The focus on translational research in clinical trials has the potential to generate clinically relevant genetic data that could have importance to patients. This raises challenging questions about communicating relevant genetic research results to individual patients. An exploratory pharmacogenetic analysis was conducted in the international ovarian cancer phase III trial, AGO-OVAR 16, which found that patients with clinically important germ-line BRCA1/2 mutations had improved progression-free survival prognosis. Mechanisms to communicate BRCA results were evaluated, because these findings may be beneficial to (...) patients and their families. Communicating individual BRCA results was not anticipated during clinical trial design. Consequently, options were not available for patients to indicate their preference for receiving their individual results when they signed pharmacogenetic informed consent. Differences in local requirements, clinical practice, and opinion regarding the ethical aspects of how to convey genetic results to patients are all potential barriers to returning individual BRCA results to patients. Communicating the aggregate BRCA result from this study provided clinical investigators with a mechanism to disseminate the overall study finding to patients while taking individual circumstances, local guidelines and clinical practice into account. This study illustrates the importance of increasing the clarity and scope of informed consent and the need for patient engagement to ensure clinical trial participants can indicate their preference regarding receipt of potentially important individual pharmacogenetic results. This study was registered in the NCT Clinical Trial Registry under NCT00866697 on March 19, 2009, following approval from participating ethics committees. (shrink)

We expand on the article “Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force” to consider the ways in which rural...

This book is a compilation of the work published by the present authors in various scientific journals mainly focused on understanding how quantum physics could decipher the experiences observed and reported during near-death and end-of-life situations. The authors claim that various theories and models proposed herein (though not propounding to be a complete one) are just an attempt to understand few aspects associated with such experiences connected to the phenomenon of death. They investigate the possible role of the quantum phenomenon (...) in the occurrence of these events and call for a detailed scientific investigation to validate any hypotheses made. (shrink)

The Tuskegee Syphilis Experiment (TSE) has shaped African Americans’ views of the American health care system, contributing to a reluctance to participate in biomedical research and a suspicion of the medical system. This essay examines public discourses surrounding President Clinton’s attempt to restore African Americans’ trust by apologizing for the TSE. Through a narrative reading, we illustrate the failure of this text as an attempt to reconcile the United States Public Health Service and the African American public. We conclude by (...) noting the limitations of rhetoric when equal prominence is not given to policy proposals in national apologies. (shrink)

Verträgt sich Religion mit Aufklärung? Was für eine Rolle spielt die Theologie dabei? Kants Der Streit der Fakultäten kommt zu dem Schluss, dass der unendliche Streit um die Religion nicht zwangsläufig zum Problem für die Aufklärung werden muss, sondern seine Institutionalisierung die beste Hoffnung für Freiheit ist: Ohne Kritik kein Fortschritt, ohne Streit bloß Irrglaube. F.W.J. Schellings, Jacques Derridas und Judith Butlers Auseinandersetzung mit Kants Werk zeigen jedoch auch, dass dabei auch die Regeln des Streites strittig werden müssen: Wer legt (...) die Regeln fest? So wird die Kritik an Religion selbst zwangsläufig mit Kritik konfrontiert: Wer hat die Macht über den vernünftigen Diskurs? Eine antagonismustheoretische Perspektive auf dieses Problem zeigt: Aus Feinden können Gegner werden und aus Krieg Streit. Doch ob sich Fortschritt und Freiheit aus braven Debatten und Reformen oder als harter Kampf einstellt - oder eben überhaupt nicht - ist eine offene Frage. (shrink)

