This paper considers Mary Midgley's views on evolution, especially as developed in her book Evolution as a Religion. In this she continues the critical campaign she waged against Dawkins’ notion of the selfish gene, but broadens her attack out to encompass many other thinkers, who are predicting dramatic and revolutionary futures for humanity, based supposedly on what evolutionary science tells us. Midgley argues that no such conclusions are scientifically warranted – hence evolution as a religion. Her own attempts to absolve (...) Darwin himself from this sort of scientism, and to remove from him any taint of social Darwinism are criticised, particularly by reference to The Descent of Man. Something is then said about Midgley's own alternative view of nature and humanity, a more holistic view, which itself has religious overtones. (shrink)

Although this collection of articles is not formally a commentary on Elizabeth Anscombe's famous article of the same title, in which she criticised the moral philosophy prevalent in 1958, a number of the contributors do take Anscombe's work as a starting point. Taken together the collection could be seen as a demonstration of the extent to which moral philosophers have since attempted to answer Anscombe's challenge, and to develop an approach to their subject which, while psychologically plausible, is neither based (...) on divine law nor permissive of the impermissible. (shrink)

What is moral philosophy? That is the question with which this important volume grapples. Its starting point is the famous critique made in 1958 by Elizabeth Anscombe, who argued that moral philosophy begins from a mistake: that it is fundamentally wrong about the sort of concept that the word 'moral' represents. Anscombe rejected moral philosophy as it was then (and mostly now still is) practised. She offered instead a blueprint for the task moral philosophers must embrace if they are to (...) speak intelligibly to society about good and bad, right and wrong, duty and obligation. The chapters in this book are inspired by Anscombe's classic text. One of the most powerful voices here, among many authoritative voices, is that of Philippa Foot – Anscombe's lifelong friend – who asserts that 'any account of practical reason evacuated of an understanding of what human beings need to flourish is inadequate and must be rejected.'. (shrink)

Although this collection of articles is not formally a commentary on Elizabeth Anscombe's famous article of the same title, in which she criticized the moral philosophy prevalent in 1958, a number of the contributors consider Anscombe's work as a starting point. The collection can be interpreted as a demonstration of the extent to which moral philosophers have since attempted to respond to Anscombe's challenge, and to develop an approach to their subject which is neither based on divine law nor permissive (...) of the impermissible. (shrink)

In *Here and There*, Stanley Cavell suggests that music, like speech, implicates the listener, so that our descriptions of music "are to be thought of not as discoveries but as impressions and assignments of meaning." Such impressions express what "makes an impression upon us," "what truly matters to us." Moreover, this aspect of music "is itself more revolutionary than ... any political event of which it could be said to form a part." I offer one indication of that significance by (...) considering a recent challenge to an old claim about the relation between jazz and democracy. Stanley Crouch claims that jazz practice is an emblem of democracy, while Benjamin Givan observes the undemocratic, hierarchical way that jazz musicians work together. But both positions rest on a limited notion of "democracy." I contrast it to the tradition in political thought that requires each citizen to find their own voice if they're to acquire the ability to govern themselves. Consequently, a better emblem of jazz's democratic advance lies in the challenge it presents to the attentive listener. Jazz listening is increasingly characterized by a learned culture of hearing what isn't played, hearing allusions, hearing unspoken interplay. The nature of this "hearing between the lines" parallels the tradition of esoteric writing in the history of political thought. It suggests that jazz's democratic importance is found in the listener's willingness to give voice to what she hears, not knowing whether her experience is shared by others or whether it singles her out, possibly for skepticism or ridicule. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Who Hears?A Zen Buddhist PerspectiveRobert AitkenWestern psychologists and neurologists have attempted to use their concepts to explain East Asian religions for more than seventy-five years. Carl Jung (1875–1961) wrote a long foreword to Richard Wilhelm's The Secret of the Golden Flower back in 1931, which gave many readers in Europe and the Americas their first glimpse of philosophical Daoism.1 A generation later, Erich Fromm's conversations with D. T. (...) Suzuki were recorded in Zen Buddhism and Psychoanalysis.2 In our own time, the Dalai Lama's collaborative work with neuroscientists and psychologists has received widespread attention,3 while academia has given James H. Austin's Zen and the Brain hearty approval.4The process of mutual understanding between Western scientists and teachers of East Asian religion is still incomplete, however, and in earlier times it had barely begun. I remember my amusement back in the 1970s, watching a video of monks trailing streams of wires attached to biofeedback instruments while they were walking formally and solemnly. Even in those early days it was apparent to me that for all their academic credentials, the scholars had started with an ignorance of the subject of their study. They were successful in measuring something in the brain relating to a samādhi condition, but while the monks may have grounded themselves more or less in a settled practice, who is to measure their appreciation of the mejiro chirping in the camellia bush just outside? Great masters of Zen, Zhaozhou, and Deshan and their successors did not talk about being settled, any more than neuroanataomists discuss the importance of the alphabet.The chirping of the mejiro might have reminded the monks of a case, a case that would lie in a dimension even further from the world of wires and dials. "Who is the master of hearing that sound?"5 This was the gist of a question by Bassui Tokushō Zenji—a question that became a public case, one kōan among many other kōans that have not been studied by science. It is time for such a study.My directory of Chinese kōans holds more than 5,500 neatly framed traditional stories set forth to guide the student.6 The modern Zen teacher is conversant with some 550 of these kōans, a number that is sufficient if... if.... There are several caveats. If the teacher treats kōans as historical artifacts, then the stories are no [End Page 89] longer kōans, and the teaching is perniciously misleading. Sometimes the teacher has gone only part way in kōan study. The great house of conventional wisdom has fallen, but he or she doesn't know it is ruined and holds forth in the old explanatory way. Sometimes the teacher has completed the long course of study, but elects to pontificate from within the wreckage of the old manor. Finally there are those who abandon the ruins completely for practice on the open road. Here is my gāthā pointing to that way:Stepping forth on the open road,I vow with all beingsTo distinguish the voices of birds,And make good use of my time.Bassui Zenji's kōan "Who is the master of hearing that sound?" could be paraphrased here at the Pālolo Zen Center as "Who is hearing that thrush singing on the railing outside?" If, in the days before I retired, a student were to respond, "I hear the thrush," I would not have approved. Bassui would not have approved. Intimacy would be missing, and intimacy is the Dao. Intimacy is the way of all the Buddhas. There is no Zen without intimacy; intimacy with what? Both the self and the thrush. That was Bassui's intention, you can be sure.Fayan met Dizang while on pilgrimage. Dizang asked, "What are you up to these days?"Fayan said, "I'm going around one pilgrimage, wherever my feet will carry me."Dizang asked, "What to you expect from pilgrimage?"Fayan said, "I don't know."Dizang said, "Not knowing is most intimate." Fayan underwent great realization. 7Zen Buddhism stresses intimacy, while in... (shrink)

According to the perceptual view of language comprehension, listeners typically recover high-level linguistic properties such as utterance meaning without inferential work. The perceptual view is subject to the Objection from Context: since utterance meaning is massively context-sensitive, and context-sensitivity requires cognitive inference, the perceptual view is false. In recent work, Berit Brogaard provides a challenging reply to this objection. She argues that in language comprehension context-sensitivity is typically exercised not through inferences, but rather through top-down perceptual modulations or perceptual learning. (...) This paper provides a complete formulation of the Objection from Context and evaluates Brogaards reply to it. Drawing on conceptual considerations and empirical examples, we argue that the exercise of context-sensitivity in language comprehension does, in fact, typically involve inference. (shrink)

This paper is an intervention within feminist and queer debates that have re-posed so-called negative states of being as offering productive possibilities for political practice and social transformation. What is sometimes called the politics of negative affect or analyses of political feeling has sought to de-pathologise shame, melancholy, failure, depression, anxieties and other forms of ‘feeling bad’, to open up new ways of thinking about agency, change and transformation. Ann Cvetkovich's recent memoir explores depression as a public feeling and argues (...) that ‘feeling bad might, in fact, be the ground for transformation’. As she suggests, the question, ‘how do I feel’ could usefully be reframed as ‘how does capitalism feel’? This performative staging of political forms of psychosocial reflexivity opens up new strategies for survival, new visions of the future, and importantly de-medicalises feeling beyond an individual expression of psychopathology. The grounds for affective politics might be found within new feminist futures that are attentive to the relations between emotion, affect, feelings and politics. This paper will be situated within these debates and the challenge of thinking about the productive possibilities of negative states of being. However, rather than focus on depression, I will turn my attention to experiences such as psychosis and temporal dissociation, based on my long-standing research with the Hearing Voices Network. In the context of discussions of disability and capability I will discuss the value of concepts such as debility, and ‘living in prognosis’, and respond to the call to think through what such states might offer for feminist and queer practice. (shrink)

