Hans Jonas argued that death is both a blessing and a burden, basing his argument on an evolutionary viewpoint. He highlighted the paradox that life carries the burden of death within itself. Daniel Callahan responded that Jonas’s failure to fully appreciate the value of life shows the deficiency of using evolution to explain how death could be a blessing for individuals. Jazmine Gabriel now convincingly defends Jonas against Callahan’s charges, showing that Jonas’s commitment to fight against the Nazis, his attack (...) against nihilism, and his rejection of the metaphysical dualism that opposes valuing, purpose-seeking humans against a value-free, purposeless world all demonstrate Jonas’s commitment to honoring individual lives. This paper affirms Gabriel’s response and advances the dialectic by considering a further paradox. As life carries within itself death, so does the blessing of death carry within itself the burden of death and the burden of death carry within itself the blessing of death. (shrink)
Although many of the pioneers of present-day bioethics came from religious and theological backgrounds, the recent controversy about the role of religion in bioethics has elicited much attention. Timothy Murphy would ban religion from bioethics altogether. Much of the ado hinges on conflicting understandings of just what bioethics is and just what religion is. This paper attempts to make more explicit how the fields of bioethics and religion have been understood in this context, and how they should not be understood. (...) We begin by looking at bioethics as a field: its origins, purpose, scope, and its methods. We then examine the notion of religion, looking especially at its importance for bioethics. Humanity is not just Homo sapiens but also Homo religiosus. Religion is more than a code of ethics; it gives insight into many of the foundational matters of bioethics. (shrink)
Patients increasingly see physicians not as humane caregivers but as unfeeling technicians. The study of philosophy in medical school has been proposed to foster critical thinking about one's assumptions, perspectives and biases, encourage greater tolerance toward the ideas of others, and cultivate empathy. I suggest that the study of ethics and philosophy by medical students has failed to produce the humane physicians we seek because of the way the subject matter is quarantined in American medical education. First, the liberal arts (...) are seen as the province of undergraduate education, and not medical school. Second, philosophy, when taught in medical school, is seen by students as just one subject to be mastered along with many other more important ones, and not as a way to foster critical thinking and empathy. What is needed is a new pedagogy that combines both cognitive and affective elements to implant and nourish the liberal arts in students. Removing the quarantine of philosophy from other facets of medical education is an important first step. (shrink)
In considering whether medical miracles occur, the limits of epistemology bring us to confront our metaphysical worldview of medicine and nature in general. This raises epistemological questions of a higher order. David Hume’s understanding of miracles as violations of the laws of nature assumes that nature is completely regular, whereas doctrines such as C. S. Peirce’s "tychism" hold that there is an element of absolute chance in the workings of the universe. Process philosophy gives yet another view of the working (...) of nature. Physicians have no epistemological grounds for declaring any cure to be miraculous. Miracles are theological (or philosophical) entities, and not medical entities. All physicians can do is to determine whether or not a cure is scientifically inexplicable according to the current epistemological standards of medical science. (edited). (shrink)
Using ideas gleaned from the philosophy of technology of Martin Heidegger and Hans Jonas and the philosophy of health of Georges Canguilhem, I argue that one of the characteristics of emerging medical technologies is that these technologies lead to new conceptions of health. When technologies enable the body to respond to more and more challenges of disease, we thus establish new norms of health. Given the continued development of successful technologies, we come to expect more and more that our bodies (...) should be able to respond to ever-new challenges of environment and disease by establishing ever-new norms of health. Technologies may aim at the prevention and treatment of disease, but they also bring about modifications of what we consider normal for the human being. Thus, new norms of health arise from technological innovation. (shrink)
This paper is a response to Christopher Boorse's recent defense of hisBiostatistical Theory (BST) of health and disease. Boorse maintains that hisconcept of theoretical health and disease reflects the ``consideredusage of pathologists.'' I argue that pathologists do not use ``disease'' inthe purely theoretical way that is required by the BST. Pathology does notdraw a sharp distinction between theoretical and practical aspects ofmedicine. Pathology does not even need a theoretical concept of disease. Itsfocus is not theoretical, but practical; pathology's goal is (...) to contribute tothe healing of patients. Pathology, even experimental pathology, is notvalue-free. Not only ``disease'' but also such terms as ``nerve'' and ``organ''are laden with conceptual values. (shrink)