Leadership and the Unmasking of Authenticity presents a philosophic treatment of the core concept of authentic leadership theory, with a view toward illuminating how authors in the history of philosophy have understood authenticity as an ideal for humanity. Such an approach requires a broader view of the historical origins of authenticity and the examination of related ideas such as self-knowledge and deception. The chapters of this volume illuminate the conflict between the contemporary understanding of authenticity and traditional philosophy by revisiting (...) the ideas of thinkers who express self-knowledge as a cornerstone of their philosophy. Tracing the origins of our contemporary concern for authenticity to the writings of 18th century philosopher Jean-Jacques Rousseau, this book explores the key thinkers writing in the wake of Rousseau's emphasis on sincerity, namely Friedrich Nietzsche and Martin Heidegger, to show that their acceptance of authenticity as an ideal for humanity was ambiguous at best. This volume also covers representative authors in the earlier history of philosophy, such as Plato, Niccolò Machiavelli, Francis Bacon, and John Locke. The result is a keen, in-depth analysis of works of philosophy and political philosophy that broach questions of authenticity, self-knowledge, and deception. This critical contribution to authentic leadership theory and the theory of authenticity will be a key resource for both undergraduate and graduate students in the fields of leadership studies, political science and philosophy. Contributors include: J.C. Byham, B.E. Cusher, E.A. Dolgoy, J. Fortier, N.W. Harter, M.A. Menaldo, H. Pedersen, J.M. Warner. (shrink)

Introduction by Ralph McInerny The essays in this volume, indebted in great part to Jacques Maritain and to other Neo-Thomists, represent a contribution to an understanding of beauty and the arts within the Aristotelian-Thomistic tradition. As such they constitute a different voice in present-day discussions on beauty and aesthetics, a voice which nonetheless shares with many of its contemporaries concern over questions such as the relationship between beauty and morality, public funding of the arts and their educational role, objective and (...) universal standards of what is beautiful. In the tradition in which the contributors of this volume reflect, beauty manifests itself in the order of the universe, an order that provides human reason with a window onto the transcendent. For Aristotle and Aquinas the natural order grounds both art and morality, and yet it is this very order which has been called into question by modern science and philosophy. Instead of pointing us to a suprahuman order, the beautiful then points to the order of human freedom and creativity. Reflection on the beautiful since the modern philosopher Immanuel Kant has thus often taken a subjectivistic turn. Because of the importance of beauty and art in human existence, in man's education and life as a moral and political being, an alternative should be sought to any reduction of the beautiful to a purely subjective experience or cultural construct. The Aristotelian-Thomistic tradition, in dialogue with modern and contemporary conceptions of the beautiful, provides us with just that alternative, and thus the essays herein represent a decisive step in the "journey for Thomistic aesthetics." THE CONTRIBUTORS: In addition to the editor, the contributors to the volume are: Brian J. Braman, Matthew Cuddeback, Christopher M. Cullen, S.J., Patrick Downey, Desmond J. FitzGerald, Donald Haggerty, Wayne H. Harter, Jeanne M. Heffernan, Thomas S. Hibbs, Gregory J. Kerr, Joseph W. Koterski, S.J., Daniel McInerny, Ralph McInerny, James P. Mesa, John F. Morris, Ralph Nelson, Katherine Anne Osenga, Carrie Rehak, Stephen Schloesser, S.J., Francis Slade, John G. Trapani, Jr., and Henk E. S. Woldring. ABOUT THE EDITOR: Alice Ramos is associate professor of philosophy at St. John's University. (shrink)

Joel Harter reconstructs Samuel Taylor Coleridge's intellectual project as a philosophy of faith that anticipates modern philosophical hermeneutics, challenges reductive notions of reason and personhood, and illustrates the progressive potential of the biblical tradition. His central claim is that Coleridge's definition of the symbol is his attempt to reclaim an allegorical vision in response to modern alienation. The symbolic imagination affirms meaning through ongoing interpretation and informs Coleridge's various efforts in literature, philosophy, theology, and cultural criticism. Harter examines (...) Coleridge's complex appropriation of Immanuel Kant and Friedrich Schelling, and clarifies the relationship of symbol to allegory and irony. Harter also responds to later postmodern challenges to meaning and transcendence. In a discussion that includes Paul Ricoeur, David Tracy, and modern theologies of symbol the author concludes that Coleridge's understanding of the symbol reconciles reason and revelation and that creative imagination is necessary for critical philosophy and theology. (shrink)

Most arguments about conscientious objections in medicine fail to capture the full scope and complexity of the concept before drawing conclusions about their permissibility in practice. Arguments favoring and disfavoring the accommodation of conscientious objections in practice tend to focus too narrowly on prima facie morally contentious treatments and religious claims of conscience, while further failing to address the possibility of moral perspectives changing over time. In this paper, I argue that standard reasons against permitting conscientious objections in practice—that their (...) permission may result in harm to patients, the idea that medical providers willingly enter into the medical field, and that conscientious objections stand contrary to medical professionalism—do not apply in all cases and that the medical field and health systems in which many physicians now practice should continue to tolerate conscientious objections in practice. (shrink)