Susan has been profoundly deaf since childhood. She is a hearing aid wearer, and likes to use the induction loops built into some public spaces, such as theaters and cinemas, to help cut down the background noise that can make hearing speech very difficult. But this depends on the building having an induction loop fitted and properly maintained. Like many other induction loop users, Susan frequently finds that the advertised loop system is either working poorly or not working at all. (...) Almost as often, she then has the experience of making a complaint about it only to have the problem denied. If she persists, she is often then met... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:How I Lost My HearingJanessa SalesI was born as a healthy and strong hearing person, but I became deaf through a result of painful and traumatic cancer treatments. I was diagnosed with a malignant brain tumor called Germinoma in 2003. I went through surgery, chemotherapy, and radiation. I was good for one and a half years. However, in 2005 when I turned 12 my cancer relapsed. My doctors told (...) me and my family that I had to undergo a much stronger treatment plan called a Bone Marrow Transplant (BMT). One of the possible side effects to this treatment was hearing loss. I unfortunately received this devastating side effect.I still remember the day that I lost my hearing. Before going to sleep that night, I received a dose of chemo. Waking up the next morning, something was terribly wrong. I couldn’t hear anything! I felt as if I were wearing earplugs. I called for my mother and I told her the alarming news, but as she was speaking back to me, I strained to hear her voice. All I saw were her lips moving. My doctors made arrangements for me to get my hearing tested with an audiologist.As the days that passed, I went through a deep depression. My doctors and my family tried different ways to communicate with me. They used note pads or white boards and wrote down what they wanted to say to me. As my hearing lessened, my other senses kicked in. I read body language and expressions. I learned to read lips. It was a little over a month before I got my hearing aids.Going back to school was very difficult, but my hearing loss, in itself, wasn’t as traumatic as the refusal to accept my new life. I spent the next four years trying to be hearing—trying to fix myself— trying to be what I once was. I always strained my ears trying to listen to my teachers. I tried fitting in with my friends, trying to keep up with their conversations, but it was no use. I couldn’t hear a thing; I was lost and confused.However, during my eighth grade year, I was given the choice to transfer to a different school. It was a mainstream school that had a DHH (Deaf and Hard of Hearing) program. It was a scary transition going to a new school, not knowing anybody. I hesitated and did not want to go at first, but eventually I got over my fears.When I transferred over to the other middle school, I still felt lost. I was still trying to be a hearing student. I only knew how to be auditory learner. I couldn’t focus because I wasn’t able to hear my teachers. I was new at sign language, so I couldn’t understand any of my interpreters. I had frequent meltdowns every week.I felt like I didn’t fit into the deaf world or the hearing world. I couldn’t understand either one. I was always misunderstanding my hearing friends, and I wasn’t able to understand my deaf peers because I didn’t fully know their language. I had low self–esteem and I felt like I didn’t belong anywhere.I had to learn to become a visual learner. I was given the use of a Frequency Modulated (FM) system. The FM system is an assistive listening device worn by the speaker to amplify his/her voice and transmit it directly to the listener’s ears via an electronic receiver and special earphones or the listener’s own hearing aids. I also had an interpreter and closed captions when needed.My DHH teacher Mr. H, who was my greatest mentor and role model, set me up with an Individualized Educational Program (IEP) that required that I had to have my homework written down instead being verbally told. I was allowed to have more time on tests when needed, and a note taker for lectures. All of these arrangements really helped me through my new “deaf world.”My mother and I took Sign Language classes at Sacramento State University where Mr. H also taught... (shrink)

An interview with poet and literary critic, Professor Angela Leighton (Senior Research Fellow, Trinity College, Cambridge). She is primarily interested in poetry of the nineteenth and twentieth centuries, but also in nineteenth-century aestheticism and its continuing legacy in the twentieth, in particular the work of Woolf, Yeats, Stevens, Bishop, Plath and W.S. Graham. In this interview, Leighton talks about her poetry, the philosophical potential of poetry and the way in which poetry means.

In lieu of an abstract, here is a brief excerpt of the content:The Seventh International Buddhist-Christian Conference:"Hear the Cries of the World"Darnise C. MartinThe SBCS Seventh International Conference honoring the ongoing Buddhist-Christian dialogue was hosted by Loyola Marymount University, June 3–8, 2005. The campus provided a picturesque and temperate backdrop to conversations, workshops, worship experiences, musical performances, and academic sessions inspired by the theme, "Hear the Cries of the World." This focus shaped our time together as we discussed issues, both (...) old and new, that continue to polarize our world and ways in which we might heal and grow into more holistic ways of being.Loyola Marymount University was pleased to welcome more than 120 participants from close to home and around the world. In addition to representation from many parts of the United States, we also had guests from Japan, Belgium, Germany, Korea, and Sweden. With such a diverse group having a range of needs and concerns, I was heartened to receive positive feedback from all of our attendees, who expressed their satisfaction with the programming and events as well as the general logistics, organization, and staff accessibility throughout the conference.The conference got underway with bittersweet opening ceremonies. We began with words of welcome to our international group, as well as expressions of sadness at the loss of David Chappell, founding member of the Society for Buddhist-Christian Studies. David's memory was lifted up in the presence of his family, dear friends, and colleagues. The Society will carry on his work of dialogue, healing, and reconciliation.The conference had many highlights. One of the most notable features of the conference was the visually and musically stunning dance performance by Viji Prakash, [End Page 185] acclaimed international choreographer and dancer. Her dance troupe, Shakti Dance Company, performed "From Prince to Buddha: A Journey to Enlightenment," an energetic production based on the life of the Buddha. The audience was thoroughly enchanted and entertained by this performance.The academic sessions offered many and varied expressions of the theme, "Hear the Cries of the World." Scholars, activists, and clergy came together to present papers and personal experiences around issues of ecological healing, prison ministry, youth outreach, women's responses to poverty and injustice, as well as the traditional figures of compassion, the Virgin Mary, Kuan Yin, and the way of the Bodhisattva.In particular, our group was intensely moved through an evening presentation on prison ministry presented by two people working intimately in the area of bringing compassion to this field. One presenter was Fleet Maull, founder of the Prison Dharma Network and the National Prison Hospice Association, who has been in the prison system as an inmate himself. He shared the experiences that led to his incarceration as well as the dehumanizing ways in which people are treated as inmates. He spoke of meditation as a tool by which prisoners may develop awareness and regain their humanity, even if for only brief moments. These moments can maintain hope for people who otherwise would have none. Maull, who was ordained a Buddhist priest while in prison, began a ministry to provide hospice care to terminally ill inmates, a ministry that has continued after his release through a growing network of participating prisons.The second presenter, Beth Ross of First African Methodist Episcopal (FAME) Church in Los Angeles, also discussed her work as part of the church's prison ministry outreach. Ross spoke about ministering not only to the person in prison, but also to the family of the inmate. Each has particular needs. The church has responded to prisoners' needs to not feel abandoned and isolated by instituting a letter-writing campaign. She said this helps people stay connected to a community and begin to heal. The church also provides re-entry support as prisoners are released and need to find housing and employment. Ross advocates for these former inmates needing a second chance. Without help, she notes, they are destined to commit further crimes against society and return to prison. FAME hopes to be a beacon of hope to these former prisoners.This was a powerful session for everyone. Speaking for myself, I had often thought about how society permanently demonizes former inmates. What chance do... (shrink)

The article engages with the protagonist of The Secret Gospel of Mary Magdalene by Michèle Roberts, first published in 1984 as The Wild Girl. Filipczak discusses scholarly publications that analyze the role of Mary Magdalene, and redeem her from the sexist bias which reduced her to a repentant whore despite the lack of evidence for this in the Gospels. The very same analyses demonstrate that the role of Mary Magdalene as Christ’s first apostle silenced by patriarchal tradition was unique. While (...) Roberts draws on the composite character of Mary Magdalene embedded in the traditional association between women, sexuality and sin, she also moves far beyond this, by reclaiming the female imaginary as an important part of human connection to the divine. At the same time, Roberts recovers the conjunction between sexuality and spirituality by framing the relationship of Christ and Mary Magdalene with The Song of Songs, which provides the abject saint from Catholic tradition with an entirely different legacy of autonomy and expression of female desire, be it sexual, maternal or spiritual. The intertext connected with The Song of Songs runs consistently through The Secret Gospel of Mary Magdalene. This, in turn, sensitizes the readers to the traces of the Song in the Gospels, which never quote from it, but they rely heavily on the association between Christ and the Bridegroom, while John 20 shows the encounter between the risen Christ and Mary Magdalene in the garden whose imagery is strongly suggestive of the nuptial meeting in The Song of Songs. (shrink)

In this essay Megan J. Laverty argues that Jean-Jacques Rousseau's conception of humane communication and his proposal for teaching it have implications for our understanding of the role of listening in education. She develops this argument through a close reading of Rousseau's most substantial work on education, Emile: Or, On Education. Laverty elucidates Rousseau's philosophy of communication, beginning with his taxonomy of the three voices—articulate, melodic, and accentuated—illustrating the ways in which they both enhance and obfuscate understanding. Next, Laverty provides (...) an account of Rousseau's philosophical psychology, with specific reference to amour-propre and amour de soi. Listening plays a central role in Rousseau's philosophy of communication, Laverty maintains, because it is in the act of listening that humans fulfill, or fail to fulfill, the imperative that we seek to understand others. (shrink)

In 'You and She*' (ANALYSIS 51.3, June 1991) C.J.F. Williams notes the importance of reflexive pronouns in attributions of propositional attitudes, and claims to improve upon an earlier account of Hector-Neri Castaneda's in [1]. However, to the extent which his remarks are accurate, they reveal nothing that Castaneda hasn't already said, while insofar as they are new, they obliterate distinctions vital to Castaneda's theory. Castaneda called these pronouns quasi-indicators and noted that they function as linguistic devices used for attributing indexical (...) reference to others. For example, in hearing Arthur say 'I am wise' we would report his claim in English with, (1) Arthur thinks that he himself is wise. where 'he himself' is a quasi-indicator used to attribute to Arthur reference to himself qua self -- an expression that Castaneda abbreviated with 'he*.' Note that (1) is quite different from, (2) Arthur thinks that I am wise for 'I', functioning here as an indexical term, represents only the speaker's reference. Nor can (1) be identified with, (3) Arthur thinks that Arthur is wise. for this fails to represent the indexical character of Arthur's thought. Thus, (3) falls short of the informational content of (1). Moreover, as Williams, echoing Castaneda, points out, Arthur might not know that he himself is Arthur, or that he is named 'Arthur.' Hence, (3) might be false even if (1) is true. Williams observes that 'she' can also be used in oratio obliqua to report an indexical 1 usage, e.g., in (4) Arthur told Mary that she ought to talk to Shirley Makepeace's.. (shrink)

In 1942, the recently bereaved Manu Gandhi arrived in Sevagram ashram, Wardha, to serve the aged Mahatma and his ailing wife Kasturba. In 1943, she was called to Poona, where the Mahatma and his as...

