Modern concepts of vocation often refer to some ambiguous understanding of personal occupation or religious life. These interpretations appear to be in tension with the Christian understanding of vocation as the call of God given to a community to a certain way of living. Christian physicians live into this communal vocation when they remain present to the suffering as a sign of God’s faithfulness. This vocational practice of medicine is threatened by a distorted understanding of the body that stems from (...) what Max Weber called the “disenchantment” of the world. By bringing an understanding of the medicine that stems from Weber’s disenchantment into conversation with the language and beliefs of the church, this essay will seek to explore practices that might serve to re-enchant an understanding of the body and the practice of medicine as a form of Christian vocation. (shrink)

Although current literature about the “cure versus care” issue tends to promote a patient-centered approach, the disease-centered approach remains the prevailing model in practice. The perceived dichotomy between the two approaches has created a barrier that could make it difficult for medical students and physicians to integrate psychosocial aspects of patient care into the prevailing disease-based model. This article examines the influence of the formal and hidden curricula on the perception of these two approaches and finds that the hidden curriculum (...) perpetuates the notion that “cure” and “care” based approaches are dichotomous despite significant changes in formal curricula that promote a more integrated approach. The authors argue that it is detrimental for clinicians to view the two approaches as oppositional rather than complementary and attempt to give recommendations on how the influence of the hidden curriculum can be reduced to get a both-cure-and-care-approach, rather than an either-cure-or-care-approach. (shrink)

What is the proper role of a clinical ethics consultant’s religious beliefs in forming recommendations for clinical ethics consultation? Where Janet Malek has argued that religious belief should have no influence on the formation of a CEC’s recommendations, Clint Parker has argued a CEC should freely appeal to all their background beliefs, including religious beliefs, in formulating their recommendations. In this paper, I critique both their views by arguing the position envisioned by Malek puts the CEC too far from religion (...) and the position envisioned by Parker puts the CEC too close. For a CEC to give recommendations about what is morally prohibited, permissible, or obligatory in the clinic, I propose a view of the CEC that is neither religious nor non-religious but quasi-religious. I argue that a quasi-religious approach avoids the problems of both religious and non-religious views while preserving their benefits. Additionally, a quasi-religious view resists the marginalization of “religious” traditions that occurs when secular ethicists come to think of their approach as somehow distinctly non-religious. (shrink)

I, along with others, have been critical of the social construction of brain death and the various social factors that led to redefining death from cardiopulmonary failure to irreversible loss of brain functioning, or brain death. Yet this does not mean that brain death is not the best threshold to permit organ harvesting—or, as people today prefer to call it, organ procurement. Here I defend whole-brain death as a morally legitimate line that, once crossed, is grounds for families to give (...) permission for organ donation. I do so in five moves. First, I make the case that whole-brain death is a social construction that transformed one thing, coma dépassé, into another thing, brain death, as a result of social pressures. Second, I explore the way that the 1981 President’s Commission tried to establish the epistemological certainty of brain death, hoping to avoid making arcane metaphysical claims and yet still utilizing metaphysical claims about human beings. Third, I explore the moral meaning of the social construction of a definition that cannot offer metaphysical certainty about the point at which somebody becomes just some body. Fourth, I describe how two moral communities—Jewish and Catholic—actually ground their metaphysical positions with regard to brain death in the normativity of prior social relations. Finally, I conclude with a reflection on the aesthetic-moral enterprise of the metaphysical-epistemological apparatus of brain death, concluding that only such an aesthetic-moral approach is sufficiently strong to stave off the utility-maximizing tendencies of late-modern Western cultures. (shrink)

It is commonly held that Christian ethics generally and Christian bioethics particularly is the application of Christian moral systems to novel problems engaged by contemporary culture and created by contemporary technology. On this view, Christianity adds its moral vision to a technology, baptizing it for use. In this essay, I show that modern technology is a metaphysical moral worldview that enacts its own moral vision, shaping a moral imaginary, shaping our moral perception, creating moral subjects, and shaping what we imagine (...) as moral intentions. In fact, modern technics has its own liturgics, which is foreign to Christian Divine Liturgy. Divine Liturgy is world forming, showing us a different world than the one that comes into relief in the ersatz liturgy of modern medical technics. (shrink)

