Analysis of the debate concerning the appropriate way of researching the effects of complementary and alternative medicine (CAM) treatments highlights the controversial issue of the mind–body bond in medical research. The article examines a range of approaches, extending from outright opposition to CAM research, through the demand to employ only rigorous trials, to suggestions to use a hierarchy of evidence, up to practice‐based research proposals. These diverse approaches are analysed using theoretical concepts from the field of sociology of science and (...) knowledge. The article uses the concept of “hybrid knowledge” to denote the knowledge being constructed in late modern CAM discourse—knowledge that hybridises differentiated and even contradictory modern categories of knowledge. The article suggests that the different approaches taken by sociologists of science and knowledge, such as strong anti‐dualism and the assertion that there are differences in our understanding of the natural and the cultural–social terrain, are all useful and are not necessarily mutually exclusive. The article seeks to clarify the debate concerning the appropriate way of researching CAM and to contribute to the ongoing development and application of sociology of knowledge. (shrink)

Most mainstream attempts to understand the “placebo effect” invoke expectancy theory, arguing that expecting certain outcomes from a treatment or intervention can manifest those outcomes. Expectancy theory is incompatible with the phenomena of placebo responses, more appropriately named “meaning responses.” The expectancy account utilizes reflexive consciousness to connect a world of conceptual representations to mechanical physiology. An alternative account based upon Merleau-Ponty's motor intentionality argues that the body understands and is capable of responding to meanings without the need for any (...) conceptual or linguistic content. A motor intentional framework of meaning poses dramatic implications for the interpretation of clinical trials and in the clinical practice of medicine. Most strongly, it argues that the empathic physician can facilitate the physiologic effects of treatments through skillful participation and manipulation of the meaning response. (shrink)

A Foucauldian assessment of the common presumption that genetic information is potent and thus oppressive demonstrates that the concern may be misplaced. Foucault's concept of “technologies of self” reveals that genetic power originates not only from the potency of genetic information but from the penchant of individuals to victimize themselves in the name of optimal health, enhanced intelligence, perfect babies, or would-be immortality. Rather than seeking liberation from the power of the new genetics, Foucault's reinterpretation of the ancient understanding of (...) concern for the self offers the possibility to avoid control by the scientific discourse. His ethical response calls for resistance rather than opposition and places responsibility for resistance in the hands of the subject. Characteristically, he avoids a generalizable form of morality but clarifies that resistance includes acknowledging the human appetite for perfection and subordinating science to ethical and aesthetic matters. (shrink)

Based on the distinction between living body and lived body, we describe the disease-subject as representing the impact of disease on the existential life-project of the subject. Traditionally, an individual's subjectivity experiences disorders of the body and describes ensuing pain, discomfort and unpleasantness. The idea of a disease-subject goes further, representing the lived body suffering existential disruption and the possible limitations that disease most probably will impose. In this limit situation, the disease-subject will have to elaborate a new life-story, a (...) new character or way-of-being-in-the-world, it will become a different subject. (shrink)

This book proposes to identify three long-term structures in causal reasoning - in particular, in terms of the relationship between cause and identity - that appear to be of value in categorizing and organizing various trends in philosophical thought.<br>Such conceptual schemes involve a host of philosophical dilemmas (such as the problem of relativism), which are examined in the first chapter. A number of naturalistic and transcendental approaches to this problem are also analysed.<br>In particular, the book attempts to construct a theoretical (...) basis for Foucault's tripartite classification of epistemological structures in European thought.<br>The final chapter attempts to buttress the above schema by extending the analysis from cause and identity to growth, change, and stability, critiquing certain ideas of Foucault and Heidegger, as well as examining the contemporary thought of process philosophy and complexity theory.<br><br>Contents<br><br>Contents: Plurality and Causality - What is a Paradigm? - Paradigms and Causal Structure - Universality and Mathesis Universalis - Temporality and Visibility - Classical and Modern Probability Theory - The Environment and Non-Monotonicity - The Marburg School and the Limit Concept; Foucault's concept of 'Man' - Nineteenth Century Philosophy of Science - A Dynamic Model - Foucault and the Birth of the Clinic - Process, Growth and Complexity - Time and History. (shrink)

