in. British spellings of judgement, centre, and colour, for example, appear in one part of a volume, while center, color, and judgment appear in another part. These are rare and not at all irksome details. On p. 220 of volume I, Aristotle has become a Stagiryte (sic). If the editors and translators actually re-checked all of those Greek, Polish and English texts--to say nothing of the Latin--they have earned a very large debt indeed. Again, my selective ignorance eliminates me from assessment. Tatarkiewicz' historical writing is surgical and Lacon-like. His major achievement lies in refraining from philosophical animadversions and for sticking strictly to his topic, no matter how tempting the theoretic distractions. Actually one expects a history of aesthetics to find the locus of aesthetic theory in the usual systematic frameworks of outstanding philosophers, but again Tatarkiewicz knows better than to try to provide these settings. His device is to stay exactly with the texts of authors, and to provide as much evidence for his statements as a printed work will allow. His scholarship is truly prodigious, and the work will live as reference for a long time to come. But it is more than a reference. There are some remarkable novelties included that bear mention. First of all, Tatarkiewicz' opening analysis of what must be included in a history of aesthetics is penetrating and convincing. In addition to the major "dualities" of aesthetics (beauty-art, subjective-objective aesthetics, psychological-sociological aesthetics, descriptive-prescriptive aesthetics, etc.) he simply accepts the necessity to find evidence of aesthetic history among statements by artists, among the inexplicit and inarticulate art works, in the vox populi and cultural actions of people. Thus the "evidence" he adduces will often displease the theoretical purist. Next, one is impressed by the great antiquity of some key issues that are being avidly pursued today. What is impressive is not that they are being repeated now, but that modern writers so rarely recognize (or acknowledge) their historical sources---or seem to care to. A careful study of this history might do much to reduce the growing volume in aesthetics----or at least to change the direction of emphasis significantly. One is surprised to note which figures emerge as of first rate importance in the history of aesthetics, important for different reasons. These figures stand out: Democritus, Plotinus, Aristotle, Vitruvius, the Pseudo-Dionysius, Johannes Scotus Erigena, to select only a few. The first Polish philosopher, Vitelo, anticipates much modern psychologizing in advancing the work of Alhazen. Ockham, not so surprising, contributes major advances, as do Augustine and Aquinas. BOOK REVIEWS 111 One fascinating item is the author's extensive account of the most violent and extended controversy in the history of aesthetics---the veneration of images and the disputes between the Iconoclasts and the Iconophiles. This sometimes physical battle raged for over 100 years! The Byzantine society, obviously, took art seriously. Tatarkiewicz' great labor is an object lesson in historiography and bibliographic technique. At one and the same time it demonstrates how much of value remains to be discovered by careful adherence to the detail of scholarship, while it also displays how much fruitful scholarship depends upon a brilliant and profoundly informed mind. Such a work, in short, could only have descended from a fully mature... (shrink)

Oxford Studies in Ancient Philosophy is an annual publication which includes original articles, which may be of substantial length, on a wide range of topics in ancient philosophy, and review articles of major books. This volume presents the published version of the Nellie Wallace Lectures in Ancient Philosophy, delivered at the University of Oxford by Professor Gisela Striker. Together, these lectures make up a connected account of Stoic ethics. The other contributors to this volume are: Thomas C. Brickhouse, G. R. (...) F. Ferrari, Montgomery Furth, Charles Kahn, John Malcolm, Nicholas D. Smith, and Paul A. Vander Waerdt. (shrink)

I have chosen my topic for this evening with an eye to something rather more than its intrinsic philosophical interest. Modern man, as we are all painfully aware, is facing a crisis of peculiar gravity. Perhaps the odds are not so very heavy against a third world war followed by world collapse into anarchy and barbarism. At such a time the philosopher is bound to ask himself whether there is no contribution which his science can make towards the succour of (...) civilization. (shrink)

Value pluralism does not imply relativism or subjectivism about values. What it does is allow respect for an at least limited toleration of values with which one may profoundly disagree. Thus a doctor can respect the autonomy of a patient whose values he does not share.

This article explores the accounts of Canadian-trained health professionals working in humanitarian and development organizations who considered not treating a patient or group of patients because of resource limitations. In the narratives, not treating the patient(s) was sometimes understood as the right thing to do, and sometimes as wrong. In analyzing participants’ narratives we draw attention to how medications and equipment are represented. In one type of narrative, medications and equipment are represented primarily as scarce resources; in another, they are (...) represented as patient care. In the contexts respondents were working, medications and equipment were often both patient care interventions and scarce resources. The analytic point is that health professionals tend to emphasize one conceptualization over the other in coming to assert that not treating is right, or wrong. Rendering tacit ethical frameworks more explicit makes them available for reflection and debate. (shrink)

ABSTRACT This article explores the proliferation of “feminine” language in Heidegger's “Die Sprache.” Through a close reading of the text, I trace Heidegger's use of certain terms such as Austragen, gebären, and Schied to show the manner in which Heidegger's reading of Trakl's poem is implicitly guided by a certain understanding of the feminine. I ultimately argue that the ontological difference is understood by Heidegger in terms of the carrying to term and birth of the world that comes about through (...) the intercourse between human beings and things. (shrink)