This paper aims to demonstrate how public disclosure can be used to balance physicians9 conscientious objections with their professional obligations to patients – specifically respect for patient autonomy and informed consent. It is argued here that physicians should be permitted to exercise conscientious objections, but that they have a professional obligation to provide advance notification to patients about those objections. It is further argued here that public disclosure is an appropriate and ethically justifiable limit to the principle of advance notification. (...) The argument for publicly disclosing physicians9 conscientious objections is made in this paper by discussing three practical benefits of public disclosure in medicine, and then addressing how publicly disclosing physicians9 conscientious objections is not an undue invasion of privacy. Three additional concerns with public disclosure of physicians9 conscientious objections are briefly addressed – potential harassment of physicians, workplace discrimination, and mischaracterising physicians9 professional aptitude – concluding that each of these concerns requires further deliberation in the realm of business ethics. (shrink)

Volume 20, Issue 7, July 2020, Page 139-141.

People are typically grateful for medical technologies used in the treatment of illness or injury. This chapter explores how Lucas has led Star Wars audiences astray into accepting false beliefs and fallacies about the value of technology, particularly in a medical context. Via the naturalistic fallacy, Lucas conveys the false belief that most technology is “unnatural” and so is bad, harmful, or associated with the dark side. Lucas is not wrong that technology can be fearful, but its value depends in (...) part on how it's intended to be used. Even the use of some medical technologies that can extend life raise questions about whether they should be used in all cases. Many bioethical conflicts center around whether a seriously ill or injured person would want certain medical interventions used to extend their life, given potential trade‐offs. Lucas's portrayal of technology in Star Wars is biased against its true value in societies. (shrink)

Background: This study attempts to understand if medical providers beliefs about the moral permissibility of honoring patient-directed refusals of life-sustaining treatment (LST) are tied to their beliefs about the patient’s decision-making capacity. The study aims to answer: 1) does concern about a patient’s treatment decision-making capacity relate to beliefs about whether it is morally acceptable to honor a refusal of LST, 2) are there differences between provider types in assessments of decision-making capacity and the moral permissibility to refuse LST, and (...) 3) do provider demographics impact beliefs about decision-making capacity and the moral permissibility to refuse LST. Methods: A mixed-methods survey using Likert assessment and vignette-based questions was administered to medical providers within a single health system in the upper Midwest (N = 714) to assess their perspectives on the moral acceptance and decision-making capacity in cases of withholding and withdrawing treatment and suicide. Results: Behavioral health providers report accepting of the moral permissibility of suicide (91.2%) more than either medical providers (77.2%) or surgeons (74.4%) (n = 283). Decision-making capacity was questioned more in the vignettes of the patients refusing life-saving surgery (36%) and voluntarily starvation (40.8%) than in the vignette of the patient requesting to deactivate a pacemaker (13%) (n = 283). Behavioral health providers were more concerned about the capacity to refuse life-saving surgery (55.9%) than medical providers (33.8%) or surgeons (23.1%) (n = 283). Conclusions: Respondents endorse the moral permissibility of persons to withhold or withdraw from treatment regardless of motive. Clinical concerns about a patient’s treatment decision-making capacity do not strongly correlate to views about the moral permissibility of honoring refusals of LST. Different provider types appear to have different thresholds for when to question treatment decision-making capacity. Behavioral health providers tend to question treatment decision-making capacity to refuse LST more than non-behavioral health providers. (shrink)

Volume 20, Issue 7, July 2020, Page 95-97.