The author examines the relation between Michel Foucault's corpus and Freudian psychoanalysis. He argues that Foucault had a complex and changing relationship to psychoanalysis for two primary reasons: his own psychopathology, personal experience, and expressed desire, and due to an ineluctable contradiction at the heart of psychoanalysis itself. The author examines the history of Foucault's personal and scholarly interest in psychology and psychiatry, tracing the emergence, development, and shift in his thought and work. He then argues that Foucault's critique of (...) psychoanalysis can be extended to the constitution of the Western educated subject, and that Foucault ultimately resolved his personal dilemma in relation to psychoanalysis by rejecting the ‘will to knowledge’ and refusing the notion of a stable and fixed identity. (shrink)

Despite its phenomenal success since its inception in the early nineteen-nineties, the evidence-based medicine movement has not succeeded in shaking off an epistemological critique derived from the experiential or tacit dimensions of clinical reasoning about particular individuals. This critique claims that the evidence-based medicine model does not take account of tacit knowing as developed by the philosopher Michael Polanyi. However, the epistemology of evidence-based medicine is premised on the elimination of the tacit dimension from clinical judgment. This is demonstrated through (...) analyzing the dichotomy between clinical and statistical intuition in evidence-based medicine’s epistemology of clinical reasoning. I argue that clinical epidemiology presents a more nuanced epistemological model for the application of statistical epidemiology to the clinical context. Polanyi’s theory of tacit knowing is compatible with the model of clinical reasoning associated with clinical epidemiology, but not evidence-based medicine. (shrink)

John Paley has rightly observed that, while spirituality is widely discussed in the nursing literature, the discussions are uncritical and unproblematic. In an effort ‘to reconfigure the spirituality‐in‐nursing debate, and to position it where it belongs: in the literature on health psychology and social psychology, and not in a disciplinary cul‐de‐sac labelled “unfathomable mystery” ’, Paley has proposed an alternative, reductionist approach to spirituality. In this paper, I identify two critiques developed by Paley: one political, the other ‘logical’. Paley's political (...) critique claims the concept of ‘spirituality’ has been appropriated by nursing theorists as part of an attempt to accrue professional power and jurisdiction over occupational territory. I suggest that Paley's analysis masks his own exclusivist, secularizing jurisdictional claim made at the expense of spirituality. Paley's so‐called ‘logical’ critique is motivated by an intention to ‘determine what the “spirituality” terrain looks like from the naturalistic point of view’. However, noting a number of inconsistencies, I challenge his ‘logical move’ as a naïve attack on a straw man. In place of Paley's reductionism, I propose my own alternative alternative and argue (after Foucault) that ‘spirituality’ is a discourse, a non‐reductionist attempt, in a post‐religious society, to speak about the human condition open to the unknown. I conclude with a definition and a description of empirically congruent spirituality. (shrink)

The following text is an introduction to Ed Cohen’s book A Body Worth Defending: Immunity, Biopolitics and the Apotheosis of the Modern Body. Author investigates the way in which immunology influences the perception of both the human body, and political entities, demonstrating that contemporary conceptualizations of these phenomena exist in a double bind. The historical framework Cohen applies allows for tracing the history of the metaphor of immunity in politics and medicine.

The analysis undertaken in this paper explores the significance of a central finding from a recent field study of home care case management practice: a notable feature of case management work is the preparation of an orderly, ordered space where care may be offered. However, out of their encounters with an almost endless variety of situations, out of people's diverse narratives of need, case managers seem able to pick out only limited range of recognized needs to which to respond and (...) demonstrate a series of responses themselves equally limited. Though this observation suggests a kind of efficiency that is currently highly valued within healthcare systems, it also underlines the system's inability to engage difference and variability in a meaningful way. This inability or limitation in effectively engaging difference is conceptualized here as, in some sense, a problem, and the nature of this problem is explored through the rhetorical process of problem setting. The central question becomes how might we develop and deploy an orderly and coherent system of care without essentializing people's experiences, without treating these experiences reductively, without, in a Foucaultian frame of reference, allowing what can be understood as similarity or resemblance among clients and situations to be folded back into sameness? As we encounter complexity, variability and difference in practice, how should we treat it? (shrink)