This is Oh, the Places You'll Never Go-the ultimate hilarious, cynical, but absolutely realistic view of a college graduate's future. And what he or she can or can't do about it. "This commencement address will never be given, because graduation speakers are supposed to offer encouragement and inspiration. That's not what you need. You need a warning." So begins Carl Hiaasen's attempt to prepare young men and women for their future. And who better to warn them about their precarious paths (...) forward than Carl Hiaasen' The answer, after reading Assume the Worst, is: Nobody. And who better to illustrate-and with those illustrations, expand upon and cement Hiaasen's cynical point of view-than Roz Chast, best-selling authorllustrator and National Book Award winner' The answer again is easy: Nobody. Following the format of Anna Quindlen's commencement address (Being Perfect) and George Saunders's commencement address (Congratulations, by the way), the collaboration of Hiaasen and Chast might look typical from the outside, but inside it is anything but. This book is bound to be a classic, sold year after year come graduation time. Although it's also a good gift for anyone starting a job, getting married, or recently released from prison. Because it is not just funny. It is, in its own Hiaasen way, extremely wise and even hopeful. Well, it might not be full of hope, but there are certainly enough slivers of the stuff in there to more than keep us all going. (shrink)

Pamela had, throughout her life, an ambivalent relationship with the church. She wanted her work to make a difference to it and she was committed to being a feminist philosopher of religion. There are many recurrent themes in her work that clearly relate to her background in the church, and particularly in the Lutheran church of her upbringing. Her challenge to the patriarchy of what she called “hyper-traditional” Christianity is clear, but also her critique of some forms of forgiveness and (...) her search for new understandings of love and vulnerability. Her work presents significant challenges to the church, but does not abandon it, instead offering new ways of connecting with some of its most profound and important teachings and themes. Her work encourages us women in the church to value our own life experience as a source of knowledge, to re-frame our vulnerabilities and to find love in ways that offer freedom and hope. Pamela saw her work as her own contribution to the community of the church. It remains important that her voice, even and especially with its “speaker vulnerability,” is heard in that place. (shrink)

Practical reasoning requires decision—making in the face of uncertainty. Xenelda has just left to go to work when she hears a burglar alarm. She doesn’t know whether it is hers but remembers that she left a window slightly open. Should she be worried? Her house may not be being burgled, since the wind or a power cut may have set the burglar alarm off, and even if it isn’t her alarm sounding she might conceivably be being burgled. Thus Xenelda (...) can not be certain that her house is being burgled, and the decision that she takes must be based on her degree of certainty, together with the possible outcomes of that decision. (shrink)

This is the English translation of a speech Bergson made at Lycée Henri-IV on July 30, 1892. This is an interesting text because it anticipates Bergson’s last book, his The Two Sources of Morality and Religion. Like the distinction in The Two Sources between the open and the closed, “Politeness” defines its subject matter in two ways. There is what Bergson calls “manners” and there is true politeness. For Bergson, both kinds of politeness concern equality. Manners or material politeness amount (...) to the ritualized greetings and formalities by means of which we usually define politeness. Unfortunately and like The Two Sources, Bergson attributes this formalized relation to other human beings with primitive and “inferior races.” Nevertheless, Bergson sees in these formalities an attempt, in the name of equality, to ignore other people’s talents and merits so that one can dominate morally superior people. In contrast, true politeness or “spiritual politeness” consists in “intellectual flexibility.” When one meets a person of superior morality, one is flexible in one’s relation to him or her; one abandons the formalities in order to really live her life and think her thoughts. Here we find equality too: “what defines this very polite person is to prefer each of his friends over the others, and to succeed in this way in loving them equally.” After making a comparison to dance, Bergson defines spiritual politeness as “a grace of the mind.” Since both kinds of politeness concern equality, Bergson associates both with justice. However, beyond these two kinds of politeness and justice there is “politeness of the heart,” which concerns charity. In order to indicate politeness of the heart, Bergson describes the kind of person, a sensitive person, who anxiously awaits a word of praise in order to feel good about herself but who also, when she hears a word of reproach, is thrown into sadness. Although Bergson calls the sensibility of this person “a bit sickly,” he also claims that the sensibility is found in the heart of each of us. It indicates a fundamental sympathy with others. For this person such a word from another makes every power of one’s being vibrate in unison. So in this short speech, one will find Bergson distinguishing between material politeness, mental or spiritual politeness, and politeness of the heart. Politeness of the heart is true openness to others. And, for Bergson, it opens up to a society exemplified by ancient philosophy: true friends of each other and of ideas. (shrink)

Imagine that the person you see through the looking glass is a real person, with her own experiences, living in an environment that is the mirror-reverse of yours. You look at your right-hand glove as you put it on your right hand; she looks at her left-hand glove as she puts it on her left hand. You feel your heart beating on your left side; she feels her heart beating on her right side. You hear a bird chirping out the (...) window to your left; she hears a bird chirping out the window to her right. Is there any difference between your experience—your what-it-is-like phenomenal character—and hers? She is looking at her left-hand glove, the mirror-reverse of you as you look at your right-hand glove. Does she see what you see, a right-hand glove, or the reverse of what you see, a left-hand glove? Since her environment is the mirror-reverse of yours, and she seems to get by in it just fine, you'd probably assume, if you had to guess, that she sees it correctly. She is looking at her left-hand glove, after all. So it stands to reason that she is having an experience as of a left-hand glove, not a right-hand glove. And it stands to reason—it seems obvious—that an experience as of a left-hand glove differs in what it is like from an experience as of a right-hand glove. In this paper, I will argue that this last presupposition, obvious though it may seem, is false. I'll argue that (unless dualism is true) there is no intrinsic difference between what it is like to experience a left-hand glove and what it is like to experience a right-hand glove: if there are any relevant experiential differences, these are either merely comparative (differences in what it is like to compare gloves) or cognitive (differences in what it is like to bring an experience of a glove under a concept like LEFT or RIGHT). So your mirror-reverse twin, who won't differ from you in what she is comparing or thinking, will have the same (type of) experience as you. I'll call the position I am arguing against orientation–experience categoricalism, and the position I am arguing for orientation–experience relationism. Orientation–experience relationism is a surprising thesis, one whose falsity you might take for granted. I will argue for it by cases. Things go wrong for the orientation–experience categoricalist in one sort of way if we imagine that you and your mirror-twin's experiences differ: basically, this leads to absurdity if we imagine that you and she both live at a world with a non-orientable spatial topology (in the sense in which a Möbius strip or Klein bottle are non-orientable). Things go wrong for the orientation–experience categoricalist in a different sort of way if we assume that you and your twin would experience the same, but that someone else might have the experience that we were just imagining that your twin might have. Under these assumptions, we have to accept the existence of partial zombies, who lack the relevant phenomenology but behave as if they have it, at very close, empirically possible worlds. In an appendix, I argue that property dualism is the best alternative for those who cannot bring themselves to accept orientation-experience relationism. (shrink)

Lerdahl and Jackendoff's Generative Theory of Tonal Music (GTTM) is an important contribution to cognitive science. Jackendoff claims it is a computationalist theory and that the mental representations it postulates are unconscious. Thus GTTM looks to be a kind of cognitive science remote from the folk-psychological. I argue that this picture of GTTM is mistaken: GTTM is at least as much music analysis as cognitive science. Jackendoff's metatheory fails to explain how a listener can tell that a structural description corresponds (...) to the way she hears, how analytically minded listeners can communicate about their hearing, and how a reader of their book can comprehend it. I suggest an alternative construal, on which GTTM's analytical vocabulary functions as a public language and its mental representations are perceptual beliefs. Interesting philosophical problems ensue about knowledge of musical structure and knowledge about what structures one hears. There is a paradox: one wants an analysis to be true to a hearing, yet to be illuminating. Though analysis and hearing coincide in content at an abstract level, they do not coincide in conceptual content. What sort of knowledge then underlies the inference from perceptual to music-analytical representation? I argue that such knowledge is a priori. (shrink)