Christians are not immune to psychological and psychiatric illness. Yet, Christians should also be careful not to permit popular cultural trends to shape the way that they think about the use of psychiatric treatment with medication. In this essay, I suggest that the tendencies for default usage of psychiatric medication can be problematic for Christians in contemporary culture where a technological imaginary exists. Modern scientific studies of psychiatric medication are partly constructive of how we imagine ourselves. The typical justification for (...) the usage of technology in contemporary culture is the theme of cocreation with God, where Christians see any usage of technology as equivalent to our participating in God’s ongoing creative activity. I challenge these ideas in the foregoing paper, noting that the modern technological imaginary that animates modern psychiatry is as constricting as it is enabling. I conclude with a different take on what it might mean for Christians to be cocreators with God. (shrink)

The essays in this issue of JMP are devoted to critical engagement of my book, The Anticipatory Corpse. The essays, for the most part, accept the main thrust of my critique of medicine. The main thrust of the criticism is whether the scope of the critique is too totalizing, and whether the proposed remedy is sufficient. I greatly appreciate these interventions because they allow me this occasion to respond and clarify, and to even further extend the argument of my book. (...) In this response essay, I maintain that the regnant social imaginary of medicine is the regnant social imaginary of our time. It is grounded in a specific ontotheology: where ontology is a power ontology; where material is malleable to the open-ended organization of power and dependent only on working out the efficient mechanisms of its enactment; where ethically it is oriented only to the immanent telos of utility maximization in the short run, and ultimately to some posthuman future in the long run. This ontotheology originates in the anticipatory corpse and is ordered toward some god-like posthuman being. The entire ontotheology finds enactment through the political economy of neoliberalism. This social imaginary constantly works to insulate itself from other social imaginaries through the use of its institutional power, through marginalization, circumscription, or absorption. The modern social imaginary of neoliberal societies marginalizes and politically isolates other social imaginaries, or transforms them into something acceptable to the neoliberal imaginary. Yet, these other social imaginaries could influence the larger social imaginary in novel ways, sometimes through withdrawal and sometimes through challenges. These other practices—again, usually practices ordered according to different ontological and teleological purposes—might serve as a source of renewal and transformation, but only if the practitioners of these other social imaginaries understand the ontotheological powers that they are up against. (shrink)

This paper examines the meaning of space and its relationship to value. In this paper, I draw on Henri Lefebvre to suggest that our ethics produce and are produced by spaces. Space is not simply a passive material container or neutral geographic location. Space includes the ideas on which buildings are modeled, the ordering of objects and movement patterns within the space, and the symbolic meaning of the space and its objects. Although often unrecognized, space itself is value-laden, and its (...) values are suggested as people interact within that space. By reflecting on the spaces of health care, we will see that we not only must attend to the quandaries caused by the delivery of health care in non-acute places, but also to the values that produce and are produced by spaces. These values influence our moral imagination and shape us as people. (shrink)

Trisomy 13 and 18 are rare chromosomal abnormalities associated with high morbidity and mortality. Improved survival rates and increased prevalence of aggressive medical intervention have resulted in families and physicians holding different perspectives regarding the appropriate management of children with T 13/18. Families were invited for open-ended interviews regarding their experiences with the medical care of a child with T 13/18 over the past 5 years. Seven of 33 invited families were surveyed; those who had spent more than 40 days (...) in the hospital were most likely to accept the invitation. Grounded theory technique was used to analyze the interviews. This method elicited four key themes regarding family perspectives on children with T 13/18: they are unique and significant, they transform the lives of others, their families can feel overwhelmed and powerless in the medical setting, their families are motivated to “carry the torch” and tell their story. Families also emphasized ways in which Internet support groups can provide both positive and negative perspectives. The ensuing discussion explores the difficulties of parents and physicians in forecasting the impact that T 13/18 will have on families and emphasizes a narrative approach to elicit a map of the things that matter to them. The paper concludes that while over-reliance on dire prognostic data can alienate families, examining the voice, character and plot of patient stories can be a powerful way for physicians to foster shared decision-making with families. (shrink)