Cartesian dualism has been viewed by medical theorists to be oneof the chief causes of a reductionist/mechanistic treatment ofthe patient. Although I aver that Cartesian dualism is one culprit for the misapprehension of the genuine treatment of patients in termsof both mind and body, I argue that interactive dualism whichstresses the interaction of mind and body is essential to treatpatients with dignity and compassion. Thus, adequate medical carethat is humanistic in nature is difficult (if not impossible)to achieve without physicians adhering (...) to a dualistic frameworkin which the body and person is treated during illness. (shrink)

Modern Western thought and culture have envisaged their task in terms of a metaphorics, a metaphysics and a technics of 'enlightenment'. However, the ethical and environmental implications of this determination to dispel all shadows have become increasingly pernicious as modernity both extends and alters the conceptualization and employment of (a now artificial) light as a tool of discovery and control. Drawing on the work of Foucault and Benjamin amongst others, this paper seeks to illustrate, through a critical ethopoietics, the 'speculative (...) aporia' of contemporary society from the perspective of radical ecology. The world does not just reflect our own instrumental interests: it has an elusive, shadowy existence of its own that can impinge upon our ethical perceptions. (shrink)

In the clinical practice of palliative medicine, recommended communication models fail to approximate the truth of suffering associated with an impending death. I provide evidence from patients' stories and empiric research alike to support this observation. Rather than attributing this deficiency to inadequate training or communication skills, I examine the epistemological premises of the biomedical language governing the patient-physician communication. I demonstrate that the contemporary biomedicine faces a fundamental aporetic occlusion in attempting to examine death. This review asserts that the (...) occlusion defines, rather than simply complicating, palliative care. Given the defining place of aporia in the care for the dying, I suggest that this finding shape the clinicians' responses to the needs of patients in clinical care and in designing palliative research. Lastly, I briefly signal that a genuinely apophatic voice construing the occlusion as a mystery rather than an aporia may be superior to the present communication and empathy models. (shrink)

Medicine maintains a distinction between the medical symptom -- the patient''ssubjective experience and expression, and the privileged medical sign -- the objective findings observable by the doctor. Although the distinction is not consistently applied, it becomes clearly visible in the undefined, medically unexplained disorders of women patients. Potential impacts of genderized interaction on the interpretation of medical signs are addressed by re-reading the diagnostic process as a matter of social construction, where diagnosis results from human interpretation within a sociopolitical context. (...) The discussion is illustrated by a case story and empirical evidence of the gendering in the doctor-patient relationship. The theoretical analysis is supported by semiotic perspectives of bodily signs, feminist theory on experience, and Foucault''sideas about medical perception and gaze, and concludes that a medical diagnosis is seldom a biological fact, but the outcome of a process where biological, cultural and social elements are interwoven. Further deconstruction of the chain of signs from a feminist perspective, assigning validity to the voice of the woman patient, might broaden the understanding of women''shealth, illness and disease. (shrink)

This paper examines five groups of women that were instrumental in the emergence of the category of "feeblemindedness" in the United States. It analyzes the dynamics of oppression and power relations in the following five groups of women: "feeble-minded" women, institutional caregivers, mothers, researchers, and reformists. Ultimately, I argue that a feminist analysis of the history of mental retardation is necessary to serve as a guide for future feminist work on cognitive disability.

According to policy makers, telemedicine offers “huge opportunities to improve the quality and accessibility of health services.” It is defined as diagnosis, treatment, and monitoring, with doctors and patients separated by space but mediated through information and communication technologies. This mediation is explored through an ethnography of a U.K. teledermatology clinic. Diagnostic image transfer enables medicine at a distance, as patients are removed from knowledge generation by concentrating their identities into images. Yet that form of identity allows images and the (...) expert gaze to be brought into potentially lifesaving proximity. Following Latour’s thread, images must be captured and then mobilized to the knowledge base, where they must be stabilized into standard diagnoses, then combined with different images, waiting lists, skin lesions, dermatologists, paper records, and beds, so that ultimately, outcomes are produced. This huge task requires new knowledges and a widening of agency that, if unacknowledged, may see telemedicine projects continue to founder. (shrink)