Part of the Renaissance genius was to look at familiar things in unfamiliar ways. Although a variety of approaches to the study of leadership are becoming familiar, it still helps to consider new ones. Of use in such moments are the works of unfamiliar writers who have spent considerable energy thinking from analien perspective. One does not have to accept their assertions uncritically in order to profit from reading them, yet it does take courage sometimes to start down a strange (...) path.In the spirit of applying new ideas to familiar themes, this article interprets volume one of Georges Batailles The Accursed Share in the light of the phenomenon we refer to as leadership. Bataille, who was born in 1897 and died in 1962, certainly qualifies as a writer with an alien perspective. He has the potential to offend. At times, he becomes positively cryptic, as in asserting 'that the sexual act is in time what the tiger is in space.' Nonetheless, the book itself develops a plausible line of reasoning.Society, it argues, is determined by how it disposes of energy. And since energy that cannot be used will be squandered, it matters how a society chooses to do this. Bataille argues further that moments of true 'sovereignty occur when we squander what would otherwise have been useful This paper summarizes theargument of The Accursed Share and applies it to the outpourings that followers make to leaders. Rather than regard these uneven relationships as examples of utilitarian reciprocity, perhaps we can tap into the idea that attentiveness to leadership is more in the form of an offering or sacrifice to something that expresses us, as an excuse to display exuberance. This approach promises insight into issues of charisma, followership as self-denial, and mass psychology. It also pertains to the tendency of followers to turn against leaders in ritual sacrifice as meaningful superfluity. (shrink)

The debate of nativisim versus empiricism is over the relative importance of evolutionary versus ontogenetic mechanisms. This is mostly seen today as a false dichotomy. The synthesis of these positions provides a modern viewpoint of grounded category formation. This combined view places equal importance on feedback between these levels in guiding development, and is more appropriately compared to culturalist positions.

Top-down dynamical models of cognitive processes, such as the one presented by Thelen et al., are important pieces in understanding the development of cognitive abilities in humans and biological organisms. Unlike standard symbolic computational approaches to cognition, such dynamical models offer the hope that they can be connected with more bottom-up, neurologically inspired dynamical models to provide a complete view of cognition at all levels. We raise some questions about the details of their simulation and about potential limitations of top-down (...) dynamical models. (shrink)

The American Journal of Bioethics, Volume 11, Issue 9, Page 12-13, September 2011.

Revision of author's thesis (doctoral)--University of Chicago, 2008 under title: The word made flesh and the mazy page: symbol and allegory in Coleridge's philosophy of faith.

Michel Foucault, one of the most cited scholars in the social sciences, devoted his last three lectures to a study of leader development. Going back to pagan sources, Foucault found a persistent theme in Hellenistic antiquity that, in order to qualify for leadership, a person must undergo processes of subjectivation, which is simply the way that a person becomes a Subject. From this perspective, an aspiring leader first becomes a Subject who happens to lead. These processes depend on a condition (...) of _parresia_, which is truth-telling at great risk that is for the edification of the other person. A leader requires a mentor and advisors in order to lead successfully, while also developing the capacity in one’s own mind to heed the truth. In other words, a leader must learn how to guide oneself. A valuable contribution to the field of leadership studies, this book summarizes these last lectures as they pertain to the study and practice of leadership, emphasizing the role of ethics and truth-telling as a check on power. It then presents several other contexts where these same lessons can be seen in practice, including in the life of Alexander Solzhenitsyn, whose career as a writer epitomized speaking truth to power, and somewhat surprisingly in the United States military, in response to its twenty-first century mission of counterinsurgency. (shrink)

This narrative symposium examines the relationship of bioethics practice to personal experiences of illness. A call for stories was developed by Tod Chambers, the symposium editor, and editorial staff and was sent to several commonly used bioethics listservs and posted on the Narrative Inquiry in Bioethics website. The call asked authors to relate a personal story of being ill or caring for a person who is ill, and to describe how this affected how they think about bioethical questions and the (...) practice of medicine. Eighteen individuals were invited to submit full stories based on review of their proposals. Twelve stories are published in this symposium, and six supplemental stories are published online only through Project MUSE. Authors explore themes of vulnerability, suffering, communication, voluntariness, cultural barriers, and flaws in local healthcare systems through stories about their own illnesses or about caring for children, partners, parents and grandparents. Commentary articles by Arthur Frank, Bradley Lewis, and Carol Taylor follow the collection of personal narratives. (shrink)