Essays explore the significance of Julia Kristeva’s concept of intimate revolt for social and political philosophy. Over the last twenty years, French philosopher, psychoanalyst, and novelist Julia Kristeva has explored how global crises threaten people’s ability to revolt. In a context of widespread war, deepening poverty, environmental catastrophes, and rising fundamentalisms, she argues that a revival of inner psychic experience is necessary and empowering. “Intimate revolt” has become a central concept in Kristeva’s critical repertoire, framing and permeating her understanding of (...) power, meaning, and identity. New Forms of Revolt brings together ten essays on this aspect of Kristeva’s work, addressing contemporary social and political issues like immigration and cross-cultural encounters, colonial and postcolonial imaginations, racism and artistic representation, healthcare and social justice, the spectacle of global capitalism, and new media. Sarah K. Hansen is Assistant Professor of Philosophy at California State University, Northridge. Rebecca Tuvel is Assistant Professor of Philosophy at Rhodes College. (shrink)

This article explores enchantment, disenchantment, and re-enchantment in reference to modern medicine’s view of the body. Before considering Weber’s enchantment paradigm, I question some core assumptions regarding sociology as methodologically scientific and value-free. Furthermore, I draw on Jenkins who helps to illustrate the difficulty of rooting terms such as enchantment, disenchantment, and re-enchantment; the question remains “which” historical and cultural period is employed as the basis for such sociological terms. Such questions are critical, but not entirely dismissive of modern medicine (...) as “disenchanted”; with some more explicit foundational and presuppositional context, disenchantment can be a helpful notion for approaching questions of the “new body.” St. Gregory Palamas’ Christian materialism and mystical anthropology present such an explicit foundation. Moreover, this Patristic foundation moves past the postmodern aporia of emphasizing either immanence or transcendence—two polar attractions that factor heavily in the way modern medicine views the body. (shrink)

The paper presents an account of suffering as a multi-level phenomenon based on concepts such as mood, being-in-the-world and core life value. This phenomenological account will better allow us to evaluate the hardships associated with dying and thereby assist health care professionals in helping persons to die in the best possible manner. Suffering consists not only in physical pain but in being unable to do basic things that are considered to bestow meaning on one’s life. The suffering can also be (...) related to no longer being able to be the person one wants to be in the eyes of others, to losing one’s dignity and identity. These three types of suffering become articulated by a narrative that holds together and bestows meaning on the whole life and identity of the dying person. In the encounter with the patient, the health-care professional attempts to understand the suffering-experience of the patient in an empathic and dialogic manner, in addition to exploring what has gone wrong in the patient’s body. Matters of physician assisted suicide and/or euthanasia—if it should be legalized and if so under which conditions—need to be addressed by understanding the different levels of human suffering and its positive counterpart, human flourishing, rather than stressing the respect for patient autonomy and no-harm principles, only. In this phenomenological analysis the notions of vulnerability and togetherness, ultimately connecting to the political-philosophical issues of how we live together and take care of each other in a community, need to be scrutinized. (shrink)

ZusammenfassungDer Artikel wirft einen kritischen Blick auf die gegenwärtige Theorie und Praxis palliativer Versorgung, auf ihren Umgang mit dem Sterben und mit Sterbenden und auf die zugrundeliegende Leitvorstellung von einem guten Sterben. Dabei wird Foucaults Begriff der Biomacht als Beschreibungs- und Deutungskategorie zu Rate gezogen. Weil mit Palliative Care das Anliegen verfolgt wird, ein gutes Sterben zu ermöglichen, sind vielfältige Kriterienkataloge und Messinstrumente entstanden, um die Behandlungen nach wissenschaftlichen Maßstäben zu planen und ihren Erfolg zu bestimmen. Im Lichte des Begriffs (...) der Biomacht zeigen sich potenziell problematische Aspekte dieser Entwicklung, die im bioethischen Diskurs üblicherweise verborgen bleiben. Indem die Lebensqualität von Sterbenden verbessert und zu diesem Zweck nicht allein körperliche Beschwerden, sondern auch psychisches, soziales und spirituelles Leiden gelindert werden soll, verschreibt sich die Palliative Care-Bewegung in einer Weise der Steigerung des Lebens, die den Einzelnen überfordern kann und seinen eigentlichen Bedürfnissen womöglich nicht gerecht wird. (shrink)