In ethics, Wittgenstein, early and late, emphasized changes of attitude over questions about how to act. He once told his friend Rhees: “One of my sister’s characteristics is that whenever she hears of something awful that has happened, her impulse is to ask what one can do about it, what she can do to help or remedy. This is a tendency in her of which I disapprove.” Instead, he says elsewhere: “If life becomes hard to bear we think of (...) improvements. But the most important & effective improvement, in our own attitude, hardly occurs to us […].” Such attitudinal changes involve a kind of clarity of thought for Wittgenstein, and his understanding of them can be explained in part by reference to his later discussion about aspect-perception. Moral problems can disappear in a way that resembles the disappearance of the rabbit-aspect of when the duck-aspect dawns. I compare moral clarification to logical-philosophical clarification. Both cases involve propositions that say nothing, but rather shed light on what other propositions say—tautologies, grammatical remarks, and philosophical elucidations on the one hand, clarificatory moral remarks like ‘think of her as someone’s daughter’ on the other. I argue that this gives a practical edge to Wittgenstein’s moral thought, a tool with which to think through moral difficulties. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Mystery on the Move:Aquinas’s Theological Method as Transforming WisdomGilles Mongeau, S.J.CONTEMPORARY APPROACHES to the thought of Thomas Aquinas have begun to recover its character as a “wisdom practice” aimed at the transformation of persons and sociocultural situations.1 The wise person helps others move along a path through the mysteries of faith toward a wisely ordered life for themselves in a justly ordered society. The starting point of this essay (...) is the supposition that Aquinas’s theological method in the Summa theologiae, rooted in the practice of the three arts of language (grammar, dialectic, and rhetoric) is itself a wisdom practice that proposes an ordered series of exercises that must be performed by the student, leading him or her to a greater participation in divine wisdom. I will show that Aquinas’s use of the tools of rhetoric, particularly the enthymemes known as arguments of fittingness, are a set of practical instructions that facilitate an affective response to divine mystery in order to enable a judgment by connaturality. [End Page 285] Thus, we can learn from Aquinas how fruitfully to order affect and reason in the exercise of the theological craft.The essay proceeds in three parts. First, a thought experiment will help us understand (a) how a medieval text works as a guide to performance, and (b) how intellect and affect interact in both artistic performance and aesthetic appreciation. Second, I will trace the role of affect and reason in knowledge for Aquinas, specifically in knowledge of the beautiful, of the good, and of divine mysteries. Third, I will show how Aquinas’s use of rhetorical enthymemes, specifically the argument of fittingness, promotes an affectively founded judgment whose fruit is true knowledge of the divine mysteries.I. A Thought ExperimentThe image below reproduces the sheet music for “O nuit d’amour,” a duet for tenor and soprano between Faust and Marguerite in Gounod’s opera Faust. A person with absolutely no training in music, looking at this page, will be able to glean only a small amount of information from it: the content of the text itself; the fact—indicated by the names “Faust” and “Marg.” listed above the score—that there are two singers; possibly, if he or she is enterprising and looks up a translation of “andante,” the fact that this piece of music is sung at a walking pace, moderately slow and mellow. But he or she is unlikely to be able to sing the duet without memorizing it from a performance he or she hears.Now, someone with singing experience in a choir, though without training in solfège, will be able to get a bit more information from the page: he or she will likely be able to recognize the time signature and the sequence and value of the notes and rests, as well as the ascending and descending patterns of the melody, so that given solid accompaniment and competent direction, and enough practice time, he or she could sing the duet. But this performance will not rely so much on the sheet music as it will rely on the external supports, and the nuances of the performance will be minimal. [End Page 286] Click for larger view View full resolutionFinally, two singers with training in solfège will be able to notice a number of things about the duet: first, that it is in D flat major, but that Faust’s part shades at bars five and six into B flat minor, adding a mysteriously ambiguous quality to his declaration of love; second, that Marguerite’s part remains always in a major key, though it shifts between D flat major and G flat major, adding a kind of temporary “lift” at key points in [End Page 287] her melody; that some of the chords in the accompaniment, at key points in the duet, are not played in their root positions, but in their second or third inversions, thus transforming the quality of the sound; they will also note instructions for holding notes. All of this information will allow a well-trained singer to sight-sing the duet and supply the necessary nuances from the... (shrink)

A person listening to music can be said to “hear space” in two senses: metaphorically, when the musical features of a composition, such as melody, harmony or rhythm, evoke a space (e.g., if she hears a “rising” melodic line) or suggest abstract concepts related to an imaginary spatial scene; and literally, when she perceives spatial information relating to sound sources and the spatial region where they are located. In this paper I will analyze the way we perceive space when (...) listening to music, focusing on the experience of physical space. I will apply a model of the way we experience non-musical (or environmental) sound sources to the perception of musical sound sources. I will argue that our experience of musical and non-musical sound sources involve similar perception of the spatial properties of sounds sources, by applying a specific model of spatial experience of non-musical sound sources to some musical compositions which exemplify different roles of space as an aesthetic tool, I will argue that our experience of musical and non-musical sound sources involve similar perception of the spatial properties of sound sources. Accordingly I will suggest that if we want to capture the difference between musical experience and the auditory experience of non-musical sounds with relation to space, we should probably focus on the experience of metaphorical space. (shrink)

Music analysis raises interesting problems for the theory of mental representation and meaning, and poses new challenges for epistemology. When an analysis purports to show the structure an analyst or reader hears a piece as having, what relation must thereby hold between hearing and analysis, and how does the analyst or reader know that it does? A paradox of analysis arises: if an analysis correctly captures the information content of a hearing, then it is bound to be uninformative. The (...) solution is to distinguish different levels of content, where analysis and hearing share content on one level and diverge on another. The question then arises of how an analyst or reader knows that she hears a piece in the way described by an analysis. The nature of this (apparently a priori) knowledge is an important, and heretofore unappreciated, problem for epistemology. Music analysis is, finally, a fertile ground for investigating the age-old problem of the relation between perception and concepts. (shrink)

We commonly hear it said that a work of art must be understood “on its own terms,” and that phrase is used in other contexts as well; people, especially people very different from ourselves, are said to have to be understood on their own terms. But what is the meaning of the expression “on its/their own terms?” Note that we do not say of every possible object of understanding that it must be understood on its own terms. The statement, “Chemistry (...) must be understood on its own terms,” sounds odd. The “on its own terms” appears to lack point. It invites the retort, “Good grief, on what other terms had you expected to understand it?!” We seem to be brought to this: where the exhortation “understand it on its own terms” is to be used in reference to some object, there must be some reasonable way of understanding that object alternative to understanding it on its own terms. We may ask the child its own childish reasons why it keeps clobbering little sister (“She took my dolly!”), or we may account for its actions in terms the child does not comprehend (“sibling rivalry”). We may on occasion even do the same sort of thing with adults, perhaps giving a reason out of Freud for something done by a person who never heard of Freud or psychoanalysis. But naturally, distinctions between “their terms” and “our terms” become of extreme importance when we attempt to understand the peoples of other cultures. In such cases there literally are different systems of terms, that is, different languages, within which we must make sense of activities. (shrink)

As I write, I hear that Dr. Jack Kevorluan has delivered another victim to the emergency room of his local Michigan hospital. Why do physicians and terminally ill patients feel we need to change the law with respect to assisted suicide when a rogue pathologist, who has been stripped of his medical license, is allowed to pursue his appetite for providing his clients with inhalation treatments of carbon monoxide gas? If no court will convict this outlaw, what makes the physicians (...) and patients who brought Compassion in Dying v. State of Washington and Quill v. Vacco fear that any court would ever convict a licensed physician of assisting in a suicide when he/she writes one of her established patients a prescription for a short-acting barbiturate? Moreover, it is not even clear that laws against assisted suicide in most jurisdictions were ever intended to apply to the actions of licensed physicians. Nonetheless, the plaintiffs in the Second and Ninth Circuit Courts of Appeals were clearly seeking some kind of redress, some kind of protection from potential legal claims they feared might be made against them. (shrink)

The provision of standardized hearing aids is now considered to be a crucial part of the UK National Health Service. Yet this is only explicable through reference to the career of a woman who has, until now, been entirely forgotten. Dr Phyllis Margaret Tookey Kerridge was an authoritative figure in a variety of fields: medicine, physiology, otology and the construction of scientific apparatus. The astounding breadth of her professional qualifications allowed her to combine features of these fields and, later in (...) her career, to position herself as a specialist to shape the discipline of audiometry. Rather than framing Kerridge in the classic ‘heroic-woman’ narrative, in this article we draw out the complexities of her career by focusing on her pursuit of standardization of hearing tests. Collaboration afforded her the necessary networks to explore the intricacies of accuracy in the measurement of hearing acuity, but her influence was enhanced by her ownership of Britain's first Western Electric audiometer, which she placed in a specially designed and unique ‘silence room’. The room became the centre of Kerridge's hearing aid clinic that, for the first time, allowed people to access free and impartial advice on hearing aid prescription. In becoming the guardian expert and advocate of the audiometer, Kerridge achieved an objectively quantified approach to hearing loss that eventually made the latter an object of technocratic intervention. (shrink)

As I write, I hear that Dr. Jack Kevorluan has delivered another victim to the emergency room of his local Michigan hospital. Why do physicians and terminally ill patients feel we need to change the law with respect to assisted suicide when a rogue pathologist, who has been stripped of his medical license, is allowed to pursue his appetite for providing his clients with inhalation treatments of carbon monoxide gas? If no court will convict this outlaw, what makes the physicians (...) and patients who brought Compassion in Dying v. State of Washington and Quill v. Vacco fear that any court would ever convict a licensed physician of assisting in a suicide when he/she writes one of her established patients a prescription for a short-acting barbiturate? Moreover, it is not even clear that laws against assisted suicide in most jurisdictions were ever intended to apply to the actions of licensed physicians. Nonetheless, the plaintiffs in the Second and Ninth Circuit Courts of Appeals were clearly seeking some kind of redress, some kind of protection from potential legal claims they feared might be made against them. (shrink)