With the introduction of the technique of auscultation in nineteenth-century medicine, the auditory became a most important means of producing diagnostic knowledge. The correct classification and interpretation of the sounds revealed by auscultation, however, remained an issue of negotiation and often controversy throughout the mid-nineteenth century. This article examines the codification of lung sounds within two cultural and geographic contexts: first, the original approach as it was developed by Laennec and his followers in Paris that came to be dominant in (...) French medicine, and second, the alternative approach that grew out of Joseph Skoda’s reception of Laennec’s method in Vienna and became widely adopted in the German-speaking world. On one hand, it will be argued that lung sound classifications attempted a standardization of the perception and the interpretation of auscultation sounds. On the other hand, it will be shown that the development of auscultation sounds was shaped by the local context in which it took place. This article seeks to shed light on the way in which auditory experiences were instrumentalized for epistemic purposes in medicine. Furthermore, it discusses the role of standardization both as a mechanism for the universalization of knowledge and as a contextually bounded practice. (shrink)

What role do nonhuman animals play in the construction of medical knowledge? Animal researchers typically claim that their use has been essential to progress – but just how have animals fitted into the development of biomedicine? In this article, I trace how nonhuman animals, and their body parts, have become incorporated into laboratory processes and places. They have long been designed to fit into scientific procedures – now increasingly so through genetic design. Animals and procedures are closely connected – animals (...) in science are disassembled and reassembled in various ways. Indeed, biomedical knowledge can be said to rest on a large pile of animal bodies and body parts. The process of producing animal body parts to order has implications for how we conceptualize the body (human or nonhuman), which I discuss in the final section. (shrink)

Where feminist critiques of bioscience have uncovered a whole set of operations that range round the Foucauldian notions of biopower and normativity, and have explored genetic discourse in particular to question the stability of self-identity, feminist bioethics has lagged behind. Despite an engagement with the technologies of postmodernity, including those associated with genetic research (and especially in its relation to reproduction), there has been, with relatively few exceptions, a reluctance to explore the implications of postmodernist theory. The difficulty is that (...) bioscience itself is now throwing up a problematic that destabilizes the central agent of ethical theory - the modernist sovereign subject. Using the field of genetics and the mapping of the human genome as a focal point, this paper suggests that bioethics should move on from conventional analytic strategies and, like feminist science studies, embrace uncertainty and complexity. The task is to fashion a new form of ethical response grounded in the notions of embodied connection and fluidity. (shrink)

This article sets the stage for a genealogy of the postgenomic body. It starts with the current transformative views of epigenetics and microbiomics to offer a more pluralistic history in which the ethical problem of how to live with a permeable body – that is plasticity as a form of life – is pervasive in traditions pre-dating and coexisting with modern biomedicine (particularly humoralism in its several ramifications). To challenge universalizing narratives, I draw on genealogical method to illuminate the unequal (...) distribution of plasticity across gender and ethnic groups. Finally, after analysing postgenomics as a different thought-style to genomics, I outline some of its implications for notions of plasticity. I argue that postgenomic plasticity is neither a modernistic plasticity of instrumental control of the body nor a postmodernist celebration of endless potentialities. It is instead closer to an alter-modernistic view that disrupts clear boundaries between openness and determination, individual and community. (shrink)

I suggest that virtue ethics can learn from Foucault’s critical observations on biopolitics and governmentality, which identify how a good cannot be disassociated from power and freedom. I chart a way through which virtue ethics internalizes this critical point. I argue that this helps address concerns that both virtue ethics and the critical scholarship inspired by Foucault otherwise ignore. I apply virtue ethics to the contexts of refugee arrival, asylum procedure, and immigrant integration in Western Europe; I then see how (...) Foucault’s critical thought provides a counterpoint to virtue ethics; I finally analyze how incorporating that critique allows virtue ethics to make sense of both the context and the stakes involved. (shrink)