Palliative care names as one of its central aims to prevent and relieve suffering. Following the concept of “total pain”, which was first introduced by Cicely Saunders, PC not only focuses on the physical dimension of pain but also addresses the patient’s psychological, social, and spiritual suffering. However, the goal to relieve suffering can paradoxically lead to a taboo of suffering and imply adverse consequences. Two scenarios are presented: First, PC providers sometimes might fail their own ambitions. If all other (...) means prove ineffective terminal sedation can still be applied as a last resort, though. However, it may be asked whether sedating a dying patient comes close to eliminating suffering by eliminating the sufferer and hereby resembles physician-assisted suicide, or euthanasia. As an alternative, PC providers could continue treatment, even if it so far prove unsuccessful. In that case, either futility results or the patient might even suffer from the perpetuated, albeit fruitless interventions. Second, some patients possibly prefer to endure suffering instead of being relieved from it. Hence, they want to forgo the various bio-psycho-socio-spiritual interventions. PC providers’ efforts then lead to paradoxical consequences: Feeling harassed by PC, patients could suffer even more and not less. In both scenarios, suffering is placed under a taboo and is thereby conceptualised as not being tolerable in general. However, to consider suffering essentially unbearable might promote assisted dying not only on an individual but also on a societal level insofar as unbearable suffering is considered a criterion for euthanasia or PAS. (shrink)

In this paper I will show how the medical image, presented to the patient by the physician, participates in medicine's cold culture of abstraction, objectification and mandated normativity. I begin by giving a brief account of the use of anatomical imaging since the Renaissance to show how images have historically functioned in contrast to how they are currently used in medical practice. Next, I examine how contemporary medical imaging techniques participate in a kind of knowledge production that objectifies the human (...) body. Finally, I elucidate how physicians ought to place the medical image within the context of the lived body so as to create a healing relationship with the patient. In all this I hope to show that the medical image, far from a piece of objective data, testifies to the interplay of particular beliefs, practices and doctrines contemporary medicine holds dear. To best treat her patient, the physician must appreciate the influence of these images and appropriately place them within the context of the patient's lived experience. (shrink)

Debates about the ethics of health care and medical research in contemporary pluralistic democracies often arise partly from competing religious and secular values. Such disagreements raise challenges of balancing claims of religious liberty with claims to equal treatment in health care. This paper proposes several mid-level principles to help in framing sound policies for resolving such disputes. We develop and illustrate these principles, exploring their application to conscientious objection by religious providers and religious institutions, accommodation of religious priorities in biomedical (...) research, and treatment of patients’ religious views in doctor–patient encounters. Given that no sound set of guiding principles yields precise solutions for every policy dispute, we explore how morally sound democracies might deliberatively resolve such policy issues, following our proposed principles. Taken together and carefully interpreted, these principles may help in guiding difficult decision making in the indefinitely large realm where government, medical providers, and patients encounter problems concerning religion and medicine. (shrink)

I argue here that Weberian disenchantment is manifest in the triumph of instrumental reason and the expansion of analytic enquiry, which now dominates not simply those sciences upon which medicine depends, but medical practice itself. I suggest ways that analytic enquiry, also referred to here as anatomical reasoning, are part of a particular ideology—a way of seeing, speaking about, and inhabiting the world—that often fails to serve the health of patients because it is incapable of “seeing” them in the moral (...) sense described by Iris Murdoch and others. I use the work of James Elkins and Wendell Berry to call for the recovery of a way of seeing the human body as both other and more than an object of scientific enquiry and social control. (shrink)

Medicine increasingly envisions health promotion in terms of reducing risk as determined by quantitative risk factors, such as blood pressure, blood lipids, or genetic variants. This essay argues that this vision of health care as risk reduction is dangerous for Christian bioethics, since risk can be infinitely reduced leading to a self-defeating spiral of iatrogenic effects. Moreover, it endangers character because this vision of health is connected to a reductionist vision of the body and an understanding of individual risk that (...) undermines the more communal virtue of solidarity. The essay concludes by discussing how recent Thomistic analyses in favor of physical enhancements illustrate some of the problems that envisioning health care in terms of risk reduction holds for Christian bioethics. (shrink)