Virtually all activities of health care are motivated at some level by hope. Patients hope for a cure; for relief from pain; for a return home. Physicians hope to prevent illness in their patients; to make the correct diagnosis when illness presents itself; that their prescribed treatments will be effective. Researchers hope to learn more about the causes of illness; to discover new and more effective treatments; to understand how treatments work. Ultimately, all who work in health care hope to (...) offer their patients hope. In this paper, I offer a brief analysis of hope, considering the definitions of Hobbes, Locke, Hume and Thomas Aquinas. I then differentiate shallow and deep hope and show how hope in health care can remain shallow. Next, I explore what a philosophy of deep hope in health care might look like, drawing important points from Ernst Bloch and Gabriel Marcel. Finally, I suggest some implications of this philosophy of hope for patients, physicians, and researchers. (shrink)
Religious voices were important in the early days of the contemporary field of bioethics but have now become decidedly less prominent. This is unfortunate because religious elements are essential parts of the most foundational aspects of bioethics. The problem is that there is an incommensurability between religious language and languages of public discourse such as the “public reason” of John Rawls. To eliminate what is unique in religious language is to lose something essential. This paper examines the reasons for the (...) marginalization of religion in bioethics, shows the limitations of Rawls’s notion of public reason, and argues for a more robust role for theology in articulating a new language for public discourse in bioethics. (shrink)
Popular visions of holistic health and holistic medicine are not so much reactions to perceived excesses of technological medicine as they are visions of the good life itself and how to attain it. This paper attempts to clarify some of the concepts associated with holistic health and medicine. The particular vision of holistic health presented here is well exemplified in the writings of Plato. First, I examine the scientific concept of holism and argue that, while medicine is inadequately characterized by (...) scientific reductionism, any plausible holistic medicine must make room for a limited scientific reductionism. Next, I analyze the complexity of Plato's usage of health and demonstrate some of the parallels between Plato's thought and popular and scientific visions of holistic health. Finally, I look at what Plato has to say about medical practice and the relation of medicine and philosophy as therapies for the whole person. (shrink)
This article is an introduction to a special issue of Theoretical Medicine and Bioethics on clinical reasoning. Clinical reasoning encompasses the gamut of thinking about clinical medical practice—the evaluation and management of patients’ medical problems. Theories of clinical reasoning may be normative or descriptive; that is, they may offer recommendations on how clinicians ought to think or they may simply attempt to describe how clinicians actually do think. This article briefly surveys these approaches in order to show the complexity of (...) clinical reasoning and the inadequacy of any one theory for capturing the full richness of clinical reasoning. The authors of this issue offer both normative and descriptive elements in their accounts. Topics discussed include the importance for clinical reasoning of tacit knowing, risk assessment, narrative and hermeneutics, wisdom, and virtue epistemology. (shrink)
The question of whether the universe is expanding or contracting serves as a model for current questions facing the medical humanities. The medical humanities might aptly be described as a metamedical multiverse encompassing many separate universes of discourse, the most prominent of which is probably bioethics. Bioethics, however, is increasingly developing into a new interdisciplinary discipline, and threatens to engulf the other medical humanities, robbing them of their own distinctive contributions to metamedicine. The philosophy of medicine considered as a distinct (...) field of study has suffered as a result. Indeed, consensus on whether the philosophy of medicine even constitutes a legitimate field of study is lacking. This paper presents an argument for the importance of a broad conception of the philosophy of medicine and the central role it should play in organizing and interpreting the various fields of study that make up the metamedical multiverse. (shrink)
“Geneticization” is a term used to describe the ways in which the science of genetics is influencing society at large and medicine in particular; it has important implications for the process of diagnostics. Because genetic diagnostics produces knowledge about genetic disease and predisposition to disease, it is essentially influenced by these innovations in the disease concept. In this paper, I argue that genetic diagnostics presents new ethical challenges not because the diagnostic process or method in genetic diagnostics is ethically different (...) in kind from traditional medical diagnostics, but because it relies on a neo-ontological concept of disease in a context of genetic reductionism. Geneticization has not produced a radically new concept of disease, however, but has introduced innovations into the classical ontological concept of disease. When this new concept of disease is held in tandem with genetic reductionism, we are led to the absurd conclusion that disease is the very essence of the human being. I argue that neither the neo-ontological concept of disease nor genetic reductionism is necessary for a proper understanding of genetic diagnostics. (shrink)
This paper is a response to Christopher Boorse's recent defense of his Biostatistical Theory of health and disease. Boorse maintains that his concept of theoretical health and disease reflects the "considered usage of pathologists." I argue that pathologists do not use "disease" in the purely theoretical way that is required by the BST. Pathology does not draw a sharp distinction between theoretical and practical aspects of medicine.