Since September 11th, we frequently hear that political differences should be put aside: the real struggle is between good and evil. What does this mean for political and social life? Is there a 'Third Way' beyond left and right, and if so, should we fear or welcome it? This thought-provoking book by Chantal Mouffe, a globally recognized political author, presents a timely account of the current state of democracy, affording readers the most relevant and up-to-date information. Arguing that liberal 'third (...) way thinking' ignores fundamental, conflicting aspects of human nature, Mouffe states that, far from expanding democracy, globalization is undermining the combative and radical heart of democratic life. Going back first to Aristotle, she identifies the historical origins of the political and reflects on the Enlightenment, and the social contract, arguing that in spite of its good intentions, it levelled the radical core of political life. Contemporary examples, including the Iraq war, racism and the rise of the far right, are used to illustrate and support her theory that far from combating extremism, the quest for consensus politics undermines the ability to challenge it. These case studies are also highly effective points of reference for student revision. _On the Political _is a stimulating argument about the future of politics and addresses the most fundamental aspects of democracy that will aid further study. (shrink)

Since September 11, we frequently hear that the struggle is between good and evil and that politics is at an end. Should we welcome or fear a 'Third Way' beyond left and right? In this timely and thought provoking book, Chantal Mouffe argues that third way thinking ignores fundamental, conflictual aspects of human nature and that far from expanding democracy, globalization is undermining the combative and radical heart of democratic life. Going back first to Aristotle, she identifies the historical origins (...) of the political. She also reflects on the Enlightenment and the social contract, arguing that in spite of its good intentions, it fatally suppressed the radical core of political life. She uses many contemporary examples, including the Iraq war, racism and the rise of the far right, to argue that far from ending dangerous extremism, the political void created by the search for consensus inflames it. (shrink)

Early in my career as a neonatologist, I was called into the hospital for a newborn who would not stop crying. Screaming, really. When I entered the unit, I was greeted by a loud, shrill, distinctive cry. After hearing the history and examining the baby, I just stood there for a while, watching and listening. It took some time, but eventually, I noticed a subtle regularity, a rhythmicity. I took off my watch, placed it on the bed next to the (...) child, and found that the crying briefly grew louder about every six or seven seconds. This baby was having an atypical seizure. This preliminary diagnosis was followed by a conversation with the parents and a neurologist, transfer to the nearby academic center for an extensive evaluation, and the eventual demise of the child from a poorly understood disease. About a year later, I walked into the same unit and heard a cry I had heard only once before. I looked over to see the same mother at a newborn's bedside, with tears in her eyes, looking back at me. She knew what the coming days held for her and for her second child. That was over twenty years ago, but two images, or moments, remain with me. One is the watch on the bed next to the first baby; the other is the mother's expression of sadness the morning the second child was born. The image of the timepiece is perhaps instructive. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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Over the last decade, attention has crawled from out of the shadows into the philosophical limelight with several important books and widely read articles. Carolyn Dicey Jennings has been a key player in the attention revolution, actively publishing in the area and promoting awareness. This book was much anticipated by insiders and does not disappoint. It is in no way redundant with respect to other recent monographs, covering both a different range of material and developing novel positions throughout. The book (...) might have been called The Attending Self, since Jennings defines attention as mental prioritization controlled by the self. This invocation of the self is among her central innovations, and may prove to be the main source of controversy. I will highlight points of contention here, but want to emphasize at the outset that the book is essential reading for anyone interested in attention. Jennings also contributes to a range of other debates, which will help a broader audience appreciate the importance this topic.After a brief introduction, Jennings provides “a philosophical landscape” of attention (chap. 2), tracing the concept through history. This is an invaluable achievement that will be welcomed by both newcomers and veterans. Jennings exhibits enormous breadth, covering areas that contemporary philosophers of mind tend to neglect: medieval philosophy, Buddhist thought, and phenomenology, to name a few. We also get perspectives on attention from core figures in the Western canon, such as Descartes, Locke, and Kant, as well as thinkers who gave the topic a more political inflection: Mary Wollstonecraft and W. E. B. DuBois. Jennings surveys contemporary literature as well, locating recent work in these older lineages. Some authors get more treatment later in the book (e.g., William James and Wayne Wu). Overall, Jennings provides the best overview of this history I have seen. She proves that attention is not a new topic, but one with deep roots and one that can inform current debates; Jennings draws on these roots throughout. I would love to see a companion piece surveying scientific theories, including “gain control” and “biased competition,” which get little airtime in the book. Some recent philosophical theories are under-explored as well, including Chris Mole’s concept of cognitive unison (Jennings discusses other aspects of his view), Carlos Montemayor and Harry Haladjian’s exploration of attention’s diversity (we get a touch of this), and my own proposal that attention is a gateway to working memory (not mentioned here). That said, no extant survey is more complete.Chapter 3 begins with the empirical claim that attention is regulated by slow brainwaves, and then takes up two issues. The first is mental causation. Endorsing moderate emergentism, Jennings argues that slow brain waves are causally efficacious even though they are not reducible to lower-level processes. (The metaphysics and neuroscience are presented accessibly, aided by three appendixes.) Second, Jennings argues that these slow brain waves indicate that attention is controlled by the self. As someone who was never moved by the mental causation problem—I don’t think overdetermination threatens efficacy—I would have welcomed more development of this second issue. For one thing, in linking attention to subjective control, Jennings eschews the idea that there can be purely “bottom-up” attention driven by stimulus features alone. This goes against the orthodoxy in attention science, and makes it hard for her to accommodate phenomena such as “pop-out,” or the commonsense idea that attention can be “captured” by a sudden flash or loud sound. For another thing, I wanted to hear more on why Jennings relates slow brain waves to the self. Does this include the slow waves that occur during deep sleep? Is there even such a thing as the self? Is there one self or many? How do slow brain waves reflect our interests, projects, values, self-conceptions, autobiographical narratives, or social identities? Does the social self invoked by Wollstonecraft and DuBois gain a foothold here? The whole chapter campaigns against metaphysical reductionism, but arrives at a perspective on the self that will strike some readers as highly reductive.In the fourth chapter, Jennings sheds further light on her conjecture that attention involves the self by advancing the thesis that attention endows sensory information with meaning. On the face of it, this may sound implausible. Object recognition, reading, and many other meaning-involving processes can take place outside of attention and outside of consciousness. But Jennings has a richer notion of “meaning” in mind. She develops the idea of “subject unity,” which is imposition of structure on perception that reflects the interests of the perceiving subject. This, she claims, is what brings perception into the space of reasons. Along the way, she has interesting observations about binding, feature integration, and demonstrative reference. The material is highly original, and Jennings’s postulation of interest-based perceptual organization is compelling. At the same time, one might wonder whether interests are really relegated to the ambit of attentional control. Consider the cocktail party effect, wherein one’s own name captures attention. This implies a preattentive filter that reflects our interests. Emotionally charged words, facial expressions, and dangerous objects also work this way, and social biases can operate preattentively as well. If these reflect our interests, then meaning may arise outside attention.Jennings’s fifth chapter explores the relationship between attention and consciousness. Some authors have argued that attention is necessary and sufficient for consciousness. Jennings focuses primarily on the necessity claim. She does not systematically review the empirical literature here, but she addresses some of the key findings, and effectively rebuts studies that allege to find consciousness outside attention. She does not rest her case there, however. Instead, she identifies a new class of examples that purport to establish the possibility of consciousness without attention. Her central example she calls “conscious entrainment,” which is what we experience when engaged in habitual or skilled activities. Other possible examples touched on in the chapter include hypervigilance in individuals with attention deficit hyperactivity disorder (ADHD), passive movie watching, dreaming, and “attentional neglect.” These states all involve intense focus, Jennings admits, but not attention. To some readers this may sound contradictory. Isn’t focus a kind of attention? Don’t these states of absorption involve stimulus selection and enhancement of relevant features, suppression of distractors, and other hallmarks of attention? Jennings says none of this is tantamount to attention. Recall that she thinks attention is controlled by the self. In these cases, we are invited to imagine that the self takes a passive role: control is either ceded to the world (movie watching) or to previously mastered routines (skills and habits). Thus, Jennings’s claim that there is no attention in these cases hangs on her contentious thesis that attention requires a controlling self. One might also push back by arguing that, in some of Jennings’s allegedly selfless examples, the self remains involved. Skilled activities and hypervigilance, for example, can reflect personal interests.Skills and hypervigilance get more airtime in chapter 6. There, Jennings turns to questions of responsibility—a neglected topic in attention research. The chapter begins with a manslaughter trial in which the teenage plaintiff was given a light sentence because the judge evidently believed that the teen’s ADHD compromised his ability to control his actions. The example may be a bit triggering for people who have a personal relationship with this diagnosis, but, putting that aside, Jennings uses it to introduce the important concept of attention-based control. With reduced control, Jennings argues, comes reduced responsibility. I am inclined to see ADHD as involving dysregulation of attention (difficulty disengaging and dividing attention, for example) rather than diminished attention, but that can still be characterized as an issue with control of attention; therefore ADHD still illustrates Jennings’s point that there is a link between responsibility and control of attention. This, it turns out, is only half of her story. Having argued for this link, one might expect Jennings to follow Wayne Wu, who contends that attention is necessary for action, and hence for responsibility. She does not. Instead, she says argues that responsibility can also arise in cases of “strategic automaticity.” This brings us back to skills. When skills are deployed, action is governed by learned pairings between stimuli and responses. The choice to exercise a skill requires attention, so attention is needed for being a responsible agent, but once a skill kicks in, attention is no longer required, and one can be held responsible for actions performed skillfully—thus attention is not required for responsibility tout court. Jennings addresses an opposing view (defended by Wu, Ellen Fridland, and Barbara Montero), according to which skills involve “automatic attention” rather than no attention. Jennings worries that this move will collapse the distinction between attention and other kinds of selection and filtering that occur throughout the nervous system, including the retina. She says that the attentional interpretation of skilled action is at odds with the lack of top-down reweighing of sensory inputs, regulated by lateral frontal cortex. These objections to automatic attention warrant response. My own view is that attention involves broadcasting to working memory, so retinal filtering is ruled out. Jennings’s insistence on top-down reweighing will not move those who believe attention can be purely bottom-up. For all that, I side with Jennings in wanting to allow for responsibility without attentional control. I think we can be responsible for implicit biases, for example. I also think attentional control is insufficient for responsibility, as when we act under duress.Jennings offers fresh perspective on the nature of attention, and its role in meaningful perception, consciousness, action, and responsibility. Each chapter can be read separately, but they hang together well, and each reflects her thesis that attention is essentially linked to the self. Though I am skeptical of that strong claim, we would do well to follow Jennings in regarding attention as interest-laden interface between mind and world. I look forward to a sequel in which attention is related to richer conceptions of identity, and where the political consequences of this link are actively explored. Meanwhile, one can hardly fault Jennings for covering too little. She tackles a remarkable range of topics, from metaphysics to ethics. Her arguments throughout demand response, repay careful study, and propel the field forward. (shrink)