Medicine often views hospice care as “giving up,” which results in a reduced quality of end-of-life care for many patients. By integrating a theology of the Sabbath with modern medicine, hospice becomes a sacred and valuable way to honor the dying patient in a comprehensive and holistic way. A theology of Sabbath as “Sacredness in Time” can provide the foundation for a shift in understanding hospice as a legitimate care plan, which shifts the focus from controlling and manipulating space for (...) the body, to rest and enjoyment of time for the whole person. First, I explore vitalism and its negative effects on the institution of hospice. Second, I address the main misconceptions and biases surrounding hospice in order to establish hospice as an appropriate option for the terminally ill. Finally, I argue for a shift away from sacredness in space (as seen in vitalism) to sacredness in time. (shrink)

Jeffrey Bishop’s The Anticipatory Corpse exposes a functional metaphysics at the root of contemporary medical practice that gives rise to inhumane medicine, especially at the end of life. His critique of medicine argues for alternative spaces and practices in which the communal significance of the body, its telos, can be restored and the meaning of a “good death” enriched. This essay develops an alternative epistemology of the body, drawing from Christian theological accounts of the communal or Eucharistic body and linking (...) liturgical practices to the cultivation of solidarity. It argues for an epistemology of the body that makes visible the invisible bodies at medicine’s margins and illumines the disparate worlds of health care globally. (shrink)

Responding to Max Weber’s modern diagnosis of nature, science, and medicine as disenchanted, this article aims to reenvision nature and medicine with a sense of enchantment drawing from the Christian themes of creation, Christology, suffering, and redemption. By reenvisioning nature as enchanted with these theological themes, the vocation of medicine might be revitalized in terms of suffering presence, healing care, and works of mercy toward the neighbor in need.

This paper argues that “backstage” gallows humor among clinical mentors not only affects medical students’ perceptions of what it means to be a doctor but is also symptomatic and indicative of a much larger problem in medicine—namely, the failure to attend fully to the complexity and profundity of the lived experiences of illness, suffering, and death. Reorienting the discourse surrounding gallows humor away from whether or in what context it is acceptable and toward the reasons why doctors feel the need (...) to use such humor in the first place addresses this issue in a more illuminating way. (shrink)

The ever-increasing technological advances of modern medicine have increased physicians’ capacity to carry out a wide array of clinical interventions near the end-of-life. These new procedures have resulted in new “types” of living where a patient’s cognitive functions are severely diminished although many physiological functions remain active. In this biomedical context, patients, surrogate decision-makers, and clinicians all struggle with decisions about what clinical interventions to pursue and when therapeutic intent should be replaced with palliative goals of care. For some patients (...) and clinicians, religious teachings about the duty to seek medical care and the care of the dying offer ethical guidance when faced with such choices. Accordingly, this paper argues that traditional Sunni Islamic ethico-legal views on the obligation to seek medical care and Islamic theological concepts of human dignity and inviolability provide the ethical grounds for non-intervention at the end-of-life and can help calibrate goals of care discussions for Muslim patients. In closing the paper highlights the pressing need to develop a holistic ethics of healthcare of the dying from an Islamic perspective that brings together multiple genres of the Islamic intellectual tradition so that it can meet the needs of the patients, clinicians and Muslim religious leaders interacting with the healthcare system. (shrink)

Although much has been written on the dead-donor rule in the last twenty-five years, scant attention has been paid to how it should be formulated, what its rationale is, and why it was accepted. The DDR can be formulated in terms of either a Don’t Kill rule or a Death Requirement, the former being historically rooted in absolutist ethics and the latter in a prudential policy aimed at securing trust in the transplant enterprise. I contend that the moral core of (...) the rule is the Don’t Kill rule, not the Death Requirement. This, I show, is how the DDR was understood by the transplanters of the 1960s, who sought to conform their practices to their ethics—unlike today’s critics of the DDR, who rethink their ethics in a question-begging fashion to accommodate their practices. A better discussion of the ethics of killing is needed to move the debate forward. (shrink)

Abraham Verghese proposes to renew medicine by training physicians to read the right texts—literary fiction and patients' bodies—with skilled attention. Analyzing Verghese's proposal with reference to Foucault's idea of the "clinical gaze," I find that Verghese conceives of patients as texts that only physicians can read, meaning that physicians become the storytellers of the bodies, lives, and deaths of the people they meet as patients. I conclude that Verghese's project is unsustainable and alternatively propose thinking analogically of physicians as ship (...) captains who maintain therapeutic distance to reopen interpretative spaces for communities outside of medicine. (shrink)