How do contemplative exercises, like meditation, help us to become better people in practice? Is there a risk that they might do the opposite, by distracting us from the world to such a degree that we neglect our everyday moral obligations? This chapter develops a dialogue between two historical traditions within Buddhism and Platonism, represented by Buddhaghosa in Sri Lanka and the Neoplatonist commentators of Mediterranean late antiquity. These schools, the chapter suggests, offer two distinct models for resolving this kind (...) of concern. First, a practitioner might alternate between contemplative absorption and action, with contemplation cultivating positive mental qualities that make for better moral agency in each moment of decision. Second, we may simultaneously experience a highly receptive contemplative state even while we act in the world, making us much less likely to react in harmful, misguided ways to everyday impressions. In both cases, genuine moral improvement flows from a radical transformation of our perception of the world. (shrink)

This chapter considers in parallel some main argumentative strategies of Nāgārjuna’s Root Verses and the “dialectical exercise” of Plato’s Parmenides. It argues that both can be seen as critically targeting the unity that is attributed to entities as coherent and individual subjects of predication. In particular, both show that it is incoherent to suppose any such subject either has the relevant kind of unity or (lacking such a unity) does not exist at all. This suggests that we may reject familiar (...) analyses of the contradictory or paradoxical conclusions of both arguments as pointing either toward a superior and consistent structure of logical categories or toward a transcendent insight into the ineffable. Instead, we may see both as pointing, rather, to a possible overcoming of the “habit” of reifying conceptualization that is deep-seated in ordinary language and practice, and thereby to the potential soteriological benefits of such an overcoming. (shrink)

Crossing the Stream, Leaving the Cave brings philosophers from two of the world’s great philosophical traditions—Platonic and Indian Buddhist—into joint inquiry on topics in metaphysics, epistemology, mind, language, and ethics. An international team of scholars address selected questions of mutual concern to Buddhist and Platonist: How can knowledge of reality transform us? Will such transformation leave us speechless, or disinterested in the world around us? What is cause? What is self-knowledge? And how can dreams shed light on waking cognition? What (...) do the paradoxes thrown up by abstract thought about fundamental notions such as being and unity reveal? Is it possible to attain unity in ourselves, and should we even try? Would doing so make us happy—and is such happiness consistent with both contemplation of reality and action in the world? With close readings of texts by Buddhaghosa, Nāgārjuna, Vasubandhu, Dignāga, Bhāviveka, Śāntideva; by Plato, Plotinus, Porphyry, Olympiodorus, and Damascius, these studies consider not just the different answers Buddhists and Platonists might give to these questions but also the criticisms they might bring to each other’s positions, the sort of arguments they use, and the use they put these arguments to. Bringing Platonic and the Buddhist perspectives jointly to bear creates a cosmopolitan philosophical exchange which yields greater conceptual clarity on the questions and the terms in which they are cast, reveals unnoticed conceptual connections, and opens up new possibilities for addressing central philosophical concerns. (shrink)

Near-death experiences are a big challenge to the fields of science and philosophy; termed as hallucinatory by neurologists and “stuff of which fantasies are made off” by sceptics, there are some unique near-death experiences which defy these claims. Memories generated during these experiences are of specific interest as they are created without a body and can be recalled post the experience. Call it the mind, soul, psyche or consciousness, if deliberated as a form of quantum generated energy, a strong correlation (...) under a reductionist based perspective can be obtained. Life at a macroscopic level may not be similar to life at a quantum level, and has been proved in quantum physics through its spooky properties like quantum entanglement. Self-sustaining quantum generated energy through entanglement is the answer to all mystical realties and the answer lies in believing in its existence in and around us. It is this energy that brings in the awareness of one’s existence and which performs tasks beyond the imagination of the current self; an energy created at the creation of all that exists; a true supernatural force. This paper reviews a unique void near-death experience and hypothesizes quantum entanglement to be involved in the conception and storage of these energy-based memories in a quantum subatomic cloud which can be restated if returned back to the body or lost to the environment upon death. (shrink)

