This article provides a discussion of the limits of both narrative and culture based on a close textual analysis of the short story, “People Like That Are the Only People Here: Canonical Babbling in Peed Onk,” by Lorrie Moore. In this story, a mother describes her experiences on a pediatric oncology ward when her infant son develops Wilms' tumor. The authors examine how the story satirically portrays the spurious claims of language, story, and culture to protect us from an unjust (...) universe and then exposes their false promises. The various personal, professional, and genre-specific narratives we use to create order and coherence from the terror of serious illness are ultimately ineffective. Similarly, the superficially comforting culture of the hospital ward cares more about creating the illusion of control than it does about the suffering of sick children. Language and culture cannot make sense of human anguish, the article concludes, yet they are all we have to hold back the chaos. Mystery and uncertainty, as part of the human condition, must become part of our stories and part of our culture. (shrink)

In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

This paper describes a pilot study of a new model for narrative medicine training, “community-based participatory narrative medicine”, which centers on shared narrative work between healthcare trainees and patients. Nine medical students and eight patients participated in one of two, five-week-long pilot workshop series. A case study of participants’ experiences of the workshop series identified three major themes: the reciprocal and collaborative nature of participants’ relationships; the interplay between self-reflection and receiving feedback from others; and the clinical and pedagogical implications (...) of the CBPNM model. Principles and proposed outcomes of the CBPNM model are presented. (shrink)

Since the early 1980’s, with the clinical advent of in vitro fertilization resulting in so-called “test tube babies,” a wide array of ethical considerations and concerns regarding artificial womb technology (AWT) have been described. Recent breakthroughs in the development of extracorporeal neonatal life support by means of AWT have reinitiated ethical interest about this topic with a sense of urgency. Most of the recent ethical literature on the topic, however, pertains not to the more imminent scenario of a physiologically improved (...) method of neonatal care through AWT, but instead to the remote scenario of “complete ectogenesis” that imagines human gestation occurring entirely outside of the womb. This scoping review of the ethical literature on AWT spans from more abstract concerns about complete ectogenesis to more immediate concerns about the soon-to-be-expected clinical life support of what we term the fetal neonate or fetonate. Within an organizing framework of different stages of human gestational development, from conception to the viable premature infant, we discuss both already identified and newly emerging ethical considerations and concerns regarding AWT and the care of the fetonate. (shrink)

We examine the impact of activated versus non-activated ethical norms on the aggressiveness of accounting decisions, in the presence of self-interest favoring aggressiveness. Using a case in which the accounting rules are ambiguous, we ask professional accountants to make an accounting decision as though they were in their own organization; we measure the ethical norms of their organization at the end of the experiment. Based on the focus theory of normative conduct, we argue that the general ethical norms of the (...) participants’ organizations are activated when the decision structure is such that the participant receives a recommendation from a subordinate, whereas those norms are not activated when the participant is making the decision alone. We find that higher ethical norms decrease aggressiveness when the decision maker receives a recommendation, whereas higher ethical norms have no impact on aggressiveness when the decision maker makes the decision alone. Our results demonstrate that general ethical norms, known to impact decisions having clear ethical content, can also curb accounting aggressiveness when these norms are activated. Furthermore, firm practices such as decision structure can activate norms. These findings are of interest to practitioners and regulators who seek to temper aggressive accounting. (shrink)

The French feminist philosopher Michèle Le Doeuff has taught us something about “the collectivity,” which she discovers in women’s struggle for access to the philosophical, but also about “the unknown” and “the unthought.” It is the unthought which will matter most to what I intend to say today about a fundamental ignorance on which speaker vulnerability is built. On International Women’s Day, it seems appropriate to speak about – or, at least, to evoke – the silencing which has been imposed (...) on women by an oppressive form of ignorance. My question is: how do our resounding voices as women – on 8 March 2016 – avoid what feminist philosophers have distinguished as wilful forms of silencing? Silencing exploits vulnerability; and speaker vulnerability is an exposure either to violence or affection, in its dependence on an audience. My response seeks to undo the silencing of women by transforming an ignorance of vulnerability into a distinctively ethical avowal. To see the significance of this undoing, we will consider how our contemporary global world reduces vulnerability to an openness to violence, ignoring what has been unthought: an openness to affection. A wilful ignorance of vulnerability develops not as a lack of knowledge but its disavowal – on which various forms of oppression are built. An active disavowal of thinking (the unthought) is the other side of a striving for invulnerability; and this striving is encouraged by a social world which remains ignorant of its own wounding, as well as its own potential for ethical relations in vulnerability. Like la mauvaise foi of the French existentialist, invulnerability is a form of self-deception; and those who claim it embrace ignorance of their own and others’ vulnerability too. (shrink)