This paper is a criticalexamination of the development of thephilosophy of medicine as a discipline. Ithighlights two major themes in the contemporarydebate about the philosophy of medicine: thescope of the discipline and the relation of thediscipline to its cognate disciplines. A broadview of the philosophy of medicine is defendedand the philosophy of medicine is seen as aphilosophical sub-discipline. These viewsdepend in important ways on three factors: ageneral metaphysical world view, particularunderstandings of the cognate disciplines, andthe perspective from which one asks (...) thequestions about the nature of the discipline. It is proposed that the future of thephilosophy of medicine may follow thephilosophy of science in that philosophical,sociological and historical studies may combinein a mutually enriching way to form ‘‘medicinestudies.’‘. (shrink)
This paper explores the role of religious belief in public debate about physician-assisted dying and argues that the role is essential because any discussion about the way we die raises the deepest questions about the meaning of human life and death. For religious people, such questions are essentially religious ones, even when the religious elements are framed in secular political or philosophical language. The paper begins by reviewing some of the empirical data about religious belief and practice in the United (...) States and Europe. It then explores the question of the proper role of religion in public policy debate and concludes with a discussion of the importance of religion and religious practices in considerations of how we die. (shrink)
The Twentieth European Conference on Philosophy of Medicine and Health Care was held in Helsinki, Finland, in August 2006 and highlighted the theme “Medicine, Philosophy and the Humanities.” The four papers in this thematic section are developed from presentations made at that conference.They are the work of physicians and philosophers and present fundamentally philosophical reflections on the medical humanities. The authors show that philosophy offers both a substantial way of humanizing the theory and practice of medicine and a way to (...) orchestrate the contributions of all the medical humanities. (shrink)
It is common to talk of wise physicians, but not so common to talk of wise patients. "Patient" is a word derived from the Latin patior - "to suffer," but also "to let be." Suffering has been the universal lot of humanity, and medicine rightly tries to relieve suffering. Medical progress, like all technological progress, leads us more and more to hope that we can control our fate. However, we do well to ask whether our attempts to control our fate (...) are wise. Wisdom played a major role in the philosophy of the ancient Stoics, and so I propose putting these questions into the context of a new stoicism. For the Stoic, happiness consists in living in accord with nature. Stoics are sometimes portrayed as apathetic fatalists, silently accepting whatever misfortune might come their way, but this is a misunderstanding. The Stoic sage, like the common person, wants to preserve life and health. The difference is that the sage's wisdom brings knowledge about what actions are appropriate in the face of suffering. The sage sees suffering not as something that demands immediate control, but as something that might reasonably direct actions. Suffering brings turmoil to the common patient, who will take any possible steps to end the suffering. The wise patient possesses the knowledge that enables a correct assessment of the options in the face of the reality that we ultimately do not control our own fate. (shrink)
The distinction between killing and letting die has been a controversial element in arguments about the morality of euthanasia and physician-assisted suicide. The killing/letting die distinction is based on causation of death. However, a number of causal factors come into play in any death; it is impossible to state a complete cause of death. I argue that John Mackie’s analysis of causation in terms of ‘inus factors,’ insufficient but nonredundant parts of unnecessary but sufficient conditions, helps us to see that (...) moral responsibility for death cannot rest on causation alone. In specifying the cause of death, some factors can be considered alternatively as either causal factors or merely parts of the presupposed background conditions. If a factor is moved from the background field into the causal field, the result is a changed background field. Comparisons of cases of killing and letting die often do just this; hence, the cases depend on different presuppositions and the causation cannot be directly compared. Moral judgments determine how to apportion factors to the causal and background fields. (shrink)