Drawing on three Platonic dialogues (Charmides, Alcibiades I, and Theaetetus) and the epistemology of Dignāga and Dharmakīrti, this chapter argues that the self-knowledge project need not depend on a metaphysics of self if the awareness present in each knowledge episode is taken to exhibit a reflexive dimension. Whatever the ultimate ground for self-knowledge, it must be such as to provide unity and coherence to experience, even if the achieved unity or harmony is not something determinate or fixed (as suggested by (...) some interpretations of the Platonic soul as form-like, hence as impersonal). The chapter argues that an account of self-knowledge that can explain what turns knowledge onto itself, what makes it personal, is better equipped to show how such knowledge can become a vehicle for self-cultivation. Doctrinal commitment to a no-self view notwithstanding, the recognition on the part of certain Buddhist thinkers that an irreflexive view of awareness may fail to capture the phenomenal and subjective dimensions of knowledge episodes further bolsters such an account. (shrink)

While causation is central to the philosophy of both Buddhism and Platonism, understanding Plato’s and Vasubandhu’s accounts of causation requires stepping back from the modern mainstream view that causes are conditions on which effects depend, whether these are necessary and/or sufficient conditions. Some philosophers and psychologists have recently argued that we have, in addition to this concept of cause as “dependence,” a concept of cause as “productive,” viz., as a power to produce an effect. These causal pluralists claim that both (...) concepts are needed to account for the full range of our causal judgments. This chapter argues that Vasubandhu’s generic account of cause in the Abhidharmakośabhāṣya embraces the two concepts insofar as it counts both producers and absences as causes, and that his discussion of the Buddha’s two formulas for dependent origination distinguishes dependence from productive causes, while Plato elaborates in the Phaedo a productive concept of cause on the model of a craft, promoting craft-intelligence to the role of the cause and subordinating dependence conditions to the role of the craftsman’s necessary materials and tools. (shrink)

This chapter shows how Plato’s goal of a harmonious community requires a ruler who displays creativity. By attributing roles, designing laws and education, the ruler keeps the different elements together that make up the whole of their community. Throughout his dialogues, Plato shows how rulers cannot automatically apply any previous knowledge but need to creatively adapt it to the specific whole of which they are in charge. To sharpen our understanding of harmony in Plato’s works, the chapter compares them with (...) Śāntideva’s Guide. Śāntideva gives pointers towards responsiveness that creates harmony in situations that might lead to suffering. He gives importance to mindfulness and introspection—which somehow parallel the monitoring role of Plato’s ruler—when bad emotions afflict the aspiring bodhisattva. However, the accomplished bodhisattva does not need monitoring: they display creative responsiveness that relieves suffering by harmonizing potentially conflicting elements, without the need to postulate a whole to which such elements belong. (shrink)

In the dialectical exercise of Plato’s Parmenides, the intrinsically contradictory deductions drawn from the hypotheses about the One imply that the One is neither existent nor nonexistent, neither endowed with an essence nor deprived thereof. Does this symmetrical negation constitute a self-refutation of Plato’s metaphysics, or is it evidence that “the One” refers to the same thing as the sovereign “Good” of the Republic, which is also supposed to stand beyond essence? Rewriting the Parmenides with Nāgārjuna’s concepts could help to (...) answer this question. It looks as if Plato used the various predicative combinations of the Mādhyamika tetralemma, especially the symmetrical negation, in order to remove our native oblivion concerning the axiological status of the One, just like Nāgārjuna used it to remove our hypostatizing habits concerning the phenomena of everyday life. Conversely, the soteriological purpose of Mādhyamika dialectic becomes clearer when contrasted with the Platonic project to reach an unconditioned principle. (shrink)

This chapter examines the relevance of the philosophical use of dreaming for the examination of the thesis that knowledge is perception. It begins by studying the position attributed to Protagoras in Plato’s Theaetetus, according to which the perceptual experiences we have when dreaming count as knowledge. It argues that this position requires two different subjects in the two different contexts of cognition (dreaming and waking). It contends that Vasubandhu’s use of dreaming in the Twenty Verses—to show that perception without external (...) objects is possible—can help make sense of Protagorean perception. It raises the problem that both positions struggle to align their metaphysics with the phenomenology of perception. With the help of dreaming, Vasubandhu can explain how transformation may yield perceptual knowledge (in the form of buddha-vision). No such transformation is possible for a Protagorean because the different subjects inhabiting different cognitive contexts are not causally related. (shrink)