Relationalism maintains that mind-independent objects are essential constituents of veridical perceptual experiences. According to the argument from hallucination, relationalism is undermined by perfect hallucinations, experiences that are introspectively indistinguishable from veridical perceptual experiences but lack an object. Recently, a new wave of relationalists have responded by questioning whether perfect hallucinations are possible: what seem to be perfect hallucinations may really be something else, such as illusions, veridical experiences of non-obvious objects, or experiences that are not genuinely possible. This paper argues (...) that however well new wave relationalism may handle brains in vats, drug users “seeing” pink elephants, and other extraordinary hallucinations, it struggles to accommodate mundane hallucinations, such as “hearing” your child cry out from the room down the hall when she is actually sound asleep or “feeling” vibrations on your thigh even when your phone isn't in your pocket. Mundane hallucinations are best explained as byproducts of noise in the perceptual system, and noise-induced hallucinations are resistant to the strategies that new wave relationalists deploy to explain away other hallucinations. Mundane hallucinations can thus underpin an especially powerful version of the argument from hallucination. (shrink)

One method Margaret Cavendish uses is something like inference to the best explanation, and so this may be what she mean by “regular sense and reason.” As Hobbes wrote in Leviathan: the cause of Sense, is the Externall Body, or object, which presseth the organ proper to each Sense, either immediatly, as in the Tast and Touch; or mediately, as in Seeing, Hearing, and Smelling. Before examining how Cavendish appeals to ordinary perceptual phenomena to argue that pressure model of perception (...) (PMP) is unacceptable, it will be helpful to sketch Cavendish’s own alternative theory of sense perception and how it fits into her broader natural-philosophical system. Cavendish’s texts thus support ascribing a third distinction to her, between two senses of “rational perception.” Cavendish’s alternative account of perception does agree with PMP in one respect, which is that sense perceptions are constituted by motions. The very existence of sense perceptions indicates that Hobbes’s PMP is an unacceptable theory, Cavendish argues. (shrink)

A woman is listening to Sinatra before work. As she later describes it, ‘suddenly from nowhere I could hear my mother singing along to it … I was there again home again, hearing my mother … God knows why I should choose to remember that … then, to actually hear her and I had this image in my head … of being at home … with her singing away … like being transported back you know I got one of those (...) … like shivery feelings really suddenly’ (Anderson 2004, 9-10). An older couple, discussing their honeymoon forty years ago, each say that they can’t remember the show they saw, until through iterative, puzzled cross-cuing they finally get there – ‘Desert Song, that’s it’ (Harris et al 2011, 292). An elderly English veteran of a prisoner of war camp in Japan, finishing up morning tea with a young Japanese social scientist interested in reconciliation, suddenly calls out loudly - in Japanese - ‘stand to attention’. He stands to attention in front of her: like many of the men she interviews, he physically re-enacts fragments of that long-past world of the camp, bringing that absent past into this new present context with a visceral shock (Murakami 2001, 2012; Middleton & Brown 2005, 133-136). (shrink)

It seems to be a humdrum fact of human agency that we act on intentions or decisions that we have made at an earlier time. At breakfast, you look at the Taco Hut menu online and decide that later today you’ll have one of their avocado burritos for lunch. You’re at your desk and you hear the church bells ring the noon hour. You get up, walk to Taco Hut, and order the burrito as planned. As mundane as this sort (...) of scenario might seem to be, philosophers have raised a problem in understanding it. If you are simply abiding by this morning’s decision, how are you acting autonomously? Your earlier self seems to be calling the shots; if you are just acting accordingly, without thinking through it or in some other way trying to ensure that the past decision conforms to your present standpoint, it is not clear how this amounts to an exercise of your present autonomous agency. It seems, rather, that your earlier self has succeeded in slaving you to her own purposes. She was the one who wanted (intended, judged it to be good, etc.) to have an avocado burrito. In simply following through, your current self seems to be just an automaton performing the commands left behind by your former self. Of course, you might not allow yourself to be shackled by your earlier self. You might refuse to follow anything but your own present judgments: you will only go to Taco Hut if this is what you judge you should do right now, and once at Taco Hut you will only eat the avocado burrito if that is what you want to eat once there. But if this is the way you generally operate, this seems to block your ability to make effective future-directed decisions. The puzzle, then, is one of explaining how the future self can do the bidding of her past self without losing her autonomy. We call this “the Problem of Diachronic Autonomy.” Philosophers raising this problem take it to show that there must be reasons or rational requirements to follow-through with our past decisions. According to these philosophers, we can only make sense of our diachronic autonomy if our past decisions put rational pressure on us to follow through. We argue that there is no Problem of Diachronic Autonomy. There is, in other words, no puzzling situation that needs explaining. Consequently, there is no need coming from this purported puzzle to think that our future-directed decisions generate reasons or rational requirements to follow through. The correct view of our diachronic autonomy is the “naïve” one: the “future self” can do the bidding of the “past self” without giving up its autonomy because, very simply, the past self is the same agent as the future self. I am acting autonomously when I get the avocado burrito, because I was the one who decided to get the burrito. I am acting on my own freely-formed decision. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:When “to die in freedom” is Written in EnglishPetar Ramadanovic* (bio)Cathy Caruth. Unclaimed Experience: Trauma, Narrative, and History. Baltimore: Johns Hopkins UP, 1996. [UE]For Teresa BrennanWhile waiting to leave Vienna in May of 1938, Sigmund Freud writes a letter to his son Ernst. “Two prospects,” he says, “keep me going in these grim times: to rejoin you all and—to die in freedom.” Almost sixty years later, Cathy Caruth comments (...) upon this letter, emphasizing that the last four words—“to die in freedom”—were written in English. It is here, Caruth suggests,in the movement from German to English, in the rewriting of the departure within the languages of Freud’s text, that we participate most fully in Freud’s central insight, in Moses and Monotheism, that history, like trauma, is never simply one’s own, that history is precisely the way we are implicated in each other’s traumas.[UE 23–24]And she concludes: “In this departure, in the leave-taking of our hearing, we are first fully addressed by Freud’s text, in ways we perhaps cannot yet fully understand” [UE 24].In this text I argue that Caruth’s understanding of trauma as “deeply tied to our own historical realities” [UE 12] offers a possibility to think anew our involvement in each other’s histories, as we examine what we mean by history, writing, and community. My reading depends in particular on the insistent recurrence of figures of “entanglement” in Caruth’s text, which I take to be Caruth’s own “translation of the concept—of the experience of trauma” [UE 7]. 1 That is, Caruth’s “entanglement” is the trace of an [End Page 54] unclaimed experience and has a function analogous to “departure” in Freud’s text and to “falling” in Paul de Man’s, both analyzed by Caruth in Unclaimed Experience. As such, “entanglement” and its variations, being “inextricably bound up” or “inextricably tied,” are not representations of trauma. They rather suggest a different, aporetic understanding of the relation between history and reference, experience and writing.I will try to show that Caruth’s notion of trauma as unclaimed experience, together with our entanglement in each other’s histories, chart a history of the modern subject as a history of implication. This subject is recognized by its inextricable ties to what cannot be experienced or subjectivized fully. And this unfinished becoming, surviving and being with others, is the form of its being and its history. The subject in or of trauma is thus, for Caruth, culturally and politically a diasporic subject, en route toward subjectivity.DiasporaFreud—the one who wants to die in freedom—is running away from a genocide, just ahead of it, so to speak. The diaspora toward which he is going is a place where one simultaneously speaks English and another language. As such, this diaspora is both a site of translation and a destination of resettlement: neither a paradise nor a melting pot, but a situation or a space which is not yet and which still waits to be thought. So we follow Freud, a Jew, who wants to die in freedom and is about to embark on a journey from Vienna to London, where he will rejoin his family. London, for Freud, is a place where language, freedom, and death somehow come together, where they will meet in the future. It is a substitute home. A substitute because Freud departs toward it. And a home because it offers shelter. Moreover, since London is also the place of Freud’s death, his departure towards it is not a simple forward movement but also what Caruth would call a return—a return to inanimate matter.If Freud’s return/departure speaks to “us” “today,” as Caruth suggests, this is not only because of the literal or figurative itinerary Freud covers but also because there are other departures that themselves inform the way we hear Freud. Indeed, Freud’s desire for freedom, a desire, as Caruth says at one point, to bring “his voice to another place” [UE 23], invokes the fundamental American myth of freedom. The phrase “to die in freedom” unwittingly carries with it... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Learning Through ServingDanny ReedI am a male CNA currently registered in Wisconsin since 1991, having worked as such since 1980 when I left high school. I have worked with ten different employers and many precious people I remember very well.I remember virtually everyone I have cared for in my over 30 years of work and yet there is not one person, place or moment that characterizes them all except (...) perhaps, May. She died within 24-hours of admission and we never spoke, except with the eyes. May had end-stage nerve and muscle wasting disease that left her mind intact but her body immobile and in pain. Her boyfriend brought her in after taking care of her at home, but he was wasted on some kind of drug, maybe her pain medication, feeling he needed it more than her. We ordered morphine and got her settled and she finally relaxed. She was gone by morning.May reminded me of Mary, another woman with a similar disease. Mary's husband Harold came to visit drunk. She could just point to a letter board similar to an Ouija board and spell out words and phrases with her right hand and then use her eyes to indicate if we were correct. Mary was a refined woman but very patient with me because I was an 18-year-old boy trying to be a man, sensitive but having a lot to learn. Mary taught me how to communicate without words—just using the eyes.These women are the core of understanding the meaning of what I have done for 30 years. Whether imprisoned by hearing loss, loss of sight or mobility, failing bodies and minds or simply being alone—the challenge was the same, to know when to reach into another's soul and touch them, to stay out of the way, and have the good sense to know the difference. Can I honestly say I fell in love with the woman that quietly said, "I'm tired of being old?" These were largely rhetorical questions without an answer.The men and women of this generation were far superior to me. I could only stand by and watch them die. Oh, I did the necessary things like I was paid to do, trained to do, but they were the ones patiently trying to teach me. I will spend the rest of my life trying to decipher their encrypted message because I am trapped here, too. Imprisoned by the ignorance of believing I understand what my eyes have seen, what I have heard, and experienced. That it can all be regulated and catalogued in journals of medicine.Is it not ironic that primary caregivers struggle to stay alive while money movers make millions, even billions tax free, moving money from here to there and acquiring the power and influence to change the world, but will not lift a finger unless they can make more money doing it? Ironic because I have taken care of them in their final hours and they would give me it all had I the power to give them more life. Yes, I have turned down a fortune because in their grief they wanted to pay me money for an hour of genuine kindness that in reality they could not afford. If you must ask how much it is worth you cannot afford it. Sincere kindness is priceless so I don't charge for it.It is not my intent to humiliate the achievements and status of professionals and others fallen upon hard times due to aging and disease because no one deserves these indignities. Indeed, I delight in restoring dignity to every human in need of it regardless of cause. I do not wish such suffering upon my worst enemy. Bill wanted one more hour. The cancer was sudden, painful, and terminal. Being sidetracked into a cozy hospice in the country is hardly comforting when given less than six months to live just when retirement promised the rewards earned from a life of hard work and sacrifice. Bill had spirituality and strong beliefs but it seemed to make matters worse because he cried every day begging God... (shrink)