Definitions of death are often referred to as legal fictions since brain death was conceived in the mid-twentieth century. Reference to legal fiction is generally paired with bioethicists’ concern that it facilitates post-mortem tissue donation and the health system generally, by determining death earlier on the continuum of dying and availing more viable tissue and therapeutic resources for others. The author argues that spatio-legal theory, drawing from legal geography, can account for the heterogeneity of effects that the fiction has in (...) spatially managing bodies (e.g., physicians, patient, family) at the bedside. The legal fiction is produced in physicians’ socio-legal practices, coordinating decision-making according to geographies of scarcity and severable, self-contained live- and dead-bodies. The determination liminally exists between private and public, enacting a sterile, affectless ordering of bodies but administered in the spectacle of sovereign death-making, conveying authority whilst managing patient’s and family’s consents. Spatialising traces of anatamo-politics and biopolitics thereby congeal and are enacted heterogeneously in and through the legal form of the fiction, securing preferred constructions of the body in the management of mortality. These spatio-legal features of the legal fiction are described from their collision with case law and literature that document competing nomoi produced from or secreted by antinomian bodies. (shrink)

I explore the role that values and interests, especially ideological interests, play in managing and balancing epistemic risks in medicine. I will focus in particular on how diseases are identified and operationalized. Before we can do biomedical research on a condition, it needs to be identified as a medical condition, and it needs to be operationalized in a way that lets us identify sufferers, measure progress, and so forth. I will argue that each time we do this, we engage in (...) epistemic risk balancing that inevitably draws upon values and interests, often including social and ideological values. My main interest here is in the conceptualization of infertility as a disease. Infertility is a rich test case for exploring the interplay between interests and epistemic risk management. There is no uncontested or standardized definition of infertility. The various definitions of it are internally ambiguous and tension-ridden, and in spectacular contradiction with one another. Many interest groups who are invested in framing infertility as a pressing problem deserving of social and medical redress are quick to insist that it is a legitimate ‘disease,’ but they cannot agree on which disease it is, what its symptoms or diagnostic markers are, or even what its basic ontology is. I suggest that there are political explanations for this epistemic mess. Indeed, I contend that there are good scientific and ethical reasons to reduce away the category of ‘infertility,’ especially understood as a scientific or medical category; I argue that we should excise the concept from our research and clinical practices. (shrink)

In 1688 the Irish scientist and politician William Molyneux sent a letter to the philosopher John Locke. In it, he asked him a question: could someone who was born blind, and able to distinguish a globe and a cube by touch, be able to immediately distinguish and name these shapes by sight if given the ability to see? -/- The philosophical puzzle offered in Molyneux’s letter fascinated not only Locke, but major thinkers such as Leibniz, Berkeley, Diderot, Reid, and numerous (...) others including psychologists and cognitive scientists today. Does such a question represent a philosophical puzzle or a problem that can be solved by experimental tests? Can vision be fully restored after blindness? What is the relation between vision and touch? Are the senses linked through learning or bound at birth? -/- Molyneux’s Question and the History of Philosophy is a major collection of essays that explore the long-standing issues Molyneux’s problem presents to philosophy of mind, perception and the senses. In addition, the volume considers the question from an interdisciplinary angle, examines the pre-history of the question, and aspects of it that have been ignored, such as perspectives from religion and disability. -/- As such, Molyneux’s Question and the History of Philosophy presents a set of philosophically rich, empirically informed, and scientifically rigorous original investigations into this famous puzzle. It will be of great interest to students and researchers in philosophy, psychology, and the cognitive sciences including neuroscience, neurobiology and ophthalmology, as well as those studying the mind, perception and the senses. (shrink)

Insights into the nondual relationship of organism and environment and their processual nature have resulted in numerous efforts at understanding human behavior and motivation from a holistic and contextual perspective. Meadian social theory, cultural historical activity theory (CHAT), ecological psychology, and some interpretations of complexity theory persist in relating human activity to the wider and more scientifically valid view that a process metaphysics suggests. I would like to articulate a concept from ecological psychology – that of the affordance, and relate (...) it to aspects of phenomenology and neuroscience such that interpretations of the self, cognition, and the brain are understood as similar to interpretations of molar behaviors exhibited in social processes. Experience with meditation as a method of joining normal reflective consciousness with ‘awareness’ is described and suggested as a useful tool in coming to better understand the nondual nature of the body. (shrink)