In The Anticipatory Corpse, Jeffrey Bishop claims that modern medicine has lost formal and final causality as the dead body has become epistemologically normative, and that a singular focus on efficient and material causality has thoroughly distorted modern medical practice. Bishop implies that the renewal of medicine will require its housing in alternate social spaces. This essay critiques both Bishop’s diagnosis and therapy by arguing, first, that alternate social imaginaries, though perhaps marginalized, are already present within the practice of medicine. (...) And second, the essay argues that alternate social imaginaries in medicine can be reclaimed not through separatist communities but in the re-narration of conceptually underdetermined practices. Given Bishop’s invitation for theology to engage medicine, this essay then draws from theologian Dietrich Bonhoeffer for the kind of diagnosis and therapy currently needed, concluding with a contemporary example of how an alternate social imaginary is being instantiated in modern medicine. (shrink)

Brummett argues that P2+ is necessary because it acknowledges the metaphysical claims ignored in P2’s approach in addressing parental refusal for treatment in certain pediatric cases that cl...

In recent years, increasingly advanced artificial intelligence (AI), and in particular machine learning, has shown great promise as a tool in various healthcare contexts. Yet as machine learning in medicine has become more useful and more widely adopted, concerns have arisen about the “black-box” nature of some of these AI models, or the inability to understand—and explain—the inner workings of the technology. Some critics argue that AI algorithms must be explainable to be responsibly used in the clinical encounter, while supporters (...) of AI dismiss the importance of explainability and instead highlight the many benefits the application of this technology could have for medicine. However, this dichotomy fails to consider the particular ways in which machine learning technologies mediate relations in the clinical encounter, and in doing so, makes explainability more of a problem than it actually is. We argue that postphenomenology is a highly useful theoretical lens through which to examine black-box AI, because it helps us better understand the particular mediating effects this type of technology brings to clinical encounters and moves beyond the explainability stalemate. Using a postphenomenological approach, we argue that explainability is more of a concern for physicians than it is for patients, and that a lack of explainability does not introduce a novel concern to the physician–patient encounter. Explainability is just one feature of technological mediation and need not be the central concern on which the use of black-box AI hinges. (shrink)

Jeffrey Bishop’s The Anticipatory Corpse demonstrates how death is present in and cloaked by contemporary practices of end-of-life care. A key to Bishop’s argument is that for modern medicine the cadaver has become epistemologically normative and that a metaphysics shorn of formal and final causes now shapes contemporary healthcare practices. The essays of this symposium laud and interrogate Bishop’s argument in three ways. First, they raise critical methodological challenges from the perspectives of human rights, Charles Taylor’s concept of social imaginaries, (...) and economics. Second, they demonstrate the analytical power of his argument by detailing how it might be extended to additional issues beyond simply end-of-life care and how it might be brought into conversation with sociology. Third, they engage the constructive turn Bishop takes at the end of the book. Bishop himself also updates readers on the reception of The Anticipatory Corpse, as well as the way his thinking has evolved over the past 5 years since its publication. He also engages the questions, challenges, and openings provided by our authors. (shrink)

Through the historical portrait of Galen, I argue that even an enchanted nature does not prevent the performance of violence against nature. Galen, the great physician-philosopher of antiquity, is best known for his systematization and innovation of the Hippocratic medical tradition, whose thought was the reigning medical orthodoxy from the medieval period into the Renaissance. His works on anatomy were the standard that Vesalius’ works on anatomy overturned. What is less known about Galen’s study of anatomy, however, is its philosophical (...) and theological edge. In this paper, I show that it is precisely because nature is enchanted that Galen undertakes the grisly practices of anatomical dissection and vivisection, which entail violence against nature. First, I illustrate the violent character of Galen’s anatomical experiments. Second, I elucidate Galen’s anatomical methodology as a form of philosophizing and theologizing with a scalpel. Third, I explicate the importance of the demonstration of divine teleology that anatomical dissection reveals. Fourth, I sketch how anatomical dissection as a way of knowing nature and God becomes a kind of anatomical, liturgical theology. I conclude that, at least for Galen, an enchanted nature is not in itself exempt from violence. (shrink)