_A portion of the revenue from this book’s sales will be donated to Doctors Without Borders to assist the humanitarian work of nurses, doctors, and other health care providers in the fight against COVID-19 and beyond._ _Concepts and Cases in Nursing Ethics_ is an introduction to contemporary ethical issues in health care, designed especially for Canadian audiences. The book is organized around six key concepts: beneficence, autonomy, truth-telling, confidentiality, justice, and integrity. Each of these concepts is explained and discussed with (...) reference to professional and legal norms. The discussion is then supplemented by case studies that exemplify the relevant concepts and show how each applies in health care and nursing practice. This new fourth edition includes an added chapter on end-of-life issues, and it is revised throughout to reflect the latest developments on topics such as global health ethics, cultural competence, social media, and palliative sedation, as well as ethical issues relating to COVID-19. (shrink)

v. 1. History of the ancient and mediaeval philosophy.--v. 2. History of modern philosophy.

La filosofía ha reflexionado a menudo acerca de la naturaleza de la burocracia, de su lógica y método, de sus consecuencias. En este artículo se quiere presentar cómo la inimputable y, por ello, irrazonable lógica burocrática se fundamenta en una psicopatológica religiosa, “mística”. Para mostrar esta temática nos servimos de lo que han escrito Max Weber en su Economía y sociedad y Hannah Arendt en Los orígenes del totalitarismo, ya que nos parecen los autores que más han comprendido y señalado (...) el fundamento místico-religioso de la lógica burocrática. Por ello, en un primer punto mostraremos en qué consiste según estos autores la lógica del pensamiento burocrático y, en un segundo punto, señalaremos el fundamento patológico-religioso de esta lógica. (shrink)

Este artículo aborda desde una perspectiva crítica la relación entre las categorías de democracia y ciudadanía en la ciudad de Valparaíso durante la última década de postdictadura. El principal supuesto del texto considera la imposibilidad de un análisis conceptual acerca de la democracia que no incluya en su discusión la tensión entre la posición y ejercicio de la ciudadanía implicada y demandante en este proceso. El análisis propuesto confronta los imaginarios hegemónicos instituidos en la postdictadura con los imaginarios instituyentes que (...) emergen de los movimientos secundarios por la defensa de la educación pública en la ciudad de Valparaíso. Estos imaginarios se expresan en formas de organización en la esfera pública, por medio de la función que ejerce el imaginario radical, que impugnan la construcción de una ciudadanía capturada y una democracia tutelada. (shrink)

Screening for prostate cancer with the prostate-specific antigen blood test is controversial, as evidence to date has not demonstrated such screening does more good than harm. While the potential benefit of PSA screening on reducing prostate cancer mortality has not been documented in randomized trials, many risks of PSA screening have been well documented. These risks include a substantially higher risk of a prostate cancer diagnosis over a screenee’s lifetime, false-positive and false-negative test results, possible complications from biopsies done in (...) response to suspicious test results, and substantial risks of side effects from subsequent prostate cancer treatments. Nevertheless, PSA screening is widespread in the United States, and many physicians in a national survey reported supporting routine PSA screening as well as getting PSA tests themselves, despite the lack of evidence. (shrink)

We refer to hospitalized convicted hunger strikers in Padua Hospital who decided to fast for specific reasons, often demanding, to be heard by the judge, to complain about the existing custodial situation or to claim unjust treatment. The medical ethics of hunger strikers are debated because the use of force feeding by physicians is widely condemned as unethical, but courts, in Italy, sometimes order to transfer the convicted person to hospital and oblige healthcare practitioners to perform forcible feeding. This can (...) engender a profound insecurity for the physicians taking action on the one hand, while preventing patients from fully availing themselves of this principle of self-determination on the other. Physicians are mainly concerned about how to manage this situation and they may request ethical consultation. When it comes to managing hospitalized hunger strikers, the ethics consultant may be able to facilitate the relationship between physicians and hunger strikers, enhance the latter’s trust in the former, ensuring that strikers are aware of the risks associated with their fasting, and helping them to arrive of their own free will at the right decision concerning their behavior and their demands. (shrink)

The aim of this paper is to propose that the common horizon of the reflections of political philosophy in Latin America is the debate that has taken place to defend liberalism or go against it. The background of this is the reference to the social collective forms. In this context, Marxism has tried to respond from heterodox visions that recover the Latin American experience. We have focused this debate on three authors, Chauí, Fernández and Echeverría, who do not exhaust the (...) problem but keep open the paths that enhance the local experience. (shrink)