In recent years both philosophers and scientists have asked whether or not our current kinds of mental disorder—e.g., schizophrenia, depression, bipolar disorder—are natural kinds; and, moreover, whether or not the search for natural kinds of mental disorder is a realistic desideratum for psychiatry. In this dissertation I clarify the sense in which a kind can be said to be “natural” or “real” and argue that, despite a few notable exceptions, kinds of mental disorder cannot be considered natural kinds. Furthermore, I (...) contend that psychopathological phenomena do not cluster together into kinds in the way that paradigmatic natural kinds (e.g., chemical kinds and species) do; and, in light of this fact, I conclude that the normative ideal of natural classification—i.e. classifying real or natural kinds—is not appropriate as a general strategy for psychiatry. In the conclusion to this dissertation I propose an alternative way forward. Rather than assuming a priori that psychopathological phenomena cluster together into kinds, a more tractable and theoretically promising approach would be to first explain how particular kinds of experiences and behaviours—e.g, hallucinations, delusions, disorganized thinking, mania, low mood, etc.—are produced. (shrink)

Deconstructing Martial Arts analyses familiar issues and debates that arise in scholarly, practitioner and popular cultural discussions and treatments of martial arts and argues that martial arts are dynamic and variable constructs whose meanings and values regularly shift, mutate and transform, depending on the context. It argues that deconstructing martial arts is an invaluable approach to both the scholarly study of martial arts in culture and society and also to wider understandings of what and why martial arts are. Placing martial (...) arts in relation to core questions and concerns of media and cultural studies around identity, value, orientalism, and embodiment, Deconstructing Martial Arts introduces and elaborates deconstruction as a rewarding method of cultural studies. (shrink)

This article offers a critique and reconstruction of the concept of medicalization. Most researchers describe medicalization as the redefinition of social problems as medical concerns, and track its spread by the proliferation of disease language and diagnostic categories. Forensic psychiatry and disorders like psychopathy are often cited in these debates. I argue that focusing on discourse overlooks how medical language can justify or mask non-medical practices and outcomes, and lead researchers to identify medicalization where it has not occurred. Building on (...) other critiques of medicalization and recent studies of medical and legal expertise, I propose an alternative conception based on conditions for the performance of medical practice and other forms of expert labor. I distinguish the participation or intervention of medical practitioners from the medicalization of expert practice and identify several institutional factors that facilitate the latter. I illustrate this approach using a critical historical case: the first adult penal psychiatric clinic in the United States, founded by the eminent psychopathologist Bernard Glueck at New York’s Sing Sing Prison in 1916. Glueck’s extensive writings reveal little evidence of medicalization: psychopaths were largely defined and diagnosed according to penal rather than medical criteria, and they received additional punishment rather than treatment. A review of recent research confirms that psychopathy remains primarily a penal rather than medical condition. I conclude that focusing studies of medicalization on practice rather than discourse clarifies the concept and avoids reifying the notion of a medicalized society. (shrink)

U radu identificiramo transformacije od individualizacije i lokalizacije praksi nad konkretnom tjelesnošću do zbirnih političkih praksi nad tijelom-populacijom. Na taj način otvaramo genealoški, a ne historicistički pristup problemu erozije paleosimbolike i pojave diskurzivnosti tijela kroz diskontinuitet tijela i teksta. U procesima sveopće društvene deritualizacije, a ponajprije javne komunikacije, koja označava racionalizaciju zapadnjačkog društva, krajem 18. stoljeća pojavile su se nove forme iskaza: medicinski, psihijatrijski, pravni, pedagoški, psihološki, koji se grupiraju u tekst/znanje/moć. Oslanjajući se na analitiku moći Michela Foucaulta, u radu (...) analiziramo način na koji se paralelno s procesom deritualizacije kažnjavanja tijela deritualizirala čitava praksa iskazivanja: kroz pojavu nove tehnologije koja je bila uspostavljena putem mehanizama moći čiji su ulog bila ljudska tijela. U radu zaključujemo da jedna od genealoških linija umnožavanja praksi razdvajanja tijela i teksta od kraja 18. stoljeća vodi k jednom novom tijelu – k društvu. (shrink)