The founder of Psychical Research, though he has not yet received the honour due to him, seems to have been King Croesus of Lydia, who reigned from 560 to 546 B.C. He carried out an interesting experiment, recorded in detail by Herodotus,2 to test the clairvoyant powers of a number of oracles. He sent embassies to seven oracles, six Greek and one Egyptian. They all started on the same day. On the hundredth day each embassy was instructed to ask its (...) oracle, “What is King Croesus, the son of Alyattes, now doing?” The answer was to be written down and brought back. The oracle of Delphi replied as follows, in hexameters, as its custom was: “I know the number of the sands and the measures of the sea. I understand the dumb, and I hear him who does not speak.” Then it went on: “There comes to my mind the smell of a strong-shelled tortoise, which is being cooked along with lamb's flesh in a brazen vessel; brass is spread beneath it, and with brass it is covered.” As a matter of fact, this answer was perfectly correct. Herodotus tells us that “having considered what would be the most difficult thing to discover and to imagine,” Croesus “cut up a tortoise and a lamb, and himself boiled them together in a brazen pot.” What happened afterwards illustrates the difficulties of this sort of investigation, difficulties which still perplex us to this day. Croesus argued, reasonably enough, that if the Delphic priestess had clairvoyant powers, she probably also had the precognitive powers, she probably also had the precognitive powers which she claimed to have. But when he consulted the oracle later about his forthcoming expedition against the Persians, he received two answers, one of which was ambiguous—“When Croesus crosses the Halys he shall destroy a great empire”—and the other correct, but too obscure to be easily interpreted. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Spiritual Experience and Psychopathology”Andrew Sims (bio)In examining this interesting paper, we need first of all to understand what the authors are doing. They are not taking the conceptual vehicles of “spiritual experience” (SE) and “psychotic phenomena” (PP) for a gentle outing, but exposing both of them to the hardest road test they can devise. From 1,000 accounts of “spiritual experiences” that were already so dramatic that those (...) involved were prepared to describe them, the authors selected three which most successfully blurred the boundaries between SE and PP. So we are not exploring whether these concepts have general practical validity, but whether their mutual frontiers are discrete or overlapping. The authors’ task is legitimate, but it needs to be recognized for what it is.Unusual spiritual experiences are interpreted by the authors as psychotic symptoms, and the definitions of the Present State Examination (PSE) descriptions are cited to justify this. However, we have known for a long time that using instruments for purposes for which they were not designed can produce unexpected results; it is rather like washing socks in a dishwasher and being surprised that it does little good to the socks. The PSE was devised for categorizing and quantifying existing psychiatric disorders in epidemiological studies. The further one gets from this, its true purpose, the less satisfactory it becomes as an instrument. A better way of evaluating symptomatology in an individual case is a skilled and painstaking interview by a well-trained descriptive psychopathologist. One can only conclude from the authors’ use of the PSE in distinguishing SE from PP, that the instrument itself is not capable of doing this, which is not really very surprising. One can form no views on the concepts of SE and PP themselves, except that in some circumstances they may be difficult to tell apart.It would be easy to dispute whether Simon’s beliefs were delusions. Believers from many religious backgrounds “know” that God gives them thoughts or ideas, and it requires detailed psychopathological examination, and not the application of a questionnaire, to distinguish this from the much more concrete experience as described in PSE of “inserted thoughts.”Rating scales, be they assessments of the quality of teaching in primary schools or quantification of established psychotic symptoms, are necessarily only a pale reflection and an over-simplification of the skilled work that professionals undertake. To imply that because a score could be given on the PSE to an otherwise healthy woman who describes the frequent experience of hearing God’s voice, denies the validity of her experience, but also affronts the professional skills of a trained psychopathologist. When psychiatrists, or even [End Page 79] untrained research workers, use the PSE they are presumably doing so as part of an epidemiological research study, and the validity of their individual result is evened out by results from a number of other subjects. If a psychiatrist is trying to decide whether Sara had “true” hallucinations, he or she will carry out a psychopathological interview in which the criteria for establishing true hallucinations are much more sophisticated than is possible in a questionnaire, and the interview will be individualized. Sara’s significant statement, “but God doesn’t take your free will away,” immediately distinguishes her diagnosis from schizophrenia. It was good that Sara’s priest did not need detailed knowledge of psychopathology to come to a common-sense evaluation of her experience.It was with some feelings of disappointment that I realized that when the authors use the word “psychotic” they merely mean that a tick could be placed in an appropriate box for the PSE. If one were to carry out an investigation of serum electrolytes on a fit athlete on completion of a marathon, one would get bizarre and probably abnormal results. For a quantified investigation to be meaningful, one must always take account of the context.When I read these three cases as a psychopathologist, I find no convincing psychotic phenomena, and the three human beings were undoubtedly not psychotic at the time of expression of their religious experiences. The word psychosis is not helpful in psychopathology: if one looks more specifically in these cases for the phenomena... (shrink)

Many people are uncomfortable with the idea that pleasure from certain sources is genuinely beneficial. These sources can be sorted into two classes: ones that involve others’ pain; and ones that involve what seems to be damage rather than benefit to the person involved. Here’s an example of the latter: a woman who claims that she enjoys her work performing in hard-core pornographic films. Some find it hard to take such a claim at face value – they instinctively assume that (...) the woman is insincere or self-deceived.1 The reason seems a strongly paternalistic one: because the activity is assumed to be bad, it’s thought that only someone who was in some way damaged could genuinely like it. A statement from Brian Hill, the director of a documentary about such women, illustrates this: ‘I felt certain that she couldn’t enjoy what she does, that there must be some reason why she’s undergoing this kind of experience. But there was nothing: no messed-up childhood, no sense of pain or humiliation.’ Forced to conclude that the woman in question really does enjoy her work, Hill changes his view to imply that the pleasure gained cannot be truly beneficial: ‘When I hear a young woman talking about doing videos of fisting and asphyxiation, I have to wonder what it’s doing to her – even if she says that she’s having fun.’. (shrink)