La justicia social tiene sus fundamentos políticos en el pensamiento de Nancy Fraser en el carácter económico de la sociedad, pero no la comprende con exclusividad, dado que existen dos dimensiones más que la complementan, el reconocimiento cultural y la representación política. En este contexto de estado de emergencia, surge la necesidad de comprender holísticamente el sentido de la justicia social y aplicarlo a la realidad peruana. De esta manera podemos evidenciar las falencias que existen dentro de cada dimensión, y (...) las medidas que el estado peruano ha tomado dentro de cada dimensión para contrarrestar o en su defecto solucionar el impacto de la pandemia. Durante la exposición de los tópicos abordaremos detalladamente que comprende la autora en cuestión acerca de los términos redistribución, reconocimiento y representación, dentro del marco de la Justicia Social y buscaremos extrapolar estas nociones teóricas a la realidad peruana dentro de la coyuntura de la pandemia, las manifestaciones de las particularidades. El presente trabajo saca a relucir no solo la improvisación de las medidas que no satisfacen las necesidades básicas que demandan cada dimensión, sino ofrece, a su vez, una crítica hacia la comprensión política de nuestras autoridades, las cuales no apuntan a alcanzar este estado de justicia social. Dicho estado de justicia tiene como horizonte un verdadero reconocimiento sostenido en cambios estructurales, para ello ineludiblemente se tiene que abordar el problema de la crisis económica, que se expresa en la desigualdad de condiciones y la falta de oportunidades. La justicia social siempre ha representado un ideal de sociedad, hasta el punto de concebirlo como un horizonte inalcanzable. Asociar la justicia con la igualdad o equidad no forma parte de la perspectiva política del país y esto se evidencia en el carácter amortiguador de los decretos legislativos establecidos por el Estado. Sin embargo, la ayuda del Estado no llega a todos los sectores de la población, y si es que llega, es asumida por el propio ciudadano mediante el retiro de su CTS o AFP. La realidad es distinta cuando se trata de las empresas, quienes tienen la potestad de despedir sin goce de haber a sus trabajadores bajo la modalidad de suspensión perfecta de labores. Dicha medida, es “perfecta” para la empresa quien no solo goza de este beneficio sino también puede acceder a un financiamiento de parte del Estado. En la sociedad la figura de la empresa se posiciona como indispensable, debido a que movilizan la economía al otorgar puestos de trabajo. Sin embargo, la integridad de los trabajadores no se ha visto como prioridad para dichas empresas, puesto que se concibe la fuerza de trabajo como un rubro que puede remplazarse con facilidad. De esta manera se evidencia una notable intención por no impartir con equidad mayores beneficios para aquellos que realmente están en una situación de desventaja. Por otro lado, los actos de corrupción acentúan la necesidad de una justicia social no como utopía sino como una obligación moral que se convierte en una exigencia patriótica. Aunque apuntemos a un reconocimiento de nuestras condiciones de existencia, dentro de nuestras particularidades, y a partir de este reconocimiento poder tener representación en las instancias a las que nos correspondan participar no existirá un verdadero reconocimiento sin una verdadera redistribución. (shrink)

The leading accounts of the nature of causation divide into probability-raising and process-linkage views. On the probability-raising view, causation is rooted in the comparative probability of the effect with the cause versus without. On the process-linkage view, causation is rooted in the existence of a connecting line from cause to effect. I propose a third alternative which synthesizes these views while solving their problem cases. On this alternative, causation is rooted in the comparative probability of the connecting line to the (...) effect with the cause versus without: causes as probability raisers of processes. In the first two sections, I (briefly) outline the probability-raising and process-linkage views and identify a space of problems, and then I focus on developing the alternative probability-raisers-of-processes solution. I identify problems for this view as well, though I conclude that it is at least in important respects a step forward. (shrink)

Today more than ever Marxism is profoundly in need of a full and precise modern reappraisal. In his belief that this may only be accomplished along with an examination of the "humanistic" young Marx, Adam Schaff presents in this volume an illumination of the thinker's early work and its relationship to the world-shaking economic philosophy that stemmed from it.

According to ‘Excluders’, descriptive uncertainty – but not normative uncertainty – matters to what we ought to do. Recently, several authors have argued that those wishing to treat normative uncertainty differently from descriptive uncertainty face a dependence problem because one's descriptive uncertainty can depend on one's normative uncertainty. The aim of this paper is to determine whether the phenomenon of dependence poses a decisive problem for Excluders. I argue that existing arguments fail to show this, and that, while stronger ones (...) can be found, Excluders can escape them. (shrink)

This article is made available under Creative Commons licence CC BY-NC-ND, which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited.