The nature of health is one of the central topics in the philosophy of medicine. The concept of health is complex because it comprises multiple features and there is no consensus on which feature is most basic or even whether some particular feature has any importance at all. This paper focuses on how several basic elements play a role in the formation of the concept of health. My central claim is that the theory of emergence offers a way to construct (...) a theory of health that is sympathetic to both analytic and holistic perspectives. In one way, this emergent theory of health looks very much like a holistic theory in that it considers not only biological factors as fundamental to understanding health, but also psychological, and social factors. In another way, this theory looks very much like an analytic theory because it sees health as a phenomenon that emerges from more basic elements: biology, psychology, and sociology. This may seem ambiguous, but this kind of ambiguity might just be the biggest virtue of the theory. (shrink)
In The City of God , XI, 10, St Augustine claims that the divine nature is simple because ‘it is what it has’ . We may take this as a slogan for the Doctrine of Divine Simplicity , a doctrine which finds its way into orthodox medieval Christian theological speculation. Like the doctrine of God's timeless eternality, the DDS has seemed obvious and pious to many, and incoherent, misguided, and repugnant to others. Unlike the doctrine of God's timeless eternality, the (...) DDS has received very little critical attention. The DDS did not originate with Augustine, but I am not primarily concerned with its pedigree. Nor am I concerned to ask how the doctrine interacts with trinitarian speculation. I will have my hands full as it is. In Section I of this paper I shall provide a rough characterization of the DDS, indicate its complexity, and focus on a particular aspect of the doctrine which will exercise us in the remainder of the paper, namely, the thesis that the divine attributes are all identical with each other and with God. In section n I shall discuss Alvin Plantinga's recent objections to Aquinas' version of the DDS. I shall then offer a more detailed presentation of what I take to be Aquinas' version , and recast it in terms of a theory of attributes which is significantly different from Plantinga's . Although the recasting of the doctrine will enable me to rebut Plantinga's objections , it by no means solves all the problems of the DDS. In section vi I shall discuss the chief lingering problem facing a defender of the DDS. (shrink)
The doctrine of divine simplicity, the doctrine that God has no physical or metaphysical complexity whatsoever, is not a doctrine designed to induce immediate philosophical acquiescence. There are severe questions about its coherence. And even if those questions can be answered satisfactorily in favour of the doctrine, there remains the question why anyone should accept it. Thomas V. Morris raises both sorts of questions about a version of the doctrine which I have put forward. In the following pages I shall (...) respond to what I take to be the most serious of Morris's objections. I shall argue that the doctrine survives Morris's onslaught, but that one observation of his points it in a direction I had hitherto not taken seriously. The bulk of Morris's paper raises questions of the first sort; perforce the bulk of my paper will also. I shall offer, at the end, a reason for thinking that neither of us is yet in a position to pronounce categorically on the second question. My remarks in this paper constitute an interim report on how I think things presently stand with divine simplicity. (shrink)
[pt. 1] Gerald Heard's psychological approach to the problem of the nature of history. (Reprinted from Social science, v. 15, no. 3, July, 1940)--[pt. 2] Troeltsch's theory of history. (Reprinted from the Personalist, v. 28, no. 1, 1947.
But in Why I Am Not a Secularist, distinguished political theorist William E. Connolly argues that secularism, although admirable in its pursuit of freedom and diversity, too often undercuts these goals through its narrow and intolerant ...
1 Non-reductive physicalists deny that there is any explanation of mentality in purely physical terms, but do not deny that the mental is entirely determined by and constituted out of underlying physical structures. There are important issues about the stability of such a view which teeters on the edge of explanatory reductionism on the one side and dualism on the other (see Kim 1998). 2 Save perhaps for eliminative materialism (see Churchland 1981 for a classic exposition). In fact, however, while.