Ask any of your single female friends — and some of your married ones — about men, and they will likely complain that the men they meet avoid commitment like rats avoid electric shock. Although the therapists of these women may say that they choose men who avoid commitment, a recent television show on being single in America treated millions of viewers to scenarios one hears women repeat a thousand times: a man comes onto a woman like she's water (...) in the desert, smothers her in the first few weeks with flowers, balloon-o-grams, phone calls, and professions of love, says he's never felt so wonderful with a woman in his over-thirty life, and then, as quickly and suddenly as he came on, he disappears. (shrink)

There you are at the opera house. The soprano has just hit her high note – a glassshattering high C that fills the hall – and she holds it. She holds it. She holds it. She holds it. She holds it. She holds the note for such a long time that after a while a funny thing happens: you no longer seem only to hear it, the note as it is currently sounding, that glass-shattering high C that is loud and (...) high and pure. In addition, you also seem to hear something more. It is difficult to express precisely what this extra feature is. One is tempted to say, however, that the note now sounds like it has been going on for a very long time. Perhaps it even sounds like a note that has been going on for too long. In any event, what you hear no longer seems to be limited to the pitch, timbre, loudness, and other strictly audible qualities of the note. You seem in addition to experience, even to hear, something about its temporal extent. (shrink)

Each month brings new scientific findings that demonstrate the ways in which human activities, from resource extraction to carbon emissions, are doing unprecedented, perhaps irreparable damage to our world. As we hear these climate change reports and their predictions for the future of Earth, many of us feel a sickening sense of _déjà vu_, as though we have already seen the sad outcome to this story. Drawing from recent scholarship that analyzes climate change as a form of “slow violence” that (...) humans are inflicting on the environment, _Climate Trauma_ theorizes that such violence is accompanied by its own psychological condition, what its author terms “Pretraumatic Stress Disorder.” Examining a variety of films that imagine a dystopian future, renowned media scholar E. Ann Kaplan considers how the increasing ubiquity of these works has exacerbated our sense of impending dread. But she also explores ways these films might help us productively engage with our anxieties, giving us a seemingly prophetic glimpse of the terrifying future selves we might still work to avoid becoming. Examining dystopian classics like _Soylent Green _alongside more recent examples like _The Book of Eli_, _Climate Trauma_ also stretches the limits of the genre to include features such as _Blindness_, _The Happening_, _Take Shelter_, and a number of documentaries on climate change. These eclectic texts allow Kaplan to outline the typical blind-spots of the genre, which rarely depicts climate catastrophe from the vantage point of women or minorities. Lucidly synthesizing cutting-edge research in media studies, psychoanalytic theory, and environmental science, _Climate Trauma _provides us with the tools we need to extract something useful from our nightmares of a catastrophic future. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:I Had Never Heard Someone Use That Word BeforeAdrienne Feller NovickThe patient was dying. As the social worker, I had arranged the meeting and sat shoulder to shoulder with the family and the attending physician in the small nondescript room. The family was grief-stricken and asked intelligent questions as they made difficult decisions about end-of-life care for their loved one. The doctor spoke with gentle kindness, acknowledging their difficult (...) decision as he completed the neon pink Medical Orders for Life Sustaining Treatment (MOLST) form and left the room. I was tangled up with emotions; I felt relieved that the meeting had gone smoothly, sad for the patient and family, and in awe of the doctor for his ability to lead the difficult conversation. I stayed behind to ask the family if there was anything I could do to help them. [End Page E4]Before I could speak, the patient's wife turned to me and said, "I am so glad that k--- left the room." (Using a derogatory word for a person of the Jewish faith). My brain began processing the statement. I am a Jewish woman. Did I hear that right? Did she say what I think she said? Should I say something? I froze, and time seemed to stop. She was looking at me expectantly, waiting for a response. Her face reminded me of someone waiting for the other person to return a "high five." I was flooded with emotion. A succession of thoughts ran through my head, everything from being rude in response or getting physical. I did neither. I said nothing. I smiled and left the room feeling like I had been gut-punched.I was in denial. I made excuses for the wife; she was stressed. I kept thinking I must not have heard her correctly and that I was overreacting. I continued to work with the family as though nothing had happened until the patient died five days later. I felt ashamed and never told anyone about what happened. I regretted not saying anything. I replayed the conversation in my mind and felt depressed and angry. Inside I felt complicit for not speaking up, but I had no words. I assumed bias in healthcare was rare. I did nothing.Years later, after I completed a patient visit in the Intensive Care Unit (ICU), I observed a group of surgical residents doing rounds. The attending welcomed me to join this valuable clinical learning experience. As the group approached the next bed, the patient pointed to one resident and loudly said, "I don't want a doctor who looks like that to come near me." I gasped aloud and froze, waiting to see what would happen next. The attending looked directly at the patient and said calmly, "We are all here to help you. That is not an appropriate thing for you to say." Then, he turned to the resident and nodded, directing them to resume their bedside assessment. The patient mumbled something inaudibly and said nothing.To my astonishment, the doctor acknowledged the microaggression (a microaggression is a statement, action, or incident regarded as discrimination), addressed the issue, respectfully supported the resident, created a safe space for everyone on the healthcare team and resumed quality patient care without missing a beat. He modeled a strategy to address patient bias and taught a valuable skill. This was a learning moment for me. It helped me refocus my past experience and provided me with a useful strategy to address bias in the future.As a member of the medical ethics consultation service, I listen, provide support, and aid in challenging communications. I had the opportunity to model the communication strategy I acquired in the ICU. The medical ethics team was consulted for a patient refusing treatment. The patient was disrespectful to healthcare team members, cursing at nurses and residents, using ethnic slurs, and saying he "would rather die than let one of them touch him. I entered the patient's room with the healthcare team, introduced myself, and explained the reason for my visit. The patient defiantly agreed he had used slurs, saying he wanted to go home. I continued, everyone here... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Putting It on the LineMichael Moore (bio)IAmong the many ways to teach aesthetic education, a compelling one is to organize pedagogy around specific works of art, music, drama, and dance. This has been the central tenet of the Lincoln Center Institute and its sister institutes around the world. They concentrate on specific works because it allows participants to focus their minds, emotions, and energies on one set of images (...) and experiences. Excited by such an approach, many teachers return year after year, eager to tackle a new and varied repertory.But they cannot repeat the summer institute forever. They may need to take other workshops to satisfy professional (re)certification requirements. The school district may no longer reimburse them for the cost of the workshop. Their team may develop other interests. Often they find that the school has displaced the arts with other priorities, particularly in the light of so-called proficiency exams mandated by state boards of education.Whatever the reason, if teachers want to continue to do something meaningful in the arts, they may well have to become their own summer institute, lesson planner, and teaching artist rolled into one. The question then becomes, "How well did you learn the lessons of the institute?" The first lesson requirement is, "Do you know how to choose an appropriate work of art around which to develop aesthetic experiences and reflection for your students?" Behind that question, however, lies another: "What is your definition of art?" This is no idle philosophical exercise because one's answer underlies everything else done in the classroom in the name of aesthetic education. [End Page 62]Several years ago, Marcia Mulder Eaton of the University of Minnesota developed an exercise that enables teachers to examine their definitions of art in a practical way. She asked teachers to complete the following sentence: "Something is a work of art if and only if _________." She then showed them several objects, with the request that they write on a piece of paper if each object was a work of art, according to the definitions that they had written down.When I ran the exercise at a summer teachers institute in Pittsburgh, I displayed in order (1) a small flag; (2) an original painting; (3) a cheap cup from Wal-Mart; (4) a piece of fruit; (5) some driftwood; (6) and a basin wrench.1 Teachers voted on each piece as it was shown. Once the voting was completed, I asked them how they voted and how they justified their vote in the light of their definitions. When I have run this exercise elsewhere, the definitions and resultant criteria have broken down into four groups: (1) it was created, therefore, it is art; (2) an expert, such as an art museum or a critic, may have decreed it to be art; (3) "it touched me in some way and I cannot describe that feeling other than to call it art"; and (4) "I'm no connoisseur but I know what I like." There are strengths and weaknesses in each position:1. Anything that humans make is art because it is an artifact. Weakness: The definition is too general2. We should respect the opinions of experts. After all, they studied the matter much longer and more deeply than we have. They know what they are talking about. Weakness: What if I think they are off base? What if there is something in the work that appeals to me?3. "It somehow has touched me and I want to cherish it." "There is something in there that causes me to respond. It, therefore, has some kind of power." Weakness: This position does not lend itself very well to public discussion, unless you have something you can point to or explain in a way that gets through to others.4. "I don't know much about art, but I know what I like." (Well, let's hear it for rugged individualism!) Weakness: It suggests a closed mind and an unwillingness to listen to others' opinions. Again, there is no opportunity for shared insights.The discussion in Pittsburgh dealt with, more or less, each of the above positions, but... (shrink)