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and (...) made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Abstract In this paper, I pursue the question whether extending democratic rights to work is good in the broadest possible sense of that term: good for workers, firms, market economies, and democratic states. The argument makes two assumptions in a broadly consequentialist framework. First, the configuration of any relationship among persons in which there is less rather than more coercion makes individuals better off. Second, extending democratic rights to work will entail costs and benefits to both the power and authority (...) of employers and meaningful work for employees. These costs and benefits cannot be determined in advance because they are largely empirical, but there are still good reasons for expanding worker participation all-things-considered. First, I examine the parallel case for extending democratic rights to the workplace based on several similarities between politics and work organization. In addition, I consider the objections from voluntariness and efficiency. Although both objections raise interesting problems I believe that a properly formulated conception of democratic workplaces can answer them. In the final section, I sketch a minimal conception of these rights at the level of the firm that does not require a large-scale transformation of the market economy. (shrink)

Bridging the traditionally separate domains of analytic and Continental philosophies, Pamela Sue Anderson presents for the first time, a feminist framework for studying the philosophy of religion.

I argue that there is nothing in Kant’s moral theory that legitimates condemnation of same-sex relations and that the arguments from natural ends Kant relies on in doing so are unjustified by the constraints placed upon morality to avoid the empirical determination of judgments. In order to make clear why same-sex activity does not contradict the requirements of the moral law, we need to understand Kant’s account of legitimate sexual activity. I provide this reconstruction in the first section, drawing upon (...) the Lectures on Ethics and Metaphysics of Morals. In the second section, I critique the first kind of argument that grounds Kant’s assessment, that from natural ends. I show how it is based upon underlying teleological premises and raise doubts concerning Kant’s reliance on “regulative ideas” in making a consistent ethical theory. In the third section, I argue that same-sex activity that conforms to the conditions of the moral law, especially given the concepts of consent and reciprocity, are in conformity with Kant’s formal requirement of the law of pure practical reason, and therefore cannot justifiably be condemned on those grounds. Finally, I conclude with some discussion about Rawls and political liberalism. I hope to show how the present Kantian revival in ethical theory can place itself in opposition to the conservative and homophobic hysteria surrounding debates on political and legal issues such as same-sex “marriage.”. (shrink)

Although theoretically rigorous, the book is comprehensible to the beginning qualitative researcher.

A good number of people currently thinking and writing about reasons identify a reason as a consideration that counts in favor of an action or attitude.1 I will argue that using this as our fundamental account of what a reason is generates a fairly deep and recalcitrant ambiguity; this account fails to distinguish between two quite different sets of considerations that count in favor of certain attitudes, only one of which are the “proper” or “appropriate” kind of reason for them. (...) This ambiguity has been the topic of recent discussion, under the head “the wrong kind of reasons problem.”2 I will suggest that confusion about “the wrong kind of reason” will be dispelled by changing our account of what a reason is. While I agree both that reasons are considerations and that certain.. (shrink)

Nearly sixty years after its publication, P. F. Strawson’s “Freedom and Resentment” continues to inspire important work. Its main legacy has been the notion of “reactive attitudes.” Surprisingly, Strawson’s central argument—an argument to the conclusion that no general thesis (such as the thesis of determinism) could provide us reason to abandon these attitudes—has received little attention. When the argument is considered, it is often interpreted as relying on a claim about our psychological capacities: we are simply not capable of abandoning (...) the reactive attitudes, across the board, in something like the way we are simply not capable of remembering everything we are told. A different line interprets Strawson as relying on something like a conceptual point: you can neither support nor call into question the whole of a practice using notions that are, themselves, constituted by that practice. Neither interpretation would lead to you to expect what you will find, looking at the central text: Strawson twice accuses his opponent of being caught in some kind of contradiction. So neither interpretation, on its own, is correct. By providing a close reading of the central text, I do my best to articulate Strawson’s more interesting, and more powerful, argument. The argument depends on an underlying picture of the nature of moral demands and moral relationships—a picture that has gone largely unnoticed, that is naturalistic without being reductionistic, and that is, I think, worthy of serious consideration. (shrink)

Many assume that we can be responsible only what is voluntary. This leads to puzzlement about our responsibility for our beliefs, since beliefs seem not to be voluntary. I argue against the initial assumption, presenting an account of responsibility and of voluntariness according to which, not only is voluntariness not required for responsibility, but the feature which renders an attitude a fundamental object of responsibility (that the attitude embodies one’s take on the world and one’s place in it) also guarantees (...) that it could not be voluntary. It turns out, then, that, for failing to be voluntary, beliefs are a central example of the sort of thing for which we are most fundamentally responsible. (shrink)

Traces the life of the Jewish philosopher, discusses his major writings, and describes his influence on modern Christian theology.

I hope to show that, although belief is subject to two quite robust forms of agency, "believing at will" is impossible; one cannot believe in the way one ordinarily acts. Further, the same is true of intention: although intention is subject to two quite robust forms of agency, the features of belief that render believing less than voluntary are present for intention, as well. It turns out, perhaps surprisingly, that you can no more intend at will than believe at will.

Pamela D. Winfield offers a fascinating juxtaposition and comparison of the thoughts of two pre-modern Japanese Buddhist masters, Kukai (774-835) and Dogen (1200-1253) on the role of imagery in the enlightenment experience.