This paper uses an ongoing ethnography of childhood rehabilitation to rethink the Heideggerian phenomenology of death. We argue that Heidegger’s threefold perishing/death/dying framework offers a fruitful way to chart how young people, their parents, and practitioners address mortality in the routine management of muscular dystrophies. Heidegger’s almost exclusive focus on being-towards-death as an individualizing existential structure, rather than the social life with and around death, is at odds with the clinical experience we explore in this paper. After looking to the (...) basic structures of Heidegger’s philosophy of death, we point to recent work by Leder, Svenaeus, Aho, and Carel, bringing health and the spaces of healthcare into our purview. Turning to ethnographic data, we argue that a revised phenomenology of death gives a nuanced account of how health care practitioners address death, dying, and perishing, and outline some steps toward a more ontologically sensitive clinical space. These revisions are in line with recent work in disability studies, that see disability as more than a death sentence. We advocate adjusting phenomenological reflections on disability, to be framed as a way of life, rather than as a deficient or especially deadly mode of human existence. (shrink)

This article focuses on the dynamic between the medical policy on intersex bodies and intersex activists in Israel. Recently, in many countries changes have taken place in medical guidelines regarding intersex patients and laws that regulate medical practices and prohibit irreversible surgeries for intersex babies for cosmetic reasons and without the patient’s consent. In Israel, intersex activists are limited by several factors. On the one hand, they are influenced by the achievements of intersex activism around the world but on the (...) other, the pathologizing medical discourse and socio-medical practices, which include early diagnosis, early irreversible surgeries, and secrecy surrounding intersexed bodies, present obstacles to achieving bodily autonomy for intersex individuals and social recognition of different sex development. Nevertheless, intersex activists are attempting to find different social and media spaces in which to achieve public acknowledgement and future bodily autonomy for intersexed people and seeking medical professionals’ cooperation. Recently, the Israeli Ministry of Health published a new circular for intersex/DSD patients, and while it does not clearly forbid irreversible surgeries, it provides information about the complexities of intersex people and their experience. (shrink)

This article pays close attention to Michel Foucault's theory that political regimes are enlightened through courageous free speech. A Foucaultian enlightenment occurs not when philosophical reason completely replaces superstition and enthusiasm in the public sphere, but instead when the parrhesiast partially organizes competing claims to know and to speak the truth. While much of the recent scholarly literature on Foucault’s later lectures emphasizes the political importance of the parrhesiast, less attention has been paid to the overlap and/or incompatibility between parrhesia (...) and the other modes of truth-telling. Below, I explain Foucault’s analysis of the basic modes of philosophical truth-telling: prophesy, philosophy, teaching, and parrhesia. I provide examples of speakers working within these modes in the ancient and modern world. I explain the overlap and tension between these modes, and I analyze Foucault’s partial organization of them through the image of the parrhesiast. I briefly compare Foucault’s position to the agonistic democratic theory of Chantal Mouffe and distinguish Foucault’s view from consensus-based views of public reason. Finally, I provide practical and theoretical examples of parrhesiastic activity in the contemporary world. (shrink)

The experience of researching as a Māori student within academia will often raise questions about how and whether the student’s research privileges Māori world views and articulates culturally specific epistemologies. This study offers some theorising, from the perspectives of a Maori doctoral student and her Maori supervisor, on the metaphysical nature of research for Maori. It emphasises that there is a space for speculative, creative and responsive thinking as a central method in the student’s doctoral research and describes how access (...) to free thinking has been only partly recognised in currently dominant methods of research. We describe this approach as ‘whakaaro’, and note its relationship to language itself, to the researcher and the interviewee, and in particular to the researcher’s intuitive and largely unknowable response to what an interviewee utters. In that act, the student envisages that she will expansively hint at the deep expression of the profoundly mysterious. Here, our thinking resonates with various Western and indigenous writings about research and adumbrates the potential of the whakaaro method without foreclosing against its various permutations. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