Does a hard-headed realist approach to international politics necessarily involve scepticism towards progressive foreign policy initiatives and global reform? Should proponents of realism always be seen as morally complacent and politically combative? In this major reconsideration of the main figures of international political theory, Bill Scheuerman challenges conventional wisdom to reveal a neglected tradition of progressive realism with much to contribute to contemporary debates about international policy-making and world government. Far from seeing international reform as well-meaning but potentially irresponsible idealism, (...) progressive realists like E.H. Carr, John Herz, Hans J. Morgenthau, and Reinhold Niebuhr developed forward-looking ideas which offer an indispensable corrective to many presently influential views about global politics. Progressive realism, Scheuerman argues, offers a compelling and provocative vision of radical global change which - when properly interpreted, can help buttress current efforts to address the most pressing international issues. After recovering key subterranean strands in mid-twentieth century realism, Scheuerman underscores their relevance to contemporary international theory. Criticizing more recent realists for abandoning their tradition's best insights, he also demonstrates that reform-minded international theories - including versions of cosmopolitanism, constructivism, the English School, liberalism, and republicanism - could all benefit from taking Progressive Realism seriously. A major contribution both to the history of international relations and contemporary debates in international theory, The Realist Case for Global Reform concludes by considering how progressive realism informs the foreign policies of US President Barack Obama. (shrink)
The ideas of Hans Morgenthau dominated the study of international politics in the United States for many decades. He was the leading representative of Realist international relations theory in the last century and his work remains hugely influential in the field. In this engaging and accessible new study of his work, William E. Scheuerman provides a comprehensive and illuminating introduction to Morgenthau’s ideas, and assesses their significance for political theory and international politics. Scheuerman shows Morgenthau to be an uneasy (...) Realist, uncomfortable with conventional notions of Realism and sometimes unsure whether his reflections should be grouped under its rubric. He was a powerful critic of the existing state system and defended the idea of a world state. By highlighting Morgenthau’s engagement with the leading lights of European political and legal theory, Scheuerman argues that he developed a morally demanding political ethics and an astute diagnosis of the unprecedented perils posed by nuclear weaponry. Believing that the irrationalities of US foreign policy were rooted partly in domestic factors, he sympathized with demands for radical political and social change. Scheuerman illustrates that Morgenthau’s thinking has been widely misunderstood by both disciples and critics and that it offers many challenges to contemporary Realists who discount his normative aspirations. With the advent of the cosmopolitan goal of international reform, Morgenthau’s work serves up an unsettling mix of sympathy and hard-headed skepticism which remains crucially important in the development of the field. Lucidly and persuasively written, this book will be a valuable resource for students and scholars seeking to understand the continued importance of Morgenthau’s thinking. (shrink)
In _The Fragility of Things_, eminent theorist William E. Connolly focuses on several self-organizing ecologies that help to constitute our world. These interacting geological, biological, and climate systems, some of which harbor creative capacities, are depreciated by that brand of neoliberalism that confines self-organization to economic markets and equates the latter with impersonal rationality. Neoliberal practice thus fails to address the fragilities it exacerbates. Engaging a diverse range of thinkers, from Friedrich Hayek, Michel Foucault, Hesiod, and Immanuel Kant to (...) Voltaire, Terrence Deacon, Friedrich Nietzsche, and Alfred North Whitehead, Connolly brings the sense of fragility alive as he rethinks the idea of freedom. Urging the Left not to abandon the state but to reclaim it, he also explores scales of politics below and beyond the state. The contemporary response to fragility requires a militant pluralist assemblage composed of those sharing affinities of spirituality across differences of creed, class, gender, sexual orientation, and ethnicity. (shrink)
In _Facing the Planetary_ William E. Connolly expands his influential work on the politics of pluralization, capitalism, fragility, and secularism to address the complexities of climate change and to complicate notions of the Anthropocene. Focusing on planetary processes—including the ocean conveyor, glacier flows, tectonic plates, and species evolution—he combines a critical understanding of capitalism with an appreciation of how such nonhuman systems periodically change on their own. Drawing upon scientists and intellectuals such as Lynn Margulis, Michael Benton, Alfred North (...) Whitehead, Anna Tsing, Mahatma Gandhi, Wangari Maathai, Pope Francis, Bruno Latour, and Naomi Klein, Connolly focuses on the gap between those regions creating the most climate change and those suffering most from it. He addresses the creative potential of a "politics of swarming" by which people in different regions and social positions coalesce to reshape dominant priorities. He also explores how those displaying spiritual affinities across differences in creed can energize a militant assemblage that is already underway. (shrink)
William Connolly presents a lucid and concise defense of the thesis of "essentially contested concepts" that can well be read as a general introduction to political theory, as well as for its challenge to the prevailing understanding of political discourse. In Connolly's view, the language of politics is not a neutral medium that conveys ideas independently formed but an institutionalized structure of meanings that channels political thought and action in certain directions. In the new preface he pursues the implications (...) of this perspective for a distinctive conception of ethics and democracy. (shrink)