Elucidating a metaphysics of medicine is vital for framing a coherent medical ethics. In this paper, I examine the historical case of Avicenna, the eleventh century physician-philosopher. Avicenna radicalizes the dissective power of reason using a logicized Aristotelian metaphysics to clarify concepts at the metaphysical level, which I call his anatomy of being. One of the practical consequences of Avicenna’s metaphysics is a dehumanizing eschatology of death. I outline the main elements of Avicenna’s thought that constitute his anatomy of being. (...) Through an examination of his logic, metaphysics, and psychology, I show how Avicenna develops a dissective logic. I conclude that one’s epistemology, as a method of knowing, entails a metaphysics, and, in turn, results in an ethical stance to the object of knowledge. For Avicenna, mental dissective logic applied to humans results in dehumanization, thereby destroying the humanistic impulse of medicine. (shrink)

Medical practice has always involved at least three roles, three complimentary identities. Practitioners have been at once clinicians dedicated to a patient’s care, members of a professional organization promoting medicine, and informed citizens engaged in public debates on health issues. Beginning in the 1970s, a series of social and technological changes affected, and in many cases restricted, the practitioner’s ability to function equally in these three identities. While others have discussed the changing realities of medical practice in recent decades, none (...) have commented on their effect on their effect on rights of practitioners as citizens. Here several cases begin an analysis of the manner in which those changes have limited the physician’s right to act conscientiously and speak publicly in the face of organizational agendas and political priorities. (shrink)

In his 1917 lecture “Science as a Vocation,” Max Weber challenged current and aspiring scholars to abandon any pretense that science bears within itself any meaning. In a disenchanted age, he argued, science could at best offer “knowledge of the techniques whereby we can control life... through calculation,” and any meaning or moral direction to scientific research—including religious meaning—must be imposed on it from without. Weber presciently anticipated that many present-day health care practitioners would struggle to find meaning for their (...) work within complex “state-capitalist” health care systems, along with predictable quasi-religious responses. But how are Christian practitioners to practice faithfully in a disenchanted age? The authors of this special issue lean deeply into the loci of Christian theology and Christian practice, some challenging the views of the body and of nature that informed Weber’s theory of disenchantment, and all offering resources and paths by which practitioners might “look the fate of the age full in the face” with courage and wisdom. (shrink)

Whereas bioethicists generally consider medicine a practice aimed at the individual good of each patient, in this paper I present an alternative conception of the goods of medicine. I first explain how modern liberal political theory gives rise to the predominant view of the medical good and then contrast this understanding of politics with that of Thomas Aquinas, informed by Aristotle. I then show how this Christian politics is implicit in certain aspects of contemporary medical practice and argue that Christians (...) ought to draw more attention to this point in order to direct medicine toward the common good. (shrink)

The present paper looks at the intersection of juridical and biopower in the U.S. Supreme Court’s school desegregation cases. These cases generally deploy “equitable relief” as a relay between the juridicially-specified injury of segregation and the biopolitical mandates of integration, allowing broad-based biopolitical remedies for juridically identified problems. This strategy enabled the Courts to negotiate between these forms of power. The analysis here thus suggests the continued relevance of juridical power, and also the limits of Foucault’s own analysis, which suggested (...) that biopower tended to fully colonize juridical power by way of norms. (shrink)

Drawing on and extending the Foucaultian philosophical framework that Jeffrey Bishop develops in his masterful book, The Anticipatory Corpse: Medicine, Power, and the Care of the Dying, we undertake a sociological analysis of the neurological procedure—deep brain stimulation —which implants electrodes in the brain, powered by a pacemaker-like device, for the treatment of movement disorders. Following Bishop’s work, we carry out this analysis through a two-fold strategy. First, we examine how a multidisciplinary team evaluates candidates for this implant at a (...) major medical center. We present excerpts from an ethnographic study of the “case conference” where disease entities are presented, contested, ratified, and made objects for intervention with this technology. The case conference becomes the key site in the transition from “person-with-illness” to “person-with-brain-implant” as a team of health professionals determines a plan of action by interpreting both statistical and “quality of life” data regarding their patients. Second, this article explores these decision-making processes through Bishop’s conceptualization of evidence-based medicine, which relies on statistical approaches as the ultimate authority in knowledge production and medical decisions. We then reflect on Bishop’s critique of the social sciences and the methodological, analytical, and substantive ramifications that The Anticipatory Corpse can offer future sociological work. (shrink)