This article argues that actor-network theory, as an alternative to critical theory, has lost its critical impetus when examining commodification in healthcare. The paper claims that the reason for this, is the way in which actor-network theory’s anti-essentialist ontology seems to black box 'intentionality' and ethics of human agency as contingent interests. The purpose of this paper was to open the normative black box of commodification, and compare how Marxism, Habermas and ANT can deal with commodification and ethics in healthcare. (...) Moreover, a new account of 'intentionality' in critical thinking was elaborated. Using Strawson's analysis of 'reactive attitudes and resentment,' the ethical implications of commodification in health care were examined as an assessment of intentions. Synthesizing critical theory with the relational materialism of actor-network theory, this article advances a new approach that seeks to bridge interdisciplinary boundaries, and guide actor-network theory in a critical and humanist direction. Providing new theoretical insights on commodification and 'intentionality' in health care. (shrink)

Approaches to business ethics can be roughly divided into two streams: ‹codes of behavior’ and ‹forms of subjectification’, with code-oriented approaches clearly dominating the field. Through an elaboration of poststructuralist approaches to moral philosophy, this paper questions the emphasis on codes of behaviour and, thus, the conceptions of the moral and responsible subject that are inherent in rule-based approaches. As a consequence of this critique, the concept of a practice-based ‹ethics of responsiveness’ in which ethics is never final but rather (...) always ‹to come’, is investigated. In such an approach the ethical self is understood as being continuously constituted within power/knowledge relations. Following this line, we ask how one can become a responsible subject while also acknowledging certain limits of full responsibility. We thereby explore responsibility as a considered but unconditional openness in response to the other. (shrink)

This paper intends to closely examine Michel Foucault’s take on power, resistance, and critical thought in the modern state, using the market-driven consumer economy and the paranoia-induced post-9/11 national security rhetoric as background. It will argue that on both domains, knowledge as similitude comes to be represented as part of the repressive configuration in the order of things. In retracing the technology of discipline where the individual unknowingly participates in his latent subjugation, the author thinks that critical thought—one that diverts (...) power away from the center to the peripheries is the only effective way of resistance against forms of social control and domination. (shrink)

The aim of this article is to present a conceptual review and analysis of symptom understanding. Subjective bodily sensations occur abundantly in the normal population and dialogues about symptoms take place in a broad range of contexts, not only in the doctor’s office. Our review of symptom understanding proceeds from an initial subliminal awareness by way of attribution of meaning and subsequent management, with and without professional involvement. We introduce theoretical perspectives from phenomenology, semiotics, social interactionism, and discourse analysis. Drew (...) Leder’s phenomenological perspectives deal with how symptom perception occurs when any kind of altered balance brings forward a bodily attention. Corporeality is brought to explicit awareness and perceived as sensations. Jesper Hoffmeyer’s biosemiotic perspectives provide access to how signs are interpreted to attribute meaning to the bodily messages. Symptom management is then determined by the meaning of a symptom. Dorte E. Gannik’s concept “situational disease” explains how situations can be reviewed not just in terms of their potential to produce signs or symptoms, but also in terms of their capacity to contain symptoms. Disease is a social and relational phenomenon of containment, and regulating the situation where the symptoms originate implies adjusting containment. Discourse analysis, as presented by Jonathan Potter and Margaret Wetherell, provides a tool to notice the subtle ways in which language orders perceptions and how language constructs social interaction. Symptoms are situated in culture and context, and trends in modern everyday life modify symptom understanding continuously. Our analysis suggests that a symptom can only be understood by attention to the social context in which the symptom emerges and the dialogue through which it is negotiated. (shrink)

Discussing the workings of technology in care as aesthetic rather than as ethical or epistemological interventions focusses on how technologies engage in and change relations between those involved. Such an aesthetic study opens up a repertoire to address values that are abundant in care, but are as yet hardly theorized. Kamphof studies the problem that sensor technology reveals things about the elderly patients without the patients being aware of this. I suggest improvement of these relations may be considered in aesthetic (...) terms, for instance by developing the affective quality of people’s technological relationships. (shrink)